bluuebunny/crossref_metadata_2025_split huggingface dataset:
Focal Pulsed Field Ablation for Pulmonary Vein Isolation and Linear Atrial Lesions
Authors: Koruth Jacob S. , Kuroki Kenji , Kawamura Iwanari , Stoffregen William C. , Dukkipati Srinivas R. , Neuzil Petr , Reddy Vivek Y. 
Published: May 2020

Background:
A novel ablation and mapping system can toggle between delivering biphasic pulsed field (PF) and radiofrequency energy from a 9-mm lattice-tip catheter. We assessed the preclinical feasibility and safety of (1) focal PF-based thoracic vein isolation and linear ablation, (2) combined PF and radiofrequency focal ablation, and (3) PF delivered directly atop the esophagus.

Methods:

Two cohorts of 6 swine were treated with pulsed fields at low dose (PF
LD
) and high dose (PF
HD
) and followed for 4 and 2 weeks, respectively, to isolate 25 thoracic veins and create 5 right atrial (PF
LD
), 6 mitral (PF
HD
), and 6 roof lines (radiofrequency+PF
HD
). Baseline and follow-up voltage mapping, venous potentials, ostial diameters, and phrenic nerve viability were assessed. PF
HD
and radiofrequency lesions were delivered in 4 and 1 swine from the inferior vena cava onto a forcefully deviated esophagus. All tissues were submitted for histopathology.

Results:

Hundred percent of thoracic veins (25 of 25) were successfully isolated with 12.4±3.6 applications/vein with mean PF times of <90 seconds/vein. Durable isolation improved from 61.5% PF
LD
to 100% with PF
HD
(
P
=0.04), and all linear lesions were successfully completed without incurring venous stenoses or phrenic injury. PF
HD
sections had higher transmurality rates than PF
LD
(98.3% versus 88.1%;
P
=0.03) despite greater mean thickness (2.5 versus 1.3 mm;
P
<0.001). PF lesions demonstrated homogenous fibrosis without epicardial fat, nerve, or vessel involvement. In comparison, radiofrequency+PF
HD
sections revealed similar transmurality but expectedly more necrosis, inflammation, and epicardial fat, nerve, and vessel involvement. Significant ablation-related esophageal necrosis, inflammation, and fibrosis were seen in all radiofrequency sections, as compared with no PF sections.

Conclusions:
The lattice-tip catheter can deliver focal PF to durably isolate veins and create linear lesions with excellent transmurality and without complications. The PF lesions did not damage the phrenic nerve, vessels, and the esophagus.
Treatment Differences in Chronic Heart Failure Patients With Reduced Ejection Fraction According to Blood Pressure
Authors: Veenis Jesse F. , Brunner-La Rocca Hans-Peter , Linssen Gerard C.M. , Van Gent Marco W.F. , Hoes Arno W. , Brugts Jasper J. ,   for the CHECK-HF Investigators
Published: May 2020

Background:
Prescribed dosages of heart failure (HF) therapy in patients with a reduced left ventricular ejection fraction remain lower than guideline recommended. It remains unclear whether systolic blood pressure (BP) influences prescription of HF drugs to HF patients with a reduced left ventricular ejection fraction in a European setting. This study aimed to investigate the role of systolic BP on the prescription rate and actual dose of guideline-recommended HF therapy.

Methods:
A total of 8246 patients with chronic HF with a reduced left ventricular ejection fraction from 34 Dutch outpatient HF clinics were included. Detailed information on prescription rates and dosages of HF drugs were assessed according to systolic BP categories (<95, 95–109, 110–129, and ≥130 mm Hg).

Results:

Patients with systolic BP <95 mm Hg receive more often triple therapy (β-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist; 40.3% versus 30.4% respectively,
P
<0.001) compared with ≥130 mm Hg. Patients with systolic BP <95 mm Hg received significantly more often mineralocorticoid receptor antagonists (64.5% versus 43.8%), ivabradine (8.3% versus 3.6%), and diuretics (94.2% versus 78.6%) and less often renin-angiotensin system inhibitors (75.4% versus 82.8%) compared with ≥130 mm Hg (
P
for all trends, <0.001). The prescribed dosages of β-blockers and renin-angiotensin system inhibitors were significantly lower in patients with systolic BP <95 mm Hg compared with ≥130 mm Hg (
P
for all trends, <0.001).

