bluuebunny/crossref_metadata_2025_split huggingface dataset:
High vagal tone predicts pulmonary vein reconnection after cryoballoon ablation for paroxysmal atrial fibrillation
Authors: Călburean Paul‐Adrian , Osorio Thiago Guimaraes , Sorgente Antonio , Almorad Alexandre , Pannone Luigi , Monaco Cinzia , Miraglia Vincenzo , Al Housari Maysam , Mojica Joerelle , Bala Gezim , Bisignani Antonio , Lipartiti Felicia , Strazdas Antanas , Ramak Robbert , Overeinder Ingrid , La Meir Mark , Ströker Erwin , Brugada Pedro , Boveda Serge , Paparella Gaetano , Iacopino Saverio , Sieira Juan , Chierchia Gian Battista , de Asmundis Carlo 
Published: November 2021

AbstractBackgroundPulmonary vein (PV) isolation is an established treatment for paroxysmal drug‐refractory atrial fibrillation (AF). High parasympathetic tone and reconnection of PVs have demonstrated to be possible culprits of AF recurrence after ablation. Our aim was to investigate the association between parasympathetic tone and reconnected PVs in patients with paroxysmal AF.MethodsConsecutive patients who underwent a redo catheter ablation procedure for atrial tachyarrhythmia recurrence by means of 3D electroanatomic mapping with documentation of presence or absence of PVs reconnection following an initial procedure of cryoballoon (CB) ablation for symptomatic drug‐refractory paroxysmal AF were screened for the study.ResultsA total of 92 patients were included, of whom 50 (54.35%) were males. Reconnected PVs were found in 64 (69%) patients. PVs reconnection could be predicted by DC (C‐statistic = .770), by SDNNI (C‐statistic = .714) and by absolute VLF power (C‐statistic = .722), while right‐sided PVs reconnection could be better predicted by DC (C‐statistic = .848) and by SDNNI (C‐statistic = .761). In multivariate binary logistic regression analysis, a DC value ≥6.45 ms and an absolute VLF power value ≥160 ms2 were associated with three times and five times higher odds of PVs reconnection, respectively. On a vein‐per‐vein analysis, absolute VLF power ≥160 ms2 was associated with three times higher odds, while reaching of −40°C within 60 s was associated with three times lower odds of PVs reconnection.ConclusionHigh parasympathetic tonus accurately predicts PVs reconnection. On a vein‐per‐vein analysis, parasympathetic markers along with biophysical parameters predicted PVs reconnection. On a case‐by‐case analysis, parasympathetic markers were the only predictors of PVs reconnection, thus being a robust PVs reconnection prediction tool.
Procedural anesthesia and sedation for children undergoing diagnostic and medical procedures — A review of postprocedural pain, nausea, and vomiting by questionnaire‐based survey
Authors: Batchelor Chloe , Drake‐Brockman Thomas , Lowe Andrew , Sommerfield Aine , von Ungern‐Sternberg Britta S. , Sommerfield David 
Published: November 2021

AbstractBackgroundSedation and anesthesia are widely used to relieve pain and ensure cooperation during elective diagnostic and medical procedures in the pediatric population. However, there is currently limited evidence about the recovery trajectory following deep sedation or general anesthesia for such procedures in children.AimsThe primary aim was to describe the severity and duration of pain, nausea, and vomiting after common diagnostic and medical procedures. Secondary outcomes include return to baseline functioning and incidence of medical re‐presentation.MethodsRecruitment was achieved postprocedurally by telephone interview with parents or legal guardians of patients who underwent botox injection, bronchoscopy, either or both a colonoscopy or upper gastrointestinal endoscopy, or MRI scan. Daily pain scores, nausea and vomiting, administration of at‐home analgesia, and any adverse events requiring medical attention were obtained. Children were followed until pain completely resolved and baseline activity resumed.ResultsA total of 307 patients were included (50 botox injection, bronchoscopy and MRI; 48 colonoscopy, 58 upper gastrointestinal endoscopy, 51 colonoscopy plus upper gastrointestinal endoscopy). Parental‐rated pain scores peaked on day of procedure across all groups and decreased over time, with most children resuming normal activity within 1 day postprocedure. Pain was mostly mild and resolved quickly in botox injection (10% moderate to severe and 22% mild), bronchoscopy (8% and 10%, respectively), and MRI (2% mild) patients. Combined upper gastrointestinal endoscopy and colonoscopy was associated with greatest pain severity (29% moderate to severe and 20% mild). Highest rates of nausea and/or vomiting were observed in colonoscopy (23%), upper gastrointestinal endoscopy (28%), and combined procedure groups (20%). At‐home simple analgesia was administered in 21% of patients. Unplanned medical re‐presentations were infrequent across all groups.ConclusionThis study demonstrates that the recovery trajectory following procedural sedation and anesthesia is short, with minimal requirement for additional medical attention. These findings will aid in alleviating parental anxiety and encourage utilization of regular simple analgesia.
Evaluation of platelet indices in children with renal scarring based on diagnostic accuracy criteria and Cohen's kappa
Authors: Erdoğan Semra , Sürmeli Döven Serra 
Published: November 2021

