bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal substrate modification strategies using catheter ablation in patients with persistent atrial fibrillation: 3‐year follow‐up outcomes
Authors: Hsieh Yu‐Cheng , Lin Yenn‐Jiang , Lo Men‐Tzung , Chen Yun‐Yu , Lin Chin‐Yu , Lin Chen , Chung Fa‐Po , Lo Li‐Wei , Chang Shih‐Lin , Chao Tze‐Fan , Hu Yu‐Feng , Tuan Ta‐Chuan , Liao Jo‐Nan , Wu Cheng‐I , Liu Chih‐Min , Vicera Jennifer‐Jeanne B. , Chen Chun‐Chao , Chin Chye‐Gen , Lugtu Isaiah C. , Chen Shih‐Ann 
Published: April 2021

AbstractObjectivesThis study aimed to assess the comparative efficacy of four ablation strategies on the incidence rates of freedom from atrial fibrillation (AF) or atrial tachycardia (AT) through a 3‐year follow‐up in patients with persistent AF.BackgroundThe optimal substrate modification strategies using catheter ablation for patients with persistent AF remain unclear.MethodsPatients with persistent AF were enrolled consecutively to undergo each of four ablation strategies: (a) Group 1 (Gp 1, n = 69), pulmonary vein isolation (PVI) plus rotor ablation assisted by similarity index and phase mapping; (b) Gp 2 (n = 75), PVI plus linear ablations at the left atrium; (c) Gp 3 (n = 42), PVI plus the elimination of complex fractionated atrial electrograms; (d) Gp 4 (n = 67), PVI only. Potential confounders were adjusted via a multivariate survival parametric model.ResultsBaseline characteristics were similar across the four groups. At a follow‐up period of 34.9 ± 38.6 months, patients in Gp 1 showed the highest rate of freedom from AF compared with the other three groups (p = .002), while patients in Gp 3 and 4 showed lower rates of freedom from AT than those of the other two groups (p = .006). Independent predictors of recurrence of AF were the ablation strategy (p = .002) and left atrial diameter (LAD) (p = .01).ConclusionIn patients with persistent AF, a substrate modification strategy using rotor ablation assisted by similarity index and phase mapping provided a benefit for maintaining sinus rhythm compared with the other strategies. Both ablation strategy and baseline LAD predicted the 3‐year outcomes of freedom from AT/AF
Sociotechnical Imaginaries of EU Defence: The Past and the Future in the European Defence Fund
Authors: Martins Bruno Oliveira , Mawdsley Jocelyn 
Published: April 2021

AbstractIn this article we investigate how a particular vision of the future of EU defence has embedded itself into different arenas of EU politics over decades, and is currently gaining material expression in the European Defence Fund (EDF). Through an historiographic approach, we traced the development of a particular narrative on security, innovation, research, and economic growth based on fears of technology gaps and dependence on the US, and a belief in the potential of military R&D to produce civilian benefits. We provide an alternative reading of the emergence of the EDF by drawing on literature within Science and Technology Studies, in particular the concept of sociotechnical imaginaries, to highlight wider socio‐political dimensions of defence technologies and expand debates on EU defence.
Frailty implications for exercise participation and outcomes in patients with heart failure
Authors: Mudge Alison M. , Pelecanos Anita , Adsett Julie A. 
Published: April 2021

AbstractBackground/ObjectivesFrailty is common in people with heart failure (HF) and associated with poorer outcomes. The aim of this study was to describe the characteristics, exercise participation, and outcomes of frail and not‐frail participants enrolled in a randomized trial of exercise training (ET) within a cardiac rehabilitation (CR) program.DesignSecondary analysis of EJECTION‐HF randomized trial (ACTRN12608000263392).SettingFive HF‐specific CR programs in Queensland, Australia.ParticipantsAdults recently hospitalized with HF.InterventionAll participated in CR including home exercise prescription and monitoring; half were randomized to center‐based ET.MeasurementsA frailty index (FI) was constructed at randomization and 6‐month follow‐up. Outcomes included ET attendance, change in 6‐min walk distance (6MWD), improved FI (>0.09 units) at 6 months, achieving physical activity (PA) guidelines at 6 months, and 12 month all‐cause death or readmission.ResultsThe FI was measured in 256 participants at randomization: 110 (43%) were not‐frail (FI 0.2 or less), 119 (46%) were frail (FI >0.2 to 0.39), and 27 (11%) were very frail (FI ≥0.4). Frailty was more common with older age, female gender, decompensated HF, worse HF symptoms, and preserved ejection fraction. ET attendance did not differ by frailty group. Participants who were more frail had lower 6WMD at enrollment, but similar improvement over 6 months. Mean FI improved by 0.03 units at 6 months (95% CI 0.02–0.04, p < 0.001). Participants who were more frail had significantly greater improvements in FI compared with not‐frail participants and were often able to achieve PA guidelines, both in intervention and control groups. Neither baseline frailty nor intervention was significantly associated with 12‐month death or readmission.ConclusionFrail people with HF participating in CR that includes home and/or center‐based ET often achieve PA guidelines, and some may have meaningful reductions in frailty.
Preliminary data demonstrate the Geriatric Surgery Verification program reduces postoperative length of stay
Authors: Jones Teresa S. , Jones Edward L. , Richardson Vanessa , Finley Julie B. , Franklin Jennifer L. , Gore Deborah L. , Horney Carolyn P. , Kovar Alexandra , Morin Theresa L. , Robinson Thomas N. 
Published: April 2021

