bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-Year Outcome of Cardiac Contractility Modulation in Patients With Reduced Ejection Fraction, Atrial Fibrillation, and Previous Resynchronization: A Pilot Study
Authors: Tint Diana , Micu Sorin 
Published: November 2022

Background:
After 6 months of therapy, cardiac contractility modulation (CCM) has been shown to improve symptoms, exercise tolerance, and quality of life as well as reduce the rate of hospitalizations in patients with heart failure with reduced left ventricular ejection fraction (HFrEF), but long-term effects data are lacking, with no randomized trial to date.

Study question:
What is the long-term benefit of the CCM device implantation in symptomatic patients with severe, optimally treated HFrEF?

Study design:
We conducted a prospective trial involving patients with symptomatic HFrEF [New York Heart Association (NYHA) Class III or IV, left ventricular ejection fraction (LVEF) ≤35%] who were supported by a CCM device.

Results:
Twenty patients (19 men), aged 66.5 ± 6.9 years, were provided with CCM therapy and followed up for an average duration of 321.7 ± 113.5 days. The etiology of heart failure was ischemic in 16 patients (80%), 9 patients (45%) had atrial fibrillation, 6 patients (30%) had diabetes mellitus, and mean creatinine clearance value was 54.8 ± 13.0 mL/min. Eleven patients (60%) had LVEF ≤25%. Although all the patients had an implanted cardioverter–defibrillator, 6 of them (30%) also had resynchronization therapy. The pharmacological treatment has been optimized in all patients. One year after implantation, the LVEF increased from 24.68% ± 4.5 to 34.6 ± 5 (P < 0.0001), NYHA class improved from 3.2 ± 0.5 to 1.4 ± 0.5 (P < 0.0001), and exercise tolerance evaluated with a 6-Minute Walk Test increased (from 307.9 ± 74.1 m to 567 ± 99.5 m; P < 0.00001). These improvements were largely seen in the first 6 months.

Conclusions:
Over the course of a year, CCM therapy was associated with improved LVEF and NYHA class, as well as significantly better exercise tolerance, even in patients with atrial fibrillation and cardiac resynchronization therapy and did not seem to be associated with additional significant device-related problems.
Using evoked compound action potentials to quantify differential neural activation with burst and conventional, 40 Hz spinal cord stimulation in ovines
Authors: Dinsmoor David A. , Usoro Joshua O. , Barka Noah D. , Billstrom Tina M. , Litvak Leonid M. , Poree Lawrence R. 
Published: November 2022

Introduction and Objectives:
Unlike conventional dorsal spinal cord stimulation (SCS)—which uses single pulses at a fixed rate—burst SCS uses a fixed-rate, five-pulse stimuli cluster as a treatment for chronic pain; mechanistic explanations suggest burst SCS differentially modulate the medial and lateral pain pathways vs conventional SCS. Neural activation differences between burst and conventional SCS are quantifiable with the spinal-evoked compound action potential (ECAP), an electrical measure of synchronous neural activation.

Methods:
We implanted 7 sheep with a dorsal stimulation lead at T9/T10, a dorsal ECAP sensing lead at T6/T7, and a lead also at T9/T10 but adjacent to the anterolateral system (ALS). Both burst and conventional SCS with stimulation amplitudes up to the visual motor threshold (vMT) were delivered to 3 different dorsal spinal locations, and ECAP thresholds (ECAPTs) were calculated for all combinations. Then, changes in ALS activation were assessed with both types of SCS.

Results:
Evoked compound action potential thresholds and vMTs were significantly higher (P < 0.05) with conventional vs burst SCS, with no statistical difference (P > 0.05) among stimulation sites. However, the vMT−ECAPT window (a proxy for the useable therapeutic dosing range) was significantly wider (P < 0.05) with conventional vs burst SCS. No significant difference (P > 0.05) in ALS activation was noted between conventional and burst SCS.

