bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ophthalmic digital image transfer: benefits to triage, patient care and resource
Authors: Goudie Colin , Lunt David , Reid Suzanna , Sanders Roshini 
Published: September 2014

AbstractPurposeHospital capacity in the UK is currently significantly challenged due to new treatments, targets and resource limitations. There have been significant improvements in training, equipment and shared care services in community primary care optometry services. Despite this the challenges to ophthalmic service delivery are considerable. One area of potential benefit is the effect on outcome when a clinical image is attached to a referral. We aimed to quantify the effect of attaching digital images to ophthalmic referrals.MethodsRetrospective analysis of 358 consecutive optometry referrals to the Hospital Eye Service in Dunfermline, Scotland using electronic referral with digital images. All images were screened by consultant ophthalmologists.ResultsThe patients were aged between 9 and 100 years (mean age 63.6 years). Sixty four (18%) referrals were deemed urgent (requiring appointment within 24–60 h), with the majority, 28 (8%) being wet macular degeneration. One hundred and seventy (48%) were deemed routine (appointment within 2–6 weeks), with categories including macular disease, glaucoma, cataract, optic disc and retinal abnormalities. Twenty seven (8%) patients were already attending the hospital eye service, or had been referred previously for the same condition. Categories were mainly glaucoma, diabetic retinopathy and cataract. Ninety‐five (25%) were ‘e‐diagnosed’ based on image and referral information (i.e. with no secondary eye care appointment). Diagnosis included glaucoma suspect (22, 6%), macular pathology (12, 3%), abnormal looking discs (9, 2.5%) and cataract (9, 2.5%). The overall ‘did not attend’ rate for those patients seen in the hospital eye service (254) was <1% (two patients).ConclusionsThe attachment of digital images improved the quality of referral triaging from optometry to secondary eye care in the hospital eye service. It allowed detection of sight threatening disease early and more appropriate allocation of patients to specific specialist clinics at first visit. They allowed safe and speedy ‘e‐diagnosis’ of a subgroup, saving hospital capacity and minimising patient inconvenience. Indirectly the service also reduced the ‘did not attend’ rate. With recent improvements in camera and internet technology digital images will have an ever increasing role in secondary eye care as it continues to adapt to meet modern demands.
Successful Percutaneous Epicardial Access in Challenging Scenarios
Authors: EBRILLE ELISA , KILLU AMMAR M. , ANAVEKAR NANDAN S. , PACKER DOUGLAS L. , MUNGER THOMAS M. , MCLEOD CHRISTOPHER J. , ASIRVATHAM SAMUEL J. , FRIEDMAN PAUL A. 
Published: September 2014

BackgroundThis case‐series highlights strategies used for successful epicardial access in challenging cases.Percutaneous epicardial access has become a valuable tool for mapping and ablating arrhythmias. However, this technique can be especially difficult in certain circumstances and is frequently avoided.MethodsAll cases of epicardial access for ablation from our institution were reviewed searching for exceptionally difficult cases in patients with complex pericardial and thoracic anatomy. The successful strategies are characterized in this report.ResultsAmong 144 patients who underwent an epicardial ablation procedure between January 2004 and June 2013, four required unconventional approaches for epicardial access for ventricular tachycardia ablation. Two patients (one with previous cardiac surgery and one with prior pericardial effusion) had substantial fibrous pericardial adhesions with no virtual pericardial space and required adhesiolysis. One patient, status postpartial colectomy, underwent computed tomography‐guided intercostal epicardial access due to the presence of bowel throughout the subdiaphragmatic space in the upper abdomen. The fourth patient had partial congenital absence of the pericardium and underwent epicardial access through the creation of a subxiphoid window. All epicardial accesses were successful and performed without major complication.ConclusionsWith precise procedural planning and cardiac imaging, percutaneous epicardial access is feasible even in patients with significant anatomical challenges.
Population‐Based Single‐Center Outcome for Pediatric Catheter Ablation of Common Supraventricular Tachycardias
Authors: HIIPPALA ANITA , HAPPONEN JUHA‐MATTI 
Published: September 2014

