bluuebunny/crossref_metadata_2025_split huggingface dataset:
You are as fast as your motor neurons: speed of recruitment and maximal discharge of motor neurons determine the maximal rate of force development in humans
Authors: Del Vecchio Alessandro , Negro Francesco , Holobar Ales , Casolo Andrea , Folland Jonathan P. , Felici Francesco , Farina Dario 
Published: February 2019

Key points
We propose and validate a method for accurately identifying the activity of populations of motor neurons during contractions at maximal rate of force development in humans.
The behaviour of the motor neuron pool during rapid voluntary contractions in humans is presented.
We show with this approach that the motor neuron recruitment speed and maximal motor unit discharge rate largely explains the individual ability in generating rapid force contractions.
The results also indicate that the synaptic inputs received by the motor neurons before force is generated dictate human potential to generate force rapidly.
This is the first characterization of the discharge behaviour of a representative sample of human motor neurons during rapid contractions.
AbstractDuring rapid contractions, motor neurons are recruited in a short burst and begin to discharge at high frequencies (up to >200 Hz). In the present study, we investigated the behaviour of relatively large populations of motor neurons during rapid (explosive) contractions in humans, applying a new approach to accurately identify motor neuron activity simultaneous to measuring the rate of force development. The activity of spinal motor neurons was assessed by high‐density electromyographic decomposition from the tibialis anterior muscle of 20 men during isometric explosive contractions. The speed of motor neuron recruitment and the instantaneous motor unit discharge rate were analysed as a function of the impulse (the time–force integral) and the maximal rate of force development. The peak of motor unit discharge rate occurred before force generation and discharge rates decreased thereafter. The maximal motor unit discharge rate was associated with the explosive force variables, at the whole population level (r2 = 0.71 ± 0.12; P < 0.001). Moreover, the peak motor unit discharge and maximal rate of force variables were correlated with an estimate of the supraspinal drive, which was measured as the speed of motor unit recruitment before the generation of afferent feedback (P < 0.05). We show for the first time the full association between the effective neural drive to the muscle and human maximal rate of force development. The results obtained in the present study indicate that the variability in the maximal contractile explosive force of the human tibialis anterior muscle is determined by the neural activation preceding force generation.
Lifestyle changes may be more important than drugs for mild hypertension
Authors: Cook Rob , Lamont Tara , Martin, Rosie 
Published: February 2019

The studySheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs R, McManus R. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension.Published on 1 December 2018 JAMA Intern Med 2018;178:1626-34.This project was funded by a grant from the National Institute for Health Research (NIHR-RP-R2-12-O15) and the Medical Research Council (MRC) Strategic Skills Postdoctoral Fellowship.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000713/lifestyle-changes-for-mild-hypertension-rather-than-drugs
CT angiography depicted lumbar spinal artery anatomic course: defining a safer zone for lumbar sympathetic and splanchnic blocks
Authors: Zhu Richard , Dean Kathryn , Mehta Neel , Gupta Ajay , Gruber Jesse , Gulati Amitabh 
Published: February 2019

IntroductionDetermining safer techniques for lumbar injections is an important goal in pain medicine. This study aims to characterize the location of the T10–L5 spinal arteries using CT angiogram scans to define a safer approach for sympathetic and splanchnic blocks that minimizes intra-arterial injection.MethodsCT angiograms of 68 patients were included this study. The path of the spinal arteries from the aorta origin along the vertebral body to the neural foramina was traced on axial CT images. The sagittal plane of the vertebral body was divided into nine quadrants to map the path of a spinal artery at a vertebral level. At a given vertebral level and laterality, the presence of an artery as well as the quadrants the artery traveled in along its path were recorded.ResultsAt the anterior vertebral body, >90% of the spinal arteries were observed either at or below the pedicle level. At the middle portion of the vertebral body from T11 to L3, >80% of the spinal arteries were found at the pedicle level. For the posterior portion of the vertebral bodies at L4 and L5, the spinal arteries terminated almost universally below the pedicle level. For other levels at the posterior vertebral bodies, the spinal arteries were equivocally located at or below the pedicle level.ConclusionUsing routine anatomic landmarks visible on CT imaging, we classified the anatomic course of low thoracic and lumbar spinal arteries originating from the aorta into the neural foraminal space. A safe recommendation to avoid intra-arterial injection for a splanchnic or lumbar sympathetic is to start above the pedicle and add a slight caudal angulation to the needle trajectory to avoid disc injury at the anterolateral vertebral body.
Hypothermia Masks Most of the Effects of Rapid Cycling VNS on Rat Hippocampal Electrophysiology
Authors: Van Lysebettens Wouter , Vonck Kristl , Larsen Lars Emil , Sprengers Mathieu , Carrette Evelien , Bouckaert Charlotte , Delbeke Jean , Jan Wadman Wytse , Boon Paul , Raedt Robrecht 
Published: February 2019

