bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified snare technique improves left ventricular lead implant success for cardiac resynchronization therapy
Authors: Marques Pedro , Nunes‐Ferreira Afonso , António Pedro S. , Aguiar‐Ricardo Inês , Lima da Silva Gustavo , Guimarães Tatiana , Bernardes Ana , Santos Igor , Pinto Fausto J. , de Sousa João 
Published: September 2020

AbstractBackgroundLeft ventricular (LV) lead placement is the most challenging aspect of cardiac resynchronization therapy (CRT) device implantation, with a failure rate of up to 10% due to complex coronary anatomies. We describe a modified snare technique for LV lead placement and evaluate its safety and efficacy in cases when standard methods fail.Methods and ResultsA prospective study was conducted of patients indicated for a CRT implant. When LV lead delivery to the target vessel failed using standard techniques, a modified snare technique was employed. Patients were evaluated every 6 months. From 2015 to 2019, 566 CRTs were implanted (26.1% female, 72 ± 10.2 years old, follow‐up duration 18.9 ± 15.8 months). The standard LV implant technique failed in 94 cases (16.6%), of which the modified snare technique was successful in 92 (97.9%). There were no differences between the modified snare and standard techniques in the rates of 30‐day postimplant CRT all‐cause mortality (3.2% vs. 1.7%, p = .33), 4‐year all‐cause mortality (15.9% vs. 15.5%, p = .49), or major acute complications (7.4% vs. 3.8%, p = .12). However, the 4‐year procedural reintervention rate was lower with the modified snare technique (3.2% vs. 10.2%, p < .05), specifically LV implant failure or dislodgement rates (0% vs. 5.3%, p < .05), improving the response rate (71.8% vs. 55.1%, p < .05).ConclusionsFor challenging coronary sinus anatomies that preclude LV lead placement by standard methods, this modified snare alternative was safe and effective, with comparable mortality and complications, but significantly lower procedural reintervention and higher response rates.
Pooled safety analysis of baricitinib in adult patients with atopic dermatitis from 8 randomized clinical trials
Authors: Bieber T. , Thyssen J.P. , Reich K. , Simpson E.L. , Katoh N. , Torrelo A. , De Bruin‐Weller M. , Thaci D. , Bissonnette R. , Gooderham M. , Weisman J. , Nunes F. , Brinker D. , Issa M. , Holzwarth K. , Gamalo M. , Riedl E. , Janes J. 
Published: September 2020

AbstractBackgroundJanus kinase (JAK) inhibition is a new mode of action in atopic dermatitis (AD); clarity about drug class safety considerations in the context of AD is important. Baricitinib, an oral, reversible, selective inhibitor of JAK1/JAK2, is in late‐stage development for adult patients with moderate‐to‐severe AD.ObjectiveTo report pooled safety data for baricitinib in patients with moderate‐to‐severe AD in the clinical development program including long‐term extension (LTE) studies.MethodsThis analysis included patient‐level safety data from six double‐blinded, randomized, placebo‐controlled studies (one phase 2 and five phase 3), one double‐blinded, randomized, LTE study and one open‐label LTE study, reported in three data sets: placebo‐controlled, 2‐mg – 4‐mg extended and All‐bari AD. Safety outcomes include treatment‐emergent adverse events, adverse events of special interest and abnormal laboratory changes. Proportions of patients with events and incidence rates were calculated.ResultsData were collected for 2531 patients who were given baricitinib for 2247 patient‐years (median duration 310 days). The frequency of serious infections, opportunistic infections and conjunctival disorders was low and similar between treatment groups in the placebo‐controlled period. The most common serious infections were eczema herpeticum [n = 11, incidence rates (IR) = 0.5], cellulitis (n = 6, IR = 0.3) and pneumonia (n = 3, IR = 0.1). There were four opportunistic infections (IR = 0.2). No malignancies, gastrointestinal perforations, positively adjudicated cardiovascular events or tuberculosis were reported in the placebo‐controlled period in baricitinib‐treated patients. Frequency of herpes simplex was higher in the 4‐mg group (6.1%) vs. the 2‐mg (3.6%) and placebo group (2.7%); IRs in the extended data set (2‐mg IR = 9.6; 4‐mg IR = 14.5) were lower vs. the placebo‐controlled data set (2‐mg IR = 12.4; 4‐mg IR = 21.3). In the All‐bari AD data set, there were two positively adjudicated major adverse cardiovascular events (2‐mg group): two venous thrombosis events (4‐mg group) and one death.ConclusionThis integrated safety analysis in patients with moderate‐to‐severe AD confirms the established safety profile of baricitinib.
Secure and precise insertion of minimally invasive resin‐bonded fixed dental prostheses after ridge augmentation by means of a positioning splint
Authors: Yazigi Christine , Elsayed Adham , Kern Matthias 
Published: September 2020

