bluuebunny/crossref_metadata_2025 huggingface dataset:
Progression in Quantum Sensing/Bio-Sensing Technologies for Healthcare
Authors: Chugh Vibhas , Basu Adreeja , Kaushik Ajeet , Basu Aviru Kumar
Published: March 2023

The 5th/6th generation bio-sensing technology is an emerging field which connects smart technologies like Artificial Intelligence, Internet of Things and Machine Learning with efficient micro/nano-enabled sensing platform for making point-of-care (POC) devices to investigate health management strategies. Recently, the integration and interfacing between quantum measurement, signaling, and optimized bio-actives has led to investigate the minute biological events with anomalous sensitivity. Such technologies are expected to provide the possibility to measure and record changes at quantum scales with varying pressure, temperature, and electromagnetic fields. Considering current scenarios, this perspective critically highlights state-of-art quantum sensing technology along with their challenges and prospects.
Quality of Life, Procedural Success, and Clinical Outcomes following Transcatheter Mitral Valve Repair
Authors: Natanzon Sharon Shalom , Koseki Keita , Kaewkes Danon , Koren Ofir , Patel Vivek , Nakamura Mamoo , Chakravarty Tarun , Makkar Raj
Published: March 2023

Background. Limited data exist regarding the association between the quality of life (QoL) and clinical outcomes following transcatheter mitral valve repair (TMVr). We aimed to evaluate the prognostic significance of QoL assessment following TMVr and to characterize those who had procedural success, yet reported a low Kansas City Cardiomyopathy Questionnaire (KCCQ-12) score. Methods. We reported the experience of Cedars-Sinai Medical Center patients between 2013 and 2020. Patients were allocated into four groups according to the 30-day KCCQ: <25, 25–49, 50–74, and ≥75. Primary outcome included 1-year all-cause death or heart failure (HF) hospitalizations. We also examined the association between QoL and the primary outcome in those with procedural success. Results. A total of 555 patients were included in our analysis, median follow-up of 650 days (IQR 243–1113). The lower KCCQ groups had a higher prevalence of functional mitral regurgitation (65%, 60%, 56%, and 43%,

p
=
0.001

), as well as a higher Society of Thoracic Surgeon (STS) score. These groups had a significantly higher occurrence of 1-year all-cause death or HF hospitalizations in a stepwise fashion (40%, 22%, 16%, and 10%,

p
<
0.001

). Multivariable Cox regression analysis revealed 30-day KCCQ as the strongest predictor of the 1-year primary outcome (HR 0.98, 95%CI (0.97–0.99),

p
=
0.006

). Approximately a quarter of patients with procedural success had a low KCCQ score. These patients had a higher rate of the combined 1-year outcome regardless of procedural success or failure. Conclusion. QoL following TMVr is a powerful prognostic factor. KCCQ assessment is an important indicator for identifying patients prone to adverse outcomes even after procedural success.
Simulating New CKO as a Model of Seismic Sea Waves via Unified Solver
Authors: Alkhidhr Hanan A. , Abdelrahman Mahmoud A. E.
Published: March 2023

Due to high rate of electrical device usage of all types and high consumption of electricity, it is necessary to search for alternative way. There are so many models of nature describing many phenomena in energy, magnetic field, heat transfer, and so on. These models are reflected in the delicate nonlinear partial differential equations. The system of coupled Konno-Oono equations is one of those models. We extract some vital solutions for this model, which describe some vital phenomena in applied science. Namely, we applied unified technique in order to perform this mechanism in a completely unified way. Finally, some simulations are performed by utilizing Matlab 18 to exhibit the behaviour of these solutions.
Microscopic Fluctuations in Power-Grid Frequency Recordings at the
Subsecond Scale
Authors: Schäfer Benjamin , Rydin Gorjão Leonardo , Yalcin G. Cigdem , Förstner Ellen , Jumar Richard , Maass Heiko , Kühnapfel Uwe , Hagenmeyer Veit
Published: March 2023

Complex systems, such as the power grid, are essential for our daily lives. Many
complex systems display multifractal behavior, correlated fluctuations and power
laws. Whether the power-grid frequency, an indicator of the balance of supply
and demand in the electricity grid, also displays such complexity remains a
mostly open question. Within the present article, we utilize highly resolved
measurements to quantify the properties of the power-grid frequency, making
three key contributions: First, we demonstrate the existence of power laws in
power-grid frequency measurements. Second, we show that below one second, the
dynamics may fundamentally change, including a suddenly increasing power
spectral density, emergence of multifractality and a change of correlation
behavior. Third, we provide a simplified stochastic model involving positively
correlated noise to reproduce the observed dynamics, possibly linked to
frequency-dependent loads. Finally, we stress the need for high-quality
measurements and discuss how we obtained the data analyzed here.
Estimation of Risk Factors Affecting Screening Outcomes of Prostate Cancer Using the Bayesian Ordinal Logistic Model
Authors: Sirengo J. L. , Alilah D. A. , Mbete D. A. , Keli R.
Published: March 2023

Prostate cancer occurs when cells in the prostate gland grow out of control. Almost all prostate cancers are adenocarcinomas. The survival rate for prostate cancer patients depends on the screening outcome, which can be either no prostate cancer, early detection, and late detection or advanced stage detection. The main objective of this study was to estimate the risk factors affecting the screening outcome of prostate cancer. With ordinal outcomes, a generalized Bayesian ordinal logistic model was considered in the analysis. The generalized Bayesian ordinal logistic model helped in estimation of coefficient parameters of the risk factors affecting each level of prostate cancer-screening outcomes. In the study, positive coefficients, that is,

