bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart Failure Is Associated With Increased Stroke Severity, In‐Hospital Mortality, Major Adverse Cardiovascular Events, and Complications: Insights From the Chinese Stroke Center Alliance
Authors: Hu Guoliang , Gu Hongqiu , Jiang Yingyu , Wang Chunjuan , Jiang Yong , Li Zixiao , Wang Yongjun , Wang Yilong
Published: February 2025

Background

Heart failure (HF) constitutes the source of various damaging pathophysiological mechanisms in acute ischemic stroke (AIS). The effect of a previous HF on the in‐hospital outcomes for patients with AIS still lacks effective research. We aimed to evaluate the severity of stroke, in‐hospital mortality, major adverse cardiovascular events, and complications associated with a previous HF in these patients.

Methods and Results

This cross‐sectional study was conducted at 1476 hospitals in the Chinese Stroke Center Alliance. Multivariable logistic regression and propensity score–matched analyses were used to evaluate the association between a history of HF and in‐hospital outcomes. Of 836 885 patients with AIS, 1.1% (n=8950) patients had a history of HF. Patients with a history of HF had a higher National Institutes of Health Stroke Scale score at admission (6.0 versus 3.0) than those without a history of HF. Multivariable analysis revealed that a history of HF was associated with an 80% higher risk of all‐cause mortality (odds ratio [OR], 1.80 [95% CI, 1.54–2.10]), a 34% higher risk of major adverse cardiovascular events (OR, 1.34 [95% CI, 1.26–1.43]), and a 92% higher risk of complications (OR, 1.92 [95% CI, 1.83–2.02]). Further propensity score matching showed that patients with a history of HF had higher risks of adverse in‐hospital outcomes (all‐cause mortality: OR, 1.62 [95% CI, 1.30–2.02]; major adverse cardiovascular events: OR, 1.39 [95% CI, 1.26–1.53]; complications: OR, 1.70 [95% CI, 1.58–1.82]).

Conclusions

Patients with AIS and a history of HF have increased risks of severe stroke, in‐hospital mortality, major adverse cardiovascular events, and complications. Systematic cardiovascular evaluation and integrated multidisciplinary care for patients with AIS in clinical practice are warranted.
Role of Biological Age in the Determination of Long‐Term Cause‐Specific Death Following Percutaneous Coronary Interventions
Authors: Singh Mandeep , Friedman Paul A. , Gulati Rajiv , El Sabbagh Abdallah , Lewis Bradley R. , Kanwar Amrit , Raphael Claire E. , Al‐Hijji Mohammed A. , Attia Zachi I. , Behfar Atta , Kirkland James L.
Published: February 2025

Background

We tested whether biologic age, as estimated by deficits, functional impairments, or Age‐Gap or their combination, provide improved estimation of cause‐specific death as compared with chronological age.

Methods

Cardiovascular and noncardiovascular deficits, functional impairments, and Age‐Gap were prospectively collected in 535 patients aged ≥55 years undergoing percutaneous coronary interventions between August 1, 2014, and March 31, 2018. Age‐Gap was calculated as the difference between chronological age and age estimated by artificial intelligence ECG using a convolutional neural network. The full biological age model included deficits, functional impairments, and Age‐Gap >2 SD. A multivariable reduced model with the least number of variables was also created to provide a comparable C index to the full model.

Results

The average chronological age was 72.1±9.5 years, and there were 68% of men. During a median follow‐up of 2.61 years, 124 (23%) patients died. There was a modest correlation between Age‐Gap and biological age (
r
=0.28 [95% CI, 0.20–0.35];
P
<0.001). When modeled with chronologic age as a covariate, Age‐Gap predicted all‐cause (hazard ratio [HR], 1.07 [95% CI, 1.04–1.10];
P
<0.001) and cardiovascular (HR, 1.07 [95% CI, 1.04–1.11];
P
<0.001) mortality. As compared with chronological age, the full biological age model noted significant improvement in the prediction of long‐term overall (95% CI, 0.65–0.78), cardiovascular (95% CI, 0.69–0.77), and noncardiovascular (95% CI, 0.55–0.86) mortality. In the reduced models, most prognostic information for noncardiovascular mortality (C index: 0.79) was obtained by subjective difficulty in performing tasks, whereas the deficit‐based estimation predicted cardiovascular mortality (C index: 0.72).

Conclusions

Estimated biological age from deficits and functional impairments was superior to chronological age in predicting long‐term cause‐specific mortality following percutaneous coronary interventions.
Right Ventricular Stiffening and Anisotropy Alterations in Pulmonary Hypertension: Mechanisms and Relations to Right Heart Failure
Authors: Neelakantan Sunder , Vang Alexander , Mehdi Rana Raza , Phelan Haley , Nicely Preston , Imran Tasnim , Zhang Peng , Choudhary Gaurav , Avazmohammadi Reza
Published: February 2025

Background

Pulmonary hypertension (PH) results in increased right ventricular (RV) afterload, leading to RV dysfunction and failure. The mechanisms underlying maladaptive RV remodeling are poorly understood. In this study, we investigated the multiscale and mechanistic nature of RV free‐wall (RVFW) biomechanical remodeling and its correlations with RV function adaptations.

Methods

Mild and severe models of PH, consisting of a hypoxia model in Sprague–Dawley rats (n=6 each, control and PH) and a Sugen‐hypoxia model in Fischer rats (n=6 each, control and PH), were used. Organ‐level function, tissue‐level stiffness, and microstructure were quantified through in vivo and ex vivo measures, respectively. Multiscale analysis was used to determine the association between fiber‐level remodeling, tissue‐level stiffness and anisotropy, and organ‐level dysfunction.

