bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 9918: Decreased Rate but Worsened Outcomes of Acute Myocardial Infarction-Related Hospitalizations Among Young Tobacco Smokers: A Decade Apart Nationwide Analysis (2007 vs 2017)
Authors: Vyas Ankit , Srikanth Sashwath , Shenwai Priya , Chintalapalli Patta Harika Varma , Rida Taherunnisa , Yar Khan Nibras , Asfeen Ummul , Gandhi Zainab J , Desai Rupak
Published: April 2024

Background:
Considering a dearth of contemporary data, we aim to compare the demographics, comorbidities, outcomes of acute myocardial infarction (AMI) hospitalizations among young smokers across two national cohorts selected a decade apart.

Methods:
We utilized National Inpatient Sample (2007 & 2017) to identify AMI in young (18-44 years) tobacco smokers. Demographics, comorbidities, outcomes (all-cause mortality, cardiogenic shock, atrial/ventricular fibrillation/flutter) including hospital resource utilization were assessed.

Results:
Overall hospitalizations for AMI decreased across a decade among young smokers from 1.7% (23,592/1,355,916) in 2007 to 1.3% (28,775/2,269,124) in 2017. Cohort of 2017 consisted of female (30.8% vs 26.0%), non-white, and Medicaid enrollees (35.1% vs 15.9%), admitted to urban teaching facilities compared to 2007. Young smokers with AMI in 2017 had comorbid hypertension (62.1% vs 48.7%), diabetes (24.3% vs 19.1%), obesity (26.6% vs 15.8%), renal failure (9.6% vs 2.8%), fluid & electrolyte disturbances (24.3% vs 9.5%), congestive heart failure (4.5% vs 1.0%), depression (8.4% vs 6.1%), liver disease (2.5% vs 0.8%) and hyperlipidemia compared to 2007 (p<0.05). Cohort of 2017 showed higher all-cause mortality [2.7% vs 0.9%; OR1.67 (CI 1.39-2.02)], post-MI complications like cardiogenic shock [3.5% vs 1.8%; OR1.40 (CI 1.21-1.62)], atrial fibrillation/flutter [4.6% vs 1.7%; OR2.55 (CI 2.21-2.96)], ventricular fibrillation/flutter [3.3% vs 2.8%; OR1.24 (CI 1.09-1.41)] and lower routine discharges. Despite shortened hospital stay, hospital charges increased in 2017 (p<0.05).

Conclusion:
Two cohorts of young tobacco smokers with AMI selected a decade-apart showed lower rate of AMI admissions, however, with significantly higher burden of CVD risk factors, all-cause mortality and post-MI complications in 2017 vs 2007.
Abstract 9949: Characterising the Impact of Type Two Diabetes on the Phenotypic Expression of Hypertrophic Cardiomyopathy
Authors: Jex Nicholas , Chowdhary Amrit , Thirunavukarasu Sharmaine , Sengupta Anshuman , Procter Henry , Poenar Ana Maria , GREENWOOD John , Plein Sven , Page Stephen , Levelt Eylem
Published: April 2024

Background:
Hypertrophic cardiomyopathy (HCM) and type 2 diabetes mellitus (DM) are increasingly frequent comorbidities. DM is associated with worsened survival outcomes in HCM patients. HCM and DM, though differing in their etiologies, share features of alterations in myocardial energetics and perfusion. The mechanisms for this adverse prognostic association are incompletely understood but are likely to include the collective impact of DM and HCM on myocardial metabolism and perfusion.

Objectives:
We aimed to determine if cardiac energetics, measured as the phosphocreatine (PCr)/ATP ratio, and rest and adenosine stress myocardial blood flows (MBF) showed greater reductions in patients with concomitant HCM and DM (HCMDM) compared to isolated HCM or isolated DM using
31
Phosphorus magnetic resonance spectroscopy (
31
P-MRS) and cardiovascular magnetic resonance (CMR).

Methods:
A total of 75 age and sex matched participants were recruited (20 HCMDM, 20 HCM, 20 DM and 15 controls). HCM groups were matched for HCM phenotype (8 with apical and 12 with asymmetric septal hypertrophy in both groups). DM groups were matched for diabetes treatment and HBA1c. Patients with a history of ischemic heart disease were excluded.

Results:
Table-1 shows clinical and CMR/
31
P-MRS data.Left ventricular ejection fraction and mass index were similar in both HCM groups. Global longitudinal strain and left atrial function were significantly reduced in HCMDM compared to HCM. PCr/ATP was similarly reduced in HCMDM and DM groups compared to HCM and controls. Stress MBF was significantly reduced only in HCMDM group.

Conclusions:
The presence of diabetes as a comorbidity confers a more malignant phenotypic expression in HCM patients with greater reductions in myocardial energetics, contractile function, and perfusion. These phenotypic differences may account for the worsened clinical outcomes in HCM patients with concomitant DM.
Table 1: Clinical Characteristics and CMR findings
Abstract 9952: Periodontal Inflammation, Periodontal Bacterial Load and Virulence Genes Expression Are Risk Factors for Myocardial Infarction
Authors: Joshi Chaitanya , Mezincescu Alice , Gunasekara Maheshi , Rudd Amelia , Botchorichvili Helene , Sabir Suleman , Dospinescu Ciprian , Noman Awsan , Cherukara George , McLernon David , Hijazi Karolin , Dawson Dana
Published: April 2024

Background:
A causal relationship between periodontitis and Myocardial Infarction (MI) is stipulated but remains incompletely characterised.

