bluuebunny/crossref_metadata_2025 huggingface dataset:
Protamine-Induced Allergic Reaction Following Cardiopulmonary Bypass
Authors: Stoelting Robert K. , Brown John W. , Winn Brad A. , Jallad Munier S.
Published: September 2023

A 59 year-old male with a 37-year history of diabetes mellitus treated with protamine zinc insulin (26 units daily) experienced cardiovascular collapse shortly after infusion of protamine (250 mg) at the conclusion of cardiopulmonary bypass for elective coronary artery bypass graft surgery. Generalized erythema of the face and arms and massive facial edema accompanied the hypotension suggesting an allergic reaction to protamine. Presumably, the patient’s prior chronic exposure to low doses of protamine in the insulin preparation (25 units contains 0.7 mg of protamine) caused the formation of antibodies to protamine. The massive dose of intravenous protamine used to reverse heparin anticoagulation relative to that present in the insulin preparation resulted in an antigen-antibody interaction manifesting as cardiovascular collapse.
Bleeding Diathesis Secondary to a Heparin-Like Anticoagulant in a Patient with Multiple Myeloma—A Case Report and Review of Literature
Authors: Desai Nihar , Biswas Seema , Chandra Dinesh , Gupta Ruchi , Gupta Anshul , Kashyap Rajesh
Published: September 2023

Multiple myeloma (MM) is a clonal plasma cell disorder that commonly presents with anemia, renal failure, hypercalcemia, and lytic bone lesions. MM is also frequently associated with thrombotic complications; however, it may rarely present with bleeding diathesis. We report a case of a 42-year-old gentleman with relapsed immunoglobulin G lambda MM who presented with epistaxis, gingival bleeding, and oozing at the venepuncture site. Routine tests of coagulation revealed a prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin time. The PT and aPTT failed to correct with pooled normal plasma and the patient was thus diagnosed to have an acquired heparin-like anticoagulant (HLAC). The source of this HLAC has long been debated, but recent data have demonstrated that this HLAC may be the paraproteins produced by the malignant plasma cells. The patient was treated with intravenous protamine sulfate, repeated cycles of plasma exchange, and a daratumumab-based quadruplet regimen but eventually succumbed to an intracranial hemorrhage. HLAC is a rare but potentially fatal complication of MM that must be considered when patients with MM present with bleeding diathesis.
Utility of Contrast-Enhanced Computed Tomography for Differentiating Pancreatic Ductal Adenocarcinoma from Inflammatory Mass in Chronic Calcific Pancreatitis
Authors: Pratap Thara , Jacob Dhanya , Venkatesh Sudhakar K. , Jalal Muhammed Jasim Abdul , K. Vishnu
Published: September 2023

Objective The aim of this study was to identify the most useful contrast-enhanced computed tomography (CECT) features for differentiating pancreatic ductal adenocarcinoma (PDAC) from mass-forming chronic pancreatitis (MFCP) in chronic calcific pancreatitis (CCP).

Methods In total, 101 patients with CCP and focal pancreatic mass formed the study group. Sixteen qualitative and four quantitative parameters were analyzed. Qualitative parameters included size, site, margin, intralesional hypodensity, collateral duct sign, abrupt pancreatic duct (PD) cutoff, upstream PD dilatation, distal pancreatic atrophy, double duct sign, enhancement pattern, contrast attenuation, peripancreatic inflammation, vascular involvement, regional nodes, and metastasis. Quantitative parameters included duct-to-body ratio, common bile duct (CBD) diameter, main pancreatic duct (MPD) diameter, and carcinoembryonic antigen 19-9 (CA19-9). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for prediction of PDAC. A receiver operating characteristic (ROC) curve analysis was performed and the area under ROC curve (AUROC) was calculated to determine diagnostic accuracy to assess the optimal cutoff.

Results PDAC was confirmed in 48 patients and MFCP in 53 patients. A duct-to-body ratio greater than 0.48 had 95.5% sensitivity, 83.3% specificity, 80.8% PPV, 96.2% NPV, and 88.5% accuracy for predicting PDAC. A CBD diameter cutoff ≥9.5 mm had an accuracy of 75% (p < 0.019) and an MPD cutoff ≥6.25 mm had an accuracy of 67.8% (p = 0.008) for predicting PDAC. On binary logistic regression, the duct-to-body ratio was found to be the significant independent factor associated with malignancy.

Conclusion A duct-to-body ratio greater than 0.48, intralesional hypodensity, and abrupt duct cutoff are the most helpful computed tomography (CT) features for distinguishing PDAC from MFCP in CCP. On binary logistic regression, the duct-to-body ratio was found to be a significant independent factor. Interspersed normal parenchyma was observed as a very specific sign of MFCP. Intraparenchymal hypodensity has high specificity, but further validation is needed.
A Pilot Study Conducted at a Tertiary Cancer Care Center, Evaluating the Serum Asparaginase Activity in Children Suffering from Acute Lymphoblastic Leukemia after the Administration of Biosimilar Pegaspargase
Authors: Venkatagiri Archana Melavarige , Bhat Vasudeva K. , Asok Arjun , Prabhu Krishnananda
Published: September 2023

Introduction L-asparaginase is considered to be the most important component in the treatment of acute lymphoblastic leukemia (ALL). Intensifying the use of L-asparaginase during treatment for ALL has resulted in a significant rise in the percentage of children and adolescents who are cured of the disease. Asparaginase trough activity more than or equal to 100 IU/L on day 7 has been found to be the desired activity level in all childhood leukemia patients.

