bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adhesive capsulitis: Review of imaging and treatment
Authors: Harris Guy , Bou‐Haidar Pascal , Harris Craig 
Published: September 2013

SummaryAdhesive capsulitis is one of the most common conditions affecting the shoulder; however, early clinical diagnosis can be challenging. Treatment is most effective when commenced prior to the onset of capsular thickening and contracture; consequently, the role of imaging is increasing. The aim of this review is to demonstrate the typical imaging appearances of adhesive capsulitis and to examine some of the evidence regarding each of these imaging modalities. An evaluation of the various management options available to the clinician is also presented.
Effect of FASN gene on milk yield and milk composition in the Chinese Holstein dairy population
Authors: Alim M. A. , Wang P. , Wu X. P. , Li C. , Cui X. G. , Zhang S. L. , Zhang Q. , Zhang Y. , Sun D. X. 
Published: September 2013

SummaryFatty acid synthase (FASN) is a multifunctional protein that catalyzes de novo synthesis of fatty acids in cells. It plays a key role in the lipid biosynthesis as well as in the general metabolism of all living animals. We herein investigated polymorphisms of FASN. As a result, six single nucleotide polymorphisms (SNPs) were found and then genotyped in 752 Chinese Holstein cows. It was found that g.17924A>G was non‐synonymous, g.13965 C>T, g.16907 T>C and g.18663T>C were synonymous mutations and two other two SNPs, g.8948 C>T (ss491228481) and g.14439T>C (rs133498277), were in intronic sequences of the gene. All such identified SNPs were found to be associated with milk yield and composition traits (P = 0.0441 to <0.0001). Significant additive and allele substitution effects were observed for three yield traits at all six loci as well (P < 0.05 to <0.01). Complete linkage disequilibrium among the five SNPs, with the exception of g.8948 C>T, was observed.
Performance of an External Transtelephonic Loop Recorder for Automated Detection of Paroxysmal Atrial Fibrillation
Authors: Velthuis Bob Oude , Bos Jorieke , Kraaier Karin , Stevenhagen Jeroen , van Opstal Jurren M. , van der Palen Job , Scholten Marcoen F. 
Published: September 2013

BackgroundAlthough atrial fibrillation (AF) is the most commonly encountered arrhythmia, some of the properties make its detection challenging. In daily practice, underdiagnosis can lead to less effective treatment in prevention of stroke. Based on data from studies on treatment of AF, more intensive follow‐up strategies, including 7‐day Holter recording, 30‐day event recording, and even implantable cardiac monitoring devices, are suggested. The study purpose is to evaluate the performance of a continuous single‐channel loop recorder with automatic AF detection and transtelephonic electrocardiogram (ECG) transmission capabilities.Methods and ResultsA consecutive cohort of 153 patients admitted to the stroke unit with a presumptive diagnosis of ischemic cerebrovascular accident was screened for AF. Twenty‐four‐hour rhythm observation was performed using a single‐channel external loop recorder (ELR) configured for automated AF detection. A total of 45 patients with a known history of AF, AF on the admission ECG, or incomplete registrations were excluded. Extensive additional frequency‐based settings were used to establish a reference registration. In total, 2923 recordings were transmitted. We evaluated all events, of which 1190 were designated by the device as AF. The sensitivity, specificity, PPV, and NPV for identifying AF using the ELR were, respectively, 93%, 51%, 5%, and 99%.ConclusionsIn this ELR validation study, the dedicated AF detection algorithm showed to be highly sensitive but not specific for AF. Applicability of an ELR might be limited for efficacious detection of AF, as manual verification is mandatory for a vast amount of recordings.
Electrocardiographic Reference Values for a Population of Older Adults in Sub‐Saharan Africa
Authors: Dewhurst Matthew J. , Di Marco Luigi Y. , Dewhurst Felicity , Adams Philip C. , Murray Alan , Orega Golda P. , Mwita Julius C. , Walker Richard W. , Langley Philip 
Published: September 2013