AbstractObjectiveSingle‐retainer resin‐bonded fixed dental prostheses (RBFDPs) are described as an excellent minimally invasive treatment modality for the replacement of a single missing incisor even in cases of congenitally missing teeth that are often associated with hard and soft tissue defects that need to be properly managed to optimize the esthetic outcome. The lack of a retentive form due to the minimally invasive preparation form makes the adhesive bonding procedure for RBFDPs relatively technique‐sensitive and might discourage practitioners from offering this treatment modality.Clinical considerationsA patient with both maxillary lateral incisors congenitally missing was assessed for eligibility for treatment with RBFDPs. Bilateral horizontal ridge defects were present and treated through ridge augmentation to ensure an ovate pontic design and enhance the esthetic outcome. A minimally invasive preparation within enamel was conducted; the restorations were digitally designed and milled out of (3Y‐TZP) zirconia ceramic with labial veneering with feldspathic ceramic for enhanced esthetics. An improved design of positioning splints was used for the adhesive bonding procedure to ensure exact, secure, and flawless insertion of the restorations.ConclusionsRBFDPs offer a highly esthetic treatment modality for missing teeth in the anterior area. Tissue defects could be overcome be means of a minor oral surgery, while using improved positioning splints might ensure flawless adhesive bonding and promote the usage of RBFDPs.Clinical SignificanceHard and soft tissue defects can be remarkably optimized through a minor ridge augmentation. Improved positioning splints allow an easy and secure positioning as well as visual inspection of the seating in end‐position and complete removal of resin cement excess. Implementing the concept of insertion splints might promote RBFDPs for anterior tooth replacement as it helps preventing bonding errors.
Nurse's difficulty and their educational needs regarding pediatric cancer care in Japan
Authors: Yoshitsugu Mayu , Sobue Ikuko 
Published: September 2020

AbstractAimAiming at environmental arrangements for pediatric cancer patients and their families to receive appropriate medical care and support with a sense of security, the Japanese Ministry of Health, Labour, and Welfare designated 15 hub hospitals for childhood cancer. These hub hospitals have established networks with approximately 200 centers/hospitals treating pediatric cancer. In order to promote equal access to nursing, we investigated nurses' difficulties and needs at these treatment hospitals with limited experience in pediatric cancer nursing.MethodsIn order to examine education on pediatric cancer nursing, we investigated difficulties felt by treatment hospital nurses, their educational experience and their educational needs. A total of 584 nurses (66.51%) from 52 hospitals from which written consent was received completed the questionnaires.ResultsNurses had difficulties regarding nursing care for patients with critical conditions, such as terminal care, and actions to be taken when a patient's physical condition rapidly changes. Nurses most strongly desired education on nursing care for patients with serious problems, such as terminal care, and follow‐up provided in the form of in‐ and hub‐hospital lectures.ConclusionOur study suggested that in order to provide nurses in treatment hospitals with education focusing on nursing care for patients with serious problems, education systems based on cooperation between hub and treatment hospitals are needed.
Exploring the factors underlying remyelination arrest by studying the post‐transcriptional regulatory mechanisms of cystatin F gene
Authors: Li Jiayi , Durose Wilaiwan Wisessmith , Ito Junko , Kakita Akiyoshi , Iguchi Yohei , Katsuno Masahisa , Kunisawa Kazuo , Shimizu Takeshi , Ikenaka Kazuhiro 
Published: September 2020

