bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanisms by Which Ranolazine Terminates Paroxysmal but Not Persistent Atrial Fibrillation
Authors: Ramirez Rafael J. , Takemoto Yoshio , Martins Raphaël P. , Filgueiras-Rama David , Ennis Steven R. , Mironov Sergey , Bhushal Sandesh , Deo Makarand , Rajamani Sridharan , Berenfeld Omer , Belardinelli Luiz , Jalife José , Pandit Sandeep V. 
Published: October 2019

Background:

Ranolazine inhibits Na
+
current (I
Na
), but whether it can convert atrial fibrillation (AF) to sinus rhythm remains unclear. We investigated antiarrhythmic mechanisms of ranolazine in sheep models of paroxysmal (PxAF) and persistent AF (PsAF).

Methods:
PxAF was maintained during acute stretch (N=8), and PsAF was induced by long-term atrial tachypacing (N=9). Isolated, Langendorff-perfused sheep hearts were optically mapped.

Results:

In PxAF ranolazine (10 μmol/L) reduced dominant frequency from 8.3±0.4 to 6.2±0.5 Hz (
P
<0.01) before converting to sinus rhythm, decreased singularity point density from 0.070±0.007 to 0.039±0.005 cm
−2
s
−
1
(
P
<0.001) in left atrial epicardium (LA
epi
), and prolonged AF cycle length (AFCL); rotor duration, tip trajectory, and variance of AFCL were unaltered. In PsAF, ranolazine reduced dominant frequency (8.3±0.5 to 6.5±0.4 Hz;
P
<0.01), prolonged AFCL, increased the variance of AFCL, had no effect on singularity point density (0.048±0.011 to 0.042±0.016 cm
−
2
s
−
1
;
P
=ns) and failed to convert AF to sinus rhythm. Doubling the ranolazine concentration (20 μmol/L) or supplementing with dofetilide (1 μmol/L) failed to convert PsAF to sinus rhythm. In computer simulations of rotors, reducing I
Na
decreased dominant frequency, increased tip meandering and produced vortex shedding on wave interaction with unexcitable regions.

Conclusions:
PxAF and PsAF respond differently to ranolazine. Cardioversion in the former can be attributed partly to decreased dominant frequency and singularity point density, and prolongation of AFCL. In the latter, increased dispersion of AFCL and likely vortex shedding contributes to rotor formation, compensating for any rotor loss, and may underlie the inefficacy of ranolazine to terminate PsAF.
Race, Natriuretic Peptides, and High-Carbohydrate Challenge
Authors: Patel Nirav , Russell Griffin K. , Musunuru Kiran , Gutierrez Orlando M. , Halade Ganesh , Kain Vasundhara , Lv Wenjian , Prabhu Sumanth D. , Margulies Kenneth B. , Cappola Thomas P. , Arora Garima , Wang Thomas J. , Arora Pankaj 
Published: October 2019

Rationale:

Lower NP (natriuretic peptide) levels may contribute to the development of cardiometabolic diseases. Blacks have lower NP levels than middle-aged and older white adults. A high-carbohydrate challenge causes an upregulation of a negative ANP regulator microRNA-425 (
miR-425
), which reduces ANP (atrial-NP) levels in whites.

Objectives:
We designed a prospective trial to study racial differences in (1) NP levels among young adults, (2) NP response to a high-carbohydrate challenge, and (3) explore underlying mechanisms for race-based differences.

Methods and Results:

Healthy self-identified blacks and whites received 3 days of study diet followed by a high-carbohydrate challenge. Gene expression from whole blood RNA was assessed in the trial participants. Additionally, atrial and ventricular tissue samples from the Myocardial Applied Genomics Network repository were examined for NP system gene expression. Among 72 healthy participants, we found that B-type-NP, NT-proBNP (N-terminal-pro-B-type NP), and MRproANP (midregional-pro-ANP) levels were 30%, 47%, and 18% lower in blacks compared with whites (
P
≤0.01), respectively. The decrease in MRproANP levels in response to a high-carbohydrate challenge differed by race (blacks 23% [95% CI, 19%–27%] versus whites 34% [95% CI, 31%–38]; P
interaction
<0.001), with no change in NT-proBNP levels. We did not observe any racial differences in expression of genes encoding for NPs (
NPPA/NPPB
) or NP signaling (
NPR1
) in atrial and ventricular tissues. NP processing (
corin
), clearance (
NPR3
), and regulation (
miR-425
) genes were ≈3.5-, ≈2.5-, and ≈2-fold higher in blacks than whites in atrial tissues, respectively. We also found a 2-and 8-fold higher whole blood RNA expression of gene encoding for Neprilysin (
MME
) and
miR-425
among blacks than whites.