AIM. Vagus nerve stimulation (VNS) modulates hippocampal dentate gyrus (DG) electrophysiology and induces hypothermia in freely moving rats. This study evaluated whether hippocampal (CA1) electrophysiology is similarly modulated and to what extent this is associated with VNS-induced hypothermia. METHODS. Six freely moving rats received a first 4[Formula: see text]h session of rapid cycling VNS (7[Formula: see text]s on/18[Formula: see text]s off), while CA1 evoked potentials, EEG and core temperature were recorded. In a second 4[Formula: see text]h session, external heating was applied during the 3rd and 4th[Formula: see text]h of VNS counteracting VNS-induced hypothermia. RESULTS. VNS decreased the slope of the field excitatory postsynaptic potential (fEPSP), increased the population spike (PS) amplitude and latency, decreased theta (4–12[Formula: see text]Hz) and gamma (30–100[Formula: see text]Hz) band power and theta peak frequency. Normalizing body temperature during VNS through external heating abolished the effects completely for fEPSP slope, PS latency and gamma band power, partially for theta band power and theta peak frequency and inverted the effect on PS amplitude. CONCLUSIONS. Rapid cycle VNS modulates CA1 electrophysiology similarly to DG, suggesting a wide-spread VNS-induced effect on hippocampal electrophysiology. Normalizing core temperature elucidated that VNS-induced hypothermia directly influences several electrophysiological parameters but also masks a VNS-induced reduction in neuronal excitability.
Reduced Hypoxic Tissue and Cognitive Improvement after Revascularization Surgery for Chronic Cerebral Ischemia
Authors: Shimada Yasuyoshi  , Kobayashi Masakazu  , Yoshida Kenji  , Terasaki Kazunori  , Fujiwara Shunrou , Kubo Yoshitaka , Beppu Takaaki , Ogasawara Kuniaki 
Published: February 2019

<b><i>Background:</i></b> Hypoxic but viable neural tissue is seen on 1-(2–<sup>18</sup>F-fluoro-1-[hydroxymethyl]ethoxy) methyl-2-nitroimidazole (<sup>18</sup>F-FRP170) positron emission tomography (PET) in patients with chronic cerebral ischemia with a combination of misery perfusion and moderately reduced oxygen metabolism. Cognitive function sometimes improves after revascularization surgery in patients with chronic cerebral ischemia. <b><i>Objectives:</i></b> We used brain perfusion single-photon emission computed tomography (SPECT) and <sup>18</sup>F-FRP170 PET to determine whether hypoxic tissue was reduced following the restoration of cerebral perfusion after carotid endarterectomy (CEA) in patients with severe stenosis of the cervical internal carotid artery (ICA) and whether the reduction in hypoxic tissue was associated with cognitive improvement. <b><i>Method:</i></b> Eighteen patients with abnormally reduced cerebral blood flow (CBF) in the affected cerebral hemispheres on preoperative brain perfusion SPECT ­underwent CEA. They underwent <sup>18</sup>F-FRP170 PET and neuropsychological tests preoperatively and 6 months postoperatively. Brain perfusion SPECT was also performed 6 months postoperatively. Regions of interest were placed in the bilateral middle cerebral artery territories on SPECT and PET images, and the ratio of values in the affected versus contralateral hemispheres was calculated. <b><i>Results:</i></b> The CBF ratio (<i>p</i> = 0.0006) and <sup>18</sup>F-FRP170 ratio (<i>p</i> = 0.0084) were significantly increased and reduced, respectively, after surgery compared to the corresponding ratios before surgery. The difference in the <sup>18</sup>F-FRP170 ratio (postoperative – preoperative value) was negatively correlated with the difference in the CBF ratio (<i>ρ</i> = –0.695; <i>p</i> = 0.0009). The difference in the <sup>18</sup>F-FRP170 ratio was significantly lower in patients with postoperative improved cognition compared to that in those without (<i>p</i> = 0.0007). The area under the receiver operating characteristics curve for the difference in the <sup>18</sup>F-FRP170 ratio for detecting postoperative improved cognition was significantly greater than that for the difference in the CBF ratio (difference between areas, 0.278; <i>p</i> = 0.0248). <b><i>Conclusions:</i></b> Hypoxic tissue is reduced following the restoration of cerebral perfusion with revascularization surgery in patients with severe atherosclerotic stenosis of the cervical ICA. The reduction in hypoxic tissue is associated with cognitive improvement in such patients.
Wasp fauna (Hymenoptera: Bethylidae, Chrysididae, Dryinidae, Tiphiidae, Mutillidae, Scoliidae, Pompilidae, Vespidae, Sphecidae, Crabronidae & Trigonalyidae) of Mordovia State Nature Reserve and its surroundings in Russia
Authors: Ruchin Alexander , Antropov Аlexander 
Published: February 2019

