bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous rhythm monitoring‐guided anticoagulation after atrial fibrillation ablation
Authors: Pothineni Naga Venkata K. , Amankwah Nigel , Santangeli Pasquale , Schaller Robert D. , Supple Gregory E. , Deo Rajat , Nazarian Saman , Garcia Fermin C. , Dixit Sanjay , Callans David J. , Marchlinski Francis E. , Frankel David S. 
Published: December 2020

AbstractIntroductionOral anticoagulation (OAC) based on estimated stroke risk is recommended following catheter ablation (CA) of atrial fibrillation (AF), regardless of the extent of arrhythmia control. However, discontinuing OAC in selected patients may be safe. We sought to evaluate a strategy of OAC discontinuation following AF ablation guided by continuous rhythm monitoring.Methods and ResultsWe prospectively studied AF ablations performed at our institution from June 2015 to December 2019. Patients that had pre‐existing cardiac implantable electronic devices (CIEDs) or underwent insertable cardiac monitor (ICM) implantation immediately following AF ablation were included. OAC was continued for 6 weeks following CA in all patients, following which OAC management was guided by CHA2DS2‐VASc score and continuous rhythm monitoring results, according to a prespecified protocol. AF recurrence was defined as ≥30 s (CIEDs) or ≥2 min (ICM). We studied 196 patients (mean age 64.7 ± 11.3 years, 66.8% male, 85.7% ICM, 14.3% CIEDs). Mean CHA2DS2‐VASc score was 2.2  ± 1.5. One‐year AF‐free survival following CA was 83% for paroxysmal AF and 63% for persistent AF patients. Over 3 year follow‐up, OAC was discontinued in 57 (33.7%) patients, mean 7.4 ± 7.1 months following ablation. Following discontinuation, OAC was restarted for AF recurrence in 9 (15.8%) patients, mean 11.7 ± 6.8 months after stopping. This discontinuation protocol led to a 21.9% reduction in overall time exposed to OAC. There were no thromboembolic or major bleeding events.ConclusionOAC can be discontinued in a significant percentage of patients following CA of AF. When guided by continuous rhythm monitoring, this practice does not unacceptably increase the risk of thromboembolic events
Endoscopic removal of entirely embedded esophagus‐penetrating foreign bodies (with video)
Authors: Wang Yun , Liu Zu‐Qiang , Xu Xiao‐Yue , Hu Hao , Qin Wen‐Zheng , Chen Wei‐Feng , Cai Ming‐Yan , Zhang Yi‐Qun , Zhong Yun‐Shi , Li Quan‐Lin , Zhou Ping‐Hong 
Published: December 2020

AbstractBackground and AimTraditionally, surgery is the only choice for esophageal foreign bodies (FBs) penetrating into the mediastinum or cervical para‐esophageal space. Recent progress in endoscopic techniques and devices has made it possible to perform endoscopic procedures in the mediastinum. Here, we describe a novel method to remove the entirely embedded esophagus‐penetrating FBs through an endoscopic approach.MethodsPatients who underwent endoscopic removal of entirely embedded esophagus‐penetrating FBs were prospectively enrolled between December 2018 and June 2020. All procedures were performed by using five major steps: localization of the FB; mucosal incision; wound debridement, myotomy, and FB exposure; FB extraction; and closure of the esophageal wound.ResultsA total of five cases of entirely embedded esophagus‐penetrating FBs were evaluated, two in children and three in adults. All FBs were successfully removed and extracted using a therapeutic endoscope and a hook knife or a hybrid knife and a grasping forceps as accessories. The average procedure time was 19.0 ± 12.4 min (range 10–40 min). The major surgical procedure was avoided in all patients. The average length of hospital stay was 3.8 ± 2.5 days (range 2–8 days). There were no severe short‐term adverse events after all procedures. During the 1 month and 3 months follow‐up, no patient developed long‐term adverse events including stenosis of the esophagus and fistula formation.ConclusionsEndoscopic approach was a safe and effective way to remove entirely embedded esophagus‐penetrating FBs.
Psychotropic Medication and Cognitive, Functional, and Neuropsychiatric Outcomes in Alzheimer's Disease (AD)
Authors: Oh Esther S. , Rosenberg Paul B. , Rattinger Gail B. , Stuart Elizabeth A. , Lyketsos Constantine G. , Leoutsakos Jeannie‐Marie S. 
Published: December 2020

