bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Connexin Expression and Gap–Junction Resistivity in Human Atrial Myocardium
Authors: Dhillon Paramdeep S. , Chowdhury Rasheda A. , Patel Pravina M. , Jabr Rita , Momin Aziz U. , Vecht Joshua , Gray Rosaire , Shipolini Alex , Fry Christopher H. , Peters Nicholas S. 
Published: March 2014

Background—
The relative roles of the gap-junctional proteins connexin40 (Cx40) and connexin43 (Cx43) in determining human atrial myocardial resistivity is unknown. In addressing the hypothesis that changing relative expression of Cx40 and Cx43 underlies an increase in human atrial myocardial resistivity with age, this relationship was investigated by direct ex vivo measurement of gap-junctional resistivity and quantitative connexin immunoblotting and immunohistochemistry.

Methods and Results—

Oil-gap impedance measurements were performed to determine resistivity of the intracellular pathway (
R
i
), which correlated with total Cx40 quantification by Western blotting (r
s
=0.64,
P
<0.01, n=20). Specific gap-junctional resistivity (
R
j
) correlated not only with Western immunoquantification of Cx40 (r
s
=0.63,
P
=0.01, n=20), but also more specifically, with the Cx40 fraction localized to the intercalated disks on immunohistochemical quantification (r
s
=0.66,
P
=0.02, n=12). Although Cx43 expression showed no correlation with resistivity values, the proportional expression of the 2 connexins, (Cx40/[Cx40+Cx43]) correlated with
R
i
and
R
j
(r
s
=0.58,
P
<0.01 for
R
i
and r
s
=0.51,
P
=0.02 for
R

j

). Advancing age was associated with a rise in
R
i
(r
s
=0.77,
P
<0.0001),
R
j
(r
s
=0.65,
P
<0.001, n=23), Cx40 quantity (r
s
=0.54,
P
=0.01, n=20), and Cx40 gap–junction protein per unit area of en face disk (r
s
=0.61,
P
=0.02, n=12).

Conclusions—
Cx40 is associated with human right atrial gap-junctional resistivity such that increased total, gap-junctional, and proportional Cx40 expression increases gap-junctional resistivity. Accordingly, advancing age is associated with an increase in Cx40 expression and a corresponding increase in gap-junctional resistivity. These findings are the first to demonstrate this relationship and a mechanistic explanation for changing atrial conduction and age-related arrhythmic tendency.
Net Clinical Benefit of Warfarin Therapy in Elderly Chinese Patients With Atrial Fibrillation
Authors: Siu Chung-Wah , Tse Hung-Fat 
Published: March 2014

Background—
Little is known about the net clinical benefit of warfarin therapy in elderly patients with atrial fibrillation.

Methods and Results—

We studied 2339 Chinese patients with nonvalvular atrial fibrillation aged ≥80 years: 1805 with no antithrombotic therapy and 534 on warfarin therapy. Patients were stratified according to their CHA
2
DS
2
-VASc and HAS-BLED score. The primary end point was a composite of hospital admission with ischemic stroke or death. After 2.2-year follow-up (5199 patient-years), a primary end point had occurred for 1861 patients (79.6%): 66.9% in patients on warfarin (66.9%) compared with 80.8% in patients with no antithrombotic therapy (80.8%; hazard ratio, 0.53; 95% confidence interval, 0.48–0.58;
P
<0.001). This was related to substantially better mortality rate (hazard ratio, 0.40; 95% confidence interval, 0.37–0.45;
P
<0.0001) and ischemic stroke rate (hazard ratio, 0.64; 95% confidence interval, 0.54–0.77;
P
<0.0001) among patients on warfarin. For the net clinical benefit, 510 ischemic strokes and 42 intracranial hemorrhage were recorded. The annual incidence of ischemic stroke and intracranial hemorrhage was 11.3%/y and 0.6%/y, respectively, in patients prescribed no antithrombotic therapy and 7.1%/y and 1.1%/y, respectively, in those prescribed warfarin. The adjusted net clinical benefit favored warfarin for all elderly patients, and the best net benefit from warfarin was in those with high stroke and intracranial hemorrhage risk. In these high-risk patients, warfarin therapy was associated with 7.2 to 8.0 fewer events per 100 patient-years compared with no antithrombotic therapy.

