bluuebunny/crossref_metadata_2025_split huggingface dataset:
Confirmation of Novel Noninvasive High-Density Electrocardiographic Mapping With Electrophysiology Study
Authors: Cakulev Ivan , Sahadevan Jayakumar , Arruda Mauricio , Goldstein Robert N. , Hong Mauricio , Intini Anselma , Mackall Judith A. , Stambler Bruce S. , Ramanathan Charu , Jia Ping , Strom Maria , Waldo Albert L. 
Published: December 2012

Background—
Twelve lead ECGs have limited value in precisely identifying atrial and ventricular activation during arrhythmias, including accessory atrioventricular conduction activation. The aim of this study was to report a single center’s clinical experience validating a novel, noninvasive, whole heart, beat-by-beat, 3-dimensional mapping technology with invasive electrophysiological studies, including ablation, where applicable.

Methods and Results—
Using an electrocardiographic mapping (ECM) system in 27 patients, 3-dimensional epicardial activation maps were generated from >250 body surface ECGs using heart–torso geometry obtained from computed tomographic images. ECM activation maps were compared with clinical diagnoses, and confirmed with standard invasive electrophysiological studies mapping. (1) In 6 cases of Wolff–Parkinson–White syndrome, ECM accurately identified the ventricular insertion site of an accessory atrioventricular connection. (2) In 10 patients with premature ventricular complexes, ECM accurately identified their ventricular site of origin in 8 patients. In 2 of 10 patients transient premature ventricular complex suppression was observed during ablation at the site predicted by ECM as the earliest. (3) In 10 cases of atrial tachycardia/atrial flutter, ECM accurately identified the chamber of origin in all 10, and distinguished isthmus from nonisthmus dependent atrial flutter. (4) In 1 patient with sustained exercise induced ventricular tachycardia, ECM accurately identified the focal origin in the left ventricular outflow tract.

Conclusions—
ECM successfully provided valid activation sequence maps obtained noninvasively in a variety of rhythm disorders that correlated well with invasive electrophysiological studies.
Prolonged QT Interval Diagnosis Suppression by a Widely Used Computerized ECG Analysis System
Authors: Garg Anubhav , Lehmann Michael H. 
Published: December 2012

Background—
Clinicians commonly rely on automated diagnostic interpretations for initial, point-of-care identification of ECG abnormalities. Our study goal was to investigate how one widely used computerized ECG analysis system performs in labeling prolongation of heart rate-corrected QT interval (QTc), an arrhythmia risk marker.

Methods and Results—
ECGs acquired in 2009–2010 from patients ≥18 years old within the University of Michigan Health System, analyzed by the Marquette 12SL ECG Analysis Program (GE Healthcare), and exhibiting sinus rhythms with heart rate <100 beats per minute and QRS duration <120 ms constituted our database. Of 97 046 study ECGs (48.2% from males), a prolonged 12SL-calculated QTc value (ie, ≥470 ms in females >60 years old, and ≥460 ms in other sex/age groups) was displayed in 16 235 (16.7%). Nonetheless, for only 7709 (47.5%) of these ECGs with prolonged QTc did the automated interpretation include an accompanying “Prolonged QT” diagnostic statement. Such prolonged QT under-reporting was manifest across all patient environments and reflected algorithmic suppression of the diagnosis, attributable to ECG waveform-based criteria, in 8526 (52.5%) ECGs with prolonged QTc. Of the latter ECGs with prolonged QT diagnosis suppression, the computer declared 3588 (42.1%) “Normal” despite QTc prolongation.

Conclusions—
In evaluating an adult patient whose 12SL-interpreted ECG lacks a prolonged QT diagnostic statement (assuming sinus rhythm <100 beats per minute and QRS duration <120 ms), physicians should examine the actual QTc value displayed on the report before concluding that this parameter is normal. Assessment of the clinical impact of prolonged QT diagnosis suppression by ECG waveform-based criteria is warranted.
Causal Relevance of Blood Lipid Fractions in the Development of Carotid Atherosclerosis
Authors: Shah Sonia , Casas Juan-Pablo , Drenos Fotios , Whittaker John , Deanfield John , Swerdlow Daniel I. , Holmes Michael V. , Kivimaki Mika , Langenberg Claudia , Wareham Nick , Gertow Karl , Sennblad Bengt , Strawbridge Rona J. , Baldassarre Damiano , Veglia Fabrizio , Tremoli Elena , Gigante Bruna , de Faire Ulf , Kumari Meena , Talmud Philippa J. , Hamsten Anders , Humphries Steve E. , Hingorani Aroon D. 
Published: December 2012

