bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Intracardiac Echocardiography Reduce Steam Pops During Half-Normal Saline Irrigated Radiofrequency Ablation?
Authors: Hasegawa Kanae , Yoneda Zachary T. , Martines-Parachini Jose R. , Powers Edward M. , Davogustto Giovanni E. , Hu Tiffany Y. , Tokutake Kenichi , Kurata Masaaki , Richardson Travis D. , Montgomery Jay A. , Shen Sharon , Estrada Juan C. , Saavedra Pablo J. , Emerson Amy , Walker Marilyn L. , Tandri Harikrishna , Michaud Gregory F. , Kanagasundram Arvindh N. , Stevenson William G. 
Published: May 2024

BACKGROUND:
Irrigated radiofrequency ablation with half-normal saline can potentially increase lesion size but may increase the risk of steam pops with the risk of emboli or perforation. We hypothesized that pops would be preceded by intracardiac echocardiography (ICE) findings as well as a large impedance fall.

METHODS:
In 100 consecutive patients undergoing endocardial ventricular arrhythmia radiofrequency ablation with half-normal saline, we attempted to observe the ablation site with ICE. Radiofrequency ablation power was titrated to a 15 to 20 Ohm impedance fall and could be adjusted for tissue whitening and increasing bubble formation on ICE. Steam pops were defined as audible or a sudden explosion of microbubbles on ICE.

RESULTS:

Of 2190 ablation applications in 100 patients (82% cardiomyopathy, 50% sustained ventricular tachycardia), pops occurred during 43 (2.0%) applications. Sites with pops had greater impedance decreases of 18 [14, 21]% versus 13 [10, 17]% (
P
<0.001). ICE visualized 1308 (59.7%) radiofrequency sites, and fewer pops occurred when ICE visualized the radiofrequency ablation site (1.4%) compared with without ICE visualization (2.8%;
P
=0.016). Of the 18 ICE-visible pops, 7 (39%) were silent but recognized as an explosion of bubbles on ICE. With ICE, 89% of pops were preceded by either tissue whitening or a sudden increase in bubbles. In a multivariable model, tissue whitening and a sudden increase in bubbles were associated with steam pops (odds ratio, 7.186;
P
=0.004, and odds ratio, 29.93;
P
<0.001, respectively), independent of impedance fall and power. There were no pericardial effusions or embolic events with steam pops.

CONCLUSIONS:
Steam pops occurred in 2% of half-normal saline radiofrequency applications titrated to an impedance fall and are likely under-recognized without ICE. On ICE, steam pops are usually preceded by tissue whitening or a sudden increase in bubble formation, which can potentially be used to adjust radiofrequency application to help reduce pops.
Skeletal Muscle SIRT3 Deficiency Contributes to Pulmonary Vascular Remodeling in Pulmonary Hypertension Due to Heart Failure With Preserved Ejection Fraction
Authors: Jheng Jia-Rong , Bai Yang , Noda Kentaro , Huot Joshua R. , Cook Todd , Fisher Amanda , Chen Yi-Yun , Goncharov Dmitry A. , Goncharova Elena A. , Simon Marc A. , Zhang Yingze , Forman Daniel E. , Rojas Mauricio , Machado Roberto F. , Auwerx Johan , Gladwin Mark T. , Lai Yen-Chun 
Published: May 2024

BACKGROUND:
Pulmonary hypertension (PH) is a major complication linked to adverse outcomes in heart failure with preserved ejection fraction (HFpEF), yet no specific therapies exist for PH associated with HFpEF (PH-HFpEF). We have recently reported on the role of skeletal muscle SIRT3 (sirtuin-3) in modulation of PH-HFpEF, suggesting a novel endocrine signaling pathway for skeletal muscle modulation of pulmonary vascular remodeling.

METHODS:

Using skeletal muscle-specific
Sirt3
knockout mice (
Sirt3
skm-/-
) and mass spectrometry-based comparative secretome analysis, we attempted to define the processes by which skeletal muscle SIRT3 defects affect pulmonary vascular health in PH-HFpEF.