AbstractRemyelination plays an important role in determining the fate of demyelinating disorders. However, it is arrested during chronic disease states. Cystatin F, a papain‐like lysosomal cysteine proteinase inhibitor, is a crucial regulator of demyelination and remyelination. Using hemizygous proteolipid protein transgenic 4e (PLP4e/‐) mice, an animal model of chronic demyelination, we found that cystatin F mRNA expression was induced at 2.5 months of age and up‐regulated in the early phase of demyelination, but significantly decreased in the chronic phase. We next investigated cystatin F regulatory factors as potential mechanisms of remyelination arrest in chronic demyelinating disorders. We used the CysF‐STOP‐tetO::Iba‐mtTA mouse model, in which cystatin F gene expression is driven by the tetracycline operator. Interestingly, we found that forced cystatin F mRNA over‐expression was eventually decreased. Our findings show that cystatin F expression is modulated post‐transcriptionally. We next identified embryonic lethal, abnormal vision, drosophila like RNA‐binding protein 1 (ELAVL‐1), and miR29a as cystatin F mRNA stabilizing and destabilizing factors, respectively. These roles were confirmed in vitro in NIH3T3 cells. Using postmortem plaque samples from human multiple sclerosis patients, we also confirmed that ELAVL‐1 expression was highly correlated with the previously reported expression pattern of cystatin F. These data indicate the important roles of ELAVL‐1 and miR29a in regulating cystatin F expression. Furthermore, they provide new insights into potential therapeutic targets for demyelinating disorders.
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Italian Nurses’ Attitudes Towards Neonatal Palliative Care: A Cross‐Sectional Survey
Authors: Cerratti Francesca , Tomietto Marco , Della Pelle Carlo , Kain Victoria , Di Giovanni Pamela , Rasero Laura , Cicolini Giancarlo 
Published: September 2020

AbstractPurposeNeonatal palliative care becomes an option for critically ill neonates when death is inevitable. Assessing nurses’ attitudes towards, barriers to, and facilitators of neonatal palliative care is essential to delivering effective nursing care.MethodsThis study was conducted from January to September 2015 and involved Italian nurses employed in Level III neonatal intensive care units in 14 hospitals in northern, central, and southern Italy. A modified version of the Neonatal Palliative Care Attitudes Scale (NiPCAS) was adopted to assess nurses’ attitudes.FindingsA total of 347 neonatal nurses filled out the questionnaire. The majority were female (87.6%), with a mean age of 40.38 (±8.3) years. The mean score in the “organization” factor was 2.71 (±0.96). The “resources” factor had a mean score of 2.44 (±1.00), while the “clinician” factor had a mean score of 3.36 (±0.90), indicating the main barriers to and facilitators of implementing palliative nursing care.ConclusionsItalian neonatal nurses may face different obstacles to delivering neonatal palliative care and to improve their attitudes in this field. In the Italian context, no facilitators of, only barriers to, palliative care delivery were identified.Clinical RelevanceNurses’ attitudes towards neonatal palliative care are essential to supporting nurses, who are constantly exposed to the emotional and moral distress connected with this field of end‐of‐life nursing care.
Exosomal microRNA‐139‐5p from mesenchymal stem cells accelerates trophoblast cell invasion and migration by motivation of the ERK/MMP‐2 pathway via downregulation of protein tyrosine phosphatase
Authors: Liu Huijie , Wang Fang , Zhang Ying , Xing Yanling , Wang Qian 
Published: September 2020

AbstractAimExosomes present essential roles for intercellular interaction via extracellular pathways during systemic dysfunctions, including preeclampsia (PE). Here, we assessed the specific mechanism of mesenchymal stem cells (MSC)‐originated exosomes in PE.MethodsThe effects of exosomes on trophoblasts were studied by EdU, wound healing, Transwell and TUNEL assays. By microarray analysis, we found that exosomes enhanced the microRNA‐139‐5p (miR‐139‐5p) in trophoblasts, and confirmed the target gene of miR‐139‐5p by bioinformatics prediction and dual‐luciferase reporter gene assay. At the same time, ERK/MMP‐2 pathway‐related biomolecules were assessed through Western blot analysis. The pathway inhibitor was used for rescue experiments. Finally, the effect of exosomes on the pathology of PE rats was verified by in vivo experiments.ResultsThe exosomes originated from hucMSC fostered the trophoblast cell migration, invasion and proliferation and obstructed apoptosis. Moreover, miR‐139‐5p could be transmitted to trophoblasts through hucMSC‐secreted exosomes. miR‐139‐5p targeted protein tyrosine phosphatase (PTEN), which regulated the ERK/MMP‐2 pathway. Inhibition of the ERK/MMP‐2 pathway significantly reduced the promoting effect of exosomes on trophoblasts. Treatment with exosomes significantly lowered blood pressure values and reduced 24‐h proteinuria in PE rats.ConclusionhucMSC‐originated exosomes overexpressing miR‐139‐5p activated the ERK/MMP‐2 pathway via PTEN downregulation, thus accelerating trophoblast cell invasion and migration, and blocking apoptosis. These results demonstrated that hucMSC‐derived exosomes overexpressing miR‐139‐5p might be an innovative direction for therapeutic approaches against PE.
Systemic amyloidosis from A (AA) to T (ATTR): a review
Authors: Muchtar E. , Dispenzieri A. , Magen H. , Grogan M. , Mauermann M. , McPhail E. D. , Kurtin P. J. , Leung N. , Buadi F. K. , Dingli D. , Kumar S. K. , Gertz M. A. 
Published: September 2020

