bluuebunny/crossref_metadata_2025_split huggingface dataset:
R/S Ratio Variability in Lead V1Observed between Selected Four 1‐Minute ECG Fragments of 24‐Hour ECG as a Predictor of Incomplete Resynchronization during Full 24‐Hour ECG: Pilot Study
Authors: Pyszno‐Prokopowicz Dominika , Baranowski Rafał , Bodalski Robert , Madej Magdalena , Piotrowicz Ryszard 
Published: October 2015

BackgroundAbout 30% of patients do not have an effective cardiac resynchronization therapy (CRT). Routine assessment of CRT by devices interrogation (DI) is not entirely reliable. Additional information provide detailed QRS analysis in 24‐hour ECG, however it is time‐consuming. The aim of the study was the assessment of R/S ratio variability in lead V1between selected fragments of 24‐hour ECG as a predictor of incomplete biventricular pacing (BIVP) during full 24‐hour ECG.MethodsThe 12‐lead 24‐hour ECGs of 43 patients with sinus rhythm were studied. During 24‐hour ECG the 6‐minute walk test (6MWT) was performed. The CRT was assessed by analyzing DI and full 24‐hour ECG and four 1‐minute fragments of these ECG recordings: during the minimum and the maximum heart rate and at the 1st and last minute of 6MWT.ResultsDuring DI the effective (>95%) BIVP was present in 36 patients (83.7%). Analysis of full 24‐hour ECG confirmed appropriate BIVP in 31 patients (72%) and suspected incomplete BIVP (≤95%) in 12 patients (28%). In 9/12 patients the R/S ratio variability in lead V1was visible between selected ECG fragments of 24‐hour ECG. These results were not associated with the results of DI but were significantly associated with full 24‐hour analysis of QRS.ConclusionsR/S variability in lead V1between selected fragments of 24‐hour ECG can be considered a predictor of potentially incomplete BIVP confirmed by further complete 24‐hour ECG analysis in patients with appropriate pacing reported during DI.
Beyond the VAD: Human Factors Engineering for Mechanically Assisted Circulation in the 21st Century
Authors: Throckmorton Amy L. , Patel‐Raman Sonna M. , Fox Carson S. , Bass Ellen J. 
Published: October 2015

AbstractThousands of ventricular assist devices (VADs) currently provide circulatory support to patients worldwide, and dozens of heart pump designs for adults and pediatric patients are under various stages of development in preparation for translation to clinical use. The successful bench‐to‐bedside development of a VAD involves a structured evaluation of possible system states, including human interaction with the device and auxiliary component usage in the hospital or home environment. In this study, we review the literature and present the current landscape of preclinical design and assessment, decision support tools and procedures, and patient‐centered therapy. Gaps of knowledge are identified. The study findings support the need for more attention to user‐centered design approaches for medical devices, such as mechanical circulatory assist systems, that specifically involve detailed qualitative and quantitative assessments of human–device interaction to mitigate risk and failure.
Bridging the gap: a genetic assessment framework for population‐level threatened plant conservation prioritization and decision‐making
Authors: Ottewell Kym M. , Bickerton Doug C. , Byrne Margaret , Lowe Andrew J. 
Published: October 2015

AbstractAimMaintaining genetic diversity and evolutionary processes are important goals in plant conservation. Genetic studies are increasingly undertaken but results from such studies are still rarely implemented as management actions in the field. We address this ‘research‐implementation gap’ by developing a plain‐language genetic assessment approach for population‐level conservation prioritization based on measurement of key genetic parameters. Our aim was to improve understanding between conservation researchers and practitioners, enabling practitioners to incorporate genetic information into conservation actions and conservation genetic researchers to address research explicitly resulting in conservation action.LocationApplicable globally.MethodsWe derived a decision‐making framework that identifies appropriate management strategies for threatened populations based on the level of genetic differentiation (FST), genetic diversity (expected heterozygosity, HE) and inbreeding (FIS), characterized as ‘high’ or ‘low’ in comparison with a reference benchmark. We demonstrate the application of the framework in two case studies of threatened plants and more broadly from the literature.ResultsApplying the decision framework, we found that for Prostanthera eurybioides, the population of conservation concern does not currently require specialized genetic management and mitigation of ecological threats should be prioritized instead. For Allocasuarina robusta, we found connectivity was high and strategies should be put in place to maintain gene flow. In both cases, genetic information was important for designing restocking strategies accounting for the genetic structure and genetic diversity of source and recipient populations. From the literature, key examples of species types that fit each of the genetic management scenarios are given.Main conclusionsWe find that the application of our simplified genetic assessment framework helps to clarify management actions based on conservation genetic information for threatened flora, and should assist in bridging the gap between researchers and conservation practitioners for integrated conservation outcomes. Our framework could equally apply to fauna conservation with appropriate consideration of animal‐specific management issues.
Identifying predictable foraging habitats for a wide‐ranging marine predator using ensemble ecological niche models
Authors: Scales Kylie L. , Miller Peter I. , Ingram Simon N. , Hazen Elliott L. , Bograd Steven J. , Phillips Richard A. 
Published: October 2015

