bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Accuracy of Transesophageal Echocardiogram for the Detection of Patent Foramen Ovale: A Meta‐Analysis
Authors: Mojadidi Mohammad Khalid , Bogush Nikolay , Caceres Jose Diego , Msaouel Pavlos , Tobis Jonathan M. 
Published: December 2013

BackgroundPatent foramen ovale (PFO) is a remnant of the fetal circulation present in 20% of the population. Right‐to‐left shunting (RLS) through a PFO has been linked to the pathophysiology of stroke, migraine with aura, and hypoxemia. While different imaging modalities including transcranial Doppler, intra‐cardiac echo, and transthoracic echo (TTE) have often been used to detect RLS, transesophageal echo (TEE) bubble study remains the gold standard for diagnosing PFO. The aim of this study was to determine the relative accuracy of TEE in the detection of PFO.Methods and ResultsA systematic review of Medline, using a standard approach for meta‐analysis, was performed for all prospective studies assessing accuracy of TEE in the detection of PFO using confirmation by autopsy, cardiac surgery, and/or catheterization as the reference. Search results revealed 3105 studies; 4 met inclusion criteria. A total of 164 patients were included. TEE had a weighted sensitivity of 89.2% (95% CI: 81.1–94.7%) and specificity of 91.4% (95% CI: 82.3–96.8%) to detect PFO. The overall positive likelihood ratio (LR+) was 5.93 (95% CI: 1.30–27.09) and the overall negative likelihood ratio (LR−) was 0.22 (95% CI: 0.08–0.56).ConclusionWhile TEE bubble study is considered to be the gold standard modality for diagnosing PFO, some PFOs may still be missed or misdiagnosed. It is important to understand the limitations of TEE and perhaps use other highly sensitive screening tests, such as transcranial doppler (TCD), in conjunction with TEE before scheduling a patient for transcatheter PFO closure.
Echocardiographic Images of a Melody Valve in the Tricuspid Position
Authors: Khan Sairah , Cheatham John P. , Kollins Kevin , Cua Clifford L. 
Published: December 2013

Mini‐AbstractImplantation of the Melody valve in the pulmonary position is well described, but implantation of this valve in other valvular positions is limited to small case series. Intra‐cardiac and three‐dimensional echocardiography clearly delineates the mechanism of tricuspid valve failure and subsequent competency of the Melody valve in the tricuspid position in this 5‐year‐old male with complex medical history. As percutaneous implantation of this valve increases in the other valve positions, obtaining images that clearly define the mechanism of the initial valve failure as well as verifying proper placement and function of the implanted valve will be essential.
A Coronary–Pulmonary Artery Fistula with Giant Aneurysm in a Child with Ventricular Septal Defect with Pulmonary Atresia
Authors: Mahimaiha Jayaranganath , Patra Soumya , Mandikal Kodanda Rama Sastry Usha , Subramaniam Anand , Agrawal Navin , Nanjappa Manjunath Cholenahally 
Published: December 2013

Mini‐AbstractPulmonary atresia with ventricular septal defect accounts for about 2% of all congenital heart diseases. Aortopulmonary collaterals are the usual source of pulmonary blood flow. Coronary–pulmonary artery fistula is a rare and sole source of pulmonary blood flow. We are reporting a case of a 6‐year‐old girl who presented with severe cyanosis, clubbing, and effort intolerance. Echocardiography demonstrated a large subaortic ventricular septal defect and pulmonary atresia with confluent pulmonary arteries. It also revealed the presence of a coronary–pulmonary artery fistula along with a giant coronary artery aneurysm. These findings were confirmed by an aortic root angiogram. She was referred for intra‐ cardiac repair.
Left Atrial Remodeling and Recurrence of Congestive Heart Failure in Patients Initially Diagnosed with Heart Failure
Authors: Yamaguchi Kazuto , Yoshitomi Hiroyuki , Ito Shimpei , Ito Saki , Adachi Tomoko , Sato Hirotomo , Watanabe Nobuhide , Kodani Nobuhiro , Sugamori Takashi , Endo Akihiro , Takahashi Nobuyuki , Tanabe Kazuaki 
Published: December 2013

