bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in the Serum Protein Fractions in Goats after Treatment of Natural Gastrointestinal Parasite Infections
Authors: Chovanová Frederika , Tóthová Csilla , Klein Róbert , Nagy Oskar
Published: November 2021

Gastrointestinal parasitic infections in small ruminants belong to major health problems. The regulation of gastrointestinal infections in goats and the responses developed against them appear to be different from those observed in sheep. In the literature, there is a lack of data on the effect of gastrointestinal parasitic infections on the serum protein profile in goats. Therefore, the aim of the study was to determine the electrophoretic pattern of serum proteins in goats naturally infected with gastrointestinal parasites and to compare the changes in the total serum proteins and serum protein fractions (albumin and α1-, α2-, β-, and γ-globulins) obtained after antihelminthic treatment. Eight adult female goats of the white shorthaired breed from a small dairy goat farm at the age ranging between 3 and 5 years with average body weight 35.4 ± 3.2 kg and body condition score (BCS) from 1.5 to 2.5 were used in the study. The serum proteins in goats were separated into five fractions: albumin, α1- and α2-globulins, and β- and γ-globulins. Significant changes after treatment were found in the relative concentrations of albumin (P<0.01) and α2- (P<0.05), β- (P<0.001), and γ-globulins (P<0.01), as well as albumin/globulin ratio (P<0.01). The mean concentration of total serum proteins was, after the antiparasitic treatment, significantly higher. Among the globulin fractions, the γ-globulin fraction contributed most significantly to these changes (P<0.001). The results presented in the study suggest a significant effect of antiparasitic treatment in goats on the synthesis of blood serum proteins and on the changes of the proportion of serum protein fractions.
The Duffing Oscillator Equation and Its Applications in Physics
Authors: Salas Salas Alvaro Humberto , Castillo Hernández Jairo Ernesto , Martínez Hernández Lorenzo Julio
Published: November 2021

In this paper, we solve the Duffing equation for given initial conditions. We introduce the concept of the discriminant for the Duffing equation and we solve it in three cases depending on sign of the discriminant. We also show the way the Duffing equation is applied in soliton theory.
Pulmonary Hypertension in Children across Africa: The Silent Threat
Authors: Namuyonga Judith , Mocumbi Ana Olga
Published: November 2021

Pulmonary hypertension (PH) is a complex puzzle in Africa, especially among children who present with a cocktail of issues including recurrent pulmonary infections, unoperated congenital heart disease, and advanced rheumatic heart disease. Sickle cell anemia and neonatal complications of transiting from fetal circulation also contribute to the burden of pulmonary hypertension. Mortality from pulmonary arterial hypertension (PAH) remains high in Africa (18-21%), claiming sufferers in the first 6 months after diagnosis. Unfortunately, PH remains underreported in sub-Saharan Africa since many centers lack the capacity to diagnose and confirm it by the recommended gold standard, right heart catheterization. The unresolved burden of unoperated congenital heart lesions and rheumatic heart disease, among other preventable causes, stand out as major causes of PH in African children. This paper highlights pediatric PAH as a result of major gaps in care and illustrates the need for its prevention as well as for the promotion of research into the most important drivers, to prevent premature mortality in the continent.
Network Analysis Identifies Regulators of Basal-Like Breast Cancer Reprogramming and Endocrine Therapy Vulnerability
Authors: Choi Sea R. , Hwang Chae Young , Lee Jonghoon , Cho Kwang-Hyun
Published: November 2021

Basal-like breast cancer is the most aggressive breast cancer subtype with the worst prognosis. Despite its high recurrence rate, chemotherapy is the only treatment for basal-like breast cancer, which lacks expression of hormone receptors. In contrast, luminal A tumors express ERα and can undergo endocrine therapy for treatment. Previous studies have tried to develop effective treatments for basal-like patients using various therapeutics but failed due to the complex and dynamic nature of the disease. In this study, we performed a transcriptomic analysis of patients with breast cancer to construct a simplified but essential molecular regulatory network model. Network control analysis identified potential targets and elucidated the underlying mechanisms of reprogramming basal-like cancer cells into luminal A cells. Inhibition of BCL11A and HDAC1/2 effectively drove basal-like cells to transition to luminal A cells and increased ERα expression, leading to increased tamoxifen sensitivity. High expression of BCL11A and HDAC1/2 correlated with poor prognosis in patients with breast cancer. These findings identify mechanisms regulating breast cancer phenotypes and suggest the potential to reprogram basal-like breast cancer cells to enhance their targetability.

Significance:

A network model enables investigation of mechanisms regulating the basal-to-luminal transition in breast cancer, identifying BCL11A and HDAC1/2 as optimal targets that can induce basal-like breast cancer reprogramming and endocrine therapy sensitivity.
Clinical Heterogeneity in Acute Symptomatic Seizures due to Autoimmune Encephalitis Related to GAD65 Antibodies
Authors: Fan Xuemei , Li Xinxin , Wang Shuai , Zhu Yafei , Liu Songyan , Han Xuemei
Published: November 2021