BackgroundCatheter ablation has become the preferred treatment for common supraventricular tachycardia (SVT) in children and adolescents, but long‐term follow‐up data on pediatric patients remain limited.MethodsTo provide follow‐up data, we created a population‐based prospective pediatric catheter ablation registry in 1997. All patients underwent clinical follow‐up at 1 month and 1 year after the procedure. The follow‐up data were completed with a single questionnaire in 2010.ResultsOf 318 patients, 289 (91%) required one to three procedures for successful ablation. A total of 211 (66%) patients had an accessory pathway, 97 (31%) atrioventricular nodal reentrant tachycardia, and 10 (3%) atrial tachycardia. Two (0.6%) of the 318 patients had serious complications: the first had a complete atrioventricular block and required a pacemaker, while the second had a hemopericardium, which was treated with drainage. A successful ablation procedure was followed by a recurrence in 18 (6%) patients during childhood. In addition, two patients had atrial fibrillation and one had a focal atrial tachycardia as adults after a successful ablation procedure during childhood. Moreover, 12 (4%) patients, who had undergone a successful ablation, complained of increased heart rate after exercise compared to their status before the procedure.ConclusionIn our cohort study of 318 pediatric patients, with a mean follow‐up of 5 years, SVT ablation was successful for 91% of the patients. Arrhythmia recurred in 6% of the patients. The increased sinus rate following radiofrequency ablation, observed in 4% of pediatric patients, constitutes a new finding, which warrants attention in other patient series.
Arrhythmogenic Evidence for Epicardial Adipose Tissue: Heart Rate Variability and Turbulence are Influenced by Epicardial Fat Thickness
Authors: BALCIOĞLU AKİF SERHAT , ÇİÇEK DAVRAN , AKINCI SİNAN , ELDEM HALİL OLCAY , BAL UĞUR ABBAS , OKYAY KAAN , MÜDERRİSOĞLU HALDUN 
Published: September 2014

BackgroundEpicardial adipose tissue (EAT) is a local source of various hormones, cytokines, and vasoactive substances affecting the myocardium. EAT contains abundant ganglionic plexi that interact with the autonomic nervous system. Evidence of the association between EAT and arrhythmia is limited, with the exception of atrial fibrillation. This study aimed to investigate the relation between EAT and cardiac autonomic function using heart rate variability (HRV) and heart rate turbulence (HRT) parameters.MethodsAll subjects underwent a 24‐hour Holter recording to assess HRV and HRT parameters and a transthoracic echocardiography to measure EAT thickness. Patients were divided into two groups according to the median EAT thickness (3.9 mm). The higher EAT group consisted of 111 patients with a >3.9‐mm thickness and the lower EAT group 113 patients with a ≤3.9‐mm EAT thickness.ResultsHRV and HRT parameters were significantly influenced in the higher EAT group. Moreover, we observed significant correlations between EAT thickness and Holter findings (standard deviation of all NN intervals [SDNN]: r = –0.462, P < 0.001; SDNN index: r = –0.349, P < 0.001; standard deviation of the average NN intervals: r = –0.465, P < 0.001; root mean square of successive differences: r = –0.251, P < 0.001; pNN50: r = –0.354, P < 0.001; turbulence onset: r = 0.172, P = 0.010; turbulence slope: r = –0.279, P < 0.001, HRT category: r = 0.169, P = 0.011). In multivariate regression analysis, EAT thickness was independently associated with all measures of HRV and HRT, with the exception of turbulence onset.ConclusionsSympathovagal imbalance, detected by HRV and HRT parameters, is related to EAT thickness. As sympathovagal imbalance is a predictor of arrhythmic events, EAT may play an important arrhythmogenic role not limited to atrial fibrillation.
Prereactivation propranolol fails to reduce skin conductance reactivity to prepared fear‐conditioned stimuli
Authors: Spring Justin D. , Wood Nellie E. , Mueller‐Pfeiffer Christoph , Milad Mohammed R. , Pitman Roger K. , Orr Scott P. 
Published: September 2014

AbstractPharmacologic blockade of memory reconsolidation has been demonstrated in fear‐conditioned rodents and humans and may provide a means to reduce fearfulness in anxiety disorders and posttraumatic stress disorder. Studying the efficacy of potential interventions in clinical populations is challenging, creating a need for paradigms within which candidate reconsolidation‐blocking interventions can be readily tested. We used videos of biologically prepared conditioned stimuli (tarantulas) to test the efficacy of propranolol in blocking reconsolidation of conditioned fear in healthy young adults. Strong differential conditioning, measured by skin conductance, was observed among a screened subset of participants during acquisition. However, subsequent propranolol failed to reduce reactivity to the reactivated conditioned stimulus. These results are consistent with other recent findings and point to a need for testing other candidate drugs.
Intersectional Approaches in Health‐Risk Research: A Critical Review
Authors: Giritli Nygren Katarina , Olofsson Anna 
Published: September 2014

