bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Hemodialysis on the Dispersion of Ventricular Repolarization
Authors: KALANTZI KALLIRROI , GOUVA CHARA , LETSAS KONSTANTINOS P. , VLACHOPANOU APHRODITE , FOULIDIS VALERIOS , BECHLIOULIS ARIS , KATOPODIS KONSTANTINOS P. , GOUDEVENOS JOHN A. , KORANTZOPOULOS PANAGIOTIS 
Published: January 2013

BackgroundSudden cardiac death is prevalent in chronic hemodialysis (HD) patients while the dialysis process may have arrhythmogenic potential. We sought to examine the effect of HD on conventional electrocardiographic parameters as well as on novel indexes of repolarization, given that increased spatial dispersion of repolarization is related to ventricular arrhythmias.MethodsWe recorded clinical, echocardiographic, and laboratory parameters as well as electrocardiographic indexes before and after a single HD session. Specifically, we calculated the QTc interval, the QRS duration, the T peak‐to‐end (Tpe) interval, and the Tpe/QT ratio.ResultsThe study population consisted of 66 chronic HD patients (mean age: 68.9 ± 11.8 years, 40 males). Heart rate, blood pressure, QRS duration, QTc interval, and QT dispersion did not change significantly after the HD session. However, the Tpe interval and the Tpe/QT ratio increased significantly (80 [65–90] ms vs 85 [77.5–100] ms; P = 0.04, and 0.21 [0.18–0.24] vs 0.25 [0.21–0.28]; P = 0.05, respectively). Correlation analysis and multiple regression analysis failed to show significant associations between the baseline parameters and the baseline values of Tpe and Tpe/QT or between the change of the laboratory parameters during HD and the corresponding change of the Tpe and the Tpe/QT values. No significant arrhythmias were observed during the HD sessions.ConclusionsHD induces an increase in novel markers of spatial dispersion of ventricular repolarization. Whether the assessment of these indexes of heterogeneity of repolarization at baseline or their change during HD has a prognostic value with regard to future untoward events, remains to be elucidated.
Efficacy of Lower Limb Compression in the Management of Vasovagal Syncope—Randomized, Crossover Study
Authors: SANTOS RAFAEL QUEIROZ DOS , SMIDT LUIS , SUZIGAN BRUNA HELENA , DE SOUZA LUCAS VIEIRA , BARBISAN JUAREZ NEUHAUS 
Published: January 2013

IntroductionVasovagal syncope (VS) is the most prevalent cause of transient loss of consciousness. The treatment consists of lifestyle modifications and pacemaker in some patients. The purpose of this study is to evaluate the effect of measures to compress the lower limbs in patients with recurrent episodes of VS submitted to the tilt‐test (TT).Methods and ResultsTwenty patients, average age 30.5 years (15–75), 13 (65%) female, with a clinical diagnosis of VS and previous TT with a positive result and who had at least one episode of syncope during the last year, were included in this placebo‐controlled randomized crossover study. The patients underwent two consecutive TT, at a 1‐hour interval, with and without compression by pneumatic compression boots with 40 mmHg at the heels and 30 mmHg for the legs. The blood pressure (BP) and heart rate (HR) of these patients were monitored continuously. The outcome assessors were blinded. The results of the TT were positive in 13 (65%) of the patients in the control groups and in two (10%) of the patients with compression (P < 0.0001). Throughout the test, the systolic BP was not different among the groups. On the other hand, the HR measures showed a difference only in the tilted position at 2 minutes, of 73 ± 16 beats per minute (bpm) in the control group and of 69 ± 16 bpm (P = 0.047) in the compression group.ConclusionCompression of the lower limbs is very effective to render the TT negative in patients with a diagnosis of VS.
QRS Duration Changes in Patients with Hypoplastic Left Heart Syndrome Undergoing Hybrid Palliation: Prehybrid to Post‐Fontan
Authors: TSAI SHANE , HUSAIN NAZIA , FISCHER ABIGAIL , RO PAMELA S. , CHEATHAM JOHN P. , GALANTOWICZ MARK , CUA CLIFFORD L. 
Published: January 2013