AbstractAimEcological niche modelling can provide valuable insight into species' environmental preferences and aid the identification of key habitats for populations of conservation concern. Here, we integrate biologging, satellite remote‐sensing and ensemble ecological niche models (EENMs) to identify predictable foraging habitats for a globally important population of the grey‐headed albatross (GHA) Thalassarche chrysostoma.LocationBird Island, South Georgia; Southern Atlantic Ocean.MethodsGPS and geolocation‐immersion loggers were used to track at‐sea movements and activity patterns of GHA over two breeding seasons (n = 55; brood‐guard). Immersion frequency (landings per 10‐min interval) was used to define foraging events. EENM combining Generalized Additive Models (GAM), MaxEnt, Random Forest (RF) and Boosted Regression Trees (BRT) identified the biophysical conditions characterizing the locations of foraging events, using time‐matched oceanographic predictors (Sea Surface Temperature, SST; chlorophyll a, chl‐a; thermal front frequency, TFreq; depth). Model performance was assessed through iterative cross‐validation and extrapolative performance through cross‐validation among years.ResultsPredictable foraging habitats identified by EENM spanned neritic (<500 m), shelf break and oceanic waters, coinciding with a set of persistent biophysical conditions characterized by particular thermal ranges (3–8 °C, 12–13 °C), elevated primary productivity (chl‐a > 0.5 mg m−3) and frequent manifestation of mesoscale thermal fronts. Our results confirm previous indications that GHA exploit enhanced foraging opportunities associated with frontal systems and objectively identify the APFZ as a region of high foraging habitat suitability. Moreover, at the spatial and temporal scales investigated here, the performance of multi‐model ensembles was superior to that of single‐algorithm models, and cross‐validation among years indicated reasonable extrapolative performance.Main conclusionsEENM techniques are useful for integrating the predictions of several single‐algorithm models, reducing potential bias and increasing confidence in predictions. Our analysis highlights the value of EENM for use with movement data in identifying at‐sea habitats of wide‐ranging marine predators, with clear implications for conservation and management.
Positive indirect effect of aquatic insects on terrestrial prey is not offset by increased predator density
Authors: DREYER JAMIN , HOEKMAN DAVID , GRATTON CLAUDIO 
Published: October 2015

1. Changes in one prey species' density can indirectly affect the abundance of another prey species if a shared predator eats both species. Sometimes, indirect effects occur when prey straddle habitats, including when riparian predator populations grow in response to emergent aquatic insects and increase predation on terrestrial prey. However, predators may largely switch to aquatic insects or become satiated, reducing predation on terrestrial prey.2. To determine the net indirect effect of aquatic insects on terrestrial arthropods via generalist spider predators, a field experiment was conducted mimicking midge influx and a wolf spider numerical response inside enclosures near an Icelandic lake. Lab mesocosms were also used to assess per capita rates of spider predation u nder differing levels of midge abundance.3. Midges always decreased sentinel prey predation, but this effect increased with predator density. When midges were absent, predation increased 30% at a high spider density, but predation was equal between spider treatments when midges were present. In situ arthropods showed no effect of midge or spider treatments, although non‐significant abundance patterns were observed congruent with sentinel prey results.4. In lab mesocosms, prey survivorship increased ≥50% where midges were present and rapidly saturated; the addition of 5, 20, 50, and 100 midges equivalently reduced spider predation, supporting predator distraction rather than satiation as the root cause.5. The present results demonstrate a strong positive indirect effect of midges and broadly support the concept that predator responses to alternative prey are a major influence on the magnitude and direction of predator‐mediated indirect effects.
Epileptic patients with de novo STXBP1 mutations: Key clinical features based on 24 cases
Authors: Di Meglio Chloé , Lesca Gaetan , Villeneuve Nathalie , Lacoste Caroline , Abidi Affef , Cacciagli Pierre , Altuzarra Cécilia , Roubertie Agathe , Afenjar Alexandra , Renaldo‐Robin Florence , Isidor Bertrand , Gautier Agnes , Husson Marie , Cances Claude , Metreau Julia , Laroche Cécile , Chouchane Mondher , Ville Dorothée , Marignier Stéphanie , Rougeot Christelle , Lebrun Marine , de Saint Martin Anne , Perez Alexandra , Riquet Audrey , Badens Catherine , Missirian Chantal , Philip Nicole , Chabrol Brigitte , Villard Laurent , Milh Mathieu 
Published: October 2015

