bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF)
Authors: Schulze P. Christian , Bogoviku Jürgen , Westphal Julian , Aftanski Pawel , Haertel Franz , Grund Sissy , von Haehling Stephan , Schumacher Ulrike , Möbius-Winkler Sven , Busch Martin
Published: July 2022

Background:

Effective diuretic regimens using loop diuretics in patients with acute decompensated heart failure are often limited by the development of worsening kidney function. Sodium-glucose cotransporter-2 inhibitors induce glucosuria and sodium excretion with nephroprotective effects in patients with stable heart failure but their role in acute decompensated heart failure is unclear.

Methods:

In this single-center, prospective, double-blind, placebo-controlled, randomized study, we randomly assigned patients with acute decompensated heart failure to empagliflozin 25 mg daily or placebo in addition to standard decongestive treatments that included loop diuretics. The primary end point was cumulative urine output over 5 days. Secondary end points included diuretic efficiency, dynamics in markers of kidney function and injury, and NT-proBNP (N-terminal pro-B-type natriuretic peptide).

Results:

Sixty patients were randomized within 12 hours of hospitalization for acute decompensated heart failure. Addition of empagliflozin daily to standard medical treatment of acute decompensated heart failure resulted in a 25% increase in cumulative urine output over 5 days (median 10.8 versus 8.7 L mL in placebo, group difference estimation 2.2 L [95% CI, 8.4 to 3.6];
P
=0.003). Empagliflozin increased diuretic efficiency compared with placebo (14.1 mL urine per milligram furosemide equivalent [95% CI, 0.6–27.7];
P
=0.041) without affecting markers of renal function (estimated glomerular filtration rate, 51±19 versus 54±17 mL/min per 1.73 m²;
P
=0.599) or injury (total urinary protein, 492±845 versus 503±847 mg/g creatinine;
P
=0.975; and urinary α1-microglobulin, 55.4±38.6 versus 31.3±33.6 mg/g creatinine;
P
=0.066) with more pronounced decrease in NT-proBNP in the empagliflozin group compared with placebo (−1861 versus −727.2 pg/mL after 5 days; quotient in slope, 0.89 [95% CI, 0.83–0.95];
P
<0.001). There were no differences in the incidence of safety events between groups.

Conclusions:

Early addition of empagliflozin to standard diuretic therapy increases urine output without affecting renal function in patients with acute decompensated heart failure.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04049045.
Platypnea‐Orthodeoxia Syndrome in the Setting of Patent Foramen Ovale Without Pulmonary Hypertension or Major Lung Disease
Authors: Othman Farrah , Bailey Brian , Collins Nicholas , Lau Edmund , Tanous David , Rao Karan , Celermajer David , Cordina Rachael
Published: July 2022

Background

Patent foramen ovale (PFO)‐associated platypnea‐orthodeoxia syndrome is characterized by dyspnea and hypoxemia when upright. The pathogenesis is thought to involve an increase in right atrial pressure or change in degree of right to left shunting with upright posture.

Methods and Results

We sought to characterize patients with platypnea‐orthodeoxia syndrome related to PFO without pulmonary hypertension. We retrospectively reviewed databases at 3 tertiary referral hospitals in New South Wales, Australia from 2000 to 2019. Fourteen patients with a mean age of 69±14 years had a PFO with wide tunnel separation. Mean New York Heart Association Classification was II (±0.9) and 7 inpatients had been confined to bed (from postural symptoms). Baseline oxygen saturations supine were 93%±5% and 84%±6% upright. Two patients had a minor congenital heart defect and 4 had mild parenchymal lung disease with preserved lung function. The mean aortic root diameter was 37±6 mm and distance between aortic root and posterior atrial wall was 16±2 mm. Platypnea‐orthodeoxia syndrome was preceded by surgery in 5 patients and 1 patient had mild pneumonia. Successful closure of the PFO using an Amplatzer device was performed in 11 of 14 patients. Post‐closure, all patients had New York Heart Association Classification I (improvement 1.6±0.9,
P
<0.003) and semi‐recumbent oxygen saturations increased by 13%±8% (
P
<0.001, n=10).

Conclusions

Platypnea‐orthodeoxia syndrome is a debilitating condition, curable by PFO closure. Anatomical distortion of the atrial septum related to a dilated aortic root or shortening of the distance between the aortic root and posterior atrial wall may contribute to the syndrome.
Educational Needs of People Living with Atrial Fibrillation: A Qualitative Study
Authors: Ferguson Caleb , Hickman Louise D. , Lombardo Lien , Downie Annie , Bajorek Beata , Ivynian Serra , Inglis Sally C. , Wynne Rochelle
Published: July 2022

Background

This study explored the educational and self‐management needs of adults living with atrial fibrillation (AF).