Objectives Due to the paucity of data on biosimilar pegaspargase in the upfront setting, we planned this prospective pilot study to evaluate the levels of serum asparaginase activity (SAA) after biosimilar pegaspargase infusion.

Materials and Methods It is a prospective, single-center, pilot study of 10 pediatric ALL patients for the duration of 6 months. All children less than 18 years with ALL on treatment with curative intent and receiving pegaspargase and who provided informed consent were included in this study. The enzymatic spectrophotometric method was used to determine SAA, and it was measured on the 7th and 14th days after the first dosage of pegaspargase-asparaginase, as well as on the 14th day after the second dose of pegaspargase-asparaginase, while toxicity was charted according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.

Results From 10 patients with a median age of 5.5 years, a grand total of 29 samples were taken for analysis. Children who received pegaspargase had either B-ALL or T-ALL. After the first dose, mean ± SD (standard deviation), SAA levels at day 7 was 131.3 ± 38 IU/L and at Day 14 was 94.8 ± 8 IU/L. After the second dose, mean ± SD SAA level at day 14 was 86.1 ± 15 IU/L. No patient had clinical hypersensitivity reaction and no patient reported any asparaginase-related toxicity. One patient died due to sepsis, infection with multidrug-resistant gram-negative bacteria.

Conclusions Biosimilar pegaspargase maintained good SAA levels 7 and 14 days after infusion.

Drug Trial Registration: Clinical Trial Registry of India vide reference CTRI/2021/08/036033 and available at https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=59285&EncHid=&userName=
Density-dependent carrier-envelope phase shift in attosecond pulse generation from relativistically oscillating mirrors
Authors: Zagidullin Rishat , Tietze Stefan , Zepf Matt , Wang Jingwei , Rykovanov Sergey
Published: September 2023

The carrier-envelope phase (CEP) φ0 is one of the key parameters in the generation of isolated attosecond pulses. In particular, “cosine” pulses (φ0 = 0) are best suited for generation of single attosecond pulses in atomic media. Such “cosine” pulses have the peak of the most intense cycle aligned with the peak of the pulse envelope, and therefore have the highest contrast between the peak intensity and the neighboring cycles. In this paper, the dynamics of single attosecond pulse generation from a relativistically oscillating plasma mirror is investigated. We use an elementary analytical model as well as particle-in-cell simulations to study few-cycle attosecond pulses. We find that the phase of the field driving the surface oscillations depends on the plasma density and preplasma scale length. This leads us to a counterintuitive conclusion: for the case of normal incidence and a sharp plasma–vacuum boundary, the CEP required for the generation of a single attosecond pulse phase is closer to φ0 = π/2 (a “sine” pulse), with the exact value depending on the plasma parameters.
Records of leopard seals Hydrurga leptonyx ashore in South Australia, 2017–2022
Authors: Shaughnessy Peter D. , Tomo Ikuko , Gibbs Susan E. , Kemper Catherine M. , Stemmer David
Published: September 2023

The leopard seal Hydrurga leptonyx is one of five phocid species with a circumpolar distribution in the Southern Ocean. They do not breed on the Australian coast. We document records of 14 leopard seals (two collected specimens, 12 live sightings) in South Australia (SA) between November 2017 and November 2022, from Fowlers Bay to the mouth of the River Murray. We used records from the SA Museum, reports from coastal officers of SA Department for Environment and Water, and information from the public. All 14 seals were juvenile and most were in fair/thin body condition. Two collected specimens and two sighted animals showed evidence of blunt trauma. Stomachs contained fish remains and feathers, and one contained 21 semi-digested smooth toadfish Tetractenos glaber, a species which contains the toxin tetrodotoxin. Necropsies on two specimens involved gross, histopathological, and diagnostic assessment of pathogens, organs, and skin lesions. All records were between June and December, similar to the seasonal distribution reported previously in southern Australia. The 14 records over 5 years to 2022 averaged 2.8 per year, higher than during a previous study in SA that ran over three decades to October 2009 at 1.2 per year.
Vascular optimality dictates plant morphology away from Leonardo’s rule
Authors: Sopp S. B. D. , Valbuena R.
Published: September 2023

