bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etomidate Modulates the Tactile Stimulation-Evoked Field Potential Responses in Cerebellar Granule Cell Layer in vivo in Mice
Authors: Pan Wen , Cui Li-Na , Chu Chun-Ping , Jin Wen-Zhe , Qiu De-Lai 
Published: September 2019

Etomidate (ET) produces sedation by binding on the γ-aminobutyric acid type A (GABA<sub>A</sub>) receptors. We previously found that ET inhibited cerebellar Purkinje cells activity via both GABA<sub>A</sub> and glycine receptors in vivo in mice, suggesting that ET modulated sensory information synaptic transmission in cerebellar cortex. In this study, we investigated the effect of ET on the sensory stimulation-evoked responses in the cerebellar granule layer (GL) in urethane-anesthetized mice, using electrophysiological and pharmacological methods. Our results showed that cerebellar surface perfusion of ET (100 μmol/L) significantly decreased amplitude and area under the curve (AUC) of the sensory stimulation-evoked excitatory component (N1) in the cerebellar GL. Application of GABA<sub>A</sub> receptor antagonist, SR95531 (20 μmol/L) significantly attenuated, but not abolished the ET-induced decrease in amplitude and AUC of facial stimulation-evoked responses. However, application of a mixture of SR95531 (20 μmol/L) and cannabinoid 1 receptor (CB1) antagonist, AM-251 (5 μmol/L), completely blocked the ET-induced decrease in amplitude and AUC of facial stimulation-evoked responses. Furthermore, application of the CB1 receptor agonist, WIN55212-2, induced a decrease in amplitude and AUC of N1 in the absence of GABA<sub>A</sub> receptors activity, as well occluded the ET-induced depression of N1. Moreover, the ET-induced changes in amplitude and AUC of N1 in absence of GABA<sub>A</sub> receptors activity were abolished by a specific protein kinase A (PKA) inhibitor, KT5720. These results indicate that ET facilitates CB1 receptors in the absence of GABA<sub>A</sub> receptors activity, resulting in a depression of the sensory stimulation-evoked synaptic transmission via PKA signaling pathway in mouse cerebellar GL.
Mapping and Ablation of Ventricular Fibrillation Associated With Early Repolarization Syndrome
Authors: Nademanee Koonlawee , Haissaguerre Michel , Hocini Mélèze , Nogami Akihiko , Cheniti Ghassen , Duchateau Josselin , Behr Elijah R. , Saba Magdi , Bokan Ryan , Lou Qing , Amnueypol Montawatt , Coronel Ruben , Khongphatthanayothin Apichai , Veerakul Gumpanart 
Published: September 2019

Background:
We conducted a multicenter study to evaluate mapping and ablation of ventricular fibrillation (VF) substrates or VF triggers in early repolarization syndromes (ERS) or J-wave syndrome (JWS).

Methods:
We studied 52 patients with ERS (4 women; median age, 35 years) with recurrent VF episodes. Body surface electrocardiographic imaging and endocardial and epicardial electroanatomical mapping of both ventricles were performed during sinus rhythm and VF for localization of triggers, substrates, and drivers. Ablations were performed on VF substrates, defined as areas that had late depolarization abnormalities characterized by low-voltage fractionated late potentials, and VF triggers.

Results:

Fifty-one of the 52 patients had detailed mapping that revealed 2 phenotypes: group 1 had late depolarization abnormalities predominantly at the right ventricular (RV) epicardium (n=40), and group 2 had no depolarization abnormalities (n=11). Group 1 can be subcategorized into 2 groups: Group 1A included 33 patients with ERS with Brugada electrocardiographic pattern, and group 1B included 7 patients with ERS without Brugada electrocardiographic pattern. Late depolarization areas colocalize with VF driver areas. The anterior RV outflow tract/RV epicardium and the RV inferior epicardium are the major substrate sites for group 1. The Purkinje network is the leading underlying VF trigger in group 2 that had no substrates. Ablations were performed in 43 patients: 31 and 5 group 1 patients had only VF substrate ablation and VF substrates plus VF trigger, respectively (mean, 1.4±0.6 sessions); 6 group 2 patients and 1 patient without group classification had only Purkinje VF trigger ablation (mean, 1.2±0.4 sessions). Ablations were successful in reducing VF recurrences (
P
<0.0001). After follow-up of 31±26 months, 39 (91%) had no VF recurrences.