AbstractBackgroundRenal scarring is a significant complication in recurrent urinary tract infections (UTIs) in children that can lead to hypertension and end‐stage renal disease. The present study evaluates whether platelet indices may be predictive of renal scarring.MethodsSixty‐nine patients aged 1–18 years with recurrent UTIs, whose medical records were reviewed to collect data on the presence of upper/lower UTIs and the results of scintigraphic investigations with 99m‐technetium dimercaptosuccinic acid, were included in the study. The platelet, platelet indices (mean platelet volume [MPV]), platelet distribution width, plateletcrit, and C‐reactive protein (CRP) values of the patients during UTI episodes were reviewed retrospectively.ResultsMean platelet volume and CRP values were higher in the renal scarring group than in the non‐renal scarring group (P < 0.001 and P = 0.003, respectively). Increases in MPV and CRP values were independent risk factors for renal scarring (OR = 5.781 [1.431–23.347] and OR = 1.922 [1.77–3.141], respectively). The sensitivity, specificity, positive and negative predictive values, and diagnostic odds ratio values of MPV at a cut‐off of >8.2 fL for renal scarring discrimination were 62.5%, 88.89%, 75.00%, 81.63%, and 13.33 [1.35–3.83], respectively. The sensitivity, specificity, positive and negative predictive values, and diagnostic odds ratio values of CRP at a cut‐off of 1.97 mg/L for renal scarring were 58.33%, 91.11%, 77.78%, 80.39%, and 14.35 [1.36–3.97], respectively.ConclusionBoth MPV and CRP can be used as predictive markers for renal scarring. While MPV had higher sensitivity, CRP had a higher specificity and diagnostic odds ratio in predicting renal scarring.
Diverse state‐level marine aquaculture policy in the United States: Opportunities and barriers for industry development
Authors: Lester Sarah E. , Gentry Rebecca R. , Lemoine Hayley R. , Froehlich Halley E. , Gardner Luke D. , Rennick Mae , Ruff Elizabeth O. , Thompson Kimberly D. 
Published: November 2021

AbstractMarine aquaculture (mariculture) plays a relatively small role in the United States’ domestic seafood production, despite considerable scope for industry development and high volumes of imported farmed seafood resulting in a significant trade deficit. Currently, most mariculture in the United States occurs in nearshore waters or land‐based tanks and is regulated and guided using state‐level policy, with a relative absence of national coordinating mechanisms to link the patchwork of state policies. There is no comprehensive evaluation showing how different state policies may be enabling or impeding mariculture development. In response, we provide the first systematic overview of state‐level mariculture policy for the 23 coastal marine states in the United States. We compiled information for 16 aquaculture and mariculture policy attributes, including legislation, regulations and management characteristics, particularly those that could enable mariculture development. We found considerable heterogeneity in how states govern and regulate mariculture. As examples, 48% of states have an aquaculture development act, 35% have spatial zoning specifically for mariculture and only 26% have a government‐provided mariculture best management practices document. We examined the relationship between enabling policies and metrics of mariculture output (e.g. production value, number of farms), and while the effect of enabling policy is often equivocal, certain features stand out as important (e.g. government‐provided best management practices). Overall, this policy synthesis suggests approaches that may be influential in enabling mariculture development, which could inform new state‐level policies, an effective overarching federal policy in the United States, or policies in other countries seeking to support an expanded mariculture industry.
Agent‐based Modeling to Evaluate Human–Environment Interactions in Community Flood Risk Mitigation
Authors: Han Yu , Mao Liang , Chen Xuqi , Zhai Wei , Peng Zhong‐Ren , Mozumder Pallab 
Published: November 2021

