bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 9856: Associations of a Polygenic Risk Score (PGS) with High Risk Coronary Artery Disease (CAD) in PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain)
Authors: Newman Jonathan D , Douglas Pamela S , Zhbannikov Ilya , Ferencik Maros , Foldyna Borek , Hoffmann Udo , Shah Svati H , Ginsburg Geoffrey S , Lu Michael T , Voora Deepak
Published: April 2024

Introduction:
PGSs summarize the polygenic risk for CAD and may have clinical utility. We tested whether a previously validated PGS for CAD is associated with coronary CT angiography (CTA) findings predictive of future cardiovascular events in the PROMISE trial, which randomized individuals with stable outpatient chest pain to standard of care vs. CTA.

Methods:
This nested case-control study compared genotyped PROMISE participants with no CAD (0% stenosis), obstructive CAD (oCAD, ≥50% stenosis) or high-risk CAD defined as either oCAD ≥70% stenosis, CAC >400, Leaman Score > 5 (measure of stenosis and plaque burden), or any high-risk plaque feature (positive remodeling, low attenuation, napkin ring sign) on CTA. The Illumina Global Screening Array with imputation from the 1000 Genomes reference panel was used with LDpred to calculate ancestry-adjusted PGS. We calculated adjusted odds ratios (aORs) of oCAD and high-risk CAD for PGS quintiles 2-5 with quintile 1 as the referent using logistic regression and age, sex, and European Society of Cardiology pre-test probability (PTP) for obstructive CAD as covariates.

Results:
Among the 518 participants, 414=no CAD, 86=oCAD, and 103=high risk CAD (overlap of oCAD and high-risk CAD=85), the median age (±S.D.) was 58 (±7) years, 58% were female, and 13% were of non-white race or Hispanic ethnicity. Baseline characteristics, family history of premature CAD, PTP risk score and medications were similar across PGRS quintiles (all P>0.2). After multivariate adjustment, PGRS quintile 5 was associated with significantly increased odds of oCAD ≥50% (aOR 6.09) and high-risk CAD (aOR 6.13) as compared with quintile 1.

Conclusions:
In a population of stable symptomatic outpatients, higher PGS was associated with oCAD and high-risk CAD on CTA, even after adjustment for age, sex and pretest probability of CAD. The PGS may be useful for risk stratification of outpatients with suspected CAD.
Abstract 9916: Relationship Between Blood Pressure Categorization and Subclinical Left Ventricular Dysfunction in Antihypertensive Medication-Naive Individuals
Authors: Nakanishi Koki , Daimon Masao , Yoshida Yuriko , Ishiwata Jumpei , Sawada Naoko , Hirokawa Megumi , Kaneko Hidehiro , Nakao Tomoko , Mizuno Yoshiko , Morita Hiroyuki , Di Tullio Marco , Homma Shunichi , Komuro Issei
Published: April 2024

Background:
The impact of blood pressure (BP) levels on subclinical left ventricular (LV) dysfunction and possible sex-specific difference remains unclarified. This study aimed to investigate the relationship between BP categories given in the new 2017 ACC/AHA hypertension guideline and subclinical LV dysfunction in subjects free of cardiac disease.

Methods:
We examined antihypertensive medication-naive 858 individuals who underwent extensive cardiovascular health check-up. LV global longitudinal (GLS) and circumferential strain (GCS) were assessed by 2-dimensional speckle-tracking echocardiography. Participants were categorized into 4 groups according to the BP levels: normal BP, elevated BP, isolated diastolic hypertension (IDH) and systolic hypertension (SH).

Results:
Among the 858 participants (61±11 years, 459 men), 422 individuals had normal BP, 113 had elevated BP, 160 had IDH, and 163 had SH. Prevalence of abnormal LVGLS (>-18.6%) was greatest in SH group (19.0%), followed by IDH (17.5%), elevated BP (14.2%) and normal BP (7.1%, p<0.001; Figure); no significant differences were observed for LVGCS (p=0.671). In the multivariable analyses, IDH and SH were associated with impaired LVGLS (adjusted odds ratio [OR] 2.69 and 2.66, p<0.001) and borderline significance was observed for elevated BP (adjusted OR 1.90, p=0.060); there was no significant association between any of the BP groups and LVGCS. In sex-stratified analysis, IDH and SH carried the significant risk of abnormal LVGLS in both sexes, while elevated BP was associated with LVGLS only in women.

Conclusion:
IDH and SH redefined by ACC/AHA guideline carried a significant risk for LVGLS, but not LVGCS. Elevated BP was associated with LVGLS only in women. Our findings provide information on cardiac correlates of the newly established BP categories.
Abstract 9987: Relation of Body Mass Index to Outcomes Among Patients Hospitalized for Heart Failure
Authors: Minhas Abdul , Sheikh Abu Baker , Ullah Waqas , Greene Stephen J , Michos Erin , Fudim Marat
Published: April 2024

Background:
Variable associations have been reported between obesity and clinical outcomes among patients with heart failure (HF), including a potential obesity paradox. The aim of the study is to evaluate the association between body mass index (BMI) and clinical outcomes in patients hospitalized for HF.

