bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ablation of Atrial Fibrillation Without Left Atrial Appendage Imaging in Patients Treated With Direct Oral Anticoagulants
Authors: Diab Mohamed , Wazni Oussama M. , Saliba Walid I. , Tarakji Khaldoun G. , Ballout Jad A. , Hutt Erika , Rickard John , Baranowski Bryan , Tchou Patrick , Bhargava Mandeep , Chung Mina , Varma Niraj , Martin David O. , Dresing Thomas , Callahan Thomas , Cantillon Daniel , Kanj Mohamed , Hussein Ayman A. 
Published: July 2020

Background:
Many centers continue to routinely perform transesophageal echocardiograms before atrial fibrillation (AF) ablation procedures in patients treated with direct oral anticoagulants (DOACs). One study suggested that the procedures could be done without transesophageal echocardiogram but used intracardiac echocardiography imaging of the appendage from the right ventricular outflow. This study aimed to assess the safety of ablation for AF without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage in DOAC compliant patients.

Methods:
All patients undergoing AF ablation at the Cleveland Clinic (2011–2018) were enrolled in a prospectively maintained data registry. All consecutive patients presenting with AF or atrial flutter on DOAC were included. Periprocedural thromboembolic complications were assessed.

Results:

A total of 900 patients were included. Their median CHA
2
DS
2
-VASc score was 2 (interquartile range 1–3). All were on DOACs (333 rivaroxaban, 285 dabigatran, 281 apixaban, and 1 edoxaban). Thromboembolic complications occurred in 4 patients (0.3%): 2 ischemic strokes, 1 transient ischemic attack without residual deficit, and 1 splenic infarct; all with no further complications. Bleeding complications occurred in 5 patients (0.4%): 2 pericardial effusions (1 intraoperative, 1 after 30 days, both drained), 3 groin hematomas (1 of them due to needing heparin for venous thrombosis, none required interventions). No patients required emergent surgeries.

Conclusions:
In DOAC compliant patients who present for ablation in AF/atrial flutter, the procedures could be performed without transesophageal echocardiogram screening or intracardiac echocardiography imaging of the appendage; with low risk of complications.
Incidence and Predictors of Very Late Recurrence of Atrial Fibrillation Following Cryoballoon Pulmonary Vein Isolation
Authors: Musat Dan L. , Milstein Nicolle S. , Bhatt Advay , Sichrovsky Tina C. , Preminger Mark W. , Pistilli Carissa , Rozylowicz Michael , Shaw Richard E. , Mittal Suneet 
Published: July 2020

Background:
A very late recurrence (VLR) of atrial fibrillation (AF) is considered present when the first recurrence of AF occurs ≥12 months following ablation. Prior studies characterizing VLR have not used an implantable loop recorder for ECG monitoring. Thus, it is unknown whether VLR truly occurs or whether these patients have simply had unrecognized AF. Our objective was to assess the incidence and predictors of VLR in patients who underwent cryoballoon pulmonary vein isolation alone, had an implantable loop recorder, and were confirmed AF free for at least 1 year.

Methods:
We enrolled consecutive patients with paroxysmal or persistent AF who underwent cryoballoon pulmonary vein isolation and had an implantable loop recorder implanted <3 months post-ablation. Patients free of AF 1 year post-ablation were followed prospectively for recurrent AF. All AF episodes were adjudicated.

Results:

We included 188 patients (66±10 years; 116 [62%] men; 102 [54%] paroxysmal AF; CHA
2
DS
2
-VASc, 2.6±1.7). After 1 year post-pulmonary vein isolation, 93 (49%) patients remained AF free. During subsequent follow-up, 30 (32%) patients had VLR of AF. The only independent risk factor for VLR was an elevated CHA
2
DS
2
-VASc score (hazard ratio, 1.317 [95% CI, 1.033–1.6979];
P
=0.026). Patients with CHA
2
DS
2
-VASc score ≥4 represented a quarter of the population and were at the highest risk.