Methods:
Prospectively recruited 160 acute MI patients underwent periodontal exam to quantify periodontal inflamed surface area (PISA), probing pocket depths (PPD) and clinical attachment loss (CAL).
Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans and Prevotella intermedia
loads were assessed in subgingival plaque, venous blood, aspirated intra-coronary thrombi and deployment balloons using quantitative polymerase chain reaction. Expression of periodontal bacterial virulence genes (n=13) was quantified with reverse transcription PCR. Myocardial injury was estimated by 12-hour troponin (TnI) and severity of coronary artery disease (CAD) burden by SYNTAX-I scores. CAD-symptom free controls (n=50) of similar age/gender distribution were used for comparison.

Results:
Compared to controls, MI patients had worse periodontitis and higher bacterial loads (all
p
<0.05). In MI cohort, after adjusting established risk factors, hierarchical linear regression showed that PISA (5%), mean PPD (3%), mean CAL (2%),
P. gingivalis
load (4%) and upregulated expression of
bioF-3
,
fimA
,
prtH
,
prtP
,
ltxA
,
cdtB
virulence genes (4-9%) were associated with an increase in Tnl release, all
p
<0.05. Similarly, mean PPD (5%), mean CAL (4%),
P. gingivalis
load (5%) and upregulated expression of
bioF-3
,
fimA
,
prtP
and
ltxA
virulence genes (4-9%) were associated with higher SYNTAX-I score, all
p
<0.05. Every 200 mm
2
PISA, 1mm mean PPD, 1mm mean CAL and 10
9
P. gingivalis
copies/ng DNA was responsible for 19,000, 32,000, 38,000 and 10,000 ng/L increase in TnI release, respectively. The SYNTAX-I score increased by 3, 4 and 1 unit with every 1mm mean PPD, 1mm mean CAL and 10
9
P. gingivalis
copies/ng DNA, respectively. Periodontal bacterial DNA was detected in coronary thrombi and subgingival plaque sampled from the same patients, with a strong correlation for
P. gingivalis
and
T. forsythia
bacterial loads (Spearman's rho=0.6 for both,
p
<0.05).

Conclusions:
These findings enable further recognition of periodontitis as a risk factor for MI; a new candidate for primary and secondary prevention.
Abstract 9968: Classification and Treatment of Post-Operative Atrial Arrhythmias in Pulmonary Thromboendarterectomy Surgery
Authors: Vanam Sai , Munir Muhammad B , Darden Douglas , Barat Masihullah , Keyt Lucas , Long Tanner , Feld Gregory , Hsu Jonathan C , Birgersdotter-green Ulrika , Ho Gordon , Krummen David , Raissi Farshad , Fernandes Timothy , Poch David , Kim Nick , Papamatheakis Demosthenes G , Kerr Kim , Pretorius Victor , Madani Michael M , Han Frederick , Hoffmayer Kurt S
Published: April 2024

Background:
Atrial arrhythmias (AA) are common after cardiac surgeries including pulmonary thromboendarterectomy (PTE) surgery. However, the arrhythmia classification, treatment and impact of these AA after PTE surgery is unclear.

Hypothesis:
We hypothesized that most AA after PTE are paroxysmal and have a significant impact on post-operative outcomes.

Methods:
We reviewed the charts of 883 consecutive patients who were referred to University of California San Diego for PTE. Demographics, lab results and imaging were extracted from chart review. Predictors and outcomes were analyzed using a multivariate backward logistic regression model or independent samples t test respectively.

Results:
A total of 158 patients (18%) of patients developed an atrial arrhythmia. Paroxysmal atrial fibrillation (AF) was most common (72%, n=113). Persistent AF occurred in 8% of patients (n=12) and atrial flutter occurred in 21% (n=33) after PTE. The average days to onset of AA was 5.6 +/-4.4 days. Strongest predictors of AA (shown in attached figure) were chronic obstructive pulmonary disease (OR 2.8, p=<0.01) and epicardial pacing requirement (OR 4.6, p=<0.01). Patients who developed an AA had significantly prolonged post-operative length of stays (LOS) (14.7 days vs 11.9 days, p=<0.01) compared to those who did not. Amiodarone was given in 73% (n=115) of patients and cardioversion was performed in 15% (n=23) of AA patients.

Conclusions:
AA are common after PTE surgery. Paroxysmal atrial fibrillation was seen most commonly. Patients who had COPD or required epicardial pacing were at highest risk of developing an AA. AA have a significantly prolonged post-operative LOS. The majority of patients received antiarrhythmic therapy with amiodarone (73%) and a minority underwent cardioversion (15%)
Abstract 9969: Determinants of Incident Atherosclerotic Cardiovascular Disease Events Among Individuals with Absent Coronary Artery Calcium: Results from the Multi-Ethnic Study of Atherosclerosis
Authors: Al Rifai Mahmoud , Blaha Michael J , NAMBI VIJAY , Shea Steven , Michos Erin , Blumenthal Roger S , Ballantyne Christie M , Szklo Moyses , Greenland Philip , Miedema Michael , Nasir Khurram , Rotter Jerome I , Guo Xiuqing , Yao Jie , Post Wendy , Virani Salim S
Published: April 2024

Introduction:
We evaluated whether traditional cardiovascular risk factors are associated with incident atherosclerotic cardiovascular disease (ASCVD) among individuals with absent coronary artery calcium (CAC=0) over long-term follow-up.

