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Ecological and health risk assessment of heavy metals: a case study of residential waste sites in Umuahia, South-East Nigeria. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:360. [PMID: 36735077 DOI: 10.1007/s10661-023-10930-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
This study assessed the human health hazards and ecological risks of heavy metals from waste sites in residential vicinity. The heavy metals analyzed were Cr, Pb, Cd, Ni, Cu, and Zn. A total of 40 soil samples were collected from waste sites in two residential estates located in the urban and suburb areas of Umuahia, Abia state. Results revealed a trend in concentrations of the heavy metals for both sites in the following order: Cu > Ni > Zn > Cr > Cd > Pb. The concentrations of heavy metals were higher in rural soils than in urban soil. The contamination factor (CF) indices for Pb, Cr, Cu, Ni, and Zn were less than 1 for both sites, signifying a low contamination scenario. The contamination factor for Cd (6 > CF) for both sites indicated a very high contamination status. The estimated degree of contamination (Cdeg) was less than the lower threshold of 8.0, denoting a low degree of contamination. Cd was the highest contributor to ecological risk with Er index value of 184.2 among measured heavy metals. The overall potential ecological risk index for urban and rural sites are 187.1 and 196.1 respectively, classifying the sites as moderate risk. The overall non-carcinogenic hazard index values (HI) for adults and children in urban and rural soils are 0.00248, 0.0198 and 0.0028, 0.0223 respectively, which are below the acceptable limit (HI < 1), indicating that the exposed residents are unlikely to experience any apparent adverse health hazards. However, children are more susceptible to non-carcinogenic hazards than adults in the study areas.
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Leadless Epicardial Pacing at the Ventricular Apex: An Animal Study. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
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Domain formation in model lipid–cholesterol liquid-crystalline aggregation. MOLECULAR SIMULATION 2022. [DOI: 10.1080/08927022.2022.2134567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Association and outcomes of vf according to involved coronary artery in STEMI – a nationwide analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ventricular fibrillation (VF) is common in acute ST segment elevation myocardial infarction (STEMI) and is associated with increased in-hospital mortality rate.
Purpose
We sought to investigate the association between VF and artery involved in STEMI
Methods
This is a retrospective observational study of hospitalizations between January 1, 2016 and December 31, 2019, using the National Inpatient Sample (NIS), the largest all-payer public database of hospital care in the United States.
Results
A total of 138,201 patients were primarily hospitalized for STEMI from 2016 to 2019. Among them 12,318 had right coronary artery (RCA) lesions, 427 had left main (LM) lesions, 2381 had left circumflex (LCx) lesions and 12,765 had left anterior descending (LAD) lesions. Mean age of patients with VF and STEMI was 62 years and that with RCA (63 years), LM (65 years), LCx (62 years), LAD (60 years), p<0.001. Females were 30.5% (n=42,231) among all STEMI group and 29.8% (n=3672) RCA, 29% (n=124) LM, 27.4%(n=653) LCx and 28.6%(n=3645) LAD, p<0.001. In-hospital mortality for all patients with STEMI was 7.9%. The in-hospital mortality associated with STEMI there was 5%, 23.4%, 6.6%, 7.1%, (p<0.001) for RCA, LM, LCx and LAD respectively. The incidence of VF among all patients with STEMI was 8.3% (n=11425) and for LM, LAD, LCX, and RCA was 12.9%, 10.7%, 9.2% and 7.9% (p<0.001). Mean hospital length of stay for VF with RCA (6.2 days), LM (5.5 days), LCx (6.9 days) and LAD (7.4 days). After adjusting for age, gender, race, income, comorbidities, hospital teaching status, region and year, patients with STEMI who had VF had higher odds of mortality (aOR 6.4, 95% CI, 6.1 to 6.8; P<0.001). The highest likelihood of mortality observed in patients with VF who had and LCx STEMI (aOR 7.9, CI 95%, 5 to 12.4; p<0.001) followed by RCA STEMI (aOR 7.4, 95% CI 6 to 9.1; p<0.001), and LM STEMI (aOR 6.1, 95% 3.1 to 12; p<0.001).