Conclusions:
There are 2 phenotypes of ERS/J-wave syndrome: one with late depolarization abnormality as the underlying mechanism of high-amplitude J-wave elevation that predominantly resides in the RV outflow tract and RV inferolateral epicardium, serving as an excellent target for ablation, and the other with pure ERS devoid of VF substrates but with VF triggers that are associated with Purkinje sites. Ablation is effective in treating symptomatic patients with ERS/J-wave syndrome with frequent VF episodes.
Effect of Once-Weekly Exenatide in Patients With Type 2 Diabetes Mellitus With and Without Heart Failure and Heart Failure–Related Outcomes
Authors: Fudim Marat , White Jennifer , Pagidipati Neha J. , Lokhnygina Yuliya , Wainstein Julio , Murin Jan , Iqbal Nayyar , Öhman Peter , Lopes Renato D. , Reicher Barry , Holman Rury R. , Hernandez Adrian F. , Mentz Robert J. 
Published: September 2019

Background:
Once-weekly exenatide (EQW) had a neutral effect on hospitalization for heart failure (HHF) in the EXSCEL study (Exenatide Study of Cardiovascular Event Lowering), with no differential treatment effect on major adverse cardiac events by baseline heart failure (HF) status. EQW’s effects on secondary end points based on HHF status have not been reported. The objective was to explore the effects of EQW on secondary end points in patients with and without baseline HF and test the effects of EQW on recurrent HHF events.

Methods:
The prespecified analysis of the randomized controlled EXSCEL trial, which enrolled patients with type 2 diabetes mellitus with and without additional cardiovascular disease, analyzed EQW effects on all-cause death, each major adverse cardiac event component, first HHF, and repeat HHF, by baseline HF status (regardless of ejection fraction). A subgroup analysis of the population stratified by preserved or reduced baseline ejection fraction was performed.

Results:

Of 14 752 EXSCEL participants, 2389 (16.2%) had HF at baseline. Compared with those without HF at baseline, patients with preexisting HF were older, and more likely to be male and white, with a higher burden of other cardiovascular diseases. Overall, those assigned to EQW had a lower incidence of all-cause death (hazard ratio [HR], 0.86 [95% CI, 0.77–0.97]) and the composite outcome of all-cause death or HHF (HR, 0.89 [95% CI, 0.80–0.99]). When stratified by presence or absence of baseline HF, there was no observed reduction in all-cause death with EQW with baseline HF (HR, 1.05 [95% CI, 0.85–1.29]), while the risk of mortality was reduced with EQW in the no-HF group (HR, 0.79 [95% CI, 0.68–0.92]) with an interaction
P
value of 0.031. The reduction in all-cause death or HHF seen with EQW in patients without baseline HF (HR, 0.81 [95% CI, 0.71–0.93]) was not seen in patients with baseline HF (HR, 1.07 [95% CI, 0.89–1.29]; interaction
P
=0.015). First, plus recurrent, HHF was reduced in the exenatide group versus placebo (HR, 0.82 [95% CI, 0.68–0.99];
P
=0.038).

Conclusions:
In EXSCEL, the use of EQW in patients with or without HF was well tolerated, but benefits of EQW on reduction in all-cause death and first hospitalization for HF were attenuated in patients with baseline HF.

Clinical Trial Registration:

https://www.clinicaltrials.gov
. Unique identifier: NCT01144338.
New Insights on Subseasonal Arctic–Midlatitude Causal Connections from a Regularized Regression Model
Authors: McGraw Marie C. , Barnes Elizabeth A. 
Published: September 2019