Background/ObjectivesOlder adults in sub‐Saharan Africa (SSA) are at greatest risk of an impending noncommunicable diseases epidemic, of which cardiac disease is the most prevalent contributor. Thus, it is essential to establish electrocardiographic reference values for a population that is likely to differ genetically and environmentally from others where reference values are established.MethodsTwo thousand two hundred thirty‐two apparently healthy community‐based participants without known cardiac disease aged 70+ in rural Tanzania underwent 12‐lead electrocardiography. Electrocardiograms were digitally analyzed and gender‐specific reference values for P duration (PD), P amplitude (PAMP), P area (PAREA), P terminal negative force (V1) (PTNF), PR interval, QRS duration (QRSD), QT/QTc, R amplitude (II, V5) (RAMP) LVH index (LVHI), R axis and R/S ratio (V1) reported, following univariate analysis of covariance using a multiple linear regression model, adjusting for age, systolic blood pressure (SBP), body mass index (BMI), and RR interval.ResultsData from 1824 subjects were suitable for analysis. Adjusted mean values for men/women were: PD 115/110 ms, PAMP (avg) 123/114 μV, PAMP (II) 203/190 μV, PAREA (avg) 5.3/4.6 mV*s, PAREA (II) 9.3/8.1mV*s, PTNF 1.7/1.4 mV*s, PR 158/152 ms, QRSD 89/84 ms, QT 370/375 ms, QTc 421/427 ms, RAMP (II) 805/854 μV, (V5) 2022/1742 μV, LVHI 3.0/2.8 mV (Sokolow‐Lyon), 1.293/1.146 mV (Cornell), R axis 51/49°, R/S 0.2/0.2. Excluding PTNF, R axis and R/S ratio, all gender differences were significant (P < 0.001 apart from LVHI [Sokolow‐Lyon; P < 0.005)] and RAMP (II) [P < 0.05]) following adjustment for age, SBP, BMI, and RR interval.ConclusionsOur description of comprehensive electrocardiographic parameters establishes reference values in this genetically and environmentally diverse SSA population thereby allowing identification of “outliers” with potential cardiac disease.
Use of Continuous ECG for Improvements in Assessing the Standing Response as a Positive Control for QT Prolongation
Authors: Fossa Anthony A. , Zhou Meijian , Brennan Nuala , Round Patrick , Ford John 
Published: September 2013

BackgroundStanding invoked change in QT interval has been identified as a promising autonomic maneuver for the assessment of QT/QTc prolongation in patients with underlying heart abnormalities or as a positive control in healthy volunteers for drug studies. Criticism for its more widespread use is the high variability in reported results and the need for a more standardized methodology with defined normal ranges.MethodsForty healthy male subjects underwent continuous ECG collection on the day before dosing in a double‐blind, placebo‐controlled, randomized, single ascending dose trial. A brisk supine to standing (3 minutes) response was conducted at three time points. Results were grouped by treatment cohort or assessed as a pooled group at each time point. Maximum time and median change from baseline (ΔTmaxQTcF, ΔQTcF) were calculated for each individual over sequential 30‐second periods staggered by 5 seconds.ResultsMaximum ΔQTcF at all time points and in all groups was significant (i.e., the lower bound of 90% CI was > 5 milliseconds) which is the ICH E14 regulatory requirement for a positive control. Variability of the time to maximum response was also reduced 9‐fold by the third time period.ConclusionsStanding invoked ΔQTcF can be utilized to validate the sensitivity of a study for assessment of the QT interval effect of drugs in early development. The methodology may be used to further improve its diagnostic use of long QT syndromes by reducing the variability and allowing adequate definition of normal limits.
Number of P‐Wave Fragmentations on P‐SAECG Correlates with Infiltrated Atrial Fat
Authors: Murthy Sindhoora , Rizzi Patricia , Mewton Nathan , Strauss David G. , Liu Chia Y. , Volpe Gustavo Jardim , Marchlinski Francis E. , Spooner Peter , Berger Ronald D. , Kellman Peter , Lima Joao A.C. , Tereshchenko Larisa G. 
Published: September 2013

BackgroundAlthough atrial fibrillation (AF) triggers are known, the underlying AF substrate is less well understood. The goal of our study was to explore correlations between electrophysiological and structural characteristics of atria in patients with paroxysmal AF and individuals at AF risk.MethodsPatients in sinus rhythm (N = 90; age 57 ± 10 year; 55 men [63.2%]) with structural heart disease and paroxysmal AF (n = 12 [13%]), or with AF risk factors and LVEF > 35% (n = 78), underwent SAECG and cardiac magnetic resonance study. Interatrial and epicardial fat was analyzed with a Dark‐blood DIR‐prepared Fat‐Water‐separated sequence in the horizontal longitudinal axis. All local P‐wave extrema were identified on SAECG leads during sinus rhythm. A P‐wave fragmentation (Pf) was defined as an absolute difference between adjacent extrema which was above three standard deviations of noise, and was normalized by the duration of the P wave in the corresponding lead.ResultsThe Pf was greater on the filtered than on the unfiltered P‐SAECG signal (13.1 ± 3.8 vs. 3.4 ± 1.2; P < 0.0001). Pf was the greatest on the Y lead (13.0 ± 3.5 on Y lead vs. 12.1 ± 3.4 on Z lead; P = 0.003. Pf on Z lead correlated with interatrial fat index (r = 0.544; P = 0.001). Epicardial fat significantly correlated with body mass index (BMI; r = 0.302; P = 0.015). After adjustment for BMI, left atrium (LA) size, epicardial fat, and interatrial septum width, interatrial fat independently associated with the Pf on Z lead (β‐coefficient 0.009 [95%CI 0.0003–0.019]; P = 0.043).ConclusionsInfiltrated atrial fat correlates with discontinuous conduction on posterior LA wall and represents AF early substrate.
Single Nucleotide Polymorphisms in Proximity to K‐Channel Genes Are Associated with Decreased Longitudinal QTc Variance
Authors: Mints Yuliya , Zipunnikov Vadim , Khurram Irfan , Calkins Hugh , Nazarian Saman 
Published: September 2013