Introduction: This study aimed to explore the diversity and clinical features of acute symptomatic seizures due to autoimmune encephalitis related to anti-glutamate decarboxylase (GAD) 65 antibodies. Methods: Clinical data of a series of 6 patients positive for anti-GAD65 antibodies were retrospectively analyzed. Results: Five of the patients were male and 1 was a female, with a median age of 44.1 years (range 18–70 years). Seizure forms were varied in 6 patients when they were admitted to the hospital: 3 cases of seizures only and 3 accompanied by other symptoms, such as mental disorder, cognitive impairment, cerebellar ataxia, and ocular movement disorder. Three patients (50%) had coexisting systemic autoimmune diseases, including diabetes mellitus, vitiligo, and hyperthyroidism. Five patients (83%) had abnormal brain MRI findings. They were all treated by immunotherapy, 5 of 6 patients improved significantly but relapsed after withdrawing methylprednisolone, and 1 patient got deteriorated. None of them were diagnosed with tumors. Conclusions: Clinical features of acute symptomatic seizures related to GAD65 antibodies are diverse, and early and continuous immunotherapy is necessary for patients.
Clinical Utility of Surgical Lung Biopsy for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Authors: Hashimoto Hiroyuki , Yamamoto Shota , Nakagawa Hiroaki , Suido Yoshihiro , Sato Shintaro , Tabata Erina , Okamori Satoshi , Yoshida Takuo , Ando Koichi , Yoshitake Shigenori , Okada Yohei
Published: November 2021

Background: Surgical lung biopsy (SLB) is performed in patients with acute respiratory distress syndrome (ARDS); however, its clinical utility remains unclear. Objectives: We categorized the pathological diagnoses and investigated the predictive value for short-term mortality. Method: Three electronic databases (MEDLINE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) were searched for the included studies. The QUADAS-2 was used to evaluate the risk of bias and its applicability. The types and populations of pathological diagnoses were investigated. The pooled sensitivity, positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) were estimated at a fixed specificity. Hierarchical summary receiver operating characteristic curves were drawn. Results: A total of 16 studies that enrolled 758 patients were included. The pathological diagnoses were as follows: diffuse alveolar damage (DAD) 29.9%; infection 24.7%; interstitial lung disease 17.2%; malignancy 3.6%; cardiovascular disease 3.6%; drug toxicity 2.3%; connective tissue disease 2.2%; allergic disease 1.1%; and nonspecific diagnosis 15.4%. To predict short-term mortality, 13 studies that enrolled 613 patients used DAD as an index test and recorded a mortality rate of 56.9% (349 of 613 patients). A total of 3 studies that used index tests other than DAD were excluded. The pooled sensitivity, fixed specificity, LR+, LR−, and DOR were 0.46 (95% confidence interval [CI]: 0.29–0.56), 0.69, 1.48 (95% CI: 0.92–1.81), 0.78 (95% CI: 0.63–1.03), and 1.90 (95% CI: 0.89–2.86), respectively. Conclusions: SLB is unlikely to provide a specific diagnosis and should not be recommended for confirming DAD or predicting ARDS prognosis.
Vascular Access and Clinical Outcomes in Underserved Hemodialysis Patients in Mexico
Authors: Maggiani-Aguilera Pablo , Raimann Jochen G. , Chávez-Iñiguez Jonathan S. , Navarro-Blackaller Guillermo , Kotanko Peter , Garcia-Garcia Guillermo
Published: November 2021

Introduction: Central venous catheter (CVC) as vascular access in hemodialysis (HD) associates with adverse outcomes. Early CVC to fistula or graft conversion improves these outcomes. While socioeconomic disparities between the USA and Mexico exist, little is known about CVC prevalence and conversion rates in uninsured Mexican HD patients. We examined vascular access practice patterns and their effects on survival and hospitalization rates among uninsured Mexican HD patients, in comparison with HD patients who initiated treatment in the USA. Methods: In this retrospective study of incident HD patients at Hospital Civil (HC; Guadalajara, MX) and the Renal Research Institute (RRI; USA), we categorized patients by the vascular access at the first month of HD and after the following 6 months. Factors associated with continued CVC use were identified by a logistic regression model. We developed multivariate Cox proportional hazards models to investigate the effects of access and conversion on mortality and hospitalization over an 18-month follow-up period. Results: In 1,632 patients from RRI, the CVC prevalence at month 1 was 64% and 97% among 174 HC patients. The conversion rate was 31.7% in RRI and 10.6% in HC. CVC to non-central venous catheter (NON-CVC) conversion reduced the risk of hospitalization in both HC (aHR 0.38 [95% CI: 0.21–0.68], p = 0.001) and RRI (aHR 0.84 [95% CI: 0.73–0.93], p = 0.001). NON-CVC patients had a lower mortality risk in both populations. Discussion/Conclusion: CVC prevalence and conversion rates of CVC to NON-CVC differed between the US and Mexican patients. An association exists between vascular access type and hospitalization and mortality risk. Prospective studies are needed to evaluate if accelerated and systematic catheter use reduction would improve outcomes in these populations.
Effects of Frequency on the Directional Auditory Sensitivity of Northern Saw-Whet Owls (Aegolius acadicus)
Authors: LaRocco Eileanor P. , Proudfoot Glenn A. , Gall Megan D.
Published: November 2021

