bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational Health Risks in Cardiac Catheterization Laboratory Workers
Authors: Andreassi Maria Grazia , Piccaluga Emanuela , Guagliumi Giulio , Del Greco Maurizio , Gaita Fiorenzo , Picano Eugenio 
Published: September 2018

Background—
Orthopedic strain and radiation exposure are recognized risk factors in personnel staff performing fluoroscopically guided cardiovascular procedures. However, the potential occupational health effects are still unclear. The purpose of this study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure.

Methods and Results—

We used a self-administered questionnaire to collect demographic information, work-related information, lifestyle-confounding factors, all current medications, and health status. A total number of 746 questionnaires were properly filled comprising 466 exposed staff (281 males; 44±9 years) and 280 unexposed subjects (179 males; 43±7years). Exposed personnel included 218 interventional cardiologists and electrophysiologists (168 males; 46±9 years); 191 nurses (76 males; 42±7 years), and 57 technicians (37 males; 40±12 years) working for a median of 10 years (quartiles: 5–24 years). Skin lesions (
P
=0.002), orthopedic illness (
P
<0.001), cataract (
P
=0.003), hypertension (
P
=0.02), and hypercholesterolemia (
P
<0.001) were all significantly higher in exposed versus nonexposed group, with a clear gradient unfavorable for physicians over technicians and nurses and for longer history of work (>16 years). In highly exposed physicians, adjusted odds ratio ranged from 1.7 for hypertension (95% confidence interval: 1–3;
P
=0.05), 2.9 for hypercholesterolemia (95% confidence interval: 1–5;
P
=0.004), 4.5 for cancer (95% confidence interval: 0.9–25;
P
=0.06), to 9 for cataract (95% confidence interval: 2–41;
P
=0.004).

Conclusions—
Health problems are more frequently observed in workers performing fluoroscopically guided cardiovascular procedures than in unexposed controls, raising the need to spread the culture of safety in the cath laboratory.
Impact of Lymphangiogenesis on Cardiac Remodeling After Ischemia and Reperfusion Injury
Authors: Shimizu Yuuki , Polavarapu Rohini , Eskla Kattri‐Liis , Pantner Yvanna , Nicholson Chad K. , Ishii Masakazu , Brunnhoelzl Daniel , Mauria Rohit , Husain Ahsan , Naqvi Nawazish , Murohara Toyoaki , Calvert John W. 
Published: September 2018

Background
Lymphatic vessels interconnect with blood vessels to form an elaborate system that aids in the control of tissue pressure and edema formation. Although the lymphatic system has been known to exist in a heart, little is known about the role the cardiac lymphatic system plays in the development of heart failure.

Methods and Results

Mice (C57
BL
/6J, male, 8 to 12 weeks of age) were subjected to either myocardial ischemia or myocardial ischemia and reperfusion for up to 28 days. Analysis revealed that both models increased the protein expression of vascular endothelial growth factor C and
VEGF
receptor 3 starting at 1 day after the onset of injury, whereas a significant increase in lymphatic vessel density was observed starting at 3 days. Further studies aimed to determine the consequences of inhibiting the endogenous lymphangiogenesis response on the development of heart failure. Using 2 different pharmacological approaches, we found that inhibiting
VEGF
receptor 3 with
MAZ
‐51 and blocking endogenous vascular endothelial growth factor C with a neutralizing antibody blunted the increase in lymphatic vessel density, blunted lymphatic transport, increased inflammation, increased edema, and increased cardiac dysfunction. Subsequent studies revealed that augmentation of the endogenous lymphangiogenesis response with vascular endothelial growth factor C treatment reduced inflammation, reduced edema, and improved cardiac dysfunction.

