bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to Learn Pulmonary Vein Isolation with a Novel Ablation Device: Learning Curve Effects Using the Endoscopic Ablation System
Authors: PERROTTA LAURA , BORDIGNON STEFANO , DUGO DANIELA , FÜRNKRANZ ALEXANDER , CHUN KR JULIAN , SCHMIDT BORIS 
Published: July 2014

Learning Curve of Laser Balloon PVIIntroductionNovel ablation devices for pulmonary vein isolation (PVI) need a careful evaluation of its efficacy and safety beyond clinical studies in a real world situation. The endoscopic ablation system (EAS) was recently approved for PVI in Europe.We sought to determine the safety, efficacy, and learning curve effects of EAS‐PVI in a large volume single center.Methods and ResultsBetween June 2010 and March 2013, all EAS guided PVI procedures were analyzed and 150 consecutive patients were divided in tertiles (T). Clinical follow‐up of 12 months assessed freedom from atrial fibrillation (AF) using 72 hour‐Holter ECG recordings.In total, 497 of 583 PVs (85%) were isolated by visual guidance only. In T 2 and T 3, visually guided PVI rates increased from 73% to 91% (P < 0.001). After gap mapping, 96% and 99% of all PVs were isolated in T 1–3, respectively (P = 0.018). Total procedure and fluoroscopy time significantly declined over time. All major periprocedural complications occurred in the first T. In 3 patients (2 in 1st and 1 in 2nd T), phrenic nerve palsy was observed (2%).At 12‐months follow‐up, 103 of 133 patients (77%) remained in stable sinus rhythm without significant differences between Ts.ConclusionWith EAS even first time users may achieve acute PVI in a high number of patients with favorable clinical outcomes after 1 year. Yet, acute procedural efficacy and safety are further improved after passing a learning curve of 50 patients.
Anatomic Relationships Between the Coronary Venous System, Surrounding Structures, and the Site of Origin of Epicardial Ventricular Arrhythmias
Authors: CARRIGAN THOMAS P. , PATEL SMITA , YOKOKAWA MIKI , SCHMIDLIN ERIC , SWANSON SCOTT , MORADY FRED , BOGUN FRANK 
Published: July 2014

Epicardial VTBackgroundEpicardial left ventricular (LV) idiopathic ventricular arrhythmias (VAs) can be approached via the pericardial space, the coronary venous system (CVS), or other surrounding structures. The anatomic relationships between epicardial sites of origin (SOO) of VAs and surrounding anatomic structures have not been systematically described.Methods and ResultsIn 17 patients with idiopathic epicardial VAs, the relationships between the SOO and the CVS and other neighboring anatomic structures were assessed by computed tomographic angiography. Ablation was successful in 12/17 patients (71%). In 10/17 patients, the SOO was at a distance of ≤4 mm from a coronary artery. The SOO was closer to the CVS (2.1 ± 1.5 mm) than to the pericardial space (9.7 ± 3.7 mm) or the LV endocardium (7.7 ± 2.7 mm). Successful ablations were carried out from the CVS (n = 3), the CVS and LV endocardium (n = 5), the CVS and the aortic cusp (n = 1), the CVS, the LV endocardium, and the aortic cusp (n = 1), the LV endocardium (n = 1), and the CVS and the pericardial space (n = 1). In the remaining 5 patients, a subxyphoid pericardial ablation procedure was attempted and failed in all 5 patients.ConclusionThe CVS is closer to the SOO of epicardial idiopathic VAs than the pericardial space, the ventricular endocardium, and the aortic cusps. Given the proximity to coronary arteries at the SOO, radiofrequency energy often cannot be safely delivered to eliminate a VA and ablation may also need to be performed from adjacent structures. A subxyphoid pericardial ablation procedure has a low probability of success in patients with idiopathic epicardial VAs.
Left Renal Nerves Stimulation Facilitates Ischemia‐Induced Ventricular Arrhythmia by Increasing Nerve Activity of Left Stellate Ganglion
Authors: HUANG BING , YU LILEI , SCHERLAG BENJAMIN J. , WANG SONGYUN , HE BO , YANG KANG , LIAO KAI , LU ZHIBING , HE WENBO , ZHANG LING , PO SUNNY S. , JIANG HONG 
Published: July 2014