Methods:
We included participants with CAC=0 at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of individuals free of clinical ASCVD at baseline. After calculating crude event rates, we used multivariable-adjusted Cox proportional hazards models to study the association between cardiovascular risk factors [cigarette smoking, diabetes mellitus, hypertension, preventive medication use (aspirin and statin), family history of premature ASCVD, chronic kidney disease, waist circumference, lipid and inflammatory markers] and adjudicated incident ASCVD events.

Results:
The study population consisted of 3,416 individuals with CAC=0 (mean (SD) age 58 (9) years; 63% were female, 33% White, 31% Black, 12% Chinese-American, and 24% Hispanic. At a median follow-up of 16 years, there were 189 ASCVD events (101 CHD, 98 stroke). The unadjusted 16-year incidence rates of ASCVD were ≤5 per 1000-person-years among individuals with CAC=0 with the exception of current cigarette smoking (7.30), diabetes mellitus (8.92), hypertension (5.44), and chronic kidney disease (6.75). ASCVD event rates were 6.19 per 1000 person-years among those with estimated baseline ASCVD risk 7.5%–<15% and 5.87 per 1000 person-years among those with estimated ASCVD risk 15%–<20%. After multivariable-adjustment, risk factors that were significantly associated with ASCVD: hazard ratio (HR) 95% confidence interval (CI) included current cigarette smoking: 2.12 (1.32,3.42), diabetes mellitus: 1.68 (1.01,2.80), and hypertension: 1.57 (1.06,2.33).

Conclusion:
In a middle-age population free of ASCVD at baseline, current cigarette smoking, diabetes mellitus, and hypertension are independently associated with incident ASCVD over 16-year follow-up among those with CAC=0. If considering a long treatment horizon, it may be reasonable to continue to recommend statin therapy in the presence of these risk factors despite the absence of CAC.
Abstract 9980: Cardio-Omentopexy Requires a Cardioprotective Innate Immune Response to Promote Myocardial Angiogenesis
Authors: Ge Zhi-Dong , Boyd Riley , Lantz Connor , Thorp Edward B , Forbess Joseph M
Published: April 2024

Introduction:
The greater omentum is replete with angiogenic factors and macrophages. Cardio-omentopexy (COP), wherein the pedicled greater omentum is applied onto ischemic or pressure-overloaded hearts, has been shown to be protective in both humans and animals. However, the protective mechanisms of COP remain unclear.

Hypothesis:
We hypothesized that COP protects the heart against pressure overload-induced cardiac hypertrophy and dysfunction via a macrophage-dependent mechanism of myocardial angiogenesis.

Methods:
C57BL/6 mice underwent transverse aortic constriction (TAC) for 6 weeks followed by COP for 8 weeks. Cardiac geometry and function were evaluated using echocardiography (n=12-13 mice/group). Histochemical analyses quantified cardiomyocyte size, fibrosis, microvessel density, and macrophages. Flow cytometry was performed to analyze neutrophil/monocyte/macrophage populations. Gene expression array was also performed. A group of mice receiving both TAC and COP were intraperitoneally injected with clodronate-liposomes (5 mg/kg every three days for 8 weeks) starting on day 3 after COP.

Results:
TAC produced concentric left ventricular hypertrophy, reduced mitral E/A ratio, increased cardiomyocyte size, and myocardial fibrosis in the mice undergoing sham COP surgery (TAC
+
/COP
-
). These maladaptive effects of TAC were abrogated by COP (TAC
+
/COP
+
). Myocardial microvessel density was elevated in TAC
+
/COP
+
mice. Gene array analysis showed activation of angiogenesis gene networks by COP. Flow cytometry revealed that COP resulted in the accumulation of cardiac MHCII
lo
Lyve1+TimD4+ resident macrophages at the omental-cardiac interface. Moreover, the depletion of macrophages with clodronate-liposomes (Clo
+
/TAC
+
/COP
+
) resulted in the failure of COP to prevent left ventricular hypertrophy, enhance mitral E/A ratio, decrease cardiomyocyte size and myocardial fibrosis, and promote angiogenesis.

Conclusions:
COP protects the pressure-overloaded left ventricle from hypertrophy and dysfunction, with associated angiogenesis. Cardiac resident macrophages accumulate near COP, and macrophage depletion eliminates the benefits of COP. These studies support a novel macrophage-dependent effector function of COP.
Abstract 9990: In-Hospital Outcomes of Left Atrial Appendage Closure with the Watchman Device in the Us: A Nationwide Study (2015-2018)
Authors: Khaloo Pegah , Uzomah Uwajachukwumma , Shaqdan Ayman , Ledesma Pablo A , Galvin Jennifer , Ptaszek Leon , Ruskin Jeremy N
Published: April 2024

Introduction:
Left atrial appendage closure with the Watchman device is the only FDA approved alternative to oral anticoagulation (OAC) therapy in patients with atrial fibrillation. The device is indicated for the reduction of thromboembolic events in patients in whom OAC is contraindicated.

Methods:
The Nationwide Inpatient Sample database was used to assess adverse events related to Watchman implants from 2015 to 2018. These were assessed using the appropriate ICD-10 codes.

Results:
Over the 39-month study period, 35,080 patients with the Watchman device were identified. Mean age was 75.9 and 58.2% of patients were male. In-hospital patient outcomes are shown in the table below. Independent predictors of in-hospital mortality were: age (adjusted odds ratio [aOR]:1.1; 95%CI:1.01-1.22), pericardial effusion without tamponade (aOR: 16.7; CI:2.34-119.44), tamponade (aOR: 34.3; 95%CI: 7.32-161.30), pneumothorax (aOR: 19.6; 95%CI: 1.79-214.49), ATRIA bleeding score (2.47; 95%CI: 1.61-3.81) and Elixhauser comorbidity score (1.12; 95%CI: 1.07-1.19).