Results

Decreased RV–pulmonary artery coupling correlated strongly with RVFW stiffening but showed a weaker association with the loss of RVFW anisotropy. Machine‐learning classification identified the range of adaptive and maladaptive RVFW stiffening. Multiscale modeling revealed that increased collagen fiber tautness was a key remodeling mechanism that differentiated severe from mild stiffening. Myofiber orientation analysis indicated a shift away from the predominantly circumferential fibers observed in healthy RVFW specimens, leading to a significant loss of tissue anisotropy.

Conclusions

Multiscale biomechanical analysis indicated that, although hypertrophy and fibrosis occur in both mild and severe PH, certain fiber‐level remodeling events, including increased tautness of collagen fibers and significant reorientations of myofibers, contributed to excessive biomechanical maladaptation of the RVFW leading to severe RV–pulmonary artery uncoupling. Collagen fiber remodeling and the loss of tissue anisotropy can provide an improved understanding of the transition from adaptive to maladaptive RV remodeling.
A Framework for Exception From Informed Consent in Trials Enrolling Patients With ST‐Segment–Elevation Myocardial Infarction and Cardiogenic Shock
Authors: Nichol Graham , Dickert Neal W. , Moeller Jacob E. , Hochman Judith S. , Facemire Carie , Adams Karen N. , Stone Gregg W. , Morrow David A. , Thiele Holger , Henry Timothy D. , Simonton Chuck , Rao Sunil V. , O'Neill William , Gilchrist Ian , Egelund Ryan , Proudfoot Alastair , Waksman Ron , West Nick E. J. , Sapirstein John S. , Krucoff Mitchell W.
Published: February 2025

Cardiogenic shock (CS) is critical end‐organ hypoperfusion attributable to reduced cardiac output. Acute ST‐segment–elevation myocardial infarction with CS (AMI‐CS) has high mortality. Clinical research is challenging in such patients as they often cannot provide consent, lack available legal representatives, and require initiation of therapy. Multiple trials have enrolled patients with AMI‐CS outside the United States under deferred consent. Trials in the United States have enrolled patients with out‐of‐hospital cardiac arrest under exception from informed consent (EFIC). However, AMI‐CS has a longer therapeutic window to initiate treatment than out‐of‐hospital cardiac arrest, and more patients or their representatives can engage in treatment decisions. We provide a rationale for how a trial enrolling patients with AMI‐CS could qualify for conduct using EFIC by meeting each criterion specified in US human subject regulations. AMI‐CS is a life‐threatening situation, available treatments are unsatisfactory, and collection of valid evidence is necessary. Obtaining informed consent is often not feasible, and trial participation could benefit subjects. Only enrolling consented patients is impracticable and could reduce the study's generalizability. We propose a therapeutic window of 30 minutes within the study intervention must be initiated, with consent sought within 15 minutes, respecting any refusal or objection to enrollment, and otherwise enrollment under EFIC. A trial could enroll patients with AMI‐CS under EFIC and can involve both patients and their representatives. Successful use of EFIC in trials of other interventions in patients with CS or enrolling patients with other acute cardiovascular conditions could increase the available evidence base to improve care.
OPTILOW: A Low‐Profile Approach for Implanting Optimus‐L Stents in Infants and Children
Authors: Gendera Katarzyna , Bentham James R. , Georgiev Stanimir , Kasem Mohamed , Ewert Peter , Michel Jörg , Haddad Raymond N.
Published: February 2025

Background

Stent implantation poses challenges in small children due to their limited vessel size and rapid growth. This multicenter study evaluates in vivo efficacy of implanting Optimus‐L stents in small patients using a low‐profile approach.

Methods

We retrospectively reviewed data from children weighing ≤20 kg with congenital heart stenotic lesions who received Optimus‐L stents manually mounted on small‐sized balloon catheters (diameter ≤12 mm) using a hand‐actuated compression tool and implanted through small‐sized sheaths (≤8 Fr) at our institutions between May 2022 and January 2024. Stent performance was assessed.

Results

We identified 28 patients (67.8% male) with median age and weight of 3.4 years (interquartile range [IQR], 1.5–5.5) and 12.9 kg (IQR, 9.1–16.4). Six (21.4%) were infants, 11 (39.3%) ≤10 kg. Stenotic lesions included 16 branch pulmonary arteries, 9 aortic isthmus, 2 right ventricular outflow tracts, and 1 Glenn anastomosis. Percentage of stenosis was 50% (IQR, 36%–58%). All implantations were successful without complications. The procedures mostly used 7 Fr sheaths for stents on 6, 7, and 8 mm balloons and 8 Fr sheaths for 9, 10, 12 mm balloons. Median stent expansion percentage was 95% (IQR, 90%–96%). Median vessel diameters increased from 4.6 mm (IQR, 3.8–5.1) to 8.8 mm (IQR, 7.5–9.5) (
P
<0.001), with median stenosis expansion at 103% (IQR, 51%–146%). Median stent shortening was 1.9% (IQR, 0%–3.9%). Two patients required redo stent balloon dilation after 18 and 20 months. Median follow‐up was 8 months (IQR, 3.2–13.2). Median last recorded Doppler velocity on implanted stents was 1.6 m/s (IQR, 1.2–2).

