bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic pulmonary vein isolation during cavotricuspid isthmus ablation for atrial flutter: A meta‐analysis
Authors: Koerber Scott M. , Turagam Mohit K. , Gautam Sandeep , Winterfield Jeffrey , Wharton J. Marcus , Lakkireddy Dhanunjaya , Gold Michael R. 
Published: February 2019

AbstractBackgroundAtrial arrhythmias (AA), including atrial fibrillation (AF), have been reported in patients after cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL). Several studies have examined the effect of performing concomitant pulmonary vein isolation (PVI) with CTI on recurrent AA. These studies were analyzed to determine the overall effect of this approach on recurrent AA.MethodsPubMed and Google Scholar were searched for randomized trials comparing the incidence of AA after CTI versus CTI + PVI until June 2018. Only patients without prior history of AF were included in the recurrent AA analysis. All patients were included in the analyses of other clinical outcomes.ResultsFour randomized control trials were included in the meta‐analysis. In the recurrent AA analysis, a total of 314 patients were randomized in the studies (n = 158 CTI, n = 156 CTI + PVI). Freedom from AA at 1 year was significantly higher in the CTI + PVI group versus CTI alone (odds ratio [OR] 0.25 [0.14, 0.44] 95% confidence interval [CI], P < 0.00001). A total of 550 patients (n = 336 CTI, n = 214 CTI + PVI) were included in analyses for procedure time, fluoroscopy time, and complications rates. Procedure time and fluoroscopy time were significantly longer in the CTI + PVI group (mean difference [MD]: 103.31 min [94.40, 112.23] 95% CI, P < 0.00001) and (MD: 16.47 min [14.89, 18.05] 95% CI, P < 0.00001), respectively. Total complications were statistically similar between groups.ConclusionThis meta‐analysis shows addition of a prophylactic PVI during CTI ablation significantly reduces recurrent AA at 1 year without significantly increasing major complications.
Esophageal position, measured luminal temperatures, and risk of atrioesophageal fistula with atrial fibrillation ablation
Authors: Sandhu Amneet , Zipse Matthew M. , Borne Ryan T. , Aleong Ryan G. , Tompkins Christine , Schuller Joseph , Rosenberg Michael , Varosy Paul D. , Tzou Wendy S. , Nguyen Duy T. , Sauer William H. 
Published: February 2019

AbstractBackgroundDespite improvement in catheter ablation for atrial fibrillation (AF), ability to recognize and prevent esophageal injury remains challenging. We hypothesized that esophageal course may impact esophageal heating, as measured through ablation, and thereby, risk of injury.MethodsWe evaluated all patients undergoing first‐time AF ablation with preprocedural computed tomography (CT) imaging from 2014 to 2016 at our institution, focusing on esophageal position at the left atrial (LA)/pulmonary vein junction. Esophageal luminal temperatures (ELTs) were analyzed by esophageal course. In exploratory work by investigation of published reports of atrioesophageal fistula (AEF), we evaluated for a relationship between esophageal course and risk of AEF.ResultsOf 68 patients, 48.5% had midline, 36.8% leftward, and 14.7% rightward esophageal positions. Of 20 patients (29% of cohort) with esophageal confinement—defined as a midline or leftward position relative to the LA, vertebrae, and aorta, with luminal distortion—14 had leftward position. No significant differences in patient or procedure characteristics were noted between confinement and nonconfinement cohorts. The average peak ELT was significantly higher in those with confinement (36.9°C vs 36.2°C, P < 0.05) and confinement with a left‐sided esophagus (37.1°C vs 36.2°C, P < 0.05). There was a significant correlation between esophageal confinement and risk of AEF (odds ratio [OR]: 2.7, 95% confidence interval [CI]: 1.2‐6.2, P < 0.01).ConclusionApproximately one‐third of patients undergoing AF ablation display leftward esophageal course along the ablation zone on preprocedure CT imaging, with a significant portion exhibiting esophageal confinement. In those with confinement, higher peak ELTs are noted with ablation. Esophageal confinement may be a risk factor for development of AEF.
Stress priming, memory, and signalling in plants
Authors: Hilker Monika , Schmülling Thomas 
Published: February 2019