Conclusions—
In elderly patients with atrial fibrillation, warfarin therapy is associated with lower death and ischemic stroke and an overall net clinical benefit.
Comparison of the First and Second Cryoballoon
Authors: Straube Florian , Dorwarth Uwe , Schmidt Martin , Wankerl Michael , Ebersberger Ulrich , Hoffmann Ellen 
Published: March 2014

Background—
Cryoballoon (CB) ablation results in >70% freedom from atrial fibrillation at 1 year. Single-center data of the first (CBG1) and second (CBG2) cryoballoon, recently introduced, were analyzed to compare safety and efficacy.

Methods and Results—

From March 2011 to December 2012, CB ablation with spiral mapping was performed consecutively in 484 patients with symptomatic atrial fibrillation. CBG1 was used in 364 of 484 (75%) and CBG2 in 120 of 484 (25%) patients. Periprocedural data were analyzed. Acute pulmonary vein (PV) isolation with CB only was achieved in 99.86% and 100% of veins with CBG1 and CBG2, respectively (
P
=0.43). Number of applications until PV isolation decreased significantly with CBG2 (1.45±0.81 versus 1.28±0.64;
P
=0.001). Procedural, left atrial, and fluoroscopy time were reduced by −5%, −11%, and −15% (
P
<0.05), respectively. Two balloons were used less frequently. Time to isolation decreased significantly with 23-mm (48 versus 33 seconds;
P
<0.0001) and 28-mm CBG2 (76 versus 52 seconds;
P
<0.0001). Early PV reconduction rarely occurred with CBG2 (2.6% versus 0.42%;
P
=0.0023). In-hospital atrial fibrillation recurrence rates were similar. Balloon temperatures were significantly warmer with 23-mm CBG2 and a trend for colder balloon temperature with 28-mm CBG2 were observed compared with their predecessors. Comparable low rates of phrenic nerve palsy were recorded (1.1% versus 1.7%;
P
=0.64). Esophageal temperatures were similar. Major complication rates were low (3.3% versus 3.33%;
P
=1.0).

Conclusions—
CBG2 attains high rates of acute PV isolation within a significant faster and less complex procedure. Time to isolation is shorter, and PV isolation is achieved with fewer applications using CBG2. These enhancements were not at the cost of complications. Long-term success rates remain to be demonstrated.
Public Health Burden of Sudden Cardiac Death in the United States
Authors: Stecker Eric C. , Reinier Kyndaron , Marijon Eloi , Narayanan Kumar , Teodorescu Carmen , Uy-Evanado Audrey , Gunson Karen , Jui Jonathan , Chugh Sumeet S. 
Published: March 2014

Background—
Sudden cardiac death (SCD) is a leading cause of death in the United States, but the relative public health burden is unknown. We estimated the burden of premature death from SCD and compared it with other diseases.

Methods and Results—
Analyses were based on the following data sources (using most recent sources that provided appropriately stratified data): (1) leading causes of death among men and women from 2009 US death certificate reporting; (2) individual cancer mortality rates from 2008 death certificate reporting from the Centers for Disease Control and Prevention’s National Program of Cancer Registries; (3) county, state, and national population data for 2009 from the US Census Bureau; and (4) SCD rates from the Oregon Sudden Unexpected Death Study (SUDS) population-based surveillance study of SCD between 2002 and 2004. Cases were identified from multiple sources in a prospectively designed surveillance program. Incidence, counts, and years of potential life lost for SCD and other major diseases were compared. The age-adjusted national incidence of SCD was 60 per 100 000 population (95% confidence interval, 54–66 per 100 000). The burden of premature death for men (2.04 million years of potential life lost; 95% uncertainty interval, 1.86–2.23 million) and women (1.29 million years of potential life lost; 95% uncertainty interval, 1.13–1.45 million) was greater for SCD than for all individual cancers and most other leading causes of death.

Conclusions—
The societal burden of SCD is high relative to other major causes of death. Accordingly, improved national surveillance with the goal of optimizing and monitoring SCD prevention and treatment should be a high priority.
Neurological, Functional, and Cognitive Stroke Outcomes in Mexican Americans
Authors: Lisabeth Lynda D. , Sánchez Brisa N. , Baek Jonggyu , Skolarus Lesli E. , Smith Melinda A. , Garcia Nelda , Brown Devin L. , Morgenstern Lewis B. 
Published: March 2014

Background and Purpose—
Our objective was to compare neurological, functional, and cognitive stroke outcomes in Mexican Americans (MAs) and non-Hispanic whites using data from a population-based study.