Methods:
We conducted a retrospective analysis of adult discharges from the U.S. National Inpatient Sample (NIS) between 2016 and 2018. ICD codes were used to identify primary HF hospitalizations. BMI<20 kg/m
2
, 25.0-29.9 kg/m
2
, and ≥ 30 kg/m
2
patients were further identified by their respective ICD codes. The remaining cohort was assumed to have normal BMI of 20-24.9 kg/m
2
. We used weighted multivariable logistic regression adjusted for patient-level and hospital-level characteristics to compare outcomes across BMI groups. Prevalence estimates were weighted using NIS-provided discharge-level weights to reflect national estimates.

Results:
Among 3,489,634 weighted primary HF hospitalizations, 59,175 (1.7%) had BMI<20 kg/m
2
, 2,519,179 (72.2%) had BMI 20-24.9 kg/m
2
, 31,680 (0.9%) had BMI 25.0-29.9 kg/m
2
, and 879,599 (25.2%) had BMI ≥ 30 kg/m
2
. On multivariate analysis, compared with individuals with a BMI of >20-24.9 kg/m
2
, those with BMI<20 kg/m
2
and BMI ≥ 25.0-29.9 kg/m
2
had higher inpatient mortality, mechanical circulatory support use, cardiogenic shock, invasive mechanical ventilation, pressors use, gastrostomy, length of stay and inflation-adjusted cost. BMI ≥ 30 kg/m
2
had lower in-hospital mortality, mechanical circulatory support use, cardiogenic shock and higher invasive mechanical ventilation, tracheostomy, acute kidney injury, length of stay and inflation-adjusted cost (Figure).

Conclusion:
Among patients hospitalized for HF, patients who were underweight and overweight had worse outcomes compared with normal weight patients, whereas patients who were obese tended to have variable outcomes, including lower in-hospital mortality.
Managing Clopidogrel Resistance in Neurointervention: Surveying Current Approaches
Authors: Kim Hyun Woo , Bach Ivo , Gutierrez Juan Carlos Martinez , Dmytriw Adam A. , D'Amato Salvatore , Zeineddine Hussein A. , Yoo Albert J. , Sheth Sunil A.
Published: April 2024

Background

Because of the variability in patient responses to clopidogrel and to reduce the risk of thromboembolic complications, adjusting the antiplatelet regimen based on platelet function testing has become a widespread practice in neurointervention. We aimed to explore current patterns related to this practice.

Methods

We conducted a survey targeting neurointerventionalists, comprising multiple‐choice questions and opportunities for free‐text responses when necessary. The survey was distributed via a professional society distribution list (the
Society of Vascular and Interventional Neurology
) and 2 consortium emailing lists (WovenEndoBridge and Neurointerventional Research Consortia). The data obtained from the responses were analyzed using descriptive statistics.

Results

A total of 133 neurointerventionalists, representing 79 institutions within 27 countries, responded to the survey. A total of 62% of respondents tested for clopidogrel resistance before any neurovascular stent placements. A total of 80% used VerifyNow point‐of‐care P2Y12 assay; other assays included multiplate analyzer, platelet function analyzer, and CYP2C19 genotype assay. Respondents reported 25 different therapeutic thresholds, with the P2Y12 reaction unit range between 60 and 180 most commonly used (16.4%). A total of 61% reported they would switch to ticagrelor in the case of persistent resistance. On the other hand, when patients are supratherapeutic, 48% did not make any changes, whereas 42% reduced clopidogrel dose. Finally, 93% opined that a well‐established protocol for management of clopidogrel resistance was needed.

Conclusions

Neurointerventional practice patterns around clopidogrel resistance remain heterogeneous. Our results underscore the need for evidence‐based guidance on the management of clopidogrel resistance in neurointervention.
Social Perception in the Infant Brain and Its Link to Social Behavior
Authors: Grossmann Tobias
Published: April 2024

The current longitudinal study (n = 98) utilized a developmental cognitive neuroscience approach to examine whether and how variability in social perception is linked to social behavior in early human development. Cortical responses to processing dynamic faces were investigated using functional near-infrared spectroscopy at 7 months. Individual differences in sociability were measured using the Early Childhood Behavior Questionnaire at 18 months. Confirming previous work with infants and adults, functional near-infrared spectroscopy results show that viewing changing faces recruited superior temporal cortices in 7-month-old infants, adding to the view that this brain system is specialized in social perception from early in ontogeny. Our longitudinal results show that greater engagement of the right superior temporal cortex at 7 months predicts higher levels of sociability at 18 months. This suggests that early variability in social perception is linked to later differences in overtly displayed social behavior, providing novel longitudinal evidence for a social brain–behavior association.
On Octavius from Maloti-Drakensberg and Golden Gate National Parks, South Africa (Coleoptera: Staphylinidae: Euaesthetinae)
Authors: JANÁK JIŘÍ
Published: April 2024

