bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postnatal undernutrition alters adult female mouse cardiac structure and function leading to limited exercise capacity
Authors: Ferguson David P. , Monroe Tanner O. , Heredia Celia Pena , Fleischmann Ryan , Rodney George G. , Taffet George E. , Fiorotto Marta L. 
Published: February 2019

Key points
Impaired growth during fetal life can reprogramme heart development and increase the risk for long‐term cardiovascular dysfunction.
It is uncertain if the developmental window during which the heart is vulnerable to reprogramming as a result of inadequate nutrition extends into the postnatal period.
We found that adult female mice that had been undernourished only from birth to 3 weeks of age had disproportionately smaller hearts compared to males, with thinner ventricle walls and more mononucleated cardiomyocytes.
In females, but not males, cardiac diastolic function, and heart rate responsiveness to adrenergic stimulation were limited and maximal exercise capacity was compromised.
These data suggest that the developmental window during which the heart is vulnerable to reprogramming by inadequacies in nutrient intake may extend into postnatal life and such individuals could be at increased risk for a cardiac event as a result of strenuous exercise.
AbstractAdults who experienced undernutrition during critical windows of development are at increased risk for cardiovascular disease. The contribution of cardiac function to this increased disease risk is uncertain. We evaluated the effect of a short episode of postnatal undernutrition on cardiovascular function in mice at the whole animal, organ, and cellular levels. Pups born to control mouse dams were suckled from birth to postnatal day (PN) 21 on dams fed either a control (20% protein) or a low protein (8% protein) isocaloric diet. After PN21 offspring were fed the same control diet until adulthood. At PN70 was measured by treadmill test. At PN80 cardiac function was evaluated by echocardiography and Doppler analysis at rest and following β‐adrenergic stimulation. Isolated cardiomyocyte nucleation and Ca2+ transients (with and without β‐adrenergic stimulation) were measured at PN90. Female mice that were undernourished and then refed (PUN), unlike male mice, had disproportionately smaller hearts and their exercise capacity, cardiac diastolic function, and heart rate responsiveness to adrenergic stimulation were limited. A reduced left ventricular end diastolic volume, impaired early filling, and decreased stored energy at the beginning of diastole contributed to these impairments. Female PUN mice had more mononucleated cardiomyocytes; under resting conditions binucleated cells had a functional profile suggestive of increased basal adrenergic activation. Thus, a brief episode of early postnatal undernutrition in the mouse can produce persistent changes to cardiac structure and function that limit exercise/functional capacity and thereby increase the risk for the development of a wide variety of cardiovascular morbidities.
Mat Pilates and aquatic aerobic exercises for women with fibromyalgia: a protocol for a randomised controlled blind study
Authors: Silva Hugo Jario de Almeida , Lins Caio Alano de Almeida , Nobre Thaiza Teixeira Xavier , de Sousa Vanessa Patrícia Soares , Caldas Renata Trajano Jorge , de Souza Marcelo Cardoso 
Published: February 2019

IntroductionPhysical exercises have been recommended to improve the overall well-being of patients with fibromyalgia, with the main objective of repairing the effects of lack of physical conditioning and of improving the symptoms, especially pain and fatigue. Although widely recommended and widely known, few studies support the use of Pilates as an effective method in improving the symptoms of the disease, comparing it with other well-founded exercise modalities. This protocol was developed to describe the design of a randomised controlled study with a blind evaluator that evaluates the effectiveness of mat Pilates, comparing it with aquatic aerobic exercises, in improving pain in women with fibromyalgia.MethodsSixty women aged 18–60 years with a diagnosis of fibromyalgia, with a score of between 3 and 8 points on the Visual Analogue Scale for pain, and who sign the clear and informed consent form will be recruited according to the inclusion criteria. They will be randomised into one of the two intervention groups: (1) Pilates, to perform an exercise programme based on mat Pilates; and (2) aquatic exercise, to participate in a programme of aerobic exercises in the swimming pool. The protocol will correspond to 12 weeks of treatment, with both groups performing the exercises with supervision twice a week. The primary outcome will be pain (Visual Analogue Scale for pain). The secondary outcomes are to include impact related to the disease, functional capacity, sleep quality and overall quality of life. The evaluations will be performed at three points: at baseline and after 6 weeks and 12 weeks of treatment.Ethics and disseminationThis protocol has been approved by the Ethics Committee of FACISA/UFRN (number: 2.116.314). Data collection will begin after approval by the ethics committee. There will be prior contact with the women, at which time all the information about the study and the objectives will be presented, as well as resolution no 466/2012 of the National Health Council of Brazil for the year 2012, which provides guidelines and regulatory standards for research involving human beings. Participants must sign the informed consent form before the study begins.Trial registration numberNCT03149198.
Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses
Authors: Barbateskovic Marija , Krauss Sara Russo , Collet Marie Oxenboell , Larsen Laura Krone , Jakobsen Janus Christian , Perner Anders , Wetterslev Jørn 
Published: February 2019

