bluuebunny/crossref_metadata_2025 huggingface dataset:
Thirteen‐year experience with hand‐assisted laparoscopic surgery in colorectal patients
Authors: Siddiqui Javariah , Young Christopher J.
Published: December 2019

Background

We report outcomes on 324 consecutive cases of hand‐assisted laparoscopic surgery (HALS) in colorectal patients over 13 years performed by a single surgeon.

Methods

A prospectively maintained database was used to identify all patients undergoing HALS colorectal procedures for benign or malignant indications from September 2004 to February 2018, at two major tertiary centres in Sydney, Australia.

Results

Median age was 64 years, 51% were female and median body mass index was 26. Colorectal cancer (55%), diverticular disease (13%) and polyp related conditions (13%) were common indications. Anterior resection (65%) and right hemicolectomy (18%) were most commonly performed. Median operative time was 244 min (190–300) and 75% of Gelport incisions were Pfannenstiel. Sixty‐three percent of colorectal cancer patients had a T3 or T4 cancer. Median tumour size was 35 mm (25–45). Seven percent required conversion to open and 4% a re‐operation in the early post‐operative period. Thirty‐six percent had a post‐operative complication, and 11% were major complications. Follow‐up extended to 12.8 years and there were 33 late deaths. Being in a high dependency unit or intensive care unit was significant for late mortality (odds ratio 2.8, 95% confidence interval 1.06–7.78, P = 0.037). Three percent developed an incisional hernia and 6% had small bowel obstruction at long‐term follow‐up.

Conclusion

HALS is an effective technique for both benign and malignant colorectal indications with the added advantage of tactile feedback and a lower rate of conversion to open.
Incidence of nasopalatine canal perforation in relation to virtual implant placement: A cone beam computed tomography study
Authors: Alkanderi Aaeshah , Al Sakka Yacoub , Koticha Tapan , Li Ji , Masood Farah , Suárez‐López del Amo Fernando
Published: December 2019

Background

The nasopalatine canal (NPC) is of special importance when considering implant therapy in the maxillary central incisors' region.

Purpose

To investigate the incidence of NPC perforation in relation to virtual immediate implant placement.

Materials and Methods

A search through the cone beam computed tomography (CBCT) database of The University of Oklahoma—College of Dentistry was conducted. First, canal related measurements were conducted. Second, digital prosthetic planning was performed. Then, immediate implants were virtually placed and additional measurements were performed. Perforation rate was assessed. Last, data obtained was statistically analyzed.

Results

A total of 217 scans fulfilled the inclusion criteria. Only 8% of cases showed NPC perforation. The perforation occurred at mid‐third of the implant or at the mid and apical third in 33% and 22% of the cases, respectively. A statistically significant association was found between perforation of NPC and bone width palatal to the root of the central incisor (P < .0001) as well as canal angulation (P = .0196). NPC angulation (°) and palatal bone width (mm) predisposed to a higher risk of perforation. Only 27.78% of the perforations could be overcome by the installation of shorter implants.

Conclusions

Low incidence of NPC perforation could be expected when immediately placing implants in the maxillary incisor region.
Accuracy of dental implant placement via dynamic navigation or the freehand method: A split‐mouth randomized controlled clinical trial
Authors: Aydemir Ceyda Aktolun , Arısan Volkan
Published: December 2019

Objectives

The aim of this split‐mouth randomized controlled clinical trial was to compare the deviations of planned and placed implants placed by the assistance of a micron tracker‐based dynamic navigation device or freehand methods.

Material and methods

A thermoplastic fiducial marker was adapted on the anterior teeth, and cone‐beam computerized tomography was used for imaging. A minimum of one implant was planned for each side of the posterior maxilla, and the dynamic navigation device or freehand method was randomly used for surgical insertion. Deviations were measured by matching the planning data with a final CBCT image. Linear deviations (mm) between the planned and placed implants were the primary outcome. The results were analysed by generalized linear mixed models (p < .05). (NCT03471208).

Results

A total of 92 implants were placed to 32 volunteers, and 86 implants were included in the final analysis. For the linear deviations, mean of differences (Δ) was 0.72mm (Standard deviation (SD): 0.26); (95% Confidence interval (CI): 0.39–1.02) in the shoulder of the implants (p < .001) and 0.69mm (SD: 0.36); (95% CI: 0.19–1.19) in the tip of the implants (p < .001). For the angular deviations, Δ was 5.33° (SD: 1.63); (95% CI: 7.17–3.48); (p < .001).

Conclusions

The navigation technique can be used to transfer virtual implant planning to the patient's jaw with increased accuracy.
Long non‐coding RNA ZEB1‐AS1 promotes colon adenocarcinoma malignant progression via miR‐455‐3p/PAK2 axis
Authors: Ni Xin , Ding Yuting , Yuan Haitao , Shao Jinmin , Yan Yan , Guo Rouyu , Luan Wenkang , Xu Min
Published: December 2019

Objective

The long non‐coding RNA zinc finger E‐box‐binding homeobox 1 antisense 1 (ZEB1‐AS1) acts as an oncogenic regulator in many human tumours. In the present study, we identify the role and potential molecular biological mechanisms of ZEB1‐AS1 in colon adenocarcinoma (COAD).

Methods

QRT‐PCR was used to detect the expression of ZEB1‐AS1, miR‐455‐3p and p21‐activated kinases 2 (PAK2) in COAD tissues. CCK8 assay, EdU assay, transwell assay and scratch wound assay were used to explore the biological function of ZEB1‐AS1 in COAD cells. Bioinformatics, luciferase reporter assays and an RNA pull‐down assay were used to demonstrate the mechanism of ZEB1‐AS1. We further explore the role of ZEB1‐AS1 in vivo though xenograft tumour assay.

