bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative analysis of psychosocial needs and support impacts in families affected by young sudden cardiac death: The role of community and peer support
Authors: Steffen Edith Maria , Timotijevic Lada , Coyle Adrian 
Published: May 2020

Background
Young sudden cardiac death (YSCD), often occurring in previously healthy individuals, is a tragic event with devastating impact on affected families, who are at heightened risk of posttraumatic stress and prolonged grief and may themselves be at risk of YSCD. Previous research suggests that surviving family members’ psychosocial support needs are often unmet.

Purpose
This study sought to identify how YSCD-affected families experience dedicated community and peer support in light of their psychosocial support needs.

Methods
The study used a qualitative design, employing a thematic analysis of focus group and interview data. Three focus groups and five individual interviews were conducted with affected family members (N = 19). The sample was drawn from a UK-based charity, Cardiac Risk in the Young. Audio-recordings of the focus groups and interviews were transcribed and subjected to thematic analysis.

Results
Three super-ordinate themes were identified: 1. YSCD community support as offering a place of safety, 2. YSCD community support as fostering sense-making, 3. YSCD community support as facilitating finding new meaning.

Conclusions
YSCD-affected families can benefit from access to dedicated community and peer support that offers a safe environment, provides affiliation, understanding and normalisation and enables sense-making and the rebuilding of a sense of self. Dedicated community support can facilitate meaningful re-engagement with life through helping prevent YSCD and through memorialisation and legacy-building to maintain a continuing bond with the deceased. Clinicians need to be aware of the need to incorporate available community and peer support into patient pathways.
One in 5 Athletes Sustain Reinjury Upon Return to High-Risk Sports After ACL Reconstruction: A Systematic Review in 1239 Athletes Younger Than 20 Years
Authors: Barber-Westin Sue , Noyes Frank R. 
Published: May 2020

Context: Anterior cruciate ligament (ACL) reconstruction (ACLR) is frequently performed in patients younger than 20 years whose goal is to return to sport (RTS). Varying reinjury rates have been reported, and the factors responsible are unclear. Studies differ with regard to age, graft type, surgical techniques, postoperative rehabilitation, RTS guidelines, and methods used to determine ACL failures. Objective: To determine RTS rates; the effect of participation in high-risk sports, sex, and graft type on ACL reinjury rates; and whether objective test criteria before RTS correlate with lower reinjury rates. Data Sources: A systematic review of the literature from inception to May 31, 2019, was conducted using the PubMed and Cochrane databases. Study Selection: Studies on transphyseal ACLR in athletes <20 years old with a minimum mean follow-up of 2 years that reported reinjury rates, the number that RTS, and detailed the type of sport were included. Study Design: Systematic review. Level of Evidence: Level 4. Results: A total of 1239 patients in 8 studies were included; 87% returned to sport and 80% resumed high-risk activities. Of the patients, 18% reinjured the ACL graft and/or the contralateral ACL. Nine percent of patellar tendon autografts and 15% of hamstring autografts failed (odds ratio [OR], 0.52; P = 0.002). Of reinjuries, 90% occurred during high-risk sports. Male patients had a significantly higher rate of ACL graft failure than female patients (OR, 1.64; P = 0.01). There was no sex-based effect on contralateral ACL injuries. Only 1 study cited objective criteria for RTS. Conclusion: A high percentage of athletes returned to sport, but 1 in 5 suffered reinjuries to either knee. Male patients were more likely to reinjure the ACL graft. Objective criteria for RTS were rarely mentioned or not detailed. The need for testing of knee stability, strength, neuromuscular control, agility, and psychological measures before RTS remains paramount in young athletes.
Functional outcomes of direct anterior approach hip arthroplasty: Oblique ‘bikini’ versus longitudinal skin incision
Authors: Menzies-Wilson Richard , Marino Iskandar Tamimi , Mahalingham Karuppiah , Field Richard 
Published: May 2020

