bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of two contemporary rotary systems in a pre‐clinical student course setting
Authors: Marending M. , Biel P. , Attin T. , Zehnder M. 
Published: June 2015

AbstractAimTo assess two contemporary rotary instrumenting systems subjectively and objectively in a pre‐clinical student course setting.MethodologyUndergraduate dental students (n = 44) prepared mesiolingual canals of 3D‐printed mandibular molar replicas (RepliDens, Zurich, Switzerland). The HyFlex and BioRace rotary systems, both previously unknown to the students, were used according to the manufacturers’ guidelines after a short theoretical introduction. For comparison, a first‐generation rotary system (ProFile .04), which the students knew from their previous education, was then used in a third RepliDens. Questionnaires were issued to note subjective experiences immediately after instrumentation. Objectively, time to instrument to size 40, .04 taper and shaping outcomes were analysed. Categorical data were compared using chi‐square and Fisher's exact tests, numerical data according to goodness of fit to the normal distribution, P < 0.05.ResultsSubjectively, the students liked the file size and sequence designation in the BioRace system significantly (P < 0.05) better than in the HyFlex counterpart, whilst they found better controllability with the HyFlex (P < 0.05), and reported no difference in cutting efficiency. They preferred both systems to the ProFile. Objectively, canal transportation was significantly less with the HyFlex (and the ProFile) systems compared to BioRace (P < 0.05). Both systems under investigation were statistically similar in terms of file fractures (nil), length control, and instrumentation time, which was considerably faster than with the ProFile control system.ConclusionsHyFlex and BioRace had perceived and quantifiable strengths and weaknesses. Both systems were equally liked by the students and preferred over the ProFile first‐generation rotary system.
Consent's Been Framed: When Framing Effects Invalidate Consent and How to Validate It Again
Authors: Chwang Eric 
Published: June 2015

AbstractIn this article I will argue first that if ignorance poses a problem for valid consent in medical contexts then framing effects do too, and second that the problem posed by framing effects can be solved by eliminating those effects. My position is thus a mean between two mistaken extremes. At one mistaken extreme, framing effects are so trivial that they never impinge on the moral force of consent. This is as mistaken as thinking that ignorance is so trivial that it never impinges on the moral force of consent. At the other mistaken extreme, framing effects are so serious that their existence shows that consent has no independent moral force. This is as mistaken as the idea that ignorance is so serious that its existence shows that consent has no independent moral force. I will argue that, instead of endorsing either of these mistaken extreme views, we should instead endorse a moderate view according to which framing effects sometimes pose a serious challenge for the validity of consent, just as ignorance does, but one which we can solve by eliminating the effect, just as we can solve the problem of ignorance by eliminating it.
Adenosine Triphosphate Test After Cryothermal Pulmonary Vein Isolation: Creating Contiguous Lesions Is Essential for Eliminating Dormant Conduction
Authors: MIYAZAKI SHINSUKE , TANIGUCHI HIROSHI , NAKAMURA HIROAKI , HACHIYA HITOSHI , ICHIHARA NOBORU , ARAKI MAKOTO , KUROI AKIO , TAKAGI TAKAMITSU , IWASAWA JIN , HIRAO KENZO , IESAKA YOSHITO 
Published: June 2015

Dormant Conduction After Cryothermal PVIBackgroundAdenosine triphosphate (ATP) testing reveals dormant pulmonary vein (PV) conduction after electrical PV isolation (PVI). This study aimed to evaluate the incidence of latent PV conduction after cryothermal PVI.MethodsFifty‐four consecutive paroxysmal atrial fibrillation patients undergoing cryothermal PVI were prospectively enrolled. PVI was performed with one 28‐mm second‐generation balloon using a 3‐minute freeze technique, and touch‐up lesions were created by focal cryothermal applications. ATP testing was performed following PVI with a 20‐mm circular mapping catheter placed in each PV.ResultsOf 217 PVs, 205 (94.5%) were isolated using a cryoballoon, and 12 required additional focal ablation. ATP testing was performed in 46 patients for 173 and 8 PVs, which were isolated by cryoballoons and focal ablation, respectively. No dormant PV conduction was provoked in any PVs, which were isolated by cryoballoons, whereas 4 (50.0%) out of 8 PVs requiring focal ablation had transient ATP‐provoked reconnections (0 vs. 50.0%, P < 0.0001) with a median duration of 11.3 (10.7–17.1) seconds. The latent PV conduction site was identical to the residual conduction gap site after cryoballoon ablation in all. All latent conduction was successfully eliminated by 2 (2.0–9.5) additional focal applications. At a mean follow‐up of 7.7 ± 1.6 months, 81.5% of the patients were arrhythmia free after a single procedure.ConclusionsNo dormant PV conduction was provoked in PVs, which were isolated by 28‐mm second‐generation cryoballoons, but was provoked in 50% of PVs, which were isolated by focal cryoablation. These findings suggest that creating contiguous lesions is essential for eliminating dormant conduction in cryothermal ablation.
Pulmonary Vein Isolation Using the Visually Guided Laser Balloon: Results of the U.S. Feasibility Study
Authors: DUKKIPATI SRINIVAS R. , WOOLLETT IAN , McELDERRY H. THOMAS , BÖHMER MARIE‐CHRISTINE , DOSHI SHEPHAL K. , GERSTENFELD EDWARD P. , HORTON RODNEY , D'AVILA ANDRE , HAINES DAVID E. , VALDERRABANO MIGUEL , MANGRUM J. MICHAEL , RUSKIN JEREMY N. , NATALE ANDREA , REDDY VIVEK Y. 
Published: June 2015