ABSTRACTArctic–midlatitude teleconnections are complex and multifaceted. By design, targeted modeling studies typically focus only on one direction of influence—usually, the midlatitude atmospheric response to a changing Arctic. The two-way, coupled feedbacks between the Arctic and the midlatitude circulation on submonthly time scales are explored using a regularized regression model formulated around Granger causality. The regularized regression model indicates that there are regions in which Arctic temperature drives a midlatitude circulation response, and regions in which the midlatitude circulation drives a response in the Arctic; however, these regions rarely overlap. In many regions, on submonthly time scales, the midlatitude circulation drives Arctic temperature variability, highlighting the important role the midlatitude circulation can play in impacting the Arctic. In particular, the regularized regression model results support recent work that indicates that the observed high pressure anomalies over Eurasia drive a significant response in the Arctic on submonthly time scales, rather than being driven by the Arctic.
Death by Neurological Criteria: Caring for Families amid Tragedy
Authors: Stahl Devan , Tomlinson Tom 
Published: September 2019

When a patient is declared dead using neurological criteria, intense emotional and ethical challenges can follow. In our experience as clinical ethicists, consults surrounding the declaration of “brain death” can be some of the most difficult. In what follows, we describe some best practices related to death by neurological criteria (DNC). We begin with important policies hospitals need to have in place to ensure that death is properly understood by all members of the clinical team and place some limits on the authority of families to demand continued “treatment” for deceased patients. Next, we explain how best to prepare families for the diagnosis. We then discuss how to talk to families when breaking the news concerning DNC. Finally, we describe how to approach a family that is resisting the determination of death. Summary: This article advises clinicians on how to talk to families about brain death.
Investigation of the pyrolysis characteristics and kinetics of oil-palm solid waste by using Coats–Redfern method
Authors: Surahmanto Fredy , Saptoadi Harwin , Sulistyo Hary , Rohmat Tri A 
Published: September 2019

The pyrolysis kinetics of oil-palm solid waste was investigated by performing experiments on its individual components, including empty fruit bunch, fibre, shell, as well as the blends by using a simultaneous thermogravimetric analyser at a heating rate of 10°C/min under nitrogen atmosphere and setting up from initial temperature of 30°C to a final temperature of 550°C. The results revealed that the activation energy and frequency factor values of empty fruit bunch, fibre, and shell are 7.58–63.25 kJ/mol and 8.045E-02–4.054E + 04 s−1, 10.45–50.76 kJ/mol and 3.639E-01–5.129E + 03 s−1, 9.46–55.64 kJ/mol and 2.753E-01–9.268E + 03, respectively. Whereas, the corresponding values for empty fruit bunch–fibre, empty fruit bunch–shell, fibre–shell, empty fruit bunch–fibre–shell are 2.97–38.35 kJ/mol and 1.123E-02–1.326E + 02 s−1, 7.95–40.12 kJ/mol and 9.26E-02–2.101E + 02 s−1, 9.14–50.17 kJ/mol and 1.249E-01–2.25E + 03 s−1, 8.35–45.69 kJ/mol and 1.344E + 01–4.23E + 05 s−1, respectively. It was found that the activation energy and frequency factor values of the blends were dominantly due to the role of the components with a synergistic effect occurred during pyrolysis.
Characterization of parotid gland tumors using T2 mapping imaging: initial findings
Authors: Wu Qian , Zhu Liu-Ning , Jiang Jia-Suo , Bu Shou-Shan , Xu Xiao-Quan , Wu Fei-Yun 
Published: September 2019

Background Preoperative accurate characterization of parotid gland tumors in different histologic types is crucial. T2 mapping has been proven to be useful for improving the accuracy of tumor characterization. Purpose To evaluate the ability of T2 mapping imaging in the characterization of parotid gland tumors. Material and Methods T2 mapping imaging was scanned in 74 patients (56 benign, 18 malignant) with pathologically confirmed parotid gland tumors. Mean T2 relaxation time was calculated and compared between benign and malignant group, and among malignant tumors, Warthin’s tumors, and pleomorphic adenomas. Independent-samples t test, one-way analysis of variance test, and receiver operating characteristic curve analyses were used for statistical analyses. Results The malignant group showed significantly lower T2 relaxation times than the benign group ( P = 0.001). Using a relaxation time of 91.5 ms as the cut-off value, optimal diagnostic performance could be achieved (area under the curve [AUC] 0.679, sensitivity 46.4%, specificity 94.4%). Pleomorphic adenomas showed significantly higher T2 relaxation times than malignant tumors ( P = 0.003) and Warthin’s tumors ( P = 0.001). However, no significant difference was found on the T2 relaxation times between Warthin’s tumors and malignant tumors ( P = 0.435). Optimal diagnostic performance could be achieved (AUC 0.783, sensitivity 58.1%, specificity 94.4%), when setting a T2 value of 92.0 ms as the threshold value for differentiating pleomorphic adenomas from malignant tumors. Meanwhile, optimal AUC, sensitivity, and specificity were 0.892, 87.1%, and 83.3%, respectively, when setting a T2 value of 80.5 ms as the threshold value for differentiating pleomorphic adenomas from Warthin’s tumors. Conclusion T2 mapping imaging could serve as an incremental imaging biomarker for characterizing parotid gland tumors.
Percutaneous nephrolithotomy versus flexible ureteroscopy in terms of cost-effectiveness in patients with 10–30 mm renal stones
Authors: Erdoğan Abdullah , Keskin Ercüment , Altun Abdulsemet 
Published: September 2019

