bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multielectrode Contact Measurement Can Improve Long-Term Outcome of Pulmonary Vein Isolation Using Circular Single-Pulse Electroporation Ablation
Authors: Groen Marijn H.A. , van Driel Vincent J.H.M. , Neven Kars , van Wessel Harry , de Bakker Jacques M.T. , Doevendans Pieter A.F. , Wittkampf Fred H.M. , Loh Peter , van Es René 
Published: August 2022

Background:
Irreversible electroporation (IRE) ablation is generally performed with multielectrode catheters. Electrode-tissue contact is an important predictor for the success of pulmonary vein (PV) isolation; however, contact force is difficult to measure with multielectrode ablation catheters. In a preclinical study, we assessed the feasibility of a multielectrode impedance system (MEIS) as a predictor of long-term success of PV isolation. In addition, we present the first-in-human clinical experience with MEIS.

Methods:
In 10 pigs, one PV was ablated based on impedance (MEIS group), and the other PV was solely based on local electrogram information (EP group). IRE ablations were performed at 200 J. After 3 months, recurrence of conduction was assessed. Subsequently, in 30 patients undergoing PV isolation with IRE, MEIS was evaluated and MEIS contact values were compared to local electrograms.

Results:

In the porcine study, 43 IRE applications were delivered in 19 PVs. Acutely, no reconnections were observed in either group. After 3 months, 0 versus 3 (
P
=0.21) PVs showed conduction recurrence in the MEIS and EP groups, respectively. Results from the clinical study showed a significant linear relation was found between mean MEIS value and bipolar dV/dt (r
2
=0.49,
P
<0.001), with a slope of 20.6 mV/s per Ohm.

Conclusions:
Data from the animal study suggest that MEIS values predict effective IRE applications. For the long-term success of electrical PV isolation with circular IRE applications, no significant difference in efficacy was found between ablation based on the measurement of electrode interface impedance and ablation using the classical EP approach for determining electrode-tissue contact. Experiences of the first clinical use of MEIS were promising and serve as an important basis for future research.
Higher Arm Versus Lower Arm Systolic Blood Pressure and Cardiovascular Outcomes: a Meta-Analysis of Individual Participant Data From the INTERPRESS-IPD Collaboration
Authors: Clark Christopher E. , Warren Fiona C. , Boddy Kate , McDonagh Sinéad T.J. , Moore Sarah F. , Teresa Alzamora Maria , Ramos Blanes Rafel , Chuang Shao-Yuan , Criqui Michael H. , Dahl Marie , Engström Gunnar , Erbel Raimund , Espeland Mark , Ferrucci Luigi , Guerchet Maëlenn , Hattersley Andrew , Lahoz Carlos , McClelland Robyn L. , McDermott Mary M. , Price Jackie , Stoffers Henri E. , Wang Ji-Guang , Westerink Jan , White James , Cloutier Lyne , Taylor Rod S. , Shore Angela C. , McManus Richard J , Aboyans Victor , Campbell John L. 
Published: August 2022

BACKGROUND:
Guidelines recommend measuring blood pressure (BP) in both arms, adopting the higher arm readings for diagnosis and management. Data to support this recommendation are lacking. We evaluated associations of higher and lower arm systolic BPs with diagnostic and treatment thresholds, and prognosis in hypertension, using data from the Inter-arm Blood Pressure Difference—Individual Participant Data Collaboration.

METHODS:
One-stage multivariable Cox regression models, stratified by study, were used to examine associations of higher or lower reading arm BPs with cardiovascular mortality, all-cause mortality, and cardiovascular events, in individual participant data meta-analyses pooled from 23 cohorts. Cardiovascular events were modelled for Framingham and atherosclerotic cardiovascular disease risk scores. Model fit was compared throughout using Akaike information criteria. Proportions reclassified across guideline recommended intervention thresholds were also compared.