Conclusions
These results suggest that the endogenous lymphangiogenesis response plays an adaptive role in the development of ischemic‐induced heart failure and supports the emerging concept that therapeutic lymphangiogenesis is a promising new approach for the treatment of cardiovascular disease.
Use of Antihypertensive Agents and Association With Risk of Adverse Outcomes in Chronic Kidney Disease: Focus on Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers
Authors: Ku Elaine , McCulloch Charles E. , Vittinghoff Eric , Lin Feng , Johansen Kirsten L. 
Published: September 2018

Background

Our objective was to determine patterns of antihypertensive agent use by stage of chronic kidney disease (CKD) and to evaluate the association between different classes of antihypertensive agents with nonrenal outcomes, especially in advanced
CKD
.

Methods and Results

We studied 3939 participants of the
CRIC
(Chronic Renal Insufficiency Cohort) study. Predictors were time‐dependent angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker , β‐blocker, and calcium channel blocker use (versus nonuse of agents in each class). Outcomes were adjudicated heart failure events or death. Adjusted Cox models were used to determine the association between predictors and outcomes. We also examined whether the associations differed based on the severity of
CKD
(early [stage 2–3
CKD
] versus advanced disease [stage 4–5
CKD
]). During median follow‐up of 7.5 years, renin‐angiotensin‐aldosterone system inhibitor use plateaued during
CKD
stage 3 (75%) and declined to 37% by stage 5, while β‐blocker, calcium channel blocker, and diuretic use increased steadily with advancing
CKD
. Renin‐angiotensin‐aldosterone system inhibitor use was associated with lower risk of heart failure (hazard ratio, 0.79; 95% confidence interval, 0.67–0.97) and death (hazard ratio, 0.78; 95% confidence interval, 0.67–0.90), regardless of severity of
CKD
. Calcium channel blocker use was not associated with risk of heart failure or death, regardless of the severity of
CKD
. β‐Blocker use was associated with higher risk of heart failure (hazard ratio, 1.62; 95% confidence interval, 1.29–2.04) and death (hazard ratio, 1.22; 95% confidence interval, 1.03–1.43), especially during early
CKD
(
P
<0.05 for interaction).

Conclusions

Angiotensin‐converting enzyme inhibitor and angiotensin receptor blocker use decreased, while use of other agents increased with advancing
CKD
. Use of agents besides angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers may be associated with suboptimal outcomes in patients with
CKD
.
‘At Me Too Someone Is Looking …’
Authors: Pattie David 
Published: September 2018

Abstract
Beckett’s writing—in prose and theatre—is commonly imagined as a series of exercises in decay and diminution. His protagonists exist in a world in which all systems decay, and where, because of this endemic system failure, they are progressively unable to express the reality of their situation through systems of discourse. This article argues that, although this may be true for Beckett’s prose pieces, it is not true of his theatrical works. Beckett’s plays rely for their effects on the fact that theatre itself can be thought of as a coercive system—one that does not decay, but which persists, even as the protagonists trapped within it are worn down to nothing.
Object-Based Algorithm for the Identification and Tracking of Convective Outflow Boundaries in Numerical Models
Authors: Chipilski Hristo G. , Wang Xuguang , Parsons David B. 
Published: September 2018

Abstract
A novel object-based algorithm capable of identifying and tracking convective outflow boundaries in convection-allowing numerical models is presented in this study. The most distinct feature of the proposed algorithm is its ability to seamlessly analyze numerically simulated density currents and bores, both of which play an important role in the dynamics of nocturnal convective systems. The unified identification and classification of these morphologically different phenomena is achieved through a multivariate approach combined with appropriate image processing techniques. The tracking component of the algorithm utilizes two dynamical constraints, which improve the object association results in comparison to methods based on statistical assumptions alone. Special attention is placed on some of the outstanding challenges regarding the formulation of the algorithm and possible ways to address those in future research. Apart from describing the technical details behind the algorithm, this study also introduces specific algorithm applications relevant to the analysis and prediction of bores. These applications are illustrated for a retrospective case study simulated with a convection-allowing ensemble prediction system. The paper highlights how the newly developed algorithm tools naturally form a foundation for understanding the initiation, structure, and evolution of bores and convective systems in the nocturnal environment.
Evaluation of Pharyngoesophageal Segment Using 320-Row Area Detector Computed Tomography
Authors: Wattanapan Pattra , Kagaya Hitoshi , Inamoto Yoko , Saitoh Eiichi , Shibata Seiko , Iida Takatoshi 
Published: September 2018