Many animals use sound as a medium for detecting or locating potential prey items or predation threats. Northern saw-whet owls (Aegolius acadicus) are particularly interesting in this regard, as they primarily rely on sound for hunting in darkness, but are also subject to predation pressure from larger raptors. We hypothesized that these opposing tasks should favor sensitivity to low-frequency sounds arriving from many locations (potential predators) and high-frequency sounds below the animal (ground-dwelling prey items). Furthermore, based on the morphology of the saw-whet owl skull and the head-related transfer functions of related species, we expected that the magnitude of changes in sensitivity across spatial locations would be greater for higher frequencies than low frequencies (i.e., more “directional” at high frequencies). We used auditory-evoked potentials to investigate the frequency-specific directional sensitivity of Northern saw-whet owls to acoustic signals. We found some support for our hypothesis, with smaller-magnitude changes in sensitivity across spatial locations at lower frequencies and larger-magnitude changes at higher frequencies. In general, owls were most sensitive to sounds originating in front of and above their heads, but at 8 kHz there was also an area of high sensitivity below the animals. Our results suggest that the directional hearing of saw-whet owls should allow for both predator and prey detection.
Is JJ Ureteral Stenting Inferior to Percutaneous Nephrostomy as a Drainage Method in Emphysematous Pyelonephritis?
Authors: Elbaset Mohamed A. , Osman Yasser , Ghobrial Fady K. , Ashour Rawdy , Badawy Mohamed , El Refaie Eman , Zahran Mohamad H.
Published: November 2021

Introduction: The aim of the study was to examine the efficacy of JJ stenting in comparison with percutaneous nephrostomy (PCN) as a drainage method in patients with emphysematous pyelonephritis (EPN). Methods: We retrospectively identified patients with EPN between January 2000 and January 2021. Platelet-to-leukocytic ratio (PLR) at the time of hospital admission and discharge, time taken to clear air locules and to normalize leukocytic count, and air locule volume in mm3 were identified. Renal drainage by either PCN or JJ stent was required if symptoms persist for ≥3 days or in obstructed renal units. Failure of drainage method was defined as conversion to another method of drainage, need for intensive care unit admission, salvage nephrectomy, and mortality. Results: Twenty-nine patients were managed by JJ stent. Treatment success was identified in 20 patients and 19 patients who were managed by PCN and JJ stent, respectively. Higher air locule volume ≥16.7 mm3 and lower PLR ≤18.4 increased the risk of drainage failure (p = 0.009 and 0.001, respectively). Conclusion: Ureteral JJ stenting is an effective method for EPN drainage with a comparable overall success to the PCN use. Higher air locule volume and lower PLR increased the risk of drainage failure.
FcεRI Cluster Size Determines Effective Mast Cell Desensitization without Effector Responses in vitro
Authors: Nagata Yuka , Suzuki Ryo
Published: November 2021

Background: Allergen-specific desensitization of mast cell (MC) IgE receptors (FcεRI) is an important mechanism of allergen-specific immunotherapy that enables tolerance induction via systemic desensitization. Experimental in vitro IgE-mediated MC desensitization is a potential tool to understand the molecular mechanisms underlying this therapy. Desensitized MCs exhibit internalized IgE and its FcεRI receptors in response to suboptimal doses of allergen without provoking activation. The ovalbumin (OVA) allergen exhibits altered allergenicity upon heat treatment. MC reactions are fundamentally regulated by allergen features (i.e., allergenicity); however, the effects of allergenicity on desensitization remain unclear. Objectives: This study aimed to examine the impact of allergenicity on the establishment of in vitro MC desensitization using naive OVA (nOVA) and heated OVA (hOVA), which could induce varying MC effector responses. Method: Bone marrow-derived MCs (BMMCs) were sensitized with OVA-specific IgE, desensitized with sequentially increasing doses of nOVA or hOVA at 10-min intervals, and challenged with nOVA. To evaluate desensitization, the cell surface expression level and subcellular localization of FcεRI-bound IgE were analyzed before and after the final nOVA challenge. MC activation was determined by measuring the release of β-hexosaminidase into supernatants. Results: Desensitized cells exhibited impaired activation following OVA challenge. Both nOVA and hOVA induced BMMC desensitization under different conditions. Formation of small IgE-FcεRI cluster BMMCs, which adequately represent the desensitized state, was significant. The size of the internalized IgE-FcεRI clusters might be correlated with the desensitized state of MCs. Conclusions: We demonstrate that the optimal size of IgE-FcεRI clusters for in vitro BMMC desensitization differed significantly depending on allergenicity, and the efficacy of desensitization was reflected by IgE-FcεRI cluster formation. Our study provides information on the characteristics of IgE-FcεRI internalization for successful desensitization in vitro.
Successful Kidney Transplant for Nephropathic Cystinosis in a Patient with Von Willebrand Disease Type III: The First Case Report
Authors: Alsultan Mohammad Khaled , Bdeir Zeina Nizar , Hassan Qussai , Ali Tahani
Published: November 2021

Nephropathic cystinosis (NC) is a rare autosomal recessive disease, which causes cysteine-crystals accumulation with progression to end-stage renal disease (ESRD). Von willebrand disease (VWD) type III is a rare subtype of von willebrand factor (VWF) abnormality, which is characterized by severe reduction of VWF and factor VIII activity. A 16-year-old patient with NC and VWD type III presented with uremic symptoms due to ESRD. Dialysis access was inserted and followed by hemodialysis (HD) for 4 months with a proper infusion of blood products. While renal transplant remains the treatment of choice of NC and superior to chronic HD, bleeding complications were a major concern in this case with coexisting VWD type III. However, with the meticulous implementation of the Hematology team’s daily recommendations, renal transplantation was successfully performed. This is the first case that mentions a new association between two inherited rare disorders, NC and VWD type III, and this entity has not been reported before. Moreover, successful kidney transplantation in our patient supports the possibility of these procedures in hereditary clotting disorders.
Timing of Initiation of Calcineurin Inhibitors in Pediatric Haploidentical Transplantation with Post-Transplantation Cyclophosphamide: Effects on Survival, Relapse, and Cytokine Release Syndrome
Authors: Uygun Vedat , Karasu Gülsün , Yalçın Koray , Öztürkmen Seda , Daloğlu Hayriye , Çelen Safiye Suna , Hazar Volkan , Yeşilipek Akif
Published: November 2021