Conclusion:
Left atrial appendage closure with the Watchman device is associated with a low rate of major adverse events. The most prevalent in-hospital complication is pericardial effusion, which is associated with a 16-fold increase in the risk of in-hospital mortality.
Abstract 9994: SVEAT Score Outperforms the HEART Score for Acute Chest Pain Risk Stratification in Patients Admitted to the Clinical Decision Unit
Authors: Antwi-Amoabeng Daniel , Awad Munadel , Roongritong Chanwit
Published: April 2024

Introduction:
Timely and accurate identification of subgroups at risk for major adverse cardiovascular events (MACE) among patients presenting with acute chest pain remains a challenge. The HEART score is one of the most used risk stratification tools in the United States. Recently, a new scoring system based on clinical symptoms (S), history of vascular disease (V), electrocardiography (E), age (A), and serum troponin (T), SVEAT score was shown to outperform the HEART score.

Hypothesis:
We predicted that the SVEAT score is superior to the HEART score in predicting a 30-day MACE in patients admitted to the clinical decision unit for chest pain evaluation.

Methods:
Medical records of 330 consecutive patients admitted to our clinical decision unit for acute chest pain between January 1st to April 17th, 2019, were retrospectively reviewed. The 30-day MACE was the combined endpoint of death, acute myocardial infarction, or confirmed coronary artery disease that required revascularization or medical therapy. The investigators assigned to calculate the SVEAT, and HEART scores were blinded to the results of the 30-day MACE. An area under the receiver-operator characteristic curve (AUC) for each score was then calculated. The C-statistic and a logistic model were used to compare the predictive performance of the two scores.

Results:
A total of 11 patients (3.33%) experienced the endpoint. The AUC of the SVEAT score (0.8876, 95% C.I. 0.82 - 0.96) was significantly higher than the HEART score (0.7960, 95% C.I. 0.71 - 0.88), p = 0.03 (Fig 1). Using logistic model, a SVEAT score with a cut-off of ≤ 4 as low-risk significantly predicts 30-day MACE (odd ratio 1.52, C.I. 1.19-1.95, p = 0.001), but the HEART score did not (odd ratio 1.29, C.I. 0.78-2.14, p = 0.32).

Conclusion:
The SVEAT score is a superior risk stratification tool to the HEART score in low-to-intermediate-risk acute chest pain patients without apparent acute coronary syndrome.
Abstract 9996: Clinical Features and Predictors of Non-Cardiac Death in Patients Hospitalized for Acute Myocardial Infarction
Authors: Wakabayashi Kohei , Shinke Toshiro , Higuchi Satoshi , Kondo Seita , MIYAUCHI Katsumi , Miyachi Hideki , Iwata Hiroshi , Ito Ryosuke , Tanaka Hiroyuki , Saji Mike , Yamasaki Masao , Yamashita Jun , Kishi Mikio , Abe Kaito , Mase Takaaki , Yahagi Kazuyuki , Asano Taku , Minatsuki Shun , Mitsuhashi Yuya , Yamamoto Takeshi , Nagao Ken , Takayama Morimasa
Published: April 2024

Introduction:
Patients with acute myocardial infarction (AMI) commonly have multiple co-morbidities, and some of these patients die in the hospital from causes other than cardiac complication. However, limited information is available on the mode of death in patients with AMI. Therefore, the present study was performed to determine the incidence, clinical characteristics and predictors of in-hospital non-cardiac death in patients with AMI, using Tokyo Cardiovascular Care Unit (CCU) network registry.

Methods:
Tokyo CCU network registry included 33,780 consecutive patients with AMI admitted to CCU between 2010-2018. The primary endpoint of the present study was in-hospital non-cardiac death. A stepwise regression model was used to identify the predictors of in-hospital non-cardiac death.

Results:
The incidence of all-cause in-hospital mortality was 7.1% (n = 2382), and the incidence was 16% (n = 381) and 84% (n = 2001) for non-cardiac and cardiac causes, respectively. The primary diseases responsible for non-cardiac deaths are shown in Figure. Old age was associated with in-hospital non-cardiac death, with a 29% increase in the risk per decade [odds 1.29, 95%CI (1.17-1.43), p < 0.001]. AMI onset in hospital [odds 2.78, 95%CI (1.98-3.92), p < 0.001], high grade of Killip class [odds 1.92, 95%CI (1.75-2.11), p < 0.001], no PCI [odds 1.76, 95%CI (1.32-2.34), p < 0.001] and history of maintenance haemodialysis [odds 2.13, 95%CI (1.38-3.30), p = 0.003] were associated with in-hospital non-cardiac death.

Conclusions:
The incidence of in-hospital non-cardiac death was significant in patients with AMI, accounting for 16% of all in-hospital deaths in the Tokyo CCU network registry. Thus, the prevention and management of non-cardiac complications are vital to reduce acute-phase mortality in patients with AMI, especially those with predictors of in-hospital non-cardiac death.
Abstract 9998: Association of Hospital Procedural Volume with Outcomes in Heart Transplantation
Authors: Minhas Abdul , Ariss Robert , NAZIR SALIK , Ahuja Keerat , Khan Muhammmad , Siddiqi Tariq Jamal , Krasuski Richard , Greene Stephen J , Fudim Marat
Published: April 2024

Background:
Studies have shown an inverse relationship between procedural volume and outcomes for numerous procedures. The aim of this study was to evaluate the association of heart transplant (HT) procedural volume and in-hospital clinical outcomes.

