bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remote Magnetic Navigation With Irrigated Tip Catheter for Ablation of Paroxysmal Atrial Fibrillation
Authors: Miyazaki Shinsuke , Shah Ashok J. , Xhaët Olivier , Derval Nicolas , Matsuo Seiichiro , Wright Matthew , Nault Isabelle , Forclaz Andrei , Jadidi Amir S. , Knecht Sébastien , Rivard Lena , Liu Xingpeng , Linton Nick , Sacher Frédéric , Hocini Mélèze , Jaïs Pierre , Haïssaguerre Michel 
Published: October 2010

Background—
The remote magnetic navigation system (MNS) has been used with a nonirrigated magnetic catheter for atrial fibrillation (AF) ablation. The objective of this study was to evaluate the feasibility and efficiency of the newly available irrigated tip magnetic catheter for index pulmonary vein isolation (PVI) in patients with paroxysmal AF (PAF).

Methods and Results—

Between January 2008 and June 2009, 30 consecutive patients with drug-resistant PAF underwent circular mapping catheter-guided PVI with MNS (MNS group). The outcomes were compared retrospectively with those of a conventional hand-controlled ablation technique during the same period in 44 consecutive patients (manual group). All 4 pulmonary veins were successfully isolated in both groups except in 4 patients in the MNS group. Radiofrequency and procedure duration were higher in the MNS group (60±27 versus 43±16 minutes;
P
=0.0019) than in the manual group (246±50 versus 153±51 minutes;
P
<0.0001). In the patients who underwent only PVI, total fluoroscopic time also was longer in the MNS group than in the manual group (58±24 versus 40±14 minutes;
P
=0.0002). At 12-month follow-up after a single procedure, 69.0% of the patients in MNS group and 61.8% of patients in manual group were free of atrial tachyarrhythmia without antiarrhythmic drugs. There was no significant difference in the atrial tachyarrhythmia-free survival between the 2 groups (
P
=0.961). Cardiac tamponade occurred in 1 patient in the manual group.

Conclusions—
In patients with PAF, MNS-guided PVI with the newly available irrigated tip magnetic catheter backed up with manual ablation whenever required is feasible. However, it requires longer ablation, fluoroscopy, and procedural times than the conventional approach in the early experience stage.
Noninvasive Diagnosis of Electroanatomic Abnormalities in Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Santangeli Pasquale , Pieroni Maurizio , Dello Russo Antonio , Casella Michela , Pelargonio Gemma , Macchione Andrea , Camporeale Antonia , Smaldone Costantino , Bartoletti Stefano , Di Biase Luigi , Bellocci Fulvio , Natale Andrea 
Published: October 2010

Background—
The diagnostic reliability and pathophysiologic relevance of different noninvasive diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) are undefined. We tested the association between noninvasive diagnostic criteria for ARVC and the presence of low-voltage areas (LVAs) detected at electroanatomic voltage mapping (EAM).

Methods and Results—

Noninvasive diagnostic criteria, including ECG, signal-averaged ECG (SAECG), and cardiac magnetic resonance (CMR) criteria, were compared with the presence and location of LVAs detected at right ventricular (RV) EAM in 17 patients (9 men) aged 50±16 years with biopsy specimen-proven ARVC. LVAs were found in 15 (88%) patients. Patients with surface ECG abnormalities showed a higher degree of RV involvement than those without ECG abnormalities (number of LVAs, 1.8±0.5 versus 0.9±0.6, respectively;
P
<0.01). A significant association was found between SAECG abnormalities and LVAs in the RV outflow tract (
P
=0.03) but not between SAECG parameters and LVAs in other RV regions. Among CMR findings, RV delayed enhancement was more significantly associated with the distribution of LVAs (free wall,
P
<0.01; outflow tract,
P
<0.01; posteroinferior wall,
P
=0.02). Regional RV dysfunction also showed a good correlation with LVAs, with the most significant association being found with the free wall (
P
=0.01), whereas RV fat infiltration at CMR was not correlated with LVAs.