RESULTS:

Sirt3
skm-/-
mice exhibited reduced pulmonary vascular density accompanied by pulmonary vascular proliferative remodeling and elevated pulmonary pressures. Comparative analysis of secretome by mass spectrometry revealed elevated secretion levels of LOXL2 (lysyl oxidase homolog 2) in SIRT3-deficient skeletal muscle cells. Elevated circulation and protein expression levels of LOXL2 were also observed in plasma and skeletal muscle of
Sirt3
skm-/-
mice, a rat model of PH-HFpEF, and humans with PH-HFpEF. In addition, expression levels of CNPY2 (canopy fibroblast growth factor signaling regulator 2), a known proliferative and angiogenic factor, were increased in pulmonary artery endothelial cells and pulmonary artery smooth muscle cells of
Sirt3
skm-/-
mice and animal models of PH-HFpEF. CNPY2 levels were also higher in pulmonary artery smooth muscle cells of subjects with obesity compared with nonobese subjects. Moreover, treatment with recombinant LOXL2 protein promoted pulmonary artery endothelial cell migration/proliferation and pulmonary artery smooth muscle cell proliferation through regulation of CNPY2-p53 signaling. Last, skeletal muscle–specific
Loxl2
deletion decreased pulmonary artery endothelial cell and pulmonary artery smooth muscle cell expression of CNPY2 and improved pulmonary pressures in mice with high-fat diet–induced PH-HFpEF.

CONCLUSIONS:

This study demonstrates a systemic pathogenic impact of skeletal muscle SIRT3 deficiency in remote pulmonary vascular remodeling and PH-HFpEF. This study suggests a new endocrine signaling axis that links skeletal muscle health and SIRT3 deficiency to remote CNPY2 regulation in the pulmonary vasculature through myokine LOXL2. Our data also identify skeletal muscle SIRT3, myokine LOXL2, and CNPY2 as potential targets for the treatment of PH

-HFpEF.
Transcranial ultrasound stimulation effect in the redundant and synergistic networks consistent across macaques
Authors: Gatica Marilyn , Atkinson-Clement Cyril , Mediano Pedro A. M. , Alkhawashki Mohammad , Ross James , Sallet Jérôme , Kaiser Marcus 
Published: May 2024

Abstract
Low-intensity transcranial ultrasound stimulation (TUS) is a noninvasive technique that safely alters neural activity, reaching deep brain areas with good spatial accuracy. We investigated the effects of TUS in macaques using a recent metric, the synergy minus redundancy rank gradient, which quantifies different kinds of neural information processing. We analyzed this high-order quantity on the fMRI data after TUS in two targets: the supplementary motor area (SMA-TUS) and the frontal polar cortex (FPC-TUS). The TUS produced specific changes at the limbic network at FPC-TUS and the motor network at SMA-TUS and altered the sensorimotor, temporal, and frontal networks in both targets, mostly consistent across macaques. Moreover, there was a reduction in the structural and functional coupling after both stimulations. Finally, the TUS changed the intrinsic high-order network topology, decreasing the modular organization of the redundancy at SMA-TUS and increasing the synergistic integration at FPC-TUS.
Brain signaling becomes less integrated and more segregated with age
Authors: Razban Rostam M. , Antal Botond B. , Dill Ken A. , Mujica-Parodi Lilianne R. 
Published: May 2024

Abstract
The integration-segregation framework is a popular first step to understand brain dynamics because it simplifies brain dynamics into two states based on global versus local signaling patterns. However, there is no consensus for how to best define what the two states look like. Here, we map integration and segregation to order and disorder states from the Ising model in physics to calculate state probabilities, Pint and Pseg, from functional MRI data. We find that integration/segregation decreases/increases with age across three databases, and changes are consistent with weakened connection strength among regions rather than topological connectivity based on structural and diffusion MRI data.
Water Sources in the Buddhist Ecology: Looking through the Engaged Tradition
Authors: Singh Anand 
Published: May 2024

Abstract
Jambudvīpa is embedded with and surrounded by perennial water sources from the Great Himalayan hills. The visual remains and literary pieces of evidence show that people in the hoary past were conscious of water sources from the great hills. The Buddha has advised the corporeal use of water in many suttas. Buddhism has vast philosophical dimensions for five elements (water is one of them. It played an essential role in forming the cosmological and corporeal views of hills and water sources. Because of the rising population, monopolization, and monetization of water, a shortage of water is felt in some regions. The paper will examine the Buddhist view on the ecological dimensions of water issues and its engaged traditions.
Building Geriatric Trauma Programs in Resource-Constrained Environments: Trauma Quality Improvement Program Guideline Implementation at Two Safety Net Hospitals in Southern California
Authors: Boyle Kelly A. , Schellenberg Morgan , Navarrete Sixta , Tyler Robin , Hambrecht Amanda C. , Ward Katherine , Yamashita Casey , Putnam Brant , Inaba Kenji , Lam Lydia 
Published: May 2024