AbstractPlants need to cope with changing environmental conditions, be it variable light or temperature, different availability of water or nutrients, or attack by pathogens or insects. Some of these changing conditions can become stressful and require strong countermeasures to ensure plant survival. Plants have evolved numerous distinct sensing and signalling mechanisms to perceive and respond appropriately to a variety of stresses. Because of the unpredictable nature of numerous stresses, resource‐saving stress response mechanisms are inducible and become activated only upon a stress experience. Furthermore, plants have evolved mechanisms by which they can remember past stress events and prime their responses in order to react more rapidly or more strongly to recurrent stress. Research over the last decade has revealed mechanisms of this information storage and retrieval, which include epigenetic regulation, transcriptional priming, primed conformation of proteins, or specific hormonal or metabolic signatures. There is also increasing understanding of the ecological constraints and relevance of stress priming and memory. This special issue presents research articles and reviews addressing various aspects of this exciting and growing field of research. Here, we introduce the topic by referring to the articles published in this issue, and we outline open questions and future directions of research.
Lack of synergistic effects in tomato plants co‐infected with tomato severe rugose virus and tomato chlorosis virus
Authors: Bampi D. , Favara G. M. , Edwards Molina J. P. , Rezende J. A. M. 
Published: February 2019

The begomovirus Tomato severe rugose virus (ToSRV) and the crinivirus Tomato chlorosis virus (ToCV), in single and co‐infections, are very common in tomato crops in Brazil. Both viruses are transmitted by the whitefly Bemisia tabaciMEAM1 (biotype B). The objective of this study was to analyse the interaction between ToSRV and ToCV in tomato plants of cultivars Santa Clara and Kada. Plants at 15, 30 and 45 days after emergence were inoculated with 30 viruliferous B. tabaci per plant. The following treatments were compared: plants inoculated with ToSRV, ToCV, ToSRV + ToCV, and healthy (control). The interaction between these viruses was analysed by measuring the virus titre by qPCR and the fresh and dry weights of the aerial parts of the tomato plants. Based on two independent assays, no significant effects for co‐infection of ToSRV and ToCV on virus titres and plant development were observed compared to single infections. The dry weight of tomato plants of both cultivars infected with ToSRV, ToCV, or co‐infected did not differ significantly. However, the dry weight of Santa Clara tomato plants infected with ToSRV, ToCV and ToSRV + ToCV showed mean reductions of 21.5%, 25.5% and 32%, respectively, compared to healthy plants, and mean reductions for Kada were 31.7%, 37.5% and 38%, respectively.
Association of blood donation with iron deficiency among adolescent and adult females in the United States: a nationally representative study
Authors: Patel Eshan U. , White Jodie L. , Bloch Evan M. , Grabowski Mary K. , Gehrie Eric A. , Lokhandwala Parvez M. , Brunker Patricia A. R. , Goel Ruchika , Shaz Beth H. , Ness Paul M. , Tobian Aaron A. R. 
Published: February 2019

BACKGROUNDBlood donation results in a loss of iron stores, which is particularly concerning for young female blood donors. This study examines the association of blood donation and iron deficiency among adolescent and adult females in the United States.STUDY DESIGN AND METHODSA cross‐sectional analysis was performed using data from the 1999–2010 National Health and Nutrition Examination Survey (NHANES). Females who reported their blood donation history in the preceding year and had serum ferritin (SF) measurements were included. Analyses were weighted and stratified by adolescents (16–19 years; n = 2419) and adults (20–49 years; n = 7228). Adjusted prevalence ratios (aPRs) were estimated by multivariable Poisson regression. Standard errors were estimated by Taylor series linearization.RESULTSGeometric mean SF levels (ng/mL) were lower in blood donors compared to nondonors among adolescents (21.2 vs. 31.4; p < 0.001) and among adults (26.2 vs. 43.7; p < 0.001). The prevalence of absent iron stores (SF < 12 ng/mL) was higher in blood donors compared to nondonors among adolescents (22.6% vs. 12.2%; aPR = 2.03 [95% confidence interval (CI) = 1.45–2.85]) and among adults (18.3% vs. 9.8%; aPR = 2.06 [95% CI = 1.48–2.88]). Additionally, the prevalence of iron deficiency anemia (SF < 26 ng/mL and hemoglobin < 12.0 g/dL) was also higher in blood donors compared to nondonors among adolescents (9.5% vs. 6.1%; aPR = 2.10 [95% CI = 1.13–3.90]) and among adults (7.9% vs. 6.1%; aPR = 1.74 [95% CI = 1.06–2.85]). Similar results were observed in a sensitivity analysis restricted to adolescents aged 16 to 18 years.CONCLUSIONSBlood donation is associated with iron deficiency among adolescent and adult females in the United States. These national data call for further development and implementation of blood donation practices aimed toward mitigating iron deficiency.
A blockage monoclonal antibody protocol as an alternative strategy to avoid anti‐CD38 interference in immunohematological testing
Authors: Chinoca Ziza Karen N. , Paiva Tainá A. , Mota Sabrina R. , Dezan Marcia Regina , Schmidt Luciana Cayres , Brunetta Denise Menezes , Ricci Gustavo , Basques Fernando Valadares , Barroso‐Duarte Fernando , Rocha Vanderson , Mendrone‐Junior Alfredo , Dinardo Carla Luana 
Published: February 2019