Conclusion—
In patients with ARVC, SAECG abnormalities correlate with the presence of LVAs selectively in the RV outflow tract, whereas surface ECG abnormalities are associated with a more diffuse RV involvement. Myocardial delayed enhancement is the CMR finding more strongly associated with LVAs, thus supporting the appropriateness of its inclusion among diagnostic criteria for ARVC.
Health Status After Treatment for Coronary Artery Disease and Type 2 Diabetes Mellitus in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial
Authors: Brooks Maria Mori , Chung Sheng-Chia , Helmy Tarek , Hillegass William B. , Escobedo Jorge , Melsop Kathryn A. , Massaro Elaine M. , McBane Robert D. , Hyde Pamela , Hlatky Mark A. ,   the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Study Group
Published: October 2010

Background—
Health status is a key outcome for comparing treatments, particularly when mortality does not differ significantly.

Methods and Results—

Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) randomized 2368 patients with type 2 diabetes mellitus and stable ischemic heart disease to (1) prompt revascularization versus medical therapy and (2) insulin sensitization versus insulin provision. Randomization was stratified by the intended method of revascularization, coronary artery bypass graft surgery or percutaneous coronary intervention. The Duke Activity Status Index and RAND Energy, Health Distress, and Self-Rated Health scales were assessed at study entry and annually thereafter; linear mixed models were used to evaluate the effect of randomized treatment on these measures. Health status improved significantly from baseline to 1 year (
P
<0.001) in each randomized treatment group. Compared with medical therapy, prompt revascularization was associated with significantly greater improvements in Duke Activity Status Index (1.32 points;
P
<0.001), Energy (1.36 points;
P
=0.02), and Self-rated Health (1.77 points;
P
=0.007) but not Health Distress (−0.47;
P
=0.46). These treatment effects were largely maintained over 4 years of follow-up. The effect of revascularization on the Duke Activity Status Index was significantly larger in the subgroup of patients intended for coronary artery bypass graft surgery compared with the subgroup intended for percutaneous coronary intervention. Health status did not differ significantly on any of the 4 measures between the insulin provision and insulin sensitization strategies.

Conclusions—
Prompt coronary revascularization was associated with small yet statistically significant improvements in health status compared with initial medical therapy among patients with diabetes mellitus and stable ischemic heart disease.

Clinical Trial Registration—

http://www.clinicaltrials.gov
. Unique identifier: NCT00006305.
Lasofoxifene and Cardiovascular Events in Postmenopausal Women With Osteoporosis
Authors: Ensrud Kristine , LaCroix Andrea , Thompson John R. , Thompson David D. , Eastell Richard , Reid David M. , Vukicevic Slobodan , Cauley Jane , Barrett-Connor Elizabeth , Armstrong Roisin , Welty Francine , Cummings Steven 
Published: October 2010

Background—
In the Postmenopausal Evaluation and Risk Reduction With Lasofoxifene (PEARL) trial, women assigned to lasofoxifene 0.5 mg/d had a lower risk of major coronary heart disease (CHD) events and stroke, whereas women assigned to lasofoxifene 0.25 mg/d had a lower risk of stroke. Both doses of lasofoxifene increased the risk of venous thromboembolic events. In this report, we provide comprehensive cardiovascular end-point data, including component events comprising the composite end point of major CHD events, and evaluate whether the effect of lasofoxifene 0.5 mg/d is consistent across different categories of CHD risk.

Methods and Results—

In this study, 8556 women 59 to 80 years of age with osteoporosis received lasofoxifene 0.25 mg/d, lasofoxifene 0.5 mg/d, or placebo for 5 years. Cardiovascular events, including major CHD events, were prespecified secondary end points. Compared with placebo, lasofoxifene 0.5 mg/d reduced the risk of major CHD events 32% (hazard ratio, 0.68; 95% confidence interval, 0.50 to 0.93), including the risk of coronary revascularization (hazard ratio, 0.56, 95% confidence interval, 0.32 to 0.98). Reductions in risk of hospitalization for unstable angina (hazard ratio, 0.55; 95% confidence interval, 0.29 to 1.04) and diagnosis of new ischemic heart disease (hazard ratio, 0.52; 95% confidence interval, 0.26 to 1.04) nearly reached significance (
P
=0.06 for both comparisons). Although both hazard ratios were <1.0, no significant effect of lasofoxifene at 0.5 mg/d was demonstrated for coronary death or nonfatal myocardial infarction. The reduction in CHD events with lasofoxifene 0.25 mg/d was not significant (hazard ratio, 0.76; 95% confidence interval, 0.56 to 1.03;
P
=0.08). The effectiveness of lasofoxifene 0.5 mg/d in reducing CHD events was similar across strata of major cardiovascular risk factors.

