bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 4145877: Association of heat exposure with cardiovascular and all-cause hospitalizations among elderly adults in the United States
Authors: Bansal Esha , Puvvula Jagadeesh , Shultz Kaitlyn , Khatana Sameed Ahmed
Published: November 2024

Background:
Heat exposure is associated with an increase in cardiovascular mortality, particularly among older adults. Climate change has led to an increase in days with hot temperatures. The burden of hospitalizations associated with heat exposure is not well known.

Methods:
Data on all hospitalizations among Medicare beneficiaries 65 years of age and older in summer months (May through September) for 2016 to 2019 were obtained from Medicare Provider Analysis and Review (MEDPAR) files. Total daily cardiovascular and all-cause hospitalizations in each US county in the contiguous United States (US) were determined and daily county-level maximum heat index levels were obtained from the gridMET dataset. Counties with <100 elderly residents were excluded. The association between daily heat index and hospitalizations was quantified using the distributive lag non-linear framework, with a generalized linear regression model – assuming a quasi-Poisson distribution. The model accounted for the lagged association, for up to 10 days, for daily heat index as well as covariates (ozone, particulate matter, and precipitation levels). Estimates from this model were used to determine the number and fraction of hospitalizations attributable to high temperatures on hot days. Hot days were defined as those with a heat index level in the 90
th
percentile based on a county-specific historical period (1979-2015).

Results:
A total of 2085 counties (out of 3108) were included. The median threshold for hot days was 90.2°F (IQR 84.8°F to 95.5°F) [32.3°C (IQR 29.3°C to 35.3°C)]. Between 2016 and 2019, hot days were associated with 3044.0 (95% CI 2641.5 to 3380.9) or 0.067% (95% CI 0.058% to 0.074%) of all cardiovascular hospitalizations. Hot days were associated with 42132.2 (95% CI 41159.9 to 43082.1) or 0.22% (95% 0.21% to 0.225%) of all hospitalizations among Medicare beneficiaries.

Conclusions:
Between 2016 and 2019 days with high heat index levels were associated with higher levels of cardiovascular and all-cause hospitalizations among elderly Medicare beneficiaries across the contiguous US. As the number of hot days continues to increase due to climate change, the burden of heat related hospitalizations is likely to continue to increase.
Abstract 4146315: Complications Associated With the 4798 Attain Stability Active Fixation Coronary Sinus Lead: Insights from the MAUDE Registry
Authors: Katapadi Aashish , Mansabdar Aditya , Katapadi Aashika , Gangasani Nikhil , Chelikam Nikhila , Darden Douglas , Gopinathannair Rakesh , Kabra Rajesh , Atkins Donita , Lakkireddy Dhanunjaya , Pothineni Naga Venkata
Published: November 2024

Background:
The Attain Stability Quad 4798 [Medtronic, Minneapolis, MN] lead was recently developed with a mechanism for active fixation into the venous wall, allowing for precise and secure placement in coronary venous branches. However, real-world data regarding complication rates are limited.

Research Question:
What are the real-world complications of the Medtronic 4798 lead?

Goals:
We reviewed the United States Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database for adverse events associated with the 4798 lead.

Methods:
We reviewed the MAUDE database on November 15, 2023, for all reported complications due to the 4798 lead from January 1, 2018 – a year before the lead was approved by the FDA – to the present.

Results:
A total of 2011 reports of adverse events occurred in mostly males (67.9%) patients with an average age of 70.86±12.1 years. Leads were used most frequently in 2023 (32.3%) for initial use (65.5%) but events commonly occurred intra-procedurally (73.7%). Device malfunction occurred in 43.4% of cases and included but was not limited to adverse events without an identified device problem (33.9%), device dislodgment (24.1%), infection (21.1%), and failure to capture (18.4%). In several cases, the guidewire was stuck (10.7%), or lead dislodgement (27.9%) occurred, resulting in direct helix damage (10.1%). Malfunctions resulted in injury and death in 55.8% and 1.1% of cases, respectively.

Conclusions:
The use of an active fixation CS lead has been associated with a significant incidence of intraprocedural helix mechanism malfunction. Further real-world surveillance and registry data can help clarify the true incidence of lead failure.
Abstract 4147606: The Risk of Cardiac Events Associated with Psychiatric Drugs in Patients with Long QT Syndrome.
Authors: Ferreira Felix Iuri , Karlinski Vizentin Vanessa , Neves Raquel , Bains Sahej , Bos Johan , Giudicessi John , Ackerman Michael
Published: November 2024

Introduction:
Long QT syndrome (LQTS) is a potentially life-threatening genetic heart disease. Patients with LQTS may also have co-existent mental health illnesses that may benefit from psychiatric medications. However, because many of these medications have QT-prolonging potential (www.crediblemeds.org), many of these patients receive suboptimal mental health care.

Objective:
To evaluate the frequency, management, and incidence of breakthrough cardiac events (BCEs) in patients with LQTS and concomitant mental health issues treated with psychiatric medications.

Methods:
A retrospective review was conducted on patients cared for in Mayo Clinic's Windland Smith Rice Genetic Heart Rhythm Clinic between 2000 and 2024 focusing on patients with LQTS and a concomitant psychiatric diagnosis requiring medication with known, possible or conditional risk of torsades de pointes (TdP). Electronic medical records were reviewed for data. BCEs were defined as LQTS-triggered syncope, seizures, appropriate ICD therapy, sudden cardiac arrest (SCA), or sudden cardiac death (SCD). Patients with missing information were excluded.

