bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hybrid Therapy of Radiofrequency Catheter Ablation and Percutaneous Transvenous Mitral Commissurotomy in Patients With Atrial Fibrillation and Mitral Stenosis
Authors: MACHINO TAKESHI , TADA HIROSHI , SEKIGUCHI YUKIO , TANAKA YASUAKI , NAITO SHIGETO , YAMASAKI HIRO , ARIMOTO TAKANORI , IGARASHI MIYAKO , KUROKI KENJI , SEO YOSHIHIRO , WATANABE SHIGEYUKI , HOSHIZAKI HIROSHI , OSHIMA SHIGERU , TANIGUCHI KOICHI , AONUMA KAZUTAKA 
Published: October 2009

AF Ablation and PTMC. Background: The rhythm control of atrial fibrillation (AF) associated with mitral stenosis (MS) is often difficult using antiarrhythmic drugs (AADs), even after a percutaneous transvenous mitral commissurotomy (PTMC). Few studies have examined the efficacy and safety of simultaneously performing radiofrequency catheter ablation (RFCA) and a PTMC in patients with MS and AF.
Methods:
Twenty consecutive patients with drug‐resistant AF and rheumatic MS underwent RFCA combined with a PTMC (n = 10; persistent AF‐8, long‐lasting [>1 year] persistent AF‐2; RFCA group) or transthoracic direct cardioversion (DC) following a PTMC (n = 10; persistent AF‐7, long‐lasting persistent AF‐3; DC group). In all patients, the mitral valve morphology was amenable to a PTMC, and more than 2 AADs had been ineffective in maintaining sinus rhythm (SR). In the RFCA group, a segmental pulmonary vein isolation (PVI) was performed in the initial 5 patients, and an extensive PVI was performed in the remaining 5.
Results:
During a mean follow‐up period of 4.0 ± 2.7 years, 8 patients (80%) in the RFCA group were maintained in SR, as compared to 1 (10%) in the DC group (hazard ratio, 0.16; 95% confidence interval, 0.03 to 0.75; P = 0.008 by the log‐rank test). The prevalence of the concomitant use of class I and/or class III AADs was comparable between the 2 groups (P = 0.70). No complications occurred during the procedure or follow‐up period in either group.
Conclusions:
The hybrid therapy using RFCA and a PTMC was safe and feasible, and significantly improved the AF free survival rate compared to DC following a PTMC. (J Cardiovasc Electrophysiol, Vol. 21, pp. 284–289, March 2010)
Mechanisms of Arrhythmia Recurrence After Video‐Assisted Thoracoscopic Surgery for the Treatment of Atrial Fibrillation: Insights from Electrophysiological Mapping and Ablation
Authors: LIU XINGPENG , DONG JIANZENG , MAVRAKIS HERCULES E. , ZHENG BIN , LONG DEYONG , YU RONGHUI , TANG RIBO , TIAN YING , VARDAS PANOS E. , MA CHANGSHENG 
Published: October 2009

Background:
Video‐assisted thoracoscopic bilateral pulmonary vein (PV) isolation with left atrial appendage (LAA) excision is a novel surgical treatment for patients who have atrial fibrillation (AF) but no indication for open heart surgery. However, the electrophysiological mechanisms of the recurrent atrial tachyarrhythmias after this procedure are unknown.
Methods:
Eight consecutive patients with highly symptomatic atrial tachyarrhythmias after failed video‐assisted thoracoscopic surgery were included in this study. A predetermined stepwise ablation protocol, aimed at termination of the arrhythmia and isolation of all PVs, was conducted. The conduction across the remnant of the LAA was also evaluated in 4 patients.
Results:
Three patients had AF, which was converted into AT by complex fractionated atrial electrogram ablation in 2. Eleven sustained ATs in 7 patients were mapped during the procedure. A majority of ATs (10 of 11) were terminated by ablation before PV isolation. In total, 10 PV gaps in 7 patients were identified. All residual PV gaps were distributed exclusively in the roof or the bottom of the PV antrum. The conduction time across the remnant of the LAA was 90.7 ± 11.5 ms. One patient underwent a repeat successful ablation procedure. After a mean follow‐up of 10.1 ± 5.0 months after the last ablation procedure, 7 of 8 patients were free of clinical atrial tachyarrhythmias recurrence.
Conclusion:
PV gaps are present, with a characteristic distribution, in the majority of patients who fail this surgical procedure, but these gaps are not responsible for the arrhythmias identified. Instead, most are macro‐reentrant, isthmus‐dependent arrhythmias related to clamp‐associated or LAA excision‐associated scars.
Emergency Department Chlamydia Screening Through Partnership with the Public Health Department
Authors: Irvin Charlene Babcock , Nowak Bruce , Moore Maureen , Flynn Kevin , Vretta Catherine 
Published: October 2009