Introduction: The direct anterior approach (DAA) for hip arthroplasty has gained popularity in recent years with numerous articles suggesting that short-term outcomes are advantageous over alternative approaches. The ‘bikini’ inguinal crease line incision is a novel variant of the DAA, which reduces the scar. Methods: We conducted a retrospective cohort study to assess functional and general health outcomes and complications of the two different surgical incisions used in DAA total hip arthroplasty (i.e. ‘bikini’ and longitudinal incisions). Results: We found no statistical difference between the novel bikini incision and the traditional DAA hip arthroplasty. Conclusion: This approach offers a cosmetically improved scar with no compromise in outcomes.
Size of Initial Bone Bruise Predicts Future Lateral Chondral Degeneration in ACL Injuries: A Radiographic Analysis
Authors: Kia Cameron , Cavanaugh Zachary , Gillis Edward , Dwyer Corey , Chadayammuri Vivek , Muench Lukas N. , Berthold Daniel P. , Murphy Matthew , Pacheco Rafael , Arciero Robert A. 
Published: May 2020

Background: Bone marrow contusions are common after an acute anterior cruciate ligament (ACL) injury. It is unknown whether the severity of this initial bruise can predict the potential of developing chondral changes even after ACL reconstructive surgery (ACLR). Purpose: To investigate whether the initial bone bruise area could be predictive of progressive chondral defects. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was performed to capture patients with an acute ACL injury with pre- and post-ACLR magnetic resonance imaging (MRI) between January 2000 and December 2017. Lesion areas were measured on initial MRI, and chondral wear was graded on final imaging by use of the modified Outerbridge classification. An ordinal model was created to determine whether the initial area was a significant predictor for future chondral degeneration. Results: A total of 40 patients with a mean age of 34.5 ± 12.6 years were included for analysis. All patients underwent ACLR at a mean 139 ± 64 days from initial injury. A lateral tibial and femoral bone bruise was most commonly present in patients (77.5% and 62.5%, respectively). A medial femoral bone bruise was found in only 12.5% (5/40) of patients. The initial contusion area significantly correlated with increasing chondral wear over time in the tibia and lateral femoral condyle ( P < .001). Patients with a bone bruise encompassing 100% of the lateral femoral compartment on MRI had a 74% chance of having grade 3 or 4 chondral changes at 5 years ( P = .001). Absence of a bone bruise on initial MRI was the greatest predictor of no cartilage wear at 5 years in all compartments ( P < .001). The presence of a concomitant lateral meniscal injury increased the risk of developing type 3 or 4 chondral wear in the lateral tibial plateau ( P = .012) but did not pose increased risk of femoral wear ( P = .23). Conclusion: A significant relationship between area of initial bone bruise at the time of injury and progressive posttraumatic chondral disease was found in the tibial and lateral femoral compartments.
Mutational dynamics and immune evasion in diffuse large B-cell lymphoma explored in a relapse-enriched patient series
Authors: Wise Jillian F. , Nakken Sigve , Steen Chloé B. , Vodák Daniel , Trøen Gunhild , Johannessen Bjarne , Lingjærde Ole Christian , Hilden Vera , Blaker Yngvild Nuvin , Bai Baoyan , Aasheim Lars Birger , Pasanen Annika , Lorenz Susanne , Sveen Anita , Lothe Ragnhild A. , Myklebost Ola , Leppä Sirpa , Meza-Zepeda Leonardo A. , Beiske Klaus , Lawrence Michael S. , Hovig Eivind , Myklebust June Helen , Smeland Erlend B. , Holte Harald 
Published: May 2020

Key Points
Diagnostic and relapse diffuse large B-cell lymphoma (DLBCL) biopsies reveal increased mutational burden/loss of heterozygosity in HLA-A. Serially sampled tumor biopsies provide insight into therapeutic targets and evolutionary divergence in relapsed/refractory DLBCL.
An evaluation of the proposal to regulate lead in hunting ammunition through the European Union’s REACH regulation
Authors: Treu Gabriele , Drost Wiebke , Stock Frauke 
Published: May 2020

