bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paternal transgenerational epigenetic mechanisms mediating stress phenotypes of offspring
Authors: Cunningham Ashley M. , Walker Deena M. , Nestler Eric J. 
Published: September 2019

AbstractDepression and anxiety risk are highly influenced by both genetic and environmental factors. Recently, it has been proposed that epigenetic mechanisms may also contribute to the transmission of both depression‐ and anxiety‐related behaviors across multiple generations. This review highlights long‐lasting epigenetic alterations observed in offspring of fathers, including some distinct effects on male and female offspring, in animal models. Available evidence emphasizes how both the developmental time point and the type of paternal stress (social vs. asocial) influence the complex transmission patterns of these phenotypes to future generations. This research is critical in understanding the factors that influence risk for depression and anxiety disorders and has the potential to contribute to the development of innovative treatments that can more precisely target vulnerable populations.
How green defaults promote environmentally friendly decisions: Attitude‐conditional default acceptance but attitude‐unconditional effects on actual choices
Authors: Taube Oliver , Vetter Max 
Published: September 2019

AbstractDefaults (i.e., options that become effective without an active choice) have been found to be powerful tools to influence decision‐making in a range of behavioral domains. However, seemingly conflicting assumptions have been expressed regarding the interplay of defaults with individual attitudes. Whereas some expect attitude‐conditional effects (i.e., a statistical default‐by‐attitude interaction), others assume an attitude‐unconditional effectiveness of defaults (i.e., statistically additive effects). Integrating both assumptions, we argue that the interplay of defaults and attitudes depends on what is considered a default effect. Specifically, whereas default acceptance is likely to be attitude‐conditional, we predicted that defaults and attitudes would add up in explaining people's actual choices. We tested these hypotheses in an online shopping scenario presenting environmentally friendly or conventional default products to 231 participants. Participants’ environmental attitude was assessed with the General Ecological Behavior scale and actual product choices were identified if participants rejected a given default product. In line with our hypotheses, default acceptance was predicted by a default‐by‐attitude interaction. In contrast, actual environmentally friendly product choices were found to be an additive function of defaults and participants’ environmental attitude. From an applied perspective, our findings suggest that defaults can readily be applied even in attitude‐heterogeneous target populations. Concurrently, however, our findings also speak of the importance of people's attitudes for understanding individual decision‐making.
Economic impact of contact force sensing in catheter ablation for atrial fibrillation
Authors: Mansour Moussa , Reddy Vivek Y. , Karst Edward , Heist Edwin Kevin , Packer Douglas L. , Dalal Nirav , Agarwal Rahul , Calkins Hugh , Ruskin Jeremy N. , Mahapatra Srijoy 
Published: September 2019

AbstractAimsThe TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) clinical trial compared clinical outcomes using a contact force (CF) sensing ablation catheter (TactiCath) with a catheter that lacked CF measurement. This analysis links recorded events in the TOCCASTAR study and a large claims database, IBM MarketScan®, to determine the economic impact of using CF sensing during atrial fibrillation (AF) ablation.Methods and ResultsClinical events including repeat ablation, use of antiarrhythmic drugs, hospitalization, perforation, pericarditis, pneumothorax, pulmonary edema, pulmonary vein stenosis, tamponade, and vascular access complications were adjudicated in the year after ablation. CF was characterized as optimal if greater than or equal to 90% lesion was performed with greater than or equal to 10 g of CF. A probabilistic 1:1 linkage was created for subjects in MarketScan® with the same events in the year after ablation, and the cost was evaluated over 10 000 iterations. Of the 279 subjects in TOCCASTAR, 145 were ablated using CF (57% with optimal CF), and 134 were ablated without CF. In the MarketScan® cohort, 9811 subjects who underwent AF ablation were used to determine events and costs. For subjects ablated with optimal CF, total cost was $19 271 ± 3705 in the year after ablation. For ablation lacking CF measurement, cost was $22 673 ± 3079 (difference of $3402, P < .001). In 73% of simulations, optimal CF was associated with lower cost in the year after ablation.ConclusionCompared to ablation without CF, there was a decrease in healthcare cost of $3402 per subject in the first year after the procedure when optimal CF was used.
Sociolinguistics going ‘wild’: The construction of auratic fields
Authors: Spitzmüller Jürgen 
Published: September 2019

