bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of single position endoscopic laser balloon ablation for atrial fibrillation: The open 8 approach
Authors: Iliodromitis Konstantinos E. , Silva Etel , De Potter Tom 
Published: December 2018

AbstractIntroductionAblation without shaft repositioning may make the endoscopic laser ablation system (EAS) more like a single shot approach. We tested the feasibility of wide circumferential ablation (WCA; no carina ablation and no shaft repositioning) in an “open 8” pattern for pulmonary vein isolation (PVI).Methods and ResultsForty‐eight patients (n = 48, age 64.6 ± 12 years) with paroxysmal and persistent atrial fibrillation (AF) were referred to our center for PVI with the EAS. WCA for the lateral and septal pulmonary veins was attempted in all patients. If not feasible, individual full circular isolation of each pulmonary vein (iPVI) was performed. Additional lesions were applied if acute complete electrical isolation was not achieved on the first encirclement. Any documented episode of AF after a 1‐month blanking period was registered as a recurrence. Bilateral WCA was feasible in 21 out of 48 patients (43.8%). Additional lesions for complete electrical isolation after the first‐pass ablation were less in WCA compared with iPVI (P = 0.02). WCA was accomplished faster, with less applied energy at both lateral (P < 0.01) and septal side (P < 0.01). The mean follow‐up of the patient population was 232 ± 150 days. AF recurrence occurred later in patients treated with WCA (315 ± 124 vs 110 ± 88 days, P = 0.008).ConclusionsWCA with the EAS is safe, at least moderately feasible and highly effective, if achieved. Compared with iPVI it may be less time consuming, results in less energy application, and suppresses AF more effectively.
Catheter ablation versus surgical ablation combined with mitral valve surgery for nonparoxysmal atrial fibrillation in patients with moderate mitral regurgitation
Authors: Chen Jindong , Xie Xiaoyi , Zhang Jianfeng , Wang Hao , Zhou Mengmeng , Zhang Jing , Wu Weihua , Zhao Liang 
Published: December 2018

AbstractObjectiveThere are scarce comparative data on efficacy and procedural safety between radiofrequency catheter ablation (RFCA) and surgical ablation (SA) combined with mitral valve (MV) surgery for patients with nonparoxysmal atrial fibrillation (AF) and moderate mitral regurgitation (MR).Methods and ResultsThis single‐center, retrospective, and observational study enrolled 155 consecutive patients with nonparoxysmal AF and moderate MR, of which 98 underwent RFCA and 57 underwent SA combined with MV surgery. Circumferential pulmonary vein ablation, bidirectional block of lines, and disappearance of complex fractionated atrial electrograms were the endpoints of RFCA, while pulmonary vein isolation and left and right atrial incisions were performed in SA. At median 24‐month follow‐up, the primary outcome of atrial tachyarrhythmia (ATa) recurrence‐free rate estimated by Kaplan‐Meier analysis was higher in SA + MV surgery vs RFCA groups (64.2% vs 38.3%; P = 0.002), and comparable between patients with and without MV prolapse in SA + MV surgery group (64.7% vs 63.1%;
P = 0.972). In adjusted Cox model, RFCA was associated with a hazard ratio for ATa recurrence of 2.27 (95% confidence interval, 1.02‐5.05;
P = 0.045). Patients with higher MR jet/LA (left atrial) area ratio had a higher risk of ATa recurrence in RFCA (
P = 0.037) but not SA + MV (
P = 0.529) groups.ConclusionSA + MV surgery yielded more favorable outcomes than RFCA for treating nonparoxysmal AF in patients with moderate MR. The MR jet/LA area ratio was positively associated with ATa recurrence rate in patients undergoing RFCA. MV prolapse did not affect prognosis in patients undergoing SA + MV surgery.
Clinical impact of insulin resistance on pulmonary vein isolation outcome in patients with paroxysmal atrial fibrillation
Authors: Hijioka Naoko , Kamioka Masashi , Matsumoto Yoshiyuki , Nodera Minoru , Yamada Shinya , Kaneshiro Takashi , Yoshihisa Akiomi , Ishida Takafumi , Takeishi Yasuchika 
Published: December 2018