RESULTS:

We analyzed 53 172 participants: mean age 60 years; 48% female. Higher arm BP, compared with lower arm, reclassified 12% of participants at either 130 or 140 mm Hg systolic BP thresholds (both
P<
0.001). Higher arm BP models fitted better for all-cause mortality, cardiovascular mortality, and cardiovascular events (all
P
<0.001). Higher arm BP models better predicted cardiovascular events with Framingham and atherosclerotic cardiovascular disease risk scores (both
P
<0.001) and reclassified 4.6% and 3.5% of participants respectively to higher risk categories compared with lower arm BPs).

CONCLUSIONS:
Using BP from higher instead of lower reading arms reclassified 12% of people over thresholds used to diagnose hypertension. All prediction models performed better when using the higher arm BP. Both arms should be measured for accurate diagnosis and management of hypertension.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: CRD42015031227.
Differential Sex-Specific Effects of Angiotensin-Converting Enzyme Inhibition and Angiotensin Receptor Blocker Therapy on Arterial Function in Hypertension: CALIBREX Trial
Authors: Rogers Steven C. , Ko Yi-An , Quyyumi Arshed A. , Hajjar Ihab 
Published: August 2022

Background:
Increased arterial stiffness is associated with adverse cardiovascular outcomes. We studied the sex-specific impact of angiotensin antagonists on vascular function in hypertension with the hypothesis that their effects on arterial stiffness may be variable in men and women.

Methods:
In 141 hypertensive participants with mild cognitive impairment (age 65.9±7.7, 57% female), candesartan (up to 32 mg, n=77) or lisinopril (up to 40 mg, n=64) were administered to achieve blood pressure <140/90 mm Hg. Pulse wave velocity, central pulse pressure, and central augmentation index were measured using applanation tonometry (SphygmoCor, Australia). Multivariate linear regression and mixed model analyses were performed using intention-to-treat and per protocol analyses for those completing the study.

Results:

Blood pressure reduction was similar among candesartan and lisinopril groups. Compared with candesartan, lisinopril therapy resulted in lower pulse wave velocity (0.5±0.8 versus −0.7±0.4 m/s, respectively;
P
=0.003) and central pulse pressure (−1±3 versus −7±4 mm Hg;
P
=0.03) after 1 year. There was a significant interaction by sex whereby the improvements in pulse wave velocity and central pulse pressure with lisinopril compared with candesartan were only observed in women. In contrast, there was greater improvement in augmentation index with candesartan compared with lisinopril (−4±7% versus −1.5±8%;
P
=0.05), with no sex differences.

Conclusions:
Despite equipotent antihypertensive effects, lisinopril was more effective than candesartan at lowering arterial stiffness in women. In contrast, candesartan was more effective than lisinopril in improving pulse wave reflections in both sexes. These findings demonstrate differential sex-specific effects of renin-angiotensin system antagonists on arterial function in hypertension that may contribute to long-term cardiovascular and neurocognitive outcomes in this population.
Factors Associated With Enhanced Low‐Density Lipoprotein Cholesterol Lowering With Bempedoic Acid
Authors: Ballantyne Christie M. , Bays Harold E. , Louie Michael J. , Smart Jeremy , Zhang Yang , Ray Kausik K. 
Published: August 2022

Background
Bempedoic acid (BA) inhibits ATP‐citrate lyase in the cholesterol synthesis pathway and lowers low‐density lipoprotein cholesterol (LDL‐C). As with other lipid‐lowering therapies, interindividual variation in response to BA was observed in clinical trials. We characterized LDL‐C response to BA using guideline‐defined statin intensity categories and identified clinical factors associated with enhanced LDL‐C lowering with BA.

Methods and Results

This post hoc analysis used pooled data from 4 phase 3 studies. Patients were randomized 2:1 to once‐daily BA 180 mg (n=2321) or placebo (n=1167) for 12 to 52 weeks and grouped based on percent change in LDL‐C from baseline to week 12 according to guideline‐established statin intensity categories. Factors associated with ≥30% reduction in LDL‐C were identified using logistic regression analyses. From baseline to week 12, BA lowered LDL‐C levels comparable to a moderate‐ or high‐intensity statin (≥30%) in 28.9% of patients; this degree of LDL‐C lowering was observed in 50.9% of patients not receiving background statin therapy. In a multivariable analysis, the absence of statins, female sex, a history of diabetes, ezetimibe use, and higher high‐sensitivity C‐reactive protein level were associated with increased rates of achieving ≥30% LDL‐C reduction with BA (
P
<0.01 for each).