Background—
Carotid intima–media thickness (CIMT), a subclinical measure of atherosclerosis, is associated with risk of coronary heart disease events. Statins reduce progression of CIMT and coronary heart disease risk in proportion to the reduction in low-density lipoprotein cholesterol. However, interventions targeting triglycerides (TGs) or high-density lipoprotein cholesterol (HDL-C) have produced inconsistent effects on CIMT and coronary heart disease risk, making it uncertain whether such agents are ineffective for coronary heart disease prevention or whether CIMT is an inadequate marker of HDL-C or TG-mediated effects. We aimed to determine the causal association among the 3 major blood lipid fractions and common CIMT using mendelian randomization analysis.

Methods and Results—
Genetic scores specific for low-density lipoprotein cholesterol, HDL-C, and TGs were derived based on single nucleotide polymorphisms from a gene-centric array in ≈5000 individuals (Cardiochip scores) and from a genome-wide association meta-analysis in >100 000 individuals (Global Lipids Genetic Consortium scores). These were used as instruments in a mendelian randomization analysis in 2 prospective cohort studies. A genetically predicted 1 mmol/L higher low-density lipoprotein cholesterol concentration was associated with a higher common CIMT by 0.03 mm (95% confidence interval, 0.01–0.04) and 0.04 mm (95% confidence interval, 0.02–0.06) based on the Cardiochip and Global Lipids Genetic Consortium scores, respectively. HDL-C and TGs were not causally associated with CIMT.

Conclusions—
Our findings confirm a causal relationship between low-density lipoprotein cholesterol and CIMT but not with HDL-C and TGs. At present, the suitability of CIMT as a surrogate marker in trials of cardiovascular therapies targeting HDL-C and TGs is questionable and requires further study.
Autosomal Recessive Atrial Dilated Cardiomyopathy With Standstill Evolution Associated With Mutation of
Natriuretic Peptide Precursor A
Authors: Disertori Marcello , Quintarelli Silvia , Grasso Maurizia , Pilotto Andrea , Narula Nupoor , Favalli Valentina , Canclini Camilla , Diegoli Marta , Mazzola Silvia , Marini Massimiliano , Del Greco Maurizio , Bonmassari Roberto , Masè Michela , Ravelli Flavia , Specchia Claudia , Arbustini Eloisa 
Published: December 2012

Background—
Atrial dilatation and atrial standstill are etiologically heterogeneous phenotypes with poorly defined nosology. In 1983, we described 8-years follow-up of atrial dilatation with standstill evolution in 8 patients from 3 families. We later identified 5 additional patients with identical phenotypes: 1 member of the largest original family and 4 unrelated to the 3 original families. All families are from the same geographic area in Northeast Italy.

Methods and Results—

We followed up the 13 patients for up to 37 years, extended the clinical investigation and monitoring to living relatives, and investigated the genetic basis of the disease. The disease was characterized by: (1) clinical onset in adulthood; (2) biatrial dilatation up to giant size; (3) early supraventricular arrhythmias with progressive loss of atrial electric activity to atrial standstill; (4) thromboembolic complications; and (5) stable, normal left ventricular function and New York Heart Association functional class during the long-term course of the disease. By linkage analysis, we mapped a locus at 1p36.22 containing the
Natriuretic Peptide Precursor A
gene. By sequencing
Natriuretic Peptide Precursor A
, we identified a homozygous missense mutation (p.Arg150Gln) in all living affected individuals of the 6 families. All patients showed low serum levels of atrial natriuretic peptide. Heterozygous mutation carriers were healthy and demonstrated normal levels of atrial natriuretic peptide.