Nineteen species of the genus Octavius Fauvel, 1873 from Maloti-Drakensberg and Golden Gate National Parks, South Africa were recognised. Thirteen species are described as new: Octavius aureaportalis Janák, sp. nov., O. clarkei Janák, sp. nov., O. flagellatus Janák, sp. nov., O. gracilis Janák, sp. nov., O. gxaligengwanus Janák, sp. nov., O. kambergensis Janák, sp. nov., O. lothenicus Janák, sp. nov., O. monachicucullus Janák, sp. nov., O. penicullatus Janák, sp. nov., O. regius Janák, sp. nov., O. squamatus Janák, sp. nov., O. subulatus Janák, sp. nov. and O. undulatus Janák, sp. nov., distribution records of additional six species of Octavius are presented and all species are illustrated.
Gender Dynamics in High School Mathematics Education: Impact of Teachers and School Environment on Female Students Attitudes and Achievement
Authors: Karadaar Ishmael , Okrah Abraham , Mensah Patrick , Jnr Joseph , Ansu Bismark
Published: April 2024

This study investigates the impact of teacher gender and school type on the attitudes and academic performance of female high school students in mathematics. Utilizing a sample of 262 final-year high school girls and 10 mathematics teachers from both mixed-gender and single-sex schools in the Sunyani West District located in Ghana, the study employs surveys and achievement tests to gather quantitative data. Statistical analyses reveal several key findings. Male and female teachers shared similar beliefs regarding female students in general. Significant differences emerged in perceptions of students' mathematical abilities. Girls taught by male teachers exhibited lower anxiety levels (t (260) > 1.96, p < 0.05) and higher self-confidence (t (260) > 1.96, p < 0.05) in mathematics compared to those taught by female teachers. Additionally, mixed-gender schools fostered more positive attitudes towards mathematics among female students compared to single-sex schools (t (260) > 1.96, p < 0.05). There were positive correlations observed between students' attitudes towards mathematics and their academic performance, highlighting the importance of teacher-student relationships in shaping students' perceptions and achievements in mathematics. These findings underscore the need for inclusive teaching practices and the recruitment of qualified mathematics educators to support the academic success of female students in mathematics. Future research could explore the disparate treatment of male and female students in mathematics classrooms and investigate effective pedagogical strategies to promote equitable learning outcomes.
Analysis of the Effects of Fiber Loading on the Mechanical Behavior of Jute Reinforced Thermoplastic Composites
Authors: Ahmed Mohammad , Miah Mohammad
Published: April 2024

Natural fiber-reinforced composites are becoming a growing trend because of their affordability, sustainability, abundant natural source, and minimal environmental effect. It has also shown to be an effective replacement of synthetic fiber, particularly in the transportation and construction sectors as ceiling, paneling, partition etc. In this study the jute fiber (Hessian Cloth) reinforced (10% to 50% fiber content by weight) Polypropylene (PP) and Polyethylene (PE) composite were made by compression molding technique to understand the effect of fiber loading on mechanical properties of two different thermoplastic composite materials. For jute fabric-reinforced thermoplastic composites, it was discovered that with 30 % fiber loading with PP and PE yielded the best results. It was found that the mechanical properties of the composites enhanced significantly with 30 % fiber content with PP and PE thermoplastic matrixes in contrast to 10% and 20% fiber content composites. However, increasing the fiber content over 30%, dramatically decrease the mechanical properties of the composite samples. The relationship between Tensile Strength (TS), Bending Strength (BS), Impact Strength (IS) and Tensile Modulus (TM), Bending Modulus (BM) was examined, along with water resistance properties for both composites. Additionally, the jute-reinforced polypropylene (PP) composite showed superior mechanical capabilities compared to the jute-polyethylene (PE) composite. This suggests that it could be a suitable replacement for the toy manufacturing, home or garden furniture, automotive and interior construction industries in the future.
Determinants of Khat Farmers' Willingness to Pay for Agricultural Insurance
Authors: Muraya David , Chege Samwel , Munyiri Shelmith
Published: April 2024

Khat farming is an important source of revenue and a possible source of potential investment in Kenya. Despite the benefits, various production and marketing risks, which negatively influence productivity, profitability, economic growth and farmers' livelihood, remains a challenge. Insurance for agricultural enterprises has the ability to open up access to essential services that boost productivity and marketing. This study aimed at determining the effect of socio-economic and institutional factors on khat farmers' willingness to pay for agricultural insurance. The data used in this study was obtained from khat farmers in Meru County, Kenya, from a sample of 323 farmers. The study employed the utility maximization theory and the double-bounded dichotomous choice model. Empirical results propose that the household size, size of land owned, awareness of agricultural insurance, credit access and the amount of khat bushes possessed by the family positively and significantly affected willingness to pay. The farmer's age and income earned from khat production negatively and significantly influenced willingness to pay. This study concluded that awareness of agricultural insurance and credit access greatly influence khat farmers' willingness to pay. The study recommends improving farmers' credit facilities to allow them access more financial capability since the study showed that the willingness to pay for insurance was proportional to credit access. The study further recommends strengthening on awareness on the importance of agricultural insurance to enhance khat farmers' involvement in agricultural insurance scheme. The results of this study will equip decision-makers with evidence-based tools to excellently market and establish demand-driven insurance products to meet the demands of khat farmers.
Study of Factors Associated with Inappropriate Complementary Feeding Among Children Aged 6 to 23 Months, Western Health Region of the Gambia, 2020
Authors: Camara Maty Diagne , Crookes Haddy , Bassoum Oumar , Tine Jean Augustin , Leye Mamadou Makhtar Mbacké , Faye Adama , Seck Ibrahima
Published: April 2024

