bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Endothelial Dysfunction and the Outcomes After Atrial Fibrillation Ablation
Authors: Okawa Keisuke , Sogo Masahiro , Morimoto Takeshi , Tsushima Ryu , Sudo Yuya , Saito Eisuke , Ozaki Masatomo , Takahashi Masahiko 
Published: May 2023

Background

Endothelial dysfunction (ED) is associated with cardiovascular events in patients with atrial fibrillation (AF). However, the utility of ED as a prognostic marker after AF ablation supplementary to the CHA
2
DS
2
‐VASc score is unclear. This study aimed to investigate the relationship between ED and 5‐year cardiovascular events in patients undergoing AF ablation.

Methods and Results

We conducted a prospective cohort study of patients who underwent a first‐time AF ablation and for whom the endothelial function was assessed by the peripheral vascular reactive hyperemia index (RHI) before ablation. We defined ED as an RHI of <2.1. Cardiovascular events included strokes, heart failure requiring hospitalization, arteriosclerotic disease requiring treatment, venous thromboses, and ventricular arrhythmias or sudden cardiac death. We compared the 5‐year incidence of cardiovascular events after AF ablation between those with and without ED. Among the 1040 patients who were enrolled, 829 (79.7%) had ED, and the RHI value was found to be associated with the CHA
2
DS
2
‐VASc score (
P
=0.004). The 5‐year incidence of cardiovascular events was higher among patients with ED than those without ED (98 [11.8%] versus 13 [6.2%]; log‐rank
P
=0.014). We found ED to be an independent predictor of cardiovascular events after AF ablation (hazard ratio [HR], 1.91 [95% CI, 1.04–3.50];
P
=0.036) along with a CHA
2
DS
2
‐VASc score of ≥2 (≥3 for women) (HR, 3.68 [95% CI, 1.89–7.15];
P
<0.001).

Conclusions
The prevalence of ED among patients with AF was high. Assessing the endothelial function could enable the risk stratification of cardiovascular events after AF ablation.
Planning for Livability? State-built New Towns and Urban Traffic Externalities in China
Authors: Wang Kunlun 
Published: May 2023

Abstract
Congestion and long commutes would lower the livability of cities. To curb such externalities, various policies have been adopted to limit urban sprawl. However, the empirical relationship between urban sprawl and traffic externalities is ambiguous. This paper investigates this issue by examining state-built new towns (a particular feature of China's urbanization processes) and congestion delay indices (measured from the data for urban trips). The results show that the number of new towns was positively correlated with intra-urban congestion and negatively correlated with traveling speed. Further, the congestion effects were severe during rush hours. Cities with more new-town projects have more residents choosing long-distance commuting modes, and greater average commuting time and distance. This finding shows a worse job–housing balance in the city. Moreover, these traffic externalities were primarily caused by new towns built since 2008, which have a larger scale and longer distances to the urban center.
Mechanisms behind differential white grub host susceptibility to entomopathogenic nematodes
Authors: Katumanyane Agil , Slippers Bernard , Wondafrash Mesfin , Malan Antoinette P. , Hurley Brett P. 
Published: May 2023

Summary
Control of white grubs, the sporadic root-feeding larvae of scarabid beetles, is difficult due to their cryptic nature and resistance to chemical insecticides. Potential exists for the use of entomopathogenic nematodes (EPN) for such control. The successful infection of white grubs by EPN, however, is limited by the white grubs’ innate reduced susceptibility in form of behavioural, morphological and physiological defences. This study aimed to determine the different physiological defence mechanisms of white grubs against attack by EPN. The white grub species, Pegylis sommeri and Schizonycha affinis, which were previously found to have a low level of susceptibility to EPN, and Maladera sp. 4, which had previously shown a relative high level of susceptibility, were examined. The ability of the EPN to penetrate the white grubs and of the EPN symbiotic bacteria to grow inside the insect haemolymph, the encapsulation rates, as well as the nematode growth inside the insect haemolymph, were determined. The results showed that the ability of the nematodes to penetrate white grubs, the encapsulation rates and growth in the haemolymph varied between EPN and white grub species. The different species of the EPN symbiotic bacteria were able to grow in the haemolymph of all the white grub species tested. The results indicate that the white grub species investigated tended to resist the initial penetration of most of the EPN studied, thus avoiding infection.
Guardians of Legality?
Authors: Thin Sarah 
Published: May 2023