Conclusions—

Autosomal recessive atrial dilated cardiomyopathy is a rare disease associated with homozygous mutation of the
Natriuretic Peptide Precursor A
gene and characterized by extreme atrial dilatation with standstill evolution, thromboembolic risk, preserved left ventricular function, and severely decreased levels of atrial natriuretic peptide.
Permanent Cardiac Pacing in Children: Choosing the Optimal Pacing Site
Authors: Janoušek Jan , van Geldorp Irene E. , Krupičková Sylvia , Rosenthal Eric , Nugent Kelly , Tomaske Maren , Früh Andreas , Elders Jan , Hiippala Anita , Kerst Gunter , Gebauer Roman A. , Kubuš Peter , Frias Patrick , Gabbarini Fulvio , Clur Sally-Ann , Nagel Bert , Ganame Javier , Papagiannis John , Marek Jan , Tisma-Dupanovic Svjetlana , Tsao Sabrina , Nürnberg Jan-Hendrik , Wren Christopher , Friedberg Mark , de Guillebon Maxime , Volaufova Julia , Prinzen Frits W. , Delhaas Tammo ,   for the Working Group for Cardiac Dysrhythmias and Electrophysiology of the Association for European Pediatric Cardiology
Published: December 2012

Background—
We evaluated the effects of the site of ventricular pacing on left ventricular (LV) synchrony and function in children requiring permanent pacing.

Methods and Results—

One hundred seventy-eight children (aged <18 years) from 21 centers with atrioventricular block and a structurally normal heart undergoing permanent pacing were studied cross-sectionally. Median age at evaluation was 11.2 (interquartile range, 6.3–15.0) years. Median pacing duration was 5.4 (interquartile range, 3.1–8.8) years. Pacing sites were the free wall of the right ventricular (RV) outflow tract (n=8), lateral RV (n=44), RV apex (n=61), RV septum (n=29), LV apex (n=12), LV midlateral wall (n=17), and LV base (n=7). LV synchrony, pump function, and contraction efficiency were significantly affected by pacing site and were superior in children paced at the LV apex/LV midlateral wall. LV dyssynchrony correlated inversely with LV ejection fraction (
R
=0.80,
P
=0.031). Pacing from the RV outflow tract/lateral RV predicted significantly decreased LV function (LV ejection fraction <45%; odds ratio, 10.72; confidence interval, 2.07–55.60;
P
=0.005), whereas LV apex/LV midlateral wall pacing was associated with preserved LV function (LV ejection fraction ≥55%; odds ratio, 8.26; confidence interval, 1.46–47.62;
P
=0.018). Presence of maternal autoantibodies, gender, age at implantation, duration of pacing, DDD mode, and QRS duration had no significant impact on LV ejection fraction.

Conclusions—
The site of ventricular pacing has a major impact on LV mechanical synchrony, efficiency, and pump function in children who require lifelong pacing. Of the sites studied, LV apex/LV midlateral wall pacing has the greatest potential to prevent pacing-induced reduction of cardiac pump function.
A Liberalism of Sincerity: The Role of Religion in the Public Square
Authors: Helfand Michael A. 
Published: December 2012

This article considers the extent to which the liberal nation-state ought to accommodate religious practices that contravene state law and to incorporate religious discourse into public debate. To address these questions, the article develops a liberalism of sincerity based on John Locke’s theory of toleration. On such an account, liberalism imposes a duty of sincerity to prevent individuals from consenting to a regime that exercises control over matters of core concern such as faith, religion, and conscience. Liberal theory grounds the legitimacy of the state in the consent of the governed, but consenting to an intolerant regime is illegitimate because it empowers government to demand insincere conduct. Thus, demanding that citizens pursue sincerity ensures that they do not consent away their individual liberties in exchange for promises of security and orderliness.
The focus on sincerity also reorients the value that liberalism places on religious pluralism. Although many liberal theorists have proposed that religious pluralism is valuable because it provides individuals with a range of choices on how to live the good life, such theories provide little reason to promote and protect any particular religion. Indeed, if religions are important only because of the range of choice they provide, then the only concern of liberalism is to maintain enough religions so as to provide a meaningful range of options for how to live the good life; conversely, there is no reason to provide accommodations for any particular religion to aid its survival. By contrast, a liberalism of sincerity impels the liberal nation-state to widen the protections afforded to the expressions of sincerity, such as religious conduct and religious discourse. Because religious conduct and religious arguments flow from an individual’s commitment to sincerity, liberalism should provide broad protection for such religious activity in order to enable citizens to pursue sincerity.
Jewish Law and Matters of State: Theory, Policy, and Practice
Authors: Stern Yedidia 
Published: December 2012