Introduction: Inappropriate complementary feeding practices are a major cause of morbidity and mortality in the first two years of life. The aim was to investigate factors associated with inappropriate complementary feeding practices among mothers of children aged 6-23 months in the Western Health Region of The Gambia. Methodology: This was a cross-sectional, descriptive and analytical study conducted from 14 September to 14 October 2020. The study population consisted of mothers of children aged 6 to 23 months attending reproductive and child health clinics and enrolled in the "Every Child Counts - My Child Project" immunization and vaccination program. Simple random sampling was used to select participants using the project. Data were collected by means of a questionnaire administered by telephone interview and concerned the socio-demographic characteristics of the mothers, the professional and economic characteristics of the parents, the socio-demographic characteristics of the children, diet and complementary feeding practices. Results: The mean age of the mothers was 28.3 (±5.4) years and that of the children 14.2 (±4.8) months. Minimum dietary diversity was 33.3%, minimum meal frequency 88% and minimum acceptable dietary intake 14.5% for all children aged 6-23 months. Non-respect of minimum dietary diversity was associated with the child's female sex, with an OR = 16.3 [1.83-145.7], with the occurrence of both diarrhea and Acute Respiratory Infection (ARI) in the two weeks preceding the survey, with an OR = 27.2 [4.26-39.8], and with the child's birth in a public health facility, with an OR = 55.1 [1.53-197.7]. Children whose mothers were aged between 25 and 34 and whose fathers did not work had a higher risk of non-respect of the dietary diversity, with OR = 54.1 [2.4 6- 118.5] and OR = 22.5 [2.32 - 31.9] respectively. The factors associated with non-respect of the minimum meal frequency were the advanced age of the children: 12 to 17 months with an OR= 28.6 [1.65 - 49.5] and 18 to 23 months with an OR= 18.9 [1.67 - 215.0] and a history of both ARI and diarrhea with an OR=. 52,9 [1,61 - 173,7]. Non-respect of the minimum acceptable dietary intake was associated with older children aged 18 to 23 months OR= 14.4 [2.25- 93.0] and those whose mothers had vocational training OR=.24.2 [1.27- 46.3]. Conclusion: Complementary feeding practices are not very satisfactory. It is important to strengthen nutrition education in order to improve infant and young child feeding practices.
Pragmatist Power Europe: Resilience and evolution in planetary organic crisis
Authors: Juncos Ana E , Pratt Simon Frankel
Published: April 2024

In this article, we join others in revisiting the concept of Normative Power Europe (NPE) through the lenses of pragmatist theory to engage with the emergent challenges of the planetary organic crisis. We argue that NPE rests on the binary distinction between moral and instrumental action and this, we argue, limits our ability to conceptualise resilience as evolutionary and to develop responses to the current crisis. Drawing on pragmatist philosophy, we argue that the project of conceptualising and pursuing planetary politics must start in the ongoing activities of actors, as an intervention into a stream of action with momentum and inertia. Our empirical analysis shows that although the European Union’s (EU) resilience turn shares some key normative commitments with a pragmatist approach, so far its resilience policies have been pragmatic rather than pragmatist. However, a closer look at the EU’s response to Russia’s war in Ukraine reveals that the EU can cultivate resilience by transforming itself. We conclude by highlighting some ways a pragmatist view on normative power and resilience-through-evolution can guide reflection and action on the threats the planetary organic crisis poses to our continued survival.
International Framing Competition Over the Women’s Protection Units (YPJ): A Comparison Between the American and Russian Media Framings
Authors: Demir Turgay , Doğan Muharrem
Published: April 2024

This article analyses the framing approaches of the Voice of America and Sputnik in the context of international framing competition since these are significant public diplomacy channels for the foreign policies of the United States and Russia. The paper questions how VOA and Sputnik frame the YPJ women by considering those countries’ policy objectives in Syria. Thematic content analysis and Robert Entman’s framing approach were applied. The paper indicates that there is a connection between policies of US and Russian governments during the Syrian civil war, particularly towards ISIS and framing tendencies of those government-sponsored media outlets over the YPJ women. While there was a consensus over the responsible agent (ISIS), framing competition has seen through factors affecting problem definition, solutions to this problem and moral justifications for the solution.
Discourse of ‘Self’ and ‘Other’ in Newspaper Editorials on Insecurity in Nigeria
Authors: Osisanwo Ayo
Published: April 2024

The spate of security threats in Nigeria has recently become quite alarming, dominating newspaper headlines and editorials. This article examines the discourse strategies deployed in the representation of ‘self’ and ‘other’ by editorials in two Nigerian newspapers on the security challenges in Nigeria. Drawing insights from Van Dijk’s socio-cognitive model of critical discourse analysis, the sampled editorials on insecurity in Nigeria from two e-versions of newspapers from the northern ( Leadership Nigeria) and southern ( Punch) parts of Nigeria, published from 2017 to 2020 are subjected to discourse analysis. The paper identified the deployment of eight discourse strategies, motivated by nationalist and humanist ideologies. The newspapers polarise between self and other through positive in-group and negative out-group ideologies on the security challenges bedevilling Nigeria with attendant implications for Africa and the world at large.
Good fences make good neighbors? Exploring potential transformative impacts of local governance towards livestock fence-in rights in Malawi
Authors: Mkondiwa Maxwell , Kabambe Vernon , Ngwira Amos
Published: April 2024