BACKGROUND/OBJECTIVESThere are growing concerns about the safety and efficacy of psychotropic medications in Alzheimer's disease (AD). We sought to examine associations between psychotropic medication exposure and longitudinal change in cognitive, functional, and neuropsychiatric outcomes in a large clinical AD cohort.DESIGNLongitudinal observational study.SETTINGNational Alzheimer's Disease Coordinating Center combining data from 39 Alzheimer's disease centers.PARTICIPANTS8,034 participants with AD dementia.MEASUREMENTSMini‐Mental State Exam (MMSE), Clinical Dementia Rating Scale‐Sum of Boxes (CDR‐SB), and Neuropsychiatric Inventory Questionnaire (NPI‐Q) Total. Probability of exposure to medication (the propensity score, PS) calculated via logistic regression. Medication classes included all antipsychotics (atypical vs conventional), antidepressants (Selective Serotonin Reuptake Inhibitor [SSRI] vs non‐SSRI), and benzodiazepines. Participants treated with a medication class were matched with participants not treated with that class with the closest‐matched PS. The effect of medication treatment was assessed using linear mixed‐effects models.RESULTSParticipants had a mean (SD) age of 75.5 (9.8) years, and mean (SD) scores of MMSE 21.3 (5.7), CDR‐SB 5.5 (3.4), and NPI‐Q Total 4.5 (4.4). Mean duration of follow‐up was 2.9–3.3 years depending on medication class. Non‐SSRI antidepressant use was associated with better CDR‐SB (2‐year difference in change‐DIC: −0.38 [−0.61, −0.15], P = .001). Atypical antipsychotic use was associated with greater decline on MMSE (DIC: −0.91 [−1.54, −0.28] P = .005) and CDR‐SB scores (DIC: 0.50 [0.14, 0.86], P = .006). Notably, no drug class was associated with better NPI‐Q scores.CONCLUSIONSUse of atypical antipsychotics was associated with poorer cognition and function, and no drug class was associated with improvement in neuropsychiatric symptoms.
Neuromuscular junction‐on‐a‐chip: ALS disease modeling and read‐out development in microfluidic devices
Authors: de Jongh Rianne , Spijkers Xandor M. , Pasteuning‐Vuhman Svetlana , Vulto Paul , Pasterkamp R. Jeroen 
Published: December 2020

AbstractAmyotrophic lateral sclerosis (ALS) is a fatal and progressive neurodegenerative disease affecting upper and lower motor neurons with no cure available. Clinical and animal studies reveal that the neuromuscular junction (NMJ), a synaptic connection between motor neurons and skeletal muscle fibers, is highly vulnerable in ALS and suggest that NMJ defects may occur at the early stages of the disease. However, mechanistic insight into how NMJ dysfunction relates to the onset and progression of ALS is incomplete, which hampers therapy development. This is, in part, caused by a lack of robust in vitro models. The ability to combine microfluidic and induced pluripotent stem cell (iPSC) technologies has opened up new avenues for studying molecular and cellular ALS phenotypes in vitro. Microfluidic devices offer several advantages over traditional culture approaches when modeling the NMJ, such as the spatial separation of different cell types and increased control over the cellular microenvironment. Moreover, they are compatible with 3D cell culture, which enhances NMJ functionality and maturity. Here, we review how microfluidic technology is currently being employed to develop more reliable in vitro NMJ models. To validate and phenotype such models, various morphological and functional read‐outs have been developed. We describe and discuss the relevance of these read‐outs and specifically illustrate how these read‐outs have enhanced our understanding of NMJ pathology in ALS. Finally, we share our view on potential future directions and challenges.
image
Promotion of vascular integrity in sepsis through modulation of bioactive adrenomedullin and dipeptidyl peptidase 3
Authors: van Lier D. , Kox M. , Pickkers P. 
Published: December 2020

