bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serratus anterior plane block in subcutaneous implantable cardioverter defibrillator implantation: A case‐control analysis
Authors: Ziacchi Matteo , Bisignani Giovanni , Palmisano Pietro , Scalone Antonio , Martignani Cristian , Elvira Mocavero Paola , Caravati Fabrizio , Della Cioppa Nadia , Mazzuero Antonio , Pecora Domenico , Vicentini Alessandro , Landolina Maurizio Eugenio , Debonis Silvana , Scimia Paolo , Lovecchio Mariolina , Valsecchi Sergio , Diemberger Igor , Droghetti Andrea 
Published: November 2019

AbstractBackgroundA two‐incision technique, in association with inter‐muscular positioning of the subcutaneous defibrillator (S‐ICD), is now the most frequently adopted implantation approach in Europe. Ultrasound‐guided serratus anterior plane block (SAPB) has been proposed to provide anesthesia/analgesia during S‐ICD implantation.ObjectiveWe performed a case‐control analysis in which a standardized SAPB approach was compared with the typical local anesthesia and sedation approach.MethodsNinety‐one consecutive patients underwent implantation of an S‐ICD with the SAPB approach for anesthesia/analgesia at 10 centers. The control group consisted of 55 consecutive patients who underwent S‐ICD implantation with a standard local approach.ResultsThe mean procedure duration was 59 ± 15 minutes in the SAPB group and 76 ± 23 minutes in the control group (P < .001). No operative complications were reported in either group. During the procedure, 79 (87%) patients in the SAPB group and 25 (46%) patients in the control group (P < .001) remained awake. Lower values of pain intensity at the device pocket (P = .005) and the lateral tunneling site (P = .046) were reported in the SAPB group. The difference in static (P = .002) and dynamic (P = .007) pain intensity between the groups persisted at 1 hour, while no differences were observed 6 hours after the end of the procedure.ConclusionsSAPB is feasible and effective in providing anesthesia/analgesia during S‐ICD implantation. The procedures were successfully accomplished and no complications occurred in either group. However, SAPB was associated with lower pain levels, enabling the need for sedation to be reduced and more patients to remain awake. Moreover, it resulted in shorter procedure durations.
How to perform left atrial transseptal access and catheter ablation of atrial fibrillation from a superior approach
Authors: Santangeli Pasquale , Kodali Santhisri , Liang Jackson J. 
Published: November 2019

AbstractThe standard technique for percutaneous catheter ablation of atrial fibrillation (AF) involves obtaining left atrial access and catheter manipulation from an inferior transfemoral venous access. However, in patients with inferior vena cava interruption, a standard transfemoral venous approach is not possible. In these cases, a percutaneous approach from a superior central vein, such as the internal jugular vein or the axillary/subclavian vein can be considered. In this article, we describe the details of our technique to obtain left atrial catheterization and perform catheter ablation of AF from a superior approach. Our technique involves the use of steerable sheaths, dedicated radiofrequency wires, and intracardiac echocardiography guidance.
Persistent atrial fibrillation in the setting of pulmonary vein isolation—Where to next?
Authors: Kistler Peter M. , Chieng David 
Published: November 2019

AbstractCatheter ablation for atrial fibrillation (AF) is indicated in symptomatic patients who are intolerant or refractory to antiarrhythmic therapy. However, outcomes from catheter ablation remain suboptimal in patients with persistent AF. Pulmonary vein antral isolation (PVAI) is established as the cornerstone of AF ablation strategies. The landmark STAR AF II study demonstrated a lack of incremental benefit with adjunctive linear and complex fractionated electrogram ablation beyond PVAI. Randomized studies thus far have failed to consistently show favorable outcomes from other trigger/substrate‐based ablation approaches over PVAI alone. In this issue of the journal, we pose an interesting clinical scenario—of a middle‐aged female who presents with recurrent persistent AF but was found to have enduring PVAI on repeat electrophysiologic study. Which approach should be undertaken next? In this review article, we aim to provide an overview of ablation strategies beyond PVAI. Finally in light of scant randomized data to guide decision making we have approached leading experts in the field to provide their approach to this scenario.
Electrophysiological parameters and anatomical evaluation of left bundle branch pacing in an in vivo canine model
Authors: Chen Xueying , Jin Qinchun , Li Bingyu , Jia Jianguo , Sharma Parikshit S. , Huang Weijian , Su Yangang , Ge Junbo 
Published: November 2019