Conclusions—
In postmenopausal women with osteoporosis, lasofoxifene 0.5 mg/d for 5 years reduced the risk of CHD events, regardless of the presence or absence of risk factors for cardiovascular disease. The significant reduction in risk of CHD events with lasofoxifene 0.5 mg/d was due primarily to lower risks of coronary revascularization procedures, hospitalization for unstable angina, and diagnosis of new ischemic heart disease.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00141323.
Multimarker Approach for the Prediction of Heart Failure Incidence in the Community
Authors: Velagaleti Raghava S. , Gona Philimon , Larson Martin G. , Wang Thomas J. , Levy Daniel , Benjamin Emelia J. , Selhub Jacob , Jacques Paul F. , Meigs James B. , Tofler Geoffrey H. , Vasan Ramachandran S. 
Published: October 2010

Background—
Several biological pathways are activated in ventricular remodeling and in overt heart failure (HF). There are no data, however, on the incremental utility of a parsimonious set of biomarkers (reflecting pathways implicated in HF) for predicting HF risk in the community.

Methods and Results—

We related a multibiomarker panel to the incidence of a first HF event in 2754 Framingham Heart Study participants (mean age, 58 years; 54 women) who were free of HF and underwent routine assays for 6 biomarkers (C-reactive protein, plasminogen activator inhibitor-1, homocysteine, aldosterone-to-renin ratio, B-type natriuretic peptide, and urinary albumin-to-creatinine ratio). We estimated model c statistic, calibration, and net reclassification improvement to assess the incremental predictive usefulness of biomarkers. We also related biomarkers to the incidence of nonischemic HF in participants without prevalent coronary heart disease. On follow-up (mean, 9.4 years), 95 first HF events occurred (54 in men). In multivariable-adjusted models, the biomarker panel was significantly related to HF risk (
P
=0.00005). On backward elimination, B-type natriuretic peptide and urinary albumin-to-creatinine ratio emerged as key biomarkers predicting HF risk; hazards ratios per 1-SD increment in log marker were 1.52 (95 confidence interval, 1.24 to 1.87) and 1.35 (95 confidence interval, 1.11 to 1.66), respectively. B-type natriuretic peptide and urinary albumin-to-creatinine ratio significantly improved the model c statistic from 0.84 (95 confidence interval, 0.80 to 0.88) in standard models to 0.86 (95 confidence interval, 0.83 to 0.90), enhanced risk reclassification (net reclassification improvement=0.13;
P
=0.002), and were independently associated with nonischemic HF risk.

Conclusion—
Using a multimarker strategy, we identified B-type natriuretic peptide and urinary albumin-to-creatinine ratio as key risk factors for new-onset HF with incremental predictive utility over standard risk factors.
Influence of Indian Summer Monsoon on Aerosol Loading in East Asia
Authors: Liu Xiaodong , Yan Libin , Yang Ping , Yin Zhi-Yong , North Gerald R. 
Published: October 2010

AbstractThe spatial and temporal variations of aerosol loading over eastern Asia specified in terms of the aerosol optical depth (AOD) at the 550-nm wavelength during July are examined in conjunction with the intensity of the Indian summer monsoon. AOD derived from Moderate Resolution Imaging Spectroradiometer (MODIS) observations, gridded reanalyses, and ground-based measurements are used in the analysis. Two contrasting years, 2002 and 2003, which represent weak and active Indian summer monsoon events, respectively, are selected for the study, with a focus on an eastern Asian southern subregion (SR; 23°–32°N, 105°–120°E) and an eastern Asian northern subregion (NR; 35°–44°N, 115°–130°E). It is shown that the interannual variation of July mean wind intensity is a major factor in regulating the midsummer spatial pattern of aerosols over eastern Asia when the Indian monsoon index is anomalously large. The AOD anomalies in the NR and SR are positive and negative, respectively, during an active monsoon year, whereas the opposite is observed during a weak monsoon year. The variation patterns of less cloudy-day visibility, observed at four meteorological stations in the SR and NR subregions, also show spatial–temporal aerosol variability evident in the MODIS AOD data. Relative to the case of a weak monsoon year, meridional winds and convection are stronger and more clouds and precipitation are observed in the NR subregion during the active monsoon year. The opposite pattern is observed in the SR subregion. The spatial–temporal variation pattern of aerosols over eastern Asia illustrates the nonnegligible role of transport and dispersal mechanisms associated with the Indian summer monsoon in the region.
Statistical Prediction of the Storm Surge Associated with Cool-Weather Storms at the Battery, New York
Authors: Salmun H. , Molod A. , Wisniewska K. , Buonaiuto F. S. 
Published: October 2010