Background: The use of unmanipulated haploidentical hematopoietic stem cell transplantations (haplo-HSCT) with post-transplant cyclophosphamide (PTCY) in children has emerged as an acceptable alternative to the patients without a matched donor. However, the timing of calcineurin inhibitors (CNIs) used in combination with PTCY is increasingly becoming a topic of controversy. Method: We evaluated 49 children with acute leukemia who underwent unmanipulated haplo-HSCT with PTCY according to the initiation day of CNIs (pre- or post-cyclophosphamide [CY]). Results: There were no significant differences in the overall survival analysis between the 2 groups. The cumulative incidence of relapse at 2 years was 21.2% in the pre-CY group and 38.9% in the post-CY group (p = 0.33). Cytokine release syndrome (CRS) was observed more frequently in the post-CY group (p = 0.04). The overall survival and event-free survival at 2 years in patients with and without CRS in the pre-CY group were 42.9% versus 87.5% (p = 0.04) and 38.1% versus 87.5% (p = 0.04), respectively. Conclusion: Our study shows that the argument for starting CNI administration after CY is tenuous, and the rationale for not starting CNIs before CY needs to be reconsidered.
Experimentally Induced Anti-Myeloperoxidase Vasculitis Is Not Attenuated in Factor B or VISTA Deficient Mice
Authors: Flórez-Barrós Fernanda , Freeley Simon J. , Tham El Li , Robson Michael G.
Published: November 2021

Background: Anti-neutrophil cytoplasmic antibody vasculitis is characterized by antibodies to myeloperoxidase or proteinase 3. Previous work in murine anti-myeloperoxidase vasculitis has shown a role for the alternative pathway complement component factor B and the anaphylatoxin C5a. However, mice deficient in properdin, which stabilizes the alternative pathway convertase, were not protected. V-Type immunoglobulin domain-containing suppressor of T-cell activation (VISTA)-deficient mice were protected in the nephrotoxic nephritis model but the role of VISTA in anti-myeloperoxidase vasculitis is unknown. Objectives: This study had 2 aims. First, we attempted to reproduce previous findings on the role of factor B in anti-myeloperoxidase vasculitis. Second, we examined the role of VISTA in this model, in order to see if the protection in the nephrotoxic nephritis model extended to anti-myeloperoxidase vasculitis. Methods: Anti-myeloperoxidase vasculitis was induced in wild type, factor B, or VISTA deficient mice. Disease was assessed by quantifying glomerular crescents and macrophages, in addition to albuminuria and serum creatinine. Results: When wild type and factor B deficient mice were compared, there were no differences in any of the histological or biochemical parameters of disease assessed. Similarly, when wild type or VISTA deficient mice were compared, there were no differences. Conclusions: Factor B deficient mice were not protected which is in contrast to previous studies. Therefore alternative pathway activation is not essential in this model, under the conditions used in this study. VISTA deficient mice were not protected, suggesting that therapies targeting VISTA may not be effective in vasculitis.
Metabolic Biomarker Discovery for Risk of Peripheral Artery Disease Compared With Coronary Artery Disease: Lipoprotein and Metabolite Profiling of 31 657 Individuals From 5 Prospective Cohorts
Authors: Tikkanen Emmi , Jägerroos Vilma , Holmes Michael V. , Sattar Naveed , Ala‐Korpela Mika , Jousilahti Pekka , Lundqvist Annamari , Perola Markus , Salomaa Veikko , Würtz Peter
Published: November 2021

Background

Peripheral artery disease (PAD) and coronary artery disease (CAD) represent atherosclerosis in different vascular beds. We used detailed metabolic biomarker profiling to identify common and discordant biomarkers and clarify pathophysiological differences for these vascular diseases.

Methods and Results

We used 5 prospective cohorts from Finnish population (FINRISK 1997, 2002, 2007, and 2012, and Health 2000; n=31 657; median follow‐up time of 14 years) to estimate associations between >200 metabolic biomarkers and incident PAD and CAD. Metabolic biomarkers were measured with nuclear magnetic resonance, and disease events were obtained from nationwide hospital records. During the follow‐up, 498 incident PAD and 2073 incident CAD events occurred. In age‐ and sex‐adjusted Cox models, apolipoproteins and cholesterol measures were robustly associated with incident CAD (eg, hazard ratio [HR] per SD for higher apolipoprotein B/A‐1 ratio, 1.30; 95% CI, 1.25–1.36), but not with incident PAD (HR per SD for higher apolipoprotein B/A‐1 ratio, 1.04; 95% CI, 0.95–1.14;
P
heterogeneity
<0.001). In contrast, triglyceride levels in low‐density lipoprotein and high‐density lipoprotein were associated with both end points (
P
heterogeneity
>0.05). Lower proportion of polyunsaturated fatty acids relative to total fatty acids, and higher concentrations of monounsaturated fatty acids, glycolysis‐related metabolites, and inflammatory protein markers were strongly associated with incident PAD, and many of these associations were stronger for PAD than for CAD (
P
heterogeneity
<0.001). Most differences in metabolic profiles for PAD and CAD remained when adjusting for traditional risk factors.

