bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventricular Arrhythmias Arising From the Left Ventricular Outflow Tract Below the Aortic Sinus Cusps
Authors: Ouyang Feifan , Mathew Shibu , Wu Shulin , Kamioka Masashi , Metzner Andreas , Xue Yumei , Ju Weizhu , Yang Bing , Zhan Xianzhang , Rillig Andreas , Lin Tina , Rausch Peter , Deiß Sebastian , Lemes Christine , Tönnis Tobias , Wissner Erik , Tilz Roland Richard , Kuck Karl-Heinz , Chen Minglong 
Published: May 2014

Background—
Ventricular arrhythmias (VAs) originating from the anterosuperior left ventricular outflow tract (LVOT) represent a challenging location for catheter ablation. This study investigates mapping and ablation of VA from anterosuperior LVOT via a transseptal approach.

Methods and Results—
This study included 27 patients with symptomatic VA, of which 13 patients had previous failed ablations. LVOT endocardial 3-dimensional mapping via retrograde transaortic and antegrade transseptal approaches was performed. Previous ECG markers for procedure failure were analyzed. In all patients, earliest activation with low-amplitude potentials was identified at the anterosuperior LVOT 5.1±2.8 mm below the aortic cusp and preceded the QRS onset by 39.5±7.7 ms only via an antegrade transseptal approach using a reversed S curve. In all patients, pace mapping failed to demonstrate perfect QRS morphology match. The anatomic location was below the left coronary cusp in 16, below the left coronary cusp/right coronary cusp junction in 8, and below the right coronary cusp in 3 patients. Radiofrequency energy resulted in rapid disappearance of VAs in all patients. ECG analysis showed aVL/aVR Q-wave amplitude ratio >1.4 in 7, lead III/II R-wave amplitude ratio >1.1 in 10, and peak deflection index >0.6 in 11 patients. There were no complications or clinical VA recurrence during a mean follow-up of 8.4±2.5 months.

Conclusions—
The anterosuperior LVOT can be reached via a transseptal approach with a reversed S curve of the ablation catheter. The rapid effect from radiofrequency energy indicates that the VA is most likely located under the endocardium. Also, previous ECG markers for procedure failure need further investigation.
Gestational Age at Birth and Outcomes After Neonatal Cardiac Surgery
Authors: Costello John M. , Pasquali Sara K. , Jacobs Jeffrey P. , He Xia , Hill Kevin D. , Cooper David S. , Backer Carl L. , Jacobs Marshall L. 
Published: May 2014

Background—
Gestational age at birth is a potentially important modifiable risk factor in neonates with congenital heart disease. We evaluated the relationship between gestational age and outcomes in a multicenter cohort of neonates undergoing cardiac surgery, focusing on those born at early term (ie, 37–38 weeks’ gestation).

Methods and Results—

Neonates in the Society of Thoracic Surgeons Congenital Heart Surgery Database who underwent cardiac surgery between 2010 and 2011 were included. Multivariable logistic regression was used to evaluate the association of gestational age at birth with in-hospital mortality, postoperative length of stay, and complications, adjusting for other important patient characteristics. Of 4784 included neonates (92 hospitals), 48% were born before 39 weeks’ gestation, including 31% at 37 to 38 weeks. Compared with a 39.5-week gestational age reference level, birth at 37 weeks’ gestational age was associated with higher in-hospital mortality, with an adjusted odds ratio (95% confidence interval) of 1.34 (1.05–1.71;
P
=0.02). Complication rates were higher and postoperative length of stay was significantly prolonged for those born at 37 and 38 weeks’ gestation (adjusted
P
<0.01 for all). Late-preterm births (34–36 weeks’ gestation) also had greater mortality and postoperative length of stay (adjusted
P
≤0.003 for all).