AbstractSepsis represents one of the major medical challenges of the 21st century. Despite substantial improvements in the knowledge on pathophysiological mechanisms, this has so far not translated into novel adjuvant treatment strategies for sepsis. In sepsis, both vascular tone and vascular integrity are compromised, and contribute to the development of shock, which is strongly related to the development of organ dysfunction and mortality. In this review, we focus on dipeptidyl peptidase 3 (DPP3) and adrenomedullin (ADM), two molecules that act on the vasculature and are involved in the pathophysiology of sepsis and septic shock. DPP3 is an ubiquitous cytosolic enzyme involved in the degradation of several important signalling molecules essential for regulation of vascular tone, including angiotensin II. ADM is a key hormone involved in the regulation of vascular tone and endothelial barrier function. Previous studies have shown that circulating concentrations of both DPP3 and ADM are independently associated with the development of organ failure and adverse outcome in sepsis. We now discuss new evidence illustrating that these molecules indeed represent two distinct pathways involved in the development of septic shock. Recently, both ADM‐enhancing therapies aimed at improving endothelial barrier function and vascular tone and DPP3‐blocking therapies aimed at restoring systemic angiotensin responses have been shown to improve outcome in various preclinical sepsis models. Given the current lack of effective adjuvant therapies in sepsis, additional research on the therapeutic application of these peptides in humans is highly warranted.
Association between periodontitis and the Mediterranean diet in young Moroccan individuals
Authors: Iwasaki Masanori , Ennibi Oum Keltoum , Bouziane Amal , Erraji Samir , Lakhdar Leila , Rhissassi Meryem , Ansai Toshihiro , Yoshida Akihiro , Miyazaki Hideo 
Published: December 2020

AbstractBackground & ObjectivesAdherence to the Mediterranean diet (MedDiet) has been reported to be associated with a lower risk of various chronic diseases. This cross‐sectional study aimed to investigate the potential association between adherence to the MedDiet and periodontitis, which is highly prevalent in young Moroccan individuals.MethodsWe evaluated 1075 Moroccan individuals (72% women, mean [standard deviation] age = 20.2 [1.5] years). Adherence to the MedDiet was assessed using the MedDiet score (MDS) based on the frequency of intake of eight food groups (vegetables, legumes, fruits, cereals or potatoes, fish, red meat, dairy products, and olive oil). A value of 0 (unhealthy) or 1 (healthy) was assigned to each food group, and the MDS (range, 0‐8 points) was generated by adding the individual scores, with a higher score indicating better adherence to the MedDiet. The logistic regression model was used to evaluate the MDS (high [5‐8 points]/low [0‐4 points]) and each component score (1/0) with the presence of periodontitis, which was determined through full‐mouth periodontal examinations. Age, sex, and oral health behavior were considered as potential confounders.ResultsIn total, 693 (64.5%) study participants showed high MDSs. Periodontitis was observed in 71 (6.6%) participants. No significant association between MDS and periodontitis was observed. Nonetheless, olive oil consumption, a component of the MDS, showed a significant inverse association with periodontitis (adjusted odds ratio = 0.55; 95% confidence interval, 0.32‐0.96).ConclusionsThe MedDiet was not significantly associated with periodontitis among young Moroccans. However, frequent consumption of olive oil may have a protective effect against periodontitis, although the temporal association needs to be clarified in further studies.
Home Radon Testing in Rural Appalachia
Authors: Stanifer Stacy R. , Rayens Mary Kay , Wiggins Amanda , Gross David , Hahn Ellen J. 
Published: December 2020

