bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrocardiographic features of failed and recurrent right ventricular outflow tract catheter ablation of idiopathic ventricular arrhythmias
Authors: Yamada Shinya , Chung Fa‐Po , Lin Yenn‐Jiang , Chang Shih‐Lin , Lo Li‐Wei , Hu Yu‐Feng , Tuan Ta‐Chuan , Chao Tze‐Fan , Liao Jo‐Nan , Lin Chung‐Hsing , Lin Chin‐Yu , Chang Yao‐Ting , Chang Ting‐Yung , Te Abigail Louise D. , Chen Shih‐Ann 
Published: October 2017

AbstractIntroductionVarious ECG algorithms have been proposed to identify the origin of idiopathic outflow tract (OT)‐ventricular arrhythmia (VA). However, electrocardiographic features of failed and recurrent right ventricular outflow tract (RVOT) ablation of idiopathic OT‐VAs have not been clearly elucidated.Methods and resultsA total of 264 consecutive patients (mean age: 44.0 ± 13.0 years, 96 male) undergoing RVOT ablation for OT‐VAs with a transition ≥V3, including 241 patients (91.6%) with initially successful procedures and 23 patients (8.4%) with failed ablation. Detailed clinical characteristics and ECG features were analyzed and compared between the two groups. VAs with failed RVOT ablation had larger peak deflection index (PDI), longer V2 R wave duration (V2Rd), smaller V2 S wave amplitude, higher R/S ratio in V2, higher V3 R wave amplitude, and larger V2 transition ratio than those with successful ablation. Multivariate analysis demonstrated that PDI, V2Rd, V2 transition ratio, and pacemapping score acquired during mapping independently predicted failed ablation (P = 0.01, P = 0.01, P = 0.01, and P < 0.001, respectively). In 31 recurrent cases (12.8%) after initially successful ablation, multivariate Cox regression analysis showed that only the earliest activation time acquired during mapping predicted the recurrences after successful ablation (P = 0.001). The recurrent cases displayed different ECG features comparing with those with failed ablation.ConclusionThe electrocardiographic features of failed RVOT ablation of idiopathic OT‐VAs with a transition ≥V3 were characterized by PDI, V2Rd, V2 transition ratio, and pacemapping score acquired during mapping, unlike the recurrent RVOT ablation.
Usefulness of epicardial impedance evaluation for epicardial mapping and determination of epicardial ablation site for ventricular tachycardia: A pilot study
Authors: Kitamura Takeshi , Fukamizu Seiji , Miyazawa Satoshi , Kawamura Iwanari , Hojo Rintaro , Aoyama Yuya , Nishizaki Mitsuhiro , Sakurada Harumizu , Hiraoka Masayasu 
Published: October 2017

AbstractBackgroundDuring epicardial mapping, determination of appropriate ablation sites in low voltage areas (LVA) is challenging because of large epicardial areas covered by adipose tissue.ObjectiveTo evaluate the impedance difference between epicardial fat and the epicardial LVA using multiple detector computed tomography (MDCT).MethodsWe enrolled patients who underwent ventricular tachycardia (VT) ablation via the epicardial approach after endocardial ablation failure. After the procedure, MDCT‐derived images of epicardial fat were loaded to the mapping system. Then, all points acquired during sinus rhythm were retrospectively superimposed and analyzed.ResultsThis study included data from 7 patients (62.5 ± 3.9 years old) who underwent eight epicardial VT ablation procedures. After the procedure, MDCT‐derived images of epicardial fat were registered in eight procedures. Retrospective analysis of 1,595 mapping and 236 ablation points was performed. Of the 1,595 mapping points on the merged electroanatomical and epicardial fat maps, normal voltage area (NVA) and low voltage area (LVA) without fat had lower impedance than those with fat (NVA without fat 182 ± 46 Ω vs. NVA with fat 321 ± 164.0 Ω, P = 0.001, LVA without fat 164 ± 69 Ω vs. LVA with fat 248 ± 89 Ω, P = 0.002). Of the 236 ablation points, initial impedance before ablation was higher on epicardial fat than on epicardial LVA without fat (134 ± 16 Ω vs. 156 ± 28 Ω, P = 0.01).ConclusionsReal time epicardial impedance evaluation may be useful to determine effective epicardial ablation sites and avoid adipose tissue. However, the number of patients in the present study is limited. Further investigation with a large number of patients is needed to confirm our result.
Thermal latency adds to lesion depth after application of high‐power short‐duration radiofrequency energy: Results of a computer‐modeling study
Authors: Irastorza Ramiro M. , d'Avila Andre , Berjano Enrique 
Published: October 2017

