bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Ripple Mapping to Visualize Slow Conduction Channels Within the Infarct-Related Left Ventricular Scar
Authors: Jamil-Copley Shahnaz , Vergara Pasquale , Carbucicchio Corrado , Linton Nick , Koa-Wing Michael , Luther Vishal , Francis Darrel P. , Peters Nicholas S. , Davies David Wyn , Tondo Claudio , Bella Paolo Della , Kanagaratnam Prapa 
Published: December 2014

Background—
Ripple mapping (RM) displays each electrogram at its 3-dimensional coordinate as a bar changing in length according to its voltage–time relationship with a fiduciary reference. We applied RM to left ventricular ischemic scar for evidence of slow-conducting channels that may act as ventricular tachycardia (VT) substrate.

Methods and Results—

CARTO-3© (Biosense Webster Inc, Diamond Bar, CA) maps in patient undergoing VT ablation were analyzed on an offline MatLab RM system. Scar was assessed for sequential movement of ripple bars, during sinus rhythm or pacing, which were distinct from surrounding tissue and termed RM conduction channels (RMCC). Conduction velocity was measured within RMCCs and compared with the healthy myocardium (>1.5 mV). In 21 maps, 77 RMCCs were identified. Conduction velocity in RMCCs was slower when compared with normal left ventricular myocardium (median, 54 [interquartile range, 40–86] versus 150 [interquartile range, 120–160] cm/s;
P
<0.001). All 7 sites meeting conventional criteria for diastolic pathways coincided with an RMCC. Seven patients had ablation colocating to all identified RMCCs with no VT recurrence during follow-up (median, 480 [interquartile range, 438–841] days). Fourteen patients had ≥1 RMCC with no ablation lesions. Five had recurrence during follow-up (median, 466 [interquartile range, 395–694] days). One of the 2 patients with no RMCC locations ablated had VT recurrence at 605 days post procedure. RMCCs were sensitive (100%; negative predictive value, 100%) for VT recurrence but the specificity (43%; positive predictive value, 35.7%) may be limited by blind alleys channels.

Conclusions—
RM identifies slow conduction channels within ischemic scar and needs further prospective investigation to understand the role of RMCCs in determining the VT substrate.
Endocarditis Pathogen Promotes Vegetation Formation by Inducing Intravascular Neutrophil Extracellular Traps Through Activated Platelets
Authors: Jung Chiau-Jing , Yeh Chiou-Yueh , Hsu Ron-Bin , Lee Chii-Ming , Shun Chia-Tung , Chia Jean-San 
Published: December 2014

Background—
Endocarditis-inducing streptococci form multilayered biofilms in complex with aggregated platelets on injured heart valves, but the host factors that interconnect and entrap these bacteria-platelet aggregates to promote vegetation formation were unclear.

Methods and Results—

In a
Streptococcus mutans
endocarditis rat model, we identified layers of neutrophil extracellular traps interconnecting and entrapping bacteria-platelet aggregates inside vegetation that could be reduced significantly in size along with diminished colonizing bacteria by prophylaxis with intravascular DNase I alone. The combination of activated platelets and specific immunoglobulin G–adsorbed bacteria are required to induce the formation of neutrophil extracellular traps through multiple activation pathways. Bacteria play key roles in coordinating the signaling through spleen tyrosine kinase, Src family kinases, phosphatidylinositol-3-kinase, and p38 mitogen-activated protein kinase pathways to upregulate the expression of P-selectin in platelets, while inducing reactive oxygen species–dependent citrullination in the arm of neutrophils. Neutrophil extracellular traps in turn serve as the scaffold to further enhance and entrap bacteria-platelet aggregate formation and expansion.

