bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flexion Dysfunction of Atlanto‐Occipital Joint Associated with Cervical Spondylosis
Authors: Gong Long , Ma Hao‐ning , Yi Ping , Tan Ming‐sheng 
Published: January 2021

ObjectiveTo investigate the association between atlanto‐occipital radiographic alignment in flexion and cervical spondylosis (CS).MethodsThis is a retrospective case‐control study. CS patients were recruited from our hospital, and the age/gender/body mass index (BMI)‐matched healthy controls were selected from the subjects in health examinations at the same hospital between January 2015 and May 2019. A total of 464 subjects was included in the study. There are 282 males and 182 females. The ages of patients were 20 to 67 years, and the mean age was 33.9 years. CS patients were considered the case group. Based on surgical treatments, they were subdivided into non‐operation group and operation group. The operation group and non‐operation group had 45 and 187 patients, respectively, while 232 subjects were included in the control group. The angle between McGregor's line and C1 line (O‐C1 angle) was evaluated on images taken in flexion (F‐OC) and neutral positions (N‐OC) independently. The relationship between the FOC (FOC=F‐OC—N‐OC) and Neck Disability Index (NDI) was examined, and the involvement of the FOC in the onset of CS was analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut‐off for detecting an increased risk of CS.ResultsThe median follow‐up time was 51.6 months (25–115 months). The case groups, especially the operation group, tended to be older (55.8 ± 11.2 vs 41.6 ± 13.8 vs 23.5 ± 5.5 years, P < 0.001), have a higher NDI score (12.2 ± 4.5 vs 6.2 ± 2.1 vs 3.2 ± 1.2, P < 0.001), and longer medical history (10.5 ± 9.5 vs 6.8 ± 11.2 years, P < 0.001). One‐way analysis of variance showed statistically significant differences in FOC between the control and case groups (1.4° ± 1.2° vs 3.6° ± 1.9° vs 7.2° ± 2.0°, P < 0.001). Besides, a post‐hoc Tukey test showed a lower FOC in the operation group compared with that in the non‐operation group (1.4° ± 1.2° vs 3.6° ± 1.9°, P < 0.001). Using FOC as a radiological predictive model to predict CS, the cut‐off value was 4.2°. Using FOC as a radiological predictive model to predict CS, the area under the curve (AUC) was 0.86 (95% CI: 0.78–0.92, P < 0.001). In the univariable risk analysis model, conditional logistic regression showed that the FOC level was an independent factor with an important role in the risk of CS. The odds rose to 8.2 times when FOC reached the level under 4.2° (OR = 8.2; 95% CI: 6.4–10.0; P < 0.001). There existed a significant negative correlation between FOC levels and NDI (r = −0.451, P = 0.016).ConclusionsStiff O‐C1, which is defined as FOC ≤ 4.2°, represented decreased flexion dysfunction of atlanto‐occipital joint and is closely associated with high risk for the occurrence of CS. This finding could show a possible relationship between upper and lower cervical spine and help spine surgeons to understand the pathological process of CS and implement appropriate management.
Machine learning method for predicting pacemaker implantation following transcatheter aortic valve replacement
Authors: Truong Vien T. , Beyerbach Daniel , Mazur Wojciech , Wigle Matthew , Bateman Emma , Pallerla Akhil , Ngo Tam N.M. , Shreenivas Satya , Tretter Justin T. , Palmer Cassady , Kereiakes Dean J. , Chung Eugene S. 
Published: January 2021

