bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different Approaches for Catheter Ablation of Para-Hisian Accessory Pathways
Authors: Liang Ming , Wang Zulu , Liang Yanchun , Yang Guitang , Jin Zhiqing , Sun Mingyu , Han Yaling 
Published: June 2017

Background—
Catheter ablation of para-Hisian accessory pathways (APs) can be challenging because of adjacent conduction tissue. Some different approaches for ablation, including the inferior vena cava approach (IVC-A), the noncoronary cusp approach (NCC-A), or the superior vena cava approach (SVC-A), have been reported. However, when should para-Hisian APs be mapped and ablated by the IVC-A, NCC-A, or SVC-A is not well established.

Methods and Results—
This study included 55 consecutive patients (mean age, 53±11 years, 36 males) with para-Hisian APs. On the basis of the approach resulting in successful ablation, patients were divided into IVC-A, NCC-A, and SVC-A groups. The clinical characteristics, surface ECG, intracardiac electrogram findings, and response to ablation were analyzed. Para-Hisian APs were eliminated by IVC-A in 48 of the 55 (87%) patients. The rates of para-Hisian APs requiring NCC-A (4/55 patients, 7%) and SVC-A (3/55 patients, 6%) were relatively low. During mapping at the para-Hisian region, the local ventricular and atrial potentials were well fused during retrograde AP conduction in 45 of the 48 patients in IVC-A group, 0 of the 4 patients in NCC-A group, and 1 of the 3 patients in SVC-A group, respectively. There was no significant difference in the preexcitation characteristics among the 3 groups.

Conclusion—
Most para-Hisian APs can be safely and effectively ablated by IVC-A, and ablation in the NCC is not an initial or a preferred approach. The degree of local ventriculoatrial fusion in the para-Hisian region during retrograde AP conduction can differentiate or predict the successful ablation site.
Predictors and Association With Clinical Outcomes of the Changes in Exercise Capacity After Transcatheter Aortic Valve Replacement
Authors: Abdul-Jawad Altisent Omar , Puri Rishi , Regueiro Ander , Chamandi Chekrallah , Rodriguez-Gabella Tania , del Trigo Maria , Campelo-Parada Francisco , Couture Thomas , Marsal Josep Ramon , Côté Mélanie , Paradis Jean-Michel , DeLarochellière Robert , Doyle Daniel , Mohammadi Siamak , Dumont Eric , Rodés-Cabau Josep 
Published: June 2017

Background:
At present, there are no objective data specifically examining the clinical impact of variations in exercise capacity post–transcatheter aortic valve replacement (TAVR). We describe the changes in exercise capacity between baseline and 6 months post-TAVR, and ascertain factors associated with and clinical implications of a lack of improvement in exercise capacity post-TAVR.

Methods:
A total of 305 patients (mean age, 79±9 years; 44% men; Society of Thoracic Surgeons predicted risk mortality score, 6.7±4.2%) undergoing TAVR completed both baseline and follow-up exercise capacity assessments at 6 months post-TAVR. Exercise capacity was evaluated by the 6-minute walk test (6MWT). Clinical outcomes were compared between patients displaying greater than (n=152; improving group) versus less than (n=153; nonimproving group) the median percentage change in distance walked between baseline and 6-month follow-up examinations. The primary outcome measure was clinical event rates, measured from the 6-month post-TAVR period onward. Further dichotomization according to baseline 6MWT distance (less than versus more than median walking distance, or slow walker versus fast walker) was also assessed.

Results:

The mean overall distances walked pre- and post-TAVR (6 months post-TAVR) were 204±119 and 263±116 m, respectively (Δ6MWT=60±106 m), with 219 (72%) patients demonstrating an increase in their walking distance (median percentage increase of the entire population was 20% [interquartile range, 0%–80%]). Factors independently correlated with reduced exercise capacity improvement included a range of baseline clinical characteristics (older age, female sex, chronic obstructive pulmonary disease;
P
<0.05 for all), periprocedural major or life-threatening bleeding (
P
=0.009) and new-onset anemia at 6 months post-TAVR (
P
=0.009). Failure to improve the 6MWT distance by at least 20% was independently associated with all-cause mortality (
P
=0.002) and cardiovascular death or rehospitalization for cardiovascular causes (
P
=0.001). Baseline slow walkers who were able to improve the 6MWT distance presented with significantly better outcomes than nonimprovers (
P
=0.01 for all-cause mortality;
P
=0.001 for cardiovascular end point).