Conclusions

Optimus‐L stents can safely treat arterial and venous stenosis in infants and small children via a low‐profile approach with good outcomes.
Suboptimal Control of Small Dense Low‐Density Lipoprotein Cholesterol Is Associated With Coronary Plaque Progression: An Intravascular Ultrasound Study
Authors: Amuti Abulikemu , Li You Ran , Yuan He , Feng Shuo , Tay Guan Poh , Tang Si Yi , Wu Xin Rui , Tao Le Yuan , Lu Lin , Zhang Rui Yan , Yang Chen Die , Wang Xiao Qun
Published: February 2025

Background

Plaque progression (PP) is critical between subclinical atherosclerosis and plaque rupture. Small dense low‐density lipoprotein cholesterol (sdLDL‐C) is considered as the most atherogenic lipoprotein. This study aims to investigate the relationship between sdLDL‐C level and PP in patients with stable coronary artery disease.

Methods

We conducted a retrospective analysis of 146 lesions in 86 patients by repeat intravascular ultrasound examinations from January 2020 to May 2023. PP was determined by increases in percent atheroma volume, defined as the atheroma volume in proportion to the volume occupied by the entire vascular wall, ≥5% during follow‐up. Time‐averaged values were calculated for all cardiometabolic parameters including sdLDL‐C. Multivariate logistic regression analysis was performed to interrogate the association between time‐averaged sdLDL‐C and PP.

Results

During a median follow‐up of 12.6 months, PP was found in 65 lesions (44.5%), and mean changes in percent atheroma volume were 4.1%±10.2%. A positive correlation was observed between time‐averaged sdLDL‐C and changes in total atheroma volume (Pearson
r
=0.29,
P
=0.006), especially in diabetic patients (Pearson
r
=0.58,
P
<0.001). After multivariate adjustment, every 0.1‐mmol/L increase in time‐averaged sdLDL‐C conferred a 1.2‐fold increased risk of PP.

Conclusions

Our findings suggest that sdLDL‐C is an independent risk factor of PP in patients with coronary artery disease. Intensive control of sdLDL‐C along with other risk factors should be considered to mitigate PP and improve cardiovascular outcomes.
Association Between No‐Flow Time, Prehospital Low‐Flow Time, and Conversion to Nonshockable Rhythm in Patients With Out‐of‐Hospital Cardiac Arrest Presenting With Initial Shockable Rhythm: A Nationwide Prospective Study in Japan
Authors: Kandori Kenji , Nakajima Satoshi , Matsuyama Tasuku , Kitamura Tetsuhisa , Narumiya Hiromichi , Hitosugi Masahito , Okada Yohei
Published: February 2025

Background

Out‐of‐hospital cardiac arrest (OHCA) with initial shockable rhythm generally has a favorable prognosis. However, the prognosis worsens when this rhythm transitions to nonshockable rhythm on hospital arrival. This study aimed to investigate the association between no‐flow time (NFT), prehospital low‐flow time (LFT), and the conversion to nonshockable rhythm on hospital arrival in patients with OHCA initially exhibiting shockable rhythm.

Methods

We analyzed adult patients with OHCA from the JAAM‐OHCA (Japanese Association for Acute Medicine Out‐of‐Hospital Cardiac Arrest) registry (June 2014–December 2020) with initial shockable rhythm. The primary outcome was rhythm conversion to nonshockable on hospital arrival. Adjusted odds ratios (aORs) with 95% CIs were calculated using a logistic model to examine the associations between NFT, prehospital LFT, and rhythm conversion.

Results

Of 68 110 patients, 3720 patients were included in our analysis. On hospital arrival, 27.9% patients achieved return of spontaneous circulation, 32.8% maintained shockable rhythm, and 39.3% transitioned to nonshockable rhythm (718 to pulseless electrical activity, 744 to asystole). Median NFT was 4 minutes (interquartile range [IQR], 1–9 minutes), and median prehospital LFT was 22 minutes (IQR, 14–31 minutes). Longer NFT and prehospital LFT were associated with higher aORs of rhythm conversion: NFT (5–9 minutes: aOR, 1.38 [95% CI, 1.14–1.67]; ≥10 minutes: aOR, 1.75 [95% CI, 1.44–2.14]); and prehospital LFT (15–19 minutes: aOR, 2.56 [95% CI, 2.00–3.27]; 20–29 minutes, aOR, 4.73 [95% CI, 3.83–5.85]; ≥30 minutes, aOR, 6.85 [95% CI, 5.49–8.56]).

Conclusions

Prolonged NFT and prehospital LFT were significantly associated with rhythm conversion to nonshockable on hospital arrival in patients with OHCA with initial shockable rhythm at the scene.
Growth Rate Assessed by Vascular Deformation Mapping Predicts Type B Aortic Dissection in Marfan Syndrome
Authors: Campello Jorge Carlos Alberto , Marway Prabhvir Singh , Tjahjadi Nicasius S. , Knauer Heather A. , Patel Himanshu J. , Hofmann Bowman Marion , Eagle Kim , Burris Nicholas S.
Published: February 2025

Background

Patients with Marfan syndrome (MFS) are at a high risk of type B aortic dissection (TBAD). Aortic growth and elongation have been suggested as risk factors for TBAD. Vascular deformation mapping is an image analysis technique for mapping 3‐dimensional aortic growth on routine computed tomography angiography (CTA) scans. We aimed to use vascular deformation mapping to examine the value of aortic growth rate in the descending thoracic aorta, among other imaging biomarkers, to identify the factors associated with risk of TBAD in MFS.