Methods—
Ischemic strokes (2008–2012) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project. Data were collected from patient or proxy interviews (conducted at baseline and 90 days poststroke) and medical records. Ethnic differences in neurological (National Institutes of Health Stroke Scale: range, 0–44; higher scores worse), functional (activities of daily living/instrumental activities of daily living score: range, 1–4; higher scores worse), and cognitive (Modified Mini-Mental State Examination: range, 0–100; lower scores worse) outcomes were assessed with Tobit or linear regression adjusted for demographics and clinical factors.

Results—
A total of 513, 510, and 415 subjects had complete data for neurological, functional, and cognitive outcomes and covariates, respectively. Median age was 66 (interquartile range, 57–78); 64% were MAs. In MAs, median National Institutes of Health Stroke Scale, activities of daily living/instrumental activities of daily living, and Modified Mini-Mental State Examination score were 3 (interquartile range, 1–6), 2.5 (interquartile range, 1.6–3.5), and 88 (interquartile range, 76–94), respectively. MAs scored 48% worse (95% CI, 23%–78%) on National Institutes of Health Stroke Scale, 0.36 points worse (95% CI, 0.16–0.57) on activities of daily living/instrumental activities of daily living score, and 3.39 points worse (95% CI, 0.35–6.43) on Modified Mini-Mental State Examination than non-Hispanic whites after multivariable adjustment.

Conclusions—
MAs scored worse than non-Hispanic whites on all outcomes after adjustment for confounding factors; differences were only partially explained by ethnic differences in survival. These findings in combination with the increased stroke risk in MAs suggest that the public health burden of stroke in this growing population is substantial.
Neuroregeneration in the Nucleus Ambiguus After Recurrent Laryngeal Nerve Avulsion in Rats
Authors: Zhao Wan , Xu Wen , Yang Wei wei 
Published: March 2014

Objectives: The objective was to investigate neuroregeneration, the origins of newborn cells and the proliferation of neuronal and glial cells in the nucleus ambiguus (NA) after ipsilateral recurrent laryngeal nerve (RLN) avulsion. Methods: All of the animals received a CM-Dil injection in the left lateral ventricle. Forty-five adult rats were subjected to a left RLN avulsion injury, while 9 rats were used as controls. 5-Bromo-2-deoxyuridine (BrdU) was injected intraperitoneally. Neuron quantification and immunohistochemical analysis were performed in the brain stems at different time points after RLN injury. Results: After RLN avulsion, CM-Dil labeled neural progenitor cells (NPCs) migrated to the ipsilateral NA and differentiated into astrocytes but not into neurons. In the NA, the neuronal cells re-expressed nestin. Only a small number of neuronal and glial cells in the NA showed BrdU immunoreactivity. Conclusions: After RLN avulsion, the NPCs in the ependymal layer of the fourth ventricle or central canal are activated, migrate to the lesion in the NA and differentiate exclusively into astrocytes. The newborn neural stem cells in the NA may arise from the mature region neurons. The presence of both cell types in the NA may play a role in repairing RLN injuries.
Effectiveness of Domain-Based Intervention for Language Development in Japanese Hearing-Impaired Children
Authors: Sugaya Akiko , Fukushima Kunihiro , Kasai Norio , Ojima Toshiyuki , Takahashi Goro , Nakagawa Takashi , Murai Seiko , Nakajima Yasoichi , Nishizaki Kazunori 
Published: March 2014

Objective: Decreasing language delay in hearing-impaired children is a key issue in the maintenance of their quality of life. Language training has been presented mainly by experience-based training; effective intervention programs are crucially important for their future. The aim of this study was to confirm the efficacy of 6-month domain-based language training of school-age, severe-to-profound hearing-impaired children. Methods: We conducted a controlled before–after study involving 728 severe-to-profound prelingual hearing-impaired children, including an intervention group (n = 60), control group (n = 30), and baseline study group (n = 638). Language scores of the participants and questionnaires to the caregivers/therapists were compared before and after the intervention. Average monthly increase in each language score of the control group and baseline study group were compared with those of the intervention group. Results: Language scores and the results of the questionnaire of the intervention group showed a significant improvement ( P < .05). The average monthly language growth of the intervention group was twice that of the control group and 3 to 4 times that of the baseline study group ( P < .05). The effect size was largest in communication (1.914), followed by syntax (0.931). Conclusion: Domain-based language training improved the language development and daily communication of hearing-impaired children without any adverse effects.
Predicting refeeding hypophosphataemia: insulin growth factor 1 (IGF-1) as a diagnostic biochemical marker for clinical practice
Authors: Goyale Atul , Ashley Sarah L , Taylor David R , Elnenaei Manal O , Alaghband-Zadeh Jamshid , Sherwood Roy A , le Roux Carel W , Vincent Royce P 
Published: March 2014

