bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct Proof of Endo-Epicardial Asynchrony of the Atrial Wall During Atrial Fibrillation in Humans
Authors: de Groot Natasja , van der Does Lisette , Yaksh Ameeta , Lanters Eva , Teuwen Christophe , Knops Paul , van de Woestijne Pieter , Bekkers Jos , Kik Charles , Bogers Ad , Allessie Maurits 
Published: April 2016

Background—
The presence of focal fibrillation waves during atrial fibrillation (AF) can, besides ectopic activity, also be explained by asynchronous activation of the atrial endo- and epicardial layer and transmurally propagating fibrillation waves. To provide direct proof of endo-epicardial asynchrony, we performed simultaneous high-resolution mapping of the right atrial endo- and epicardial wall during AF in humans.

Method and Results—

Intraoperative mapping of the endo- and epicardial right atrial wall was performed during (induced) AF in 10 patients with AF (paroxysmal: n=3; persistent: n=4; and longstanding persistent: n=3) and 4 patients without a history of AF. A clamp made of 2 rectangular 8×16 electrode arrays (interelectrode distance 2 mm) was inserted into the incision in the right atrial appendage. Recordings of 10 seconds of AF were analyzed to determine the incidence of asynchronous endo-epicardial activation times (≥15 ms) of opposite electrodes. Asynchronous endo-epicardial activation ranged between 0.9 and 55.9% without preference for either side. Focal waves appeared equally frequent at endocardium and epicardium (11% versus 13%;
P
=0.18). Using strict criteria for breakthrough (presence of an opposite wave within 4 mm and ≤14 ms before the origin of the focal wave), the majority (65%) of all focal fibrillation waves could be attributed to endo-epicardial excitation.

Conclusions—
We provided the first evidence for asynchronous activation of the endo-epicardial wall during AF in humans. Endo-epicardial asynchrony may play a major role in the pathophysiology of AF and may offer an explanation why in some patients therapy fails.
Pial Collateral Reactivity During Hypertension and Aging
Authors: Chan Siu-Lung , Sweet Julie G. , Bishop Nicole , Cipolla Marilyn J. 
Published: April 2016

Background and Purpose—
We investigated vasoactive properties of leptomeningeal arterioles (LMAs) under normotensive conditions and during hypertension and aging that are known to have poor collateral flow and little salvageable tissue.

Methods—
LMAs, identified as distal anastomotic arterioles connecting middle and anterior cerebral arteries, were studied isolated and pressurized from young (18 weeks) or aged (48 weeks) normotensive Wistar Kyoto (WKY18, n=14; WKY48, n=6) rats and spontaneously hypertensive rats (SHR18, n=16; SHR48, n=6). Myogenic tone and vasoactive responses to pressure as well as endothelial function and ion channel activity were measured.

Results—

LMAs from WKY18 had little myogenic tone at 40 mm Hg (8±3%) that increased in aged WKY48 (30±6%). However, LMAs from both WKY groups dilated to increased pressure and demonstrated little myogenic reactivity, a response that would be conducive to collateral flow. In contrast, LMAs from both SHR18 and SHR48 displayed considerable myogenic tone (56±8% and 43±7%;
P
<0.01 versus WKY) and constricted to increased pressure. LMAs from both WKY and SHR groups had similar basal endothelial nitric oxide and IK channel activity that opposed tone. However, dilation to sodium nitroprusside, diltiazem and 15 mmol/L KCl was impaired in LMAs from SHR18.

Conclusions—
This study shows for the first time that LMAs from young and aged SHR are vasoconstricted and have impaired vasodilatory responses that may contribute to greater perfusion deficit and little penumbral tissue. These results also suggest that therapeutic opening of pial collaterals is possible during middle cerebral artery occlusion to create penumbral tissue and prevent infarct expansion.
The effect of a core exercise program on Cobb angle and back muscle activity in male students with functional scoliosis: a prospective, randomized, parallel-group, comparative study
Authors: Park Yun Hee , Park Young Sook , Lee Yong Taek , Shin Hee Suk , Oh Min-Kyun , Hong Jiyeon , Lee Kyoung Yul 
Published: April 2016

