bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior Left Atrial Adipose Tissue Attenuation Assessed by Computed Tomography and Recurrence of Atrial Fibrillation After Catheter Ablation
Authors: El Mahdiui Mohammed , Simon Judit , Smit Jeff M. , Kuneman Jurrien H. , van Rosendael Alexander R. , Steyerberg Ewout W. , van der Geest Rob J. , Száraz Lili , Herczeg Szilvia , Szegedi Nándor , Gellér László , Delgado Victoria , Merkely Bela , Bax Jeroen J. , Maurovich-Horvat Pál 
Published: March 2021

Background:
Atrial fibrillation (AF) recurrence following catheter ablation remains high. Recent studies have shown a relation between epicardial adipose tissue and AF. epicardial adipose tissue secretes several proinflammatory and anti-inflammatory adipokines that directly interact with the adjacent myocardium. The aim of the current study was to evaluate whether posterior left atrial (LA) adipose tissue attenuation, as marker of inflammation, is related to AF recurrences after catheter ablation.

Methods:
Consecutive patients with symptomatic AF referred for first AF catheter ablation who underwent computed tomography were included. The total epicardial adipose tissue and posterior LA adipose tissue were manually traced and adipose tissue was automatically recognized as tissue with Hounsfield units (HU) between −195 and −45. The attenuation value of the posterior LA adipose tissue was assessed, and the population was divided according to the mean HU value (−96.4 HU).

Results:

In total, 460 patients (66% male, age 61±10 years) were included in the analysis. After a median follow-up of 18 months (interquartile range, 6–32), 168 (37%) patients had AF recurrence. Patients with higher attenuation (≥−96.4 HU) of the posterior LA adipose tissue showed higher AF recurrence rates compared with patients with lower attenuation (<−96.4 HU; log-rank test
P
=0.046). Univariate analysis showed an association between AF recurrence and higher posterior LA adipose tissue attenuation (≥−96.4 HU;
P
<0.05). On multivariable analysis, posterior LA adipose tissue attenuation (hazard ratio, 1.26 [95% CI, 0.90–1.76];
P
=0.181) remained a promising predictor of AF recurrence following catheter ablation.

Conclusions:
Posterior LA adipose tissue attenuation is a promising predictor of AF recurrence in patients who undergo catheter ablation. Higher adipose tissue attenuation might signal increased local inflammation and serve as an imaging biomarker of increased risk of AF recurrence.

Graphic Abstract:

A
graphic abstract
is available for this article.
Surgical Explantation of Transcatheter Aortic Valve Bioprostheses
Authors: Brescia Alexander A. , Deeb G. Michael , Sang Stephane Leung Wai , Tanaka Daizo , Grossman P. Michael , Sukul Devraj , He Chang , Theurer Patricia F. , Clark Melissa , Shannon Francis L. , Chetcuti Stanley J. , Fukuhara Shinichi ,   on behalf of the Michigan Society of Thoracic and Cardiovascular Surgeons and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium
Published: March 2021

Background:
Despite the rapid adoption of transcatheter aortic valve replacement (TAVR) since its initial approval in 2011, the frequency and outcomes of surgical explantation of TAVR devices (TAVR-explant) is poorly understood.

Methods:
Patients undergoing TAVR-explant between January 2012 and June 2020 at 33 hospitals in Michigan were identified in the Society of Thoracic Surgeons Database and linked to index TAVR data from the Transcatheter Valve Therapy Registry through a statewide quality collaborative. The primary outcome was operative mortality. Indications for TAVR-explant, contraindications to redo TAVR, operative data, and outcomes were collected from Society of Thoracic Surgeons and Transcatheter Valve Therapy databases. Baseline Society of Thoracic Surgeons Predicted Risk of Mortality was compared between index TAVR and TAVR-explant.