AbstractPurposeThis study compared differences in sociodemographic characteristics, personal risk perception of lung cancer, lung cancer worry, and synergistic risk perception among rural Appalachia residents who completed home radon testing with those who did not, after receiving a free long‐term test kit at a rural primary care clinic. The study also examined the association between the Teachable Moment Model constructs and home radon testing.MethodsThe study was an exploratory correlational design with a convenience sample of (N = 58) adult participants recruited from 2 rural primary care clinics in Appalachia Kentucky. Participants completed a brief survey and were given a free long‐term home radon test kit. Multiple logistic regression was used to determine characteristics associated with home radon testing.FindingsTwenty‐eight participants (48%) completed home radon testing. There were no differences in personal risk perception of lung cancer, lung cancer worry, or synergistic risk perception between those who completed home radon testing and those who did not. Age was the only significant factor associated with completion of radon testing (B = 0.077, P = .005). For every 5‐year increase in age, participants were 47% more likely to test their home for radon.ConclusionProviding free home radon test kits in the primary care setting shows promise in prompting radon testing in rural Appalachia. As radon‐induced lung cancer risk increases with exposure over time, health care providers in rural Appalachia need to encourage patients of all ages to test their home for radon, especially those who smoke or report smoking in the home.
Species delimitation of North AmericanNyssaspecies
Authors: Yang Yan‐Ting , Yang Xu‐Chen , Wang Ming‐Cheng , Zhong Lin‐Ling , Ma Rui , Ma Tao , Liu Jian‐Quan , Davis Charles C. , Xi Zhen‐Xiang 
Published: December 2020

AbstractThe development of next‐generation sequencing technologies allows researchers to address complex problems in species delimitation, especially for non‐model organisms. The taxonomic status of North AmericanNyssaspecies has long been debated and remains controversial. To elucidate the genetic structure and phylogenetic relationships of the five currently recognized North AmericanNyssaspecies, we conducted whole‐genome sequencing of representative individuals and identified genome‐wide single‐nucleotide polymorphisms (SNPs) by utilizing the recently released chromosome‐level assembly ofNyssa sinensisgenome. Population genetic and phylogenetic analyses consistently inferred four well‐supported genetic clusters from our sampled individuals, that is,N. aquatica, N. ogeche, N. sylvatica, andN. biflora–N. ursina. Although the identification ofN. bifloraandN. ursinais primarily based on the morphological characteristics of leaves and drupes, the present evidence, including our principal components analysis of leaf morphological traits, strongly supports the taxonomic designation ofN. bifloraandN. ursinaas a single species. In addition, these four genetic clusters were grouped into two major clades, that is, clade 1 (N. aquaticaandN. ogeche) and clade 2 (N. sylvaticaandN. biflora–N. ursina). Despite the fact that no evidence of widespread gene flow was found between these two major clades, our analyses revealed the possibility of introgression fromN. sylvaticaintoN. biflora, albeit at a relatively low frequency. This study demonstrates the use of whole‐genome sequences as a promising avenue for delimiting species boundaries and further advocates for an integrative approach in the assessment of species delimitation.
Safe administration of drug desensitizations in pediatric patients
Authors: Herr Sarah , Ferdman Ronald , Braskett Melinda 
Published: December 2020

AbstractPurposePatients with certain types of allergic reactions to medication may safely receive the culprit medication through an elaborate allergy procedure called a drug desensitization. Nurses play a key role in this process which is only performed when a certain medication is absolutely indicated as optimal therapy. Nurses are instrumental in the planning stages of drug desensitizations for coordination of interdisciplinary care and anticipation of adverse effects. Thus, it is paramount that nurses performing this procedure understand the mechanism of desensitizations and have access to the resources needed to safely complete these procedures in pediatric patients.ConclusionExcellence in nursing clinical acumen and a detailed order set are essential to patient safety during dug desensitization. With the following methodology and coordination by nursing, we have had great success at Children's Hospital Los Angeles in over one hundred drug desensitizations in pediatric patients which allowed them to received first line therapies. We have created order sets from published references and years of clinical experience. The nursing care of adult patients undergoing drug desensitization procedures is well described in the literature but few resources exist for pediatric nurses. There is paucity of published nursing resources for pediatric drug desensitizations. Repeated PubMed searches for “pediatric drug desensitizations” in 2019‐2020, revealed only one recent reference geared toward physicians.Practice ImplicationsWith appropriate training, staffing, and coordination, drug desensitizations can be safely performed in pediatric patients with close observation by a multi‐disciplinary team. The bedside nurse has a pivotal role as coordinator and clinician for these high‐risk resource‐intensive procedures.
Altered gene expression signatures by calcitonin gene‐related peptide promoted mast cell activity in the colon of stress‐induced visceral hyperalgesia mice
Authors: Sun Hanliang , Ma Yanhan , An Shuhong , Wang Zhaojin 
Published: December 2020