Conclusions:
Approximately one-third of patients undergoing TAVR did not improve their exercise capacity postprocedure. The lack of functional improvement post-TAVR was predicted by a mix of baseline and periprocedural factors translating into poorer clinical outcomes. These results suggest that systematically implementing exercise capacity assessment pre- and post-TAVR may help to improve patient risk stratification.
Plasminogen Activator Inhibitor Type I Controls Cardiomyocyte Transforming Growth Factor-β and Cardiac Fibrosis
Authors: Flevaris Panagiotis , Khan Sadiya S. , Eren Mesut , Schuldt Adam J. T. , Shah Sanjiv J. , Lee Daniel C. , Gupta Sweta , Shapiro Amy D. , Burridge Paul W. , Ghosh Asish K. , Vaughan Douglas E. 
Published: June 2017

Background:
Fibrosis is the pathological consequence of stress-induced tissue remodeling and matrix accumulation. Increased levels of plasminogen activator inhibitor type I (PAI-1) have been shown to promote fibrosis in multiple organ systems. Paradoxically, homozygous genetic deficiency of PAI-1 is associated with spontaneous age-dependent, cardiac-selective fibrosis in mice. We have identified a novel PAI-1-dependent mechanism that regulates cardiomyocyte-derived fibrogenic signals and cardiac transcriptional pathways during injury.

Methods:

Cardiac fibrosis in subjects with homozygous mutation in
SERPINE-1
was evaluated with late gadolinium-enhanced cardiac magnetic resonance imaging. A murine cardiac injury model was performed by subcutaneous infusion of either saline or Angiotensin II by osmotic minipumps. We evaluated blood pressure, cardiac function (by echocardiography), fibrosis (with Masson Trichrome staining), and apoptosis (with TUNEL staining), and we performed transcriptome analysis (with RNA sequencing). We further evaluated fibrotic signaling in isolated murine primary ventricular myocytes.

Results:

Cardiac fibrosis was detected in 2 otherwise healthy humans with complete PAI-1 deficiency because of a homozygous frameshift mutation in
SERPINE-1
. In addition to its suppressive role during spontaneous cardiac fibrosis in multiple species, we hypothesized that PAI-1 also regulates fibrosis during cardiac injury. Treatment of young PAI-1
−/−
mice with Angiotensin II induced extensive hypertrophy and fibrotic cardiomyopathy, with increased cardiac apoptosis and both reactive and replacement fibrosis. Although Angiotensin II-induced hypertension was blunted in PAI-1
−/−
mice, cardiac hypertrophy was accelerated. Furthermore, ventricular myocytes were found to be an important source of cardiac transforming growth factor-β (TGF-β) and PAI-1 regulated TGF-β synthesis by cardiomyocytes in vitro as well as in vivo during cardiac injury. Transcriptome analysis of ventricular RNA after Angiotensin II treatment confirmed that PAI-1 deficiency significantly enhanced multiple TGF-β signaling elements and transcriptional targets, including genes for extracellular matrix components, mediators of extracellular matrix remodeling, matricellular proteins, and cardiac integrins compared with wild-type mice.

Conclusions:
PAI-1 is an essential repressor of cardiac fibrosis in mammals. We define a novel cardiomyocyte-specific regulatory mechanism for TGF-β production by PAI-1, which explains the paradoxical effect of PAI-1 deficiency in promoting cardiac-selective fibrosis. Thus, PAI-1 is a molecular switch that controls the cardiac TGF-β axis and its early transcriptional effects that lead to myocardial fibrosis.
Resistance of Coffea arabica genotypes against Meloidogyne paranaensis and M. incognita under controlled and field conditions
Authors: Peres Ana Catarina J. , Salgado Sonia M.L. , Correa Valdir R. , Santos Marcilene F.A. , Mattos Vanessa S. , Monteiro Jessica M.S. , Carneiro Regina M.D.G. 
Published: June 2017

