bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of symptomatic recurrent tachyarrhythmia after thoracoscopic ablation for persistent atrial fibrillation
Authors: Gwag Hye Bin , Jeong Dong Seop , Hwang Jin Kyung , Park Seung‐Jung , On Young Keun , Kim June Soo , Park Kyoung‐Min 
Published: March 2019

AbstractBackgroundRecurrent atrial tachyarrhythmia (ATa) is a challenge in all ablation procedures for atrial fibrillation (AF). However, data on ATa after totally thoracoscopic ablation (TTA) is lacking. This study aimed to investigate the mechanisms and outcomes of recurrent ATa after TTA.MethodsEligible patients for the present study were those who underwent electrophysiologic study and catheter‐based radiofrequency ablation (RFA) at least 3 months after TTA for symptomatic recurrent ATa that was refractory to antiarrhythmic drugs and/or cardioversion. Follow‐up outcomes included recurrent ATa after first or repeated RFA.ResultsA consecutive 154 TTA patients were evaluated. A total of 24 patients showed symptomatic recurrent ATa after TTA, and 22 underwent RFA. Half of the patients (11/22, 50%) had AF as a form of recurrent ATa. Nonpulmonary vein (PV)‐related mechanisms of ATa were noted in half of patients. PV gaps showed a characteristic distribution: most gaps in right PVs were located at the posterior ridge (71.4%) with the posterior ridge of left PVs saved in all patients. Post‐RFA recurrence rate was 27.3% during a median follow‐up of 9.1 months, with all recurrences except for one occurring within 3 months after first RFA.ConclusionsDuring a median of 17.8 months after TTA, 24 patients (24/154, 15.6%) developed symptomatic recurrent ATa, and 22 patients underwent RFA. Post‐RFA recurrence rate was 27.3%, which mostly occurred within 3 months after RFA. Catheter‐based ablation of recurrent arrhythmias may be effective, but challenging.
Drug reaction with eosinophilia and systemic symptoms in a cohort of Asian children
Authors: Han Xiuhui D. , Koh Mark J.‐A. , Wong Sharon M.Y. 
Published: March 2019

AbstractBackground/objectivesDrug reaction with eosinophilia and systemic symptoms (DRESS) is rare but potentially fatal in children. Fever and rash, which are salient features of DRESS, may mimic other commonly encountered pediatric conditions. We profiled the DRESS cases in a tertiary children's hospital in Singapore.MethodsThe medical records of all pediatric DRESS patients diagnosed from 2006 to 2016. Data on epidemiology, inciting drugs, clinical, pathologic manifestations, and treatment were assessed.ResultsTen patients aged 4‐16 years old were diagnosed with DRESS within the 10‐year period. Drugs implicated were antibiotics, such as trimethoprim‐sulfamethoxazole, and anticonvulsants, such as carbamazepine, phenobarbitone, and levetiracetam. All patients had fever and pruritic exanthems. Desquamation, purpura, and oral mucositis were also observed. Lymphadenopathy, hepatomegaly, and facial edema occurred frequently. There was liver involvement in all cases, but none progressed to liver failure. Seven patients had eosinophilia, and nine had atypical lymphocytosis. Other laboratory abnormalities included low hemoglobin, thrombocytosis, and prolonged coagulation times. All patients received systemic corticosteroids of varying durations and dosages. Systemic steroids were weaned after 19 days to 4 months. Disease resolution, with liver enzyme levels returning to normal, occurred within 28‐90 days. One patient developed TSH‐receptor‐antibody‐positive hyperthyroidism 6 months after the onset of DRESS, while another patient developed chronic urticaria 4 months after resolution of DRESS.ConclusionEarly recognition of DRESS is important to ensure that the inciting drug is discontinued, and supportive treatment started expediently. Liver involvement was very common but responded well to systemic steroids.
Use of dried urine spots for screening of inborn errors of bile acid synthesis
Authors: Naritaka Nakayuki , Suzuki Mitsuyoshi , Takei Hajime , Chen Huey‐Ling , Oh Seek‐hi , Kaewplang Pinyada , Zhang Chunhua , Murai Tsuyoshi , Kurosawa Takao , Kimura Akihiko , Shimizu Toshiaki , Nittono Hiroshi 
Published: March 2019