Abstract
There is an essential conflict at the heart of the international judicial function. On the one hand, interstate courts and tribunals (ict s) are viewed as guardians of international legality; organs of the international community itself. On the other, they are the tools of their creator states. Accordingly, traditional conceptions of the international judicial function frame ict s as dispute settlors pure and simple, a perspective which comes into conflict with a more community-oriented role for ict s. This article explores these different approaches to the international judicial function, presenting them as two opposing perspectives: one bilateralist, one based on the community interest in legality and the international rule of law. It then assesses the practice and procedure of the icj, itlos, and the wto dsm in relation to jurisdiction and admissibility against these differing views of the international judicial function. It concludes that, although the bilateralist perspective still holds considerable sway, a more systemic, community interest-oriented international judicial function is clearly emerging in the field of international adjudication.
The Military Career of the Fifth Marquis of Távara (1604–1665)
Authors: García Hernán Enrique 
Published: May 2023

Abstract
The military career of the Marquis of Távara, a less well-known historical figure among the nobility of Early Modern Spain, deserves attention because his life-experience progressed from his local roles in particular kingdoms to culmination in major duties such as President of the Council of Orders. His career advanced from mere adventurer to maestre de campo (field commander of a tercio), thereafter he held vice-regal office in Sicily and Navarre and the captaincies-general of Aragon, Galicia, Old Castile and Extremadura, and he was involved in the wars against the Portuguese and Catalans during the crisis of the 1640s. Also, he held responsibility for the Monarchy’s entire artillery, and he became an active member of the Council of War. Quite apart from his aristocratic origins, this paper explores how his meritorious military career in combination with his three strategic marriages assisted him in setting and shaping a strategy for military promotion.
Implementing a Surveillance-Based Approach to Create a Statewide Viral Clearance Cascade for Hepatitis C Among People With HIV and HCV Coinfection in Connecticut
Authors: Wegener Maximilian , Brooks Ralph , Speers Suzanne , Nichols Lisa , Villanueva Merceditas 
Published: May 2023

Objectives: Highly effective direct-acting antiviral medications have made it feasible to achieve elimination of hepatis C virus (HCV), including for people with HIV and HCV coinfection. The Centers for Disease Control and Prevention offers guidance for a laboratory surveillance–based HCV viral clearance cascade, which allows public health departments to track the outcomes of people with HCV based on the following steps: ever infected, virally tested, initial infection, and cured or cleared. We examined the feasibility of this approach among people with HIV and HCV coinfection in Connecticut. Methods: We matched an HIV surveillance database, which included cases from the enhanced HIV/AIDS Reporting System as of December 31, 2019, and the HCV surveillance database, the Connecticut Electronic Disease Surveillance System, to define a cohort of coinfected people. We used HCV laboratory results obtained from January 1, 2016, through August 3, 2020, to determine HCV status. Results: Of 1361 people who were ever infected with HCV as of December 31, 2019, 1256 (92.3%) received HCV viral testing, 865 of 1256 people tested (68.9%) were HCV infected, and 336 of 865 infected people (38.8%) were cleared or cured. People who had undetectable HIV viral loads at most recent HIV test (<200 copies/mL) were more likely than those with detectable HIV viral loads to achieve HCV cure ( P = .02). Conclusions: A surveillance-based approach that includes data based on the Centers for Disease Control and Prevention HCV viral clearance cascade is feasible to implement, can help track population-level outcomes longitudinally, and can help identify gaps to inform HCV elimination strategies.
The Support Needs and Current Practices of Public Health Nurses in the Republic of Ireland Who Provide Support to Breastfeeding Mothers: A Cross-Sectional Survey
Authors: Walsh Annemarie , McCluskey Rachel , Cassidy Deirdre , McGoldrick Gerardine , Howlin Claire , Muldoon Kathryn , Butler Éadaoin , Byrne Gobnait 
Published: May 2023