Renal Sympathetic Nerves and Ventricular ArrhythmiasIntroductionRenal sympathetic nerve (RSN) activity plays a key role in systemic sympathetic hyperactivity. Previous studies have shown that cardiac sympathetic hyperactivity, especially the left stellate ganglion (LSG), contributes to the pathogenesis of ventricular arrhythmias (VAs) after acute myocardial infarction (AMI).Methods and ResultsTwenty‐eight dogs received 3 hours of continuous left‐sided electrical stimulation of RSN (LRS; Group‐1, n = 9), sham RSN stimulation (Group‐2, n = 9), or LSG ablation plus 3 hours of LRS (Group‐3, n = 10) were included. AMI was induced by ligating the proximal left anterior descending coronary artery. LRS was performed using electrical stimulation on the adventitia of left renal artery at the voltage increasing the systolic blood pressure (BP) by 10%. BP, heart rate variability (HRV), serum norepinephrine (NE) level, and LSG function were measured at baseline and the end of each hour of LRS. C‐fos and nerve growth factor (NGF) protein expressed in the LSG were examined in Group‐1 and Group‐2. Compared with baseline, 3 hours of LRS induced a significant increase in BP, sympathetic indices of HRV, serum NE level, and LSG function. The incidence of VAs in Group‐1 was significantly higher than other groups. The expression of c‐fos and NGF protein in the LSG was significantly higher in Group‐1 than Group‐2.ConclusionThree hours of LRS induces both systemic and cardiac sympathetic hyperactivity and increases the incidence of ischemia‐induced VAs.
The Association Between ICD Interventions and Mortality is Independent of their Modality: Clinical Implications
Authors: BENCARDINO GIANLUIGI , DI MONACO ANTONIO , RIO TERESA , FRONTERA ANTONIO , SANTANGELI PASQUALE , LEO MILENA , PELARGONIO GEMMA , PERNA FRANCESCO , NARDUCCI MARIA LUCIA , GABRIELLI FRANCESCA , LANZA GAETANO ANTONIO , BELLOCCI FULVIO , REBUZZI ANTONIO , CREA FILIPPO 
Published: July 2014

ICD Interventions and MortalityBackgroundPatients with severe structural heart disease have increased mortality after implantable cardioverter‐defibrillator (ICD) shocks. Whether this is limited to ICD shock therapy only or extends also to no‐shock therapies, such as antitachycardia pacing (ATP), is unclear. We investigated the impact of different ICD therapies on long‐term mortality.MethodsWe enrolled 573 patients who underwent ICD implantation at our institution from 2004 to 2011. The population was divided into 3 groups: no device interventions (group 1), ATP interventions (group 2), and shock interventions (group 3). The endpoint was the all‐cause mortality.ResultsOver a follow‐up period of 48 months (range 1–110), 447 (78%) had no device interventions, 71 (12%) had ATP therapy only, and 55 (10%) had at least one shock intervention. All‐cause mortality occurred in 94 patients in group 1 (21%), 23 patients (43%) in group 2, and 21 patients (38%) in group 3. At multivariable Cox regression analysis, ATP intervention (HR: 1.8; 95% CI 1.1–3; P < 0.001), shock intervention (HR: 1.39; 95% CI 1.09–1.77; P = 0.008), age (HR: 1.05; 95% CI 1.02–1.07; P < 0.001), and LVEF (HR: 0.95; 95% CI 0.93–0.98; P = 0.001) were predictors of all‐cause mortality. No significant difference in mortality was found between group 2 and 3.ConclusionPatients with ICDs who receive appropriate interventions are at increased risk of mortality. Such risk is not dependent on different types of ICD therapy, such as shocks or ATP. Our data suggest that sustained ventricular arrhythmias per se have a negative impact on prognosis rather than modality of ICD therapy.
Energy Use and Greenhouse Gas Emissions of Air‐Source Heat Pump and Innovative Ground‐Source Air Heat Pump in a Cold Climate
Authors: Mattinen Maija K. , Nissinen Ari , Hyysalo Sampsa , Juntunen Jouni K. 
Published: July 2014