Metabolic scaling theory (MST) provides an understanding of scaling in organismal morphology. Empirical data on the apparently universal pattern of tip-to-base conduit widening across vascular plants motivate a set of generalized MST (gMST) relationships allowing for variable rates of conduit coalescence and taper and a transition between transport and diffusive domains. Our model, with coalescence limited to the distalmost part of the conductive system, reconciles previous MST-based models and extends their applicability to the entire plant. We derive an inverse relationship between stem volume taper and conduit widening, which implies that plant morphology is dictated by vascular optimality and not the assumption of constant sapwood area across all branching levels, contradicting Leonardo’s rule. Thus, energy efficiency controls conduit coalescence rate, lowering the carbon cost needed to sustain the vascular network. Our model shows that as a plant grows taller, it must increase conduit widening and coalescence, which may make it more vulnerable to drought. We calculated how our gMST model implies a lower carbon cost to sustain a similar network compared to previous MST-based models. We also show that gMST predicts the cross-sectional area of vessels and their frequency along the relative length better than previous MST models for a range of plant types. We encourage further research obtaining data that would allow testing other gMST predictions that remain unconfirmed empirically, such as conduit coalescence rate in stems. The premise of energy efficiency can potentially become instrumental to our understanding of plant carbon allocation.
An intraflagellar transport dependent negative feedback regulates the MAPKKK DLK-1 to protect cilia from degeneration
Authors: Sun Yue , Jin Yishi
Published: September 2023

Primary cilia are specialized organelles supporting the development and function of cells and organisms. Intraflagellar transport (IFT) is essential for cilia formation, maintenance, and function. In
C. elegans
ciliated sensory neurons, IFT interacts with signaling molecules to generate distinct morphological and function features and also to maintain the integrity of cilia. Here, we report an IFT-dependent feedback control on the conserved MAPKKK DLK-1 in the ciliated sensory neurons. DLK proteins are widely known to act in synapse formation, axon regeneration, and degeneration, but their roles in other neuronal compartments are understudied. By forward genetic screening for altered expression of the endogenously tagged DLK-1 we identified multiple
ift
mutants showing increased DLK-1 accumulation in the defective sensory endings. We show that in response to acute IFT disruption, DLK-1 accumulates rapidly and reversibly. The expression levels of the transcription factor CEBP-1, known to act downstream of DLK-1 in the development and maintenance of synapses and axons, are also increased in the ciliated sensory neurons of
ift
mutants. Interestingly, the regulation of CEBP-1 expression shows sensory neuron-type dependency on DLK-1. Moreover, in the sensory neuron AWC, which has elaborate cilia morphology, up-regulated CEBP-1 represses DLK-1 at the transcription level, thereby dampening DLK-1 accumulation. Last, the IFT-dependent regulatory loop of DLK-1 and CEBP-1 offers neuroprotection in a cilia degeneration model. These findings uncover a surveillance mechanism in which tight control on the DLK-1 signaling protects cilia integrity in a context-specific manner.
CPT1A-mediated fatty acid oxidation confers cancer cell resistance to immune-mediated cytolytic killing
Authors: Liu Zheng , Liu Wenjie , Wang Wei , Ma Yibao , Wang Yufeng , Drum David L. , Cai Jinyang , Blevins Hallie , Lee Eun , Shah Syed , Fisher Paul B. , Wang Xinhui , Fang Xianjun , Guo Chunqing , Wang Xiang-Yang
Published: September 2023

Although tumor-intrinsic fatty acid β-oxidation (FAO) is implicated in multiple aspects of tumorigenesis and progression, the impact of this metabolic pathway on cancer cell susceptibility to immunotherapy remains unknown. Here, we report that cytotoxicity of killer T cells induces activation of FAO and upregulation of carnitine palmitoyltransferase 1A (CPT1A), the rate-limiting enzyme of FAO in cancer cells. The repression of CPT1A activity or expression renders cancer cells more susceptible to destruction by cytotoxic T lymphocytes. Our mechanistic studies reveal that FAO deficiency abrogates the prosurvival signaling in cancer cells under immune cytolytic stress. Furthermore, we identify T cell–derived IFN-γ as a major factor responsible for induction of CPT1A and FAO in an AMPK-dependent manner, indicating a dynamic interplay between immune effector cells and tumor targets. While cancer growth in the absence of CPT1A remains largely unaffected, established tumors upon FAO inhibition become significantly more responsive to cellular immunotherapies including chimeric antigen receptor-engineered human T cells. Together, these findings uncover a mode of cancer resistance and immune editing that can facilitate immune escape and limit the benefits of immunotherapies.
The dynamic duo of microtubule polymerase Mini spindles/XMAP215 and cytoplasmic dynein is essential for maintaining
Drosophila
oocyte fate
Authors: Lu Wen , Lakonishok Margot , Gelfand Vladimir I.
Published: September 2023

In many species, only one oocyte is specified among a group of interconnected germline sister cells. In
Drosophila melanogaster
, 16 interconnected cells form a germline cyst, where one cell differentiates into an oocyte, while the rest become nurse cells that supply the oocyte with mRNAs, proteins, and organelles through intercellular cytoplasmic bridges named ring canals via microtubule-based transport. In this study, we find that a microtubule polymerase Mini spindles (Msps), the
Drosophila
homolog of XMAP215, is essential for maintenance of the oocyte specification. mRNA encoding Msps is transported and concentrated in the oocyte by dynein-dependent transport along microtubules. Translated Msps stimulates microtubule polymerization in the oocyte, causing more microtubule plus ends to grow from the oocyte through the ring canals into nurse cells, further enhancing nurse cell-to-oocyte transport by dynein. Knockdown of
msps
blocks the oocyte growth and causes gradual loss of oocyte determinants. Thus, the Msps-dynein duo creates a positive feedback loop, ensuring oocyte fate maintenance by promoting high microtubule polymerization activity in the oocyte, and enhancing dynein-dependent nurse cell-to-oocyte transport.
Habitat fragmentation decouples fire-stimulated flowering from plant reproductive fitness
Authors: Beck Jared , Waananen Amy , Wagenius Stuart
Published: September 2023