Root-knot nematodes negatively impact on coffee yield worldwide. The use of resistant cultivars is the most effective way to manage these pests. The goal of this study was to identify Coffea arabica genotypes with resistance to Meloidogyne paranaensis and M. incognita race 1. Eighteen C. arabica genotypes (EPAMIG’s Germplasm Bank), previously selected for poor host suitability in a M. paranaensis-infested field, plus a resistant and a susceptible standard, were inoculated with these two Meloidogyne species to determine their resistance using nematode reproduction factor (). Accessions for which were considered resistant, while those for which were considered moderately resistant or susceptible, also according to statistical analysis. Five accessions from crossing ‘Catuaí Vermelho’ × ‘Amphillo MR 2-161’, one from ‘Catuaí Vermelho’ × ‘Amphillo MR 2-474’, two from ‘Timor Hybrid (UFV 408-01)’ and the standard ‘IPR-100’ were resistant to M. incognita race 1 with . Four accessions from ‘Catuaí Vermelho’ × ‘Amphillo MR 2-161’, one from ‘Timor Hybrid (UFV 408-01)’, one from ‘Catuaí Vermelho’ × ‘Amphillo MR 2-474’ and the resistant standard ‘IPR100’ were resistant to M. paranaensis (). Field evaluations with parental genotypes showed that plants that originated from progenies ‘Catuaí Vermelho’ × ‘Amphillo MR 2-161’ were resistant to M. paranaensis and also gave a good yield compared to commercial cultivars, showing promising agronomic traits that can be used in breeding programmes to develop new cultivars of C. arabica.
Effects of Fluticasone Furoate Nasal Spray on Parameters of Eosinophilic Inflammation in Patients With Nasal Polyposis and Perennial Allergic Rhinitis
Authors: Špadijer Mirković Cveta , Perić Aleksandar , Vukomanović Đurđević Biserka , Vojvodić Danilo 
Published: June 2017

Objectives: Regulated on activation normal T cell expressed and secreted (RANTES) and eotaxin-2 have been postulated to be responsible for eosinophilia in chronically inflamed nasal mucosa. This study evaluated mucosal production of RANTES and eotaxin-2 in patients with perennial allergic rhinitis (PAR) and nonallergic and allergic form of chronic rhinosinusitis with nasal polyps (CRSwNP) before and after nasal corticosteroid treatment. Methods: Twenty patients with PAR, 20 nonallergic and 20 allergic CRSwNP patients, and 20 healthy controls were included. The RANTES and eotaxin-2 levels were measured in nasal secretion samples. The patients with chronic inflammation were treated with fluticasone furoate nasal spray for 2 weeks. Cytological examination and measurement of RANTES and eotaxin-2 in nasal fluid were performed before and after the treatment. Results: The levels of RANTES were higher in patients with PAR ( P < .05) and nonallergic ( P < .01) and allergic CRSwNP patients ( P < .001) compared to controls. Eotaxin-2 levels were higher in all 3 inflammation groups compared to healthy subjects ( P < .001). After the treatment, we found a significant decrease of RANTES and eotaxin-2 concentrations ( P < .001) in all 3 groups of patients. Conclusion: The levels of RANTES and eotaxin-2 in nasal fluid could be reliable markers for assessing corticosteroid administration outcomes.
Head Injuries and Changes in Delinquency from Adolescence to Emerging Adulthood
Authors: Schwartz Joseph A. , Connolly Eric J. , Brauer Jonathan R. 
Published: June 2017

Objectives: The current study examines whether head injuries suffered earlier in the life course are associated with subsequent changes in self-control and delinquency. Methods: Latent growth curve models and path analysis are used to analyze the developmental trajectories of self-control and delinquency as well as the potential associations between head injury, self-control, and delinquency among a sample of youth offenders from the pathways to desistance study. Results: The results revealed significant associations between head injuries and short-term changes in self-control and subsequent increases in aggressive delinquency. Indirect pathway models revealed that lower levels of self-control significantly mediated the association between head injuries and starting levels in aggressive delinquency. The association between head injuries and changes in aggressive delinquency was also significantly mediated by self-control, but the association was negative, indicating that youth who previously suffered head injuries desisted from aggressive delinquency at a slightly faster rate than their noninjured peers. Additional analyses revealed that, despite accelerated rates of decline, injured youth engaged in significantly higher levels of aggressive delinquency throughout the entire observation period. Conclusion: Head injuries represent one environmental factor that may influence delinquent behaviors through their influence on biological and developmental processes.
Pre-hospital oily chloramphenicol treatment in meningitis outbreaks in low resources environments
Authors: Bregani Enrico Rino , Conti Matilde , Valcarenghi Caterina 
Published: June 2017