Background Refeeding syndrome (RS) is a potentially fatal condition that can occur following the re-introduction of nutrition after a period of starvation. Hypophosphataemia following the reintroduction of nutrition is often the only reliable biochemical marker of RS. Refeeding index (RI) generated from baseline insulin-like growth factor-1 (IGF-1) and leptin has been proposed as a useful biochemical marker for the identification of patients at risk of developing refeeding hypophosphataemia (RH). Methods A prospective study included 52 patients referred for parenteral nutrition (PN). The sensitivity and specificity of IGF-1 measured using a sensitive assay was compared to the RI in predicting the development of RH (a ≥30% drop in PO4 during the first 36-h of PN administration). Leptin and IGF-1 were analysed on baseline samples using a quantitative enzyme-linked immunoassay. Daily blood samples were collected from all patients for routine biochemistry for the full duration of PN administration. Results High sensitivity IGF-1 measurement alone was comparable with the RI, using receiver–operating characteristic (ROC) curve analysis, with areas under the curve being 0.79 and 0.80, respectively, and superior to leptin alone (0.72) for predicting ≥30% drop in PO4. The cut-off value for IGF-1 that gave best sensitivity (91% [95% CI 75–98%]) and specificity (65% [95% CI 41–85%]) was 63.7 µg/L, with a likelihood ratio of 2.59. Conclusion Baseline IGF-1 is an objective, sensitive and specific biochemical marker in identifying patients who are at high risk of developing RH prior to PN administration and therefore may have a role in clinical practice.
The bipolar spectrum: Conceptions and misconceptions
Authors: Ghaemi S Nassir , Dalley Shannon 
Published: March 2014

Objective: This review aims to address concerns about the potential overinclusiveness and vagueness of bipolar spectrum concepts, and also, concerns about the overlap between bipolar illness and borderline personality. Method: Narrative review based on historical and empirical studies. Results: Bipolar disorder (BD) and major depressive disorder (MDD) came to be separate entities with the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III), in contrast to the Kraepelinian manic-depressive insanity (MDI) concept, which included both. The bipolar spectrum concept is a return to this earlier Kraepelinian perspective. Further, very different features differentiate the disease of bipolar illness (family history of bipolar illness, severe recurrent mood episodes with psychomotor activation) from the clinical picture of borderline personality (dissociative symptoms, sexual trauma, parasuicidal self-harm). The term ‘disorder’ obfuscates an ontological difference between diseases, such as manic-depressive illness, and clinical pictures, such as hysteria/post-traumatic stress disorder/dissociation/borderline personality. Conclusions: Bipolar spectrum concepts are historically rooted in Kraepelin’s manic-depressive illness concept, are scientifically testable, and can be clearly formulated. Further, they differ in kind from traumatic/dissociative conditions in ways that can be both historically and scientifically established.
Is there evidence that social class at birth increases risk of psychosis? A systematic review
Authors: Kwok Wingfai 
Published: March 2014

Background: In the 1950s, researchers showed an association between low socio-economic status (SES) and psychosis. Two competing theories social causation and social drift were proposed to explain the findings. In the intervening years, contrasting evidence emerged as some studies showed no association between SES and schizophrenia. At present, the nature of the relationship is still unclear; currently, there are no reviews in the literature examining the association between social class at birth and psychosis. Aim: To search the literature to clarify the relationship between social class at birth, measured by paternal occupation at birth, and the risk of adult-onset psychosis. Methods: A systematic search of the literature using a combination of keywords in Group 1 together with the keywords in Group 2 was performed in October 2012 in the following online databases: (a) MEDLINE (1946–2012), (b) PubMed, (c) Embase (1980–2012), (d) PsycINFO (1806–2012) and (e) Web of Science (1899–2012). Reference lists were also hand searched. The search provided 3,240 studies; following screening of the titles and abstracts by inclusion and exclusion criteria and quality assessment of the full text, 14 studies were identified to be appropriate for the review. The keywords used for the search were as follows: Group 1 – social class, social status, socioeconomic, socio-economic, SES; Group 2 – psychosis, psychoses, schizophrenia. Results: Seven studies showed an association between low SES and psychosis. Four studies showed no association, and three studies showed an association with high SES. Conclusion: There is not enough evidence to support the association between social class and psychosis. While some findings showed an association between low social class and psychosis, there were a number of conflicting studies showing no association or a link with higher social class. Interestingly, the results followed a temporal pattern, as all the studies conducted after 2001 supported an association between low SES at birth and psychosis. Four of the six studies employed a prospective design with large sample populations, indicating the need for further investigation.
Orbital tuberculosis in a paediatric population
Authors: Khurana Saurbhi , Pushker Neelam , Naik Sreedhara Shankara , Kashyap Seema , Sen Seema , Bajaj Mandeep S 
Published: March 2014