Conclusions—
Birth during the early term period of 37 to 38 weeks’ gestation is associated with worse outcomes after neonatal cardiac surgery. These data challenge the commonly held perception that delivery at any time during term gestation is equally safe and appropriate and question the related practice of elective delivery of fetuses with complex congenital heart disease at early term.
Impact of Farnesylation Inhibitors on Survival in Hutchinson-Gilford Progeria Syndrome
Authors: Gordon Leslie B. , Massaro Joe , D’Agostino Ralph B. , Campbell Susan E. , Brazier Joan , Brown W. Ted , Kleinman Monica E. , Kieran Mark W. 
Published: May 2014

Background—
Hutchinson-Gilford progeria syndrome is an ultrarare segmental premature aging disease resulting in early death from heart attack or stroke. There is no approved treatment, but starting in 2007, several recent single-arm clinical trials administered inhibitors of protein farnesylation aimed at reducing toxicity of the disease-producing protein progerin. No study assessed whether treatments influence patient survival. The key elements necessary for this analysis are a robust natural history of survival and comparison with a sufficiently large patient population that has been treated for a sufficient time period with disease-targeting medications.

Methods and Results—

We generated Kaplan–Meier survival analyses for the largest untreated Hutchinson-Gilford progeria syndrome cohort to date. Mean survival was 14.6 years. Comparing survival for treated versus age- and sex-matched untreated cohorts, hazard ratio was 0.13 (95% confidence interval, 0.04–0.37;
P
<0.001) with median follow-up of 5.3 years from time of treatment initiation. There were 21 of 43 deaths in untreated versus 5 of 43 deaths among treated subjects. Treatment increased mean survival by 1.6 years.

Conclusions—
This study provides a robust untreated disease survival profile that can be used for comparisons now and in the future to assess changes in survival with treatments for Hutchinson-Gilford progeria syndrome. The current comparisons estimating increased survival with protein farnesylation inhibitors provide the first evidence of treatments influencing survival for this fatal disease.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique Indentifiers: NCT00425607, NCT00879034, and NCT00916747.
Understanding the episodic everyday of disrupted lives: Scoping the occupational therapy literature
Authors: Milbourn Benjamin T. , McNamara Beverley A. , Buchanan Angus J. 
Published: May 2014

Background. The concept “everyday” appears unchallenged and problematic when applied to people who experience disrupted lives through illness or disability. Purpose. This study draws upon social and philosophical theory to review the relevance of the concept “everyday” when applied to contemporary occupational therapy and the lives of individuals who experience biographical disruption. Method. A literature review guided by a scoping framework was undertaken followed by a critical analysis drawing on Bauman to determine the frequency and meaning of the concept “everyday” used in the occupational therapy and occupational science literature. Findings. Definitions of the “everyday” are used infrequently despite recurrent use of the concept. A large proportion of literature reviewed in this manuscript does not acknowledge or discuss the philosophical and sociological influences that contribute to an understanding of the “everyday,” leaving the reader to make her or his own interpretations. Implications. Reconceptualizing lived “everyday” experience within the contextual “here and now” provides a postmodern “episodic” lens for occupational therapists working with individuals who experience biographical disruption.
“The Promotora Explained Everything”
Authors: Shepherd-Banigan Megan , Hohl Sarah D. , Vaughan Catalina , Ibarra Genoveva , Carosso Elizabeth , Thompson Beti 
Published: May 2014

Purpose The purpose of this study is to describe participant experiences of a household-level, community health worker-led intervention to improve diabetes-related health behaviors and outcomes. Methods The Home Health Parties (HHP) aimed to improve diabetes self-management among Hispanics living in a rural, agricultural area in eastern Washington State. Trained promotores (community health workers) delivered a series of education sessions and distributed incentives to support diabetes-related behavior change. Open-ended, semi-structured questionnaires were administered to a random sample of 40 HHP participants. Qualitative methods were used to code and analyze the interview transcripts. Results Four primary themes emerged from interviews: (1) participants’ desire for improving knowledge about diabetes; (2) experiences of building skills for diabetes management; (3) developing social support; and (4) embracing household-level change. Conclusion This study shows that involving family members and increasing social support are effective strategies for improving health behaviors and chronic health outcomes among vulnerable Hispanics living with diabetes. Our findings demonstrate several important considerations regarding the design of diabetes management interventions for rural Hispanic populations including the following: (1) promotores are critical as they provide social support and encourage behavior change by building relationships based on trust and cultural understanding; (2) well-designed tools that provide step-by-step examples of healthy behaviors, such as cookbooks, and tools that aid participants to monitor behavior change, such as pedometers and glucose monitors, serve to build skills and improve confidence to achieve goals; and (3) targeting households is a promising strategy for individual and family lifestyle changes that benefit the entire family unit.
Treatment of endothelial cell with flavonoids modulates transendothelial leukocyte migration
Authors: Werner Isabella , Guo Fengwei , Kiessling Arndh H , Juengel Eva , Relja Borna , Lamm Peter , Stock Ulrich A , Moritz Anton , Beiras-Fernandez Andres 
Published: May 2014