Objectives: The aim of this study was to determine the shape and area of the pharyngoesophageal segment (PES) during swallowing using 320-row area detector computed tomography, which can acquire a volume data set covering a 16-cm area in a single rotation. Methods: Twenty healthy subjects were scanned during swallowing 3, 10, and 20 mL of honey-thick barium (5% w/v). PES was identified using cross-sectional images of 0.5-mm slice thickness, and the area in each section was measured. Results: The PES opening area and the anteroposterior and lateral diameters of the PES were volume dependent. However, there was no statistical difference in anteroposterior and lateral diameters between 3- and 10-mL bolus swallowing. Conclusions: Three hundred twenty–row area detector computed tomography provided new information about PES. This technique will facilitate further understanding of the mechanisms of PES opening and swallowing physiology.
Partially dead, partially separated: establishing the mechanism between ambiguous loss and grief reaction among caregivers of patients with prolonged disorders of consciousness
Authors: Zaksh Yael , Yehene Einat , Elyashiv Maya , Altman Arie 
Published: September 2018

Objectives: To trace the psychological mechanism underlying caregivers’ emotional experience in prolonged disorders of consciousness, by examining the mediating role of boundary ambiguity in the relationship between ambiguous loss and grief. Design: Cross-sectional design. Setting: The Respiratory Rehabilitation Division of a long-term medical and rehabilitation institute. Subjects: A total of 64 primary caregivers (69% female) of patients in a vegetative state ( n = 49) or minimally conscious state ( n = 15), with a mean age of 55.5 (SD = 12.3) years. Participants were mostly the patient’s children (62%) or partners (27%). The mean caregiving duration was 4.9 (SD = 5.1) years. Main measures: The Boundary Ambiguity Scale, the Revised Need for Closure Scale, an adapted version of the multifactor Two-Track Bereavement Questionnaire, and a sociodemographic questionnaire, which included items regarding caregiving: frequency of visits and perception of the patient’s psychological presence. Results: (1) Caregivers’ grief scores (total TTBQ: mean = 2.97; SD = 0.55) did not significantly differ from those exhibited by a normative bereavement sample. (2) Time since injury did not affect caregivers’ grief scores (three-year cut-point; P > .05). (3) Mediation analyses revealed that boundary ambiguity (mean = 34.03; SD = 7.55) significantly mediates the relationship between need for closure ( B = .11; confidence interval (CI) = .04–.23) and grief; frequency of visits ( B = .05, CI = .02–.10) and grief and perception of psychological presence ( B = .26, CI = .00–.61) and grief in three separate models. Conclusion: Ambiguity concerning relational boundaries hinders caregivers’ ongoing grief reaction and impedes their ability to integrate the loss. High frequency of visits, belief in the patient’s psychological presence and difficulties in tolerating uncertainty are all clinical manifestations of caregivers’ entangled experience.
The moderating effect of psychedelics on the prospective relationship between prescription opioid use and suicide risk among marginalized women
Authors: Argento Elena , Braschel Melissa , Walsh Zach , Socias M Eugenia , Shannon Kate 
Published: September 2018