Background: To improve care of geriatric trauma patients, the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) updated guidelines in 2021. Amid geriatrician shortages in Southern California, 2 Los Angeles County safety net hospitals were tasked with creating a strategy to meet geriatric trauma guidelines despite constrained resources. Methods: All trauma patients ≥ 60 years admitted to a safety net hospital in Southern California were enrolled without exclusions (August 2022-April 2023). Primary outcome was frailty screening with documentation to identify older trauma patients at a high risk for adverse outcomes. Results: Needs assessment discovered no standardized process to identify high-risk geriatric patients, no geriatric care guidelines, and no inpatient geriatric consultation service. An action plan composed of a resident-led frailty screen resulted in identification of high-risk patients. Overall, 217 patients met criteria. Ninety-six patients (44%) successfully underwent frailty screening. Frailty screening compliance increased over the study, beginning at 37% capture in the first month and increasing to 81% in the final study month. After achieving nearly uniform frailty screening, a form was developed for the EMR for ease of documentation, data capture/tracking, and compliance monitoring. Discussion: In this study, creativity, collaboration, and resourcefulness allowed TQIP guideline implementation at 2 county hospitals. A systematic process is now in place to identify and triage high-risk geriatric trauma patients based on frailty screen to receive inpatient medicine consultation for medical comorbidity optimization. Continued interdisciplinary and interfacility collaboration will be crucial for continued delivery of the optimal care to older injured patients.
Ensuring a sustainable and healthy primary school of the future: Finding answers through group concept mapping
Authors: Conjaerts Martien , Stoyanov Slavi , Edelman Eric , Kirschner Paul , de Groot Renate 
Published: May 2024

Objectives: Overweight and obesity among school-aged children pose a threat to both their academic performance and public health. The Healthy Primary School of the Future (HPSF) initiative was established to address this issue. Our objective was to explore the conditions that make HPSF sustainable based on the perspectives of relevant stakeholders. Design: The study utilised Group Concept Mapping, a structured methodology for conducting mixed-methods participative research, combining qualitative data collection with quantitative data analysis measures. Method: Participants included parents, teachers, school directors, politicians, labour unions, educational, nutrition and health scientists and policymakers. They were asked to respond to the prompt, ‘A necessary condition to make the HPSF sustainable is . . .’. The statements generated were then assessed for their importance and feasibility. Using multidimensional scaling and hierarchical cluster analyses, we identified the shared vision among the stakeholders. Results: A total of 106 unique statements were generated and grouped statistically into 10 clusters. The most significant clusters were identified as Financing; Accessibility for everyone; and Content/Lifestyle/School Programme. The clusters that were deemed most feasible included Content/Lifestyle/School Programme; Accessibility for everyone; and Evaluation. Conclusion: Achieving sustainability for the HPSF requires a comprehensive approach that addresses the conditions outlined in all 10 clusters. Based on the ratings of feasibility and importance, our recommendation is to prioritise implementation of Content/Lifestyle/School Programme and Accessibility for everyone. Subsequently, efforts should be directed towards realising the less feasible but crucial conditions, such as Financing and Evaluation, followed by the remaining six clusters of conditions as identified.
The familial transmission of suicide and non-suicidal self-injury in different income levels in town
Authors: Yu Mei , Li Xuemei , Lei Tingting , He Yuqian , Gan Xieyu , Wang Wenjing , Zhu Dan , Chen Runsen , Zhou Xinyu 
Published: May 2024