BACKGROUNDAs CD38 is expressed on red blood cells (RBCs), the plasma of patients on daratumumab (DARA) reacts with the panel cells of pretransfusion tests, masking underlying alloantibodies. The treatment of RBCs with dithiothreitol (DTT) is the most disseminated method to overcome DARA effect on immunohematological tests, but it hampers the identification of potentially harmful antibodies. Our goal was to validate a new strategy, the blockage monoclonal antibody protocol (BMAP), to mitigate the DARA interference on RBCs using anti‐CD38 and antihuman globulin.METHODSSamples of patients receiving DARA were included in the study. Sera were tested using both DTT‐ and BMAP‐treated RBCs, which comprised three steps: 1) titration of monoclonal anti‐CD38, 2) treatment of RBCs obtained from donors with anti‐CD38, and 3) blockage of anti‐CD38–adsorbed RBCs with antihuman globulin.RESULTSTwenty patients were included in the study. Donor RBCs were treated with anti‐CD38 and successfully blocked with antihuman globulin. In 19 patients, DARA‐mediated agglutination was eliminated using both DTT‐ and BMAP‐treated RBCs. In one patient, agglutination persisted when tested against the BMAP‐treated RBCs, and alloantibodies were identified. Patient samples were mixed with commercial anti‐D, ‐C, −e, ‐K, −Jka, ‐Kpb and tested against antigen‐positive BMAP‐treated RBCs, resulting in detection of these antibodies.CONCLUSIONThis study validated a new strategy to minimize the interference of DARA on immunohematological tests. The protocol preserves the integrity of RBC antigens, permitting the detection of antibodies from all blood group systems. The BMAP has potential use in other situations where specific antibodies may interfere with pretransfusion screening.
Diphenhydramine pharmacokinetics after oral and intravenous administration of diphenhydramine and oral administration of dimenhydrinate to healthy dogs, and pharmacodynamic effect on histamine‐induced wheal formation: a pilot study
Authors: Ehling Sarah , Bäumer Wolfgang , Papich Mark G. 
Published: February 2019

BackgroundHistamine type‐1 (H1) receptor antagonists such as diphenhydramine are frequently used for treatment of pruritus in dogs, yet therapeutic efficacy for allergic disorders is reported to be highly variable. Dimenhydrinate is a salt of diphenhydramine and 8‐chlorotheophylline, and has been reported to produce superior oral absorption of diphenhydramine.Hypothesis/ObjectiveTo determine the pharmacokinetic and pharmacodynamic properties of diphenhydramine in dogs after intravenous (1 mg/kg) and oral (5 mg/kg) administration, and when given orally as dimenhydrinate at a dose of 10 mg/kg (≈5 mg/kg diphenhydramine).AnimalsEach drug was administered to six healthy, fasted mixed‐breed dogs in a research facility, using a cross‐over design.Methods and materialsBlood samples were collected for pharmacokinetic analysis of diphenhydramine and chlorotheophylline at defined intervals. Pharmacodynamic response was measured by histamine‐mediated cutaneous wheal formation.ResultsThere was great variability in the data and one dog was an extreme outlier. The mean systemic availabilities of diphenhydramine were 7.8% and 22.0% after oral administration of diphenhydramine and dimenhydrinate, respectively, whereas the mean maximum concentrations were 36 (± 20) and 124 (± 46) ng/mL. The terminal elimination half‐lives of diphenhydramine and dimenhydrinate were 5.0 (± 7.1) and 11.6 (± 17.7) h, respectively. Plasma diphenhydramine concentrations did not correlate with the percentage reduction in histamine‐induced wheal formation. Theophylline reached plasma concentrations considered to be therapeutic for dogs.ConclusionOral absorption of diphenhydramine was approximately three times greater with a longer half‐life when it was administered as the combination product dimenhydrinate.
Clinicopathological findings and clinical outcomes in 49 cases of feline pemphigus foliaceus examined in Northern California, USA (1987–2017)
Authors: Jordan Tyler J.M. , Affolter Verena K. , Outerbridge Catherine A. , Goodale Elizabeth C. , White Stephen D. 
Published: February 2019