Methods:
We conducted a retrospective analysis of adult hospitalizations from the Nationwide Readmissions Database (NRD) 2018. International Classification Diseases (ICD) codes were used to identify patients who underwent HT. Hospitals were categorized into 3 groups on the basis of tertiles of annual procedural volume: low (1-14 procedures/year), medium (14 to 27 procedures /year), and high (28 to 115 procedures /year). Hierarchical mixed effect logistic regression modeling with hospital as a random effect was used to examine the association between hospital procedural volume and outcomes. These models were adjusted for patient-level and hospital-level characteristics. Low volume hospitals were used as the reference category.

Results:
This study included 1689 procedures performed across 69 hospitals (
Table
). On multivariate analysis, there was no statistically significant difference in inpatient mortality, discharge to nursing home/long term care facility, stroke, acute kidney injury, bleeding requiring transfusion, pericardial complications, vascular complications or length of stay among low, medium and high-volume centers (
Table
). Interestingly there was a trend toward lower length of stay and lower inpatient mortality in high volume centers that did not reach statistical significance.

Conclusion:
Our study did not find any association between hospital HT procedural volume and clinical outcomes. Further studies are needed to confirm this.
Mental Health Acts — Perspectives from Mental Health and Law in Ireland and in Portugal
Authors: Moreira Ana Lúcia R. , Whelan Darius , Colón Máximo F. , Fouto Ana Caldeira
Published: April 2024

Mental health legislation is a cornerstone to ensure that individuals with severe mental illness access proper care and treatment. Each country establishes their own legislation. We aimed to compare the Portuguese and Irish Mental Health Acts (MHAs). We reviewed the respective MHA and the literature. While the definition of mental disorder is similar in general, who, where, when and how one can be detained differ. Judges decide on detentions in Portugal, while consultant psychiatrists may do so in Ireland. Community-based compulsory treatment is possible and used in Portugal while it is not possible in Ireland. Pros and cons of each approach are discussed with a reflection on the protection of human rights. Further theoretical and empirical studies comparing systems in different jurisdictions would be helpful to deepen our understanding of the legislation and guide on how to better serve individuals with severe mental illness.
Concrete Freedom at Work: Hegel’s normative conception of freedom and its relevance to organization studies
Authors: Thaning Morten S. , Gersel Johan , Pedersen Michael
Published: April 2024

In organization studies, the prevailing understanding of freedom has revolved around a specific concept of autonomy. However, we propose an alternative and normative concept of freedom, drawing inspiration from the philosophy of Hegel and a reinterpretation of his ideas by Robert Brandom. We begin by diagnosing the liberal conceptions of freedom as opportunity and autonomy that shape the predominant understanding of freedom at work within organization studies. We then follow Hegel and conceive freedom as the expansive realization of oneself through the commitment to meaningful constraints. In contrast to the dominant liberal notions of freedom, Hegel allows us to understand professional commitments and communal obligations at work as the medium of freedom. We argue that concrete freedom at work requires (a) that workers see their work as intrinsically valuable and (b) that neither they nor their employers are unconditionally free to define norms for how work is to be organized and pursued. We then demonstrate the theoretical implications of shifting from the liberal conceptions of freedom prevalent in organization studies to a Hegelian conception of freedom. The Hegelian theory leads to a more nuanced understanding of worker decision-discretion, motivation and the meaningfulness of work. Additionally, it has implications for research on bureaucracy and institutional logics. We end by considering the limits of the empirical applicability of our Hegelian theory, and by highlighting its normative value for practitioners and critical management scholars.
More accurate less meaningful? Why quality indicators do not unveil the socio-technical practices inscribed into land use maps
Authors: Braun Andreas Christian
Published: April 2024

Remote sensing plays an important role for modern geography and environmental science. At the same time, it often stands on a weak epistemological foundation. Remote sensing results are mostly treated as strictly objective, context-independent artifacts. This vastly ignores the human practices that led to these results. Thus, remote sensing data are uncritically incorporated into (environmental) policy decision-making processes without understanding exactly how they were generated. Recent research has been critical of this. In a previous study, I showed that the accuracy of land use results can be increased by class aggregation, while the geographic or environmental meaning of the results suffers. I called this provocatively the “more accurate, less meaningful (MALM)” effect and showed that it exists regardless of the technical level of classification. In this study, I discuss the extent to which MALM can be remedied by choosing an appropriate quality indicator. I show that, to the largest extent conceivable, the quality indicator does not and cannot unveil the effects of socio-technical practices, which are materially inscribed into land use maps. Hence, quality indicators are unable to objectivize the effects of practices and values by the researchers. Consequently, they do not solve the MALM problem. On the contrary, I show that the explicit inclusion of geographic knowledge in quality addresses the MALM effect to the largest extent possible. This reinforces my claim that more attention needs to be paid to considering the values and practices behind remote sensing information. I discuss the results in a broad context and argue that and why critical remote sensing based on critical (physical) geography and science-and-technology studies is vital to better incorporate such results into policymaking.
The influence of needleless connectors and inserted catheters on flow rates through vascular introducer sheaths
Authors: Smeltz Alan M , Patel Dillon S , Williams James H
Published: April 2024

