bluuebunny/crossref_metadata_2025_split huggingface dataset:
The coronary artery calcium score correlates with left atrial low‐voltage area: Sex differences
Authors: Hojo Rintaro , Fukamizu Seiji , Tokioka Sayuri , Inagaki Dai , Kimura Takashi , Takahashi Masao , Kitamura Takeshi , Sakurada Harumizu , Hiraoka Masayasu 
Published: November 2020

AbstractIntroductionIn patients with coronary artery disease, a high coronary artery calcium score (CACS) correlates with atrial fibrillation (AF); however, the association between left atrial (LA) remodeling progression and coronary arteriosclerosis is unclear. This study aimed to evaluate the relationship between LA remodeling progression and the CACS.MethodsThis retrospective study enrolled 148 patients with AF (paroxysmal AF, n = 94) who underwent catheter ablation. Voltage mapping for the left atrium and coronary computed tomography for CACS calculations were performed. The ratio of the LA low‐voltage area (LA‐LVA), defined by values less than 0.5 mV divided by the total LA surface without pulmonary veins, was calculated. Patients with LA‐LVA (<0.5 mV) >5% and ≤5% were classified as the LVA (n = 30) and non‐LVA (n = 118) groups, respectively. Patient characteristics and CACS values were compared between the two groups.ResultsLA volume, age, CHA2DS2VASc score, and percentage of female patients were significantly higher, and the estimated glomerular filtration rate was lower in the LVA group than in the non‐LVA group. The CACS was significantly higher in the LVA group (248.4 vs. 13.2; p = .001). Multivariate analysis identified the LA volume index and CACS as independent predictors of LA‐LVA (<0.5 mV) greater than 5%. The areas under the receiver operating characteristic curves for predicting LA‐LVA (<0.5 mV) greater than 5% with CACS were 0.695 in the entire population, 0.782 in men, and 0.587 in women.ConclusionProgression of LA remodeling and coronary artery calcification may occur in parallel. A high CACS may indicate advanced LA remodeling, especially in men.
Association of mean corpuscular volume with sarcopenia and visceral obesity in individuals without anemia
Authors: Tanaka Muhei , Okada Hiroshi , Hashimoto Yoshitaka , Kumagai Muneaki , Nishimura Hiromi , Fukui Michiaki 
Published: November 2020

AbstractAims/IntroductionSarcopenia and visceral obesity are major global public health issues, and higher mean corpuscular volume (MCV) levels are related to adverse outcomes. Nevertheless, no study has determined the association between MCV and body composition. Therefore, we evaluated the association between MCV levels and trunk muscle quality, muscle quantity and visceral fat area.Materials and MethodsIn our cross‐sectional study, we investigated 702 middle‐aged Japanese individuals without anemia and with normal MCV levels who underwent physical checkups. The cross‐sectional area of skeletal muscle or visceral fat was analyzed by computed tomography.ResultsIn the adjusted model, the MCV was independently associated with the visceral fat area index (β = −0.107, P = 0.0007), total skeletal muscle index (β = 0.053, P = 0.0341) and total skeletal muscle density (β = 0.099, P = 0.0012). MCV as a continuous variable was related to the prevalence of sarcopenia (odds ratios [OR] 0.93, 95% confidence intervals (CI) 0.88–0.98, per 1.0 fL increment; P = 0.0097) and visceral obesity (OR 0.91, 95% CI 0.86–0.97, per 1.0 fL increment; P = 0.0046). The highest MCV quartile was independently associated with the prevalence of sarcopenia (OR 0.48, 95% CI 0.27–0.83; P = 0.0089) and visceral obesity (OR 0.49, 95% CI 0.27–0.88; P = 0.0170), compared with the lowest quartile.ConclusionsIn individuals without anemia and with normal MCV levels, a lower MCV was associated with unfavorable body composition, including lower muscle quality, lower muscle quantity, sarcopenia and visceral obesity.
The novel peptide NbPPI1 identified from Nicotiana benthamiana triggers immune responses and enhances resistance against Phytophthora pathogens
Authors: Wen Qujiang , Sun Manli , Kong Xianglan , Yang Yang , Zhang Qiang , Huang Guiyan , Lu Wenqin , Li Wanyue , Meng Yuling , Shan Weixing 
Published: November 2020