AbstractIntroductionLeft bundle branch pacing (LBBP), a form of conduction system pacing in addition to His bundle pacing (HBP), can potentially maintain left ventricular electrical synchrony with better sensing and a low and stable capture threshold.MethodsWe performed both HBP and LBBP using a canine model (n = 3; male; weight 30‐40 kg). The electrocardiogram (ECG), intracardiac electrogram characteristics, and pacing parameters were compared between HBP and LBBP. The hearts were isolated and stained by Lugol's iodine (5%) to assess the relative locations of the leads in relation to the conduction system.ResultsThe average potential to ventricle interval was longer with HBP compared to LBBP (26.67 ± 3.06 ms vs 12.67 ± 1.15 ms; P = .002). There were also notable differences in the pacing parameters between HBP and LBBP: R‐wave amplitude (2.67 ± 0.42 mV vs 11.33 ± 3.06 mV; P = .008), pacing impedance (423.3 ± 40.4 vs 660.0 ± 45.8; P = .003), and threshold (2.30 ± 0.66 V/0.4ms vs 0.67 ± 0.15 V/0.4 ms; P = .014). The paced morphology of ECG was similar to the intrinsic with HBP while a right bundle branch block pattern was noted with LBBP. The anatomical evaluation revealed the location of the leads and the average lead depth was significantly more with LBBP as compared to HBP (12.33 ± 1.53 mm vs1.83 ± 0.29 mm; P < .0001). Furthermore, with LBBP, the tip of the lead helix was noted to be around the LBB.ConclusionThis in vivo canine model study confirms the significant differences between HBP and LBBP. Furthermore, this model provides a precise anatomic evaluation of the location and the depth of the leads in relation to the conduction system.
Reduced expression of proteolipid protein 2 increases ER stress‐induced apoptosis and autophagy in glioblastoma
Authors: Feng Zichao , Zhou Wenjing , Wang Jiwei , Qi Qichao , Han Mingzhi , Kong Yang , Hu Yaotian , Zhang Yulin , Chen Anbin , Huang Bin , Chen Anjing , Zhang Di , Li Wenjie , Zhang Qing , Bjerkvig Rolf , Wang Jian , Thorsen Frits , Li Xingang 
Published: November 2019

AbstractProteolipid protein 2 (PLP2) is an integral ion channel membrane protein of the endoplasmic reticulum. The protein has been shown to be highly expressed in many cancer types, but its importance in glioma progression is poorly understood. Using publicly available datasets (Rembrandt, TCGA and CGGA), we found that the expression of PLP2 was significantly higher in high‐grade gliomas than in low‐grade gliomas. We confirmed these results at the protein level through IHC staining of high‐grade (n = 56) and low‐grade glioma biopsies (n = 16). Kaplan‐Meier analysis demonstrated that increased PLP2 expression was associated with poorer patient survival. In functional experiments, siRNA and shRNA PLP2 knockdown induced ER stress and increased apoptosis and autophagy in U87 and U251 glioma cell lines. Inhibition of autophagy with chloroquine augmented apoptotic cell death in U87‐ and U251‐siPLP2 cells. Finally, intracranial xenografts derived from U87‐ and U251‐shPLP2 cells revealed that loss of PLP2 reduced glioma growth in vivo. Our results therefore indicate that increased PLP2 expression promotes GBM growth and that PLP2 represents a potential future therapeutic target.
A Statewide Program to Improve Management of Suspected Urinary Tract Infection in Long‐Term Care
Authors: Salem‐Schatz Susanne , Griswold Paula , Kandel Ruth , Benjamin‐Bothwell Sharon , DeMaria Alfred , McElroy Nora , Bolstorff Barbara , McHale Eileen , Doron Shira 
Published: November 2019

