bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Atrial Tachyarrhythmia Recurrence on the Development of Long‐Term Adverse Clinical Events Following Catheter Ablation in Patients With Atrial Fibrillation With Systolic Impairment: A Single‐Center Observational Study
Authors: Ishiguchi Hironori , Yoshiga Yasuhiro , Shimizu Akihiko , Ueyama Takeshi , Ono Makoto , Fukuda Masakazu , Kato Takayoshi , Fujii Shohei , Hisaoka Masahiro , Uchida Tomoyuki , Omuro Takuya , Shimokawa Mototsugu , Okamura Takayuki , Kobayashi Shigeki , Yano Masafumi 
Published: February 2022

Background
Catheter ablation can improve long‐term prognosis of patients with atrial fibrillation with systolic impairment. However, atrial tachyarrhythmia (ATA) recurrence increases during long‐term follow‐up. We aimed to investigate the impact of ATA recurrence on the development of long‐term adverse clinical events following catheter ablation for atrial fibrillation and to identify predictors for the development of adverse clinical events.

Methods and Results

This single‐center observational study included 75 patients with systolic impairment (left ventricular ejection fraction <50%) who underwent the first catheter ablation procedure for atrial fibrillation at our institution (median follow‐up period: 3.5 [range: 2.4–4.7] years). We compared the cumulative incidence of adverse clinical events (all‐cause death, heart failure hospitalization, stroke, or acute myocardial infarction) between the groups with and without ATA recurrence following the first and last procedures. Multivariable analyses were performed to identify predictors for developing adverse clinical events. Twenty‐one patients (28%) developed adverse clinical events at a median of 2.2 (range: 0.64–2.8) years following the first procedure. The proportion of freedom from adverse clinical events following the first procedure was significantly lower in the ATA recurrence group than in the nonrecurrence group (41% [n=40] versus 95% [n=35],
P
<0.0005); the proportion following the last procedure also showed a similar tendency (35% [n=26] versus 57% [n=49],
P
<0.0001). ATA recurrence emerged as an independent predictor for adverse clinical events following both procedures after multivariable adjustment.

Conclusions
ATA recurrence following catheter ablation procedure could predict adverse clinical events in patients with atrial fibrillation with systolic impairment.
Microbial DNA Enrichment Promotes Adrenomedullary Inflammation, Catecholamine Secretion, and Hypertension in Obese Mice
Authors: Gao Hong , Jin Zhongmou , Tang Kechun , Ji Yudong , Suarez Jorge , Suarez Jorge A. , Cunha e Rocha Karina , Zhang Dinghong , Dillmann Wolfgang H. , Mahata Sushil K. , Ying Wei 
Published: February 2022

Background
Obesity is an established risk factor for hypertension. Although obesity‐induced gut barrier breach leads to the leakage of various microbiota‐derived products into host circulation and distal organs, the roles of microbiota in mediating the development of obesity‐associated adrenomedullary disorders and hypertension have not been elucidated. We seek to explore the impacts of microbial DNA enrichment on inducing obesity‐related adrenomedullary abnormalities and hypertension.

Methods and Results

Obesity was accompanied by remarkable bacterial DNA accumulation and elevated inflammation in the adrenal glands. Gut microbial DNA containing extracellular vesicles (mEVs) were readily leaked into the bloodstream and infiltrated into the adrenal glands in obese mice, causing microbial DNA enrichment. In lean wild‐type mice, adrenal macrophages expressed CRIg (complement receptor of the immunoglobulin superfamily) that efficiently blocks the infiltration of gut mEVs. In contrast, the adrenal CRIg+ cell population was greatly decreased in obese mice. In lean CRIg
−/−
or C3
−/−
(complement component 3) mice intravenously injected with gut mEVs, adrenal microbial DNA accumulation elevated adrenal inflammation and norepinephrine secretion, concomitant with hypertension. In addition, microbial DNA promoted inflammatory responses and norepinephrine production in rat pheochromocytoma PC12 cells treated with gut mEVs. Depletion of microbial DNA cargo markedly blunted the effects of gut mEVs. We also validated that activation of cGAS (cyclic GMP‐AMP synthase)/STING (cyclic GMP–AMP receptor stimulator of interferon genes) signaling is required for the ability of microbial DNA to trigger adrenomedullary dysfunctions in both in vivo and in vitro experiments. Restoring CRIg+ cells in obese mice decreased microbial DNA abundance, inflammation, and hypertension.