β

k

>
0

, indicated that the higher values on the explanatory variable increased the chances of the respondent being in a higher category of the dependent variable than the current one, while the negative coefficients, that is,

β

k

<
0

, signified that the higher values on the explanatory variable increased the likelihood of being in the current or lower category of prostate cancer. For instance, from the analysis, positive or negative outcomes of prostate cancer showed that an increase in weight lowered the chances of an individual having the disease.
Sharing and Cooperation of Improved Cross-Entropy Optimization Algorithm in Telemedicine Multimedia Information Processing
Authors: Wu Hongjiao
Published: March 2023

In order to improve the efficiency of medical multimedia information sharing, this paper combines cloud computing technology and SOA (service-oriented architecture) technology to build a medical multimedia information sharing system. Building a medical information sharing platform requires integrating information resources stored in information systems of medical institutions and nonmedical information systems related to medical information and forming a huge resource pool. It is important to mine and analyze the information resources in the resource pool to realize the sharing and interaction of medical information. To this end, this paper proposes a gain-adaptive control algorithm with online adjustable parameters and investigates the extension of the mutual entropy optimization algorithm in the control domain and its integrated processing capability in the process of medical multimedia information processing. In addition, this paper constructs a medical multimedia information sharing and collaboration platform with medical multimedia information sharing and telemedicine as the core and verifies the effectiveness of the platform through experiments. The simulation results and comparison results with other systems prove that the system in this paper can realize fast data processing, retrieve and analyze massive data, and meet the demand of remote intelligent diagnosis under the premise of safety and stability. Meanwhile, the system in this paper can help hospitals achieve fast and accurate diagnosis, which has strong theoretical and practical values.
Extraction of Rhenium from Lead Sludge of Copper Production
Authors: Zhumakynbai Nazigul , Shaimerden Zhanna B. , Berdikulova Feruza A. , Ondiris Bagzhan G. , Khamidulla Aigerim G. , Seidakhmetova Nazira M.
Published: March 2023

The article presents the results of oxidative leaching of lead sludge from copper production in order to extract rhenium into solution. The optimum regimes for product leaching man-made product in the presence of sodium peroxocarbonate Na2CO3·1.5H2O2 has been established: Experimental work was carried out under the following conditions: oxidant consumption 5% by weight of the raw material, leaching temperature 70°C, duration 30–60 minutes, stirring speed 200 rpm, and the ratio of liquid to solid S : L = 1 : 3. The degree of extraction of rhenium into the solution is 95–97%, and the content reaches 500–520 mg/L Re.
Spontaneous Closure of a Coronary Artery Bypass Graft Pseudoaneurysm Embedded in a Mediastinal Hematoma
Authors: Hess Daniel L. , Horde Gaither W. , Sarode Karan , Morgan William S. , Kamal Salmaan Z. , Watts Jubal R. , Chapman Gregory D.
Published: March 2023

Coronary artery bypass graft (CABG) pseudoaneurysms are a rare but often unrecognized clinical entity. They are prone to rupture and hemodynamic compromise and should therefore be on the differential in the appropriate patient. We present a case of a gentleman with a recent CABG surgery who presented with acute onset dyspnea and a large pleural effusion. Imaging revealed a saphenous vein graft pseudoaneurysm embedded in a mediastinal hematoma. Four weeks later, prior to planned stenting, the pseudoaneurysm had spontaneously closed. This case highlights an unusual acute presentation of a CABG pseudoaneurysm and a multidisciplinary approach to its management.
Perceived Appropriateness of Assessing for Health-related Socioeconomic Risks Among Adult Patients with Cancer
Authors: Vu Milkie , Boyd Kelly , De Marchis Emilia H. , Garnache Bridgette G. , Gottlieb Laura M. , Gross Cary P. , Lee Nita K. , Lindau Stacy Tessler , Mun Sophia , Winslow Victoria A. , Makelarski Jennifer A.
Published: March 2023

Cancer treatment can trigger or exacerbate health-related socioeconomic risks (HRSR; food/housing insecurity, transportation/utilities difficulties, and interpersonal violence). The American Cancer Society and National Cancer Institute recommend HRSR screening and referral, but little research has examined the perceptions of patients with cancer on the appropriateness of HRSR screening in healthcare settings. We examined whether HRSR status, desire for assistance with HRSRs, and sociodemographic and health care–related factors were associated with perceived appropriateness of HRSR screening in health care settings and comfort with HRSR documentation in electronic health records (EHR). A convenience sample of adult patients with cancer at two outpatient clinics completed self-administered surveys. We used χ2 and Fisher exact tests to test for significant associations. The sample included 154 patients (72% female, 90% ages 45 years or older). Thirty-six percent reported ≥1 HRSRs and 27% desired assistance with HRSRs. Overall, 80% thought it was appropriate to assess for HRSRs in health care settings. The distributions of HRSR status and sociodemographic characteristics were similar among people who perceived screening to be appropriate and those who did not. Participants who perceived screening as appropriate were three times as likely to report prior experience with HRSR screening (31% vs. 10%, P = 0.01). Moreover, 60% felt comfortable having HRSRs documented in the EHR. Comfort with EHR documentation of HRSRs was significantly higher among patients desiring assistance with HRSRs (78%) compared with those who did not (53%, P < 0.01). While initiatives for HRSR screening are likely to be seen by patients with cancer as appropriate, concerns may remain over electronic documentation of HRSRs.