Objective To assess the effect of core strengthening exercises on Cobb angle and muscle activity in male college students with functional scoliosis. Methods Static and dynamic back muscle activity were evaluated via surface electromyography (sEMG). A core exercise protocol comprising 18 exercises was performed three times/week for 10 weeks. Patients were randomly allocated to either a home- or community-based exercise programme. Cervical thoracolumbar scans and sEMG were performed after 10 weeks. Results A total of 87 students underwent cervical thoracolumbar scans. Of these, 53 were abnormal and were randomised between the home-based ( n = 25) or community-based ( n = 28) groups. After the 10-week exercise programme, Cobb angles were significantly lower and back muscle strength was significantly improved than baseline in both groups, but there were no statistically significant between group differences. Conclusions A 10-week core strengthening exercise programme decreases Cobb angle and improves back muscle strength in patients with functional scoliosis.
Efficacy of Parent–Child Interaction Therapy With Chinese ADHD Children
Authors: Leung Cynthia , Tsang Sandra , Ng Gene S. H. , Choi S. Y. 
Published: April 2016

Purpose: This study aimed to evaluate the efficacy of Parent-Child Interaction Therapy (PCIT) in Chinese children with attention-deficit/hyperactivity disorder (ADHD) or ADHD features. Methods: This study adopted a randomized controlled trial design without blinding. Participants were randomized into either the intervention group ( n = 32) and offered PCIT by trained PCIT practitioners or the waitlist control group ( n = 32) and offered PCIT after the intervention group had completed treatment. Parent participants were requested to complete questionnaires on their children’s behavior and their parental stress. PCIT practitioners observed parent–child interactions according to a coding system. Results: Analysis was by intention to treat. The results indicated a significant decrease in child behavior and attention problems, parental stress, and negative parenting practices and an increase in positive parenting practices in the intervention group at postintervention ( p ≤ .002 in all cases). Conclusion: This study provided promising evidence on the effectiveness of PCIT in Chinese children with ADHD or ADHD features.
Psychometric Properties of the Patients’ Satisfaction Instrument FAMCARE-P13 in a Palliative Care Unit
Authors: Parpa Efi , Galanopoulou Natasa , Tsilika Eleni , Galanos Antonis , Mystakidou Kyriaki 
Published: April 2016

Purpose: To investigate the psychometric properties of the Greek 13-item measure of patients’ satisfaction (FAMCARE-P13) in palliative care setting. Methods: A hundred patients completed the FAMCARE-P13. Exploratory factor analysis and confirmatory factor analysis (CFA) have been conducted. Two factors’ solution was revealed from CFA. The questionnaire was administered to an initial validation sample and then for test–retest in a sample of 40 patients 3 days later. The Rosenberg Self-Esteem Scale measuring global self-esteem has been also used as a gold standard for construct validity. Subscale and known groups validity have also been tested for FAMCARE-P13s’ validity. Results: A reduced 13-item version of our measure (FAMCARE-P13) possessed 2-factor structure with high reliability. Patient satisfaction was correlated with physical distress, communication and relationship with health-care providers, and caregiver satisfaction. Conclusions: We recommend the use of the Greek FAMCARE-P13 to assess care satisfaction of patients with advanced-stage cancer.
Are Inflammatory Biomarkers Increased in Varicose Vein Blood?
Authors: Lattimer Christopher R. , Kalodiki Evi , Geroulakos George , Hoppensteadt Debra , Fareed Jawed 
Published: April 2016

Objectives: To test for the presence of inflammatory biomarkers in blood taken from varicose veins versus antecubital blood of the same patient and compare this to levels in healthy controls. Methods: Using a multiplex biochip array method (Randox, United Kingdom), the interleukins (ILs) IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10; vascular endothelial growth factor; interferon γ, tumor necrosis factor α ; monocyte chemotactic protein 1 (MCP-1); and epidermal growth factor were measured in citrated plasma samples drawn from the arms and legs of 24 patients with varicose veins and 24 controls. Results: Expressed as median (interquartile range) in pg/mL, leg samples from patients with varicose veins had significantly higher levels of IL-8 and MCP-1 compared to their own arm samples (IL-8: local 2.3 [1.71-3.3] vs systemic 2.3 [1.62-2.98], P = .023; MCP-1: local 114.42 [84.29-139.05] vs systemic 103.56 [79.75-126.42], P < .0005). This was not observed in the control group. Leg samples from both patients with varicose vein and controls had higher levels of IL-6 compared to their own arm samples (patients: local 1.67 [0.82-4.48] vs systemic 1.24 [0.58-3.26], P = .002; controls: local 1.23 [0.83-1.7] vs systemic 1.03 [1.7-1.52], P = .005). No significant differences were detected with the other biomarkers. Conclusions: Blood drawn from the site of varicose veins appears to have significantly increased concentrations of IL-6, IL-8, and MCP-1 when compared to the same patient’s arm blood. This supports the hypothesis that inflammation is activated from the tissues drained by the varicose veins.
Retrospective comparison of negative pressure wound therapy and silver-coated foam dressings in open-wound treatment in cats
Authors: Nolff Mirja Christine , Fehr Michael , Reese Sven , Meyer-Lindenberg Andrea E 
Published: April 2016