AbstractBackgroundAn accurate assessment of permanent pacemaker implantation (PPI) risk following transcatheter aortic valve replacement (TAVR) is important for clinical decision making. The aims of this study were to investigate the significance and utility of pre‐ and post‐TAVR ECG data and compare machine learning approaches with traditional logistic regression in predicting pacemaker risk following TAVR.MethodsFive hundred fifity seven patients in sinus rhythm undergoing TAVR for severe aortic stenosis (AS) were included in the analysis. Baseline demographics, clinical, pre‐TAVR ECG, post‐TAVR data, post‐TAVR ECGs (24 h following TAVR and before PPI), and echocardiographic data were recorded. A Random Forest (RF) algorithm and logistic regression were used to train models for assessing the likelihood of PPI following TAVR.ResultsAverage age was 80 ± 9 years, with 52% male. PPI after TAVR occurred in 95 patients (17.1%). The optimal cutoff of delta PR (difference between post and pre TAVR PR intervals) to predict PPI was 20 ms with a sensitivity of 0.82, a specificity of 0.66. With regard to delta QRS, the optimal cutoff was 13 ms with a sensitivity of 0.68 and a specificity of 0.59. The RF model that incorporated post‐TAVR ECG data (AUC 0.81) more accurately predicted PPI risk compared to the RF model without post‐TAVR ECG data (AUC 0.72). Moreover, the RF model performed better than logistic regression model in predicting PPI risk (AUC: 0.81 vs. 0.69).ConclusionsMachine learning using RF methodology is significantly more powerful than traditional logistic regression in predicting PPI risk following TAVR.
Electrophysiological characteristics of epicardial to endocardial breakthrough in intractable cavotricuspid isthmus‐dependent atrial flutter
Authors: Su Chen , Xue Yumei , Li Teng , Liu Menghui , Liu Yang , Deng Hai , Li Jie , Jiang Jingzhou , Ma Yuedong , Feng Chong , Liu Jun , Tang Anli , Dong Yugang , He Jiangui , Wang Lichun 
Published: January 2021

AbstractBackgroundEpicardial to endocardial breakthrough (EEB) exists widely in atrial arrhythmia and is a cause for intractable cavotricuspid isthmus (CTI)‐dependent atrial flutter (AFL). This study aimed to investigate the electrophysiological features of EEB in EEB‐related CTI dependent AFL.MethodsSix patients with EEB‐related CTI‐dependent AFL were identified among 142 consecutive patients who underwent CTI‐dependent AFL catheter ablation with an ultra‐high‐density, high‐resolution mapping system in three institutions. Activation maps and ablation procedure were analyzed.ResultsA total of seven EEBs were found in six patients. Four EEBs (including three at the right atrial septum and one in paraseptal isthmus) were recorded in three patients during tachycardia. The other three EEBs were identified at the inferolateral right atrium (RA) during pacing from the coronary sinus. The conduction characteristics through the EEB‐mediated structures were evaluated in three patients. Two patients only showed unidirectional conduction. Activation maps indicated that CTI‐dependent AFL with EEB at the atrial septum was actually bi‐atrial macro‐reentrant atrial tachycardia (BiAT). Intensive ablation at the central isthmus could block CTI bidirectionally in four cases. However, ablation targeted at the inferolateral RA EEB was required in two cases. Meanwhile, local potentials at the EEB location gradually split into two components with a change in activation sequence.ConclusionsEEB is an underlying cause for intractable CTI‐dependent AFL. EEB‐mediated structure might show unidirectional conduction. CTI‐dependent AFL with EEB at the atrial septum may represent BiAT. Intensive ablation targeting the central isthmus or EEB at the inferolateral RA could block the CTI bidirectionally.
High‐power short‐duration ablation of atrial fibrillation: A contemporary review
Authors: Naniwadekar Aditi , Dukkipati Srinivas R. 
Published: January 2021

AbstractCatheter ablation using radiofrequency (RF) energy has been widely used to treat patients with atrial fibrillation (AF). The optimal levels of power and duration to increase the success rate while minimizing complications have not been fully established. Different centers continue to use various power protocols for catheter ablation of AF. Herein, we present a comprehensive review of the impact of power output on efficacy and safety of RF ablation for AF. High‐power short‐duration (HPSD) ablation can be performed safely with similar procedural efficacy as low‐power long‐duration ablation strategy. HPSD ablation has the potential to shorten procedural and RF times and create more durable and localized lesions.
Association between human leukocyte antigens (HLAs) and human neutrophil antigens (HNAs) and autoimmune neutropenia of infancy in Danish patients
Authors: Nielsen Kaspar René , Bojsen Signe Rolskov , Masmas Tania Nicole , Fjordside Anne‐Louise , Baech John , Haunstrup Thure Mors , Steffensen Rudi 
Published: January 2021