AbstractThis paper sets out to focus the “linguistic construction of publics” (Gal & Woolard, 2014 [2001]: 1) in a sense of the word that is often excluded from sociolinguistic discussion of linguistic action in the public sphere: it discusses how the public is constructed as an indexical (‘auratic’) arena, and a field for positioning, in sociolinguistic research. The paper attempts to point out how the public is (and has been for a long time), on the one hand, envisaged as a sort of counter‐field for academic linguistics (associated with “threatening” metalinguistic practices such as prescriptivism; Cameron, 1995: 5) and thereby juxtaposed to linguistics itself as an allegedly separate field of action, and on the other hand as that appealing place of ‘authentic’ linguistic practice (‘the field,’ ‘the real world,’ etc.) socially oriented linguists ultimately want to explore. The notions ofwild publicsandcreativityare discussed as cases in point.
Bradykinin signaling regulates solute permeability and cellular junction organization in lymphatic endothelial cells
Authors: Kempe Sybille , Fois Giorgio , Brunner Cornelia , Hoffmann Thomas K. , Hahn Janina , Greve Jens 
Published: September 2019

AbstractObjectiveDetermine the effect of bradykinin on solute permeability and cellular junctional proteins in human dermis microvascular endothelial cells.MethodsCells were characterized by immunofluorescence and fluorescence‐activated cell sorting. Macromolecular transport of dextran and albumin was monitored. Junctional protein expression and phosphorylation were determined by immunoblot analyses. Intracellular calcium and cAMP levels were evaluated. Target gene expression at mRNA and protein levels was determined.ResultsHuman dermis microvascular endothelial cells comprised 97% lymphatic endothelial cells. Bradykinin increased the permeability to dextran in a concentration‐dependent manner, while reduced the permeability to albumin. Bradykinin treatment down‐regulated VE‐cadherin expression and affected its phosphorylation status at Tyr731. It also down‐regulated claudin‐5 expression at the transcriptional level through bradykinin‐2‐receptor signaling. An increase in the intracellular calcium levels and a reduction in the cAMP concentration were associated effects. Finally, bradykinin induced the up‐regulation of vascular endothelial growth factor‐C protein which was found increased in BK‐induced human dermis microvascular endothelial cells culture supernates.ConclusionsHuman dermis microvascular endothelial cells represent a model of lymphatic endothelial cells, in which bradykinin‐2‐receptor is expressed. Bradykinin‐induced bradykinin‐2‐receptor signaling through intracellular calcium mobilization and reduction in cAMP levels, triggered changes in solute permeability and cellular junction expression. It further up‐regulated vascular endothelial growth factors‐C protein expression, which is a key modulator of lymphatic vessels function and lymphangiogenesis.
Localized acquired lymphangiectasias after breast surgery: Enhanced non‐invasive diagnosis using dermoscopy and reflectance confocal microscopy
Authors: Verzì Anna Elisa , Lacarrubba Francesco , Tedeschi Aurora , Micali Giuseppe 
Published: September 2019

AbstractBackgroundAcquired lymphangiectasias represent cystic dilatations of the cutaneous lymphatic vessels resulting from damage and/or obstruction of previously normal lymphatics, usually secondary to surgery, radiotherapy, and/or infections.Materials and MethodsThe clinical, dermoscopic, and confocal microscopy features of three cases of acquired lymphangiectasias occurring after breast surgery are described along with histopathological correlations.ResultsPolarized dermoscopy revealed in all lesions the presence of well‐circumscribed, white‐yellowish lacunae surrounded by pale septa. In addition, some lesions showed scattered reddish areas and red lacunae. Confocal microscopy showed in the upper dermis numerous, roundish dark cavities separated by thin septa. These features corresponded histopathologically to saccular dilations and ectatic lymphatic vessels lined by a single layer of endothelial cells in the papillary/reticular dermis.ConclusionThe use of non‐invasive diagnostic techniques may be addressed to an enhanced non‐invasive diagnosis of acquired lymphangiectasias by showing peculiar features, thus avoiding the need for skin biopsy.
Implications of habitual endurance and resistance exercise for dynamic cerebral autoregulation
Authors: Perry Blake G. , Cotter James D. , Korad Stephanie , Lark Sally , Labrecque Lawrence , Brassard Patrice , Paquette Myriam , Le Blanc Olivier , Lucas Samuel J. E. 
Published: September 2019

New Findings
What is the central question of this study?
Does habitual resistance and endurance exercise modify dynamic cerebral autoregulation?