Conclusion:
When dosed equivalently, no differentially unique change in ALS activation results with burst SCS vs conventional SCS; in addition, sub-ECAPT burst SCS results in no discernable excitability changes in the neural pathways feeding pain relevant supraspinal sites.
Radiation therapy post radical prostatectomy: who, when and why?
Authors: Latorzeff Igor , Le Guevelou Jennifer , Sargos Paul 
Published: November 2022

Purpose of review
During decades, adjuvant radiotherapy (ART) has been the standard of care after surgery, based on four randomized clinical trials (RCTs). As early salvage radiotherapy (SRT) recently challenged the ART paradigm, the optimal timing to initiate radiotherapy remains a matter of debate.

Recent findings
Three RCTs evaluated ART or SRT for postprostatectomy patients, with pathological risk factors (Gleason score > 8, pT3, positive margins). The ARTISTIC meta-analysis demonstrated similar 5-year biochemical recurrence-free survival for ART and SRT (89 vs. 88%). Lower rates of late genitourinary toxicity were demonstrated within the SRT arm, favouring early SRT in clinical practice.
The addition of pelvic lymph node radiotherapy recently demonstrated an improvement in freedom from progression within the randomized RTOG 0534 trial, especially for patients with pretreatment prostate serum antigen (PSA) levels more than 0.35 ng/ml. The most appropriate androgen deprivation therapy duration remains a point of controversy.

Summary
The SRT approach can be favoured for the vast majority of patients, provided close monitoring of PSA and early treatment in the event of biochemical recurrence. Radiotherapy dose and volumes and ADT use might be correlated to SRT timing (early vs. late). Results from trials including genomic tests and metabolic imaging will probably help to refine these criteria.
Traumatic peripheral nerve injuries: diagnosis and management
Authors: Barnes Stephanie L. , Miller Thomas A. , Simon Neil G. 
Published: November 2022

Purpose of review
To review advances in the diagnostic evaluation and management of traumatic peripheral nerve injuries.

Recent findings
Serial multimodal assessment of peripheral nerve injuries facilitates assessment of spontaneous axonal regeneration and selection of appropriate patients for early surgical intervention. Novel surgical and rehabilitative approaches have been developed to complement established strategies, particularly in the area of nerve grafting, targeted rehabilitation strategies and interventions to promote nerve regeneration. However, several management challenges remain, including incomplete reinnervation, traumatic neuroma development, maladaptive central remodeling and management of fatigue, which compromise functional recovery.

Summary
Innovative approaches to the assessment and treatment of peripheral nerve injuries hold promise in improving the degree of functional recovery; however, this remains a complex and evolving area.
Neurology education in the era of artificial intelligence
Authors: Kedar Sachin , Khazanchi Deepak 
Published: November 2022

Purpose of review
The practice of neurology is undergoing a paradigm shift because of advances in the field of data science, artificial intelligence, and machine learning. To ensure a smooth transition, physicians must have the knowledge and competence to apply these technologies in clinical practice. In this review, we describe physician perception and preparedness, as well as current state for clinical applications of artificial intelligence and machine learning in neurology.

Recent findings
Digital health including artificial intelligence-based/machine learning-based technology has made significant inroads into various aspects of healthcare including neurological care. Surveys of physicians and healthcare stakeholders suggests an overall positive perception about the benefits of artificial intelligence/machine learning in clinical practice. This positive perception is tempered by concerns for lack of knowledge and limited opportunities to build competence in artificial intelligence/machine learning technology. Literature about neurologist's perception and preparedness towards artificial intelligence/machine learning-based technology is scant. There are very few opportunities for physicians particularly neurologists to learn about artificial intelligence/machine learning-based technology.

Summary
Neurologists have not been surveyed about their perception and preparedness to adopt artificial intelligence/machine learning-based technology in clinical practice. We propose development of a practical artificial intelligence/machine learning curriculum to enhance neurologists’ competence in these newer technologies.
Clozapine-Induced Fever and Plasma Cytokine Changes in a Patient With Schizophrenia
Authors: Nakamura Masaru , Nagamine Takahiko 
Published: November 2022

Introduction
Clozapine-induced fever is frequently documented in the early stages of administration. Fever during clozapine treatment often presents a clinical challenge, because there are no established guideline to decide when fever is the adverse effect. Although the etiology of clozapine-induced fevers remains unknown, evidence has suggested that fever may develop secondarily to a generalized inflammatory response as a manifestation of the immune-modulating effects of clozapine.

