bluuebunny/crossref_metadata_2025_split huggingface dataset:
Second‐generation cryoballoon ablation for recurrent atrial fibrillation after an index procedure with radiofrequency versus cryo: Different pulmonary vein reconnection patterns but similar long‐term outcome—Results of a multicenter analysis
Authors: Glowniak Andrzej , Tarkowski Adam , Fic Piotr , Wojewoda Katarzyna , Wojcik Jaroslaw , Wysokinski Andrzej 
Published: April 2019

AbstractIntroductionRepeated procedures are often needed for long‐term success of atrial fibrillation ablation. There are scarce data regarding cryoballoon use for such procedure.Methods and ResultsWe analyzed acute effect and long‐term follow‐up of second‐generation cryoballoon ablation, performed as a repeat procedure after an index radiofrequency vs cryoballoon ablation. Sixty‐one patients from three centers were included. In 36 cases radiofrequency (RF‐I) and in 25 cryoballoon ablation (CB‐I) was the index procedure. During redo procedure, pulmonary vein reconnection was less frequent in CB‐I vs RF‐I (51.5% vs 66.9%; P = 0.017). After cryoballoon, left inferior (P =  0.027) and right superior (P = 0.06) pulmonary veins were less likely to exhibit reconnection. Moreover, patients after initial RF ablation frequently presented multiple‐vein reconnection (P = 0.018), while patients after cryoablation more often had only one vein reconnected (P = 0.008).During reablation procedures, all 149 reconnected veins in both groups were isolated, with no differences in procedural parameters, except for procedure time, shorter in CB‐I group (65.5 vs 71.1 minutes; P = 0.04). Transient phrenic nerve palsy was the only complication in both groups (5.6% and 8.0%; ns). After mean follow‐up of 15 ± 9 months, 70.3% of patients were free from atrial fibrillation (AF), with no differences between the groups (P = 0.71). In multivariate Cox‐regression analysis, the persistent form of arrhythmia (P = 0.009) and relapse in the blanking period (P = 0.0004) were the only independent predictors of AF recurrence.ConclusionsThe use of second‐generation cryoballoon is associated with less frequent pulmonary vein reconnection compared with RF ablation. Cryoballoon is safe and effective for repeated AF ablation, regardless of the technique used for the initial procedure.
The mechanical effects of CRT promoting autophagy via mitochondrial calcium uniporter down‐regulation and mitochondrial dynamics alteration
Authors: Yu Ziqing , Gong Xue , Yu Yong , Li Minghui , Liang Yixiu , Qin Shengmei , Fulati Zibire , Zhou Nianwei , Shu Xianhong , Nie Zhenning , Dai Shimo , Chen Xueying , Wang Jingfeng , Chen Ruizhen , Su Yangang , Ge Junbo 
Published: April 2019

AbstractThe mechanism of cardiac resynchronization therapy (CRT) remains unclear. In this study, mitochondria calcium uniporter (MCU), dynamin‐related protein‐1 (DNM1L/Drp1) and their relationship with autophagy in heart failure (HF) and CRT are investigated. Thirteen male beagle's dogs were divided into three groups (sham, HF, CRT). Animals received left bundle branch (LBB) ablation followed by either 8‐week rapid atrial pacing or 4‐week rapid atrial pacing and 4‐week biventricular pacing. Cardiac function was evaluated by echocardiography. Differentially expressed genes (DEGs) were detected by microarray analysis. General morphological changes, mitochondrial ultrastructure, autophagosomes and mitophagosomes were investigated. The cardiomyocyte stretching was adopted to imitate the mechanical effect of CRT. Cells were divided into three groups (control, angiotensin‐II and angiotensin‐II + stretching). MCU, DNM1L/Drp1 and autophagy markers were detected by western blots or immunofluorescence. In the present study, CRT could correct cardiac dysfunction, decrease cardiomyocyte's size, alleviate cardiac fibrosis, promote the formation of autophagosome and mitigate mitochondrial injury. CRT significantly influenced gene expression profile, especially down‐regulating MCU and up‐regulating DNM1L/Drp1. Cell stretching reversed the angiotensin‐II induced changes of MCU and DNM1L/Drp1 and partly restored autophagy. CRT's mechanical effects down‐regulated MCU, up‐regulated DNM1L/Drp1 and subsequently enhanced autophagy. Besides, the mechanical stretching prevented the angiotensin‐II‐induced cellular enlargement.
Attitude, source of knowledge, and supporting factors on evidence‐based nursing among cardiovascular nurses: A cross‐sectional descriptive study in Turkey
Authors: Kilicli Arnel Boke , Kelber Sheryl Talcott , Akyar Imatullah , Litwack Kim 
Published: April 2019