Significance:

National organizations recommend addressing HRSRs such as food/housing insecurity, transportation/utilities difficulties, and interpersonal violence among patients with cancer. In our study, most patients with cancer perceived screening for HRSRs in clinical settings as appropriate. Meanwhile, concerns may remain over the documentation of HRSRs in EHRs.
Serum Inflammation Parameters and Survival in Hepatocellular Carcinoma Patients: Importance of Albumin and Gamma-Glutamyltranspeptidase
Authors: Carr Brian I. , Guerra Vito
Published: March 2023

Introduction: Many single and combination blood tests that reflect local or systemic inflammation have been shown to be useful prognosticators in patients with a variety of tumor types. To try to clarify, this issue in patients with nonsurgically treatable hepatocellular carcinoma, multiple serum parameters were evaluated for their relationship to survival. Methods: A prospectively collected database was interrogated of 487 patients with known hepatocellular carcinoma and documented survival and having all the inflammation parameters of interest in this study, together with baseline tumor characteristics from CT scans. Serum parameters included NLR, PLR, CRP, ESR, albumin, and GGT. Results: All the parameters had significant hazard ratios on Cox regression model. Combination double parameters with hazard ratios >2.0 were: ESR plus GGT, albumin plus GGT, albumin plus ESR. The triplet combination of albumin plus GGT plus ESR had a hazard ratio of 6.33. Using Harrell’s concordance index (C-index), the highest inflammation-based 2-parameter prognostic score was for albumin plus GGT. When clinical characteristics of patients with high values for albumin plus low values for GGT were compared to low values for albumin plus high values for GGT (worse prognosis), statistically significant differences were found for tumor size, tumor focality, macroscopic portal vein invasion, and serum alpha-fetoprotein levels. Addition of ESR did not provide additional tumor information. Conclusion: The combination of serum albumin plus GGT levels was the most prognostically useful among the inflammation parameters that were tested, and reflected significant differences in tumor aggressiveness characteristics.
Cerebellar Superficial Siderosis in Cerebral Amyloid Angiopathy on 1.5T T2*-Weighted Imaging
Authors: Renard Dimitri , Laurent-Chabalier Sabine , Leonte Adelina , Hackius Marc , Parvu Teodora , Wacongne Anne , Thouvenot Eric
Published: March 2023

Background: Cerebellar superficial siderosis (SS) has been recently reported to be present in about 10% of both hereditary and sporadic cerebral amyloid angiopathy (CAA) on 3T MRI using primarily susceptibility-weighted imaging. Objectives: Our aim was to assess cerebellar SS in sporadic CAA patients using 1.5T T2*-weighted MRI and to evaluate possible underlying mechanisms. Method: We retrospectively screened MRI scans of sporadic probable CAA patients initially presenting with intracerebral hemorrhage-, acute subarachnoid hemorrhage- or cortical SS-related symptoms between September 2009 and January 2022 registered in our stroke database. Patients with familial CAA were excluded. On 1.5T T2*-weighted MRI, cerebellar SS (including kappa statistics for interobserver agreement) was assessed together with typical CAA hemorrhagic features and with the presence of supratentorial macrobleed and cortical SS adjacent to the tentorium cerebelli (TC) and TC hemosiderosis. Results: We screened 151 patients and finally included 111 CAA patients (median age 77) with cerebellar SS observed in 6 (5%) patients. Cerebellar SS presence was associated with a higher number of supratentorial macrobleeds (median n = 3 vs. n = 1, p = 0.0012), presence of supratentorial macrobleed adjacent to the TC (p = 0.002), and TC hemosiderosis (p = 0.005). Conclusions: Cerebellar SS in CAA patients can be identified on 1.5T T2*-weighted imaging. Associated MRI characteristics suggest contamination from supratentorial macrobleeds.
Dantrolene Significantly Improves Cerebral Blood Flow in a Rat Model of Hemorrhagic Vasospasms
Authors: Crespo María J. , Román Marie , Tirado Guillermo , Martins Antonio Henrique , Ferrer-Acosta Yancy , Martinez-Jimenez Solianne M.
Published: March 2023

Introduction: A cerebral vasospasm (CVSP) is a potent vasoconstriction of the cerebral vasculature and the primary cause of morbidity and mortality following a subarachnoid hemorrhage. The middle cerebral artery (MCA) is commonly affected by CVSPs. Concomitant administration of dantrolene and nimodipine synergistically reduces vasospasms in aortic rings from Sprague Dawley rats. To determine if the effects observed in the systemic vasculature extend to the cerebral circulation, we investigated the effect of intravenous administration of dantrolene (2.5 mg/kg) and nimodipine (1 mg/kg and 2 mg/kg) on MCA blood flow velocity (BFV) 7 days after the induction of CVSPs. Methods: Vasospasms were induced by bathing the left common carotid artery with autologous whole blood. Age-matched sham rats were used as controls. BFV, mean arterial pressure (MAP), and heart rate (HR) were measured with a PeriFlux 5000 Laser Doppler System, and a CODA non-invasive blood pressure system, before and after administering the drugs. Morphometric evaluations were also performed to assess vascular alterations. Results: BFV was reduced by 37% with dantrolene alone (n = 6, p ≤ 0.05) and by 27% with 2 mg/kg nimodipine (n = 6, p < 0.05), while it was not affected by 1 mg/kg nimodipine. The combination of 1 mg/kg nimodipine with dantrolene, however, decreased BFV by 35% (from 435.70 ± 21.53 to 284.30 ± 23.13 perfusion units, n = 7, p ≤ 0.05). A similar reduction (31%) was obtained with dantrolene and 2 mg/kg nimodipine (from 536.00 ± 32.61 to 367.80 ± 40.93 perfusion units, n = 6, p ≤ 0.05). Neither MAP nor HR was affected by dantrolene or nimodipine alone. The combination of dantrolene with 2 mg/kg nimodipine, however, decreased MAP and increased HR. Furthermore, 7 days after the induction of vasospasms, lumen area of the left common carotid artery decreased, whereas media thickness and the wall-to-lumen ratio increased when compared to contralateral controls. The latter finding suggests that vascular remodeling was present at this stage. Conclusion: Altogether, our results indicate that 2.5 mg/kg dantrolene significantly reduces BFV in the MCA without altering systemic hemodynamic parameters to a similar extent than the highest dose of nimodipine or the combination of dantrolene and the lowest dose of nimodipine. Therefore, dantrolene may provide a promising alternative to lower the risk, or partially revert, CVSP.
Identification of a Splicing Variant c.3813-3A>G in NPHP3 by Reanalysis of Whole Exome Sequencing in a Chinese Boy with Nephronophthisis
Authors: Zhang Xinjie , Zhi Xiufang , Wang Xin , Dong Yan , Shu Jianbo , Wang Wenhong , Cai Chunquan
Published: March 2023