Conclusions:
Racial differences in NP levels are evident in young, healthy adults suggesting a state of NP deficiency exists in blacks. Impaired NP processing and clearance may contribute to race-based NP differences. Higher miR-425 levels in blacks motivate additional studies to understand differences in NP downregulation after physiological perturbations.

Clinical Trial Registration:

URL:
https://clinicaltrials.gov/ct2/show/NCT03072602
. Unique identifier: NCT03072602.
Renal Dysfunction and In‐Hospital Outcomes in Patients With Acute Ischemic Stroke After Intravenous Thrombolytic Therapy
Authors: Rao Zhen‐Zhen , Gu Hong‐Qiu , Wang Xian‐Wei , Xie Xue‐Wei , Yang Xin , Wang Chun‐Juan , Zhao Xingquan , Xian Ying , Wang Yi‐Long , Li Zi‐Xiao , Xiao Rui‐Ping , Wang Yong‐Jun ,   the Chinese Stroke Center Alliance investigators
Published: October 2019

Background

The impact of estimated glomerular filtration rate (
eGFR
) on clinical short‐term outcomes after stroke thrombolysis with tissue plasminogen activator remains controversial.

Methods and Results

We analyzed 18 320 ischemic stroke patients who received intravenous tissue plasminogen activator at participating hospitals in the Chinese Stroke Center Alliance between June 2015 and November 2017. Multivariate logistic regression models were used to evaluate associations between
eGFR
(<45, 45–59, 60–89, and ≥90 mL/min per 1.73 m
2
) and in‐hospital mortality and symptomatic intracerebral hemorrhage, adjusting for patient and hospital characteristics and the hospital clustering effect. Of the 18 320 patients receiving tissue plasminogen activator, 601 (3.3%) had an
eGFR
<45, 625 (3.4%) had an
eGFR
45 to 59, 3679 (20.1%) had an
eGFR
60 to 89, and 13 415 (73.2%) had an
eGFR
≥90. As compared with
eGFR
≥90,
eGFR
values <45 (6.7% versus 0.9%, adjusted odds ratio, 3.59; 95%
CI
, 2.18–5.91), 45 to 59 (4.0% versus 0.9%, adjusted odds ratio, 2.00; 95%
CI
, 1.18–3.38), and 60 to 89 (2.5% versus 0.9%, adjusted odds ratio, 1.67; 95%
CI
, 1.20–2.34) were independently associated with increased odds of in‐hospital mortality. However, there was no statistically significant association between
eGFR
and symptomatic intracerebral hemorrhage.

Conclusions

eGFR
was associated with an increased risk of in‐hospital mortality in acute ischemic stroke patients after treatment with tissue plasminogen activator.
eGFR
is an important predictor of poststroke short‐term death but not of symptomatic intracerebral hemorrhage.
Contrast-Associated Acute Kidney Injury in Endovascular Thrombectomy Patients With and Without Baseline Renal Impairment
Authors: Diprose William K. , Sutherland Luke J. , Wang Michael T.M. , Barber P. Alan 
Published: October 2019

Background and Purpose—
In ischemic stroke, baseline renal impairment is present in 20 to 35% of patients and may increase the risk of contrast-associated acute kidney injury (CA-AKI). We aimed to determine whether endovascular thrombectomy (EVT) patients with baseline renal impairment are at increased risk of CA-AKI.

Methods—
Consecutive EVT patients were identified from a prospective database. Patients were stratified by estimated glomerular filtration rate. The primary outcome was CA-AKI assessed at 24 to 72 hours following EVT, defined as an increase in serum creatinine of ≥26.5 µmol/L or 1.5× baseline serum creatinine. Secondary outcomes included requirement for renal replacement therapy and 3-month mortality.

Results—

Three hundred thirty-three EVT patients (201 men; mean±SD age 63.9±15.8 years) were included. The mean±SD iohexol contrast volume used in diagnostic and EVT imaging was 236±77 mL per patient. CA-AKI occurred in 11 (3.3%) patients; none required renal replacement therapy, but 4 of 11 (36.4%) had died by 3 months. Propensity score–adjusted logistic regression showed that estimated glomerular filtration rate <30 mL/(min·1.73 m
2
) was a significant predictor of CA-AKI (odds ratio, 19.93; 95% CI, 2.33–170.74;
P
=0.006). The dose of contrast was not associated with an increased risk of CA-AKI (
P
>0.05). Multiple logistic regression adjusted for potential confounders demonstrated that CA-AKI was independently associated with increased mortality (odds ratio, 4.68; 95% CI, 1.05–20.97;
P
=0.04).