Purpose: Kidney stones are one of the most common urological problems. When deciding on the method of treatment for this common disease, the cost of the procedure should also be taken into consideration. Materials and methods: We performed a retrospective analysis of 55 patients who underwent percutaneous nephrolithotomy and 75 patients who underwent retrograde intrarenal surgery between January 2016 and November 2018. Until operative success was achieved, all additional surgical procedures, extracorporeal shock wave lithotripsy procedures, and interventional procedures required to resolve complications were recorded. Total cost was compared between the percutaneous nephrolithotomy and retrograde intrarenal surgery groups. Results: No significant difference was found between the percutaneous nephrolithotomy and retrograde intrarenal surgery groups in terms of gender, mean age, stone side, stone localization and stone surface area. The total cost of 55 patients that underwent percutaneous nephrolithotomy was calculated as US$14.766 after the first operation, and the total cost of 75 patients that underwent retrograde intrarenal surgery was determined to be US$46.627. The mean cost per patient was calculated US$320 ± US$186 for percutaneous nephrolithotomy and US$749 ± US$242 for retrograde intrarenal surgery (p < 0.001). Conclusions: Percutaneous nephrolithotomy is a lower-cost and successful method in the surgical treatment of 1–3 cm stones, but the serious complications involved in this operation should be kept in mind.
‘Yet this comes in useful for building ships’: Shipbuilding and repairs in New Netherland
Authors: Heijink Martijn 
Published: September 2019

Contemporaries cited the great wood reserves of the colony of New Netherland on the Hudson River as an excellent resource for shipbuilding. However, this remained a small industry during the colony’s Dutch period between 1624 and 1664. Ship repairs in New Netherland took off on a small scale: vessels calling at the colony were repaired with limited means or entirely new vessels were constructed if a ship was found to be irreparable. Skilled workers who could construct small boats were at least present in New Netherland around 1630. There is evidence for structural shipbuilding in the 1630s. In this decade, the West India Company had a small shipyard on Manhattan and employed a shipwright who was mainly concerned with building small vessels for local and regional use, as well as repairs to Company ships calling at the colony. This pattern seems to have continued in later years. The scale of shipbuilding and repairs in New Netherland was much smaller than in New England. The latter colony had a geography comparable to the former and developed a significant export trade of newly built ships. New England developed this shipbuilding industry because it lacked other export goods, such as cash crops. New Netherland did not need to do this, because it could focus on its lucrative export of beaver skins. New Netherland also faced much heavier competition from shipyards in the Netherlands than New England did from British shipyards.
Vulnerability and Stressors for Burnout Within a Population of Hospital Nurses: A Qualitative Descriptive Study
Authors: Geuens Nina , Franck Erik , Verheyen Helena , De Schepper Sarah , Roes Leen , Vandevijvere Herman , Geurden Bart , Van Bogaert Peter 
Published: September 2019

