Manual Chest PRESSURE During Direct Current Cardioversion for Atrial Fibrillation: A Randomized Control Trial (PRESSURE-AF).

Background: Direct current cardioversion is frequently used to return patients with atrial fibrillation (AF) to sinus rhythm. Chest pressure during cardioversion may improve the efficacy of cardioversion through decreasing transthoracic impedance and increasing cardiac energy delivery.

Objectives: This study aimed to assess the efficacy and safety of upfront chest pressure during direct current cardioversion for AF with anterior-posterior pad positioning.

Enhancing Guidewire Efficacy for Transradial Access: The EAGER Randomized Controlled Trial.

Background: The 1.5 mm Baby J hydrophilic narrow J-tipped wire is a development of the standard 0.035" 3-mm J-tipped peripheral guidewire, designed to improve efficiency of transradial coronary procedures by safely navigating small caliber radial arteries to the aorta.

Computed tomographic angiography measures of coronary plaque in clinical trials: .

Atherosclerotic coronary artery disease (CAD) is the causal pathological process driving most major adverse cardiovascular events (MACE) worldwide. The complex development of atherosclerosis manifests as intimal plaque which occurs in the presence or absence of traditional risk factors. There are numerous effective medications for modifying CAD but new pharmacologic therapies require increasingly large and expensive cardiovascular outcome trials to assess their potential impact on MACE and to obtain regulatory approval.

Association between vessel-specific coronary Aggregated plaque burden, Agatston score and hemodynamic significance of coronary disease (The CAPTivAte study).

Background: CT coronary angiography (CTCA) is a guideline-endorsed assessment for patients with stable angina and suspected coronary disease. Although associated with excellent negative predictive value in ruling out obstructive coronary disease, there are limitations in the ability of CTCA to predict hemodynamically significant coronary disease. The CAPTivAte study aims to assess the utility of Aggregated Plaque Burden (APB) in predicting ischemia based on Fractional Flow Reserve (FFR).

A perceptual approach to address complex water management issues in lowland permeable catchments.

Water quality management is a pressing global concern, and an increasingly complex issue due to climate and land-use change, legacy pollution, and the persistent release of well-known and emerging contaminants from diffuse and point sources. The increasing availability of high-frequency monitoring data is leading existing, often heuristic approaches, to be judged inadequate. Water managers frequently rely on simple qualitative and/or quantitative approaches for decision-making, but a lack of tangible improvement in freshwater quality outcomes is demanding new and innovative approaches that rely more on physical process understanding, rather than precedent.

Coronary perforation incidence, outcomes and temporal trends (COPIT): a systematic review and meta-analysis.

Unlabelled: Coronary perforation is a potentially life-threatening complication of percutaneous coronary intervention (PCI). We studied incidence, outcomes and temporal trends following PCI-related coronary artery perforation (CAP).

Methods: Prospective systematic review and meta-analysis including meta-regression using MEDLINE and EMBASE to November 2020.

Early-onset post-cardiotomy severe constrictive pericarditis: a case report.

Background: Constrictive pericarditis (CP) can be one of the most challenging conditions to diagnose within cardiovascular medicine. Iatrogenic causes of CP are increasingly recognized in higher income countries. This case provides insight into the need for clinical suspicion when diagnosing this relatively under recognized clinical entity as well as the need for multimodality imaging combined with invasive haemodynamic assessment.

Is water quality in British rivers "better than at any time since the end of the Industrial Revolution"?

We explore the oft-repeated claim that river water quality in Great Britain is "better now than at any time since the Industrial Revolution". We review available data and ancillary evidence for seven different categories of water pollutants: (i) biochemical oxygen demand (BOD) and ammonia; (ii) heavy metals; (iii) sewage-associated organic pollutants (including hormone-like substances, personal care product and pharmaceutical compounds); (iv) macronutrients (nitrogen and phosphorus); (v) pesticides; (vi) acid deposition and (vii) other variables, including natural organic matter and pathogenic micro-organisms. With a few exceptions, observed data are scarce before 1970.

