bluuebunny/crossref_metadata_2025_split huggingface dataset:
“A riddle to myself I am”
Authors: Gather Kirsten 
Published: June 2018

Abstract
This article presents and refines the main results of a larger study on left-shifted arguments in congregational song (see Gather 2014) and discusses its implications for genre studies in general. Argument shifting1 is defined as the deviation from any unmarked order of obligatory arguments, as in the title of the famous carol We three kings of Orient are. Very often, requirements of meter and rhyme are evident causes of shifting. In this article, I provide the results obtained for congregational song, which lead to two major patterns of argument shifting with distinct syntactic and poetic criteria. The comparison to secular poetry shows the uniqueness of the phenomenon in congregational song and the conservatism of the genre.
A gene therapeutic approach to inhibit calcium and integrin binding protein 1 ameliorates maladaptive remodelling in pressure overload
Authors: Grund Andrea , Szaroszyk Malgorzata , Döppner Janina K , Malek Mohammadi Mona , Kattih Badder , Korf-Klingebiel Mortimer , Gigina Anna , Scherr Michaela , Kensah George , Jara-Avaca Monica , Gruh Ina , Martin Ulrich , Wollert Kai C , Gohla Antje , Katus Hugo A , Müller Oliver J , Bauersachs Johann , Heineke Joerg 
Published: June 2018

Abstract

Aims
Chronic heart failure is becoming increasingly prevalent and is still associated with a high mortality rate. Myocardial hypertrophy and fibrosis drive cardiac remodelling and heart failure, but they are not sufficiently inhibited by current treatment strategies. Furthermore, despite increasing knowledge on cardiomyocyte intracellular signalling proteins inducing pathological hypertrophy, therapeutic approaches to target these molecules are currently unavailable. In this study, we aimed to establish and test a therapeutic tool to counteract the 22 kDa calcium and integrin binding protein (CIB) 1, which we have previously identified as nodal regulator of pathological cardiac hypertrophy and as activator of the maladaptive calcineurin/NFAT axis.

Methods and results
Among three different sequences, we selected a shRNA construct (shCIB1) to specifically down-regulate CIB1 by 50% upon adenoviral overexpression in neonatal rat cardiomyocytes (NRCM), and upon overexpression by an adeno-associated-virus (AAV) 9 vector in mouse hearts. Overexpression of shCIB1 in NRCM markedly reduced cellular growth, improved contractility of bioartificial cardiac tissue and reduced calcineurin/NFAT activation in response to hypertrophic stimulation. In mice, administration of AAV-shCIB1 strongly ameliorated eccentric cardiac hypertrophy and cardiac dysfunction during 2 weeks of pressure overload by transverse aortic constriction (TAC). Ultrastructural and molecular analyses revealed markedly reduced myocardial fibrosis, inhibition of hypertrophy associated gene expression and calcineurin/NFAT as well as ERK MAP kinase activation after TAC in AAV-shCIB1 vs. AAV-shControl treated mice. During long-term exposure to pressure overload for 10 weeks, AAV-shCIB1 treatment maintained its anti-hypertrophic and anti-fibrotic effects, but cardiac function was no longer improved vs. AAV-shControl treatment, most likely resulting from a reduction in myocardial angiogenesis upon downregulation of CIB1.

Conclusions
Inhibition of CIB1 by a shRNA-mediated gene therapy potently inhibits pathological cardiac hypertrophy and fibrosis during pressure overload. While cardiac function is initially improved by shCIB1, this cannot be kept up during persisting overload.
Selection of Patients’ Recumbent Position Laterality According to Physician Handedness Bias Increases the Success Rate of Lumbar Puncture: A Multicenter Study
Authors: Zhao Jian-Lan , Sun Yi-Rui , Shan Qiao , Xiao Zhi-Peng , Hou Ben-Chao , Hu Jin 
Published: June 2018