Case Presentation
We presented a 59-year-old male patient with a treatment-resistant schizophrenia, who was introduced clozapine for the first time. He became febrile on day 14 at 75 mg/d. He was diagnosed clozapine-induced fever, which was improved by dose reduction on day 27 at 25 mg/d. However, we noticed significant high levels of blood urea nitrogen and serum creatinine on day 29, which resulted in withdrawal of clozapine. Also, we found continuous eosinophilia on day 33. After we provided conservative therapy with appropriate intravenous fluids, his kidney function and eosinophilic counts returned to normal on day 59 and day 53, respectively. The time-sequential changes of levels of interleukin 6 and tumor necrosis factor α suggested that the upregulated cytokines play a role on clozapine-induced fever and subsequent eosinophilia under severe renal failure condition.

Conclusions
To our knowledge, this is the first case presentation of clozapine-induced fever discussing the mechanism, differential diagnosis, and decision making of clozapine treatment focusing on plasma cytokines. If once fever occurs, an extensive medical workup for the fever and a careful systemic medical management should be promptly proceeded to avoid clozapine-associated severe complications.
A Case of Multidrug-Resistant Lance-Adams Syndrome Successfully Treated With Phenobarbital
Authors: Yeniay Süt Nurşah , Yıldırım Miraç , Bektaş Ömer , Kendirli Tanıl , Teber Serap 
Published: November 2022

ObjectiveLance-Adams syndrome is a rare but devastating disorder characterized by rest, action, and stimulus-sensitive myoclonus after cardiorespiratory arrest. We aimed to present a case of multidrug-resistant Lance-Adams syndrome that was successfully treated with oral phenobarbital therapy.Method and ResultsWe report a previously healthy 11-year, 6-month-old boy was referred to our pediatric intensive care unit because of severe hypoxic ischemic brain injury due to sudden cardiorespiratory arrest. On the 15th day of hospitalization, he developed myoclonic jerks involving his limbs, trunk, and eyes. Despite many antiseizure medications in different combinations, myoclonic jerks persisted. Then, phenobarbital was started, and myoclonic jerks disappeared the next day. At the final evaluation, additional phenobarbital treatment was continued for 6 months and the patient remained myoclonus-free during this time.ConclusionsTo the best of our knowledge, this case is the first report describing significant improvement with phenobarbital in a patient with multidrug-resistant Lance-Adams syndrome. We suggest that phenobarbital is an effective option and should be kept in mind in patients with multidrug-resistant Lance-Adams syndrome.
Zobellella iuensis sp. nov., an aerobic denitrifying bacterium isolated from activated sludge
Authors: Li Jiangwei , Hu Anyi , Liang Xiaoxuan , Yang Xiaoyong , Jia Yanwen , Yu Chang-Ping 
Published: November 2022

An aerobic denitrifying bacterium, designated as strain CPY4T, was isolated from activated sludge treating urban sewage under alternating aerobic/anaerobic conditions by an enrichment culture technique. Cells of strain CPY4T were Gram-stain-negative, aerobic, long rod-shaped, motile by means of single polar flagellum and capable of aerobic denitrification with citrate as the carbon source. Growth of strain CPY4T was observed at 10–45 °C (optimum, 30–35 °C), at pH 6.0–10.5 (optimum, pH 8.0–8.5) and in 0–5 % NaCl (optimum, 0–3 %; w/v). The 16S rRNA gene sequence of strain CPY4T showed the highest similarity to

Zobellella denitrificans

ZD1T (97.9 %), followed by

Zobellella endophytica

59N8T (97.6 %),

Zobellella aerophila

JC2671T (97.2 %),

Zobellella taiwanensis

ZT1T (97.1 %) and

Zobellella maritima

102-Py4T (96.3 %). Genome comparisons between CPY4T and other

Zobellella

species showed highest digital DNA–DNA hybridization with

Z. denitrificans

ZD1T (43.8 %) and highest average nucleotide identity (ANIb and ANIm) of genome nucleotide sequences with

Z. denitrificans

ZD1T(90.7 and 92 %, respectively). Phylogenetic analysis revealed that strain CPY4T fell within the clade comprising the type strains of

Zobellella

species and formed a phyletic line with them, which was distinct from other members of the family