Abstract
The winter and early spring weather in the New York City metropolitan region is highly influenced by extratropical storm systems, and the storm surge associated with these systems is one of the main factors contributing to inundation of coastal areas. This study demonstrates the predictive capability of an established statistical relationship between the “storm maximum” storm surge associated with an extratropical storm system and the “average maximum” significant wave height during that storm. Data from publicly available retrospective forecasts of sea level pressure and wave heights, along with a regression equation for storm surge, were used to predict the storm-maximum storm surge for 41 storms in the New York metropolitan region during the period from February 2005 to December 2008. The statistical storm-surge estimates were compared with the surge values predicted by NOAA’s extratropical storm-surge model and NOAA’s operational surge forecast, which includes an error correction, and with water gauge observations taken at the Battery, located at the southern tip of Manhattan Island, New York. The mean difference between the statistical surge prediction and the observed values is shown to be smaller than the difference between NOAA’s deterministic surge prediction and the observed surge at the 95% significance level and to be statistically indistinguishable from the difference between NOAA’s operational surge forecast and the observed values of surge. These statistical estimates can be used as part of a system for predicting coastal flooding.
Teleconnection Pattern Influence on Sea-Wave Climate in the Bay of Biscay
Authors: Le Cozannet Gonéri , Lecacheux Sophie , Delvallee Etienne , Desramaut Nicolas , Oliveros Carlos , Pedreros Rodrigo 
Published: October 2010

Abstract
The potential modification of hydrodynamic factors, such as waves, is a source of concern for many coastal communities because of its potential effect on shoreline evolution. In the northern Atlantic, swell is created by storm winds that cross the Atlantic following west–east tracks. These tracks are shifted more southward or northward depending on the season and on recurring large-scale atmospheric pressure anomalies, also called teleconnection patterns. This study investigates the trends of sea-wave patterns in the Bay of Biscay and relates their interannual variability to teleconnection patterns.
Sea-wave parameter time series from the 40-yr European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERA-40) show a satisfying correlation with an in situ buoy of Météo-France during the period they overlap. Using a k-means algorithm, data from this 44-yr-long time series were clustered into a few sea-state modes, each of them corresponding to an observable sea state associated with an averaged value for wave height, period, and direction.
This analysis shows that most of the increase in annual mean sea-wave height since the 1970s has occurred because the relative frequency of occurrence of persistent observable sea states is evolving over time: from 1970 to 2001, the data indicate that energetic northwest swell becomes more frequent than low-energy intermediate sea states. Moreover, anomalies of the relative frequency of occurrence of observable sea states are related to large-scale recurring pressure anomalies: principally, the Northern Atlantic Oscillation (NAO) but also (during winters) the east Atlantic (EA) pattern, as well other teleconnection patterns of the Northern Hemisphere (NOAA data).
Influence of the Meridional Shifts of the Kuroshio and the Oyashio Extensions on the Atmospheric Circulation
Authors: Frankignoul Claude , Sennéchael Nathalie , Kwon Young-Oh , Alexander Michael A. 
Published: October 2010