AbstractSystemic amyloidosis is a rare protein misfolding and deposition disorder leading to progressive organ failure. There are over 15 types of systemic amyloidosis, each caused by a different precursor protein which promotes amyloid formation and tissue deposition. Amyloidosis can be acquired or hereditary and can affect various organs, including the heart, kidneys, liver, nerves, gastrointestinal tract, lungs, muscles, skin and soft tissues. Symptoms are usually insidious and nonspecific resulting in diagnostic delay. The field of amyloidosis has seen significant improvements over the past decade in diagnostic accuracy, prognosis prediction and management. The advent of mass spectrometry‐based shotgun proteomics has revolutionized amyloid typing and has led to the discovery of new amyloid types. Accurate typing of the precursor protein is of paramount importance as the type dictates a specific management approach. In this article, we review each type of systemic amyloidosis to provide the practitioner with practical tools to improve diagnosis and management of these rare disorders.
Literature review on congenital glucose–galactose malabsorption from 2001 to 2019
Authors: Wang Weiyan , Wang Liang , Ma Ming 
Published: September 2020

AimCongenital glucose–galactose malabsorption (CGGM) is a rare disease characterised by severe diarrhoea, dehydration and weight loss. To better understand CGGM, we investigated all the case reports and series of CGGM from 2001 to 2019.MethodsA review of reports of CGGM published from 2001 to 2019 was undertaken, using PubMed, Ovid Medline, Springer, Wanfang Database, CBMD database and CKNI database. The clinical features, diagnosis, treatment and prognosis of CGGM in these reports were obtained and analysed.ResultsWe reviewed 107 cases for this study. Out of 55 cases from Saudi Arabia and Turkey, 43 cases (78.2%) were from consanguineous marriage. Forty‐nine cases (73.1%) were infants. Dehydration, diarrhoea and weight loss occurred in almost all cases. Half of the cases presented hypernatremia and abdominal distension. Vomiting, polyuria/haematuria and fever were reported in 11, 7 and 3 cases, respectively. Twenty cases (18.7%) showed hypercalcaemia or nephrolithiasis. Stool pH was tested in 43 cases (40.2%). Fifty‐five cases (51.4%) were diagnosed for more than 1 month after the onset of symptoms. Two cases (1.9%) died, one needed amputation, and the other 104 cases (97.2%) recovered with fructose formula. Seventy‐three cases (68.2%) underwent gene testing, 30 SLC5A1 gene mutations were detected, with 23 cases homozygous, and seven heterozygous mutation.ConclusionThe clinical characteristics of CGGM are nonspecific, and the diagnosis method is not conventionally applied. Fasting and gene testing are the two most important diagnostic methods. The best treatment of CGGM is supplementation with fructose‐based formula.
Prognostic accuracy of FIB‐4, NAFLD fibrosis score and APRI for NAFLD‐related events: A systematic review
Authors: Lee Jenny , Vali Yasaman , Boursier Jerome , Spijker Rene , Anstee Quentin M. , Bossuyt Patrick M. , Zafarmand Mohammad H. 
Published: September 2020

AbstractBackground & AimsFibrosis is the strongest predictor for long‐term clinical outcomes among patients with non‐alcoholic fatty liver disease (NAFLD). There is growing interest in employing non‐invasive methods for risk stratification based on prognosis. FIB‐4, NFS and APRI are models commonly used for detecting fibrosis among NAFLD patients. We aimed to synthesize existing literature on the ability of these models in prognosticating NAFLD‐related events.MethodsA sensitive search was conducted in two medical databases to retrieve studies evaluating the prognostic accuracy of FIB‐4, NFS and APRI among NAFLD patients. Target events were change in fibrosis, liver‐related event and mortality. Two reviewers independently performed reference screening, data extraction and quality assessment (QUAPAS tool).ResultsA total of 13 studies (FIB‐4:12, NFS: 11, APRI: 10), published between 2013 and 2019, were retrieved. All studies were conducted in a secondary or tertiary care setting, with follow‐up ranging from 1 to 20 years. All three markers showed consistently good prognostication of liver‐related events (AUC from 0.69 to 0.92). For mortality, FIB‐4 (AUC of 0.67‐0.82) and NFS (AUC of 0.70‐0.83) outperformed APRI (AUC of 0.52‐0.73) in all studies. All markers had inconsistent performance for predicting change in fibrosis stage.ConclusionsFIB‐4, NFS, and APRI have demonstrated ability to risk stratify patients for liver‐related morbidity and mortality, with comparable performance to a liver biopsy, although more head‐to‐head studies are needed to validate this. More refined models to prognosticate NAFLD‐events may further enhance performance and clinical utility of non‐invasive markers.
Genetic and phenotypic evidence of a contact zone between divergent colour morphs of the iconic red‐eyed treefrog
Authors: Akopyan Maria , Gompert Zachariah , Klonoski Karina , Vega Andres , Kaiser Kristine , Mackelprang Rachel , Rosenblum Erica Bree , Robertson Jeanne M. 
Published: September 2020