Background: Prior researches have established that suicide and non-suicidal self-injury (NSSI) exhibit familial transmission patterns. However, the extent to which these patterns vary across different income levels remains unclear, as well as the specific factors that influence them. This study aimed to explore these questions. Methods: We analyzed data from 13,988 parent-child pairs in Chongqing, China, where the children were aged from 7 to 12 years old. Six income levels were considered, and the children’s depression and anxiety symptoms were assessed using standardized scales (the Center for Epidemiological Studies Depression Scale for Children, [CES-DC], and the Screen for Child Anxiety Related Emotional Disorders [SCARED], respectively). Binary logistic regression analysis was employed to examine the transmission of suicide and NSSI across different income levels. Results: Familial transmission of suicide was significant difference in all income levels except the highest, while familial transmission of NSSI was significant difference in all income levels except the lowest. Notably, in both low- and high-income levels, suicide and NSSI transmissions primarily occurred among male children, mothers with higher education, and children who spent long time with their mothers. Additionally, the transmissions were mediated partially or entirely by children’s depression and anxiety symptoms. Limitations: Future studies should investigate the separate effects of fathers’ and mothers’ suicide and NSSI histories on familial transmission patterns. Conclusion: The familial transmissions of suicide and NSSI exhibited distinct patterns across different income levels.
Influence of parameter variation intervals on pyrolysis sensitivity analysis for charring and non-charring materials
Authors: Amokrane Abdenour , Fleurotte Manon , Hodroj Ali , Authier Olivier , Debenest Gérald , Fontaine Gaëlle , Bourbigot Serge 
Published: May 2024

This study applies the Morris method for a sensitivity analysis to evaluate the input parameters’ influence on the heat release rate in a pyrolysis model, focusing on two materials, poly(methyl methacrylate) (non-charring) and poly(vinyl chloride) (charring), examined under a cone calorimeter. A key aspect of our exploration was the role of input parameter variation intervals on the sensitivity outcomes. We analyzed three interval-setting methods: 1. A standard ±10% deviation from the nominal value, commonly used in the literature. 2. A range determined by the experimental uncertainties for individual parameters. 3. A span from minimum to maximum values found in existing literature for each parameter. Our intensive literature review supported the framing of intervals for the latter two methods. Our findings underscore the critical role of the selected variation interval. Specifically, while a uniform ±10% variation identified activation energies as the primary influencers—consistent with prior literature—the introduction of experimental uncertainties shifted this prominence toward heats of reaction. Thus, the selected interval can drastically reshape the perceived importance of certain parameters. This original work challenges the traditionally employed variation ranges in sensitivity studies, emphasizing the need for a nuanced approach.
Technical Aspects and Outcome of Multi-Staged and Single-Staged Thoracoabdominal Fenestrated Endovascular Aortic Repair
Authors: Frese Jan Paul , Walter Corinna , Carstens Jan , Bürger Matthias , Greiner Andreas , Assadian Afshin , Kapahnke Sebastian , Falkensammer Jürgen 
Published: May 2024

Purpose: In some cases of endovascular thoracoabdominal or juxtarenal aortic aneurysm repair, a thoracic endograft in combination with a fenestrated renovisceral device may be needed in order to create a sufficient proximal landing zone. This study aimed to evaluate the technical aspects and postoperative morbidity of a single- or 2-stage approach. Methods: Eighty-seven consecutive patients undergoing thoracic endovascular aortic repair (TEVAR) in combination with elective fenestrated repair (fenestrated endovascular aortic repair [FEVAR]; fenestrated Anaconda device) from 2015 to 2022 were included in this retrospective bicentric study. Underlying pathologies, aortic morphology, technical details, and postoperative morbidity were recorded. Results: Single-staged (“1S,” n=61) and 2-staged (“2S,” n=26) interventions were compared. Indications were thoracoabdominal aneurysms (TAAAs) (Crawford I-IV) (n=56, 64%) and juxtarenal aneurysms (n=31, 36%). In 2S, the proportion of TAAA was higher than in 1S (2S: 77%, 1S: 59%; p=0.001). In 2S, the covered length of the descending aorta was longer (1S: 128±60 mm, 2S: 202±64 mm; p=0.003). Temporary aneurysm sack perfusion (TASP) was established in 11 (18%) of 1S and 1 (4%) of 2S patients (p=0.079), as well as cerebrospinal fluid (CSF) drainage catheter in 48 (79%) of 1S and 19 (73%) of 2S. The rate of spinal cord ischemia (SCI) and the severity of SCI were not different in both groups, with a total of 3 cases of persisting paraplegia. The rate of access complications was higher in 2S (n=6, 23%) than in 1S (n=4, 7%; p=0.027). Postoperative 30 day morbidity did not significantly differ in both groups and neither did 30 day mortality (4.6% in 1S vs 3.8% in 2S; p=0.083). Conclusion: The combination of TEVAR and FEVAR using a fenestrated endograft is feasible and safe. Aortic morphology does not change significantly after endovascular repair. A single-staged strategy is feasible with excellent results, especially in Crawford IV, Crawford V, or juxtarenal aneurysms. Two-staged repair is recommended in cases with long aortic coverage and a higher American Society of Anesthesiologists (ASA) class. Follow-up data are needed to evaluate the long-term stability of the TEVAR/FEVAR interconnection. Clinical impact Our study has revealed the safety and efficacy of the combination of TEVAR and FEVAR in the treatment of TAAAs and juxtarenal aneurysms with compromised supravisceral landing zones. A single-staged concept is not necessary in all cases. Staged procedures may reduce postoperative morbidity in cases with long aortic coverage and higher ASA class.
RTMS of the Cerebellum Using an Accelerated Stimulation Protocol Improved Gait in Parkinson’s Disease
Authors: Grobe-Einsler Marcus , Lupa Annemarie , Weller Johannes , Kaut Oliver 
Published: May 2024