Conclusions:
In this large cross-sectional cohort of patients with reduced left ventricular ejection fraction, patients with lower systolic BP receive more HF drugs but at lower dose relative to the target dose recommended in HF guidelines. Discussion is warranted regarding what target BP is acceptable and what should be limiting factors in uptitration to adequate levels of HF medication.
In‐Depth Extracorporeal Cardiopulmonary Resuscitation in Adult Out‐of‐Hospital Cardiac Arrest
Authors: Dennis Mark , Lal Sean , Forrest Paul , Nichol Alistair , Lamhaut Lionel , Totaro Richard J. , Burns Brian , Sandroni Claudio 
Published: May 2020

The use of extracorporeal cardiopulmonary resuscitation (E‐
CPR
) for the treatment of patients with out‐of‐hospital cardiac arrest who do not respond to conventional cardiopulmonary resuscitation CPR) has increased significantly in the past 10 years, in response to case reports and observational studies reporting encouraging results. However, no randomized controlled trials comparing E‐
CPR
with conventional CPR have been published to date. The evidence from systematic reviews of the available observational studies is conflicting. The inclusion criteria for published E‐
CPR
studies are variable, but most commonly include witnessed arrest, immediate bystander
CPR
, an initial shockable rhythm, and an estimated time from
CPR
start to establishment of E‐
CPR
(low‐flow time) of <60 minutes. A shorter low‐flow time has been consistently associated with improved survival. In an effort to reduce low‐flow times, commencement of E‐
CPR
in the prehospital setting has been reported and is currently under investigation. The provision of an E‐
CPR
service, whether hospital based or prehospital, carries considerable cost and technical challenges. Despite increased adoption, many questions remain as to which patients will derive the most benefit from E‐
CPR
, when and where to implement E‐
CPR
, optimal post‐arrest E‐
CPR
care, and whether this complex invasive intervention is cost‐effective. Results of ongoing trials are awaited to determine whether E‐
CPR
improves survival when compared with conventional
CPR
.
The Effects of Physician and Hospital Integration on Medicare Beneficiaries' Health Outcomes
Authors: Koch Thomas G. , Wendling Brett W. , Wilson Nathan E. 
Published: May 2020

Abstract
We consider whether hospital acquisitions of physicians lead to improved clinical outcomes for medicare patients aged 65 and older. The analysis combines 2005–2012 Medicare fee-for-service and enrollment data with merger and physician affiliation information from the Levin Reports and SK&A, respectively. We determine the effect of acquisitions on several health outcomes: mortality, acute myocardial infarctions, acute circulatory conditions, ischemic heart disease, glaucoma, symptomatic diabetes complications, and asymptomatic diabetes complications. These outcomes represent the progression of hypertension and diabetes into worse health states. Our results indicate that hospital acquisitions of existing physician practices have little effect on the health outcomes we consider.
Velocity and Purpose among Reindeer Herders in the Verkhoyansk Mountains
Authors: Vitebsky Piers , Alekseyev Anatoly 
Published: May 2020

Abstract
Why would anyone want to travel fast? This paper places local evaluations of velocity in the context of purpose, distinguishing between the excursion of the hunter, the perpetual annual circuit of the reindeer herder and the one-off journey. Reindeer hooves and sledge runners enhance human velocity on the ground. In its extreme reduction of friction, aviation mimics the soul-flight of shamans and compresses distance, but also creates new purposes and concepts of destination, while telecommunication abolishes distance altogether. In generating their own purposes and rhythms, reindeer, aircraft and radio each generate different kinds of personhood and ways of feeling.
Slow Connection
Authors: Safonova Tatiana , Santha Istvan 
Published: May 2020

