bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single‐sweep pulmonary vein isolation using the new third‐generation laser balloon—Evolution in ablation style using endoscopic ablation system
Authors: Tohoku Shota , Bordignon Stefano , Chen Shaojie , Zanchi Simone , Bianchini Lorenzo , Trolese Luca , Operhalski Felix , Urbanek Lukas , Chun K. R. Julian , Schmidt Boris 
Published: September 2021

AbstractBackgroundThe endoscopic ablation system (EAS) is an established ablation device for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). The novel X3 EAS is now equipped with a contiguous circumferential ablation mode (RAPID mode).AimTo determine the feasibility of single‐shot fashioned ablation using X3.MethodsConsecutive patients who underwent AF ablation using X3 were enrolled. We assessed the acute procedural data focusing on “Single‐sweep PVI” defined as successful PVI with a single RAPID mode energy application, and on “first‐pass isolation” defined as successful PVI after initial circular lesion set.ResultsOne hundred AF patients (56% male, age: 68 ± 10 years, 66% paroxysmal AF) were analyzed. A total of 379 of 383 PVs (99%) were isolated with X3. Single‐sweep PVI and first‐pass‐isolation were achieved in 214 PVs (56%) and in 362 PVs (95%), respectively. Single‐sweep PVI rates varied across PVs with higher rates at the superior PVs (61.2% vs. inferior PVs: 49.5%, p = .0239) and at PVs with maximal ostial diameter <24 mm (57.6% vs. >24 mm: 36.8%, p = .0151). The mean total procedure and fluoroscopy times were 43.0 ± 10 and 4.0 ± 2 min, respectively. In none of the patients an acute thromboembolic event (stroke or transient ischemic attack) or a pericardial effusion/tamponade occurred. A single transient phrenic nerve palsy was observed.ConclusionThe new X3 EAS allows for single‐shot fashioned ablation in terms of single‐sweep PVI in half or more of PVs. The new RAPID ablation mode leads to an improved rate of first‐pass isolation associated with very short procedure times without compromising safety.
Earliest pulmonary vein potential‑guided cryoballoon ablation is associated with better clinical outcomes than conventional cryoballoon ablation: A result from two randomized clinical studies
Authors: Mizutani Yoshiaki , Yanagisawa Satoshi , Kanashiro Masaaki , Yamashita Daiki , Yonekawa Jun , Makino Yuichiro , Hiramatsu Takatsugu , Ichimiya Hitoshi , Uchida Yasuhiro , Watanabe Junji , Ichimiya Satoshi , Inden Yasuya , Murohara Toyoaki 
Published: September 2021

AbstractIntroductionWith regard to short‐term outcome in atrial fibrillation (AF), the benefit of cryoballoon ablation (CBA) by pressing a balloon against the earliest pulmonary vein (PV) potential site during PV isolation (earliest potential [EP]‐guided CBA) has been previously demonstrated. The present study aimed to evaluate the long‐term outcome of the EP‐guided CBA.Methods and ResultsThis study included 136 patients from two randomized studies, who underwent CBA for paroxysmal AF for the first time. Patients were randomly assigned to the EP‐guided and conventional CBA groups in each study. In the EP‐guided CBA group, we pressed a balloon against the EP site when the time‐to‐isolation (TTI) after cryoapplication exceeded 60 and 45 s in the first and second studies, respectively. We compared the clinical outcomes for 1 year after the procedure between the EP‐guided CBA group (68 patients) and the conventional CBA group (68 patients). The primary endpoint was the recurrence of atrial arrhythmia after ablation. No significant differences in baseline characteristics were observed between the two groups. Compared with the conventional CBA group, the EP‐guided CBA group had a significantly higher success rate at TTI ≤ 90 s (98.5% vs. 90.0%, p < .001); lower touch‐up rate and total cryoapplication; and shorter procedure time, and fluoroscopy time. The recurrence at 1 year after ablation was significantly lower in the EP‐guided CBA group than in the conventional CBA group (6.0% vs. 19.4%; p = .019).ConclusionsThe EP‐guided CBA approach can facilitate the ablation procedure and achieve low recurrence at 1 year after ablation.
Outcomes and predictors of readmission after implantation of a percutaneous left atrial appendage occlusion device in the United States: A propensity score‐matched analysis from The National Readmission Database
Authors: Pasupula Deepak Kumar , Munir Muhammad B. , Bhat Anusha Ganapati , Siddappa Malleshappa Sudeep K. , Meera Srinidhi J. , Spooner Michael , Koranne Ketan , Olshansky Brian , Hirji Sameer , Hsu Jonathan C. 
Published: September 2021