Methods and Results

This is a qualitative study of adults living with AF, clinicians, and expert key stakeholders. Interviews were conducted via a one‐to‐one semistructured videoconference or phone and transcribed verbatim for thematic analysis. A total of 34 participants were recruited and included in analyses (clinicians n=13; experts n=13, patients n=8). Interviews were on average 40 (range 20–70) minutes in duration. Three key themes were identified: (1) “Patient‐centered AF education”; (2) “Prioritizing AF education”; and (3) “Timing AF education.” The availability of credible information was perceived as highly variable. Information primarily focused on anticoagulation, or procedural information, as opposed to other aspects of management, such as risk factor reduction. Factors to optimize learning, such as multimedia, apps, case studies, or the use of visuals were perceived as important. Continuity of care, including engagement of caregivers, was important to help develop relationships, and facilitate understanding, while concurrently creating opportunities for timely targeted education. Clinicians described acute care as a suboptimal setting to deliver education. Competing interests aligned with the time‐pressured context of acute care were prioritized over patient education. In contrast, patients valued continuity of care. AF education strategies need to pivot from a “one size fits all” approach and modernize to implement a range of approaches.

Conclusions

There remain many unmet needs in the provision of quality AF education to support self‐management. Multimodal offerings and the ability to tailor to individual patient needs are important design considerations for new education programs.
Value of Periprocedural Electrophysiology Testing During Transcatheter Aortic Valve Replacement for Risk Stratification of Patients With New‐Onset Left Bundle‐Branch Block
Authors: Badertscher Patrick , Knecht Sven , Spies Florian , Auberson Chloé , Salis Marc , Jeger Raban V. , Fahrni Gregor , Kaiser Christoph , Schaer Beat , Osswald Stefan , Sticherling Christian , Kühne Michael
Published: July 2022

Background

Despite being the most frequent complication following transcatheter aortic valve replacement (TAVR), optimal management of left bundle‐branch block (LBBB) remains unknown. Electrophysiology study has been proposed for risk stratification. However, the optimal timing of electrophysiology study remains unknown. We aimed to investigate the temporal dynamics of atrioventricular conduction in patients with new‐onset LBBB after TAVR by performing serial electrophysiology study and to deduce a treatment strategy.

Methods and Results

We assessed consecutive patients undergoing TAVR via His‐ventricular interval measurement prevalve and postvalve deployment and the day after TAVR. Infranodal conduction delay was defined as a His‐ventricular interval >55 milliseconds. Among 107 patients undergoing TAVR, 53 patients (50%) experienced new‐onset LBBB postvalve deployment and infranodal conduction delay was noted in 24 of 53 patients intraprocedurally (45%). LBBB resolved the day after TAVR in 35 patients (66%). In patients with new‐onset LBBB postvalve deployment and no infrahisian conduction delay intraprocedurally, the His‐ventricular interval did not prolong in any patient to >55 milliseconds the following day. Overall, 4 patients (7.5%) with new‐onset LBBB after TAVR were found to have persistent infrahisian conduction delay 24 hours after TAVR. During 30‐day follow‐up, 1 patient (1.1%) with new LBBB and a normal His‐ventricular interval after TAVR developed new high‐grade atrioventricular block.

Conclusions

Among patients with new‐onset LBBB postvalve deployment, infrahisian conduction delay can safely be excluded intraprocedurally, suggesting that early intracardiac intraprocedural conduction studies may be of value in these patients.
Conventional Vasopressor and Vasopressor‐Sparing Strategies to Counteract the Blood Pressure–Lowering Effect of Small Interfering RNA Targeting Angiotensinogen
Authors: Uijl Estrellita , Ye Dien , Ren Liwei , Mirabito Colafella Katrina M. , van Veghel Richard , Garrelds Ingrid M. , Lu Hong S. , Daugherty Alan , Hoorn Ewout J. , Nioi Paul , Foster Don , Danser A. H. Jan
Published: July 2022

Background

A single dose of small interfering RNA (siRNA) targeting liver angiotensinogen eliminates hepatic angiotensinogen and lowers blood pressure. Angiotensinogen elimination raises concerns for clinical application because an angiotensin rise is needed to maintain perfusion pressure during hypovolemia. Here, we investigated whether conventional vasopressors can raise arterial pressure after angiotensinogen depletion.

Methods and Results

Spontaneously hypertensive rats on a low‐salt diet were treated with siRNA (10 mg/kg fortnightly) for 4 weeks, supplemented during the final 2 weeks with fludrocortisone (6 mg/kg per day), the α‐adrenergic agonist midodrine (4 mg/kg per day), or a high‐salt diet (all groups n=6–7). Pressor responsiveness to angiotensin II and norepinephrine was assessed before and after siRNA administration. Blood pressure was measured via radiotelemetry. Depletion of liver angiotensinogen by siRNA lowered plasma angiotensinogen concentrations by 99.2±0.1% and mean arterial pressure by 19 mm Hg. siRNA‐mediated blood pressure lowering was rapidly reversed by intravenous angiotensin II or norepinephrine, or gradually reversed by fludrocortisone or high salt intake. Midodrine had no effect. Unexpectedly, fludrocortisone partially restored plasma angiotensinogen concentrations in siRNA‐treated rats, and nearly abolished plasma renin concentrations. To investigate whether this angiotensinogen originated from nonhepatic sources, fludrocortisone was administered to mice lacking hepatic angiotensinogen. Fludrocortisone did not increase angiotensinogen in these mice, implying that the rise in angiotensinogen in the siRNA‐treated rats must have depended on the liver, most likely reflecting diminished cleavage by renin.