Background:Lumbar puncture (LP) is a medical procedure required during spinal anesthesia and for obtaining cerebrospinal fluid samples in the diagnosis of neurological disorders. The aim of this study was to assess the effects of physicians’ handedness bias and the laterality of patients’ recumbent position on the success rate of LPs.Methods and Patients:A prospective multicenter study including 36 physicians (18 left-handed and 18 right-handed) and 7200 patients was conducted in 6 medical centers. In each center, 1200 patients were randomized into group L (LPs performed by left-handed physicians) or group R (LPs performed by right-handed physicians). Each physician performed 200 cases of LPs, of which the laterality of the recumbent position (either on the left or right side) was decided after a second randomization. A successful LP was considered when the free flow of cerebrospinal fluid was observed upon the first attempt.Results:There was no significant difference in patient characteristics between groups L and R. Right-handed physicians had a significantly higher LP success rate with patients in the left lateral recumbent position (LRP) (1595/1800 vs. 1408/1800; odds ratio, 0.539; 95% confidence interval, 0.348-0.836;P=0.006). For left-handed physicians, the LP success rate was higher when patients were in the right LRP (1424/1800 vs. 1593/1800, odds ratio, 0.449; 95% confidence interval, 0.283-0.711;P=0.001). Patients’ age, sex, height, and weight were not statistically related to LP success during multivariate analyses.Conclusions:Physicians handedness bias and patient laterality of recumbent position affects the success of LPs. Right-handed physicians have a greater chance of performing successful LPs when patients are in the left LRP, and vice versa.
Closed Incision Negative Pressure Therapy in Oncological Breast Surgery: Comparison with Standard Care Dressings
Authors: Ferrando Pietro M. , Ala Ada , Bussone Riccardo , Bergamasco Laura , Actis Perinetti Federica , Malan Fabrizio 
Published: June 2018

Background:
Negative pressure wound therapy was developed for treating wounds associated with unfavorable healing factors. The principles of the negative pressure wound therapy applied on clean and closed surgical incision originate the closed incision negative pressure therapy (ciNPT). We evaluated the use of ciNPT in the setting of oncological breast surgery.

Methods:
From January 1, 2015, to June 31, 2015, we prospectively selected 37 patients undergoing oncological breast surgery with a minimum of 4 risk factors. Seventeen patients (25 surgeries) voluntary tested ciNPT (ciNPT sample), whereas the remaining 20 (22 surgeries) chose conventional postsurgery dressing (Standard Care sample). Follow-up controls to evaluate postsurgical complications were performed on days 7, 14, 30, and 90. At 12 months, the quality of life, scar, and overall aesthetic outcomes were evaluated with specific questionnaires filled in by surgeon and patient. The Standard Care sample was investigated on risk factors associated with poor healing.

Results:
The ciNPT sample showed a significant prevalence of high risk factors, especially extensive undermining and bilateral surgeries, and a predominance of women under 65 years; only 1/25 (4%) surgical procedures was followed by complications. In the Standard Care sample, 10 of 22 surgeries (45%) were followed by complications. The difference in complication rate between the 2 samples was significant. The BIS (Body Image Scale) scores suggested that most patients were satisfied with their body image regardless of the type of dressing. All other questionnaire scores clearly vouched for a significant superiority of the ciNPT. Previous surgery ≤ 30 days emerged as the surgery-related high risk factor most frequently associated with postsurgery complications.

Conclusion:
The results of our study support the use of ciNPT in oncological breast surgery: it showed to be a well-tolerated, adaptable, and reliable dressing capable of reducing postsurgical complications and improving scar outcomes in patients presenting with high risk factors.
Predictors of Persistent Tricuspid Regurgitation after Transcatheter Aortic Valve Replacement in Patients with Baseline Tricuspid Regurgitation
Authors: Worku Berhane , Valovska Marie-Therese , Elmously Adham , Kampaktsis Polydoros , Castillo Catherine , Wong Shing-Chiu , Salemi Arash 
Published: June 2018