BackgroundQRS prolongation has been shown to be a predictor of mortality in patients with certain forms of congenital heart disease. QRS changes have not been well described in patients with single ventricle physiology, particularly in those undergoing the hybrid procedure.ObjectiveTo describe QRS changes in a cohort of patients with hypoplastic left heart syndrome (HLHS) who underwent hybrid palliation and to evaluate if QRS duration is associated with mortality.MethodsChart review of 54 patients with HLHS who underwent hybrid procedure between 2002 and 2009 was performed. Patients awaiting surgical palliation were excluded. Patients who survived Fontan completion (HLHS‐S, n = 30) were compared to non‐survivor (HLHS‐NS, n = 24). Electrocardiograms were reviewed for maximal QRS duration (ms) at three pre‐ and postsurgical stages: (1) hybrid procedure, (2) comprehensive stage 2 procedure, and (3) Fontan procedure.ResultsIn HLHS‐S, there was a significant increase in QRS from birth to Fontan completion (15.6 ± 9.3 ms). QRS duration increased 8.5 ± 8.9 ms between posthybrid to precomprehensive stage 2, and 5.4 ± 9.7 ms between postcomprehensive stage 2 to Fontan. Following Fontan procedure, mean QRS decreased 4.3 ± 8.5 ms. There was no significant mean difference in QRS change between HLHS‐S and HLHS‐NS following hybrid procedure. Pre‐ and posthybrid and pre‐ and postcomprehensive stage 2 QRS durations were not different between HLHS‐S and HLHS‐NS who underwent a comprehensive stage 2 procedure. There was a significant difference in QRS difference following comprehensive stage 2 in HLHS‐S (0.9 ± 7.1 ms) compared to HLHS‐NS (−7.1 ± 10.0 ms).ConclusionsQRS duration significantly increased from hybrid to Fontan completion in HLHS‐S. There was a significant decrease in QRS duration in patients who died following comprehensive stage 2 procedure. Larger studies are needed to assess the significance of these QRS changes.
Percutaneous Radiofrequency Ablation of the Splanchnic Nerves in Patients with Chronic Pancreatitis: Results of Single and Repeated Procedures in 11 Patients
Authors: Verhaegh Bas P.M. , van Kleef Maarten , Geurts José W. , Puylaert Martine , van Zundert Jan , Kessels Alphons G.H. , Masclee Ad A.M. , Keulemans Yolande C.A. 
Published: January 2013

AbstractBackgroundPain is a major problem for chronic pancreatitis (CP) patients. Unfortunately, medical therapy often fails. Endoscopic and surgical treatments are invasive, and results vary. Percutaneous radiofrequency ablation of the splanchnic nerves (RFSN) is a relatively new and minimally invasive procedure for treatment of intractable pain in CP patients.Materials and MethodsWe retrospectively evaluated 18 RFSN procedures in 11 CP patients, all refractory to analgesics. Five patients underwent a second procedure; two patients underwent a third procedure. NRS pain scores were assessed. Complications, analgesics usage, and length of the pain‐free period were recorded.ResultsRadiofrequency ablation of the splanchnic nerves was effective in 15/18 interventions. The mean NRS pain score decreased from 7.7 ± 1.0 to 2.8 ± 2.7 (P ≤ 0.001). The pain‐free period lasted for a median period of 45 weeks. The effect of repeated interventions was comparable to the initial procedure. One transient side effect was reported. Four patients reported significantly reduced analgesic usage; 4 patients completely stopped their pain medication.ConclusionRadiofrequency ablation of the splanchnic nerves is a minimally invasive, effective procedure for pain relief. After the effect has subsided, RFSN can be successfully repeated. RFSN might become an alternative treatment in a selected group of CP patients. A larger, randomized trial is justified to substantiate these findings.
Control limits for accumulation of plant metabolites: brute force is no substitute for understanding
Authors: Morandini Piero 
Published: January 2013