Conclusions

Intact pressor responsiveness to conventional vasopressors provides pharmacological means to regulate the blood pressure–lowering effect of angiotensinogen siRNA and may support future therapeutic implementation of siRNA.
Neopheosia pseudofasciata sp. nov., a new species of Notodontidae (Lepidoptera) from Wuyishan National Park, southeastern China
Authors: ZHANG YU-LONG , WANG MIN , MA FANG-ZHOU
Published: July 2022

A new species of the genus Neopheosia Matsumura, 1920, N. pseudofasciata sp. nov. is described and illustrated from Fujian province. The species resembles N. fasciata (Moore, 1888) but differs in a forewing pattern in M3 cell; diagnostic differences are observed in genitalia characters as well. DNA barcode data of the new species and its relatives are deposited in GenBank. A key to the Neopheosia species based on morphology is presented. The holotype is deposited in the Department of Entomology, College of Plant Protection, South China Agricultural University, Guangzhou.
Assessing Raindrop Breakup Parameterizations Using Disdrometer Observations
Authors: Saleeby Stephen M. , Dolan Brenda , Bukowski Jennie , Van Valkenburg Kristen , van den Heever Susan C. , Rutledge Steven A.
Published: July 2022

An intercomparison of raindrop mean diameter frequency distribution (RDFD) is performed for numerical simulations of precipitating cloud systems using an array of models and microphysics schemes. This includes results from the Regional Atmospheric Modeling System (RAMS) double-moment microphysics, the Hebrew University Cloud Model bin microphysics (HUCM) interfaced to the RAMS parent model, and the Weather Research and Forecasting (WRF) Model with the Thompson, Morrison, double-moment 6-class (WDM6), and National Severe Storms Laboratory (NSSL) double-moment schemes. Simulations are examined with respect to the raindrop size distribution (DSD) volume-number mean diameter (Dm) and intercept parameter (Nw). When compared to a suite of disdrometer observations, the RDFD resulting from each microphysics scheme exhibits varying degrees of mean drop size constraints and peaks in the frequency distribution of Dm. A more detailed investigation of the peaked RDFD from the RAMS simulations suggests that the parameterization of raindrop collisional breakup can impose strong limitations on the evolution of simulated drop growth. As such, a summary and comparison of the drop breakup parameterizations among the aforementioned microphysics schemes is presented. While some drop breakup parameterizations are adjusted toward the observations by modifying the threshold diameter for the onset of breakup, this study explores the use of a modified maximum breakup efficiency. This method permits the parameterization to retain its threshold breakup diameter, while limiting the strength of drop breakup and permitting a broader range of drop sizes. As a result, the simulated mean drop sizes are in better agreement with observations.
Dynamical Mechanism of the Summer Circulation Trend Pattern and Surface High Temperature Anomalies over the Russian Far East
Authors: Kim Dong Wan , Lee Sukyoung
Published: July 2022

This study investigates the mechanism behind the recent boreal summer circulation trend pattern and associated high surface temperature anomalies over the Russian Far East. This circulation pattern includes a prominent anticyclone over the Kamchatka Peninsula where heat extremes have been trending upward. Observational analysis and numerical model simulations indicate that latent heating anomalies centered over Yakutia, west of Kamchatka Peninsula, can excite this anticyclone and the downstream circulation trend pattern. However, this anticyclone alone is insufficient for generating the anomalously high temperature over the region. Instead, the high temperature emerges when there is an upstream precursor that resembles the Eurasian circulation trend pattern. Warm advection by this upstream circulation initiates a positive temperature anomaly over the Russian Far East, one week prior to the onset of the anticyclone in this region. As this anticyclone develops, the temperature anomalies further intensify by adiabatic warming and shortwave radiative heating. If upstream circulation anomalies are opposite to those of the Eurasian trend pattern, the initial temperature over the Russian Far East is anomalously negative. As a result, the adiabatic warming and shortwave radiative heating within this anticyclonic region are unable to bring the temperature to an extreme condition. These findings indicate that the temperature extremes over the Russian Far East are contributed by a combination of remote and local circulation forcings and provide insights into subseasonal forecasts of heat waves over this region.
Dismantling the National Health Service in England
Authors: Roderick Peter , Pollock Allyson M.
Published: July 2022

The National Health Service was established in the United Kingdom in 1948 as a universal, comprehensive service free at the point of delivery, which is publicly provided, funded, and accountable. Market incrementalism in England has eroded this system over three decades. The recently enacted Health and Care Act will erode it further. This article first explains briefly how legislation and policy initiatives in 1990, 2003, and 2012 furthered development of the market and private provision of health services, and then describes the main structural changes in the new Act and their implications. England is now moving decisively toward a marketized, two-tier, mixed-funding system with several similarities to the United States.
The bipolar patients’ family experiences of the outcomes of encountering stigma in Tehran: A qualitative study
Authors: Latifian Maryam , Raheb Ghoncheh , Abdi Kianoush , Alikhani Rosa
Published: July 2022

Introduction:

Nowadays, the most common psychological-social pressure to which bipolar patients’ families are exposed is stigma. Therefore, the present study was conducted to delve into the bipolar patients’ family experiences of the outcomes of encountering stigma.

Method:

The study was of qualitative type. Purposive sampling was used to select the participants from the persons suffering from bipolar disorder and their families. Twenty seven of the participants were interviewed. The main data collection instrument was semi-structured interview with open questions. Additionally, the collected data were analyzed via inductive content analysis method. The accuracy and validity of the study rooted in four factors: credibility, transferability, verifiability, and reliability.