Results:
Overall, 195 /1899 LQTS patients [10%, 86 (43%) with LQT1, 83 (42%) with LQT2, and 16 (8%) with LQT3] had a concomitant psychiatric diagnosis requiring medication [150 female (76%), mean age at diagnosis 27 ± 18 years, median follow-up time 6.6 years (IQR 2.9-13)]. The most common psychiatric conditions were depression (71%), anxiety (62%), and ADHD (9%). The mean duration of therapy was 3.36 +/- 3.48 years and the most common medications used were fluoxetine (26%), sertraline (14%), and escitalopram (11%). There was no significant difference in QTc after starting the first psychiatric medication when compared to baseline (473 ± 33 vs 474 ± 35 ms, p=0.6). Prior to their LQTS diagnosis and while therefore untreated, 61/195 (31%) had at least 1 LQTS-associated cardiac event. This occurred in the setting of a psychiatric drug in 7 patients (11%). Following LQTS diagnosis and treatment, 14/195 patients (7%) have experienced a non-lethal BCE of which only 3/14 (21%) while on psychiatric medications.

Conclusions:
Although avoidance of medications with known QT-prolonging potential is prudent, attention to patient’s overall well-being besides just their LQTS must be given. After correct diagnosis and treatment, LQTS patients with concomitant mental health issues may be safely and effectively treated with medications known to prolong QTc.
Abstract 4147610: Efficacy and Safety of Selective Cardiac Myosin Inhibitors in Symptomatic Hypertrophic Obstructive Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials
Authors: Bhatia Hitesh , Khan Muhammad , Rao Adishwar , Agrawal Akriti , Agrawal Siddharth , Parul . , Jayasree Rajendran Rakendu , Bhattarai Shraddha , Aafreen Asna , Sharma Saurabh
Published: November 2024

Background:
Hypertrophic Obstructive Cardiomyopathy (HOCM) is an autosomal dominant inherited condition with limited management options, primarily focusing on symptom improvement through beta blockers. A novel selective cardiac myosin inhibitor, Mavacamten has been shown to improve exercise tolerance and NYHA functional class as compared to placebo in multiple randomized controlled trials (RCTs). A recent RCT from 2024 studied another oral cardiac myosin inhibitor, Aficamten which potentially decreases left ventricular outflow tract obstruction (LVOTO) in symptomatic HOCM. One limitation of all these RCTs, for obvious reasons, is the small sample size, which poses a challenge in its actual clinical significance.

Aims:
To analyze the efficacy and safety of novel selective cardiac myosin inhibitors in symptomatic HOCM patients

Methods:
We included 4 RCTs, comparing the efficacy and safety of selective cardiac myosin inhibitors and placebo groups. These studies were selected through a detailed search of the MEDLINE, COCHRANE, and PUBMED databases. We compared various common primary and secondary endpoints between both the groups: changes in exercise tolerance, NYHA functional class, and Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS). The results were reported as Odds Ratios (OR) with 95% confidence intervals (CI), using a random effects model.

Results:
The outcomes from 704 HOCM patients, which consisted of 361 patients who received a myosin inhibitor and 343 who received a placebo were analyzed. The primary endpoint in all the studies was improvement in exercise tolerance [measured as 1.5 mL/kg per min or greater increase in peak oxygen consumption (pVO2)], which was not statistically significant in our study (OR: 1.75, 95% CI: 0.89-3.43, p:0.1). There was a statistically significant improvement in ≥1 NYHA functional Class (OR: 3.9, 95% CI:2.49-6.12 p<0.05). There was no significant change seen in KCCQ-CSS (OR: 1.26, 95% CI: 0.75-2.12, p:0.3) and1 or more Serious Adverse Events (OR: 0.75, 95% CI: 0.42-1.32, p:0.3). (Figures A-D)

Conclusion:
Novel cardiac myosin inhibitors have shown statistically significant results in improving NYHA functional class, but not much difference in objective criteria like pVO2 with no significant adverse events. While these results appear promising and 2024 ACC/AHA guidelines have Class 1 Recommendation regarding their use for symptomatic HOCM, further analysis from a large population is needed.
Abstract 4147632: Unusually Expeditious Expansion of an Atrial Myxoma
Authors: del Toro Mijares Raul , Algheriani Hedaia , Cazares Parson Marco Alan , Chang Joseph , Srinivas Sunil
Published: November 2024

Description of the Case Report:
A 44-year-old female with a past medical history of unspecified skin cancer presented with exertional dyspnea for 1 day before admission and syncope 7 months before admission. Physical exam was noted for soft low low-pitched diastolic murmur at the cardiac apex, not appreciated on prior exam. Echocardiography revealed a 3.3x4.7 cm pedunculated, homogenous mass in the left atrium obstructing the mitral valve. Serum BNP was measured as 326. An echocardiogram from less than 29 months prior was reviewed and showed no mass in the left atrium. The patient underwent successful surgical resection of the mass. The mass measured approximately 7x6x2 cm. Histologic analysis reported a proliferation of myxoid stroma with cytologically bland spindle cells positive for calretinin, compatible with cardiac myxoma. Following the surgery, the patient experienced resolution of symptoms.