Objective: This study aimed to investigate the influence of the flavonoid oxerutin (Venoruton®, Novartis, Basel, Switzerland) on endothelial cell apoptosis and transendothelial migration of peripheral blood mononuclear cells and to elucidate the potential mechanisms affecting these processes. Methods: Human endothelial cells were treated with Venoruton to assess the potential effect on apoptosis and on the transendothelial migration process. Endothelial nitric oxide synthase and inducible nitric oxide synthase expression in endothelial cell after Venoruton treatment as well as reactive oxygen species levels were analyzed. Results: Low-dose Venoruton shows a protective effect on endothelial cells and inhibits transendothelial migration of peripheral blood mononuclear cells through an endothelial monolayer, but high-dose Venoruton inversely elevated transendothelial migration of peripheral blood mononuclear cells. Meanwhile, a dose-dependent action of Venoruton on endothelial cell apoptosis could be observed. Endothelial nitric oxide synthase and inducible nitric oxide synthase expression were gradually increased in endothelial cells with increasing Venoruton dosage. In addition, reactive oxygen species were significantly reduced by 0.1 mM and 0.5 mM Venoruton and elevated after high dose treatment. Conclusion: These data suggest that the increased transendothelial migration of peripheral blood mononuclear cells is related to the excessive activation of the nitric oxide-axis and subsequent relaxation of the endothelial cells.
Fluoroscopically guided transurethral removal and/or replacement of ureteric stents in women
Authors: McCarthy Eoghan , Kavanagh John , McKernan Sean , O’Mahony Niamh , McEniff Niall , Ryan J Mark , Guiney Michael 
Published: May 2014

BackgroundTraditionally double J ureteric stents have been removed and replaced via cystoscopy. Fluoroscopically guided procedures for the removal/replacement of stents using endovascular snare devices have previously been described as a successful alternative.PurposeTo evaluate the technical and clinical success of fluoroscopically guided transurethral removal and/or replacement of ureteric stents in women. To assess radiation dose and screening time associated with this approach.Material and MethodsA 31-month retrospective review of all ureteric stent removals and/or replacements under fluoroscopic guidance performed in a university hospital radiology department.ResultsOne hundred and fourteen procedures were performed in 83 patients. Thirty ureteric stents were removed and 84 ureteric stents were replaced. The majority of patients required stents for urinary tract obstruction secondary to malignancy (78.3%). Overall technical and clinical success rates (defined respectively as satisfactory removal/replacement and drainage of the collecting system) of 98.2% were attained. Mean screening time was 13.9 min (range, 1.0–67.6 min). Effective radiation dose was in the range of 0.69–132 mSv with a mean of 11.18 mSv equating to the dose of a contrast-enhanced computed tomography abdomen/pelvis.ConclusionTransurethral ureteric stent removal and replacement under fluoroscopic guidance is highly successful, well tolerated by patients with acceptable radiation exposure, and can obviate the need for cystoscopic retrieval.
Changes of gray matter volume and amplitude of low-frequency oscillations in amnestic MCI: An integrative multi-modal MRI study
Authors: Zhao Zhi-Lian , Fan Feng-Mei , Lu Jie , Li Hui-Jie , Jia Long-Fei , Han Ying , Li Kun-Cheng 
Published: May 2014