Results:

Data analysis led to 1,326 primary codes, which were further categorized into five main categories as the main outcomes of encountering stigma (social deprivation, emotional and sentimental excitement, objective and behavioral reflections, family solidarity threat, and separation from society) and 21 sub-categories.

Conclusion:

Given then irreparable outcomes of stigma for bipolar patients’ family, it is necessary to take it into consideration. It is recommended to use media and also hygienic-treatment centers to educate different levels of society as to appropriate treatment with these patients and their families.
Disseminated tuberculosis masquerading as depression
Authors: Riaz R Mohamed , Kotian Chitra M , Devaramane Virupaksha , Umakanth Shashikiran
Published: July 2022

We report the case of a 23-year-old man without any significant premorbid conditions initially presenting to a psychiatrist with suspected depression but later referred to our hospital owing to the possibility of systemic disease and subsequently diagnosed as having disseminated tuberculosis.
Role of intrapulmonary artery septation in univentricular hearts
Authors: Haranal Maruti , Kiniu Naomi Mukuhi , Srimurugan Balaji , Latiff Haifa Abdul , Sivalingam Sivakumar
Published: July 2022

The optimal management of functionally univentricular hearts with a significant unbalanced pulmonary blood flow is unclear. The role of cavopulmonary shunt in the rehabilitation of hypoplastic pulmonary arteries is limited. Intrapulmonary artery septation is a technique, wherein a systemic-to-pulmonary artery shunt provides an additional source of blood flow to rehabilitate the hypoplastic pulmonary artery. We report a case of functionally univentricular heart with hypoplastic left pulmonary artery following a cavopulmonary shunt in whom intrapulmonary artery septation resulted in adequate growth of the left pulmonary artery.
Food insecurity and medication restricting behavior among persons with diabetes in the United States
Authors: McClintock Heather F. , Imel Brittany E.
Published: July 2022

Background

Medication restricting behaviours are common among persons with diabetes increasing risk for poor health outcomes. Persons with diabetes are more likely to experience food insecurity than persons without diabetes.

Aim

This study aimed to assess the relationship between food insecurity and medication restricting behaviour among persons with diabetes in the United States.

Methods

Data from the 2019 National Health Interview Survey (NHIS) data conducted in the United States was used for this analysis. Medication restricting behaviour was assessed by questions asking whether four restricting behaviours were present (skipped medication, took less medication, delayed filling a prescription and/or took less medication due to cost). Food insecurity status was obtained through a 10-item scale and participants were categorized as either food secure, low food security, or very low food security. Poisson regression evaluated the relationship between medication restricting behaviour and food insecurity controlling for confounders.

Results

Participants with very low food security had a significantly higher mean number of medication restricting behaviours than participants who were food secure (adjusted mean ratio (AMR) = 4.01; 95% confidence interval (CI) = (3.09, 5.21)). Similarly, participants with low food security had a significantly higher mean ratio than participants who were food secure (AMR = 3.76; 95% CI = (2.86. 4.94).

Conclusion

Persons with diabetes who have low or very low food security are at an increased risk for engaging in medication restricting behaviours.
Who succeeds and who fails? Exploring the role of background variables in explaining the outcomes of L2 language tests
Authors: Gujord Ann-Kristin Helland
Published: July 2022

This study explores whether and to what extent the background information supplied by 10,155 immigrants who took an official language test in Norwegian affected their chances of passing one, two, or all three parts of the test. The background information included in the analysis was prior education, region (location of their home country), language (first language [L1] background, knowledge of English), second language (hours of second language [L2] instruction, L2 use), L1 community (years of residence, contact with L1 speakers), age, and gender. An ordered logistic regression analysis revealed that eight of the hypothesised explanatory variables significantly impacted the dependent variable (test result). Several of the significant variables relate to pre-immigration conditions, such as educational opportunities earlier in life. The findings have implications for language testing and also, to some extent, for the understanding of variation in learning outcomes.
Research trends and output among information studies postgraduate students in Tanzania, 2000–2017: A reflection of the University of Dar es Salaam
Authors: Elia Emmanuel F. , Ndenje-Sichalwe Esther
Published: July 2022

The study assessed the research pattern of postgraduate students in the field of Library and Information Science (LIS) in Tanzania. Covering a span of 17 years, the study used content analysis to study and identify research areas postgraduate students studied. In all, 269 dissertations were evaluated for the 2000–2017 period. Most of the dissertations (n = 247; 92%) were for the Master's degree and the least (n = 22; 8%) for doctoral studies, with the majority of LIS graduates being male. The study findings show that user studies accounted for the most researched upon (n = 67; 24.9%) area by postgraduate students in Tanzania followed by information industry economics and management (n = 45;16.7%), information/learning society (n = 37;13.7%), diffusion studies (n = 36;13.3%) and finally, information technology (n = 32; 11.9%). The least covered research areas were methodology, information ethics and law. Implicitly, the students preferred user-studies centred research followed by technology. The study concludes no direct association between gender, level of education, year of study and students’ choice of research themes except for information technology. It is recommended that students ought to be exposed to new LIS global research trends for enhanced and broadened research areas to materialise.
Reproducibility of pulmonary magnetic resonance angiography in adults with muco-obstructive pulmonary disease
Authors: Wucherpfennig Lena , Triphan Simon MF , Weinheimer Oliver , Eichinger Monika , Wege Sabine , Eberhardt Ralf , Puderbach Michael U , Kauczor Hans-Ulrich , Heussel Claus P , Heussel Gudula , Wielpütz Mark O
Published: July 2022

Background

Recent studies support magnetic resonance angiography (MRA) as a diagnostic tool for pulmonary arterial disease.