BackgroundFew studies have described the pathophysiology, clinical course, treatment outcomes and quality of life (QoL) of cats with pemphigus foliaceus (PF).ObjectiveDescribe clinicopathological features, treatment outcomes and impacts on QoL in felinePF.AnimalsForty‐nine client‐owned cats withPFthat presented to a veterinary teaching hospital between 1987 and 2017.Methods and materialsMedical records and histopathological reports were reviewed to obtain clinicopathological data and treatment outcomes. Owners were contacted and requested to complete a questionnaire to obtain long‐term follow‐up and evaluate the impacts ofPFon QoL of cats and owners.ResultsDomestic short/medium/long hair breeds were most commonly affected, with pinnae, head, haired face, nasal planum and ungual folds most frequently involved. Associated pruritus and systemic signs of illness were common. Vasculopathological changes were noted in a small proportion of cats. Corticosteroid monotherapy was sufficient to induce complete remission in the majority of cats. Pemphigus foliaceus and its management had a negative impact on QoL of both cats and owners. Receiving/administering medications, attending veterinary appointments, and financial and time commitments were cited sources of stress for affected cats and/or owners.Conclusions and clinical importanceResults illustrate that affected cats generally respond favourably to treatment but do require long‐term therapy. The exact aetiology of the vasculopathological changes was unclear; it may reflect the stage or severity of disease or suggest the presence of a cutaneous adverse drug reaction. Clinicians managing cats withPFshould be aware of the potential negative impact on QoL of owners and cats and adjust management accordingly.
First report of the rare RhCE‐depleted D‐‐phenotype in sixteen people of Iranian origin
Authors: Shahverdi Ehsan , Moghaddam Mostafa , Abolghasemi Hassan 
Published: February 2019

Background and ObjectivesIn transfusion medicine, it may be a challenge to acquire compatible blood for patients who have clinically important alloantibodies to high‐prevalence antigens. The aim of this study was to study prevalence of rare D‐‐ phenotype in samples from patients and their relatives referred to the Immunohematology reference laboratory of the Iranian Blood Transfusion Organization and the detection and identification of the phenotype and associated antibodies, particularly in an antenatal setting. This is the first report of the cases evaluated by the IBTO and family studies of the D‐‐ proposita in Iran and possibly the first attempted comprehensive study in the current transfusion‐related literatures.Materials and MethodsThis retrospective cross‐sectional study was carried out on 6720 pregnant women and individuals with difficult positive pretransfusion testing referred for ABO/Rh(D) typing and antibody screening during a period of 8 years from 2008 to December 2016 in the Immunohematology Reference Laboratory of the Iranian Blood Transfusion Organization, Tehran, Iran.ResultsDuring 2008 to December 2016, 16 persons from ten families were detected to have rare D‐‐ phenotype. Anti‐Rh17 and anti‐c were identified in plasma of the 11 persons, including 10 females with a history of multiple unsuccessful pregnancy and the total number of 24 abortions and one male with history of blood transfusion vs. 5 individuals, including an unmarried single woman, 1 person with a history of first‐time pregnancy and 3 persons with a history of multiple pregnancy, who showed no alloimmunization. Based on these collective findings, we interpreted these results as being confirmed as D‐‐ phenotype (0.23%).ConclusionIrrespective of Rh (D) group a serological antibody screening test is recommended to be required in a National prenatal testing guideline.
Waveform-Dependent Electrosurgical Effects on Soft Hydrated
Tissues
Authors: Karaki Wafaa , Lopez Carlos A. , Rahul  , Borca-Tasciuc Diana-Andra , De Suvranu 
Published: February 2019

Abstract
Electrosurgical procedures are ubiquitously used in surgery. The commonly used power modes, including the coagulation and blend modes, utilize nonsinusoidal or modulated current waveforms. For the same power setting, the coagulation, blend, and pure cutting modes have different heating and thermal damage outcomes due to the frequency dependence of electrical conductivity of soft hydrated tissues. In this paper, we propose a multiphysics model of soft tissues to account for the effects of multifrequency electrosurgical power modes within the framework of a continuum thermomechanical model based on mixture theory. Electrical and frequency spectrum results from different power modes at low- and high-power settings are presented. Model predictions are compared with in vivo electrosurgical heating experiments on porcine liver tissue. The accuracy of the model in predicting experimentally observed temperature profiles is found to be overall greater when frequency-dependence is included. An Arrhenius type model indicates that more tissue damage is correlated with larger duty cycles in multifrequency modes.
Validation of the disposable T-piece resuscitator (Neo-Tee): a bench study
Authors: de Groene Lizzy , De Jaegere Anne P , Nijland Olivier J , van Kaam Anton H 
Published: February 2019