AbstractIntroductionThe relationship between insulin resistance and atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) remains unclear.MethodsDrug‐refractory 114 paroxysmal AF patients (89 males, 62 ± 8 years) who underwent successful PVI were enrolled. Homeostasis model assessment of insulin resistance (HOMA‐IR) was calculated and a value of ≥2.5 was defined as insulin resistant. The left atrial volume index (LAVI) was measured using echocardiography before and 1 year after PVI. Tumor necrosis factor‐α (TNF‐α) and TGF‐β1 serum levels were measured before PVI, and the left atrium (LA) conduction velocity was calculated. The patients were divided into two groups (group 1: HOMA‐IR < 2.5, n = 81; group 2: HOMA‐IR ≥ 2.5, n = 33).ResultsThe LAVI between the two groups before PVI did not significantly differ (P > 0.05), nor did TNF‐α (7.7 ± 2.0 vs 7.5 ± 1.0 pg/mL; P = 0.149) or TGF‐β1 (28.4 ± 12.0 vs 27.6 ± 10.3 ng/mL; P = 0.757). LAVI before and 1 year after PVI in each group did not change. The conduction velocity of group 2 was slower than that of group 1 (0.7 ± 0.1 vs 1.1 ± 0.3 m/s, P < 0.001). Kaplan‐Meier analysis showed significantly higher AF recurrence in group 2 than that in group 1 (
P = 0.019). Cox multivariable analysis revealed that insulin resistance was an independent predictor of recurrence (hazard ratio 1.287, P = 0.004).ConclusionOur results suggest that insulin resistance promotes LA electrical remodeling and might be related to AF recurrence after PVI.
Mechanisms and management of inappropriate therapy in subcutaneous implantable cardioverter defibrillators
Authors: Karnik Ankur A. , Helm Robert H. , Monahan Kevin M. 
Published: December 2018

AbstractSubcutaneous implantable cardioverter defibrillators (S‐ICDs) provide reliable defibrillation and have enhanced supraventricular tachycardia discrimination and fewer infection rates compared with traditional transvenous systems. However, inappropriate shocks remain a frequent problem. Herein, we review the various mechanisms of these inappropriate therapies, some of which are unique to S‐ICDs, and propose an algorithm for preventing recurrences. Proper screening of preimplants is essential to help minimize inappropriate therapies, but patients with hypertrophic cardiomyopathy, Brugada syndrome, and arrhythmogenic right ventricular cardiomyopathy are at particular risk and may require additional measures.
Impact of myo‐inositol trispyrophosphate (ITPP) on tumour oxygenation and response to irradiation in rodent tumour models
Authors: Tran Ly‐Binh‐An , Cao‐Pham Thanh‐Trang , Jordan Bénédicte F. , Deschoemaeker Sofie , Heyerick Arne , Gallez Bernard 
Published: December 2018

AbstractTumour hypoxia is a well‐established factor of resistance in radiation therapy (RT). Myo‐inositol trispyrophosphate (ITPP) is an allosteric effector that reduces the oxygen‐binding affinity of haemoglobin and facilitates the release of oxygen by red blood cells. We investigated herein the oxygenation effect of ITPP in six tumour models and its radiosensitizing effect in two of these models. The evolution of tumour pO2 upon ITPP administration was monitored on six models using 1.2 GHz Electron Paramagnetic Resonance (EPR) oximetry. The effect of ITPP on tumour perfusion was assessed by Hoechst staining and the oxygen consumption rate (OCR) in vitro was measured using 9.5 GHz EPR. The therapeutic effect of ITPP with and without RT was evaluated on rhabdomyosarcoma and 9L‐glioma rat models. ITPP enhanced tumour oxygenation in six models. The administration of 2 g/kg ITPP once daily for 2 days led to a tumour reoxygenation for at least 4 days. ITPP reduced the OCR in six cell lines but had no effect on tumour perfusion when tested on 9L‐gliomas. ITPP plus RT did not improve the outcome in rhabdomyosarcomas. In 9L‐gliomas, some of tumours receiving the combined treatment were cured while other tumours did not benefit from the treatment. ITPP increased oxygenation in six tumour models. A decrease in OCR could contribute to the decrease in tumour hypoxia. The association of RT with ITPP was beneficial for a few 9L‐gliomas but was absent in the rhabdomyosarcomas.
Outcomes following colorectal cancer surgery: Results from a population‐based study in Queensland, Australia, using quality indicators
Authors: Theile David E. , Philpot Shoni , Blake Michael , Harrington John , Youl Philippa H. 
Published: December 2018