AbstractBackgroundAutoimmune neutropenia of infancy (AIN) is a frequent cause of neutropenia in children. The disease is caused by antibodies against epitopes on the immunoglobulin G (IgG) Fc receptor type 3b (FcγIIIb). We investigated the possible association of human neutrophil antigens (HNA), human leukocyte antigen (HLA)‐DR, and HLA‐DQ alleles with AIN and the association of these genotypes with the presence of autoantibodies.MethodsEighty AIN cases with a median age of 13.5 months were included. Controls were healthy unrelated Danish blood donors. Anti‐HNA‐1a autoantibodies were detected using a flow cytometric granulocyte immunofluorescence test (Flow‐GIFT) with phenotyped donor cells for detection of antibody specificity. Molecular determination of HNA genotypes was determined using real‐time polymerase chain reaction (q‐PCR). High‐resolution HLA‐DRB1 and HLA‐DQB1 were determined by next‐generation sequencing.ResultsAntibodies against HNA‐1a were detected in 51% (n = 41) of AIN patients, and anti‐HNA‐1b was detected in 3% (n = 2) of cases. In 46% of cases, the antibodies were anti‐FcγIIIb‐reactive. FCGR3B*01+,*02‐,*03‐ was more common (odds ratio, 6.70; P < .0001), and FCGR3B*01‐,*02+,*03‐ was less common (odds ratio, 0.30; P < .0001) among AIN cases. HNA‐1a antibodies were significantly more frequent among AIN cases with the FCGR3B*01+,*02‐,*03‐ genotype (odds ratio, 3.86; P < .007). The HLA‐DRB1*14 ‐ HLA‐DQB1*05:03 haplotype was significantly more common (odds ratio, 7.44; P < .0001) in AIN patients.ConclusionThe HLA haplotype HLA‐DRB1*14 ‐ DQB1*05:03 is associated with Danish AIN cases. Among Danish AIN patients, anti‐HNA‐1a is the most common autoantibody, and the antibody is more common in cases with the FCGR3B*01+,*02‐,*03‐ genotype.
Effect of extensively hydrolyzed casein vs. conventional formula on the risk of asthma and allergies: The TRIGR randomized clinical trial
Authors: Virtanen Suvi M. , Cuthbertson David , Couluris Marisa , Savilahti Erkki , Knip Mikael , Krischer Jeffrey P. ,   the TRIGR Investigators
Published: January 2021

AbstractBackgroundThe role of hydrolyzed infant formulas in the prevention of asthma and allergies remains inconsistent. We tested whether extensively hydrolyzed casein formula compared to conventional cow's milk–based formula prevented asthma, allergic rhinitis, or atopic eczema.MethodsIn the randomized double‐blind Trial to Reduce IDDM in Genetically at Risk (TRIGR), comparing extensively hydrolyzed to standard cow's milk–based infant formula during the first 6‐8 months of life, we assessed the effect of the intervention on the incidence of asthma, allergic rhinitis, and eczema when the children were 9‐ to 11‐years old. The asthma, allergic rhinitis, and eczema occurrence was assessed using online standardized and validated ISAAC questionnaire. Of the 1106 children who participated in this Ancillary study, 560 had been randomized to the experimental (extensively hydrolyzed casein formula) and 546 to the control arm (cow's milk–based formula).ResultsThe risk of persistent asthma, allergic rhinitis, or atopic eczema did not differ by treatment, the hazard ratios (95% CI) being 1.00 (0.66‐1.52), 0.95 (0.66‐1.38), and 0.89 (0.70‐1.15), respectively, in the intention‐to‐treat analysis. Neither were there any differences in the per‐protocol analysis.ConclusionsExtensively hydrolyzed casein formula did not protect from asthma, rhinitis, or eczema in this population carrying genetic risk for type 1 diabetes.
Dose estimation for bivalirudin during pediatric cardiopulmonary bypass
Authors: Wolstencroft Philip , Arnold Philip , Anderson Brian J. 
Published: January 2021