Methods

Computed tomography angiography scans spanning 2004 to 2023 from adult patients with MFS with native descending thoracic aorta were analyzed by vascular deformation mapping. Other measurements included multilevel thoracoabdominal aortic diameters and the length of the descending thoracic aorta by centerline analysis.

Results

Among the 105 patients with MFS analyzed, 63.8% were men, with median age of 40 (range, 18–73) years and a median surveillance interval of 5.3 (range, 2.0–18.3) years. During surveillance, 12 (11.4%) patients developed TBAD. Patients with TBAD had a higher radial growth rate (0.63 versus 0.23 mm/year;
P
<0.001) and elongation rate (2.4 versus 0.5 mm/year;
P
<0.001), on univariate and multivariable analysis, but predissection descending aortic diameter was not significantly different. Predictors of growth rate included younger age, higher baseline maximal diameter of the descending thoracic aorta, smoking history, and warfarin use.

Conclusions

Radial growth and elongation rates of the descending thoracic aorta were independent predictors of TBAD occurrence in MFS. TBAD often occurred at nonaneurysmal diameters (<4.0 cm). These findings emphasize the role of growth over absolute diameter in risk stratification for TBAD in MFS.
Synthetic Data for the Get With The Guidelines–Stroke Registry
Authors: Wang Lanjing , Manchanda Vihaan , Picotte Holly , Beon Chandler , Hall Jennifer L. , Zhao Juan , Feng Xue
Published: February 2025

The American Heart Association's Get With The Guidelines–Quality Improvement registry is a vital resource for real‐world cardiovascular and stroke data and research, containing >14 million records from >2800 participating hospitals. To facilitate and streamline research, we aim to generate a synthetic data set that increases access to real‐world data and facilitates data exploration of the Get With The Guidelines–Stroke registry. We first randomly sampled 1000 records from the entire registry data set from 2005 to 2021 containing 7.8 million records. To preserve privacy and break the links from the original data, we shifted all data time variables and replaced all patient identifiers. To evaluate the generated synthetic data, we compared the distributions of patient demographics (eg, age, race, sex) and other key stroke‐related measures. The generated synthetic data exhibited similar distributions in age, race, sex, and time‐sensitive metrics such as door‐to‐needle time and time to intravenous thrombolytic therapy, demonstrating that this open access data set can provide all researchers the opportunity to explore real‐world cardiovascular and stroke data.
RORγt Mediates Angiotensin II‐Induced Pressor Responses, Microglia Activation, and Neuroinflammation by Disrupting the Blood–Brain Barrier in Rats
Authors: Yu Yang , Xue Baojian , Tong Lei , Bassuk Alexander G. , Johnson Alan K. , Wei Shun‐Guang
Published: February 2025

Background

The RORγt (nuclear receptor retinoid‐related orphan receptor γt) has been identified as a master transcription factor critical for the differentiation of T helper 17 cells, the primary source of IL‐17A (interleukin‐17A). We previously demonstrated that IL‐17A promotes neuroinflammation and sympathetic excitation, contributing to cardiac dysfunction in heart failure and angiotensin II (ANG II)‐induced hypertension. The present study sought to determine whether inhibiting RORγt, thereby reducing IL‐17A production, could attenuate microglial activation, neuroinflammation, and sympathetic excitation by preserving the integrity of the blood–brain barrier (BBB) in ANG II‐induced hypertensive rats.

Methods

Rats underwent a 2‐week subcutaneous infusion of ANG II, with concurrent daily subcutaneous administration of the RORγt inhibitor digoxin or vehicle.

Results

Compared with controls, ANG II‐infused rats exhibited elevated IL‐17A levels in both the periphery and brain, along with increased blood pressure and sympathetic tone—effects that were significantly attenuated by inhibiting RORγt with digoxin. ANG II‐infused rats also displayed heightened BBB permeability, decreased expression of the BBB regulator Mfsd2a (major facilitator superfamily domain‐containing protein 2a), increased caveolar transcytosis, and degradation of tight junction proteins in BBB endothelial cells within the hypothalamic paraventricular nucleus, a key autonomic regulatory brain center, all of which were alleviated by digoxin. Additionally, ANG II‐infused rats showed marked microglial activation and elevated expression of proinflammatory cytokines within the paraventricular nucleus, both of which were mitigated by digoxin.

Conclusions

These findings suggest that RORγt inhibition reduces neuroinflammation and sympathetic activation to ameliorate ANG II‐induced hypertension, likely by mitigating IL‐17A‐induced BBB disruption and microglial activation in the paraventricular nucleus.
New data on the presence of species of the genus Anapagurus (Anomura, Paguridae) in the Canary Islands
Authors: Almón Bruno , González José A. , Telle Arthur
Published: February 2025

This study examines the occurrence of species of the hermit crab genus Anapagurus in the Canary Islands, based on historical and recent information. The presence of Anapagurus laevis (Bell, 1845) and A. pusillus Henderson, 1888 is confirmed, albeit supported by a single record, while previous reports of A. longispina A. Milne-Edwards & Bouvier, 1900 and A. chiroacanthus (Liljeborg, 1856) are considered erroneous due to the misleading nature of the map on which they were based. The first documented record of A. chiroacanthus in the Canary Islands is provided and the list of Anapagurus species is updated accordingly.
Morphometrics, length-weight relationships and relative condition factor in Portunus sanguinolentus (Herbst, 1783) from the southeastern Arabian Sea
Authors: Josileen Jose , Najmudeen Theparambil Mohamed , Retheesh Thankappan , Sunil Karayil Tharayil Sadanandan , Vijayan Manakkathara Thathi
Published: February 2025