ObjectiveThe Neo-Tee Infant T-piece resuscitator is a disposable T-piece resuscitator. The aim of this bench study was to assess the accuracy of the Neo-Tee using a measurement set-up and settings mimicking clinical practice.Study designNine Neo-Tee devices were tested using a face mask interface and a manikin. Pressures were set using the built-in manometer and simultaneously measured at the interface. Peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) were studied under static conditions and positive pressure ventilation (PPV), using a wide range of clinically relevant flows and pressures. Pressures were measured without adjusting for a possible offset of PIP and PEEP after switching from static pressures to PPV. In an additional subset of measurements, PIP/PEEP offsets on the Neo-Tee manometer after starting PPV were adjusted.ResultsUnder static conditions, setting the PEEP level with the Neo-Tee manometer results in overestimation of the true PEEP applied at the airway opening, with a difference of approximately 1.5 cmH2O. When switching to PPV, this difference almost disappears. In contrast to PEEP, PIP levels measured at the airway opening were accurate.Adjusting PIP and PEEP on the built-in manometer after starting PPV was necessary in all measurements, but this did not improve the accuracy of the targeted pressure delivery, especially for PEEP. A gas flow rate of 5 L/min was insufficient to reach commonly used PEEP levels of 5 cmH2O.ConclusionThe Neo-Tee T-piece resuscitator is accurate for delivering a static inflation and PPV, but not for delivering continuous positive airway pressure.
People with chronic obstructive pulmonary disease exacerbations prefer early discharge, then treatment at home
Authors: Cook Rob , Thomas Vaughan , Martin Rosie 
Published: February 2019

The study
Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation
Echevarria C, Gray J, Hartley T, Miller J, Simpson AJ, Gibson GJ, Bourke SC

Published on 24 April 2018
Thorax
2018;73:713-22

This project was funded by the National Institute for Health Research—Research for Patient Benefit Programme (project number PB-PG-0213-30105).

To read the full NIHR Signal, go to:
https://discover.dc.nihr.ac.uk/content/signal-000691/hospital-at-home-treatment-for-copd-flare-ups
Multicentre pilot randomised clinical trial of early in-bed cycle ergometry with ventilated patients
Authors: Kho Michelle E , Molloy Alexander J , Clarke France J , Reid Julie C , Herridge Margaret S , Karachi Timothy , Rochwerg Bram , Fox-Robichaud Alison E , Seely Andrew JE , Mathur Sunita , Lo Vincent , Burns Karen EA , Ball Ian M , Pellizzari Joseph R , Tarride Jean-Eric , Rudkowski Jill C , Koo Karen , Heels-Ansdell Diane , Cook Deborah J 
Published: February 2019

IntroductionAcute rehabilitation in critically ill patients can improve post-intensive care unit (post-ICU) physical function. In-bed cycling early in a patient’s ICU stay is a promising intervention. The objective of this study was to determine the feasibility of recruitment, intervention delivery and retention in a multi centre randomised clinical trial (RCT) of early in-bed cycling with mechanically ventilated (MV) patients.MethodsWe conducted a pilot RCT conducted in seven Canadian medical-surgical ICUs. We enrolled adults who could ambulate independently before ICU admission, within the first 4 days of invasive MV and first 7 days of ICU admission. Following informed consent, patients underwent concealed randomisation to either 30 min/day of in-bed cycling and routine physiotherapy (Cycling) or routine physiotherapy alone (Routine) for 5 days/week, until ICU discharge. Our feasibility outcome targets included: accrual of 1–2 patients/month/site; >80% cycling protocol delivery; >80% outcomes measured and >80% blinded outcome measures at hospital discharge. We report ascertainment rates for our primary outcome for the main trial (Physical Function ICU Test-scored (PFIT-s) at hospital discharge).ResultsBetween 3/2015 and 6/2016, we randomised 66 patients (36 Cycling, 30 Routine). Our consent rate was 84.6 % (66/78). Patient accrual was (mean (SD)) 1.1 (0.3) patients/month/site. Cycling occurred in 79.3% (146/184) of eligible sessions, with a median (IQR) session duration of 30.5 (30.0, 30.7) min. We recorded 43 (97.7%) PFIT-s scores at hospital discharge and 37 (86.0%) of these assessments were blinded.DiscussionOur pilot RCT suggests that a future multicentre RCT of early in-bed cycling for MV patients in the ICU is feasible.Trial registration numberNCT02377830.