Conclusions
A large percentage of patients receiving BA achieved LDL‐C reductions comparable to a moderate‐ or high‐intensity statin. Factors including statin absence, female sex, diabetes history, ezetimibe use, and a higher high‐sensitivity C‐reactive protein level may be useful to identify patients who may have a greater LDL‐C reduction with BA.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT02666664, NCT02991118, NCT02988115, NCT03001076.
Controls on the Development and Circulation of Terminal versus Transient Congestus Clouds and Implications for Midlevel Aerosol Transport
Authors: Leung Gabrielle R. , van den Heever Susan C. 
Published: August 2022

Abstract
Cumulus congestus is the middle mode of tropical convection, with cloud tops around or exceeding the 0°C level (∼5 km AGL). While some congestus are terminal, meaning capped by the 0°C stable layer, others are transient and may develop into deep convection. Although this distinction impacts convective transport of water vapor and aerosols into the midtroposphere and the congestus to deep convection transition, there is still much to be understood about the processes causing congestus to overshoot the 0°C level and continue growing. We simulate a field of tropical congestus using high-resolution idealized model simulations, identify and track the updrafts, and composite congestus properties. Terminal and transient congestus updrafts are characterized by a similar overturning circulation between the updraft and subsiding shell. However, transient congestus have stronger updrafts, and the downward branch of their corresponding circulations are constrained by the 0°C level. The balance between buoyancy and perturbation pressure gradient accelerations predominantly determines the shape of the vertical velocity profile, though vertical advection through bulk and subplume fluctuations are also shown to be important near and above the 0°C level. Our findings support previous results suggesting buoyancy as a control on congestus height. We find that congestus developing in more humid midlevel environments are more likely to be transient. Finally, we explore how congestus updrafts influence their near moisture and aerosol environments: terminal congestus return more aerosol to the atmosphere through evaporation along their edges, while transient congestus create stronger midlevel detrainment layers of aerosol and water vapor due to the trapping of the regenerated aerosol above the 0°C level.
Parental COVID-19 Vaccine Hesitancy in the United States
Authors: Ruiz Jeanette B. , Bell Robert A. 
Published: August 2022

Objective: Little is known about parents’ willingness to vaccinate their children against COVID-19. We assessed the prevalence of vaccine hesitancy among parents with a child or adolescent aged 12-15 years, examined predictors of parents’ COVID-19 vaccine hesitancy, their reasons for resisting a pediatric COVID-19 vaccine, and the correlation between parents’ intentions to vaccinate their child and the acceptance of a vaccine for themselves. Methods: We conducted a national online survey of 637 parents of a child or adolescent aged 12-15 years in March 2021, before COVID-19 vaccines had been approved for this age group. We assessed univariate predictors of vaccine hesitancy, and we used logistic regression analysis to assess independent effects of variables on vaccine hesitancy. Results: Nearly one-third (28.9%; 95% CI, 25.5%-32.5%) of respondents reported pediatric vaccine hesitancy. Vaccine-hesitant parents were less knowledgeable about vaccines, more accepting of vaccine conspiracies, and less worried about COVID-19 risks to their child’s health than vaccine-accepting parents were. Vaccine hesitancy was higher among female (vs male), single (vs married/living as married), older (vs younger), low income (vs high income), non–college graduates (vs college graduates), and Republican (vs Democrat) parents. The primary concerns expressed by vaccine-hesitant parents pertained to vaccine safety rather than vaccine effectiveness. One-quarter of vaccine-hesitant parents preferred that their child obtain immunity through infection rather than vaccination. Non–vaccine-hesitant parents’ reasons for vaccinating focused on protecting the health of their child and others. Childhood COVID-19 vaccine acceptance was strongly associated with parents’ intentions to get the vaccine for themselves. Conclusion: A messaging strategy for effective public health interventions that includes educating the public about vaccination, countering misinformation about vaccine development and safety, and stressing the safety of approved COVID-19 vaccines may boost vaccine acceptance among vaccine-hesitant parents.
A Multi‐institutional Analysis of Late Complications in Scapula, Fibula, and Osteocutaneous Radial Forearm Free Flaps
Authors: Bollig Craig A. , Walia Amit , Pipkorn Patrik J. , Jackson Ryan S. , Puram Sidharth V. , Rich Jason T. , Paniello Randy C. , Zevallos Jose P. , Stevens Madelyn N. , Wood C. Burton , Rohde Sarah L. , Sykes Kevin , Kakarala Kiran , Bur Andres , Wieser Margaret E. , Galloway Tabitha L.I. , Tassone Patrick , Sadeghi Jairan , Mattingly Tyler R. , Pluchino Tyler , Jorgensen Jeffrey B. 
Published: August 2022