Results

We found that ZEB1‐AS1 expression was significantly up‐regulated in COAD tissues, and high ZEB1‐AS1 level was correlated with the poor prognosis of COAD patients. MiR‐455‐3p plays an anti‐cancer role in COAD by targeting PAK2. We confirmed that ZEB1‐AS1 promotes PAK2 expression by sponging miR‐455‐3p, thus facilitating COAD cell growth and metastasis.

Conclusions

To sum up, this result illustrates the novel molecular mechanism of ZEB1‐AS1 in COAD and provides a new target for the diagnosis and treatment of COAD patients.
Emerging roles of non‐coding RNAs in scoliosis
Authors: Li Zheng , Li Xingye , Shen Jianxiong , Zhang Lin , Chan Matthew T. V. , Wu William K. K.
Published: December 2019

Scoliosis, a complex three‐dimensional deformity of the spine with the Cobb angle (a measure of the spinal lateral curvature) >10 degree, encompasses a spectrum of pathologies, including congenital, idiopathic, syndromic and neuromuscular aetiologies. The pathogenesis is multifactorial involving both environmental and genetic factors but the exact cellular and molecular mechanisms of disease development remain largely unknown. Emerging evidence showed that non‐coding RNAs (ncRNAs), namely microRNAs, long ncRNAs and circular RNAs, are deregulated in many orthopaedic diseases, including scoliosis. Importantly, these deregulated ncRNAs functionally participate in the initiation and progression of scoliosis. Here, we review recent progress in ncRNA research on scoliosis.
Vulvar malignancies: an interdisciplinary perspective
Authors: Wohlmuth Christoph , Wohlmuth‐Wieser Iris
Published: December 2019

Vulvar cancer represents the fourth most common gynecologic malignancy and is often encountered by the general Dermatologist or Gynecologist. Dermatooncologists and Gynecologic Oncologists share expertise in this field and the diagnosis and treatment should ideally be interdisciplinary. All subtypes are typically seen in the later decades of life, although all histologic subtypes have been described in women younger than 30 years. The diagnosis is often delayed. Exact mapping of biopsies is of high importance, as the location and distance from the midline guides the surgical approach depending on the underlying histology. Squamous cell carcinoma accounts for more than 76 % of vulvar cancer with vulvar intraepithelial neoplasia being an important precursor. Basal cell carcinoma is the second most common vulvar malignancy. Melanoma accounts for 5.7 % of vulvar cancer and has a worse prognosis compared to cutaneous melanoma. Most of the trials on checkpoint inhibitors and targeted therapy have not excluded patients with vulvar melanoma and the preliminary evidence is reviewed in the manuscript.

Surgery remains the primary treatment modality of locally resectable vulvar cancer. In view of the rarity, the procedure should be performed in dedicated cancer centers to achieve optimal disease control and maintain continence and sexual function whenever possible.
Pyrene and nile red fluorescence probes for in‐situ study of polarity and viscosity of soil organic coatings implicated in soil water repellency
Authors: Balshaw Helen M. , Douglas Peter , Davies Matthew L. , Doerr Stefan H.
Published: December 2019

Soil water repellency, that is, the reduced ability of soils to absorb water, is thought to be caused by organic coatings with predominantly non‐polar properties on soil particle surfaces. Given the important role of particle surface polarity in determining soil water repellency, we explored the use of fluorescent probes as a method for the direct in‐situ determination of the distribution and polarity of organics on bulk soil surfaces, and of their molecular mobility. We used nile red and pyrene, which have both been used successfully as environmental probes in previous studies, but have not been applied before to bulk soils. The probes were either (a) co‐deposited with other organics known to induce water‐repellent behaviour with acid‐washed sand to produce ‘model soils’ or (b) adsorbed directly onto sandy soils that were naturally water repellent to different degrees, and studied using fluorescence microscopy and steady‐state and time‐resolved fluorescence. Reliable measurements could be made using pyrene as an in‐situ probe on both model and natural soils, and a viscosity/mobility probe on model soils, whereas nile red was found not to be a useful probe. On model soils, made using hexadecane (HEX), octadecane (OCT) or stearic acid (SA) on acid‐washed sand, pyrene excimer formation kinetics showed a decrease in environment mobility as the organic layer changes from a liquid through to a hard wax. Spectra from pyrene adsorbed to natural soils indicated varying environmental polarity and heterogeneity within the soil samples studied.

Highlights

Exploration of in‐situ fluorescent probes to study polarity and viscosity of organics on soils.

Fluorescent probes have never been used in situ on bulk soils before.

Pyrene probe shows variation in mobility, polarity and heterogeneity of organics on soils.

Pyrene is a useful in‐situ fluorescent probe of polarity and mobility of organics on soils.
Water evaporation from cracked soil under moist conditions as related to crack properties and near‐surface wind speed
Authors: Poulsen Tjalfe G. , Cai Weiling , Garg Ankit
Published: December 2019

The impacts of five factors (wind speed, crack width, crack distance, crack depth and crack orientation (compared to wind direction)), on evaporation from cracked soil under moist soil conditions were investigated experimentally. Experiments were carried out under laboratory conditions in a wind tunnel with a 1 m × 1 m × 2.5 m test section using large‐scale (50 cm diameter, 25 cm depth) samples of natural soils wetted to a soil water content of 0.2 g g−1. To reduce the number of necessary experiments, a 2k factorial experimental design was used. Crack widths, crack distances, crack depths and crack orientations of 5–20 mm, 40–100 mm, 50–200 mm and 0–90°, respectively, were used. Effects of each factor on evaporation rate, individually and by interaction between multiple factors, were subsequently calculated. Results showed that individual effects of all five factors on evaporation rate were significant at the 95% level. Wind speed had the largest impact on evaporation rate, followed by crack width, crack distance, crack depth and crack orientation in that order. Overall, the four crack properties together explained 47% of the variations in evaporation rate.

