bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenging Achievement of Bidirectional Block After Linear Ablation Affects the Rhythm Outcome in Patients With Persistent Atrial Fibrillation
Authors: Kim Tae‐Hoon , Park Junbeom , Uhm Jae‐Sun , Kim Jong‐Youn , Joung Boyoung , Lee Moon‐Hyoung , Pak Hui‐Nam 
Published: October 2016

Background

It is not clear whether bidirectional block (
BDB
) of linear ablations reduces atrial fibrillation (
AF
) recurrence after radiofrequency catheter ablation. We hypothesized that
BDB
of linear ablation has prognostic significance after
radiofrequency catheter ablation
for persistent
AF
.

Methods and Results

Among 1793 consecutive patients in the Yonsei
AF
ablation cohort, this observational cohort study included 398 patients with persistent AF (75.6% male; age, 59.8±10.3 years) who underwent catheter ablation with a consistent ablation protocol of the Dallas lesion set: circumferential pulmonary vein isolation; cavotricuspid isthmus ablation (
CTI
); roof line (
RL
); posterior‐inferior line (
PIL
); and anterior line (
AL
).
BDB
rates of de novo ablation lines were 100% in circumferential pulmonary vein isolation, 100% in
CTI
, 84.7% in
RL
, 44.7% in
PIL
, and 63.6% in
AL
. During 29.0±18.4 months of follow‐up, 31.7% (126/398) of the patients showed clinical recurrence. Left atrial posterior wall (
LAPW
) isolation (
BDB
s of
RL
and
PIL
) was independently associated with lower clinical
AF
/atrial tachycardia recurrence (hazard ratio, 0.68; 95% CI, 0.47–0.98;
P
=0.041; log‐rank,
P
=0.017), whereas
BDB
s of
RL
or
AL
were not (log‐rank,
P
=0.178 for
RL;
P
=0.764 for
AL
). Among 52 patients who underwent repeat procedures (23.0±16.1 months after de novo procedure), the
BDB
maintenance rates for
CTI
,
RL
,
PIL
, and
AL
were 94.2% (49 of 52), 63.5% (33 of 47), 62.1% (18 of 29), and 61.8% (21 of 34), respectively.

Conclusions

Although
PIL
crosses the esophageal contact area,
LAPW
isolation is important for better clinical outcome in catheter ablation with a linear ablation strategy for patients with persistent AF.
Redescription of two species of Asterocheres Boeck, 1860 (Copepoda: Siphonostomatoida), A. corneliae Schirl, 1973 and A. boeckii (Brady, 1880), and proposal of a new genus for Asterocheres fastigatus Kim, 2010
Authors: BANDERA EUGENIA , CONRADI MERCEDES 
Published: October 2016

Asterocheres Boeck, 1860 is the largest genus in the family Asterocheridae and includes approximately 96 nominal species. Nevertheless, according to Kim (2010), the current assignment of twelve of these species to Asterocheres is debatable, and fifteen species are too incompletely described for reliable comparisons to be made. In this paper, two species, A. corneliae Schirl, 1973 and A. boeckii (Brady, 1880), are redescribed and compared with their congeners. As a result of the comparison between A. boeckii and A. fastigatus Kim, 2010, a new genus, Kimcheres, is erected to accommodate the only species of Asterocheres displaying the armature formula (0-1) on the second endopodal segment of leg 4. The taxonomic position of A. longisetosus Nair & Pillai, 1984, considered as species inquirenda by Kim (2010), is discussed. Examination of the original description and illustrations, especially the antennules and the mandible, casts doubts on the validity of the species. Asterocheres Boeck, 1860 is the largest genus in the family Asterocheridae and includes approximately 96 nominal species. Nevertheless, according to Kim (2010), the current assignment of twelve of these species to Asterocheres is debatable, and fifteen species are too incompletely described for reliable comparisons to be made. In this paper, two species, A. corneliae Schirl, 1973 and A. boeckii (Brady, 1880), are redescribed and compared with their congeners. As a result of the comparison between A. boeckii and A. fastigatus Kim, 2010, a new genus, Kimcheres, is erected to accommodate the only species of Asterocheres displaying the armature formula (0-1) on the second endopodal segment of leg 4. The taxonomic position of A. longisetosus Nair & Pillai, 1984, considered as species inquirenda by Kim (2010), is discussed. Examination of the original description and illustrations, especially the antennules and the mandible, casts doubts on the validity of the species.
The Youth Throwing Score: Validating Injury Assessment in Young Baseball Players
Authors: Ahmad Christopher S. , Padaki Ajay S. , Noticewala Manish S. , Makhni Eric C. , Popkin Charles A. 
Published: October 2016