Malawi's export earnings are dominated by tobacco, accounting for over 60% of export earnings. The demand for an alternative export commodity, pigeon pea, has been rising over the past decade, especially from India. In addition to their export potential, pigeon pea is an effective cover crop to protect soil heath and productivity in the dry season. They are mostly grown in southern region on very small farms, however, there are opportunities for expansion into central region given the existence of larger farms and agroecological suitability for the crop. Currently, social norms in the central region constrain this expansion. Livestock, and goats in particular, are left to roam free in the dry season by over two-thirds of farmers, relative to only one-third in the south. This leads to significant damage to pigeon pea crops and discourages farmers from growing them and taking advantage of the increased export demand. Much land is left bare and the few farmers that do grow crops during the dry season are forced to put up fences. This study assesses ex-ante implications, especially on agroecological transformation and economic growth, of shifting local governance arrangements among farmers around keeping livestock towards controlled systems. These externalities have been understudied in the development programming, yet their impacts are substantial, especially in lower-income countries. The policy solution under study is for the local government and non-state actors to support local governance arrangements through indirect payments to agroecosystem services. These can include information campaigns on benefits of controlled livestock systems, training and subsidizing modern goat house construction and feed preservation, and contract farming and product certification for adhering to acceptable community norms. Medium-term policy interventions include varietal development of adaptable short duration pigeon pea, initiating a review of the appropriate laws, and instituting more studies to understand these community norms.
Cracking the Deck: National origins and promotions in the Dutch East India Company, 1700–1796
Authors: Wezel Filippo Carlo , Ruef Martin
Published: April 2024

Organizational scholars highlight various challenges in reducing inequality within organizations. Due to unanticipated consequences, many programs launched by organizations fail to accomplish this goal. We leverage historical data from the Dutch East India Company to claim that training programs may be an effective tool against inequality when coupled with teamwork incentives and included in broader programs for change. We study the effects of these programs on the unequal promotion rates between Dutchmen and non-Dutchmen across periods of time in which those programs were offered and in which they were not. Our analyses of promotions to top-ranked positions on the Company’s ships suggest a two-fold conclusion: first, the introduction of leadership training and teamwork incentives reduced the differential weights given to the experience of Dutchmen and non-Dutchmen; and, second, those benefits disappeared when the policies were rescinded. The results underscore the opportunities and difficulties that organizations face in implementing durable interventions against inequality.
Benefits of a prolonged-release amino acid mixture in four pregnant women with phenylketonuria
Authors: Sestito Simona , Brodosi Lucia , Ferraro Stefania , Carella Rosa , De Giovanni Donatella , Mita Dorina , Moretti Michele , Moricca Maria Teresa , Concolino Daniela , Tummolo Albina
Published: April 2024

Background: Maternal phenylketonuria (mPKU) is a pathologic condition occurring in the fetus of a mother with PKU that is caused by prolonged elevated intrauterine blood phenylalanine (Phe) levels, which can lead to congenital abnormalities and mental retardation of newborns. Management of PKU during pregnancy can be challenging as protein substitutes may exacerbate nausea, vomiting, and gastrointestinal symptoms. Aim: To report the successful management of four PKU pregnant women. Methods: The patients were administered with prolonged-release amino acid supplementation and were recommended to follow a strict diet. Blood Phe concentration, adherence to diet, and occurrence of adverse events were monitored. Results: All patients achieved safe levels of blood Phe concentration (120–360 µmol/L) since preconception and during pregnancy (mean Phe concentration values of 143.34 ± 137.59, 226.48 ± 194.57, 186.68 ± 133.67, and 187.47 ± 42.59 µmol/L). During the first trimester of pregnancy, all patients manifested gastrointestinal symptoms such as nausea, gastrointestinal reflux, and abdominal bloating, which were managed by either changing protein substitute or extending the time window between different meals and amino acid mixtures administration. The four women continued their pregnancies without experiencing further complications and delivered neonates with normal growth parameters and no malformations. Conclusion: Findings of this case series suggest that the intake of a prolonged-release amino acid mixture in granules is well tolerated by pregnant PKU patients, eventually leading to good metabolic control and fetal growth within normal ranges.
The approach to extracorporeal cardiopulmonary resuscitation (ECPR) in children. A narrative review by the paediatric ECPR working group of EuroELSO
Authors: Mensink HA , Desai A , Cvetkovic M , Davidson M , Hoskote A , O’Callaghan M , Thiruchelvam T , Roeleveld PP
Published: April 2024

Extracorporeal Cardiopulmonary Resuscitation (ECPR) has potential benefits compared to conventional Cardiopulmonary Resuscitation (CCPR) in children. Although no randomised trials for paediatric ECPR have been conducted, there is extensive literature on survival, neurological outcome and risk factors for survival. Based on current literature and guidelines, we suggest recommendations for deployment of paediatric ECPR emphasising the requirement for protocols, training, and timely intervention to enhance patient outcomes. Factors related to outcomes of paediatric ECPR include initial underlying rhythm, CCPR duration, quality of CCPR, medications during CCPR, cannulation site, acidosis and renal dysfunction. Based on current evidence and experience, we provide an approach to patient selection, ECMO initiation and management in ECPR regarding blood and sweep flow settings, unloading of the left ventricle, diagnostics whilst on ECMO, temperature targets, neuromonitoring as well as suggested weaning and decannulation strategies.
The spatial polarization of housing wealth accumulation across Spain
Authors: Arundel Rowan , Torrado Jose Manuel , Duque-Calvache Ricardo
Published: April 2024