Highlights

Evaporation from cracked, moist soil under windy conditions was investigated.

Crack orientation significantly affects wind conditions close to the surface.

Both wind speed and crack properties significantly affected evaporation rate.

Crack properties together explained 47% of variations in evaporation rate.
Volume change in amygdala enlargement as a prognostic factor in patients with temporal lobe epilepsy: A longitudinal study
Authors: Na Han Kyu , Lee Ho‐Joon , Hong Seok‐Jun , Lee Dong Hyun , Kim Kyung Min , Lee Hyung Woo , Heo Kyoung , Cho Kyoo Ho
Published: December 2019

Objective

Considering the clinical heterogeneity of temporal lobe epilepsy with amygdala enlargement (TLE‐AE), identifying distinct prognostic subgroups of TLE‐AE has clinical implications. Until now, baseline volume of the enlarged amygdala (EAV) has consistently failed to predict prognosis in TLE‐AE. Based on studies suggesting that patients responsive to antiepileptic drugs (AEDs) exhibit remission of AE on follow‐up imaging, we investigated whether reduction rate of EAV is predictive of long‐term prognosis in TLE‐AE.

Methods

Sixty‐one consecutive patients with two separate magnetic resonance imaging (MRI) scans were enrolled. To utilize longitudinally measured biomarkers in prediction, the period beyond the first MRI acquisition was split into two periods: the “observation window” (period between the two MRIs) and “prediction window” (follow‐up period beyond the second MRI). Patients were classified according to their AED responsiveness during the observation window, and AED‐responsive patients were further subdivided by initial seizure frequency: (a) AED‐responsive patients presenting with low‐frequency seizures (<5 seizures/3 mo; Group A, n = 25), (b) high‐frequency seizures (≥5 seizures/3 mo; Group B, n = 23), and (c) patients with poor initial treatment response (Group C, n = 13). Multivariate logistic regression models were constructed for identification of prognostic factors. Along with factors obtained at baseline, factors derived from the observation window (annual percentage change of EAV [APCEAV] and initial AED responsiveness) were also considered as potential predictors.

Results

Favorable initial treatment response and faster volume reduction rate (APCEAV ≤ −5.0%/y) were identified as factors predictive of achieving overall seizure freedom. Among the AED‐responsive patients, Group A (low‐frequency seizures) showed slower remission of AE and higher rate of seizure recurrence, whereas Group B (high‐frequency seizures) exhibited faster remission of AE and lower rate of seizure recurrence.

Significance

Faster recuperation of AE in patients with initial high‐frequency seizures may be indicative of seizure‐induced changes. As volume reduction rate serves as a prognostic marker in TLE‐AE, short‐term MRI follow‐up may be useful in prognostication.
Enzymatic promiscuity and the evolution of bioluminescence
Authors: Adams Spencer T. , Miller Stephen C.
Published: December 2019

Bioluminescence occurs when an enzyme, known as a luciferase, oxidizes a small‐molecule substrate, known as a luciferin. Nature has evolved multiple distinct luciferases and luciferins independently, all of which accomplish the impressive feat of light emission. One of the best‐known examples of bioluminescence is exhibited by fireflies, a class of beetles that use d‐luciferin as their substrate. The evolution of bioluminescence in beetles is thought to have emerged from ancestral fatty acyl‐CoA synthetase (ACS) enzymes present in all insects. This theory is supported by multiple lines of evidence: Beetle luciferases share high sequence identity with these enzymes, often retain ACS activity, and some ACS enzymes from nonluminous insects can catalyze bioluminescence from synthetic d‐luciferin analogues. Recent sequencing of firefly genomes and transcriptomes further illuminates how the duplication of ACS enzymes and subsequent diversification drove the evolution of bioluminescence. These genetic analyses have also uncovered candidate enzymes that may participate in luciferin metabolism. With the publication of the genomes and transcriptomes of fireflies and related insects, we are now better positioned to dissect and learn from the evolution of bioluminescence in beetles.
Experimental evaluation of fatigue behaviour of thin Al5456 welded joints
Authors: Shahani Amir Reza , Shakeri Iman
Published: December 2019

Because of wide applications of welded structures in different industries, using design codes and standards such as IIW recommendations is known as a safe and common method to design welded joints. The weld geometry and thickness of welded joint are the most important parameters that affect the fatigue strength of welded joints. In the present study, the fatigue behaviour of thin Al5456 butt‐welded joints has been investigated, and the effect of thickness on fatigue strength has been evaluated. Contrary to the above‐mentioned recommendations about thin welded joints, it was shown that the thickness of welded joints affects the fatigue strength. Moreover, the fatigue test results have been compared with the IIW design recommendations for three well‐known approaches in order to analyse the reliability of the codes. According to the design stress‐life diagrams, it was found that in some cases, the fatigue strength has much larger values than the IIW predictions, and IIW‐based design causes an over conservative design. While in some other cases, the fatigue strength is lower than IIW recommendations, and it leads to a non‐conservative design. Based on the experimental results, the new values for slope of S‐N curve and FAT have been proposed in order to improve the design diagrams.
Assessing the effect of landscape features on pond colonisation by an elusive amphibian invader using environmental DNA
Authors: Vimercati Giovanni , Labadesse Myriam , Dejean Tony , Secondi Jean
Published: December 2019

Environmental DNA (eDNA) is becoming an essential tool for detecting aquatic invasive species and investigating their spread. Surprisingly, this technique has been very rarely used to investigate habitat selection, site occupancy, and colonisation despite its higher capacity to detect many species.