AbstractIn plants, recognition of small secreted peptides, such as damage/danger‐associated molecular patterns (DAMPs), regulates diverse processes, including stress and immune responses. Here, we identified an SGPS (Ser‐Gly‐Pro‐Ser) motif‐containing peptide, Nicotiana tabacum NtPROPPI, and its two homologs in Nicotiana benthamiana, NbPROPPI1 and NbPROPPI2. Phytophthora parasitica infection and salicylic acid (SA) treatment induced NbPROPPI1/2 expression. Moreover, SignalP predicted that the 89‐amino acid NtPROPPI includes a 24‐amino acid N‐terminal signal peptide and NbPROPPI1/2‐GFP fusion proteins were mainly localized to the periplasm. Transient expression of NbPROPPI1/2 inhibited P. parasitica colonization, and NbPROPPI1/2 knockdown rendered plants more susceptible to P. parasitica. An eight‐amino‐acid segment in the NbPROPPI1 C‐terminus was essential for its immune function and a synthetic 20‐residue peptide, NbPPI1, derived from the C‐terminus of NbPROPPI1 provoked significant immune responses in N. benthamiana. These responses led to enhanced accumulation of reactive oxygen species, activation of mitogen‐activated protein kinases, and up‐regulation of the defense genes Flg22‐induced receptor‐like kinase (FRK) and WRKY DNA‐binding protein 33 (WRKY33). The NbPPI1‐induced defense responses require Brassinosteroid insensitive 1‐associated receptor kinase 1 (BAK1). These results suggest that NbPPI1 functions as a DAMP in N. benthamiana; this novel DAMP provides a potentially useful target for improving plant resistance to Pytophthora pathogens.
Transcranial direct‐current stimulation enhances implicit motor sequence learning in persons with Parkinson's disease with mild cognitive impairment
Authors: Firouzi Mahyar , Van Herk Karlijn , Kerckhofs Eric , Swinnen Eva , Baeken Chris , Van Overwalle Frank , Deroost Natacha 
Published: November 2020

Implicit motor sequence learning (IMSL) is affected in Parkinson's disease (PD). Research in healthy young participants shows the potential for transcranial direct‐current stimulation (tDCS) over the primary motor cortex (M1) to enhance IMSL. In PD, only null effects have been reported to date. We determined concurrent, short‐term, and long‐term effects of anodal tDCS over M1 on IMSL, as measured by the serial reaction time (SRT) task, in persons with PD with mild cognitive impairment (MCI). Concurrent (anodal/sham tDCS intervention during the SRT task), short‐term (5 min post‐intervention), and long‐term (1 week post‐intervention) effects on IMSL were evaluated in persons with idiopathic PD (Hoehn and Yahr stage II‐III) with MCI. Results of 11 persons with PD (8 men and 3 women; mean age = 77.1 years; mean disease duration = 7.7 years) showed significant IMSL in the anodal (p = .016), but not in the sham tDCS condition (p = .937). Post‐hoc analyses showed that IMSL reached statistical significance at 1 week post‐intervention (p < .001). Anodal tDCS over M1 exerted beneficial effects on IMSL in persons with PD with MCI, in particular one week post‐intervention. Our study is the first to report a positive effect of tDCS on IMSL in PD. Further research should include a larger, more cognitively diverse sample and additional follow‐up periods.
“Invisible Voices”: A Critical Incident Study of Family Caregivers’ Experience of Nursing Homes After Their Elder Relative’s Death
Authors: Aschieri Filippo , Barello Serena , Durosini Ilaria 
Published: November 2020