Portunus sanguinolentus is widely distributed all along the Indian coast and constitutes the most dominant marine crab landed in the country. In Kerala also, the species’ share is maximal in the marine landings and recorded an average of 1200 tonnes during 2007-2020. The bulk of the catch is contributed by trawlers and the species is mainly fished from the 20-30 m depth zone. It grows to a maximum size of 20 cm in carapace width (CW) and the estimated life span is approximately three years. Knowledge on the body weight-length/width relationships and relative condition factor in populations is important for estimating the population size of a stock and its exploitation. Hence, morphometric relationships between various characters, viz., carapace width (CW) and length (CL) and chelar propodus length (CPL) and height (CPH) in males, as well as CW and CL and abdominal width (AW) and length (AL) in females, were estimated using a total of 2476 male and 2965 female crabs. The CW/CL-weight relationship was studied in both sexes on a total of 5595 crabs using the allometric growth equation. The allometric relationships between the characters of this set suggest that most relationships are positive and highly significant (). The b values for CW-weight in males (55-171 mm/CW), females (54-170 mm/CW), and pooled were 2.9657, 2.8028, and 2.8914, respectively. The results show an isometric growth pattern for males and considerable deviation from isometric growth in females, also when all sizes are pooled. An analysis of covariance indicates that there is a significant difference between sexes () with respect to the carapace width-weight relationship. The relative condition factor () values estimated in males and females (based on CW) were 0.942 ± 0.145 and 1.371 ± 0.255, respectively, and the estimated values based on CL were 0.985 ± 0.204 and 1.022 ± 0.233, respectively.
Shaping the Evolution of International Law in View of its Core Effects
Authors: Vestner Tobias
Published: February 2025

In an international system that is undergoing change, states use international law in a strategic manner. Thereby, they shape the evolution of international law. This article explores how states proceed in this regard. It reviews the role of international law and its strategic use in international politics as well as describes the core effects of international law, namely to constrain, screen, and authorize state behavior. It then examines these effects in terms of the modes that states can use to influence the evolution of international law – agreements and related initiatives, legal positions, state activity, adjudication, and scholarship – and deduces states’ respective strategic options. The article then discusses overarching dynamics and implications for the international legal order. It concludes by arguing that negotiation theory and analysis should give broader attention to the processes that shape the evolution of international law other than by treaty-making.
Peace Processes as a Double Promise: The Risk of Linking Memory and Hope in Times of Distrust
Authors: Rosoux Valérie
Published: February 2025

This article explores the temporalities of peace processes. The objective is not to reflect on ripeness, sequences, or duration, but to question the responsibility assumed by the parties at the negotiation table. For whom do they feel responsible: past, present, and/or future generations? In other words, do they only address current urgent issues to be resolved or do they also view peace processes as opportunities to make a double promise, that is, a promise to past generations and a promise to future generations? To examine this, the article focuses on one case study, the 1963 Elysée Treaty between France and Germany. The analysis shows that this agreement is the outcome of genuine memory work (looking towards past generations) and a determined hope (looking towards future generations).
Comparison of Technetium-99m Tilmanocept to Technetium-99 Sulfur Colloid Radiotracer for Sentinel Lymph Node Biopsy in Head and Neck Melanoma
Authors: Maddineni Sainiteesh , Tosoni Sofia M. , Sunwoo John B. , Baik Fred M.
Published: February 2025

Background:

Sentinel lymph node biopsy (SLNB) is integral to management of head and neck melanomas (HNM). Here, we evaluate how radiotracer selection (Tc-99m tilmanocept or Tc-99m sulfur colloid) and imaging modality (planar imaging or single positron emission computed tomography (SPECT)) may influence SLNB and its outcomes.

Methods:

We performed a retrospective chart review of patients who received SLNB for HNM at our institution between January 2000 and July 2022.

Results:

A total of 211 patients received Tc-99m tilmanocept (Tc-tilmanocept) and 113 received Tc-99m sulfur colloid (Tc-SC). There was no difference between Tc-tilmanocept and Tc-SC in terms of number of nodal levels to which the radiotracers localized (1.48 ± 0.93 SD vs 1.38 ± 0.93, respectively). Tc-tilmanocept had a lower rate of failed sentinel node identification as reported on radiology reports compared to Tc-SC (1.9% vs 11.5%, P < .001). There was a lower 5-year recurrence rate with Tc-tilmanocept versus Tc-SC (20.9% vs 28.3%, respectively P = .07), but this difference was not significant. When analyzing only cases in which SPECT was obtained, this there was no observed difference in 5-year recurrence rate. With SPECT, fewer patients had non-specific description of their node localization as “cervical” without further detailing of nodal basin (0% SPECT vs 9.7% non-SPECT, P < .001). Multivariable linear regression analysis for predictors of HNM 5-year recurrence found the odds ratio for SPECT imaging was 0.43, but not statistically significant ( P = .06).

