bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of different lead types and implantation techniques in pediatric populations with permanent pacemakers: Single‐center with 10 years' experience
Authors: Ergul Yakup , Yukcu Bekir , Ozturk Erkut , Kafali Hasan Candas , Ayyildiz Pelin , Ergun Servet , Onan Ismihan Selen , Haydin Sertac , Guzeltas Alper 
Published: November 2020

AbstractBackgroundPermanent pacemaker (PM) implantation is performed for various indications and by different techniques in children; however, many problems with lead performance are encountered during follow‐up. This study aims to evaluate the possible effects of different lead types and implantation techniques on pacing at early and midterm in children with a permanent PM.Patients and methodsPediatric patients who underwent permanent PM system implantation at our tertiary cardiac surgery center between January 1, 2010 and January 1, 2020 were evaluated retrospectively. Patients were categorized in the epicardial pacing lead (EP), transvenous pacing lead (TP), and transvenous bipolar lumenless (Select Secure [SS]) lead groups according to the lead implantation technique and lead type with the same manufacturer. Groups were evaluated statistically for demographic features, pacing type and indication for implantation, lead electrical performance, lead failure, complications, and outcome.ResultsOver 10 years, 323 lead implantations were performed on 167 patients (96 males, median age 68 months [5 days‐18 years]). Of 323 leads, 213 (66%) were EP, 64 (20%) were TP, and 46 (14%) were SS. Of the total, 136 of the leads were implanted in atria, and 187 were implanted in ventricles. Primary pacing indications were postoperative complete atrioventricular (AV) block (n = 95), congenital AV block (n = 71), sinus node dysfunction (n = 13), and acquired complete AV block (n = 1). Additional cardiac diseases were present in 115 patients (69%). No statistically significant difference was observed in gender, syndrome, or pacing indication (P > .05). Atrial and ventricular capture, threshold, sensing, and lead impedance measurements were not significantly different at the initial and follow‐up periods (P > .05). The median follow‐up duration was 3.3 years (6 months‐10 years). Twenty lead failures were determined in 15 patients (EP: 14 lead failures in 10 patients; TP: two lead failures in two patients; and SS: four lead failures in three patients) during follow‐up, and no statistically significant difference was found between groups (P = .466). The 5‐year lead survival was 98% for TP, 95% for EP, and 90% for SS; the 10‐year lead survival was 90% for TP, 70% for EP, and 70% for SS. There was no mortality related to chronic pacing or due to the procedure of implantation.ConclusionsDespite improvements in technology, lead failure is still one of the most critical problems during these patients' follow‐up. Early to midterm lead survival rates of all three lead types were satisfactory.
Cutaneous manifestations in pediatric oncology patients
Authors: Özkur Ezgi , Sert Cansu , Kıvanç Altunay İlknur , Yıldırırmak Zeynep Yıldız , Genç Dildar Bahar , Vural Sema , Erdem Yasemin 
Published: November 2020

AbstractBackground/ObjectivesOncology patients present with various skin manifestations related to primary disease and treatments. Although these skin toxicities are well described in adults, studies of pediatric oncology patients are limited. The objective of this study was to evaluate the cutaneous findings in pediatric oncology patients receiving chemotherapy.MethodsIn this prospective cohort study conducted from December 2018 to March 2020, all pediatric oncology patients were examined and patients who had a dermatologic finding at any point during their treatments were recorded. Dermatologic examinations were performed by the same dermatologists, and biopsy and microbiologic tests were performed according to clinical need. Patients were grouped according to their oncologic diagnoses and types of chemotherapies.ResultsA total of 80 patients with a mean age of 9.1 ± 5.0 years were included in the study. Seventy‐five (93.7%) of them developed a dermatologic manifestation during the study period. Most of the patients had hematologic malignancies (n = 48, 60%). Antimetabolites were the most frequently used class of chemotherapeutic agents. Anagen effluvium was the most common dermatologic finding (61.3%, n = 49), followed by inflammatory dermatoses (51.2%, n = 41, most commonly diaper dermatitis in 33 patients), xerosis (35%, n = 28), and nail changes (20%, n = 16, most commonly nail pigmentation in seven patients). Mucositis was seen in 13 (16.2%) patients. Five patients (6.2%) had drug‐induced cutaneous hyperpigmentation, and five (6.2%) had toxic erythema of chemotherapy. The highest percentage of xerosis (45.4%) was detected in patients using antitumor antibiotics, whereas inflammatory dermatoses were observed more in patients using antimetabolites (48.6% of patients using antimetabolites), and pigmentation changes were more frequently detected in patients using alkylating agents.ConclusionIdentification, diagnosis, and treatment of these reactions are important to dermatologists and oncologists so that appropriate management may be provided to pediatric oncology patients.
Relational turbulence and health‐compromising behaviors: Integrating relational turbulence and stress theories
Authors: Weigel Daniel J. , Shrout M. Rosie 
Published: November 2020