ObjectivesWe assessed the evidence from reviews and meta-analyses of randomised clinical trials on the effects of pharmacological prevention and management of delirium in intensive care unit (ICU) patients.MethodsWe searched for reviews in July 2017 in: Cochrane Library, MEDLINE, Embase, Science Citation Index, BIOSIS Previews, CINAHL and LILACS. We assessed whether reviews were systematic according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and assessed the methodological quality using ROBIS.Outcome measuresPrimary outcomes: all-cause mortality, serious adverse events, prevention of delirium and management of delirium. Secondary outcomes: quality of life; non-serious adverse events and cognitive function.ResultsWe included 378 reviews: 369 narrative reviews, eight semisystematic reviews which failed on a maximum of two arbitrary PRISMA criteria and one systematic review fulfilling all 27 PRISMA criteria. For the prevention of delirium, we identified the one systematic review and eight semisystematic reviews all assessing the effects of alpha-2-agonists. None found evidence of a reduction of mortality (systematic review RR 0.99, 95% CI 0.79 to 1.24). The systematic review and three semisystematic reviews found no evidence of an effect for the prevention of delirium (systematic review RR 0.85, 0.63 to 1.14). Conversely, four semisystematic reviews found a beneficial effect. Serious adverse events, quality of life, non-serious adverse events and cognitive function were not assessed. We did not identify any systematic or semisystematic reviews addressing other pharmacological interventions for the prevention of delirium. For the management of manifest delirium, we did not identify any systematic or semisystematic review assessing any pharmacological agents.ConclusionBased on systematic reviews, the evidence for the use of pharmacological interventions for prevention or management of delirium is poor or sparse. A systematic review with low risk of bias assessing the effects of pharmacological prevention of delirium and management of manifest delirium in ICU patients is urgently needed.PROSPERO registration numberCRD42016046628.
Nicotine arms race: JUUL and the high-nicotine product market
Authors: Jackler Robert K , Ramamurthi Divya 
Published: February 2019

ObjectiveUntil recently, purveyors of vaping products marketed e-liquids in the 1%–3% range of nicotine concentration with those at 3% described as ‘super high’ intended for two packs/day smokers. The goal of this study is to evaluate the degree to which JUUL, with its 5% nicotine and 75% US market share, has spurred other e-liquid vendors to raise the nicotine levels of their products.MethodsOnline search to identify brands offering e-liquid in exceptionally high nicotine concentration (≥5%) and to catalogue the appearance of devices which emulate JUUL.ResultsJUUL compatible pods (14) and JUUL knock off devices (39) were identified which offer equal or higher nicotine than JUUL. More than 70 e-liquid brands sell high-nicotine products (≥5%) in bulk (≥30 mL) equivalent to >40 cigarette packs. All of these products come in multiple youth appealing sweet and fruity flavours. It was noted that nicotine percentage is inconsistently reported (eg, JUUL is 5% by weight vs 5.9% by volume).ConclusionsJUUL has triggered a widespread rush among aerosol purveyors to market e-liquid in unprecedentedly high nicotine concentrations. The rapidly rising popularity of high-nicotine e-liquids threatens to addict a generation of youth. When sold in large quantity bottles (eg, 30 mL) they represent a childhood poisoning risk. Labelling of nicotine concentration in e-liquids needs to be standardised to avoid consumer confusion. The addictiveness and toxicity of these products makes it imperative that regulators act swiftly to enact protective measures.
Effect of three nitrogen fertilizer sources on denitrification rate under irrigated potato production on sandy soils
Authors: Perron Isabelle , Cambouris Athyna N. , Zebarth Bernie J. , Rochette Philippe , Ziadi Noura 
Published: February 2019