BACKGROUND/OBJECTIVESSuspected urinary tract infection (UTI) is the most common indication for antibiotic use in long‐term care (LTC). Due to the high prevalence of asymptomatic bacteriuria, for which antibiotics are not warranted, these antibiotics are frequently unnecessary. We implemented a collaborative quality improvement program to improve the management of suspected UTI in LTC residents by increasing awareness of current guidelines, with a focus on decreasing treatment in the absence of symptoms.DESIGN/INTERVENTIONTwo separate collaboratives included workshops, webinars, and coaching calls.PARTICIPANTSA total of 31 facilities participated in the first collaborative, with 17 submitting sufficient data for analysis and 34 in the second, with data analyzed from 25.MEASUREMENTSFacilities reported monthly numbers of urine cultures, UTI diagnoses, Clostridioides difficile infections (CDIs), and resident days.RESULTSWhen comparing the baseline period to the first collaborative period, the intercollaborative period to the second collaborative period, and the first collaborative period to the second, the incident rate ratios (95% confidence intervals) were 0.74 (0.68‐0.81), 0.83 (0.73‐0.94), and 0.63 (0.57‐0.69), respectively, for urine culturing rate; 0.73 (0.64‐0.83), 0.86 (0.70‐1.05), and 0.60 (0.51‐0.69), respectively, for UTI diagnosis rate; and 0.56 (0.40‐0.82), 1.61 (0.71‐4.14), and 0.45 (0.27‐0.74), respectively, for CDI rate.CONCLUSIONThe program we implemented was associated with reductions in urine cultures, UTI diagnosis, and CDI; and it suggests that this type of intervention can promote appropriate management of UTI in the LTC setting. J Am Geriatr Soc 68:62–69, 2019
The contribution of ascitic fluid to body weight in patients with liver cirrhosis, and its estimation using girth: a cross‐sectional observational study
Authors: Lamarti E. , Hickson M. 
Published: November 2019

AbstractBackgroundThere is a high prevalence of malnutrition among people with decompensated liver disease. Standard nutritional screening tools use weight and body mass index (BMI) to identify risk, although these are difficult to measure for those with ascites, often secondary to liver cirrhosis. Dietetic guidance suggests adjusting for ascitic weight by 2.2–14 kg, although there is a lack of evidence to substantiate these values. The present study aimed to measure the contribution of ascitic fluid weight and compare this with the current guidance, as well as to examine whether girth circumference can be used to estimate ascitic weight.MethodsA cross‐sectional, observational study was conducted over 13 weeks. Participants attending for paracentesis were weighed, their girths measured, and BMI was calculated pre‐ and post‐paracentesis. Fluid removed via paracentesis was recorded. Ethical approval was received (IRAS project ID: 218747).ResultsEighteen participants underwent paracentesis. The range of ascitic fluid drained was 3.8–19 L [mean (SD) = 8.7 (3.7) L]. Weight difference between pre‐ and post‐paracentesis was in the range 4.5–20 kg [mean (SD) = 8.7 (3.9) kg]. Ascitic fluid weight is shown to be higher in each category (minimal, moderate, severe ascites) than the current guidance values. Weight difference was greater than 14 kg in 11% (n = 2) of participants. A strong, statistically significant relationship (rho = 0.68, P ≤ 0.01) between ascitic weight and pre‐paracentesis girth was found. An equation was formulated to enable the estimation of ascitic fluid from pre‐paracentesis girth.ConclusionsCurrent dietetic guidance should be re‐evaluated to reflect the greater weight differences identified. Measuring girth pre‐paracentesis may help to inform dry weight estimation. Further research is required to verify the accuracy of estimating ascitic weight from pre‐paracentesis girth.
Relationship between lip motion detected with a compact 3D camera and swallowing dynamics during bolus flow swallowing in Japanese elderly men
Authors: Yamamoto Yushi , Sato Hideo , Kanada Hisako , Iwashita Yoichiro , Hashiguchi Makiko , Yamasaki Youichi 
Published: November 2019

AbstractClinical application of a swallowing function evaluation system that is minimally invasive and enables an objective evaluation is necessary. We constructed a system that can synchronise and analyse lip motion with a three‐dimensional (3D) camera and swallowing dynamics with videofluoroscopy (VF) and clarified the relationship between lip movement and swallowing dynamics. A compact 3D camera was adapted to Microsoft XBox One Kinect Sensor®. We examined Kinect's accuracy and repeatability and analysed the highest measurement accuracy and repeatability of the distance between anguli oris muscles. The constructed system simultaneously measured, synchronised and analysed lip motion by Kinect and swallowing dynamics by VF. Fourteen elderly men without dysphagia were included. Barium turbid solution (5, 10, 15 and 20 mL) was used for swallowing. Measurement parameters were the 3D distance between angulus oris displacement (TDDD), swallowing quantity (SQ), oral transit time (OTT), stage transit duration (STD), pharyngeal transit time (PTT) and total swallowing duration (TSD). Statistical analyses were performed. The measurement accuracy and reproducibility were optimum within a 10° horizontal imaging angle at a 120‐cm measurement distance. SQ, TDDD, OTT, STD, PTT and TSD showed significant differences, and correlation was found between TDDD and OTT. SQ affected TDDD, OTT, STD, PTT and TSD; OTT could be predicted from TDDD. Improvement in the system and analysis method was considered to enable prediction of swallowing dynamics from body surface movement of the head and neck, including realisation of measurement conditions with higher precision and reproducibility, and from lip motion.
Understanding the Risk of Sexual Abuse for Adults With Intellectual and Developmental Disabilities from an Ecological Framework
Authors: Curtiss Sarah L. , Kammes Rebecca 
Published: November 2019