AbstractBackgroundIn pediatric patients with cholestasis of unknown cause, inborn errors of bile acid (BA) synthesis (IEBAS) may be considered. For the initial screening for IEBAS, clarification of the urine BA profile is essential. The transportation of urine in a frozen state via air delivery, however, is laborious and costly. This study assessed the feasibility of using dried urine spots (DUS) to establish a more convenient and affordable method of IEBAS screening.MethodsWe created DUS using urine samples from patients with 3β‐hydroxy‐Δ5‐C27‐steroid dehydrogenase/isomerase deficiency (3β‐HSD) and Δ4‐3‐oxo‐steroid 5β‐reductase deficiency as standard preparations. We started accepting DUS specimens by regular mail.ResultsThe ratio of unusual to usual BA is essential for the initial detection of IEBAS, and the recovery rates of abnormal BA were acceptable. The recovery rate of Δ4‐BA on day 28 decreased to 31.8% at 25°C, and to 19.6% at 37°C. Therefore, the sending of DUS should be avoided under conditions of high temperature. Of a total of 49 children with cholestasis, eight new patients were diagnosed with IEBAS using this screening method.ConclusionThe mailing screening system is expected to facilitate the shipment, from regions outside of Japan, of samples for IEBAS screening.
Trichodysplasia spinulosa mimicking lichen nitidus in a renal transplant patient
Authors: Barone Hope , Brockman Ross , Johnson Luke , Al‐Uzri Amira , Wright Mary , Mengden‐Koon Stephanie , Funk Tracy 
Published: March 2019

AbstractTrichodysplasia spinulosa (TS) is a rare cutaneous condition associated with the TSPyV and characterized by skin‐colored, folliculocentric papules with keratin spicule formation. TS is seen almost exclusively in immunosuppressed individuals, often presenting in patients with a history of solid organ transplantation or chemotherapy for a lymphoreticular malignancy. We report a case of widespread TS in a 9‐year‐old girl with a history of renal transplantation complicated by BK viremia, which is also caused by a polyomavirus, BKPyV. The clinical presentation of TS in this case morphologically resembled the more common, harmless skin condition known as “lichen nitidus,” and was more extensive than expected for TS, creating a diagnostic challenge. This case illustrates an important presentation of severe TS of which transplant teams, oncologists, primary care providers, and dermatologists should be aware.
Does smoking during pregnancy mediate educational disparities in preterm delivery? Findings from three large birth cohorts
Authors: Poulsen Gry , Andersen Anne‐Marie Nybo , Jaddoe Vincent W. V. , Magnus Per , Raat Hein , Stoltenberg Camilla , Osler Merete , Mortensen Laust Hvas 
Published: March 2019

AbstractBackgroundSocio‐economic disparities in preterm delivery have often been attributed to socially patterned smoking habits. However, most existing studies have used methods that potentially give biased estimates of the mediating effect of smoking. We used a contemporary mediation approach to study to which extent smoking during pregnancy mediates educational disparities in preterm delivery.MethodsWe performed a comparative analysis of data from three large birth cohort studies: the Danish National Birth Cohort (DNBC), the Dutch Generation R Study, and the Norwegian Mother and Child Cohort Study (MoBa). Risk of preterm delivery by maternal education is reported as risk differences and decomposed into a part explained by smoking and a part explained by other pathways.ResultsProportions of preterm singleton deliveries were 4.8%‐4.9% in all three cohorts. Total effects of maternal education were 2.0 (95% confidence interval [CI] 1.4, 2.5), 3.2 (95% CI 0.8, 5.2) and 2.0 (95% CI 0.9, 3.0) excess preterm deliveries per 100 singleton deliveries in DNBC, Generation R and MoBa when comparing primary/lower secondary education to an academic degree or equivalent. Smoking mediated, respectively, 22%, 10% and 19% of the excess risk in the DNBC, Generation R and MoBa cohorts. Adjustment for potential misclassification of smoking only increased mediated proportions slightly.ConclusionsSmoking during pregnancy explains part of educational disparities in preterm delivery, but the mediated proportion depends on the educational gradient in smoking, emphasising that educational disparities in preterm birth may be mediated by different risk factors in different countries.
Metre‐scale cycles in shallow water carbonate successions: Milankovitch and stochastic origins
Authors: Kemp David B. , Van Manen Saskia M. 
Published: March 2019