SummaryObjectiveMutations in the syntaxin binding protein 1 gene (STXBP1) have been associated mostly with early onset epileptic encephalopathies (EOEEs) and Ohtahara syndrome, with a mutation detection rate of approximately 10%, depending on the criteria of selection of patients. The aim of this study was to retrospectively describe clinical and electroencephalography (EEG) features associated with STXBP1‐related epilepsies to orient molecular screening.MethodsWe screened STXBP1 in a cohort of 284 patients with epilepsy associated with a developmental delay/intellectual disability and brain magnetic resonance imaging (MRI) without any obvious structural abnormality. We reported on patients with a mutation and a microdeletion involving STXBP1 found using array comparative genomic hybridization (CGH).ResultsWe found a mutation of STXBP1 in 22 patients and included 2 additional patients with a deletion including STXBP1. In 22 of them, epilepsy onset was before 3 months of age. EEG at onset was abnormal in all patients, suppression‐burst and multifocal abnormalities being the most common patterns. The rate of patients carrying a mutation ranged from 25% in Ohtahara syndrome to <5% in patients with an epilepsy beginning after 3 months of age. Epilepsy improved over time for most patients, with an evolution to West syndrome in half. Patients had moderate to severe developmental delay with normal head growth. Cerebellar syndrome with ataxic gait and/or tremor was present in 60%.SignificanceOur data confirm that STXBP1 mutations are associated with neonatal‐infantile epileptic encephalopathies. The initial key features highlighted in the cohort of early epileptic patients are motor seizures either focal or generalized, abnormal initial interictal EEG, and normal head growth. In addition, we constantly found an ongoing moderate to severe developmental delay with normal head growth. Patients often had ongoing ataxic gait with trembling gestures. Altogether these features should help the clinician to consider STXBP1 molecular screening.
Developing clinical practice guidelines for epilepsy: A report from the ILAE Epilepsy Guidelines Working Group
Authors: Sauro Khara M. , Wiebe Samuel , Perucca Emilio , French Jacqueline , Dunkley Colin , de Marinis Alejandro , Kirkpatrick Martin , Jetté Nathalie 
Published: October 2015

SummaryClinical practice guidelines (CPGs) contain evidence‐based recommendations to guide clinical care, policy development, and quality of care improvement. A recent systematic review of epilepsy guidelines identified considerable variability in the quality of available guidelines. Although excellent frameworks for CPG development exist, processes are not followed uniformly internationally, and resources to develop CPGs may be limited in certain settings. An International League Against Epilepsy (ILAE) working group was charged with proposing methodology to guide the development of future epilepsy‐specific CPGs. A comprehensive literature search (1985–2014) identified articles related to CPG development and handbooks. Guideline handbooks were included if they were publicly available, and if their methodology had been used to develop CPGs. The working group's expertise also informed the creation of methodologies and processes to develop future CPGs for the ILAE. Five handbooks from North America (American Academy of Neurology), Europe (Scottish Intercollegiate Guidelines Network & National Institute for Health and Care Excellence), Australia (National Health and Medical Research Council), World Health Organization (WHO), and additional references were identified to produce evidence‐based, consensus‐driven methodology for development of epilepsy‐specific CPGs. Key components of CPG development include the following: identifying the topic and defining the scope; establishing a working group; identifying and evaluating the evidence; formulating recommendations and determining strength of recommendations; obtaining peer reviews; dissemination, implementation, and auditing; and updating and retiring the CPG. A practical handbook and toolkit was developed. The resulting CPG development toolkit should facilitate the development of high‐quality ILAE CPGs to improve the care of persons with epilepsy.
Brivaracetam augments short‐term depression and slows vesicle recycling
Authors: Yang Xiaofeng , Bognar Joseph , He Tianyu , Mohammed Mouhari , Niespodziany Isabelle , Wolff Christian , Esguerra Manuel , Rothman Steven M. , Dubinsky Janet M. 
Published: October 2015