Nephronophthisis is an autosomal recessive cystic kidney disease characterized by tubular injury and commonly results in kidney failure. We reported a case of 4-year-old Chinese boy presented with severe anemia, kidney, and liver dysfunction. Whole exome sequencing (WES) was performed to identify the candidate variant with a negative result initially. After complete collection of clinical information, reanalysis of WES identified a homozygous NPHP3 variant c.3813-3A>G (NM_153240.4). The effect on mRNA splicing of the intronic variant was predicted through software (three in silico splice tools). Furthermore, in vitro minigene assay was conducted to validate the predicted deleterious effects of the intronic variant. All of the splice prediction programs and minigene assay indicated that the variant had an impact on the normal splicing pattern of NPHP3. Our study confirmed the effect of the c.3813-3A>G variant on NPHP3 splicing in vitro, which gives additional evidence for the clinical significance of the variant and provides a basis for genetic diagnosis of nephronophthisis 3. In addition, we think that it is essential to reanalyze WES data after the complete clinical information collection to avoid missing some important candidate variants.
Antiepileptic Drugs Modulate Alzheimer-Related Tau Aggregation in a Neuronal Activity-Independent Manner
Authors: Ito Yuki , Takeda Shuko , Moroi Sayaka , Nakajima Tsuneo , Oyama Akane , Miki Kunihiro , Sugihara Nanami , Takami Yoichi , Takeya Yasushi , Shimamura Munehisa , Rakugi Hiromi , Morishita Ryuichi
Published: March 2023

Introduction: A rapidly increasing number of patients with dementia present a serious social problem. Recently, the incidence of epilepsy in patients with Alzheimer’s disease (AD) is increasing, drawing attention to the pathological relationship between the two conditions. Clinical studies have suggested the protective action of antiepileptic agents on dementia; however, the underlying mechanism remains unknown. We evaluated the effects of multiple antiepileptic drugs using tau aggregation assay systems to determine the effects of antiepileptic agents on tau aggregation, a major neuropathological finding associated with AD. Methods: We evaluated the effects of seven antiepileptic agents on intracellular tau aggregation using a tau-biosensor cell-based high-throughput assay. Next, we tested these agents in a cell-free tau aggregation assay using thioflavin T (ThT). Results: The assay results revealed that phenobarbital inhibited tau aggregation, whereas sodium valproate, gabapentin, and piracetam promoted tau aggregation. In the cell-free tau aggregation assay using ThT, we confirmed that phenobarbital significantly inhibited tau aggregation. Conclusion: Antiepileptic drugs may modify the tau pathology in AD in a neural activity-independent manner. Our finding may provide an important insight into the optimization of antiepileptic drug therapy in older adults with dementia.
Therapeutic Plasma Exchange in ICU Patients with Acute Hypertriglyceridemia-Induced Pancreatitis Improves Patient Outcomes
Authors: Krauß Lea U. , Brosig Andreas-M. , Schlosser Sophie , Pavel Vlad , Mehrl Alexander , Gülow Karsten , Kandulski Arne , Müller Martina , Schmid Stephan
Published: March 2023

Background: Acute severe pancreatitis is associated with high morbidity and mortality. Hypertriglyceridemia is the third most common cause of acute pancreatitis and higher triglyceride levels increase the risk for severe acute pancreatitis. Plasma exchange is an effective treatment method to lower triglycerides. Our study aimed to investigate the efficiency of plasma exchange as a treatment option for acute hypertriglyceridemia-induced pancreatitis (HTGP), the impact on mortality assessed by the SOFA, SAPS II, BISAP Score, Ranson’s, and Glasgow-Imrie Criteria, as well as the overall length of stay in hospital and ICU. Methods: In this retrospective single-center cohort study, triglycerides before and after plasma exchange were compared. SOFA and SAPS II were taken on ICU admission and at discharge. To further characterize the patient cohort, BISAP Score (on admission), Ranson’s Criteria (on admission and after 48 h), and the Glasgow-Imrie Criteria (48 h after admission) were calculated. Results: The study included 11 patients (91% male; median age 45 years). Triglycerides were reduced from 4,266 ± 3,560.6 to 842 ± 575.9 mg/dL during plasmapheresis (p < 0.001). The median ICU length of stay was 3 ± 4.2 days. In-hospital mortality was 0%. The SOFA score was significantly reduced from 4 ± 3.4 points on admission to 2 ± 2.1 points at discharge (p = 0.017). Triglycerides and cholesterol decreased from 3,126 ± 3,665 to 531 ± 273 mg/dL (p = 0.003) and from 438 ± 137.9 to 222 ± 59.5 mg/dL (p = 0.028), respectively. The BISAP Score on admission was 3 ± 0.5 points, Ranson’s Criteria were 3 ± 1.5 points (48 h after admission, cumulative), and Glasgow-Imrie Criteria 3 ± 1.3 points (48 h after admission). Conclusion: Plasmapheresis is an efficient and safe treatment method for ICU patients with acute HTGP and significantly reduces triglycerides. Furthermore, plasmapheresis significantly improves the clinical outcomes of patients with HTGP.
Rapamycin Does Not Act as a Dietary Restriction Mimetic in the Protection against Ischemia Reperfusion Injury
Authors: van den Akker Eline , Dor Frank J.M.F. , IJzermans Jan N.M. , de Bruin Ron W.F.
Published: March 2023