Aeromonadaceae

. The sole respiratory ubiquinone was quinone 8. The predominant fatty acids (>10 % of the total fatty acids) of strain CPY4T were summed feature 8 (C18 : 1
ω6c and/or C18 : 1
ω7c), summed feature 3 (C16 : 1
ω6c and/or C16 : 1
ω7c) and C16 : 0. The genomic DNA G+C content was 62.7 mol %. In the polar lipid profile, diphosphatidylglycerol, phosphatidylglycerol, phosphatidyl ethanolamine, phospholipids and aminolipids were the major compounds. Based on the genotypic and phenotypic data, strain CPY4T represents a novel species of the genus

Zobellella

, for which the name Zobellella iuensis sp. nov. is proposed. The type strain is CPY4T (=JCM 34456T=CGMCC 1.18722T).
Time to full enteral feeds in hospitalised preterm and very low birth weight infants in Nigeria and Kenya
Authors: Imam Zainab O , Nabwera Helen M , Tongo Olukemi O , Andang’o Pauline EA , Abdulkadir Isa , Ezeaka Chinyere V , Ezenwa Beatrice N , Fajolu Iretiola B , Mwangome Martha K , Umoru Dominic D , Akindolire Abimbola E , Otieno Walter , Olwala Macrine , Nalwa Grace M , Talbert Alison W , Abubakar Ismaela , Embleton Nicholas D , Allen Stephen J 
Published: November 2022

AbstractBackgroundPreterm (born < 37 weeks’ gestation) and very low birthweight (VLBW; <1.5kg) infants are at the greatest risk of morbidity and mortality within the first 28 days of life. Establishing full enteral feeds is a vital aspect of their clinical care. Evidence predominantly from high income countries shows that early and rapid advancement of feeds is safe and reduces length of hospital stay and adverse health outcomes. However, there are limited data on feeding practices and factors that influence the advancement of feeds among these vulnerable infants in sub-Saharan Africa.AimTo identify factors that influence the time to full enteral feeds, defined as tolerance of 120ml/kg/day, in hospitalised preterm and VLBW infants in neonatal units in two sub-Saharan African countries.MethodsDemographic and clinical variables were collected for newborns admitted to 7 neonatal units in Nigeria and Kenya over 6-months. Multiple linear regression analysis was conducted to identify factors independently associated with time to full enteral feeds.ResultsOf the 2280 newborn infants admitted, 484 were preterm and VLBW. Overall, 222/484 (45.8%) infants died with over half of the deaths (136/222; 61.7%) occurring before the first feed. The median (inter-quartile range) time to first feed was 46 (27, 72) hours of life and time to full enteral feeds (tFEF) was 8 (4.5,12) days with marked variation between neonatal units. Independent predictors of tFEF were time to first feed (unstandardised coefficient B 1.75; 95% CI 1.16 to 2.34; p value <0.001) and the occurrence of respiratory distress (−1.89; −3.27 to −0.5; <0.007) and necrotising enterocolitis (4.59; 1.16 to 7.92; <0.009).ConclusionThe use of standardised feeding guidelines may decrease variations in clinical practice, shorten tFEF and thereby improve newborn outcomes.
Protein unfolding. Thermodynamic perspectives and unfolding models
Authors: Seelig Joachim , Seelig Anna 
Published: November 2022