AbstractBackground:  The emergency department (ED) serves a population that may benefit from numerous screening initiatives but screening in the ED is challenging due to crowding as well as resource and time constraints. One option may be to collect specimens in the ED and then partner with the public health department (PHD) to analyze the specimens off‐site and arrange follow‐up treatment.Objectives:  The objective was to explore the feasibility of chlamydia screening in females using a partnership model in which the ED is responsible for urine collection and the PHD is responsible for chlamydia testing, notification, and treatment.Methods:  A collaborative partnership‐based chlamydia screening project was initiated at a large (90,000 visits/yr), urban, teaching ED from April 2007 to April 2008. Study information sheets were handed out to a convenience sample of eligible female patients and visitors (15–24 yr of age). Those wishing to participate provided a urine sample and follow‐up contact information. The information sheet also asked if they had either lower abdominal pain or vaginal discharge (affirmative answer for either was considered symptomatic). Specimens collected in the ED were retrieved by PHD staff for off‐site testing. The PHD contacted those participants testing positive using the patient provided contact information and arranged for treatment.Results:  Of the 633 women offered screening, 296 (47%) agreed to testing and provided samples. Of the 296 tested, 38 (12.8%) were positive for chlamydia infection, and 25 (66%) received follow‐up and treatment; 13 could not be contacted through information they provided. A higher percentage of symptomatic subjects (23 of 115, or 20%) tested positive for chlamydia than asymptomatic subjects (15 of 181, or 8.3%; p < 0.01).Conclusions:  This study demonstrates the feasibility of an ED–PHD partnership for chlamydia screening in young women. This model can potentially be applied to other initiatives and may improve public health screening without creating significant additional burdens for crowded EDs.
Six‐month Follow‐up of a Brief Intervention on Self‐reported Safety Belt Use Among Emergency Department Patients
Authors: Fernandez William G. , Winter Michael R. , Mitchell Patricia M. , Bullock Holly , Donovan Jacqueline , George Jill St. , Feldman James A. , Gallagher Susan S. , McKay Mary Pat , Bernstein Edward , Colton Theodore 
Published: October 2009

AbstractObjectives:  Safety belt use (SBU) reduces motor vehicle deaths by 45%. We previously reported that a brief intervention improved self‐reported SBU among emergency department (ED) patients at 3 months. We sought to determine if these effects were sustained at 6 months postenrollment.Methods:  This was a prospective, randomized controlled trial of adult patients (age ≥ 21 years) at an academic medical center ED from February 2006 to May 2006. Patients were systematically sampled for self‐reported SBU. Those with self‐reported SBU less than “always” were asked to participate. Subjects were surveyed at baseline with a nine‐item series of situational SBU questions scored on a five‐point Likert scale (e.g., 5 = always, 1 = never). This nine‐item average comprised the mean SBU score. Subjects were randomized to a control group (CG) and an intervention group (IG). The CG received an injury prevention brochure; the IG received a brief motivation interview by a trained interventionist and the brochure. Subjects were phoned at 3 and 6 months to determine interval change in SBU scores via a standard script. Repeated‐measures analysis of covariance and t‐tests were used to analyze trends in mean SBU scores between groups, as well as to test mean changes in SBU scores from the 3‐ to 6‐month intervals.Results:  Of 432 eligible patients, 292 enrolled (mean age = 35 years, SD ± 11.2 years; 61% male). At baseline, there were no significant demographic differences; the IG (n = 147) and CG (n = 145) had similar mean SBU scores (2.8 vs. 2.6, p = 0.31), and 66% (n = 96 in each) completed both 3‐ and 6‐month follow‐up. The mean SBU score at 6 months in the IG was greater than in the CG group (3.6 vs. 2.9, p < 0.001), as were the mean SBU score differences from baseline (IG = 0.84 vs. CG = 0.29, p < 0.001). These differences were sustained from the 3‐month interval (IG = −0.02 vs. CG = −0.06, p > 0.05).Conclusions:  The previously reported finding that ED patients who received a brief motivation interview reported higher SBU scores at 3 months compared to a CG was sustained at 6‐month follow‐up. Although limited by self‐report, a brief intervention may enhance lasting SBU behavior among high‐risk ED patients.
Using innovative group‐work activities to enhance the problem‐based learning experience for dental students
Authors: Grady R. , Gouldsborough I. , Sheader E. , Speake T. 
Published: October 2009