Conclusions
The leakage of gut mEVs leads to adrenal enrichment of microbial DNA that are pathogenic to induce obesity‐associated adrenomedullary abnormalities and hypertension. Recovering the CRIg+ macrophage population attenuates obesity‐induced adrenomedullary disorders.
Effectiveness and Safety of Anticoagulation Therapy in Frail Patients With Atrial Fibrillation
Authors: Kim Daehoon , Yang Pil-Sung , Sung Jung-Hoon , Jang Eunsun , Yu Hee Tae , Kim Tae-Hoon , Uhm Jae-Sun , Kim Jong-Youn , Pak Hui-Nam , Lee Moon-Hyoung , Lip Gregory Y.H. , Joung Boyoung 
Published: February 2022

Background:
Frail patients with atrial fibrillation (AF) are less likely to receive anticoagulation than nonfrail patients with AF despite frailty being associated with poorer clinical outcomes including stroke. Using a population-based cohort, we sought to assess the effectiveness and safety of oral anticoagulants (OACs) in frail patients with AF.

Methods:
This retrospective cohort study analyzed 83 635 patients aged at least 65 years with AF and frailty (≥5 Hospital Frailty Risk Score) between January 1, 2013 and December 31, 2016 from the Korean National Health Insurance Service database. To account for the differences between patients receiving OAC or not and across different OAC regimens, propensity score–weighting was used. Net adverse clinical event, defined as the first event of ischemic stroke, major bleeding, or cardiovascular death, was compared. In addition, each individual outcome was examined separately.

Results:

In the study population (57.1% women; mean age, 78.5±7.2 years), a total of 14 968 net adverse clinical event, 3718 ischemic stroke, 5536 major bleeding, and 6188 cardiovascular death occurred. In comparison with no OAC use, OAC use was associated with lower risks of net adverse clinical event (hazard ratio, 0.78 [95% CI, 0.75–0.82]), ischemic stroke (hazard ratio, 0.91 [95% CI, 0.86–0.97]), and cardiovascular death (hazard ratio, 0.52 [95% CI, 0.49–0.55]), but no difference was observed for major bleeding (hazard ratio, 1.02 [95% CI, 0.95–1.10]). Compared with warfarin, all four individual direct OAC were associated with decreased risks of net adverse clinical event, ischemic stroke, major bleeding, and cardiovascular death. The associations for OAC use (compared to no OAC use) or direct OAC use (compared to warfarin) with favorable outcomes were more prominent in individuals with a higher CHA
2
DS
2
-VASc score of at least 3.

Conclusions:
Among frail patients with AF, OAC treatment was associated with a positive net clinical outcome. Direct OACs provided lower incidences of stroke, bleeding, and mortality, compared with warfarin.
The Tree, the Snake and the Goddess
Authors: Jones Dhivan Thomas 
Published: February 2022

Abstract
Some scholars have argued that early Buddhism offers little theoretical support for an environmental ethics because it regards nature as having no intrinsic value, since it is impermanent and unsatisfactory. I disagree, and argue that the mythic context of the Buddha’s life-story shows the Buddha in an intimate relationship with nature, and gaining Awakening while dependent on it. The Bodhi tree is not just a sacred tree but a symbol of the place of Awakening and a version of the Tree of Life. The mythical snakes or nāgas who support and encourage the Bodhisattva on his way to the Bodhi tree represent chthonic powers of living nature. The Earth Goddess who appears to witness the Bodhisattva’s practice of the perfections represents a culmination of this relationship. Her image derives historically from the Greek goddess Gaia. Nature therefore has an intrinsic value in relation to Awakening.
Christian Affections in Romans 8
Authors: Story J. Lyle 
Published: February 2022