Conclusions

The metabolic biomarker profile for future PAD risk is distinct from that of CAD. This may represent pathophysiological differences.
Myocardial Strain and Association With Clinical Outcomes in Danon Disease: A Model for Monitoring Progression of Genetic Cardiomyopathies
Authors: Bui Quan M. , Hong Kimberly N. , Kraushaar Megan , Ma Gary S. , Brambatti Michela , Kahn Andrew M. , Battiha Carol Elias , Boynton Kylie , Storm Garrett , Mestroni Luisa , Taylor Matthew R. G. , DeMaria Anthony N. , Adler Eric A.
Published: November 2021

Background

Myocardial strain can identify subclinical left ventricular dysfunction in various cardiac diseases, but its association with clinical outcomes in genetic cardiomyopathies remains unknown. Herein, we assessed myocardial strain in patients with Danon disease (DD), a rare X‐linked autophagic disorder that causes severe cardiac manifestations.

Methods and Results

Echocardiographic images were reviewed and used to calculate myocardial strain from a retrospective, international registry of patients with DD. Regression analyses were performed to evaluate for an association of global longitudinal strain (GLS) and ejection fraction with the composite outcome (death, ventricular assist device, heart transplantation, and implantable cardioverter defibrillator for secondary prevention). A total of 22 patients with DD (male 14 [63.6%], median age 16.5 years) had sufficient echocardiograms for analysis. Absolute GLS was reduced with a mean of 12.2% with an apical‐sparing pattern observed. Univariable regression for GLS and composite outcome showed an odds ratio of 1.32 (95% CI, 1.02–1.71) with
P
=0.03. For receiver operating characteristic analysis, the areas under the curve for GLS and ejection fraction were 0.810 (
P
=0.02) and 0.605 (
P
=0.44), respectively. An absolute GLS cutoff of 10.0% yielded a true positive rate of 85.7% and false positive rate of 13.3%.

Conclusions

In this cohort of patients with DD, GLS may be a useful assessment of myocardial function and may predict clinical outcomes. This study highlights the potential use of myocardial strain phenotyping to monitor disease progression and potentially to predict clinical outcomes in DD and other genetic cardiomyopathies.
Dietary and Circulating Long‐Chain Omega‐3 Polyunsaturated Fatty Acids and Mortality Risk After Myocardial Infarction: A Long‐Term Follow‐Up of the Alpha Omega Cohort
Authors: Pertiwi Kamalita , Küpers Leanne K. , de Goede Janette , Zock Peter L. , Kromhout Daan , Geleijnse Johanna M.
Published: November 2021

Background

Habitual intake of long‐chain omega‐3 fatty acids, especially eicosapentaenoic and docosahexaenoic acid (EPA+DHA) from fish, has been associated with a lower risk of fatal coronary heart disease (CHD) in population‐based studies. Whether that is also the case for patients with CHD is not yet clear. We studied the associations of dietary and circulating EPA+DHA and alpha‐linolenic acid, a plant‐derived omega‐3 fatty acids, with long‐term mortality risk after myocardial infarction.

Methods and Results

We analyzed data from 4067 Dutch patients with prior myocardial infarction aged 60 to 80 years (79% men, 86% on statins) enrolled in the Alpha Omega Cohort from 2002 to 2006 (baseline) and followed through 2018. Baseline intake of fish and omega‐3 fatty acids were assessed through a validated 203‐item food frequency questionnaire and circulating omega‐3 fatty acids were assessed in plasma cholesteryl esters. Hazard ratios (HRs) with 95% CIs were obtained from Cox regression analyses. During a median follow‐up period of 12 years, 1877 deaths occurred, of which 515 were from CHD and 834 from cardiovascular diseases. Dietary intake of EPA+DHA was significantly inversely associated with only CHD mortality (HR, 0.69 [0.52–0.90] for >200 versus ≤50 mg/d; HR, 0.92 [0.86–0.98] per 100 mg/d). Similar results were obtained for fish consumption (HR
CHD
, 0.74 [0.53–1.03] for >40 versus ≤5 g/d;
P
trend
: 0.031). Circulating EPA+DHA was inversely associated with CHD mortality (HR, 0.71 [0.53–0.94] for >2.52% versus ≤1.29%; 0.85 [0.77–0.95] per 1‐SD) and also with cardiovascular diseases and all‐cause mortality. Dietary and circulating alpha‐linolenic acid were not significantly associated with mortality end points.

Conclusions

In a cohort of Dutch patients with prior myocardial infarction, higher dietary and circulating EPA+DHA and fish intake were consistently associated with a lower CHD mortality risk.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03192410.
Thrombectomy With and Without Computed Tomography Perfusion Imaging in the Early Time Window: A Pooled Analysis of Patient-Level Data
Authors: Jadhav Ashutosh P. , Goyal Mayank , Ospel Johanna , Campbell Bruce C. , Majoie Charles B.L.M. , Dippel Diederik W. , White Phil , Bracard Serge , Guillemin Francis , Davalos Antoni , Hill Michael D. , Demchuk Andrew M. , Brown Scott , Saver Jeffrey L. , Muir Keith W. , Mitchell Peter , Desai Shashvat M. , Jovin Tudor G.
Published: November 2021

Background:

The optimal imaging paradigm for endovascular thrombectomy (EVT) patient selection in early time window (0–6 hours) treated acute ischemic stroke patients remains uncertain. We aimed to compare post-EVT outcomes between patients who underwent prerandomization basic (noncontrast computed tomography [CT], CT angiography only) versus additional advanced imaging (computed tomography perfusion [CTP] imaging) and to determine the association of performance of prerandomization CTP imaging with clinical outcomes.