AbstractRationale, aims, and objectivesCardiovascular nursing has been a rapidly growing specialty since the 1960s. Assessing cardiovascular nurses' EBN (evidence‐based nursing) attitudes and beliefs and the factors supporting EBN is important to assist the training programmes in fostering EBN practice in a clinical environment. Few investigations have been conducted on EBN knowledge, attitudes, beliefs, and implementation among cardiovascular nurses. The present study aims to investigate cardiovascular nurses' attitudes towards EBN, sources of knowledge, and the factors supporting EBN in Turkey.MethodsA cross‐sectional survey with a descriptive and comparative design was conducted with 62 cardiovascular nurses working at two hospitals in Turkey. Data were collected by using the Evidence‐Based Nursing Attitude Questionnaire, a sociodemographic questionnaire concerning demographic information and including questions about nurses' sources of knowledge, supporting factors to implement EBN, research experience, use of clinical guidelines, and barriers to applying EBN. Data were analysed with descriptive and inferential statistics.ResultsThe research revealed that cardiovascular nurses have positive attitudes, feelings, beliefs, and intention of conduct towards EBN. Cardiac surgery nurses reported significantly higher positive feelings, beliefs, intention of conduct, and attitude towards EBN than cardiology nurses. Nursing experience and information acquired through nursing school were the most frequently used sources of knowledge rather than research results (35.5%) in their clinical practice. Half of the respondents (47%) were familiar with EBN. Cardiovascular nurses who had graduate degrees, reviewed nursing research and were familiar with EBN had significant positive attitudes towards EBN. Nurses needed enough time and resources, a background in clinical practice, and support from the hospital administration to implement EBN.ConclusionsAn education intervention should be provided about EBN knowledge and skills for cardiovascular nurses. Mentor nurses should be trained and assigned in cardiovascular clinics to implement EBN.
The development of adaptation pathways for the long‐term planning of urban drainage systems
Authors: Babovic Filip , Mijic Ana 
Published: April 2019

AbstractCities must adapt their drainage systems to cope with the effects of land use and climate change on growing flood risk. However, the development of robust adaptation strategies remains a challenge due to the deep uncertainty surrounding future conditions. To address this problem, an Adaptation Tipping Points (ATP) approach was utilised to investigate the impacts of future rainfall with respect to increases in both depth and intensity on an urban drainage system. A set of adaptation pathways was generated to assess how the drainage system could be adapted using a range of infrastructure solutions. The most effective combination of adaptations to increase the system's ATP was an increase in system storage followed by green infrastructure solutions to add additional capacity to the system. The methodology enabled no‐regret adaptation by proposing a set of selected interventions that can be incrementally implemented to achieve maximal combined effect. The resulting pathways effectively communicate to decision makers how short‐term solutions allow for long‐term adaptation and sustainable development. The ATP approach proved to be an effective tool for decision‐making that provided a structured approach for the long‐term planning of urban drainage systems.
Does Gender Matter in Septic Patient Outcomes?
Authors: Failla Kim Reina , Connelly Cynthia D. , Ecoff Laurie , Macauley Karen , Bush Ruth 
Published: April 2019