Abstract
Background
Despite extensive evidence that exposure to lead from ingested ammunition harms humans and wildlife, and in contravention of European states’ commitments under multilateral environmental agreements to minimize lead emissions, lead in hunting ammunition is still poorly regulated in Europe. The proposed restriction on lead gunshot under the REACH regulation is currently discussed for adoption to protect birds in wetlands from lead poisoning. Based on a subsequent investigation report concluding that additional measures are warranted to control the use of lead ammunition in terrestrial environments, ECHA is preparing a new restriction until October 2020. To help inform this process, we describe REACH management instruments and evaluate the effectiveness and enforceability of different legislative alternatives as well as socio-economic aspects of restricting lead shot in comparison to a total ban. We further discuss how the risks and environmental emissions of lead in rifle bullets can be most effectively controlled by legislative provisions in the future.

Results
Among different management tools, restriction was shown to be most effective and appropriate, since imports of lead ammunition would be covered. The partial restriction of lead gunshot limited to wetlands covers only a minor proportion of all lead used in hunting ammunition in the European Union, leaving multiple wildlife species at risk of being poisoned. Moreover, lead shot will be still purchasable throughout the EU. Within Europe, the costs associated with impacts on wildlife, humans and the environment would be considerably lower when switching to alternative gunshot and rifle bullets.

Conclusion
We argue that there is sufficient evidence to justify more effective, economic, and practical legislative provisions under REACH, i.e., restricting the use and placing on the market of lead in hunting ammunition. The enforcement would be significantly facilitated and hunters could easier comply. A crucial step is to define a realistic phasing-out period and chemical composition standards for non-lead substitutes while engaging all stakeholders to improve acceptance and allow adaptation. Until the total restriction enters into force, Member States could consider imposing more stringent national measures. A total restriction would reduce wildlife poisoning, harmonize provisions of national and European laws, and foster any efforts to decelerate loss of biodiversity.
Occurrence and multiple-level ecological risk assessment of pharmaceuticals and personal care products (PPCPs) in two shallow lakes of China
Authors: Liu Na , Jin Xiaowei , Yan Zheng , Luo Ying , Feng Chenglian , Fu Zhiyou , Tang Zhi , Wu Fengchang , Giesy John P. 
Published: May 2020

AbstractBackgroundManagement of pharmaceuticals and personal care products (PPCPs) in the environment has become a social issue. In the present study, concentrations of 140 PPCPs at 20 sites in Baiyangdian Lake and Tai Lake from 2016 to 2017 were analyzed by ultra performance liquid chromatography mass spectrometer (UPLC–MS). Risk quotients (RQ) were calculated for each detected chemical at all sites and prioritization indices (PI), based on maximum RQ, were calculated. To assess the risk of chemicals that identified high priority (PI > 1), a more accurate method of joint probability curves (JPCs) was applied.ResultsA total of 42 PPCPs were identified and quantified detected in the two lakes, with maximum concentrations ranging from 0.04 to 889 ng/L. Among these, seven PPCPs were identified as high or moderate-risk pollutants for at least one site, 3 in Tai Lake and 5 in Baiyangdian Lake. Carbamazepine posed significant ecological risk at all 20 sites, such that more attention should be paid to that drug. Based on results of the JPCs, sulfamethoxazole, caffeine, diethyltoluamide, and carbamazepine were categorized as high or intermediate risks.ConclusionOccurrences and distributions of PPCPs were different in the two lakes. Multiple-level risk assessment from simple to more complex was appropriate in chemical risk management.
How to coordinate the relationship between renewable energy consumption and green economic development: from the perspective of technological advancement
Authors: Xie Fangming , Liu Yali , Guan Fangyuan , Wang Ning 
Published: May 2020

Abstract
Background
Green economic development refers to reducing pollution emissions and increasing production efficiency while promoting economic growth. Although the renewable energy consumption is “green,” it may not promote green economic development due to the constraints of existing technical conditions. Therefore, the technological advancement approach that can help coordinate the relationship between renewable energy consumption and green economic development should be identified. That is, determining whether to develop new technologies or improve existing technologies should be paid more attention in the context of continuous increase in renewable energy consumption.