AbstractProtein unfolding is a dynamic cooperative process with many short-lived intermediates. Cooperativity means that similar molecular elements act dependently on each other. The thermodynamics of protein unfolding can be determined with differential scanning calorimetry (DSC). The measurement of the heat capacity provides the temperature profiles of enthalpy, entropy and free energy. The thermodynamics of protein unfolding is completely determined with these thermodynamic properties. We emphasise the model-independent analysis of the heat capacity. The temperature profiles of enthalpy H(T), entropy S(T) and free energy G(T) can be obtained directly by a numerical integration of Cp(T). In evaluating different models for protein unfolding. It is essential to simulate all thermodynamic properties, not only the heat capacity. A chemical equilibrium two-state model is a widely used approximation to protein unfolding. The model assumes a chemical equilibrium between only two protein conformations, the native protein (N) and the unfolded protein (U). The model fits the heat capacity Cp(T) quite well, but fails in simulating the other thermodynamic properties. In this review we propose a modification of the chemical equilibrium two-state model, which removes these inconsistencies. We also propose a new statistical-mechanical two-state model based on a simple, two-parameter partition function Z(T), from which all thermodynamic parameters can be derived. The thermodynamic predictions of the new models are compared to published DSC-experiments obtained with lysozyme, a globular protein, and β-lactoglobulin, a β-barrel protein. Good fits to all thermodynamic properties are obtained. In particular, the models predict a zero free energy for the native protein, which is confirmed experimentally by DSC. This is in contrast to the often-cited chemical equilibrium two-state model, which predict a positive free energy for the native protein. Two-state models use macroscopic fit parameters, the conformational enthalpy and the heat capacity difference between native and unfolded protein. These simulations provide no molecular insight. The review therefore includes a recently published multistate cooperative model based on physicality well-defined molecular parameters only.
Site-specific cancer incidence by race and immigration status in Canada 2006-2015: a population-based data linkage study
Authors: Malagón Talía , Morais Samantha , Tope Parker , El-Zein Mariam , Franco Eduardo L 
Published: November 2022

AbstractIntroductionThe Canadian Cancer Registry does not collect demographic data beyond age and sex, making it hard to monitor health inequalities in cancer incidence in Canada, a country with public healthcare and many immigrants. Using data linkage, we compared site-specific cancer incidence rates by race.MethodsWe used data from the 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs), which are population-based probabilistically linked datasets of 5.9 million respondents of the 2006 Canadian long-form census and 6.5 million respondents of the 2011 National Household Survey. Respondents’ race was self-reported using Indigenous identity and visible minority group identity questions. Respondent data were linked with the Canadian Cancer Registry up to 2015. We calculated age-standardized incidence rate ratios (ASIRR), comparing group-specific rates to the overall population rate with bootstrapped 95% confidence intervals (95%CI). We used negative binomial regressions to adjust rates for socioeconomic variables and assess interactions with immigration status.ResultsThe age-standardized cancer incidence rate was lower in almost all non-White racial groups than in White individuals, except for Indigenous peoples who had a similar overall age-standardized cancer incidence rate (ASIRR 0.99, 95%CI 0.97-1.01). Immigrants had substantially lower age-standardized overall cancer incidence rates than non-immigrants (ASIRR 0.83, 95%CI 0.82-0.84). Non-White racial groups generally had significantly lower or equivalent site-specific cancer incidence rates than the overall population, except for stomach, liver, and thyroid cancers and for multiple myeloma. Differences in incidence rates by race persisted even after adjusting for household income, education, and rural residence, with immigration status being an important modifier of cancer risk.ConclusionsDifferences in cancer incidence between racial groups are likely influenced by differences in lifestyles and early life exposures, as well as selection factors for immigration. This suggests a strong role of environment in determining cancer risk and further potential for cancer prevention.
EV Fingerprinting: Resolving extracellular vesicle heterogeneity using multi-parametric flow cytometry
Authors: von Lersner Ariana K. , Fernandes Fabiane C. L. , Ozawa Patricia M. M. , Lima Sierra M. , Vagner Tatyana , Sung Bong Hwan , Wehbe Mohamed , Franze Kai , Wilson John T. , Irish Jonathan M. , Weaver Alissa , Vizio Dolores Di , Zijlstra Andries 
Published: November 2022

AbstractMammalian cells release a heterogeneous array of extracellular vesicles (EVs) that impact human biology by contributing to intercellular communication. To resolve EV heterogeneity and define the EV populations associated with specific biological processes, we developed a method named “EV Fingerprinting” that discerns distinct vesicle populations using dimensional reduction of multi-parametric data collected by quantitative single-EV flow cytometry. After validating this method against synthetic standards, the EV Fingerprinting analysis of highly purified EVs enabled a much more granular resolution of biochemically distinct EV populations than previously established methods. The analysis of EVs produced after molecular perturbation of EV biogenesis through ablation of the GTPase Rab27a and overexpression of the tetraspanin CD63 revealed that EV Fingerprinting reflects the molecular state of a cell. Subsequent analysis of human plasma demonstrates the capacity of EV Fingerprinting to resolve EV populations in complex biological samples and detect tumor-cell derived EVs.