AbstractPurposeThe purpose of this study was to examine potential gender disparities in relation to factors associated with sepsis management among a cohort of patients admitted through an emergency department with a discharge diagnosis of severe sepsis or septic shock. Sepsis is one of the leading causes of death globally, with significant associated costs. Predictors of survival for those with sepsis‐related diagnoses are complex.Design and MethodsThe study had a retrospective, descriptive cross‐sectional design. The sample (N = 482) included patients 18 years of age or older who presented to the emergency department of a nonprofit, Magnet‐recognized, acute care hospital located in southern California. Subjects included those who subsequently met the criteria for a discharge diagnosis of severe sepsis or septic shock as defined by the Surviving Sepsis Campaign. Patient characteristics, clinical variables, care management processes, and outcomes were extracted from the electronic health record. A multivariate model was analyzed.FindingsThe sample included 234 women (48.5%) and 248 men (51.5%). Logistic regression with eight independent variables (discharge diagnosis, age, comorbidities, length of hospital stay, source of infection, first serum lactate level measured, recommended fluids administered, and gender) reliably predicted odds for patient survival, ϰ2 (12) = 118.38, p < .001, and correctly classified 77.3% of cases. All eight independent variables significantly contributed to the model. Men had a higher likelihood of hospital survival than women (odds ratio 1.68; 95% confidence interval 1.01–2.79; p = .045).ConclusionsThe Surviving Sepsis Campaign has provided a clear pathway for care of patients with sepsis‐related diagnoses. Therapeutic strategies should be developed to address differences in outcome by gender. The adoption of more aggressive applications of evidence‐based interventions for these patients may result in better patient outcomes.Clinical RelevanceProviders should understand the importance of adhering to sepsis protocols, minimizing treatment disparities, and recognizing gender differences.
Practice‐based nursing research: Evaluation of clinical and professional impacts from a research training programme
Authors: Black Agnes T. , Ali Shazbeen , Baumbusch Jennifer , McNamee Kate , Mackay Martha 
Published: April 2019

AbstractAims and ObjectivesTo determine the clinical and professional impacts of nurses’ and other clinicians’ involvement in a research training programme.BackgroundEvidence‐based practice (EBP) can be supported by nurses’ involvement in research. Registered nurses report common barriers to EBP and research, but training programmes have been shown to overcome some of those barriers and lead to successful research engagement and EBP enhancement.DesignThis mixed‐methods evaluation study used a survey and interviews to explore the clinical and professional impacts of research training programme participation on nurses’ and other clinicians’ clinical practice, appreciation for EBP, interest in advanced education, future research involvement and dissemination activities.MethodsThe study adhered to the SQUIRE guidelines for quality improvement studies as part of the EQUATOR network (Enhancing the Quality and Transparency of Health Research). Survey invitations were sent to 126 clinicians who had participated in a research training programme. All were invited to complete the questionnaire and participate in an interview.ResultsSurvey results and interview responses showed a positive impact. Participants reported examples of sustained practice changes, enhanced EBP, heightened interest in graduate studies, strong interest in future research engagement and a large number of dissemination activities, including publications and conference presentations.ConclusionsThe evaluation found that participation in a research training programme can have a positive clinical and professional impact on participants, including enhancing their appreciation for EBP and research, their interest in advanced education and meaningful dissemination of findings to improve patient care.Relevance to Clinical PracticeAs healthcare leaders seek to increase EBP to improve patient care, successful models for nurses’ engagement in research and EBP are critically important. This research training programme is one promising model for supporting nurses’ and other clinicians’ engagement in EBP and research.
Influencing factors when living with Parkinson’s disease: A cross‐sectional study
Authors: Ambrosio Leire , Portillo Mari Carmen , Rodriguez‐Blazquez Carmen , Rojo Jose Manuel , Martinez‐Martin Pablo ,   EC‐PC Validation Group
Published: April 2019

AbstractAims and objectivesTo identify the personal‐ and disease‐related factors that are associated with living with Parkinson's disease.BackgroundLiving with Parkinson's disease affects the physical, psychological, social and spiritual areas of the person. Health professionals need to know which factors influence the daily living with Parkinson's disease, in order to facilitate a positive living.DesignA multicentre cross‐sectional study.MethodsA total of 324 patients with Parkinson's disease diagnoses were included in the study through a consecutive case sampling. Data were collected from January–June 2015, in specialised units of movement disorders of public and private and community centres, from Spain, Argentina, Mexico, Ecuador and Cuba. Nine measures were applied to evaluate personal‐related factors (age, gender, psychosocial function, satisfaction with life, social support, home economical situation) and Parkinson's disease‐related factors (duration of disease, motor symptoms and non‐motor symptoms). The STROBE checklist was used to ensure quality reporting during the study (see File S1). Multiple linear regression analysis was carried out.ResultsResults indicated that social support, followed by satisfaction with life and home economical situation are the only three factors that significantly influence in living with Parkinson’s disease. The rest of the factors analysed did not present significant influence in the daily living with this neurodegenerative disease.ConclusionThis study highlights the necessity to put more emphasis on the person and his/her daily living with the condition and less on symptoms and treatment. Health professionals need to develop person‐centred interventions that also deal with other elements of the experience of living with a long‐term condition like Parkinson's disease.Relevance to clinical practiceInterventions to foster positive living with Parkinson's disease in clinical practice should integrate strategies to tackle and prevent loneliness and interagency elements to increase community resources and systems of support.
Pre‐ and post evaluations of the effects of the Connect, Ask, Respond and Empathise (CARE) protocol on nursing handover: A case study of a bilingual hospital in Hong Kong
Authors: Pun Jack , Chan Engle Angela , Man Manbo , Eggins Suanne , Slade Diana 
Published: April 2019