Many plant species in historically fire-dependent ecosystems exhibit fire-stimulated flowering. While greater reproductive effort after fire is expected to result in increased reproductive outcomes, seed production often depends on pollination, the spatial distribution of prospective mates, and the timing of their reproductive activity. Fire-stimulated flowering may thus have limited fitness benefits in small, isolated populations where mating opportunities are restricted and pollination rates are low. We conducted a 6-y study of 6,357
Echinacea angustifolia
(Asteraceae) individuals across 35 remnant prairies in Minnesota (USA) to experimentally evaluate how fire effects on multiple components of reproduction vary with population size in a common species. Fire increased annual reproductive effort across populations, doubling the proportion of plants in flower and increasing the number of flower heads 65% per plant. In contrast, fire’s influence on reproductive outcomes differed between large and small populations, reflecting the density-dependent effects of fire on spatiotemporal mating potential and pollination. In populations with fewer than 20 individuals, fire did not consistently increase pollination or annual seed production. Above this threshold, fire increased mating potential, leading to a 24% increase in seed set and a 71% increase in annual seed production. Our findings suggest that density-dependent effects of fire on pollination largely determine plant reproductive outcomes and could influence population dynamics across fire-dependent systems. Failure to account for the density-dependent effects of fire on seed production may lead us to overestimate the beneficial effects of fire on plant demography and the capacity of fire to maintain plant diversity, especially in fragmented habitats.
Probing shock dynamics inside micro-wire targets after high-intensity laser irradiation using small angle x-ray scattering of a free-electron laser
Authors: Kluge Thomas , Bussmann Michael , Galtier Eric , Glenzer Siegfried , Grenzer Jörg , Gutt Christian , Hartley Nicholas J , Huang Lingen , Garcia Alejandro Laso , Lee Hae Ja , McBride Emma E , Metzkes-Ng Josefine , Nakatsutsumi Motoaki , Nam Inhyuk , Pelka Alexander , Prencipe Irene , Randolph Lisa , Rehwald Martin , Rödel Christian , Rödel Melanie , Toncian Toma , Yang Long , Zeil Karl , Schramm Ulrich , Cowan Thomas E
Published: September 2023

In this paper, we present an experiment that explores the plasma dynamics of a

7
μ

m

diameter carbon wire after being irradiated with a near-relativistic-intensity short pulse laser. Using an x-ray free electron laser pulse to measure the small angle x-ray scattering signal, we observe that the scattering surface is bent and prone to instability over tens of picoseconds. The dynamics of this process are consistent with the presence of a sharp, propagating shock front inside the wire, moving at a speed close to the hole boring velocity or that expected from a thermal shock at a few tens of Mbar.
Multi-agent blind quantum computation without universal cluster states
Authors: Cao Shuxiang
Published: September 2023

Blind quantum computation (BQC) protocols enable quantum algorithms to be executed on third-party quantum agents while keeping the data and algorithm confidential. The previous proposals for measurement-based BQC require preparing a highly entangled cluster state. In this paper, we show that such a requirement is not necessary. Our protocol only requires pre-shared Bell pairs between delegated quantum agents, and there is no requirement for any classical or quantum information exchange between agents during the execution. Our proposal requires fewer quantum resources than previous proposals by eliminating the need for a universal cluster state.
Constraining primordial magnetic fields with line-intensity mapping
Authors: Adi Tal , Libanore Sarah , Cruz Hector Afonso G. , Kovetz Ely D.
Published: September 2023

Primordial magnetic fields (PMFs) offer a compelling explanation for the origin of observed magnetic fields, especially on extragalactic scales. Such PMFs give rise to excess of power in small scale matter perturbations that could strongly influence structure formation. We study the impact of the magnetically enhanced matter power spectrum on the signal that will be observed by line-intensity mapping (LIM) surveys targeting carbon monoxide (CO) emission from star-forming galaxies at high redshifts. Specifically, the voxel intensity distribution of intensity maps provides access to small-scale information, which makes it highly sensitive to signatures of PMFs on matter overdensities. We present forecasts for future LIM CO surveys, finding that they can constrain PMF strength as small asB1Mpc∼ 0.006–1 nG, depending on the magnetic spectral index and the targeted redshifts.
New Continuum Observations of the Andromeda galaxy M31 with FAST
Authors: Zhang Wenjun , Sun Xiaohui , Wang Jie
Published: September 2023

We present a new total intensity image of M31 at 1.248 GHz, observed with the Five-hundred-meter Aperture Spherical radio telescope (FAST) with an angular resolution of

