bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Pressure Overload Decreases ETV1 Expression in the Left Atrium, Contributing to Atrial Electrical and Structural Remodeling
Authors: Yamaguchi Naoko , Xiao Junhua , Narke Deven , Shaheen Devin , Lin Xianming , Offerman Erik , Khodadadi-Jamayran Alireza , Shekhar Akshay , Choy Alex , Wass Sojin Y. , Van Wagoner David R. , Chung Mina K. , Park David S. 
Published: November 2020

Background:
Elevated intracardiac pressure attributable to heart failure induces electrical and structural remodeling in the left atrium (LA) that begets atrial myopathy and arrhythmias. The underlying molecular pathways that drive atrial remodeling during cardiac pressure overload are poorly defined. The purpose of this study is to characterize the response of the ETV1 (ETS translocation variant 1) signaling axis in the LA during cardiac pressure overload in humans and mouse models and explore the role of ETV1 in atrial electrical and structural remodeling.

Methods:

We performed gene expression profiling in 265 left atrial samples from patients who underwent cardiac surgery. Comparative gene expression profiling was performed between 2 murine models of cardiac pressure overload, transverse aortic constriction banding and angiotensin II infusion, and a genetic model of
Etv1
cardiomyocyte-selective knockout (
Etv1

f/f

Mlc2a

Cre
/+

).

Results:

Using the Cleveland Clinic biobank of human LA specimens, we found that
ETV1
expression is decreased in patients with reduced ejection fraction. Consistent with its role as an important mediator of the NRG1 (Neuregulin 1) signaling pathway and activator of rapid conduction gene programming, we identified a direct correlation between
ETV1
expression level and
NRG1
,
ERBB4
,
SCN5A
, and
GJA5
levels in human LA samples. In a similar fashion to patients with heart failure, we showed that left atrial ETV1 expression is downregulated at the RNA and protein levels in murine pressure overload models. Comparative analysis of LA RNA sequencing datasets from transverse aortic constriction and angiotensin II–treated mice showed a high Pearson correlation, reflecting a highly ordered process by which the LA undergoes electrical and structural remodeling. Cardiac pressure overload produced a consistent downregulation of
ErbB4
,
Etv1
,
Scn5a
, and
Gja5
and upregulation of profibrotic gene programming, which includes
Tgfbr1/2, Igf1
, and numerous collagen genes.
Etv1

f/f

Mlc2a

Cre
/+

mice displayed atrial conduction disease and arrhythmias. Correspondingly, the LA from
Etv1

f/f

Mlc2a

Cre
/+

mice showed downregulation of rapid conduction genes and upregulation of profibrotic gene programming, whereas analysis of a gain-of-function ETV1 RNA sequencing dataset from neonatal rat ventricular myocytes transduced with
Etv1
showed reciprocal changes.

Conclusions:
ETV1 is downregulated in the LA during cardiac pressure overload, contributing to both electrical and structural remodeling.
Provider Communication and Telepresence Enhance Veteran Satisfaction With Telestroke Consultations
Authors: Lyerly Michael , Selch Griffin , Martin Holly , LaPradd Michelle , Ofner Susan , Graham Glenn , Anderson Jane , Martini Sharyl , Williams Linda S. 
Published: November 2020

Background and Purpose:
Telestroke has been demonstrated to be a cost-effective means to expand access to care and improve outcomes in stroke; however, information on patient perceptions of this system of care delivery are limited. This study seeks to examine patient feedback of a national telestroke system within the Veterans Health Administration.

Methods:
Patients who received a telestroke consultation were eligible for a phone interview 2 weeks later, including questions about technology quality, telepresence, and telestroke provider communication. Satisfaction scores ranged from 1 to 7 (higher=more satisfied) and for analyses were dichotomized as 6 to 7 indicating high satisfaction versus <6. Patient variables including stroke severity (measured by the National Institutes of Health Stroke Scale) were obtained from study records. Generalized estimating equation models were used to determine what factors were associated with patient satisfaction.