Conclusion
Highest in-hospital mortality was observed in patients with STEMI who had VF in LCx, followed by RCA and LM. There was higher occurrence of VF in STEMI involving LM.
Funding Acknowledgement
Type of funding sources: None.
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Patient activation and health-related quality-of-life in association with smartwatch alerts for atrial fibrillation detection. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Smartwatches with various alert systems are becoming increasingly popular in the detection of atrial fibrillation (AF) post stroke, however their impact on psychological well-being remains unknown.
Purpose
Assess the association between smartwatch alerts for detected atrial fibrillation in older stroke survivors and patient activation as well as health-related quality-of-life.
Methods
Data were used from the Pulsewatch study, a multiphase, randomized controlled trial, which enrolled older adults (≥50 years of age) from the UMass Memorial Health System with history of a stroke and no contraindications to anticoagulation, who were given a smartwatch for AF detection. In Phase I, participants were randomized 3:1 (intervention:control) to receive a smartwatch/smartphone pair and an FDA-approved cardiac patch monitor or only the patch (control) to monitor for AF for 14 days. In Phase II, participants were re-randomized 1:1, with the intervention group being offered the smartwatch/smartphone pair for an extra 30 days. Participants were grouped into those receiving at least one alert of a possible abnormal rhythm versus those who did not receive any alerts from their smartwatch. At baseline, 14 days, and 44 days the Consumer Health Activation Index was used to assess patient activation and the Physical and Mental Component Summary of Short-Form Health Survey were utilized to evaluate physical and mental health-related quality-of-life, respectively. Mixed-effects repeated measures linear regression models were used to examine changes in patient activation and physical and mental health-related quality-of-life, in relation to alerts, adjusting for confounding variables including age, sex, race, history of arrhythmias, history of congestive heart failure, history of coronary artery disease, baseline depression, and baseline cognitive impairment, over the study period.
Results
94 participants (64.6±9.1 years of age, 87.2% non-Hispanic white, and 43.6% female) were included in the analysis; 16 of whom received at least one alert. Specifically, twelve participants received 1 to 3 alerts, three participants received 11 to 18, and one participant received 226. In fully adjusted models, receiving alerts was not associated with changes in patient activation or mental health-related quality-of-life (β −1.70, p-value 0.60 and β 2.85, p-value 0.09 respectively), but was associated with a significant reduction in physical health-related quality-of-life (β −4.67, p-value 0.04).
Conclusions
In a cohort of older stroke survivors who wore smartwatches for up to 44 days, reception of alerts was not significantly associated with changes in patient activation or mental health-related quality-of-life but was significantly related to a decline in physical health-related quality-of-life. Further studies are necessary to explore the use of smartwatches in AF screening and their impact on psychological health and quality-of-life.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): R01HL137734 from the National Heart, Lung, and Blood Institute
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Periprocedural outcomes of transcatheter aortic valve replacement (TAVR) in patients with and without cardiac amyloidosis-analysis from 2016–2019 national inpatient sample. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac Amyloidosis is often misdiagnosed due to its non-specific presenting symptoms. There is a lack of evidence on the clinical outcomes in patients with cardiac amyloidosis undergoing transcatheter aortic valve replacement (TAVR).
Purpose
To study periprocedural outcomes in patients hospitalised primarily for TAVR with and without cardiac amyloidosis.
Methods
This is a retrospective observational study involving index hospitalizations for TAVR between January 1, 2016 to December 31, 2019 from the National Inpatient Sample (NIS), the largest all-payer public database of hospital care data in the United States. Our study sample included discharged adult patients (≥18 years) primarily hospitalised for TAVR using ICD-10 codes. Confounders were adjusted using multivariable regression analysis.
Results
During 2016–2019, there were 43270 principal hospitalizations (unweighted sample) identified for TAVR, among them 4999 patients had a history of cardiac amyloidosis. Mean age was 79.3±8.4 years. Among patients hospitalised for TAVR, 54.4% (n=23539) were males, 45.6% (n=19731) were females (p<0.001), 1.71% (n=740) developed cardiogenic shock, 1.53% (n=662) required mechanical ventilation with an in-hospital mortality of 1.3% (n=563). There were 87% Whites, 4.2% Blacks, 4.8% Hispanics, 1.3% Asians, and 2.7% were other races. A total of 23,819 (55.1%) hospitalizations had a Charlson Comorbidity Index (CCI) of three or higher.