AbstractObjectives(1) Evaluate the association of flap type with late complications in patients undergoing osseous head and neck reconstruction with the fibula free flap (FFF), osteocutaneous radial forearm free flap (OCRFFF), and scapula free flap (SFF). (2) Compare the prevalence of late complications based on minimum duration of follow‐up.Study DesignRetrospective cohort study.SettingMultiple academic medical centers.MethodsPatients undergoing FFF, OCRFFF, or SFF with ≥6‐month follow‐up were stratified by type of flap performed. The association of flap type with late complications was analyzed via univariable and multivariable logistic regression, controlling for relevant clinical risk factors. Additionally, the frequency of late complications by minimum duration of follow‐up was assessed.ResultsA total of 617 patients were analyzed: 312 (50.6%) FFF, 230 (37.3%) OCRFFFF, and 75 (12.2%) SFF. As compared with the SFF, the FFF (adjusted odds ratio [aOR], 3.05; 95% CI, 1.61‐5.80) and OCRFFF (aOR, 2.17; 95% CI, 1.12‐4.22) were independently associated with greater odds of overall late recipient site wound complications. The SFF was independently associated with the lowest odds of hardware exposure when compared with the FFF (aOR, 2.61; 95% CI, 1.27‐5.41) and OCRFFF (aOR, 2.38; 95% CI, 1.11‐5.12). The frequency of late complications rose as minimum duration of follow‐up increased until plateauing at 36 months.ConclusionsThis multi‐institutional study suggests that the long‐term complication profile of the SFF and OCRFFF compares favorably to the FFF. The SFF may be associated with the fewest overall late recipient site complications and hardware exposure, while the FFF may be associated with the most of these 3 options.
Does Prophylactic Replacement of Voice Prosthesis Make Sense? A Study to Predict Prosthesis Lifetime
Authors: Heirman Anne N. , van der Noort Vincent , van Son Rob , Petersen Japke F. , van der Molen Lisette , Halmos Gyorgy B. , Dirven Richard , van den Brekel Michiel W.M. 
Published: August 2022

AbstractObjectiveVoice prosthesis leakage significantly affects the quality of life of patients undergoing laryngectomy, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages.Study DesignRetrospective cohort study.SettingTertiary hospital.MethodsThis study included all patients who underwent laryngectomy between 2000 and 2012 in the Netherlands Cancer Institute. Device lifetimes and voice prosthesis replacements of a retrospective cohort were used to calculate the number of needed voice prostheses per patient per year to prevent 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: adaptive strategies based on the individual patient's history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics.ResultsPatients used a median 3.4 voice prostheses per year (range, 0.1‐48.1). We found high inter‐ and intrapatient variability in device lifetime. When prophylactic replacement is applied, this would become a median 9.4 voice prostheses per year, which means replacement every 38 days, implying >6 additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients and only a median 25% can be prevented. Monte‐Carlo simulations showed that prophylactic replacement is not feasible due to the high coefficient of variation (SD/mean) in device lifetime.ConclusionBased on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter‐ and intrapatient variation in device lifetime.
Beneficial effect of transient desflurane inhalation on relieving inflammation and reducing signaling induced by MPTP in mice
Authors: Yu Zhiyang , Qin Guowei , Ge Zhenzhong , Li Weiyan 
Published: August 2022