4
′

and a sensitivity of about 16 mK. The new FAST image clearly reveals weak emission outside the ring due to its high sensitivity on large-scale structures. We derive a scale length of 2.7 kpc for the cosmic ray electrons and find that the cosmic ray electrons propagate mainly through diffusion by comparing the scale length at 4.8 GHz. The spectral index of the total intensity varies along the ring, which can be attributed to the variation of the spectra of synchrotron emission. This variation is likely caused by the change of star formation rates along the ring. We find that the azimuthal profile of the non-thermal emission can be interpreted by an axisymmetric large-scale magnetic field with varying pitch angle along the ring, indicating a complicated magnetic field configuration in M31.
Optimization of parameters for portable X-ray diffraction/X-ray fluorescence combined analysis device (P-XRDF-CAD)
Authors: He Z. , Xu Y.J. , Huang N. , Wang P. , Peng B. , Yuan J.X. , An Z.
Published: September 2023

This paper aims to optimize the parameters of a portable
device that combines X-ray diffraction (XRD) and X-ray fluorescence
(XRF) analysis techniques. By using the same X-ray source and
detector, the device enables the simultaneous acquisition of
two-dimensional XRD and XRF information from a sample with the
advantage of high analysis efficiency and consistency in the
measurement points. The equipment and slit materials are discussed,
including the selection of the X-ray source (Moxtek MAGNUM) and the
detector (Andor CCD camera). We also explore two different slit
designs (the bottom-hole and side-hole) and optimize their
dimensions using rectangular holes instead of inclined trapezoidal
holes. Considering the fluorescence X-rays of the filters in the
X-ray tube spectra, a theoretical formula is derived for rapid and
accurate calculation. The calculated results are compared with the
experimental results of Al and Ni filters, demonstrating good
agreement across various tube voltages and filter
thicknesses. Furthermore, an XRD/XRF comprehensive analysis platform
is established. The effects of tube voltage, tube current, exposure
time, and pixel-binning on the single-pixel events of the CCD camera
are investigated and can be used to guide the selection of
appropriate device parameters. The effects of the frame and tube
voltage on the XRD/XRF analysis efficiency are examined for several
sample materials, including Al, α-Fe, Zn, and
ZrO2(Y2O3).
Nonlinear multivariate constitutive equations for modeling hot deformation behavior
Authors: Ahmedabadi Parag M
Published: September 2023

Nonlinear constitutive equations are proposed to model variations in flow stress as a function of strain rate and temperature during hot deformation. Modified constitutive are applied to seventy data sets about hot deformation of alloys. Two modifications to conventional constitutive models are introduced, viz. (1) nonlinear and (2) multivariate models with the fitting of flow stress simultaneously with two variables. The predictive accuracy of constitutive equations was evaluated using three statistical parameters and compared with a conventional Arrhenius-like model. It is shown that nonlinear constitutive equations have improved predictive accuracy for variations in flow stress during hot deformation. The advantages of multivariate models include less computation and material parameters that are constants independent of temperature or strain rate. In another type of multivariate model, flow stress is expressed as linear and nonlinear polynomial functions of the Zener-Holloman parameter. This approach gives a single value of the activation energy of hot deformation. The results have indicated that a generalized second-order multivariate constitutive equation can be used to better predict flow stress, as a function strain rate and temperature, during hot deformation.
A new method for preventing stress cracking in repairable ceramic packages by changing the sealing ring shape
Authors: Yao Xin , Tian Shuang , Fang Yucai , Jiao Honghao , Wang Jianfeng , Wang Bo , Zhou Jian , Xue Feng
Published: September 2023

High-reliable ceramic packages are impressionable to the parallel seam welding (PSW) parameters leading to low yield and reliability. In this study, the structure of the ceramic package was modified by changing the sealing ring to improve weldability and high-temperature reliability. Three types of ceramic packages with different-shaped sealing rings, which are conventional rectangular rings, notch inward rings, and notch outward rings, were fabricated by Au-Sn soldering and a follow-up PSW process. The packages with the rectangular ring failed in the subsequent high-temperature aging test. The packages with the notch inward ring exhibited an early failure after PSW. Cracks were generated in the Au-Sn solder and propagated into the ceramic substrate. The packages with the notch outward ring exhibited remarkable weldability and reliability. Sequential thermo-structural coupling was used to simulate the temperature and stress distribution in the packages. The maximum principal stress in the aforementioned ceramic substrates rapidly increased to approximately 170.0 MPa, 168.5 MPa and 101.4 MPa in the PSW process. Stress concentration existed at the outside corner around the rectangular and notch inward-shaped sealing rings. The maximum temperature at the local position in the ceramic was raised to 250.3 °C, 238.6 °C and 157.2 °C depending on the shape of the sealing ring. The extra transmission path in the notch outward ring relieved thermal mismatch and deformation at the Au-Sn/ceramic interface during PSW. The packages with notch outward rings were recommended especially in the repairable ceramic packaging.
Climate change hazards, physical infrastructure systems, and public health pathways
Authors: Ikonomova Maria , MacAskill Kristen
Published: September 2023