Abstract
Using ethnographic materials collected in 2008 and 2009 in a distant and isolated village in East Siberia, this article shows how slow and distorted connections contribute to the development of a specific eco-biopolitical space that can be likened to a spaceship physically disconnected from the mainland. Life in such a ‘bubble’ is dependent on supplies from the mainland, which create rhythms of activities in the community. The lack of access to state services and institutions is compensated by local initiatives to mimic such organisations. The state provides channels of escape from the village, such as emergency flights, but does not invest in infrastructures that would link this settlement to other places. The community ‘bubble’ exists not because of infrastructural absence per se, but because this isolation is asymmetrical. It is easier and faster to get from the village to the centre than it is to return. This imbalance expresses the power relations between the centre and periphery and systematically reproduces conditions in which resources drain from the village. This ‘slow connection’ is the condition for the creation of a specific eco-biopolitical regime, in which a rich place is occupied by people living in poverty.
Downward the Ground is Hard; Upward the Sky is Far
Authors: Legrain Laurent 
Published: May 2020

Abstract
This article provides an extended case study of an elder’s journey back to his homeland in Hovd Province after years of absence. The hazards of life mingled with lingering resentment have weakened the ties to the homeland and generate distance from his relatives so much that the return proves to be more complicated than expected. The story that the article tells is used to delineate theoretically a very general figure of prominence present in Mongolian social life that the author calls ‘the ruler’, i.e. a person capable of bringing order to the multiple forces that constitute a Mongolian nutag and able to put them all in line with his own agenda.
A short bevel needle with a very thin tip improves vein puncture performance of peripheral intravenous catheters: An experimental study
Authors: Tanabe Hidenori , Kawasaki Manami , Ueda Takehiko , Yokota Takayuki , Zushi Yasunobu , Murayama Ryoko , Abe-Doi Mari , Sanada Hiromi 
Published: May 2020

Background: Peripheral intravenous catheter placement is frequently unsuccessful at the first attempt. One suggested risk factor is a small vein size, because of the consequences of mechanical forces generated by the needle tip. We developed short bevel needles with a very thin tip and evaluated their puncture performance in two in vitro models. Methods: Peripheral intravenous catheters with a new needle ground using the lancet method (experimental catheter (L)) or backcut method (experimental catheter (B)) were compared with a conventional peripheral intravenous catheter (Surshield Surflo®) in a penetration force test and a tube puncture test. Penetration forces were measured when peripheral intravenous catheters penetrated a polyethylene sheet. The tube puncture test was used to evaluate whether the peripheral intravenous catheters could puncture a polyvinyl chloride tube at two positions, at the center and at 0.5 mm from the center of the tube. Results: Mean penetration forces at the needle tip produced by experimental catheters (L) (0.05 N) and (B) (0.04 N) were significantly lower than those produced by the conventional catheter (0.09 N) (p < 0.01). At the catheter tip, mean forces produced by experimental catheter (B) and the conventional catheter were 0.16 N and 0.26 N, respectively (p < 0.05). In the tube puncture test, the frequency at which the conventional catheter punctured the center-shifted site on the tube at an angle of 20° and speed of 50 mm/min was low (40%). In contrast, experimental catheters (L) and (B) were 100% successful at puncturing both the center and center-shifted sites at 20°. Conclusion: Puncture performance was comparable between the lancet-ground and backcut-ground needles except for penetration forces at the catheter tip. The experimental catheters produced lower penetration forces and induced puncture without target displacement at smaller angles compared with the conventional catheter. Therefore, optimization of the needle can prevent vein deformation and movement, which may increase the first-attempt success rate.
Meta-analysis of effect of renin–angiotensin–aldosterone system blockers on contrast-induced nephropathy
Authors: Wang Weidong , Qu Wei , Sun Dan , Liu Xiaodan 
Published: May 2020