Objectives The objective of this study was to evaluate negative pressure wound therapy (NPWT) for the treatment of complicated wounds in cats. Methods Twenty cats undergoing open-wound treatment in two clinics were classed according to treatment method: NPWT (group A, n = 10) and polyurethane foam dressing (group B, n = 10). Pairs of patients from each group were matched based on wound conformation, localisation and underlying cause. Cats from both groups were compared in terms of duration of previous treatment, time to closure and complications. Results Signalment, duration of previous treatment, antibiotic and antiseptic treatment, and bacterial status were comparable between groups. Total time to wound closure was significantly shorter ( P = 0.046, strong effect size; Cohen d = 0.8) in group A (25.8 days, range 11.0–57.0 days) compared with group B (39.5 days, range 28.0–75.0 days). NPWT-treated wounds suffered fewer complications and became septic less frequently during treatment compared with wounds treated with a foam dressing. The progression of fat tissue necrosis was particularly well controlled under NPWT, resulting in fewer deaths due to this condition in this group. However, although a strong effect of NPWT on the progression of infection, fever and sepsis was detected (Cramer-V 0.5), this difference was not significant. Conclusions and relevance This study demonstrated that time to healing was considerably shorter, and complication rate lower, in NPWT-treated animals compared with foam dressing-treated cats. In particular, the effective management of infection by NPWT emphasises the value of NPWT in the treatment of cats suffering from infected wounds.
Narrative abilities of preschool bilingual Norwegian-Russian children
Authors: Rodina Yulia 
Published: April 2016

Aim and objectives/purpose/research questions: The study aims at conducting a comprehensive examination of the initial stages of narrative development in both languages of typically developing Norwegian-Russian simultaneous bilinguals. The objective of the study was to investigate whether narrative structure (macrostructure) and narrative productivity (microstructure) are language-dependent abilities (cf. The Linguistic Interdependence Hypothesis) and to explore language exposure effects on the narrative composites. Design/methodology/approach: The Multilingual Assessment Instrument for Narratives was used to assess narrative comprehension and production in preschool Norwegian-Russian children ( N = 16, M = 4;6) as well as in Norwegian- ( N = 16, M = 4;5) and Russian monolinguals ( N = 16, M = 4;5). Data and analysis: Multiple regression and correlation analysis was conducted to establish the relationship between the narrative macro- and microstructure in bilinguals and through the bilingual–monolingual comparison. In addition, more detailed quantitative and qualitative analysis at each level was performed. Individual bilingual children’s data were also considered. Findings/conclusions: Overall the comparison of the narrative macro- and microstructure in the two languages of bilinguals supports the Linguistic Interdependence Hypothesis. Norwegian-Russian children’s ability to compose and especially understand a story is equally developed in both languages. Exposure effects revealing the superiority of Norwegian, the majority language, are found primarily for microstructure measures. The complete picture is achieved through the bilingual–monolingual comparison, which suggests that narrative abilities in the minority language are sensitive to the amount of exposure and their acquisition can be vulnerable. Originality and significance/implications: The study provides new evidence on bilinguals’ narrative abilities in a previously unstudied language combination. The new evidence contributes to better understanding of the initial stages of narrative development in typically developing simultaneous bilinguals and establishing the norms for the relevant abilities. Importantly, the study highlights the importance of examining language data in both languages of a bilingual child.
Early myocardial impairment in type 1 diabetes patients without known heart disease assessed with tissue Doppler echocardiography: The Thousand & 1 study
Authors: Jensen Magnus Thorsten , Sogaard Peter , Andersen Henrik Ullits , Gustafsson Ida , Bech Jan , Hansen Thomas Fritz , Theilade Simone , Almdal Thomas , Rossing Peter , Jensen Jan Skov 
Published: April 2016