Results
(1) The inverted N-shaped relationship between renewable energy consumption and green economic development under the existing technical conditions. The degree of renewable energy consumption can merely promote green economic development in the interval of 0.67–10.87. That is, the renewable energy consumption (% of total energy consumption) is less than 0.67% or greater than 10.87%, which is not conducive to green economic development. (2) Developing new technologies can stimulate the positive effect of renewable energy consumption on green economic development. However, the improvement of existing technologies fails to exhibit an effective impact on the relationship between renewable energy consumption and green economic development. (3) Coordinating the relationship between renewable energy consumption and green economic development can also be achieved by reducing the dependence of Gross Domestic Product (GDP) on fossil fuels. (4) The stage of economic development might impact the effect of renewable energy on green economic development.

Conclusions
It is particularly important to improve technological innovation capabilities, especially in countries with a high proportion of renewable energy consumption. In addition, the government should guide the funds and resources to the renewable energy industry through the credit rationing system to promote the transition of the industrial structure to an environmentally friendly direction. For countries with relatively low levels of economic development, this does not mean that these countries should reduce their demand for renewable energy. Instead, these countries need to take more proactive measures, such as increasing technological innovation capabilities and optimizing industrial structure to coordinate the relationship between renewable energy consumption and green economic development.
Chloroplast (Cp) Transcriptome of P. davidiana Dode×P. bolleana Lauch provides insight into the Cp drought response and Populus Cp phylogeny
Authors: Zhang Xin , Gu Chenrui , Zhang Tianxu , Tong Botong , Zhang Heng , Wu Yueliang , Yang Chuanping 
Published: May 2020

Abstract
Background
Raw second-generation (2G) lignocellulosic biomass materials have the potential for development into a sustainable and renewable source of energy. Poplar is regarded as a promising 2G material (P. davidiana Dode×P. bolleana Lauch, P. bolleana, P. davidiana, P. euphratica, et al). However, their large-scale commercialization still faces many obstacles. For example, drought prevents sufficient irrigation or rainfall, which can reduce soil moisture and eventually destroy the chloroplast, the plant photosynthetic organelle. Heterosis is widely used in the production of drought-tolerant materials, such as the superior clone “Shanxinyang” selected from the offspring of Populus davidiana Dode×Populus bolleana Lauch. Because it produces good wood and is easily genetically transformed, “Shanxinyang” has become a promising material for use in tree genetics. It is also one of the most abundant biofuel plants in northern China. Understanding the genetic features of chloroplasts, the cp transcriptome and physiology is crucial to elucidating the chloroplast drought-response model.

Results
In this study, the whole genome of “Shanxinyang” was sequenced. The chloroplast genome was assembled, and chloroplast structure was analysed and compared with that of other popular plants. Chloroplast transcriptome analysis was performed under drought conditions. The total length of the “Shanxinyang” chloroplast genome was 156,190 bp, the GC content was 36.75%, and the genome was composed of four typical areas (LSC, IRa, IRb, and SSC). A total of 114 simple repeats were detected in the chloroplast genome of “Shanxinyang”. In cp transcriptome analysis, we found 161 up-regulated and 157 down-regulated genes under drought, and 9 cpDEGs was randomly selected to conduct reverse transcription (RT)–qPCR., in which the Log2 (fold change) was significantly consistent with the qPCR results. The analysis of chloroplast transcription under drought provided clues for understanding chloroplast function under drought. The phylogenetic position of “Shanxinyang” within Populus was analysed by using the chloroplast genome sequences of 23 Populus plants, showing that “Shanxinyang” belongs to Sect. Populus and is sister to Populus davidiana. Further, mVISTA analysis showed that the variation in non-coding (regulatory) regions was greater than that in coding regions, which suggests that further attention should be paid to the chloroplast in order to obtain new evolutionary or functional insights related to aspects of plant biology.