BackgroundLeft atrial volumes (LAVs) have been suggested to represent long‐term exposure to elevated pressures. This study examined the recurrence of heart failure (HF) based on LAV in patients initially diagnosed with congestive HF (CHF).MethodsThis study comprised 77 patients (age, 75 ± 8 years) with well‐documented, clinically defined HF, and complete two‐dimensional echocardiographic examinations. The echocardiographic examinations were performed on admission and after medical treatment (90 ± 43 days after initial examination). Patients with atrial fibrillation, flail mitral valve, or mitral valve replacement were excluded from this study.ResultsThe initial left ventricular ejection fraction (LVEF) was 44 ± 17% and the indexed LAV (LAVI) was 61 ± 22 mL/m2. After medical treatment, a decreased LAVI was observed in 38 patients and an increased LAVI (LA remodeling) was observed in 39 patients. With median follow‐up periods of 454 days, compared to patients with decreased LAVI, patients with LA remodeling had a significantly higher incidence of CHF recurrence (P = 0.008). Patients with LA remodeling had a CHF‐free survival rate of 36 ± 13% vs. 81 ± 9% (those without LA remodeling). A multivariate analysis indicated that, follow‐up LV end‐systolic volume (P = 0.04), LVEF (P = 0.005) and LAVI (P = 0.04) independently predicted CHF recurrence.ConclusionsPatients initially diagnosed with CHF follow divergent courses based on their LAV. LA remodeling after medical treatment can be useful for predicting CHF recurrence during follow‐up.
Doppler‐Derived Strain Imaging Detects Left Ventricular Systolic Dysfunction in Children with Turner Syndrome
Authors: Oz Fahrettin , Cizgici Ahmet Y. , Ucar Ahmet , Karaayvaz Ekrem B. , Kocaaga Mehmet , Bugra Zehra , Mercanoglu Fehmi , Oncul Aytac , Nisli Kemal , Oflaz Huseyin 
Published: December 2013

ObjectivesChildren with Turner syndrome (TS) are at increased risk of cardiovascular disease (CVD), but associations with subclinical CVD are not well‐characterized. The purpose of this study was to assess myocardial function using strain imaging (SI) by echocardiography in children with TS and without known CVD.MethodsThe study included 48 children with TS aged 4–16 years and 20 healthy control children. Children with TS were excluded if they had a cardiac malformation, a decreased left ventricular (LV) systolic function, or any chronic disease. Each child had an echocardiographic examination with conventional echocardiography and one‐dimensional longitudinal strain (1DST) echocardiography.ResultsSeptal and lateral systolic strain (S) and strain rate (SR) values, which are indicative of longitudinal myocardial function, were significantly decreased in TS patients. However, LV ejection fraction (LVEF) and LV fractional shortening (LVFS) was not significantly different between groups. LV mass index (LVMi), interventricular septum (IVS) thickness, LV posterior wall (LVPW) thickness, and left atrial (LA) diameter index were significantly higher in TS children compared to controls. Peak transmitral flow velocity in late diastole (peak A) was significantly higher, whereas peak transmitral flow velocity in early diastole (peak E), deceleration time (DT), and the ratio of early to late diastolic filling were significantly lower, in TS patients.ConclusionReduced LV systolic S and SR in children with TS may indicate early myocardial dysfunction before any detectable change in LVEF.
The Neoliberal Racial Project: The Tiger Mother and Governmentality
Authors: Rhee Jeong‐eun 
Published: December 2013

AbstractCombining the conceptual approach of racial formation and racial projects with the Foucauldian concept of governmentality, Jeong‐eun Rhee theorizes the “neoliberal racial project” (NRP) and examines contemporary meanings and operations of race and racism in relation to neoliberalism. She analyzes Amy Chua's popular parenting memoir, Battle Hymn of the Tiger Mother, as a specific case of the NRP, and demonstrates how in this text race is pressed to work in new — neoliberal — ways, re/generating different kinds of categories and meanings, yet also continuously drawing upon old categories and meanings, to effect and rationalize social arrangements of power and exploitation, violence and expropriation. What is noteworthy is the way in which racial neoliberalism builds silently on the structural conditions of racism while disabling the very categories of their recognizability. Consequently, Rhee argues for new, historically bounded theories that can articulate how the meanings, categories, and concepts of races are constantly being reconfigured.
Putting Spivakian Theorizing to Work: Decolonizing Neoliberal Scientism in Education
Authors: Daza Stephanie L. 
Published: December 2013