Conclusions:

Tc-tilmanocept may be associated with greater rate of successful radiotracer migration along lymphatics compared to Tc-SC. SPECT imaging may confer more precision of the nodal basin to which radiotracer localizes as fewer patients receiving SPECT had radiology findings showing nonspecific localization of nodes to “cervical” basins without further specification. More patients are necessary to determine if Tc-tilmanocept and SPECT imaging are associated with lower melanoma recurrence rate.
Matthew 13.1–9 and Soil Degradation: A Subaltern and Ecological Reading
Authors: Ibita Ma. Marilou S.
Published: February 2025

This article contributes to the discussion of soil degradation from the perspective of ecological biblical hermeneutics. It characterizes the interrelationship of human and more-than-human creation, particularly the various kinds of soils, in Mt. 13.1–9 through the lens of subalternity and symbiotic interrelationship. While the original application of subalternity was primarily focused on humans, its use was expanded by including the subordinated (subaltern) pair in traditional binaries: human/animal, culture/nature, and subject/object. This paper holds that the various kinds of soils, regarded as subalterns in this parable, are active characters in warning about soil degradation. They also hint at how they collaborate with more-than-human characters towards the lengthy process of soil regeneration and sustainability amidst the extractive agriculture in Roman-colonized Galilee. This ecological biblical reading of the parable contributes to ecological education to help achieve the United Nations Sustainable Development Goal 15: Life on Land amid eco-critical times.
Upon All Flesh: An Ecological Reading of Acts 2.17–21
Authors: Griffiths John D.
Published: February 2025

The Lukan Peter’s quotation of LXX Joel 3.1–5a is the central co-text that frames the outpouring of the Spirit in Acts 2. In this article, I offer three supporting arguments for understanding πᾶσα σάρξ found in Acts 2.17 as referencing all of creation. First, the connection between the Spirit of God and all flesh in the Hebrew Bible always has a creation-wide context. This connection between Spirit and flesh then introduces the flood narrative as a key co-text for Joel 2.28, as Joel sees the outpouring of the Spirit as an inversion of the withdrawal of the Spirit at the flood. Third, this creation-wide understanding of πᾶσα σάρξ in Acts 2.17 is further supported by three editorial changes the Lukan Peter makes to his quotation of LXX Joel 3.1–5a. Therefore, the outpouring of the Spirit at Pentecost is a creation-wide event.
Optimization of New Energy Storage System Configurations Considering Wind–Solar Energy Consumption Capacity
Authors: Dong Haonan , Yu Zuoliang , Li Yuehua , Han Qianwen , Zhou Li
Published: February 2025

In order to reduce energy waste caused by insufficient absorption capacity, improve the stability and reliability of the wind and solar energy storage system, reduce power costs, reduce greenhouse gas emissions, and enhance environmental benefits. A new optimization method for vanadium redox batteries that considers the wind and solar absorptive capacity is studied. The outputs of the wind worm wheel, photovoltaic, and new vanadium redox batteries in the wind–solar vanadium redox battery are calculated and analyzed. Based on the calculation results, the wind light memory capacity majorization arrange blueprint is constructed, and the impersonal ability of the blueprint is to determine the maximum total consumption of recyclable energy, the highest energy utilization efficiency, the minimum cycle energy of energy memory battery and the minimum cycle fever memory of fever memory tank, and the minimum amount of wind and light discarded. After the relevant constraints are designed, the upgraded quantum particle flock majorization arithmetic is used to solve the impersonal ability to obtain the arrange majorization results of the new vanadium redox battery. The test results show that after the majorization of energy memory arrange by this method, the maximum values of distributed generation absorption ratio, load peak valley difference degree, and load fluctuation degree are 0.74, 0.15, and 0.17, respectively; energy utilization efficiency reaches 75.5%; the change of the state of condition of the vanadium redox battery is relatively gentle, and the fluctuation range is between 0% and 60%; the effective wind and solar absorptive capacity of each node is above 11 GW/h.
Rescue Tracheal Reconstruction via Platysma Myocutaneous Flap Following Necrosis of Sternocleidomastoid Muscle Myoperiosteal Flap
Authors: Yan Fangxu , Xia Xin , Chen Xingming
Published: February 2025

A case of a 60-year-old male patient with thyroid cancer invading the trachea was presented in the current study. After the initial surgery via a sternocleidomastoid muscle (SCM) clavicular periosteal flap for tracheal reconstruction, the patient experienced flap necrosis. Subsequent debridement and tracheocutaneostomy were performed, followed by a successful repair of the tracheal defect using a platysma myocutaneous flap. The case underscores the critical role of preserving the SCM’s integrity to ensure adequate blood supply and reduce the risk of flap necrosis. A staged approach, involving initial debridement and tracheocutaneostomy, followed by secondary reconstruction with a platysma myocutaneous flap, proved effective in managing flap necrosis post-SCM myoperiosteal flap reconstruction. This strategy offers a safe and viable alternative for tracheal defect re-reconstruction.
Tanzanian Teachers and Students’ Conceptualizations of Giftedness and Talent
Authors: Milinga Joseph R.
Published: February 2025

This article explores how the teachers and students in Tanzania’s special secondary schools conceptualize giftedness and talent. It draws on focus group discussions and interview data from a sample of 30 teachers and 73 students and analyzed through a reflexive thematic analysis procedure. The findings revealed commonalities in conceptualizing giftedness and talent between the teachers and students while suggesting the need for more information on the constructs among the participants. It implies that the development of students’ academic talents in the schools is at stake despite the efforts put in place. The study recommends training teachers on giftedness and talent to improve their understanding and promote a growth mindset among teachers and students to develop the students’ academic potential adequately. Further, the findings suggest the potential to embrace the students’ prior knowledge to develop their academic talents and as an essential resource for improving their provisions in Tanzania.
Good Neighbor
Authors: Tarricone Paul
Published: February 2025

Outdoor lighting is kept inside the property line at a Utah country club
Radiomics from dual-energy CT-derived iodine maps for predicting lymph node metastases in patients with resectable rectal cancer
Authors: Liu Xia , Yuan Yi , Chen Xiao-li , Fang Zhu , Liu Si-yun , Pu Hong , Li Hang
Published: February 2025

Background

Lymph node metastasis (LNM) is a poor prognostic predictor and is highly correlated with local recurrence in rectal cancer patients.