AbstractIntroductionThe use of ultra‐short RF pulses could achieve greater lesion depth immediately after the application of the pulse due to thermal latency.Methods and resultsA computer model of irrigated‐catheter RF ablation was built to study the impact of thermal latency on the lesion depth. The results showed that the shorter the RF pulse duration (keeping energy constant), the greater the lesion depth during the cooling phase. For instance, after a 10‐second pulse, lesion depth grew from 2.05 mm at the end of the pulse to 2.39 mm (17%), while after an ultra‐short RF pulse of only 1 second the extra growth was 37% (from 2.22 to 3.05 mm). Importantly, short applications resulted in deeper lesions than long applications (3.05 mm vs. 2.39 mm, for 1‐ and 10‐second pulse, respectively). While shortening the pulse duration produced deeper lesions, the associated increase in applied voltage caused overheating in the tissue: temperatures around 100 °C were reached at a depth of 1 mm in the case of 1‐ and 5‐second pulses. However, since the lesion depth increased during the cooling period, lower values of applied voltage could be applied in short durations in order to obtain lesion depths similar to those in longer durations while avoiding overheating.ConclusionThe thermal latency phenomenon seems to be the cause of significantly greater lesion depth after short‐duration high‐power RF pulses. Balancing the applied total energy when the voltage and duration are changed is not the optimal strategy since short pulses can also cause overheating.
The Impact of Blamer‐softening on Romantic Attachment in Emotionally Focused Couples Therapy
Authors: Burgess Moser Melissa , Johnson Susan M. , Dalgleish Tracy L. , Wiebe Stephanie A. , Tasca Giorgio A. 
Published: October 2017

Emotionally Focused Couples Therapy (EFT; Johnson, ) treats relationship distress by targeting couples' relationship‐specific attachment insecurity. In this study, we used hierarchical linear modeling (Singer & Willett, ) to examine intercept and slope discontinuities in softened couples' trajectories of change in relationship satisfaction and relationship‐specific attachment over the course of therapy from a total sample of 32 couples. Softened couples (n = 16) reported a significant increase in relationship satisfaction and a significant decrease in attachment avoidance at the softening session. Although softened couples displayed an initial increase in relationship‐specific attachment anxiety at the softening session, their scores significantly decreased across post‐softening sessions. Results demonstrated the importance of the blamer‐softening change event in facilitating change in EFT.
Oral health of children and adolescents with mucopolysaccharidosis and mother's Sense of Coherence
Authors: Ruy Carneiro Natália Cristina , Duda Deps Tahyná , Campos França Esdras , Ribeiro Valadares Eugênia , Almeida Pordeus Isabela , Borges‐Oliveira Ana Cristina 
Published: October 2017

AbstractAimsThe purpose of this study is assess the association between mother's Sense of Coherence (SOC) and the oral health status of children with and without mucopolysaccharidosis (MPS).MethodsA cross‐sectional study was carried out with 29 children/adolescents with MPS and 29 children/adolescents without MPS, and their mothers in Brazil. Mothers completed the Antonovsky's SOC instrument (SOC‐13) and their children's oral cavity had been examined for developmental defects of enamel (DDE), occlusal problems, dental caries (DMFT/dmft) and oral hygiene. This study was approved by the Research Ethics Committee of the Universidade Federal de Minas Gerais.ResultsMothers of children with MPS had lower SOC scores (mean: 33.3 [±4.0]) compared with mothers of children without MPS (mean: 36.9 [±4.5]) (p < 0.001). Mother's SOC of children with MPS were lower for those children with one or more decayed teeth (31.5 [±3.2]) than for those children/adolescents without caries (35.7 [±3.8]) (p = 0.004) and lower for those children/adolescents with one or more missing teeth (30.2 [±0.9]) than for those individuals identified without missing teeth (33.8 [±4.1]) (p = 0.046).ConclusionMothers’ SOC of children/adolescents with MPS was associated with dental caries experience in their children. Improving mothers’ SOC should contribute to a better quality of life for their children.
Outcomes of oxygen saturation targeting during delivery room stabilisation of preterm infants
Authors: Oei Ju Lee , Finer Neil N , Saugstad Ola Didrik , Wright Ian M , Rabi Yacov , Tarnow-Mordi William , Rich Wade , Kapadia Vishal , Rook Denise , Smyth John P , Lui Kei , Vento Maximo 
Published: October 2017