Purpose

To determine MRA image quality and reproducibility, and the dependence of MRA image quality and reproducibility on disease severity in patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF).

Material and Methods

Twenty patients with COPD (mean age 66.5 ± 8.9 years; FEV1% = 42.0 ± 13.3%) and 15 with CF (mean age 29.3 ± 9.3 years; FEV1% = 66.6 ± 15.8%) underwent morpho-functional chest magnetic resonance imaging (MRI) including time-resolved MRA twice one month apart (MRI1, MRI2), and COPD patients underwent non-contrast computed tomography (CT). Image quality was assessed visually using standardized subjective 5-point scales. Contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured by regions of interest. Disease severity was determined by spirometry, a well-evaluated chest MRI score, and by computational CT emphysema index (EI) for COPD.

Results

Subjective image quality was diagnostic for all MRA at MRI1 and MRI2 (mean score = 4.7 ± 0.6). CNR and SNR were 4 43.8 ± 8.7 and 50.5 ± 8.7, respectively. Neither image quality score nor CNR or SNR correlated with FEV1% or chest MRI score for COPD and CF (r = 0.239–0.248). CNR and SNR did not change from MRI1 to MRI2 ( P = 0.434–0.995). Further, insignificant differences in CNR and SNR between MRA at MRI1 and MRI2 did not correlate with FEV1% nor chest MRI score in COPD and CF (r = −0.238–0.183), nor with EI in COPD (r = 0.100–0.111).

Conclusion

MRA achieved diagnostic quality in COPD and CF patients and was highly reproducible irrespective of disease severity. This supports MRA as a robust alternative to CT in patients with underlying muco-obstructive lung disease.
Through Running and Integration of Federal Railroad Administration and Federal Transit Administration Regulated Passenger Trains: A Path Toward Mixing Intercity, Commuter, Metro, and Light Rail on the Same Tracks
Authors: Lytton Dennis
Published: July 2022

U.S. rail transit (subways, metros, and light rail) and Federal Railroad Administration (FRA) regulated heavy rail (commuter, intercity and regional rail) operate completely separately in revenue service. This necessitates transfers between the modes at terminals. While not unique to the U.S.A., its version of this practice is extreme and prevents the development of robust seamless rail networks. Especially in the post-Covid environment, this leaves commuter rail in search of a mission and rail transit isolated from suburbs. This paper discusses the statutory regulatory scheme that divides the two modes in the U.S.A. It will analyze the justification for the segregation and its history. Such issues include potential collisions, weight, crashworthiness, electrification, signaling, loading gauge, platform height, and operating practices. This paper concludes that the regulatory barrier preventing an FRA-regulated train from going onto a non-FRA railroad are surmountable. Running through trains between the FRA-regulated system and the rail transit network would enhance regional networks. The “Karlsruhe model” in Germany and the through running of regional trains onto the Tokyo subway network are two prime examples. Recent technological advances—such as dual mode battery multiple units, robust signaling systems such as Communications Based Train Control and Positive Train Control, and advanced car body designs able to deal with different loading gauges—make through running more practical. With little or no new right-of-way, it is possible to create far more useful rail networks. Potential shared networks at the conceptual level are discussed for Los Angeles, Seattle, Washington, D.C., Dallas, and Sacramento.
“We’re Not All Anti-Choices”: How Controlling Images Shape Latina/x Feminist Abortion Advocacy
Authors: R. García Rocío
Published: July 2022

Reproductive politics and Latinxs’ politics demonstrate a preoccupation with representations and discourses across time and space. Intersectional feminists theorize how controlling images function as mechanisms of social control by distorting holistic perceptions of marginalized people. While social movement research documents the importance of culture in collective action, little research applies a controlling images interpretive framework to social movement contexts. An important case for examining Latina/x representations is the ideological terrain created by pro-abortion Latina/x feminist advocates. Utilizing a three-year ethnography with California Latinas for Reproductive Justice (CLRJ), written materials produced by the organization, and in-depth interviews with staff, I argue that CLRJ highlights the limitations of existing research, uses feminist approaches to dialogue, and creates structural analyses of inequalities to challenge la santa (the saint), a controlling image centering cisgender mestiza and white Latinas used to assume that all Latinas make poor advocates for reproductive autonomy.
E-CPR in Cardiac Arrest due to Accidental Hypothermia Using Intensivist Cannulators: A Case Series of Nine Consecutive Patients
Authors: Kraai Erik , Wray Trenton C. , Ball Emily , Tawil Isaac , Mitchell Jessica , Guliani Sundeep , Dettmer Todd , Marinaro Jonathan
Published: July 2022