BackgroundAtrial fibrillation (AF) is the most common form of cardiac arrhythmia. Despite significant progress in identification of predisposing factors, the pathophysiology of AF remains to be elucidated. Previous studies have reported that single nucleotide polymorphisms (SNPs) in potassium‐channel genes associate with AF and the instantaneous corrected QT interval (QTc). The purpose of this study was to examine the association between SNPs in proximity to KCNQ1, KCNH2, KCNE2, and KCNJ2 and longitudinal QTc variations in patients with AF.Methods and ResultsWe conducted a retrospective cohort study of 800 electrocardiograms from 93 patients with AF. All patients were Caucasian, with an average age of 61.2 years, and 72% were male. Of all patients, 37% had persistent AF, and 63% had paroxysmal AF. Following DNA extraction from blood, SNPs at the AF‐associated loci KCNQ1, KCNH2, KCNE2, and KCNJ2 were genotyped using the Sequenom MassARRAY. Using a linear regression model and adapting a resampling inference, a decrease in longitudinal QTc variance was found to associate with SNPs near KCNH2 (rs10240738) and KCNJ2 (rs8079702) when adjusted for patient age, gender, AF type, and average QTc. On average, patients with these SNPs had a shorter QTc interval. In addition, we fitted a multilevel mixed effects regression model accounting for subject level heterogeneity and found no longitudinal association between presence of SNPs near K‐channel genes and changes in QTc.ConclusionPolymorphisms near specific potassium‐channel genes in AF patients are associated with decreased longitudinal QTc variance and a shorter average QTc. These results support the hypothesis that effects on myocardial repolarization may mediate the association of these SNPs and AF.
Personalisation of adult social care: self‐directed support and the choice and control agenda
Authors: Kendall Sophie , Cameron Ailsa 
Published: September 2013

Accessible summary

This study explores the impact differing ideas about personalisation has on the way in which self‐directed support operates, particularly in the light of cuts to social service budgets.

Six participants from a local authority social care transformation team, five from a user‐led organisation and two national experts were interviewed.

The findings suggest that whilst generally a positive process, in some cases, self‐directed support has become confusing, and personal budget holders have had less say over how their outcomes are met.

The research is useful for people with learning disabilities as it provides an insight into what is happening in local authorities and the impact of the cuts on self‐directed support.

SummaryIn 2007, ‘self‐directed support’ was introduced in adult social care in England to establish choice and control – in the assessment process itself and over service provision – for all service users. The personalisation agenda is underpinned by a range of ideologies, particularly a civil rights empowerment approach and neoliberal market discourses. This research sought to explore how tensions between these discourses are reflected in the operation of self‐directed support, particularly in the light of the changing political and economic climate. The small‐scale study involved semi‐structured interviews with 13 participants: six professionals from a local authority social care transformation team, five from a user‐led organisation and two national experts. The findings suggest that whilst the choice and control agenda may be consistent with market discourses, it is not compatible with neoliberal aspirations of cost‐cutting. To maintain trust and provide as much opportunity for choice and control as possible, the adjustments being made to the personalisation agenda in the light of the current budgetary pressures need to be made explicit to service users.
Double staining with crystal violet and methylene blue is appropriate for colonic endocytoscopy: An in vivo prospective pilot study
Authors: Ichimasa Katsuro , Kudo Shin‐ei , Mori Yuichi , Wakamura Kunihiko , Ikehara Nobunao , Kutsukawa Makoto , Takeda Kenichi , Misawa Masashi , Kudo Toyoki , Miyachi Hideyuki , Yamamura Fuyuhiko , Ohkoshi Shogo , Hamatani Shigeharu , Inoue Haruhiro 
Published: September 2013