SummaryThis article compares climate impacts of two heat‐pump systems for domestic heating, that is, energy consumption for space heating of a residential building. Using a life cycle approach, the study compared the energy use and greenhouse gas (GHG) emissions of direct electric heating, a conventional air‐source heat pump, and a novel ground‐source air heat pump innovated by a citizen user, to assess whether such user innovation holds benefit. The energy use of the heat pumps was modeled at six temperature intervals based on duration curves of outdoor temperature. Additionally, two heat pump end‐of‐life scenarios were analyzed. Probabilistic uncertainty analysis was applied using a Monte Carlo simulation. The results indicated that, in ideal conditions, that is, assuming perfect air mixing, the conventional air‐source heat pump's emissions were over 40% lower and the ground‐air heat pump's emissions over 70% lower than in the case of direct electric heating. Although proper handling of the refrigerant is important, total leakage from the retirement of the heat‐pump appliance would increase GHG emissions by just 10%. According to the sensitivity analysis, the most influential input parameters are the emission factor related to electricity and the amount of electricity used for heating.
Eco‐efficiency Based on Social Performance and its Relationship with Financial Performance
Authors: Suh Yongyoon , Seol Hyeonju , Bae Hyerim , Park Yongtae 
Published: July 2014

SummaryAs corporate responsibility for environmental management has gained attention, eco‐efficiency has become recognized as an important concept for improving the social performance of the business sector as well as that of the public sector. Improving eco‐efficiency is widely accepted not only as a means of increasing economic value, but also as a means of reducing environmental effects. However, managing for eco‐efficiency should take into consideration the differences among industries, because the impact of eco‐efficiency on financial and social performance varies among industries. To explore this variation, we conducted a cross‐industry analysis of eco‐efficiency based on social performance using data envelopment analysis (DEA). DEA measures relative efficiency and is a useful tool for taking into account the relative importance of industry‐specific characteristics. Using DEA, eco‐efficiency scores were derived based on the ratio of two factors of social performance: (1) value‐added inducing and production‐inducing economic spillover effects and (2) the amount of greenhouse gases emitted and energy used. Then, we identified the relationships between our eco‐efficiency score and financial performance, which is a measure of the firm's stability. The case study is based on 272 firms in 16 industries in South Korea. Results show that firms in product manufacturing and service‐intensive industries tend to have higher eco‐efficiency scores than those in raw material or chemical‐intensive industries. In addition, most of the industries reveal no relationship between traditional financial performance metrics and eco‐efficiency scores. A handful of industries had significant relationships with one or more financial performance metrics; in some cases, these relationships were negative, whereas in others they were positive. Surprisingly, almost all industries have no significant relationships between eco‐efficiency and financial performance. This result implies that government support for policies that reward firms that attempt to be eco‐efficient are needed, or that other nonfinancial metrics that influence eco‐efficiency, such as employment and brand reputation, should be considered. This article is expected to support policy makers as they formulate industry‐specific environmental strategies.
Cannabinoid receptor 1 modulates the autophagic flux independent of mTOR‐ and BECLIN1‐complex
Authors: Hiebel Christof , Kromm Tanja , Stark Marcel , Behl Christian 
Published: July 2014

AbstractCannabinoid Receptor 1 (CB1) has been initially described as the receptor for Delta‐9‐Tetrahydrocannabinol in the central nervous system (CNS), mediating retrograde synaptic signaling of the endocannabinoid system. Beside its expression in various CNS regions, CB1 is ubiquituous in peripheral tissues, where it mediates, among other activities, the cell's energy homeostasis. We sought to examine the role of CB1 in the context of the evolutionarily conserved autophagic machinery, a main constituent of the regulation of the intracellular energy status. Manipulating CB1 by siRNA knockdown in mammalian cells caused an elevated autophagic flux, while the expression of autophagy‐related genes remained unaltered. Pharmacological inhibition of CB1 activity using Rimonabant likewise caused an elevated autophagic flux, which was independent of the mammalian target of rapamycin complex 1, a major switch in the control of canonical autophagy. In addition, knocking down coiled‐coil myosin‐like BCL2‐interacting protein 1, the key‐protein of the second canonical autophagy control complex, was insufficient to reduce the elevated autophagic flux induced by Rimonabant. Interestingly, lysosomal activity is not altered, suggesting a specific effect of CB1 on the regulation of autophagic flux. We conclude that CB1 activity affects the autophagic flux independently of the two major canonic regulation complexes controlling autophagic vesicle formation.
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Regulation of the autophagic flux in certain physiological situations such as an imbalance of nutrient supply as well as in pathological stages is of major importance for neuronal and non‐neuronal cells. CB1 (Cannabinoid receptor 1) affects the metabolism of cells directly. In this study, we provide evidence that CB1 signaling has a direct influence on autophagy which might help the cell to find the right adjustment to different metabolic states and CB1 activity exerts its modulatory action independent of the canonical mTOR‐ and BECLIN1‐complexes regulating autophagy.
Anti‐inflammatory effect of 635 nm irradiations on in vitro direct/indirect irradiation model
Authors: Lim WonBong , Choi Hongran , Kim Jisun , Kim Sangwoo , Jeon SangMi , Zheng Hui , Kim DoMan , Ko Youngjong , Kim Donghwi , Sohn HongMoon , Kim OkJoon 
Published: July 2014