Large inputs of nitrogen (N) are required to optimize yield and quality of potato (Solanum tuberosum L.), and it may result in a high potential for N losses including denitrification. This 5 yr study compared the effect of three N fertilizer sources [ammonium nitrate (AN), ammonium sulfate (AS), and polymer-coated urea (PCU)] at 200 kg N ha−1 (N200) and an unfertilized control (N0) on denitrification rate (DR) from irrigated potato production on a coarse-textured soil in eastern Canada. Fertilizer was banded all at-planting (PCU) or split 40% at-planting and 60% at-hilling (AN and AS). The DR was measured biweekly from planting to harvest at two locations (ridge and furrow) using the acetylene blockage technique. The mean annual DR, averaged across N treatments, ranged from 0.8 to 8.0 μg N2O-N kg dry soil−1 d−1, and it was most closely related to the water inputs in the 72 h before DR measurements. Mean DR averaged across year was greater for N200 than for N0 (4.2 vs. 3.4 μg N2O-N kg dry soil−1 d−1) but did not differ among N sources. Our results suggest that choice of N fertilizer source in sandy soils is more important in controlling losses of N by leaching than by denitrification.
Costal and crural diaphragm function during sustained hypoxia in awake canines
Authors: Ikegami Tetsunori , Ji Michael , Fujimura Naoyuki , Suneby Jagers Jenny V. , Kieser Teresa M. , Easton Paul A. 
Published: February 2019

In humans and other mammals, isocapnic hypoxia sustained for 20–60 min exhibits a biphasic ventilation pattern: initial increase followed by a significant ventilatory decline (“roll-off”) to a lesser intermediate plateau. During sustained hypoxia, the mechanical action and activity of the diaphragm have not been studied; thus we assessed diaphragm function in response to hypoxic breathing. Thirteen spontaneously breathing awake canines were exposed to moderate levels of sustained isocapnic hypoxia lasting 20–25 min (80 ± 2% pulse oximeter oxygen saturation). Breathing pattern and changes in muscle length and electromyogram (EMG) activity of the costal and crural diaphragm were continuously recorded. Mean tidal shortening and EMG activity of the costal and crural diaphragm exhibited an overall biphasic pattern, with initial brisk increase followed by a significant decline ( P < 0.01). Although costal and crural shortening did not differ significantly with sustained hypoxia, this equivalence in segmental shortening occurred despite distinct and differing EMG activities of the costal and crural segments. Specifically, initial hypoxia elicited a greater costal EMG activity compared with crural ( P < 0.05), whereas sustained hypoxia resulted in a lesser crural EMG decline/attenuation than costal ( P < 0.05). We conclude that sustained isocapnic hypoxia elicits a biphasic response in both ventilation and diaphragmatic function and there is clear differential activation and contribution of the two diaphragmatic segments. This different diaphragm segmental action is consistent with greater neural activation of costal diaphragm during initial hypoxia, then preferential sparing of crural activation as hypoxia is sustained. NEW & NOTEWORTHY In humans and other mammals, during isocapnic hypoxia sustained for 20–60 min ventilation exhibits a biphasic pattern: initial increase followed by significant ventilatory decline (“roll-off”). During sustained hypoxia, the function of the diaphragm is unknown. This study demonstrates that the diaphragm reveals a biphasic action during the time-dependent hypoxic “roll-off” in ventilation. These results also highlight that the two diaphragm segments, costal and crural, show differing, distinctive contributions to diaphragm function during sustained hypoxia.
Haptoglobin Phenotype Is Associated With High-Density Lipoprotein–Bound Hemoglobin Content and Coronary Endothelial Dysfunction in Patients With Mild Nonobstructive Coronary Artery Disease
Authors: Asleh Rabea , Levy Andrew P. , Levy Nina S. , Asleh Ayat , Goldenstein Hagit , Segol Inbar , Gulati Rajiv , Lerman Lilach O. , Lerman Amir 
Published: February 2019

Objective—
Coronary endothelial dysfunction (ED) is an early stage of atherosclerosis and is associated with impaired high-density lipoprotein (HDL) function. A functional polymorphism at the haptoglobin (Hp) gene locus (rs72294371) has been associated with marked differences in HDL structure and function. We sought to determine whether Hp phenotype was associated with coronary ED and whether the amount of hemoglobin (Hb) tethered to HDL via Hp was Hp-type dependent and associated with ED.