What is the main finding and its importance?
To the authors’ knowledge, this is the first study to directly assess dynamic cerebral autoregulation in resistance‐trained individuals, and potential differences between exercise training modalities. Forced oscillations in blood pressure were induced by repeated squat–stands, from which dynamic cerebral autoregulation was assessed using transfer function analysis. These data indicate that dynamic cerebral autoregulatory function is largely unaffected by habitual exercise type, and further document the systemic circulatory effects of regular exercise.

AbstractRegular endurance and resistance exercise produce differential but desirable physiological adaptations in both healthy and clinical populations. The chronic effect of these different exercise modalities on cerebral vessels’ ability to respond to rapid changes in blood pressure (BP) had not been examined. We examined dynamic cerebral autoregulation (dCA) in 12 resistance‐trained (mean ± SD, 25 ± 6 years), 12 endurance‐trained (28 ± 9 years) and 12 sedentary (26 ± 6 years) volunteers. The dCA was assessed using transfer function analysis of forced oscillations in BP vs. middle cerebral artery blood velocity (MCAv), induced via repeated squat–stands at 0.05 and 0.10 Hz. Resting BP and MCAv were similar between groups (interaction: both P ≥ 0.544). The partial pressure of end‐tidal carbon dioxide () was unchanged (P = 0.561) across squat–stand manoeuvres (grouped mean for absolute change +0.6 ± 2.3 mmHg). Gain and normalized gain were similar between groups across all frequencies (both P ≥ 0.261). Phase showed a frequency‐specific effect between groups (P = 0.043), tending to be lower in resistance‐trained (0.63 ± 0.21 radians) than in endurance‐trained (0.90 ± 0.41, P = 0.052) and ‐untrained (0.85 ± 0.38, P = 0.081) groups at slower frequency (0.05 Hz) oscillations. Squat–stands induced mean arterial pressure perturbations differed between groups (interaction: P = 0.031), with greater changes in the resistance (P < 0.001) and endurance (P = 0.001) groups compared with the sedentary group at 0.05 Hz (56 ± 13 and 49 ± 11 vs. 35 ± 11 mmHg, respectively). The differences persisted at 0.1 Hz between resistance and sedentary groups (49 ± 12 vs. 33 ± 7 mmHg, P < 0.001). These results indicate that dCA remains largely unaltered by habitual endurance and resistance exercise with a trend for phase to be lower in the resistance exercise group at lower fequencies.
Biological effect of tissue plasminogen activator (t-PA) and DNase intrapleural delivery in pleural infection patients
Authors: Kanellakis Nikolaos I , Wrightson John M , Hallifax Rob , Bedawi Eihab O , Mercer Rachel , Hassan Maged , Asciak Rachelle , Hedley Emma , Dobson Melissa , Dong Tao , Psallidas Ioannis , Rahman Najib M 
Published: September 2019

