bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interaction of Localized Drivers and Disorganized Activation in Persistent Atrial Fibrillation
Authors: Kowalewski Christopher A.B. , Shenasa Fatemah , Rodrigo Miguel , Clopton Paul , Meckler Gabriela , Alhusseini Mahmood I. , Swerdlow Mark A. , Joshi Vijay , Hossainy Samir , Zaman Junaid A.B. , Baykaner Tina , Rogers Albert J. , Brachmann Johannes , Miller John M. , Krummen David E. , Sauer William H. , Peters Nicholas S. , Wang Paul J. , Narayan Sanjiv M. 
Published: June 2018

Background:
Mechanisms for persistent atrial fibrillation (AF) are unclear. We hypothesized that putative AF drivers and disorganized zones may interact dynamically over short time scales. We studied this interaction over prolonged durations, focusing on regions where ablation terminates persistent AF using 2 mapping methods.

Methods:
We recruited 55 patients with persistent AF in whom ablation terminated AF prior to pulmonary vein isolation from a multicenter registry. AF was mapped globally using electrograms for 360±45 cycles using (1) a published phase method and (2) a commercial activation/phase method.

RESULTS:

Patients were 62.2±9.7 years, 76% male. Sites of AF termination showed rotational/focal patterns by methods 1 and 2 (51/55 vs 55/55;
P
=0.13) in spatially conserved regions, yet fluctuated over time. Time points with no AF driver showed competing drivers elsewhere or disordered waves. Organized regions were detected for 61.6±23.9% and 70.6±20.6% of 1 minute per method (
P
=nonsignificant), confirmed by automatic phase tracking (
P
<0.05). To detect AF drivers with >90% sensitivity, 8 to 32 s of AF recordings were required depending on driver definition.

Conclusions:
Sites at which persistent AF terminated by ablation show organized activation that fluctuate over time, because of collision from concurrent organized zones or fibrillatory waves, yet recur in conserved spatial regions. Results were similar by 2 mapping methods. This network of competing mechanisms should be reconciled with existing disorganized or driver mechanisms for AF, to improve clinical mapping and ablation of persistent AF.

Clinical Trial Registration:

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02997254.
Charismatic Cultures
Authors: Åkerlund Truls , Tangen Karl Inge 
Published: June 2018

Abstract
While confirming Heuser and Klaus’s twenty-year-old warning about the shadow side of charismatic leadership in pentecostal organizations, the article points out the leader-centric bias in this and similar works and seeks to advance the discussion by addressing charismatic leadership from a structure/agency perspective. Drawing on Margaret Archer’s critical realist framework, the authors go beyond the focus on the sole charismatic leader to suggest that all partners in the leadership relation bear responsibility for avoiding destructive charismatic cultures and promoting ethical agency. The study proposes that it is possible to have forms of charismatic leadership that reflect pentecostal characteristics without being destructive if organizations promote reflexivity, ethical policies and moral accountability, and active followership.
Pentecostal Epistemology, the Problem of Incommensurability, and Creational Hermeneutic
Authors: Shin Yoon 
Published: June 2018

Abstract
This article expounds James K.A. Smith’s pentecostal epistemology, analyzing its characteristics as affective, pretheoretical knowledge and its ambiguous relationship to cognitive, theoretical knowledge, and then correlating this relationship to Smith’s exposition of the problem of incommensurability between pretheoretical transcendence and theoretical immanence. I argue that Smith’s epistemology is partly rooted in Heidegger’s notion of Dasein as being-in-the-world in order to clarify the relationship between the affects and cognition. I then address the problem of incommensurability and argue that Smith’s creational hermeneutic eliminates the problem altogether, healing the ambiguous relationship between affective, pretheoretical knowledge and cognitive, theoretical knowledge that affects his pentecostal epistemology.
Spirit Baptism as a Moral Source in a Secular Age
Authors: Redick Caroline 
Published: June 2018

