bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tropical Intraseasonal Variability Response to Zonally Asymmetric Forcing in an Idealized Moist GCM
Authors: MacDonald Cameron G. , Ming Yi 
Published: September 2022

Abstract
The tropical intraseasonal variability in an idealized moist general circulation model (GCM) coupled to a slab ocean is investigated. The model has a simple moist convection scheme and realistic radiative transfer, but no parameterization of cloud processes. In a zonally symmetric aquaplanet state, variability is dominated by westward-propagating Rossby waves. Enforcing zonal asymmetry through the application of a prescribed ocean heat flux in the bottom boundary leads to the development of a slow, eastward propagating mode that bears some of the characteristics of the observed Madden–Julian oscillation (MJO). When the ocean heat flux is made stronger, high-frequency Kelvin waves exist alongside the MJO mode. The strength of the disturbances and the spatial distribution of their precipitation anomalies are sensitive to the strength of intraseasonal sea surface temperature (SST) anomalies. The greatest resemblance to the MJO is observed when shallow slab ocean depths (1 m) are used, but the mode still exists at deeper slabs. Sensitivity experiments to the parameters of the convection scheme suggest that the simulated MJO mode couples to convection in a way that is distinct from both Kelvin and Rossby waves generated by the model. Analysis of the column moist static energy (CMSE) budget of the MJO mode suggests that column radiative heating plays only a weak role in destabilizing the mode relative to the stabilizing contribution of vertical advection. The CMSE budget analysis highlights the importance of the life cycle of horizontal advection for the destabilization and propagation of the MJO. Synergies between the generated MJO mode and linear theories of the MJO are discussed as well.
Violence without Truce: Hondurans in the Gulf of Mexico Corridor
Authors: Rodríguez L. María Teresa 
Published: September 2022

The Mexican states of Chiapas and Tabasco have for decades been linked to Central American migrations, largely through cross-border labor mobility. Today, however, the diversification of receiving areas in Mexico requires focusing attention on how the dynamics of mobility, settlement, and/or transit impact new contexts. The state of Veracruz, part of the so-called Gulf of Mexico corridor that connects the country’s southern and northern borders on the east, has emerged as an unplanned destination—a place of temporary or permanent residence—for Central American migrants, especially Hondurans. Examination of the types of violence experienced by in-transit undocumented migrants and temporary or permanent residents in the area shows how the coercive migration policies of the Mexican government contribute to maintaining a continuum of violence that affects people “trapped in mobility.” Los estados mexicanos de Chiapas y Tabasco han estado vinculados durante décadas a las migraciones centroamericanas, en gran parte a través de la movilidad laboral transfronteriza. Hoy, sin embargo, la diversificación de las áreas receptoras en México requiere que enfoquemos la atención en cómo la dinámica de movilidad, asentamiento y/o tránsito impacta en nuevos contextos. El estado de Veracruz, parte del llamado corredor del Golfo de México que conecta las fronteras sur y norte del país en el lado este, se ha convertido en un destino no planificado, un lugar de residencia temporal o permanente, para los migrantes centroamericanos, especialmente los hondureños. Un análisis de los tipos de violencia que experimentan los migrantes indocumentados en tránsito y los residentes temporales o permanentes en la zona muestra cómo las políticas migratorias coercitivas del gobierno mexicano contribuyen a mantener un ciclo de violencia que afecta a aquellos “atrapados en la movilidad”.
Reducing Negative Aging Stereotypes via Educational Intervention in Older People: A Randomized Controlled Study
Authors: Doncel-García Borja , Lizaso Izarne , Fraile-Bermúdez Ana Belén , Mosquera-Lajas Álvaro , Santamaría-Trincado Beatriz , Sanz Begoña , Irazusta Jon 
Published: September 2022