AbstractProblem‐based learning (PBL) in medical and dental curricula is now well established, as such courses are seen to equip students with valuable transferable skills (e.g. problem‐solving or team‐working abilities), in addition to knowledge acquisition. However, it is often assumed that students improve in such skills without actually providing direct opportunity for practice, and without giving students feedback on their performance. ‘The Manchester Dental Programme’ (TMDP) was developed at The University of Manchester, UK as a 5‐year, integrated enquiry‐led curriculum. The existing PBL course was redesigned to include a unique, additional PBL session (‘Session 4’) that incorporated an activity for the group to complete, based on the subject material covered during student self‐study. A summative mark was awarded for each activity that reflected the teamwork, organisational and overall capabilities of the groups. This paper describes the different types of activities developed for the Session 4 and presents an analysis of the perceptions of the students and staff involved. The student response to the Session 4 activities, obtained via questionnaires, was extremely positive, with the majority finding them fun, yet challenging, and ‘worthwhile’. The activities were perceived to enhance subject understanding; develop students’ problem‐solving skills; allow the application of knowledge to new situations, and helped to identify gaps in knowledge to direct further study. Staff found the activities innovative and exciting learning tools for the students. The Session 4 activities described here are useful educational resources that could be adapted for other PBL courses in a wide variety of subject areas.
Paediatric dentistry in outreach settings: an essential part of undergraduate curricula?
Authors: Hunter M. L. , Chaudhry U. 
Published: October 2009

AbstractIntroduction:  Although placements in primary care settings remote from dental schools are becoming a common feature of undergraduate dental curricula, little evidence is available regarding the experience of paediatric dentistry gained in this way.Materials and methods:  Treatment logs relating to salaried primary care placements undertaken by the Class of 2007 at Cardiff University School of Dentistry were examined, particular attention being paid to paediatric‐specific procedures.Results:  Forty‐nine logs relating to placements undertaken in South East Wales and 51 relating to those in North Wales were retrieved. In South East Wales, 90% of students gained experience of primary tooth restoration, 61% carrying out primary endodontics. Sixty‐three percent of students undertaking placements in South East Wales and 69% of those placed in North Wales gained experience of primary tooth extraction under local anaesthesia. All but three students gained experience of administering inhalation sedation.Discussion:  The findings of this study should go some way towards reassuring those who have expressed concern that recruitment difficulties within dental schools inevitably lead to increasing numbers of students qualifying without clinical experience of paediatric dental procedures considered to be within the remit of a newly qualified dental practitioner. However, there remains wide variation in the breadth and depth of experience of individual students and it is still possible for some students to graduate without what might be considered core experience in paediatric dentistry.Conclusion:  Salaried primary care settings are ideally placed to provide students with experience of paediatric‐specific procedures. Clinical education in paediatric dentistry should, therefore, incorporate the strengths of dental school and placement education.
Implementation of the virtual learning environment into a UK orthodontic training programme: the postgraduate and lecturer perspective
Authors: Shah R. , Cunningham S. J. 
Published: October 2009