The African clawed frog (Xenopus laevis) is a principally aquatic amphibian introduced in several continents from South Africa. In western France, no recent systematic survey of the invasion range has been attempted, mainly because of the elusive nature of the species. Furthermore, the influence of landscape features on invasion has never been investigated, even if adults and juveniles are known to disperse overland and along river networks.

Using presence–absence data generated by an eDNA survey conducted across the known invasion front ofX. laevisin western France, we aimed to determine whether and how the landscape features surrounding a pond influence the probability that a pond is colonised.

Xenopus laeviswas detected well beyond the formerly known invasive distribution and at the outward end of some transects, suggesting that we did not reach the actual invasion front in these parts of the range. The landscape variables that best predicted the presence ofX. laevisin a pond were topographic wetness index and grass cover within a buffer of 250 m.

Higher values of both topographic wetness index and grass cover were negatively related to the occurrence probability. The effects of these two variables more likely to reflect dispersal behaviour than habitat preferences at the pond scale.

By combining the high detection probability of eDNA survey techniques and a landscape ecology approach, we may gain valuable insight into the colonisation process of water bodies by elusive invasive species. Such information is crucial to prevent access to specific sites and locate invasion front areas where connectivity can be disrupted, thus increasing the effectiveness of management countermeasures.
Chromosome 15q13.3 microduplications are associated with treatment refractory major depressive disorder
Authors: McClain Lora , Segreti Anna M. , Nau Sharon , Shaw Patricia , Finegold David N. , Pan Lisa A. , Peters David G.
Published: December 2019

Major depressive disorder (MDD) affects approximately 15 million Americans. Approximately 2 million of these are classified as being refractory to treatment (TR‐MDD). Because of the lack of available therapies for TR‐MDD, and the high risk of suicide, there is interest in identifying new treatment modalities and diagnostic methods. Understanding of the impact of genomic copy number variation in the etiology of a variety of neuropsychiatric phenotypes is increasing. Low copy repeat elements at 15q13.3 facilitate non‐allelic homologous recombination, resulting in recurrent copy number variants (CNVs). Numerous reports have described association between microdeletions in this region and a variety of neuropsychiatric phenotypes, with CHRNA7 implicated as a candidate gene. However, the pathogenicity of 15q13.3 duplications is less clear. As part of an ongoing study, in which we have identified a number of metabolomic anomalies in spinal fluid from TR‐MDD patients, we also evaluated genomic copy number variation in patients (n = 125) and controls (n = 26) via array‐based copy number genomic hybridization (CGH); the case frequency was compared with frequencies reported in a prior study as well as a larger population‐sized cohort. We identified five TR‐MDD patients with microduplications involving CHRNA7. CHRNA7 duplications are the most common CNVs identified by clinical CGH in this cohort. Therefore, this study provides insight into the potential involvement of CHRNA7 duplications in the etiology of TR‐MDD and informs those involved with care of affected individuals.
Risk factors for adverse drug reactions in older inpatients of geriatric wards at admission: Multicenter study
Authors: Kojima Taro , Matsui Toshifumi , Suzuki Yusuke , Takeya Yasushi , Tomita Naoki , Kozaki Koichi , Kuzuya Masafumi , Rakugi Hiromi , Arai Hiroyuki , Akishita Masahiro
Published: December 2019

Aim

To investigate the characteristics of adverse drug reactions (ADR) and their risk factors among very old patients in five geriatric wards in Japan.

Methods

A retrospective observational multicenter study was carried out to investigate factors related to ADR in older inpatients from geriatric wards of five university hospitals in Japan. Data including drugs profile and short‐form comprehensive geriatric assessment were obtained from medical charts. ADR were identified from geriatrician's reports. For each ADR, symptoms and causal drugs were clarified, and factors associated with ADR were analyzed statistically.

Results

In 1155 patients (52.5% women, mean age 82.8 ± 7.0 years), the proportion with ADR was 15.4%. There was a great variety of signs and symptoms of ADR, and a great variety of drugs suspected to be the cause of ADR. On multiple logistic regression analysis, ADR was significantly associated with an increase in drugs (odds ratio 1.11, 95% CI 1.07–1.16) and emergency admission (odds ratio 2.76, 95% CI 1.82–4.15). Receiver operating characteristic curve analysis showed that the optimal cut‐off number of drugs for predicting ADR was ≥7.