In recent years Jewish religious leaders have often expressed religious opinions in matters concerning the foreign and security policy of the State of Israel. The present article focuses on the internal religious legitimacy of halakhic rulings in these matters and reveals the prerequisites that decisors must satisfy before voicing a binding halakhic opinion on issues concerning the Israeli Arab conflict, peace agreements, Jewish settlements in Judah and Samaria, etc.
The article is divided into three parts that answer the following questions: (a) are matters of State policy subject to halakhic norms or are they situated outside the realm of Halakha? (b) does Halakha have a judicial policy seeking to rule on these issues? (c) what are the practical difficulties that decisors face if they wish to rule on them? The article points out the diversity of internal halakhic opinions on the questions under investigation, and outlines an analytical method for a halakhic discussion aimed at answering them.
Violent deaths among Russian and EU male older adults
Authors: Innamorati Marco , Serafini Gianluca , Lester David , Amore Mario , Girardi Paolo , Pompili Maurizio 
Published: January 2013

Aims: This ecological comparison study explored temporal trends since 1985 in age-adjusted suicide and homicide rates for older male adults (over the age of 65) resident in the EU and the Russian Federation. Methods: The data were extracted from the World Health Organization’s (WHO) European mortality database. Results: Older men resident in the Russian Federation had a higher risk of dying a violent death (by homicide and by suicide) than their younger compatriots (relative risks (RR) ranging from 1.13 to 1.31). Conversely, in the EU, older men had a higher risk of dying from suicide (RRs of 1.52 for men over the age of 65 and 3.27 for men over the age of 75) and a lower risk of being victims of homicide (RRs ranging between 0.84 and 0.89) than their younger compatriots. Conclusions: The European region is characterized by great inequalities in rates of violent deaths among the elderly.
Presence of IL-9 in Paired Samples of Human Colostrum and Transitional Milk
Authors: Marcuzzi Annalisa , Vecchi Brumatti Liza , Caruso Lorenzo , Copertino Marco , Davanzo Riccardo , Radillo Oriano , Comar Manola , Monasta Lorenzo 
Published: December 2012

Background: Human colostrum and breast milk are known to contain high levels of cytokines, cytokine receptors, and chemokines. Objective: To investigate the presence and compare levels of soluble cytokines in paired samples of human colostrum and milk. Methods: Levels of 27 cytokines were measured in 9 paired samples of human colostrum (day 2 after delivery) and breast milk (day 4 or 5 after delivery) by using multiplex technology. Results: The majority of cytokines and chemokines investigated have been previously described in colostrum and/or breast milk. For the first time, we describe the presence of IL-9 in both human colostrum and milk. Of the 27 cytokines investigated, only IL-5 was absent in both colostrum and milk, whereas IL-1β, IL-2, IL-4, IL-15, IL-17, and MIP-1α were present in colostrum, but not in breast milk. In general, colostrum contained higher concentrations of cytokines with respect to human milk. Conclusion: Our data confirm and expand previous studies showing that human colostrum and breast milk are rich in cytokines and chemokines, including IL-9, which might contribute to the development of the immune system of the newborn.
Angiotensin-converting enzyme I/D gene polymorphism affects early cardiac response to professional training in young footballers
Authors: Saber-Ayad Maha M , Nassar Yasser S , Latif Inas A 
Published: January 2013

Background: The renin–angiotensin–aldosterone system plays a role in physiological and pathological responses of the heart to both static and dynamic exercise. Previous studies showed that the level of angiotensin II is determined by the angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism. Aim: We aimed in this study to determine the effect of ACE I/D gene polymorphism on the extent of functional and structural cardiac changes in response to one year of professional football training in young footballers. Methods and results: We studied 68 young male football players and a comparable control group. Besides medical history and clinical examination, 12 lead ECG and transthoracic 2D echocardiography examination were performed. Genotyping of ACE was analyzed using PCR-based technique. There was no statistically significant difference in distribution of genotypes among athletes compared with control subjects. D allele showed a graded effect on both EF (73.55, 67.5 and 60.2%, p=0.03) and PASP (37.6, 26.1 and 21.39 mmHg, p=0.02) in DD, ID and II subjects, respectively. Conclusion: Early cardiac changes in young footballers can be affected by ACE I/D polymorphism. There is a summative effect of the D allele in increasing EF and PASP in response to professional football training.
AB-QTL analysis reveals new alleles associated to proline accumulation and leaf wilting under drought stress conditions in barley (Hordeum vulgareL.)
Authors: Sayed Mohammed A , Schumann Henrik , Pillen Klaus , Naz Ali A , Léon Jens 
Published: December 2012

Abstract

Background
Land plants have evolved several measures to maintain their life against abiotic stresses. The accumulation of proline is the most generalized response of plants under drought, heat or salt stress conditions. It is known as an osmoprotectant which also acts as an instant source of energy during drought recovery process. But, both its role and genetic inheritance are poorly understood in agriculture crops. In the present work, advanced backcross quantitative trait locus (AB-QTL) analysis was performed to elucidate genetic mechanisms controlling proline accumulation and leaf wilting in barley under drought stress conditions.