AbstractAims and objectivesTo evaluate (a) the perceived effects of the training provided to nurses under a standardised Connect, Ask, Respond and Empathise (CARE) protocol; (b) the ability to enhance the effectiveness of the ISBAR checklist; (c) any increase in nurses’ spoken interactions and/or improved comprehension of the patient conditions upon the transfer of responsibility.BackgroundNursing handover is a pivotal act of communication with effects on both patient safety and risk management. Previous studies of critical incidents have highlighted ineffective communication, including a lack of interaction and incomplete and unstructured handovers, as a major contributor to patient harm.DesignA pre‐ and post evaluation study involving a questionnaire survey before and after the 3‐hours training.MethodsForty‐nine randomly selected bilingual nurses with no previous professional development experience in handover communication were trained according to the CARE protocol, and their perceptions of nursing handovers were assessed before and after training using questionnaire. The STROBE checklist is used (See File S1).ResultsTraining of the CARE protocol improved key areas of the handover process. All participating nurses exhibited significant improvements in their perceptions of effective handover from before to after training. Particularly, improvements were observed in the interactive frequency and quality and completeness of the presented patient information per handover.ConclusionsThe nurses reported a deeper understanding of their perceptions of handover after a patient‐centred intervention, a better quality of interactions (e.g., querying and checking by incoming nurses), a greater focus when managing handovers and a more complete and comprehensive transfer of information between nurses.Relevance to clinical practiceCARE protocol‐based training yielded significant improvements in nursing handover practice.
Construct validity and reliability of the Full Outline of UnResponsiveness (FOUR) score in spontaneous subarachnoid haemorrhage caused by aneurysm rupture
Authors: Oh HyunSoo , Shin SeonYoung , Kim SooHyun , Seo WhaSook 
Published: April 2019

AbstractAims and objectivesThis study aimed at examining the construct validity and reliability of the Full Outline of UnResponsiveness score in patients with spontaneous subarachnoid haemorrhage caused by aneurysm rupture.BackgroundThe Full Outline of UnResponsiveness score is known to be a valid and reliable consciousness assessment tool and provides comprehensive information not given by the Glasgow Coma Scale. However, the validity and reliability of this tool have not been tested in patients with spontaneous subarachnoid haemorrhage.DesignA nonexperimental, descriptive, correlational study design was adopted.MethodsThe STROBE statement was used for reporting this study. The study participants were 72 patients with spontaneous subarachnoid haemorrhage caused by aneurysm rupture, admitted to an intensive care unit in a university hospital between August 2016–July 2017. Data on demographic characteristics, Hunt–Hess clinical stage scores, Fisher CT stage scores, disease‐related characteristics, Full Outline of UnResponsiveness scores and 1‐month Glasgow Outcome Scale scores were subjected to analysis.ResultsFull Outline of UnResponsiveness scores were found to have significant correlations with scores on Hunt–Hess clinical or Fisher CT stage tool and adequately predict 1‐month recovery. This tool also exhibited excellent inter‐rater agreement and internal consistency.ConclusionsThe Full Outline of UnResponsiveness score is valid and reliable for consciousness evaluation in spontaneous subarachnoid haemorrhage. It has been believed that use of this tool may help prevent negative consequences arising from impaired consciousness and improve the outcomes of patients with spontaneous aneurysmatic subarachnoid haemorrhage.Relevance to clinical practiceThe Full Outline of UnResponsiveness score is a consciousness assessment tool that provides more neurological detail because it includes consideration of brainstem reflexes, visual tracking, breathing patterns and respiratory drive, and can be applied in cases of spontaneous subarachnoid haemorrhage and other types of brain injury, especially in patients with severe consciousness impairment.
Polymerase chain reaction for antigen receptor rearrangement: Benchmarking performance of a lymphoid clonality assay in diverse canine sample types
Authors: Ehrhart E. J. , Wong Shukmei , Richter Keith , Zismann Victoria , Grimes Carolyn , Hendricks William , Khanna Chand 
Published: April 2019