Bacterial meningitis is an important cause of death and disability in sub-Saharan Africa and, with pre-treatment in peripheral health centres, the poorest populations could avoid early death, especially if they live far from hospital. During the 2001 meningitis epidemic in south Chad, Moyen Chari sanitary district peripheral health centres were equipped with oily chloramphenicol (CAP) to administer before hospital referral in suspected cases of meningitis. Eighty-six patients treated with CAP in whom the diagnosis was definitively confirmed subsequently in hospital were compared with patients receiving CAP at hospital admission during the same period. A statistically significant reduction in lethality rate, need of second line treatment or adjunctive antibiotics, and mean hospital stay were confirmed in pre-treated patients.
Pilot randomised controlled trial of focused narrative intervention for moderate to severe depression in palliative care patients: DISCERN trial
Authors: Lloyd-Williams Mari , Shiels Christopher , Ellis Jacqueline , Abba Katharine , Gaynor Edward , Wilson Kenneth , Dowrick Christopher 
Published: June 2017

Background: Depression is poorly detected and sub-optimally managed in palliative care patients, and few trials of psychosocial interventions have been carried out in this group of patients. Aims: A pilot trial to determine the effect of a focused narrative intervention on depression in palliative care patients when used in addition to usual care. Design: Patients scoring 10 or higher on Patient Health Questionnaire-9 randomised to focused narrative intervention in addition to usual care or usual care only and followed up at 2, 4 and 6 weeks. A reduction of five points on Patient Health Questionnaire-9 was regarded as clinically significant response to treatment. Setting/participants: Palliative care patients aged over 18 recruited from hospice day care services – exclusion criteria included an estimated prognosis of 6 weeks or less, cognitive impairment and unable to understand written or spoken English. Results: Out of 57 participating patients (71% female), with mean age 65.1 years (range 36–88 years), 33 patients were randomised to the intervention and 24 to usual care only. Mean Patient Health Questionnaire-9 score at baseline was 16.4. Patients receiving intervention had greater reduction in Patient Health Questionnaire-9 score at 6-week follow-up ( p = 0.04). Median survival was 157 days for intervention and 102 days for control group patients ( p = 0.07). Conclusion: This pilot trial suggests a focused narrative intervention in palliative care patients with moderate to severe depression can reduce depression scores more than usual care alone. Patients receiving intervention appeared to have longer survival. These results support the need for a fully powered trial.
Plasma microRNA-9 as a diagnostic and prognostic biomarker in patients with esophageal squamous cell carcinoma
Authors: Cui Yuantao , Xue Yuan , Dong Shangwen , Zhang Peng 
Published: June 2017

Purpose Emerging evidence indicates that circulating microRNAs (miRs) might act as noninvasive biomarkers for cancer diagnosis and prognosis. We examined the expression pattern and clinical significance of plasma miR-9 in patients with esophageal squamous cell carcinoma (ESCC). Methods Venous blood samples (6 mL) were collected from 131 patients with ESCC and 131 healthy controls, and the plasma miR-9 concentration was detected by reverse transcription polymerase chain reaction. The association of plasma miR-9 expression with clinicopathologic factors and survival of patients with ESCC was evaluated. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the clinical value of plasma miR-9 for ESCC diagnosis. Results The plasma miR-9 expression levels in patients with ESCC were significantly upregulated compared with normal controls. High plasma miR-9 concentrations were significantly correlated with poor tumor differentiation, large tumor size, deep local invasion, lymph node metastasis, advanced clinical stage, and poor survival. ROC curve analysis showed that the plasma miR-9 concentration could efficiently distinguish patients with ESCC from healthy controls. Multivariate survival analysis confirmed plasma miR-9 as an independent prognostic factor for ESCC. Conclusions Plasma miR-9 expression was upregulated in ESCC and might act as a novel diagnostic and prognostic biomarker.
Postoperative recurrence of adult renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion
Authors: Wang Zhen , Liu Ning , Gan Weidong , Li Xiaogong , Zhang Gutian , Li Dongmei , Guo Hongqian 
Published: June 2017