After undergoing TAVR, compared to the non-cardiac amyloidosis cohort, the cardiac amyloidosis cohort had less females (27.8% vs 45.6%, p=0.01), had similar age (mean age: 80.2 vs 79.3; p=0.665), higher incidence of congestive heart failure (CHF) (100% vs 74%, p=0.012), higher mechanical ventilation requirement (11.1% vs 1.5%, p=0.001)) but with a similar length of hospital stay (3.9% vs 3.9%, p=0.99). Multivariate regression analysis revealed that TAVR in cardiac amyloidosis cohort did not significantly increase the odds of in-hospital mortality than the non-cardiac amyloidosis cohort (aOR: 5.2; 95% CI: 0.7, 38.3; p=0.103). However, females had higher odds of mortality post-TAVR compared to males (aOR: 1.45; 95% CI: 1.22, 1.73; p<0.001) after controlling for age, sex, race, regional hospital location, hospital bed capacity, income, and CCI. There is an increasing trend of index TAVR hospitalizations with cardiac amyloidosis with 109.4 per 100,000 hospitalizations in 2016, 139.7 per 100,000 in 2017, 157.5 per 100,000 in 2018, 201.4 per 100,000 in 2019 (p trend<0.001).
Conclusions
After TAVR, cardiac amyloidosis is associated with higher incidence of CHF increased need for mechanical ventilation, similar in-hospital mortality rate in comparison to non-cardiac amyloidosis cohort. There was an increasing trend in the index hospitalizations for TAVR with cardiac amyloidosis from 2016–2019.
Funding Acknowledgement
Type of funding sources: None.
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Repeat Radiofrequency Catheter Ablation of Atrial Tachycardias in Patients with Congenital Heart Disease. J Cardiovasc Electrophysiol 2022; 33:943-952. [PMID: 35199408 DOI: 10.1111/jce.15422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Atrial tachycardias (AT) in patients with congenital heart disease (CHD) are significantly contributing to morbidity and mortality. Aim of this study was to evaluate the long-term course of CHD patients requiring repeat ablation procedures (RAP) of AT. PATIENTS AND METHODS All 144 patients with CHD who had undergone ablation of AT at our center between January 2003 and October 2018 were enrolled. Patients were classified according to complexity of CHD: complex CHD (cCHD), moderate CHD (mCHD) and simple CHD (sCHD). RESULTS A total of 101 RAP were performed in 64 patients. One RAP was performed in n=40, two in n=13, three in n=10 and 5 in n=1. Acute success rate was 82% (83/101) and was not associated with complexity of CHD (p=1.0). Number of procedures was lower in patients with sCHD than in patients with mCHD and cCHD (sCHD 1.3±0.6, mCHD 1.8±1.0 and cCHD 1.8±1.1, p=0.04). RAP were most frequent in patients after Fontan palliation or Atrial switch procedure (2.0±1.1 (n=41) vs. 1.6±0.9 all others, p=0.016) and in patients with multiple unstable AT´s (2.5±1.1 (n=11) vs. 1.7±1.0, p=0.008). Major complications occurred in 4/101 procedures. Complete follow-up was available in 125 patients. Since last RAP 73% of the patients were in sinus/atrial rhythm and 34/125 patients (27%) with AT recurrence did not require re-ablation with mean follow-up of 52±40 months. CONCLUSIONS Recurrences after ablation of AT in CHD patients were frequent. After RAP promising long-term results could be achieved. Data encourage repetitive ablation procedures in this patient population. This article is protected by copyright. All rights reserved.