SummaryWhich factors limit metabolite accumulation in plant cells? Are theories on flux control effective at explaining the results? Many biotechnologists cling to the idea that every pathway has a rate limiting enzyme and target such enzymes first in order to modulate fluxes. This often translates into large effects on metabolite concentration, but disappointing small increases in flux. Rate limiting enzymes do exist, but are rare and quite opposite to what predicted by biochemistry. In many cases however, flux control is shared among many enzymes. Flux control and concentration control can (and must) be distinguished and quantified for effective manipulation. Flux control for several ‘building blocks’ of metabolism is placed on the demand side, and therefore increasing demand can be very successful. Tampering with supply, particularly desensitizing supply enzymes, is usually not very effective, if not dangerous, because supply regulatory mechanisms function to control metabolite homeostasis. Some important, but usually unnoticed, metabolic constraints shape the responses of metabolic systems to manipulation: mass conservation, cellular resource allocation and, most prominently, energy supply, particularly in heterotrophic tissues. The theoretical basis for this view shall be explored with recent examples gathered from the manipulation of several metabolites (vitamins, carotenoids, amino acids, sugars, fatty acids, polyhydroxyalkanoates, fructans and sugar alcohols). Some guiding principles are suggested for an even more successful engineering of plant metabolism.
Development and validation of the K‐VSCOR for scoring Koebner's phenomenon in vitiligo/non‐segmental vitiligo
Authors: Diallo Abou , Boniface Katia , Jouary Thomas , Seneschal Julien , Morice‐Picard Fanny , Prey Sorilla , Cario‐André Muriel , Mazereeuw‐Hautier Juliette , Taieb Alain , Ezzedine Khaled 
Published: January 2013

SummaryThe relation of vitiligo/non‐segmental vitiligo (NSV) to Koebner's phenomenon is variably appreciated. Our objective was to develop and validate a simple clinical score for Koebner's phenomenon (KP) in patients with vitiligo/NSV. The study population was composed of 351 individuals in the development sample and 285 patients in the validation sample. Seven variables were independently associated with the presence of KP: disease duration of more than 3 yr, forehead + scalp areas, eyelids, wrists, genital + belt areas, knees and tibial crests. The score computed by the weighted sum of the rounded coefficients of these seven variables ranged from 0 to 56 (mean 38.39 ± 22.93). The probability of having KP was computed as follows: exp (−2.37 + 0.1*score)/exp [1 + (−2.37 + 0.1*score)]. When applying the score to each patient in the validation and the development sample, the score maintained adequate discrimination and calibration (AUC‐ROC = 0.78), arguing that KP can be adequately predicted using our score. Further studies should evaluate KP assessed by the K‐VSCOR in clinical practice with the aim to determine its association with clinical profile, course and treatment response of vitiligo.
The use of lyophilized plasma in a severe multi‐injury pig model
Authors: Lee Tim H. , Van Philbert Y. , Spoerke Nicholas J. , Hamilton Gregory J. , Cho S. David , Watson Kate , Differding Jerome , Schreiber Martin A. 
Published: January 2013