Objective This study sought to analyze outcomes in patients with moderate-severe tricuspid regurgitation (TR) undergoing transcatheter aortic valve replacement (TAVR). The consequences of uncorrected significant TR in patients undergoing TAVR remain undefined. Methods Between 2009 and 2014, 369 patients underwent TAVR at our institution, and 58 of these had baseline moderate-severe TR. Preoperative, 30-day, and 1-year transthoracic echocardiograms were analyzed. Predictors of persistent TR at 30 days and survival were assessed. Results Fifty-eight patients with baseline moderate-severe TR underwent TAVR. Transcatheter aortic valve replacement resulted in significant reductions in pulmonary artery pressures and TR severity (100% vs 64%; P < 0.001) at 30 days. This was sustained at 1 year and was associated with significant improvements in stroke volume index and New York Heart Association functional class. No changes in right ventricular function or size were noted. The only independent predictor of persistent moderate-severe TR at 30 days was preoperative atrial fibrillation [AF; odds ratio (OR), 4.56; 95% confidence interval, 1.1–18.3; P = 0.033]. Independent predictors of overall long-term survival included AF (OR, 0.41; P = 0.001) and chronic lung disease (OR, 0.47; P = 0.011), but not baseline moderate-severe TR. In patients with baseline moderate-severe TR, persistent moderate-severe TR at 30 days was associated with worsened overall survival (log-rank P = 0.02). Conclusions Baseline moderate-severe TR is not uncommon in patients undergoing TAVR, and frequently improves. However, the presence of AF suggests that that TR is likely to persist after TAVR and is also indicative of a poor long-term outcome. Whether redirecting such patients to surgery for concomitant tricuspid valve repair will further improve outcomes requires further study.
Chronic stress-associated visceral hyperalgesia correlates with severity of intestinal barrier dysfunction
Authors: Creekmore Amy L. , Hong Shuangsong , Zhu Shengtao , Xue Jing , Wiley John W. 
Published: June 2018

Abstract
In humans, chronic psychological stress is associated with increased intestinal paracellular permeability and visceral hyperalgesia, which is recapitulated in the chronic intermittent water avoidance stress (WAS) rat model. However, it is unknown whether enhanced visceral pain and permeability are intrinsically linked and correlate. Treatment of rats with lubiprostone during WAS significantly reduced WAS-induced changes in intestinal epithelial paracellular permeability and visceral hyperalgesia in a subpopulation of rats. Lubiprostone also prevented WAS-induced decreases in the epithelial tight junction protein, occludin (Ocln). To address the question of whether the magnitude of visceral pain correlates with the extent of altered intestinal permeability, we measured both end points in the same animal because of well-described individual differences in pain response. Our studies demonstrate that visceral pain and increased colon permeability positively correlate (0.6008, P = 0.0084). Finally, exposure of the distal colon in control animals to Ocln siRNA in vivo revealed that knockdown of Ocln protein inversely correlated with increased paracellular permeability and enhanced visceral pain similar to the levels observed in WAS-responsive rats. These data support that Ocln plays a potentially significant role in the development of stress-induced increased colon permeability. We believe this is the first demonstration that the level of chronic stress-associated visceral hyperalgesia directly correlates with the magnitude of altered colon epithelial paracellular permeability.
A Randomized Controlled Trial of Balloon Dilation as a Treatment for Persistent Eustachian Tube Dysfunction With 1-Year Follow-Up
Authors: Meyer Ted A. , O’Malley Ellen M. , Schlosser Rodney J. , Soler Zachary M. , Cai Jason , Hoy Mark J. , Slater Patrick W. , Cutler Jeffrey L. , Simpson Roger J. , Clark Michael J. , Rizk Habib G. , McRackan Theodore R. , D’Esposito Christopher F. , Nguyen Shaun A. 
Published: June 2018

Objective:
Compare Eustachian tube balloon dilation versus continued medical therapy (control) for treating persistent Eustachian tube dysfunction (ETD).

Study Design:
Prospective, multicenter, randomized controlled trial.

Setting:
Tertiary care academic center and private practice.

Patients:
Diagnosed with medically refractory persistent ETD.

Interventions:
1:1 Randomization to balloon dilation or control. After 6 weeks, control participants had the option to undergo balloon dilation if symptoms persisted.

Main Outcome Measures:
Primary efficacy endpoint was the comparison between treatment arms in the mean change from baseline in the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score. Primary safety endpoint was complication rate.

Results:
Sixty participants were randomized (31 balloon dilation, 29 control). Mean (SD) change in overall ETDQ-7 score at 6 weeks was −2.9 (1.4) for balloon dilation compared with −0.6 (1.0) for control: balloon dilation was superior to control (p < 0.0001). No complications were reported in either study arm. Among participants with abnormal baseline assessments, improvements in tympanogram type (p < 0.006) and tympanic membrane position (p < 0.001) were significantly better for balloon dilation than control. Technical success was 100% (91 successful dilations/91 attempts) and most procedures (72%) were completed in the office under local anesthesia. Improvements in the ETDQ-7 scores were maintained through 12 months after balloon dilation.