Background Numerous studies have reported that the amnestic-type mild cognitive impairment (aMCI) patients have impaired brain structural integrity and functional alterations separately. Purpose To investigate the changes of gray matter and amplitude of low-frequency oscillations in patients with aMCI by combining structural and functional magnetic resonance imaging (fMRI). Material and Methods Thirty-four patients with aMCI and 34 controls were recruited. We adopted optimized voxel-based morphometry to detect regions with gray matter volume (GMV) loss induced by aMCI. Then regional differences in amplitude of slow-4 band (0.027–0.073 Hz) oscillations among these regions between patients and healthy controls were examined. Both slow-4 amplitude of low-frequency fluctuations (ALFF) and slow-4 fractional ALFF (fALFF; the relative amplitude that resides in the low frequencies) were employed. Results Patients with aMCI demonstrated significant GMV loss in the ventral medial prefrontal cortex (vMPFC), posterior cingulate cortex (PCC), bilateral hippocampus, right superior parietal gyrus, left insula and left middle temporal gyrus ( P < 0.01). The patients exhibited significant decreases of slow-4 ALFF in the left hippocampus ( P = 0.05) and PCC ( P = 0.02), while the decreased slow-4 fALFF was detected in PCC ( P = 0.01) and increased slow-4 fALFF in vMPFC ( P = 0.03). In PCC, aMCI and controls exhibited significant different GMV-fALFF correlation ( P < 0.05), with opposite correlation trend. Conclusion The correlates between anatomical deficits and functional alterations in aMCI suggest that anatomical and functional deficits are linked to each other. The differences of GMV-fALFF correlations demonstrated altered anatomical-functional relationship in aMCI.
Rehabilitation Regimen After Surgical Treatment of Acute Achilles Tendon Ruptures
Authors: Huang Jiazhang , Wang Chen , Ma Xin , Wang Xu , Zhang Chao , Chen Li 
Published: May 2014

Background: The choice of rehabilitation management after the surgical repair of acute Achilles tendon (AT) ruptures remains controversial because of insufficient clinical evidence. The current study analyzes the postoperative rehabilitation of AT ruptures based on the current clinical evidence. Purpose: To identify and analyze the high-level clinical evidence regarding postoperative rehabilitation after the surgical repair of AT ruptures. Subgroup analyses were also performed to obtain more reliable and specific results. Study Design: Meta-analysis. Methods: The studies were retrieved by searching the Medline, Embase, and Cochrane databases through the OVID retrieval engine from 1990 to August 14, 2013. Two independent reviewers critically reviewed the studies using preset inclusion and exclusion criteria. The quality of the eligible studies was assessed by the Cochrane 12-item scale. All included studies were summarized, and their data were extracted. Subgroup analyses were performed according to the different protocols of early functional rehabilitation. Results: Nine studies, consisting of 6 randomized controlled trials and 3 quasi-randomized studies, were ultimately included. A total of 402 patients were identified. Six of the included studies utilized early weightbearing combined with early ankle motion exercises, while the other 3 only employed early ankle motion exercises. The subgroup analyses demonstrated that 11 of the 15 functional outcome measurements were significantly superior for patients who underwent both early weightbearing and ankle motion exercises than for those who underwent conventional cast immobilization. Similar rates of reruptures (odds ratio [OR], 1.36; 95% CI, 0.38-4.91; P = .64) and major complications (OR, 0.67; 95% CI, 0.24-1.87; P = .44) as well as a significantly lower rate of minor complications (OR, 0.51; 95% CI, 0.27-0.95; P = .03) were also observed in this early functional rehabilitation group. For the patients who solely performed early ankle motion exercises, only 2 of the 14 functional measurements were observed to be significantly superior to immobilization. There were also no significant differences in the rates of reruptures (OR, 0.47; 95% CI, 0.08-2.70; P = .40) and other complications (OR, 1.09; 95% CI, 0.41-2.92; P = .86) between the 2 groups. Conclusion: Postoperative early weightbearing combined with early ankle motion exercises is associated with a lower minor complication rate and achieves superior and more rapid functional recovery than conventional immobilization after surgical AT repair. In contrast, few advantages were identified when only early ankle motion exercises were applied.
Treatment of moderately to severely active systemic lupus erythematosus with adrenocorticotropic hormone: a single-site, open-label trial
Authors: Fiechtner JJ , Montroy T 
Published: May 2014