Results:

Twenty-four surgeons at 12 hospitals performed TAVR-explants in 46 patients (median age, 73). The frequency of TAVR-explant was 0.4%, and the number of explants increased annually. Median time to TAVR-explant was 139 days and among known device types explanted, most were self-expanding valves (29/41, 71%). Common indications for TAVR-explant were procedure-related failure (35%), paravalvular leak (28%), and need for other cardiac surgery (26%). Contraindications to redo TAVR included need for other cardiac surgery (28%), unsuitable noncoronary anatomy (13%), coronary obstruction (11%), and endocarditis (11%). Overall, 65% (30/46) of patients underwent concomitant procedures, including aortic repair/replacement in 33% (n=15), mitral surgery in 22% (n=10), and coronary artery bypass grafting in 16% (n=7). The median Society of Thoracic Surgeons Predicted Risk of Mortality was 4.2% at index TAVR and 9.3% at TAVR-explant (
P
=0.001). Operative mortality was 20% (9/46) and 76% (35/46) of patients had in-hospital complications. Of patients alive at discharge, 37% (17/37) were discharged home and overall 3-month survival was 73±14%.

Conclusions:
TAVR-explant is rare but increasing, and its clinical impact is substantial. As the utilization of TAVR expands into younger and lower-risk patients, providers should consider the potential for future TAVR-explant during selection of an initial valve strategy.
Testosterone Metabolite 6β‐Hydroxytestosterone Contributes to Angiotensin II‐Induced Abdominal Aortic Aneurysms in
Apoe

–/–

Male Mice
Authors: Mukherjee Kamalika , Pingili Ajeeth K. , Singh Purnima , Dhodi Ahmad N. , Dutta Shubha R. , Gonzalez Frank J. , Malik Kafait U. 
Published: March 2021

Background

Sex is a prominent risk factor for abdominal aortic aneurysms (AAAs), and angiotensin II (Ang II) induces AAA formation to a greater degree in male than in female mice. We previously reported that cytochrome P450 1B1 contributes to the development of hypertension, as well as AAAs, in male mice. We also found that a cytochrome P450 1B1‐generated metabolite of testosterone, 6β‐hydroxytestosterone (6β‐OHT), contributes to Ang II‐induced hypertension and associated cardiovascular and renal pathogenesis in male mice. The current study was conducted to determine the contribution of 6β‐OHT to Ang II‐induced AAA development in

Apoe
–/–

male mice.

Methods and Results

Intact or castrated

Apoe
–/–
/Cyp1b1
+/+

and

Apoe
–/–
/Cyp1b1
–/–

male mice were infused with Ang II or its vehicle for 28 days, and administered 6β‐OHT every third day for the duration of the experiment. Abdominal aortas were then evaluated for development of AAAs. We observed a significant increase in the incidence and severity of AAAs in intact Ang II‐infused

Apoe
–/–
/Cyp1b1
+/+

mice, compared with vehicle‐treated mice, which were minimized in castrated

Apoe
–/–
/Cyp1b1
+/+

and intact

Apoe
–/–
/Cyp1b1
–/–

mice infused with Ang II. Treatment with 6β‐OHT significantly restored the incidence and severity of AAAs in Ang II‐infused castrated

Apoe
–/–
/Cyp1b1
+/+

and intact

Apoe
–/–
/Cyp1b1
–/–

mice. However, administration of testosterone failed to increase AAA incidence and severity in Ang II‐infused intact

Apoe
–/–
/Cyp1b1
–/–

mice.

Conclusions

Our results indicate that the testosterone‐cytochrome P450 1B1‐generated metabolite 6β‐OHT contributes to Ang II‐induced AAA development in

Apoe
–/–

male mice.
Fact-Finding in Situations of Atrocities: In Search of Legitimacy
Authors: Parisi Piergiuseppe 
Published: March 2021

Abstract
While international inquiries have long been used by states and international organisations to address situations of human rights violations, it is only since the turn of the millennium that they have increasingly become the focus of academic reflection. Harwood’s book is unique in that it represents the first effort at systematically surveying and systematising the practice of atrocity-related UN inquiries. In this essay, building on both the arguments set out in the book and other relevant scholarship, I propose three lenses to read through Harwood’s meticulous review of the practice of UN inquiries: legitimacy, juridification, and roles and functions. While Harwood makes a largely critical-descriptive argument that positions atrocity-related UN inquiries in the liminal space between principle and pragmatism, I contend that any discussion about the roles and functions of international inquiries should be informed by a reflection on their legitimacy.
Basinwide Connections of Upper-Ocean Temperature Variability in the Equatorial Indian Ocean
Authors: Song Ge , Huang Bohua , Ren Rongcai , Hu Zeng-Zhen 
Published: March 2021