Background: Breastfeeding continuation rates are low in Ireland. The Breastfeeding Observation and Assessment Tool (BOAT) was developed to assist public health nurses in assessing breastfeeding challenges; however, little is known of its actual usage, the level of training experienced or desired by public health nurses, or their level of confidence in the support they provide to breastfeeding mothers. Research Aim: To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland. Method: An online questionnaire was devised to collect respondents’ confidence with breastfeeding issues, caseload, and practices. It was distributed to public health nurses with a current child health caseload in one Community Healthcare Organization. Mann Whitney U tests were used to ascertain the relationship between public health nurses’ confidence level and those with qualifications in midwifery or as an International Board Certified Lactation Consultant (IBCLC). Results: The survey was completed by 66 public health nurses. Only 14 respondents (21.2%) indicated that they always used the BOAT. The most common reason for not doing so was a lack of education on its use ( n = 17, 25.8%). Postholders also certified as IBCLCs were considered by participants to be the most appropriate professionals to resolve certain breastfeeding issues. Confidence levels to manage breastfeeding issues were highest among public health nurses with IBCLC credentialing ( U = 12.5, p = .001) while no difference was seen when comparing those with a midwifery degree to those without ( U = 184.0, p = .92). Face-to-face workshops and blended-learning approaches were ranked as the preferred formats for breastfeeding education (Median rank = 2). Conclusions: Breastfeeding education incorporating a face-to-face component is needed to support public health nurses who work with breastfeeding mothers, as is prioritization of recruitment in the community of public health nurses with IBCLC credentials.
A review of the development of gangrene in patients with systemic lupus erythematosus – A 44-year follow-up study
Authors: Rua Joana , Isenberg David 
Published: May 2023

Objectives This review addresses the question of what happens long-term to those systemic lupus erythematosus (SLE) patients who develop gangrene. It also seeks to find common clinical and serological features, risk factors and triggers and how best to manage this challenging complication. Methods We reviewed 850 patients with SLE attending a UK tertiary referral center, followed up over 44 years, assessing their demographics, clinical and serological features, treatment in the acute phase, their long-term outcome and long-term management. Results Ten out of 850 patients (1.2%) developed gangrene; the mean age of onset was 17 years (range 12–26 years) Eight out of 10 patients had a single episode of gangrene. One of the other two was not willing to have anticoagulation. The first episode of gangrene ranged from presentation to 32 years after SLE onset, mean duration of SLE at the onset of the gangrene was 18.5 years SD 11.5 years. Anti-phospholipid (PL) antibodies were over-represented in the patients with gangrene. All had active SLE at the time the gangrene developed. All patients were treated with intravenous (IV) iloprost infusions, and the antiphospholipid-antibody positive patients were anti-coagulated, most staying on long term anticoagulation. Underlying possible triggers were treated appropriately. Two patients who did not respond to the initial treatment needed further immunosuppression. All patients suffered digit loss. Conclusion Although rare, gangrene is a sinister, potentially late developing complication of SLE, it rarely recurs. It is associated with anti-phospholipid antibodies, active disease, and other possible triggers such as infection and cancer. Anticoagulation therapy, steroids and iloprost, and further immunosuppression may be needed to stop the evolution of gangrene.
How Display Rules Influence Turnover in Healthcare Teams and the Moderating Role of Team Negative Affective Tone
Authors: Nguyen Helena , Groth Markus , Johnson Anya 
Published: May 2023

Team display rules are expressive norms shared by team members about how to positively impact a customer's perception of service quality and satisfaction. For frontline employees' working in teams, however, the costs and benefits of team display rules are less clear as empirical links to objective, behavioral outcomes, such as turnover, are rare. In a study of 442 healthcare professionals, working within 72 teams in a large children’s hospital, we investigate the effects of positive team display rules (i.e., shared expectations among team members to express positive emotions) and negative team display rules (i.e., shared expectations among team members to suppress negative emotions) on time-lagged objective voluntary turnover. We found that positive team display rules prompted retention, while negative team display rules reduced psychological attachment (i.e., affective commitment) and increased voluntary turnover 12 months later. Team negative affective tone (i.e., negative emotions associated with different healthcare team contexts) amplified the detrimental effects of negative team display rules. Overall, this study highlights the important and nuanced effects of the socioemotional context of service teams, in particular, the consequential influence of team display rules on FLEs turnover behavior in a critical service context, that is, healthcare.
Immunopathogenic Insights on Preferential Human Herpesvirus-6 Reactivation in Drug Rash With Eosinophilia and Systemic Symptoms: A Scoping Review
Authors: Zhu Harrison , Ren Vicky 
Published: May 2023