AbstractBackgroundLeft atrial appendage occlusion (LAAO) devices have become a favorable alternative option among nonvalvular atrial fibrillation (AF) patients with long‐term contraindication to anticoagulation. Real‐world experience with postprocedural readmission rates and predictors of readmission in LAAO patients is limited.ObjectiveTo assess all‐cause 30‐day readmission rate and predictors of readmission after LAAO procedure in the United States.MethodThis retrospective observational study included all AF patients undergoing percutaneous LAAO procedures in the United States from January 1, 2016, and December 31, 2017, in the National Readmission Database. The primary outcome measure was all‐cause 30‐day readmission. A propensity score‐matched analysis compared outcomes with a non‐LAAO AF cohort.ResultAmong 14 024 LAAO procedures (age: 76 ± 8 years; 60.5% males), 9.4% were readmitted within 30‐days and, 0.2% died during their index hospitalization. The most frequent primary diagnosis during readmission among LAAO was gastrointestinal bleeding (12%). The incidence of LAAO procedures increased by 102%. In the multivariate model, gender and CHA2DS2‐VASc failed to predict readmission. Age 55–64 years had lower odds (adjusted odds ratios [aOR]: 0.41; 95% confidence interval [CI]: 0.18–0.94), while drug abuse (aOR: 4.1; 95% CI: 1.34–12.54), and deficiency anemia (aOR: 1.88; 95% CI: 1.12–3.18) had higher odds of readmission. In propensity‐matched cohort, compared to non‐LAAO AF, LAAO patients had lower 30‐day readmission (9.4% vs. 10.98%, p = .002) and all‐cause in‐hospital mortality (0.19% vs. 0.57%, p < .001).ConclusionThe readmission rate following the LAAO procedure is substantial (approximately 10%), and largely attributable to gastrointestinal bleeding. Factors such as drug abuse and anemia must be explored further to minimize readmission risk.
Human Placental Mesenchymal Stem/Stromal cells (pMSCs) inhibit agonist‐induced platelet functions reducing atherosclerosis and thrombosis phenotypes
Authors: Al Subayyil Abdullah , Basmaeil Yasser S. , Alenzi Reem , Khatlani Tanvir 
Published: September 2021

AbstractMesenchymal stem/stromal cells isolated from human term placenta (pMSCs) have potential to treat clinically manifested inflammatory diseases. Atherosclerosis is a chronic inflammatory disease, and platelets play a contributory role towards its pathogenesis. During transplantation, MSCs interact with platelets and exert influence on their functional outcome. In this study, we investigated the consequences of interaction between pMSCs and platelets, and its impact on platelet‐mediated atherosclerosis in vitro. Human platelets were treated with various types of pMSCs either directly or with their secretome, and their effect on agonist‐mediated platelet activation and functional characteristics were evaluated. Human umbilical vein endothelial cells (HUVECs) were used as control. The impact of pMSCs treatment on platelets was evaluated by the expression of activation markers and by platelet functional analysis. A subset of pMSCs reduced agonist‐induced activation of platelets, both via direct contact and with secretome treatments. Decrease in platelet activation translated into diminished spreading, limited adhesion and minimized aggregation. In addition, pMSCs decreased oxidized LDL (ox‐LDL)‐inducedCD36‐mediated platelet activation, establishing their protective role in atherosclerosis. Gene expression and protein analysis show that pMSCs express pro‐ and anti‐thrombotic proteins, which might be responsible for the modulation of agonist‐induced platelet functions. These data suggest the therapeutic benefits of pMSCs in atherosclerosis.
Phylogenetic conservation of behavioural variation and behavioural syndromes
Authors: Dalos Jeremy , Royauté Raphaël , Hedrick Ann V. , Dochtermann Ned A. 
Published: September 2021