Abstract
Emotions course through Romans 8 and Paul provides numerous reasons (cognitive content) for various emotions, e.g. hope. The Jesus-story and the Holy Spirit (21 references) support Christian affections. This article gives attention to the emotions of hope, freedom, and related joy, comfort, encouragement, security, love, peace, confidence, and gratitude – all leading to confession, adoration, and worship. The approach counters scholarly tendencies to dismiss human emotions. In Romans 8, Paul intends for a feeling response from his Roman readers.
High-Flying Interns: NASA’s Student Airborne Research Program (SARP)
Authors: Schaller Emily L. , Bennett J. Ryan , Blake Donald R. , Kudela Raphael M. , Lefer Barry L. , Martin Melissa Yang , Roberts Dar A. , Shetter Richard E. , Tagg Bruce A. , Kaye Jack A. 
Published: February 2022

Abstract
NASA’s Student Airborne Research Program (SARP) has completed 13 years of airborne student research since its inception in 2009. The 8-week summer internship program provides students, typically rising undergraduate seniors, with an opportunity to get hands-on experience in making Earth system measurements using NASA’s airborne science platforms. Students also make complementary surface-based measurements, analyze airborne and surface data in the context of related data (e.g. coincident satellite measurements or prior-year SARP data), and present results to peers, program leadership, agency management, and the community. The program splits its time between the NASA Armstrong flight facility in Palmdale, California, and the University of California, Irvine. It is implemented with participation of faculty advisors (who provide many of the instruments used) and graduate student mentors, under the overall leadership of the NASA Earth Science Division. Disciplinary foci include atmospheric gases and aerosols, ocean biology, and terrestrial ecology using both in situ and remote sensing instruments. Students are also taken on site visits to nearby laboratories and facilities and attend lectures from visiting faculty and NASA agency personnel. The program engages approximately 30 students per year, with overall approximate gender balance. The program has a high rate of STEM retention, and its alumni are actively engaged in graduate and postgraduate programs in Earth system science and other disciplines. A summary of scientific and programmatic outcomes and a description of how the program has evolved will be presented.
Accuracy of Cirrus Detection by Surface-Based Human Observers
Authors: Kotarba Andrzej Z. , Huu Z˙aneta Nguyen 
Published: February 2022

Abstract
The longest cirrus time series are ground-based, visual observations captured by human observers [synoptic observations (SYNOP)]. However, their reliability is impacted by an unfavorable viewing geometry (cloud overlap) and misclassification due to low cloud optical thickness, especially at night. For the very first time, this study assigns a quantitative value to uncertainty. We validate 15 years of SYNOP observations (2006–20) against data from the cloud lidar flown on board the Cloud–Aerosol Lidar and Infrared Pathfinder (CALIPSO) spacecraft. We develop a dedicated method to match SYNOP reports (with a hemispherical field of view) with lidar samples (along-track profiles). Our evaluation of the human eye’s sensitivity to cirrus revealed that it is moderate, at best. In perfect conditions (daytime with no mid/low-level clouds) the probability of correct detection was 44%–83% (Cohen’s kappa coefficient < 0.6), and this fell to 24%–42% (kappa < 0.3) at night. Lunar illumination improved detection, but only when the moon’s phase exceeded 50%. Cirrus optical depth had a clear impact on detection. When clouds at all levels were considered (i.e., real-life conditions), the reliability of the visual method was moderate to poor: it detected 47%–71% of cirrus (kappa < 0.45) during the day and 28%–43% (kappa < 0.2) at night and decreased with an increasing low/midlevel cloud fraction. These kappa coefficients suggest that agreement with CALIPSO data was close to random. Our findings can be directly applied to estimations of cirrus frequency/trends. Our reported probabilities of detection can serve as a benchmark for other ground-based cirrus detection methods.

Significance Statement
Cirrus clouds heat the atmosphere, so any increase in their frequency will contribute to climate warming. The longest cirrus time series (including the presatellite era) are surface-based detections by a human observer at a meteorological station. Our study is the first to quantitatively evaluate the reliability of these observations. Our results show that, because of the viewing geometry (cloud overlap) and human eye sensitivity, reliability ranges from moderate at best to very low. Nighttime detections are especially unreliable, as well as those in the presence of low/midlevel cloud. Cirrus frequencies and trends calculated from visual observations should, thus, be considered with caution.
Physical Drivers of Ocean Wave Attenuation in the Marginal Ice Zone
Authors: Montiel Fabien , Kohout Alison L. , Roach Lettie A. 
Published: February 2022