Low‐level laser therapy (LLLT) has been promoted for its beneficial effects on tissue healing and pain relief. As during laser treatment it is possible to irradiate only a small area of the surface body or wound and, correspondingly, of a very small volume of the circulating blood, it is necessary to explain how its photomodification can lead to a wide spectrum of therapeutic effects. To establish the experimental model for indirect irradiation, irradiation with 635 nm was performed on immortalized human gingival fibroblasts (IGFs) in the presence of Porphyromonas gingivalis lipopolysaccharides (LPS). The irradiated medium was transferred to non‐irradiated IGFs which were compared with direct irradiated IGFs. The protein expressions were assessed by Western blot, and prostaglandin E2 (PGE2) was measured using an enzyme‐linked immunoassay. Reactive oxygen species (ROS) were measured by DCF‐DA; cytokine profiles were assessed using a human inflammation antibody array. Cyclooxygenase‐2 (COX‐2) protein expression and PGE2 production were significantly increased in the LPS‐treated group and decreased in both direct and indirect irradiated IGFs. Unlike direct irradiated IGFs, ROS level in indirect irradiated IGFs was decreased by time‐dependent manners. There were significant differences of released granulocyte colony‐stimulating factor (G‐CSF), regulated on activated normal T‐cell expressed and secreted (RANTES), and I‐TAC level observed compared with direct and indirect irradiated IGFs. In addition, in the indirect irradiation group, phosphorylations of C‐Raf and Erk1/2 increased significantly compared with the direct irradiation group. Thus, we suggest that not only direct exposure with 635 nm light, but also indirect exposure with 635 nm light can inhibit activation of pro‐inflammatory mediators and may be clinically useful as an anti‐inflammatory tool.
Activation of TLR9‐dependent p38MAPK pathway in the pathogenesis of primary Sjögren's syndrome in NOD/Ltj mouse
Authors: Shi Huan , Yu Chuang‐Qi , Xie Li‐Song , Wang Zhi‐Jun , Zhang Ping , Zheng Ling‐Yan 
Published: July 2014

ObjectiveThe objective of this study was to investigate the potential role of Toll‐like receptor 9‐dependent p38 MAPK signaling pathway in the pathogenesis of primary Sjögren's syndrome (pSS) in NOD/Ltj mouse, aiming to identify an ideal target therapy model for human pSS.MethodsNOD/Ltj mice were chosen as a model of pSS. The Toll‐like receptor 9 and p‐p38 MAPK double‐positive peripheral blood mononuclear cells (PBMCs) of 4‐, 5‐, 8‐, 10‐, and 15‐week‐old NOD/Ltj mouse were analyzed by flow cytometry. The expressions of Toll‐like receptor 9 and p‐p38 MAPK in the submandibular gland (SMG) were also examined by immunohistochemistry. The change of stimulated salivary flow rate was dynamically measured, and the histopathology of SMG was evaluated by hematoxylin and eosin stain.ResultsThe stimulated salivary flow rate in NOD/Ltj was reduced to 50–60% of the flow rate of control mice since the fifth week onwards. The Toll‐like receptor 9 and p‐p38 MAPK double‐positive PBMCs in both groups increased gradually from 5 weeks, peaked at 8 weeks and then gradually decreased at 10 weeks, yet the percentage of Toll‐like receptor 9 and p‐p38MAPK double‐positive PBMCs in 5‐, 8‐, and 10‐week‐old NOD/Ltj mouse was significantly increased compared with those in control subjects. After the 10th week onwards, there were no significant differences in the Toll‐like receptor 9 and p‐p38 MAPK double‐positive PBMCs between NOD/Ltj mice and controls. Immunohistochemical staining showed that Toll‐like receptor 9 was positive in the acinar epithelium cells and infiltrating lymphocytes in NOD/Ltj mice. p‐p38 MAPK was detected in infiltrating lymphocytes and few ductal or acinar epithelium cells adjacent to infiltrating lymphocytes in NOD/Ltj mice.ConclusionsFrom the fifth week till the tenth week, Toll‐like receptor 9 and p‐p38 MAPK double‐positive PBMCs were significantly increased in NOD/Ltj mice, accompanied with reduced stimulated salivary flow rate and Toll‐like receptor 9 or p‐p38 MAPK positive infiltrating lymphocytes observed in the SMG of NOD/Ltj mouse. Our results indicated that activation of Toll‐like receptor 9‐depended p38 MAPK signal pathway in PBMCs was an early event in pSS which made NOD/Ltj as an ideal therapy model to test the treatment effects of p38 MAPK or Toll‐like receptor 9 inhibitors on pSS.
Localized juvenile spongiotic gingival hyperplasia featuring unusual p16INK4A labeling and negative human papillomavirus status by polymerase chain reaction
Authors: Argyris Prokopios P. , Nelson Andrew C. , Papanakou Styliani , Merkourea Stavroula , Tosios Konstantinos I. , Koutlas Ioannis G. 
Published: July 2014

