bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corticotropin-releasing hormone projections from the paraventricular nucleus of the hypothalamus to the nucleus of the solitary tract increase blood pressure
Authors: Wang Lei A. , Nguyen Dianna H. , Mifflin Steve W. 
Published: December 2018

Activation of corticotropin-releasing hormone (CRH) type 2 receptors (CRHR2) in the nucleus of the solitary tract (NTS) contributes to the development of hypertension, but the source of CRH inputs to the NTS that increases blood pressure remains unknown. This study tested the hypothesis that activation of CRH-containing projections from the paraventricular nucleus of the hypothalamus (PVN) to the NTS increase blood pressure. We expressed channelrhodopsin 2 (ChR2), a light-sensitive ion channel, into CRH-containing neurons in the PVN. This was achieved by injecting Cre-inducible virus expressing ChR2 into the PVN of CRH-Cre mice. CRH-Cre mice are genetically modified mice expressing Cre recombinase only in neurons producing CRH. We found that optogenetic stimulation of CRH-containing somas in the PVN or CRH-containing fibers in the NTS originating from the PVN significantly increased blood pressure and heart rate. Microinjection of K-41498 (CRHR2 antagonist) into the NTS attenuated the pressor and tachycardiac responses induced by optogenetic stimulation of CRH-containing somas in the PVN. In vitro loose-patch recordings revealed that optogenetic stimulation of CRH-containing fibers in the NTS originating from the PVN significantly increased the discharge frequency of NTS neurons. This effect was attenuated by pretreatment of K-41498 and was abolished by pretreatment of kynurenic acid (nonselective glutamate receptor antagonist). These results suggest that activation of PVN-NTS CRH-containing projections increases blood pressure and heart rate. The cardiovascular responses may be mediated at least in part by the corelease of CRH and glutamate from NTS CRH-containing axons originating from the PVN. NEW & NOTEWORTHY Optogenetic stimulation of paraventricular nucleus of the hypothalamus (PVN) corticotropin-releasing hormone (CRH)-containing somas or nucleus of the solitary tract (NTS) CRH-containing fibers originating from the PVN increased blood pressure and heart rate. Corelease of CRH and glutamate from NTS CRH-containing axons originating from the PVN may contribute to the pressor and tachycardiac responses elicited by optogenetic stimulation of PVN CRH-containing somas.
Impact of Family Socioeconomic Status on Health‐Related Quality of Life in Children With Critical Congenital Heart Disease
Authors: Xiang Li , Su Zhanhao , Liu Yiwei , Huang Yuan , Zhang Xiaoling , Li Shoujun , Zhang Hao 
Published: December 2018

Background

Socioeconomic status (
SES
) is associated with health‐related quality of life (
HRQOL
) for children with critical congenital heart disease; however, literature from newly industrialized countries is scarce.

Methods and Results

This cross‐sectional study included 2037 surviving patients operated on for critical congenital heart disease at a tertiary hospital in China between May 2012 and December 2015. All eligible patients were aged 2 to 12 years.
HRQOL
was measured by the Pediatric Quality of Life Inventory 4.0 generic and 3.0 cardiac modules. Family
SES
was assessed by a composite of household income in the past year and occupation and education level of each parent in the family. Mean scores of major domains in
HRQOL
were significantly lower in the low‐
SES
group than in the medium‐ and high‐
SES
groups (total generic scores: 71.2±7.9 versus 75.0±8.0 and 76.0±7.9, respectively [
P
<0.001]; psychosocial functioning: 70.8±9.0 versus 74.4±8.4 and 75.3±8.4 [
P
<0.001]; physical functioning: 71.6±10.4 versus 76.0±9.7 and 77.1±9.4 [
P
<0.001]; heart symptoms: 71.9±11.6 versus 75.7±11.0 and 76.8±10.3 [
P
<0.001]; cognitive problems: 65.4±11.1 versus 69.4±12.1 and 74.6±13.6 [
P
<0.001]). After adjustment for other clinical and demographic variables in the multivariable linear regression model, family
SES
significantly affected all dimensions of
HRQOL
except for treatment barriers, treatment anxiety, physical appearance and communication.