Conclusions—
Neutrophil extracellular traps promote and expand vegetation formation through enhancing and entrapping bacteria-platelet aggregates on the injured heart valves. (Circulation. 2015;131:571–581. DOI: 10.1161/CIRCULATIONAHA.114.011432.)
Cardiac Sarcoidosis
Authors: Kandolin Riina , Lehtonen Jukka , Airaksinen Juhani , Vihinen Tapani , Miettinen Heikki , Ylitalo Kari , Kaikkonen Kari , Tuohinen Suvi , Haataja Petri , Kerola Tuomas , Kokkonen Jorma , Pelkonen Markus , Pietilä-Effati Päivi , Utrianen Seppo , Kupari Markku 
Published: December 2014

Background—
This study was designed to assess the epidemiology, characteristics, and outcome of cardiac sarcoidosis (CS) in Finland.

Methods and Results—

We identified in retrospect all adult (>18 years of age) patients diagnosed with histologically confirmed CS in Finland between 1988 and 2012. A total of 110 patients (71 women) 51±9 years of age (mean±SD) were found and followed up for outcome events to the end of 2013. The annual detection rate of CS increased >20-fold during the 25-year period, reaching 0.31 in 1×10
5
adults between 2008 and 2012. The 2012 prevalence of CS was 2.2 in 1×10
5
. Nearly two thirds of patients had clinically isolated CS. Altogether, 102 of the 110 patients received immunosuppressive therapy, and 56 received an intracardiac defibrillator. Left ventricular function was impaired (ejection fraction <50%) in 65 patients (59%) at diagnosis and showed no overall change over 12 months of steroid therapy. During follow-up (median, 6.6 years), 10 patients died of a cardiac cause, 11 patients underwent transplantation, and another 11 patients suffered an aborted sudden cardiac death. The Kaplan–Meier estimates for 1-, 5-, and 10-year transplantation-free cardiac survival were 97%, 90%, and 83%, respectively. Heart failure at presentation predicted poor outcome (log-rank
P
=0.0001) with a 10-year transplantation-free cardiac survival of only 53%.

Conclusions—
The detection rate of CS has increased markedly in Finland over the last 25 years. With current therapy, the prognosis of CS appears better than generally considered, but patients presenting with heart failure still have poor long-term outcome.
Metformin Beyond Diabetes: Pleiotropic Benefits of Metformin in Attenuation of Atherosclerosis
Authors: Forouzandeh Farshad , Salazar Gloria , Patrushev Nikolay , Xiong Shiqin , Hilenski Lula , Fei Baowei , Alexander R. Wayne 
Published: December 2014

Background
Clinical studies show that metformin attenuates all‐cause mortality and myocardial infarction compared with other medications for type 2 diabetes, even at similar glycemic levels. However, there is paucity of data in the euglycemic state on the vasculoprotective effects of metformin. The objectives of this study are to evaluate the effects of metformin on ameliorating atherosclerosis.

Methods and Results

Using ApoE
−/−
C57BL/6J mice, we found that metformin attenuates atherosclerosis and vascular senescence in mice fed a high‐fat diet and prevents the upregulation of angiotensin II type 1 receptor by a high‐fat diet in the aortas of mice. Thus, considering the known deleterious effects of angiotensin II mediated by angiotensin II type 1 receptor, the vascular benefits of metformin may be mediated, at least in part, by angiotensin II type 1 receptor downregulation. Moreover, we found that metformin can cause weight loss without hypoglycemia. We also found that metformin increases the antioxidant superoxide dismutase‐1.

Conclusion
Pleiotropic effects of metformin ameliorate atherosclerosis and vascular senescence.
Mental illness and housing outcomes among a sample of homeless men in an Australian urban centre
Authors: Spicer Bridget , Smith David I , Conroy Elizabeth , Flatau Paul R , Burns Lucy 
Published: December 2014