Results:

Over 18 months, 186 interviews were completed, and 142 (76%) reported high satisfaction with telestroke. Patients with more severe stroke were less likely to recall the consultation. Factors significantly associated with patient satisfaction were higher ratings of the technology (
P
<0.0001), telepresence (
P
<0.0001), provider communication ratings (
P
<0.0001), and overall Veterans Affairs satisfaction (
P
=0.02). In the multivariate model, telepresence (odds ratio, 3.10 [95% CI, 1.81–5.31]) and provider ratings (odds ratio, 2.37 [95% CI, 1.20–4.68]) were independently associated with satisfaction. Veterans who were satisfied were more likely to recommend the technology (
P
<0.0001).

Conclusions:
Provider qualities, including telepresence and provider ratings, were associated with overall Veteran satisfaction with the telestroke consultation. Technology quality may be necessary but not sufficient to impact patient experience. Training providers to improve telepresence could improve patient experience with telestroke consultation.
Abstract Neural Representations of Category Membership beyond Information Coding Stimulus or Response
Authors: Mok Robert M. , Love Bradley C. 
Published: November 2020

AbstractFor decades, researchers have debated whether mental representations are symbolic or grounded in sensory inputs and motor programs. Certainly, aspects of mental representations are grounded. However, does the brain also contain abstract concept representations that mediate between perception and action in a flexible manner not tied to the details of sensory inputs and motor programs? Such conceptual pointers would be useful when concepts remain constant despite changes in appearance and associated actions. We evaluated whether human participants acquire such representations using fMRI. Participants completed a probabilistic concept learning task in which sensory, motor, and category variables were not perfectly coupled or entirely independent, making it possible to observe evidence for abstract representations or purely grounded representations. To assess how the learned concept structure is represented in the brain, we examined brain regions implicated in flexible cognition (e.g., pFC and parietal cortex) that are most likely to encode an abstract representation removed from sensory–motor details. We also examined sensory–motor regions that might encode grounded sensory–motor-based representations tuned for categorization. Using a cognitive model to estimate participants' category rule and multivariate pattern analysis of fMRI data, we found the left pFC and human middle temporal visual area (MT)/V5 coded for category in the absence of information coding for stimulus or response. Because category was based on the stimulus, finding an abstract representation of category was not inevitable. Our results suggest that certain brain areas support categorization behavior by constructing concept representations in a format akin to a symbol that differs from stimulus–motor codes.
Differences between Severe and Nonsevere Warm-Season, Nocturnal Bow Echo Environments
Authors: Mauri Ezio L. , Gallus William A. 
Published: November 2020

AbstractNocturnal bow echoes can produce wind damage, even in situations where elevated convection occurs. Accurate forecasts of wind potential tend to be more challenging for operational forecasters than for daytime bows because of incomplete understanding of how elevated convection interacts with the stable boundary layer. The present study compares the differences in warm-season, nocturnal bow echo environments in which high intensity [>70 kt (1 kt ≈ 0.51 m s−1)] severe winds (HS), low intensity (50–55 kt) severe winds (LS), and nonsevere winds (NS) occurred. Using a sample of 132 events from 2010 to 2018, 43 forecast parameters from the SPC mesoanalysis system were examined over a 120 km × 120 km region centered on the strongest storm report or most pronounced bowing convective segment. Severe composite parameters are found to be among the best discriminators between all severity types, especially derecho composite parameter (DCP) and significant tornado parameter (STP). Shear parameters are significant discriminators only between severe and nonsevere cases, while convective available potential energy (CAPE) parameters are significant discriminators only between HS and LS/NS bow echoes. Convective inhibition (CIN) is among the worst discriminators for all severity types. The parameters providing the most predictive skill for HS bow echoes are STP and most unstable CAPE, and for LS bow echoes these are the V wind component at best CAPE (VMXP) level, STP, and the supercell composite parameter. Combinations of two parameters are shown to improve forecasting skill further, with the combination of surface-based CAPE and 0–6-km U shear component, and DCP and VMXP, providing the most skillful HS and LS forecasts, respectively.
Caudal duplication syndrome in an adolescent: Rare concoction of duplication anomalies
Authors: Aggarwal Parul , Nair Nikhil 
Published: November 2020