AbstractIn this article, the interannual variability of upper-ocean temperature in the equatorial Indian Ocean (IO) and its basinwide connections are investigated using 58-yr (1958–2015) comprehensive monthly mean ocean reanalysis data. Three leading modes of an empirical orthogonal function (EOF) analysis dominate the variability of upper-ocean temperature in the equatorial IO over a wide range of time scales. A coherent interannual band within the first two EOF modes identifies an oscillation between the zonally tilting thermocline across the equatorial IO in its peak phases and basinwide displacement of the equatorial thermocline in its transitional phases. Consistent with the recharge oscillation paradigm, this oscillation is inherent in the equatorial IO with a quasi-periodicity around 15 months, in which the wind-induced off-equatorial Rossby waves near 5°–10°S provide the phase-transition mechanism. This intrinsic IO oscillation provides the biennial component in the observed IOD variations. The third leading mode shows a nonlinear long-term trend of the upper-ocean temperature, including the near-surface warming along the equatorial Indian Ocean, accompanied by cooling trend in the lower thermocline originating farther south. Such vertical contrary trends may lead to an enhanced stratification in the equatorial IO.
Desire for control and the integrated motivational-volitional model of suicidal behavior: Results from a pilot investigation of adults in the United Kingdom
Authors: Saint-Cyr Neielle , Gallagher Brendan , Cramer Robert J , Rasmussen Susan 
Published: March 2021

Background: Suicidal behavior remains a pressing problem in the United Kingdom. Continued theory development is a critical step toward designing effective prevention. Aims: The present study tested a novel element to suicide theory, the Desire for Control, for its direct and moderating roles within the Integrated Motivational-Volitional (IMV) Model of Suicidal Behavior. Method: An online-administered cross-sectional suicide risk survey study ( n = 116) was conducted among adults living in the United Kingdom. Results: Mean suicidal ideation scores were in the non-clinical range. DOC Leadership and Destiny Control were associated with good mental health. DOC Decision Avoidance was associated with poor mental health. DOC Decision Avoidance also acted as a motivational moderator in which the entrapment-suicidal thinking link was worse among those high in decisional avoidance. Conclusion: DOC represents a novel, valuable addition to suicide theory and may inform suicide-specific psychotherapeutic intervention. Additional research is needed to full understand the role of DOC and its factor structures in the IMV.
The Thermal Damage of Canine Vocal Fold by CO2 Laser Under Different Laser Emission Mode
Authors: Li Xumao , Li Jiaying , Cui Xidong , Hu Xinqi , Yu Pengcheng , Sun Guangbin 
Published: March 2021

Objective: The purpose of this study is to review the differences between continuous wave (CW) and UltraPulse (UP) on thermal damage of the laser with different power. Methods: Four adult beagle dogs underwent transoral laser microsurgery (TLM) using CO2 laser. The laser emission mode and power was CW (3 W, 5 W, and 8 W) and UP (3 W and 5 W), respectively. The tissue from 4 animals was evaluated histologically on postoperative days 1 and 3. The thermal damage of the laser was measured using slide scan system via SlideViewer version 1.5.5.2 software. Results: All dogs underwent TLM uneventfully. Under microscope examined, the laser damage area was composed of 2 parts: the vaporized zone (VPZ) and thermal damage area. The thermal damage area can be divided into thermal coagulative necrosis area (TCN) and hydropic degeneration area. The width of VPZ and TCN in UP mode was less than that in CW mode ( P < .01). The data indicate that lower laser power created less thermal damage ( P < .01). In addition, the width of VPZ on postoperative day 3 was less than that on postoperative day 1 ( P < .01). Conclusion: CO2 laser with UP and lower power could decrease the laser thermal damage and may offer more prompt wound healing.
Effects of tailored lateral wedge insoles on medial knee osteoarthritis based on biomechanical analysis: 12-week randomized controlled trial
Authors: Ferreira Vitor , Machado Leandro , Vilaça Adélio , Xará-Leite Francisco , Roriz Paulo 
Published: March 2021