Background The multitude of negative consequences of nurse burnout calls for interventions to protect the well-being of the individual nurses, patients, and hospital organizations. However, much is still to be discovered about the development of this complex psychological syndrome. Purpose This study aimed to describe the development of nurse burnout for a population of Flemish hospital nurses while considering vulnerability and situational stressors as indicated by the vulnerability-stress model. Methods Ten registered nurses were enlisted for semistructured interviews through purposive sampling. All selected nurses were currently suffering from burnout, showed a burnout risk, or had gone through a burnout in the past. A descriptive thematic analysis was performed with themes inductively emerging from the data. Results Four main themes emerged: “being passionate about doing well or being good,” “teamwork,” “manager,” and “work and personal circumstances.” More specifically, it was the discrepancy between the first individual vulnerability factor and the three situational stressors that led to feelings of stress and burnout. Conclusions The essence of the development of nurse burnout was found in the discrepancy between individual vulnerability and situational stressors. Therefore, we recommend burnout prevention to target both factors.
Age-Related Differences in Medication Adherence, Symptoms, and Stigma in Poorly Adherent Adults With Bipolar Disorder
Authors: Smilowitz Stephen , Aftab Awais , Aebi Michelle , Levin Jennifer , Tatsuoka Curtis , Sajatovic Martha 
Published: September 2019

Objective: We present a secondary analysis of data reporting differences in medication adherence, psychiatric symptom severity, and internalized stigma levels in older (age ≥ 55 years) versus younger (age < 55 years) adults with bipolar disorder (BD) and poor medication adherence. Methods: Data used for this analysis came from 184 participants in a National Institute of Mental Health–funded randomized controlled trial, comparing a customized adherence enhancement (CAE) intervention intended to promote BD medication adherence with a BD-specific educational program (EDU). At screen, study participants were ≥20% nonadherent with BD medications as measured by the Tablets Routine Questionnaire (TRQ). Psychiatric symptoms, functional status, and internalized stigma were measured using validated scales. Results: Older adults had significantly lower anxiety disorder comorbidity ( P < .01 for 1 or more anxiety disorders), depressive symptom severity scores ( P = .011), and self-stigma scores ( P = .001) compared to their younger counterparts. In the analyses evaluating change over time in TRQ between older and younger participants by treatment arm (ie, CAE and EDU), there was a significant finding of interaction between time, age-group, and treatment arm ( P = .007). Conclusions: Older adults may be less anxious and depressed, with less self-stigma, compared to younger people with BD and poor adherence. With respect to medication adherence, older individuals in EDU appear to do less well than younger individuals over time.
Micropulse transscleral cyclophotocoagulation using a standard protocol in patients with refractory glaucoma naive of cyclodestruction
Authors: Souissi Soufiane , Baudouin Christophe , Labbé Antoine , Hamard Pascale 
Published: September 2019

Purpose: To assess the efficacy and safety of a standardized micropulse transscleral diode laser cyclophotocoagulation procedure in refractory glaucoma. Methods: Retrospective, interventional study in a series of 37 consecutive patients with refractory glaucoma, cyclodestructive procedure-naive, who underwent micropulse transscleral diode laser cyclophotocoagulation from December 2016 to October 2017. A successful laser treatment was defined as (1) intraocular pressure between 6 and 18 mm Hg; (2) 20% of baseline intraocular pressure reduction; (3) no additional glaucoma medications; (4) no decrease in vision due to complications or change in intraocular pressure; and (5) no need for additional glaucoma surgery except micropulse transscleral diode laser cyclophotocoagulation retreatment. Results: Mean age was 60.2 years. Mean follow-up was 9.7 ± 3.9 months. The mean preoperative intraocular pressure (28.7 mm Hg) significantly decreased to 21.0 mm Hg at 1 month, 18.5 mm Hg at 3 months, 18.4 mm Hg at 6 months, and 18.5 mm Hg at 12 months ( p < 0.01 at all time points). The mean number of preoperative glaucoma medications (4.7) decreased to 4.0 at 1 month ( p = 0.14), 4.5 at 3 months ( p < 0.05), 3.9 at 6 months ( p < 0.05), and 3.6 at 12 months ( p < 0.05). At 1 year, the success rate was 35% with a mean intraocular pressure lowering of 36%. One patient had hypotony and a loss of best-corrected visual acuity. Mild transient postoperative inflammation was observed in 8% of the cases. Conclusion: Using a standardized procedure, micropulse transscleral diode laser cyclophotocoagulation allows a mild intraocular pressure decrease with a low rate of complications and thus achieves a relatively good profit risk benefit, mostly for moderately hypertensive refractory glaucoma.