Caudal duplication syndrome is a rare and interesting entity with a reported prevalence of <1/100,000 births. Caudal duplication syndrome encompasses a diverse spectrum of anomalies primarily involving partial or complete duplication of organs comprising the gastrointestinal, genitourinary and distal neural tube systems. The term ‘caudal duplication syndrome’ was coined by Dominguez et al. in 1993, in a case series of six patients presenting with findings pertaining to duplication anomalies of genitourinary system, hindgut, lumbosacral spine and cord. We here report a unique case of caudal duplication presenting in late adolescence and briefly review the available literature on this rare abnormality.
A study of mapping usual care and unmet need for vocational rehabilitation and psychological support following major trauma in five health districts in the UK
Authors: Kettlewell Jade , Timmons Stephen , Bridger Kay , Kendrick Denise , Kellezi Blerina , Holmes Jain , Patel Priya , Radford Kate 
Published: November 2020

Objective: To identify where and how trauma survivors’ rehabilitation needs are met after trauma, to map rehabilitation across five UK major trauma networks, and to compare with recommended pathways. Design: Qualitative study (interviews, focus groups, workshops) using soft-systems methodology to map usual care across trauma networks and explore service gaps. Publicly available documents were consulted. CATWOE (Customers, Actors, Transformation, Worldview, Owners, Environment) was used as an analytic framework to explore the relationship between stakeholders in the pathway. Setting: Five major trauma networks across the UK. Subjects: 106 key rehabilitation stakeholders (service providers, trauma survivors) were recruited to interviews ( n = 46), focus groups ( n = 4 groups, 17 participants) and workshops ( n = 5 workshops, 43 participants). Interventions: None. Results: Mapping of rehabilitation pathways identified several issues: (1) lack of vocational/psychological support particularly for musculoskeletal injuries; (2) inconsistent service provision in areas located further from major trauma centres; (3) lack of communication between acute and community care; (4) long waiting lists (up to 12 months) for community rehabilitation; (5) most well-established pathways were neurologically focused. Conclusions: The trauma rehabilitation pathway is complex and varies across the UK with few, if any patients following the recommended pathway. Services have developed piecemeal to address specific issues, but rarely meet the needs of individuals with multiple impairments post-trauma, with a lack of vocational rehabilitation and psychological support for this population.
Effects of rehabilitation methods on lower-limb muscle function and functional performance in patients with cystic fibrosis: A systematic review
Authors: Poncin William , Evrard Sarah , Mareschal Alice , Gohy Sophie , Reychler Gregory 
Published: November 2020

Objective: To investigate the effects of rehabilitation methods on leg muscle function and functional performance in cystic fibrosis. Data sources: A literature search was conducted in PubMed (MEDLINE), Scopus and the Cochrane Library from inception to October 12, 2020. A secondary hand search through reference lists from identified articles was conducted. Review methods: Three authors independently checked the full-text copies for eligibility of relevant articles. Randomized controlled trials were included. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The PRISMA guidelines were followed. Results suggestive of leg muscle function (e.g. strength, power, endurance, and fatigue) and functional performance were reported. Results: The search identified 8 studies (233 patients). The overall quality of these articles was good. Rehabilitation modalities investigated were physical exercises (aerobic, anaerobic and resistance training) ( n = 7) and neuromuscular electrical stimulation ( n = 1). Most studies ( n = 4) reported on the effects of combined aerobic and resistance training and showed improvement on leg strength when exercises were supervised. Aerobic training alone or the use of neuromuscular electrical stimulation also enhanced leg strength, whereas anaerobic training did not. Two studies evaluated leg fatigue and found no improvement compared to standard care. One study assessed the effect of exercises on functional performance and found no improvement when compared to standard care. No studies emphasized the impact of rehabilitation methods on leg muscle endurance or power. Conclusion: Combined aerobic and resistance training enhances leg muscle strength in cystic fibrosis. There is insufficient data on other leg muscle outcomes, nor on alternative rehabilitation strategies.
ZMILE, a multicomponent self-management intervention for adults with epilepsy: Rationale and description of the intervention
Authors: Chan Hoi Yau , Leenen Loes AM , Wijnen Ben FM , van der Putten Ingeborg M , Evers Silvia MAA , HJM Majoie Marian , van Heugten Caroline M 
Published: November 2020