Anti-ageism interventions traditionally target younger individuals. We analyzed the effect of an educational intervention that combined an infusion of aging content with videos to reduce negative stereotypes toward aging in a randomized controlled study of 56 community-dwelling older adults. The experimental group received a single one-hour information session and video viewing on ageism; the control group viewed 1 hour of videos unrelated to ageism. Repeated-measures ANOVA indicated that the experimental group reported a significantly reduced Negative Stereotypes Toward Aging Questionnaire (CENVE) total score along with an independent measure of the character–personality factor in this questionnaire 1 week and 1 month after the intervention compared to baseline. The control group showed no changes. This work reports for the first time that a one-hour information session about aging combined with video viewing on ageism can efficiently reduce negative stereotypes of aging in older people in the short and medium term.
Long-Term Comparison of Aortic Arch Replacement with or without Elephant Trunk Procedure via Retrograde Cerebral Perfusion for Aortic Arch Dissection
Authors: Kirali Kaan , Ömeroğlu Suat N. , Ardal Hasan , Toker Mehmet E. , Erdoğan Hasan B. , Dağlar Bahadir , Balkanay Mehmet , İpek Gökhan , Işik Ömer , Yakut Cevat 
Published: September 2022

Objective The aim of this study is to investigate the effects of the duration of retrograde cerebral perfusion (RCP) in patients with aortic arch dissection. Methods Between 1993 and December 2000, 56 patients were operated on for aortic arch dissection. Elephant trunk procedure was performed in 28 patients (Group A) and semiarcus replacement in 28 patients (Group B). Type I dissection ( P=0.003), chronic ethiology ( P=0.006), medial degeneration ( P<0.001), and preoperative hemodynamic instability ( P=0.004) were observed significantly more in Group A. In both groups RCP was used for cerebral protection. Results Hospital mortality was higher in Group A than Group B (32.1% versus 7.1%; P=0.015). Late mortality was observed only in Group A (10.5%; P=0.049). Actuarial survival was 55.1±11.55% in Group A and 91.67±5.64% in Group B at 5 yr ( P=0.0113). while cumulative survival for all patients was 78.38±5.77% at 5 yr. RCP time was longer in Group A (62.7±16.8 versus 34.2±19.5 min; P<0.001). Forward stepwise logistic regression analysis showed that chronic obstructive pulmonary disease ( P=0.014) and renal insufficiency ( P=0.004) were significantly predictors for hospital mortality, whereas elephant trunk ( P=0.052) and RCP (>60 min) ( P=0.175) did not increase early mortality. Only hemodynamic instability was significantly ( P=0.006) predictors for late mortality. Conclusions Preoperative severity of dissection, hemodynamic instability or organ dysfunctions impair early or late outcome. Elephant trunk technique with increased RCP time do not increase early or late mortality. To shorten RCP time (<60–65 min) can improve surgical results.
Assessment of Left Mammary Artery Grafts (LIMA) to Left Anterior Descending Artery (LAD) after Off-Pump Coronary Artery Bypass Grafting by Color Doppler
Authors: Driever R. , Fuchs S. , Schmitz E. , Vetter H. O. 
Published: September 2022

Background: Off-pump coronary artery bypass grafting (OPCAB) on a beating heart with a LIMA graft to the LAD is established for patients with one vessel disease. The aim of the study was to assess the LIMA patency noninvasive by transcutaneous duplex ultrasound. Methods: 25 patients (16 male, 9 female, mean age 58±13 yr) with LIMA grafts to LAD by OPCAB procedures were studied 7–20 days after surgery. Doppler velocity parameters were measured by use of a 7 MHz transducer placed in left intercostal space. The conventional coronary angiographies performed showed the LIMA graft patent. Results: In all cases a typical biphasic pattern of blood flow was recorded with forward flow in both systole and diastole respectively. Under basal conditions the mean peak velocities in systole were 0.36 m/s and the mean peak velocities in diastole were 0.27 m/s with a mean systolic/diastolic ratio of 1.33. Conclusion: Transcutaneous Doppler ultrasound is useful in the detection of the LIMA graft flow. This non-invasive technique may find applications for routine postoperative follow-up of patients with LIMA grafts.
Hemorrhage Related Reexploration following Open Heart Surgery: The Impact of Pre-Operative and Post-Operative Coagulation Testing
Authors: Hall Timothy S. , Sines Jean C. , Spotnitz Alan J. 
Published: September 2022