AbstractMetre‐scale cycles are a common feature in Precambrian and Phanerozoic shallow water carbonate successions, and astronomically forced changes in sea‐level (Milankovitch cycles) may have been an important driver controlling their deposition. Nevertheless, the degree to which potentially low amplitude astronomically paced sea‐level oscillations may have controlled carbonate accumulation in deep time is unclear. In this study, a stochastic model of carbonate accumulation demonstrates how metre‐scale exposure‐bound sequences can be generated under conditions of random sea‐level change. These sequences have characteristic durations close to Milankovitch cycles, despite the absence of any astronomical control on their formation. Metre‐scale sequences with sub‐Milankovitch (millennial‐scale) durations can also be generated by the model, potentially shedding light on the origin of sub‐Milankovitch sequences such as those recorded on the Middle Triassic Latemar platform of Northern Italy. Sensitivity tests demonstrate how shallow water carbonates may be very sensitive to weak (i.e. low amplitude) astronomically forced sea‐level oscillations. Notably, strong statistical evidence (P < 0·01) for astronomical cycles can be preserved in modelled successions even when astronomical forcing contributes <1% of the sea‐level variance on million year timescales. Taken together, metre‐scale cycles with Milankovitch‐scale durations in ancient carbonate successions may reveal very little about the amplitude, or even the existence, of astronomical forcing as a sea‐level driver.
Circulating CD137+CD8+ T cells accumulate along with increased functional regulatory T cells and thoracic tumour burden in lung cancer patients
Authors: Nong Jingying , Wang Jinghui , Gao Xin , Zhang Qi , Yang Bin , Yan Zhuohong , Wang Xiaojue , Yi Ling , Wang Qunhui , Gao Yuan , Hu Aimin , Qin Na , Wei Panjian , Zhang Hongtao , Zhang Shucai 
Published: March 2019

AbstractCD137 is a promising target for immunostimulation strategies against cancer. Previous studies showed that CD137+CD8+ T cells are enriched in antitumour effector T cells in both preclinical tumour models and cancer patients, but to date, such T cells in the blood of lung cancer patients have not been sufficiently investigated. In this study, circulating antigen‐activated CD8+ T cell subsets, identified as CD137+CD8+ or PD‐1+ (programmed cell death protein 1) CD8+, and regulatory T cells (Treg), identified as CD4+CD25+CD127low/−, in 40 untreated lung cancer patients and in 49 age‐ and sex‐matched healthy controls (HCs) were assessed by flow cytometry. Results were evaluated for associations with lung cancer patient clinical characteristics. Correlations between antigen‐activated CD8+ T cells and effector Treg (CTLA‐4+ [cytotoxic T‐lymphocyte antigen 4] CD4+CD25+CD127low/−) were also investigated. Higher percentages of PD‐1+, CD137+ and PD‐1+CD137+ amongst CD8+ T cells were observed in lung cancer patients compared with HCs. The percentages of CD137+CD8+ and PD‐1+CD137+CD8+ T cell subsets amongst CD8+ T cells were positively correlated with thoracic tumour burden and were strongly positively correlated with the percentage of effector Treg subset. Smoking patients harboured higher percentages of the PD‐1+CD8+ T cell subset compared with non‐smoking patients. This study demonstrated that circulating antigen‐activated CD8+ T cells accumulated in lung cancer patients along with increased effector Treg and thoracic tumour burden. These findings aid a better understanding of immune‐host interactions in lung cancer patients using peripheral blood, and further support immunotherapeutic intervention strategies using combination therapy for differential control of Treg and activation of tumour‐specific effector T cells.
Why self‐regulation success is not the opposite of failure
Authors: Kroese Floor M. 
Published: March 2019