AbstractRationale, aims and objectivesColorectal cancer (CRC) is one of the most common cancers diagnosed worldwide, and rates are continuing to rise. Surgery is the primary treatment for CRC, and our aim was to examine clinical outcomes following major resection using a series of established quality indicators and to identify factors associated with poor clinical outcomes.MethodThis population‐based retrospective study included 4321 patients with diagnosed with CRC in 2012 and 2014 in Queensland, Australia, who underwent a major resection. Primary outcomes included in‐hospital mortality, 30‐day unplanned readmission, extended hospital stay (>21 days), and 30‐ and 90‐day mortality. Multivariable logistic regression modelling was conducted to establish factors independently associated with each outcome of interest.ResultsOverall, in‐hospital mortality was 1.5%, 3.0% had an unplanned readmission, 8% had an extended hospital stay, and 30‐ and 90‐day postoperative mortality was 1.6% and 3.1%, respectively. After adjustment, we found that factors such as older age, presence of comorbidities, emergency admission, and stoma formation were significantly associated with poorer outcomes with these findings being consistent across each of the outcomes of interest. In addition to these factors, the risk of 90‐day mortality was significantly elevated for patients with advanced stage disease (OR = 1.95, CI 1.35‐2.82). Sex, primary site, hospital volume, residential location, nor socioeconomic status was found to be associated with any of the outcomes of interest.ConclusionOverall, the risk of poorer clinical outcomes for CRC patients in Queensland, Australia, is low. There is however a subgroup of patients at particularly elevated risk of poorer outcomes following CRC. Strategies to reduce the poorer clinical outcomes this group of patients experience should be explored.
Validation of a laser based in‐line aflatoxin sorting technology in Spanish type raw peanut in factory‐scale production conditions
Authors: Liu Jenney Jing , Cai Zhenzhen , Liao Yongcheng , Zhao Lina , Moulin Julie , Hartmann Christoph 
Published: December 2018

AbstractAflatoxin (AF) contamination of peanuts represents a significant food safety risk. Developing a rapid and non‐destructive method for in‐line AF detection has received significant attentions. This study confirmed the effectiveness of a laser based in‐line AF sorting technology in a peanut processing factory, with 99% specificity and 75% sensitivity for aflatoxin B1 (AFB1). In total, 80 in‐line sorting trials were undertaken. The accepted samples from 99% trials had AFB1 below 10 μg/kg. In 75% of the trials, the AFB1 content of the rejected material exceeded 10 μg/kg by up to a factor of ca. 20. At a throughput of 2.4–4.0 tons per hour, the rejection rate ranged from 0.7 to 4.7%. No significant differences in AFB1 level and rejection rate were observed among different suppliers nor were there differences among the different quality grades. Overall, the sorter effectively removed AF contaminated peanuts without comprising the line throughput.Practical applicationsThe validated in‐line sorting technology can be used in food factories for the control of aflatoxins in food samples such as oilseeds and grains. Furthermore, the technology can be developed for the control of other kinds of mycotoxins.
Aiming for complete safety of first trocar insertion of laparoscopic surgery: usefulness of preoperative ultrasonography of umbilical region
Authors: Nishimura Kazuaki , Yoshimura Kazuaki , Hoshino Kaori , Myoga Mai , Hachisuga Toru 
Published: December 2018