Information is presented on 249 vespine species from 11 families in two regions of Mordovia (including Mordovia State Nature Reserve (MSNR)) and three districts of Nizhny Novgorod region (including Sarov) in Russia. Of these, 31 species are new to the Republic of Mordovia. Fauna of separate families of wasps in Mordovia State Nature Reserve is represented by 220 species: one species in Bethylidae, 31 in Chrysididae, two in Tiphiidae, two in Mutillidae, one in Scoliidae, 28 in Pompilidae, 37 in Vespidae, nine in Sphecidae, 108 in Crabronidae, and one in Trigonalyidae. The biodiversity of wasps in the reserve is very high. Of the 283 species of wasps in Mordovia, 220 (77.7%) are found within the reserve. Species characteristics such as geographic distribution and certain aspects of biology are also provided. There is an obvious extension of the ranges of three species, Priocnemis fastigiata, Sceliphron deforme, and Scolia hirta, to the north.
Comparative Safety of Aspiration Thrombectomy Catheters Utilizing Prospective, Active Surveillance of the NCDR CathPCI Registry
Authors: Majithia Arjun , Matheny Michael E. , Paulus Jessica K. , Marinac-Dabic Danica , Robbins Susan , Ssemaganda Henry , Hewitt Kathleen , Ponirakis Angelo , Loyo-Berrios Nilsa , Moussa Issam , Drozda Joseph , Normand Sharon-Lise , Resnic Frederic S. 
Published: February 2019

Background:
Current strategies for ensuring the postmarket safety of medical devices are limited by small sample size and reliance on voluntary reporting of adverse events. Prospective, active surveillance of clinical registries may provide early warnings in the postmarket evaluation of medical device safety but has not been demonstrated in national clinical data registries.

Methods and Results:
The CathPCI DELTA (Data Extraction and Longitudinal Trend Analysis) study was designed to assess the feasibility of prospective, active safety surveillance of medical devices within a national cardiovascular registry. We sought to assess the ability of our surveillance strategy to avoid false safety alerts by conducting an active safety surveillance study of aspiration thrombectomy catheters using data within the National Cardiovascular Data Registry CathPCI registry, where no difference in safety outcomes were anticipated for the primary in-hospital safety outcome of death and major adverse cardiovascular events (MACE). We performed a propensity-matched analysis of 5 aspiration thrombectomy catheter devices used during percutaneous coronary intervention among 95 925 patients presenting with ST-segment–elevation myocardial infarction between January 1, 2011 and September 30, 2013. After 33 months of surveillance, no safety alerts were triggered for the primary safety endpoints of death or MACE, with no between-catheter differences observed. The absolute risk of death during acute hospitalization ranged from 5.11% to 5.32% among the most commonly used aspiration thrombectomy catheter devices, with relative risks for death ranging from 0.96 to 1.03. The absolute risk of MACE ranged from 9.78% to 10.18%, with relative risks for MACE ranging from 0.99 to 1.02. There were no statistically significant differences in the rates of death or MACE between any of the aspiration thrombectomy catheter devices analyzed.

Conclusions:
The CathPCI DELTA study demonstrates that prospective, active safety surveillance of national clinical registries is feasible to provide near-real-time safety assessments of new medical devices.
High Carbon Monoxide Levels from Charcoal Combustion Mask Acute Endothelial Dysfunction Induced by Hookah (Waterpipe) Smoking in Young Adults
Authors: Rezk-Hanna Mary , Mosenifar Zab , Benowitz Neal L. , Rader Florian , Rashid Mohamad , Davoren Katherine , Moy Norma B. , Doering Lynn , Robbins Wendie , Sarna Linda , Li Ning , Chang L. Cindy , Elashoff Robert M. , Victor Ronald G. 
Published: February 2019

Background:
Hookah smoking is marketed to youth as a harmless alternative to cigarettes. Although cigarette smoking acutely impairs endothelial function, the effect of smoking fruit-flavored hookah tobacco is unknown. Because charcoal traditionally is used to heat the hookah tobacco in the waterpipe, hookah smoke delivers tobacco toxicants and nicotine plus charcoal combustion products: not only carbon-rich nanoparticles, oxidants that may destroy nitric oxide and impair endothelial function, but also large amounts of carbon monoxide (CO), a putative vasodilator molecule.