Visually Guided PV IsolationIntroductionVisually guided laser balloon (VGLB) ablation is unique in that the operator delivers ablative energy under direct visual guidance. In this multicenter study, we sought to determine the feasibility, efficacy, and safety of performing pulmonary vein isolation (PVI) using this VGLB.MethodsPatients with symptomatic, drug‐refractory paroxysmal atrial fibrillation (AF) underwent PVI using the VGLB with the majority of operators conducting their first‐ever clinical VGLB cases. The primary effectiveness endpoint was defined as freedom from treatment failure that included: Occurrence of symptomatic AF episodes ≥1 minutes beyond the 90‐day blanking, the inability to isolate 1 superior and 2 total PVs, occurrence of left atrial flutter or atrial tachycardia, or left atrial ablation/surgery during follow‐up.ResultsA total of 86 patients (mean age 56 ± 10 years, 67% male) were treated with the VGLB at 10 US centers. Mean fluoroscopy, ablation, and procedure times were 39.8 ± 24.3 minutes, 205.2 ± 61.7 minutes, and 253.5 ± 71.3 minutes, respectively. Acute PVI was achieved in 314/323 (97.2%) of targeted PVs. Of 84 patients completing follow‐up, the primary effectiveness endpoint was achieved in 50 (60%) patients. Freedom from symptomatic or asymptomatic AF was 61%. The primary adverse event rate was 16.3% (8.1% pericarditis, phrenic nerve injury 5.8%, and cardiac tamponade 3.5%). There were no cerebrovascular events, atrioesophageal fistulas, or significant PV stenosis.ConclusionsThis multicenter study of operators in the early stage of the learning curve demonstrates that PVI can be achieved with the VGLB with a reasonable safety profile and an efficacy similar to radiofrequency ablation.
Feasibility of Transseptal Access in Patients With Previously Scarred or Repaired Interatrial Septum
Authors: ARKLES JEFFREY , ZADO ERICA , SUPPLE GREGORY , FRANKEL DAVID S. , CALLANS DAVID , MARCHLINSKI FRANCIS , DIXIT SANJAY 
Published: June 2015

Challenging Transseptal AccessBackgroundMany patients (pts) with interatrial septal repair (ASR) and/or multiple prior transseptal puncture (MTSP) are being referred for atrial fibrillation (AF) ablation. We examine the feasibility of repeat TSP in these settings.MethodsRecords were reviewed from a single center from 2001 to 2012. Criteria for MTSP were >2 priorAF ablation procedures and criteria for ASR were prior surgical or percutaneous interatrial septal repair. Intracardiac echocardiography (ICE) was used for all procedures. Repeat transseptal puncture (TSP) outcomes were classified as (1) routine, (2) challenging (additional tools, sheaths, multiple attempts), (3) failed, or (4) complicated (adverse event possibly related to TSP). Five hundred pts selected at random over the same time period undergoing 1st AF ablation without history of prior cardiac surgery were used as control.ResultsTwo hundred and fifty‐one pts met the criteria (MTSP = 224; ASR = 27). TSP was routinely accomplished in the majority (212 pts [95%] in MTSP; 20 pts [74%] in ASR). In the MTSP group, the number of challenging/failed cases increased proportionately with number of prior AF ablation procedures. There were no complications in the ASR group and 2 (1%) in MTSP. This was not different from that in the control arm (n = 6 [1%]; P = ns). Pericardial effusion was the only complication seen in all groups.ConclusionsIn the majority of pts with scarred and/or repaired IAS, repeat TSP can be routinely accomplished using ICE guidance without any other special tools. Although repeat TSP can be occasionally difficult in pts with MTSP and ASR, it can be accomplished in the majority without serious complications.
Direct Pulmonary Vein Ablation With Stenosis Prevention Therapy
Authors: DeSIMONE CHRISTOPHER V. , HOLMES DAVID R. , EBRILLE ELISA , SYED FAISAL F. , LADEWIG DOROTHY J. , MIKELL SUSAN B. , POWERS JOANNE , SUDDENDORF SCOTT H. , GILLES EMILY J. , DANIELSEN ANDREW J. , HODGE DAVID O. , KAPA SURAJ , ASIRVATHAM SAMUEL J. 
Published: June 2015