AbstractInspired by some of current Western societies' most pressing problems, much research attention has been devoted to understanding self‐regulation failure. While this has yielded some very valuable insights, the current paper underlines that understanding self‐regulation failure does not mean that we also understand self‐regulation success. Whereas failure and success are semantic antonyms, in terms of self‐regulation research, they should not be regarded as mere opposites. First, on the process level, self‐regulation success versus failure is not simply a matter of inverse explanatory factors (e.g., the capacity to inhibit impulses vs. a lack thereof). Second, on the outcome level, self‐regulation success versus failure is not strictly a matter of inverse behavioral action (e.g., abstaining from versus indulging in immediate gratification). This has significant implications, the most important one being that to understand self‐regulation success, researchers need to take a more holistic perspective rather than mainly considering single instances when studying self‐regulation.
The narrative identity approach and romantic relationships
Authors: Bühler Janina Larissa , Dunlop William L. 
Published: March 2019

AbstractNarrative identity is an internal and evolving life story in which the narrator integrates conceptions of the personal past, present, and presumed future within a coherent story‐based framework. Carrying a number of personal and social implications, this construct represents a psychological resource. We contend that, like life itself, one's history within the romantic domain as well as one's current romantic relationship(s) are often viewed using story‐based frameworks. As such, we argue that the greater adoption of the narrative identity approach within the close relationships literature would complement and extend current assessment paradigms used to study romantic relationships. In this article, we outline the conceptual and methodological background of the narrative identity approach. This is followed by a brief review of extant research using narrative methodologies in the study of romantic relationships. Finally, a series of current and future research directions are presented that rest at the nexus between the narrative identity approach and the study of romantic relationships. We conclude that the more extensive integration of the narrative identity approach within the close relationships literature would contribute to the understanding of such relationships. This is a story worth telling.
Effects of Implementing a Health Team Communication Redesign on Hospital Readmissions Within 30 Days
Authors: Opper Kristi , Beiler Joseph , Yakusheva Olga , Weiss Marianne 
Published: March 2019

AbstractBackground and RationalePoor communication between health team members can interfere with timely, coordinated preparation for hospital discharge. Research on daily bedside interprofessional health team rounds and nursing bedside shift handoff reports provides evidence that these strategies can improve communication.AimsTo improve health team communication and collaboration about hospital discharge; improve patient experience of discharge measured by patient‐reported quality of discharge teaching, readiness for discharge, and postdischarge coping difficulty; and reduce readmissions and emergency department (ED) visits postdischarge.MethodsA two‐sample pre‐ and postintervention design provided baseline data for redesign of health team communication processes and comparison data for evaluation of the new process’ impact. Health team members (n = 105 [pre], n = 95 [post]) from two surgical units of an academic medical center in the midwestern United States provided data on discharge‐related communication and collaboration. Patients (n = 413 [pre], n = 191 [post]) provided data on their discharge experience (quality of discharge teaching, readiness for discharge, postdischarge coping difficulty) and outcomes (readmissions, ED visits). Chi‐square and t tests were used for unadjusted pre‐ and postintervention comparisons. Logistic regression of readmissions with a matched pre‐ and postintervention sample included adjustments for patient characteristics and hospitalization factors.ResultsReadmissions decreased from 18% to 12% (p < .001); ED visits decreased from 4.4% to 1.5% (p < .001). Changes in health team communication and collaboration and patients’ experience of discharge were minimal.DiscussionThe targeted outcomes of readmission and ED visits improved after the health team communication process redesign. The process indicators did not improve; potential explanations include unmeasured hospital and unit discharge, and other care process changes during the study timeframe.Linking Evidence to PracticeEvidence from daily interprofessional team bedside rounding and bedside shift report studies was translated into a redesign of health team communication for discharge. These strategies support readmission reduction efforts.
Nonpharmacological Interventions for Cancer‐Related Fatigue: A Systematic Review and Bayesian Network Meta‐Analysis
Authors: Wu Chunxiao , Zheng Yan , Duan Yuting , Lai Xin , Cui Shaoyang , Xu Nenggui , Tang Chunzhi , Lu Liming 
Published: March 2019