Abstract
Despite a recent resurgence of observational studies attempting to quantify the ice-induced attenuation of ocean waves in polar oceans, the physical processes governing this phenomenon are still poorly understood. Most analyses have attempted to relate the spatial rate of wave attenuation to wave frequency, but have not considered how this relationship depends on ice, wave, and atmospheric conditions. An in-depth analysis of the wave-buoy data collected during the 2017 Polynyas, Ice Production, and Seasonal Evolution in the Ross Sea (PIPERS) program in the Ross Sea is conducted. Standard techniques are used to estimate the spatial rate of wave attenuation α, and the influence of a number of potential physical drivers on its dependence on wave period T is investigated. A power law is shown to consistently describe the α(T) relationship, in line with other recent analyses. The two parameters describing this relationship are found to depend significantly on sea ice concentration, mean wave period, and wind direction, however. Looking at cross correlations between these physical drivers, three regimes of ice-induced wave attenuation are identified, which characterize different ice, wave, and wind conditions, and very possibly different processes causing this observed attenuation. This analysis suggests that parameterizations of ice-induced wave decay in spectral wave models should be piecewise, so as to include their dependence on local ice, wave, and wind conditions.

Significance Statement
This work attempts to quantify how ice, wave, and wind conditions in polar oceans affect the way that ocean waves decay as a result of their interactions with sea ice. In situ wave data collected in the Ross Sea are analyzed along with several freely available ice, wave, and wind datasets. A simple relationship is shown to describe how wave attenuation due to sea ice depends on the wave period consistently across all data analyzed. However, the parameters of this relationship are significantly affected by sea ice concentration, mean wave period, and wind direction. This finding suggests that large-scale wave models need to account for this dependence on ice, wave, and wind conditions to improve wave forecast in ice-covered oceans.
The Air-Launched Autonomous Micro Observer
Authors: Jayne Steven R. , Owens W. Brechner , Robbins Pelle E. , Ekholm Alexander K. , Bogue Neil M. , Sanabia Elizabeth R. 
Published: February 2022

Abstract
The Air-Launched Autonomous Micro Observer (ALAMO) is a versatile profiling float that can be launched from an aircraft to make temperature and salinity observations of the upper ocean for over a year with high temporal sampling. Similar in dimensions and weight to an airborne expendable bathythermograph (AXBT), but with the same capability as Argo profiling floats, ALAMOs can be deployed from an A-sized (sonobuoy) launch tube, the stern ramp of a cargo plane, or the door of a small aircraft. Unlike an AXBT, however, the ALAMO float directly measures pressure, can incorporate additional sensors, and is capable of performing hundreds of ocean profiles compared to the single temperature profile provided by an AXBT. Upon deployment, the float parachutes to the ocean, releases the air-deployment package, and immediately begins profiling. Ocean profile data along with position and engineering information are transmitted via the Iridium satellite network, automatically processed, and then distributed by the Global Telecommunications System for use by the operational forecasting community. The ALAMO profiling mission can be modified using the two-way Iridium communications to change the profiling frequency and depth. Example observations are included to demonstrate the ALAMO’s utility.
Buffering Climate Change with Nature
Authors: Hessen Dag O. , Vandvik Vigdis 
Published: February 2022

Abstract
It is increasingly evident that climate sustainability depends not only on societal actions and responses, but also on ecosystem functioning and responses. The capacity of global ecosystems to provide services such as sequestering carbon and regulating hydrology is being strongly reduced both by climate change itself and by unprecedented rates of ecosystem degradation. These services rely on functional aspects of ecosystems that are causally linked—the same ecosystem components that efficiently sequester and store carbon also regulate hydrology by sequestering and storing water. This means that climate change adaptation and mitigation must involve not only preparing for a future with temperature and precipitation anomalies, but also actively minimizing climate hazards and risks by conserving and managing ecosystems and their fundamental supporting and regulating ecosystem services. We summarize general climate–nature feedback processes relating to carbon and water cycling on a broad global scale before focusing on Norway to exemplify the crucial role of ecosystem regulatory services for both carbon sequestration and hydrological processes and the common neglect of this ecosystem–climate link in policy and landscape management. We argue that a key instrument for both climate change mitigation and adaptation policy is to take advantage of the climate buffering and regulative abilities of a well-functioning natural ecosystem. This will enable shared benefits to nature, climate, and human well-being. To meet the global climate and nature crises, we must capitalize on the importance of nature for buffering climate change effects, combat short-term perspectives and the discounting of future costs, and maintain or even strengthen whole-ecosystem functioning at the landscape level.