Background/aims: Given high rates of depression and suicide among marginalized women, and increasing calls to integrate trauma-informed biomedical and community-led structural interventions, this study longitudinally examines the potential moderating effect of psychedelic use on the relationship between other illicit drug use and suicide risk. Methods: Data (2010–2017) were drawn from a community-based, prospective open cohort of marginalized women in Vancouver, Canada. Extended Cox regression analyses examined the moderating effect of psychedelic use on the association between other illicit drug use and incidence of suicidal ideation or attempt over follow-up. Results: Of 340 women without suicidal ideation or attempt at baseline, 16% ( n=53) reported a first suicidal episode during follow-up, with an incidence density of 4.63 per 100 person-years (95% confidence interval 3.53–6.07). In unadjusted analysis, psychedelic use moderated the relationship between prescription opioid use and suicide risk: among women who did not use psychedelics, prescription opioid use increased the hazard of suicide (hazard ratio 2.91; 95% confidence interval 1.40–6.03) whereas prescription opioid use was not associated with increased suicidal ideation or attempt among those who used psychedelics (hazard ratio 0.69; 95% confidence interval 0.27–1.73) (interaction term p-value: 0.016). The moderating effect of psychedelics remained significant when adjusted for confounders (interaction term p-value: 0.036). Conclusions: Psychedelic use had a protective moderating effect on the relationship between prescription opioid use and suicide risk. In the context of a severe public health crisis around prescription opioids and lack of addiction services tailored to marginalized women, this study supports calls for innovative, evidence-based and trauma-informed interventions, including further research on the potential benefits of psychedelics.
The evolutionary old forebrain as site of action to develop new psychotropic drugs
Authors: Loonen Anton JM , Ivanova Svetlana A 
Published: September 2018

Background: Previously, the authors have developed a model of how reward-seeking and distress- avoiding behaviour is regulated by the human brain. The forebrain’s evolution in vertebrates was taken as a starting point. Aims: The authors want to inspire colleagues to study in particular the pharmacological effects on the described ancient forebrain structures in order to modify specific symptoms of mental disorders. Methods: Compilation of data and ideas of previous articles, with examples to illustrate. Results: A primary (lamprey-like), secondary (frog-like) and tertiary (mammal-like) forebrain can be distinguished, organized according to a Russian doll model. The first constituent is primarily involved in producing the emotional response, while the last is principally concerned with constructing conscious cognitive behaviour (including verbal and written communication). Mental disorders comprise (partly related and partly unrelated) biological and rational phenomena. The secondary system regulates the intensity of reward-seeking and distress-avoiding behaviour. An essential component of the primary forebrain evaluates the results of behavioural actions: the lateral habenula-projecting pallidum. These neurons regulate the activity of ascending dopaminergic pathways. The authors suggest that these habenula-projecting pallidum neurons are targeted by subanaesthetic dosages of ketamine. The medial habenula is enriched with nicotinergic acetylcholine receptors and regulates the activity of ascending adrenergic and serotonergic neurons. This may link varenicline-induced hostility to selective serotonin reuptake inhibitor-induced aggression. Conclusions: Studying the effects of new compounds on the primary and secondary brains in lampreys and frogs may yield interesting new treatments of mental disorders.
The dose-dependent psychomotor effects of intravenous delta-9-tetrahydrocannabinol (Δ9-THC) in humans
Authors: Boggs Douglas L , Cortes-Briones Jose A , Surti Toral , Luddy Christina , Ranganathan Mohini , Cahill John D , Sewell Andrew R , D’Souza Deepak C , Skosnik Patrick D 
Published: September 2018

Background: Binding studies have demonstrated that levels of the cannabinoid receptor type-1 are highest in the basal ganglia and cerebellum, two areas critical for motor control. However, no studies have systematically examined the dose-related effects of intravenous delta-9-tetrahydrocannabinol, the primary cannabinoid receptor type-1 partial agonist in cannabis, on broad domains of psychomotor function in humans. Aims: Therefore, three domains of psychomotor function were assessed in former cannabis users (cannabis abstinent for a minimum of three months; n=23) in a three test-day, within-subject, double-blind, randomized, cross-over, and counterbalanced study during which they received intravenous delta-9-tetrahydrocannabinol (placebo, 0.015 mg/kg, and 0.03 mg/kg). Methods: Gross motor function was assessed via the Cambridge Neuropsychological Test Automated Battery Motor Screening Task, fine motor control via the Lafayette Instrument Grooved Pegboard task, and motor timing via a Paced Finger-Tapping Task. In addition, the Cambridge Neuropsychological Test Automated Battery Rapid Visual Processing Task was utilized to determine whether delta-9-tetrahydrocannabinol-induced motor deficits were confounded by disruptions in sustained attention. Results/outcomes: Delta-9-tetrahydrocannabinol resulted in robust dose-dependent deficits in fine motor control (Grooved Pegboard Task) and motor timing (Paced Finger-Tapping Task), while gross motor performance (Motor Screening Task) and sustained attention (Rapid Visual Processing Task) were unimpaired. Interestingly, despite the observed dose-dependent increases in motor impairment and blood levels of delta-9-tetrahydrocannabinol, subjects reported similar levels of intoxication in the two drug conditions. Conclusions/interpretation: These data suggest that while several domains of motor function are disrupted by delta-9-tetrahydrocannabinol, subjective feelings of intoxication are dissociable from cannabinoid-induced psychomotor effects. Results are discussed in terms of the potential neural mechanisms of delta-9-tetrahydrocannabinol in motor structures.
Outcomes of infants undergoing laparoscopic pyeloplasty: A single-center experience
Authors: Erol İbrahim , Karamık Kaan , İslamoğlu Mahmut Ekrem , Ateş Mutlu , Savaş Murat 
Published: September 2018