Conclusions:
Our data using implantable loop recorders for continuous ECG monitoring post-AF ablation show that VLR occurs in a third of patients after an apparently successful cryoballoon pulmonary vein isolation procedure. Additional strategies are needed to ensure long-term freedom from AF recurrences in these high-risk patients.
Positive and synergistic effects of oxytetracycline and β-glucan on non-specific immune responses in the white shrimp, Litopenaeus vannamei (Boone, 1931) (Dendrobranchiata, Penaeidae)
Authors: Lee Po-Tsang , Wu Yu-Sheng , Chen Hsiang-Yin , Liao Zhen-Hao , Huang Huai-Ting , Chen Yu-Chun , Nan Fan-Hua 
Published: July 2020

Abstract
This study was to examine the immunomodulatory effects of oxytetracycline (OTC) on the white shrimp Litopenaeus vannamei (Boone, 1931). Immune parameters were not suppressed by OTC treatment in haemocytes in vitro. A total of 96 healthy shrimp were divided into four groups. Group 1 was the control group. Group 2 received 50 mg OTC/kg body weight/day. Group 3 received 1 g β-glucan/kg feed. Group 4 received 50 mg OTC/kg body weight/day and 1 g/kg β-glucan. OTC residues were more highly accumulated in the hepatopancreas than in muscle tissue during the rearing period, and the addition of β-glucan prolonged the retention time of OTC in the muscle tissue. Additionally, dietary administration of OTC in combination with β-glucan facilitated the excretion of OTC from the hepatopancreas. Shrimp that orally ingested OTC alone had an elevated total haemocyte count, phagocytosis, superoxide anion production and prophenoloxidase activity, and these immunostimulatory effects were further enhanced in shrimp receiving OTC in combination.
Flexibility and Sharīʿah Compliance of Islamic Financial Contracts: An Evaluative Framework
Authors: Moqbel Tareq , Ahmed Habib 
Published: July 2020

Abstract
Although the key distinguishing feature of Islamic finance is compliance with Sharīʿah, there is criticism from various quarters on the Sharīʿah compliance of its products. However, there is no objective way to assess the Sharīʿah compliance of Islamic financial contracts. This article develops a structured framework for analysing Sharīʿah compliance of Islamic financial contracts by deconstructing them and developing principles of evaluation based on concepts from Islamic legal theory. Other than providing a framework to assess Sharīʿah compliance of Islamic financial contracts, this article also alludes to an important issue regarding the contracts’ flexibility. Using concepts from Islamic legal theory, the article classifies different contractual stipulations according to their legal weight, and identifies how legal perspectives on the requirements of compliance can determine the flexibility of contracts. An evaluative framework is used to assess the Sharīʿah compliance of an actual muḍārabah (silent partnership) contract and finds it to be defective.
Evaluation of Ethical Review and Oversight Processes by AAALAC International
Authors: Guillén Javier , Borkowski Gary L. 
Published: July 2020

Abstract
AAALAC International is a nonprofit organization that evaluates and accredits research, testing and educational animal care and use programs around the world. The ethical review and oversight processes are key elements of a program, and therefore are thoroughly assessed during the accreditation process. Legal approaches to ethical review and oversight vary across geopolitical areas and are nonexistent in some regions, creating a heterogeneous landscape of processes globally. In AAALAC’s interpretation, ethical and oversight processes must first comply with applicable legislation (engineering standards), but also they must be effective (performance standards). To evaluate the efficacy of each system and be consistent in the assessments, AAALAC relies on a performance-based approach which focuses on the outcome of the process, as AAALAC considers that the same satisfactory outcome can be achieved by different procedures. How AAALAC assesses the combination of legal compliance and the efficacy of ethical review and oversight processes in the international context is described.
Vertical Heat Fluxes beneath Idealized Sea Ice Leads in Large-Eddy Simulations: Comparison with Observations from the SHEBA Experiment
Authors: Bourgault Pascal , Straub David , Duquette Kevin , Nadeau Louis-Philippe , Tremblay Bruno 
Published: July 2020