Discussion:
Atrial myxomas are the most common primary cardiac tumors. They present as mitral valve obstruction, mitral valve regurgitation, arrhythmias, or systemic thromboembolism. They are exceedingly rare with an incidence of 0.5 to 1 case per million individuals annually and typically resected immediately. Therefore, instances with well-documented growth rates are uncommon.

In this case, we present an unusually fast-growing myxoma in a woman with shortness of breath and syncope. The reported growth rate of atrial myxomas ranges from 1.3 to 6.9 mm a month. Our patient had a negative echocardiogram less than 2.5 years before her presentation, followed by the development of a 7 x 6 x 2 cm mass. Since the onset is unknown, the precise growth rate of our patient's tumor is unknown but was at least 24 mm/month. It is important to consider myxoma in the differential diagnosis of a woman with new onset murmur and syncopal episode. Furthermore, recognizing the potential for rapid expansion is crucial to assessing the risks versus benefits of myxoma section.
Abstract 4147639: Trends in Atherosclerosis-related mortality in the United States from 1999 to 2020; A Retrospective Analysis
Authors: Hayat Malik Saad , Shoaib Muhammad Mukarram , Naseer Rayyan , Wajeeh Ul Hassan Muhammad , Javeid Javeria , Shaukat Muhammad Talha , Mohsin Aleenah , Rehman Wania , Rehman Aqeeb Ur , Ahmad Hadia , Qureshi Muhammad Ahmad
Published: November 2024

Background and Aims:
Atherosclerotic diseases, including but not limited to myocardial infarction and stroke, are the leading cause of morbidity and mortality worldwide. Here we aim to identify and quantify temporal trends of atherosclerotic disease mortality among adults in the United States from 1999 to 2020, and pinpoint racial, local, regional, age and gender-wise variations in this trend.

Methods:
Data was sourced from the CDC WONDER database, with atherosclerosis identification based on ICD-10 Codes I70. We determined the crude death rates and age-adjusted mortality rates (AAMRs) per 100,000 individuals from 1999-2020. JointPoint regression was employed to examine the changes in AAMR across the years through annual percent change (APC) and the average annual percent change (AAPC).

Results:
The AAMR for atherosclerosis shows a uniformly declining trend from 1999 to 2020 with AAPC= -7.25; 95% CI -6.34 to -8.14. The analysis revealed significant disparities in mortality rates among different demographic groups. Mortality was significantly higher among female patients (AAPC=-7.09%; 95% CI -6.48 to -8.58), American Indian patients (AAPC=-7.88%; 95% CI -.6.58 to -9.11), and rural populations (AAPC=-7.62%; 95% CI -6.53 to -8.70). Most deaths occurred in the southern region of the US (AAPC: -7.62%; 95% CI -7.45 to -9.19). A notable exception to this was California which accounted for the highest mortality in the US.

Conclusion:
Our nationwide analysis showed an overall decreasing mortality trend due to atherosclerosis among adults in the US. However, the higher mortality rate among females, American Indians, and rural populations is concerning and requires further investigation that can explain and expand on the findings of our study and explain this variation in mortality rates.
Abstract 4147647: Effects on Cognition, Sleep, Quality of life and Exercise Capacity of a 12-week Tele-yoga Intervention in Persons with Heart Failure - Results from 3 and 6 Months Follow-up
Authors: Stromberg Anna , Klompstra Leonie , Papageorgiou Joanna-Maria , Hedbom Towe , Pathak Dola , Lundberg Marie , Orvelius Lotti , Thylen Ingela , Jaarsma Tiny
Published: November 2024

Background and Objectives:
Yoga may be a promising form of mind-body rehabilitation for patients with long term illness. Digitally delivered yoga increases access to participation but has not previously been evaluated in the heart failure population. The aim of this study was to examine the effects of tele-yoga on cognition, sleep, health-related quality of life and exercise capacity in persons with heart failure.

Methods:
The Tele-yoga study (ClinicalTrials.gov, ID: NCT 03703609) was a parallel two-arm randomised controlled trial (RCT) with 1:1 distribution to an intervention and control group. Study participants were randomised to tele-yoga including live-streamed group-yoga for 60 minutes twice weekly during 12 weeks and yoga individually for 10 minutes/day using an app, or to a control group receiving individual exercise advice. Cognition (Montreal Cognitive Assessment: MoCA), sleep (minimal insomnia symptom scale; MISS), health-related quality of life (EQ-5D VAS) and sub-maximal exercise capacity (6 minute walk test; 6MWT) were assessed at baseline, after 3 and 6 months. Linear mixed model with random intercept for patients as the random effect and group-time interaction along with age was taken as the fixed effects to analyse outcomes.

Results:
A total of 311 participants were included (tele-yoga n=156 and active controls n=155), mean age 66 years, 70% men. Adherence to the group yoga was very good. The linear mixed models showed a significant change in cognition, health-related quality of life and exercise capacity favouring the tele-yoga group. No significant differences between the groups were seen regarding sleep. When analysing the fixed effects of all outcomes, age, group assignment and time-points interaction had significant effects on EQ-5D VAS score, 6MWT distance and MoCA scores. For EQ-5D VAS the tele-yoga group performed significantly better than the control group at 3 months, but not at 6 months. For the 6MWT distance, the tele-yoga group performed better than the control group at 3 months, but not at 6 months. The tele-yoga group had significantly higher MoCA scores than the control group at both 3 and 6 months.