Direct Pulmonary Vein Ablation With Stenosis Prevention TherapyIntroductionThe dominant location of electrical triggers for initiating atrial fibrillation (AF) originates from the muscle sleeves inside pulmonary veins (PVs). Currently, radiofrequency ablation (RFA) is performed outside of the PVs to isolate, rather than directly ablate these tissues, due to the risk of intraluminal PV stenosis.MethodsIn 4 chronic canine experiments, we performed direct PV muscle sleeve RFA ± postablation drug‐coated balloon (DCB) treatment with paclitaxel/everolimus. Of the 4 PVs, 2 PVs were ablated and treated with DCB, 1 PV was ablated without DCB treatment (positive control), and 1 PV was left as a negative control. Local electrograms were assessed in PVs for near‐field signals and were targeted for ablation. After 12–14 weeks survival, PVs were interrogated for absence of near‐field PV potentials, and each PV was assessed for stenosis.ResultsAll canines survived the study period without cardiorespiratory complications, and remained ambulatory. In all canines, PVs that were ablated and treated with DCB remained without any significant intraluminal stenosis. In contrast, PVs that were ablated and not treated with DCB showed near or complete intraluminal stenosis. At terminal study, PV potentials remained undetectable. A blinded, histologic analysis demonstrated that ablated PVs without DCB treatment had extensive thrombus, fibrin, mineralization, and elastin disruption.ConclusionOur chronic canine data suggest that direct PV tissue ablation without subsequent stenosis is feasible with the use of postablation DCBs.
Prevalence of Liddle Syndrome Among Young Hypertension Patients of Undetermined Cause in a Chinese Population
Authors: Wang Lin‐Ping , Yang Kun‐Qi , Jiang Xiong‐Jing , Wu Hai‐Ying , Zhang Hui‐Min , Zou Yu‐Bao , Song Lei , Bian Jin , Hui Ru‐Tai , Liu Ya‐Xin , Zhou Xian‐Liang 
Published: June 2015

Liddle syndrome, an autosomal dominant form of monogenic hypertension, has been regarded as a rare disorder, which leads to many Liddle syndrome patients being misdiagnosed and experiencing severe complications at an early age. Little is known about the prevalence of Liddle syndrome. In this study, the authors investigated the prevalence of Liddle syndrome confirmed by genetic testing among young hypertension patients of undetermined causes in China. A total of 330 hypertensive patients aged 14 to 40 years after exclusion of common secondary causes of hypertension were enrolled and serum potassium concentrations were measured. Patients with hypokalemia underwent genetic testing of the 13th exon of genes encoding β and γ subunits of the epithelial sodium channel (ENaC). Diagnosis was established by identification of mutations that destroy the PY motif of ENaC. Five patients were diagnosed with Liddle syndrome (prevalence, 1.52%), as well as 12 of their relatives. These patients with Liddle syndrome presented with an earlier onset of hypertension, a stronger family history of hypertension, and higher blood pressure than those with essential hypertension. All patients had hypokalemia and suppressed plasma renin activity. The results demonstrated that Liddle syndrome is an important etiology of hypertension in this young population. Screening of Liddle syndrome should focus on young hypertension patients, particularly those with early penetrance, hypokalemia, and low renin levels after exclusion of common secondary causes.
European Integration and Outward FDI from Central and Eastern Europe – Is There Any Evidence of Knowledge‐seeking?
Authors: Jindra Björn , Hassan Sohaib S. , Günther Jutta , Cantner Uwe 
Published: June 2015