AbstractLarge-eddy simulations (Δx = Δz = 1 m) are used to examine vertical ocean heat fluxes driven by mechanical and buoyancy forcing across idealized sea ice leads. Forcing parameters approximate conditions from a shear event during the Surface Heat Budget of the Arctic (SHEBA) experiment in March 1998. In situ measurements near the lead showed isopycnal displacements of 14 m and turbulent vertical heat fluxes up to 400 W m−2, both of which were attributed to a strong cyclonic stress curl localized along the lead axis. By contrast, the large-eddy simulations show cyclonic shear across the lead to produce no turbulence, with vertical heat transport instead related to an overturning cell that connects a broad upwelling near the lead to downwelling farther away. Anticyclonic forcing produces an opposite-signed overturning cell, but with an intense, narrow downwelling jet and strong turbulent heat fluxes (~100 W m−2) near the lead. For both signs of curl, domain-integrated heat transport due to the overturning cells is somewhat larger than the turbulent heat flux, the latter being confined to the vicinity of the lead. Buoyancy forcing related to sea ice formation in the lead was found to increase both the turbulent and the cell-related heat fluxes (by up to 50% and 10%, respectively). Vertical isopycnal displacements for the upwelling case were found to increase linearly with the strength of the forcing. Possible reasons for the discrepancies with the observations include finer scale variation in the surface ocean stress and turbulence associated with the formation of a ridge during the shear event.
Abyssal Circulation Driven by Near-Boundary Mixing: Water Mass Transformations and Interior Stratification
Authors: Drake Henri F. , Ferrari Raffaele , Callies Jörn 
Published: July 2020

AbstractThe emerging view of the abyssal circulation is that it is associated with bottom-enhanced mixing, which results in downwelling in the stratified ocean interior and upwelling in a bottom boundary layer along the insulating and sloping seafloor. In the limit of slowly varying vertical stratification and topography, however, boundary layer theory predicts that these upslope and downslope flows largely compensate, such that net water mass transformations along the slope are vanishingly small. Using a planetary geostrophic circulation model that resolves both the boundary layer dynamics and the large-scale overturning in an idealized basin with bottom-enhanced mixing along a midocean ridge, we show that vertical variations in stratification become sufficiently large at equilibrium to reduce the degree of compensation along the midocean ridge flanks. The resulting large net transformations are similar to estimates for the abyssal ocean and span the vertical extent of the ridge. These results suggest that boundary flows generated by mixing play a crucial role in setting the global ocean stratification and overturning circulation, requiring a revision of abyssal ocean theories.
Wave-by-Wave Forecasting via Assimilation of Marine Radar Data
Authors: Simpson Alexandra , Haller Merrick , Walker David , Lynett Patrick , Honegger David 
Published: July 2020

AbstractThis work describes a phase-resolving wave-forecasting algorithm that is based on the assimilation of marine radar image time series. The algorithm is tested against synthetic data and field observations. The algorithm couples X-band marine radar observations with a phase-resolving wave model that uses the linear mild slope equations for reconstruction of water surface elevations over a large domain of O(km) and a prescribed time window of O(min). The reconstruction also enables wave-by-wave forecasting through forward propagation in space and time. Marine radar image time series provide the input wave observations through a previously given relationship between backscatter intensity and the radial component of the sea surface slope. The algorithm assimilates the wave slope information into the model via a best-fit wave source function at the boundary that minimizes the slope reconstruction error over an annular region at the outer ranges of the radar images. The wave model is then able to propagate the waves across a polar domain to a location of interest at nearer ranges. The constraints on the method for achieving real-time forecasting are identified, and the algorithm is verified against synthetic data and tested using field observations.
Assimilating Observations with Spatially Correlated Errors Using a Serial Ensemble Filter with a Multiscale Approach
Authors: Ying Yue 
Published: July 2020