Summary

A vascular introducer sheath is often used for rapid volume replacement. However, common manipulations such as the addition of needleless connectors to infusion ports and the insertion of catheters or other devices through the introducer sheath may impede flow. In this study we utilised a rapid infuser to deliver room-temperature normal saline through two introducer sheath configurations with and without the addition of needleless connectors and the placement of catheters through the introducer sheaths. The maximal flow rate delivered by the rapid infuser was 1000 mL/min, which was observed with both introducer sheath sizes tested without additional resistive elements. However, with the addition of a needleless connector, flow rates through the introducer sheaths were substantially lower (64 (standard deviation (SD) 6) mL/min and 61 (SD 7) mL/min for the 8.5 Fr and 9 Fr introducers, respectively). Flow rates were also reduced when catheters were placed within the sheaths (298 (SD 9) mL/min with the 7 Fr catheter and 74 (SD 9) mL/min with the 8 Fr catheter placed in an 8.5 Fr sheath; 649 (SD 6) mL/min with the 7 Fr catheter and 356 (SD 14) mL/min with the 8 Fr catheter placed in the 9 Fr sheath). These findings indicated that both needleless connectors and the placement of catheters through vascular introducer sheaths substantially reduced potential flow rates. Even ‘large’ vascular introducer sheaths capable of delivering high flow rates could be rendered minimally effective for rapid fluid administration when used in this way. Clinicians should consider these impediments to flow when rapid fluid administration is required, and obtain alternative vascular access if necessary.
Women's Experiences of Sexual Agency Under Constrained Choice: A Systematic Review
Authors: Balint Storm
Published: April 2024

In Western societies, women are encouraged to present themselves in sexualized ways and are expected to experience this as a form of sexual agency. However, research on women's sexual agency is new and still developing, leading to inconsistent definitions and understandings. In addition, women's experiences of and resistance to violations of their sexual boundaries are frequently overlooked. The current systematic review answers research questions on how sexual agency has been conceptualized, how it has been studied in relation to sexual violence, and how women's social positionality influences sexual agency. A systematic strategy was used to search 10 health and social science databases and analyze 95 full-text articles. A feminist social constructionist framework guided this mixed-methods synthesis and provided a framework for addressing the research questions. The findings contribute to a deeper understanding of how society and researchers understand women's sexual agency and how intersectionality is largely ignored. Findings also identify an urgent need for future research to consider the relations between violence against women and women's perceptions of (or lack of) sexual agency. Future policymakers, researchers, and educators should move away from a one-size-fits-all approach in their work and instead, consider the diverse impact of societal expectations on women. By doing so, we can develop policies and programming that are specifically tailored to address the unique needs and challenges faced by women in society.
Mechanisms of Political Responsiveness: The Information Sources Shaping Elected Representatives' Policy Actions
Authors: Willems Evelien , Maes Bart , Walgrave Stefaan
Published: April 2024

This study examines the micro-level foundations of how policy responsiveness may come about. Our study builds on the assumption that elected officials' information source use shapes their policy actions. We analyze the variation in information sources elected officials rely on for agenda-setting and policy formulation, distinguishing between public opinion sources, advocacy sources, and expert sources. Additionally, we examine how elected officials' public opinion sources vary across individuals, parties, and political systems. Based on a 2015 survey with 345 Members of Parliament in Belgium and Canada, the results indicate that the actions of elected representatives are more affected by public opinion sources like citizens and the mass media when they initially prioritize issues for policy action, while interest groups are prominent in both stages, and parties and expert sources are more used in the policy formulation phase. Furthermore, politicians in majoritarian systems, those belonging to the opposition and members of populist parties, tend to rely more on public opinion sources than their peers in proportional systems, those in the majority and non-populist parties.
Women-led research in urban China studies: Introduction to a special issue
Authors: Liu Zhilin , Fan C. Cindy , Zhang Fangzhu
Published: April 2024

While women scholars have made important contribution to the emerging scholarship of urban China research, this field also has seen increasing female representation among the new generations of urban scholars. This special issue aims to promote women’s scholarship on urban China studies. In this introduction, we provide an overview of the nine articles led by women researchers that are included in the special issue, discussing how these studies are linked and contribute to the wider debates in the urban literature on China and globally. We argue that, while women scholars not surprisingly bring a sensitivity to gender perspective into the study of Chinese cities, their research is by no means limited to gender and women’s experiences. As showcased in this collection, their scholarship covers a wide variety of urban issues in China, ranging across migration, informality, accessibility, social cohesion, sustainability and urban governance, while engaging in the academic and policy debates in the global urban literature.
Trends and prescribing patterns of antimigraine medicines in nine major cities in China from 2018 to 2022: a retrospective prescription analysis
Authors: Huang Jing , Wang Xinwei , Jin Yiyi , Lou Guodong , Yu Zhenwei
Published: April 2024

Background

The objective of this study was to investigate the trends and prescribing patterns of antimigraine medicines in China.

Methods

The prescription data of outpatients diagnosed with migraine between 2018 and 2022 were extracted from the Hospital Prescription Analysis Cooperative Project of China. The demographic characteristics of migraine patients, prescription trends, and corresponding expenditures on antimigraine medicines were analyzed. We also investigated prescribing patterns of combination therapy and medicine overuse.