Abstract
The meridional shifts of the Oyashio Extension (OE) and of the Kuroshio Extension (KE), as derived from high-resolution monthly sea surface temperature (SST) anomalies in 1982–2008 and historical temperature profiles in 1979–2007, respectively, are shown based on lagged regression analysis to significantly influence the large-scale atmospheric circulation. The signals are independent from the ENSO teleconnections, which were removed by seasonally varying, asymmetric regression onto the first three principal components of the tropical Pacific SST anomalies. The response to the meridional shifts of the OE front is equivalent barotropic and broadly resembles the North Pacific Oscillation/western Pacific pattern in a positive phase for a northward frontal displacement. The response may reach 35 m at 250 hPa for a typical OE shift, a strong sensitivity since the associated SST anomaly is 0.5 K. However, the amplitude, but not the pattern or statistical significance, strongly depends on the lag and an assumed 2-month atmospheric response time. The response is stronger during fall and winter and when the front is displaced southward. The response to the northward KE shifts primarily consists of a high centered in the northwestern North Pacific and hemispheric teleconnections. The response is also equivalent barotropic, except near Kamchatka, where it tilts slightly westward with height. The typical amplitude is half as large as that associated with OE shifts.
How Much Should Climate Model Output Be Smoothed in Space?
Authors: Räisänen Jouni , Ylhäisi Jussi S. 
Published: October 2010

AbstractThe general decrease in the quality of climate model output with decreasing scale suggests a need for spatial smoothing to suppress the most unreliable small-scale features. However, even if correctly simulated, a large-scale average retained by the smoothing may not be representative of the local conditions, which are of primary interest in many impact studies. Here, the authors study this trade-off using simulations of temperature and precipitation by 24 climate models within the Third Coupled Model Intercomparison Project, to find the scale of smoothing at which the mean-square difference between smoothed model output and gridbox-scale reality is minimized. This is done for present-day time mean climate, recent temperature trends, and projections of future climate change, using cross validation between the models for the latter. The optimal scale depends strongly on the number of models used, being much smaller for multimodel means than for individual model simulations. It also depends on the variable considered and, in the case of climate change projections, the time horizon. For multimodel-mean climate change projections for the late twenty-first century, only very slight smoothing appears to be beneficial, and the resulting potential improvement is negligible for practical purposes. The use of smoothing as a means to improve the sampling for probabilistic climate change projections is also briefly explored.
How Large-Scale and Cyclogeostrophic Barotropic Instabilities Favor the Formation of Anticyclonic Vortices in the Ocean
Authors: Perret Gaële , Dubos Thomas , Stegner Alexandre 
Published: October 2010

Abstract
Large-scale vortices, that is, eddies whose characteristic length scale is larger than the local Rossby radius of deformation Rd, are ubiquitous in the oceans, with anticyclonic vortices more prevalent than cyclonic ones. Stability or robustness properties of already formed shallow-water vortices have been investigated to explain this cyclone–anticyclone asymmetry. Here the focus is on possible asymmetries during the generation of vortices through barotropic instability of a parallel flow. The initial stage and the nonlinear stage of the instability are studied by means of linear stability analysis and direct numerical simulations of the one-layer rotating shallow-water equations, respectively. A wide variety of parallel flows are studied: isolated shears, the Bickley jet, and a family of wakes obtained by combining two shears of opposite signs.
The results show that, when the flow is characterized by finite relative isopycnal deviation, the barotropic instability favors the formation of large-scale anticyclonic eddies. The authors emphasize here that the cyclone–anticyclone asymmetry of parallel flows may appear at the linear stage of the instability. This asymmetry finds its origin in the linear stability property of localized shear flows. Indeed, for both the cyclogeostrophic regime (finite Rossby number) and the frontal geostrophic regime (small Burger number), an anticyclonic shear flow has higher linear growth rates than an equivalent cyclonic shear flow. The nonlinear saturation then leads to the formation of almost axisymmetric anticyclones, while the cyclones tend to be more elongated in the shear direction.
However, although some unstable parallel flows exhibit the asymmetry at the linear stage, others exhibit such asymmetry at the nonlinear stage only. If the distance separating two shear regions is large enough, the barotropic instability develops independently in each shear, leading in the frontal and the cyclogeostrophic regime to a significant cyclone–anticyclone asymmetry at the linear stage. Conversely, if the two shear regions are close to each other, the shears tend to be coupled at the linear stage. The most unstable perturbation then resembles the sinuous mode of the Bickley jet, making no distinction between regions of cyclonic or anticyclonic vorticity. Nevertheless, when the nonlinear saturation occurs, large-scale anticyclones tend to be axisymmetric while the cyclonic structures are highly distorted and elongated along the jet meander.