AbstractPurposeThe literature provides few examples of family caregivers’ retrospective evaluation of nursing home services. This study aimed at analyzing narratives of Italian family caregivers of elders who experienced nursing home placement.Design and MethodsData were gathered through in‐depth interviews with family members after their relatives’ death. The interviews were based on the Critical Incident Technique, which allowed the categorization of the most memorable positive and negative events from the perspective of family members of elders deceased in nursing homes. Interviews were interpreted with a phenomenologically inspired thematic analysis approach. Participants were screened for complicated grief disorder as a confounding variable in relatives’ accounts of the treatment.ResultsResults suggested that positive long‐term recollection of the nursing home was associated with different themes emerging from the interviews: medical reliability and expertise, active demonstrations of care that extend beyond the contract with the facility, individualized attention, responsiveness, openness to dialog with family members about routines, management of the first impression, and family engagement. Lack of professionals’ expertise and medical failures, lack of care for patients’ personal goods, lack of family involvement, lack of individualized attention, lack of responsiveness, poor patient surveillance, and structural limits of the facilities were the themes that were more frequently negatively associated with the nursing home experience.Implications for PracticeFocusing on the key dimensions connected to the quality of the experience of family members can enrich the quality of existing nursing home services and allow healthcare policymakers and managers to design better facilities for the patients.
Intravascular papillary endothelial hyperplasia in the oral mucosa and jawbones: A collaborative study of 20 cases and a systematic review
Authors: Vieira Carolina Clasen , Gomes Ana Paula Neutzling , Galdino dos Santos Laylla , de Almeida Douglas Silva , Hildebrand Laura Campos , Flores Isadora Luana , dos Santos Jean Nunes , Schuch Lauren Frenzel , Vasconcelos Ana Carolina Uchoa 
Published: November 2020

AbstractBackgroundIntravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion.MethodsBiopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases.ResultsOf the 65 205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13 cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty‐nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables.ConclusionDespite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.
Paying for expertise: The effect of experience on insurance demand
Authors: Anand Vaibhav , Tyler Leverty James , Wunder Kenny 
Published: November 2020

AbstractThis paper investigates whether corporations purchase insurance for the real services that insurers provide. We examine the real‐service efficiency hypothesis in the insurance industry by exploiting within firm‐year variation in reinsurance usage and experience at the line of business level. Our results show that insurers purchase reinsurance to access reinsurers’ expertise and specialized knowledge. We find that, within the same year, the average multi‐line insurer purchases 2.4%–3.3% points more reinsurance for new lines relative to existing lines. The demand for reinsurance declines by 0.55%–0.80% points with each additional year of experience. The size of these effects differs by the line of business, indicating that the development of internal expertise and specialized knowledge varies by line.
Construction and validation of a Brazilian educational comic book for pediatric perioperative care
Authors: Vasques Marcela C. M. Z. , Silva Brenda B. , de Avila Marla A. G. 
Published: November 2020

AbstractPurposeEducational material can facilitate familiarization with the hospital and surgical contexts for children and guardians and minimize potential difficulties experienced during hospitalization. This study aimed to construct and validate a comic book for guiding children in perioperative care.Design and MethodsA descriptive study was conducted at a pediatric ward in a university hospital in Brazil. A content validity index with a concordance of 0.8 was used for validation.ResultsThe content was validated with the participation of 19 content judges (nurses, anesthesiologists, and surgeons); face validity was achieved with the participation of 22 parents and their respective children aged 7–12 years old. The contents of the comic book included perioperative care (hospitalization, fasting, surgical team, operating room, and anesthesia). Universal content validity indices of 0.89 and 0.99 were obtained for content and face validity, respectively. Free Portuguese educational material titled “Getting to know the Surgery Center” was created in the form of a 19‐page comic book in print and digital formats. The comic book was face and content validated and considered relevant for children in perioperative care. The suggestions of the healthcare professional and families who participated contributed toward the final version of this educational comic book.Practice ImplicationsThis study aimed to further the development of educational materials that help alleviate stress, fear, and anxiety among children awaiting surgery, as well as their parents/guardians. As such, it offers a positive and appropriate contribution to perioperative nursing. The study further contributes to a discussion on pediatric nursing, which goes beyond clinical care and procedure. In the context of pediatric surgery and the children themselves, the results indicate that the family must be included in the surgical process and that the language employed must be appropriate to the target audience. Our comic book can be used by nurses to develop similar resources for diverse needs.
Pattern of progression in advanced hepatocellular carcinoma treated with ramucirumab
Authors: Reig Maria , Galle Peter R. , Kudo Masatoshi , Finn Richard , Llovet Josep M. , Metti Andrea L. , Schelman William R. , Liang Kun , Wang Chunxiao , Widau Ryan C. , Abada Paolo , Zhu Andrew X. 
Published: November 2020