AbstractObjectives/BackgroundThe Geriatric Surgery Verification (GSV) Program promotes clinical standards aimed to optimize the quality of surgical care delivered to older adults. The purpose of this study was to determine if preliminary implementation of the GSV Program standards improves surgical outcomes.DesignProspective study with cohort matching.SettingData from a single institution compared with a national data set cohort.ParticipantsAll patients aged ≥75 years undergoing inpatient operations between January 2018 and December 2019 were included. Cohort matching by age and procedure code was performed using a national data set.MeasurementsBaseline pre‐ and intraoperative characteristics prospectively recorded using Veterans Affairs Surgical Quality Improvement Program (VASQIP) variable definitions. Postoperative outcomes were recorded including complications as defined by VASQIP, 30‐day mortality, and length of stay.ResultsA total of 162 patients participated in the GSV program, and 308 patients comprised the matched comparison group. There was no difference in postoperative occurrence of one or more complications (p = 0.81) or 30‐day mortality (p = 0.61). Patients cared for by the GSV Program had a reduced postoperative length of stay (median 4 days [range 1,31] vs. 5 days [range 1,86]; p < 0.01; and mean 5.4 ± 4.8 vs. 8.8 ± 11.8 days; p < 0.01) compared with the matched cohort. In a multivariable regression model, the GSV Program's reduced length of stay was independent of other associated covariates including age, operative time, and comorbidities (p < 0.01).ConclusionPreliminary implementation of the GSV Program standards reduces length of stay in older adults undergoing inpatient operations. This finding demonstrates both the clinical and financial value of the GSV Program.
Evaluation of classification methods for identifying multiwalled carbon nanotubes collected on mixed cellulose ester filter media
Authors: Smith Devin , Neu‐Baker Nicole M. , Eastlake Adrienne C. , Zurbenko Igor G. , Brenner Sara A. 
Published: April 2021

AbstractEnhanced darkfield microscopy (EDFM) and hyperspectral imaging (HSI) are being evaluated as a potential rapid screening modality to reduce the time‐to‐knowledge for direct visualisation and analysis of filter media used to sample nanoparticulate from work environments, as compared to the current analytical gold standard of transmission electron microscopy (TEM). Here, we compare accuracy, specificity, and sensitivity of several hyperspectral classification models and data preprocessing techniques to determine how to most effectively identify multiwalled carbon nanotubes (MWCNTs) in hyperspectral images. Several classification schemes were identified that are capable of classifying pixels as MWCNT(+) or MWCNT(–) in hyperspectral images with specificity and sensitivity over 99% on the test dataset. Functional principal component analysis (FPCA) was identified as an appropriate data preprocessing technique, testing optimally when coupled with a quadratic discriminant analysis (QDA) model with forward stepwise variable selection and with a support vector machines (SVM) model. The success of these methods suggests that EDFM‐HSI may be reliably employed to assess filter media exposed to MWCNTs. Future work will evaluate the ability of EDFM‐HSI to quantify MWCNTs collected on filter media using this classification algorithm framework using the best‐performing model identified here – quadratic discriminant analysis with forward stepwise selection on functional principal component data – on an expanded sample set.
A through‐focus scanning optical microscopy dimensional measurement method based on deep‐learning classification model
Authors: Nie Haitao , Peng Renju , Ren Jiajun , Qu Yufu 
Published: April 2021