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A Review of the EUSO-Balloon Pathfinder for the JEM-EUSO Program. SPACE SCIENCE REVIEWS 2022; 218:3. [PMID: 35153338 PMCID: PMC8807436 DOI: 10.1007/s11214-022-00870-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
EUSO-Balloon is a pathfinder for JEM-EUSO, the mission concept of a spaceborne observatory which is designed to observe Ultra-High Energy Cosmic Ray (UHECR)-induced Extensive Air Showers (EAS) by detecting their UltraViolet (UV) light tracks "from above." On August 25, 2014, EUSO-Balloon was launched from Timmins Stratospheric Balloon Base (Ontario, Canada) by the balloon division of the French Space Agency CNES. After reaching a floating altitude of 38 km, EUSO-Balloon imaged the UV light in the wavelength range ∼290-500 nm for more than 5 hours using the key technologies of JEM-EUSO. The flight allowed a good understanding of the performance of the detector to be developed, giving insights into possible improvements to be applied to future missions. A detailed measurement of the photoelectron counts in different atmospheric and ground conditions was achieved. By means of the simulation of the instrument response and by assuming atmospheric models, the absolute intensity of diffuse light was estimated. The instrument detected hundreds of laser tracks with similar characteristics to EASs shot by a helicopter flying underneath. These are the first recorded laser tracks measured from a fluorescence detector looking down on the atmosphere. The reconstruction of the direction of the laser tracks was performed. In this work, a review of the main results obtained by EUSO-Balloon is presented as well as implications for future space-based observations of UHECRs.
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1080 An Audit on Compliance with Recommended Duration of Surgical Antimicrobial Prophylaxis in St. Vincent’s University Hospital, Dublin, Ireland. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Surgical site infection (SSI) is a common healthcare-associated infection, and a frequent cause of post-operative morbidity. SSI comprises any infection of the operative incision, cavity or involved organ, that occurs within the 30-day post-operative period. Antimicrobial prophylaxis is critical in reducing SSIs. Our aim was to assess adherence to the recommended surgical antimicrobial prophylaxis guidelines in St. Vincent’s University Hospital (SVUH), as part of the hospital antimicrobial stewardship programme. Compliance of surgical services was measured against the recommended regimens described in the SVUH Antimicrobial Guidelines.
Method
Data on duration and choice of prophylaxis were prospectively gathered on inpatients undergoing elective surgery during a three-week period between August-September 2020. Patients undergoing transplant procedures, inpatients in the intensive care unit, and patients who moved off-site postoperatively were excluded.
Results
Eighty-one patients were included. Sixty-four (79%) were compliant with prophylaxis duration, while seventeen (21%) were not. Reasons for extended prophylaxis included three (18%) cases where there were intra-operative complications and five (29%) cases of routine prescribing of an additional 24-hour coverage. Nine (53%) did not document the reason for extended cover.
Conclusions
Compliance with recommended duration of prophylaxis improved in comparison to prior audits. Among patients receiving extended prophylaxis, documentation of the indication was poor. Patients with evidence of post-operative infection may be better served with targeted antimicrobial therapy rather than extended prophylaxis. One reason for extended prophylaxis may be due to difficulty accessing guidelines on recommended prophylaxis duration, hence a targeted smartphone application was introduced to improve accessibility.
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Rationalisierungspotentiale mit schleiftechnischem Informationssystem ausschöpfen. ACTA ACUST UNITED AC 2021. [DOI: 10.1515/zwf-1991-861123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Simulation der Randzonenbeeinflussung beim Schleifen unter Verwendung der Fuzzy Logic. ACTA ACUST UNITED AC 2021. [DOI: 10.1515/zwf-1993-880216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Computation of distribution of relaxation times by Tikhonov regularization for Li ion batteries: usage of L-curve method. Sci Rep 2021; 11:12624. [PMID: 34135360 PMCID: PMC8209233 DOI: 10.1038/s41598-021-91871-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
In this paper, the distribution of relaxation times (DRTs) functions are calculated numerically in Matlab for synthetic impedance data from single parallel \documentclass[12pt]{minimal}
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\begin{document}$$RC$$\end{document}RC circuits connected in series, experimental impedance data from supercapacitors and α-LiFeO2 anode based Li ion batteries. The quality of the impedance data is checked with the Kramers–Krönig (KK) relations. The DRTs are calculated within the KK compatible regime for all the systems using Tikhonov regularization (TR) method. Here we use a fast and simple L-curve method to estimate the TR parameter (λ) for regularization of the Fredholm integral equations of first kind in impedance. Estimation of the regularization parameters are performed effectively from the offset of the global corner of the L-curve rather than simply using the global corner. The physical significances of DRT peaks are also discussed by calculating the effective resistances and capacitances coupled with peak fitting program. For instance, two peaks in the DRTs justify the electrical double layer capacitance and ion diffusion phenomena for supercapacitors in low to intermediate frequencies respectively. Moreover, the surface film effect, Li/electrolyte and electrode/electrolyte charge transfer related processes are identified for α-LiFeO2 anode based Li-ion batteries. This estimation of the offset of the global corner extends the L-curve approach coupled with the Tikhonov regularization in the field of electrochemistry and can also be applied in similar process detection methods.