Author Correction: Global karst springs hydrograph dataset for research and management of the world's fastest-flowing groundwater.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Global karst springs hydrograph dataset for research and management of the world's fastest-flowing groundwater.

Karst aquifers provide drinking water for 10% of the world's population, support agriculture, groundwater-dependent activities, and ecosystems. These aquifers are characterised by complex groundwater-flow systems, hence, they are extremely vulnerable and protecting them requires an in-depth understanding of the systems. Poor data accessibility has limited advances in karst research and realistic representation of karst processes in large-scale hydrological studies.

The stable oxygen isotope ratio of resin extractable phosphate derived from fresh cattle faeces.

Rationale: Phosphorus losses from agriculture pose an environmental threat to watercourses. A new approach using the stable oxygen isotope ratio of oxygen in phosphate (δ O value) may help elucidate some phosphorus sources and cycling. Accurately determined and isotopically distinct source values are essential for this process.

Phosphate stable oxygen isotope variability within a temperate agricultural soil.

In this study, we conduct a spatial analysis of soil total phosphorus (TP), acid extractable phosphate (PO) and the stable oxygen (O) isotope ratio within the PO molecule (δO ) from an intensively managed agricultural grassland site. Total P in the soil was found to range from 736 to 1952 mg P kg, of which between 12 and 48% was extractable using a 1 M HCl (HCl ) solution with the two variables exhibiting a strong positive correlation. The δO of the extracted PO ranged from 17.

Quantifying landscape-level methane fluxes in subarctic Finland using a multiscale approach.

Quantifying landscape-scale methane (CH4 ) fluxes from boreal and arctic regions, and determining how they are controlled, is critical for predicting the magnitude of any CH4 emission feedback to climate change. Furthermore, there remains uncertainty regarding the relative importance of small areas of strong methanogenic activity, vs. larger areas with net CH4 uptake, in controlling landscape-level fluxes.

The flux of dissolved nitrogen from the UK--evaluating the role of soils and land use.

Fluvial dissolved nitrogen (dissolved organic nitrogen [DON], nitrate and ammonium) fluxes from the terrestrial biosphere of the UK to surrounding oceans are explained on the basis of combined predictions of soil to water transfer and in-stream loss. The flux of different nitrogen species from land to surface waters is estimated using an export coefficient model employing catchment soil, land use and hydroclimatic characteristics, fitted to flux estimates derived from the Harmonised Monitoring Scheme between 2001 and 2007 for 169 UK catchments. In-stream losses of DON, nitrate and ammonium were estimated using a transit time filter in the fluvial network.

Monitoring fluvial water chemistry for trend detection: hydrological variability masks trends in datasets covering fewer than 12 years.

This paper sub-samples four 35 year water quality time series to consider the potential influence of short-term hydrological variability on process inference derived from short-term monitoring data. The data comprise two time series for nitrate (NO(3)-N) and two for DOC (using water colour as a surrogate). The four catchments were selected not only because of their long records, but also because the four catchments are very different: upland and lowland, agricultural and non-agricultural.

Nitrate in United kingdom rivers: policy and its outcomes since 1970.

Modern conventional farming provides Western Europe and North America with reliable, high quality, and relatively cheap supplies of food and fiber, increasingly viewed as a potential source of fuel. One of the costs is continued widespread pollution of rivers and groundwater-predominantly by nutrients. In 1970, in both the United States and UK, farming was focused on maximizing yield and management practices were rapidly modernizing.

Long-term monitoring of river water nitrate: how much data do we need?

Long records of river water quality are invaluable for helping to understand the biogeochemistry of hydrological systems. They allow relationships to be established between changes in water quality (including seasonal cycles, episodic responses and long-term trends) and potential drivers, such as climatic forcing or human activity; they can act as a stimulus for process-oriented experimental research; they can be used to help to make predictions about future temporal and spatial patterns; and they can help to guide management options to mitigate water pollution. In this paper we present the case in favour of maintaining some long records of river water nitrate concentration at "benchmark" sites, in terms of enhancing process understanding and identifying system lags.