Results

A total of 32,246 outpatients who were diagnosed with migraine at 103 hospitals were included in this study. There were no significant trend changes in total outpatient visits, migraine prescriptions, or corresponding expenditures during the study period. Of the patients who were prescribed therapeutic medicines, 70.23% received analgesics, and 26.41% received migraine-specific agents. Nonsteroidal anti-inflammatory drugs (NSAIDs; 28.03%), caffeine-containing agents (22.15%), and opioids (16.00%) were the most commonly prescribed analgesics, with corresponding cost proportions of 11.35%, 4.08%, and 19.61%, respectively. Oral triptans (26.12%) were the most commonly prescribed migraine-specific agents and accounted for 62.21% of the total therapeutic expenditures. The proportion of patients receiving analgesic prescriptions increased from 65.25% in 2018 to 75.68% in 2022, and the proportion of patients receiving concomitant triptans decreased from 29.54% in 2018 to 21.55% in 2022 (both P <  0.001). The most frequently prescribed preventive medication classes were calcium channel blockers (CCBs; 51.59%), followed by antidepressants (20.59%) and anticonvulsants (15.82%), which accounted for 21.90%, 34.18%, and 24.15%, respectively, of the total preventive expenditures. Flunarizine (51.41%) was the most commonly prescribed preventive drug. Flupentixol/melitracen (7.53%) was the most commonly prescribed antidepressant. The most commonly prescribed anticonvulsant was topiramate (9.33%), which increased from 6.26% to 12.75% (both P <  0.001). A total of 3.88% of the patients received combined therapy for acute migraine treatment, and 18.63% received combined therapy for prevention. The prescriptions for 69.21% of opioids, 38.53% of caffeine-containing agents, 26.61% of NSAIDs, 13.97% of acetaminophen, and 6.03% of triptans were considered written medicine overuse.

Conclusions

Migraine treatment gradually converges toward evidence-based and guideline-recommended treatment. Attention should be given to opioid prescribing, weak evidence-based antidepressant use, and medication overuse in migraine treatment.
Mora: abundance aware metagenomic read re-assignment for disentangling similar strains
Authors: Zheng Andrew , Shaw Jim , Yu Yun William
Published: April 2024

Background

Taxonomic classification of reads obtained by metagenomic sequencing is often a first step for understanding a microbial community, but correctly assigning sequencing reads to the strain or sub-species level has remained a challenging computational problem.

Results

We introduce Mora, a MetagenOmic read Re-Assignment algorithm capable of assigning short and long metagenomic reads with high precision, even at the strain level. Mora is able to accurately re-assign reads by first estimating abundances through an expectation-maximization algorithm and then utilizing abundance information to re-assign query reads. The key idea behind Mora is to maximize read re-assignment qualities while simultaneously minimizing the difference from estimated abundance levels, allowing Mora to avoid over assigning reads to the same genomes. On simulated diverse reads, this allows Mora to achieve F1 scores comparable to other algorithms while having less runtime. However, Mora significantly outshines other algorithms on very similar reads. We show that the high penalty of over assigning reads to a common reference genome allows Mora to accurately infer correct strains for real data in the form of E. coli reads.

Conclusions

Mora is a fast and accurate read re-assignment algorithm that is modularized, allowing it to be incorporated into general metagenomics and genomics workflows. It is freely available at https://github.com/AfZheng126/MORA.
Identification of QTNs, QTN-by-environment interactions, and their candidate genes for salt tolerance related traits in soybean
Authors: Chen Ying , Yue Xiu-Li , Feng Jian-Ying , Gong Xin , Zhang Wen-Jie , Zuo Jian-Fang , Zhang Yuan-Ming
Published: April 2024

Background

Salt stress significantly reduces soybean yield. To improve salt tolerance in soybean, it is important to mine the genes associated with salt tolerance traits.

Results

Salt tolerance traits of 286 soybean accessions were measured four times between 2009 and 2015. The results were associated with 740,754 single nucleotide polymorphisms (SNPs) to identify quantitative trait nucleotides (QTNs) and QTN-by-environment interactions (QEIs) using three-variance-component multi-locus random-SNP-effect mixed linear model (3VmrMLM). As a result, eight salt tolerance genes (GmCHX1, GsPRX9, Gm5PTase8, GmWRKY, GmCHX20a, GmNHX1, GmSK1, and GmLEA2-1) near 179 significant and 79 suggested QTNs and two salt tolerance genes (GmWRKY49 and GmSK1) near 45 significant and 14 suggested QEIs were associated with salt tolerance index traits in previous studies. Six candidate genes and three gene-by-environment interactions (GEIs) were predicted to be associated with these index traits. Analysis of four salt tolerance related traits under control and salt treatments revealed six genes associated with salt tolerance (GmHDA13, GmPHO1, GmERF5, GmNAC06, GmbZIP132, and GmHsp90s) around 166 QEIs were verified in previous studies. Five candidate GEIs were confirmed to be associated with salt stress by at least one haplotype analysis. The elite molecular modules of seven candidate genes with selection signs were extracted from wild soybean, and these genes could be applied to soybean molecular breeding. Two of these genes, Glyma06g04840 and Glyma07g18150, were confirmed by qRT-PCR and are expected to be key players in responding to salt stress.

Conclusions

Around the QTNs and QEIs identified in this study, 16 known genes, 6 candidate genes, and 8 candidate GEIs were found to be associated with soybean salt tolerance, of which Glyma07g18150 was further confirmed by qRT-PCR.
Whole-exome sequencing revealed a likely pathogenic variant in NF1 causing neurofibromatosis type I and Arrhythmogenic Cardiomyopathy
Authors: Pourirahim Maryam , Houshmand Golnaz , Abdolkarimi Leyla , Maleki Majid , Kalayinia Samira
Published: April 2024

Background

Neurofibromatosis type I (NF1) is a genetic disorder characterized by the tumor’s development in nerve tissue. Complications of NF1 can include pigmented lesions, skin neurofibromas, and heart problems such as cardiomyopathy. In this study, we performed whole-exome sequencing (WES) on an Iranian patient with NF1 to identify the genetic cause of the disease.