BackgroundShock and severe tissue injury lead to an endogenous coagulopathy mediated by activation of Protein C and hyperfibrinolysis known as acute traumatic coagulopathy. Together, hemodilution, acidosis, inflammation, and hypothermia result in a global trauma‐induced coagulopathy. Coagulopathy in trauma is associated with mortality. Early and effective hemostatic resuscitation is critical in restoring perfusion, correcting coagulopathy, and saving lives in exsanguinating trauma. Lyophilized plasma (LP) provides a logistically superior alternative to fresh frozen plasma (FFP).Study Design and MethodsPlasma was lyophilized following whole blood collection from anesthetized swine. A series of studies were performed using anesthetized swine subjected to a validated model of polytrauma and hemorrhagic shock including a Grade V liver injury. Animals were randomized to resuscitation using reconstituted LP fluids. Physiologic data and blood loss were measured. Coagulation status and inflammatory mediators were evaluated.ResultsFull volume reconstituted LP (100%LP) retains on average 86% coagulation factor activity compared to fresh plasma and when used in 1:1 ratios with red blood cells demonstrated superior hemostatic efficacy compared to FFP. Hypertonic LP reconstituted using 50% of the original plasma volume (50%LP) had higher coagulation factor concentrations, was well tolerated in swine, and equally effective compared to 100%LP with respect to physiologic and hemostatic properties. Buffering with ascorbic acid resulted in significant reductions in serum levels of tumor necrosis factor alpha and interleukin‐6.ConclusionBy minimizing the volume of reconstituted LP and optimizing its anti‐inflammatory properties, an LP resuscitation fluid may be created to provide effective hemostatic resuscitation with superior logistical properties.
Spray‐dried plasma and fresh frozen plasma modulate permeability and inflammation in vitro in vascular endothelial cells
Authors: Wataha K. , Menge T. , Deng X. , Shah A. , Bode A. , Holcomb J.B. , Potter D. , Kozar R. , Spinella P.C. , Pati S. 
Published: January 2013

BackgroundAfter major traumatic injury, patients often require multiple transfusions of fresh frozen plasma (FFP) to correct coagulopathy and to reduce bleeding. A spray‐dried plasma (SDP) product has several logistical benefits over FFP use in trauma patients with coagulopathy. These benefits include ease of transport, stability at room temperature, and rapid reconstitution for infusion. Our past work suggests that FFP promotes endothelial stability by inhibiting endothelial permeability.Study Design and MethodsThe main goal of this project is to determine if solvent‐detergent‐treated SDP is equivalent to FFP in inhibiting vascular endothelial cell (EC) permeability and inflammation in vitro. Furthermore, this study aimed to determine if solvent‐detergent treatment and spray drying of plasma alters the protective effects of FFP on EC function. The five groups tested in our studies are the following: 1) fresh frozen‐thawed plasma (FFP); 2) solvent‐detergent‐treated FFP; 3) solvent‐detergent‐treated SDP; 4) lactated Ringer's solution; and 5) Hextend.ResultsThis study demonstrates that in vitro SDP and FFP equivalently inhibit vascular EC permeability, EC adherens junction breakdown, and endothelial white blood cell binding, an effect that is independent of changes in Vascular Cell Adhesion Molecule 1, Intracellular Adhesion Molecule 1, or E‐selectin expression on ECs. Solvent‐detergent treatment of FFP does not alter the protective effects of FFP on endothelial cell function in vitro.ConclusionThese data suggest the equivalence of FFP and SDP on modulation of endothelial function and inflammation in vitro.
Primary hemostatic capacity of whole blood: a comprehensive analysis of pathogen reduction and refrigeration effects over time
Authors: Pidcoke Heather F. , McFaul Steve J. , Ramasubramanian Anand K. , Parida Bijaya K. , Mora Alex G. , Fedyk Chriselda G. , Valdez‐Delgado Krystal K. , Montgomery Robbie K. , Reddoch Kristin M. , Rodriguez Armando C. , Aden James K. , Jones John A. , Bryant Ron S. , Scherer Michael R. , Reddy Heather L. , Goodrich Raymond P. , Cap Andrew P. 
Published: January 2013