AbstractIndividuals frequently differ consistently from one another in their average behaviours (i.e. ‘animal personality’) and in correlated suites of consistent behavioural responses (i.e. ‘behavioural syndromes’). However, understanding the evolutionary basis of this (co)variation has lagged behind demonstrations of its presence. This lag partially stems from comparative methods rarely being used in the field. Consequently, much of the research on animal personality has relied on ‘adaptive stories’ focused on single species and populations. Here, we used a comparative approach to examine the role of phylogeny in shaping patterns of average behaviours, behavioural variation and behavioural correlations. In comparing the behaviours and behavioural variation for five species of Gryllid crickets, we found that phylogeny shaped average behaviours and behavioural (co)variation. Despite differences among species, behavioural responses and variation were most similar among more closely related species. These results suggest that phylogenetic constraints play an important role in the expression of animal personalities and behavioural syndromes and emphasize the importance of examining evolutionary explanations within a comparative framework.
The evolution of flower longevity in unpredictable pollination environments
Authors: Xu Kuangyi , Servedio Maria R. 
Published: September 2021

AbstractPollination requires a flower to remain open for long enough to allow for the arrival of pollinators. However, maintaining flowers costs energy and resources. Therefore, flower longevity, the length of time a flower remains viable, is critical for the outcome of plant reproduction. Although previous studies showed that the evolution of flower longevity depends on the rates of pollen deposition and removal, whether plants should increase or decrease flower life span when the pollination environment is unpredictable has not been explored. Moreover, the common hypothesis that an unpredictable pollination environment should select for increased flower longevity may be too simplistic since there is no distinction drawn between the effects of spatial and temporal variation. Adopting evolutionary game theory, we investigate the evolution of flower longevity under three types of variation: spatial heterogeneity, daily fluctuations within a flowering season and yearly fluctuations between flowering seasons. We find that spatial heterogeneity often selects for a shorter flower lifespan, while temporal fluctuations of fitness accrual rates at both daily and yearly time scales tends to favour greater longevity, although daily and yearly fluctuations have somewhat different effects. However, the presence of correlation between female and male fitness accrual rates seems to have no effect on flower longevity. Our work suggests that explicit measurements of spatial and temporal variation in both female and male functions may provide a better understanding of the evolution of flower longevity and reproduction.
Antiviral activity of esculin against white spot syndrome virus: A new starting point for prevention and control of white spot disease outbreaks in shrimp seedling culture
Authors: Shan Li‐Peng , Zhang Xu , Hu Yang , Liu Lei , Chen Jiong 
Published: September 2021

AbstractWhite spot syndrome virus (WSSV) is a pathogenic and threatening virus in shrimp culture for which there is no effective control strategy. Finding antiviral lead compounds for the development of anti‐WSSV drugs is urgent and necessary; in this study, esculin from 12 monomeric compounds exhibited an excellent anti‐WSSV activity. The results showed that esculin increased the survival rate of WSSV‐infected shrimps by 59% and reduced the virus copy number in vivo over 90% at 100 μM. In the pre‐treatment and post‐treatment experiments, esculin could prevent and treat WSSV infection. Compared with the control group, the virus copy number decreased by 30% after 6 h of esculin pre‐incubation with WSSV particles and inhibited horizontal transmission of WSSV to a certain extent. Considering that the antiviral activity of esculin was stable in the aquacultural water for 2 days, we evaluated the dosing pattern of continuous medication changes. Obviously, the survival rate of WSSV‐infected shrimps was 0% at 108 h when no esculin exchange was made, while at 120 h the survival rate was over 40% at continuous medicine changes. In addition, esculin significantly increased the expression of antimicrobial peptides and thus improved the ability of shrimp to resist WSSV. Overall, our findings suggest that esculin has the potential to be developed into an anti‐WSSV medicine.
Development of extra virgin olive and olive pomace oil nanoemulsions (o/w and w/o) enriched with surface‐active phenolic compounds
Authors: Katsouli Maria , Papatheodorou Spyridon‐Andreas , Giannou Virginia , Tzia Constantina 
Published: September 2021