Conclusion:
This adequately powered RCT showed that digitally delivered mind-body training in the format of group and individual yoga during 12 weeks lead to an improvement in cognition, quality of life and exercise capacity at the end of the intervention. The effect was sustained for cognition also after 6 months.
Abstract 4148089: Comparative Efficacy of Carvedilol versus Metoprolol in Patients with Implantable Cardioverter Defibrillators and Ventricular Arrhythmias: A Systematic Review and Meta-Analysis
Authors: Ali Ahmed , Ahmed Marwan , Ali Karim , Awad Mohamed
Published: November 2024

Background:
Ventricular arrhythmias are major causes of morbidity and mortality in patients with cardiovascular disease. Implantable cardioverter-defibrillators (ICDs) are commonly used to prevent sudden cardiac death in these patients. However, patients with ICDs frequently experience recurrent arrhythmias and inappropriate shocks, which can impact their quality of life. Beta-blockers, specifically carvedilol and metoprolol, are commonly prescribed to manage these arrhythmias. This meta-analysis aims to compare the impact of both medications in this patient population.

Methods:
A comprehensive literature search was conducted to identify relevant studies comparing carvedilol to metoprolol in patients with ventricular arrhythmias or ICDs. Study outcomes included all-cause mortality, recurrent ventricular arrhythmia, and inappropriate ICD shocks. Effect estimates are presented as hazard ratios (HR) with 95% confidence intervals (CI).

Results:
1,453 studies were identified through database search. After full-text screening, a total of 5 studies involving 9,292 patients were included. We found no significant difference in the incidence of recurrent ventricular arrhythmias between carvedilol and metoprolol (HR = 0.99, 95% CI [0.75, 1.32], P = 0.97). Additionally, Carvedilol showed a trend toward reduction of all-cause mortality (HR = 0.83, 95% CI [0.68, 1.03], P = 0.09). On the other hand, Carvedilol was associated with a statistically significant reduction of inappropriate ICD shocks (HR = 0.61, 95% CI [0.48, 0.78], P < 0.001).

Conclusion:
Carvedilol may offer additional benefits over metoprolol in managing patients with ventricular arrhythmias or ICDs, particularly in minimizing the incidence of inappropriate ICD shocks. However, no significant difference was found in terms of all-cause mortality and recurrent ventricular arrhythmia incidence. Further research is needed to confirm these findings and guide clinical decision-making.
Abstract Sa1101: Association Between Changes in Hypoxic-Ischemic Brain Injury and Neurological Outcomes in Cardiac Arrest Survivors.
Authors: Jeon So Young , Park Jung Soo , Kang Changshin , You Yeonho , Min Jin Hong , Jeong Wonjoon , Ahn Hong Joon , IN YONGNAM
Published: November 2024

Aim:
Quantitative analysis of hypoxic-ischemic brain injury (HIBI) using apparent diffusion coefficient (ADC) values from brain magnetic resonance imaging (MRI) is used to predict poor neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors. Our study aimed to determine the association between changes in HIBI and neurological outcomes in OHCA survivors using two types of MRI.

Methods:
This observational study used data collected prospectively from a tertiary academic hospital. The study included adult comatose OHCA survivors who underwent targeted temperature management (TTM) and brain MRI within 6 hours (first) and 72–96 hours (second) using the same MR scanner. We analyzed the neurological outcomes based on brain volumes below a specific ADC value using 10-step intervals within the range of 200–1200 × 10
-6
mm
2
/s for the first and second MRIs. ADC-R(x) represents the proportion of total brain volume occupied by voxels, with ADC values ranging from 200 × 10
-6
mm
2
/s to each threshold. Additionally, ADC(x) represents the proportion of total brain volume occupied by voxels that are “threshold - 10” at each threshold.

Poor neurological outcomes were categorized as cerebral performance levels 3–5, observed 6 months after OHCA.

Results:
Overall, 122 patients (25% female) were included in the analysis, of whom 61 (50%) showed poor neurological outcomes. Higher ADC-R(x) were observed in the poor neurological outcome group on both the first and second MRI scans at all ADC intervals (all P < 0.05) (Figure 1). In the Good Neurological Outcome group, the ADC-R values ranged between 370 and 940, with the second MRI value being smaller than that of the first (right shift, P < 0.05). In contrast, the Poor Neurological Outcome group showed ADC-R values ranging between 340 and 1190, with the second MRI value being higher than that of the first (left shift, P < 0.05) (Figure 2). The difference in ADC(x) between the second and first MRI based on neurological outcome showed a positive change in ADC below 620 for a poor neurological outcome and a positive change in ADC above 740 for a good neurological outcome (Figure 3).

Conclusions:
In this cohort study, we observed that the initial HIBI that occurred during OHCA worsened or returned to normal depending on the neurological outcome after TTM. Prospective multicenter studies are required to generalize our findings.
Abstract Su804: Use of Machine Learning Models to Predict Neurologically Intact Survival for Advanced Age Adults Following Out-of-hospital Cardiac Arrest
Authors: Coute Ryan , Soundararajan Kameshwari , Adams Dylana , Nathanson Brian , Mader Timothy , Godwin Ryan , Melvin Ryan
Published: November 2024

Background:
We recently published a multivariable logistic regression model that successfully predicted neurologic outcomes in advanced age adults (≥ 65 years old) who achieve return of spontaneous circulation following out-of-hospital cardiac arrest (OHCA). Prior to externally validating this model, we sought to compare the predictive performance of our logistic regression model against common machine learning (ML) algorithms using the same dataset.