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Pulmonary artery injury in left atrial appendage closure device implantation: a systematic review of a potentially fatal complication. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary artery (PA) injury is a rarely reported complication following percutaneous left atrial appendage closure (LAAC). This study aims to systematically review all reported cases of PA injury associated with LAAC.
Methods
PubMed/Medline, SCOPUS, EMBASE, Google Scholar and the MAUDE databases were searched to find studies reporting PA injury during or after LAAC with the Amplatzer Amulet (AA), Amplatzer Cardiac Plug (ACP) or Watchman device through October 2019. Categorical data were reported in terms of numbers and/or percentages (%).
Results
We found 13 cases (mean age 71.4 yrs) with reported PA injury associated with LAAC. Of these, 9 were case reports, 3 were reported in observational studies, and 1 was in the MAUDE database. Most cases (n=8) were reported in Europe followed by Australia (n=2) and Asia (n=2). The indication for device implantation in all patients was a high bleeding risk with anticoagulation for atrial fibrillation. Five cases were reported with the ACP (1/5 patients died), 5 with AA (2/5 patients died), and 3 with the Watchman (1/2 patients died). Acute and late presentations following implantation were reported for all three devices. 69.2% of cases (9/13) occurred acutely (during or within 24 hours of intervention). Of these, 3/9 occurred during device implantation. 2/4 of the delayed cases occurred >2 weeks following implantation. The mortality rate for acute and delayed cases was 22% (2/9 patients) and 50% (2/4 patients), respectively. A majority of the cases were attributable to barb/strut/hook injury of the PA. PA injury was associated with a mortality rate of approximately 31%. All surviving patients were managed with surgical intervention.
Conclusion
PA injury is an infrequently reported complication following LAAC and is associated with high mortality. Cases can present acutely (intra-procedurally or within 24 hours) or delayed (>24 hours post-implantation). A majority of cases are due to direct injury of the PA by the struts/hooks/barbs of the device. Practitioners should be cognizant of this life-threatening complication, which requires a high index of suspicion for diagnosis and can occur weeks after device implantation.