Conclusions

Family
SES
is an important factor associated with
HRQOL
in patients with critical congenital heart disease. Further targeted interventions to improve HRQOL that consider the family and environmental issues confronted by those who are economically disadvantaged might help these patients have better outcomes.
First record of the leafhopper genus Xenovarta Viraktamath (Hemiptera, Cicadellidae, Deltocephalinae) from India with description of a new species
Authors: MESHRAM NARESH M. , STUTI STUTI , HASHMI TAHSEEN RAZA 
Published: December 2018

The genus Xenovarta Viraktamath is recorded from India for the first time and Xenovarta viraktamathi sp. nov. from India is described and illustrated. Materials are deposited in the National Pusa Collection, Division of Entomology, ICAR-Indian Agricultural Research Institute (IARI), New Delhi, India. A key to species of the genus are provided, with molecular evidence of the specimen in the form of partial mtCOI sequences.
Normalising domestic space heating demand using post hoc models
Authors: Mitchell Rachel , Natarajan Sukumar 
Published: December 2018

Current evidence suggests that the energy performance gap between predicted and actual use of energy in buildings is significantly weighted towards under prediction and can be as high as 200%. High-quality modelled and actual data are needed to ensure like for like comparisons when investigating the energy performance gap. Internal temperature ( ti) normalisation is a key process to ensure like for like comparisons but is often hampered by the lack of the original model due to the time lag between design, construction and occupancy. Here, we demonstrate the use of models created after data collection – i.e. post hoc – as a substitute for original models in evaluating the energy performance gap. The robustness of the internal temperature normalisation factor ( fti) is tested using measured data from 20 Passivhaus homes. The data from each home are inputted into 10 Passive House Planning Package and 10 Standard Assessment Procedure models with highly different domestic and non-domestic building configurations, creating 400 model variants. Each variant is further split into four cases of varying internal gains and solar radiation creating a total of 1600 variants. Results demonstrate that fti is resilient to differences in building configuration, solar radiation levels and varying internal gains (SEM < 0.02). Even though SEM increases when measured internal temperatures are below base assumptions, the impact of this error on the computed space heating demand is at most 4%. This suggests that post hoc models can be a substitute for actual models in evaluating the energy performance gap and that limited site data can still yield robust results. Practical application: Identifying the causes of the energy performance gap (the difference between modelled and measure energy demand) is complex. Normalising space heating demand for internal temperatures means that some differences between modelled and actual space heating demand can be accounted for. Building models such as Passive House Planning Package (PHPP) and Standard Assessment Procedure (SAP) are readily available and allow variations in climate and temperature data to be inputted. This research demonstrates that in practice any PHPP and SAP model can be used for normalisation, not just one that is building specific and that some parameters (internal temperature) are more important than others. This provides a simple and easily accessible approach to temperature normalisation that can be applied by industry to domestic dwellings.
Clinical implementation of a novel myocardial protection pathway in coronary artery bypass surgery with minimal extracorporeal circulation
Authors: Koechlin Luca , Zenklusen Urs , Doebele Thomas , Rrahmani Bejtush , Gahl Brigitta , Berdajs Denis , Grapow Martin T.R. , Eckstein Friedrich S. , Reuthebuch Oliver 
Published: December 2018