Methods:

The HERMES collaboration (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) pooled patient-level data from randomized controlled trials comparing EVT with usual care for acute ischemic stroke due to anterior circulation large vessel occlusion. Good functional outcome, defined as modified Rankin Scale score 0 to 2 at 90 days, was compared between randomized patients with and without CTP baseline imaging. Univariable and multivariable binary logistic regression analysis was performed to determine the association of baseline CTP imaging and good functional outcome.

Results:

We analyzed 1348 patients 610 (45.3%) of whom underwent CTP prerandomization. The benefit of EVT compared with best medical management was maintained irrespective of the baseline imaging paradigm (90-day modified Rankin Scale score 0–2 in EVT versus control patients: with CTP: 46.0% (137/298) versus 28.9% (88/305), without CTP: 44.1% (162/367) versus 27.3% (100/366). Performance of CTP baseline imaging compared with baseline noncontrast CT and CT angiography only yielded similar rates of good outcome (odds ratio, 1.05 [95% CI, 0.82–1.33], adjusted odds ratio, 1.04, [95% CI, 0.80–1.35]).

Conclusions:

Rates of good functional outcome were similar among patients in whom CTP was or was not performed, and EVT treatment effect in the 0- to 6-hour time window was similar in patients with and without baseline CTP imaging.
Mapping Covid-19 Governance in Lebanon: Territories of Sectarianism and Solidarity
Authors: Harb Mona , Gharbieh Ahmad , Fawaz Mona , Dayekh Luna
Published: November 2021

Many states, including Lebanon, have used the Covid-19 pandemic as an occasion to reassert their power and to consolidate their policing and repressive apparatuses. We are far from a seamless scenario, however. Rather than a mere reproduction of the sectarian political system, we argue in this paper that the governance of the pandemic in Lebanon reveals tensions between powerful political parties, weakened public agencies, as well as multiple solidarity groups with diverging aspirations, colliding over the imagined future of the country. Using various sources of information (broadcast, print and online news media, social media), we build a database of the types of actors and the categories of actions across locations, and analyze the territorial and political variations of the governance of the pandemic. The paper demonstrates that the Covid-19 response in Lebanon operates through ongoing negotiations over the national territory in which timid yet visible aspirations for a non-sectarian country confront sectarian territorialities through back-and-forth cycles.
Gladiolus izzet-baysalii (Iridaceae, Crocoideae), a new species from Turkey
Authors: EKER İSMAİL , SAĞIROĞLU MEHMET
Published: November 2021

Gladiolus izzet-baysalii is described and illustrated as a new species from Karaman province in Southern Anatolia. Gladiolus izzet-baysalii is not morphologically close to any of the species of Gladiolus in Turkey. Although it has some similarities with G. illyricus and G. hamzaoglui in terms of habitus, G. izzet-baysalii differs significantly in tunic structure, number of leaves, inflorescence, perianth, anther, style, capsule and seed features. In this study, the diagnostic morphological features, distribution, conservation status, habitat and ecological characteristics of the new species are discussed. Micromorphological characteristics of G. izzet-baysalii, G. illyricus and G. hamzaoglui seeds are also examined and compared using stereomicroscope and SEM analyses.
New shallow water species of Caribbean Ircinia Nardo, 1833 (Porifera: Irciniidae)
Authors: KELLY JOSEPH B. , THACKER ROBERT W.
Published: November 2021

Seven Ircinia morphospecies were collected from three sites in the Caribbean (Bocas del Toro, Panama; the Mesoamerican Barrier Reef, Belize; and the Florida Keys, United States of America). Previous research used an integrative taxonomic framework (genome-wide SNP sampling and microbiome profiling) to delimit species boundaries among these Ircinia. Here, we present morphological descriptions for these species, six of which are new to science (Ircinia lowi sp. nov., Ircinia bocatorensis sp. nov., Ircinia radix sp. nov., Ircinia laeviconulosa sp. nov., Ircinia vansoesti sp. nov., Ircinia ruetzleri sp. nov.) in addition to one species conferre (Ircinia cf. reteplana Topsent, 1923).
Observing, Measuring, and Assessing the Consequences of Snow Drought
Authors: Gottlieb Alexander R. , Mankin Justin S.
Published: November 2021

Warmer and shorter winters from climate change will reduce snowpacks in most seasonally snow-covered regions of the world, with consequences for freshwater availability in spring and summer when people and ecosystems demand water most. Recent record-low snowpacks, such as those in the winters of 2013/14 and 2014/15 in the western United States, have led to a surge in research on “snow droughts,” which are pointed to as harbingers of global warming that pose significant societal hazards. Yet, despite the importance of understanding snow droughts to best prepare for their attendant impacts, the concept remains amorphous, with no agreed-upon definition of what they are, how best to measure them, and how such snow droughts connect to warm-season impacts. These knowledge gaps limit our understanding of the risks posed by snow droughts in the present and future, and thus our preparedness for their differential impacts on freshwater resources. To address these issues, we compile a hemispheric ensemble of in situ, satellite, and reanalysis snowpack datasets. We use this ensemble to evaluate the scientific challenges and uncertainties arising from differences in defining and measuring snow droughts, and to identify opportunities to leverage this information to better understand the significance of snow droughts. We show that a clearer quantification of what constitutes a snow drought, including its uncertainties, improves our ability to anticipate costly and disruptive warm-season droughts, which is vital for informing risk management and adaptation to changing snow regimes.
Feasibility of Umbilical Hernia Repair Under Local Anesthesia and Monitored Anesthesia Care at a Veteran Affairs Hospital
Authors: Loss Lindsey , Meier Jennie , Phung Tri , Ordonez Javier , Huerta Sergio
Published: November 2021