AbstractCurrent research on sexual violence perpetrated against individuals with intellectual and developmental disabilities (IDD) focuses on rates of victimization and individual risk factors. This research suggests that individuals with IDD are at a greater risk for sexual violence compared with the general public. At this time, there is no comprehensive theoretical framework to explain sexual abuse risk factors for individuals with IDD. This article describes such a framework by examining how an ecological perspective can be used to understand why individuals with IDD are at increased risk as well as provide a roadmap for how to prevent sexual abuse. An ecological framework, first introduced by Bronfenbrenner in 1979, examines individuals at multiple contextual levels. Current research on sexual violence and adults with IDD is reviewed through an ecological lens. We argue that an ecological approach is necessary for examining the nature of sexual violence and IDD, understanding why individuals with IDD are at a greater risk for sexual violence, and providing insight into how to prevent sexual violence.
In‐field evaluation of Xpert® HCV viral load Fingerstick assay in people who inject drugs in Tanzania
Authors: Mohamed Zameer , Mbwambo Jessie , Rwegasha John , Mgina Nicodem , Doulla Basra , Mwakale Promise , Tuaillon Edouard , Chevaliez Stephane , Shimakawa Yusuke , Taylor‐Robinson Simon D. , Thursz Mark R. , Brown Ashley S. , Lemoine Maud 
Published: November 2019

AbstractBackgroundAlthough novel hepatitis C virus (HCV) RNA point‐of‐care technology has the potential to enhance the diagnosis in resource‐limited settings, very little real‐world validation of their utility exists. We evaluate the performance of HCV RNA quantification using the Xpert® HCV viral load Fingerstick assay (Xpert® HCV VL Fingerstick assay) as compared to the World Health Organisation pre‐qualified plasma Xpert® HCV VL assay among people who inject drugs (PWID) attending an opioid agonist therapy (OAT) clinic in Dar‐es‐Salaam, Tanzania.MethodsBetween December 2018 and February 2019, consecutive HCV seropositive PWID attending the OAT clinic provided paired venous and Fingerstick samples for HCV RNA quantification. These were processed onsite using the GeneXpert® platform located at the Central tuberculosis reference laboratory.ResultsA total of 208 out of 220 anti‐HCV‐positive participants recruited (94.5%) had a valid Xpert® HCV VL result available; 126 (61%; 95% CI 53.8‐67.0) had detectable and quantifiable HCV RNA. About 188 (85%) participants had paired plasma and Fingerstick whole blood samples; the sensitivity and specificity for the quantification of HCV RNA levels were 99.1% and 98.7% respectively. There was an excellent correlation (R2 = .95) and concordance (mean difference 0.13 IU/mL, (95% CI −0.9 to 0.16 IU/mL) in HCV RNA levels between plasma samples and Fingerstick samples.ConclusionThis study found excellent performance of the Xpert® HCV VL Fingerstick assay for HCV RNA detection and quantification in an African‐field setting. Its clinical utility represents an important watershed in overcoming existing challenges to HCV diagnosis, which should play a crucial role in HCV elimination in Africa.
Cucumber mosaic virus 2b proteins inhibit virus‐induced aphid resistance in tobacco
Authors: Tungadi Trisna , Donnelly Ruairí , Qing Ling , Iqbal Javaid , Murphy Alex M. , Pate Adrienne E. , Cunniffe Nik J. , Carr John P. 
Published: November 2019