AbstractIn this article, Stephanie Daza draws on Gayatri Spivak's theorizing to help make visible how education is shaped by an elusive conceptual apparatus of neoliberal scientism. She begins with an example of high‐stakes learning and global competition as commonsensical policy practice at an elementary school. Then Daza develops an analysis that shows the possibilities of a Spivakian theoretical approach as an interpretive practice for education, and teacher education specifically.
Decolonizing the Curriculum for Global Perspectives
Authors: Subedi Binaya 
Published: December 2013

AbstractIn this article Binaya Subedi explores the multiple ways the idea of “global” is theorized within the school curriculum and suggests the utility of approaching the idea of global perspectives through decolonizing frameworks. In particular, she explores the deficit, accommodation, and decolonization approaches as offering three ways that the notion of global has been or can be infused within the school curriculum. Subedi traces the politics each of these approaches may advocate and the kinds of knowledge that may be included or silenced when proposing the utility of learning about global formations. The article proposes that scholars utilize decolonizing lenses to scrutinize how the idea of global perspectives has been articulated within writings on globalizing and internationalizing the curriculum.
Cytogenetic classification in Korean multiple myeloma patients: prognostic significance of hyperdiploidy with 47–50 chromosomes and the number of structural abnormalities
Authors: Lim Ji‐Hun , Seo Eul‐Ju , Park Chan‐Jeoung , Jang Seongsoo , Chi Hyun‐Sook , Suh Cheolwon , Kim Hawk , Kim Sung‐Ryul 
Published: December 2013

AbstractChromosomal abnormalities are important prognostic factors for patients diagnosed with multiple myeloma (MM). We retrospectively reviewed the clinical and laboratory data of 525 MM patients to assess the abnormalities frequently found by conventional cytogenetic analysis and to determine their relationship to prognosis and clinical parameters. Samples from 222 (42.3%) patients had abnormal karyotypes. Hyperdiploidy‐1 (>50 chromosomes), hyperdiploidy‐2 (47–50 chromosomes), pseudodiploidy (46 with abnormalities), and hypodiploidy (<46 chromosomes) were found in 55, 44, 42, and 81 patients, respectively. The median overall survival (OS) was significantly shorter in patients with hyperdiploidy‐2 (20.9 months), pseudodiploidy (19.9 months), and hypodiploidy (18.3 months) compared with patients with normal karyotype (66 months) and hyperdiploidy‐1 (55.4 months) (P < 0.001). Among patients with chromosomal abnormalities, those with 1q amplification had a shorter median OS (17 vs. 25.1 months, P = 0.018). Patients with a chromosome 13 deletion in the pseudodiploidy group also had a shorter OS. A karyotype with more than six structural abnormalities was found to have the most significant independent prognostic value by multivariate analysis. These data show that hyperdiploidy with 47–50 chromosomes should be recategorized as an unfavorable risk group, and the number of structural abnormalities needs to be considered as an important factor for prognosis. In conclusion, our findings imply that subclassification of chromosomal abnormalities by conventional cytogenetics could be applied to the prognostic assessment of MM.
Long‐term follow‐up after callosotomy—A prospective, population based, observational study
Authors: Stigsdotter‐Broman Lina , Olsson Ingrid , Flink Roland , Rydenhag Bertil , Malmgren Kristina 
Published: December 2013

ObjectiveAnalyze the long‐term outcome of callosotomies with regard to seizure types and frequencies and antiepileptic drug treatment.MethodsThis longitudinal observational study is based on data from the prospective Swedish National Epilepsy Surgery Register. Thirty‐one patients had undergone callosotomy in Sweden 1995–2007 and had been followed for 2 and 5 or 10 years after surgery. Data on their seizure types and frequencies, associated impairments, and use of antiepileptic drugs have been analyzed.ResultsThe median total number of seizures per patient and month was reduced from 195 before surgery to 110 two years after surgery and 90 at the long‐term follow‐up (5 or 10 years). The corresponding figures for drop attacks (tonic or atonic) were 190 before surgery, 100 2 years after surgery, and 20 at the long‐term follow‐up. Ten (56%) of the 18 patients with drop attacks were free from drop attacks at long‐term follow‐up. Three of the remaining eight patients had a reduction of >75%. At long‐term follow‐up, four were off medication. Only one of the 31 patients had no neurologic impairment.SignificanceThe present population‐based, prospective observational study shows that the corpus callosotomy reduces seizure frequency effectively and sustainably over the years. Most improvement was seen in drop attacks. The improvement in seizure frequency over time shown in this study suggests that callosotomy should be considered at an early age in children with intractable epilepsy and traumatizing drop attacks.
High‐resolution molecular genomic autopsy reveals complex sudden unexpected death in epilepsy risk profile
Authors: Klassen Tara L. , Bomben Valerie C. , Patel Ankita , Drabek Janice , Chen Tim T. , Gu Wenli , Zhang Feng , Chapman Kevin , Lupski James R. , Noebels Jeffrey L. , Goldman A.M. 
Published: December 2013