Housing wealth is central to structuring inequalities across societies. Processes of financialization have intensified the speculative nature of housing, while labour and welfare restructuring increase the importance of property wealth towards economic security. Housing, however, represents an exceptional asset given its inherently spatial nature and buy-in barriers. This implies that not only access to homeownership but where households enter the housing market is central to wealth trajectories. Spatial inequality in housing trends thus fundamentally structures wealth dynamics. While some scholarship has posited increasing housing market spatial polarization, there remains a lack of empirical evidence. This research turns to the context of Spain, to directly assess spatial polarization in housing value accumulation. Employing an innovative dataset at a detailed geographic scale, the analyses reveal strong increases in polarization across the national territory over the past decade. Strikingly, these dynamics appear resistant to major upheavals, including the post-GFC crash and Covid-19 impacts, and are robust across scales. The analyses reveal that more expensive areas saw greater absolute gains and higher rates of appreciation. The findings expose a structural intensification of spatial polarization and provide crucial empirical evidence of how the housing market acts in amplifying inequality through the spatial sorting of wealth accumulation.
Intraoperative methadone for day-case gynaecological laparoscopy: A double-blind, randomised controlled trial
Authors: Green Kyle W , Popovic Gordana , Baitch Luke
Published: April 2024

Optimal pain relief in day-case surgery is imperative to patient comfort and timely discharge from hospital. Short-acting opioids are commonly used for analgesia in modern anaesthesia, allowing rapid recovery after surgery. Plasma concentration fluctuations from repeated dosing of short-acting opioids can cause patients to oscillate between analgesia with potential adverse effects, and inadequate analgesia requiring rescue dosing. Methadone’s unique pharmacology may offer effective and sustained analgesia with less opioid consumption, potentially reducing adverse effects. Using a double-blind, randomised controlled trial, we compared post-anaesthesia care unit opioid consumption between day-case gynaecological laparoscopy patients who received either intravenous methadone (10 mg), or short-acting opioids intraoperatively. The primary outcome was post-anaesthesia care unit opioid consumption in oral morphine equivalents. Secondary outcomes included total opioid consumption, discharge opioid consumption, pain scores (0–10) until discharge, adverse effects (respiratory depression, postoperative nausea and vomiting, excess sedation), and rate of admission. Seventy patients were randomly assigned. Patients who received methadone consumed on average 9.44 mg fewer oral morphine equivalents in the post-anaesthesia care unit than the short-acting group (18.02 mg vs 27.46 mg, respectively, 95% confidence interval 0.003 to 18.88, P = 0.050) and experienced lower postoperative pain scores at every time point, although absolute differences were small. There was no evidence of lower hospital or discharge opioid consumption. No significant differences between the methadone and short-acting groups in other outcomes were identified: respiratory depression 41.2% versus 31.4%, Padjusted >0.99; postoperative nausea and vomiting 29.4% versus 42.9%, Padjusted >0.99; overnight admission 17.7% versus 11.4%, Padjusted >0.99; excess sedation 8.82% versus 8.57%, Padjusted >0.99. This study provides evidence that, although modestly, methadone can reduce post-anaesthesia care unit opioid consumption and postoperative pain scores after day-case gynaecological laparoscopy. There were no significant differences in any secondary outcomes.
3D Full-Waveform Tomography of Standard Penetration Test-Seismic Wavefields in Karst Florida Limestone
Authors: Tran Khiem T. , Mirzanejad Majid , Horhota David , Wasman Scott J.
Published: April 2024

The shallow subsurface across large parts of Florida consists of weathered karst limestone, a spatially variable porous stratigraphy with significant influence in the design and load capacity of deep foundations. For reliable load transfer of the super structure into the bearing soil/rock, detection of voids and weak zones is crucial. This study investigated the capabilities of a recently developed standard penetration test (SPT)-seismic testing method for characterizing a large volume of soil/rock properties with a single SPT. The method utilizes a three-dimensional full-waveform inversion (3D FWI) of wavefields induced by SPT blows at depths (in-depth source) to characterize the subsurface around the SPT borehole. A site in Florida that presents shallow, surface karst limestone, was the location of a field experiment that consisted of two 36- × 18-m areas, each with an SPT at the area center. Seismic wavefields induced by SPT blows at depth were recorded by 72 vertical geophones on the ground surface and analyzed by the 3D FWI. The results revealed that subsurface soil/rock properties were characterized in submeter pixels over a large 3D domain of 24 × 36 × 18 m (depth × length × width). Multiple voids at various depths from 5 to 17 m were successfully detected at the site and confirmed by SPT data. The results suggested that the SPT-seismic method is an efficient tool for site investigation, as a bridge pier or pile group could be designed with only one SPT.
Logistics and Urban Planning: A Review of Literature
Authors: Charters-Gabanek Kamilah , Raimbault Nicolas , Hall Peter V.
Published: April 2024