AbstractThe overall aim of this article is to explore how the intersectional approach is used in health‐risk research. The concept has been recognized in health‐risk research since the early 2000s, but not as much as in the broader field of health‐inequality studies. However, in the past 5 years, Social Science and Medicine has published a series of review articles that argue for the necessity of bringing intersectional perspectives to the field of health‐risk studies more generally and quantitative health‐risk research in particular. Asking what it means for health‐risk researchers to practise intersectionality shows the implications of translating a theoretical approach across fields and disciplines. When applying intersectional theory in relation to health‐risks, the theoretical conceptualization of health and risk are often very limited and treated as fixed categories – something that becomes problematic when taken within an intersectional framework. This does not mean that this work is unimportant, but rather that the link between theoretically driven intersectionality and empirical‐focused health research is weak. In order to overcome the dividing lines of health‐risk research and intersectionality, we argue for a new approach that echoes the ‘doing gender’ of gender studies: doing risk.
Maternal Frontal EEG Asymmetry and Chronic Stressors Moderate the Link between Child Conduct Problems and Maternal Negativity
Authors: Chen Nan , Bell Martha Ann , Deater‐Deckard Kirby 
Published: September 2014

AbstractFrontal electroencephalographic (EEG) asymmetry is associated with individual differences in positive/negative emotionality and approach/avoidance tendencies. The current study examined the moderating role of maternal resting frontal EEG asymmetry on the link between child behavior problems and maternal harsh parenting within the context of differing degrees of chronic family stressors (father unemployment, single parenthood, caring for multiple children, and household chaos). The sample included 121 mother–child pairs. Results showed that stressors and frontal EEG asymmetry together moderated the link. Child problem behaviors were moderately associated with greater maternal negativity for mothers with right frontal asymmetry, or mothers who experienced more stressors. However, no association existed between child behavior problems and maternal negativity for mothers with few stressors and left frontal asymmetry. The findings implicate transactions between household stress and a psychophysiological indicator of maternal emotional reactivity and mothers' approach/avoidance tendencies in the etiology of parental negativity toward challenging child behaviors.
An O‐methyltransferase modifies accumulation of methylated anthocyanins in seedlings of tomato
Authors: Gomez Roldan Maria Victoria , Outchkourov Nikolay , van Houwelingen Adèle , Lammers Michiel , Romero de la Fuente Irene , Ziklo Noa , Aharoni Asaph , Hall Robert D. , Beekwilder Jules 
Published: September 2014

SummaryAnthocyanins contribute to the appearance of fruit by conferring to them a red, blue or purple colour. In a food context, they have also been suggested to promote consumer health. In purple tomato tissues, such as hypocotyls, stems and purple fruits, various anthocyanins accumulate. These molecules have characteristic patterns of modification, including hydroxylations, methylations, glycosylations and acylations. The genetic basis for many of these modifications has not been fully elucidated, and nor has their role in the functioning of anthocyanins. In this paper, AnthOMT, an O‐methyltransferase (OMT) mediating the methylation of anthocyanins, has been identified and functionally characterized using a combined metabolomics and transcriptomics approach. Gene candidates were selected from the draft tomato genome, and their expression was subsequently monitored in a tomato seedling system comprising three tissues and involving several time points. In addition, we also followed gene expression in wild‐type red and purple transgenic tomato fruits expressing Rosea1 and Delila transcription factors. Of the 57 candidates identified, only a single OMT gene showed patterns strongly correlating with both accumulation of anthocyanins and expression of anthocyanin biosynthesis genes. This candidate (AnthOMT) was compared to a closely related caffeoyl CoA OMT by recombinant expression in Escherichia coli, and then tested for substrate specificity. AnthOMT showed a strong affinity for glycosylated anthocyanins, while other flavonoid glycosides and aglycones were much less preferred. Gene silencing experiments with AnthOMT resulted in reduced levels of the predominant methylated anthocyanins. This confirms the role of this enzyme in the diversification of tomato anthocyanins.
The mitochondrial outer membrane AAA ATPase AtOM66 affects cell death and pathogen resistance in Arabidopsis thaliana
Authors: Zhang Botao , Van Aken Olivier , Thatcher Louise , De Clercq Inge , Duncan Owen , Law Simon R. , Murcha Monika W. , van der Merwe Margaretha , Seifi Hamed Soren , Carrie Chris , Cazzonelli Christopher , Radomiljac Jordan , Höfte Monica , Singh Karam B. , Van Breusegem Frank , Whelan James 
Published: September 2014