AbstractAimA typical adult‐based bivalirudin regimen during cardiopulmonary bypass uses a loading dose of 1 mg kg−1 and a circuit prime (volume L × 13 mg) with a subsequent intravenous infusion 2.5 mg h−1 kg−1. Dose in children remains unknown. We wished to determine a practical bivalirudin dosing schedule for children undergoing surgery with cardiopulmonary bypass.MethodsPublished pharmacokinetic parameters in children who were anticoagulated for cardiac catheterization using bivalirudin were compared to adult by scaling for size using allometry. An infusion regimen suitable for children was determined using a bivalirudin target concentration (13 mg L−1) common in adults for effect during cardiopulmonary bypass. Predicted bivalirudin infusion rates in children were compared to regimens published as case reports.ResultsCurrent pediatric bivalirudin infusion rates are based on those used in adults with titration during cardiopulmonary bypass to achieve activated clotting times longer than 400 s. Bivalirudin clearance (mL min−1 kg−1) can be estimated in children by scaling adult parameters using allometry. Clearance decreases through childhood and higher infusion rates in children would achieve target concentration rapidly without the need to titrate initial infusion rate. An infusion rate of 4.5 mg h−1 kg−1 in a 10 kg infant, 4 mg h−1 kg−1 in a 20 kg child and 3.5 mg h−1 kg−1 in a child 30–40 kg will target an activated clotting time slower than 400 s. Adult regimens could be used in those children heavier than 50 kg.ConclusionBivalirudin infusion in children should be started after loading dose at rates greater than those used in adults. Dose in neonates remains uncertain because neither pharmacokinetics nor coagulation pharmacodynamics have been adequately characterized.
Fatal GNAQ‐mutated CNS melanoma in an adolescent with nevus of Ota
Authors: Blundell Andrew R. , Moustafa Danna , Samore Wesley R. , Hawryluk Elena B. 
Published: January 2021

AbstractNevus of Ota is an uncommon benign mesodermal melanosis that involves the first and second divisions of the trigeminal nerve. Primary non‐cutaneous melanoma often involves distinct genetic mutations compared to cutaneous melanoma. In primary central nervous system (CNS) melanomas associated with nevus of Ota, somatic mutations most commonly occur at the Q209 and R183 residues of GNAQ and likely induce tumorigenesis through upregulation of the MAP kinase pathway. This case underscores the importance of elucidating neurologic symptoms early in patients with nevus of Ota, as a delayed presentation of CNS melanoma could portend a devastating outcome.
Nonoperative management for umbilical hernia in infants using adhesive strapping
Authors: Kurobe Masashi , Baba Yuji , Hiramatsu Tomomasa , Otsuka Masahiko 
Published: January 2021

AbstractBackgroundThe aim of this study was to evaluate the efficacy of adhesive strapping (AS) for umbilical hernia (UH) in infants.MethodsA retrospective review of 30 mature infants without any treatment for UH between January 2006 and December 2008 and 87 infants (42 mature and 45 premature) who were treated with AS between January 2010 and December 2014 was conducted. The rate and age of closure of UH were compared between the groups and the complications and limitations of AS were evaluated.ResultsIn the observation‐only group, 24 UHs spontaneously closed at a mean age of 13.5 months, but a protruding umbilicus with redundant skin was present in three of 27 infants. Three infants had persistent UH, so a total of six infants, including the three with redundant skin and three with persistent UH, underwent surgery at the mean age of 30.0 months. In the AS group, 72 UHs were cured at a mean age of 4.3 months, which was significantly earlier than in the observation‐only group (P < 0.01). Eleven infants did not continue AS because of skin irritation or discomfort. Four infants underwent repair due to persistent UH, but not for redundant skin of the umbilicus.ConclusionsAdhesive strapping is effective for promoting the early resolution of UH in infants and preventing the forming of redundant skin, which can reduce the need for surgical intervention. To achieve better results with AS, we recommend applying this technique before the UH grows large.
Climate, Health, and Nursing Tool (CHANT): Initial survey results
Authors: Schenk Elizabeth C. , Cook Cara , Demorest Shanda , Burduli Ekaterina 
Published: January 2021

AbstractObjectivesThis study measured nurses' awareness, motivation, concern, self‐reported behaviors at work, and self‐reported behaviors at home regarding climate change and health.DesignDescriptive study using an anonymous and voluntary web‐based survey.SampleA nonrepresentative sample recruited from nurses.MeasurementsThe CHANT (Climate, Health and Nursing Tool) with five psychometrically evaluated scales used to measure awareness, motivation, concern, behaviors at work, and behaviors at home.ResultsThe 489 respondents reported moderate levels of awareness (2.97 mean score of 0–4) and high levels of concern (3.43) about health impacts of climate change. They were motivated to reduce greenhouse gas emissions (3.27), yet few did at home (2.28), and even fewer at work (1.81). They were motivated by clean air and water and concern about the future. Barriers to action included not knowing what to do and feeling overwhelmed. Respondents reported discussing climate and health with friends or family more frequently than they did with their colleagues. A majority (63%) never contacted elected officials.ConclusionThe respondents were aware of climate and health impacts and motivated to act. However, they reported lower frequencies of changing behaviors at work, and communicating about climate and health professionally and with elected officials.
Tick hypersensitivity and human tick‐borne diseases
Authors: Ng Yu Quan , Gupte Trisha P. , Krause Peter J. 
Published: January 2021