Objective: The over-representation of mental illness among homeless people across the globe is well documented. However, there is a dearth of Australian literature on the mental health needs of homeless individuals. Furthermore, longitudinal research examining the factors that contribute to better housing outcomes among this population is sparse. The aim of this research is to describe the mental illness profile of a sample of homeless men in an Australian urban centre (in Sydney) and examine the factors associated with better housing outcomes at 12-month follow-up. Methods: A longitudinal survey was administered to 253 homeless men who were involved in the Michael Project: a 3-year initiative which combined existing accommodation support services with assertive case management and access to coordinated additional specialist allied health and support services. A total of 107 participants were followed up 12 months later. The survey examined the demographics of the sample and lifetime mental disorder diagnoses, and also included psychological screeners for current substance use and dependence, psychological distress, psychosis, and post-traumatic stress. Results: Consistent with existing literature, the prevalence of mental illness was significantly greater amongst this sample than the general Australian population. However, mental illness presentation was not associated with housing situation at 12-month follow-up. Instead, type of support service at baseline was the best predictor of housing outcome, wherein participants who received short to medium-term accommodation and support were significantly more likely to be housed in stable, long-term housing at the 12-month follow-up than participants who received outreach or emergency accommodation support. Conclusions: This study provides evidence to support an innovative support model for homeless people in Australia and contributes to the limited Australian research on mental illness in this population.
Recovery Assessment Scale – Domains and Stages (RAS-DS): Its feasibility and outcome measurement capacity
Authors: Hancock Nicola , Scanlan Justin Newton , Honey Anne , Bundy Anita C , O’Shea Katrina 
Published: December 2014

Objective: A self-report instrument of mental health recovery is needed both to facilitate collaborative, recovery-oriented practice and measure recovery-focused outcomes. The Recovery Assessment Scale – Domains and Stages (RAS-DS) has been developed to simultaneously fulfill these goals. The aim of this study was to test the feasibility and measurement properties of the RAS-DS. Method: Feasibility was examined by 58 consumer-staff pairs volunteering from 3 non-government organisations. Consumers completed the RAS-DS, discussed it with staff, and then both completed Usefulness Questionnaires. The psychometric properties were examined using Rasch analysis with the data from these consumer participants and from additional participants recruited from two Partners in Recovery programs ( N=324). Results: Over 70% of consumers reported taking 15 minutes or less to complete the RAS-DS and rated the instrument as easy or very easy to use. Qualitative data from both consumers and staff indicated that, for most, the RAS-DS was an easy to use, meaningful resource that facilitated shared understandings and collaborative goal setting. However, for a very small number of consumers, the instrument was too confronting and hard to use. Rasch analysis demonstrated evidence for excellent internal reliability and validity. Raw scores were highly correlated with Rasch-generated overall scores and thus no transformation is required, easing use for clinicians. Preliminary evidence for sensitivity to change was demonstrated. Conclusions: The results provide evidence of the feasibility and psychometric strengths of the RAS-DS. Although further research is required, the RAS-DS shows promise as a potential addition to the national suite of routine outcome measures.
Thinking ahead – the need for early Advance Care Planning for people on haemodialysis: A qualitative interview study
Authors: Bristowe Katherine , Horsley Helen L , Shepherd Kate , Brown Heather , Carey Irene , Matthews Beverley , O’Donoghue Donal , Vinen Katie , Murtagh Felicity EM 
Published: December 2014

Background: There is a need to improve end-of-life care for people with end-stage kidney disease, particularly due to the increasingly elderly, frail and co-morbid end-stage kidney disease population. Timely, sensitive and individualised Advance Care Planning discussions are acceptable and beneficial for people with end-stage kidney disease and can help foster realistic hopes and goals. Aim: To explore the experiences of people with end-stage kidney disease regarding starting haemodialysis, its impact on quality of life and their preferences for future care and to explore the Advance Care Planning needs of this population and the timing of this support. Study design: Semi-structured qualitative interview study of people receiving haemodialysis. Interviews were analysed using thematic analysis. Recruitment ceased once data saturation was achieved. Setting/participants: A total of 20 patients at two UK National Health Service hospitals, purposively sampled by age, time on haemodialysis and symptom burden. Results: Themes emerged around: Looking Back, emotions of commencing haemodialysis; Current Experiences, illness and treatment burdens; and Looking Ahead, facing the realities. Challenges throughout the trajectory included getting information, communicating with staff and the ‘conveyor belt’ culture of haemodialysis units. Participants reported a lack of opportunity to discuss their future, particularly if their health deteriorated, and variable involvement in treatment decisions. However, discussion of these sensitive issues was more acceptable to some than others. Conclusion: Renal patients have considerable unmet Advance Care Planning needs. There is a need to normalise discussions about preferences and priorities in renal and haemodialysis units earlier in the disease trajectory. However, an individualised approach is essential – one size does not fit all.
Ethics rounds
Authors: Silén Marit , Ramklint Mia , Hansson Mats G , Haglund Kristina 
Published: December 2014