Background and AimEndocytoscopy (EC) at ultra‐high magnification enables in vivo visualization of cellular atypia of gastrointestinal mucosae. Clear images are essential for precise diagnosis by EC. The aim of the present study was to evaluate the optimal staining method for EC in the colon.MethodsThirty prospectively enrolled patients were allocated 1:1:1 to three distinct staining methods: 0.05% crystal violet (CV) alone, 1% methylene blue (MB) alone, or CV + MB (CM double). Normal rectal mucosae were stained with each dye and videos of EC images were recorded. Visibility of nuclei and gland formation after staining were evaluated as ‘recognizable’ or ‘not recognizable’. Time for each parameter to become ‘recognizable’ was measured, and the average times for the three staining regimens were compared.ResultsMB alone and CM double staining resulted in ‘recognizable’ (102 ± 27 vs 89 ± 22 s, P = 0.263) nuclei within comparable periods of time, whereas CV alone was unable to identify nuclei. Gland formation became ‘recognizable’ sooner after CM double staining than after MB alone (61 ± 16 vs 108 ± 24 s, P < 0.001).ConclusionsDouble staining with CV and MB, which rapidly provided recognizable images of both nuclei and gland formation, is an appropriate staining regimen for colonic EC.
Double Orifice Mitral Valve in Rheumatic Heart Disease
Authors: Choudhury Partha P. , Chaturvedi Vivek 
Published: September 2013

Mini‐AbstractA 55‐year‐old female, presented to our outpatient department with complaints of dyspnea on exertion, NYHA grade II for 7 years, which had progressed to NYHA Grade III in the past 6 months. An echocardiogram done showed severe mitral stenosis with mitral valve fused in the middle to create an appearance of 2 separate valves (complete bridge type) with 2 separate turbulent jets of flow across these valves. No other congenital anomaly was seen. Due to presence of severe subvalvular disease, she was sent for elective mitral valve replacement. This case demonstrates that a careful analysis of the subvalvular apparatus of the mitral valve is needed before making a decision for definitive treatment of this condition.
Effects of Pergolide Mesylate on Plasma Adrenocorticotropic Hormone Concentration in Horses with Pituitary Pars Intermedia Dysfunction
Authors: Rendle D.I. , Taylor E. , Duz M. , Parkin T.D. , Copas V.E.N. , Durham A.E. 
Published: September 2013

AimsPituitary pars intermedia dysfunction (PPID) is a common degenerative neuropathy of horses associated with ageing. Pergolide mesylate (pergolide) is the only licensed treatment for PPID in the UK; however, published evidence of its efficacy is limited to small case series and anecdotal reports. This study evaluated adrenocorticotropic hormone (ACTH) responses in horses treated with pergolide and investigated factors that may influence response to treatment.MethodsA retrospective review of submissions to The Liphook Equine Hospital Laboratory was performed from January 2007 to December 2012 and cases in which ACTH concentration was measured before and after instigation of pergolide treatment were identified. Data were analysed using Rv.2.15 software (R Development Core Team). Improvement was defined as a reduction of ACTH concentration of ≥75%, or a return of ACTH concentration to within seasonally adjusted reference intervals.ResultsA total of 2122 cases satisfied the inclusion criteria. Improvement was identified in 54.8% of horses at the first follow‐up assessment; however, ACTH concentration returned to within reference intervals in only 28%. Equids with a higher ACTH concentration pretreatment were more likely to improve (odds ratio [OR] 1.01, 95% confidence intervals [CI] 1.00–1.02; P = 0.027), but less likely to return to within the reference interval (OR 0.97; 95% CI 0.96–0.98; P<0.001). Older equids were significantly less likely to improve (OR 0.56, 95% CI 0.46–0.67; P<0.001). Improvement was more likely after a cumulative dose of 50 mg (OR 1.59, 95% CI 1.10–2.29; P = 0.013) and duration of treatment was positively associated with treatment response (P = 0.039). A daily dose >0.5 μg/kg bwt was less likely to be associated with a reduction in ACTH concentration (OR 0.86, 95% CI 0.77–0.96; P = 0.009). Native breeds, mini and draught horses were more likely to return to the reference range than other breeds (OR 1.6, 95% CI 1.24–2.07; P<0.001). Neither gender nor season were associated with response to treatment.Conclusions and practical significancePergolide is an effective means of reducing ACTH concentration in equids with PPID.Ethical animal researchNot required by this Congress: retrospective clinical study. Sources of funding: None. Competing interests: Rendle and Durham have acted as paid speakers and consultants for Boehringer Ingelheim, manufacturers of Prascend, the licensed equine pergolide product.
On the slope of the fatigue resistance curve for laser stake‐welded T‐joints
Authors: Frank Darko , Remes Heikki , Romanoff Jani 
Published: September 2013