Background

Local anesthesia (LA) for open umbilical hernia tissue repair (OUHTR) is not widely utilized in academic centers in the United States. We hypothesize that LA for OUHTR is feasible in a veteran patient population.

Methods

From 2015 to 2019, 449 umbilical hernias were repaired at our institution utilizing a standardized technique in veteran patients. OUHTR was included in this analysis (n = 283). Since 2017, 18.7% (n = 53) UH were repaired under LA. We compared outcomes and operative times between general anesthesia and LA in patients undergoing OUHTR. Univariable and multivariable analyses were performed to determine significance.

Results

The entire cohort was composed of older (56.3 ± 12.1 years), White (75.5%), obese (body mass index [BMI] = 32.3 ± 4.6 kg/m2) men (98.0%). The average hernia size for the entire cohort was 2.42 ± 1.2 cm. The groups were similar in age and BMI. Patients with higher American Society of Anesthesiologists (ASA) (Odds ratio [OR] 3.1; 95% CI 1.5-6.8) and cardiovascular disease (OR 2.7; 95% CI 1.0-7.2) were more likely to receive LA. Recurrence (0.0% vs 6.0%; P = .9) and 30-day complications (6.0% vs 13%; P = .9) were similar between LA and GA after correcting for hernia size. Operating room times were reduced in the LA group (17.7 minutes; P < .05). None of the patients with LA required postanesthesia care unit for recovery. The patients who received LA reported being comfortable (78.9% of patients), with the worst reported pain being 2.4 ± 2.4 (out of a scale of 10), and 94.7% would elect to receive LA if they had another hernia repair.

Conclusion

Patients who received LA had more cardiac disease and a higher ASA. Complications were similar between both groups. LA reduced operating room times. Patients were satisfied with LA.
Safety and Clinical Value of Prophylactic Ureteral Stenting Before Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy
Authors: Hanna David N. , Hermina Andrew , Bradley Emma , Ghani Muhammad O. , Mina Alexander , Bailey Christina E. , Idrees Kamran , Magge Deepa
Published: November 2021

Background

Prophylactic ureteral stents (PUS) are typically placed prior to complex abdominal or pelvic operations at the surgeon’s discretion to help facilitate detection of iatrogenic ureteral injury. However, its usefulness and safety in the setting of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) have not been examined. This study aims to evaluate the potential clinical value and risk profile of prophylactic ureteral stent placement prior to CRS-HIPEC.

Methods

We performed a single-institutional retrospective analysis of 145 patients who underwent CRS-HIPEC from 2013 to 2021. Demographic and operative characteristics were compared between patients who underwent PUS placement and those that did not. Ureteral stent–related complications were evaluated.

Results

Of the 145 patients included in the analysis, 124 underwent PUS placement. There were no significant differences in patient demographics, medical comorbidities, or tumor characteristics. Additionally, PUS placement did not significantly increase operative time and was not associated with increased pelvic organ resection. However, patients who underwent prophylactic ureteral stenting had significantly higher peritoneal carcinomatosis index score (15.1 vs 9.1, P =.002) and increased rate of ureteral complications (24.2% vs 14.3%, P =.04), which led to lengthened hospital stay (13.2 days vs 8.1 days, P = .03). Notably, the sole ureteral injury and three cases of hydronephrosis were seen in patients who underwent PUS.

Conclusion

Prophylactic ureteral stent placement in patients undergoing CRS-HIPEC may be useful, particularly in patients with predetermined extensive pelvic disease. However, PUS placement is not without potential morbidity and should be selectively considered in patients for whom benefits outweigh the risks.
Faith and FACES: Black Parents’ Perceptions of Autism, Faith, and Coping
Authors: Pearson Jamie N. , Stewart-Ginsburg Jared H. , Malone Kayla , Avent Harris Janeé R.
Published: November 2021

Faith, spirituality, and religious involvement can promote stress-related coping for parents raising children with autism, yet little research has explored religious coping in Black parents raising children with autism. Given the high levels of religiosity and increased incidence of autism in Black families, the purpose of this qualitative study was to highlight perceptions of Black parents raising children with autism on mental health and religious coping within the context of a parent advocacy intervention efficacy study. We used a grounded theory method with structural coding of group session transcripts and written responses to center the voices of seven Black parents raising children with autism. Three significant findings emerged: (a) mental health conceptualization; (b) double disenfranchisement; and (c) communal coping.
Health Power Resources Theory: A Relational Approach to the Study of Health Inequalities
Authors: Reynolds Megan M.
Published: November 2021