An assessment of the risk to surface water ecosystems of groundwater P in the UK and Ireland.

A good quantitative understanding of phosphorus (P) delivery is essential in the design of management strategies to prevent eutrophication of terrestrial freshwaters. Most research to date has focussed on surface and near-surface hydrological pathways, under the common assumption that little P leaches to groundwater. Here we present an analysis of national patterns of groundwater phosphate concentrations in England and Wales, Scotland, and the Republic of Ireland, which shows that many groundwater bodies have median P concentrations above ecologically significant thresholds for freshwaters.

Water quality, nutrients and the European union's Water Framework Directive in a lowland agricultural region: Suffolk, south-east England.

The water quality of 13 rivers in the lowland, agricultural county of Suffolk is investigated using routine monitoring data for the period 1981 to 2006 collected by the Environment Agency of England and Wales (EA), and its predecessors, with particular emphasis on phosphorus (as total reactive phosphorus, TRP) and total (dissolved and particulate) oxidised nitrogen (TOxN--predominantly nitrate NO3). Major ion and flow data are used to outline fundamental hydrochemical characteristics related to the groundwater provenance of base-flow waters. Relative load contributions from point and diffuse sources are approximated using Load Apportionment Modelling for both TRP and TOxN where concurrent flow and concentration data are available.

Temporal and spatial analysis of nitrate concentrations from the Frome and Piddle catchments in Dorset (UK) for water years 1978 to 2007: evidence for nitrate breakthrough?

This paper analyses time series of nitrate concentration for 35 sites throughout the Frome and Piddle catchments in southern England for the period 1978--2007. The Piddle catchment lies wholly within the Chalk aquifer in its upper reaches, whereas the headwaters of the Frome are a mixture of Chalk and other lithologies; both rivers flow across Palaeogene sands and clays in their lower reaches, before discharging into Poole Harbour. At each site sources of observed variation arise from differences between sample month (seasonality) and year (underlying trend).

Hormones restore biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats.

Objective: The objective of the study was to determine the impact of hormones on the biomechanical properties of the vagina and its supportive tissues following surgical menopause in young vs middle-aged rats.

Study Design: Long-Evans rats (4-month virgin [n = 34], 4-month parous [n = 36], and 9-month parous [n = 34]), underwent ovariectomy (OVX) or sham surgery. OVX animals received hormones (estrogen [E2] or estrogen plus progesterone [E2 plus P4]), placebo, or a matrix metalloproteinase inhibitor (chemically modified tetracycline-8 [CMT-8]).

Reference urodynamic values for stress incontinent women.

Objective: To determine reference urodynamic values for preoperative urodynamic studies in women undergoing surgery for pure or predominant stress urinary incontinence (SUI).

Materials And Methods: Six hundred fifty-five women with pure or predominant SUI were enrolled in a multicenter surgical trial and were randomized to undergo a Burch or autologous fascia sling procedure as part of the Urinary Incontinence Treatment Network (UITN) Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr). Preoperative free uroflowmetry, filling cystometry, and pressure flow studies were performed in all women using a standardized research protocol and standardized urodynamic interpretation guidelines.

Biomechanical adaptations of the rat vagina and supportive tissues in pregnancy to accommodate delivery.

Objective: We hypothesize that in pregnancy and at the time of delivery, the vagina and supportive tissues undergo dramatic alterations to accommodate passage of the fetus. In this study, we sought to characterize these changes in the rat using an established biomechanical testing protocol.

Methods: Seventy-four 3-month-old Long Evans rats divided into virgin, mid and late pregnant, vaginal delivery (immediate and 4-week postpartum), and abdominal delivery (immediate and 4-week postpartum) groups were killed.