AbstractThrough‐focus scanning optical microscopy (TSOM) is an economical, non‐contact and nondestructive method for rapid measurement of three‐dimensional nanostructures. There are two methods using TSOM image to measure the dimensions of one sample, including the library‐matching method and the machine‐learning regression method. The first has the defects of small measurement range and strict environmental requirements; the other has the disadvantages of feature extraction method greatly influenced by human subjectivity and low measurement accuracy. To solve the problems above, a TSOM dimensional measurement method based on deep‐learning classification model is proposed. TSOM images are used to train the ResNet50 and DenseNet121 classification model respectively in this paper, and the test images are used to test the model, the classification result of which is taken as the measurement value. The test results showed that with the number of training linewidths increasing, the mean square error (MSE) of the test images is 21.05 nm² for DenseNet121 model and 31.84 nm² for ResNet50 model, both far lower than machine‐learning regression method, and the measurement accuracy is significantly improved. The feasibility of using deep‐learning classification model, instead of machine‐learning regression model, for dimensional measurement is verified, providing a theoretical basis for further improvement on the accuracy of dimensional measurement.
Efficacy of intra‐arterial thrombolytic therapy for vision loss resulting from hyaluronic acid filler embolization
Authors: Xu Xiao , Zhou Guiwen , Fu Qiang , Zhang Lixia , Yu Youtao , Dong Ying , Liang Liming , Chen Minliang 
Published: April 2021

AbstractBackgroundThe incidence of hyaluronic acid (HA) embolism has increased markedly in recent years. HA embolism can lead to serious complications such as blindness, eye and eyelid movement disorders, skin necrosis, and cerebral embolism. However, there is a lack of robust clinical evidence regarding the benefits of treatment of HA embolism with intra‐arterial thrombolytic therapy (IATT).MethodsIn the present study, we enrolled 45 patients with decreased visual acuity, including 40 patients with symptoms of vision loss and eight patients with symptoms of intracranial embolism. The patients underwent emergency IATT via hyaluronidase and papaverine injections, followed by conventional sequential therapy.ResultsIn the 45 patients with symptoms of vision loss, 16 (36%) exhibited improvements in final visual acuity, even when the clinical application of the thrombolytic treatments was performed beyond the recommended window for optimal treatment. The facial skin necrosis of all patients was restored to near normal appearance. Notably, for eight patients with suspected symptoms of intracranial infarction we performed cerebral angiography and IATT, and in two patients obtained partial recanalization of the obstruction, the symptoms of heavy headache and binocular distension pain were improved in one patient with intracranial embolism after IATT treatment.ConclusionOur results indicate that IATT is feasible for patients with vision loss induced by HA embolism. IATT combined with conventional sequential therapy was beneficial in the recovery from other serious HA embolism complications. Nevertheless, the underlying pathophysiological mechanism needs to be clarified in future animal experiments.
Oral tranexamic acid, hydroquinone 4% and low‐fluence 1064 nm Q‐switched Nd:YAG laser for mixed melasma: Clinical and dermoscopic evaluation
Authors: Elkamshoushi Abdelaal M. , Romisy Doaa , Omar Salma S. 
Published: April 2021

AbstractBackgroundTranexamic acid (TA) can prevent melanocyte activation by various stimuli. Combining TA with either hydroquinone 4% or Q‐switched Nd:YAG laser may be associated with greater improvement of melasma.ObjectivesWe aimed to evaluate the efficacy and safety of oral TA alone and combined with either topical hydroquinone 4% or low‐fluence 1064 nm Q‐switched Nd:YAG laser in treatment of mixed melasma.Patients & MethodsPatients were randomly divided into three groups of 20 patients each. Group A were treated with oral TA 250 mg twice daily for three months; group B were treated with TA similarly combined with topical hydroquinone 4% cream; group C were treated with TA combined with two sessions of 1064 nm low‐fluence Q‐switched ND:YAG laser (850–1200 mJ/cm2, 4–5 Hz,spot size 4 mm) spaced 4 weeks apart. Patients were followed monthly for 9 months.ResultsAfter cessation of therapy, the mean mMASI score was lowest in group B (2.34 ± 2.37) followed by groups A (6.38 ± 4.04) and C (7.24 ± 4.95).Mean percentage of mMASI score improvement was 35.91 ± 24.13, 77.47 ± 19.07, and 24.94 ± 27.79 in groups A, B, and C (p < 0.001). There was a significant reduction of telangiectasia in the three groups. Reported side effects were itching & irritation, post‐inflammatory hyperpigmentation, and gastritis.ConclusionOral TA is a tolerable effective treatment modality for melasma. Combining hydroquinone 4% with oral TA is associated with a relatively earlier and better cosmetic outcome.
Membrane vesicles from periodontal pathogens and their potential roles in periodontal disease and systemic illnesses
Authors: Ma Li , Cao Zhengguo 
Published: April 2021