AbstractBackground & AimsRadiological progression patterns to first‐line sorafenib have been associated with post‐progression and overall survival in advanced hepatocellular carcinoma, but these associations remain unknown for therapies in second‐ and later‐line settings. This post hoc analysis of REACH and REACH‐2 examined outcomes by radiological progression patterns in the second‐line setting of patients with advanced hepatocellular carcinoma treated with ramucirumab or placebo.MethodsPatients with advanced hepatocellular carcinoma, Child‐Pugh A and Eastern Cooperative Oncology Group Performance Status 0 or 1 with prior sorafenib were randomized to receive ramucirumab 8mg/kg or placebo every 2 weeks. Among 625 patients with ≥1 progression pattern (new extrahepatic lesion [including new macrovascular invasion], new intrahepatic lesion, extrahepatic growth or intrahepatic growth), data were analysed by trial and for pooled individual patient data for REACH‐2 and REACH (alpha‐fetoprotein ≥400 ng/mL). Cox models evaluated prognostic implications of progression patterns on overall and post‐progression survival.ResultsPost‐progression survival was worse among those with new extrahepatic lesions in REACH (HR 2.33, 95% CI 1.51‐3.60), REACH‐2 (HR 1.49, 95% CI 0.72‐3.08) and the pooled population (HR 1.75, 95% CI 1.12‐2.74) compared to other progression patterns. Overall survival was also significantly reduced in those with new extrahepatic lesions across studies. Ramucirumab provided an overall survival benefit across progression patterns, including patients with new extrahepatic lesions (HR 0.56, 95% CI 0.39‐0.80) in the pooled population.ConclusionsThe emergence of new extrahepatic lesions in the second‐line setting is a poor prognostic factor for post‐progression survival. The benefit of ramucirumab for overall survival was consistent across progression patterns.
Investigating apoptotic, inflammatory, and growth markers in poor responders undergoing natural in vitro fertilization cycles: a pilot study
Authors: Sfakianoudis Konstantinos , Tsioulou Petroula , Maziotis Evangelos , Grigoriadis Sokratis , Glava Argyro , Nitsos Nikolaos , Giannelou Polina , Makrakis Evangelos , Pantou Agni , Rapani Anna , Koutsilieris Michael , Mastorakos George , Pantos Konstantinos , Simopoulou Mara 
Published: November 2020

AbstractThis study investigates follicular fluid (FF) from patients with poor and normal ovarian response undergoing natural assisted reproductive technology cycles. We report about (1) cell‐free DNA (cfDNA), which reflects apoptosis; (2) corticotropin‐releasing hormone (CRH); (3) interleukin (IL)‐15, which reflects inflammation; (4) granulocyte colony–stimulating factor (G‐CSF); (5) vascular endothelial growth factor (VEGF); and (6) insulin‐like growth factor I (IGF‐I), which reflects follicular growth. Forty‐four poor responders and 44 normal responders—according to the Bologna criteria—were recruited. FF samples were prepared for cfDNA quantification employing Q‐PCR and for CRH, IL‐15, G‐CSF, VEGF, and IGF‐I quantification employing ELISA. Statistically nonsignificant different levels of FF cfDNA, CRH, IL‐15, VEGF, and IGF‐I were observed. Interestingly, statistically significant higher G‐CSF levels were observed in normal responders (302.48 ± 474.36 versus 200.10 ± 426.79 pg/mL, P = 0.003). Lower cfDNA integrity was observed in cycles resulting in clinical pregnancy for both groups (normal: 0.07 ± 0.04 versus 0.25 ± 0.17 ng/μL, P < 0.001; poor: 0.10 ± 0.06 versus 0.26 ± 0.12 ng/μL, P < 0.001). The results predominantly showcase similarities between normal and poor responders pertaining to inflammatory, apoptotic, and growth factors. This may be attributed to the employment of natural cycles in order to exclude controlled ovarian stimulation as a factor—indicating its detrimental effect. As G‐CSF levels presented significantly higher in normal responders, its vital role in understanding a compromised ovarian response is highlighted.
The role of osteopontin in oral cancer: A brief review with emphasis on clinical applications
Authors: dos Santos Erison Santana , Ramos Joab Cabral , Roza Ana Luiza Oliveira Corrêa , Mariz Bruno Augusto Linhares Almeida , Paes Leme Adriana Franco 
Published: November 2020