BackgroundLocalized juvenile spongiotic gingival hyperplasia (LJSGH) is a distinct type of gingival hyperplastic lesion with specific clinicopathologic features. Evaluation of the morphological characteristics of LJSGH indicates the potential role of human papillomavirus (HPV) infection as an underlying etiopathogenetic mechanism.MethodsAll cases of LJSGH from 2008 to present were retrieved. Clinical and demographic data were collected. HPV status was investigated by p16INK4A immunohistochemistry and HPV‐Polymerase chain reaction (PCR).ResultsTwenty‐one cases of LJSGH were identified, 14 (66.7%) affecting males and seven (33.3%) females (M:F = 2:1, age range: 8–36, mean: 13 years). All lesions were well‐demarcated, exophytic, erythematous, and hemorrhagic with granular or slightly papillary surface. Preponderance for the maxillary gingiva (19, 90.5%) was observed. Two (9.5%) patients presented with recurrence 20 and 21 months after excision (mean follow‐up: 18.7 months). Histopathologically, all LJSGH lesions featured epithelial hyperplasia with intense neutrophilic exocytosis and spongiosis. All cases demonstrated positivity for p16INK4A with the majority of specimens (47.6%) intensely decorated in >50% of the overlying epithelium with focal immunostaining observed in 47.6% and diffuse in 52.4%. Thirteen cases (61.9%) were negative for HPV DNA by PCR, while two (9.5%) were suspicious for the presence of low levels of HPV DNA but definitive genotyping was not possible. One case (4.8%) displayed positivity for HPV‐31. The remaining five cases failed the PCR reaction.ConclusionsHuman papillomavirus does not participate in the pathogenesis of LJSGH. P16INK4A expression in the absence of detectable HPV DNA can likely be attributed to the intense inflammation associated with LJSGH.
THE RENAL PATIENT SUPPORT GROUP: SUPPORTING PATIENTS WITH CHRONIC KIDNEY DISEASE THROUGH SOCIAL MEDIA
Authors: Muhammad Shahid , Allan Michelle , Ali Filson , Bonacina Magda , Adams Meshia 
Published: July 2014

SUMMARYBackgroundThe Renal Patient Support Group (RPSG) is a voluntary Facebook group that was developed in 2009 in the UK. The RPSG now has in excess of 5000 members.ObjectiveTo highlight the work of the RPSG and to describe how the use of social media has helped raise awareness of chronic kidney disease (CKD). The RPSG offers online peer support internationally, with members sharing their experiences.MethodsSince the RPSG is mainly a Facebook platform, this medium has lent itself to raising CKD awareness, also allowing group members to share real‐life stories.ConclusionThe RPSG continues to expand and invites health professionals to gain opportunities provided by social media networks to improve the health of their patients by facilitating and getting involved in ‘real’ discussions.
The effects of nutrition‐induced abnormal food metabolism in the Southern Plains woodrat (Neotoma micropus): comparisons of variations of the Western diet
Authors: Post D. M. , Hawkins B. L. , Eldridge J. A. 
Published: July 2014

SummaryWe investigated the effects of several modifications of the Western diet on a medium‐sized rodent, Neotoma micropus, that lives in the area of the wildland‐urban interface. We conducted a laboratory study of the response of N. micropus to high fat‐high fructose (HFHF), high fat‐high sucrose (HFHS), high fat‐low sugar (HFLSu) and control (low fat‐low sugar) diets. We found a significant increase in hepatic lipid deposition and a significant decrease in podocytes in those animals that consumed the HFHF and HFLSu diets compared to those on the HFHS and control diets. We found no significant differences in Bowman's space or hepatic collagen formation. We predict that N. micropus in the wild, with access to anthropogenic resources, will show similar effects as a result of the consumption of anthropogenic resources.