Funding Acknowledgement
Type of funding source: None
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Atrial Septal Defect (ASD) Occluder–Histopathology in 59 Human Explanted Devices. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Proteomic Mapping of Atrial and Ventricular Protein Abundance in Patients with Aortic Valve Stenosis. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Long-Term Follow-up after Radiofrequency Catheter Ablation of Atrial Tachycardias in Patients with Congenital Heart Disease. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Epicardial Leadless Pacemaker in a Lamb Model. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Clinical Course of Patients with Long-QT Syndrome: Is There a Genotype–Phenotype Relationship? Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
UNLABELLED Hypophosphatasia (HPP) is a rare inherited disorder of bone and mineral metabolism caused by loss of function mutations in the ALPL gene. The presentation in children and adults can be extremely variable and natural history is poorly understood particularly in adults. Careful patient evaluation is required with consideration of pharmacologic intervention in individuals meeting criteria for therapy. INTRODUCTION The purposes of this review are to present current evidence regarding the diagnosis and management of hypophosphatasia in children and adults and provide evidence-based recommendations for management. METHOD A MEDLINE, EMBASE, and Cochrane database search and literature review was completed. The following consensus recommendations were developed based on the highest level of evidence as well as expert opinion. RESULTS Hypophosphatasia is a rare inherited disorder of bone and mineral metabolism due to loss of function mutations in the tissue non-specific alkaline phosphatase (ALPL) gene causing reductions in the activity of the tissue non-specific isoenzyme of alkaline phosphatase (TNSALP). Deficient levels of alkaline phosphatase result in elevation of inhibitors of mineralization of the skeleton and teeth, principally inorganic pyrophosphate. The impaired skeletal mineralization may result in elevations in serum calcium and phosphate. Clinical features include premature loss of teeth, metatarsal and subtrochanteric fractures as well as fragility fractures. Poor bone healing post fracture has been observed. Myalgias and muscle weakness may also be present. In infancy and childhood, respiratory and neurologic complications can occur. CONCLUSIONS HPP is associated with significant morbidity and mortality. Pharmacologic intervention can result in significant clinical improvement. This Canadian position paper provides an overview of the musculoskeletal, renal, dental, respiratory, and neurologic manifestations of hypophosphatasia. The current state of the art in the diagnosis and management of hypophosphatasia is presented.
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Abstract
In the article mentioned above an author's name was misspelled.
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Abstract OT1-08-01: A pilot randomized usual care controlled study of yoga for persistent chemotherapy-induced peripheral neuropathy (CIPN) in breast and gynecological cancer survivors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot1-08-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CIPN is a common, painful, and debilitating side effect of many standard chemotherapy regimens. Patients with CIPN typically experience paresthesia (tingling, numbness), pain, and muscle weakness, and may exhibit significant functional decline and diminished quality of life. Our prior study showed that more than half of breast cancer survivors experience persistent CIPN up to a mean duration of 5.6 years and that this symptom is associated with a doubled fall risk. There is an urgent need to identify nonpharmacological approaches to reduce CIPN symptoms and improve cancer survivors' functional outcomes. Yoga is a mind-body modality that includes stretching, flexibility, and balance training; however, little is known about its effects on symptoms and functional outcomes among cancer survivors with CIPN.
Trial Design: We are conducting a two-arm pilot randomized usual care controlled trial in breast and gynecological cancer survivors at Memorial Sloan Kettering Cancer Center (MSK), New York, NY. Eligible subjects in the intervention arm receive one-hour Hatha Yoga classes taught twice weekly for eight weeks, and practice home-based yoga for a total of 12 weeks. Subjects in the wait list control (WLC) arm continue usual care for 12 weeks, followed by eight weeks of yoga classes and home-based yoga.
Eligibility Criteria: 1) Patients with a primary diagnosis of stage I-III breast, ovarian, uterine, or endometrial cancer; 2) moderate to severe CIPN, defined by four or greater on a 0–10 Numeric Rating Scale (NRS); 3) completion of neurotoxic chemotherapy at least three months prior; 4) no changes in anti-neuropathy medications within three months of enrollment; and 5) an ECOG performance status of 0–2.
Specific Aims: The primary endpoint is safety, feasibility, and NRS changes at eight weeks (end of treatment). The secondary endpoints include the Neuropathic Pain Scale (NPS) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) at eight, 12, and 20 weeks.
Statistical Methods: We will accrue 40 patients to get 36 patients evaluable for the primary endpoint at eight weeks. Using an ANCOVA analysis with a sample size of 36, we will be able to detect an effect size of 00.58 standard deviations (SD) of NRS (moderate effect size) between yoga and WLC assuming a NRS correlation between pre- and post-yoga of 0.5 SD. If we assume a 10% dropout rate based on our recently completed trial, we will need to recruit 20 subjects per arm (total of 40) to fall within the precision noted in the sample size calculation. We recognize that the sample size calculation was based on detecting a moderate effect between yoga and WLC and may miss small but clinically meaningful effects that can be used to design a future trial that is sufficiently powered.
Present accrual and target accrual: 40 participants. We have accrued 25 participants as of June 2018 and anticipate accrual completion by October 2018.