Background: Epidemic levels of shoulder and elbow injuries have been reported recently in youth and adolescent baseball players. Despite the concerning frequency of these injuries, no instrument has been validated to assess upper extremity injury in this patient population. Purpose/Hypothesis: The purpose of this study was to validate an upper extremity assessment tool specifically designed for young baseball players. We hypothesized that this tool will be both reliable and valid. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The Youth Throwing Score (YTS) was constructed by an interdisciplinary team of providers and coaches as a tool to assess upper extremity injury in youth and adolescent baseball players (age range, 10-18 years). The psychometric properties of the test were then determined. Results: A total of 223 players completed the final survey. The players’ mean age was 14.3 ± 2.7 years. Pilot analysis showed that none of the 14 questions received a mean athlete importance rating less than 3 of 5, and the final survey read at a Flesch-Kincaid level of 4.1, which is appropriate for patients aged 9 years and older. The players self-assigned their injury status, resulting in a mean instrument score of 59.7 ± 8.4 for the 148 players “playing without pain,” 42.0 ± 11.5 for the 60 players “playing with pain,” and 40.4 ± 10.5 for the 15 players “not playing due to pain.” Players playing without pain scored significantly higher than those playing with pain and those not playing due to pain ( P < .001). Psychometric analysis showed a test-retest intraclass correlation coefficient of 0.90 and a Cronbach alpha intra-item reliability coefficient of 0.93, indicating excellent reliability and internal consistency. Pearson correlation coefficients of 0.65, 0.62, and 0.31 were calculated between the YTS and the Pediatric Outcomes Data Collection Instrument sports/physical functioning module, the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, respectively. Injured players scored a mean of 9.4 points higher after treatment ( P < .001), and players who improved in their self-assigned pain categorization scored 16.5 points higher ( P < .001). Conclusion: The YTS is the first valid and reliable instrument for assessing young baseball players’ upper extremity health.
Evaluating Teach One Reach One—An STI/HIV Risk-Reduction Intervention to Enhance Adult–Youth Communication About Sex and Reduce the Burden of HIV/STI
Authors: Dave Gaurav , Ritchwood Tiarney , Young Tiffany L. , Isler Malika Roman , Black Adina , Akers Aletha Y. , Gizlice Ziya , Blumenthal Connie , Atley Leslie , Wynn Mysha , Stith Doris , Cene Crystal , Ellis Danny , Corbie-Smith Giselle 
Published: October 2016