BackgroundWhole blood (WB) has been used in combat since World War I as it is readily available and replaces every element of shed blood. Component therapy has become standard; however, recent military successes with WB resuscitation have revived the debate regarding wider WB use. Characterization of optimal WB storage is needed. We hypothesized that refrigeration preserves WB function and that a pathogen reduction technology (PRT) based on riboflavin and ultraviolet light has no deleterious effect over 21 days of storage.Study Design and MethodsWB units were stored for 21 days either at 4°C or 22°C. Half of each temperature group underwent PRT, yielding four final treatment groups (n = 8 each): CON 4 (WB at 4°C); CON 22 (WB at 22°C); PRT 4 (PRT WB at 4°C); and PRT 22 (PRT WB at 22°C). Testing was at baseline, Days 1‐7, 10, 14, and 21. Assays included coagulation factors; platelet activation, aggregation, and adhesion; and thromboelastography (TEG).ResultsProthrombin time (PT) and partial thromboplastin time increased over time; refrigeration attenuated the effects on PT (p ≤ 0.009). Aggregation decreased over time (p ≤ 0.001); losses were attenuated by refrigeration (p ≤ 0.001). Refrigeration preserved TEG parameters (p ≤ 0.001) and PRT 4 samples remained within normal limits throughout the study. Refrigeration in combination with PRT inhibited fibrinolysis (p ≤ 0.001) and microparticle formation (p ≤ 0.031). Cold storage increased shear‐induced platelet aggregation and ristocetin‐induced platelet agglutination (p ≥ 0.032), as well as GPIb‐expressing platelets (p ≤ 0.009).ConclusionThe in vitro hemostatic function of WB is largely unaffected by PRT treatment and better preserved by cold storage over 21 days. Refrigerated PRT WB may be suitable for trauma resuscitation. Clinical studies are warranted.
The challenges of measuring bleeding outcomes in clinical trials of platelet transfusions
Authors: Estcourt Lise J. , Heddle Nancy , Kaufman Richard , McCullough Jeffrey , Murphy Michael F. , Slichter Sherrill , Wood Erica M. , Stanworth Simon J. ,   Biomedical Excellence for Safer Transfusion (BEST) Collaborative
Published: January 2013

BackgroundMany platelet (PLT) transfusion trials now use bleeding as a primary outcome; however, previous studies have shown a wide variation in the amount (5%‐70%) and type of bleeding documented. Differences in the way bleeding has been identified, recorded, and graded may account for some of this variability. This study's aim was to compare trials' method to document and grade bleeding.Study Design and MethodsData were collected via three methods: a review of study publications, study case report forms, and a questionnaire sent to the authors. Authors of randomized controlled trials of PLT transfusion that used bleeding as an outcome measure were identified from the searches reported by two recent systematic reviews. Twenty‐four authors were contacted, and 13 agreed to participate. Data submitted were reviewed and summarized.ResultsMore recent studies with trained bleeding assessors, detailed documentation, and expanded grading systems have reported higher overall levels of bleeding. The World Health Organization grading system was widely used to grade bleeding, but there was no consistency in the bleeding grade definitions. For example, bleeding classified as Grade 2 in some studies (spreading petechiae) was classified as Grade 1 in other studies.ConclusionsThis study has highlighted differences in the method of recording and grading bleeding, which may account for some of the variation in reported bleeding rates. To ensure that differences between studies can be attributed to trial interventions or types of participant included, this study group is developing consensus bleeding definitions, a standardized approach to record and grade bleeding, and guidance notes to educate and train bleeding assessors.
Direct Costs of Bovine Spongiform Encephalopathy Control Measures in Germany
Authors: Probst C. , Gethmann J. M. , Heuser R. , Niemann H. , Conraths F. J. 
Published: January 2013