AbstractHybrid zones act as natural laboratories where divergent genomes interact, providing powerful systems for examining the evolutionary processes underlying biological diversity. In this study, we characterized patterns of genomic and phenotypic variation resulting from hybridization between divergent intraspecific lineages of the Neotropical red‐eyed treefrog (Agalychnis callidryas). We found genetic evidence of a newly discovered contact zone and phenotypic novelty in leg colour—a trait suspected to play a role in mediating assortative mating in this species. Analysis of hybrid ancestry revealed an abundance of later‐generationFnindividuals, suggesting persistence of hybrids in the contact zone. Hybrids are predominantly of southern ancestry but are phenotypically more similar to northern populations. Genome‐wide association mapping revealed QTL with measurable effects on leg‐colour variation, but further work is required to dissect the architecture of this trait and establish causal links. Further, genomic cline analyses indicated substantial variation in patterns of introgression across the genome. Directional introgression of loci associated with different aspects of leg colour are inherited from each parental lineage, creating a distinct hybrid colour pattern. We show that hybridization can generate new phenotypes, revealing the evolutionary processes that potentially underlie patterns of phenotypic diversity in this iconic polytypic frog. Our study is consistent with a role of hybridization and sexual selection in lineage diversification, evolutionary processes that have been implicated in accelerating divergence in the most phenotypically diverse species.
Fatherhood group sessions: A descriptive and summative qualitative study
Authors: Berlin Anita , Rosander Michael , Frykedal Karin F. , Törnkvist Lena , Barimani Mia 
Published: September 2020

AbstractThe aim of this qualitative study of fatherhood group sessions offered as part of child health care services for new parents was to examine the activities, roles, and topics initiated by the leader and describe fathers' participation. Eight new fathers took part in three audio‐ and video‐recorded sessions led by a male leader. Three qualitative content analysis approaches were used to analyze the data. The analysis showed that the group leader took on four leadership roles, mainly that of discussion leader, but also expert, friend, and organizer. When the group leader acted as discussion leader, fathers participated by discussing challenges and changes in their new situation. Challenges were related to raising the child, partner relationships, everyday life, and gender equality. Fathers also discussed changes in their partner relationships and an increased focus on practicalities in daily life. Fatherhood groups can help new fathers form social networks and can create space for fathers to work through challenging topics, such as gender equality in parenting. The discussion leader's choice of role is crucial to creating the space for such discussions.
GERD for the nongastroenterologist: successful evaluation, management, and lifestyle‐based symptom control
Authors: Stein Ellen , Sloan Josh , Sonu Irene , Kathpalia Priya , Jodorkovsky Daniela 
Published: September 2020

AbstractGastroesophageal reflux disease (GERD) is a complex disorder. Symptoms of heartburn can help find the disorder of GERD. pH testing is the mainstay of evaluation of symptoms, including 24‐h and longer pH studies to detect pathologic acid exposure. The use of proton pump inhibitor (PPI) therapy for approved indications is helpful for both symptomatic relief and esophagitis healing in the majority of patients with abnormal acid exposure. PPI medications are safe in short‐ or long‐term use. It is recommended not to maintain cirrhotic patients on PPI therapy without a meaningful indication. Dietary adjustment can provide benefit to some patients, but the data are mixed on how much benefit has been demonstrated from specific food avoidance. Reduction in weight improves reflux. Obesity has measurable effects on the esophageal acid exposure but fewer effects on the motility of the esophagus itself. Controlling weight and changing lifestyle can be helpful for improving GERD symptoms. For some patients in whom either the control of reflux with medications and lifestyle change is not sufficient or a hernia is contributing to symptom generation, surgical and endosurgical interventions can be considered to help manage reflux after a thorough workup with pH testing and manometry.