SummaryAdvanced variant detection in genes underlying risk of sudden unexpected death in epilepsy (SUDEP) can uncover extensive epistatic complexity and improve diagnostic accuracy of epilepsy‐related mortality. However, the sensitivity and clinical utility of diagnostic panels based solely on established cardiac arrhythmia genes in the molecular autopsy of SUDEP is unknown. We applied the established clinical diagnostic panels, followed by sequencing and a high density copy number variant (CNV) detection array of an additional 253 related ion channel subunit genes to analyze the overall genomic variation in a SUDEP of the 3‐year‐old proband with severe myoclonic epilepsy of infancy (SMEI). We uncovered complex combinations of single nucleotide polymorphisms and CNVs in genes expressed in both neurocardiac and respiratory control pathways, including SCN1A, KCNA1, RYR3, and HTR2C. Our findings demonstrate the importance of comprehensive high‐resolution variant analysis in the assessment of personally relevant SUDEP risk. In this case, the combination of de novo single nucleotide polymorphisms (SNPs) and CNVs in the SCN1A and KCNA1 genes, respectively, is suspected to be the principal risk factor for both epilepsy and premature death. However, consideration of the overall biologically relevant variant complexity with its extensive functional epistatic interactions reveals potential personal risk more accurately.
Coagulation, oncotic and haemodilutional effects of a third‐generation hydroxyethyl starch (130/0.4) solution in horses
Authors: Viljoen A. , Page P. C. , Fosgate G. T. , Saulez M. N. 
Published: December 2013

SummaryReasons for performing studyClinical indications for hydroxyethyl starches (HES) in horses include rapid plasma volume expansion and oncotic support during periods of hypoproteinaemia. Side effects such as coagulopathies associated withHESadministration pose limitations to their use in veterinary medicine. In man, tetrastarch (130/0.4) has demonstrated less profound effects on coagulation compared with first‐ and second‐generationHES.ObjectivesTo evaluate the haemostatic and oncotic effects of tetrastarch (130/0.4) administered at 10, 20 and 40 ml/kg bwt in healthy horses.Study designRandomised crossover experiment.MethodsTetrastarch (130/0.4) was administered to 6 healthy pony mares at 10, 20 and 40 ml/kg bwt with a 2‐week washout period. Packed cell volume, plasma total solids, colloid osmotic pressure (COP), platelet count and thromboelastography (TEG) were measured at baseline, immediately after infusion (0 h), and 1, 6, 12, 24, 48 and 96 h after tetrastarch infusion.ResultsAllTEGvariables remained within normal reference ranges in all 3 treatment groups. Administration of tetrastarch at 40 ml/kg bwt resulted in a prolongedK‐time (P = 0.049) at 6 h post infusion, and decreased maximum amplitude at 0 (P<0.001), 1 (P = 0.022), 6 (P = 0.006), 24 (P<0.001) and 48 h (P = 0.013) post infusion compared with baseline. Administration of tetrastarch increased meanCOPvalues above baseline in all 3 treatment groups, persisting to 24, 6 and 48 h for the 10, 20 and 40 ml/kg bwt doses, respectively.ConclusionsAlthough still within established reference ranges, compared with lower dosages, the administration of 40 ml/kg bwt tetrastarch (130/0.4) is more likely to induce changes in coagulation as measured byTEG. Tetrastarch increasedCOPat all dosages evaluated in healthy horses. Tetrastarch (130/0.4) at 10 and 20 ml/kg bwt has potential as a synthetic colloid for resuscitation and provision of oncotic support in horses.
Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions
Authors: Naylor R. J. , Taylor A. H. , Knowles E. J. , Wilford S. , Linnenkohl W. , Mair T. S. , Johns I. C. 
Published: December 2013