AbstractThis article deals with household‐level flood risk mitigation. We present an agent‐based modeling framework to simulate the mechanism of natural hazard and human interactions, to allow evaluation of community flood risk, and to predict various adaptation outcomes. The framework considers each household as an autonomous, yet socially connected, agent. A Beta–Bernoulli Bayesian learning model is first applied to measure changes of agents’ risk perceptions in response to stochastic storm surges. Then the risk appraisal behaviors of agents, as a function of willingness‐to‐pay for flood insurance, are measured. Using Miami‐Dade County, Florida as a case study, we simulated four scenarios to evaluate the outcomes of alternative adaptation strategies. Results show that community damage decreases significantly after a few years when agents become cognizant of flood risks. Compared to insurance policies with pre‐Flood Insurance Rate Maps subsidies, risk‐based insurance policies are more effective in promoting community resilience, but it will decrease motivations to purchase flood insurance, especially for households outside of high‐risk areas. We evaluated vital model parameters using a local sensitivity analysis. Simulation results demonstrate the importance of an integrated adaptation strategy in community flood risk management.
Resolution of Th/Tc17‐driven inflammation during anti‐TNFα treatment of rheumatoid arthritis reveals a unique immune biomarker profiling pattern
Authors: Bjarnadóttir Una , Einarsdóttir Helga K. , Stefánsdóttir Elínborg , Helgason Einar Axel , Jónasdóttir Dagrún , Gudmundsson Sveinn , Gudbjornsson Bjorn , Ludviksson Björn R. 
Published: November 2021

AbstractRheumatoid arthritis (RA) is a chronic multisystem disease with a complex immunopathology. Its inflammatory state is dominated by pro‐inflammatory cytokines such as TNFα and activated Th1/Th17. Only proportion of patients achieve clinical remission despite potent biologics targeting these pathways. This study investigated the resolution of inflammation in RA patients (naïve for biologics) receiving TNFα inhibitors (TNFi) and evaluated the biological mechanisms behind treatment response and assessed them using clinical scoring systems. The majority showed a good clinical response after six months (6M) and a significant drop in DAS28‐CRP (P ≤ .002), CDAI (P ≤ .0001) and RheumXpert (P ≤ .0001). Before treatment, the patients demonstrated a chronic innate and adaptive inflammatory state. The improved clinical condition was reflected with a decrease in Th17/Tc17 (P ≤ .05) and an increase in Tregs after 6M (P ≤ .05). Using a logistic regression model on serum data, IL‐6, IL‐18, IL‐21, IL‐22, IFNγ and TNFα were identified as the main contributing biomarkers in the chronic inflammatory state of RA. A specific test score (STS) was defined and converted to a single cytokine composite test score (CCTS), which showed the disease outcome on a scale 0‐100, providing sensitivity and specificity of ≥90%. Thus, the immunological complexity in RA is driven by a complex interplay of pro‐inflammatory cytokines and effector T‐cell response dominated by Th17/Tc17. In addition, the resolution of inflammation could be linked to a partially Treg‐driven homeostatic innate immune response. Therefore, a more complex therapeutic approach against the above markers might be of value to obtain full clinical remission in the future.
Effectiveness of different health delivery agents of parenting stimulation interventions on child development outcomes among children aged 0 to 36 months: a systematic review protocol
Authors: Solís-Cordero Katherine , Duarte Luciane Simões , Jeong Joshua , Fujimori Elizabeth 
Published: November 2021

ABSTRACT

Objective:
This review will evaluate the effectiveness of different health delivery agents of parenting stimulation interventions versus usual care, no intervention, or a different type of delivery agent on child development outcomes among children aged 0 to 36 months.