Introduction: Short-term fasting protects against renal ischemia reperfusion injury (IRI). mTOR signaling is downregulated and may be involved in its protective effect. Rapamycin is considered a possible mimetic as it inhibits the mTOR pathway. This study examines the effect of rapamycin on renal IRI. Material and Methods: Mice were divided into four groups: ad libitum (AL), fasted (F), AL treated with rapamycin (AL+R), and F treated with rapamycin (F+R). Rapamycin was administered intraperitoneally 24 h before bilateral renal IRI was induced. Survival was monitored for 7 days. Renal cell death, regeneration, and mTOR activity were determined 48 h after reperfusion. Oxidative stress resistance of human renal proximal tubular and human primary tubular epithelial cells after rapamycin treatment was determined. Results: All F and F+R mice survived the experiment. Although rapamycin substantially downregulated mTOR activity, survival in the AL+R group was similar to AL (10%). Renal regeneration was significantly reduced in AL+R but not in F+R. After IRI (48 h), pS6K/S6K ratio was lower in F, F+R, and AL+R groups compared to AL fed animals (p = 0.02). In vitro, rapamycin also significantly downregulated mTOR activity (p < 0.001) but did not protect against oxidative stress. Conclusion: Rapamycin pretreatment does not protect against renal IRI. Thus, protection against renal IRI by fasting is not exclusively mediated through inhibition of mTOR activity but may involve preservation of regenerative mechanisms despite mTOR downregulation. Therefore, rapamycin cannot be used as a dietary mimetic to protect against renal IRI.
Racionalidades educacionais (pós-) pandêmicas: atlas 2020
Authors:   Universidade de São Paulo. Instituto de Estudos Avançados, Aquino Julio Groppa
Published: March 2023

O trabalho que ora se apresenta é o resultado inaugural da pesquisa A educação no horizonte pós-pandêmico: contributos para a construção de pautas investigativas e práticas, levada a cabo no Programa Ano Sabático do Instituto de Estudos Avançados da Universidade de São Paulo durante 2022. O estudo devota-se a perspectivar as racionalidades em circulação no campo educacional brasileiro durante o triênio 2020-2022, depois da eclosão da pandemia de Covid-19, ou seja, desde a interrupção do atendimento escolar, passando pela implementação do ensino remoto emergencial, até a retomada das atividades presenciais. Neste trabalho, apenas 2020 é focalizado, devendo o tratamento dos dois anos subsequentes ser dado a público de modo sequencial em futuro próximo.
Patient Characteristics, Outcomes, and Effects of Dapagliflozin According to the Duration of Heart Failure: A Prespecified Analysis of the DELIVER Trial
Authors: Kondo Toru , Jering Karola S. , Borleffs C. Jan Willem , de Boer Rudolf A. , Claggett Brian L. , Desai Akshay S. , Dobreanu Dan , Inzucchi Silvio E. , Hernandez Adrian F. , Janssens Stefan P. , Jhund Pardeep S. , Kosiborod Mikhail N. , Lam Carolyn S.P. , Langkilde Anna Maria , Martinez Felipe A. , Petersson Magnus , Vinh Pham Nguyen , Vaduganathan Muthiah , Solomon Scott D. , McMurray John J.V.
Published: March 2023

Background:

How patient characteristics and outcomes vary according to the duration of heart failure (HF) is unknown in individuals with mildly reduced or preserved ejection fraction. We compared these, and the efficacy and safety of dapagliflozin, according to the time from diagnosis of HF in a prespecified analysis of the DELIVER trial (Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure).

Methods:

HF duration was categorized as ≤6 months, >6 to 12 months, >1 to 2 years, >2 to 5 years, or >5 years. The primary outcome was the composite of worsening HF or cardiovascular death. The effect of treatment was examined by HF duration category.

Results:

The number of patients in each category was as follows: 1160 (≤6 months), 842 (>6 to 12 months), 995 (>1 to 2 years), 1569 (>2 to 5 years), and 1692 (>5 years). Patients with longer-duration HF were older and had more comorbidities with worse symptoms. The rate of the primary outcome (per 100 person-years) increased with HF duration: ≤6 months, 7.3 (95% CI, 6.3 to 8.4); >6 to 12 months, 7.1 (6.0 to 8.5); >1 to 2 years, 8.4 (7.2 to 9.7); >2 to 5 years, 8.9 (7.9 to 9.9); and >5 years, 10.6 (9.5 to 11.7). Similar trends were seen for other outcomes. The benefit of dapagliflozin was consistent across HF duration category: the hazard ratio for the primary outcome in the ≤6-month group was 0.67 (95% CI, 0.50 to 0.91); >6 to 12 months, 0.78 (0.55 to 1.12); >1 to 2 years, 0.81 (0.60 to 1.09); >2 to 5 years, 0.97 (0.77 to 1.22); and >5 years, 0.78 (0.64 to 0.96;
P
interaction
=0.41). The absolute benefit was greatest in longest-duration HF; the number needed to treat for HF >5 years was 24 versus 32 for ≤6 months.