Methods:
We performed a retrospective observational analysis of the Cardiac Arrest Registry to Enhance Survival database from 2013-2021. All non-traumatic OHCA occurring in adults (≥65 years) who survived to hospital admission were included. The primary outcome measure was neurologically intact survival defined as a cerebral performance category (CPC) score of 1 or 2 at hospital discharge. Our original logistic regression model was compared to Boosted Trees and Decision Tree ML algorithms and assessed using accuracy, Area Under the Receiver Operating Characteristic Curve (AUC-ROC) and Area Under the Precision-Recall Curve (AUC-PR). The model variables included age, gender, race/ethnicity, location, witnessed status, who initiated cardiopulmonary resuscitation, whether an automated external defibrillator was applied prior to emergency medical services arrival, and first monitored rhythm.

Results:
A total of 83,561 OHCA were included. Median age was 75 years (IQR 69-82), 58.9% were male, 53% were White, 67% experienced an OHCA at home, 52% were witnessed by a bystander, 44% received bystander CPR, and 34% were found in shockable rhythm. Neurologically intact survival (CPC 1 or 2) occurred in 23% of patients. The logistic regression model had an accuracy of 79.6%, AUC-PR 0.542, and AUC-ROC of 0.774. The Boosted Trees model had an accuracy of 79.2%, AUC-PR 0.555, and AUC-ROC of 0.774. The Decision Tree Model had an accuracy of 79.3%, AUC-PR 0.490, and AUC-ROC of 0.717.

Conclusion:
Boosted Trees and Decision Tree ML models performed comparably to the logistic regression model in predicting favorable versus unfavorable neurological outcomes following successful resuscitation from OHCA in advanced-age adults. Given their similar performance, logistic regression may be preferred for its simplicity and interpretability over alternative ML models. Future efforts to improve and ultimately externally validate the model are warranted.
Neuropathological Correlates of White Matter Hyperintensities in Cerebral Amyloid Angiopathy
Authors: Makkinejad Nazanin , Zanon Zotin Maria Clara , van den Brink Hilde , Auger Corinne A. , vom Eigen Kali A. , Iglesias Juan Eugenio , Greenberg Steven M. , Perosa Valentina , van Veluw Susanne J.
Published: November 2024

Background

White matter hyperintensities (WMHs) are frequently observed on magnetic resonance imaging (MRI) in patients with cerebral amyloid angiopathy (CAA). The neuropathological substrates that underlie WMHs in CAA are unclear, and it remains largely unexplored whether the different WMH distribution patterns associated with CAA (posterior confluent and subcortical multispot) reflect alternative pathophysiological mechanisms.

Methods and Results

We performed a combined in vivo MRI—ex vivo MRI—neuropathological study in patients with definite CAA. Formalin‐fixed hemispheres from 19 patients with CAA, most of whom also had in vivo MRI available, underwent 3T MRI, followed by standard neuropathological examination of the hemispheres and targeted neuropathological assessment of WMH patterns. Ex vivo WMH volume was independently associated with CAA severity (
P
=0.046) but not with arteriolosclerosis (
P
=0.743). In targeted neuropathological examination, compared with normal‐appearing white matter, posterior confluent WMHs were associated with activated microglia (
P
=0.043) and clasmatodendrosis (
P
=0.031), a form of astrocytic injury. Trends were found for an association with white matter rarefaction (
P
=0.074) and arteriolosclerosis (
P
=0.094). An exploratory descriptive analysis suggested that the histopathological correlates of WMH multispots were similar to those underlying posterior confluent WMHs.

Conclusions

This study confirmed that vascular amyloid β severity in the cortex is significantly associated with WMH volume in patients with definite CAA. The histopathological substrates of both posterior confluent and WMH multispots were comparable, suggesting overlapping pathophysiological mechanisms, although these exploratory observations require confirmation in larger studies.
Eight‐Year Outcomes of Cardiosphere‐Derived Cells in Single Ventricle Congenital Heart Disease
Authors: Hirai Kenta , Sawada Ryusuke , Hayashi Tomohiro , Araki Toru , Nakagawa Naomi , Kondo Maiko , Yasuda Kenji , Hirata Takuya , Sato Tomoyuki , Nakatsuka Yuki , Yoshida Michihiro , Kasahara Shingo , Baba Kenji , Oh Hidemasa ,   the TICAP/PERSEUS Study Group
Published: November 2024

Background

Cardiosphere‐derived cell (CDC) infusion was associated with better clinical outcomes at 2 years in patients with single ventricle heart disease. The current study investigates time‐to‐event outcomes at 8 years.