Methods:
To test the acute effect of hookah smoking on endothelial function, in young adult hookah smokers (n=30, age 26±1 years, mean±SE), we measured plasma nicotine, exhaled CO, and brachial artery flow-mediated dilation (FMD) before and after charcoal-heated hookah smoking. To remove the effect of charcoal combustion, the same measurements were performed when the same flavored hookah tobacco product was heated electrically (n=20). As a positive internal control, we studied age-matched cigarette smokers (n=15) who smoked 1 cigarette. To isolate the effect of the CO boost on FMD, hookah smokers (n=8) inhaled a 0.1% CO gas mixture to approximate their CO boost achieved with charcoal-heated hookah smoking.

Results:

Nicotine levels increased similarly with all types of smoking, whereas exhaled CO increased 9- to 10-fold more after charcoal-heated hookah than after either electrically heated hookah or cigarette smoking. FMD did not decrease after smoking charcoal-heated hookah but instead increased by +43±7% (
P
<0.001). In contrast, FMD decreased by –27±4% (
P
<0.001) after smoking electrically heated hookah, comparable to the decrease after cigarette smoking. FMD increased markedly by 138±71% (
P
<0.001) after breathing CO gas, 2.8 times more than the increase induced in the same subjects after smoking charcoal-heated hookah (
P
<0.001), despite comparable increases in exhaled CO (24±1 versus 28±3 ppm, hookah versus CO).

Conclusions:
Smoking hookah tobacco, similar to cigarette tobacco, acutely impairs endothelial function. With traditional charcoal-heated hookah smoking, the acute endothelial dysfunction is masked by high levels of carbon monoxide, a potent vasodilator molecule generated by charcoal combustion. With respect to large-artery endothelial function, smoking hookah is not harmless.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifiers: NCT 03616002 and NCT 03067701.
Autoantibodies Against β
1
‐Adrenoceptor Exaggerated Ventricular Remodeling by Inhibiting CTRP9 Expression
Authors: Du Yunhui , Zhang Shihan , Yu Haicun , Wu Ye , Cao Ning , Wang Wen , Xu Wenli , Li Yuming , Liu Huirong 
Published: February 2019

Background

Autoantibodies against the second extracellular loop of the β
1
‐adrenoceptor (β
1
‐
AA
) act similarly to agonist of β
1
‐adrenergic receptor, which plays an important role in the pathophysiological characteristics of ventricular remodeling. Recently, considerable lines of evidence have suggested that CTRP9 (C1q tumor necrosis factor–related protein 9) is a potent cardioprotective cardiokine and protects the heart from ventricular remodeling. The aim of this study was to determine the role of
CTRP
9 in ventricular remodeling induced by β
1
‐
AA
.

Methods and Results

Blood samples were collected from 131 patients with coronary heart disease and 131 healthy subjects. The serum levels of β
1
‐
AA
and
CTRP
9 were detected using
ELISA
. The results revealed that
CTRP
9 levels in β
1
‐
AA
–positive patients were lower than those in β
1
‐
AA
–negative patients, and serum
CTRP
9 concentrations were inversely correlated with β
1
‐
AA
. β
1
‐
AA
monoclonal antibodies (β
1
‐
AA
mAbs) were administered in mice with and without
rAAV
9‐
cTnT
‐Full Ctrp9‐
FLAG
virus for 8 weeks. Reverse transcription–polymerase chain reaction/Western analysis showed that cardiomyocyte
CTRP
9 expression was significantly reduced in β
1
‐
AA
mAb–treated mice. Moreover, compared with the β
1
‐
AA
mAb alone group, cardiac‐specific
CTRP
9 overexpression improved cardiac function, attenuated adverse remodeling, and ameliorated cardiomyocyte apoptosis and fibrosis. Mechanistic studies demonstrated that
CTRP
9 overexpression decreased the levels of G‐protein–coupled receptor kinase 2 and promoted the activation of AMP‐dependent kinase pathway. However, cardiac‐specific overexpression of
CTRP
9 had no effect on the levels of
cAMP
and protein kinase A activity elevated by β
1
‐AAmAb.