Conclusions:

Patients with longer-duration HF were older, had more comorbidities and symptoms, and had higher rates of worsening HF and death. The benefits of dapagliflozin were consistent across HF duration. Even patients with long-standing HF and generally mild symptoms are not stable, and it is not too late for such patients to benefit from a sodium–glucose cotransporter 2 inhibitor.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03619213.
A revision of Geostachys (Zingiberaceae: Alpinioideae) in Cambodia, Laos and Vietnam, including a new species, G. aristata
Authors: LEONG-ŠKORNIČKOVÁ JANA , QUỐC BÌNH NGUYỄN , ĐĂNG TRẦN HỮU , TRƯỜNG LƯU HỒNG , NURALIEV MAXIM S.
Published: March 2023

A revision of the ginger genus Geostachys (Zingiberaceae: Alpinioideae: Alpinieae) in Cambodia, Laos and Vietnam is presented. Three species are formally recognised, all endemic to the area of study, including one new species from central Vietnam. Lectotypes are designated for G. annamensis and G. pierreana. The uncertainty about the type locality of G. pierreana is highlighted; the absence of this species in Thailand and Vietnam is demonstrated. The presence of Geostachys in Laos is discussed. The key to the species of the genus is provided. For each species, description, notes on etymology/eponymy, distribution, IUCN preliminary assessment, habitat and phenology, and taxonomy are given. The newly described species, G. aristata, is compared to the morphologically closest congener, G. annamensis, from which it differs by green leaf sheaths and ligules, greenish bracts and bracteoles with prominently aristate apices, prominently mucronate calyx lobes and labellum with crimson spots extending to the margins.
The genus Astragalus (Leguminosae: Papilionoideae: Galegeae) in Mexico
Authors: ESTRADA CASTILLÓN EDUARDO , VILLARREAL QUINTANILLA JOSÉ ÁNGEL , DELGADO-SALINAS ALFONSO , REBMAN JON P.
Published: March 2023

Astragalus is the most diverse genus within flowering plants with almost 2500 species, it is widely distributed around the world, very abundant in temperate regions of the Northern Hemisphere, in central and western Asia, Turkey, Iran, and Afghanistan, central Asia, Europe, Mongolia, Siberia, northeastern China, and Japan. In the American continent it is especially abundant in Canada, western United States, Mexico, and South America. Given the diversity of Astragalus species present in Mexico, the recent description of at least 15 new species for this country, the absence of a recent study that encompasses all the new findings and that the last general study for Mexico dates back almost 60 years, we consider necessary a new taxonomic synopsis that encompasses all the new information, which is presented here. The study records 102 species of Astragalus in Mexico. This work is based essentially on the review of collections of specimen samples, type specimens in national and foreign herbaria, data bases, and the collection of specimens of this genus by the authors in the last 40 years and that covers practically the entire area where this genus is distributed in Mexico. In this study we recorded 102 species and 46 infraspecific taxa; seventy one species and 17 varieties are endemic to Mexico. Baja California (32), Chihuahua (25), Durango (23), Sonora (22), Coahuila (20), San Luis Potosí (17), Nuevo León (17), and Zacatecas (15) are the states with the greatest species richness. In Mexico, the diversity of Astragalus species decreases from north to south and from west to east. Most of the species of Astragalus in Mexico are distributed in the mountains, followed by low and arid plains, including coastal dunes, those last ones, exclusively of the northwestern region. There are no records of any Astragalus species in Campeche, Tabasco, Quintana Roo or Yucatan. The dichotomous keys are based mainly on the color of flowers, the shape of the pod and if the fruit is sessile or stipitate. For each species is included also a morphological description, habitat, altitudinal range, and distribution map.
Contemporary Treatment Paradigms are Associated with Improved Survival in Pancreatic Cancer
Authors: Kelly Bridget N. , Nicolais Laura , Mohamed Abdimajid , Fitzgerald Timothy L.
Published: March 2023

Introduction

Over the last decade, a paradigm shift has been made in treating pancreatic cancer. Starting in 2011, several trials demonstrated a survival advantage for multiagent chemotherapy (MAC). However, the implication for survival at the population level remains unclear.

Methods

A retrospective study of the National Cancer Database from 2006 to 2019 was conducted. Patients treated from 2006 to 2010 were classified as “Era 1”, and those treated from 2011 to 2019 as “Era 2.”

Results

A total of 316,393 patients with pancreatic adenocarcinoma were identified, with 87,742 treated in Era 1 and 228,651 in Era 2. Survival increased from Era 1 to Era 2 in all patients and sub-analyses; surgical (18.7 vs 24.6 months, HR .85, 95% CI 0.82-.88, P < .001), imminently resectable (Stage IA and IB, 12.2 vs 14.8 months, HR .90, 95% CI 0.86-.95, P < .001), high-risk (Stage IIA, IIB, and III, 9.6 vs 11.6 months, HR .82, 95% CI 0.79-.85, P < .001), and Stage IV (3.5 vs 3.9 months, HR .86, 95% CI 0.84-.89, P < .001). Survival was decreased for those who were African American ( P = .031), on Medicaid ( P < .001), or in the lowest quartile of annual income ( P < .001). Surgery rates decreased from 20.5% in Era 1 to 19.8% in Era 2 ( P < .001).