Methods and Results

This cohort enrolled patients with single ventricles who underwent stage 2 or stage 3 palliation from January 2011 to January 2015 at 8 centers in Japan. The primary outcomes were time‐dependent CDC treatment effects on death and late complications during 8 years of follow‐up, assessed by restricted mean survival time. Among 93 patients enrolled (mean age, 2.3±1.3 years; 56% men), 40 received CDC infusion. Overall survival for CDC‐treated versus control patients did not differ at 8 years (hazard ratio [HR], 0.60 [95% CI, 0.21–1.77];
P
=0.35). Treatment effect had nonproportional hazards for death favoring CDCs at 4 years (restricted mean survival time difference +0.33 years [95% CI, 0.01–0.66];
P
=0.043). In patients with heart failure with reduced ejection fraction, CDC treatment effect on survival was greater over 8 years (restricted mean survival time difference +1.58 years [95% CI, 0.05–3.12];
P
=0.043). Compared with control participants, CDC‐treated patients showed lower incidences of late failure (HR, 0.45 [95% CI, 0.21–0.93];
P
=0.027) and adverse events (subdistribution HR, 0.50 [95% CI, 0.27–0.94];
P
=0.036) at 8 years.

Conclusions

By 8 years, CDC infusion was associated with lower hazards of late failure and adverse events in single ventricle heart disease. CDC treatment effect on survival was notable by 4 years and showed a durable clinical benefit in patients with heart failure with reduced ejection fraction over 8 years.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT01273857 and NCT01829750.
Speak So I May See You: Doing Public Theology in an Arab-Muslim Context
Authors: Estafanos Eshak
Published: November 2024

Public theology is a contemporary field that transcends mere trendiness; it stands as a vital imperative for the Arab Church. This imperative arises not only from the need for effective communication with its counterparts but also as a means to bridge the cultural chasm between the East and the West. Rooted in historical legacies and lived realities, Arab Christian theology boasts rich wellsprings of wisdom, yet it also confronts distinct challenges. While it shares commonalities with global public theology, the Arab Church’s presence in this pivotal region renders its public theology distinctive and profoundly significant.
The Rise of Catholic Thought on Social Communication in the Pontificate of Paul VI
Authors: Sánchez-Camacho Jesús
Published: November 2024

In a period of mass media emergence and renewal of Catholicism after Vatican II, the church initiated into a profound approach to its Social Doctrine on the media. With a theology of communication as a cornerstone, numerous ecclesial documents published during the Papacy of Paul VI explored the implications of the media for society and the internal life of the church. This study aims to analyse the contents on the media addressed in official documents of the Catholic Church during the Pontificate of Paul VI. The conclusions of the research show to what extent communication is a significant issue for public theology and delve into the meaning of the right to information and public opinion, the place of the media in education, the training of communicators and recipients, the importance of the media for the church, and the involvement of Catholics in the media.
2. 1st-person wayyiqṭol Morphology
Authors: Hornkohl Aaron D.
Published: November 2024

The study of 1st-person wayyiqṭol morphology in Biblical Hebrew (BH) reveals three distinct patterns—short, long, and augmented forms—each linked to different historical phases and sources. In Late Biblical Hebrew (LBH) and other post-exilic biblical traditions and extrabiblical sources texts there is a marked preference for long and augmented forms. Bn contrast, Classical Biblical Hebrew (CBH), particularly the Torah, shows a conservative retention of shorter wayyiqṭol forms, reflecting an earlier linguistic stage, as confirmed by comparative data from the Meshaʿ Stele. For their part, non-Pentateuchal CBH texts, i.e., in the Prophets Writings, appear to display a transitional phase, where long forms are common, but augmented forms are rare. Though the historical development of the three patterns is variously explained, the chapter argues that internal diversity within CBH is most compellingly explained as an organic linguistic difference between CBH sub-chronolects. The study raises questions about the conventional dichotomy between CBH and LBH, suggesting the need for finer distinctions within the diachronic framework of Biblical Hebrew. It also weighs implications for the Documentary Hypothesis.
5. Qal Internal Passive versus nifʿal Morphology
Authors: Hornkohl Aaron D.
Published: November 2024

The broad move away from qal morphology to other stems included a shift away from qal internal passive morphology in favour of nifʿal morphology. This is clear in late forms of ancient Hebrew, biblical and extrabiblical, where qal internal passive forms are rare to non-existent. The process seems secondarily to have affected even early biblical texts, but only where the consonantal spelling was amenable to reinterpretation by means of the imposition of nifʿal pronunciation, which created many cases of artificial suppletion. While the nifʿal was by no means an innovation in Classical Biblical Hebrew (CBH), its frequency there according to the Tiberian reading tradition does not align with its representation in the corresponding written tradition. The dissonance between the two traditions makes it difficult to perceive diachronic patterns in qal versus nifʿal usage in CBH, but by focusing on commonly used verbs, one can see the emergence of meaningful patterns. These arguably indicate a difference between the CBH of the Torah and the CBH of the relevant Prophets and Writings. They have mixed results as far as Source Theory is concerned.
8. FS אוה versus אי ִ ה
Authors: Hornkohl Aaron D.
Published: November 2024

The Tiberian written tradition of the Pentateuch is notable outlier when it comes to the third-person feminine singular (3FS) independent subject pronoun. Written היא in most of the Masoretic Bible and elsewhere throughout ancient Hebrew sources and traditions, it appears as הוא in the Tiberian Torah. Explanations for the anomaly can be divided into graphic and linguistic categories. Graphic explanations suggest that הוא is a mistake. Linguistic explanations propose various theories about the morphology of the pronouns. One suggestion posits that the Tiberian Torah preserves an epicene 3CS pronoun, which does not appear in other biblical texts, leading to speculation about its historical usage. Alternatively, some researchers propose that the written forms reflect distinct morphological developments for the 3FS pronoun, which later aligned with standard usage in the reading tradition. These linguistic theories suggest a more complex diachronic development of pronouns within the Tiberian Pentateuch, which may have allowed for the preservation of older forms, the realisation of which eventually aligned with later linguistic practices in other biblical texts. Ultimately, all explanations remain speculative, emphasising the need for further research to elucidate the relationship between the written and reading traditions of the Tiberian Torah, as well as the broader implications for the historical evolution of Hebrew pronominal forms.
Impact of the Belt and Road Initiative on Global Trade and Economic Growth Amid China’s Slowing Growth
Authors: Hwang Kyuyeon , Lee Joohyeong
Published: November 2024