Background Alternative therapeutic options are needed for patients with systemic lupus erythematosus (SLE) not adequately controlled with or intolerant to traditional treatments. This study evaluated the efficacy of Acthar® Gel (ACTH(1-39)) for reducing active SLE severity among patients receiving underlying conventional maintenance therapies. Methods Ten females (mean age = 49 yrs, disease duration = 7 yrs, Systemic Lupus Erythematosus Disease Activity Index-2000 [SLEDAI-2 K] = 10) currently on maintenance self-administered ACTH(1–39) gel 1 mL (80 U/mL) for 7–15 days and were assessed weekly for 28 days. Outcome measures included Physician and Patient Global Assessments, SLEDAI-2 K, Lupus Quality of Life scale, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) scale, erythrocyte sedimentation rate, and C-reactive protein. Student’s t-test compared data obtained at days 7, 14, and 28 with those from baseline. Results The primary endpoint of SLEDAI-2 K improvement was reached at all observation times ( p < 0.05) and statistically significant improvements were observed for most other parameters. No treatment-related serious or unexpected adverse events were observed. Conclusions The trial results reveal that among SLE patients in need of therapeutic alternatives, ACTH(1-39) gel may provide significant disease activity reduction.
Central Venous Catheter Flushing Recommendations
Authors: Conway Margaret Anne , McCollom Claire , Bannon Cynthia 
Published: May 2014

Background: Treatment for many children with blood disorders or cancer includes the use of central venous catheters (CVCs). Few prospective studies have been conducted to address flushing guidelines in pediatric hematology oncology patients. Eighteen pediatric hematology oncology units were surveyed regarding current CVC flushing policies and procedures. Results reported extreme variations in CVC flush procedures, which instigated this systematic review. Aims: The purpose of this project was to critically review current literature and expert opinion regarding CVC flushing practice in the hopes of reporting standardized recommendations. Dissemination of consistent recommendations may reduce practice variability and complications associated with CVCs as well as increase patient and family confidence and competence in providing CVC care. Methods: Literature searches used PubMed, Medline, CINAHL, National Guidelines Clearinghouse, and Cochrane Database of Systematic Reviews. Multiple reviewers evaluated results relevant to CVC flushing procedures. Studies excluded were those that included neonates, peripheral intravenous catheters, dialysis catheters, and valved catheters. Results: Evaluation of 5 randomized controlled trials, 3 observational studies, 2 systematic reviews, 7 guidelines, and 1 literature review using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Appraisal of Guidelines for Research & Evaluation II (AGREE II) tools, an overall low level of evidence, and weak recommendation for practice was concluded. Conclusion: Weak recommendation for daily flushing of noninfusing Broviac/Hickman catheters and accessed implanted ports may be made. There was not sufficient evidence for heparin volume or concentration recommendations. No recommendations can be reported for peripherally inserted central venous catheters. Further research is indicated for CVC flushing procedures in pediatric hematology oncology patients.
Adjuvant valproate therapy for patients with suspected mixed-depressive features
Authors: Liu Chen-Chung 
Published: May 2014

Objective: Mixed-depressive features imply an occult bipolarity and might be linked to resistance to antidepressant therapy and a higher risk of suicide. Currently, there is no consensus about or any clinical guidelines available for this ill-defined clinical entity. The aim of this study was to assess the effectiveness, safety, and tolerability of mood stabilizers, such as valproate, for adjuvant therapy in patients suspected of having mixed-depressive features. Methods: This retrospective observational study reviewed medical records of psychiatric outpatients attended by the author from 2008 to 2013. Patients who presented with inadequately treated, long-lasting atypical depressive- and/or anxiety-spectrum symptoms, and who started adjuvant valproate therapy for the first time in their course of treatment, were identified. Patient demographics, clinical profiles, treatment responses, and treatment-emergent adverse events (AEs) were examined in detail. Results: A total of 22 patients (7 men and 15 women) ranging in age between 25 and 78 years were treated with valproate 100–1250 mg/day and observed for 3–60 months. The majority exhibited much or moderate improvement, and only four showed a limited response. During follow up, 12 continued adjuvant valproate, 3 were intermittent users, and 3 quit after no apparent response; 4 experienced an aggravation of symptoms after discontinuation but were stabilized soon after reinstitution. AEs were reported by 12 patients and 4 stopped valproate for intolerability despite improvement. Conclusion: Adjuvant valproate therapy seems to be a promising approach to treating patients who manifest atypical neurotic or mood disorders with subthreshold bipolarity at a dosage around the lower end of that used to treat full-syndromal bipolar disorders.