Conclusions

In geriatric inpatients, polypharmacy (especially ≥7 drugs) and emergency admission were associated with ADR. Because there was a great variety of ADR in the study, clinicians must consider reviewing all drugs to prevent adverse drugs reactions during admission in this vulnerable population. Geriatr Gerontol Int 2019; ••: ••–••. Geriatr Gerontol Int 2020; 20: 144–149.
Pro‐inflammatory effects of extracellular Hsp70 on NCI‐H292 human bronchial epithelial cell line
Authors: Hulina‐Tomašković Andrea , Grdić Rajković Marija , Jelić Dubravko , Bosnar Martina , Sladoljev Lucija , Žanić Grubišić Tihana , Rumora Lada
Published: December 2019

Extracellular Hsp70 (eHsp70) exerts its biological actions via Toll‐like receptors 2 and 4, and is increased in sera of chronic obstructive pulmonary disease (COPD) patients. The aim of this study was to explore the pro‐inflammatory effects and cytotoxicity of eHsp70 alone and in combination with bacterial components lipoteichoic acid (LTA) and lipopolysaccharide (LPS) on NCI‐H292 airway epithelial cells. NCI‐H292 cells were treated with recombinant human Hsp70 protein (rhHsp70), LPS, LTA and their combinations for 4, 12, 24 and 48 hours. IL‐6, IL‐8 and TNF‐α levels were measured by an ELISA method. Cell viability was determined by the MTS method, and caspase‐3/7, caspase‐8 and caspase‐9 assays. rhHsp70 induced secretion of IL‐6 and IL‐8 in a concentration‐ and time‐dependent manner, with the highest secretion at 24 hours. rhHsp70 combined with LTA had antagonistic and with LPS synergistic effect on IL‐6 secretion, while the interactions between rhHsp70 and LPS or LTA on IL‐8 were synergistic. TNF‐α was not detected in the applied conditions. rhHsp70, LPS or LTA did not affect cell viability, and rhHsp70 even suppressed caspase‐3/7 activities. We suggest that pro‐inflammatory effects of eHsp70, together with other damaging molecules and/or COPD risk factors, might contribute to the aggravation of chronic inflammation in human bronchial epithelium.
What are the atrioventricular delays in right ventricular apical and septal pacing for optimal hemodynamics in patients with normal left ventricular function?
Authors: Shenthar Jayaprakash , George Jacob , Banavalikar Bharatraj , Padmanabhan Deepak , Prabhu Mukund A.
Published: December 2019

Introduction

There is a surge of interest in alternate site pacing to prevent pacing‐induced left ventricular dysfunction. However, little is known regarding the appropriate atrioventricular (AV) delay between right ventricular (RV) septal and RV apical pacing for optimal hemodynamic benefit.

Objectives

To determine the programmed values of atrial sensed and atrial paced AV delays in basal RV septal and apical RV pacing that results in the maximum delivered stroke volume (SV).

Methods

We calculated the Doppler‐derived SV at various sensed and paced AV delays in 50 patients with complete AV block implanted with a dual‐chamber pacemaker (group A: 25 RV apical pacing; group B: 25 RV septal pacing). The hemodynamic difference in terms of the SV between sensed and paced AV delay, corresponding to the site of RV pacing was then compared for statistical significance.

Results

In group A, maximal SV was derived at a sensed AV delay of 123.2 ± 11 ms and paced AV delay of 129.2 ± 10 ms, and in group B, at a sensed AV delay of 123.6 ± 8 ms and paced AV delay of and 132.8 ± 7 ms. At these intervals, there was no difference in the SV between septal and apical RV pacing (P = .28 and .22, respectively).

Conclusion

The atrial sensed and atrial paced AV delays for septal and apical RV pacing for optimal hemodynamics are similar. For optimal hemodynamics, the atrial paced AV delay is longer than the atrial sensed AV delay.
Ablation of persistent atrial fibrillation: Challenges and solutions
Authors: Terricabras Maria , Piccini Jonathan P. , Verma Atul
Published: December 2019

Catheter ablation is commonly used for treatment of persistent atrial fibrillation (AF). Pulmonary vein isolation (PVI) is still the cornerstone for the procedure, however, outcomes are consistently lower compared to paroxysmal AF. It is hypothesized that it could be due to lack of durable lesions or the presence of non‐PV targets that remain after PVI. Numerous advances in ablation catheter technologies and mapping systems may potentially achieve lower recurrence rates in the future. Ongoing research is required to discover the best technique for persistent AF ablation. The purpose of this review is to describe the new, developing technologies that may improve the outcome of this procedure in the persistent AF population.
Myocardial deformation as a predictor of right ventricular pacing‐induced cardiomyopathy in the pediatric population
Authors: Dasgupta Soham , Madani Rohit , Figueroa Janet , Cox David , Ferguson Eric , Border William , Sachdeva Ritu , Fischbach Peter , Whitehill Robert
Published: December 2019

Introduction

Right ventricular pacing is associated with pacemaker induced cardiomyopathy and lesser degrees of pacing‐induced LV dysfunction (PIVD) manifested by a reduction in left ventricular ejection fraction (LVEF). Our objective was to determine whether apical 4 chamber strain (A4C) by echocardiography can identify patients at risk of PIVD before LVEF declines.

Methods and Results

A retrospective chart review of patients (0‐21 years) who had a pacemaker with a ventricular lead placed between 2011 and 2017 was performed. Patients were divided into group A (LVEF <55% and/or >10% decline in LVEF within 12 months of pacemaker placement) and group B. Data have collected before and 1 and 12 months postpacemaker implantation. There were 30 patients in the group A and 60 in group B. At 1 and 12 months postpacemaker implantation, the LVEF was significantly lower while the A4C and QRS duration on electrocardiogram were significantly higher in the group A. While the LVEF and A4C became markedly abnormal in group A as early as 1 month, the A4C did not seem to demonstrate such marked abnormalities in group B. However, a sub‐analysis of patients in the group A with preserved LVEF at 1 month demonstrated significant worsening in their A4C at that time.