Background: Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection. Aim: The aim of this study was to gain a deeper understanding of how the ethics rounds were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff. Research design: An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews. Participants and research context: A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed. Ethical considerations: The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards. Findings: The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work. Discussion: A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care. Conclusion: By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues.
Comparison of professional values between nursing students in Taiwan and China
Authors: Lin Yu-Hua , Li Jie , Shieh Show-Ing , Kao Chia-Chan , Lee I , Hung Shu-Ling 
Published: December 2014

Background: People in both Taiwan and China originally descended from the Han Chinese, but the societies have been separated for approximately 38 years. Due to different political systems, variations exist in healthcare and nursing education systems in Taiwan and China. Objective: The purpose of this study was to examine the professional values of nursing students in Taiwan and China. Design: A cross-sectional design was applied in this study. The Nursing Professional Value Scale–Revised was used to measure the professional values of the students. The questionnaire was distributed to eligible undergraduate students in a classroom setting. Ethical considerations: This study was approved by the Institutional Review Board at the first investigator’s university. Participants were informed that completion and return of the questionnaire was voluntary, and confidentiality was ensured by keeping the responses anonymous. Participants: A convenience sample included 292 Taiwanese students and 654 Chinese students. Findings: A total of 11 individual Nursing Professional Value Scale–Revised items showed significant differences between the two groups. These results reflect the differences in the perceived importance of these items between the groups. There was no significant difference between the two groups in the mean overall scores for the Nursing Professional Value Scale–Revised (p = .766) and three subscales (all p > .05). Conclusion: There are some differences in professional values between nursing students in Taiwan and China. Given the increasingly frequent and close interactions between Taiwan and China and the globalization of nursing, understanding these differences may help nursing educators identify students’ perceptions of their professional values and support the development of strategies to improve weaknesses in professional values.
Macroscopic Anomalies and Pathological Findings in and Around the Achilles Tendon
Authors: Johansson Kristian , Lempainen Lasse , Sarimo Janne , Laitala-Leinonen Tiina , Orava Sakari 
Published: December 2014

Background: Nonsurgical treatments for chronic Achilles tendinopathy (AT) results in unpredictable success rates. Surgical treatment may be chosen as reports show mostly encouraging but variable success rates depending on the pathology. The distribution of surgically confirmed pathologies in AT is largely unknown. Purpose: To ascertain the distributions of macroscopically observed anomalies in participants undergoing surgical treatment for chronic AT. Study Design: Case series; Level of evidence, 4. Methods: The main macroscopic pathologies of 1661 chronic Achilles tendon overuse injuries, which were diagnosed and surgically treated by a single surgeon, were reviewed. The surgeries were performed on professional and recreational athletes during the years 1976-1980, 1986-1990, 1996-2000, and 2006-2010. Surgical diagnoses, along with age- and sport-specific characteristics, were collected retrospectively from patient records. Results: The relative proportion of tendinosis increased during the study period from 4.2% to 21%, and paratenonitis decreased from 50% to 26%. Retrocalcaneal pathologies were the most common surgically confirmed lesions at 30%, while the mean age at surgery increased by 11 years over the entire study period. Conclusion: Surgically confirmed pathologies in and around the Achilles tendon showed coherent changes, chronic paratenonitis, and retrocalcaneal problems as the most prevalent findings. The classification of midportion and insertional tendinopathy and retrocalcaneal bursitis in AT should strictly be used as a clinical diagnosis. During surgical evaluations, the diagnosis is further clarified as more specific pathologies may be identified.
Thriving beyond survival: Understanding utilization of perinatal health services as predictors of birth registration: A cross-sectional study
Authors: Jackson Michelle , Duff Putu , Kusumaningrum Santi , Stark Lindsay 
Published: December 2014