Significance Statement
Natural ecosystems such as forests, wetlands, and heaths are key for the cycling and storage of water and carbon. Preserving these systems is essential for climate mitigation and adaptation and will also secure biodiversity and associated ecosystem services. Systematic failure to recognize the links between nature and human well-being underlies the current trend of accelerating loss of nature and thereby nature’s ability to buffer climate changes and their impacts. Society needs a new perspective on spatial planning that values nature as a sink and store of carbon and a regulator of hydrological processes, as well as for its biodiversity. We need policies that fully encompass the role of nature in preventing climate-induced disasters, along with many other benefits for human well-being.
Comparison of Narrative Video and Flipchart Presentation to Promote Cervical Cancer Screening Among Latinas Along the Border
Authors: Calderón-Mora Jessica , Alomari Adam , Shokar Navkiran 
Published: February 2022

Introduction Cervical cancer incidence and mortality is higher among Latinas compared with non-Hispanic White women and barriers to screening include lack of knowledge, lack of access to health care, and cultural factors. Both video and printed material have been found effective as health education tools in underserved populations. The purpose of this study was to show no difference between a flipchart presentation facilitated by a community health worker and a narrative video with limited in-person interaction in increasing cervical cancer screening rates among Latinas along the U.S.–Mexico border. Methods Study design: Randomized controlled study. Participants: women in a community-based cervical cancer screening program. Outcomes Primary outcome was screening completion and secondary outcomes were changes in psychosocial variables. Results Total sample size was 500. Most participants were born in Mexico, had a low annual income, preferred Spanish, and did not have a regular doctor. Overall, 371 (74.2%) participants completed screening. There was no significant difference in screening completion between educational delivery modes. The only variable significantly associated with screening completion was age, with 51- to 65-year-olds being 44% more likely than 21- to 40-year-olds to have a Pap test. The only psychosocial variable that was significantly different by delivery mode was perceived susceptibility. The majority of all participants found both the video and flipchart presentation to be acceptable. Conclusion A health promotion program delivered via self-administered video or PowerPoint slides showed no difference in increasing cervical cancer screening rates.
Rehabilitation in the Setting of Untreated Cancer-Associated Acute Deep Vein Thrombosis
Authors: Pally Annie , Tennison Jegy 
Published: February 2022

Objective: Research is needed to guide the timing and safety of rehabilitation (physical and occupational therapy) in patients with acute deep venous thrombosis (DVT) that is untreated due to contraindications. Case Description: A 21-year-old man with Hodgkin lymphoma was admitted to the hospital for neutropenic fever. He developed gastrointestinal bleeding, diffuse alveolar hemorrhage, and bilateral lower-extremity DVT. He was not a candidate for chemical anticoagulation or placement of an inferior vena cava filter owing to thrombocytopenia. Rehabilitation was initially deferred because of concern that the thrombus could travel to the lungs, causing a pulmonary embolism. Rehabilitation was, however, started 4 days after the initial diagnosis of lower-extremity DVT to assess functional mobility and activities of daily living skills to prepare for discharge from the hospital. Results: The patient experienced no bleeding events during rehabilitation, and his acute, untreated DVT did not propagate based on clinical assessment. His Activity Measure for Post-Acute Care (AM-PAC) “6 Clicks” Basic Mobility score improved from 30.25 to 35.55 over the period of 11 days while he received rehabilitation. Conclusion: Despite having an acute bilateral lower-extremity DVT that was untreatable owing to thrombocytopenia, the patient successfully participated in rehabilitation and improved his physical functional status without an adverse event. Untreated acute venous thromboembolism in the setting of recent history of major bleeding raise concerns about physical activity restrictions. It is critical to consider both the risks and benefits of mobilizing patients and prescribing exercises in patients with these conditions.