Conclusion

Myocardial deformation imaging may be a clinically useful tool for the prediction of a decline in LV systolic function following pacemaker implantation. Abnormalities in A4C seem to appear before LVEF decline and as soon as 1‐month postpacemaker implantation.
Optimization of the hot balloon ablation strategy using real‐time pulmonary vein potential monitoring
Authors: Chikata Akio , Kato Takeshi , Usuda Kazuo , Fujita Shuhei , Takaoka Motoki , Tsuda Toyonobu , Hayashi Kenshi , Furusho Hiroshi , Takamura Masayuki
Published: December 2019

Introduction

Optimal radiofrequency‐generated thermal energy applications have not been established for hot balloon ablation (HBA) systems. We investigated the feasibility of real‐time monitoring of pulmonary vein (PV) potentials and optimal time‐to‐isolation (TTI)‐guided application strategies in HBAs.

Methods and Results

Real‐time monitoring of PV potentials was performed using a four‐electrode unidirectional catheter in 34 consecutive patients. Acute isolation was achieved when PV potentials disappeared during HBAs and were undetected by high‐resolution mapping. The TTI, the difference between TTI and the time to reach target temperature (TTRT), and ablation time after isolation were examined for 177 applications in 136 PVs. Real‐time monitoring of PV activity was obtained in 167 out of 177 applications (94.3%) and acute isolation was achieved in 97 out of 177 (54.8%) applications. TTI‐TTRT was significantly shorter, and ablation times after isolation were significantly longer in the acute isolation group than in the other groups. TTI‐TTRT <4.5 seconds and TTIs <33.5 seconds predicted acute isolation (sensitivity 74.2%, specificity 88.4%; sensitivity 76.3%, specificity 76.7%, respectively). Ablation time after isolation >148.5 seconds (sensitivity 93.6%, specificity 51.7%) and >120.5 seconds (sensitivity 84.0%, specificity 78.6%) predicted acute isolation in superior PVs and inferior PVs, respectively.

Conclusions

Real‐time assessment of PV isolation can be achieved during HBAs with single‐shot techniques. (TTI‐TTRT)s <4.5 seconds and TTIs <33.5 seconds predicted for acute isolation. Ablation time after isolation >148.5 seconds in superior PVs and >120.5 seconds in inferior PVs were effective application durations.
Adjunctive percutaneous ablation targeting epicardial arrhythmogenic structures in patients of atrial fibrillation with recurrence after multiple procedures
Authors: Yu Lu , Liu Qiang , Jiang Ru‐Hong , Zhang Pei , Sun Ya‐Xun , Sheng Xia , Chen Shi‐Quan , Zhang Zu‐Wen , Fu Guo‐Sheng , Jiang Chen‐Yang
Published: December 2019

Introduction

Repeat ablation strategy for atrial fibrillation (AF) recurrence after multiple ablation procedures is known to be challenging. This study evaluated the insights of adjunctive ablation for epicardial arrhythmogenic substrates in those patients via a percutaneous epicardial approach.

Methods and Results

Thirty‐five consecutive patients with AF/atrial tachycardia (AT) recurrence, who had two or more prior ablation procedures, were enrolled from September 2016 to December 2018. In addition to a standard endocardial approach, epicardial mapping and ablation were performed via a percutaneous subxiphoid access in the electrophysiology lab. Adjunctive epicardial ablations for left lateral ridge (LLR) were performed in 31 of 35 patients (88.6%) for efficient transmural lesions with pacing capture loss. Marshall Bundle (MB) potentials were documented on epicardial LLR in three patients and abolished by direct epicardial ablation. Bachmann's bundle (BB) was ablated as an epicardial conduction gap in four patients with a refractory anterior wall line. Two epicardial AT/AF triggers were detected followed by successful termination with epicardial ablation. No periprocedural complications occurred. About 23 of 35 patients (65.7%) remained free from AF/AT after 23.2 ± 9 months of the procedure.

Conclusions

Patients with multiple failed prior AF procedures refractory to antiarrhythmic therapy might warrant a percutaneous epicardial mapping and ablation strategy, with adjunctive therapy for targeting LLR/MB, BB, and underlying epicardial triggers in addition to a standard endocardial approach.
Collective Identity as a Legal Limit to European Integration in Areas of Core State Powers*
Authors: Garben Sacha
Published: December 2019

To what extent does collective identity, as expressed by national constitutions, provide a legal limit to (creeping) European integration in areas of core state powers? This article contrasts the approaches by the EU and national legal orders. While EU law does not allow any area to be a priori carved out of its scope of application, certain national courts consider they can disapply EU law where it too deeply affects areas that are considered core to the state, in order to guarantee sufficient space for national self‐determination so as to sustain national collective identity. Article 4(2) TEU, although touted as a platform to mediate constitutional conflict about the limits of EU powers, has made little difference in this respect. At the same time, the discord should not be overstated: national actors that credibly invoke legitimate interests within the framework of EU law will often find these recognized by the CJEU.
The roles of endomembrane trafficking in plant abiotic stress responses
Authors: Wang Xiangfeng , Xu Min , Gao Caiji , Zeng Yonglun , Cui Yong , Shen Wenjin , Jiang Liwen
Published: December 2019