Introduction:
Stimulation interventions vary in terms of implementation. While some interventions are delivered by professionals, most are delivered by non-professionals. Several prior systematic reviews on this topic have been conducted; however, no known study has evaluated the effectiveness of stimulation interventions on child development by type of delivery agent.

Inclusion criteria:
This review will consider randomized controlled trials assessing parenting stimulation interventions delivered by different health delivery agents. These will be compared to usual care, no intervention, or a different delivery agent, targeted at caregiver-child dyads of children aged 0 to 36 months. The outcomes will include motor, language, cognitive, and socio-emotional development. The review will exclude studies including children with specific characteristics, interventions that do not focus on parenting, and protocols of randomized clinical trials.

Methods:
The review will include both published and unpublished studies. The key information sources to be searched are: MEDLINE, APA (PsycNet), Embase, Scopus, Web of Science Core Collection, CINAHL, VHL Regional Portal, Google Scholar, Science Direct, Theses Canada Portal, and Library and Archives Canada. Studies in English, Spanish, and Portuguese will be included. Critical appraisal and data extraction will be conducted using standardized tools. Quantitative data, where possible, will be pooled in statistical meta-analysis, or if statistical pooling is not possible, the findings will be reported narratively.

Systematic review registration number:
PROSPERO CRD42021245245
Clinical interprofessional education in the health professions: a scoping review protocol
Authors: Moote Rebecca , Ratcliffe Temple , Gaspard Christine , Kennedy Angela , Leach Elena Riccio , Vives Marta , Zorek Joseph A. 
Published: November 2021

ABSTRACT

Objective:
The objective of this scoping review is to identify, characterize, and summarize evidence from the published literature on clinical interprofessional education.

Introduction:
Clinical interprofessional education refers to learning within clinical learning environments, such as hospitals, primary care clinics, and long-term care facilities. The learning involves direct interaction with real patients, where learners collaborate to deliver care and improve health outcomes.

Inclusion criteria:
This scoping review will consider clinical interprofessional education activities in the context of patient care. Criteria include two or more health professions, two or more learner groups, and involvement of real patients/patient care.

Methods:
This review will be conducted in accordance with the JBI methodology for scoping reviews. Databases searched will include PubMed, CINAHL, and Scopus. Results will be limited to English language publications from 2015 to the present. Extracted data will include the different types of clinical learning environments, the professions involved, the targeted learning/competency outcomes, and the measurement tools used by the authors. Titles/abstracts and full texts of articles will be screened by two reviewers for potential inclusion, with discrepancies resolved by a third reviewer if necessary. Extracted data will be presented in diagrammatic or tabular format. A narrative summary will accompany the tabulated and/or charted results, describing how the results relate to the review objective and research questions, and how the results might inform future clinical interprofessional education in health professions education.
Selection Methodology of Femoral Stems According to the Cross Section and the Maximum Stresses
Authors: López Galiano Iván Camilo , Juha Mario , Ortiz Juan Guillermo , Echeverry-Mejia Julián 
Published: November 2021

Abstract
The maximum stresses on a femoral stem must be known for selecting the right size and shape of the shaft cross-sectional area for reducing the stress shielding effect generated after the total hip arthroplasty (THA) surgical procedure. The methodology proposed in this study provides the tools to the designers of femoral stems and orthopedic surgeons to select the adequate femoral stem cross section, decreasing the stiffness of the stem, thus reducing the stress shielding effect in the patient bones. The first contribution is the theoretical development of the maximum static stress calculation for 12 different femoral stem models with the beam theory, followed by the comparison with the static finite element analysis (FEA) simulations and finally the experimental corroboration of one femoral stem model measuring the strain with linear strain gages and transform it to stresses, the three different approaches provide comparable results, with a maximum average error of less than 8.5%. The second contribution is the formulation of a new selection methodology based on maximum stresses in the femoral stem and the cross section area for decreasing the stress shielding effect, optimizing the area needed for withstand the loads and decreasing the overall stiffens of the stem.
Numerical Investigation of Flow and Heat Transfer From a Rotating Sphere With Constant Angular Velocity Around Vertical Axis Floating in Stationary Fluid
Authors: Safarzadeh S. , Rahimi A. B. 
Published: November 2021