Objective: In this paper, we aim to provide a comprehensive description of the multicomponent self-management intervention for adults with epilepsy, ZMILE. Rationale or theory: Acquiring self-management skills has been shown to play a vital role in enabling patients with epilepsy overcoming (health-related) struggles in daily life and coping with limitations their condition poses on them. ZMILE is a course consisting of education (to increase concordance to treatment), goal-setting (proactive coping), and self-monitoring. Resources needed: The course is guided by two nurse practitioners and each patient is allowed to bring one family member or friend. Self-monitoring plays an important role and can be done through e-Health tools or written diaries. Processes involved: During and after the course, patients are required to work toward a personally defined goal using a five-step approach by means of pro-active coping. Moreover, patients are expected to use self-monitoring tools to reflect on their own behavior and identify ways to optimize medication intake when required. Quantification: ZMILE is provided in an outpatient setting over five weekly group sessions and one booster session. From the start, patients are encouraged to set individual goals. Each group session will have a different theme but part of every session is reflecting on personal goals and to learn from eachother. Conclusions: The ZMILE-intervention has been evaluated and may be a promising intervention in terms of effectiveness and feasibility for adults with epilepsy, relatives, and professionals. We present the adapted version which can be implemented in clinical practice.
Predicting 1p/19q codeletion status using diffusion-, susceptibility-, perfusion-weighted, and conventional MRI in IDH-mutant lower-grade gliomas
Authors: Yang Xiefeng , Lin Yu , Xing Zhen , She Dejun , Su Yan , Cao Dairong 
Published: November 2020

Background Isocitrate dehydrogenase (IDH)-mutant lower-grade gliomas (LGGs) are further classified into two classes: with and without 1p/19q codeletion. IDH-mutant and 1p/19q codeleted LGGs have better prognosis compared with IDH-mutant and 1p/19q non-codeleted LGGs. Purpose To evaluate conventional magnetic resonance imaging (cMRI), diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) for predicting 1p/19q codeletion status of IDH-mutant LGGs. Material and Methods We retrospectively reviewed cMRI, DWI, SWI, and DSC-PWI in 142 cases of IDH mutant LGGs with known 1p/19q codeletion status. Features of cMRI, relative ADC (rADC), intratumoral susceptibility signals (ITSSs), and the value of relative cerebral blood volume (rCBV) were compared between IDH-mutant LGGs with and without 1p/19q codeletion. Receiver operating characteristic curve and logistic regression were used to determine diagnostic performances. Results IDH-mutant and 1p/19q non-codeleted LGGs tended to present with the T2/FLAIR mismatch sign and distinct borders ( P < 0.001 and P = 0.038, respectively). Parameters of rADC, ITSSs, and rCBVmax were significantly different between the 1p/19q codeleted and 1p/19q non-codeleted groups ( P < 0.001, P = 0.017, and P < 0.001, respectively). A combination of cMRI, SWI, DWI, and DSC-PWI for predicting 1p/19q codeletion status in IDH-mutant LGGs resulted in a sensitivity, specificity, positive predictive value, negative predictive value, and an AUC of 80.36%, 78.57%, 83.30%, 75.00%, and 0.88, respectively. Conclusion 1p/19q codeletion status of IDH-mutant LGGs can be stratified using cMRI and advanced MRI techniques, including DWI, SWI, and DSC-PWI. A combination of cMRI, rADC, ITSSs, and rCBVmax may improve the diagnostic performance for predicting 1p/19q codeletion status.
Lower lobe origin is related to unfavorable outcomes in patients with stage I–III lung cancer treated with radical chemoradiotherapy
Authors: Liu Fangfang , Yuan Xun , Jiang Jizong , Zhang Peng , Chen Yuan , Chu Qian 
Published: November 2020