ABSTRACTThe paper investigates the influence of highly localised stress distribution around the notch tips of the laser stake‐welded T‐joints to the slope of the fatigue resistance curve. The study considers experimental data of eight series involving joints under tension or bending loads. Various boundary conditions and plate thicknesses are considered. The stress distribution in the singularity‐dominated zone ahead of the notch tips is investigated by means of the finite element analysis. The aim is to relatively distinguish the stress distribution from one case to another. The growth rate of the elastic singular stress with respect to the distance from the tip is described by the dimensionless gradient. This gradient is equal to the slope of the linear stress‐distance function when presented in double‐logarithmic scale. The slope of the fatigue resistance curve varies approximately from 4 to 8. It is observed that the change of the slope can be closely associated with the gradient of the maximum principal stress evaluated in the plane that is orthogonal to the crack path. The orthogonal plane corresponds to the maximum principal stress direction. In contrast, there is a large scatter in the relation between the slope and the gradient evaluated in the commonly assumed crack plane. The study shows that the dimensionless gradient exhibits sensitivity towards plate thicknesses, local weld geometry and the loading condition.
Effects of Marine Overwash for Atoll Aquifers: Environmental and Human Factors
Authors: Bailey Ryan T. , Jenson John W. 
Published: September 2013

AbstractInundation of atoll islands by marine overwash is a serious threat to fresh groundwater, which can be a critical emergency water resource after artificial storage or other water resource infrastructure has been exhausted or destroyed. In contrast to drought, which slowly exhausts water supplies and often can be forecasted in time, overwash can occur with little warning and can ruin both rain catchment storage and groundwater reserves. In this study, a SUTRA‐based model is applied to estimate how groundwater contamination by overwash and subsequent recovery of fresh groundwater are influenced by geologic factors (aquifer hydraulic conductivity, dispersivity, and the presence or absence of a reef flat plate), the seasonal timing of the event (wet vs. dry), and the presence of hand‐dug wells that penetrate the reef flat plate. Actual tidal and rainfall data from regions in the western Pacific are applied to simulated 30‐month recovery periods for hypothetical islands with properties and conditions characteristic of the western Pacific. For all scenarios, results indicate that 12 to 16 months are required to achieve 60% recovery of fresh groundwater. However, the time required to restore useful quantities of groundwater to acceptable salt concentration at depths typical of hand‐dug wells is only 3 to 6 months. Of particular interest is the influence of the reef flat plate, which acts as a barrier to infiltrating seawater, thus preserving a pocket of confined freshwater during an overwash event and the recovery, which could probably be utilized if the necessary tools and equipment are on hand.
Factor VIII concentrate infusion in patients with haemophilia results in decreased von Willebrand factor and ADAMTS‐13 activity
Authors: van Bladel E. R. , Tuinenburg A. , Roest M. , de Groot P. G. , Schutgens R. E. G. 
Published: September 2013

SummaryThe effects of coagulation factor concentrate infusion on restoring secondary haemostasis in patients with haemophilia are obvious. It is not known whether coagulation factor concentrate infusion affects primary haemostasis or induces an acute inflammatory response. In this study, the influence of a factor VIII (FVIII) concentrate bolus infusion on platelet activation and responsiveness, endothelial activation, and inflammation in adult patients with severe haemophilia A was assessed. VWF showed a mild, but significant decrease 15 min after FVIII infusion (85.02 IU dL−1) vs. before infusion (92.04 IU dL−1; P = 0.017), while ADAMTS‐13 levels also show a mild but significant decrease from 66.1 ng mL−1 before infusion, to 53.9 ng mL−1 (P = 0.012) 15 min after and 50.8 ng mL−1 (P = 0.050) 60 min after infusion. Platelet P‐selectin expression decreased 15 min (33.3 AU) and 60 min (38.7 AU) after infusion compared to before infusion (41.3 AU; P = 0.018 and 0.036). In conclusion, a single infusion of a high dose FVIII concentrate in haemophilia A patients may influence primary haemostasis by decreasing VWF, ADAMTS‐13 and the number of circulating activated platelets. These effects possibly occur as a consequence of binding of the infused FVIII to VWF, influencing its processing. When treating severe haemophilia A patients with coagulation concentrate infusion, one should realize this does not merely correct FVIII levels but also may influence primary haemostasis.