Climate-related hazards such as heatwaves, flooding, wildfires, and storms will increase morbidity and mortality unless infrastructure decision-makers—including urban planners, infrastructure asset managers, and utility providers—implement preventive measures to protect public health from these hazards. Existing research and policies have not systematically identified the key risk factors that these decision-makers need to manage to protect public health in a changing climate. This gap leads to unclarity regarding what infrastructure interventions are required to prevent climate-related health risks and what actors have a responsibility to manage these risks. The Climate-Health-Infrastructure-Pathways Model is introduced in this paper to address this gap and provide a conceptual map that captures the role of physical infrastructure systems in the pathways between climate-related hazards and health risks. The model surpasses what can be found in existing climate change research and policy, including the latest IPCC reporting, and is a conceptual qualitative tool that offers a typology of climate and health risks for infrastructure management. Decision-makers can use the model as a starting point to review the coverage of their current climate risk management plans and identify further opportunities to develop preventive infrastructure responses to protect public health in a changing climate.
Iron deficiency in myocardial ischaemia: molecular mechanisms and therapeutic perspectives
Authors: Corradi Francesco , Masini Gabriele , Bucciarelli Tonino , De Caterina Raffaele
Published: September 2023

Systemic iron deficiency (SID), even in the absence of anaemia, worsens the prognosis and increases mortality in heart failure (HF). Recent clinical–epidemiological studies, however, have shown that a myocardial iron deficiency (MID) is frequently present in cases of severe HF, even in the absence of SID and without anaemia. In addition, experimental studies have shown a poor correlation between the state of systemic and myocardial iron. MID in animal models leads to severe mitochondrial dysfunction, alterations of mitophagy, and mitochondrial biogenesis, with profound alterations in cardiac mechanics and the occurrence of a fatal cardiomyopathy, all effects prevented by intravenous administration of iron. This shifts the focus to the myocardial state of iron, in the absence of anaemia, as an important factor in prognostic worsening and mortality in HF. There is now epidemiological evidence that SID worsens prognosis and mortality also in patients with acute and chronic coronary heart disease and experimental evidence that MID aggravates acute myocardial ischaemia as well as post-ischaemic remodelling. Intravenous administration of ferric carboxymaltose (FCM) or ferric dextrane improves post-ischaemic adverse remodelling. We here review such evidence, propose that MID worsens ischaemia/reperfusion injury, and discuss possible molecular mechanisms, such as chronic hyperactivation of HIF1-α, exacerbation of cytosolic and mitochondrial calcium overload, amplified increase of mitochondrial [NADH]/[NAD+] ratio, and depletion of energy status and NAD+ content with inhibition of sirtuin 1–3 activity. Such evidence now portrays iron metabolism as a core factor not only in HF but also in myocardial ischaemia.
Non-invasive estimation of left ventricular systolic peak pressure: a prerequisite to calculate myocardial work in hypertrophic obstructive cardiomyopathy
Authors: Batzner Angelika , Hahn Patrick , Morbach Caroline , Störk Stefan , Maack Christoph , Verheyen Nicolas , Gerull Brenda , Frantz Stefan , Seggewiss Hubert
Published: September 2023

Aims

Myocardial work (MyW) is an echocardiographically derived parameter to estimate myocardial performance. The calculation of MyW utilizes pressure strain loops from global longitudinal strain and brachial blood pressure (BP) as a surrogate of left ventricular systolic pressure (LVSP). Since LVSP cannot be equated with BP in hypertrophic obstructive cardiomyopathy (HOCM), we explored whether LVSP can be derived non-invasively by combining Doppler gradients and BP.

Methods and results

We studied 20 consecutive patients (8 women, 12 men; mean age 57.0 ± 13.9 years; NYHA 2.1 ± 0.8; maximal septal thickness 24.7 ± 6.3 mm) with indication for first alcohol septal ablation. All measurements were performed simultaneously in the catheterization laboratory (CathLab)—invasively: ascending aortic and LV pressures; non-invasively: BP, maximal (CWmax) and mean (CWmean) Doppler gradients.

LVSP was 188.9 ± 38.5 mmHg. Mean gradients of both methods were comparable (CathLab 34.3 ± 13.4 mmHg vs. CW 31.0 ± 13.7 mmHg). Maximal gradient was higher in echocardiography (64.5 ± 28.8 mmHg) compared with CathLab (54.8 ± 24.0 mmHg; P < 0.05). Adding BP (143.1 ± 20.6 mmHg) to CWmax resulted in higher (207.7 ± 38.0 mmHg; P < 0.001), whereas adding BP to CWmean in lower (174.1 ± 26.1 mmHg; P < 0.01) derived LVSP compared with measured LVSP. However, adding BP to averaged CWmax and CWmean resulted in comparable results for measured and derived LVSP (190.9 ± 31.6 mmHg) yielding a favourable correlation (r = 0.87, P < 0.001) and a good level of agreement in the Bland–Altman plot.

Conclusion

Non-invasive estimation of LVSP in HOCM is feasible by combining conventional BP and averaged CWmean and CWmax gradients. Hereby, a more reliable estimation of MyW in HOCM may be feasible.
Examining the Malleability of Negative Views of Aging, Self-Efficacy Beliefs, and Behavioral Intentions in Middle-Aged and Older Adults
Authors: Diehl Manfred , Rebok George W , Roth David L , Nehrkorn-Bailey Abigail , Rodriguez Diana , Tseng Han-Yun , Chen Diefei
Published: September 2023

Objectives

This study examined the malleability of a tripartite cluster of purported mechanistic variables targeted in a 4-week intervention program designed to improve adults’ engagement in physical activity. The targeted cluster of purported mechanisms consisted of negative views of aging (NVOA), self-efficacy beliefs, and behavioral intentions.

Methods

A randomized single-blind control group design was used to implement the AgingPLUS program in a sample of middle-aged and older adults (N = 335; Mage = 60.1 years; SDage = 8.3 years; age range 45–75 years).

Results

Using an intention-to-treat approach and analyses of covariance adjusting for participants’ baseline scores, findings showed significant improvements in the purported mechanistic variables both at the immediate (Week 4) and delayed posttest (Week 8) in the treatment group but not in the control group. These improvements were for the most part maintained until 8-month postrandomization, although to a smaller extent. Specifically, participants in the AgingPLUS group showed significant improvements in NVOA, self-efficacy beliefs, and behavioral intentions compared to the Health Education control group. Standardized effect sizes for statistically significant effects were variable and ranged from small (d = −0.23) to large (d = 0.80). Effect sizes showed some decay of the intervention at the 8-month posttest.

Discussion

Taken together, the findings supported the efficacy of the AgingPLUS program and showed that variables representing the purported mechanisms of the intervention were significantly moved in a positive direction. In doing so, the AgingPLUS program met a major requirement of the experimental medicine approach to behavior change interventions.

Clinical Trials Registration Number

NCT0329948
Associations of Perceived Stress and Psychological Resilience With Cognition and a Modifiable Dementia Risk Score in Middle-Aged Adults
Authors: Franks Katherine H , Bransby Lisa , Cribb Lachlan , Buckley Rachel , Yassi Nawaf , Chong Trevor T -J , Saling Michael M , Lim Yen Ying , Pase Matthew P
Published: September 2023

Objectives

Psychological stress has been proposed as a risk factor for cognitive impairment and dementia. However, it remains unclear how an individual’s stress-coping ability (i.e., psychological resilience) is related to cognition. This cross-sectional study investigated whether perceived stress and psychological resilience were associated with cognition and a modifiable dementia risk score in a large community-based sample of cognitively normal adults. The moderating effect of psychological resilience was also examined.

Methods

Participants (mean age = 57 ± 7 years) enrolled in the web-based Healthy Brain Project completed the Perceived Stress Scale and the Connor–Davidson Resilience Scale. Domains of attention and working memory were assessed using the Cogstate Brief Battery (n = 1,709), and associative memory was assessed using the Cambridge Neuropsychological Test Automated Battery (n = 1,522). Dementia risk was estimated for 1,913 participants using a modified version of the Cardiovascular Risk Factors, Aging, and Incidence of Dementia dementia risk score, calculated using only readily modifiable dementia risk factors.

Results

In separate linear regression analyses adjusted for age, sex, education, and race, greater levels of perceived stress and lower levels of psychological resilience were associated with poorer performance across all cognitive domains, as well as a higher modifiable dementia risk score. Psychological resilience did not moderate the effect of perceived stress on cognition or the dementia risk score.

Discussion

Higher perceived stress and lower resilience were associated with poorer cognition and a greater burden of modifiable dementia risk factors. Intervention studies are required to determine if lowering stress and building resilience can mitigate cognitive deficits and reduce dementia risk.
1. General Introduction
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

This chapter serves as an introduction to the law of tort. It first discusses the historical development of tort law, covering its early origins; the forms of action including the writ of trespass and the action on the case; the development of fault-based liability; the recognition of a distinct liability for negligence in the eighteenth century and the move away from the erstwhile distinction between direct and indirect injury; early attempts at the classification of the law of obligations; and the modern pre-eminence of negligence. The focus then turns to theories of tort, covering the aims of the law of tort and modern doctrinal classifications. Finally, the chapter considers modern influences on tort law, covering the impacts of insurance and human rights; and concerns about ‘compensation culture’.
3. Negligence—Introduction
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

This chapter introduces the tort of negligence. It first discusses the formulation of a general duty of care, highlighting the case of Donoghue v Stevenson, which established the pre-eminent role of the ‘duty of care’ concept in the tort of negligence, and using the example of product liability to show how the different elements of negligence interact. The chapter then turns to the role of the duty of care concept in modern negligence law, including how the courts determine whether a duty of care is owed, before considering the relationship between negligence and public law.
5. Causation and Scope of Liability
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

Before liability can arise in negligence a causal link must be established between the negligence of the defendant and the injury for which the claimant claims compensation. The first hurdle that must be overcome is to show an historical connection between the defendant’s negligence and the injury (factual causation). This is normally decided by the application of the but-for test: but for the defendant’s negligence, would the claimant have suffered the injury that they did? If factual causation is satisfied, the claimant must then show that the defendant should be legally responsible for the damage the claimant has suffered. This second strand of the causation enquiry may involve issues of ‘legal causation’, which is to say consideration of the effect of intervening acts, whether of the claimant or of a third party, occurring between the defendant’s negligence and the claimant’s injury. It may also involve consideration of whether the defendant should not have to pay for the full extent of the damage because it is considered too remote. These issues are considered in this chapter.
7. Negligence: Duty of Care—Psychiatric Illness
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

This chapter examines liability for psychiatric illness in negligence, and in particular the limits that are placed on claims for such illness at the duty of care stage. It considers liability to a person who was involved as a participant in the traumatic event (‘primary victim’ cases); liability to a person who witnessed the death, injury or imperilment of a third party (‘secondary victim’ cases); and other types of case, such as illness caused by stress at work. The chapter concludes with an evaluation of the current law in this area and a consideration of proposals that have been made for its reform.
9. Negligence: Duty of Care—Omissions and Acts of Third Parties
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

This chapter examines liability for omissions and for the acts of a third party in negligence. Despite the general principle excluding liability for omissions, liability may arise in certain exceptional circumstances, but no precise categorisation is possible of the various situations in which a duty of affirmative action is recognised. The question of liability for the acts of a third party often overlaps with the question of liability for omissions because in a third-party case the complaint is often of an omission, for example a failure to control a third party, or to prevent a dangerous situation from being sparked off by a third party. But not all third-party cases involve omissions. Sometimes the complaint is simply that the defendant provided the third party with the opportunity or the means to injure the claimant, and it is that conduct which is alleged to be negligent, regardless of whether the defendant unreasonably failed at some subsequent point of time to intervene to prevent the injury. In this chapter, analysis of these issues is book-ended by sections addressing the distinction between acts and omissions, and the reasons for treating the latter differently from the former (I), and the specific question of nonfeasance by public bodies (IV).
10. Statutory Liability Regimes
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

Although most of the law of tort is based upon common law principles, there are a number of situations where statutory liability regimes have been created. This chapter focuses on two of these statutory liability regimes, the liability of occupiers to those coming onto their land (governed by the Occupiers’ Liability Acts of 1957 and 1984) and liability in respect of defective products (governed by the Consumer Protection Act 1987). In both these areas Parliament has intervened to remedy perceived failings in the common law. The final part of this chapter considers the common law action for breach of statutory duty. This differs from the action for negligence in that the source of the defendant’s duty is not the common law; rather, the claimant’s case is founded on a breach of a duty imposed on the defendant by Parliament.
11. Nuisance and the Rule in Rylands v Fletcher
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

This chapter examines the two forms of nuisance action in modern law: public and private nuisance. Public nuisance is a crime which may give rise to tort liability. Private nuisance protects an occupier’s right to use and enjoy their land free from unreasonable interferences. The discussion of private nuisance starts with the nature of the tort, before going on to consider the requirement of unreasonable interference; the relationship between nuisance, negligence and fault; who can sue; defences; and remedies. The chapter also considers the rule in Rylands v Fletcher, which imposes strict liability for damage caused by an escape of a dangerous thing in the course of a non-natural use of land. The discussion of this rule begins with the leading case, before proceeding to look at the relationship between the rule and nuisance; the elements of a claim; defences; fire cases; and the future of the rule.
12. Defamation
Authors: Nolan Donal , Oliphant Ken
Published: September 2023

This chapter examines the law of defamation, which protects a claimant’s reputation. It explains the distinction between libel and slander, and outlines the elements of the cause of action for defamation: that the statement must be defamatory; must refer to the claimant; and must be published. The chapter then considers the general defences to liability for defamation: (1) truth, (2) honest opinion, (3) privilege (both absolute and qualified), (4) publication on matter of public interest, (5) offer of amends and (6) innocent dissemination. The chapter concludes with analysis of remedies for defamation and discussion of the balance to be struck between protection of reputation and freedom of speech.
Random attractors for a stochastic nonlocal delayed reaction–diffusion equation on a semi-infinite interval
Authors: Hu Wenjie , Zhu Quanxin , Caraballo Tomás
Published: September 2023

The aim of this paper is to prove the existence and qualitative property of random attractors for a stochastic non-local delayed reaction–diffusion equation (SNDRDE) on a semi-infinite interval with a Dirichlet boundary condition at the finite end. This equation models the spatial–temporal evolution of the mature individuals for a two-stage species whose juvenile and adults both diffuse that lives on a semi-infinite domain and subject to random perturbations. By transforming the SNDRDE into a random evolution equation with delay, by means of a stationary conjugate transformation, we first establish the global existence and uniqueness of solutions to the equation, after which we show the solutions generate a random dynamical system. Then, we deduce uniform a priori estimates of the solutions and show the existence of bounded random absorbing sets. Subsequently, we prove the pullback asymptotic compactness of the random dynamical system generated by the SNDRDE with respect to the compact open topology, and hence obtain the existence of random attractors. At last, it is proved that the random attractor is an exponentially attracting stationary solution under appropriate conditions. The theoretical results are illustrated by application to the stochastic non-local delayed Nicholson’s blowfly equation.