Endomembrane trafficking is a fundamental cellular process in all eukaryotic cells and its regulatory mechanisms have been extensively studied. In plants, the endomembrane trafficking system needs to be constantly adjusted to adapt to the ever‐changing environment. Evidence has accumulated supporting the idea that endomembrane trafficking is tightly linked to stress signaling pathways to meet the demands of rapid changes in cellular processes and to ensure the correct delivery of stress‐related cargo molecules. However, the underlying mechanisms remain unknown. In this review, we summarize the recent findings on the functional roles of both secretory trafficking and endocytic trafficking in different types of abiotic stresses. We also highlight and discuss the unique properties of specific regulatory molecules beyond their conventional functions in endosomal trafficking during plant growth under stress conditions.
Tumor necrosis factor alpha mediates orofacial discomfort in an occlusal dental interference model in rats: The role of trigeminal ganglion inflammation
Authors: Silva Paulo Goberlânio de Barros , de Lima Martins Joyce Ohana , de Lima Praxedes Neto Raimundo Antonio , Mota Lemos José Vitor , Machado Larissa Carvalho , Matos Carlos Anna Clara Aragão , Alves Ana Paula Negreiros Nunes , Lima Ramille Araújo
Published: December 2019

Background

Tumor necrosis factor alpha (TNF‐α) is a proinflammatory cytokine that plays an important role in the early stages of inflammation. In this study, we investigated its role in orofacial discomfort in rats subjected to occlusal dental interference (ODI).

Methods

Female Wistar rats (180‐200 g) were divided in three groups (n = 30/group): sham group, without ODI, and two experimental groups with ODI pre‐treated with 0.1 mL/kg saline (ODI + SAL) or 5 mg/kg infliximab (ODI + INF) and treated every 3 days. The animals were euthanized after 1, 3, and 7 days. The number of bites and scratches and grimace scale scores were determined daily, and the bilateral trigeminal ganglion was histomorphometrically (neuronal body area) analyzed and submitted for immunohistochemistry for TNF‐α, nitric oxide synthesis (NOS) neuronal (nNOS) and inducible (iNOS), peroxisome proliferator‐activated receptors (PPAR) y (PPARy) and δ/β (PPARδ/β), and glial fibrillary acidic protein (GFAP). One‐way/two‐way ANOVA/Bonferroni tests were used (P < .05, GraphPad Prism 5.0).

Results

ODI + SAL showed a large number of bites (P = .002), scratches (P = .002), and grimace scores (P < .001) in the firsts days, and ODI + INF partially reduced these parameters. The contralateral and ipsilateral neuronal body area was significantly reduced on day 1 in ODI + SAL, but returned to the basal size on days 3 and 7, by increase in TNF‐α, nNOS, PPARy, PPARδ/β, and GFAP immunostaining. The infliximab treatment attenuated these alterations (P < .05). There was no iNOS immunostaining.

Conclusion

Occlusal dental interference induced transitory orofacial discomfort by trigeminal inflammatory mediator overexpression, and TNF‐α blockage attenuated these processes.
Are Eating Habits Associated with Adequate Sleep among High School Students?
Authors: Bhurosy Trishnee , Thiagarajah Krisha
Published: December 2019

BACKGROUND

Sleep deprivation adversely impacts cognitive performance. A nutritious diet is one strategy that can prevent sleep deprivation and its adverse effects. However, few data exist regarding the influence of diet on sleep duration among adolescents. Hence, it is important to assess whether dietary habits are linked to adequate sleep among adolescents.

METHODS

The 2013 Youth Risk Behavior Survey data were used in the analysis. Nationally representative samples of adolescents were obtained using a 3‐stage cluster design. Selected survey items included number of hours slept on a school night, fruit and vegetable intake, soda and milk intake, breakfast consumption, and demographic variables. Data were analyzed with SAS 9.4 using a logistic regression model.

RESULTS

Holding other variables constant, an increase in total daily consumption of vegetables, milk, and breakfast increased the odds of sleeping ≥8 hours among participants (p < .01). An increase in daily soda intake decreased the odds of sleeping ≥8 hours among participants (p < .01). Separate logistic models for males and females yielded similar findings (p < .01).

CONCLUSIONS

Promoting healthy eating habits such as intake of vegetables, milk, and breakfast consumption among adolescents may increase their likelihood of getting adequate sleep.
Do High School Students Participate in Second Chance Breakfast Programs?
Authors: Grannon Katherine Y. , Nanney Marilyn S. , Wang Qi , Larson Nicole , Hearst Mary O. , Berge Jerica , Caspi Caitlin E.
Published: December 2019

BACKGROUND

Breakfast consumption often decreases as youth get older. The School Breakfast Program (SBP) provides an opportunity to intervene and increase breakfast consumption, especially among high school students.

METHODS

Project breakFAST implemented an expanded breakfast service at 12 high schools. In this longitudinal evaluation, school administrators provided SBP participation and demographic data on all ninth and 10th graders for two full consecutive school years. Students screened for eating breakfast <3 times/week were randomly selected to participate in the cohort study. The cohort completed a survey on perceived barriers, benefits, and breakfast habits.

RESULTS

At baseline, all 12 schools had only traditional before school cafeteria SBP service. Mean participation was 16.3% and ranged from 7.9 to 38.1%. After the intervention, there was an increase in participation to 25.7% (p = .004) ranging from 14.1 to 47.5%. There was no change in breakfast participation before school (13.3%, p = .06). Students who traveled to school by car, bike, or walking at baseline were 4.5% less likely to participate in second chance breakfast at follow‐up than those who took the bus to school (p = .006).