Abstract
Charles Taylor notes that moderns aspire to high moral standards, such as universal justice and benevolence, but lack the moral resources necessary to fulfill these standards. Instead, the weak motivations of egoism, guilt, and obligation result in hypocrisy or the projection of blame on others when we fail to meet these ideals. Taylor’s work seeks to uncover deep moral sources, such as agape, that make it possible to fulfill these standards. This article will complement Taylor’s excavation of powerful moral resources by arguing that Spirit baptism, understood as intense participation in divine love, is a retrieval of agape as an empowering moral source as well as a way to contact this source through spiritual articulation. It is a particular kind of retrieval that resonates with the modern sense of the self through a language of personal resonance and an elevation of the ordinary person into the extraordinary life.
Morphological characteristics for sexing living adults of Chaetoptelius vestitus (Coleoptera, Curculionidae)
Authors: Ghrissi Ibtihel , Braham Mohamed , Said Imen , LaBonte James R. , Shahan Thomas 
Published: June 2018

Abstract
The pistachio bark beetle, Chaetoptelius vestitus (Mulsant & Rey, 1861) is a serious pest of pistachio trees. Despite its phytosanitary importance, some aspects of its biology are still unclear. For example, determining the sex of this beetle is usually complicated by the lack of a discrete, externally visible gender-specific character. Here, the morphological characteristics of C. vestitus were studied in order to detect discriminative features for sexing living beetles. The shape of the seventh visible tergite effectively enabled the separation of the sexes. This method can be quickly learned, is non-destructive and permits sex determination of living C. vestitus adults with 100% accuracy and without damaging the insects. Sex determination using external morphology was confirmed by dissection under a stereomicroscope and by rearing experiments. These morphological criteria were further successfully verified on insects collected on seven other sites in Tunisia.
The Soul of Historiography
Authors: Fairbrother Daniel 
Published: June 2018

Abstract
This paper argues for a new version of holism about historiography. The argument starts with an analogy with Aristotle’s conceptions of soul and character. The aim is to overcome the central problem critics have identified in Ankersmit’s holism about historical representations: it is not clear how a posited holistic entity can make a difference to a work of history. The solution offered in this paper is that there are two – modally distinct – dimensions of content in works of history. One comprises its explicit content as given in its statements. This corresponds to actuality, action, and narrative in Aristotle. The other is where we find a holistic entity: a work of history’s representation of a historical situation. This is analysed here as a unified range of possibilities for action generated by the interrelated complex of factors introduced by the work’s explicit contents. This corresponds to potentiality, soul, and character in Aristotle. The theory is further developed in relation to two examples, one idealized, the other an example of real historiography. By distinguishing between actuality and possibility as dimensions of a historical representation, the holistic entity is enabled to be implicit while having real importance in relation to the content of historiography.
An Aretaic Jurisprudence Approach to the Character of the Secretary-General of the United Nations as a Norm Entrepreneur to Save the Earth from the Adverse Impact of Climate Change
Authors: Juwita Ratna 
Published: June 2018

Abstract
In 2015, the Paris Agreement was adopted to strengthen the legal continuum to combat climate change. The Secretary-General as the chief administrative, world premier diplomat and norm entrepreneur of the UN has to diplomatically persuade all member States to ratify the international legal instruments. This research suggests that the Secretary-General must possess virtuous character in order to carry on the mandate of the UN Charter, especially as a norm entrepreneur to address the issue of climate change. Aretaic jurisprudence approach is used to interpret further the character that has to be possessed by the Secretary-General. Based on the Aristotelian virtues as the core philosophy of aretaic jurisprudence, the Secretary-General has to possess the virtues of courage and temperance. In the fight against climate change, a virtuous Secretary-General will play the pivotal role as a norm entrepreneur in inviting and persuading all member States to cooperate in unity.
The South China Sea Arbitral Award amidst Shifting Philippine Foreign Policy
Authors: Bautista Lowell 
Published: June 2018