Conclusions

This study provides the first evidence that the long‐term existence of β
1
‐
AA
mAb suppresses cardiac
CTRP
9 expression and exaggerates cardiac remodeling, suggesting that
CTRP
9 may be a novel therapeutic target against pathologic remodeling in β
1
‐
AA
–positive patients with coronary heart disease.
Complex Role for E‐Prostanoid 4 Receptors in Hypertension
Authors: Herrera Marcela , Yang Ting , Sparks Matthew A. , Manning Michael W. , Koller Beverly H. , Coffman Thomas M. 
Published: February 2019

Background

Prostaglandin E
2
(
PGE
2
) is a major prostanoid with multiple actions that potentially affect blood pressure (
BP
).
PGE
2
acts through 4 distinct E‐prostanoid (
EP
) receptor isoforms:
EP
1 to
EP
4. The
EP
4 receptor (
EP
4R) promotes
PGE
2
‐dependent vasodilation, but its role in the pathogenesis of hypertension is not clear.

Methods and Results

To address this issue, we studied mice after temporal‐ and cell‐specific deletion of
EP
4R. First, using a mouse line with loss of
EP
4 expression induced universally after birth, we confirm that
EP
4R mediates a major portion of the acute vasodilatory effects of infused
PGE
2
. In addition,
EP
4 contributes to control of resting
BP
, which was increased by 5±1 mm Hg in animals with generalized deficiency of this receptor. We also show that
EP
4 is critical for limiting elevations in
BP
caused by high salt feeding and long‐term infusion of angiotensin
II
. To more precisely identify the mechanism for these actions, we generated mice in which
EP
4R loss is induced after birth and is limited to smooth muscle. In these mice, acute
PGE
2
‐dependent vasodilation was attenuated, indicating that this response is mediated by
EP
4R in vascular smooth muscle cells. However, absence of
EP
4R only in this vascular compartment had a paradoxical effect of lowering resting
BP
, whereas the protective effect of
EP
4R on limiting angiotensin II–dependent hypertension was unaffected.

Conclusions

Taken together, our findings support a complex role for
EP
4R in regulation of
BP
and in hypertension, which appears to involve actions of the
EP
4R in tissues beyond vascular smooth muscle cells.
Angiography‐Based Machine Learning for Predicting Fractional Flow Reserve in Intermediate Coronary Artery Lesions
Authors: Cho Hyungjoo , Lee June‐Goo , Kang Soo‐Jin , Kim Won‐Jang , Choi So‐Yeon , Ko Jiyuon , Min Hyun‐Seok , Choi Gun‐Ho , Kang Do‐Yoon , Lee Pil Hyung , Ahn Jung‐Min , Park Duk‐Woo , Lee Seung‐Whan , Kim Young‐Hak , Lee Cheol Whan , Park Seong‐Wook , Park Seung‐Jung 
Published: February 2019

Background

An angiography‐based supervised machine learning (
ML
) algorithm was developed to classify lesions as having fractional flow reserve ≤0.80 versus >0.80.

Methods and Results

With a 4:1 ratio, 1501 patients with 1501 intermediate lesions were randomized into training versus test sets. Between the ostium and 10 mm distal to the target lesion, a series of angiographic lumen diameter measurements along the centerline was plotted. The 24 computed angiographic features based on the diameter plot and 4 clinical features (age, sex, body surface area, and involve segment) were used for
ML
by XGBoost. The model was independently trained and tested by 2000 bootstrap iterations. External validation with 79 patients was conducted. Including all 28 features, the
ML
model with 5‐fold cross‐validation in the 1204 training samples predicted fractional flow reserve ≤0.80 with overall diagnostic accuracy of 78±4% (averaged area under the curve: 0.84±0.03). The 12 high‐ranking features selected by scatter search were involved segment; body surface area; distal lumen diameter; minimal lumen diameter; length of a lumen diameter <2.0 mm, <1.5 mm, and <1.25 mm; mean lumen diameter within the worst segment; sex; diameter stenosis; distal 5‐mm reference lumen diameter; and length of diameter stenosis >70%. Using those 12 features, the
ML
predicted fractional flow reserve ≤0.80 in the test set with sensitivity of 84%, specificity of 80%, and overall accuracy of 82% (area under the curve: 0.87). The averaged diagnostic accuracy in bootstrap replicates was 81±1% (averaged area under the curve: 0.87±0.01). External validation showed accuracy of 85% (area under the curve: 0.87).

Conclusions

Angiography‐based
ML
showed good diagnostic performance in identifying ischemia‐producing lesions and reduced the need for pressure wires.