AbstractThis study drew upon key elements of relational turbulence and stress and coping theories to advance a conceptual model linking relational turbulence with stress, depression, and involvement in health‐compromising behavior, such as drug and alcohol use, limited or extreme physical activity, disordered eating patterns, and unprotected sex. Romantically involved individuals (N = 476) completed an online survey. Structural equation modeling revealed that greater relational turbulence was related to higher perceived stress and depression which, in turn, were related to more frequent engagement in health‐compromising health behavior. The study provides an extension to both the relational turbulence and health literatures by identifying the downstream effects of relational turbulence on psychological and behavioral health.
The effects of pollination, herbivory and autonomous selfing on the maintenance of flower colour variation inSilenelittorea
Authors: Buide M. L. , Del Valle J. C. , Prado‐Comesaña A. , Narbona E. 
Published: November 2020

AbstractIntraspecific flower colour variation has been generally proposed to evolve as a result of selection driven by biotic or abiotic agents.In a polymorphic population ofSilene littoreawith pink‐ and white‐flowered plants, we studied pollinators, analysed flower colour perception and tested for differences in pollinator visitation. We also experimentally analysed pollinator limitation in fruit and seed set, and the degree of autonomous selfing. The incidence of florivory and leaf herbivory was compared over 3–4 years.Silene littoreais mainly pollinated by bees and butterflies. Pollinators preferred pink flowers, which did not show pollinator limitation. On the contrary, white flowers showed pollinator limitation in fruit set. White‐flowered plants had less floral display and higher levels of florivory than pink plants. Flower colour morphs ofS. littoreacan reproduce in the absence of pollinators by autonomous selfing, setting 20% and 12% of fruit and seeds in the pink morph and 27% and 20% in the white morph, respectively. Fruit set of white flowers produced by autonomous selfing did not differ from open‐pollinated flowers.In conclusion,S. littoreais pollinated by insects of different orders that more frequently visit pink flowers, which is reflected in pollinator limitation of fruit set in white flowers. Moreover, this species has a mixed mating system in which both colour morphs can reproduce in the absence of pollinators by autonomous selfing, although white flowers mainly produce fruits by autogamy. We suggest that reproductive assurance by autonomous selfing helps to maintain flower colour polymorphism in this population.
Fire frequency effects on cleistogamy expression and progeny performance inCologania broussonetii
Authors: Carbone L. M. , Cascone G. , Aguilar R. 
Published: November 2020

AbstractIncreased fire frequency usually erodes microenvironmental conditions, causing a drastic limitation of edaphic resources. Thus, the production of permanently closed‐small flowers (cleistogamous, CL) should increase in sites with high fire frequency as this implies a less expensive reproductive assurance strategy. However, because open, insect‐pollinated flowers (chasmogamous, CH) have the potential capacity to outcrossviapollinators, CH progeny produced at any site should outperform selfed CL progeny.We evaluate the effect of fire frequency on the relative production of CL/CH flowers and fruits, and their seed set, along with several progeny performance parameters inCologania broussonetii(Fabaceae), a resprouting herb with dimorphic cleistogamy native to the Chaco Serrano.Fire frequency increased cleistogamy expression, reaching extreme levels in high fire frequency sites. Seed set was similarly high for both CH and CL flowers in the unburned condition, while in burned sites the few developed CH flowers set more seeds than CL flowers. However, progeny performance was similar between CH and CL progeny at each and across all fire frequency conditions.Cleistogamy expression inC. broussonetiiis maximized in abiotically degraded frequently burned habitats, although the selfed CL progeny is as successful as potentially outcrossed CH progeny. Fire frequency may decreased floral size and abundance, selecting for autogamous reproduction, which restricts not only the genetic potential of plant populations but also the resources offered to pollinators. At the community level, increased cleistogamy expression may potentially have negative implications for non‐cleistogamous, more outcrossing species surviving in frequently burned environments.
Spatio-temporal model to estimate life expectancy and to detect unusual trends at the local authority level in England
Authors: Boulieri Areti , Blangiardo Marta 
Published: November 2020