Purpose:Parents and caregivers play an important role in sexual socialization of youth, often serving as the primary source of information about sex. For African American rural youth who experience disparate rates of HIV/sexually transmitted infection, improving caregiver–youth communication about sexual topics may help to reduce risky behaviors. This study assessed the impact of an intervention to improve sexual topic communication.Design:A Preintervention–postintervention, quasi-experimental, controlled, and community-based trial.Setting:Intervention was in 2 rural North Carolina counties with comparison group in 3 adjacent counties.Subjects:Participants (n = 249) were parents, caregivers, or parental figures for African American youth aged 10 to 14.Intervention:Twelve-session curriculum for participating dyads.Measures:Audio computer-assisted self-interview to assess changes at 9 months from baseline in communication about general and sensitive sex topics and overall communication about sex.Analysis:Multivariable models were used to examine the differences between the changes in mean of scores for intervention and comparison groups.Results:Statistically significant differences in changes in mean scores for communication about general sex topics ( P < .0001), communication about sensitive sex topics ( P < .0001), and overall communication about sex ( P < .0001) existed. Differences in change in mean scores remained significant after adjusting baseline scores and other variables in the multivariate models.Conclusions:In Teach One Reach One intervention, adult participants reported improved communication about sex, an important element to support risk reduction among youth in high-prevalence areas.
Exploring Online Asynchronous Counseling With Tobacco Treatment Specialists in the QUIT-PRIMO and National Dental PBRN HI-QUIT Studies: Who Uses It and What Do They Say?
Authors: Williams Jessica H. , DeLaughter Kathryn , Volkman Julie E. , Sadasivam Rajani S. , Ray Midge N. , Gilbert Gregg H. , Houston Thomas K. 
Published: October 2016

Purpose: To describe the content of messages sent by smokers through asynchronous counseling within a Web-based smoking cessation intervention. Design: Qualitative. Setting: National community-based setting of patients who had been engaged by the medical or dental practices at which they attended or via Google advertisements. Participants: Adults older than 19 years who were current smokers and interested in quitting. Participants throughout the United States referred to a Web-based cessation intervention by their medical or dental provider or by clicking on a Google advertisement. Methods: We conducted a qualitative review of 742 asynchronous counseling messages sent by 270 Web site users. Messages were reviewed, analyzed, and organized into qualitative themes by the investigative team. Results: The asynchronous counseling feature of the intervention was used most frequently by smokers who were white (87%), female (67%), aged 45 to 54 (32%), and who had at least some college-level education (70%). Qualitative analysis yielded 7 basic themes—Talk about the Process of Quitting, Barriers to Quitting, Reasons to Quit, Quit History, Support and Strategies for Quitting, Quitting with Medication, and Quit Progress. The most common theme was Support and Strategies for Quitting with 255 references among all messages. Conclusion: We found rich communication across the spectrum of the quit process, from persons preparing to quit to those who had successfully quit. Asynchronous smoking cessation counseling provides a promising means of social support for smokers during the quit process.
Mid- to Long-term Results of Supramalleolar Osteotomy
Authors: Krähenbühl Nicola , Zwicky Lukas , Bolliger Lilianna , Schädelin Sabine , Hintermann Beat , Knupp Markus 
Published: October 2016

Background: Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA). However, no mid- to long-term results have been reported. The aim of this study was to gain a better insight into the indications and contraindications for realignment surgery. Methods: Two hundred ninety-four patients (298 ankles) underwent realignment surgery between December 1999 and June 2013. Kaplan-Meier survival analysis was performed with total ankle replacement and arthrodesis of the ankle joint as endpoints. A Cox proportional hazards model was performed to identify risk factors for failure. The mean time to follow-up was 5.0 ± 3.7 years. Results: The overall 5-year survival rate was 88%. Thirty-eight patients (12.9%) underwent either secondary total ankle replacement or ankle arthrodesis (30 total ankle replacements, 8 ankle arthrodesis). Risk factors for failure following realignment surgery were age at the time of surgery and a Takakura score of 3b preoperatively. Conclusion: Realignment surgery of the hindfoot was an excellent treatment option for young and physically active patients with early to mid-stage ankle OA. Level of Evidence: Level IV, prospective observational study.
HAMR: A dataflow-based real-time in-memory cluster computing engine
Authors: Wu Yao , Zheng Long , Heilig Brian , Gao Guang R 
Published: October 2016