AbstractPeriodontium is an ordered ecological system where a dynamic equilibrium exists between oral microorganisms and the host defense system, and periodontal disease occurs whenever the balance is broken. Periodontal pathogens mainly include gram‐negative anaerobic bacteria and emerging gram‐positive microbes, which have a large variety of virulence factors and influence disease initiation and progression. Recently, different types of bacterial membrane vesicles (MVs), formed by bubbling of membrane materials from living cells or in conditions of endolysin‐triggered cell death, have gained interests as a novel virulence factor for periodontopathogens. MVs load multiple sorted cargo molecules, such as proteins, lipids, and genetic materials, and actively participate in toxin transport, signal delivery, and periodontal disease pathogenesis. Since periodontitis is recognized as a risk factor for many systemic diseases, periodontal MVs could work as a bridge for periodontal diseases and systemic illnesses. Furthermore, MVs with unique nature and advantages are promising candidates as vaccines and drug delivery vehicles. In this review, we provided an overview of different types and compositions of periodontal MVs, described their involvements in the pathogenesis of periodontitis and several general diseases, and discussed potential applications of periodontal MVs in vaccination and drug delivery.
Sleep scoring based on video‐electroencephalography monitoring in an Epileptology Unit: Comparison with polysomnography
Authors: Nguyen‐Michel Vi‐Huong , Herlin Bastien , Gales Ana , Vaz Soraia , Levy Pierre , Dupont Sophie , Adam Claude , Navarro Vincent , Frazzini Valerio 
Published: April 2021

SummaryThe aim of the study was to compare the performance of video‐ electroencephalography (EEG) monitoring and standard polysomnography for sleep scoring in an Epileptology Unit. We calculated the level of agreement between two methods of sleep scoring, using either 27‐electrode video‐EEG or polysomnography for 1 night in 22 patients admitted to our Epileptology Unit. Independent experts manually scored sleep using the American Academy of Sleep Medicine 2017 guidelines. We evaluated the number of sleep cycles and their distribution on hypnogram, total sleep time, sleep efficiency, sleep and rapid eye movement sleep‐onset latency, wake after sleep‐onset, and sleep stages. We then extracted sub‐samples of recordings to examine the agreement in microarousal and rapid eye movement scoring. We used Bland and Altman plots and Cohen’s kappa test to measure agreement. Bland and Altman plots showed at least 95% agreement for all studied sleep parameters with the exception of wake after sleep onset, where there was an 11 min difference. Cohen’s kappa test showed an agreement for the recognition of microarousal (0.89) and of rapid eye movements (0.96) in sub‐samples. Video‐EEG represents an acceptable alternative tool for sleep architecture study in patients admitted to an Epileptology Unit.
Imaging and histopathologic features of reversible nerve root and peripheral nerve edema secondary to disc herniation in a cat
Authors: Herzig Robert , Wang‐Leandro Adriano , Steffen Frank , Matiasek Kaspar , Beckmann Katrin M. 
Published: April 2021

AbstractNerve root enlargement with increased contrast uptake has been reported in dogs and humans secondary to nerve root compression. In cats, nerve root enlargement and contrast uptake only have been reported in association with inflammatory and neoplastic diseases, but not as a sequela to nerve root compression. An 8‐year‐old oriental short hair cat was presented with acute neurologic deficits consistent with left‐sided sciatic nerve deficit and possible L6‐S1 myelopathy. Magnetic resonance imaging (MRI) was performed and identified compression of the cauda equina and L7 nerve root associated with intervertebral disc herniation (IVDH) at L6‐L7 as well as widespread sciatic nerve enlargement with moderate rim enhancement. A hemilaminectomy was performed to evacuate herniated disc material. The nerve root was biopsied and submitted for histological evaluation. Interstitial nerve edema was diagnosed. Follow‐up MRI 3 months postoperatively showed complete remission of the changes. Nerve root thickening together with contrast enhancement may represent nerve edema in cats secondary to IVDH.
Thirteen dogs and a cat with ultrasonographically detected gallbladder wall edema associated with cardiac disease
Authors: Lisciandro Gregory R. , Gambino Jennifer M. , Lisciandro Stephanie C. 
Published: April 2021