ObjectivesTo estimate life expectancy at the local authority level and detect those areas that have a substantially low life expectancy after accounting for deprivation.DesignWe used registration data from the Office for National Statistics on mortality and population in England, by local authority, age group and socioeconomic deprivation decile, for both men and women over the period 2001–2018. We used a statistical model within the Bayesian framework to produce robust mortality rates, which were then transformed to life expectancy estimates. A rule based on exceedance probabilities was used to detect local authorities characterised by a low life expectancy among areas with a similar deprivation level from 2012 onwards.ResultsWe confirmed previous findings showing differences in the life expectancy gap between the most and least deprived areas from 2012 to 2018. We found variations in life expectancy trends across local authorities, and we detected a number of those with a low life expectancy when compared with others of a similar deprivation level.ConclusionsThere are factors other than deprivation that are responsible for low life expectancy in certain local authorities. Further investigation on the detected areas can help understand better the stalling of life expectancy which was observed from 2012 onwards and plan efficient public health policies.
Pulmonary passport: a service evaluation study of a standardised web-based procedure logbook to aid specialist respiratory training and appraisal
Authors: Cheng Andrew , Saba Tarek , Duncan Tracy , Grundy Seamus , Evison Matthew 
Published: November 2020

IntroductionThe pulmonary passport (PP) is a secure web-based procedural logbook for specialist respiratory trainees with enhanced functionality that includes automated analysis to provide key performance metrics and in-platform interactions with supervisors.MethodsThis service evaluation study used preimplementation and postimplementation online surveys in both trainees and supervisors along with analysis of recorded data within the PP to evaluate the impact of this service on data capture, training, appraisal and quality assurance.ResultsFrom August 2017 to August 2019, 69/73 (95%) specialist respiratory trainees eligible to use the PP across two UK health education deaneries registered with the system and logged 7352 procedures. 3105 thoracic ultrasound procedures identified 2145 pleural effusions and resulted in 1253 pleural procedures of which 96% were successful. 4% of ultrasounds required referral to a more expert sonographer. Iatrogenic bleeding and pneumothorax both occurred in ≤1% of all pleural procedures. 1909 basic diagnostic bronchoscopies were recorded including 1236 bronchial washes, 328 brushes and 221 endobronchial biopsies where definite tumour was identified (biopsy sensitivity 74%). Preimplementation and postimplementation survey data confirmed the PP had increased the consistency of logging procedures by trainees, the depth of data captured, the review of procedural performance metrics in appraisal and the frequency of formal supervisor feedback.DiscussionIn this regional project, the implementation of a web-based procedural logbook has been feasible with excellent uptake and has enhanced procedural recording, supervision and appraisal. Furthermore, it provides unprecedented quality assurance at an individual trainee, trust and deanery level and has a number of potential wider applications in the future.
Improving postoperative mobilisation rates in patients undergoing elective major hepatopancreatobiliary surgery
Authors: Tang Jun Han , Wang Bei , Chow Jie Ling Jaclyn , Joseph Priscilla M , Chan Jia Ying , Abdul Rahman Nursharazilla , Low Yi Hui , Tan Yen Pin , Shelat Vishalkumar G 
Published: November 2020