Purpose To report the clinical profile and management of orbital tuberculosis (TB) in children. Methods Eight cases were studied retrospectively. Results Ages in the range of 3–16 years. Three cases presented with discharging sinus in upper lid, three with a cystic mass and two with lid necrosis. Underlying bony changes were found in five patients. Drainage and curettage was done for five patients, needle drainage of fluid was done in one patient and in two patients local debridement was done. Polymerase chain reaction for tuberculosis was positive in four cases and acid fast bacilli (AFB) were isolated on culture in three cases. On histopathology, six cases had granulomatous inflammation with caseating necrosis in one, though AFB could not be found. A favourable response to anti-tubercular treatment was achieved in all cases. Conclusion High index of suspicion is required for diagnosis of orbital TB. Microbiological and pathological diagnosis may not be achieved in all cases.
Role of Human Papillomavirus in the Pathogenesis of Laryngeal Dysplasia
Authors: Pagliuca Giulio , Martellucci Salvatore , Degener Anna Marta , Pierangeli Alessandra , Greco Antonio , Fusconi Massimo , De Virgilio Armando , Gallipoli Camilla , de Vincentiis Marco , Gallo Andrea 
Published: March 2014

ObjectiveA synergistic effect between smoking and alcohol intake is the major cause of premalignant and malignant lesions of the larynx, but the risk factors and pathogenesis of the neoplastic transformation in nonsmokers remain poorly defined. The aim of this retrospective study is to establish the relationship between smoking habits and human papillomavirus (HPV) infection in laryngeal dysplasia.Study DesignCross‐sectional study.SettingAcademic university hospital.Subjects and MethodsHPV DNA was amplified from 30 paraffin‐embedded laryngeal dysplasia tissue specimens by the polymerase chain reaction using 2 groups of different consensus primers (MYO9/MY11 and LCRF1‐4, E7R1‐4). Fifteen samples were taken from smokers and 15 from nonsmokers.ResultsThe present investigation failed to demonstrate the HPV genome in all samples of laryngeal precancerous lesions, whereas HPV was detected in 4 laryngeal papilloma samples used as control to confirm the reliability of our method on paraffin‐embedded samples.ConclusionsAlthough the small number of cases in our series limits the power of our statistical analysis, the absence of viral genomes in the specimens analyzed in this study suggests the lack of a relationship between HPV infection and laryngeal dysplasia in smokers as well as in nonsmokers.
Understanding innovations in the evolving practice of blood and crystalloid cardioplegia
Authors: Bhakri KP , Mulholland J , Punjabi PP 
Published: March 2014

The use of cardioplegia solution has substantially increased the safety of cardiac surgery. It protects the myocardium by inducing a rapid and complete diastolic arrest, minimizing myocardial energy requirements, preventing ischaemic damage during the arrest phase and minimizing or preventing reperfusion injury once coronary blood flow is restored. This article is a summary of important information that has accumulated in the literature about cardioplegia and describes how our understanding of cardioplegia has evolved. The basic principles of myocardial ischaemia and reperfusion injury and how they relate to myocardial protection are described. Blood and crystalloid cardioplegia are compared with respect to biochemical and physiological differences. Recent patient demographic changes, with surgeons operating on older, more complex patients who have more severe and diffuse disease, are discussed. This cohort of patients potentially requires prolonged elective ischaemia; hence, improved myocardial protection would be of benefit. We highlight areas of study that have demonstrated a new concept of myocardial protection, known as polarized arrest. Many pharmacological agents have been shown (in experimental studies) to have the ability to induce a polarized arrest and to provide improved protection.