AbstractAimVascular or intestinal injuries at the time of the first trocar insertion can cause serious complications during laparoscopic surgeries. In this study, we evaluate the usefulness of ultrasound scans of the umbilical region as well as intraumbilical conditions to help prevent serious complications.MethodsThe subjects included 430 cases who underwent laparoscopic gynecologic surgeries. The umbilical ultrasound scan was performed after tracheal intubation to observe the intestinal movements associated with respiration. Structures of the umbilical region as well as peristalsis and the movement of the intestinal tract were observed. Then, the thickness of the subcutaneous fat (between the umbilical skin surface and the rectus fascia) and the preperitoneal fat (between the rectus fascia and the peritoneum) were measured. The relationship between body mass index (BMI), insertion time of the first trocar and ultrasound measurements were analyzed.ResultsThe anatomical structures of the umbilical region (the subcutaneous tissue and the preperitoneal fat) were clearly observed in all cases. The BMI score had a significant relationship with subcutaneous fat thickness (r = 0.547), but remarkably not with preperitoneal fat thickness (r = 0.174). There was no significant relationship between BMI and insertion time. However, insertion time of the first trocar had a significant relationship with preperitoneal fat thickness (r = 0.534).ConclusionsPreoperative ultrasonography of the umbilical region is asimple process, and it is helpful inpreventing serious complications caused by the first trocar insertion. We have found that preperitoneal fat thickness seems to be an important factor in predicting the potential difficulty of the first trocar insertion.
Motherhood Penalties in the U.S., 1986–2014
Authors: Jee Eunjung , Misra Joya , Murray‐Close Marta 
Published: December 2018

ObjectiveThis article aims to determine whether the wage penalty for motherhood changed in the United States between 1986 and 2014 and to assess the relative impact of education and experience on the penalty over time.BackgroundMothers earn less than childless women. Although mothers' educational levels and labor market experience have increased over time, most studies do not analyze the motherhood penalty over time.MethodThis article uses ordinary least squares and fixed effects regressions to estimate the motherhood penalty in three time periods (1986–1995, 1996–2004, and 2006–2014) and compares the penalty across time periods. The data used in the analysis are from the U.S. Panel Study of Income Dynamics, one of the only nationally representative data sets that contains a measure of actual labor market experience.ResultsThe motherhood penalty remains quite stable over time and may have worsened for mothers with one child. The gross gap in pay between childless women and mothers of two or more children has narrowed only because mothers' have increased their investments in human capital, such as education and workforce experience. Ordinary least squares and fixed effects models provide similar results.ConclusionMothers' human capital investment may not be enough to lower the motherhood wage penalty in the United States.
The deadlock of saying “That is what we already do!” A thematic analysis of mental healthcare professionals’ reactions to using an evidence‐based intervention
Authors: Jørgensen Rikke , Christiansen Jette , Nissen Hanne Becker , Kristoffersen Karin , Zoffmann Vibeke 
Published: December 2018

Accessible SummaryWhat is known on this subject?

There is a need to shed light on healthcare professionals’ reactions to the use of the Guided Self‐Determination method in a mental health hospital to better understand and adjust the implementation process of evidence‐based practice.

Healthcare professionals´ values and beliefs play an important role when implementing evidence‐based practice in real‐world healthcare settings.

What this paper adds to existing knowledge?

The study identifies opposite positions in mental healthcare professionals: being ready or resistant to change when implementing an evidence‐based intervention. The positions are elaborated in four thematic dynamic continuums describing reactions to using the intervention.

In addition, this is the first study to explore mental healthcare professionals´ reactions to using the Guided Self‐Determination method in a mental health context.

What are the implications for practice?

When preparing implementation of an evidence‐based intervention, it is important to consider adaptation of the intervention, the mental healthcare professionals’ acceptability, support from management and participation in supervision.

In future research, it is important to consider collecting data from mental healthcare professionals trained in using an evidence‐based intervention, however not using it in clinical practice, to understand barriers towards evidence‐based practice.

AbstractIntroductionEvidence‐based interventions are required in mental health nursing to improve quality and outcome for patients. However, there is a need to shed light on professionals’ reactions to the use of evidence‐based interventions to better understand and adjust the implementation process.AimTo explore mental healthcare professionals´ reactions to using the evidence‐based intervention Guided Self‐Determination method in the care of inpatients with severe mental illness.MethodA qualitative study conducted in relation to an 8 months implementation program. Data collection: 9 qualitative interviews and field notes generated from supervision of the intervention.ResultsFour themes emerged from a thematic analysis: “The expert becomes novice,” “Theory used as a looking glass,” “Guided Self‐Determination perceived as an interruption” and “Becoming an informer of the impact of GSD.”DiscussionUsing the themes may help leaders or researchers predict or discover the support needed by individual professionals.Implications for practiceWhen preparing implementation of an evidence‐based intervention, it is important to consider adaptation and acceptability, as well as support from management and participation in supervision. Finally, it is worth to consider collecting data from trained professionals, who did not use the intervention in practice to understand barriers towards evidence‐based practise.
Textural, mechanical, and microstructural properties of restructured pimiento alginate‐guar gels
Authors: Mousavi Seyyed Mohammad Reza , Rafe Ali , Yeganehzad Samira 
Published: December 2018