Objective

To investigate the value of radiomics from dual-energy CT-derived iodine maps for the preoperative prediction of LNM in rectal cancer patients.

Methods

A total of 176 patients were enrolled in this study (training group, n = 123; validation group, n = 53). A radiomic signature was constructed via support vector machine (SVM) modeling. Seven models, including a clinical feature model (Model 1), an arterial model (Model 2), a venous model (Model 3), an arterial-venous model (Model 4), an arterial–clinical model (Model 5), a venous-clinical model (Model 6) and an arterial–venous–clinical model (Model 7), were established via logistic regression modeling. Diagnostic performance was assessed via receiver operating characteristic (ROC) curves.

Results

Tumor location and carcinoembryonic antigen levels were used to construct Model 1 (training group, AUC [area under the ROC curve] = 0.721, 95% CI [confidence intervals], 0.630–0.813; validation group, AUC = 0.729, 95% CI, 0.593–0.865). Model 6 and Model 7 further improved the discriminatory performance in the training (AUC = 0.850 and 0.869, 95% CI, 0.782–0.919 and 0.807–0.932, respectively; p = 0.250) and validation groups (AUC = 0.780 and 0.716, 95% CI, 0.653–0.906 and 0.576–0.856, respectively; p = 0.115). Moreover, decision curve analysis revealed a greater net benefit with Model 6.

Conclusions

The combination of radiomic features based on dual-energy CT-derived iodine maps and clinical features provides better diagnostic performance for predicting LNM in rectal cancer patients.
Examining the impact of occupational stress and shift work schedules on the cognitive functions among firefighters in normal condition
Authors: Askari Ali , Feyzi Vafa , Farhadi Alireza , Dashti Ahmad , Poursadeqiyan Mohsen , Salehi Sahl Abadi Ali
Published: February 2025

Background:Firefighters are exposed to a wide range of psychological and physical hazards. Objective: The present study, in 2023 was conducted to investigate the impact of job-related stress and shift work on the cognitive abilities of firefighters in an oil field located in western Iran. Methods: The cognitive performance and job stress levels of study participants were evaluated using IVA-2 software version 2020 and OSIPOW questionnaire, respectively. Results were analyzed using SPSS software version 2022. Results: The study found a significant discrepancy in cognitive performance between day and night shifts (P < 0.001) for firefighters. During the day shift, Auditory Persistence and Visual Stamina had the highest (100.88) and lowest (84.04) scores, respectively, while the night shift had higher scores in Auditory Speed and Visual Sensory-Motor. Overall, cognitive performance was better during the day shift, but both shifts had a notable gap in average scores with a baseline. Shift work is connected to role duality (P < 0.05), responsibility (P < 0.001), and the physical environment (P < 0.001). Furthermore, the attention scale is connected to the physical environment (P < 0.05). Conclusion: Firefighters’ performance is impacted by shift work and job stress, even under normal conditions. To maintain and improve cognitive abilities, corrective actions should focus on improving efficiency, creating suitable working conditions, and improving shift work management. Prioritizing individual responsibility is also suggested based on the correlation between stress and cognitive performance
A unified rock damage constitutive model under different confining pressures
Authors: Liu Dongqiao , Guo Yunpeng , He Manchao
Published: February 2025

This study investigates the damage evolution characteristics throughout the complete deformation process of rocks. The analysis reveals five distinct stages in the stress–strain curves of rocks: elastic recovery, damage retention, damage initiation, damage acceleration, and damage slowdown. To simulate the stress–strain relationship of rocks, a damage model based on logistic equation is proposed. The model is developed using the “elastic modulus method,” derived from the hypothesis of strain equivalence, and experimental data obtained from complete stress–strain curves of marble and quartzite under various confining pressures. The proposed model effectively captures the brittle fracture deformation of rocks under uniaxial compression, as well as the strain softening, brittle–ductile transformation, and strain hardening deformation behaviors of rocks under different confining pressures. It adopts a simple function form with distinct parameters derived from physical characteristics, enabling the description of both pre-peak and post-peak deformation characteristics of rocks. The theoretical results obtained from the model align well with existing experimental findings. The physical significance of the model parameters is discussed in relation to damage evolution and constitutive relations, affirming the rationality of the proposed model. Overall, the proposed model exhibits significant potential for broad application in rock engineering.
Basal Cell Carcinoma: A Digital Study of Immunohistochemical BCL2, P53 and CD138 Expression in Low- and High-Risk Types
Authors: de Stadler Janet Lyndsay , Ramburan Amsha , Roberts Riyaadh
Published: February 2025

Introduction

Basal cell carcinoma (BCC) is the leading cancer in Caucasians globally. Certain histological types of BCC are defined as high-risk for recurrence by the World Health Organisation (WHO). Identifying biological differences, such as protein expression, between histological types could result in druggable targets and improve future management, potentially offsetting rising costs in the health sector due to an increase in the global incidence of aggressive BCC.

Methods

A laboratory-based, immunohistochemical study was undertaken at our institution. BCL2, P53 and CD138 antibodies were applied to formalin-fixed, paraffin-embedded tissue from low-risk and high-risk BCC types; followed by whole slide scanning and digital interpretation using QuPath software. Staining intensity, proportion and scores were assessed with the addition of BCL2 labelling and CD138 location. Statistical analyses were performed using STATA and R. A p value < 0.05 was considered statistically significant.