Abstract
Convective heat transfer for a rotating sphere around a vertical axis floating in stationary fluid is studied numerically using the model of volume of fluid (VOF). The effects of the immersion angle and rotating velocity on the streamlines, isotherm and volume fraction contours, mean and local Nusselt numbers, volumetric flow rate, and water film thickness are investigated for the angular rotational velocity, 1500≤Ω≤3500 and the immersion angle, 30 deg≤θi≤60 deg. The results show that the sphere's rotation causes the liquid to be sucked from the lower pole of the sphere, which is thrown out after stopping in the equator. Due to the strong jet flow in the equatorial zone, heat is transferred by forced convection, but diffusion is dominant for heat transfer in other zones. At low rotational velocities, the liquid film is thrown out of the equator in the form of large droplets, but as the rotational velocity increases, its shape changes to a jet. Also, it is found that there is a direct relation between the Reynolds number and mean Nusselt number at different immersion angles so that an average of 27.5% increase for the mean Nusselt number is achieved by increasing the immersion angle from θi=30 deg to θi=60 deg. In addition, at a constant rotational velocity, the volumetric flow rate increases with increasing immersion angle.
Thermal Fatigue of Pressurized Water Reactor Coolant System Loop Drain Lines Due to Outflow Activities
Authors: Zou Yue , Derreberry Brian 
Published: November 2021

Abstract
Thermal cycling induced fatigue is widely recognized as one of the major contributors to the damage of nuclear plant piping systems, especially at locations where turbulent mixing of flows with different temperature occurs. Thermal fatigue caused by swirl penetration interaction with normally stagnant water layers has been identified as a mechanism that can lead to cracking in dead-ended branch lines attached to pressurized water reactor (PWR) primary coolant system. Electric Power Research Institute (EPRI) has developed screening methods, derived from extensive testing and analysis, to determine which lines are potentially affected as well as evaluation methods to perform evaluations of this thermal fatigue mechanism for the U.S. PWR plants. However, recent industry operating experience (OE) indicates that the model used to predict thermal fatigue due to swirl penetration is not fully understood. There are limitations with the EPRI generic evaluation. In addition, cumulative effects from other thermal transients, especially those resulted from outflow activities, may also contribute to the failure of reactor coolant system (RCS) branch lines. In this paper, we report direct OE from one of our PWR units where thermal fatigue cracking is observed at the RCS loop drain line close to the welded region of the elbow. A conservative analytical approach that takes into account the influence of thermal stratification, in accordance with ASME section III class 1 piping stress method, is also proposed to evaluate the severity of fatigue damage to the RCS drain line, as a result of various transients, particularly the transients from outflow activities. Finally, recommendations are made for future operation and inspection based on results of the evaluation.
Applicability of the Equivalent Diameter Approach to Estimate Vortex Shedding Frequency and Acoustic Resonance Excitation From Different Finned Cylinders in Cross-Flow
Authors: Alziadeh Mohammed , Mohany Atef 
Published: November 2021

Abstract
This article explores the applicability of utilizing different equivalent diameter (Deq) equations to estimate the vortex shedding frequency and onset of self-excited acoustic resonance for various types of finned cylinders. The focus is on three finned cylinder types that are commonly used in industrial heat exchangers: straight, twist-serrated, and crimped spirally finned cylinders. Within each fin type, at least three different finned cylinders are investigated. The results indicate that at off-resonance conditions, utilizing the appropriate equivalent diameter collapses the Strouhal number data within the typical Strouhal number variations of an equivalent diameter circular, bare cylinder. However, when acoustic resonance is initiated, the onset and the peak of resonance excitation in all of the finned cylinder cases generally occurred at a reduced flow velocity earlier than that observed from their equivalent diameter bare cylinders. This suggests that although utilizing the appropriate equivalent diameter can reasonably estimate the vortex shedding frequency away from acoustic resonance excitation, it cannot be used to predict the onset of acoustic resonance in finned tubes. The findings of this study indicate that the effective diameter approach is not sufficient to capture the intrinsic changes in the flow-sound interaction mechanism as a result of adding fins to a bare cylinder. Thus, a revision of the acoustic Strouhal number charts is required for finned tubes of different types and arrangements.