While logistics has come to be understood as central to the functioning of global and urban economies, this field is often ignored by urban planners. This literature review presents a broad discussion of the links between the logistics industry and a series of urban planning concerns, including spatial reorganization, real estate markets, urban planning, labor, and urban governance. We develop a framework around the forces shaping the supply of, and demand for, land for logistics to engage with current conversations in urban studies on the production of urban spaces, as well as to assist urban and regional planners.
The Great Neoliberal War: Conflict in Contemporary Mexico
Authors: Lerch Alejandro
Published: April 2024

In the past decades, Mexico has hosted one of the world’s deadliest internal conflicts. There are few global parallels to the scale of killing, disappearances, mass graves, feminicides, kidnappings, extortion, murder of social activists and violence against journalists. Predominant interpretations and governmental narratives cast Mexico’s conflict as owing fundamentally to state weakness and criminal organizations bidding to control drug flows. This article advances a different interpretation. Drawing from structuralist perspectives, the article underscores the extensive criminogenic dynamics set in motion by Mexico’s radical commitment to neoliberal transformation. Similarly, the article underlines the extent to which violence in many cases transpires less from drug conflicts than the creation of new export markets and new commodity chains. Turned invisible by a ‘Drug War’ narrative, Mexico represents a powerful lens into the social violence generated by and paving the way towards our neoliberal futures.
Intelligent vehicle trajectory tracking control based on physics-informed neural network dynamics model
Authors: Cao Xiuchen , Cai Yingfeng , Li Yicheng , Xiaoqiang Sun , Chen Long , Wang Hai
Published: April 2024

In order to solve the accuracy problem of trajectory tracking control method based on data-driven model, an intelligent vehicle trajectory tracking control method based on physics-informed neural network (PINN) vehicle dynamics model is proposed. Aiming at the problem of poor interpretability of data-driven model, a vehicle dynamics model based on the PINN is established, and the physics-driven deep learning method is used instead of the data-driven deep learning method to obtain the dynamic characteristics of the intelligent vehicle, to benefit from both the physical-based method and the data-driven method. A sequential training method is also proposed to solve the coupling problem when training multiple PINNs simultaneously. The model takes the nonlinearity of the neural network model and physical interpretability into consideration compared to the standard neural network model. Then, based on the PINN vehicle dynamics model, a trajectory tracking controller based on the iterative linear quadratic regulator (ILQR) control algorithm is developed. The optimal control law is derived by optimizing the ILQR control algorithm to implement the intelligent vehicle’s precise and stable tracking for the desired trajectory. The Levenberg-Marquardt (LM) algorithm and line search technology are used and damping factor adjustment rules are set up to enhance the convergence performance of the ILQR control algorithm. In order to verify the effectiveness of the proposed method, the simulation is conducted under the condition of double lane change. The simulation results demonstrate that the proposed method can track the reference trajectory accurately under the limited conditions. Its control performance is much better than other algorithms.
Synchronizing the Western Gotland Basin (Baltic Sea) and Lake Kälksjön (central Sweden) sediment records using common cosmogenic radionuclide production variations
Authors: Czymzik Markus , Christl Marcus , Dellwig Olaf , Muscheler Raimund , Müller Daniela , Kaiser Jérôme , Schwab Markus J , Nantke Carla KM , Brauer Achim , Arz Helge W
Published: April 2024

Multi-archive studies of climate events and archive-specific response times require synchronous time scales. Aligning common variations in the cosmogenic radionuclide production rate via curve fitting methods provides a tool for the continuous synchronization of natural environmental archives down to decadal precision. Based on this approach, we synchronize 10Be records from Western Gotland Basin (WGB, Baltic Sea) and Lake Kälksjön (KKJ, central Sweden) sediments to the 14C production time series from the IntCal20 calibration curve during the Mid-Holocene period ~6400 to 5200 a BP. Before the synchronization, we assess and reduce non-production variability in the 10Be records by using 10Be/9Be ratios and removing common variability with the TOC record from KKJ sediments based on regression analysis. The synchronizations to the IntCal20 14C production time scale suggest decadal to multi-decadal refinements of the WGB and KKJ chronologies. These refinements reduce the previously centennial chronological uncertainties of both archives to about ± 20 (WGB) and ±40 (KKJ) years. Combining proxy time series from the synchronized archives enables us to interpret a period of ventilation in the deep central Baltic Sea basins from ~6250 to 6000 a BP as possibly caused by inter-annual cooling reducing vertical water temperature gradients allowing deep water formation during exceptionally cold winters.
Induction treatment for lupus nephritis at a high-complexity hospital in Chile
Authors: Ramirez Paulina , Giglio Andres , Verdugo Jorge , Gutierrez Francisco
Published: April 2024

Introduction

Systemic lupus erythematosus (SLE) causes kidney compromise in up to 40% of patients, contributing significantly to morbidity. Lupus nephritis (LN), an early onset manifestation in most patients, is histologically classified into six types, with types III, IV, and V requiring treatment with induction therapies, usually glucocorticoids with mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC). However, up to 60% of patients fail to achieve complete remission, and 27%–66% have subsequent flares. There is scarce literature on the superiority of IVC or MMF in the Latin population.