AbstractBackgroundUltrasonographically detected gallbladder wall edema (GBWE) is a marker for anaphylaxis in dogs. Cardiac disease can cause GBWE with similar signs and should be included as a differential diagnosis to prevent interpretation errors.Hypothesis/ObjectivesDocument GBWE associated with cardiac disease.AnimalsFourteen client‐owned animals.MethodsProspective case series with abdominal focused assessment with abdominal sonography in trauma, triage and tracking (AFAST), and thoracic focused assessment with abdominal sonography in trauma, triage, and tracking (TFAST) performed at triage. Animals with GBWE and cardiac disease were enrolled. A board‐certified radiologist reviewed images to confirm cardiac disease, GBWE, and characterize the caudal vena cava (CVC) and hepatic veins.ResultsThirteen dogs and 1 cat had GBWE associated with cardiac disease. Gallbladder findings included mural thickness ranging from 3 to 5 mm, mild to moderate sludge (n = 3), and mild to moderate luminal distension (n = 6). CVC and hepatic venous distension were found in 5/6. Cardiac diagnoses in dogs included 11 with pericardial effusion (PCE) and 1 each with dilated cardiomyopathy and right‐sided myocardial failure. Severity of PCE was rated as mild (n = 1), moderate (n = 6), or severe (n = 4). Seven of 11 had pericardiocentesis performed. Nine of 13 had ascites with 4 having abdominal fluid scores of 1 (n = 2), 2 (n = 2), 3 (n = 1), and 4 (n = 0). Lung ultrasound findings were as follows: dry lung (n = 6), B‐lines (n = 4), and nodules (n = 1). The cat had moderate PCE, ascites scored as 1, and severe right‐sided ventricular enlargement associated with a ventricular septal defect. Primary presenting complaints included acute weakness (n = 9), acute collapse (n = 5), gastrointestinal signs (n = 3), respiratory distress (n = 2), and need for cardiopulmonary resuscitation (n = 1).Conclusions and Clinical ImportanceUltrasonographically detected GBWE was associated with PCE in this small cohort of cases.
Neophyte invasions in European grasslands
Authors: Axmanová Irena , Kalusová Veronika , Danihelka Jiří , Dengler Jürgen , Pergl Jan , Pyšek Petr , Večeřa Martin , Attorre Fabio , Biurrun Idoia , Boch Steffen , Conradi Timo , Gavilán Rosario G. , Jiménez‐Alfaro Borja , Knollová Ilona , Kuzemko Anna , Lenoir Jonathan , Leostrin Artem , Medvecká Jana , Moeslund Jesper Erenskjold , Obratov‐Petkovic Dragica , Svenning Jens‐Christian , Tsiripidis Ioannis , Vassilev Kiril , Chytrý Milan 
Published: April 2021

AbstractQuestionsThe human‐related spread of alien plants has serious environmental and socioeconomic impacts. Therefore, it is important to know which habitats are most threatened by invasion and why. We studied a wide range of European grasslands to assess: (a) which alien species are the most successful invaders in grasslands; (b) how invasion levels differ across European regions (countries or their parts) and biogeographical regions; and (c) which habitat types are the most invaded.LocationEurope.MethodsWe selected 97,411 grassland vegetation plots from the European Vegetation Archive (EVA) and assigned a native or alien status to each of the 8,212 vascular plant species found in these plots. We considered only neophytes (alien species introduced after 1500 AD), which we further divided according to their origin. We compared the levels of invasion using relative neophyte richness in the species pool, relative neophyte richness and cover per plot, and percentages of invaded plots among regions and habitats.ResultsOnly 536 species, representing 6.5% of all grassland vascular plant species, were classified as neophytes. These were mostly therophytes or hemicryptophytes with low habitat specificity. Most of them were present in very few plots, while only three species were recorded in more than 1% of all plots (Onobrychis viciifolia, Erigeron annuus and Erigeron canadensis). Although invasion levels were generally low, we found more invaded plots in the Boreal and Continental regions. When considering only non‐European neophytes, the Pannonian region was the most invaded. Among different grassland habitats, sandy grasslands were most invaded, and alpine and oromediterranean grasslands least invaded.ConclusionsIn general, natural and semi‐natural European grasslands have relatively low levels of neophyte invasions compared with human‐made habitats or alluvial forests, as well as with grasslands on other continents. The most typical neophytes invading European grasslands are species with broad ecological niches.