Background: Severe accidental hypothermia (AH) accounts for over 1300 deaths/year in the United States. Early extracorporeal life support (ECLS) is recommended for hypothermic cardiac arrest. We describe the use of a rapid-deployment extracorporeal cardiopulmonary resuscitation (E-CPR) team using intensivist physicians (IPs) as cannulators and report the outcomes of consecutive patients cannulated for ECLS to manage cardiac arrest due to AH. Methods: We reviewed all patients managed with veno-arterial (V-A) ECLS for hypothermic cardiac arrest between January 1, 2017 and November 1, 2021. For each patient- age, sex, cause of hypothermia, initial core temperature, initial rhythm, time from arrest to cannulation, cannula configuration, pH, lactate, potassium, cannulation complications, duration of ECLS, hospital length of stay, mortality, and cerebral performance category (CPC) at discharge were reviewed. Results: Nine consecutive patients were identified that underwent V-A ECLS for cardiac arrest due to AH. Seven (78%) were witnessed arrests. Initial rhythm was ventricular fibrillation (VF) in eight patients and pulseless electrical activity (PEA) in one. The mean initial core temperature was 23.8 degrees Celsius. The mean time from arrest to cannulation was 58 min (range 17 to 251 min). There were no complications related to cannulation. The mean duration of ECLS was 39.1 h. All nine patients were discharged alive with a Cerebral Performance score of one or two. Conclusion: In this case series of consecutive patients reporting intensivist-deployed E-CPR for cardiac arrest due to AH, all patients survived to discharge with a favorable neurologic outcome. A rapidly available E-CPR team utilizing intensivist cannulators may improve outcomes in patients with cardiac arrest due to AH.
Corrosion resistance of 3D printed SS316L post-processed by ultrasonic shot peening at optimum energy level
Authors: Alharbi Naif
Published: July 2022

The layer-upon-layer nature of production by additive manufacturing (AM) made surface treatment as mandatory post-processing for increasing the surface integrity and subsequent tribological properties. In the present work an experimental study was carried out to understand how the ultrasonic shot peening (USP) enhances the corrosion rate, surface compressive residual stress, surface roughness and hardness of stainless steel 316 manufactured by selective laser melting (SLM). In order to do so, series of USP experiments carried out based on full factorial design taking into account the effects of ultrasonic power, processing time, and ball diameters on foresaid responses. Multi-objective optimization of process using desirability approach function was performed to obtain a process window including trade-off between energy consumption and sample’s quality characteristics. The optimization results revealed that it is not possible to have minimum energy and the best product’s quality at same time. In other word, to fabricate samples with best quality characteristics, more energy needs to be consumed. The optimum sample was selected through the trade-off graph based on the transition point where after this point the energy consumption dramatically increases but no further improvement in product’s quality characteristics are attained. By identifying the optimum sample, series of surface integrity examination tests were carried out to show the efficiency of USP on enhancement the surface integrity and corrosion properties of AM material. It was found that the sample processed by USP at optimum parameter setting by ultrasonic power of 60%, process time of 15 min, and ball diameter of 6 mm is an optimum process setting that meets the condition described for transition point and causes 120% improvement in corrosion rate.
Energy, exergy, economic, environmental, advanced exergy and exergoeconomic (extended exergy) analysis of hybrid wind-solar power plant
Authors: Jani Hardik K. , Kachhwaha Surendra Singh , Nagababu Garlapati , Das Alok , Ehyaei MA
Published: July 2022

Aiming to net-zero emissions, hybrid power generation through renewable means has gained substantial attention across the globe. Considering the stochastic nature of renewable energy resources, a comprehensive performance assessment is a must prior to project development. Present work is a novel multidimensional 6E analysis (energy, exergy, economic, environmental, advanced exergy, and exergoeconomic) to evaluate the performance of hybrid wind-solar energy systems. The analysis is performed using long-tern (41 years) high-resolution ERA5 reanalysis resource data and the mathematical modeling by means of MATLAB R2018a computation software. The long-term data facilitates reliable and precise predictions of resource availability, power generation, and system performance during the lifespan of the project. The performance of HWSES in terms of capacity factor and exergy efficiency is computed to be 9.6–35.5% and 4.7–10.4% respectively, whereas the extended exergy efficiency lies in the range of 3.39–5.79%. Hybridizing wind power projects with solar power enhances the overall system capacity factor, exergy efficiency, and extended exergy efficiency by 3.46%, 5.12%, and 2.87% respectively. Hence, the hybridization leads to superior year-round system performance with smaller power fluctuations than the standalone systems. Further, wind, solar and hybrid systems would annually reduce the Specific Emission Reduction of 1128 tone/kW, 1685 tone/kW, and 1407tone/kW respectively. The present research will be helpful to the policy-makers and the project developers in the project feasibility study of hybrid energy systems.
The older person’s experience of autonomy in healthcare decision-making in Ireland: The relationship between law, policy, and practice
Authors: Lombard John , Davidson Hope
Published: July 2022