AbstractThe virtual learning environment (VLE) was formally introduced into the orthodontic postgraduate teaching programme at the UCL Eastman Dental Institute in October 2006 with the main role to support the existing didactic teaching. The aim of this study was to establish the programme co‐ordinator, lecturer and postgraduate perspective on the introduction of the VLE as an adjunct to other teaching methods. All participants were interviewed utilising open‐ended questions to ascertain their response. The interviews were semi‐structured and were continued until no new information was elicited. The interviews suggested that the programme co‐ordinator, lecturers and the majority of the postgraduates were confident that the VLE could produce a better learning experience. The VLE has a number of advantages and disadvantages, however, there is great potential for the VLE to encourage a constructivist approach to teaching and learning. Moves have been made to align aspects, such as assessment, with the VLE and the rest of the curriculum.
The definition of human viability: a historical perspective
Authors: Pignotti MS 
Published: October 2009

AbstractAim: To investigate the current concepts related to the definition of human viability in a historical perspective.Methods: A review of the international literature was performed by using PubMed, Google, Embase to find definitions of Human Viability. The papers collected were divided chronologically.Results: Over the years, many authors have debated the concept of the limit of human viability, starting from Ballantyne in the early 1900. The definition differs from author to author.Conclusion: The definition of human viability is still under discussion. It depends primarily, but not only, on gestational age. A number of genetic, cultural, social and technological variables are also influential. This definition could have an impact on legislation and the widespread misunderstanding of this concept in the lay public could also be enhanced by a frank discussion among clinicians and other professionals.
Gestational diabetes and offspring body disproportion
Authors: Ahlsson F , Lundgren M , Tuvemo T , Gustafsson J , Haglund B 
Published: October 2009

AbstractAim:  It has been demonstrated that females born large for gestational age (LGA) in weight but not length are at increased risk of being obese at childbearing age. We addressed the question whether women with gestational diabetes mellitus (GDM) are at increased risk of giving birth to such infants.Methods:  Birth characteristics of 884 267 infants of non‐diabetic mothers and 7817 of mothers with GDM were analysed. LGA was defined as birth weight or birth length >2 standard deviation scores for gestational age. Multiple logistic regression analysis was performed.Results:  The odds ratio (OR) for a woman with GDM to give birth to an LGA infant that was heavy alone was four times increased (OR: 3.71, 95% CI: 3.41–4.04). Furthermore, in the population of mothers giving birth to LGA infants, the proportion heavy alone was 68% in the group of women with GDM compared with 64.4% in the group of non‐diabetic women. The risks were independent of gender of the foetus.Conclusion:  Women with GDM have an almost four times higher risk of delivering an LGA infant that is heavy alone. The noted disproportion between weight and length in infants of such mothers may have an impact on the risk of later obesity.
Predicting recovery of urination control in cats after sacrocaudal injury: a prospective study
Authors: Tatton B. , Jeffery N. , Holmes M. 
Published: October 2009

Objectives: To determine whether intact tail base pain sensation predicts control of urination after sacrocaudal fracture‐subluxation in cats. Methods: Twenty–one cats affected by sacrocaudal fracture‐subluxation were diagnosed routinely by radiography. The ability of each cat to detect a painful stimulus applied to the tail base was tested by application of pressure using a standard surgical instrument. Cats were then hospitalised for up to 30 days and categorised according to whether they showed control of urination. A value of P<0·05 was regarded as significant. The results were analysed to produce data regarding sensitivity, specificity and the positive and negative predictive value of the test. Results: All 11 cats that had intact tail base sensation showed control of urination within three days. Four of the 10 cats without tail base pain sensation did not recover control of urination by day 30. Clinical Significance: Intact tail base sensation predicts control of urination and is therefore a useful screening test.
Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases
Authors: Hayes G. 
Published: October 2009