Background: Lateral wedge insoles adjusted by biomechanical analysis may improve the condition of patients with medial knee osteoarthritis. Design: This is a prospective, randomized, controlled, single-blind clinical trial. Setting: The study was conducted in a biomechanics laboratory. Subjects: A total of 38 patients with medial knee osteoarthritis were allocated to either an experimental group (lateral wedge insoles) or a control group (neutral insoles). Interventions: Experimental group ( n = 20) received an adjusted lateral wedge insole of 2, 4, 6, 8, or 10 degrees, after previous biomechanical analysis. Control group ( n = 18) received a neutral insole (0 degrees). All patients used the insoles for 12 weeks. Main measures: Visual analogue scale, Knee Injury and Osteoarthritis Outcome Score questionnaire, biomechanical parameters: first and second peak of the external knee adduction moment and knee adduction angular impulse, and physical performance tests: 30-second sit-to-stand test, the 40-m fast-paced walk test, and the 12-step stair-climb test. Results: After 12 weeks, between-group differences did not differ significantly for pain intensity (−12.5 mm, (95% CI −29.4–4.4)), biomechanical parameters ( p = 0.05), Knee Injury and Osteoarthritis Outcome Score, and physical performance tests, except on the Knee Injury and Osteoarthritis Outcome Score subscale other symptoms ( p = 0.002; 13.8 points, (95% CI 5.6–22.0)). Conclusion: Tailored wedge insoles were no more effective at improving biomechanical or clinically meaningful outcomes than neutral insoles, except on symptoms. More participants from the experimental group reported they felt some improvement. However, these effects were minimal and without clinical significance.
Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study
Authors: Yıldız Erman 
Published: March 2021

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHODS: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.
Feline cardiopulmonary resuscitation: Getting the most out of all nine lives
Authors: Ward Melody J , Blong April E , Walton Rebecca A 
Published: March 2021

Practical relevance: Cardiopulmonary arrest (CPA) can occur in any veterinary or animal care setting and is a particular risk in scenarios involving ill, injured or anesthetized patients. Education of all staff on the prevention and recognition of CPA, as well as the performance of cardiopulmonary resuscitation (CPR), is vital to influencing outcome. Evidence base: While there is a plethora of information regarding CPA and CPR in human medicine, there are comparably few studies in the veterinary literature. Many of the current veterinary guidelines are extrapolated from human medicine or studies based on animal models. Ongoing work is needed to tailor guidelines and recommendations to our domestic feline (and canine) patients in a clinical setting. Aim: The aim of this article, which is intended for veterinarians in all areas of small animal practice, is to provide an evidence-based review of CPA and CPR in feline patients. The authors have drawn heavily on detailed recommendations published by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) initiative – one of the few resources specific to the veterinary clinical setting – as well as reviewing the available peer-reviewed literature studies, in constructing this article. Among the topics discussed are recognizing and preventing CPA, staff training and clinic preparedness, basic life support and advanced life support interventions, and appropriate post-cardiac arrest care.
Coincidental ocular findings during retinopathy of prematurity telescreening of 9105 neonates
Authors: Ranjan Ratnesh , Das Abhishek , Prema Subramaniam , Shah Parag K , Venkatapathy Narendran 
Published: March 2021