The law on healthcare decision-making in Ireland is in a period of transition and will be enhanced with the full commencement of the Assisted Decision-Making (Capacity) Act (ADMC Act) 2015. The legislation is intended to empower a person to make decisions relating to their healthcare and personal affairs where they lack or may in the future lack the capacity to make their own decisions. This is especially relevant for the older person in terms of planning for future healthcare decisions. This article reports on quantitative and qualitative research which examined the exercise of autonomy by the older person in Ireland in the context of healthcare decision-making. The research compared the lived experience of healthcare decision-making with the existing legal and policy framework. The research sought to identify what is currently understood about the ADMC Act and awareness of the changes it will bring about in decision-making for the older person. These data assist in identifying strengths, such as a feeling of involvement, and weaknesses, such as an asymmetry of information, in the operation of the current decision-making framework while also identifying potential hurdles to the meaningful implementation of the 2015 Act.
Altered Intestinal Permeability Biomarkers in Schizophrenia: A Possible Link with Subclinical Inflammation
Authors: Gokulakrishnan Kuppan , Nikhil Joyappa , VS Sreeraj , Holla Bharath , Thirumoorthy Chinnasamy , Sandhya Narasimhan , Nichenametla Sonika , Pathak Harsh , Shivakumar Venkataram , Debnath Monojit , Venkatasubramanian Ganesan , Varambally Shivarama
Published: July 2022

Background and Purpose

Emerging studies have shown that gut-derived endotoxins might play a role in intestinal and systemic inflammation. Although the significance of intestinal permeability in modulating the pathogenesis of Schizophrenia (SCZ) is recognized, not much data on the specific role of intestinal permeability biomarkers, viz., zonulin, lipopolysaccharide-binding protein (LBP), and intestinal alkaline phosphatase (IAP) in SCZ is available. Therefore, we measured the plasma levels of zonulin, LBP, and IAP and its correlation with neutrophil-to-lymphocyte ratio (NLR); a marker of systemic inflammation in patients with SCZ.

Methods

We recruited 60 individuals, patients with SCZ ( n = 40) and healthy controls ( n = 20), from a large tertiary neuropsychiatry center. Plasma levels of zonulin, IAP, and LBP were quantified by enzyme-linked immunosorbent assay.

Results

Plasma levels of both LBP and zonulin were significantly increased ( P <0.05), whereas the IAP levels ( P <0.05) were significantly decreased in patients with SCZ compared to healthy controls. Pearson correlation analysis revealed that zonulin and LBP had a significant positive correlation with NLR, and IAP negatively correlated with NLR. Individuals with SCZ had higher independent odds of zonulin [odds ratio (OR): 10.32, 95% CI: 1.85–57.12], LBP [OR: 1.039, 95% CI: 1.02–1.07], and IAP [OR: 0.643, 95% CI: 0.471–0.879], even after adjusting for potential confounders.

Conclusion

Our study demonstrates an association of zonulin, LBP, and IAP in Asian Indian SCZ patients and correlates with NLR. Our results indicate that low-grade inflammation induced by metabolic endotoxemia might be implicated in the pathoetiology of SCZ.
Sagittal Growth Restriction of the Midface Following Isolated Cleft Lip Repair: A Systematic Review and Meta-Analysis
Authors: Celie Karel-Bart , Wlodarczyk Jordan , Naidu Priyanka , Tapia Maria Fernanda , Nagengast Eric , Yao Caroline , Magee William
Published: July 2022

Midface hypoplasia (MFH) is a long-term sequela of cleft lip and palate repair, and is poorly understood. No study has examined the aggregate data on sagittal growth restriction of the midface following repair of the lip, but not palate, in these patients.

A systematic review of 3780 articles was performed. Twenty-four studies met inclusion criteria and 11 reported cephalometric measurements amenable to meta-analysis. Patients with Veau class I-III palatal clefts were included so long as they had undergone only lip repair. Groups were compared against both noncleft and unrepaired controls.

Cephalometrics were reported for 326 patients (31.3% female). Noncleft controls had an average SNA angle of 81.25° ± 3.12°. The only patients demonstrating hypoplastic SNA angles were those with unilateral CLP with isolated lip repair (77.4° ± 4.22°). Patients with repaired CL had SNA angles similar to noncleft controls (81.4° ± 4.02°). Patients with unrepaired CLP and CL tended toward more protruding maxillae, with SNA angles of 83.3° ± 4.04° and 87.9° ± 3.11°, respectively. Notably, when comparing SNA angles between groups, patients with CLP with isolated lip repair had significantly more hypoplastic angles compared to those with repaired CL ( P < .0001). Patients with CLP with isolated lip repair were also more hypoplastic than noncleft controls ( P < .0001). In contrast, there was no significant difference between the SNA of patients with repaired CL and controls ( P = .648).

We found that cleft lip repair only appeared to contribute to MFH in the setting of concurrent cleft palate pathology, suggesting that scarring from lip repair itself is unlikely to be the predominant driver of MFH development. However, studies generally suffered from inadequate reporting of timing, technique, follow-up time, and cleft severity.
Novel porous structures with non-cubic symmetry: Synthesis, elastic anisotropy, and fatigue life behavior
Authors: García-Ávila Josué , Cuan-Urquizo Enrique , Ramírez-Cedillo Erick , Rodríguez Ciro A , Vargas-Martínez Adriana
Published: July 2022