Citation Format: Zhi WI, Leeolou MC, Piulson L, Chen P, Patterson C, Paul T, Patil S, Mao JJ, Bao T. A pilot randomized usual care controlled study of yoga for persistent chemotherapy-induced peripheral neuropathy (CIPN) in breast and gynecological cancer survivors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-08-01.
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5329Exploring hypertrophic cardiomyopathy in iPSC-derived cardiomyocytes from patients with a novel autosomal recessive form of Noonan syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Extracardiac Implantable Cardioverter Defibrillators in Infants and Children: Is Routine Defibrillation Threshold Testing Appropriate? Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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25
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Geometrically intricate sheet-on-pillar/flake hierarchy embracing cobaltosic and manganese oxides over flexible carbon scaffold for binder-free high-energy-density supercapacitor. CrystEngComm 2018. [DOI: 10.1039/c8ce01182f] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Sheet-on-rod/flake hierarchy embracing Co3O4 and MnO2 on carbon fabric is used for binder-free high-energy-density supercapacitor. Electrochemical behaviour is illuminated on the basis of shape-porosity-property correlation.
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26
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Inferences on mass composition and tests of hadronic interactions from 0.3 to 100 EeV using the water-Cherenkov detectors of the Pierre Auger Observatory. Int J Clin Exp Med 2017. [DOI: 10.1103/physrevd.96.122003] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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27
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Handlungsempfehlung nach der Leitlinie „Bradykarde Herzrhythmusstörungen im Kindes- und Jugendalter“. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0404-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Abstract
Necrotizing enterocolitis (NEC) is the most common acquired disease of the gastrointestinal tract (GIT) in premature infants and newborns. It is defined as an ulcerative inflammation of the intestinal wall. The clinical signs of incipient NEC are often very discrete, and range from localized intestinal symptoms to generalized signs of sepsis. NEC is classified depending on its severity into disease states according to the modified Bell's Classification. Treatment of NEC ranges, depending on its severity, from a conservative therapeutic approach to surgery with resection of the affected parts of the intestine. Mortality is considerably high in extremely small preterm infants reaching up to 42% of the affected children. Measures such as breastfeeding or alternatively nutrition with pasteurized human donor milk from a milk bank, administration of probiotics, avoidance of histamine type II receptor antagonists, and restrictive antibiotic treatment should be considered early on for prevention of NEC.
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Book Notes. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/bf03394647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Health Related Quality of Life in Morbidly Obese Women Attending a
Tertiary Care Hospital in India. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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31
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Appropriate and Inappropriate ICD Shocks in Children, Adolescents, and Adults with Congenital Heart Disease. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Catheter Ablation in Asymptomatic Pediatric WPW Patients: Results from a Large Multicenter Study. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Long-Term Follow-up after Catheter Ablation of Accessory Pathways in Children. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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The Value of the Newly Validated Cardiovascular Magnetic Resonance Derived Total Right/Left Volume Index in the Course of Ebstein Anomaly: A Prospective Long-Term Follow-up Study. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int 2017; 28:1-19. [PMID: 27613721 PMCID: PMC5206263 DOI: 10.1007/s00198-016-3716-2] [Citation(s) in RCA: 256] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 07/20/2016] [Indexed: 01/02/2023]
Abstract
The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.
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36
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Testing Hadronic Interactions at Ultrahigh Energies with Air Showers Measured by the Pierre Auger Observatory. PHYSICAL REVIEW LETTERS 2016; 117:192001. [PMID: 27858429 DOI: 10.1103/physrevlett.117.192001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Indexed: 06/06/2023]
Abstract
Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170 TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons.
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37
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Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy. PHYSICAL REVIEW LETTERS 2016; 116:241101. [PMID: 27367377 DOI: 10.1103/physrevlett.116.241101] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Indexed: 06/06/2023]
Abstract
We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8±0.7(stat)±6.7(syst) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principles calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.