Conclusions:
Balloon dilation is a safe and effective treatment for persistent ETD. Based on improved ETDQ-7 scores, balloon dilation is superior to continued medical management for persistent ETD. Symptom improvement is durable through a minimum of 12 months. Procedures are well tolerated in the office setting under local anesthesia.
Hearing Preservation Outcomes After Cochlear Implantation Depending on the Angle of Insertion: Indication for Electric or Electric-Acoustic Stimulation
Authors: Helbig Silke , Adel Youssef , Leinung Martin , Stöver Timo , Baumann Uwe , Weissgerber Tobias 
Published: June 2018

Objective:
This study reviewed outcomes of hearing preservation (HP) surgery depending on the angle of insertion (AOI) in a cochlear implant (CI) patient population who used electric stimulation (ES) or combined electric-acoustic stimulation (EAS).

Study Design:
Retrospective case review.

Setting:
Tertiary referral university hospital.

Patients:
Ninety-one patients with different degrees of preoperative low-frequency residual hearing who underwent HP surgery with a free-fitting lateral-wall electrode array (MED-EL Flex) with lengths ranging from 20.0 to 31.5 mm.

Intervention:
Cochlear implantation using HP surgery technique and subsequent fitting with CI speech processor for ES, or combined CI and hearing aid speech processor for EAS.

Main Outcome Measures:
Individual AOI were estimated using modified Stenvers’ projection. Freiburg monosyllable test in quiet (free-field presentation at 65 dB SPL) and pure-tone averages for low frequencies (125, 250, and 500 Hz; PTAlow) were evaluated during a follow-up period of 12 months after implantation.

Results:
Estimated AOIs showed bimodal distribution: shallow insertion (SI) with mean AOI of 377 degrees and deep insertion (DI) with mean AOI of 608 degrees. Speech test scores after 12 months were comparable between AOI groups, however, they were significantly different between stimulation types with better scores for EAS. Only ES showed a positive correlation (r = 0.293) between speech test score and AOI. When HP was possible, both SI and DI showed significant postoperative PTAlow shifts with mean of 17.8 and 21.6 dB, respectively. These were comparable between AOI groups and no significant shifts were observed in follow-up intervals. Audiometric indication for HP and subsequent EAS is proposed up to 65 dB HL at 500 Hz, and up to 87 dB HL for HP.

Conclusions:
CI candidates can benefit from HP surgery with deep insertion when only using ES due to insufficient residual hearing. Conversely, candidates with preoperative threshold up to 65 dB HL at 500 Hz could perform significantly better with EAS which requires shallow insertion.
Automated Metrics in a Virtual-Reality Myringotomy Simulator: Development and Construct Validity
Authors: Huang Caiwen , Cheng Horace , Bureau Yves , Ladak Hanif M. , Agrawal Sumit K. 
Published: June 2018

Objectives:
The objectives of this study were: 1) to develop and implement a set of automated performance metrics into the Western myringotomy simulator, and 2) to establish construct validity.

Study Design:
Prospective simulator-based assessment study.

Setting:
The Auditory Biophysics Laboratory at Western University, London, Ontario, Canada.

Participants:
Eleven participants were recruited from the Department of Otolaryngology–Head & Neck Surgery at Western University: four senior otolaryngology consultants and seven junior otolaryngology residents.

Interventions:
Educational simulation.

Main Outcome Measure:
Discrimination between expert and novice participants on five primary automated performance metrics: 1) time to completion, 2) surgical errors, 3) incision angle, 4) incision length, and 5) the magnification of the microscope.

Methods:
Automated performance metrics were developed, programmed, and implemented into the simulator. Participants were given a standardized simulator orientation and instructions on myringotomy and tube placement. Each participant then performed 10 procedures and automated metrics were collected. The metrics were analyzed using the Mann–Whitney U test with Bonferroni correction.

Results:
All metrics discriminated senior otolaryngologists from junior residents with a significance of p < 0.002. Junior residents had 2.8 times more errors compared with the senior otolaryngologists. Senior otolaryngologists took significantly less time to completion compared with junior residents. The senior group also had significantly longer incision lengths, more accurate incision angles, and lower magnification keeping both the umbo and annulus in view.