SummaryObjectiveBrivaracetam (BRV) decreases seizure activity in a number of epilepsy models and binds to the synaptic vesicle glycoprotein 2A (SV2A) with a higher affinity than the antiepileptic drug levetiracetam (LEV). Experiments were performed to determine if BRV acted similarly to LEV to induce or augment short‐term depression (STD) under high‐frequency neuronal stimulation and slow synaptic vesicle recycling.MethodsElectrophysiologic field excitatory postsynaptic potential (fEPSP) recordings were made from CA1 synapses in rat hippocampal slices loaded with BRV or LEV during intrinsic activity or with BRV actively loaded during hypertonic stimulation. STD was examined in response to 5 or 40 Hz stimulus trains. Presynaptic release of FM1‐43 was visualized using two‐photon microscopy to assess drug effects upon synaptic vesicle mobilization.ResultsWhen hippocampal slices were incubated in 0.1–30 μm BRV or 30 μm–1 mm LEV for 3 h, the relative CA1 field EPSPs decreased over the course of a high‐frequency train of stimuli more than for control slices. This STD was frequency‐ and concentration‐dependent, with BRV being 100‐fold more potent than LEV. The extent of STD depended on the length of the incubation time for both drugs. Pretreatment with LEV occluded the effects of BRV. Repeated hypertonic sucrose treatments and train stimulation successfully unloaded BRV from recycling vesicles and reversed BRVs effects on STD, as previously reported for LEV. At their maximal concentrations, BRV slowed FM1‐43 release to a greater extent than in slices loaded with LEV during prolonged stimulation.SignificanceBRV, similar to LEV, entered into recycling synaptic vesicles and produced a frequency‐dependent decrement of synaptic transmission at 100‐fold lower concentrations than LEV. In addition, BRV slowed synaptic vesicle mobilization more effectively than LEV, suggesting that these drugs may modify multiple functions of the synaptic vesicle protein SV2A to curb synaptic transmission and limit epileptic activity.
Lessons learned from a strangles outbreak on a large Standardbred farm
Authors: Christmann U. , Pink C. 
Published: October 2015

SummaryStreptococcus equisubspecies (ssp.)equiinfection (strangles) remains one of the most frequently diagnosed and costly infectious diseases of horses. Large breeding herds, where a disease outbreak competes for personnel and financial resources needed for foaling management, present a special challenge for equine practitioners. A 15‐month outbreak involving 62 clinical cases of strangles occurred on a large Standardbred breeding farm (average population of 1400 horses). Sixteen asymptomatic horses were found to be PCR (polymerase chain reaction)‐positive forS. equissp.equi. During the outbreak, serological samples from 48 clinically normal horses were found to be seropositive forS. equissp.equi, confirming herd‐wide exposure. After several clinical cases of strangles had been diagnosed, an intranasalS. equissp.equivaccine was administered to clinically normal horses (n = 558) considered to be at risk of exposure. Strangles complications included 7 fatalities (none in vaccinated horses) and 6 cases of purpura haemorrhagica (4 in vaccinated horses). Midway through the outbreak, injectable, sustained release ceftiofur crystalline free acid (CCFA), given as an initial dose followed by a second dose 4 days later, was used exclusively for systemic antimicrobial treatment of clinically affected and PCR‐positive horses. This antimicrobial regimen coincided with a reduction in disease incidence and eventual resolution of the outbreak. Two horses with persistent guttural pouch infection were endoscopically confirmed as carrier horses. The herd history demonstrated that a strangles outbreak will often result in asymptomatic carrier horses and that identification and treatment of these horses are necessary to eliminate long‐term sources of infection. Ceftiofur crystalline free acid was found to be a suitable antimicrobial due to its activity againstS. equissp.equiand the efficiencies associated with twice parenteral dosing during a 10‐day treatment period. Occurrence of purpura in 4 vaccinated horses suggests that vaccination should be reserved for healthy seronegative horses and avoided during an active outbreak.
Thrombin generation and bleeding in haemophilia inhibitor patients during immune tolerance induction
Authors: Ragni M. V. , DiMichele D. M. , Hay C. M. , Malec L. M. , Seaman C. D. , Li J. , Yabes J. G. , Butenas S. , Brummel‐Ziedins K. 
Published: October 2015