Purpose: To describe the magnitude and spectrum of abnormal ocular findings other than retinopathy of prematurity (ROP) detected during an ROP telescreening programme. Methods: Retrospective review of the records of all premature babies screened for ROP from August 2015 to December 2019. Results: A total 9105 babies were screened during the study period with total 17,075 imaging sessions. Non-ROP ocular abnormalities were seen in 566 eyes of 383 babies (4.2%) including 207 male (54%) and 176 female babies (46%). Posterior segment abnormalities were seen in 88.2% babies (338/383) with haemorrhage being the most common (77%, 295/383). Anterior segment pathologies were seen in 12% babies (46/383) with congenital cataract being the most common pathology requiring surgical intervention. Other findings included globe abnormalities in 0.8% babies (3/383), adnexal disorders in 0.5% babies (2/383) and squint in 0.3% babies (1/383). Rare life-threatening conditions such as retinoblastoma and lipaemia retinalis were also detected. Eighty-seven babies (22.7%) were diagnosed with referral-warranted non-ROP pathologies, with an overall prevalence of 1% (87/9105). Prompt surgical intervention was advised for 7.3% babies (28/383), 3.4% babies (13/383) were treated medically and 4.2% babies (16/383) needed visual rehabilitation for non-amenable pathologies. Conclusion: This is the largest study describing the magnitude and spectrum of neonatal ocular pathologies other than ROP in a cohort of premature babies. Digital imaging has a significant impact on early detection and timely intervention for various vision as well as life-threatening non-ROP pathologies, which would have been missed or delayed otherwise.
A comparison of 2 cementing techniques in hip resurfacing using human femoral heads
Authors: Shiels Sarah J , Williams Martin , Bannister Gordon C , Baker Richard P 
Published: March 2021

Introduction: Hip resurfacing remains a valid option in young male patients. The creation of the optimum cement mantle aids fixation of the femoral component. If the cement mantle is too thick the prosthesis can remain proud leading to early failure or if it penetrates too far into the femoral head, it may cause osteonecrosis. Method: 18 of 96 femoral heads collected from patients undergoing total hip arthroplasty were matched for their surface porosity. They were randomly allocated into 2 different cementing groups. Group 1 had the traditional bolus of cement technique, while group 2 had a modified cementing technique (swirl) where the inside of the femoral component was lined with an even layer of low viscosity cement. Results: The traditional bolus technique had significantly greater cement mantle thickness in 3 of 4 zones of penetration ( p = 0.002), greater and larger air bubble formation (6 of 9 in bolus technique vs. 1 in 9 in swirl technique, p = 0.05) and more incomplete cement mantles compared with the swirl technique. There was no relationship to femoral head porosity. Conclusion: The swirl technique should be used to cement the femoral component in hip resurfacing. Long-term clinical studies would conform if this translates into increased survivorship of the femoral component.
Ionizing radiation exposure from dialysis tunneled catheters procedures: European directive and legal implications
Authors: De Mauri Andreana , Matheoud Roberta , Guzzardi Giuseppe , Vaccarone Valentina , David Paola , Brambilla Marco , Chiarinotti Doriana 
Published: March 2021

Background: Advances in medical imaging and interventional procedures have been associated with increased exposure to ionizing radiation. Thus, the International Commission on Radiological Protection (ICRP) established uniform safety standards to protect the general public against the dangers arising from ionizing radiations. In Europe, the ICRP standards are listed in the European Directive 2013/59/EURATOM, which should be transposed into national legislation by member states. They require that the administered dose must be part of the radiological report and identify the practitioners’ responsibilities in justifying and optimizing the dose and correctly informing the patient. Despite these indications, the literature lacks information about the dose from fluoroscopically inserted dialysis tunneled central venous catheters (td-CVC). This study aimed to quantify the effective dose and organ dose to relevant organs in td-CVC to comply with the EU statements. Methods: We revised fluoroscopically-guided procedures of td-CVC insertion, considering dose per area product, fluoroscopic time, effective dose, organ dose, and anatomical district. We also compared these parameters with those of fluoroscopically inserted oncological central venous devices (Port-a-cath). Results: The dose-area product, fluoroscopic time, and organ dose for td-CVC were 13 ± 22.2 Gy*cm2, 81 ± 129 s, and 1.9 ± 3.3 mSv. The radiological parameters for the left internal jugular, subclavian and femoral veins were similar but higher than for the right internal jugular vein. The radiological parameters were significantly higher for td-CVC than for Port-a-cath. Conclusions: Fluoroscopically inserted td-CVC are associated with a relatively low dose of ionizing radiation, with considerable variability due to the anatomical puncture site and previous accesses’ history. In light of the European Directive, it is a concern for nephrologists to be aware of the administered ionizing dose to comply with their legal responsibilities.