Introduction: The aim of this study was to report the clinical implementation of the joint use of the Myocardial Protection System (MPS®) and the minimal extracorporeal circulation system (MiECC), in conjunction with an institutionally refined dose/volume-dependent microplegia in coronary artery bypass grafting (CABG). Methods: Patients with isolated CABG surgery were included. The final protocol to achieve cardioplegic arrest consisted of warm blood cardioplegia with 20 mmol potassium (K), 1.6 g magnesium (Mg) and 40 mg lidocaine per liter (L) blood. We prospectively collected intra- and postoperative data to monitor and validate this novel approach. Results: Eighty patients were operated accordingly. Mean (SD) aortic clamping time and extracorporeal perfusion time were 67.5 (22.6) and 101.1 (31.9) minutes, respectively. Failure to induce cardiac arrest was seen in six patients at the early stage of refinement of the formula. Median (IQR) high -sensitivity cardiac troponin T (hs-cTnT) on the first postoperative day (POD) and peak hs-cTnT were 262.5 ng/L (194.3–405.8) and 265.5 ng/L (194.3–405.8), respectively. Median (IQR) creatine kinase-myocardial type (CK-MB) on POD 1 and peak CK-MB were 14.2 µg/L (10.5–22.7) and 14.2 µg/L (10.7-23.2), respectively. Median (IQR) creatine kinase (CK) on POD 1 and peak CK were 517.5 U/L (389.3-849.8) and 597.5 U/L (455.0-943.0), respectively. No patient died during hospitalization. Conclusions: The combination of this cardioplegic formula with MPS® and MiECC in CABG was safe and feasible. With the final chemical makeup, cardiac arrest was reliably achieved. Remarkably low postoperative cardiac markers indicate shielded cardiac protection during surgery.
The pharmacological management of acute behavioural disturbance: Data from a clinical audit conducted in UK mental health services
Authors: Paton Carol , Adams Clive E , Dye Stephen , Fagan Elizabeth , Okocha Chike , Barnes Thomas RE 
Published: December 2018

Background: A quality improvement programme addressing prescribing practice for acutely disturbed behaviour was initiated by the Prescribing Observatory for Mental Health. Method: This study analysed data from a baseline clinical audit conducted in inpatient mental health services in member trusts. Results: Fifty-eight mental health services submitted data on 2172 episodes of acutely disturbed behaviour. A benzodiazepine alone was administered in 60% of the 1091 episodes where oral medication only was used and in 39% of the 1081 episodes where parenteral medication (rapid tranquillisation) was used. Haloperidol was combined with lorazepam in 22% of rapid tranquillisation episodes and with promethazine in 3%. Physical violence towards others was strongly associated with receiving rapid tranquillisation in men (odds ratio 1.74, 1.25–2.44; p<0.001) as was actual or attempted self-harm in women (odds ratio 1.87, 1.19–2.94; p=0.007). Where physical violence towards others was exhibited, a benzodiazepine and antipsychotic was more likely to be prescribed than a benzodiazepine alone (odds ratio 1.39, 1.00–1.92; p=0.05). The data suggested that 25% of patients were at least ‘extremely or continuously active’ in the hour after rapid tranquillisation was administered. Conclusion: The current management of acutely disturbed behaviour with parenteral medication may fail to achieve a calming effect in up to a quarter of episodes. The most common rapid tranquillisation combination used was lorazepam and haloperidol, for which the randomised controlled trial evidence is very limited. Rapid tranquillisation prescribing practice was not wholly consistent with the relevant National Institute for Health and Care Excellence guideline, which recommends intramuscular lorazepam on its own or intramuscular haloperidol combined with intramuscular promethazine. Clinical factors prompting the use of rapid tranquillisation rather than oral medication may differ between the genders.
New technique for reduction of irreducible anterior glenohumeral shoulder dislocation
Authors: Orbach Hagay , Rozen Nimrod , Rubin Guy 
Published: December 2018

Objective This study was performed to describe a new technique for reduction of anterior glenohumeral dislocation in four non-sedated patients in whom traditional techniques were unsuccessful. Methods Four patients with clinically and radiographically proven acute anterior glenohumeral dislocations were admitted to the emergency department. An oral analgesic and local infiltration of lidocaine into the glenohumeral joint were administered prior to the reduction attempts. Four to six reduction attempts using a variety of traditional maneuvers were unsuccessful before applying our technique. The glenohumeral joint was then successfully reduced using our technique and confirmed on radiographs. A sling was placed for post-reduction pain relief. Results All four patients underwent successful closed reduction, proven clinically and by radiographs, after the first attempt using our technique. No complications occurred. Conclusion Our maneuver provides safe and successful closed reduction for irreducible acute anterior glenohumeral dislocation.
Selected Abstracts
Authors: Mcgill Palliative Care , Roy David J. 
Published: December 2018