ObjectiveTo determine the association between SpO2at 5 min and preterm infant outcomes.DesignData from 768 infants <32 weeks gestation from 8 randomised controlled trials (RCTs) of lower (≤0.3) versus higher (≥0.6) initial inspiratory fractions of oxygen (FiO2) for resuscitation, were examined.SettingIndividual patient analysis of 8 RCTsInterventionsLower (≤0.3) versus higher (≥0.6) oxygen resuscitation strategies targeted to specific predefined SpO2before 10 min of age.PatientsInfants <32 weeks gestation.Main outcome measuresRelationship between SpO2at 5 min, death and intraventricular haemorrhage (IVH) >grade 3.Results5 min SpO2data were obtained from 706 (92%) infants. Only 159 (23%) infants met SpO2study targets and 323 (46%) did not reach SpO280%. Pooled data showed decreased likelihood of reaching SpO280% if resuscitation was initiated with FiO2<0.3 (OR 2.63, 95% CI 1.21 to 5.74, p<0.05). SpO2<80% was associated with lower heart rates (mean difference −8.37, 95% CI −15.73 to –1.01, *p<0.05) and after accounting for confounders, with IVH (OR 2.04, 95% CI 1.01 to 4.11, p<0.05). Bradycardia (heart rate <100 bpm) at 5 min increased risk of death (OR 4.57, 95% CI 1.62 to 13.98, p<0.05). Taking into account confounders including gestation, birth weight and 5 min bradycardia, risk of death was significantly increased with time taken to reach SpO280%.ConclusionNot reaching SpO280% at 5 min is associated with adverse outcomes, including IVH. Whether this is because of infant illness or the amount of oxygen that is administered during stabilisation is uncertain and needs to be examined in randomised trials
Chest compression during sustained inflation versus 3:1 chest compression:ventilation ratio during neonatal cardiopulmonary resuscitation: a randomised feasibility trial
Authors: Schmölzer Georg M , O Reilly Megan , Fray Caroline , van Os Sylvia , Cheung Po-Yin 
Published: October 2017

BackgroundCurrent neonatal resuscitation guidelines recommend 3:1 compression:ventilation (C:V) ratio. Recently, animal studies reported that continuous chest compressions (CC) during a sustained inflation (SI) significantly improved return of spontaneous circulation (ROSC). The approach of CC during SI (CC+SI) has not been examined in the delivery room during neonatal resuscitation.HypothesisIt is a feasibility study to compare CC+SI versus 3:1 C:V ratio during neonatal resuscitation in the delivery room. We hypothesised that during neonatal resuscitation, CC+SI will reduce the time to ROSC. Our aim was to examine if CC+SI reduces ROSC compared with 3:1 C:V CPR in preterm infants <33 weeks of gestation.Study designRandomised feasibility trial.MethodOnce CC was indicated all eligible infants were immediately and randomly allocated to either CC+SI group or 3:1 C:V group. A sequentially numbered, brown, sealed envelope contained a folded card box with the treatment allocation was opened by the clinical team at the start of CC.Study interventionsInfants in the CC+SI group received CC at a rate of 90/min during an SI with a duration of 20 s (CC+SI). After 20 s, the SI was interrupted for 1 s and the next SI was started for another 20 s until ROSC. Infants in the ‘3:1 group’ received CC using 3:1 C:V ratio until ROSC.Primary outcomeOverall the mean (SD) time to ROSC was significantly shorter in the CC+SI group with 31 (9) s compared with 138 (72) s in the 3:1 C:V group (p=0.011).ConclusionCC+SI is feasible in the delivery room.Trial registration numberClinicaltrials.gov NCT02083705, pre-results.
Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation
Authors: Edwards A David , Redshaw Maggie E , Kennea Nigel , Rivero-Arias Oliver , Gonzales-Cinca Nuria , Nongena Phumza , Ederies Moegamad , Falconer Shona , Chew Andrew , Omar Omar , Hardy Pollyanna , Harvey Merryl Elizabeth , Eddama Oya , Hayward Naomi , Wurie Julia , Azzopardi Denis , Rutherford Mary A , Counsell Serena 
Published: October 2017