Abstract
The South China Sea Arbitral Tribunal award was an overwhelming legal and moral victory for the Philippines. The arbitral tribunal categorically declared that China’s nine-dash line claim is incompatible with the UN Convention on the Law of the Sea. However, China’s defiance of the ruling and refusal to honor and implement the award pose a serious challenge to Manila’s victory. In addition, the astonishing shift in Philippine foreign policy direction, alongside the change in government, flouts the arbitral award and undermines previous State policies assertive of Philippine maritime and territorial claims in the South China Sea. The current direction of Philippine-China relations under Philippine President Rodrigo Duterte has demonstrated positive signs of improvement compared with acrimonious bilateral relations pursued by the previous Aquino administration. The arbitral award has largely been set aside in the government’s effort to restore amicable economic and diplomatic relations with China. This paper examines the South China Sea arbitral award amidst shifting Philippine foreign policy under the administration of President Rodrigo Duterte.
CMIP5 Projected Change in Northern Hemisphere Winter Cyclones with Associated Extreme Winds
Authors: Kar-Man Chang Edmund 
Published: June 2018

AbstractIn this study, 19 simulations from phase 5 of the Coupled Model Intercomparison Project (CMIP5) have been analyzed to examine how winter cyclones producing extreme near-surface winds are projected to change. Extreme wind thresholds correspond to a top 5 or top 1 cyclone per winter month in the entire Northern Hemisphere (NH). The results show that CMIP5 models project a significant decrease in the number of such cyclones, with a 19-model mean decrease of about 17% for the entire NH toward the end of the twenty-first century, under the high-emission RCP8.5 scenario. The projected decrease is larger in the Atlantic (about 21%). Over the Pacific, apart from an overall decrease (about 13%), there is a northeastward shift in the extreme cyclone activity. Less decrease is found in the frequency of cyclones producing extreme winds at 850 hPa (about 5% hemisphere-wide), with models mainly projecting a northeastward shift in the Pacific. These results suggest that 850-hPa wind changes may not be a good proxy for near-surface wind changes. These results contrast with those for the Southern Hemisphere, in which the frequency of cyclones with extreme winds are projected to significantly increase in all four seasons.
Differential analysis of disease risk assessment using binary logistic regression with different analysis strategies
Authors: Xu Wenbo , Zhao Yang , Nian Shiyan , Feng Lei , Bai Xuejing , Luo Xuan , Luo Feng 
Published: June 2018

Objective To investigate the importance of controlling confounding factors during binary logistic regression analysis. Methods Male coronary heart disease (CHD) patients (n = 664) and healthy control subjects (n = 400) were enrolled. Fourteen indexes were collected: age, uric acid, cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B100, lipoprotein a, homocysteine, total bilirubin, direct bilirubin, indirect bilirubin, and γ-glutamyl transferase. Associations between these indexes and CHD were assessed by logistic regression, and results were compared by using different analysis strategies. Results 1) Without controlling for confounding factors, 14 indexes were directly inputted in the analysis process, and 11 indexes were finally retained. A model was obtained with conflicting results. 2) According to the application conditions for logistic regression analysis, all 14 indexes were weighed according to their variances and the results of correlation analysis. Seven indexes were finally included in the model. The model was verified by receiver operating characteristic curve, with an area under the curve of 0.927. Conclusions When binary logistic regression analysis is used to evaluate the complex relationships between risk factors and CHD, strict control of confounding factors can improve the reliability and validity of the analysis.
The Attitudes, Needs, and Requirements at End of Life in the Republic of Georgia (Comparative Analysis of Groups of Patients With Cancer and Elders)
Authors: Chikhladze Nana , Tebidze Nino , Chabukiani Tamar , Chabukiani Nana , Chkhartishvili Nikoloz , Jincharadze Memed , Kordzaia Dimitri 
Published: June 2018