Conclusions—
There is utility in obtaining baseline creatinine levels to identify patients at risk of CA-AKI and to establish a diagnosis of CA-AKI in patients with subsequent creatinine rises. However, contrast-requiring diagnostic imaging and EVT should not be delayed by waiting for the results of baseline renal function.
Blood Pressure after Endovascular Therapy for Ischemic Stroke (BEST)
Authors: Mistry Eva A. , Sucharew Heidi , Mistry Akshitkumar M. , Mehta Tapan , Arora Niraj , Starosciak Amy K. , De Los Rios La Rosa Felipe , Siegler James Ernest , Barnhill Natasha R. , Patel Kishan , Assad Salman , Tarboosh Amjad , Dakay Katarina , Salwi Sanjana , Cruz Aurora S. , Wagner Jeffrey , Fortuny Enzo , Bennett Alicia , James Robert F. , Jagadeesan Bharathi , Streib Christopher , O’Phelan Kristine , Kasner Scott E. , Weber Stewart A. , Chitale Rohan , Volpi John J. , Mayer Stephan , Yaghi Shadi , Jayaraman Mahesh V. , Khatri Pooja 
Published: October 2019

Background and Purpose—
To identify the specific post-endovascular stroke therapy (EVT) peak systolic blood pressure (SBP) threshold that best discriminates good from bad functional outcomes (a priori hypothesized to be 160 mm Hg), we conducted a prospective, multicenter, cohort study with a prespecified analysis plan.

Methods—
Consecutive adult patients treated with EVT for an anterior ischemic stroke were enrolled from November 2017 to July 2018 at 12 comprehensive stroke centers accross the United States. All SBP values within 24 hours post-EVT were recorded. Using Youden index, the threshold of peak SBP that best discriminated primary outcome of dichotomized 90-day modified Rankin Scale score (0–2 versus 3–6) was identified. Association of this SBP threshold with the outcomes was quantified using multiple logistic regression.

Results—

Among 485 enrolled patients (median age, 69 [interquartile range, 57–79] years; 51% females), a peak SBP of 158 mm Hg was associated with the largest difference in the dichotomous modified Rankin Scale score (absolute risk reduction of 19%). Having a peak SBP >158 mm Hg resulted in an increased likelihood of modified Rankin Scale score 3 to 6 (odds ratio, 2.24 [1.52–3.29],
P
<0.01; adjusted odds ratio, 1.29 [0.81–2.06],
P
=0.28, after adjustment for prespecified variables).

Conclusions—
A peak post-EVT SBP of 158 mm Hg was prospectively identified to best discriminate good from bad functional outcome. Those with a peak SBP >158 had an increased likelihood of having a bad outcome in unadjusted, but not in adjusted analysis. The observed effect size was similar to prior studies. This finding should undergo further testing in a future randomized trial of goal-targeted post-EVT antihypertensive treatment.
Syntactic and Semantic Specialization and Integration in 5- to 6-Year-Old Children during Auditory Sentence Processing
Authors: Wang Jin , Rice Mabel L. , Booth James R. 
Published: October 2019

Abstract
Previous studies have found specialized syntactic and semantic processes in the adult brain during language comprehension. Young children have sophisticated semantic and syntactic aspects of language, yet many previous fMRI studies failed to detect this specialization, possibly due to experimental design and analytical methods. In this current study, 5- to 6-year-old children completed a syntactic task and a semantic task to dissociate these two processes. Multivoxel pattern analysis was used to examine the correlation of patterns within a task (between runs) or across tasks. We found that the left middle temporal gyrus showed more similar patterns within the semantic task compared with across tasks, whereas there was no difference in the correlation within the syntactic task compared with across tasks, suggesting its specialization in semantic processing. Moreover, the left superior temporal gyrus showed more similar patterns within both the semantic task and the syntactic task as compared with across tasks, suggesting its role in integration of semantic and syntactic information. In contrast to the temporal lobe, we did not find specialization or integration effects in either the opercular or triangular part of the inferior frontal gyrus. Overall, our study showed that 5- to 6-year-old children have already developed specialization and integration in the temporal lobe, but not in the frontal lobe, consistent with developmental neurocognitive models of language comprehension in typically developing young children.
Integration of nematology as a training and research discipline in sub-Saharan Africa: progress and prospects
Authors: Cortada Laura , Dehennin Inge , Bert Wim , Coyne Danny 
Published: October 2019