Abstract
Background
There are an estimated 35 million unregistered children in Indonesia. To understand ways to best leverage existing health system-related resources and ensure greater protective measures for these vulnerable children, this study explores the predictive relationship between the utilization of perinatal health services and birth certificate ownership in two Indonesian provinces.

Methods
This study employed a cross-sectional design with interviewer-administered household surveys to heads of households in West Nusa Tenggara and East Nusa Tenggara from May to July of 2013. The primary outcome of interest was birth certificate ownership among children under the age of 5 years old. Bivariate and multivariable regression analyses using Generalized Estimating Equations (GEE) considered a set of covariates that represented child and household socio-demographic characteristics along with health services utilization variables during pregnancy and post-pregnancy periods.

Results
389 heads of households were interviewed, yielding data on a sample of 451 children under the age of 5. Fewer than 28% of children in this sample possessed a birth certificate. Nearly 57% (n = 259) of children were delivered in a clinical facility, though only 36% (n = 93) of these were legally registered. Of children born in the home (n = 194), registration dropped to 16% (n = 31). Adjusted analyses accounting for socio-demographic factors suggest that children born in a clinic facility (AOR = 2.33, 95% CI: 1.27, 4.33), hospital (AOR = 2.38, 95% CI: 1.12, 5.09), or in the presence of a skilled birth attendant (AOR = 2.35, 95% CI: 1.31, 4.23) were significantly more likely to be registered. Children whose mothers sought post-natal care were 2.99 times more likely to possess a birth certificate (AOR = 2.99, 95% CI: 1.1, 7.57). Pre-natal care was not associated with birth registration.

Conclusion
These findings suggest that use of perinatal health services increases the likelihood of registering a child’s birth despite a lack of formal integration of vital registration with the health sector. Formally leveraging existing community-based health workers and perinatal services may serve to further increase registration rates in hard to reach areas of Indonesia.
A novel model of demyelination and remyelination in a GFP-transgenic zebrafish
Authors: Fang Yangwu , Lei Xudan , Li Xiang , Chen Yanan , Xu Fei , Feng Xizeng , Wei Shihui , Li Yuhao 
Published: December 2014

ABSTRACT
Demyelinating diseases consist of a variety of autoimmune conditions in which the myelin sheath is damaged due to genetic and/or environmental factors. During clinical treatment, some patients undergo partial remyelination, especially during the early disease stages. However, the mechanisms that regulate demyelination remain unclear. The myelin structure, myelin formation and myelin-related gene expression are highly conserved between mammals and zebrafish. Therefore, the zebrafish is an ideal model organism to study myelination. In this study, we generated a transgenic zebrafish Tg(mbp:nfsB-egfp) expressing a fusion protein composed of enhanced green fluorescent protein (EGFP) and NTR from the myelin basic protein (mbp) promoter. Tg(mbp:nfsB-egfp) expressed NTR-EGFP reproducibly and hereditarily in oligodendrocytes along the spinal cord. Treatment of zebrafish larvae Tg(mbp:nfsB-egfp) with metronidazole (Mtz) resulted in the selective ablation of oligodendrocytes and led to demyelination, accompanied by behavioral changes, including decreased total movement distance, velocity, total movement time and fast movement time. After withdrawal of Mtz for a seven day recovery period, the expression of EGFP and MBP protein was observed again which indicates remyelination. Additionally, locomotor capacity was restored. Collectively, Tg(mbp:nfsB-egfp), a heritable and stable transgenic line, provides a novel, powerful tool to study the mechanisms of demyelination and remyelination.