Objectives:To establish predilection sites of obstruction and to investigate clinical factors associated with a poor outcome.Methods:A retrospective study of 208 consecutive cases over a 48‐month period from first‐opinion practice.Results:Overall, 91 per cent of cases recovered with higher survival rates from discrete foreign bodies (94 per cent in dogs and 100 per cent in cats) as opposed to linear foreign bodies (80 per cent in dogs and 63 per cent in cats). English bull terriers, springer spaniels, Staffordshire bull terriers, Border collies and Jack Russell terriers were over‐represented. In dogs, 63 per cent of obstructions occurred in the jejunum but foreign objects were encountered at all points along the gastrointestinal tract. A longer duration of clinical signs, the presence of a linear foreign body and multiple intestinal procedures were associated with significantly increased mortality. Neither the degree of obstruction (partial or complete) nor the location of the foreign body was shown to have a significant influence on survival.ClinicalSignificance:Prompt presentation, diagnosis and surgical intervention improve the outcome of gastrointestinal obstruction by foreign bodies. At surgery, the minimal number of intestinal procedures should be performed to restore the integrity of the alimentary tract.
Outcome following removal of canine spindle cell tumours in first opinion practice: 104 cases
Authors: Chase D. , Bray J. , Ide A. , Polton G. 
Published: October 2009

Objectives:To define the outcome of a cohort of canine patients with a histological diagnosis of spindle cell tumour of soft tissue managed solely by surgery in first opinion practice.Methods:Clinical details of 104 spindle cell sarcomas submitted to Finn Pathologists during the year 2000 were reviewed. Questionnaires were sent to the submitting veterinarians, requesting details about the tumour, surgery performed and ultimate outcome of the patient.Results:The method of surgical resection was described as marginal in 45 dogs (44·2 per cent). Excision margins of 3 cm or more were described in less than 10 per cent of cases. Tumours recurred locally in 29 dogs (27·9 per cent). Eighteen dogs (21·7 per cent) died of tumour‐related causes. Most deaths were unrelated to sarcoma (50 dogs, 60·2 per cent) or unknown (15 dogs, 18 per cent). The median survival time was 1013 days. Tumour size, location or degree of surgical resection were not significantly related to survival or tumour recurrence. A palpable assessment of tumour invasion into underlying tissues was significantly associated with decreased disease‐free interval (P<0·0001) and survival time (P = 0·0070).ClinicalSignificance:The results of this retrospective study indicate that many spindle cell tumours managed in first opinion practice exhibit a low‐grade biological behaviour and may respond well to more conservative surgery than current recommendations advise.
Energy, Climate Change, Meat, and Markets: Mapping the Coordinates of the Current World Food Crisis
Authors: Jarosz Lucy 
Published: October 2009

AbstractThe widely used metaphor of a perfect storm identifies the world food crisis as a contingent event that will end when food prices decline. The problem is one of supply and demand. The solution is a technological fix focused upon increasing the productivity of small farmers through a second green revolution and integrating them into markets. An international political economy/ecology approach to the food crisis reveals that the food crisis is a predictable outcome of an oil‐dependent feedgrain–livestock complex supplying a meat‐centric diet for those who can buy it. This complex contributes substantially to climate change and is framed by neoliberal development policies, which deepen the commoditization of food, monetize food security and leave the world’s people vulnerable to periodic food price spikes. The food crisis is linked to energy, climate change, the financial crisis and a socially and environmentally unsustainable grain–livestock complex and must be analyzed and addressed in its relational position to these other crises.
Spaces of Work and Everyday Life: Labour Geographies and the Agency of Unorganised Temporary Migrant Workers
Authors: Rogaly Ben 
Published: October 2009

AbstractIn this study, I focus on the agency of unorganised temporary migrant workers – people who travel away to work for just a few weeks or months. Such workers have been relatively neglected in labour geography. Perhaps surprisingly, given the focus on the agency of capital in much of his writing, I build on two arguments made by David Harvey. First, workers’ spatial mobility is complex and may involve short as well as longer term migrations, and secondly that this can have significance both materially and in relation to the subjective experience of employment. The spatial embeddedness of temporary migrant workers’ everyday lives can be a resource for shaping landscapes (and ordinary histories) of capitalism, even though any changes may be short‐lived and take place at the micro‐scale. The article is illustrated with case study material from research with workers in the agriculture sector in India and the UK, and concludes with more general implications for labour geographers engaged with other sectors and places.