Purpose: Cardiovascular disease is the most common cause of mortality in type 1 diabetes; patients with albuminuria are at greatest risk. We investigated myocardial function and premature myocardial impairment in type 1 diabetes patients with and without albuminuria compared to controls. Methods: This study included a cross-sectional survey of 1093 type 1 diabetes patients from Steno Diabetes Center and 200 healthy controls. Conventional and tissue Doppler echocardiographic measurements were analysed in multivariable models in normoalbuminuria ( n = 760), microalbuminuria ( n = 227) and macroalbuminuria ( n = 106). Investigators were blinded to degree of albuminuria. Results: For the type 1 diabetes patients, mean age was 49.6 years, 53% were men and mean diabetes duration was 25.5 years. In multivariable models systolic velocity s′ did not differ between type 1 diabetes patients with normoalbuminuria and controls (β-coefficient [95% confidence interval]: −0.17 [−0.41; 0.08], p = 0.19), but was impaired between controls and microalbuminuria (−0.53 [−0.84; −0.23], p = 0.001) and macroalbuminuria (−0.59 [−0.96; −0.22], p = 0.002). Diastolic measurements ( e′, a′, e′/ a′, and E/ e′) were all significantly impaired in type 1 diabetes, for example, e′/ a′: normoalbuminuria, microalbuminuria and macroalbuminuria versus controls: −0.38 [−0.52; −0.23], p < 0.001; −0.49 [−0.67; −0.32], p < 0.001; and −0.81 [−1.03; −0.59], p < 0.001. In age-related analyses, myocardial impairment occurred prematurely in type 1 diabetes compared to controls (e.g. E/ e′ = 8; 9.2 years [normoalbuminuria], 17.3 years [microalbuminuria] and 41.4 years [macroalbuminuria] prematurely, respectively). Conclusion: In type 1 diabetes patients with albuminuria, both systolic and diastolic functions are impaired, whereas in patients without albuminuria only diastolic function is affected. Myocardial impairment is detectable many years prematurely in type 1 diabetes, especially in patients with albuminuria.
Absence of the Effect of Pretransplant Body Mass Index on Post Kidney Transplant Outcomes
Authors: Tremblay Simon , Kaiser Tiffany E. , Alloway Rita R. , Woodle E. Steve , Diwan Tayyab S. 
Published: April 2016

Context: Obesity has been reported as risk factor for reduced posttransplant graft and patient survival and increased delayed graft function (DGF). Objective: The purpose of this work is to analyze the effect of body mass index (BMI) on defined transplant outcomes in patients transplanted under defined guidelines in a kidney transplant program. Design: Review of a prospectively collected database in renal transplant recipients receiving rabbit antithymocyte globulin induction, mycophenolate mofetil, tacrolimus, and early corticosteroid withdrawal between 2001 and 2011. Setting: This review was conducted in a single abdominal transplant program in the United States. Main Outcome Measures: Primary outcome was death-censored graft survival categorized by posttransplant body mass groups. Secondary outcomes included DGF as well as patient survival. Results: Four hundred sixty seven patients were identified. No difference was observed in graft survival or DGF between BMI groups. One-year, death-censored graft survival and patient survival rates ranged from 97.5% to 100% and 96.6% to 100%, respectively. Delayed graft function was uncommon across all BMI groups, ranging from 5.3% to 9.1%, with the lowest incidence in patients with a BMI ≥ 35 kg/m2. Biopsy-proven acute rejection rates at 1 year were similar across all groups (10.1%-14%) as were estimated glomerular filtration rates were at 1, 3, and 5 years. Conclusion: Our results do not show an effect of BMI on posttransplant outcomes, suggesting that relaxation of BMI criteria may be warranted for recipient selection.
Diagnosis, Incidence, and Clinical Implications of Perioperative Myocardial Injury in Vascular Surgery
Authors: Thomas Kate N. , Cotter James D. , Williams Michael J. A. , van Rij André M. 
Published: April 2016