Discussion

Adoption of MAC regimens at a population level correlates with improved pancreatic cancer survival. Unfortunately, socioeconomic factors are associated with an unequal benefit from new treatment regimens, and underuse of surgery for resectable neoplasms persists.
Endoscopic Sleeve Gastroplasty Leading to Gastric Ischemia and Perforation
Authors: Stolz Michael P. , Gibson Brian H. , Vassy William M.
Published: March 2023

Endoscopic sleeve gastroplasty (ESG) is performed by using endoscopic suctioning to reduce the volume of the stomach by plicating the greater curvature with an endoscopic suturing device or stapler. This allows for the endoscopist to perform an elective outpatient weight loss procedure. We will describe a single case of post-procedure day zero complication involving ESG resulting in ischemia, perforation, and peritonitis; what was discovered intra-operatively; and our operative management.
Collaborative Consumers Can Be Ethical Consumers: Adapting the Defining Issues Test to Understand Ethical Reasoning in Collaborative Consumption Markets
Authors: Müller Sebastian , Hoffmann Nils Christian , Heidbrink Ludger , Hoffmann Stefan
Published: March 2023

Collaborative consumption activities like saving food and buying used clothes are an important and rapidly growing part of sustainable consumer behavior. Many political and commercial campaigns promote collaborative consumption practices by highlighting subsets of normative motives, such as sustainable, social, and ecological effects. Whether or not consumers can comprehend these claims and incorporate them into their decision-making process is, however, unclear. This article introduces a new experimental study design to ethical consumer research—an adapted version of the Defining Issues Test—that enables to assess consumers’ ability to cognitively and intuitively understand moral arguments in collaborative consumption contexts. The experiment was conducted with N = 435 collaborative consumers from Germany. The findings indicate that in different collaborative consumption contexts, consumers consider different moral arguments as important. Furthermore, the findings also indicate that consumers can incorporate the provider’s point of view in their moral judgment.
The Interaction Effect of Pronunciation and Lexicogrammar on Comprehensibility: A Case of Mandarin-Accented English
Authors: Miao Yongzhi , Rose Heath , Hosseini Sepideh
Published: March 2023

Scholars have argued that comprehensibility (i.e., ease of understanding), not nativelike performance, should be prioritized in second language learning, which inspired numerous studies to explore factors affecting comprehensibility. However, most of these studies did not consider potential interaction effects of these factors, resulting in a limited understanding of comprehensibility and less precise implications. This study investigates how pronunciation and lexicogrammar influences the comprehensibility of Mandarin-accented English. A total of 687 listeners were randomly allocated into six groups and rated (a) one baseline and (b) one of six experimental recordings for comprehensibility on a 9-point scale. The baseline recording, a 60 s spontaneous speech by an L1 English speaker with an American accent, was the same across groups. The six 75-s experimental recordings were the same in content but differed in (a) speakers’ degree of foreign accent (American, moderate Mandarin, and heavy Mandarin) and (b) lexicogrammar (with errors vs. without errors). The study found that pronunciation and lexicogrammar interacted to influence comprehensibility. That is, whether pronunciation affected comprehensibility depended on speakers’ lexicogrammar, and vice versa. The results have implications for theory-building to refine comprehensibility, as well as for pedagogy and testing priorities.
Changing Temporal Opportunity Structures? Two Cohorts of Young Women’s Thoughts about Future Work, Family and Education
Authors: Nilsen Ann
Published: March 2023

This article seeks to explore if and how period specific conditions affect young women’s thoughts about their future lives. A contextualist analysis is done of a small sample of biographical interviews with Norwegian women in two cohorts born 1970–1975 and 1990–1995 interviewed 20 years apart when they were in their early 20s. The focus is on their thoughts about future education, work and family. Theoretically the article relates itself to concepts of time and temporalities in life course theory. Inspired by Ken Roberts’ concept of opportunity structures, the notion termed ‘temporal opportunity structures’ emerged from the analysis. The analyses demonstrate how wider period specific circumstances and standards of timeliness form a landscape that young women navigate when they envisage future options and opportunities. Findings indicate differences between the two cohorts in biographical timing in that standards of timeliness and temporal opportunity structures appear to have narrowed.
Pope Francis’s Contribution to Catholic Thinking and Acting on War and Peace
Authors: De Volder Jan
Published: March 2023

In modern times, the papacy has consistently advocated peace, disarmament, and peaceful resolution of conflicts, limiting the scope of traditional just war theory, particularly in the era of weapons of mass destruction. However, no pope has gone as far as Pope Francis, who has stated that there is no such thing as just war and that “Only Peace is Just.” This contribution examines how Francis expressed and developed his thought in the context of his humanitarian diplomacy and theological thinking during the first ten years of his pontificate. In the last part, I argue that the Ukraine war is a test for Pope Francis, who has repeatedly called for peace negotiations and condemned arms supply, while recognizing the moral right for Ukrainian self-defense. While this may seem contradictory, his policy shows Francis’s deeper conviction that “war is always a defeat for humanity.” More interested in peace-making and assisting victims than in doctrinal issues, Francis has not jettisoned the just war concept in theory, but has done so in his witness and actions.
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset
Authors: Narindrarangkura Ploypun , Alafaireet Patricia E. , Khan Uzma , Kim Min Soon
Published: March 2023

Objective

People with diabetes have a higher risk of suicidal behaviors than the general population. However, few studies have focused on understanding this relationship. We investigated risk factors and predicted suicide attempts in people with diabetes using Least Absolute Shrinkage and Selection Operator (LASSO) regression.