Introduction: In developing a model of palliative care, the attitudes, needs, and requirements of its beneficiaries recognizing the limited remaining life expectancy need to be met. We aimed to map and compare these issues at the end of life in the groups of patients with advanced cancer and elderly individuals. Materials and Methods: The prospective study based on the analysis of semistructured interviews was conducted. Fifty individuals aged older than 85 and 50 incurable patients with advanced cancer were studied. Transcripts of interviews were analyzed qualitatively (the interviews were divided into logically completed themes, and the compliance of each with one of the levels of Abraham Maslow pyramid was determined) and quantitatively (data comparisons of 2 groups were tested in bivariate analysis using Pearson χ2 or Fisher exact test. Two-sided significance tests were used; P value of <.05 was deemed significant). Results: It was assumed that 120 themes were relevant to a certain level of Maslow pyramid. Their comparison showed small differences in the narratives of the patients with advanced cancer and elderly individuals aged 85 and older—concerning the past, present, and future terms of lives. In studied themes explicitly prevail the stories that are consistent with satisfaction of the upper levels of the hierarchy of needs and demands of Maslow: social relation (belonging), love, esteem, and transcendence. Conclusion: The attitudes, needs, and requirements at the end of life of the people are basically similar, regardless of what determined the sense of limitation of the remaining life—incurable disease or advanced age.
Management of diabetic macular edema with intravitreal dexamethasone implants: Expert recommendations using a Delphi-based approach
Authors: Giovannini Alfonso , Parravano Mariacristina , Ricci Federico , Bandello Francesco 
Published: June 2018

Objectives: Despite being approved and effective, steroids, and especially dexamethasone intravitreal implants, still have a poorly-defined role in management of diabetic macular edema. In order to overcome some of the limitations in current recommendations, a group of experts met to define consensus on some of the most controversial issues on the use of dexamethasone intravitreal implants in daily management of diabetic macular edema. Methods: A Delphi-based approach was utilized to develop clinically relevant statements applicable to routine treatment settings. A Steering Committee composed of four experts formulated 30 relevant statements, which were voted upon by a panel of 40 ophthalmologists/retinal specialists from across Italy. Results: Dexamethasone intravitreal implants were considered to be a valid first-line alternative to treatment with an anti–vascular endothelial growth factor agent and should be the first choice in pseudophakic and vitrectomized patients. A Pro Re Nata regimen was felt to be appropriate for retreatment with dexamethasone intravitreal implants while a 6-month waiting period was not considered suitable. Among steroid treatments, dexamethasone intravitreal implants were considered to have the best ocular tolerability. In patients with persistent macular edema after the loading-phase treatment with an anti–vascular endothelial growth factor, consensus was reached that clinicians should consider switching therapy to dexamethasone intravitreal implants. Moreover, dexamethasone intravitreal implants can reduce the treatment burden for individuals who are not able to cope with the more intensive treatment regimen required by anti–vascular endothelial growth factor therapy. Conclusions: While further studies are needed, this survey provides some key recommendations for clinicians treating diabetic macular edema that may be useful when choosing dexamethasone intravitreal implants in daily practice.
Utility of the Psychosocial Assessment of Candidates for Transplantation in Patients Undergoing Continuous-Flow Left Ventricular Assist Device Implantation
Authors: Halkar Meghana , Nowacki Amy S. , Kendall Kay , Efeovbokhan Nephertiti , Gorodeski Eiran Z. , Moazami Nader , Starling Randall C. , Young James B. , Lee Sangjin , Tang W.H. Wilson 
Published: June 2018