SummaryOne of the most stress‐responsive genes encoding a mitochondrial protein in Arabidopsis (At3g50930) has been annotated as AtBCS1 (cytochrome bc1 synthase 1), but was previously functionally uncharacterised. Here, we show that the protein encoded by At3g50930 is present as a homo‐multimeric protein complex on the outer mitochondrial membrane and lacks the BCS1 domain present in yeast and mammalian BCS1 proteins, with the sequence similarity restricted to the AAA ATPase domain. Thus we propose to re‐annotate this protein as AtOM66 (Outer Mitochondrial membrane protein of 66 kDa). While transgenic plants with reduced AtOM66 expression appear to be phenotypically normal, AtOM66 over‐expression lines have a distinct phenotype, showing strong leaf curling and reduced starch content. Analysis of mitochondrial protein content demonstrated no detectable changes in mitochondrial respiratory complex protein abundance. Consistent with the stress inducible expression pattern, over‐expression lines of AtOM66 are more tolerant to drought stress but undergo stress‐induced senescence earlier than wild type. Genome‐wide expression analysis revealed a constitutive induction of salicylic acid‐related (SA) pathogen defence and cell death genes in over‐expression lines. Conversely, expression of SA marker gene PR‐1 was reduced in atom66 plants, while jasmonic acid response genes PDF1.2 and VSP2 have increased transcript abundance. In agreement with the expression profile, AtOM66 over‐expression plants show increased SA content, accelerated cell death rates and are more tolerant to the biotrophic pathogen Pseudomonas syringae, but more susceptible to the necrotrophic fungus Botrytis cinerea. In conclusion, our results demonstrate a role for AtOM66 in cell death and amplifying SA signalling.
Delayed Parasite Clearance after Treatment with Dihydroartemisinin-Piperaquine in Plasmodium falciparum Malaria Patients in Central Vietnam
Authors: Thriemer Kamala , Hong Nguyen Van , Rosanas-Urgell Anna , Phuc Bui Quang , Ha Do Manh , Pockele Evi , Guetens Pieter , Van Nguyen Van , Duong Tran Thanh , Amambua-Ngwa Alfred , D'Alessandro Umberto , Erhart Annette 
Published: September 2014

ABSTRACT

Reduced susceptibility of
Plasmodium falciparum
toward artemisinin derivatives has been reported from the Thai-Cambodian and Thai-Myanmar borders. Following increasing reports from central Vietnam of delayed parasite clearance after treatment with dihydroartemisinin-piperaquine (DHA-PPQ), the current first-line treatment, we carried out a study on the efficacy of this treatment. Between September 2012 and February 2013, we conducted a 42-day
in vivo
and
in vitro
efficacy study in Quang Nam Province. Treatment was directly observed, and blood samples were collected twice daily until parasite clearance. In addition, genotyping, quantitative PCR (qPCR), and
in vitro
sensitivity testing of isolates was performed. The primary endpoints were parasite clearance rate and time. The secondary endpoints included PCR-corrected and uncorrected cure rates, qPCR clearance profiles,
in vitro
sensitivity results (for chloroquine, dihydroartemisinin, and piperaquine), and genotyping for mutations in the Kelch 13 propeller domain. Out of 672 screened patients, 95 were recruited and 89 available for primary endpoint analyses. The median parasite clearance time (PCT) was 61.7 h (interquartile range [IQR], 47.6 to 83.2 h), and the median parasite clearance rate had a slope half-life of 6.2 h (IQR, 4.4 to 7.5 h). The PCR-corrected efficacy rates were estimated at 100% at day 28 and 97.7% (95% confidence interval, 91.2% to 99.4%) at day 42. At day 3, the
P. falciparum
prevalence by qPCR was 2.5 times higher than that by microscopy. The 50% inhibitory concentrations (IC
50
s) of isolates with delayed clearance times (≥72 h) were significantly higher than those with normal clearance times for all three drugs. Delayed parasite clearance (PCT, ≥72 h) was significantly higher among day 0 samples carrying the 543 mutant allele (47.8%) than those carrying the wild-type allele (1.8%;
P
= 0.048). In central Vietnam, the efficacy of DHA-PPQ is still satisfactory, but the parasite clearance time and rate are indicative of emerging artemisinin resistance. (This study has been registered at ClinicalTrials.gov under registration no. NCT01775592.)
Pharmacokinetic Interaction between Nevirapine and Nortriptyline in Rats: Inhibition of Nevirapine Metabolism by Nortriptyline
Authors: Usach Iris , Melis Virginia , Gandía Patricia , Peris José-Esteban 
Published: September 2014