Background: The purpose of this study was to systematically evaluate the effect of renin–angiotensin–aldosterone system blockers on the incidence of contrast-induced nephropathy in patients undergoing coronary angiography or percutaneous coronary intervention. Methods: A systematic literature search of several databases was conducted to identify studies that met the inclusion criteria. A total of 12 studies with 14 trials that performed studies on a total of 4864 patients (2484 treated with renin–angiotensin–aldosterone system blockers and 2380 in the control group) were included. The primary endpoint was the overall incidence of contrast-induced nephropathy. Analyses were performed with STATA version 12.0. Results: The overall contrast-induced nephropathy incidence in renin–angiotensin–aldosterone system blocker and control groups was 10.43% and 6.81%, respectively. The pooled relative risk of contrast-induced nephropathy incidence was 1.22 (95% confidence interval: 0.81–1.84) in the renin–angiotensin–aldosterone system blocker group. An increased risk of developing contrast-induced nephropathy in the renin–angiotensin–aldosterone system blocker group was observed among older people, non-Asians, chronic users, and studies with larger sample size, and the pooled RRs and 95% confidence intervals were 2.02 (1.21–3.36), 2.30 (1.41–3.76), 1.69 (1.10–2.59) and 1.83 (1.28–2.63), respectively. Conclusions: Intervention with renin–angiotensin–aldosterone system blockers was associated with an increased risk of contrast-induced nephropathy among non-Asians, chronic users, older people, and studies with larger sample size. Large clinical trials with strict inclusion criteria are needed to confirm our results and to evaluate the effect further.
Utility of the integrated palliative care outcome scale (IPOS): a cross-sectional study in hospitalised patients with heart failure
Authors: Roch Carmen , Palzer Johanna , Zetzl Teresa , Störk Stefan , Frantz Stefan , van Oorschot Birgitt 
Published: May 2020

Aim
The aim of this study was to evaluate the suitability and comprehensibility of the integrated palliative care outcome scale for the evaluation of palliative care needs in patients with heart failure.

Methods and results
This cross-sectional study investigated 100 heart failure patients (40 women, 60 men; median age 79 years) within the first few days of their hospitalisation by applying the integrated palliative care outcome scale (3-day recall period) and two additional self-developed questions about the suitability and comprehensibility of the integrated palliative care outcome scale. Clinically relevant somatic and psycho-emotional symptoms were reported very frequently (approximately 75% each), followed by communicational needs or practical issues. Ninety-five per cent of patients thought the integrated palliative care outcome scale very easy to understand, and 91% judged the integrated palliative care outcome scale suitable to assess palliative care needs.

Conclusion
The integrated palliative care outcome scale was well accepted by hospitalised patients with heart failure and identified a high burden of both physical and psycho-emotional symptoms. Screening for palliative care has to consider patients and their relatives alike, and should be part of a comprehensive care concept jointly integrated into clinical routine by primary and specialised palliative care teams.
Subjective reports of physical activity levels and sedentary time prior to hospital admission can predict utilization of hospital care and all-cause mortality among patients with cardiovascular disease
Authors: Ek Amanda , Kallings Lena V , Ekström Mattias , Börjesson Mats , Ekblom Örjan 
Published: May 2020

Background
In prevention, sedentary behaviour and physical activity have been associated with risk of cardiovascular disease and mortality. Less is known about associations with utilization of hospital care.

Aim
To investigate whether physical activity level and sedentary behaviour prior to cardiac ward admission can predict utilization of hospital care and mortality among patients with cardiovascular disease.

Methods
Longitudinal observational study including 1148 patients admitted and treated in cardiac wards in two hospitals. Subjective reports of physical activity levels and sedentary time prior to admission were collected during inpatient care and categorized as low, medium or high. The associations between physical activity level and sedentary time with hospital stay, readmission and mortality were analysed using linear, logistic and Cox regressions.

Results
Median hospital stay was 2.1 days. One higher step in the physical activity level, or lower sedentary time, was related to an approximately 0.9 days shorter hospital stay. Sixty per cent of patients were readmitted to hospital. The risk of being readmitted was lower for individuals reporting high physical activity and low sedentary time (odds ratios ranging between 0.44 and 0.91). A total of 200 deaths occurred during the study. Mortality was lower among those with high and medium physical activity levels and low sedentary time (hazard ratios ranging between 0.36 and 0.90).