AbstractThe European Union (EU) Member States in central and eastern Europe (CEE) witnessed a surge in outward foreign direct investment (OFDI) between 2000 and the start of the global financial crisis. This article investigates whether the European integration process altered the relative importance of host country location factors. In particular, we investigate to what extent knowledge‐seeking is a relevant investment motive, which has been documented as a key determinant for OFDI from other emerging economies. We apply a discrete choice approach to model foreign location choice of firms from CEE countries (CEECs) within the EU 27 (1996–2010). We find that the EU integration process is related with increasing importance of market access and less emphasis on labour cost advantages. We find heterogeneity in the valuation of foreign knowledge‐related assets. The location probability within the EU15 is positively associated with knowledge‐seeking. It also plays a role for technology‐intensive industries and larger firms.
Correlation of serum testosterone with insulin resistance in elderly male type 2 diabetes mellitus patients with osteoporosis
Authors: Xia Jin‐wei , Tan Shi‐jin , Zhang Xing‐liang , Jun Tao , Sun Xiao‐kang , Ling Wang 
Published: June 2015

AbstractAims/IntroductionThe present study was designed to investigate the correlations between the serum testosterone level and insulin sensitivity in elderly male type 2 diabetes patients with osteoporosis.Materials and MethodsA total of 35 elderly male patients with type 2 diabetes (type 2 diabetes group), 30 elderly male type 2 diabetes patients combined with osteoporosis (DO group) and 30 healthy elderly men (normal control group) participated in the present study. The fasting plasma glucose, fasting insulin, testosterone (T) and estradiol (E2) were measured. The insulin sensitivity index (ISI), homeostasis model assessment of insulin resistance (HOMA‐IR) and E2/T were calculated. Then, the correlations of serum testosterone level with ISI and HOMA‐IR were analyzed by statistical methods.ResultsThe HOMA‐IR, E2 and E2/T of the type 2 diabetes group and DO group were significantly increased, whereas the bone mineral density, ISI, T and sex hormone binding globulin were decreased compared with those of the normal control group. Serum testosterone levels of the type 2 diabetes group and DO group were negatively correlated to the HOMA‐IR (r = −0.496, −0.506; P < 0.05), whereas they were positively correlated to the fasting insulin (r = 0.281, 0.292; P < 0.05) and ISI (r = 0.364, 0.403; P < 0.05).ConclusionsThe reduced level of serum testosterone in elderly male type 2 diabetes patients with osteoporosis might promote insulin resistance.
Correlations of serum visfatin and metabolisms of glucose and lipid in women with gestational diabetes mellitus
Authors: Liang Zhaoxia , Wu Ying , Xu Jianyun , Fang Qin , Chen Danqing 
Published: June 2015

AbstractAims/IntroductionVisfatin is a newly discovered adipocytokine hormone, which exerts an insulin‐like effect by binding to the insulin receptor‐1. However, the role of visfatin in human gestational diabetes mellitus (GDM) remains controversial. The purpose of the present study was to investigate the correlation between serum visfatin and metabolism of glucose and lipid in GDM.Materials and MethodsThis was a prospective study. A total of 38 GDM patients and 35 age‐ and body mass index‐matched controls were studied between January 2012 and October 2013. Fasting serum levels of visfatin, fasting plasma glucose, hemoglobin A1c and lipid profile were measured. Two‐tailed t‐tests and Pearson's correlation coefficient were used to analyze the data.ResultsPerinatal visfatin levels were negatively correlated with fasting plasma glucose, insulin resistance index and triglycerides in controls (r = −0.47, −0.51, −0.57, respectively; P < 0.05), and positively correlated with high‐density lipoprotein cholesterol (r = 0.32, P < 0.05). A positive correlation with visfatin level only appeared in weight gain and body mass index in women with GDM (r = 0.36, 0.45, respectively; P < 0.05).ConclusionsVisfatin appears to be involved in glucose and lipid metabolism regulation and insulin resistance, suggesting a role in GDM pathogenesis.
Viscous relaxation of grain‐scale pressure variations
Authors: Dabrowski M. , Powell R. , Podladchikov Y. 
Published: June 2015

AbstractIn the presence of grain‐scale pressure variations, there will be a natural tendency for deformation to flatten pressure gradients to establish pressure equilibrium. We explore the time‐scale of the survival of pressure variations in the presence of power‐law creep. Such viscous relaxation turns out to be strongly dependent on the exponent in the power‐law creep constitutive relation. For larger exponents, there is the possibility of maintaining pressure variations for the order of a million years, orders of magnitude longer than the viscoelastic relaxation time that is commonly used as a proxy for the pressure relaxation time. Petrologically, this means that while pressure variations may only be transient, their effect may contribute to mineral textural development, even if not preserved in mineral assemblages and mineral compositions.
Characterization of protective immune response elicited by a trimeric envelope protein from an Indian clade C HIV‐1 isolate in rhesus macaques
Authors: Menon Veena , Sneha Priya Rangasamy , Labranche Celia , Montefiori David , Mahalingam Sundarasamy , Kalyanaraman Vaniambadi S. , Pal Ranajit 
Published: June 2015