ABSTRACTBackgroundEarly mobilisation reduces postoperative complications such as pneumonia, deep vein thrombosis and hospital length of stay. Many authors have reported poor compliance with early mobilisation within Enhanced Recovery After Surgery initiatives.ObjectivesThe primary objective was to increase postoperative day (POD) 2 mobilisation rate from 23% to 75% in patients undergoing elective major hepatopancreatobiliary (HPB) surgery within 6 months.MethodsWe report a multidisciplinary team clinical practice improvement project (CPIP) to improve postoperative mobilisation of patients undergoing elective major HPB surgery. We identified the common barriers to mobilisation and analysed using the fishbone or cause-and-effect diagram and Pareto chart. A series of Plan–Do–Study–Act cycles followed this. We tracked the rate of early mobilisation and mean distance walked. In the post hoc analysis, we examined the potential cost savings based on reduced hospital length of stay.ResultsMobilisation rate on POD 2 following elective major HPB surgery improved from 23% to 78.9%, and this sustained at 6 months after the CPIP. Wound pain was the most common reason for failure to ambulate on POD 2. Hospital length of stay reduced from a median of 8 days to 6 days with an estimated cost saving of S$2228 per hospital stay.ConclusionMultidisciplinary quality improvement intervention effort resulted in an improved POD 2 mobilisation rate for patients who underwent elective major HPB surgery. This observed outcome was sustained at 6 months after completion of the CPIP with potential cost savings.
Strategic organisational skills predict surgical training success
Authors: James Osian Penri , Robinson David Bryan Thomas , Hopkins Luke , Bowman Chris , Powell Arfon , Brown Chris , Hemington-Gorse Sarah , Egan Richard John , Lewis Wyn G 
Published: November 2020

AbstractIntroductionSurgical career progression is determined by examination success and Annual Review of Competence Progression (ARCP) outcome, yet data on organisational skills are sparse. This study aimed to determine whether organisational skills related to Core Surgical Training (CST) outcome. Primary outcome measures include operative experience, publications, examination success (Membership of the Royal College of Surgeons or the Diploma in Otolaryngology—Head and Neck Surgery (MRCS/DO-HNS)) and ARCP outcome.MethodsThe study was conducted prospectively at three consecutive CST induction boot camps (2017–2019) providing clinical and simulation training for 125 trainees. Arrival time at course registration was the selected surrogate for organisational skills. Trainees were advised to arrive promptly at 8:45 for registration and that the course would start at 9:00. Trainee arrival times were grouped as follows: early (before 8:45), on time (8:45–8:59am) or late (after 9:00). Arrival times were compared with primary outcome measures.SettingHealth Education and Improvement Wales' School of Surgery, UK.ResultsMedian arrival time was 8:53 (range 7:55–10:03), with 29 trainees (23.2%) arriving early, 63 (50.4%) on-time and 33 (26.4%) late. Arrival time was associated with operative experience (early vs late; 206 vs 164 cases, p=0.012), publication (63.2% vs 18.5%, p=0.005), MRCS/DO-HNS success (44.8% vs 15.2%, p=0.029), ARCP outcome (86.2% vs 60.6% Outcome 1, p=0.053), but not National Training Number success (60.0% vs 53.3%, p=0.772).ConclusionsBetter-prepared trainees achieved 25% more operative experience, were four-fold more likely to publish and pass MRCS, which aligned with consistent desirable ARCP outcome. Timely arrival at training events represents a skills-composite of travel planning and is a useful marker of strategic organisational skills.
The relationship of iodine value with pork carcass weight and composition
Authors: Zhou Z.Y. , Wormsbecher L. , Roehrig C. , Smetanin M. , Bohrer B.M. 
Published: November 2020

This study examined the relationship of iodine value (IV) with carcass weight, fat depth, muscle depth, and predicted lean yield from 37 488 pork carcasses. Five IV categories were formed, which were defined as low (<64.99), medium-low (65.00–69.99), medium (70.00–74.99), medium-high (75.00–79.99), and high (>80.00). Correlation analysis indicated IV was weakly correlated (r ≤ 0.26; P < 0.05) with all carcass traits; however, the categorical analysis revealed that greater IV was associated with heavier weight and leaner carcasses. Segregation systems of pork carcasses based on IV should consider the relationships of IV with other carcass parameters before implementation.
Effect of Aspirin and Statins on Pulmonary Function and Inflammation in Patients with AECOPD
Authors: Duan Guangqing , Lv Kaixuan , Lyu Juncheng , Tian Na , Zhang Lichun , Liu Qi , Wang Mengjie , Sun Shiyu , Yu Jielun , Guo Guifang , Tan Wei , Yang Nana 
Published: November 2020