ABSTRACTOne of the most frequent comorbidities of HIV infection is depression, with a lifetime prevalence of 22 to 45%. Therefore, it was decided to study a potential pharmacokinetic interaction between the nonnucleoside reverse transcriptase inhibitor nevirapine (NVP) and the tricyclic antidepressant nortriptyline (NT). NVP and NT were administered to rats either orally, intraduodenally, or intravenously, and the changes in plasma levels and pharmacokinetic parameters were analyzed. Experiments with rat and human hepatic microsomes were carried out to evaluate the inhibitory effects of NT on NVP metabolism. NVP plasma concentrations were significantly higher when this drug was coadministered with NT. The maximum plasma concentrations of NVP were increased 2 to 5 times and the total plasma clearance was decreased 7-fold in the presence of NT. However, statistically significant differences in the pharmacokinetic parameters of NT in the absence and presence of NVP were not found.In vitrostudies with rat and human hepatic microsomes confirmed the inhibition of NVP hepatic metabolism by NT in a concentration-dependent way, with the inhibition being more intense in the case of rat microsomes. In conclusion, a pharmacokinetic interaction between NVP and NT was detected. This interaction was a consequence of the inhibition of hepatic metabolism of NVP by NT.In vivohuman studies are required to evaluate the effects of this interaction on the pharmacokinetics of NVP before it can be taken into account for patients receiving NVP.
Population Pharmacokinetics of Teicoplanin in Children
Authors: Ramos-Martín V. , Paulus S. , Siner S. , Scott E. , Padmore K. , Newland P. , Drew R. J. , Felton T. W. , Docobo-Pérez F. , Pizer B. , Pea F. , Peak M. , Turner M. A. , Beresford M. W. , Hope W. W. 
Published: September 2014

ABSTRACT

Teicoplanin is frequently administered to treat Gram-positive infections in pediatric patients. However, not enough is known about the pharmacokinetics (PK) of teicoplanin in children to justify the optimal dosing regimen. The aim of this study was to determine the population PK of teicoplanin in children and evaluate the current dosage regimens. A PK hospital-based study was conducted. Current dosage recommendations were used for children up to 16 years of age. Thirty-nine children were recruited. Serum samples were collected at the first dose interval (1, 3, 6, and 24 h) and at steady state. A standard 2-compartment PK model was developed, followed by structural models that incorporated weight. Weight was allowed to affect clearance (CL) using linear and allometric scaling terms. The linear model best accounted for the observed data and was subsequently chosen for Monte Carlo simulations. The PK parameter medians/means (standard deviation [SD]) were as follows: CL, [0.019/0.023 (0.01)] × weight liters/h/kg of body weight; volume, 2.282/4.138 liters (4.14 liters); first-order rate constant from the central to peripheral compartment (

K
cp

), 0.474/3.876 h
−1
(8.16 h
−1
); and first-order rate constant from peripheral to central compartment (

K
pc

), 0.292/3.994 h
−1
(8.93 h
−1
). The percentage of patients with a minimum concentration of drug in serum (
C
min
) of <10 mg/liter was 53.85%. The median/mean (SD) total population area under the concentration-time curve (AUC) was 619/527.05 mg · h/liter (166.03 mg · h/liter). Based on Monte Carlo simulations, only 30.04% (median AUC, 507.04 mg · h/liter), 44.88% (494.1 mg · h/liter), and 60.54% (452.03 mg · h/liter) of patients weighing 50, 25, and 10 kg, respectively, attained trough concentrations of >10 mg/liter by day 4 of treatment. The teicoplanin population PK is highly variable in children, with a wider AUC distribution spread than for adults. Therapeutic drug monitoring should be a routine requirement to minimize suboptimal concentrations.

IMPORTANCE
(This trial has been registered in the European Clinical Trials Database Registry [EudraCT] under registration number 2012-005738-12.)