AbstractBackgroundRecent preclinical studies have demonstrated the use of properly folded trimeric HIV‐1 envelope proteins as immunogen for eliciting protecting immune response in macaques.MethodsTrimeric gp145 protein of Indian clade C HIV‐1 (93IN101) was characterized for antigenicity by evaluating its binding to sCD4, and several monoclonal antibodies to HIV‐1 by bio‐layer interferometry. Ten macaques were immunized four times with purified gp145 in adjuplex adjuvant, and serum antibodies were characterized for binding to gp145 and neutralization. Immunized macaques were subjected to weekly low‐dose vaginal challenge with SHIV1157‐ipEL‐p for 8 weeks.ResultsEnv protein elicited strong antibody response in macaques. Following challenge, seven of ten immunized macaques resisted challenge, while six of eight control animals were infected.ConclusionsEnv proteins from a clade C Indian isolate can elicit protective immune response and therefore may be a candidate for inclusion in a multiclade‐based HIV‐1 vaccine.
Systematic Review: Bridging the Gap in RPN‐to‐RN Transitions
Authors: Suva Grace , Sager Shelley , Mina Elaine Santa , Sinclair Nancy , Lloyd Monique , Bajnok Irmajean , Xiao Sarah 
Published: June 2015

AbstractPurposeTo review the evidence examining the influences of successful education and professional role transition for registered practical nurses (RPNs) pursuing a baccalaureate degree in nursing (BScN) and registered nurse (RN) licensure through RPN‐to‐RN bridging programs.DesignSystematic review of papers published between 1995 and 2014 that evaluated students’ education and professional role transitions from RPN to RN.MethodsThirty‐nine papers were selected that observed or studied the change or transition in designation from RPN to RN, or its equivalent, through bridging programs and analyzed thematically according to Meleis, Sawyer, Im, Hilfinger Messias, and Schumacher's transition model.FindingsPersonal, community, and social conditions related to preparation for entry, program enrolment, and postgraduate clinical integration influence successful education and professional role transitions for RPN‐to‐RN bridging students.ConclusionsProviding key transition supports may enhance the potential for successful student transition into and throughout a bridging program, but further research is necessary to enhance this understanding and to recommend best practices for optimizing students’ success.Clinical RelevanceThe evidence from this review identifies facilitators and barriers to successful education and professional role transition for RPN‐to‐RN bridging students, and identifies important considerations for future research.
Asthma phenotyping: a necessity for improved therapeutic precision and new targeted therapies
Authors: Chung Kian Fan 
Published: June 2015

AbstractAsthma is a common heterogeneous disease with a complex pathophysiology that carries a significant mortality rate and high morbidity. Current therapies based on inhaled corticosteroids and long‐acting β‐agonists remain effective in a large proportion of patients with asthma, but ~10% (considered to have ‘severe asthma’) do not respond to these treatments even at high doses or with the use of oral corticosteroids. Analytical clustering methods have revealed phenotypes that include dependence on high‐dose corticosteroid treatment, severe airflow obstruction and recurrent exacerbations associated with an allergic background and late onset of disease. One severe phenotype is eosinophilic inflammation‐predominant asthma, with late‐onset disease, rhinosinusitis, aspirin sensitivity and exacerbations. Blood and sputum eosinophilia have been used to distinguish patients with high Th2 inflammation and to predict therapeutic response to treatments targeted towards Th2‐associated cytokines. New therapies in the form of humanized antibodies against Th2 targets, such as anti‐IgE, anti‐IL4Rα, anti‐IL‐5 and anti‐IL‐13 antibodies, have shown encouraging results in terms of reduction in exacerbations and improvement in airflow in patients with a ‘Th2‐high’ expression profile and blood eosinophilia. Research efforts are now focusing on elucidating the phenotypes underlying the non‐Th2‐high (or Th2‐low) group, which constitutes ~50% of severe asthma cases. There is an increasing need to use biomarkers to indicate the group of patients who will respond to a specifically targeted treatment. The use of improved tools to measure activity of disease, a better definition of severe asthma and the delineation of inflammatory pathways with omics analyses using computational tools, will lead to better‐defined phenotypes for specific therapies.