Methods

Following clinical assessment, WES was used to identify genetic variants in a family with a son suffering from NF1. No symptomatic manifestations were observed in other family members. In the studied family, in silico and segregation analysis were applied to survey candidate variants.

Results

Clinical manifestations were consistent with arrhythmogenic cardiomyopathy (ACM). WES detected a likely pathogenic heterozygous missense variant, c.3277G > A:p.Val1093Met, in the NF1 gene, confirmed by PCR and Sanger sequencing. The patient’s parents and brother had a normal sequence at this locus.

Conclusions

Although there is no cure for NF1, genetic tests, such as WES, can detect at-risk asymptomatic family members. Furthermore, cardiac evaluation could also help these patients before heart disease development.
Prognostic analysis of hepatocellular carcinoma based on cuproptosis -associated lncRNAs
Authors: Wei Mingwei , Lu Libai , Luo Zongjiang , Ma Jiasheng , Wang Jianchu
Published: April 2024

Objectives

Cuproptosis represents an innovative type of cell death, distinct from apoptosis, driven by copper dependency, yet the involvement of copper apoptosis-associated long non-coding RNAs (CRLncRNAs) in hepatocellular carcinoma (HCC) remains unclear. This study is dedicated to unveiling the role and significance of these copper apoptosis-related lncRNAs within the context of HCC, focusing on their impact on both the development of the disease and its prognosis.

Methods

We conducted an analysis of gene transcriptomic and clinical data for HCC cases by sourcing information from The Cancer Genome Atlas database. By incorporating cuproptosis-related genes, we established prognostic features associated with cuproptosis-related lncRNAs. Furthermore, we elucidated the mechanism of cuproptosis-related lncRNAs in the prognosis and treatment of HCC through comprehensive approaches, including Lasso and Cox regression analyses, survival analyses of samples, as well as examinations of tumor mutation burden and immune function.

Results

We developed a prognostic model featuring six cuproptosis-related lncRNAs: AC026412.3, AC125437.1, AL353572.4, MKLN1-AS, TMCC1-AS1, and SLC6A1-AS1. This model demonstrated exceptional prognostic accuracy in both training and validation cohorts for patients with tumors, showing significantly longer survival times for those categorized in the low-risk group compared to the high-risk group. Additionally, our analyses, including tumor mutation burden, immune function, Gene Ontology, Kyoto Encyclopedia of Genes and Genomes pathway enrichment, and drug sensitivity, further elucidated the potential mechanisms through which cuproptosis-associated lncRNAs may influence disease outcome.

Conclusions

The model developed using cuproptosis-related long non-coding RNAs (lncRNAs) demonstrates promising predictive capabilities for both the prognosis and immunotherapy outcomes of tumor patients. This could play a crucial role in patient management and the optimization of immunotherapeutic strategies, offering valuable insights for future research.
A challenging case of carbapenem resistant Klebsiella pneumoniae-related pyogenic liver abscess with capsular polysaccharide hyperproduction: a case report
Authors: Sohrabi Maryam , Pirbonyeh Neda , Alizade Naini Mahvash , Rasekhi Alireza , Ayoub Abbas , Hashemizadeh Zahra , Shahcheraghi Fereshteh
Published: April 2024

Background

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, necessitating the administration of polymyxin E (colistin) as a last-line antibiotic. Meanwhile, the mortality rate associated with colistin-resistant K. pneumoniae infections is seriously increasing. On the other hand, importance of administration of carbapenems in promoting colistin resistance in K. pneumoniae is unknown.

Case presentation

We report a case of K. pneumoniae-related pyogenic liver abscess in which susceptible K. pneumoniae transformed into carbapenem- and colistin-resistant K. pneumoniae during treatment with imipenem. The case of pyogenic liver abscess was a 50-year-old man with diabetes and liver transplant who was admitted to Abu Ali Sina Hospital in Shiraz. The K. pneumoniae isolate responsible for community-acquired pyogenic liver abscess was isolated and identified. The K. pneumoniae isolate was sensitive to all tested antibiotics except ampicillin in the antimicrobial susceptibility test and was identified as a non-K1/K2 classical K. pneumoniae (cKp) strain. Multilocus sequence typing (MLST) identified the isolate as sequence type 54 (ST54). Based on the patient’s request, he was discharged to continue treatment at another center. After two months, he was readmitted due to fever and progressive constitutional symptoms. During treatment with imipenem, the strain acquired blaOXA−48 and showed resistance to carbapenems and was identified as a multidrug resistant (MDR) strain. The minimum inhibitory concentration (MIC) test for colistin was performed by broth microdilution method and the strain was sensitive to colistin (MIC < 2 µg/mL). Meanwhile, on blood agar, the colonies had a sticky consistency and adhered to the culture medium (sticky mucoviscous colonies). Quantitative real-time PCR and biofilm formation assay revealed that the CRKP strain increased capsule wzi gene expression and produced slime in response to imipenem. Finally, K. pneumoniae-related pyogenic liver abscess with resistance to a wide range of antibiotics, including the last-line antibiotics colistin and tigecycline, led to sepsis and death.

Conclusions

Based on this information, can we have a theoretical hypothesis that imipenem is a promoter of resistance to carbapenems and colistin in K. pneumoniae? This needs more attention.