AbstractBackgroundCalcitonin gene‐related peptide (CGRP) is possibly involved in recruitment of mucosal mast cells (MCs) in the gut that may be associated with the development of irritable bowel syndrome (IBS), but the role of CGRP on the activation of MCs is still unknown.MethodsUsing RNA sequencing (RNA‐seq), we examined differentially expressed genes (DEGs) in mouse MCs following CGRP treatment. The expression of key genes in colonic MCs and their relationship with CGRP‐containing fibers were examined by immunofluorescence in chronic water‐avoidance stress (WAS)‐induced visceral hyperalgesia mice.Key ResultsA total of 29 DEGs were found significantly changed with 28 upregulated and 1 downregulated following treatment of MCs with CGRP. Bioinformatics analysis showed that key higher DEGs included those associated with response to corticotropin‐releasing hormone (CRH), regulation of transcription, MC activation, and proliferation. These processes are enriched for genes associated with stress‐induced MC activation in IBS. Western blot verified changes in representative DEGs (Nr4a3, Crem, Gpr35, FosB, Sphlk1) and real‐time cell analysis (RTCA) verified the MC proliferation. The vast majority of colonic MCs nearly CGRP‐containing fibers in WAS mice overexpressed only Nr4a3 with little to no FosB, Gpr35, Sphlk1, or Crem expression. Nr4a3 knockdown may attenuate the promotion effect of CGRP on MC viability.Conclusions & InferencesOur results suggest that CGRP is a critical regulator of key expressed genes in MC activation. Nr4a3 as a novel regulator of MC function may have an effect on stress‐induced visceral hyperalgesia, and this may represent the novel target for drug development.
Trait plasticity and trade‐offs shape intra‐specific variation in competitive response in a foundation tree species
Authors: Cope Olivia L. , Lindroth Richard L. , Helm Andrew , Keefover‐Ring Ken , Kruger Eric L. 
Published: December 2020

Summary

The ability to tolerate neighboring plants (i.e. degree of competitive response) is a key determinant of plant success in high‐competition environments. Plant genotypes adjust their functional trait expression under high levels of competition, which may help explain intra‐specific variation in competitive response. However, the relationships between traits and competitive response are not well understood, especially in trees. In this study, we investigated among‐genotype associations between tree trait plasticity and competitive response.

We manipulated competition intensity in experimental stands of trembling aspen (Populus tremuloides) to address the covariance between competition‐induced changes in functional trait expression and aspects of competitive ability at the genotype level.

Genotypic variation in the direction and magnitude of functional trait responses, especially those of crown foliar mass, phytochemistry, and leaf physiology, was associated with genotypic variation in competitive response. Traits exhibited distinct plastic responses to competition, with varying degrees of genotypic variation and covariance with other trait responses.

The combination of genotypic diversity and covariance among functional traits led to tree responses to competition that were coordinated among traits yet variable among genotypes. Such relationships between tree traits and competitive success have the potential to shape stand‐level trait distributions over space and time.
Atmospheric blocking events: a review
Authors: Lupo Anthony R. 
Published: December 2020

AbstractEven though meteorologists have been aware of atmospheric blocking for more than 100 years, it is a phenomenon still not well forecast or completely understood. Also, while there is not one standard accepted definition, there are some commonalities known about the understanding of blocking behavior. Blocking occurs less often than other destructive phenomena, but globally their occurrence has increased since the beginning of the century. The longevity of blocking means it can negatively impact agricultural and economic activity and human comfort by bringing extreme conditions not only to the areas where they occur but also to locations well upstream and downstream. Additionally, while it is known where blocking occurs and their general character has been well described, operational models still struggle to replicate the intensity and duration even though improvement has been noted in the timing and location of onset. Climatologically, models still underestimate their occurrence. In the last 40 years, investigators have used case study analysis and numerical and theoretical models to understand the onset and maintenance of blocking. Comparatively few have examined block decay. This review endeavors to cover the highlights of the history of blocking investigations, especially in the last few decades, in order to provide an understanding for a more general scientific audience.