Since the inception of the Belt and Road Initiative (BRI), China’s trade relations with participating nations have experienced substantial growth. This study utilises data from the World Trade Organization (WTO) covering the years 2003 to 2021 to explore the dynamics of China’s foreign trade and assess the impact of the BRI on trade interactions with China. One of the central objectives of our research is to determine whether participation in the BRI has significantly contributed to trade growth with China, thereby strengthening economic ties and fostering bilateral cooperation. Another important objective is to analyse the changes in the BRI’s role in driving global economic growth amid China’s slowing growth. Through empirical analysis using data from over 180 countries, we evaluate the heterogeneous effects of the BRI across different continents. Our findings indicate that the BRI has had the most pronounced trade-stimulating impact on the continents of America, Europe and Africa, while trade volumes with Asian countries have seen only marginal increases. The relatively smaller trade growth in Asian countries can be attributed to the already high volume of trade activities due to their geographical proximity to China, which diminishes the marginal impact of the BRI. Additionally, the significant infrastructure investments under the BRI have been predominantly directed towards Africa and Europe, further explaining the smaller trade-enhancing effects observed in Asia compared to other continents. Furthermore, we identified the spillover effects of the BRI on non-participating countries. Moreover, significant differences in the BRI’s impact on global economic growth were observed before and after China’s economic slowdown. This article offers actionable policy recommendations to inform future decisions based on these findings.
Comparison of low-velocity impact damage in laminated composites for two thermoplastic material systems
Authors: Jackson Wade , Rose Cheryl , Leone Frank , Miller Sandi
Published: November 2024

Aircraft manufacturers are investigating thermoplastic material systems to produce parts more quickly and efficiently. Detailed damage data is needed to evaluate existing damage analysis methods, developed for thermoset materials, to predict damage in thermoplastic materials. Damage maps were created for two thermoplastic material systems subjected to low-velocity impact over a range of impact energies. In this paper, the damage maps were used to investigate and compare the damage response of the different material systems. Impact specimens were manufactured from TC1225 LMPAEK T700G from Toray Industries and APC AS4D/PEKK-FC from Solvay. The effect of the degree of crystallinity on the damage response was also investigated using a third set of specimens manufactured using the Toray material and a quenching process. Using a combination of data obtained from X-ray computed tomography and ultrasonic testing, damage maps were created for every interface and ply for selected specimens showing matrix cracks, delamination outlines, and fractured fibers. The LMPAEK specimens were found to have fewer and smaller delaminations than the PEKK specimens for impacts at the same energy. However, the LMPAEK specimens contained a larger number of fiber breaks. A similar trend was observed when comparing low-crystallinity LMPAEK specimens with the baseline LMPAEK specimens. The LMPAEK specimens often contained lines of fiber fractures in near-surface plies emanating from the contact region that were not present in the PEKK specimens. The different damage responses may indicate that the material selection will be a function of the application and loading.
Rejections Are Stickier Than Choices
Authors: Xu Minzhe , Yang Yang , Janiszewski Chris
Published: November 2024

Consumers frequently make the same decision repeatedly, by either choosing the products they like more or rejecting the products they like less. Holding everything else constant, does the mere act of choosing versus rejecting influence the extent to which consumers seek variety? Eight studies (N = 2,814) identify a robust effect: Consumers tend to seek less variety across repeated decisions if they make each decision by rejecting than if they make each decision by choosing. This effect occurs because an initial rejection (vs. choice) reduces the liking of the unselected option(s) and thus widens the liking gap between the selected and unselected options. An increased liking gap, in turn, decreases the consumer's likelihood of selecting a previously unselected option(s) in subsequent decisions. The findings also show that the enlarged liking gap is driven by increased negative inferences about the unselected option(s). Theoretically, this research extends the literatures on variety seeking and choosing versus rejecting. Practically, it offers implications for consumer welfare: The rejection task can improve (worsen) the decision quality in situations in which consumers typically seek too much (too little) variety.
‘I do feel proud that almost everyone I know voted’: The emotional foundations of dutiful citizenship
Authors: Manning Nathan
Published: November 2024

Democratic politics in many parts of the world seems increasingly characterised by intense emotions, bitter divisions and growing polarisation. Amidst this charged political atmosphere it is a common refrain that an emotional politics forfeits rational dialogue and threatens our democracy. In contrast to such claims this article argues that emotions are central to citizenship and political participation. Drawing upon qualitative archival material from the British Mass Observation Project (1983–2017) the article explores the enduring emotional dimensions of dutiful citizenship. Civically engaged respondents experienced electoral politics emotionally and with a striking intensity. In contrast to accounts which associate dutiful citizenship with dry notions of duty, responsibility and obligation, this article begins an exploration of the emotional underpinnings of dutiful citizenship; the deep and abiding feelings citizens can have towards democratic politics and their political engagement. Findings indicate that a wide range of emotions are central to the evaluative and sense-making processes of dutiful citizens and the ways in which they are mobilised for sustained political engagement. The article concludes by suggesting that a focus on the emotional and expressive aspects of dutiful citizenship may help to cultivate committed young democrats for the future.
State, Market and Development: Private Sector Participation in Public Services
Authors: Sapra Ipsita , Prakash Aseem
Published: November 2024

K. B. Saxena, Private Sector Participation in Public Services—Health (Aakar Books, 2022), 296 pp., ₹995, ISBN: 978-9350027615 (Hardback).