BackgroundPleural infection (PI) is a major global disease with an increasing incidence, and pleural fluid (PF) drainage is essential for the successful treatment. The MIST2 study demonstrated that intrapleural administration of tissue plasminogen activator (t-PA) and DNase, or t-PA alone increased the volume of drained PF. Mouse model studies have suggested that the volume increase is due to the interaction of the pleura with the t-PA via the monocyte chemoattractant protein 1 (MCP-1) pathway. We designed a study to determine the time frame of drained PF volume induction on intrapleural delivery of t-PA±DNase in humans, and to test the hypothesis that the induction is mediated by the MCP-1 pathway.MethodsData and samples from the MIST2 study were used (210 PI patients randomised to receive for 3 days either: t-PA and DNase, t-PA and placebo, DNase and placebo or double placebo). PF MCP-1 levels were measured by ELISA. One-way and two-way analysis of variance (ANOVA) with Tukey’s post hoc tests were used to estimate statistical significance. Pearson’s correlation coefficient was used to assess linear correlation.ResultsIntrapleural administration of t-PA±DNase stimulated a statistically significant rise in the volume of drained PF during the treatment period (days 1–3). No significant difference was detected between any groups during the post-treatment period (days 5–7). Intrapleural administration of t-PA increased MCP-1 PF levels during treatment; however, no statistically significant difference was detected between patients who received t-PA and those who did not. PF MCP-1 expression was not correlated to the drug given nor the volume of drained PF.ConclusionsWe conclude that the PF volume drainage increment seen with the administration of t-PA does not appear to act solely via activation of the MCP-1 pathway.
PP23 Evaluation of pre-hospital use of a valsalva assist device (VAD) in the Emergency treatment of supraventricular tachycardia (SVT). A randomised controlled feasibility trial [EVADE]
Authors: Green Jonathan , Ewings Paul , Appelboam Andy 
Published: September 2019

BackgroundSupraventricular tachycardia (SVT) is a common heart rhythm disorder. The Valsalva Manoeuvre (VM) is a safe, internationally recommended, initial treatment, but has a low success rate in normal practice. Recent studies have shown much better cardioversion rates, approaching 50%, can be achieved using a postural modification (the modified VM) and a manometer controlled 40 mmHg strain. Successful cardioversion could avoid hospital conveyance and unpleasant treatments, such as adenosine. Routine use of a manometer is not practical out of hospital. Blowing on an empty syringe has been suggested as an alternative but is unreliable in providing correct and consistent pressures. A Valsalva Assist Device (VAD), designed to provide a 40 mmHg strain resistance has been developed. It is small, portable, can be packaged with instructions for the modified VM and if successful, may be left with the patient.MethodsWe conducted a pragmatic, randomised controlled feasibility trial, comparing VAD versus standard practice delivered VMs. All other aspects of care were according to SWASFT guidelines. Participants were followed up to ask their views on trial procedures.Interim results (month 5 of 6)23 volunteer Station Leads recruited 22 Study Clinicians from 27 ambulance stations. 29 patients were enrolled over 5 months, 19 in the last 2 months (the first 3 months included steady recruitment and setup). The later enrolment rate extrapolates to a presentation rate of approximately 220 eligible patients to SWASFT each year. Complete data sets were available in 100% of participants. When followed up, participants reported verbal consent to be widely acceptable, although SVT symptoms were substantially distracting for many during this process.ConclusionOur experience of recruitment and data collection suggest a definitive trial, using similar methodology, is possible, but the low occurrence rate may challenge feasibility. Consent taking methods may require refinement for a larger trial.
PP24 Lay understanding of head injury and when an ambulance might be needed: a mixed methods study
Authors: Halter Mary , Kulnik Stefan Tino , Hilton Ann , Baron Aidan , Garner Stuart , Jarman Heather 
Published: September 2019

BackgroundHead injury results in a high use of emergency services, although most people with head injuries do not require hospitalisation. Conversely, some evidence suggests that lay recognition of the seriousness of head injury can be problematic, for example in sports settings.AimTo investigate how members of the public - parents of young children, school staff, sports coaches, informal carers of older adults, young adults and other adults - understood head injury terminology and when an emergency ambulance/999 call was required for head injury, against UK public guidance.MethodsA mixed methods exploratory study, comprising of electronic and paper self-completion surveys across the UK and focus groups or interviews. Survey data were analysed statistically against the outcomes of understanding of terms and selection of the correct action by symptom. Focus group/interview data were analysed thematically.ResultsWe received 520 survey responses, with respondents from across gender, age group, ethnicity and first aid experience. Out of 19 given signs and symptoms of head injury, participants could differentiate the most serious (e.g. unconsciousness 92% call 999) from those that could be observed (e.g. nausea 5%, and altered behaviour 5–30% call 999). The proportion of ‘correct’ actions ranged from just below half to almost 100%. Those aged 18–24 had a lower percentage of correct answers. Focus groups and/or interviews were held with 44 participants. Hypothetical scenarios elicited a range of responses, from calling 999 in any instance, to not calling in serious situations. Participants described ‘life experience’ as influential in the decision whether to call 999 or feel confident to observe.ConclusionDistinguishing severity of head injury was reported as difficult and confidence about the best course of action was low. The study was limited by regional recruitment biases, but supports the need for public health guidance in head injury.
PP26 Incidence of acute respiratory failure cases in west midlands ambulance service (WMAS) – sub-study of ACUTE (ambulance CPAP: use, treatment effect and economics) trial
Authors: Gunson Imogen M , Herbert Esther , Fuller Gordon 
Published: September 2019