Summary
Within sub-Saharan Africa (SSA), although nematodes are viewed among the most important threats to crop production and food security, the presence of trained nematologists working within this discipline has traditionally been viewed as scarce. The few research studies concerning this subject address this topic from a country or sub-regional perspective and generally portray nematology as ‘insufficient’. Over the past two decades, a few initiatives have been instrumental in building greater nematology expertise. For the first time a structured survey was undertaken, involving interviews with individuals from SSA that were (or currently are) involved in nematology training programmes, research, national extension services or in African universities. This paper provides evidence of the positive impact of various initiatives and shows an increase in the number of available nematology positions, together with high rates of graduates that return home to occupy qualified positions. Our findings will help researchers, policy makers and donors to identify areas requiring support to increase the promotion of nematology in SSA and to make an impact for end-users.
A Multitude of Actors in Early Modern Diplomacy
Authors: Tremml-Werner Birgit , Goetze Dorothée 
Published: October 2019

Abstract
This special issue has been motivated by the drive to contextualize the role of individuals of various backgrounds in early modern foreign relations. All contributions cover a broad geographic scope and stress the impact of non-European practices and stages for the study of early modern foreign relations. Four thematic articles follow diverse diplomatic actors, ranging from non-elite envoys to chartered companies, Catholic friars and ministers on ships, to foreign courts, and behind their desks. They provide insights into these individual actors’ functions and achievements and raise questions about social belonging and knowledge channels. The introduction below portrays the development of an actor-oriented research angle in the field of New Diplomatic History over the past decades and addresses blurring concepts and over-generalizations. It attempts to redefine the heterogeneous group of early modern diplomatic actors as products of their involvement in political and material struggles, both at home and abroad.
Physical Exercise Intensity During Submersion Selectively Affects Executive Functions
Authors: Möller Fabian , Hoffmann Uwe , Dalecki Marc , Dräger Tobias , Doppelmayr Michael , Steinberg Fabian 
Published: October 2019

Objective The intact cognitive processing capacity in highly demanding and dynamically changing situations (e.g., in extreme environmental conditions) is of central relevance for personal safety. This study therefore investigated whether underwater physical exercise (PE) affected cognitive performance by comparing these effects during underwater fin-swimming as opposed to inactivity under normal environmental conditions. Background Although acute bouts of PE can modulate cognitive performance under highly controlled and standardized laboratory conditions, no previous study has determined whether PE acutely modulates cognitive performance in non-laboratory testing conditions involving extreme environments (e.g., underwater). Method A total of 27 healthy volunteers (16 males and 11 females; 28.9 ± 7.4 years of age) participated in two experiments involving either moderate or high PE intensity. A PRE/POST crossover design was employed among participants while performing cognitive tests in a counterbalanced order (i.e., before and after 20 min of PE in submersion [WET] and once before and after inactivity [DRY] while in the laboratory). Cognitive performance was measured as a combination of executive functions through the Eriksen Flanker (inhibition) and Two-Back (working memory) Tasks using an underwater tablet computer. Results ANOVAs revealed enhanced reaction times only in the Flanker test after moderate PE for the WET condition. No other effects were detected. Conclusion These findings indicate that cognitive performance is exercise-intensity-dependent with enhanced effects during moderate PE, even in extreme environments (i.e., underwater). Application These results should be relevant in recreational and occupational contexts involving underwater activity and may also apply to microgravity (e.g., during extra-vehicular activities). Description This study compared the acute effects of physical exercise (PE) on cognitive performance in an underwater environment while participants fin-swam with SCUBA (self-contained underwater breathing apparatus) gear. Findings revealed that 20 min of moderate PE positively affected cognitive performance (i.e., inhibitory control ability). However, no changes were observed after high-intensity exercise.
La religion dans une société pluraliste Jalons pour une observation du phénomène
Authors: Remy J. 
Published: October 2019

To what extent the coexistence of a plurality of legitimations in a society could, in certain cases, be a factor contributing to the wellbeing of the society, rather than its desintegration is the question posed by this analysis. To do this, two models of society are set up as ideal types opposed to one another. All the elements of the cultural system in the slightly differentiated society, the system of legitimation, the system of values and the system of norms are closely related and are based on one another. By way of contrast, in a highly differentiated society, particularly if there is one accepted set of values, the system of legitimation and the system of norms may be relatively autonomous. This being so, christians sharing a common system of legitimation could find themselves on other levels of the cultural system, closer to non-christians than to other christians. This presupposes on the part of individuals an interiorisation of certain attitudes, particularly vis-à-vis people different from themselves, with whom nevertheless they are collaborating to a limited extent.
Prevalence and factors associated with major depressive disorder among adolescents attending a primary care facility in Kampala, Uganda
Authors: Kyohangirwe Leticia , Okello Elialilia , Namuli Justine D , Ndeezi Grace , Kinyanda Eugene 
Published: October 2019