Methodology

A retrospective cohort study of 72 LN patients at a high-complexity hospital in Chile between 2016 and 2021 was conducted. Demographics, urine studies, creatinine levels, complement levels, antibody profiles, biopsy results, and response to treatment were analysed.

Results

The median age of the cohort was 29 years, with women representing 90% of patients. At diagnosis, 87.5% of the patients presented with proteinuria, 55% had haematuria, and 49% had acute kidney injury. The most common LN type was type IV. For induction therapy, half of the patients were treated with IVC, and the other half with MMF. The response to treatment did not differ significantly between the two.

Discussion

This is one of the few studies to focus on the Latin American population, specifically Chile. These results are consistent with the current understanding of LN treatment. Despite its limitations, this study provides valuable insights into the treatment effectiveness of IVC and MMF in this population.

Conclusion

This study did not find significant differences in the clinical response to IVC or MMF at 6 months. Future prospective studies are required to determine the optimal induction therapy for LN, especially in Latin populations.
Knowledge, Attitude, and Practices Toward Kangaroo Mother Care Among Mothers in a Tertiary Neonatal Care Unit
Authors: Pradhan Monalisa , Kar Shrutiprajna , Sahoo Tanushree , Som Tapas , Mohanty Pankaj Kumar , Devi Usha
Published: April 2024

Aim: To study the knowledge, attitude, and practices of Kangaroo Mother Care (KMC) among eligible postnatal mothers in the postnatal ward (PNW) and neonatal intensive care unit (NICU) of a tertiary neonatal unit in Eastern India.

Methods: A cross-sectional survey was conducted among 100 mothers of low-birth-weight babies in our PNW and NICU. As part of the unit protocol, all mothers of eligible babies were counseled about KMC at first contact verbally as well as by using an informative video on KMC. Data was collected using a structured questionnaire after the routine counseling of the mothers on their first visit after delivery. The analysis of the data was done using appropriate statistics.

Results: More than three-fourths (83.2%) of mothers had good knowledge of KMC. A good attitude toward using KMC was found in 91.6% of the mothers. Almost all the mothers (98%) knew the correct KMC position, and 12% of mothers had a previous preterm baby and had given KMC. Many mothers felt the small size of the baby, pain after cesarean section, and central or peripheral intravenous lines in the baby were barriers to KMC.

Conclusion: The knowledge regarding KMC among mothers whose babies were admitted into the PNW/NICU was good. Though the attitude toward KMC was good, mothers felt there were multiple barriers to initiating KMC.
Sexual Knowledge, Sexual Attitudes, and the Need for Sex Education Among Adolescent Defectors From North Korea
Authors: Lee In-Sook , Jeon Jung-Hee , Kim Kyoung Ja
Published: April 2024

Introduction:

Adolescent North Korean defectors are vulnerable due to harmful environments during defection, limited access to sex education in North Korea, and exposure to different sexual norms in South Korea. The purpose of this study was to investigate the sexual knowledge, attitudes, and sex education needs of North Korean refugee adolescents.

Methods:

A cross-sectional, descriptive survey was administered to 102 North Korean refugee adolescents.

Results:

The correct answer rate for questions on genital anatomy, physiology, masturbation, and contraception was less than 20%. The participants exhibited conservative attitudes toward female contraception, masturbation, and having friends of the opposite sex. A significant positive correlation was found between knowledge and the need for sex education.

Discussion:

These results highlight the importance of tailored sex education in providing accurate information, improving sexual knowledge, fostering positive attitudes, and enabling healthy behaviors among adolescent North Korean defectors.
The Relationship of Coronary Thrombus Burden and Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Score in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Coşkun Gökhan , Ozde Cem , Kayapinar Osman , Aktore Gulsah , Ekşi Ensar , Afşin Hamdi , Sayın Ahmet Egemen
Published: April 2024

Background

The anticoagulation and risk factors in atrial fibrillation (ATRIA) score is associated with adverse cardiovascular events. However, its relationship with coronary thrombus burden is unclear. Therefore, we aimed to investigate the relationship between the ATRIA score and thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI).

Materials and Methods

The study was designed as a prospective cross-sectional observational study. Our study included 319 patients who were prospectively admitted with STEMI between January 2021 and April 2022. Patients were divided into 2 groups with low thrombus burden (LTB) (grade <3) and high thrombus burden (HTB) (grade ≥3). ATRIA score was calculated and recorded for all patients. ATRIA scores of both groups were compared.

Results

In our study, 58.9% ( n  =  188) of patients in the LTB group and 41% ( n  =  131) of patients in the HTB group. The ATRIA risk score ( p < .001) was significantly higher in the HTB group. In multivariate logistic regression analysis, ATRIA score, glomerular filtration rate, hypertensıon, abciximab usage, and no-reflow were found to be independent predictors of HTB in STEMI patients undergoing primary PCI. In receiver operating characteristic analysis, ATRIA score >4 had a sensitivity of 66.2% and specificity of 95.2%, and ATRIA score >8 sensitivity of 98% and specificity of 100% predicted HTB.

Conclusion

In this study, we found that thrombus burden may be associated with ATRIA risk score in patients presenting with STEMI.