SummaryReasons for performing studyEx vivo evidence suggests that cyclo‐oxygenase (COX) 2‐preferential inhibitor nonsteroidal anti‐inflammatory drugs (NSAIDs), such as meloxicam, have a less detrimental effect on intestinal healing than flunixin meglumine (FM). Whether this translates to a beneficial effect in horses with naturally occurring strangulating small intestinal (SSI) lesions is unknown.ObjectivesTo compare the clinical outcome of horses with naturally occurring SSI lesions treated with meloxicam or FM.Study designRandomised prospective study.MethodsCases presenting to the Royal Veterinary College Equine Referral Hospital and Bell Equine Veterinary Clinic during 2010 and 2011 in which an SSI lesion was identified at exploratory laparotomy were eligible for inclusion. Horses received either 1.1 mg/kg bwt FM or 0.6 mg/kg bwt meloxicam i.v. q. 12 h. Clinical outcomes and clinical and laboratory parameters associated with endotoxaemia were compared between groups.ResultsSixty cases were enrolled, 32 horses received FM and 28 received meloxicam. There was no difference in signalment, physical examination or surgical factors between groups. The overall survival to discharge was 81%; there was no difference in survival (P = 0.14) or incidence of post operative ileus (P = 0.25) between groups. There was no significant difference between the plasma lipopolysaccharide (LPS) concentrations at 0 h (P = 0.18) or 48 h (P = 0.60); however, there was a significant difference between neutrophil count at 48 h (P<0.05) and at 96 h (P<0.01) with significantly greater cell numbers in horses receiving meloxicam compared with FM. Blinded pain score evaluation showed that more horses receiving meloxicam showed gross signs of pain than those treated with FM (P = 0.04).ConclusionsNonsteroidal anti‐inflammatory drug choice did not affect major clinical outcomes in horses with SSI lesions but had some effects on signs of pain. This study provides no evidence to recommend one NSAID treatment above another based on survival or the incidence of ileus; however, evaluation of a larger number of cases is required.
The emerging physiological roles of the glycerophosphodiesterase family
Authors: Corda Daniela , Mosca Maria G. , Ohshima Noriyasu , Grauso Laura , Yanaka Noriyuki , Mariggiò Stefania 
Published: December 2013

The glycerophosphodiester phosphodiesterases are evolutionarily conserved proteins that have been linked to several patho/physiological functions, comprising bacterial pathogenicity and mammalian cell proliferation or differentiation. The bacterial enzymes do not show preferential substrate selectivities among the glycerophosphodiesters, and they are mainly dedicated to glycerophosphodiester hydrolysis, producing glycerophosphate and alcohols as the building blocks that are required for bacterial biosynthetic pathways. In some cases, this enzymatic activity has been demonstrated to contribute to bacterial pathogenicity, such as with Hemophilus influenzae. Mammalian glyerophosphodiesterases have high substrate specificities, even if the number of potential physiological substrates is continuously increasing. Some of these mammalian enzymes have been directly linked to cell differentiation, such as GDE2, which triggers motor neuron differentiation, and GDE3, the enzymatic activity of which is necessary and sufficient to induce osteoblast differentiation. Instead, GDE5 has been shown to inhibit skeletal muscle development independent of its enzymatic activity.
Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care
Authors: Hogden Anne , Greenfield David , Nugus Peter , Kiernan Matthew C 
Published: December 2013

AbstractBackgroundPatients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS .ObjectiveThe aim was to examine the question: how can decision making that is both effective and patient‐centred be enacted in ALS multidisciplinary care?Setting and participantsFifty‐four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi‐structured interviews. Interviews were transcribed, coded and analysed thematically.ResultsComparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision‐making process; patient‐centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non‐specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: ‘Participant Engagement’; ‘Option Information’; ‘Option Deliberation’; and ‘Decision Implementation’.DiscussionEffective and patient‐centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient‐centred decision making, by incorporating patients' cyclic decision‐making patterns and facilitating carer inclusion in decision processes.ConclusionsThe model captures the complexities of patient‐centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment.