bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance Evaluation of Low-Temperature KF-NaF-AlF3 Electrolytes for Aluminum Electrolysis Using Vertical Inert Cu–Ni–Fe Alloy Anodes
Authors: Singh Kamaljeet , Gunnarsson Gudmundur , Magnusson Jon Hjaltalin , Haarberg Geir Martin , Saevarsdottir Gudrun
Published: November 2023

In this study, the performance of low-temperature electrolytes in a 40 A laboratory oxygen-evolving aluminum electrolysis cell with vertical inert electrodes for two compositions of NaF-KF-AlF3 based electrolyte is investigated. Two compositions of Cu–Ni–Fe alloy, single-phase homogenized, 20Cu-42Ni-38Fe wt% and 5Cu-48Ni-47Fe wt%, are evaluated as anodes. Titanium diboride (TiB2) is used as a wetted cathode. The characteristics of a protective oxide layer, pre-formed on the anode through high-temperature air oxidation, are examined using X-ray diffraction (XRD) and scanning electron microscopy (SEM). It is found that a multilayered oxide morphology, revealing Fe2O3 and NiFe2O4 as major constituents, is dense and adherent to the base alloy. The effects of electrolyte compositions, anode alloys, and electrolysis conditions on cell voltage evolution, current efficiency, contamination levels in the electrolyte and produced aluminum, and anode wear rate are systematically studied. A protective oxide layer, formed through oxidation treatment on the 20Cu-42Ni-38Fe wt% alloy, not only remains compact post-electrolysis but also performs significantly better in a K-rich electrolyte in terms of wear rate and the purity of the aluminum obtained. Influences of electrolyte composition on anode degradation behavior are discussed.
Cardiorespiratory Fitness is Associated with Estimates of Myocardial Perfusion: Influence of Age and Sex
Authors: Carlini Nicholas A. , Cloud Ryan M.T. , Harber Matthew P. , Fleenor Bradley S.
Published: November 2023

Cardiorespiratory fitness (CRF) and the subendocardial viability ratio (SEVR) decline with age and predict future cardiovascular disease (CVD) events in a sex-dependent manner. However, the relation between CRF and SEVR in apparently healthy males and females across the age span is largely unknown. We hypothesized higher CRF is associated with greater SEVR in older females, but not males. Two hundred and sixty-two (126M/136F, age range 20-84 yr) participants underwent measures of CRF (maximal O2 consumption [VO2max]) and SEVR (pulse wave analysis, PWA). A 2-way analysis of variance (ANOVA) was used to examine differences in baseline characteristics between younger (<45 y) and middle-aged and older (MA/O, ≥45 y) males and females. Bivariate correlations assessed the relation between CRF, SEVR, and age in males and females. Partial correlations adjusted for CVD risk factors and medications. MA/O females had the lowest CRF and SEVR compared to all other groups (p<0.05, both). SEVR was negatively correlated with age (r=-0.29) and positively correlated with CRF (r=0.53) in females (p<0.05, both) which persisted after controlling for CVD risk factors and medications (p<0.05, all). SEVR was correlated with CRF in males only after adjusting for CVD risk factors and medications (r=0.26, p<0.05). These findings collectively demonstrate higher CRF is associated with greater SEVR in males and females after adjusting for CVD risk factors and medications, therefore highlighting subtle sex-specific nuances which warrant further investigation.
Uniformity‐Comprehensive Multiobjective Optimization Evolutionary Algorithm Based on Machine Learning
Authors: Luan Yuxuan , He Junjiang , Yang Jingmin , Lan Xiaolong , Yang Geying
Published: November 2023

When solving real‐world optimization problems, the uniformity of Pareto fronts is an essential strategy in multiobjective optimization problems (MOPs). However, it is a common challenge for many existing multiobjective optimization algorithms due to the skewed distribution of solutions and biases towards specific objective functions. This paper proposes a uniformity‐comprehensive multiobjective optimization evolutionary algorithm based on machine learning to address this limitation. Our algorithm utilizes uniform initialization and self‐organizing map (SOM) to enhance population diversity and uniformity. We track the IGD value and use K‐means and CNN refinement with crossover and mutation techniques during evolutionary stages. Our algorithm’s uniformity and objective function balance superiority were verified through comparative analysis with 13 other algorithms, including eight traditional multiobjective optimization algorithms, three machine learning‐based enhanced multiobjective optimization algorithms, and two algorithms with objective initialization improvements. Based on these comprehensive experiments, it has been proven that our algorithm outperforms other existing algorithms in these areas.
Diabetes Mellitus across the Arabo-Islamic World: A Revolution
Authors: Fleifel Mohamad , Fleifel Bassem , El Alam Andrew
Published: November 2023

Background. Mankind continues to suffer from the ever-growing diabetes epidemic and the rapid rise of type 2 diabetes mellitus (T2DM). This metabolic disease has been studied since ancient civilizations. The Arabo-Islamic civilization excelled in establishing some of the most notable discoveries and teachings that remained the blueprint for years to come in the field of diabetology. Aim. This article aimed to review the ancient history of diabetes mellitus, with its main focus on the Arabo-Islamic civilization, and to report our subjective views and analysis of some of the past recommendations based on modern-day findings. Discussion. It is natural to have the teachings of medicine dynamically inspired by one civilization to another, as various fields continue to expand and evolve. This also applies to diabetology as the Arabo-Islamic world used the outlines of prior civilizations to revolutionize the understanding of the disease. Al-Razi and Ibn Sina are probably two of the most renowned polymaths in history, and their contributions to diabetology are well documented. Ibn Maymun’s postulation about the higher prevalence of diabetes in Egypt as compared to Andalusia is something to be carefully studied. It could be that diabetes mellitus’ underdiagnosis and late-stage detection are some of the major reasons for the disparity between the two mentioned regions. Modern-day Arabo-Islamic scholars continue to excel in revolutionizing diabetology. Conclusion. The Arabo-Islamic world houses an impressive bout of scholars who have contributed since the ancient times to diabetology. This scientific locomotion shows no signs of stopping, as it continues to shine during the present day, and likely in the future.
The Poverty-Related Stress Scale: Development and Validation of a Multidimensional Measure Assessing Poverty-Related Stressors
Authors: Allen Brianna , Klibert Jeffrey , van Zyl Llewellyn E.
Published: November 2023

Background. Poverty-related stress plays a pivotal role in mediating the impact of poverty on behavioral health outcomes. However, existing research on adult poverty-related stress suffers from limited scope and inadequate measurement approaches. To address these shortcomings, our study undertakes a comprehensive investigation to develop and validate a multidimensional Poverty-Related Stress Scale (PRSS). Methods. A multistudy research design was employed to develop and validate the PRSS. Study 1 (N=206) established a multidimensional framework for poverty-related stress by exploring the factor structure and internal consistency of our measure. Study 2 (N=400) evaluated nuanced psychometric properties, including factorial validity, internal consistency, and temporal invariance, using confirmatory factor analyses (CFA) and modern exploratory structural equation models (ESEM). Lastly, Study 3 (N=470/219) examined the criterion validity of our scale by investigating its concurrent and predictive relationships with depression, anxiety, and flourishing. Results. The findings consistently supported a hierarchal ESEM model for overall poverty-related stress, reflecting the dynamic interaction among three stressors: noise disturbance, housing dysfunction, and financial distress. This model exhibited temporal invariance, with different studies reliably measuring distinct components of poverty-related stress. Concurrent validity was demonstrated by significant associations between overall poverty-related stress and theoretically relevant constructs, such as depression, anxiety, and flourishing, at different time points. Additionally, predictive validity was established, showing poverty-related stress measured at time 1 accounted for variations in depression, anxiety, and flourishing at time 2. The results provide robust evidence for the validity and reliability of the PRSS as a tool for measuring poverty-related stress and its underlying factors. Conclusions. Our findings offer compelling preliminary support for the utility of our measure. Further research and potential clinical applications are discussed to deepen the understanding of poverty-related stress and its implications for behavioral health outcomes.
Rainfall Scouring Mechanism of the High-Speed Railway Subgrade Slope with Coarse-Grained Soil
Authors: Wei Shao-Wei , Cai De-Gou , Lv Song , Jiang Jian-Jie , Cui Zhen-Dong
Published: November 2023

The hydraulic erosion of the subgrade slope can lead to serious loss of filling materials and landslides, affecting stability. In particular, there is no quantitative consideration of the scouring calculation method for the design codes of High-Speed Railway Subgrade Slope (HRSS). This paper mainly focuses on the anti-erosion stability of HRSS with coarse-grained soil and analyzes the current research shortcomings. The scouring on the subgrade slope was analyzed by establishing an incipient flow velocity formula that optimized the derivation process and parameters. Compared with the two types of cases, the exactitude of the formula derivation is verified. Finally, combined with orthogonal grouping, a single-factor analysis was conducted on the slope gradient and soil shear strength. With the same particle size, the incipient flow velocity decreases with the increase of the slope gradient (29.7° – 45°). When the particle size is upwards of 0.1 mm, the slope gradient has a great impact on the incipient flow velocity. And as the slope gradient decreases, the acceleration of incipient flow velocity with the same particle size increases. The incipient flow velocity increases with the increase of C (Cohesion) or φ (internal friction angle). The value of φ influences more deeply in the particle size range of 0.1 – 20 mm, that is, to advance the resisting erosion capacity, the shear strength of the slope soil is encouraged to improve when designing slope protection measures.
Dietary Wood and Activated Charcoal Improved Ammonium Removal, Heavy Metals Detoxification, Growth Performance, Blood Biochemistry, Carcass Traits, and Histopathology of European Seabass
Authors: Elhetawy Ashraf I. G. , Abdel-Rahim Mohamed M. , Sallam Ahmed E. , Shahin Shimaa A. , Lotfy Ayman M. A. , El Basuini Mohammed F.
Published: November 2023

A 120-day growth trial was completed to assess rearing water quality and fish performance in terms of growth, feed efficacy, digestive enzymes, immunity, and antioxidant activity of seabass fed an experimental diet (ED) supplemented with commercial wood charcoal (WC) and activated wood charcoal (AC). Three levels (0, 10, and 20 g) of WC and AC were administered, representing five treatments: control (CD) fish-fed ED without additives, (WC-1) fish-fed ED containing 10 g kg−1 WC, (WC-2) fish-fed ED containing 20 g kg−1 WC, (AC-1) fish-fed ED containing 10 g kg−1 AC, and (AC-2) fish-fed ED containing 20 g kg−1 AC. Three hundred fish (60.12 ± 0.20 g/fish) were stocked in 15 cement tanks (4.0 m × 2.0 m × 1.2 m, water volume 5 m3 each) at 20 fish/tank and a daily feed ration of 3% of body weight. Results revealed significant improvements with increased growth variables (final weight, weight gain, and specific growth rate), decreased FCR, and decreased ammonia levels and heavy metals (Cu, Cd, Fe, Mn, and Zn) content in rearing water, muscle, and liver with fish fed WC and AC supplemented diets. Furthermore, considerable improvements in digestive enzymes, immunity, and antioxidant activity, with enhanced kidneys, liver, intestines, gills, and spleen. Fish fed the WC-1 diet had a higher final weight (171.90 g), better FCR (1.25), and improved internal organs than the other groups.
Clinical Value of Detecting Fecal Calprotectin by Using Colloidal Gold Assay in Screening or Diagnosing Crohn’s Disease
Authors: Zhang Wangdong , Fan Yanyun , Chen Meijun
Published: November 2023

Background. Crohn’s disease (CD) is a chronic inflammatory disease, and its incidence is gradually increasing. Thus, the use of a simple and convenient examination method to detect CD in the natural population as early as possible is crucial. This study is aimed at using the colloidal gold semiquantitative assay to detect fecal calprotectin (FCP) and determine whether it is helpful in screening or diagnosing CD. Methods. Using a prospectively maintained database, 59 patients with CD were analyzed using FCP measurement. Subsequently, 76 patients and 89 healthy individuals were assigned to the gastrointestinal dysfunction and control groups, respectively. To aid in the screening or diagnosis of CD, the receiver operating characteristic curve was used to determine the diagnostic efficacy of FCP thresholds. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were presented with 95% confidence intervals (CIs). Results. Patients with CD showed significantly higher FCP levels. Compared with the healthy population, when the FCP level cut-off was 15 μg/g and 60 μg/g, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4–88.6%), 84.3% (CI, 76.7%–91.8%) and 98.9% (CI, 96.7%–100%), 80.6% (CI, 71.5%–89.7%) and 97.9% (CI, 93.7%–100%), and 98.7% (CI, 96.2%–100%) and 87.1% (CI, 80.6%–93.6%), respectively. The AUCs were 0.969 (CI, 0.941–0.997). Compared with the gastrointestinal dysfunction group, using the same FCP level cut-off, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4%–88.6%), 71.1% (CI, 60.9%–81.3%) and 89.5% (CI, 82.3%–96.7%), 72.5% (CI, 62.7%–82.3%) and 85.2% (CI, 75.7%–94.7%), and 98.1% (CI, 94.5%–100%) and 84.0% (CI, 76.0%–92.0%), respectively. The AUCs were 0.908 (CI, 0.856–0.960). Conclusion. Detecting FCP by using the colloidal gold semiquantitative assay can be effective in screening and adjunct diagnosing of CD.
Supplementary Table S4 from Cancer-prone Phenotypes and Gene Expression Heterogeneity at Single-cell Resolution in Cigarette-smoking Lungs
Authors: Nakayama Jun , Yamamoto Yusuke
Published: November 2023

Signature genes of smoking basal-d clusters from DEGs analysis.
Supplementary Table S2 from Cancer-prone Phenotypes and Gene Expression Heterogeneity at Single-cell Resolution in Cigarette-smoking Lungs
Authors: Nakayama Jun , Yamamoto Yusuke
Published: November 2023

The details of integrated scRNA-seq samples in the atlas.
Supplementary Figure S7 from Cancer-prone Phenotypes and Gene Expression Heterogeneity at Single-cell Resolution in Cigarette-smoking Lungs
Authors: Nakayama Jun , Yamamoto Yusuke
Published: November 2023

Lymphoid cell analysis of smoker and never-smoker lungs.
FIGURE 4 from Cancer-prone Phenotypes and Gene Expression Heterogeneity at Single-cell Resolution in Cigarette-smoking Lungs
Authors: Nakayama Jun , Yamamoto Yusuke
Published: November 2023

Cancer-related alteration in the basal-d cluster. Expression profiles of DEGs in the basal-d clusters between smokers and never-smokers. A, Gene and pathway networks of marker genes for the basal-d cluster. The network plot was generated by IPA. B, Enrichment analysis of marker genes for the basal-d cluster. Significantly enriched pathways are shown based on IPA data. C, Marker expression patterns in the smoker basal-d clusters. Violin plots of KRT5, ATF3, FOS, and JUN between smokers and never-smokers. Welch t test D. Survival analysis of LUSC cohorts in TCGA with basal-d smoker signature genes. GSVA scores using smoking basal-d signature genes were calculated by GAVA algorithm. log-rank test.
A Novel Hemostatic Peptide Solution for Common Acute Gastrointestinal Bleeding Diseases: First Case Series Study on the Treatment Results of Endoscopic Hemostasis by Nonexpert Endoscopists
Authors: Fujimoto Ai , Ishii Tsuyoshi , Hiraoka Tomomi , Ogawa Yurie , Sato Nobuyuki , Watanabe Naoko , Nogami Akira , Soejima Keita , Fujii Kodai , Hojo Aya , Shimizu Ryo , Nishikawa Yusuke , Dan Nobuhiro , Kobayashi Syunsuke , Okamoto Yosuke , Kimura Ryusuke , Yamaguchi Kazuhisa , Ono Masashi , Toba Takahito , Matsuda Takahisa
Published: November 2023

Introduction: We investigated the hemostatic effect and safety of a hemostatic peptide solution for the treatment of gastrointestinal bleeding requiring emergency endoscopy. Methods: We retrospectively examined the patient backgrounds, hemostatic results, and procedural safety in patients who were treated with a hemostatic peptide solution for hemostasis during emergency endoscopies for gastrointestinal bleeding. All hemostatic procedures were performed by nonexpert physicians with less than 10 years of endoscopic experience. All of the cases were treated at a single institution over the months from January 2022 to January 2023. Results: Twenty-six consecutive patients (17 males and 9 females) with a median age of 74 (45–95) years were included. Their conditions requiring emergency endoscopy were melena in 8 patients, hematochezia in 2, hematemesis in 8, anemia in 6, and bleeding during esophagogastroduodenoscopy in 2. The sites of bleeding were the esophagus in 3 patients, the stomach in 17, the duodenum in 3, the small intestine in 2, and the colon in 1. Hemostasis was obtained with another hemostasis device used in conjunction with the hemostatic peptide solution in 13 cases and with the hemostatic peptide solution alone in 13 cases. The hemostasis success rate was 100%, with no complications. Rebleeding occurred within 1 week in 4 cases. Conclusion: Hemostasis with the hemostatic peptide solution was safe and provided a temporary high hemostatic effect in emergency gastrointestinal endoscopy.
Diabetic Retinopathy and Chronic Kidney Disease: Associations and Comorbidities in a Large Diabetic Population – The Tongren Health Care Study
Authors: Gao Li Qin , Xue Can Can , Cui Jing , Xu Jie , Zhang Chun , Chen Dong Ning , Jonas Jost B. , Wang Ya Xing
Published: November 2023

Introduction: The aim of the study was to investigate associations between diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with type 2 diabetes (TD2). Methods: The participants of the cross-sectional, community-based Tongren Health Care Study underwent a detailed medical and ophthalmological examination. We defined TD2 by a fasting plasma glucose concentration of ≥7.0 mmol/L or a medical history. CKD was classified as either reduced estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 mm2 or presence of albuminuria. DR was assessed using color fundus photographs. Results: Out of 62,217 participants of the Tongren Health Care Study, 5,103 (8.2%) patients had TD2. The prevalence of DR was 12.8% (95% CI, 11.8%, 13.7%), CKD was 13.3% (95% CI, 12.4%, 14.3%), and the subtypes of CKD including reduced eGFR and albuminuria was 4.6% (95% CI, 4.2%, 5.1%) and 10.1% (95% CI, 9.3%, 10.9%), respectively. DR was detectable in 21.0% of the patients with CKD, while CKD was present in 20.9% of the DR patients. Higher DR prevalence was associated with higher prevalence of albuminuria and reduced eGFR (both p < 0.05). Factors independently associated with the presence of CKD instead of DR were older age (p < 0.001, OR = 1.05), a higher body mass index (p < 0.001, OR = 1.14), a higher serum concentration of triglycerides (p < 0.001, OR = 1.26), and a lower blood glucose (p < 0.001, OR = 0.93). Having hypertension was additionally associated with the presence of reduced eGFR as compared with DR (p = 0.005, OR = 4.47). Conclusions: TD2 patients of older age and with higher body mass index, hypertension, and dyslipidemia had a higher probability of being affected by CKD rather than DR, while those with a higher blood glucose level were more prone to DR than CKD.
Advances in the Study of KRAS in Brain Arteriovenous Malformation
Authors: Pang Miao , Zhang Guanghao , Shang Chenghao , Zhang Yuhang , Chen Rundong , Li Zhe , Ding Xin , Duan Guoli , Li Qiang
Published: November 2023

Background: Brain arteriovenous malformation (bAVM) is an abnormal vascular mass with disordered arteriovenous connection. Endothelial KRAS mutation is common in bAVM. In vivo studies have demonstrated that mutations of KRAS in somatic cells can induce bAVM-like angiogenesis, suggesting that KRAS gene may play a key role in the development and progression of bAVM. Summary: In this article, we will provide a comprehensive review of action mechanisms of KRAS mutations in the development of bAVM and summarize potential targeting drugs for KRAS mutations in bAVM somatic cells. Key Message: KRAS mutation in human brain endothelial cells is a key driver in the pathogenesis of sporadic cerebral arteriovenous malformations. It is of great clinical importance to explore and summarize the changes in the signaling pathway induced by KRAS mutation, which may provide additional targets for the treatment of sporadic bAVM development.
Association Between Premature Menopause and Cardiovascular Diseases and All‐Cause Mortality in Korean Women
Authors: Lee Gyu Bae , Nam Ga Eun , Kim Wonsock , Han Byoungduck , Cho Kyung Hwan , Kim Seon Mee , Choi Youn Seon , Kim Do Hoon , Park Yong‐Gyu , Jung Jin‐Hyung , Han Kyungdo , Kim Yang‐Hyun
Published: November 2023

Background

Mortality from cardiovascular diseases in Asian populations is considerable. Menopause is a risk‐enhancing factor for cardiovascular disease, but it is unclear whether menopause is an independent risk factor for cardiovascular disease and mortality in Asian women.

Methods and Results

A total of 1 159 405 postmenopausal women, who had participated in the health examinations of the Korean National Health Insurance Service in 2009, were analyzed, and their reproductive histories were taken. A multivariable Cox proportional hazard model assessed the hazard ratios (HRs) of myocardial infarction (MI), ischemic stroke, and all‐cause mortality, according to the history of premature menopause and age at menopause. After an average 10‐year follow‐up, there were 31 606, 45 052, and 77 680 new cases of MI, ischemic stroke, and all‐cause mortality, respectively. The women with premature menopause exhibited increased risks of MI (HR, 1.40 [95% CI, 1.31–1.50]), ischemic stroke (HR, 1.24 [95% CI, 1.17–1.31]), and all‐cause mortality (HR, 1.19 [95% CI, 1.14–1.24]) when compared with women with menopause aged ≥50 years. The highest risk was evident with menopause between the ages of 30 and 34 years (HR for MI, 1.52 [95% CI, 1.30–1.78]; HR for ischemic stroke, 1.29 [95% CI, 1.12–1.48]; HR for all‐cause mortality, 1.33 [95% CI, 1.20–1.47]) when compared with women with menopause aged ≥50 years.

Conclusions

Earlier age at menopause was associated with increased risks for MI, ischemic stroke, and all‐cause mortality. Future guidelines and risk assessment tools should consider menopause as an independent risk factor of cardiovascular disease in Korean women.
Association Between a First‐Degree Family History and Self‐Reported Personal History of Obesity, Diabetes, and Heart and Blood Conditions: Results From the All of Us Research Program
Authors: Rasooly Danielle , Moonesinghe Ramal , Littrell Kevin , Hull Leland , Khoury Muin J.
Published: November 2023

Background

Family history reflects the complex interplay of genetic susceptibility and shared environmental exposures and is an important risk factor for obesity, diabetes, and heart and blood conditions (ODHB). However, the overlap in family history associations between various ODHBs has not been quantified.

Methods and Results

We assessed the association between a self‐reported family history of ODHBs and their risk in the adult population (age ≥20 years) of the AoU (All of Us) Research Program, a longitudinal cohort study of diverse participants across the United States. We conducted a family history‐wide association study to systematically assess the association of a first‐degree family history of 15 ODHBs in AoU. We performed stratified analyses based on racial and ethnic categories, education, household income and gender minority status, and quantified associations by type of affected relatives. Of 125 430 participants, 76.8% reported a first‐degree family history of any ODHB, most commonly hypertension (n=64 982, 51.8%), high cholesterol (49 753, 39.7%), and heart attack (29 618, 23.6%). We use the FamWAS method to estimate 225 familial associations among 15 ODHBs. The results include overlapping associations between family history of different types of cardiometabolic conditions (such as type 2 diabetes and coronary artery disease), and their risk factors (obesity, hypertension), where adults with a family history of 1 ODHB exhibited 1.1 to 5.6 times (1.5, on average) the odds of having a different ODHB.

Conclusions

Our findings inform the utility of family history data as a risk assessment and screening tool for the prevention of ODHBs and to provide additional insights into shared risk factors and pathogenic mechanisms.
Sleep‐Disordered Breathing, Hypoxia, and Pulmonary Physiologic Influences in Atrial Fibrillation
Authors: Heinzinger Catherine M. , Thompson Nicolas R. , Milinovich Alex , Diniz Araujo Matheus Lima , Orbea Cinthya Pena , Foldvary‐Schaefer Nancy , Haouzi Philippe , Faulx Michael , Van Wagoner David R. , Chung Mina K. , Mehra Reena
Published: November 2023

Background

We leverage a large clinical cohort to elucidate sleep‐disordered breathing and sleep‐related hypoxia in incident atrial fibrillation (AF) development given the yet unclear contributions of sleep‐related hypoxia and pulmonary physiology in sleep‐disordered breathing and AF.

Methods and Results

Patients who underwent sleep studies at Cleveland Clinic January 2, 2000, to December 30, 2015, comprised this retrospective cohort. Cox proportional hazards models were used to examine apnea hypopnea index, percentage time oxygen saturation <90%, minimum and mean oxygen saturation, and maximum end‐tidal carbon dioxide on incident AF adjusted for age, sex, race, body mass index, cardiopulmonary disease and risk factors, antiarrhythmic medications, and positive airway pressure. Those with spirometry were additionally adjusted for forced expiratory volume in 1 second, forced vital capacity, and forced expiratory volume in 1 second/forced vital capacity. This cohort (n=42 057) was 50.7±14.1 years, 51.3% men, 74.1% White individuals, had median body mass index 33.2 kg/m
2
, and 1947 (4.6%) developed AF over 5 years. A 10‐unit apnea hypopnea index increase was associated with 2% higher AF risk (hazard ratio [HR], 1.02 [95% CI, 1.00–1.03]). A 10‐unit increase in percentage time oxygen saturation <90% and 10‐unit decreases in mean and minimum oxygen saturation were associated with 6% (HR, 1.06 [95% CI, 1.04–1.08]), 30% (HR, 1.30 [95% CI, 1.18–1.42]), and 9% (HR, 1.09 [95% CI, 1.03–1.15]) higher AF risk, respectively. After adjustment for spirometry (n=9683 with available data), only hypoxia remained significantly associated with incident AF, although all coefficients were stable.

Conclusions

Sleep‐related hypoxia was associated with incident AF in this clinical cohort, consistent across 3 measures of hypoxia, persistent after adjustment for pulmonary physiologic impairment. Findings identify a strong role for sleep‐related hypoxia in AF development without pulmonary physiologic interdependence.
Survival Benefit of Multiple Arterial Revascularization With and Without Supplementary Saphenous Vein Graft
Authors: Ren Justin , Tian David H. , Gaudino Mario , Fremes Stephen , Reid Christopher M. , Vallely Michael , Smith Julian A. , Srivastav Nilesh , Royse Colin , Royse Alistair
Published: November 2023

Background

It is unknown if the presence of saphenous vein grafting (SVG) adversely affects late survival following coronary surgery with multiple arterial grafting (MAG) versus single arterial grafting.

Methods and Results

A retrospective, observational, multicenter cohort study from 2001 to 2020 was conducted using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Database linked to the National Death Index. Patients undergoing primary isolated coronary artery bypass grafting with ≥2 grafts were included, and exclusions were patients aged <18 years, reoperations, concomitant or previous cardiac surgery, and the absence of arterial grafting. Demographics, comorbidities, medication, and operative configurations were propensity score matched between cohorts. The primary outcome was all‐cause late death. Of 59 689 eligible patients, 35 113 were MAG (58.8%), and 24 576 were single arterial grafting (41.2%). Of the MAG cohort, 17 055 (48.6%) patients did not receive supplementary SVG (total arterial revascularization). Matching separately generated 22 764 patient pairs for MAG versus single arterial grafting, and 11 137 patient pairs for MAG with total arterial revascularization versus MAG with ≥1 supplementary vein grafts. At a median follow‐up duration of 5.0 years postoperatively, the mortality rate was significantly lower for MAG than single arterial grafting (hazard ratio [HR], 0.79 [95% CI, 0.76–0.83];
P
<0.001). The stratified MAG analysis found that MAG with total arterial revascularization had a lower risk of late death (HR, 0.85 [95% CI, 0.80–0.91];
P
<0.001) compared with MAG with ≥1 supplementary vein grafts. Sensitivity analyses produced consistent outcomes as the primary analysis. Following adjustment for the presence of SVG in the Cox model, the survival advantage of incremental number of arteries was lost.

Conclusions

Multiple arterial grafting has significantly improved long‐term survival compared with single arterial grafting. A further incremental survival benefit exists when no SVG is used.
New Data Concerning the Historical Development of the Frame Tale of the Nights
Authors: Marzolph Ulrich
Published: November 2023

The anonymous thirteenth-century Arabic compilation of wisdom texts, Fiqar al-ḥukamāʾ, contains a hitherto not discussed version of narrative elements that are otherwise known from the frame tale of the Nights, notably both The Thousand and One Nights and its shorter Maghrebi sibling, The Hundred and One Nights. As the Fiqar al-ḥukamāʾ is little known, the present contribution at first introduces the work’s manuscripts and its content before discussing the tale in question.
Fledgling Farms and Failing Health: How the Polypore State Transforms the Multispecies Relations in Serbia’s Raspberry Fields
Authors: Thiemann André
Published: November 2023

Extending from an ethnographic case study that demonstrates the existential troubles of Serbian farmers to continue raspberry production for the global market, this article anthropologically hones in on the intertwining of human and non-human labour (production) with socio-economic and techno-scientific policies of care (reproduction). Different waves of state transformation—the build-up and decay of formal employment coupled with the emergence, then exhaustion of the welfare state, its socio-liberal transformation in the early 2000s, followed by its polypore repurposing for illiberal ends since 2012, have led to a zombified hope in the state’s will to care for its population. Skilled and unskilled workers have emigrated to Western labour markets, while the climate crisis gained momentum because of the underfunding of critical infrastructures of value. Adopting a Marxist-Eco-Feminist care perspective, the case study thus embeds seemingly disconnected concerns within wider struggles on the boundaries of the (welfare) state, economy and techno-science.
Internal Lee Wave Generation from Geostrophic Flow in the Northwestern Pacific Ocean
Authors: Li Ji , Xu Zhenhua , Hao Zhanjiu , You Jia , Zhang Peiwen , Yin Baoshu
Published: November 2023

Among the global mapping of lee wave generation, a missing piece exists in the northwestern Pacific Ocean (NPO), which features complex topographies and energetic circulations. This study applies Bell’s theory to estimate and map internal lee waves generated by geostrophic flows in the NPO using Mercator Ocean reanalysis data and the full topographic spectra obtained from the latest synthetic bathymetry product. Unlike the dominant contributions from abyssal hills in the Southern Ocean, multiple topographies, including ridges, rises, and continental margins, result in an inhomogeneous lee wave generation with multiple hotspots in the NPO. The generation rate is generally higher in the Philippine basin and lower in the central Pacific seamounts. Over ridges, the rough topography creates a high potential for triggering lee waves. Over rises and continental margins, the stronger currents at the shallow depths are favorable for lee wave generation. In the Kuroshio extension region, the rough topography and strong currents cause the strongest lee wave generation, with an energy flux reaching 100 mW m−2. By mean–eddy decomposition, it is found that the lee wave hotspots contributed by mean flow are concentrated in specific regions, while those by geostrophic eddies are widely distributed. Geostrophic eddies are the primary contributor to lee wave generation, which account for 74.6% of the total energy transferred from geostrophic flow to lee waves. This study also reveals that tides suppress the lee wave generation by 14%, and geostrophic flow can cause an asymmetric generation of internal tides.
Utilising routine clinical laboratory data to support quality improvement in health care: Application of a national acute kidney injury alert system as a proof of concept
Authors: Holmes Jennifer , Higginson Ray , Geen John , Phillips Aled
Published: November 2023

Background

Acute kidney injury (AKI) is a global health issue known to cause avoidable harm and death. Improvement in its prevention and management is therefore considered an important goal for the health-care sector. The work here aimed to develop a tool which could be used to robustly and reliably measure, monitor, and compare the effectiveness of health-care interventions related to AKI across the Welsh NHS, a mechanism which did not exist previously.