AbstractBackgroundNonpharmacological interventions are the first recommendation for cancer‐related fatigue, according to current guidelines. There are many forms of nonpharmacological interventions for addressing cancer‐related fatigue, but the preferred means remain controversial and are not stated in the guidelines. Therefore, we evaluated the comparative effects and ranks of all major nonpharmacological interventions, according to different assessment methods, in cancer patients with fatigue.MethodsMedline, Embase, Cochrane Library, and Allied and Complementary Medicine Database were searched for randomized controlled trials on nonpharmacological treatments for cancer‐related fatigue. We assessed the trials’ methodological quality using the Cochrane Risk of Bias tool. A Bayesian network meta‐analysis and a comparative effects ranking were performed with Aggregate Data Drug Information System software.ResultsA total of 16,675 items were obtained from the databases, and 182 studies comprising 18,491 participants were included in the analysis. Based on the ranking probabilities, multimodal therapy and qigong ranked best with a Brief Fatigue Inventory; for a Functional Assessment of Cancer Therapy‐fatigue scale, combined psychosocial therapies and bright white light therapy ranked best; for the Piper Fatigue Scale, resistance exercise and mindfulness‐based stress reduction ranked best; for a multidimensional fatigue inventory, multimodal therapy and cognitive behavioral therapy (CBT) ranked best; for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ‐C30), acupuncture and CBT ranked best; and for the Profile of Mood States Fatigue Subscale, multimodal therapy, qigong, aerobic exercise, and CBT ranked best. Comprehensive analysis of the results indicated that multimodal therapy, CBT, and qigong might be the optimum selections for reducing cancer‐related fatigue. Most of the included studies had low risk of methodological quality problems; however, 59 studies had low methodological quality.Linking Evidence to ActionDifferent interventions have their own sets of advantages for addressing cancer‐related fatigue. These results can be utilized as evidence‐based interventions for healthcare workers and patients to manage cancer‐related fatigue.
Patient, Nurse, and Organizational Factors That Influence Evidence‐Based Fall Prevention for Hospitalized Oncology Patients: An Exploratory Study
Authors: Tucker Sharon , Sheikholeslami Deborah , Farrington Michele , Picone Debra , Johnson Janis , Matthews Grace , Evans Rhonda , Gould Renee , Bohlken Deborah , Comried Lynn , Petrulevich Kelly , Perkhounkova Elena , Cullen Laura 
Published: March 2019

AbstractBackgroundHospital falls remain common despite decades of studies and guidelines to reduce their rate. Research evidence alone is insufficient, and integration of patient values and preferences, clinician expertise and experiences, and organizational culture is needed to ensure sustainable practice changes. Little is known about the best strategies for integrating these constructs to sustain effective fall prevention programs.AimsGuided by the Comprehensive Framework for Implementation Research (CFIR), this study aimed to identify patient, nursing staff, and organizational‐level factors that influence effective and sustainable fall prevention strategies with the goal of identifying variables amenable to targeted interventions.MethodsA descriptive research design engaged four oncology units in a Midwestern academic medical center and included patients (N = 39) and nursing staff (N = 70). Questionnaire data were collected from patients with interview assistance, and nursing staff completed a demographic form and two standardized instruments adapted for the study. Data were analyzed using descriptive statistics and narrative summaries.ResultsFindings indicated two‐thirds of patients did not see themselves at risk for falling, despite nearly half having a fall history. Nursing staff indicated knowledge gaps related to specific known risks and interventions, and confidence in fall prevention management was lowest for team communication about patient risks and engaging patients and families in preventing falls.Linking Evidence to ActionEngagement of patients in fall risk assessment and management, clear and routine communication among team members, and creating a culture of true engagement with appropriate leadership and resources can potentially improve the sustainability of successful fall prevention programs. The CFIR can guide the planning of fall prevention and other evidence‐based practice changes to become hardwired and sustainable over time even with the ongoing introduction of new initiatives.