CONCLUSION

Second chance breakfast is an option for increasing high school breakfast participation, especially for those riding the bus.
Processing grapefruit juice with γ-cyclodextrin attenuates its inhibitory effect on cytochrome P450 3A activity
Authors: Yamasaki Keishi , Iohara Daisuke , Oyama Yoko , Nishizaki Narumi , Kawazu Seitaro , Nishi Koji , Kadowaki Daisuke , Taguchi Kazuaki , Otagiri Masaki , Seo Hakaru
Published: December 2019

Objectives

Grapefruit (Citrus paradisi) juice enhances the oral bioavailability of drugs that are metabolized by intestinal cytochrome P450 3A4 (CYP3A4). Patients are advised to avoid drinking grapefruit juice to prevent this drug–grapefruit juice interaction. The aim of this study was to investigate whether processing grapefruit juice with cyclodextrins (CDs) would result in preventing or inhibiting this interaction.

Methods

Grapefruit juice and the major furanocoumarins found in grapefruit, bergamottin (BG) and 6′, 7′-dihydroxy bergamottin (DHBG) were mixed with α, β and γCDs. The effects of these processed juice samples and furanocoumarins on CYP3A activity were compared with the corresponding values for unprocessed juices and furanocoumarins. Interactions between CDs and these furanocoumarins were also investigated by phase solubility and 1H NMR studies.

Key findings

The inhibition of CYP3A by grapefruit juice was significantly attenuated by processing particularly with γCD. Similar attenuation effects by γCD were observed in the cases of BG and DHBG. Furthermore, BG and DHBG were suggested to be strongly encapsulated in the cavity of γCD.

Conclusion

The encapsulation of BG and DHBG by γCD and the resulting attenuation of the inhibition of CYP3A activity by grapefruit juice may be applicable to juice processing for preventing drug-grapefruit juice interactions.
Comparative phylogenetic analyses of Chinese Horsfieldia (Myristicaceae) using complete chloroplast genome sequences
Authors: Cai Chao‐Nan , Ma Hui , Ci Xiu‐Qin , Conran John G. , Li Jie
Published: December 2019

The biologist's ruler for biodiversity is the species; accurate species identification is fundamental to the conservation of endangered species and in‐depth biological scientific exploration. However, the delimitation and affinities of Horsfieldia in China has been controversial, owing in part to very low levels of molecular divergence within the family Myristicaceae. Because species boundaries and phylogenetic relationships within Horsfieldia are also unclear, 13 samples were collected across its distribution in China and their genomes were subjected to shotgun sequencing using Illumina platforms. A total of 40 487 994–84 801 416 pair‐end clean reads were obtained and, after assembly, the complete chloroplast genome was recovered for all samples. Annotation analysis revealed a total of 112 genes, including 78 protein‐coding genes, 30 transfer RNA, and 4 ribosomal RNA genes. Six variable loci (petN‐psbM, trnH‐psbA, ndhC‐trnV, psbJ‐psbL, ndhF, and rrn5‐rrn23) were identified. Phylogenetic analyses strongly support the presence of four distinct species of Horsfieldia in China. In addition, samples that had been identified previously as Horsfieldia kingii (Hook. f.) Warb. were indistinguishable from those of H. prainii (King) Warb., suggesting that if H. kingii does occur in China, it was not collected in this study. Similarly, the chloroplast genome of one H. hainanensis Merr. sample from Guangxi province was identical to H. tetratepala C. Y. Wu, suggesting that the distribution range of H. hainanensis might be narrower than assumed previously. The phylogenetic relationships between the Chinese Horsfieldia species based on the whole chloroplast genomes was supported strongly, indicating the potential for using entire chloroplast genomes as super‐barcodes for further resolution of the phylogeny of the genus Horsfieldia.
Epigenetic alterations in salivary gland tumors
Authors: dos Santos Erison S. , Ramos Joab C. , Normando Ana Gabriela C. , Mariano Fernanda V. , Paes Leme Adriana F.
Published: December 2019

Salivary gland tumors (SGTs) comprise a heterogeneous group of benign and malignant neoplasms that exhibit significant variability in their microscopic appearance, clinical presentation, and biological behavior. The etiologic factors are unknown; however, chromosomic translocation, secondary radiation, and chemotherapy can be associated with the development of SGT. It has been indicated that epigenetic alterations can be responsible for the development and progress of these neoplasms. The epigenetic mechanisms are defined as a set of DNA changes that do not alter the sequence of nucleotide bases but alter the expression of the proteins. These alterations have been studied in the SGT, and they were associated with the development and progress of these neoplasms and may influence on SGT prognosis. Hence, we critically review the currently available data on the participation of epigenetic events on salivary gland tumors.
Taking Time (and Space) Seriously: How Scholars Falsely Infer Policy Diffusion from Model Misspecification
Authors: Drolc Cody A. , Gandrud Christopher , Williams Laron K.
Published: December 2019

Scholars have long been interested in how policies and ideas spread from one observation to another. Yet, the spatial and temporal dynamics of policy diffusion present unique challenges that empirical researchers often neglect. Scholars often use temporally lagged spatial lags (TLSL)—such as the number (or percentage) of prior adopters in a neighborhood—to test various mechanisms of delayed policy diffusion but are largely unaware of two under appreciated issues. First, the effects are not limited to one time period but persist over time by changing the future value of neighboring observations. Second, minor, yet common, choices in model specification—such as omitting spatially correlated and/or autoregressive covariates—can increase the risk of falsely inferring that the outcome is a result of spatial diffusion. Indeed, we offer two applications where small changes to the model specification of an otherwise well‐specified model result in drastically different inferences about policy diffusion. We argue that scholars should avoid haphazardly including TLSLs without considerable theoretical justification, and we conclude on an optimistic note by offering straightforward solutions and new software to address these issues.