Objective To determine if the beneficial effects of transient desflurane application mitigates inflammation and decrease associated signaling induced by 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) in mice. Methods Mice were induced to develop Parkinson’s disease (PD) by intraperitoneal injection with MPTP for 20 consecutive days, and validated mice were randomly allocated to four groups. Collected samples from euthanized mice were designated for the following analyses: 1) immunohistochemical staining for positive dopaminergic neurons in the substantia nigra and striatum, 2) immunofluorescence staining for ionized calcium binding adaptor molecule-1 (Iba1) and glial fibrillary acid protein (GFAP), and 3) western blotting for p38, p-p38, toll-like receptor 4, and tumor necrosis factor (TNF)-α. Results The inhalation of desflurane for 1 hour ameliorated locomotory dysfunctions of PD mice by recovering the loss of Iba1- and GFAP-positive dopaminergic neurons, deactivating microglial cells and astrocytes, and decreasing the amounts of inflammatory cytokines (TNF-α). Conclusions These findings suggest that transient desflurane inhalation may provide some benefits for PD through ameliorating inflammation and enhancing locomotor activity.
Ballistic studies on Kevlar - glass fibre hybrid laminated epoxy composites
Authors: Kumar Saurabh S , Magarajan Udayakumar , Dharani Kumar Selvan 
Published: August 2022

In this present work, post ballistic studies on Kevlar – Glass Fibre laminated composite targets has been made. The targets made of Kevlar and Glass fibre with epoxy matrix were prepared by hand lay-up method. A total of seven laminated composites were fabricated by altering the number of Kevlar and glass fibre layers; and ballistic experiments were conducted by firing 9 × 19 mm parabellum projectiles on the targets. The Specific Energy Absorption (SEA) and the Back Face Signature (BFS) of the targets were calculated after the projectile impact. The results indicate BFS values of the laminate composite targets were below 44 mm as per the requirement of NIJ standard. The amount of kinetic energy required to completely penetrate the projectile into the glass fibre hybrid laminate composite was higher compare to pure Kevlar fibre laminates. Also, from the Scanning Electron Microscopy (SEM) analysis, the failure mechanisms of the Kevlar - Glass fibre composite targets were studied and discussed in detail.
Pars plana vitrectomy and therapeutic keratoplasty in endophthalmitis and infectious keratitis
Authors: Zapata Cuevas María Alejandra , García de Oteyza Gonzalo , Alvarado-Villacorta Rosa , Quintana Hernández Luis Manuel , Ordoñez-Ranz Gabriela , de Wit Carter Guillermo , García-Albisua Ana Mercedes 
Published: August 2022

Purpose To describe the anatomical and functional outcomes of patients with infectious keratitis (IK) and secondary endophthalmitis who underwent penetrating keratoplasty (PK) after pars plana vitrectomy (PPV) assisted by temporary keratoprosthesis (TKP). Methods An observational retrospective case series was performed. Data were collected from January 2013 to July 2020. Patients over 18 years old with a clinical and microbiological diagnosis of IK, and clinical, ultrasonographic, and or microbiological diagnosis of endophthalmitis were included. Anatomical success was defined as infection resolution with preservation of the ocular globe integrity. No change or improvement of best-corrected visual acuity (VA) at the last follow-up was considered as a functional success. Results A total of 32 eyes of 32 patients were analyzed. The anatomic success was obtained in 87.5% eyes in which the infection was eradicated. The 63% patients maintained or improved their best-corrected VA, 37.5% ended up with hand motion VA. Conclusions Our results suggest that PPV assisted by TKP followed by PKP can be a good approach for treating patients with endophthalmitis secondary to IK while allowing further visual improvement after an optical PK. Further prospective studies need to be done to evaluate final visual rehabilitation of these patients.