SummaryOn 26 November 2000, the first autochthonous case of bovine spongiform encephalopathy (BSE) was detected in Germany. Since then, a total of 413 BSE cases have been confirmed, resulting in the culling and destruction of 17 313 heads of cattle. In view of the possible risks for human and animal health, Germany has adopted EU regulations along with some additional requirements concerning active surveillance and response measures after detecting a BSE‐positive animal. In this study, we used a stochastic model to estimate the costs incurred by the ensuing legislative amendments responding to BSE between November 2000 and December 2010. The total costs were estimated to range between 1847 and 2094 million Euros. They peaked in 2001 (about 394 million Euros) and declined since. About 54% of the costs (approximately 1000 million Euros) were incurred by the extension of the feed ban for animal protein to all farmed livestock. Active surveillance accounted for 21% (405 million Euros), the incineration of animal protein for 13% (249 million Euros) and the removal of specified risk material for 11% (225 million Euros). Only 1% of the costs was related to response measures after detecting a BSE‐positive animal, including indemnity payments for culled cattle and confiscated carcasses at the slaughterhouse.
A "Judeo-Christian" Myth of Disestablishment: The Legacy of McGowan v. Maryland
Authors: Rubens Heather Miller 
Published: January 2013

While "Judeo-Christian" has been used to describe various aspects of American religion, there is scant discussion on how the term has affected the legal definition of religion in the United States. After briefly mapping the various ways the term has been used in Supreme Court opinions, I focus on the Court's very first use of the term in McGowan v. Maryland, unpacking the working definition of "Judeo-Christian" that is suggested, and tracing how "Judeo-Christian" has influenced the Court's understanding of religious establishment infringement. I argue that in the McGowan line of Court opinions, the term "Judeo-Christian," while intended to gesture towards religious inclusivity, works instead to support de facto Christian establishment.
Optimization of the Cutoff Value for a Commercial Anti-Dengue Virus IgG Immunoassay
Authors: Marrero-Santos Karla M. , Beltrán Manuela , Carrión-Lebrón Jessica , Sanchez-Vegas Carolina , Hamer Davidson H. , Barnett Elizabeth D. , Santiago Luis M. , Hunsperger Elizabeth A. 
Published: January 2013

ABSTRACTA commercial anti-dengue virus (anti-DENV) indirect IgG enzyme-linked immunosorbent assay (ELISA) for serological diagnosis was evaluated for its utility in determining previous DENV exposure in U.S. travelers. The Boston Area Travel Medicine Network clinics used Focus Diagnostics anti-DENV IgG ELISA to measure anti-DENV IgG antibodies in 591 pretravel specimens from U.S. residents who had traveled to countries where dengue is endemic. When using the manufacturer's index cutoff value for this ELISA, false-positive results were observed that overestimated the perceived past DENV exposure in U.S. travelers. Validation of 121 of these anti-DENV IgG results by plaque reduction neutralization test (PRNT) was used for receiver operating characteristic (ROC) curve optimization of the index cutoff value from 1 to 3.0, improving the specificity of the anti-DENV IgG ELISA from 24% to 95.7%. Additionally, previous vaccination with yellow fever virus contributed to 52.8% of the false-positive rate in the anti-DENV IgG ELISA results. Optimization of the cutoff value of the anti-DENV IgG ELISA provided better interpretation and confidence in the results and eliminated the need for confirmation by PRNT. The travel history of U.S. travelers was also useful for categorizing these travelers into groups for analysis of previous DENV exposure.
Molecular Epidemiological Surveillance of Multidrug-Resistant Pseudomonas aeruginosa Isolates in a Pediatric Population of Patients with Cystic Fibrosis and Determination of Risk Factors for Infection with the Houston-1 Strain
Authors: Luna Ruth Ann , Millecker Laura A. , Webb C. Renee , Mason Sally K. , Whaley Elaine M. , Starke Jeffrey R. , Hiatt Peter W. , Versalovic James 
Published: January 2013

ABSTRACT

Multiyear molecular epidemiological surveillance of multidrug-resistant
Pseudomonas aeruginosa
(MRPA) in a pediatric cystic fibrosis care center identified an endemic MRPA strain (Houston-1). Recent hospitalization was found to be a statistically significant risk factor for acquisition of the endemic strain. Multiple infection control improvements led to the reduced incidence of the Houston-1 strain in the CF population.