AbstractTextural, mechanical, microstructural, and thermal properties of reconstituted pimiento alginate‐guar gels subjected to thermal and mechanical stresses during pasteurization process were investigated. Alginate‐guar gelling system at ratio 2:1 at different calcium chloride concentrations (2–8%) and varying acid conditions including citric and lactic acid 1% were evaluated. Textural profile analysis parameters viz. hardness, springiness, gumminess, cohesiveness, adhesiveness as well as mechanical properties, structural, thermal, and morphological characteristics of pimiento strips were examined. Gel strength and elasticity of pimiento strips were increased at higher calcium levels. Fracturability was decreased clearly revealed the gel system, regain its strength in spite of high pulp content (25%) and can maintain its own structure. Increase in hardness and reduction in springiness showed loss of elasticity, which may be attributed to the gel shrinkage during thermal processing, making it more compact and dense. Therefore, the restructured pimiento strips were completely thermo stable at pasteurization temperature. By increasing alginate and calcium level in the pimiento strip, glass transition temperature was reduced from 112 to 98°C. Fourier transform infrared spectroscopy studies confirmed that the gel network structure at acidic conditions was stable and acid type did not has significant effect on the chemical interactions. The microstructural results showed ellipsoidal and compact structure in which can be an evidence of high elasticity and rigidity of pimiento gels. These results completely approved the high elasticity and rigidity of the pimiento strips and their ability to sustain successfully thermal and mechanical stresses with appreciable textural integrity during processing such as pasteurization.Practical applicationsRestructured pimiento strip for stuffing into cocktail olives is a challenging problem in binary composite hydrogels of alginate and guar gum. The strips should be designed to be strong enough to handle mechanically and cut easily without tearing. Furthermore, it had to withstand to pasteurization process and be flexible to bend like a hairpin into the pit hole of olive. In addition, it also had low syneresis and shrinkage that the strips not fall out of the olive hole during storage. In the view point of marketing and nutritional aspects, it is more advantageous to develop a restructured fruit gel systems several times higher than the limiting 10% pulp because of its weak structure. Therefore, alginate‐gel systems containing 25% pimiento pulp were evaluated at different levels of calcium chloride and thermal processing.
Molecular epidemiology of hepatitis B virus mutants associated with vaccine escape, drug resistance and diagnosis failure
Authors: Di Lello Federico A. , Ridruejo Ezequiel , Martínez Alfredo P. , Pérez Paula S. , Campos Rodolfo H. , Flichman Diego M. 
Published: December 2018

SummaryThe massive implementation of the vaccine and antiviral agents against hepatitis B virus (HBV), targeting the envelope and viral polymerase genes, induces a selection pressure that might lead to the emergence of variants that impair the effectiveness of the vaccine, diagnostic methods and antiviral therapy. The aim of this study was to evaluate the prevalence of HBV vaccine escape mutants (VEMs), diagnostic failure mutants (DFMs) and treatment resistance mutants (ARMs) among individuals from Buenos Aires, Argentina. HBV surface antigen and polymerase sequences obtained from serum samples of 530 HBV‐infected individuals were analysed. Samples belonged to genotypes A (28.1%), D (13.6%) and F (58.3%). VEMs, DMFs and ARMs were present in 40 (7.5%), 57 (10.7%) and 27 (5.1%) samples within the studied population. Additionally, eight nonpreviously reported VEMs and nine DFMs were identified. VEMs and DFMs were biased by genotype, being higher in genotype D (33.3% and 33.3%) compared to genotype A (6% and 17.4%) and genotype F (2.3% and 2.3%) (P > 0.001). On the contrary, there was no association between the presence of ARMs and HBV genotype (P = 0.324). VEMs, DFMs and ARMs create public health concerns. The current study provided valuable information about mutants in surface antigen and polymerase in HBV‐infected patients from Argentina where HBV‐F is the most prevalent genotype. Consequently, it constitutes an important reference for Latin American clinicians in order to optimize the management of HBV‐infected patients.