Purpose: Psychosocial assessment of patients comprises an important element in the selection process of appropriate candidates for left ventricular assist device (LVAD) implantation. We sought to determine the association of the well-validated psychosocial assessment of candidates for transplantation (PACT) scale to clinical outcomes post-LVAD implantation. Materials and Methods: The PACT scale was used retrospectively to reconstruct psychosocial profiles of all patients who underwent a continuous-flow LVAD implantation for all indications at our institution between March 2008 and August 2012 (N = 230). Psychosocial elements including social support, psychological health, lifestyle factors, comprehension of the operation, and follow-up were evaluated. The primary outcome was overall survival, and the secondary outcomes were hospital readmission, pump thrombosis, hemolysis, gastrointestinal (GI) bleeding, and LVAD driveline infections. Results: The mean age of patients was 55.3 years, with 83% being male; 58% (N = 135) were bridge to transplant and 42% (N = 95) were destination therapy. Up to 1-year post-LVAD implant, there were no statistical differences among the 5 PACT candidate groups in terms of survival ( P = .79), hospital readmissions ( P = .55), suspected or confirmed pump thrombosis ( P = .31), hemolysis ( P = .43), GI bleeding ( P = .71), or driveline infections ( P = .06). Conclusions: In this single-center retrospective review, post hoc reconstruction of psychosocial profiles using the PACT scale and independent assessment of postimplant outcomes, including survival and adverse events, did not show any association. However, given the small number of patients in the low score PACT groups as well as limited duration of follow-up, further studies are required to elucidate the association.
Transverse venous sinus stenting for idiopathic intracranial hypertension: Safety and feasibility
Authors: Koovor Jerry ME , Lopez Gloria V , Riley Kalen , Tejada Juan 
Published: June 2018

Purpose Transverse sinus stenosis is commonly seen in patients with idiopathic intracranial hypertension. It is not clear whether it is the cause or the result of idiopathic intracranial hypertension. Stenting for idiopathic intracranial hypertension has been carried out in several prior series. Our goal was to evaluate the clinical and imaging follow-up results of patients with idiopathic intracranial hypertension that underwent stenting for this condition at our center. Materials and Methods We reviewed the clinical, venographic and follow-up imaging data in patients who underwent elective transverse sinus stenting during the period from 2011 to 2017. Results In total, 18 patients with idiopathic intracranial hypertension were identified. The mean lumbar cerebrospinal fluid opening pressure recorded was 408 mmH20. Overall, 16 patients met the inclusion criteria and underwent transverse sinus stenting. At venography, the mean pressure gradient across the dominant transverse sinus stenosis was 21 mmHg. The pressure gradient immediately after stenting in all of those measured was negligible. Following stenting, headaches improved in 10 of the 16 cases, with persistent headaches in four patients, one of which had persistent baseline migraines. All cases showed resolution of the papilledema on follow up. Follow-up imaging with computed tomography venography showed that the stents remained widely patent. The follow up in clinic was done for a mean period of 35.5 months. Follow up with computed tomography venography was done for a mean of 10.3 months. Conclusion Venous sinus stenting is a safe and effective procedure. It relieves papilledema in all cases and improves headaches in most cases.
Evaluating the use of high-fidelity simulators during mock neonatal resuscitation scenarios in trying to improve confidence in residents
Authors: Hossino Deena , Hensley Christina , Lewis Karen , Frazier Marie , Domanico Renee , Burley Melissa , Harris Jeffrey , Miller Bobby , Flesher Susan L 
Published: June 2018

Objective: The purpose of this study was to investigate the effect of the use of high-fidelity simulators with multidisciplinary teaching on self-reported confidence in residents. Methods: A total of 26 residents participated in a session led by a pediatric faculty member and a Neonatal Intensive Care Unit transport nurse using a high-fidelity pediatric simulator. Multiple scenarios were presented and each resident took turns in various roles. Pre-intervention surveys based on a 5-point Likert-type scale were given before the scenarios and were compared to the results of identical post-intervention surveys. Results: Statistically significant (p < 0.05) pre to post gains for self-confidence were observed. Improvements in confidence were analyzed using the mean difference. The largest improvement in confidence was seen in the ability to treat neonatal respiratory arrest. This was followed by the ability to supervise/run a code, and the ability to place an umbilical venous catheter. Conclusion: These results revealed that high-fidelity simulation-based training has significant positive gains in residents’ self-reported confidence.