Introduction: Routine measurement of cardiac biomarkers such as troponin T (TnT) is recommended perioperatively, especially in high-risk vascular surgery. Long-term prognosis is worse even in those with nonspecific perioperative myocardial injury. However, a clear understanding of these biomarker profiles and how they should affect patient management is lacking. Methods: We examined the perioperative profile of high-sensitivity TnT (hsTnT) release in 85 patients undergoing elective major vascular surgery. Plasma hsTnT was measured preoperatively, at 6, 12, and 24 hours postoperatively, and then every 24 hours for a maximum of 5 days. Significant elevations in hsTnT with/without clinical indicators of ischemia were used to diagnose myocardial infarction or injury. Results: A high incidence of myocardial injury was evident (46% had elevated hsTnT); only 5% were associated with myocardial infarction, and 41% were due to myocardial injury. Conclusions: This study emphasizes the high incidence of perioperative myocardial injury and stress in vascular surgery as revealed by the use of the robust and very sensitive biomarker of myocardial damage, hsTnT. The high availability and swift development of increasingly sensitive assays allow detection of abnormal elevated hsTnT levels in a higher proportion of the population. Consequent challenges are the reduced specificity to separate acute events as well as to deduce the prognostic value of elevations due to confusing criteria; this is especially the case in a patient group with multiple comorbidities that affect hsTnT levels chronically.
Missions from Korea 2016: Sustainability and Revitalization
Authors: Moon Steve Sang-Cheol 
Published: April 2016

According the most recent survey directed by the author, there are 20,672 Korean missionaries working through 159 mission agencies in 171 countries. The number of missionaries grew by 205 persons in 2015 marking an annual growth rate of 1.01 percent. The annual growth rate dropped phenomenally from 2.19 percent in 2012, to 1.90 percent in 2014, and further down to 1.01 percent in 2015. The Korean missionary movement is entering an unfamiliar phase of development characterized by losing momentum for further growth. Most of the Korean missionaries are well aware of the current situation and share certain realistic views and outlooks.
Inequalities in medication adherence to statin treatment after stroke: A nationwide observational study
Authors: Sjölander Maria , Eriksson Marie , Glader Eva-Lotta 
Published: April 2016

Introduction The objective was to investigate differences in adherence to statins after stroke based on age, sex, socioeconomic status and country of birth. Patients and methods Patients with ischemic stroke in 2009–2010 were included from the Swedish stroke register. Adherence to statin treatment was measured over two years as proportion of days covered with 80% as cut-off for adherence. Income, education, and country of birth were obtained from official registers. Factors associated with adherence were controlled for in multivariable logistic regression. Results Of 15,192 included patients, 73.9% had an adherence rate ≥80%. The oldest (85+ years) and youngest (18–54 years) had the lowest adherence, and a smaller proportion of women were adherent (odds ratio (OR) 0.84; 95% confidence interval (CI) 0.77–0.92). Adherence was less common in patients born in Nordic countries (OR 0.82; 95% CI (0.68–0.97), Europe (OR 0.78; 95% CI 0.65–0.93), and in non-European countries (OR 0.65; 95% CI 0.50–0.84) compared to Sweden-born. Patients with university education were to a lower extent adherent compared to patients with primary school education (OR 0.81; 95% CI 0.72–0.91). There was no association between adherence and income. Discussion The study was based on individual level real-life data with national coverage. Adherence was estimated from data on filled prescriptions, but filled prescription does not mean that drugs are used as intended. Conclusion Adherence to statin treatment over two years was suboptimal, and adherence was less common among women, patients born outside of Sweden and patients with university education.
Insulin resistance modifies the association between obesity and current asthma in adults
Authors: Cardet Juan Carlos , Ash Samuel , Kusa Tope , Camargo Carlos A. , Israel Elliot 
Published: April 2016

Insulin resistance potentiates the association between obesity and childhood asthma, but this relationship appears inconsistent in relatively small studies of adults. We investigated effect modification in adults using the National Health and Nutrition Examination Survey 2003–2012, a large, nationally representative database.Insulin resistance and a history of physician-diagnosed current asthma were obtained from 12 421 adults, ages 18–85 years. We used logistic regression to determine associations between obesity and current asthma, adjusting for age, sex, race/ethnicity, poverty income ratio and smoking status. An interaction term evaluated effect modification by insulin resistance of the obesity–asthma association.As expected, obesity was positively associated with current asthma. Insulin resistance modified this association, with obesity measured as body mass index, waist circumference or waist-to-height ratio. The relationship between obesity and current asthma was stronger with increasing insulin resistance tertiles (OR 2.05, 95% CI 2.76–3.00; p-value for interaction 0.03). This association was robust to adjustments for other components of the metabolic syndrome (hypertriglyceridaemia, hypertension, hyperglycaemia and systemic inflammation). None of these components were themselves effect modifiers of the obesity–asthma association.In this large, nationally representative sample, insulin resistance modified the association between obesity and current asthma in adults. Targeting insulin resistance may represent a novel therapeutic strategy for obese patients with asthma.