Purpose: Our objective was to determine the association of pre-operative and post-operative coagulation testing abnormalities with the cause of post-operative bleeding requiring re-exploration following cardiac surgery. Methods: Retrospective chart review of post-operative bleeding and the incidence of re-exploration for hemorrhage in 2263 adult patients undergoing elective and emergency open heart surgery which included coronary artery bypass, valvular, and combined valve coronary procedures. Results: Eighty-two patients (3.6%) required re-exploration. Sixty-six percent had surgical bleeding; the remaining 34% were coagulopathic (no surgical site found). The pre-operative PT and ACT were significantly elevated in coagulopathic patients ( P<0.005). Post-operative ACT, PT, and APTT were increased and fibrinogen levels were decreased in coagulopathic patients ( P<0.05). Conclusions: Pre-operative testing (ACT, PT) weakly correlated with post-operative coagulopathy. Post-operative coagulation abnormalities were identified with high risk ratios and good diagnostic accuracy when using testing cut-off values to assist in surgical decision making.
Predictors of Nephrological Morbidity after Coronary Artery Bypass Surgery
Authors: Janssen Douglas P. B. , Noyez Luc , van Druten Johannes A. M. , Skotnicki Stefan H. , Lacquet Leon K. 
Published: September 2022

Aim: The aim of this study was to analyse the nephrological morbidity after myocardial revascularization. Methods and results: We analysed the pre- per and postoperative data of 3815 patients who underwent a primary isolated coronary bypass grafting between January 1987 and December 1995. Nephrological complications were divided into renal dysfunction and requiring dialysis. The increase in nephrological complications (1.2–4%) is the result of an increase of patients with renal dysfunction. Unifactorial risk analysis identified age, diabetes, hypertension, nephrological pathology, perfusion time, aortic cross-clamp time, emergency operation and perioperative myocardial infarction as risk factors. Multifactorial risk analysis identified age, diabetes, hypertension, nephrological pathology, perfusion time, perioperative myocardial infarction and the cohorts operated upon in 1990–92, 1993–95 as independent risk factors for renal dysfunction, and age, nephrological pathology and perioperative myocardial infarction for those needing dialysis. Conclusion: Several variables have been identified as risk factors for nephrological complications; especially important are pre-existing nephrological pathology and perioperative myocardial infarction.
Computed Tomography-Detected Abnormalities following Conventional AAA Repair
Authors: Libertiny G. , Gibson M. , Torrie E. P. H. , Magee T. R. , Galland R. B. 
Published: September 2022

Purpose: To determine how time since the operation influences vascular abnormalities following conventional infrarenal abdominal aortic aneurysm (AAA) repair. Methods: In 47 patients computed tomography was performed 1 to 12 years following the aneurysm repair. Aortic diameters at different levels were measured and other abnormalities recorded. Results: Significant correlation was found between time since operation and diameter of the suprarenal aorta ( R= 0.51. P<0.001) but not with aortic neck diameter ( R=–0.10, P= 0.48) or diameter of the prosthetic graft ( R= 0.07, P= 0.66). However, measured diameters of graft and aortic neck showed a significant positive correlation ( R= 0.40. P= 0.005). Conclusions: Dilatation of the suprarenal aorta has a different pattern from aortic neck dilatation. The latter showed correlation with the diameter of the prosthetic graft. This may be of interest for future design of endovascular stent-grafts.
Intraoperative Transesophageal Echo-Doppler Evaluation of Stentless Aortic Xenografts. Incidence and Significance of Moderate Gradients
Authors: Morocutti G. , Gelsomino S. , Spedicato L. , Frassani R. , Bernardi G. , Da Col P. , Paparella G. , Fioretti P. , Livi U. 
Published: September 2022