As the attention given to big data grows, cluster computing systems for distributed processing of large data sets become the mainstream and critical requirement in high performance distributed system research. One of the most successful systems is Hadoop, which uses MapReduce as a programming/execution model and takes disks as intermedia to process huge volumes of data. Spark, as an in-memory computing engine, can solve the iterative and interactive problems more efficiently. However, currently it is a consensus that they are not the final solutions to big data due to a MapReduce-like programming model, synchronous execution model and the constraint that only supports batch processing, and so on. A new solution, especially, a fundamental evolution is needed to bring big data solutions into a new era. In this paper, we introduce a new cluster computing system called HAMR which supports both batch and streaming processing. To achieve better performance, HAMR integrates high performance computing approaches, i.e. dataflow fundamental into a big data solution. With more specifications, HAMR is fully designed based on in-memory computing to reduce the unnecessary disk access overhead; task scheduling and memory management are in fine-grain manner to explore more parallelism; asynchronous execution improves efficiency of computation resource usage, and also makes workload balance across the whole cluster better. The experimental results show that HAMR can outperform Hadoop MapReduce and Spark by up to 19x and 7x respectively, in the same cluster environment. Furthermore, HAMR can handle scaling data size well beyond the capabilities of Spark.
What is the value of conducting a trial of r-tPA for the treatment of mild stroke patients?
Authors: Guzauskas Gregory F , Chen Er , Lalla Deepa , Yu Elaine , Tayama Darren , Veenstra David L 
Published: October 2016

Background The Phase IIIb, Double-Blind, Multicenter Study to Evaluate the Efficacy and Safety of Alteplase in Patients With Mild Stroke: Rapidly Improving Symptoms and Minor Neurologic Deficits (PRISMS) trial will assess r-tPA in ischemic stroke patients who present with mild deficits (i.e. mild stroke). Aims To assess PRISMS’s societal value in clarifying the optimal care for patients with mild ischemic stroke. Methods A value of information (VOI) decision model was developed to compare the outcomes of mild stroke patients treated vs. not treated with r-tPA. Model inputs were derived from a subset of Third International Stroke Trial patients, a recent meta-analysis of r-tPA trials, expert opinion, and other published sources. VOI analyses were also used to assess the expected US societal value of the PRISMS trial and the expected value of reducing uncertainty in key trial estimates. Results The expected net societal value of the PRISMS trial was approximately $210 million ($160 m–$260 m), representing a six-fold return on investment. The value of reducing uncertainty in r-tPA efficacy was approximately $150 million ($100 m–$200 m), while reducing uncertainty in r-tPA safety (increased risk for symptomatic intracranial hemorrhage) did not add additional value in comparison. Conclusions Developing a better understanding of the outcomes of r-tPA treatment in patients with mild ischemic stroke will provide tremendous societal value by clarifying current uncertainty around treatment effectiveness. Enrollment in the PRISMS trial for patients presenting with mild ischemic stroke within 0–3 h of symptom onset should be highly encouraged.
Systematic review and meta-analysis: the effects of fermented milk with Bifidobacterium lactis CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population
Authors: Eales Jacqui , Gibson Peter , Whorwell Peter , Kellow John , Yellowlees Ann , Perry Richard H. J. , Edwards Mary , King Sarah , Wood Hannah , Glanville Julie 
Published: October 2016

Background: It has been suggested that probiotics may improve gastrointestinal discomfort. Not all probiotics exhibit the same effects and consequently meta-analyses on probiotics should be confined to well-defined strains or strain combinations. The aim of this study was to evaluate the effectiveness of a probiotic fermented milk (PFM) that includes Bifidobacterium lactis ( B. lactis) CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population. Methods: Double-blind randomized controlled trials in the general adult population comparing PFM with a control dairy product for at least 4 weeks were searched from multiple literature databases (up to February 2015). Meta-analyses using random-effects models, with individual participant data were undertaken to calculate an odds ratio (OR) or standard mean difference (SMD), with a 95% confidence interval (CI). Results: The search strategy identified 12,439 documents. Overall, three trials with a total of 598 adults (female = 96.5%) met the inclusion criteria. Consumption of the PFM product was associated with a significant improvement in overall gastrointestinal discomfort compared with the control product (OR = 1.48; 95% CI 1.07–2.05), with a number needed to treat (NNT) of 10.24 (95% CI 5.64–55.93). PFM was also superior to the control in reducing digestive symptoms, as measured using a composite score (SMD = −0.21; 95% CI −0.37 to −0.05). Sensitivity analyses produced similar results, and the heterogeneity between studies was minimal. Conclusions: This meta-analysis shows that the consumption of PFM with B. lactis CNCM I-2494 and lactic acid bacteria is associated with a modest but consistent and significant improvement of outcomes related to gastrointestinal discomfort in healthy adults.
Analysis of the psychometric properties of the Multiple Sclerosis Impact Scale-29 (MSIS-29) in relapsing–remitting multiple sclerosis using classical and modern test theory
Authors: Bacci ED , Wyrwich KW , Phillips GA , Vollmer T , Guo S 
Published: October 2016