Link and Phelan’s pioneering 1995 theory of fundamental causes urged health scholars to consider the macro-level contexts that “put people at risk of risks.” Allied research on the political economy of health has since aptly demonstrated how institutions contextualize risk factors for health. Yet scant research has fully capitalized on either fundamental cause or political economy of health’s allusion to power relations as a determinant of persistent inequalities in population health. I address this oversight by advancing a theory of health power resources that contends that power relations distribute and translate the meaning (i.e., necessity, value, and utility) of socioeconomic and health-relevant resources. This occurs through stratification, commodification, discrimination, and devitalization. Resurrecting historical sociological emphases on power relations provides an avenue through which scholars can more fully understand the patterning of population health and better connect the sociology of health and illness to the central tenets of the discipline.
Will Business and Human Rights regulation help Rajasthan's bonded labourers who mine sandstone?
Authors: Marshall Shelley , Taylor Kate , Connor Tim , Haines Fiona , Tödt Sara
Published: November 2021

Some of the worst human rights conditions globally are found in Rajasthan’s sandstone quarries. This paper asks if state-based regulation in the economic-North advanced under the Business and Human Rights agenda: disclosure-based regimes, due diligence compliance regimes and trade-based regimes, could advance efforts to improve respect for human rights in this sector. It adopts fields of struggle lens and global value chain theoretical approaches to business power and governance to understand the challenging political and economic dynamics that entrench harm within sandstone quarrying in Rajasthan. This analysis suggests that company-based disclosure and due diligence regimes will struggle to ameliorate these dynamics whilst trade-based approaches hold some potential to generate meaningful change.
Dog-related activities and human well-being in Brazilian dog owners: A framework and cross-cultural comparison with a British study
Authors: Corrêa Graziani F , Barcelos Ana Maria , Mills Daniel S
Published: November 2021

Despite the abundance of studies investigating the benefits of having a dog, the specific aspects of dog ownership that impacts human well-being are not well understood. This study used a qualitative approach to create a framework of the main dog-related activities perceived by Brazilian owners to impact their well-being and compared the findings with those of a similar study in England. Thirty-two Brazilian dog owners from the five regions of the country were remotely interviewed. The thematic analysis of the transcripts generated a total of 58 dog-related activities, organised into 13 themes. Most activities were reported to have a positive effect on participants’ well-being, accounting for 76.8% of the total number of mentions in the interviews. ‘Playing with dog’ and ‘Dog presence’ were the themes most frequently associated with positive well-being outcomes, whereas ‘Unwanted behaviours’ and ‘Failing to meet dog's needs’ were the most commonly associated with negative outcomes. The dog-related activities reported by Brazilian dog owners and the well-being outcomes linked to those activities were consistent with the previous British sample in the framework that emerged. These findings suggest reliability between the two methods used to gather data (remote interview versus focus group) and, most importantly, provide consistent cross-cultural evidence for how certain activities impact dog owner’s well-being.
Power and Resistance: Digital-Free Tourism in a Connected World
Authors: Cai Wenjie , McKenna Brad
Published: November 2021

Although digital-free tourism is growing in popularity, research in this area has not unpacked the complex power relations between humans and technology through a critical perspective. Building on Foucault’s analysis of power and resistance, we theorized technology as disciplinary power and conducted a collaborative autoethnography to explore how individuals resist the dominant discourse. Through a reflexive account, we theorize digital-free travel as a process of negotiating and rejecting the dominant discourse of technology, particularly through effective personal strategies of engaging in full disconnection, redefining punishments and rewards, recalling nostalgic memories, and constantly reflecting on embodied feelings and self-transformations in the power relations. Theoretically, this study contributes to understanding digital-free tourism through the lens of power and resistance; it also contributes to critical studies in technology and tourism. Methodologically, we emphasize the potential of applying collaborative autoethnography in analyzing embodied self-transformations. Practically, this study offers suggestions for digital-free tourism providers.
Leader-following consensus of heterogeneous linear multi-agent systems: New results based on linear transformation method
Authors: Chen Yangzhou , Xu Guangyue , Zhan Jingyuan
Published: November 2021

This paper studies the leader-following state consensus problem for heterogeneous linear multi-agent systems under fixed directed communication topologies. First, we propose a consensus protocol consisting of four parts for high-order multi-agent systems, in which different agents are allowed to have different gain matrices so as to increase the degree of design freedom. Then, we adopt a state linear transformation, which is constructed based on the incidence matrix of a directed spanning tree of the communication topology, to equivalently transform the state consensus problem into a partial variable stability problem. Meanwhile, the results of the partial variable stability theory are used to derive a sufficient and necessary consensus criterion, expressed as the Hurwitz stability of a real matrix. Then, this criterion is further expressed as a bilinear matrix inequality condition, and, based on this condition, an iterative algorithm is proposed to find the gain matrices of the protocol. Finally, numerical examples are provided to verify the effectiveness of the proposed protocol design method.
Dynamic event-triggered control for linear systems subject to asymmetric actuator saturation
Authors: Li Hongchao , Zhang Nan , Deng Huimin
Published: November 2021

This paper investigates dynamic event-triggered control for systems subject to asymmetric actuator saturation. The asymmetric saturation could severely degrade the performance of systems, which always exists in control engineering. A dynamic event-triggered scheme considering the character of asymmetric saturation is proposed to reduce triggered number of events, under the premise that the closed-loop system subject to asymmetric actuator saturation is asymptotically stabilized. Sufficient conditions are derived to stabilize the system and the minimum inter-event time interval is calculated to exclude Zeno behaviour. An optimization problem is solved to estimate the contractive invariant set as the stable region of the system. A numerical example is given to illustrate the theoretical results.