Natural porous structures are often anisotropic in their elastic properties, i.e., they have directional variations that are related to their topology and geometry. This paper presents the synthesis and simulation framework of novel families of non-cubic porous structures based on implicit modeling of cosine surfaces in the three-dimensional Euclidean space. The synthesis was performed using Field-Driven Design (FDD). An in-depth study of the elastic properties and simulated fatigue compression–compression behavior of a selection of five structures from the orthotropic anisotropy family is presented as case studies exposing the stretching-dominated mechanisms. The apparent properties characterized include Young’s modulus [Formula: see text], Poisson’s ratio [Formula: see text], shear modulus [Formula: see text], bulk modulus [Formula: see text], and relative density [Formula: see text]. A systematic approach to the characterization of average apparent properties was performed according to the schemes of Voigt, Reuss, and Hill. We show the anisotropic variation of the cosine surface–based porous structures using the Universal Elastic Anisotropy Index (AU) and compare it with six well-known triply periodic minimal surface (TPMS) structures by analyzing the stiffness tensor to validate and discuss which individual property (stiffness, rigidity, compressibility) has a higher impact on the final anisotropy value. We also provide a formal curvature analysis, based on the notions of mean [Formula: see text] and Gaussian [Formula: see text] curvatures to evidence the ridge-shaped surface in the structures. The proposed porous structures showed advantages when compared to cubic TPMS structures. From the data processing of the five analyzed porous structures, two synthesized structures have AU = 0.394 and 0.478, which are lower values than the structures based on Neovius and Schwarz’s Primitive surfaces with AU = 0.529 and 0.604. In addition, simulation results of cyclic compressive fatigue loading indicate that the fatigue resistance properties of the non-cubic porous structures are higher than the TPMS structures.
Professional networks, collegial support, and school leaders: How physical education teachers manage reality shock, marginalization, and isolation in a decentralized school system
Authors: Ferry Magnus , Westerlund Runa
Published: July 2022

There are many factors and duties that novice teachers do not know about when they enter the profession. Isolation, for instance, affects physical education (PE) teachers because the position often comes with a secluded workplace adjacent to the gym and through the subject's marginalization. These challenges, among others, can send the novice teacher into shock, and there is a risk the teacher becomes disengaged from the profession. This study aimed to provide insights into PE teachers’ experiences of reality shock, isolation, and marginalization over time, as well as how they managed these challenges. Semi-structured interviews were conducted with nine Swedish PE teachers six to 10 years after graduation from PE teacher education (PETE). Qualitative content analysis was used. All participants retrospectively described a reality shock when they were novices, where non-subject-specific teacher assignments were experienced as more challenging compared to teaching PE. Further, isolation had a severe effect. However, the marginalization of PE was not that apparent as when they were novices. Over time, the participants created their own networks to mitigate, for example, isolation. In turn, marginalization seemed to be a remaining challenge to the participants despite an increased societal focus on health. Even though it is impossible for PETE to prepare teachers for every challenge they could face in the profession, PETE should inform preservice teachers of common phenomena such as isolation and marginalization, as well as how to create supporting networks. Further, we argue that perceived autonomy combined with systematic guidance could positively affect novice teachers’ development.
Lighting measurement with a 360° panoramic camera: Part 1 – Technical procedure and validation
Authors: Li H , Cai H
Published: July 2022

This study developed a 360° field of view (FOV) lighting measurement method with the aid of the Ricoh Theta Z1 panoramic camera. As versatile lighting information from all viewing directions within 360° FOV can be retrieved from a single 360° high dynamic range (HDR) image, this new method improves the lighting measurement efficiency. Part 1 of this study reported in the present paper focuses on technical procedure and validation. Firstly, all technical issues were solved for using the Theta Z1 camera to conduct 360° FOV lighting measurement with a provided and validated step-by-step procedure. A new illuminance measurement method was then developed with the aid of the Theta Z1 camera for calculating all directional illuminance data at the camera measurement point from any viewing direction within the 360° panoramic FOV, retrieved from a single 360° HDR image taken in the field. This 360° FOV lighting measurement method has average error rate of 4.0% ± 2.4% for luminance measurement and 3.1% ± 2.6% for illuminance measurement in building interiors. Reported outcomes include the detailed procedure and algorithms for the configuration, calibrations and post-image processing, and corresponding MATLAB code and Python programs are shared online.
A Meta-Analysis of the Relative Contribution of Leadership Styles to Followers’ Mental Health
Authors: Montano Diego , Schleu Joyce Elena , Hüffmeier Joachim
Published: July 2022

It is well-established that different leadership styles are associated with followers’ mental health. However, little is known about the relative strength of the relationship of different leadership styles with followers’ mental health. So far, there is no meta-analysis comparing the incremental contribution of different leadership styles to mental health and studying potentially problematic construct proliferation. We included studies that compared at least two leadership styles in view of their relationships with followers’ mental health and directly estimated the relative contribution of seven leadership styles (i.e., transformational, transactional, laissez-faire, task-oriented, relationship-oriented, and destructive leadership, as well as leader-member exchange) to followers’ mental health. Using meta-analytical regression models, we compared the strength of the relationships between these leadership styles and followers’ overall mental health as well as positive (well-being and psychological functioning) and negative aspects of their mental health (affective symptoms, stress, and health complaints). Fifty-three studies with 217 effect sizes comprising 93,470 participants met the inclusion criteria. Transformational and destructive leadership were the strongest predictors of overall and negative aspects of mental health among followers. In contrast, the strongest predictors of positive mental health outcomes among followers were relations-oriented and task-oriented leadership, followed by transformational leadership. In sum, our results suggest that various leadership styles make unique contributions to explaining followers’ mental health and thus construct proliferation mostly does not pose a major problem when predicting relevant outcomes in this domain of leadership research. Our results are relevant for leadership development programs and for future organizational leadership models.