Background Investigations using classical test theory support the psychometric properties of the original version of the Multiple Sclerosis Impact Scale (MSIS-29v1), a disease-specific measure of multiple sclerosis (MS) impact (physical and psychological subscales). Later, assessments of the MSIS-29v1 in an MS community-based sample using Rasch analysis led to revisions of the instrument’s response options (MSIS-29v2). Objective The objective of this paper is to evaluate the psychometric properties of the MSIS-29v1 in a clinical trial cohort of relapsing–remitting MS patients (RRMS). Methods Data from 600 patients with RRMS enrolled in the SELECT clinical trial were used. Assessments were performed at baseline and at Weeks 12, 24, and 52. In addition to traditional psychometric analyses, Item Response Theory (IRT) and Rasch analysis were used to evaluate the measurement properties of the MSIS-29v1. Results Both MSIS-29v1 subscales demonstrated strong reliability, construct validity, and responsiveness. The IRT and Rasch analysis showed overall support for response category threshold ordering, person-item fit, and item fit for both subscales. Conclusions Both MSIS-29v1 subscales demonstrated robust measurement properties using classical, IRT, and Rasch techniques. Unlike previous research using a community-based sample, the MSIS-29v1 was found to be psychometrically sound to assess physical and psychological impairments in a clinical trial sample of patients with RRMS.
A novel distractive and mobility-enabling lumbar spinal orthosis
Authors: DiAngelo Denis J , Hillyard Daniel C 
Published: October 2016

Purpose Lumbar spinal orthoses are often used as non-surgical treatment and serve to support the spine and alleviate low back pain. More recently, dynamic orthoses claiming to decompress the spine have been introduced. A previously developed prototype of dynamic mobility orthosis (DMO1) was designed that provided a distractive load across the lumbar spine but required higher sagittal bending moments and was unable to maintain spinal off-loading throughout extended ranges of movement. The objective was to design a new orthosis (DMO2) that reduced bending moment buildup and sustained spinal off-loading throughout daily living ranges of flexion and extension movement. Methods A mechanical analog upper torso model and programmable robotic testing platform were used to design features of DMO2: a mobility-enabling component and a distractive force component. Test conditions for DMO2 were 300  N of applied vertical torso load over a range of 25° flexion to 10° extension. Loads carried by the brace were determined throughout flexion and extension ranges. Applied moments to the upper torso model and transferred moments to the spine were measured. The difference in applied and transferred moments represented brace moment effects. Results The DMO2 prototype improved spinal off-loading capacity from 172  N to 290  N at end-range flexion and from 247  N to 293  N at end range extension compared to the original DMO1 prototype. End-range applied moments (flexion-DMO1: 32.4 Nm/DMO2: 21.7 Nm; extension-DMO1: 15.0 Nm/DMO2: 10.9 Nm) and brace moments (flexion-DMO1: 18.6 Nm/DMO2: 6.6 Nm; extension-DMO1: 15.0 Nm/DMO2: 4.4 Nm) were also reduced. Conclusions A novel dynamic spinal orthosis was designed that maintained spinal off-loading throughout extended ranges of flexion and extension movement without buildup of adverse bending moments.