Results

Of 121 BCCs examined, 78 were low- and 43 high-risk. BCL2, P53 and CD138 tumoural expression in BCC were 78%, 91% and 100%, respectively. BCL2 staining was predominantly weak and focal while P53 and CD138 were diffuse. Significantly decreased tumoural BCL2 labelling (p = 0.04) and CD138 scores (p = 0.0035) were observed in high-risk BCCs. Conversely, significantly increased peritumoural stromal CD138 expression was observed in this category (p < 0.0001). There was no significant difference in P53 expression between the two categories.

Conclusion

The identification of decreased BCL2 labelling in high-risk BCC highlights an important area for further research to evaluate the effect BCL2 downregulation has on non-surgical therapeutic options in aggressive BCC.
Migrants’ resilience during the upheaval towards the postponed ending of the Zimbabwe Exemption Permit (ZEP) in South Africa
Authors: Mbeve Oncemore
Published: February 2025

The growing diasporan community requires carefully designed psychological support, because this population is crucial for global socioeconomic development. This article explores the role of resilience among Zimbabweans who were affected by upheavals connected to the announcement of the Zimbabwe Exemption Permits’ (ZEP) termination. This longitudinal qualitative study employed purposive and snowball sampling to recruit 31 Zimbabwean participants from Pretoria and Johannesburg. Data was collected using semi-structured interviews through a mix of WhatsApp and direct phone calls. Furthermore, unstructured observations of participants were conducted through WhatsApp statuses and regular communication through texts. Thematic data analysis was used to analyse the data.

Findings

The study's findings shed light on the resilience trajectory that was evident in participants. The findings focus on: discussing the background that formed the basis for resilience which includes the interruptions in their everyday lives owing to the upheavals associated with the termination of their visas. The findings further show the anxieties and worries that were caused by the news of the ending of their visas, and the evidence of resilience that followed in form of hope, coping, and bouncing back.

Applications

This study offers valuable insights into Zimbabwean migrants’ resilience in South Africa (SA). The findings highlight the specific challenges they face and the strategies they employ to cope, providing a framework for social workers to develop targeted interventions that promote their psychological wellbeing. This study serves as a foundation for further exploration of the multifaceted nature of migrant resilience and its implications for social work practice.
Blazing the trail! Commentary on “Intra-arterial lidocaine administration in middle meningeal artery for short-term treatment of subarachoid hemorrhage-related headaches” by Qureshi et al.
Authors: Sirakov Alexander , Ninov Kristian , Sirakova Kristina , Sirakov Stanimir Stefanov
Published: February 2025

In their recently published INR study, Qureshi et al. present their results on intra-arterial lidocaine administration in the middle meningeal artery for the short-term treatment of subarachnoid hemorrhage (SAH)-related headaches. The authors demonstrate that their proposed intra-arterial treatment consistently alleviates headaches in patients with SAH. The purpose of this commentary is to commend the authors on their paper and the notable results they have achieved. It is always pleasant to encounter studies that not only make it to the “Latest Online” section of neurointerventional journals but also push the boundaries, advancing our understanding and care for patients in the most meaningful ways. There is no doubt that our field has witnessed remarkable progress and an expanding spectrum of interventions that endovascular neuroservices can offer. Several therapeutic approaches have emerged from similarly constructive articles, including intra-arterial chemotherapy for malignant cerebral tumors, innovative treatments for cerebrospinal fluid-venous fistulas, hydrocephalus, and chronic subdural hematomas, as well as the implantation of brain–computer interface devices.
Two-year feasibility and safety of open-label autologous peripheral nerve tissue implantation during deep brain stimulation in patients with Parkinson's disease
Authors: Quintero Jorge E , Chau Monica J , Slevin John T , Koehl Lisa , Gurwell Julie A , Wallace Elizabeth , Kryscio Richard J , El Khouli Riham , Anderson-Mooney Amelia J , Schmitt Frederick A , Gerhardt Greg A , van Horne Craig G
Published: February 2025

Background

Motor dysfunction in Parkinson's disease (PD) is characterized by a loss of functioning neurons in the substantia nigra. Two options exist when encountering damaged neurons: replace or support. We implemented a strategy of using autologous peripheral nerve tissue, in a reparative state, to provide a collection of neurorestorative support to unhealthy neurons with the goal of modifying the motor progression of PD.

Objective

Report on two-year compliance feasibility, safety, and clinical experience of combining this delivery at the time of deep brain stimulation (DBS) surgery.

Methods

Participants with PD undergoing open-label peripheral nerve tissue implantation to the substantia nigra at the time of DBS surgery were followed from pre-surgery to two years after surgery through clinical evaluations.

Results

Seventeen of 18 participants who underwent the procedure completed the 2-year study visits. No study-related serious adverse events occurred.

Conclusions

The trial met its primary endpoints of feasibility and safety. We were able to practicably and safely implant participants and have participants comply with 2-year visits and exams. Adverse events related to study participation were deemed manageable by participants.
Taking forward sexuality-based solidarities in a geopolitical world in transition
Authors: Tucker Andrew
Published: February 2025

In this response, I engage with the commentaries on my article, ‘A Sexuality Pivot’, paying particular attention to the very different ways each author engages with it. The intent, as with my original article, is therefore to consider how connections between sexuality, solidarities, and geopolitics may present important and exciting directions for future research. As an addendum, and in light of the 2024 US election result, this response also briefly reflects on some of the implications for sexuality-based solidarities moving forward.