Conclusions:
Automated quantitative performance metrics were successfully developed and implemented, and construct validity was established by discriminating between expert and novice participants.
Evaluation of the Severity of Hyperlipidemia Pancreatitis Using CT-measured Visceral Adipose Tissue
Authors: Ji Ting , Li Xueliang , Zhang Xiangcheng , Hui Liangliang , Shang Futai , Zhu Xingxing , Guo Lili , Xu Yiming 
Published: June 2018

Background:
Computed tomography–measured visceral adipose tissue (VAT) and the distribution of VAT are highly correlated with the severity and prognosis of acute pancreatitis (AP). To date, all available data are from the overall AP patient population; no subgroup analysis has been conducted to evaluate patients with moderately severe AP or patients with hyperlipidemia acute pancreatitis (HLAP) as independent populations. Currently, studies on the relationship between VAT and HLAP are lacking.

Materials and Methods:
A total of 235 patients with moderately severe AP or severe acute pancreatitis were divided into 2 groups according to whether hyperlipidemia was present: the HLAP group and the non-HLAP group. The general inpatient information was collected, and computed tomography was used to measure VAT, subcutaneous adipose tissue (SAT), total adipose tissue, and VAT/SAT (V/S). The data were subjected to t test, χ2 test, matrix scatter plot, logistic regression, and receiver operating characteristic analyses to evaluate the relationship between VAT and HLAP severity.

Results:
Significant differences were observed in VAT, SAT, total adipose tissue, and triglycerides (TGs) between the HLAP group and the non-HLAP group (P<0.001). Significant correlations were observed between VAT and body mass index (r=0.425, P=0.017) and between VAT and TG (r=0.367, P=0.042). In the HLAP group, VAT, V/S, TG, and local complications may have significant effects on disease severity. The receiver operating characteristic curves showed that VAT and V/S were more reliable than TGs in evaluating disease severity [area under the curve (AUC) of VAT: 0.819, P<0.001; AUC of V/S: 0.855, P<0.001; AUC of TG: 0.671, P=0.04]. Disease severity was reliably evaluated at 139 cm2, the cut-off value of VAT. The cut-off value of V/S was 1.145; high V/S was associated with extended intensive care unit stay. VAT and its distribution had no significant effects on mortality.

Conclusions:
For patients with moderately severe to severe HLAP, VAT was correlated with body mass index and TG. VAT and V/S were valuable factors for evaluating disease severity and prognosis. However, VAT had no effect on mortality, and VAT could not be used to evaluate patients with moderately severe to severe non-HLAP.
Usefulness of the 2-Devices-in-1-Channel Method in Case of Difficult Selective Biliary Cannulation Due to Parapapillary Diverticulum/Diverticular Papilla
Authors: Sakai Yuji , Tsuyuguchi Toshio , Sugiyama Harutoshi , Mikata Rintaro , Ohyama Hiroshi , Yasui Shin , Nakamura Masato , Takahashi Koji , Kumagai Junichjiro , Yamato Mutsumi , Kusakabe Yuko , Shingyoji Ayako , Iino Yotaro , Kato Naoya 
Published: June 2018

Purpose:
To investigate whether the 2-devices-in-1-channel method is useful for selective biliary cannulation in patients with parapapillary diverticulum or intradiverticular papilla, where the papilla cannot be seen from the front.

Materials and Methods:
Biliary cannulation using the 2-devices-in-1-channel method was performed in 28 patients who presented difficulty due to parapapillary diverticulum or intradiverticular papilla. There were 15 men and 13 women whose mean age was 68.8 (58 to 88) years. There were 22 patients with common bile duct stones, 5 with pancreatic cancer, and 1 with gallbladder cancer.

Results:
Selective biliary cannulation was successful in all 28 patients. Common bile duct stones could be removed in all 22 patients after endoscopic sphincterotomy or endoscopic balloon dilation, and all 5 patients with pancreatic cancer as well as the patient with gallbladder cancer were successfully drained. There were no procedure-related complications.

Conclusions:
From these results, we consider the 2-devices-in-1-channel method is useful and safe to perform selective biliary cannulation when the papilla cannot be seen from the front due to parapapillary diverticulum, or intradiverticular papilla.