Method

Data was retrieved from Cerner Real-World Data and included over 3 million diabetes patients in the study. LASSO regression was applied to identify associated factors. Gender, diabetes-type, and depression-specific LASSO regression models were analyzed.

Results

There were 7764 subjects diagnosed with suicide attempts with an average age of 45. Risk factors for suicide attempts in diabetes patients were American Indian or Alaska Native race ( β = 0.637), receiving atypical antipsychotic agents ( β = 0.704), benzodiazepines ( β = 0.784), or antihistamines ( β = 0.528). Amyotrophy was negatively associated with suicide attempts in males ( β = 2.025); in contrast, amyotrophy significantly increased the risk in females ( β = 3.339). Using a MAOI was negatively related to suicide attempts in T1DM patients ( β = 7.304). Age less than 20 was positively associated with suicide attempts in depressed ( β = 2.093) and non-depressed patients ( β = 1.497). The LASSO model achieved a 94.4% AUC and 87.4% F1 score.

Conclusions

To our knowledge, this is the first study to use LASSO regression to identify risk factors for suicide attempts in patients with diabetes. The shrinkage technique successfully reduced the number of variables in the model to improve the fit. Further research is needed to determine cause-and-effect relationships. The results may help providers to identify high-risk groups for suicide attempt among diabetic patients.
Teachers of Students With Visual Impairments: Motivations for Entering the Field of Visual Impairment and Reflections on Pre-Service Training
Authors: Schles Rachel Anne , Chastain Madeline
Published: March 2023

Introduction: The shortage of teachers of students with visual impairments is well documented, yet little research exists exploring the motivations of why individuals join the profession. This study evaluated why alumni of a Southeastern teacher preparation program became teachers of students with visual impairments and how they chose which program to attend. Methods: A mixed methods survey was distributed to program alumni who graduated between 2000 and 2020 with a bachelor’s or master's degree in Visual Disabilities Special Education. Quantitative and qualitative data about participant demographics, motivation to become a teacher of students with visual impairments, the decision to choose the program, and experiences in the program were collected. Multiple measures were used for reliability and credibility in data analysis. Results: Forty-seven responses were received. Most respondents held at least one teaching license ( n = 32) before entering the program and were drawn to the field after working with a student with visual impairment or a teacher of students with visual impairments. Participants reported hands-on and practical experiences in the community and the relationships with professors, mentors, and peers as the most impactful components of their training. Discussion: Most participants had prior teaching experiences before entering the program. Personnel preparation programs may focus program recruitment on current teachers who may be interested in becoming a teacher of students with visual impairments. Expanding the current survey to a national audience could allow for a better understanding of the motivations of the individuals who enter the profession. This information may be used to improve the recruitment of future teachers of students with visual impairments throughout the United States, and, particularly, in areas that are most affected by a shortage of these teachers. Implications for Practitioners: Relationships between school districts, teachers, teachers of students with visual impairments, and preparation programs are discussed, as well as implications for recruiting future teachers of students with visual impairments who will be motivated to stay in the field long-term.
Relationship between perioperative cardiopulmonary bypass time, platelet count, fibrinogen level, rotational thromboelastometry data, antithrombin level, and blood loss volume and the effects of deep hypothermic circulatory arrest: An observational study
Authors: Kodaka M , Ichikawa J , Komori M
Published: March 2023

Introduction

We hypothesized that perioperative fibrinogen level, platelet count, and rotational thromboelastometry (ROTEM) data values decrease in proportion to cardiopulmonary bypass (CPB) time, particularly in patients who underwent deep hypothermic circulatory arrest (DHCA).

Methods

A total of 160 patients were enrolled and divided into the following three groups depending on CPB time: <2-h, 2– 3-h, and >3-h groups. Blood samples were obtained during CPB weaning. Platelet count, ROTEM data, fibrinogen level, and antithrombin level were determined. For propensity matching, we selected 15 patients who underwent DHCA and 15 patients who did not undergo DHCA and used propensity scores to match CPB time and other characteristics.

Results

The <2-h, 2–3-h, and >3-h groups included 74, 63, and 23 patients, respectively. No significant differences in platelet count and fibrinogen level were observed between the groups. Antithrombin level and amplitude of clot firmness at 10 min in the EXTEM and FIBTEM tests were lowest in the >3-h group. Similarly, blood loss volume and transfusion volume were highest in the >3-h group. Significant differences in platelet count, ROTEM data, lowest esophageal and bladder temperatures, and transfusion volume were observed between patients who underwent DHCA and patients who did not undergo DHCA.

Conclusions

The longer the CPB time, the greater the perioperative blood loss volume and transfusion volume, particularly if CPB time is greater than 3 hours. Sub-group analysis revealed that DHCA affects perioperative platelet count and function as well as blood loss volume.
Transitive Analogies and the Meaning of Balaam’s Origin: A Literary Analysis
Authors: Gelblum Oren
Published: March 2023

A set of parallels between the Balaam pericope and the encounter with Edom in Num. 20.14-21 form a literary allusion to the latter, which also draws on elements in the Jacob cycle – especially in Genesis 27. I suggest that these parallels encourage us to associate Balaam with Edom – as do Gen. 36.31-32 and other previously discovered evidence. A key to understanding these literary connections is the sword motif in Num. 20.14-21 and Num. 22.21-35, which points back to “you shall live by your sword” in Gen. 27.40. The allusion seems to present Esau’s sword blessing and Balaam’s intended curse as futile against the divine will. Another layer of meaning of the Balaam-Edom connection becomes clear when we consider the biblical motif of Edom as a symbol of the “nations” (Israel’s enemies), as well as Frisch’s recent proposal that Balaam’s jenny is a symbol of Israel.