AbstractThe serial ensemble square root filter (EnSRF) typically assumes observation errors to be uncorrelated when assimilating the observations one at a time. This assumption causes the filter solution to be suboptimal when the observation errors are spatially correlated. Using the Lorenz-96 model, this study evaluates the suboptimality due to mischaracterization of observation error spatial correlations. Neglecting spatial correlations in observation errors results in mismatches between the specified and true observation error variances in spectral space, which cannot be resolved by inflating the overall observation error variance. As a remedy, a multiscale observation (MSO) method is proposed to decompose the observations into multiple scale components and assimilate each component with separately adjusted spectral error variance. Experimental results using the Lorenz-96 model show that the serial EnSRF, with the help from the MSO method, can produce solutions that approach the solution from the EnSRF with correctly specified observation error correlations as the number of scale components increases. The MSO method is further tested in a two-layer quasigeostrophic (QG) model framework. In this case, the MSO method is combined with the multiscale localization (MSL) method to allow the use of different localization radii when updating the model state at different scales. The combined method (MSOL) improves the serial EnSRF performance when assimilating observations with spatially correlated errors. With adjusted observation error spectral variances and localization radii, the combined MSOL method provides the best solution in terms of analysis accuracy and filter consistency. Prospects and challenges are also discussed for the implementation of the MSO method for more complex models and observing networks.
Mirror Book Therapy for the treatment of Idiopathic Facial Palsy
Authors: Barth Jodi Maron , Stezar Gincy L. , Acierno Gabriela C. , Kim Thomas J. , Reilly Michael J. 
Published: July 2020

Objective: To determine the utility of treating facial palsy with mirror book therapy in conjunction with facial physical rehabilitation. Methods: We randomly selected and reviewed the charts of 25 patients with idiopathic facial palsy. 10 of these patients received facial physical rehabilitation including manual therapy and postural exercises. 15 of these patients received mirror book therapy in conjunction with standard facial rehabilitation. Before and after treatment, patients in both groups were rated using the Facial Grading System (FGS) score, the Facial Disability Index--Physical (FDIP) score, and the Facial Disability Index--Social (FDIS) score. Differences in response to therapy were analyzed. Results: Patients in the facial physical rehabilitation group without mirror book therapy group showed on average a 20.8% increase in the FGS score, a 19% increase in the FDIP score, and a 14.6% increase in the FDIS score. Patients in the mirror book therapy group showed an average of 24.9% increase in the Facial Grading System (FGS) score, a 21.6% increase in the Facial Disability Index--Physical (FDIP) score, and a 24.5% increase in the Facial Disability Index--Social (FDIS) score. Conclusion: The addition of mirror book therapy to standard facial rehabilitation treatments does significantly improve outcomes in the treatment of idiopathic facial palsy.
Changing patterns of mortality during the COVID-19 pandemic: Population-based modelling to understand palliative care implications
Authors: Bone Anna E , Finucane Anne M , Leniz Javiera , Higginson Irene J , Sleeman Katherine E 
Published: July 2020

Background: COVID-19 has directly and indirectly caused high mortality worldwide. Aim: To explore patterns of mortality during the COVID-19 pandemic and implications for palliative care, service planning and research. Design: Descriptive analysis and population-based modelling of routine data. Participants and setting: All deaths registered in England and Wales between 7 March and 15 May 2020. We described the following mortality categories by age, gender and place of death: (1) baseline deaths (deaths that would typically occur in a given period); (2) COVID-19 deaths and (3) additional deaths not directly attributed to COVID-19. We estimated the proportion of people who died from COVID-19 who might have been in their last year of life in the absence of the pandemic using simple modelling with explicit assumptions. Results: During the first 10 weeks of the pandemic, there were 101,614 baseline deaths, 41,105 COVID-19 deaths and 14,520 additional deaths. Deaths in care homes increased by 220%, while home and hospital deaths increased by 77% and 90%, respectively. Hospice deaths fell by 20%. Additional deaths were among older people (86% aged ⩾ 75 years), and most occurred in care homes (56%) and at home (43%). We estimate that 22% (13%–31%) of COVID-19 deaths occurred among people who might have been in their last year of life in the absence of the pandemic. Conclusion: The COVID-19 pandemic has led to a surge in palliative care needs. Health and social care systems must ensure availability of palliative care to support people with severe COVID-19, particularly in care homes.
Do morphologic characteristics play a role in nodal metastatic progression of well-differentiated pancreatic neuroendocrine tumors?
Authors: Ugras Nesrin , Hasdemir Seçil , Yerci Ömer , Taşar Pınar , Dündar Halit Ziya , Macunluoğlu Aslı Ceren 
Published: July 2020