Results
The analysis revealed eight QTL associated to proline content (PC) and leaf wilting (WS). QTL for PC were localized on chromosome 3H, 4H, 5H and 6H. The strongest QTL effect QPC.S42.5H was detected on chromosome 5H where drought inducible exotic allele was associated to increase PC by 54%. QTL effects QPC.S42.3H, QPC.S42.4H and QPC.S42.6H were responsible to heighten PC due to the preeminence of elite alleles over the exotic alleles which ranged from 26% to 43%. For WS, QTL have been localized on chromosome 1H, 2H, 3H and 4H. Among these, QWS.S42.1H and QWS.S42.4H were associated to decrease in WS due to the introgression of exotic alleles. In addition, two digenic epistatic interaction effects were detected for WS where the additive effect of exotic alleles imparted a favorable increase in the trait value.

Conclusions
The present data represents a first report on whole-genome mapping of proline accumulation and leaf wilting in barley. The detected QTL are linked to new alleles from both cultivated and wild accessions which bring out an initial insight on the genetic inheritance of PC and WS. These QTL alleles are fixed in the isogenic background of Scarlett, which will allow for positional cloning of underlying genes and to develop drought resilient barley cultivars.
Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study
Authors: Pastò Luisa , Portaccio Emilio , Ghezzi Angelo , Hakiki Bahia , Giannini Marta , Razzolini Lorenzo , Piscolla Elisa , De Giglio Laura , Pozzilli Carlo , Paolicelli Damiano , Trojano Maria , Marrosu Maria Giovanna , Patti Francesco , La Mantia Loredana , Mancardi Gian Luigi , Solaro Claudio , Totaro Rocco , Tola Maria Rosaria , Di Tommaso Valeria , Lugaresi Alessandra , Moiola Lucia , Martinelli Vittorio , Comi Giancarlo , Amato Maria Pia ,   and for the MS Study Group of the Italian Neurological Society
Published: December 2012

Abstract

Background
Few studies have systematically addressed the role of epidural analgesia and caesarean delivery in predicting the post-partum disease activity in women with Multiple Sclerosis (MS).
The objective of this study was to assess the impact of epidural analgesia (EA) and caesarean delivery (CD) on the risk of post-partum relapses and disability in women with MS.

Methods
In the context of an Italian prospective study on the safety of immunomodulators in pregnancy, we included pregnancies occurred between 2002 and 2008 in women with MS regularly followed-up in 21 Italian MS centers. Data were gathered through a standardized, semi-structured interview, dealing with pregnancy outcomes, breastfeeding, type of delivery (vaginal or caesarean) and EA. The risk of post-partum relapses and disability progression (1 point on the Expanded Disability Status Sclae, EDSS, point, confirmed after six months) was assessed through a logistic multivariate regression analysis.

Results
We collected data on 423 pregnancies in 415 women. Among these, 349 pregnancies resulted in full term deliveries, with a post-partum follow-up of at least one year (mean follow-up period 5.5±3.1 years). One hundred and fifty-five patients (44.4%) underwent CD and 65 (18.5%) EA. In the multivariate analysis neither CD, nor EA were associated with a higher risk of post-partum relapses. Post-partum relapses were related to a higher EDSS score at conception (OR=1.42; 95% CI 1.11-1.82; p=0.005), a higher number of relapses in the year before pregnancy (OR=1.62; 95% CI 1.15-2.29; p=0.006) and during pregnancy (OR=3.07; 95% CI 1.40-6.72; p=0.005). Likewise, CD and EA were not associated with disability progression on the EDSS after delivery. The only significant predictor of disability progression was the occurrence of relapses in the year after delivery (disability progression in the year after delivery: OR= 4.00; 95% CI 2.0-8.2; p<0.001; disability progression over the whole follow-up period: OR= 2.0; 95% CI 1.2-3.3; p=0.005).

Conclusions
Our findings, show no correlation between EA, CD and postpartum relapses and disability. Therefore these procedures can safely be applied in MS patients. On the other hand, post-partum relapses are significantly associated with increased disability, which calls for the need of preventive therapies after delivery.