AbstractThe present study explored the potential use and the effectiveness of extra virgin olive oil (EVOO) and olive pomace oil (OPO) for water in oil (w/o) and oil in water (o/w) nanoemulsion preparations. Nonionic food grade emulsifiers were examined in the formulation of the nanoemulsions and the incorporation of polyphenols extracted from olive kernel on their physicochemical properties was also investigated. The effect of the dispersed phase and the incorporated bioactive compounds was evaluated based on the mean droplet diameter (MDD) and polydispersity index (PDI), turbidity and viscosity, MDD growth, surface tension, and total phenolic content of the nanoemulsions during storage. Results were statistically evaluated using analysis of variance and Duncan's test was performed where applicable. The most effective type and the optimum ratio of the emulsifier was determined in each system (o/w–w/o, EVOO–OPO). The nanoemulsions produced presented desirable properties, in terms of kinetic stability, MDD, PDI, and viscosity and they demonstrated satisfactory physical and chemical stability during storage. MDD and PDI values were minimum in the case of o/w nanoemulsion prepared with 4% Tween 40. The stability of the nanoemulsion was enhanced by polyphenols while their retention reached ~80% being higher in o/w nanoemulsions. It was concluded that it is possible to prepare fine o/w and w/o nanoemulsions using both EVOO and OPO. The incorporation of bioactive compounds can significantly affect the nanoemulsions' properties, improving their kinetic and chemical stability.Practical ApplicationsAlthough olive oil has been thoroughly studied for nanoemulsion preparations, there is still limited study on olive pomace oil applications. Hence, this present study was designed to compare the effectiveness of extra virgin olive oil and olive pomace oil on the formation of o/w and w/o nanoemulsion enriched with phenolic compounds extracted from the olive kernel. The novelty of work is highlighted in the following: both extra virgin olive and olive pomace oil can be suitable for the preparation of o/w and w/o nanoemulsions with good physical stability and without excessive droplet growth upon storage. These nanoemulsions can be used as a suitable means for the incorporation and protection of bioactive ingredients, such as polyphenolic compounds, and serve as an excellent delivery system as they exhibit satisfactory retention during storage.
Collaborative care for depression yields similar improvement among older and younger rural adults
Authors: Renn Brenna N. , Johnson Morgan , Powers Diane M. , Vredevoogd Mindy , Unützer Jürgen 
Published: September 2021

AbstractBackgroundDepressive disorders are among the most prevalent mental health conditions; however, significant barriers to treatment access persist. This study examined differences in depression outcomes between younger and older adults in a large‐scale implementation demonstration of the collaborative care model (CoCM).MethodsSecondary data analysis of a longitudinal, observational implementation demonstration at eight primary care clinics across low‐resourced rural or frontier areas of the Western United States. Seven of these clinics were federally qualified health centers. The sample consisted of 3722 younger (18–64 years) and older (65+ years) adult primary care patients diagnosed with unipolar depression. All participants received depression treatment via CoCM, which enhances usual primary care and makes efficient use of specialists by using a behavioral healthcare manager and a psychiatric consultant to support primary care providers. Clinics were followed for up to 27 months. Patients were followed until they completed treatment or dropped out. The Patient Health Questionnaire (PHQ‐9) assessed depressive symptoms at baseline (enrollment) and at most follow‐up contacts. The primary treatment outcome was a change between a patient's first and last recorded PHQ‐9 scores.ResultsAcross both age groups, there was an average overall reduction of 6.9 points on the PHQ‐9. Older adults demonstrated a greater decrease in depression scores of 2.06 points (95% CI −2.98 to −1.14, p < 0.001) on the PHQ‐9 compared with younger adults. Estimates were robust when adjusting for gender, race, and clinic.ConclusionsCoCM resulted in meaningful improvement in depressive symptoms across age groups.
Changes in activity levels, physical functioning, and fall risk during the COVID‐19 pandemic
Authors: Hoffman Geoffrey J. , Malani Preeti N. , Solway Erica , Kirch Matthias , Singer Dianne C. , Kullgren Jeffrey T. 
Published: September 2021