Objective To analyze the postoperative recurrence of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion (Xp11.2 tRCC). Methods This retrospective study was approved by the institutional review board and performed in accordance with the ethical standards established by the institution. Demographic, clinical, pathological, and follow-up data were compiled for the study cohort. Results During a mean follow-up of 41.3 months (range, 3–104 months), 8 of 34 patients with Xp11.2 tRCC were confirmed to have recurrence. Three of these patients died with poor outcomes due to a vena cava tumor embolus, and one died of distant metastasis 48 months after the initial nephrectomy during which lymph node metastasis was found. Three patients survived after cytoreduction surgery. One patient was diagnosed with lung metastasis 11 months postoperatively. Conclusions The TNM classification provides significant prognostic information for Xp11.2 tRCC. A relatively active surveillance algorithm is recommended, and cytoreduction surgery is an effective approach for recurrent Xp11.2 tRCC. Larger studies are required to more extensively investigate the recurrence of these potentially aggressive tumors.
Sense of responsibility in ICU end-of-life decision-making: Relatives’ experiences
Authors: Lind Ranveig 
Published: June 2017

Background: Relatives of intensive care unit patients who lack or have reduced capacity to consent are entitled to information and participation in decision-making together with the patient. Practice varies with legislation in different countries. In Norway, crucial decisions such as withdrawing treatment are made by clinicians, usually morally justified to relatives with reference to the principle of non-maleficence. The relatives should, however, be consulted about whether they know what the patient would have wished in the situation. Research objectives: To examine and describe relatives’ experiences of responsibility in the intensive care unit decision-making process. Research design: A secondary analysis of interviews with bereaved relatives of intensive care unit patients was performed, using a narrative analytical approach. Participants and research context: In all, 27 relatives of 21 deceased intensive care unit patients were interviewed about their experiences from the end-of-life decision-making process. Most interviews took place in the participants’ homes, 3–12 months after the patient’s death. Ethical considerations: Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services and by the Regional Committee for Medical and Health Research Ethics. Findings: The results show that intensive care unit relatives experienced a sense of responsibility in the decision-making process, independently of clinicians’ intention of sparing them. Some found this troublesome. Three different variants of participation were revealed, ranging from paternalism to a more active role for relatives. Discussion: For the study participants, the sense of responsibility reflects the fact that ethics and responsibility are grounded in the individual’s relationship to other people. Relatives need to be included in a continuous dialogue over time to understand decisions and responsibility. Conclusion: Nurses and physicians should acknowledge and address relatives’ sense of responsibility, include them in regular dialogue and help them separate their responsibility from that of the clinicians.
Rapid and sensitive insulated isothermal PCR for point-of-need feline leukaemia virus detection
Authors: Wilkes Rebecca P , Anis Eman , Dunbar Dawn , Lee Pei-Yu A , Tsai Yun-Long , Lee Fu-Chun , Chang Hsiao-Fen G , Wang Hwa-Tang T , Graham Elizabeth M 
Published: June 2017

Objectives Feline leukaemia virus (FeLV), a gamma retrovirus, causes diseases of the feline haematopoietic system that are invariably fatal. Rapid and accurate testing at the point-of-need (PON) supports prevention of virus spread and management of clinical disease. This study evaluated the performance of an insulated isothermal PCR (iiPCR) that detects proviral DNA, and a reverse transcription (RT)-iiPCR that detects both viral RNA and proviral DNA, for FeLV detection at the PON. Methods Mycoplasma haemofelis, feline coronavirus, feline herpesvirus, feline calicivirus and feline immunodeficiency virus were used to test analytical specificity. In vitro transcribed RNA, artificial plasmid, FeLV strain American Type Culture Collection VR-719 and a clinical FeLV isolate were used in the analytical sensitivity assays. A retrospective study including 116 clinical plasma and serum samples that had been tested with virus isolation, real-time PCR and ELISA, and a prospective study including 150 clinical plasma and serum samples were implemented to evaluate the clinical performances of the iiPCR-based methods for FeLV detection. Results Ninety-five percent assay limit of detection was calculated to be 16 RNA and five DNA copies for the RT-iiPCR, and six DNA copies for the iiPCR. Both reactions had analytical sensitivity comparable to a reference real-time PCR (qPCR) and did not detect five non-target feline pathogens. The clinical performance of the RT-iiPCR and iiPCR had 98.82% agreement (kappa[κ] = 0.97) and 100% agreement (κ = 1.0), respectively, with the qPCR (n = 85). The agreement between an automatic nucleic extraction/RT-iiPCR system and virus isolation to detect FeLV in plasma or serum was 95.69% (κ = 0.95) and 98.67% (κ = 0.85) in a retrospective (n = 116) and a prospective (n = 150) study, respectively. Conclusions and relevance These results suggested that both RT-iiPCR and iiPCR assays can serve as reliable tools for PON FeLV detection.