BackgroundWe tested the hypothesis that routine MRI would improve the care and well-being of preterm infants and their families.DesignParallel-group randomised trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42).SettingParticipants from 14 London hospitals, imaged at a single centre.Patients511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results and 255 only ultrasound from a paediatrician unaware of unallocated results; one withdrew before allocation.Main outcome measuresMaternal anxiety, measured by the State-Trait Anxiety inventory (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment, health-related costs and quality of life.ResultsAfter MRI, STAI fell from 36.81 (95% CI 35.18 to 38.44) to 32.77 (95% CI 31.54 to 34.01), 31.87 (95% CI 30.63 to 33.12) and 31.82 (95% CI 30.65 to 33.00) at 14 days, 12 and 20 months, respectively. STAI fell less after ultrasound: from 37.59 (95% CI 36.00 to 39.18) to 33.97 (95% CI 32.78 to 35.17), 33.43 (95% CI 32.22 to 34.63) and 33.63 (95% CI 32.49 to 34.77), p=0.02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (area under the receiver operator characteristic curve (CI) 0.74; 0.66 to 0.83 vs 0.64; 0.56 to 0.72, p=0.01) but cost £315 (CI £295–£336) more per infant.ConclusionsMRI increased costs and provided only modest benefits.Trial registrationClinicalTrials.gov NCT01049594https://clinicaltrials.gov/ct2/show/NCT01049594.EudraCT: EudraCT: 2009-011602-42 (https://www.clinicaltrialsregister.eu/).
Management of pneumatosis intestinalis in children over the age of 6 months: a conservative approach
Authors: Nellihela Leel , Mutalib Mohamed , Thompson David , Jochen Kammermeier , Upadhyaya Manasvi 
Published: October 2017

BackgroundPneumatosis intestinalis (PI) is an uncommon and poorly understood condition. Although it can be an incidental finding in asymptomatic individuals, it can also be secondary to life-threatening bowel ischaemia and sepsis. In premature infants, it is a pathognomonic sign of necrotising enterocolitis. There is no consensus regarding management and long-term outcome of children with PI.AimReview of our experience of PI in children beyond the early infantile period.MethodsRetrospective review of patient’s records and radiological images from 2013 to 2015.ResultsEighteen patients (three girls) had radiologically confirmed PI. The median age was 4.5 years (range 8 months–13 years). Background medical conditions (number): short bowel syndrome (one), congenital heart disease (two), sickle cell disease (one), epilepsy (three), cerebral palsy (six), myotonic dystrophy (four) and peroxisomal biogenesis defect (one).Six children (33%) presented with abdominal distension, four (22%) with abdominal pain, three (17%) with bilious vomiting, two (11%) with diarrhoea and one (6%) with rectal bleeding. Two (11%) were asymptomatic. One had air in portal vein and two had pneumoperitoneum.All patients with symptomatic PI were treated conservatively with successful outcome and complete resolution of PI. None required surgical intervention.ConclusionPI in children who are not on chemotherapy or immunosuppressant appears to follow a benign course and is responsive to conservative management. In contrast to adults, portal venous gas and pneumoperitoneum do not predict the need for surgical intervention.
Biosimilar infliximab use in paediatric IBD
Authors: Richmond Lisa , Curtis Lee , Garrick Victoria , Rogers Pam , Wilson Michelle , Tayler Rachel , Henderson Paul , Hansen Richard , Wilson David C , Russell Richard K 
Published: October 2017

BackgroundBiosimilar infliximab became available in the UK in 2015. Paediatric experience to date on its use is limited. We prospectively evaluated the safety and efficacy of biosimilar infliximab (Remsima) in two paediatric gastroenterology networks in patients with inflammatory bowel disease.MethodsProspective clinical data were collected from laboratory reports, electronic patient records and case notes of 40 patients starting Remsima for the first time. Disease activity scores together with blood and stool biomarkers were used to assess response.ResultsOur data set highlights that Remsima was associated with a significant clinical and biochemical improvement (p<0.01 or less for all parameters assessed) in Crohn’s disease post induction. There were no significant safety issues noted. The total cost saving was £47 800, representing a 38% reduction from originator.ConclusionWe found that biosimilar infliximab is as effective as originator infliximab and its use is associated with significant cost savings.
Should tumbling E go out of date in amblyopia screening? Evidence from a population-based sample normative in children aged 3–4 years
Authors: Guimaraes Sandra , Fernandes Tiago , Costa Patrício , Silva Eduardo 
Published: October 2017