AbstractOsteopontin (OPN) is a calcium‐binding glycol‐phosphoprotein present in many physiologic and pathological processes. This protein can control bone cell adhesion, osteoclastic activity, and bone matrix mineralization. However, its participation in pathological processes such as atherosclerosis, sarcoidosis, tuberculosis, and cancer have been described. Some studies have shown that OPN may participate in the development and progression of oral cancer. Although the role of OPN in oral cancer is not fully understood, some studies have suggested that this protein may induce malignant phenotype of cells by activation of PI3K/AKT/mTOR pathway, which favors cell proliferation, invasion, metastasis, angiogenesis, and failure of treatment. This review discusses the possible mechanism of involvement of OPN in oral cancer and its potential clinical application in diagnosis and prognosis.
Comparison of postoperative cytokine and hormone between endoscopically assisted and open parotid tumor resection
Authors: Zhao Luodan , Ye Yushan , Jiao Jiuyang , Liao Junkun , Lin Zhaoyu , Zhong Jianglong , Wu Jialing , Fang Zezhen , Kontos Filippos , Chen Weiliang , Huang Xiaoming , Dias‐Ribeiro Eduardo , Yang Zhaohui , Li Jinsong , Fan Song 
Published: November 2020

AbstractObjectiveEndoscopically assisted extracapsular dissection through a single incision along the cephaloauricular furrow has been adapted as a method of access for operating on benign parotid gland tumors. However, no study has compared the immune and stress responses after surgery between the endoscopic procedure and conventional open surgery.MethodsThrough a randomized method, 50 patients with benign parotid gland tumors were assigned to undergo either endoscopically assisted extracapsular dissection or open parotidectomy. The postoperative inflammatory changes and hormonal response in the patients were analyzed at serum level during the preoperative period and at 12, 24, and 72 hr after either surgery.ResultsTwenty‐three patients received an endoscopic procedure, while 27 underwent open surgery. The size of the incision, amount of intraoperative bleeding, volume of drainage, postoperative pain score, and satisfaction with appearance were all improved in the endoscopic procedure group. Additionally, the serum levels of C‐reactive protein, interleukin (IL)‐6, IL‐10, and cortisol were significantly lower in the endoscopy group in comparison with those in the open surgery group.ConclusionEndoscopically assisted extracapsular dissection on patients with benign parotid gland tumors is associated with lower inflammatory changes and hormone responses than open surgery, thereby reducing perioperative pathophysiological disturbance and enhancing recovery after surgery.
Meta‐analysis of catheter ablation in patients with post‐infarct cardiomyopathy undergoing defibrillator implantation
Authors: Kheiri Babikir , Simpson Timothy F. , Nazer Babak 
Published: November 2020

AbstractBackgroundPatients with post‐infarct cardiomyopathy and ventricular arrhythmias (VT) necessitating implantable cardioverter defibrillators (ICD) are at risk of recurrent shocks with increased morbidity.MethodsA comprehensive search of electronic databases for all randomized clinical trials that evaluated the role of catheter ablation as a preventive strategy at the time of secondary prevention ICD implantation was performed. We calculated hazard ratios (HR) and 95% confidence intervals (CI) using random‐effects model.ResultsFour trials were identified with a total of 505 patients (average age 66.4 ± 9.0 years; 87.7% were male). Preventive ablation was associated with a significant reduction in appropriate device therapies (shocks and/or anti‐tachycardia therapy) (HR = 0.62; 95% CI = 0.46‐0.82; P < .01), sustained VT (HR = 0.74; 95% CI = 0.55‐0.99; P = .04) compared to control. There were no differences in inappropriate device shocks (HR = 0.80; 95% CI = 0.38‐1.71), all‐cause death (HR = 0.93; 95% CI = 0.53‐1.64), cardiac death (HR = 0.63; 95% CI = 0.29‐1.36), arrhythmic death (HR = 0.26; 95% CI = 0.05‐1.31), or cardiac hospitalization (HR = 0.79; 95% CI = 0.57‐1.11) between strategies. Preventive ablation was associated with improved SF‐36 physical component (mean difference = 2.81; 95% CI‐0.53‐5.10; P = .02), but not the mental component (mean difference = 1.30; 95% CI = ‐2.06‐4.66).ConclusionAmong patients with post‐infarct cardiomyopathy and VT, preventive catheter ablation at the time of ICD implantation is associated with a significant reduction of appropriate ICD therapy and sustained VT, and improvement in the physical component of quality‐of‐life, but no reduction in mortality.