BackgroundAcute respiratory failure (ARF) is a life-threatening emergency and pre-hospital CPAP may improve outcomes. A CPAP cost-effectiveness determinant is the incidence of eligible patients with ARF. This sub-study of the ACUTE trial aimed to determine the number of adults with ARF potentially suitable for CPAP, presenting to WMAS.MethodsThis observational study was conducted between 1stAugust 2017 and 31stJuly 2018. Adult patients presenting with SpO2 <94% were identified from WMAS electronic patient records. Electronic filters applied ACUTE trial inclusion and exclusion criteria, with subsequent manual clinical review by a research paramedic. A second research paramedic checked a sub-sample for inter-rater agreement. Overall and monthly incidence rates were calculated, census data provided the population denominator.Results108,391 potential patients were identified from electronic patient records (EPR), after filter application 4,526 cases were eligible for review (Figure 1). After review, 1017 cases were considered CPAP candidates. Inter-rater agreement was 86%. Overall incidence was 17.35 per 100,000 population per year (95%CI 16.3–18.5). Marked seasonal variation was present, increasing over winter (Figure 2). Urban areas had the highest proportion of eligible patients (67.6% v 18.3% Rural v 14.2% semi-rural); and 53.0% of all eligible were male.ConclusionsThe incidence of eligible ARF patients impacts on the cost-effectiveness of pre-hospital CPAP, but previous reports have been variable, using sub-optimal methods or from non-UK settings. We report a valid NHS estimate of 17 patients per 100,000 who do not respond to current pre-hospital ARF management and could be candidates for CPAP.
PP29 ‘Breaking down Barriers: experiences from the first year of an ED to EMS feedback ‘Postbox
Authors: Sommers Nicola , Evans Lauren , Collingwood Terry , Dykes Linda 
Published: September 2019

Background‘Closing the feedback loop’ is an important part of clinical reflective practice, but case feedback can be difficult for EMS staff to access. Our ‘Paramedic Postbox’ opened in July 2017, enabling paramedics to request case feedback directly from Emergency Department doctors.AimsTo review utilisation of our PostboxTo assess user satisfaction and user–reported educational benefits of the feedbackMethodThe first 12 months of feedback requests were analysed.User satisfaction data was obtained by inviting participation in an online survey (consent was obtained at the time of the feedback requests(s)).ResultsThere were 148 feedback requests from 60 individuals in the first year. 76% used the Postbox more than once, with 15% using it more than five times. 33/60 Postbox users responded to the user survey, of which 32 had received their requested feedback and completed the questionnaire. All respondents were satisfied with the service (75% excellent, 25% good), would use it again, and recommend it to colleagues. User-reported goals when requesting feedback were to check their pre-hospital diagnosis (67%) or treatment given (39%), ascertain patient outcome (64%), as a specific question (15%) and all of these in 36%.Two-thirds of users agreed the Postbox had allowed them to reflect on a case or clarify something they were unsure about, and half said they’d learned something new. 42% agreed their ‘practice had changed’ as a result. Free-text comments confirmed the Postbox is encouraging learning and changing behaviour.DiscussionThis feedback system is now well established in our ED and has been adopted by multiple other UK Emergency Departments. We are encouraged by the positive reception our Postbox has received, and especially the high rate of repeat use. In time, we hope to identify topics where paramedics feel under-confident, and explore the characteristics of the 15% ‘super-reflectors’.