It is my responsibility, as editor of the Journal of Palliative Care, to ensure that the readership is kept up to date on important events and advances in the field. The publication of abstracts on appropriate occasions serves this purpose. The 19th International Congress on Palliative Care merits serious attention in this Canadian-based international journal. I am happy to publish selected abstracts of research fora, workshops and proffered papers, and posters that will be presented to this interdisciplinary gathering of palliative care experts from around the world. Since the Journal is dedicated to promoting quality articles and methodologically rigorous research in palliative care, I look forward to the publication in the near future of a number of the papers announced in these abstracts.
Novel Vasopressors in the Treatment of Vasodilatory Shock: A Systematic Review of Angiotensin II, Selepressin, and Terlipressin
Authors: Rodriguez Ryan , Cucci Michaelia , Kane Sean , Fernandez Erica , Benken Scott 
Published: December 2018

Study Objective: Vasodilatory shock is the most common type of shock. Catecholamine vasopressors are the cornerstone of hemodynamic therapy but carry risks. Angiotensin II (AT2) was recently approved, and other novel agents (selepressin and terlipressin) are under investigation and used outside the United States (terlipressin). We performed a systematic review to summarize the efficacy and safety of these novel vasopressors and to offer guidance on their appropriate use. Design: Systematic review of controlled trials. Methods: Numerous databases were searched using terms related to angiotensin II, selepressin, terlipressin, vasopressor, and shock. Twenty-one citations, including 16 prospective comparative trials and 5 post hoc analyses reporting effects of AT2, selepressin, and terlipressin, were reviewed for data on outcomes related to hemodynamic measures, mortality, severity and duration of illness, concomitant vasopressor utilization, and adverse effects. Findings from eligible literature are described qualitatively using Cochrane methods. Results: Fourteen controlled trials were assessed after exclusion of 2 dated trials of a distinct AT2 formulation. Trials are limited for AT2 (n = 2) and selepressin (n = 1), while terlipressin was investigated in 11 small trials. Overall, the trials have an unclear risk of bias. Most report mean arterial pressure (MAP) as primary end point, and all indicate novel vasopressors increase MAP compared to placebo and to a similar degree as with catecholamine vasopressors. Mortality findings are preliminary, as they have been limited to specific subgroups in trials of terlipressin and post hoc analyses of one trial of AT2. Trials reported safety concerns for each agent including thromboembolism with AT2 and ischemia with terlipressin/selepressin. Conclusion: In this systematic review, controlled trials of novel vasopressors in treatment of vasodilatory shock were limited and of low quality. Angiotensin II, selepressin, and terlipressin appear to significantly increase MAP, but further study is required, particularly for selepressin, to determine their safety, efficacy, and role in treatment of vasodilatory shock.
What Do you Need to Get Started in Your Own Career Counselling Practice?
Authors: Abramson Rachel 
Published: December 2018

Picture this. You are sitting in your own office. Perhaps you have an office with a view. The name on the door says: (Your Name) & Associates. Or perhaps it says: (Your Name), Career Counsellor. Either way, you are your own boss. You may even have others working for you. You can determine your own salary — pay yourself what you are really worth. You spend your time seeing the kinds of clients you enjoy seeing. You control how you spend every hour of your working day. No. It is no longer a working day; it is your business day. A colleague might happen past and notice you are there. With delight, your colleague might say: “Wow! When did you set up your own shop? How did you do it? How did you manage to get there?” Perhaps on reading the above scenario, you are wondering whether it is at all possible. Perhaps you are wondering whether you even have any entrepreneurial skill or the necessary know-how in running a business. This article is the first of a two-part series designed to help you through the process of establishing and running your own business.
Microvasculature of the Plantar Plate Using Nano–Computed Tomography
Authors: Finney Fred T. , McPheters Aaron , Singer Natalie V. , Scott Jaron C. , Jepsen Karl J. , Holmes James R. , Talusan Paul G. 
Published: December 2018