Approach and Results—

Microvascular and epicardial coronary endothelial function was assessed in 338 individuals with nonobstructive coronary artery disease. Microvascular ED was defined as <50% change in coronary blood flow and epicardial ED as ≥20% decrease in coronary artery diameter after intracoronary acetylcholine infusion. The amount of Hb bound to HDL was measured by ELISA after HDL purification from plasma samples using immune-affinity chromatography. One hundred and seventy of the individuals in this study (50.3%) were diagnosed with microvascular ED, 143 (42.3%) with epicardial ED, and 67 (19.7%) had diabetes mellitus (DM). Hp phenotype was significantly associated with microvascular (
P
=0.01) and epicardial ED (
P
=0.04) among DM individuals. There was a significant and inverse correlation between the amount of HDL-bound Hb and change in coronary blood flow (r=−0.40;
P
<0.0001) and in coronary artery diameter (r=−0.44;
P
<0.0001) in response to acetylcholine infusion. Hb content of HDL was significantly increased in individuals with Hp 2-2 and DM. In a logistic regression model, Hp 2-2 phenotype was associated with microvascular ED (odds ratio, 1.9;
P
=0.03) and the amount of HDL-bound Hb was an independent predictor of both microvascular (odds ratio, 4.6 for each 1-SD increase;
P
<0.0001) and epicardial (odds ratio, 2.2;
P
<0.0001) ED.

Conclusions—
Hp phenotype is significantly associated with coronary ED in DM individuals. This association is likely related to increased Hb tethering to HDL via Hp 2-2 in DM.
Deformation of breast masses between supine ultrasound and prone magnetic resonance imaging
Authors: Yoshida Mariko , Goto Mariko , Sakai Koji , Kiba Maki , Nagano Hitomi , Yamada Kei 
Published: February 2019

Background Breast masses will deform between different postures and modalities in the background mammary gland. However, this difference in deformation between benign and malignant masses has not been studied. Purpose To investigate the feasibility of using the change of the longitudinal-transverse ratio (L/T) of a breast mass from supine ultrasonography (US) and prone magnetic resonance imaging (MRI) as representing deformation in differentiating between benign and malignant masses. Material and Methods The participants were 197 consecutive patients with 201 breast masses (55 benign, 146 malignant) who had undergone both US and MR examinations with histological diagnoses at our hospital from January 2012 to December 2014. On US, the largest transverse diameter of the mass (TUS) parallel to the pectoral muscle and the longitudinal diameter (LUS) perpendicular to the muscle were measured. On prone MRI, the largest transverse diameter of the mass (TMR) parallel to the pectoral muscle and the orthogonally oriented diameter as the longitudinal direction (LMR) were measured. The change of the L/T between these modalities was compared between benign and malignant masses. Results Malignant breast masses showed significantly smaller change of the L/T (median [interquartile range (IQR)] = 13.5% [4.29–24.4]) than benign ones (36.7% [24.3–52.4]) ( P < 0.001). The optimum cut-off value of the change of the L/T for differentiating malignant from benign was 19.1%, with sensitivity, specificity, and area under the curve of 63.7%, 90.9%, and 0.834, respectively. Conclusion The change of the L/T may be a feasible and useful quantitative index for differentiating breast masses.
Epicardial fat, left ventricular strain, and T1-relaxation times in obese individuals with a normal ejection fraction
Authors: Homsi Rami , Yuecel Seyrani , Schlesinger-Irsch Ulrike , Meier-Schroers Michael , Kuetting Daniel , Luetkens Julian , Sprinkart Alois , Schild Hans H. , Thomas Daniel K 
Published: February 2019