AbstractImmune‐mediated hypersensitivity reactions to ticks and other arthropods are well documented. Hypersensitivity to ixodid (hard bodied) ticks is especially important because they transmit infection to humans throughout the world and are responsible for most vector‐borne diseases in the United States. The causative pathogens of these diseases are transmitted in tick saliva that is secreted into the host while taking a blood meal. Tick salivary proteins inhibit blood coagulation, block the local itch response and impair host anti‐tick immune responses, which allows completion of the blood meal. Anti‐tick host immune responses are heightened upon repeated tick exposure and have the potential to abrogate tick salivary protein function, interfere with the blood meal and prevent pathogen transmission. Although there have been relatively few tick bite hypersensitivity studies in humans compared with those in domestic animals and laboratory animal models, areas of human investigation have included local hypersensitivity reactions at the site of tick attachment and generalized hypersensitivity reactions. Progress in the development of anti‐tick vaccines for humans has been slow due to the complexities of such vaccines but has recently accelerated. This approach holds great promise for future prevention of tick‐borne diseases.
Dynamics of cercospora leaf spot disease determined by aerial spore dispersal in artificially inoculated sugar beet fields
Authors: Imbusch Frederike , Liebe Sebastian , Erven Tobias , Varrelmann Mark 
Published: January 2021

AbstractCercospora beticola is one of the most important fungal pathogens of sugar beet, causing cercospora leaf spot (CLS) disease. Due to the decreasing efficacy of various fungicides caused by resistance traits, the development of a sustainable disease management strategy has become more important. Therefore, detailed knowledge about the epidemiology of the pathogen is crucial. Until now, little was known about the spatiotemporal dispersal of C. beticola spores from the primary inoculum source. Rapid detection of C. beticola spores could facilitate a more precise and targeted disease control. Therefore, a TaqMan real‐time PCR assay for detection and quantification of C. beticola spores caught with Rotorod spore traps was established. In 2016 and 2017, field trials were conducted to monitor C. beticola aerial spore dispersal and disease development within an inoculated field and in the adjacent noninoculated area. With the established detection method, C. beticola spores were successfully quantified and used as a measure for aerial spore dispersal intensity. The analysis of the spatiotemporal spread of C. beticola spores revealed a delay and decrease of aerial spore dispersal with increasing distance from the inoculated area. Consequently, disease incidence and severity were reduced in a similar manner. These results imply that spore dispersal occurs mainly on a small scale within a field, although long distances can be overcome by C. beticola spores. Moreover, secondary aerial spore dispersal from sporulating leaf spots seems to be the main driver for CLS disease development. These results provide an important basis for further improvement of CLS control strategies.
Acoustic startle stimuli inhibit pain but do not alter nociceptive flexion reflexes to sural nerve stimulation
Authors: English Amber , Drummond Peter D. 
Published: January 2021

AbstractAcoustic startle stimuli inhibit pain, but whether this is due to a cross‐modal inhibitory process or some other mechanism is uncertain. To investigate this, electrical stimulation of the sural nerve either preceded or followed an acoustic startle stimulus (by 200 ms) or was presented alone in 30 healthy participants. Five electrical stimuli, five acoustic startle stimuli, 10 startle + electrical stimuli, and 10 electrical + startle stimuli were presented in mixed order at intervals of 30–60 s. Effects of the startle stimulus on pain ratings, pupillary dilatation and nociceptive flexion reflexes to the electric shock were assessed. The acoustic startle stimulus inhibited electrically evoked pain to the ensuing electric shock (p < .001), and the electrical stimulus inhibited the perceived loudness of a subsequent acoustic startle stimulus (p < .05). However, the startle stimulus did not affect electrically evoked pain when presented 200 ms after the electric shock, and electrically evoked pain did not influence the perceived loudness of a prior startle stimulus. Furthermore, stimulus order did not influence the pupillary responses or nociceptive flexion reflexes. These findings suggest that acoustic startle stimuli transiently inhibit nociceptive processing and, conversely, that electrical stimuli inhibit subsequent auditory processing. These inhibitory effects do not seem to involve spinal gating as nociceptive flexion reflexes to the electric shock were unaffected by stimulus order. Thus, cross‐modal interactions at convergence points in the brainstem or higher centers may inhibit responses to the second stimulus in a two‐stimulus train.