SummaryBackgroundInhibitor formation complicates haemophilia treatment and requires immune tolerance induction to rid inhibitors over 5 BU. In the prospective, randomized International Immune Tolerance Study, immune tolerance induction was equally effective with high‐dose (HD) (200 IU kg−1day−1) and low‐dose (LD) (50 IU kg−13× per week) factorVIII, but haemorrhages were twofold higher in theLDarm. This finding was unexpected as inhibitors neutralizeFVIIIactivity. We hypothesized that the thrombin generation assay (TGA), a global measure of clot formation, might predict bleeding better thanFVIIIlevels.MethodsWe evaluatedTGAusing relipidated tissue factor (TF) on 83 thawed, recalcified corn trypsin inhibitor/citrate plasma samples from 31 subjects (17HD, 14LD) who participated on theITIstudy, and who had sufficient sample available and appropriate informed consent.ResultsThere were no significant differences in peak thrombin, estimated thrombin potential, maximum rate or lag time betweenHDandLDarms; between pre‐, during and post‐ITItime points, or afterFVIIIspiking. In 19 subjects (12HD, 7LD) with anti‐FVIII<1.0 BU, the prevalence of non‐neutralizing antibody (NNA) and neutralizing antibody (NA) was 89.5% (17/19), and the latter strongly correlated with anti‐VIIItiter, r = 0.73 [95%CI: 0.55, 0.88].ConclusionIn haemophilia inhibitor patients, thrombin generation is present, but does not predict bleeding risk. Following tolerance induction, NNA remains detectable in the majority.
A Pilot Study Assessing ECG versus ECHO Ventriculoventricular Optimization in Pediatric Resynchronization Patients
Authors: PUNN RAJESH , HANISCH DEBRA , MOTONAGA KARA S. , ROSENTHAL DAVID N. , CERESNAK SCOTT R. , DUBIN ANNE M. 
Published: October 2015

Pediatric Resynchronization PatientsIntroductionCardiac resynchronization therapy indications and management are well described in adults. Echocardiography (ECHO) has been used to optimize mechanical synchrony in these patients; however, there are issues with reproducibility and time intensity. Pediatric patients add challenges, with diverse substrates and limited capacity for cooperation. Electrocardiographic (ECG) methods to assess electrical synchrony are expeditious but have not been extensively studied in children. We sought to compare ECHO and ECG CRT optimization in children.MethodsProspective, pediatric, single‐center cross‐over trial comparing ECHO and ECG optimization with CRT. Patients were assigned to undergo either ECHO or ECG optimization, followed for 6 months, and crossed‐over to the other assignment for another 6 months. ECHO pulsed‐wave tissue Doppler and 12‐lead ECG were obtained for 5 VV delays. ECG optimization was defined as the shortest QRSD and ECHO optimization as the lowest dyssynchrony index. ECHOs/ECGs were interpreted by readers blinded to optimization technique. After each 6 month period, these data were collected: ejection fraction, velocimetry‐derived cardiac index, quality of life, ECHO‐derived stroke distance, M‐mode dyssynchrony, study cost, and time. Outcomes for each optimization method were compared.ResultsFrom June 2012 to December 2013, 19 patients enrolled. Mean age was 9.1 ± 4.3 years; 14 (74%) had structural heart disease. The mean time for optimization was shorter using ECG than ECHO (9 ± 1 min vs. 68 ± 13 min, P < 0.01). Mean cost for charges was $4,400 ± 700 less for ECG. No other outcome differed between groups.ConclusionECHO optimization of synchrony was not superior to ECG optimization in this pilot study. ECG optimization required less time and cost than ECHO optimization.