Background Cardiac magnetic resonance (CMR) may detect early signs of cardiomyopathy. Purpose The purpose of this CMR study was to evaluate epicardial fat volume (EFV), T1-relaxation times (T1), and left ventricular (LV) strain in non-obese (<30 kg/m2) and obese (>30 kg/m2) individuals with no other cardiovascular risk factor and with a normal LV ejection fraction (LVEF) to detect early changes of obesity cardiomyopathy. Material and Methods Seventy-five individuals (38 men) without additional cardiovascular risk factors were examined at 1.5 T. EFV was assessed by a 3D-Dixon sequence. A 3(3)3(3)5 MOLLI scheme was used to assess T1 (ms). Myocardial strain (%) was evaluated by longitudinal (LS) and circumferential strain (CS) analysis. Results Obese individuals (n = 34; age = 55.6 ± 13.8 years; BMI = 33.4 ± 2.9 kg/m2) had higher EFVs (70.2 ± 27.9 vs. 56.1 ± 25.2 mL/m2; P < 0.05) and T1 values (991.0 ± 38.6 vs. 974.6 ± 32.0; P = 0.061) as well as worse LS and CS values (LS = −21.0 ± 4.8 vs. −23.2 ± 3.7; CS = −23.8 ± 5.7 vs. −27.7 ± 4.2; P < 0.05, for all) compared to non-obese individuals (n = 41; age = 57.2 ± 15.5 years; BMI = 25.1 ± 2.3 kg/m2). Individuals with severe obesity (BMI > 35 kg/m2) had a significantly higher T1 compared to non-obese (1010.5 ± 39.9 vs. 974.6 ± 32.0 ms; P < 0.05). There were no significant differences regarding age or gender. Conclusion Obesity is associated with an increased EFV and a disturbed LV contractility despite a normal LVEF. Myocardial fibrosis as well as metabolic and inflammatory mechanisms of increased epicardial fat may play role. Multi-parametric CMR may be a valuable tool for the detection of such early signs of an obesity cardiomyopathy.
The Addition of Hip Arthroscopy to Periacetabular Osteotomy Does Not Increase Complication Rates: A Prospective Case Series
Authors: Sabbag Casey M. , Nepple Jeffrey J. , Pascual-Garrido Cecilia , Lalchandani Gopal R. , Clohisy John C. , Sierra Rafael J. 
Published: February 2019

Background: Previous studies on periacetabular osteotomy (PAO) reported complication and reoperation rates of 5.9% and 10%, respectively. Hip arthroscopy is increasingly utilized as an adjunct procedure to PAO to precisely treat associated intra-articular pathology. The addition of this procedure has the potential of further increasing complication rates. Purpose: To determine the rates of complication and reoperation of combined hip arthroscopy and PAO for the treatment of acetabular deformities and associated intra-articular lesions. Study Design: Case series; Level of evidence, 4. Methods: Using a prospective database, the authors retrospectively reviewed 248 hips (240 patients) that underwent combined hip arthroscopy and PAO between 2007 and 2016. Data were collected at scheduled follow-up visits at approximately 1 month, 3 to 4 months, and 1 and 2 years after surgery. Mean follow-up from surgery was 3 years (range, 1-8 years). A total of 220 PAOs were done for symptomatic acetabular dysplasia, 18 for symptomatic acetabular retroversion, and 10 for combined acetabular dysplasia and acetabular retroversion. Central compartment arthroscopy was performed for treatment of intra-articular chondrolabral pathology in all cases. Select cases underwent femoral head-neck junction osteochondroplasty either arthroscopically before the PAO or through an open approach after it. Complications were graded according to the modified Dindo-Clavien complication scheme, which was validated for hip preservation procedures. Reoperations (excluding hardware removal) were recorded. Results: Grade III complications occurred among 7 patients (3%) while there were no grade IV complications. Grade III complications included deep infection (n = 3), wound dehiscence (n = 1), hematoma requiring exploration (n = 1), symptomatic heterotopic ossification requiring excision (n = 1), and deep venous thrombosis (n = 1). There were 13 reoperations (5%), and 3 were repeat hip arthroscopy. Univariate Cox hazard models were used to estimate the relative risk factors for complication and reoperation. Increased age (per decade) showed over twice the increased likelihood for complications (hazard ratio, 2.5; 95% CI, 1.67-3.74). Also, preoperative diagnosis of acetabular retroversion, not acetabular dysplasia, showed >3 times the increased risk of reoperation (hazard ratio, 3.05; 95% CI, 1.41-6.61). Conclusion: The rate of complications reported is comparable (3%) with previously published complication rates of PAO without hip arthroscopy. In this cohort, increasing age and diagnosis of acetabular retroversion were associated with higher complication and reoperation rates.