Methods

Using serum creatinine (SCr) as a biomarker for AKI and a validated national data-set collected from the all Wales Laboratory Information Management System, work involved applying Donabedian’s framework to develop indicators with which to measure outcomes related to AKI, and exploring the potential of statistical process control (SPC) techniques for analysing data on these indicators.

Results

Rate of AKI incidence and 30-day AKI-associated mortality are proposed as valid, feasible indicators with which to measure the effectiveness of health-care interventions related to AKI. The control chart, funnel plot, and Pareto chart are proposed as appropriate, robust SPC techniques to analyse and visualise variation in AKI-related outcomes.

Conclusions

This work demonstrates that routinely collected large SCr data offer a significant opportunity to monitor and therefore inform improvement in patient outcomes related to AKI. Moreover, while this work concerns utilisation of SCr data for improvement in AKI strategies, it is a proof of concept which could be replicated for other routinely collected clinical laboratory data, to improve the prevention and/or management of the conditions to which they relate.
Substantive Representation, Women’s Health, and Regime Type
Authors: Mechkova Valeriya , Edgell Amanda B.
Published: November 2023

A large body of literature investigates whether increasing the number of women in legislative office translates into policies that benefit women in society. This research builds upon theories about descriptive and substantive representation. However, these theories may not travel well to authoritarian contexts, where we see some of the largest gains in women legislators in recent years. This article unpacks the link between women’s descriptive representation, healthcare spending, and health outcomes by regime type. Using a sample of 169 countries from 2000 to 2018, we find that the percentage of women legislators is associated with increased healthcare spending across all regimes. However, women’s health outcomes do not improve with women’s descriptive representation in closed autocracies. Meanwhile, the results for democracies and electoral autocracies are similar, suggesting that even limited vertical accountability through semi-competitive elections may facilitate substantive representation of women.
Well-Behaved Women: Engendering Political Interest in Public Opinion Research
Authors: Haider Erum A. , Nooruddin Irfan
Published: November 2023

Women form a large part of the voting public in India. In the 2009 Indian National Election post-election survey, 82% of all adult women surveyed reported voting, but only 32% said that they were interested in politics. The paradox between high female turnout but low levels of interest has been noted in multiple developing country contexts, but the phenomenon is under-theorized. We suggest the reason is that women’s ideas (interest in politics) are discouraged and suppressed by societal patriarchal norms enforced in the household, but women’s bodies (their votes) are valued in competitive elections. We illustrate our argument using matched samples from two rounds (2009 and 2014) of the Indian National Election Survey and an original post-election survey in 2019. We find that women are consistently less likely to report either an interest in politics, or an opinion on political issues, if their spouse or an adult family member observes the interview. Our findings suggest that women’s political agency is systematically under-estimated by researchers, and that women are more likely to assert themselves politically in survey contexts, if given the privacy to do so.
Analysis of factors associated with family disease burden and correlation with social support among family caregivers of patients with severe mental illnesses
Authors: Zhang Xia , Wang Sizhe , Zhao Ran , Zhao Nan , Tao Shilong , Zhang Haiyang , Wu Baiqun , Xia Xiaojuan , Fan Hong
Published: November 2023

Background:

Caregivers are responsible for the home care of family members with severe mental illnesses (SMIs) and their lives are often subject to changes that can create stress and burden. The purpose of this study was to explore the current state of family disease burden and its correlation with social support among family caregivers of SMIs patients.

Methods:

Using a random sampling method, a total of 1,108 family caregivers of SMIs patients in community health service centers were selected. A general information questionnaire of family caregivers and patients, the Family Disease Burden Scale, and the Social Support Rating Scale were used.

Results:

The score of the Family Disease Burden Scale of 1108 family caregivers was 16.57 ± 10.65. Family disease burden was negatively correlated with social support ( p < .05). The main influencing factors of family disease burden were average annual family income, duration of illness, distance to medical care, risk of unpredictable behavior, social support, caregiver-patient relationship, gender, and comorbid chronic conditions ( p < .05).

Conclusion:

Family caregivers of SMIs patients have a relatively low level of caregiver-perceived social support. Interventions to enhance perceived social support could help maintain the health of family caregivers and improve the quality of family care.
A Sense of Place: African Americans, Ethnogenesis and the Search for a “Black Mecca”
Authors: Obinna Denise N.
Published: November 2023

Ethnogenesis is a powerful mechanism which outlines how ethnic groups are formed. It is a complex process which often involves factors such as migration, cultural exchanges, intermarriage as well as religion. Ethnogenesis is also described as the historical and contemporary emergence of a group of people who define themselves in relation to a common socio-cultural and historical heritage. Focusing on African American migration during the Great Migration and its subsequent reverse migration, this study uses the theme of ethnogenesis to describe how migration to northern cities were shaped by a desire for solidarity and opportunity in as much as an escape from racial violence in the South. In the current trend of reverse migration, this work contends that migration is built on a need for opportunity as well as a desire for connectedness to ancestral homelands in the South. Examining the emergence of the “New South” in the post Jim-Crow landscape, this work evaluates the cultural, social and economic appeal of current migration streams. Using data from the Census Bureau’s American Community Survey (ACS) Public Use Microdata Sample (PUMS) files, significant population declines are reported in former destinations like San Francisco, Chicago, and New York. Data also show southern resurgences in destinations like Lafayette, Louisiana and Charlotte, North Carolina. Likewise, there are also marked increases in new destinations like Las Vegas, Nevada and Phoenix-Mesa-Glendale, Arizona. Additionally, data show that the Black population is growing in its diversity as well as density. People who identify as single-race Black, Black Latinx, and Black multiracial are a large (and growing) part of the Black population.
Is Deceitful Autobiographical Memory Really Forgotten?
Authors: Sengupta Rakesh , Rao P. Venkata Ramana , Prusty Anjana , Jackson B. Micheal , Raja Shekar P. V.
Published: November 2023