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38
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Data for phase angle shift with frequency. Data Brief 2016; 7:1389-92. [PMID: 27158655 PMCID: PMC4845075 DOI: 10.1016/j.dib.2016.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 02/10/2016] [Accepted: 04/05/2016] [Indexed: 11/05/2022] Open
Abstract
Phase angle shift between the current and voltage with frequency has been reported for a single phosphoric acid fuel cell in the cell temperature from 100 °C to 160 °C and the humidifier temperature from 40 °C to 90 °C. An electrochemical workbench is employed to find the shift. The figure of phase angle shift shows a peak in high humidifier temperatures. The peak in phase angle shift directs to lower frequency side with decreasing humidifier temperature. The estimation of electrochemical reaction time is also evaluated in the humidifier temperature zone from 50 °C to 90 °C.
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39
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Image formation properties and inverse imaging problem in aperture based scanning near field optical microscopy. OPTICS EXPRESS 2016; 24:4128-4142. [PMID: 26907063 DOI: 10.1364/oe.24.004128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Aperture based scanning near field optical microscopes are important instruments to study light at the nanoscale and to understand the optical functionality of photonic nanostructures. In general, a detected image is affected by both the transverse electric and magnetic field components of light. The discrimination of the individual field components is challenging as these four field components are contained within two signals in the case of a polarization resolved measurement. Here, we develop a methodology to solve the inverse imaging problem and to retrieve the vectorial field components from polarization and phase resolved measurements. Our methodology relies on the discussion of the image formation process in aperture based scanning near field optical microscopes. On this basis, we are also able to explain how the relative contributions of the electric and magnetic field components within detected images depend on the chosen probe. We can therefore also describe the influence of geometrical and material parameters of individual probes within the image formation process. This allows probes to be designed that are primarily sensitive either to the electric or magnetic field components of light.
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40
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Long-Term Follow-up after Catheter Ablation of AV Nodal Reentrant Tachycardia in Children. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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41
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Atrioventricular Mechanics and Heart Failure in Ebstein's Anomaly—A Cardiovascular Magnetic Resonance Imaging Study. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Effects of Triple Cryoenergy Application on Early Lesion Formation and Coronary Arteries in the Developing Myocardium. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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43
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Ivabradine: A Useful Agent for Treatment of Congenital Junctional Ectopic Tachycardia. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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44
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Echokardiographische Quantifizierung der Pulmonalklappeninsuffizienz bei angeborenen Herzfehlern im Vergleich zur kardialen Magnetresonanztomographie. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Search for patterns by combining cosmic-ray energy and arrival directions at the Pierre Auger Observatory. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2015; 75:269. [PMID: 26120280 PMCID: PMC4477714 DOI: 10.1140/epjc/s10052-015-3471-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 05/20/2015] [Indexed: 06/04/2023]
Abstract
Energy-dependent patterns in the arrival directions of cosmic rays are searched for using data of the Pierre Auger Observatory. We investigate local regions around the highest-energy cosmic rays with [Formula: see text] eV by analyzing cosmic rays with energies above [Formula: see text] eV arriving within an angular separation of approximately 15[Formula: see text]. We characterize the energy distributions inside these regions by two independent methods, one searching for angular dependence of energy-energy correlations and one searching for collimation of energy along the local system of principal axes of the energy distribution. No significant patterns are found with this analysis. The comparison of these measurements with astrophysical scenarios can therefore be used to obtain constraints on related model parameters such as strength of cosmic-ray deflection and density of point sources.
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46
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Interventionelle Therapie einer Coarctatio aortae mittels Hybrid-Eingriff bei einem hypotrophen Frühgeborenen mit aktuell 1300 g. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1556012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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47
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ICD Therapy after Atrial Switch Repair for d-Transposition of the Great Arteries—German Multicenter Experience. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1555977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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48
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Catheter Ablation of Atrial Reentry Tachycardia in Patients with Congenital Heart Disease—Efficacy and Safety. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1556005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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49
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Thromben am Ansatz von RV-PA-Conduit-Taschenklappen. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1555962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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50
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SU-E-T-102: An Efficient Method to Quantitatively Detect Sub-Millimeter MLC Bank Alignment Errors Using a Well-Known QA Device. Med Phys 2015. [DOI: 10.1118/1.4924463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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