AbstractBackgroundPhysical function worsens with older age, particularly for sedentary and socially isolated individuals, and this often leads to injuries. Through reductions in physical activity, the COVID‐19 pandemic may have worsened physical function and led to higher fall‐related risks.MethodsA nationally representative online survey of 2006 U.S. adults aged 50–80 was conducted in January 2021 to assess changes in health behaviors (worsened physical activity and less daily time spent on feet), social isolation (lack of companionship and perceived isolation), physical function (mobility and physical conditioning), and falls (falls and fear of falling) since March 2020. Multivariable logistic regression was used to assess relationships among physical activity, social isolation, physical function, falls, and fear of falling.ResultsAmong respondents, 740 (36.9%) reported reduced physical activity levels, 704 (35.1%) reported reduced daily time spent on their feet since March 2020, 712 (37.1%) reported lack of companionship, and 914 (45.9%) social isolation. In multivariable models, decreased physical activity (adjusted risk ratio, ARR: 2.92, 95% CI: 2.38, 3.61), less time spent on one's feet (ARR: 1.95, 95% CI: 1.62, 2.34), and social isolation (ARR: 1.51, 95% CI: 1.30, 1.74) were associated with greater risks of worsened physical conditioning. Decreased physical activity, time spent daily on one's feet, and social isolation were similarly associated with worsened mobility. Worsened mobility was associated with both greater risk of falling (ARR: 1.70, 95% CI: 1.35, 2.15) and worsened fear of falling (ARR: 2.02, 95% CI: 1.30, 3.13). Worsened physical conditioning and social isolation were also associated with greater risk of worsened fear of falling.ConclusionThe COVID‐19 pandemic was associated with worsened physical functioning and fall outcomes, with the greatest effect on individuals with reduced physical activity and social isolation. Public health actions to address reduced physical activity and social isolation among older adults are needed.
Consumer acceptance of circular business models and potential effects on economic performance: The case of washing machines
Authors: Gülserliler Ece G. , Blackburn Joseph D. , Van Wassenhove Luk N. 
Published: September 2021

AbstractA key principle of the circular economy is to fundamentally reconsider the nature of the transaction between producer and consumer. To facilitate circularity and enhance sustainability, producers retain ownership of a product throughout its lifetime, and consumers lease, rent, or share the product. This paper examines the feasibility of leasing instead of buying a product from both the consumer's and manufacturer's perspectives. We focus on repeated leasing with refurbishment in‐between for the specific case of washing machines. Through an online experiment, we assess the preferences of consumers among the alternatives of purchasing a new machine and leasing a new or a used machine. The results reveal that the market is segmented and consumers have distinct preferences driven by psychological antecedents such as disgust, pride of ownership, and convenience of leasing. While there is some demand for leasing new and used machines, there are also barriers to the transition from selling to leasing: a significant number of consumers prefer to buy instead of lease at any price that would sustain a manufacturer's profitability. Moreover, there appears to be an imbalance in the consumer demand for leasing new and leasing used—a mismatch that poses an obstacle to the economic feasibility of a circular economy.
Clinical application of traditional Chinese medicine moisture exposed burn ointment in the treatment of facial soft tissue defect
Authors: Wang Jun , Hao Lanqing , Zhou Xiaolong , He Wanggang , Hu Ming 
Published: September 2021

AbstractObjectiveTo introduce a new method of treating facial soft tissue defect by observing the clinical curative effects of traditional Chinese medicine moisture exposed burn ointment in treating facial soft tissue defect.MethodsA total of 85 patients with facial soft tissue defects were treated with traditional Chinese medicine moisture exposed burn ointment, and the clinical therapeutic effects were analyzed by observing the wound healing time, scar formation and changes of facial appearance and functions.ResultsOf the 85 patients, the shortest wound healing time was 12 days and the longest was 72 days; the facial appearance and functions restored to be normal in 74 patients, with good skin elasticity and mild scar formation in the wound area; 11 patients were lost to the follow‐up; two patients suffered from the longest wound healing time due to their skin defect of nasal tip and nasal columella and the cartilage defect of nasal wings, and V‐shaped defects were left at the edge of the left nostrils after the wound healing, which may be attributed to the ineffectiveness of MEBT/MEBO on cartilage.ConclusionTraditional Chinese medicine moisture exposed burn ointment can realize more satisfying healing effects when applied in the treatment of facial soft tissue defects, including user‐friendly operation, no special requirements for medical devices, obviously lower treatment cost, etc., and thus it is an easy‐to‐operate and effective way for such patients, especially for elderly patients, patients with poor body conditions and patients unbearable to undergo complicated operations.