Background: Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of common clinical conditions. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been defined. We investigated the microvasculature of the plantar plate by employing a novel technique involving microvascular perfusion and nano–computed tomography (nano-CT) imaging. Methods: Twelve human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The second through fourth toe metatarsophalangeal (MTP) joints of 12 feet were imaged with nano-CT at 14-micron resolution. Images were then reconstructed for analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate. Results: A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The midsubstance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 29% and distal 22% of the plantar plate. Conclusion: There is a vascular network extending from the surrounding soft tissues into the proximal and distal attachments of the plantar plate. Clinical relevance: The hypovascular midportion of the plantar plate may play an important role in the underlying pathoanatomy and pathophysiology of this area. These findings may have significant clinical implications for the reparative potential of this region and the surgical procedures currently described to accomplish anatomic plantar plate repair.
MRI in 30 cats with traumatic brain injury
Authors: Caine Abby , Brash Robert , De Risio Luisa , Van Dijk Jan , Cherubini Giunio Bruto , Dennis Ruth 
Published: December 2018

Objectives The aim of this study was to evaluate the MRI findings in cats following traumatic brain injury (TBI), and establish which features identified might correlate with prognosis. Methods The magnetic resonance images of 30 cats with clinical signs attributed to the brain following TBI were retrospectively reviewed to assess the imaging features seen and their correlation with outcome. Results Twenty-one of 30 cats had a good outcome (full recovery or minor ongoing neurological deficits); the other nine either died or had ongoing neurological deficits that significantly affected quality of life. There was evidence of parenchymal injury in only 20/30 cats, including 8/9 that had a poor outcome. The frequency of bilateral or multifocal parenchymal lesions on T2-weighted imaging, and mass effect, particularly caudal transtentorial herniation, was statistically significantly higher in patients with a poorer outcome. Extra-axial haemorrhage was not identified. Concurrent soft tissue injury was noted in all cats, with a poorer prognosis statistically associated with a peripharyngeal pattern of injury and orbital trauma. Conclusions and relevance The number of cases with MRI-identified brain pathology, the patterns of injuries identified and the specific imaging features that appear to have effects on prognosis differ in this series of cats from those published in similar case series of dogs. Further work is needed to establish if cat-specific guidelines are needed to assess brain MRI following trauma.
Parastomal Hernia Repair; Seldom Performed and Seldom Reported: Results From a Nationwide Survey
Authors: Odensten C. , Strigård K. , Dahlberg M. , Gunnarsson U. , Näsvall P. 
Published: December 2018

Background: Parastomal hernia is common, but there are few population-based studies showing the frequency and outcome of parastomal hernia repair in routine surgical practice. The aim of this study was to identify patients undergoing surgery for parastomal hernia in Sweden and to define risk factors for complication and recurrence. Methods: A broad search of the Swedish National Patient Register 1998–2007 for all possible parastomal hernia repairs using surgical procedure codes. Records of all patients identified were reviewed and those with a definite parastomal hernia procedure were included and analyzed. Results: A total of 71 patients were identified after review of the records. The most common reason for surgery was cosmetic and the most frequent method was relocation of the stoma. Parastomal hernia recurrence rate was 18% during follow-up of a minimum 2 years. Overall, a surgical complication occurred in 32%. Possible risk factors were analyzed including emergency surgery versus planned, gender, age, indication for surgery, and method of surgery; none of which was significant. Conclusion: The frequency of parastomal hernia procedures was much lower than suggested by previous studies. The number of procedures per surgeon was even lower than expected. No specific risk factor could be identified. Parastomal hernia auditing in the form of a nationwide quality register should be mandatory. Centralization should be considered.