Background: The aim of this study was to assess the utility of intraoperative transesophageal echocardiography (TEE) in the evaluation of patients undergoing aortic valve replacement with the CryoLife-O'Brien® (CLOB) Stentless Porcine Aortic Bioprosthesis. Methods: Between May 1994 and March 1995, 26 patients (15 men, mean age 68.4±10.78 years) had a CLOB valve in the aortic position. Transprosthetic gradients and valve regurgitation were detected by intraoperative TEE. Prosthetic regurgitation and transvalvular gradients were evaluated at six-month intervals using transthoracic echo-Doppler (TTE). Results: The majority of implants resulted in low gradients (83.7%), with only four patients exhibiting a moderate gradient (15.3%). Color flow Doppler imaging showed central aortic regurgitation in only four of 25 patients (trivial, n = 4; mild, n = 1). There was one paravalvular leak (trivial. n= 1). At follow-up examination (mean 37±12 months), 24 of 25 patients exhibited low mean gradients (7.25±2.81 mmHg). At follow-up one patient who had low velocities in the LVOT at perioperative evaluation exibited a moderate gradient (45 mmHg) with an effective orifice area of 0.8–0.9 cm2. Conclusions: Intraoperative TEE was effective in assessing prosthetic stentless valve function.
Surgical Results of Aortic Valve Replacement via Partial Upper Sternotomy: Comparison with Median Sternotomy
Authors: Masiello Paolo , Coscioni Enrico , Panza Antonio , Triumbari Franco , Preziosi Giuseppe , Di Benedetto Giuseppe 
Published: September 2022

Background: the theoretical advantages of mini-invasive cardiac surgery are shorter hospitalisation, better surgical results and costs reduction. In November 1997 we started a non-coronary mini-invasive surgery program using a partial upper median sternotomy. This study has been conceived to retrospectively compare two groups of patients who underwent isolate aortic valve replacement using the conventional and the mini-invasive technique. Material and methods: in Group A 100 patients (mean age 62±12 years; 58 male) underwent isolated aortic valve replacement through a partial upper median sternotomy. Group B was composed by the last 100 patients (mean age 63±8 years; 56 male) who underwent the same operation through a conventional median sternotomy. For both groups we recorded the ECC and ischaemic times, postoperative intubation time, total postoperative bleeding, intensive care unit length of stay and total hospitalisation time. Major and minor complications were reported. Results: operating times, were significantly longer in Group A (p<0.001). Mechanical ventilation time, 1CU and total hospital stay, and total postoperative bleeding showed no significant difference. Adjunctive statistical evidenced the absence of learning curve. Mortality and other complications failed to reveal any significant difference between the two groups. Conclusions: in our experience, partial upper median sternotomy does not increase surgical risks but failed to demonstrate clear advantages. Apart for an increase in operating times, the surgical results are similar to those of a conventional median sternotomy with only improvement in the aesthetical aspect. In our opinion, this supports the conviction that this approach can be proposed to selected patients, to obtain a better cosmethical result for the same given risk.
The Impact of the Duration of Mechanical Ventilation on the Respiratory Outcome in Smokers Undergoing Cardiac Surgery
Authors: Ngaage D. L. , Martins E. , Orkell E. , Griffin S. , Cale A. R. J. , Cowen M. E. , Guvendik L. 
Published: September 2022

Study objective. To determine the impact of the duration of mechanical ventilation on the rate of pulmonary complications in smokers undergoing cardiac surgery. Methods: Retrospective analysis of 2163 patients who underwent elective cardiac surgery between September 1993 and August 1999. Based on a 3-month preoperative smoking cessation, patients were classified as smokers, ex-smokers and non-smokers. Their postoperative pulmonary complications were compared and related to the duration of mechanical ventilation. Results: Postoperative pulmonary complications were twice as common in smokers (29.5%) as non-smokers (13.6%) and ex-smokers (14.7%). Although smokers required a longer duration of mechanical ventilation, this was not statistically significant. Smokers had a higher rate of increase in postoperative pulmonary complications beyond 6 h of mechanical ventilation (P<0.002). Conclusion: Prolonged mechanical ventilation in active smokers undergoing cardiac surgery is associated with a significant increase in the respiratory morbidity. Surgical strategies that allow early extubation may improve the respiratory outcome in smokers.
Surgical Treatment of Abdominal Aortic Aneurysms Associated with Aortic Valve Incompetence: Strategies and Outcomes
Authors: Neri E , Toscano T. , Massetti M. , Frati G. , Buklas D. , Tucci E. , Capannini G. , Mondillo S. , Picchi A. , Guerrini F. , Sassi C. 
Published: September 2022