Background Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological and noninvasive brain stimulation technique that has been proven to be effective in Parkinson’s disease (PD). The combination of rTMS and treadmill training improved gait function in PD greater than treadmill training alone. Objective The aim of our study was to evaluate the combination of a novel high-intensity, short intervention rTMS treatment and a multimodal treatment protocol including of physiotherapy, occupational therapy and language therapy, the so-called Parkinson’s Disease Multimodal Complex Treatment (PD-MCT), to improve motor function. Methods In this randomized double-blind sham-controlled trial rTMS with 48 Hz or sham was applied over the cerebellum 3 times a day for 5 consecutive days. Patients were assessed at baseline (V0), after 5 days of treatment (V1), and 4 weeks later (V2). The primary clinical outcome measure was the motor sum-score of the Unified PD Rating Scale (UPDRSIII), secondary clinical outcomes were quantitative motor tasks. Results A total of 36 PD patients were randomly allocated either to rTMS (n = 20) or sham (n = 16), both combined with PD-MCT. rTMS improved the UDPRSIII score comparing baseline and V1 in the treatment group by −8.2 points ( P = .004). The 8MW and dynamic posturography remained unchanged in both groups after intervention. Conclusion. Compressing weeks of canonical rTMS protocols into 5 days was effective and well tolerated. rTMS may serve as an add-on therapy for augmenting the multimodal complex treatment of motor symptoms, but seems to be ineffective to treat postural instability.
Poor efficacy of immune checkpoint inhibitor treatment in advanced thymic carcinoma patients with liver metastases
Authors: Hao Yue , Xu Manyi , Zeng Xiaohong , Wang Yina , Wang Wenxian , Lin Gen , Li Bihui , Huang Jianhui , Xu Chunwei , Zhang Yongchang , Song Zhengbo 
Published: May 2024

Background: Although immune checkpoint inhibitor treatment for advanced thymic carcinoma exhibits promising efficacy, factors that affect the efficacy and prognosis, including metastases sites, remain uncertain. Objectives: Our study aimed to investigate the determinants of survival among patients with advanced thymic carcinoma who underwent immunotherapy in real-world settings, with implications for clinical practice. Designs: Different therapy regimens of immunotherapy were produced to analyze the influence of liver metastases on survival and prognosis for advanced thymic carcinoma patients. Methods: Data for advanced thymic carcinoma patients receiving immunotherapy and their metastases sites were collected for analysis from seven different hospitals between January 2015 and January 2023. Progression-free survival (PFS) and overall survival (OS) analyses were performed using the Kaplan–Meier method. Cox analysis was used to evaluate factors influencing survival. Results: The present study analyzed 136 advanced thymic carcinoma patients from seven different hospitals. The PFS for all patients receiving immunotherapy was 6.4 months, while the OS was 24.0 months. The objective response rate was different for patients with liver and non-liver metastases (11.9% versus 37.2%, p = 0.003). The disease control rate values were also different between the two groups (47.6% versus 80.9%, p = 0.037). The PFS for patients with liver metastases demonstrated poor immunotherapy efficacy compared to patients with non-liver metastases (3.0 versus 8.0 months, p < 0.0001). The OS was also significantly different between these two patient groups (16.1 versus 29.1 months, p = 0.009). Conclusion: Immunotherapy had poor efficacy in advanced thymic carcinoma patients with liver metastases.