Information on major depressive disorder (MDD) in primary care settings in sub-Saharan Africa is limited, yet this is required to improve service development. We explored prevalence and factors associated with MDD among adolescents attending a primary care facility in urban Uganda. At Naguru Teenage Information and Health Centre, 281 adolescents were assessed for MDD using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-Kid). Prevalence and risk factors were determined using frequencies and regressions, respectively. The prevalence of adolescent MDD was 18.2 %. Vulnerability factors were orphanhood, childhood trauma (particularly emotional abuse and physical neglect) while social support was protective. Considerable burden of clinically significant depression exists in primary care settings in Uganda; this may well contribute to a poor quality of life.
Postoperative adjuvant transarterial chemoembolization improves the prognosis of hepatocellular carcinoma patients with microvascular invasion: a systematic review and meta-analysis
Authors: Li Lian , Li Bo , Zhang Ming 
Published: October 2019

Background Microvascular invasion has been widely accepted as a major risk factor of hepatocellular carcinoma prognoses after surgery. It is still controversial whether postoperative adjuvant transarterial chemoembolization could improve the survival of hepatocellular carcinoma patients with microvascular invasion. Purpose To evaluate the effect of postoperative adjuvant transarterial chemoembolization for postoperative hepatocellular carcinoma patients with microvascular invasion. Material and Methods PubMed, Web of Science, and Embase databases were searched for eligible studies, and the one-, three-, and five-year recurrence rates and overall survival rates were extracted for meta-analysis. Results A total of eight studies were included in this study. The results showed that the one-, three-, and five-year recurrence rate of the postoperative adjuvant transarterial chemoembolization group were better than those of the hepatectomy alone group, with a pooled risk ratio (RR) of 0.66 (95% confidence interval [CI] 0.58–0.75, P < 0.00001), 0.82 (95% CI 0.76–0.88, P < 0.00001), and 0.89 (95% CI 0.82–0.97, P = 0.007), respectively. The overall survival rates with one-, three-, and five-year pooled RR were 0.34 (95% CI 0.25–0.47, P < 0.00001), 0.69 (95% CI 0.60–0.79, P < 0.00001), and 0.78 (95% CI 0.69–0.89, P = 0.0001), respectively. No serious side effects have been reported, indicating that postoperative intervention is safe. Conclusion For hepatocellular carcinoma patients with microvascular invasion confirmed by postoperative pathology, postoperative adjuvant transarterial chemoembolization is a safe treatment, which could reduce the tumor recurrence rate and improve the patient’s overall survival.
A multicentre survey of pain management in cancer patients and physicians attending radiotherapy clinics in Shandong Province, China
Authors: Tan Bingxu , Li Baosheng , An Yongheng , Ma Xuezhen , Jiang Yuhua , Song Yipeng , Ge Xingping , Yuan Shengli , Liu Liping , Dou Yan , Yu Yanxia , Ji Pu , Li Xia , Cheng Yufeng 
Published: October 2019

Objective To obtain a better understanding of the prevalence and management of pain in patients undergoing radiotherapy for cancer in Shandong Province, China. Methods This cross-sectional study used a questionnaire during face-to-face interviews to collect data from physicians and patients regarding the recognition, prevalence and treatment of pain during the waiting period before commencement of radiotherapy and during the radiotherapy period. Physicians and patients were recruited from 10 tertiary Class A hospitals across Shandong Province, China. Results A total of 184 patients and 87 physicians were recruited to the study. During the waiting period, pain was reported by the physicians according to their experience to affect 26.0% of patients, which almost agreed with the patients’ data (36.5%; 160 of 438). During the radiotherapy period, there was a significant difference in the reported prevalence of pain during the radiotherapy period between the physicians’ data (23.0%) based on their experience and the patients’ data (84.1%; 169 of 201 patients). The majority of physicians (98.9%; 86 of 87) agreed to the use opioids for pain management and 90.8% (79 of 87) were satisfied with the analgesic effect, but more than half of the patients who received pain treatment reported inadequate analgesia. Conclusion There was a high incidence of cancer pain, but insufficient assessment, inadequate treatment and inadequate education about pain in both the waiting and radiotherapy periods.