Background: The exact incidence of associated aortic valve incompetence (AVI) and abdominal aortic aneurysm (AAA) in the general population is not known. In recent years, we have observed this association with increasing frequency. This observation is probably due to the extensive preoperative screening of the cardiac and vascular status of patients who are candidates for surgical procedures. The choice of the optimal surgical strategy is needed to achieve low operative morbidity and mortality. The present study reviews our experience with a subset of patients suffering the association of AVI and large AAA. Surgical strategy, clinical management and outcome are presented. Methods: Between January 1982 and May 2000, 76 patients with the association of AAA and AVI have been evaluated in our institution. Forty-four patients have been treated for both AAA and aortic valve (AV) regurgitation. These patients have been divided into three groups on the basis of the surgical strategy adopted. Group 1: combined procedure (16 patients); group 2: AAA repair prior to AV surgery (nine patients); group 3: AV surgery prior to aneurysm repair (19 patients). Results: Hospital mortality was 4.5% (two patients); overall mortality was 6.8% (three patients). Conclusions: In patients with AAA and AVI. an accurate and complete preoperative evaluation is essential. Surgical strategy should be individualized on the basis of the cardiac preoperative status.
Radial Artery Grafts: Surgical Anatomy and Harvesting Techniques
Authors: Galajda Z. , Jagamos E. , Maros T. , Péterffy Á. 
Published: September 2022

At present more and more surgeons are using the radial artery as a graft for coronary bypass. The statistics until now show that the patency of radial grafts exceeds that of the venous grafts used up to the present. In our department we used radial artery for coronary bypass in 515 patients between January1990 and December 2000. The radial artery harvesting with minimally invasive technique developed by us was applied in 50 of these patients while the rest were performed with the traditional method. No ischemic complications occurred in forearm or hand following either of the methods. One year after the operation we carried out control examinations on 197 consecutive patients. Our surveys showed that following the traditional technique of radial artery harvesting neurological complications (temporary dysaesthesia) occurred in 16.5% of the patients. After the minimally Invasive procedure, temporary dysaesthesia occurred in one case (2%). These complaints ceased within 1–12 months (an average of 3.8 months). Definitive neurological complications did not occur in any of the patients. In summation, we experienced that both operating techniques can be safely applied. The proportion of temporary neurological complications is higher following the traditional procedure, therefore, further development and application of the minimally invasive procedure should be considered.
Full Sternotomy with Minimal Skin Incision for Congenital Heart Surgery
Authors: Jun Tae-Gook , Park Pyo Won , Lee Young Tak , Park Kay-Hyun , Sung Kiick , Kang I. Seok , Lee Heung Jae 
Published: September 2022

Purpose: The purpose of this paper is to analyze the feasibility of the full sternotomy with minimal skin incision and its related complications and risks. Methods: A total of 405 patients with simple congenital heart disease underwent open heart surgery exclusively under full sternotomy with minimal skin incision. We reviewed the available medical records of the patients retrospectively. Bypass time, aorta cross clamp time, and period of hospital stay were compared with the control group (223 patients with standard long skin incision). Results: Full sternotomy with minimal skin incision provided adequate surgical views and successful repair was done in all patients. There was no mortality. One patient had chylopericardium after the operation and another patient had a postoperative bleeding at the sternum. Minimal skin incision took the similar aorta cross-clamp time and total cardiopulmonary bypass time compared with full skin incision in atrial septal defect patients. Among the ventricular septal defect patients, minimal skin incision took a little longer aorta cross-clamp time (10%). but similar total cardiopulmonary bypass time compared with full skin incision. Conclusion: Minimal skin incision with full sternotomy provides improved cosmetic results. There was no increased mortality and morbidity using minimal access. It can be applied to more complex congenital heart disease contrast to other minimal invasive techniques for atrial septal defect.