SummaryCucumber mosaic virus (CMV), which is vectored by aphids, has a tripartite RNA genome encoding five proteins. In tobacco (Nicotiana tabacum), a subgroup IA CMV strain, Fny‐CMV, increases plant susceptibility to aphid infestation but a viral mutant unable to express the 2b protein (Fny‐CMV∆2b) induces aphid resistance. We hypothesized that in tobacco, one or more of the four other Fny‐CMV gene products (the 1a or 2a replication proteins, the movement protein, or the coat protein) are potential aphid resistance elicitors, whilst the 2b protein counteracts induction of aphid resistance. Mutation of the Fny‐CMV 2b protein indicated that inhibition of virus‐induced resistance to aphids (Myzus persicae) depends on amino acid sequences known to control nucleus‐to‐cytoplasm shuttling. LS‐CMV (subgroup II) also increased susceptibility to aphid infestation but the LS‐CMV∆2b mutant did not induce aphid resistance. Using reassortant viruses comprising different combinations of LS and Fny genomic RNAs, we showed that Fny‐CMV RNA 1 but not LS‐CMV RNA 1 conditions aphid resistance in tobacco, suggesting that the Fny‐CMV 1a protein triggers resistance. However, the 2b proteins of both strains suppress aphid resistance, suggesting that the ability of 2b proteins to inhibit aphid resistance is conserved among divergent CMV strains.
Variable preservation potential and richness in the fossil record of vertebrates
Authors: Walker Fiona M. , Dunhill Alexander M. , Benton Michael J. 
Published: November 2019

AbstractVariation in preservation and sampling probability clouds our estimates of past biodiversity. The most extreme examples are Lagerstätten faunas and floras. Although such deposits provide a wealth of information and represent true richness better than other deposits, they can create misleading diversity peaks because of their species richness. Here, we investigate how Lagerstätten formations add to time series of vertebrate richness in the UK, Germany and China. The first two nations are associated with well‐studied fossil records and the last is a country where palaeontology has a much shorter history; all three nations include noted Lagerstätten in their fossil records. Lagerstätten provide a larger proportion of China's sampled richness than in Germany or the UK, despite comprising a smaller proportion of its fossiliferous deposits. The proportions of taxa that are unique to Lagerstätten vary through time and between countries. Further, in all regions, we find little overlap between the taxa occurring in Lagerstätten and in ‘ordinary’ formations within the same time bin, indicating that Lagerstätten preserve unusual faunas. As expected, fragile taxa make up a greater proportion of richness in Lagerstätten than the remainder of the fossil record. Surprisingly, we find that Lagerstätten account for a minority of peaks in the palaeodiversity curves of all vertebrates (18% in the UK; 36% in Germany and China), and Lagerstätten count is generally not a good overall predictor of the palaeodiversity signal. Vastly different sampling probabilities through taxa, locations and time require serious consideration when analysing palaeodiversity curves.
Internet‐Based Pain Self‐Management for Veterans: Feasibility and Preliminary Efficacy of the Pain EASE Program
Authors: Higgins Diana M. , Buta Eugenia , Williams David A. , Halat Allison , Bair Matthew J. , Heapy Alicia A. , Krein Sarah L. , Rajeevan Haseena , Rosen Marc I. , Kerns Robert D. 
Published: November 2019

AbstractObjectiveTo develop and test the feasibility and preliminary efficacy of a cognitive behavioral therapy–based, internet‐delivered self‐management program for chronic low back pain (cLBP) in veterans.MethodsPhase I included program development, involving expert panel and participant feedback. Phase II was a single‐arm feasibility and preliminary efficacy study of the Pain e‐health for Activity, Skills, and Education (Pain EASE) program. Feasibility (ie, website use, treatment credibility, satisfaction) was measured using descriptive methods. Mixed models were used to assess mean within‐subject changes from baseline to 10 weeks post‐baseline in pain interference (primary outcome, West Haven‐Yale Multidimensional Pain Inventory, scale of 0 to 6), pain intensity, mood, fatigue, sleep, and depression.ResultsPhase I participants (n = 15) suggested modifications including style changes, content reduction, additional “Test Your Knowledge” quizzes, and cognitive behavioral therapy skill practice monitoring form revisions for enhanced usability. In Phase II, participants (n = 58) were mostly male (93%) and White (60%), and had an average age of 55 years (standard deviation [SD] = 12) and moderate pain (mean score 5.9/10); 41 (71%) completed the post‐baseline assessment. Participants (N = 58) logged on 6.1 (SD = 8.6) times over 10 weeks, and 85% reported being very or moderately satisfied with Pain EASE. Pain interference improved from a mean of 3.8 at baseline to 3.3 at 10 weeks (difference 0.5 [95% confidence interval 0.1 to 0.9], P = 0.008). Within‐subject improvement also occurred for some secondary outcomes, including mood and depression symptoms.DiscussionVeterans with cLBP may benefit from technology‐delivered interventions, which may also reduce pain interference. Overall, veterans found that Pain EASE, an internet‐based self‐management program, is feasible and satisfactory for cLBP.