AimsTo determine a normative of tumbling E optotype and its feasibility for visual acuity (VA) assessment in children aged 3-4 years.MethodsA cross-sectional study of 1756 children who were invited to participate in a comprehensive non-invasive eye exam. Uncorrected monocular VA with crowded tumbling E with a comprehensive ophthalmological examination were assessed. Testability rates of the whole population and VA of the healthy children for different age subgroups, gender, school type and the order of testing in which the ophthalmological examination was performed were evaluated.ResultsThe overall testability rate was 95% (92% and 98% for children aged 3 and 4 years, respectively). The mean VA of the first-day assessment (first-VA) and best-VA over 2 days’ assessments was 0.14 logMAR (95% CI 0.14 to 0.15) (decimal=0.72, 95% CI 0.71 to 0.73) and 0.13 logMAR (95% CI 0.13 to 0.14) (decimal=0.74, 95% CI 0.73 to 0.74). Analysis with age showed differences between groups in first-VA (F(3,1146)=10.0; p<0.001; η2=0.026) and best-VA (F(3,1155)=8.8; p<0.001; η2=0.022). Our normative was very highly correlated with previous reported HOTV-Amblyopia-Treatment-Study (HOTV-ATS) (first-VA, r=0.97; best-VA, r=0.99), with 0.8 to 0.7 lines consistent overestimation for HOTV-ATS as described in literature. Overall false-positive referral was 1.3%, being specially low regarding anisometropias of ≥2 logMAR lines (0.17%). Interocular difference ≥1 line VA logMAR was not associated with age (p=0.195).ConclusionsThis is the first normative for European Caucasian children with single crowded tumbling E in healthy eyes and the largest study comparing 3 and 4 years old testability. Testability rates are higher than found in literature with other optotypes, especially in children aged 3 years, where we found 5%–11% better testability rates.
Organised screening for cervical cancer in France: a cost-effectiveness assessment
Authors: Barré Stéphanie , Massetti Marc , Leleu Henri , De Bels Frédéric 
Published: October 2017

ObjectiveAccording to the third cancer plan, organised screening (OS) of cervical cancer (CC) among women aged 25–65 years should be implemented in France in the forthcoming years. The most efficient way to implement OS in the French healthcare system is yet to be determined.MethodsA microsimulation model was developed adopting a collective ‘all payers’ perspective. A closed cohort of women eligible for CC screening and representative in terms of age and participation in individual screening (IndScr) by annual Papanicolaou (Pap) testing every 3 years was modelled on a lifetime horizon. Different OS strategies, additive to IndScr with a 61.9% participation rate based on mailed invitations to non-participant women to perform OS were assessed. Similar modalities were applied to OS and IndScr participants. Strategies implied different screening tests (Papanicolaou (Pap) test, human papillomavirus (HPV) test and p16/Ki67 double staining) and OS periodicity.ResultsCompared with IndScr only, all OS strategies were associated with decreased cancer incidence/mortality (from 14.2%/13.5% to 22.9%/25.8%). Most strategies generated extra costs ranging from €37.9 to €1607 per eligible woman. HPV testing every 10 and 5 years were cost saving. HPV tests every 10 and 5 years were the most efficient strategies, generating more survival at lower costs than Pap-based strategies. Compared to IndScr only, an HPV test every 10 years was cost saving. The most effective strategies were p16/Ki67 as primary or HPV positive confirmation tests, with respective incremental cost-effectiveness ratios of €6 541 250 and €101 391 per life year. Pap-based strategies generated intermediary results.ConclusionOS strategies based on the HPV test appear highly efficient. However, our results rely on the assumption that women and practitioners comply with the recommended OS periodicities (3, 5, 10 years). Implementing these OS modalities will require major adaptations to the current CC screening organisation. Pap test-based strategies might be simpler to setup while preparing an appropriate implementation of more efficient OS screening modalities.