AbstractBackgroundPolymerase chain reaction for antigen receptor rearrangement (PARR) is a molecular diagnostic tool used for discrimination of lymphoid malignancies in dogs from benign processes. Assay variations have been described and are commercially available, but performance metrics are not uniformly reported.ObjectivesTo describe performance (accuracy, sensitivity, specificity) and rigorous benchmarking of a PARR protocol (ePARR) in clinically relevant samples.AnimalsOne hundred eighty‐one client‐owned dogs.MethodsLymphoma and benign tissues representative of the clinical spectrum with gold standard histopathologic and immunohistochemical diagnoses were collected. Assay development and benchmarking were performed on fresh frozen (FF) tissue, formalin‐fixed paraffin‐embedded (FFPE) tissue, flow cytometry pellets, and air‐dried fine‐needle aspirates (FNA). Assay performance was determined for FFPE from 56 dogs (18 B‐cell lymphoma, 24 T‐cell lymphoma, and 14 non‐lymphoma), 80 frozen flow cytometry pellets (66 B‐cell lymphoma, 14 T‐cell lymphoma, 0 non‐lymphoma), and 41 air‐dried FNA slides (23 lymphoma, 18 non‐lymphoma).ResultsFor discrimination of lymphoma versus non‐lymphoma, ePARR had 92% and 92% sensitivity and specificity on FFPE with 92% accuracy, 85% sensitivity from flow cytometry pellets (non‐lymphoma was not evaluated to calculate specificity) with 85% accuracy, and 100% and 100% sensitivity and specificity for FNA with 100% accuracy. Stringent quality control criteria decreased assay success rate without significant performance improvement. Performance metrics were lower in most cases for discrimination of B‐ or T‐cell versus non‐B‐ or non‐T‐cell samples than for lymphoma versus non‐lymphoma.Conclusions and Clinical ImportanceThese benchmarking data facilitate effective interpretation and application of PARR assays in multiple sample types.
Activation of the oncogenic miR‐21‐5p promotes HCV replication and steatosis induced by the viral core 3a protein
Authors: Clément Sophie , Sobolewski Cyril , Gomes Diana , Rojas Angela , Goossens Nicolas , Conzelmann Stéphanie , Calo Nicolas , Negro Francesco , Foti Michelangelo 
Published: April 2019

AbstractBackground & aimsmiR‐21‐5p is a potent oncogenic microRNA targeting many key tumour suppressors including phosphatase and tensin homolog (PTEN). We recently identified PTEN as a key factor modulated by hepatitis C virus (HCV) to promote virion egress. In hepatocytes, expression of HCV‐3a core protein was sufficient to downregulate PTEN and to trigger lipid droplet accumulation. Here, we investigated whether HCV controls PTEN expression through miR‐21‐5p‐dependent mechanisms to trigger steatosis in hepatocytes and to promote HCV life cycle.MethodsMiR‐21‐5p expression in HCV‐infected patients was evaluated by transcriptome meta‐analysis. HCV replication and viral particle production were investigated in Jc1‐infected Huh‐7 cells after miR‐21‐5p inhibition. PTEN expression and steatosis were assessed in HCV‐3a core protein‐expressing Huh‐7 cells and in mouse primary hepatocytes having miR‐21‐5p inhibited or genetically deleted respectively. HCV‐3a core‐induced steatosis was assessed in vivo in Mir21a knockout mice.ResultsMiR‐21‐5p expression was significantly increased in hepatic tissues from HCV‐infected patients. Infection by HCV‐Jc1, or transduction with HCV‐3a core, upregulated miR‐21‐5p expression and/or activity in Huh‐7 cells. miR‐21‐5p inhibition decreased HCV replication and release of infectious virions by Huh‐7 cells. HCV‐3a core‐induced PTEN downregulation and steatosis were further prevented in Huh‐7 cells following miR‐21‐5p inhibition or in Mir21a knockout mouse primary hepatocytes. Finally, steatosis induction by AAV8‐mediated HCV‐3a core expression was reduced in vivo in Mir21a knockout mice.ConclusionMiR‐21‐5p activation by HCV is a key molecular step, promoting both HCV life cycle and HCV‐3a core‐induced steatosis and may be among the molecular changes induced by HCV‐3a to promote carcinogenesis.