K. B. Saxena, Private Sector Participation in Public Services—Education (Aakar Books, 2022), 348 pp., ₹995, ISBN: 978-9350027622 (Hardback).

K. B. Saxena, Private Sector Participation in Public Services—Civic Amenities (Aakar Books, 2023), 492 pp., ₹1,200, ISBN: 978-9350028070 (Hardback).
U.S. Public Opinion About the Personal Development and Social Capital Benefits of Sport: Analyzing Components of the Great Sport Myth
Authors: Davis Evan A. , Knoester Chris
Published: November 2024

Beliefs that sport participation inherently leads to personal development and social capital benefits are essential components of the Great Sport Myth (GSM). The purpose of this study was to examine the extent to which U.S. adults embrace these components of the GSM. Also, we sought to better understand the extent to which primary groups, social stratification indicators, and sport experiences pattern beliefs in the personal development and social capital benefits of sports. Data were collected through a large national U.S. survey, the National Sports and Society Survey, and analyzed with multiple regression analyses. Findings suggest that most Americans espouse beliefs in the personal development and social capital benefits of sports. Furthermore, primary groups, stratification indicators, and positive sport experiences consistently appear to shape beliefs about these aspects of the GSM.
Reasons for resistance to technology adoption in university libraries in Bangladesh
Authors: Rahman Md. Habibur , Mohammed Ghazali Asmadi Bin , Bin Mohamed Sawal Mohd Zool Hilmie
Published: November 2024

This article explores the reasons for resistance to technology adoption in university libraries in Bangladesh. Through interviews and focus group discussions with LIS professionals, four main themes emerged: personal, organizational, social, and financial factors. Personal barriers included lack of awareness, reluctance to learn, and fear of consequences. Organizational challenges encompassed cultural norms, change Management Strategies, and management support. Social influences included peer pressure and power dynamics, while financial factors involved budgetary constraints and ongoing operating costs, which pose significant challenges to technology adoption. Recommendations for overcoming resistance include providing training and support, fostering a culture of change, effective communication, incentivizing adoption, collaborative decision-making, pilot testing, continual evaluation, education and training, incentives and rewards, communication and collaboration, user-centered design, and change management. Implementing these strategies can facilitate technology adoption, enhancing library services in Bangladesh and beyond.
Enhancing Early Intervention For Caregivers of Autistic Children with Online Reciprocal Imitation Training Learning Modules
Authors: Higgins Johanna P. , Kaczmarek Louise A. , King Seth A.
Published: November 2024

In this study, we taught caregivers of four young autistic children to implement Reciprocal Imitation Training, a focused naturalistic developmental behavioral intervention (NDBI), using a hybrid approach, combining online modules with in vivo coaching. Early Intervention (Part C) services are often the first to support autistic children; therefore, providers must focus on training caregivers to deliver NDBIs such as RIT, within daily activities that are meaningful to the family in the home. We used a multiple-probe design to examine the effect of home visits enhanced by online modules completed before the coaches’ arrival. Results indicated caregivers acquired intervention procedures effectively after approximately six coaching sessions. While most caregivers maintained acceptable fidelity levels, outcomes for children varied, with mixed results in spontaneous imitation. We discuss considerations for providers delivering NDBIs, including factors that impacted outcomes, barriers to intervention, and recommendations for Part C services.
An Index to Identify and Classify the Spectrum of U.S. Peri-Urban Informal Subdivisions
Authors: Reyes Ariadna , Newton Josh , Caudillo Camilo , Kharel Subham
Published: November 2024

This paper proposes a replicable, data-driven index to identify informal subdivisions and measure levels of peri-urban housing informality. Dallas (Texas) and Catawba (North Carolina) county assessment data, a review of the literature, and insights from qualitative research in North Texas yielded variables which were reduced to two factors through exploratory factor analysis. We identified 128 and fifty-three highly informal subdivisions in Dallas and Catawba counties, respectively. This work highlights the pervasiveness of peripheral informal subdivisions and helps guide planners’ efforts to locate and assist the most precarious subdivisions.
Web-Series Ads as a New Marketing Media: Toward a Commercial-Independent Digital Integration Model
Authors: Aharoni Matan , Roth-Cohen Osnat
Published: November 2024

This study presents a new type of advertisement—web-series ads. This undiscussed form of advertising is unique, as it presents an independent digital cultural field. By examining the main structural and narrative features of web-series ads and consumers’ responses, this research presents an integration model which explains how advertisements, as a commercial system, integrate into an independent new media system. Using thematic, narrative–structural, and textual analysis methods, this research shows how marketers convey messaging by introducing a free-from-constraints new online advertising media type. The use of polysystem theory offers a new theoretical perspective to media research and explains the findings.