Conclusions
Our findings indicate that complex prokaryotic genome regulation occurs when processing transcripts under drought stress. The results not only offer clues for understanding the chloroplast genome and transcription features in woody plants but also serve as a basis for future molecular studies on poplar species.
Omentin-1 is associated with atrial fibrillation in patients with cardiac valve disease
Authors: Chen Yubin , Liu Fen , Han Fei , Lv Lizhi , Tang Can-e , Xie Zhongshang , Luo Fanyan 
Published: May 2020

Abstract
Background
Epicardial adipose tissue (EAT) remodeling and adipocytokines are associated with structural remodeling in atrial fibrillation (AF). However, the role of omentin-1, a novel adipocytokine, in structural remodeling remains unknown.

Methods
Hematoxylin and eosin (H&E) and Masson’s trichrome stains were used to investigate the histology of EAT and right atrial appendages. The expression levels of adipocytokines in these human samples were determined by immunohistochemical assay and western blotting. Models of transforming growth factor (TGF)-β1-induced activation of cardiac fibroblasts (CFs) and TGF-β1-induced endothelial-mesenchymal transition (EndMT) of human umbilical vein endothelial cell (HUVEC) were established to explore roles of omentin-1 in these processes. To determine changes in adipocytokines secretion under hypoxia conditions, adipocytes were treated with 5% O2 and 95% N2, and then CFs and HUVECs were co-cultured with the conditioned medium of adipocytes to determine the effects of hypoxia-treated adipocytes on these cells.

Results
Expression of omentin-1 was downregulated in the EAT and right atrial appendages from patients with AF compared to samples from patients without AF, while the TGF-β1 level was upregulated in EAT from patients with AF. EAT from patients with AF exhibited adipocyte hypertrophy and severe interstitial fibrosis. Omentin-1 inhibited TGF-β1-induced CF activation and reversed TGF-β1-induced HUVEC EndMT. Adipocytes treated with hypoxia exhibited downregulation of omentin-1 and partly activated CFs.

Conclusions
This study demonstrated that omentin-1 was an antifibrotic adipocytokine and was downregulated in patients with AF, which was partly mediated by hypoxia.
Intra-cardiac ultrasound guided approach for catheter ablation of typical right free wall accessory pathways
Authors: Jan Matevž , Kalinšek Tine Prolič , Štublar Jernej , Jelenc Matija , Pernat Andrej , Žižek David , Lakič Nikola 
Published: May 2020

Abstract
Background
Right free wall accessory pathways (AP) are difficult to treat with catheter ablation as ablation catheter (AC) instability at the tricuspid annulus often precludes successful procedure.
The aim of our study was to test a novel intra-cardiac echocardiography (ICE) guided technique for AC placement. Feasibility and success rates were observed.

Methods
Eight consecutive patients (aged 29 ± 21 years, 4 female) with Wolff-Parkinson-White syndrome and a right free wall AP were included in the study. ICE, three-dimensional (3D) electro-anatomic mapping (EAM) system, and a steerable long sheath were used together with either an irrigated or a non-irrigated tip radio-frequency AC to achieve a “loop” manoeuvre which provided AC tip stability at the ventricular aspect of the tricuspid annulus. X-ray fluoroscopy was not used.

Results
Three patients had an anterior and five had a lateral location of the right free wall AP. Procedures were successful in all patients, without recurrences during the mean follow-up of 397 ± 363 days. Average procedural duration was 90 ± 31 min. On average, 6.6 ± 5.7 ablations were needed. Average time to terminate AP conduction after the start of ablation was 4.8 ± 4.2 s. In five patients (62%) AP conduction was successfully terminated with the first ablation. There were no procedural complications.

Conclusions
The novel ICE-guided approach with concomitant use of the steerable sheath and the 3D EAM system for zero-fluoroscopy mapping and ablation of the right free wall APs proved feasible and resulted in excellent acute and long-term outcomes.