Background: Pancreatic neuroendocrine neoplasms (NENs) are tumors with histopathologic and prognostic heterogeneity that pose difficulties in establishing standards for diagnosis, classification, and treatment. Among NENs, well-differentiated neuroendocrine tumors (NETs) have been classified as grade 1, 2, and 3 in the most recently released World Health Organization classification. Although well-differentiated NETs are associated with relatively better prognosis, they have a potential for malignant behavior such as extrapancreatic spread, metastasis, or recurrence. The present study aimed to evaluate clinical and histomorphologic findings of patients with well-differentiated pancreatic NETs and to identify histopathologic findings effective in predicting nodal metastatic progression. Methods: The study group consisted of 54 patients diagnosed with well-differentiated NET. All preparations and blocks of the patients were examined for the following histopathologic parameters: tumor diameter, microscopic tumor growth pattern (solid, trabecular, acinar, and mixed), cellular features (clear, eosinophilic, oncocytic, peliotic, and pseudopapillary), stromal changes (calcification, lymphocytic infiltration, and stromal hyalinization), presence of necrosis, perineural invasion, lymphovascular invasion, mitotic activity, and Ki67 proliferative index. Results: Lymph node metastasis was present in 7 patients. Lymph node metastasis was significantly associated with tumor diameter of >2 cm ( p = 0.012), Ki67 proliferative index of >20% ( p = 0.022), grade 3 tumors ( p = 0.002), presence of dense stromal hyalinization ( p = 0.034), and mild lymphocytic infiltration ( p = 0.041). Conclusion: The present study revealed that the new findings such as presence of dense stromal hyalinization and absence of remarkable lymphocytic infiltration could be predictive morphologic findings for the development of lymph node metastasis.
Comparison of the HEART and HEARTS3 scores to predict major adverse cardiac events in chest pain patients at the emergency department
Authors: Aydin Hasan , Ozpinar Yasin , Karaoglu Ulas , Issever Muhittin , Aygun Huseyin , Karaca Oguz , Bulut Mehtap 
Published: July 2020

Introduction: The aim of this study was to determine the risk assessment of acute coronary syndrome and prediction of major adverse cardiac events by HEART (History, ECG, Age, Risk factors, Troponin) and HEARTS3 (HEART + 3S = Sex, Serial 2-h ECG, and Serial 2-h delta Troponin) scoring systems in patients admitted to the emergency department with chest pain. Methods: This is a single-center prospective cohort study. This study was conducted in patients admitted to the emergency department with chest pain, without ST-elevation myocardial infarction, who were 18 years or older, and agreed to participate in the study. The primary endpoint is the occurrence of major adverse cardiovascular events within 30 days. The receiver operating characteristic curve was used to assess the power of HEART and HEARTS3 scores to predict major adverse cardiovascular events. Results: The mean age of 239 patients was 47.91 ± 13.93 years and 72.4% (173) were male. Major adverse cardiovascular events developed in 20.1% (48) of the patients. The mean HEART and HEARTS3 scores of the patients with major adverse cardiovascular events (5.67 ± 1.46 and 9.38 ± 3.91, respectively) were both statistically and significantly higher than the scores of the patients without major adverse cardiovascular events (2.33 ± 1.44 and 2.22 ± 1.39; p = 0.001). The area under the curve values of HEART and HEARTS3 scores were found to be 0.943 (95% confidence interval: 0.905–0.968) and 0.990 (0.968–0.999), respectively. Conclusion: In our study, the power of HEARTS3 score to predict major adverse cardiovascular events was better in the risk assessment of acute coronary syndrome in patients admitted to the emergency department with chest pain compared to the HEART score. We think that patients with a low HEARTS3 score can be safely discharged from emergency department without further cardiac examination.