Introduction Human herpesvirus-6 (HHV-6) is a ubiquitous lymphotropic betaherpesvirus that can reactivate in drug rash with eosinophilia and systemic symptoms (DRESS). Despite recent publications advancing our understanding of HHV-6 in DRESS, the exact role of HHV-6 in disease pathogenesis remains unclear. Methods A scoping review with the PubMed query “(HHV 6 AND (drug OR DRESS OR DIHS)) OR (HHV6 AND (drug OR DRESS OR DIHS))” was conducted in accordance with PRISMA guidelines. Articles containing original data on at least one DRESS patient with HHV-6 testing were included. Results Our search returned a total of 373 publications, of which 89 met eligibility criteria. HHV-6 reactivation occurred in 63% of DRESS patients (n = 748), which was significantly more often than other herpesviruses. HHV-6 reactivation was associated with worse outcomes and greater severity in controlled studies. Case reports have demonstrated sometimes fatal HHV-6-related multi-organ involvement. Temporally, HHV-6 reactivation typically occurs 2 to 4 weeks after DRESS onset and has been linked to markers of immunologic signaling, such as OX40 (CD134), an HHV-6 entry receptor. Efficacy of antiviral or immunoglobulin treatment has only been demonstrated anecdotally, and steroid use may affect HHV-6 reactivation. Conclusion HHV-6 is implicated in DRESS more than in any other dermatologic condition. It is still unclear whether HHV-6 reactivation is cause or consequence of DRESS dysregulation. Similar pathogenic mechanisms precipitated by HHV-6 in other contexts may be relevant in DRESS. Future randomized controlled studies to assess effects of viral suppression on clinical outcomes is needed.
Two-Year Outcomes With Bentley BeGraft as Bridging Stent-Grafts for Reno-Visceral Target Vessels During Fenestrated Endovascular Aortic Repair
Authors: D’Oria Mario , Mezzetto Luca , Silingardi Roberto , Freyrie Antonio , Galeazzi Edoardo , Frigatti Paolo , Milite Domenico , Veraldi Gian Franco , Lepidi Sandro , Cabrini Elisa , di Pinto Luca Calia , Calvagna Cristiano , D’Andrea Alessia , Farneti Fabrizio , Furlan Federico , Gennai Stefano , Isler Thomas , Leone Nicola , Mastrorilli Davide , Migliari Mattia , Perini Paolo , Pilon Fabio , Scrivere Paola , Xodo Andrea 
Published: May 2023

Introduction: The aim of this study was to present the short-term and 2-year outcomes after use of the Bentley BeGraft as bridging stent-graft (BSG) for reno-visceral target vessel (TV) during fenestrated endovascular aortic repair (FEVAR) from a contemporary multicentric experience. Methods: A retrospective review of all consecutive patients who underwent elective FEVAR at 7 institutions located in Italy from 2015 to 2021 was performed. The main outcomes of interest for this study were technical success and TV instability, defined in accordance with current reporting standards. Patients’ survival was also assessed. Results: Overall, 81 patients received elective FEVAR during the study period. Mean age of patients was 78 years, and 89% were men. Most patients were treated for a juxta-pararenal abdominal aortic aneurysm (AAA) (68%), and 23% had already received an infrarenal aortic reconstruction. Most endografts had 3-vessel or 4-vessel design (27% and 55%, respectively), and a Cook endograft was used in 73% of cases. Overall, 266 Bentley BeGraft were implanted, of which 44 (16.5%) in the celiac trunk, 69 (26%) in the superior mesenteric artery, 79 (29.5%) in the right renal artery, and 74 (28%) in the left renal artery. Technical success was 94%, with 5 instances of technical failure that were recorded and required an additional intraoperative procedure. The early mortality rate was 4%, and acute kidney injury occurred in 14 cases with 1 requiring definitive hemodialysis. Survival at 6, 12, and 24 months in the overall cohort was 98.8%, 95.3%, and 83.4%, respectively. Freedom from TV instability at 6, 12, and 24 months in the overall cohort was 98.4%, 97.9%, and 97.2%, respectively. Events of TV instability included 3 cases of type 1C endoleak and 3 cases of type 3C endoleak, while no events of BSG fracture or thrombosis were noted. Five out of 6 cases of TV instability occurred in renal arteries, and they were all successfully treated by endovascular means. Conclusions: The data from this multicentric study show favorable short-term and 2-year outcomes of the Bentley BeGraft as BSG for reno-visceral TV during FEVAR, with low rates of TV-related endoleak and no stent occlusion up to 2 years. Clinical Impact The data from this multicentric study show satsfactory outcomes up to two years of follow-up for the Bentley BeGraft when used for brdiging reno-visceral vessels during fenestrated endovascular aortic repair. Further research will be needed to identify predictors of stent-related reinterventions and ascertain the long-term durability.
Transthoracic Aortic Clamp Technique for Port-Only Endoscopic Robotic Mitral Surgery
Authors: Murphy Douglas A. , Arrington Ryon L. , Jonsson Amalia A. , Halkos Michael E. 
Published: May 2023