Background: The influence of coronary atherosclerosis and related treatment drugs on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) development requires in-depth study. The study investigated the effect of coronary artery calcification (CAC) and drugs for CAC on the development of AECOPD. Methods: This retrospective clinical study recruited subjects with AECOPD from May 2017 to May 2019. All subjects performed spirometry and coronary computed tomography (CT), and were divided into three groups according to whether coronary CT revealed CAC and whether they had received oral aspirin and statins: AECOPD group, AECOPD[Formula: see text]CAC nonmedication and AECOPD[Formula: see text]CAC medication. The t-test and nonparametric test were used for analyzing the lung function, arterial blood gas, routine blood and lipid between groups. Results: Compared with the AECOPD group, Lym% were significantly higher ([Formula: see text]) in both the AECOPD[Formula: see text]CAC nonmedication and the AECOPD[Formula: see text]CAC medication. The AECOPD[Formula: see text]CAC medication group also had significantly higher PaO2 ([Formula: see text]). WBC, Neu, and Neu% in the AECOPD[Formula: see text]CAC medication group were significantly lower ([Formula: see text]) compared to the AECOPD group. Conclusions: Aspirin and statins for the treatment of cardiovascular diseases may be linked to improving lung function, normalizing blood gas levels, and reducing inflammation in patients with AECOPD and CAC. Further, randomized controlled trials are needed to explore this topic.
Transcatheter Mitral Valve Repair in Patients With and Without Cardiac Resynchronization Therapy
Authors: Kosmidou Ioanna , Lindenfeld JoAnn , Abraham William T. , Kar Saibal , Lim D. Scott , Mishell Jacob M. , Whisenant Brian K. , Kipperman Robert M. , Boudoulas Konstantinos D. , Redfors Björn , Shahim Bahira , Zhang Zixuan , Mack Michael J. , Stone Gregg W. 
Published: November 2020

Background:
In the COAPT trial (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation), treatment of heart failure (HF) patients with moderate-severe or severe secondary mitral regurgitation with transcatheter mitral valve repair (TMVr) using the MitraClip plus guideline-directed medical therapy (GDMT) reduced 2-year rates of HF hospitalization and all-cause mortality compared with GDMT alone. Whether the benefits of the MitraClip extend to patients with previously implanted cardiac resynchronization therapy (CRT) is unknown. We sought to examine the effect of prior CRT in patients enrolled in COAPT.

Methods:
Patients (N=614) with moderate-severe or severe secondary mitral regurgitation who remained symptomatic despite maximally tolerated doses of GDMT were randomized 1:1 to the MitraClip (TMVr arm) versus GDMT only (control arm). Outcomes were assessed according to prior CRT use.

Results:

Among 614 patients, 224 (36.5%) had prior CRT (115 and 109 randomized to TMVr and control, respectively) and 390 (63.5%) had no CRT (187 and 203 randomized to TMVr and control, respectively). Patients with CRT had similar 2-year rates of the composite of death or HF hospitalization compared with those without CRT (57.6% versus 55%,
P
=0.32). Death or HF hospitalization at 2 years was lower with TMVr versus control treatment in patients with prior CRT (48.6% versus 67.2%, hazard ratio, 0.60 [95% CI, 0.42–0.86]) and without CRT (42.5% versus 66.9%, hazard ratio, 0.52 [95% CI, 0.39–0.69]; adjusted
P
interaction
=0.23). The effects of TMVr with the MitraClip on reducing the 2-year rates of all-cause death (adjusted
P
interaction
=0.14) and HF hospitalization (adjusted
P
interaction
=0.82) were also consistent in patients with and without CRT as were improvements in quality-of-life and exercise capacity.

Conclusions:
In the COAPT trial, TMVr with the MitraClip improved the 2-year prognosis of patients with HF and moderate-severe or severe secondary mitral regurgitation who remained symptomatic despite maximally tolerated GDMT, regardless of prior CRT implantation.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01626079.
Reconfiguring the Theodicy–Antitheodicy Boundary between Responses to the Holocaust
Authors: Tollerton David 
Published: November 2020

Abstract
Responding to Zachary Braiterman’s and Daniel Garner’s ideas on post-Holocaust religious thought, the author proposes a new model of relationships between theodicy and antitheodicy in which divine perfection is no longer privileged as the single key factor. Building on Peter Berger’s and Clifford Geertz’s treatments of the problem of evil, it is suggested that focusing on meaning-making and tradition can result in a stratified view of theodicy–antitheodicy more able to engage with the dynamics of several well-known thinkers associated with religious responses to the Holocaust.