Autobiographical memory for deceitful events is said to be forgotten over time to reduce guilt and stress. People who engage in deceitful behavior continue to do so because they are able to stretch their memories to match their moral outlook. In this study, the authors wanted to see if participants who engage in deceitful behavior will change their behavior if they are reminded of their previous misdeeds and compare it with reminding them of past moral behavior and any neutral event. We also studied how the experience, or phenomenology of remembering, differs between immoral and moral memories. In Experiment 1, we found evidence to suggest that reminding deceptive autobiographical memory does not reduce deceptive behavior. In Experiment 2, we found evidence to suggest phenomenological characteristics of Immoral and moral memories are not significantly different from each other but they are both significantly different from that of neutral memory. This contradicts established results in the field. It is interesting to note that only emotional valence is significantly different between immoral and moral memory.
Negotiating the exclusive right to public schools in China’s education-featured gated communities under multiscalar and multidirectional urban entrepreneurialism
Authors: He Shenjing , Cai Rong
Published: November 2023

How urban entrepreneurialism is enacted at the neighbourhood level while connecting with broader urban processes remains insufficiently explored. This study introduces a novel conceptual framework of multiscalar and multidirectional urban entrepreneurialism to examine the governance of gated communities that involves dynamic interactions between the entrepreneurial local state, developers, gated communities and individual homeowners/investor-citizens. In Chinese cities, the pursuit of quality living and good schools has given rise to ‘education-featured gated communities’ that package privileged access to K–12 schools with tailor-made residential services. By turning education from a public good into a club good that can be capitalised in the housing price and leveraged in urban (re)development, education-featured gated communities are highly sought after by homebuyers, developers, and local states, becoming an important and integral component of urban entrepreneurialism. When the rising demands of gated community homeowners for school places are not met, activism for quality education within gated communities becomes ubiquitous. Drawing on multiple case studies and multi-source empirical data including national and local policies/documents, in-depth interviews, non-participant observation and site visits, this research examines how homeowners negotiate their exclusive right to public schools through intensive interactions with local authorities. We argue that the semi-private governance of gated communities forms the institutional basis for the ‘shareholding enterprise’ centring on property values. By unpacking the multidirectional processes of entrepreneurial governance that built upon an effective feedback loop involving multiscalar entrepreneurial endeavours based on shareholder value, this study offers a nuanced and enriched understanding of contemporary urban entrepreneurialism.
The Soviet occupation of Polish Lwów (September 1939–July 1941) in light of some unpublished British diplomatic reports by John Russell, R.D. Macrae and Thomas Preston
Authors: Halikowski Smith Stefan
Published: November 2023

The Soviet occupation of Polish Lwów between September 1939 and July 1941 is investigated in light of some unpublished British diplomatic reports contained in dossier F.O. (Foreign Office). 371, file 116 in the National Archives, London and produced from first-hand experience of conditions in the occupied lands. The missions, primarily to secure the safe exit of British and Jewish subjects, contain information contributing to an understanding of the radical changes brought about in that territory, its impromptu incorporation into the Ukrainian SSR, the beginnings of mass deportations both to Siberian GULags and kolkhoz farms in Kazakhstan, and the steady eradication of private ownership.
Functional neurological disorder in Saudi Arabia: A retrospective study
Authors: Tayeb Haythum O.
Published: November 2023

Objectives

To describe the clinical profile of a sample of Saudi patients with Functional Neurological Disorder (FND).

Method

A retrospective chart review of FND patients seen from 2021-2023 at a neuropsychiatry clinic at an academic tertiary care center in Jeddah, Saudi Arabia.

Results

Out of 473 patients seen in the clinic during the review period, 52 (11%) had FND. Mean age was 34 years (standard deviation = 10.7), and 77% were female. Family dispute (39%) was the most reported risk factor, followed by sexual abuse (15%). The most common FND symptoms were nonepileptic seizures (61.5%) and abnormal movements (30.8%). Pain was reported by 57.7% and cognitive symptoms by 36.5%. FND symptoms were frequently attributed to supernatural causes (67.3%). During the last follow-up visit, 53.9% of patients reported FND symptom improvement, whereas 21.2% reported no change, 10.2% reported worsening, and 15% were lost to follow-up. The proportion of patients without symptom improvement was higher among patients with cognitive symptoms (45.5% vs 18% respectively, X2 = 10.08, df = 3, p = .018). The mean number of visits was highest in patients reporting worsening and the lowest was among patients reporting no change (F = 4.21, p = .017).

Conclusion

The role of family disputes in FND in the Middle East, the role of supernatural concepts in how FND is perceived, and the relatively high rate of subjective improvement within this sample of Saudi FND patients merit further exploration. Cognitive symptoms may be another prognostic indicator. Prospective multicenter studies of those with FND using standardized assessment measures are needed.