Purpose: The influence of tumor location on survival was investigated in patients with lung cancer who received radical chemoradiotherapy. Methods: We examined the relationships between radiation site and survival outcome in patients with lung cancer. A total of 14,640 patients with lung cancer who received radical chemoradiotherapy for stage I–III disease were reviewed from Surveillance, Epidemiology, and End Results Program (SEER) datasets. We further retrospectively collected cases from a cohort of 148 eligible patients diagnosed between December 2013 and December 2019. Results: Female sex, adenocarcinoma, and stage III disease were significantly correlated with right lung lobe tumor. Advanced age at diagnosis was associated with lower lung tumor origin. For the patients who received radical chemoradiotherapy, 1- and 3-year survival rates were 56.5% and 22.9%. Lower lobe origin was closely related to a shorter overall survival compared to non-right lower lobe tumors ( p < 0.001). We also validated the difference in our cohort ( p = 0.004). Conclusions: Our results suggest that lower lobe tumor increases mortality risk in patients with lung cancer treated with radical chemoradiotherapy.
Factors Predicting Frequency and Severity of Postoperative Pain After Arthroscopic Rotator Cuff Repair Surgery
Authors: Rizvi Syed Mohammed Taif , Bishop Mitchell , Lam Patrick H. , Murrell George A.C. 
Published: November 2020

Background: Postoperative pain after arthroscopic rotator cuff repair (RCR) is difficult to predict and manage. The experience of pain is thought to be influenced by a range of different factors. Determining which patient factors contribute to the pain may help us to better understand and manage it. Purpose: To evaluate the preoperative patient characteristics that may be predictive of, and correlated with, postoperative pain after arthroscopic RCR. Study Design: Cohort study; Level of evidence, 3. Methods: The study evaluated 2172 patients who underwent an arthroscopic RCR between February 2004 and December 2015. Pain frequency and severity were measured preoperatively and at 6 weeks after surgery using a modified L’Insalata questionnaire with Likert scales. This 6-week time point was chosen as previous studies have shown patients rank this time point as high in terms of pain after RCR. Logistic regression analysis was conducted to examine the relationship between postoperative pain scores and preoperative pain scores, age, sex, tear size, strength, level of sporting and work activity, and work-related injury status. Results: The severity of preoperative pain at night ( r = 0.33; P < .001), preoperative pain at rest ( r = 0.32; P < .001), and frequency of extreme pain ( r = 0.31; P < .001) were the strongest independent associations with the frequency of pain at 6 weeks postoperatively. Other associations with postoperative pain frequency included reduced liftoff strength ( r = −0.21; P < .001), work-related injury status ( P < .001), younger age ( P = .001), and female sex ( P = .04). Tear size was inversely related with pain severity ( R2 = 0.85). The severity of preoperative pain had the strongest independent association with the severity of postoperative pain at 6 weeks after surgery ( r = 0.35; P < .001). Other associations with postoperative pain severity included increased patient-ranked preoperative stiffness ( P < .001), a poorer impression of one’s shoulder ( P < .001), reduced level of sporting activity ( P < .001), and work-related injury status ( P < .001). Conclusion: Multiple risk factors have been identified for postoperative pain after RCR, the strongest of which is preoperative pain. However, of note, the magnitude of the correlations between preoperative severity and frequency of pain and postoperative severity and frequency of pain were found to be weak to moderate ( r = 0.30-0.35). This suggests that while preoperative pain and its severity are associated with postoperative pain, other factors are likely involved in predicting pain. Smaller tear size, younger age, female sex, and work-related injuries were also associated with postoperative pain at 6 weeks after surgery.