Purpose: The aim of this study was to evaluate the outcomes of laparoscopic pyeloplasty in children less than 12 months of age. Materials and methods: The records of 20 infants, who had pelviureteric junction obstruction and subsequently underwent LP from January 2013 to November 2016 with at least 1 year of follow-up, were retrospectively reviewed. Patients demographics, the results of preoperative and postoperative imaging studies, perioperative details, complications, and results were noted. Results: The mean age of 20 infants was 4.75 months. The gender of cases was 5 females (25%) and 15 males (75%). Of that, 13 (65%) laparoscopic pyeloplasties were in left side and 7 (35%) were in right side. No cases needed open conversation. Aberrant crossing vessel was observed in three patients (15%). The mean operation time was 79.35 min (45–128 min). The mean hospital stay was 2.9 ± 0.308 days (2–3 days). There were complications in three children (15%); two patients developed stent migration and one child had fever over 38°. Three children with complications did not require a second intervention. In one child, the kidney was non-functioning in follow-up and nephrectomy was performed. The anteroposterior diameter significantly reduced. Preoperative mean value was 24.305 ± 5.6157 and postoperative mean value was 15.40 ± 6.030 (p = 0.000, p < 0.05). There was a significant degree of improvement in renal split function for all patients. Preoperative mean values were 45.53 ± 11.512, while postoperative values were 47.850 ± 13.347 (p = 0.029, p < 0.05). Conclusion: Although there are doubts about the reliability and efficacy of results for pyeloplasty in children less 12 months, many studies including this study show that laparoscopic pyeloplasty is an effective and reliable method for infants.
Risk of Nephrotoxicity Associated With Nonrenally Adjusted Intravenous Polymyxin B Compared to Traditional Dosing
Authors: Maniara Bejoy P. , Healy Lauren E. , Doan Thien-Ly 
Published: September 2018

Background: Polymyxin B’s package insert recommends renal adjustment. Contemporary studies suggest it does not require renal adjustment. Objective: To determine whether time to acute kidney injury (AKI) differs between renally adjusted and nonadjusted intravenous (IV) polymyxin B. Methods: This retrospective chart review compared time to AKI after renally adjusted and nonadjusted IV polymyxin B administration. It included patients who were 18 years or older, received IV polymyxin B, and had creatinine clearance below 80 mL/min, and excluded ones who had AKI, received renal replacement therapy, or were pregnant. Results: Fifty-four patients were included. There was not any statistical association between dosing type and time to AKI ( P = .13). Incidence of nephrotoxicity, mortality, and length of stay (LOS) were higher in the renally adjusted arm (21.7% vs 6.5%, 17.4% vs 6.5%, and 16 vs 14 days, respectively). Four patients received concomitant ascorbic acid; not one developed AKI. Conclusion: A significant association between IV polymyxin B dosing type and time to AKI was not found. Adverse events were higher in the renally adjusted arm. This suggests that nonadjusted IV polymyxin B may be preferred in patients with renal impairment. Ascorbic acid may mitigate IV polymyxin B's nephrotoxic potential. Further studies are needed to corroborate these findings.