Conclusion
Both physical activity level and sedentary time during the period preceding hospitalization for cardiac events were predictors of hospital utilization and mortality. This highlights the prognostic value of assessing patients’ physical activity and sedentary behaviour.
Corticosterone Induces Depressive-Like Behavior in Female Peri-Pubescent Rats, but Not in Pre-Pubescent Rats
Authors: Nickle Tyler R. , Stanley Erica M. , Middlemas David S. 
Published: May 2020

Background There are no data on the effect of exogenous corticosterone on depressive-like behavior in juvenile rats. Furthermore, it has not been tested whether the effects of corticosterone in female rats is different before or after puberty. Objective We tested the effect of corticosterone treatment on female pre- and peri-pubescent juvenile rats on depressive-like behavior. Methods Female juvenile rats were divided into pre-pubescent (post-natal day 7–27) or peri-pubescent (post-natal day 28–48) groups and administered daily corticosterone (40 mg kg−1 day−1) for 21 days. Depressive-like behavior was assessed using a modified forced swim test and the sucrose preference test. After behavioral assessment, brains were analyzed to determine if there were changes in cell proliferation and newborn neuron survival in the dentate gyrus of the dorsal hippocampus. Results Chronic corticosterone treatment did not affect behavior or neurogenesis in female pre-pubescent juvenile rats. However, female peri-pubescent rats injected with corticosterone showed increased depressive-like behavior as well as a decrease in cell proliferation in the subgranular zone. Furthermore, there was an inverse correlation between time spent immobile in the forced swim test and cell proliferation in the granule cell layer in peri-pubescent rats. Conclusions Corticosterone induces depressive-like behavior in peri-pubescent, but not in pre-pubescent female rats. Finally, our results suggest that depressive-like behavior may be associated with a decrease in hippocampal cell proliferation in female peri-pubescent rats.
Disrupted functional connectivity between sub-regions in the sensorimotor areas and cortex in migraine without aura
Authors: Qin Zhaoxia , Su Jingjing , He Xin-Wei , Ban Shiyu , Zhu Qian , Cui Yangyang , Zhang Jilei , Hu Yue , Liu Yi-Sheng , Zhao Rong , Qiao Yuan , Li Jianqi , Liu Jian-Ren , Du Xiaoxia 
Published: May 2020

Abstract
Background
Migraine is a severe and disabling brain disorder, and the exact neurological mechanisms remain unclear. Migraineurs have altered pain perception, and headache attacks disrupt their sensory information processing and sensorimotor integration. The altered functional connectivity of sub-regions of sensorimotor brain areas with other brain cortex associated with migraine needs further investigation.

Methods
Forty-eight migraineurs without aura during the interictal phase and 48 age- and sex-matched healthy controls underwent resting-state functional magnetic resonance imaging scans. We utilized seed-based functional connectivity analysis to investigate whether patients exhibited abnormal functional connectivity between sub-regions of sensorimotor brain areas and cortex regions.

Results
We found that patients with migraineurs without aura exhibited disrupted functional connectivities between the sensorimotor areas and the visual cortex, temporal cortex, posterior parietal lobule, prefrontal areas, precuneus, cingulate gyrus, sensorimotor areas proper and cerebellum areas compared with healthy controls. In addition, the clinical data of the patients, such as disease duration, pain intensity and HIT-6 score, were negatively correlated with these impaired functional connectivities.

Conclusion
In patients with migraineurs without aura, the functional connectivities between the sensorimotor brain areas and other brain regions was reduced. These disrupted functional connectivities might contribute to abnormalities in visual processing, multisensory integration, nociception processing, spatial attention and intention and dysfunction in cognitive evaluation and modulation of pain. Recurrent headache attacks might lead to the disrupted network between primary motor cortex and temporal regions and between primary somatosensory cortex and temporal regions. Pain sensitivity and patient quality of life are closely tied to the abnormal functional connectivity between sensorimotor regions and other brain areas.