Objective: Many robotic mitral surgeons utilize right thoracotomy with transthoracic clamping of the aorta, while a smaller number employ a port-only endoscopic approach with endoaortic balloon occlusion of the aorta. We present our technique for a port-only endoscopic robotic approach with transthoracic clamping. Methods: From July 2019 through December 2022, 133 patients underwent port-only endoscopic robotic mitral surgery with transthoracic clamp aortic occlusion and antegrade cardioplegia. Perfusion was through the femoral artery in 101 patients (76%) and axillary in 32 patients (24%). Clamp technique involved placing the clamp at the mid-ascending aorta, dynamic valve testing to 90 mm aortic root pressure, and closure of the cardioplegia cannula site prior to clamp removal. Indications for clamp utilization over balloon occlusion included both balloon supply issues and aortoiliac anatomy. Results: Mitral repair was performed in 122 patients (92.7%) and mitral valve replacement in 11 patients (8.3%). Mean aortic occlusion time was 92 ± 21.4 min. Mean time from left atrial closure to clamp removal was 8.7 (7.2 to 12.8) min. There were no injuries to the aorta or surrounding structures, mortality, strokes, or renal failure. Conclusions: For robotic teams with endoaortic balloon capability, this technique may be useful in certain patients with aorto-iliac pathology or limited femoral artery access. Alternatively, robotic teams who employ transthoracic aortic clamping through a thoracotomy may find this technique useful to transition to a port-only endoscopic approach.
Intra-Articular Antegrade Intramedullary Screw Fixation for Proximal Phalanx Fractures: Impact of Articular Surface Defects on Joint Contact Pressures
Authors: Boe Chelsea C. , Telfer Scott , Kennedy Stephen 
Published: May 2023

Background: Intramedullary headless screw fixation is increasingly used for fixation of proximal phalanx fractures. However, the impact of screw entry defects on joint contact pressures is not well defined and may have implications for arthrosis. The objective of this cadaveric biomechanical study was to assess joint contact pressures at the metacarpophalangeal (MCP) joint before and after passage of 2 sizes of antegrade intramedullary fixation. Methods: Seven fresh frozen cadaver specimens without arthritis or deformity were included in this study. Antegrade intramedullary screw fixation of proximal phalanx fracture was simulated using an intra-articular technique. Flexible pressure sensors were inserted into the MCP joints and cyclic loading was performed. Peak contact pressures were determined and averaged across loading cycles for each finger in the native state, with 2.4- and 3.5-mm drill defects in line with the medullary canal. Results: Peak pressure increased with the size of the drill hole defect. Contact pressure increases were greater in extension, with peak contact pressures increased by 24% for the 2.4-mm defect and 52% for the 3.5-mm defect. Increase in peak contact pressure was statistically significant with a 3.5-mm articular defect. Contact pressures were not consistently increased for the 2.4-mm defect. Testing in flexion of 45° resulted in reduced contact pressure for these defects. Conclusions: Our study demonstrates that antegrade intramedullary fixation of proximal phalanx fractures can increase MCP joint peak contact pressures, particularly in an extended joint position. Effect increases with defect size. This has implications for the management of proximal phalanx fractures using this technique.