bluuebunny/crossref_metadata_2025 huggingface dataset:
Micro-local analysis of contact Anosov flows and band structure of the Ruelle spectrum
Authors: Faure Frédéric , Tsujii Masato
Published: November 2024

We develop a geometric micro-local analysis of contact Anosov flow, such as the geodesic flow on negatively curved manifold. This micro-local analysis is based on the wavepacket transform discussed by Faure and Tsujii [Ann. H. Lebesgue 6 (2023), pp. 331–426]. The main result is that the transfer operator is well approximated (in the high frequency limit) by the quantization of the Hamiltonian flow naturally defined from the contact Anosov flow and extended to some vector bundle over the symplectization set. This has a few important consequences: the discrete eigenvalues of the generator of transfer operators, called Ruelle spectrum, are structured into vertical bands. If the right-most band is isolated from the others, most of the Ruelle spectrum in it concentrates along a line parallel to the imaginary axis and, further, the density satisfies a Weyl law as the imaginary part tends to infinity. Some of these results were announced by Faure and Tsujii [C. R. Math. Acad. Sci. Paris 351 (2013), pp. 385–391].
Conditional Euclidean distance optimization via relative tangency
Authors: Di Rocco Sandra , Gustafsson Lukas , Sodomaco Luca
Published: November 2024

We introduce a theory of relative tangency for projective algebraic varieties. The dual variety

X
Z
∨

X_Z^\vee

of a variety

X
X

relative to a subvariety

Z
Z

is the set of hyperplanes tangent to

X
X

at a point of

Z
Z

. We also introduce the concept of polar classes of

X
X

relative to

Z
Z

. We explore the duality of varieties of low rank matrices relative to special linear sections. In this framework, we study the critical points of the Euclidean Distance (ED) function from a data point to

X
X

, lying on

Z
Z

. The locus where the number of such conditional critical points is positive is called the ED data locus of

X
X

given

Z
Z

. The generic number of such critical points defines the conditional ED degree of

X
X

given

Z
Z

. We show the irreducibility of ED data loci, and we compute their dimensions and degrees in terms of relative characteristic classes.
The CDK8 kinase module: A novel player in the transcription of translation initiation and ribosomal genes
Authors: Friedson Brittany , Willis Stephen D. , Shcherbik Natalia , Campbell Alicia N. , Cooper Katrina F.
Published: November 2024

Survival following stress is dependent upon reprogramming transcription and translation. Communication between these programs following stress is critical for adaptation but is not clearly understood. The Cdk8 kinase module (CKM) of the Mediator complex modulates the transcriptional response to various stresses. Its involvement in regulating translational machinery has yet to be elucidated, highlighting an existing gap in knowledge. Here, we report that the CKM positively regulates a subset of ribosomal protein (RP) and translation initiation factor (TIF)-encoding genes under physiological conditions in Saccharomyces cerevisiae. In mouse embryonic fibroblasts and HCT116 cells, the CKM regulates unique sets of RP and TIF genes, demonstrating some conservation of function across species. In yeast, this is mediated by Cdk8 phosphorylation of one or more transcription factors which control RP and TIF expression. Conversely, the CKM is disassembled following nutrition stress, permitting repression of RP and TIF genes. The CKM also plays a transcriptional role important for promoting cell survival, particularly during translational machinery stress triggered by ribosome-targeting antibiotics. Furthermore, in mammalian cells, the activity of CDK8 and its paralogue, CDK19, promotes cell survival following ribosome inhibition. These results provide mechanistic insights into the CKM's role in regulating expression of a subset of genes associated with translation.
Irish Elites
Authors: O’Neill Ciaran
Published: November 2024

This chapter opens with Peggy Keating’s search for her absentee landlady in London and uses this case as a way to explore the wider issues of absence and encumbrance among the Irish landed gentry. Absenteeism was an imperial issue as well as an Irish one, and the chapter explores the idea of absence on both a physical and an emotional plane. By examining the complex web of relationships between landlords, tenants, and the land itself, this chapter reveals how the phenomenon of absenteeism was both a symptom of and a contributing factor to the broader social, economic, and cultural upheavals of the time.
The Spiritual Path
Authors: Whitehouse Deja
Published: November 2024

This chapter examines Harris’s spiritual path and beliefs prior to her involvement with Crowley. Consideration is given to spiritual seekers who were unable to find fulfilment in conventional religions. The beliefs of Harris’s parents are analysed, set in the context of middle-class Christian society. Primary source material includes Harris’s own catalogue of esoteric and mystical texts, and this chapter seeks to identify pre-Crowley interests. Harris’s possible involvement in spiritualism and her documented participation in Christian Science are discussed. Influences such as the Celtic Revival and Greek mythology are explored, with specific reference to her illustrated story Winchelsea, published in 1926. Her early interest in Theosophy and Anthroposophy is considered, and her involvement in Freemasonry is also explored.
The Book of Thoth
Authors: Whitehouse Deja
Published: November 2024

This chapter concentrates on The Book of Thoth, from initial discussions between Harris and Crowley in 1937 up to the book’s first publication in 1944, charting the development of the book’s content and Harris’s supporting artwork. Harris’s role in the creation of The Book of Thoth is compared with Pamela Colman Smith’s contribution to A. E. Waite’s Pictorial Key to the Tarot. The development of Harris’s Tarot paintings is considered in detail with reference to Crowley’s reworking of the Golden Dawn Book T descriptions and the astrological, planetary, and Kabbalistic symbolism to be employed. Harris’s endeavours to promote the Tarot, including staging exhibitions and other activities to raise sponsorship, are discussed. The impact of the project on Harris’s relationship with both her husband and Crowley is examined. The chapter then considers the initial publication of The Book of Thoth and Harris’s subsequent endeavours to secure a publisher for both the Tarot cards and the book.
Association of Discrimination Experiences with Rapid Subsequent Changes in Anxiety and Depressive Symptoms in U.S. Adults During the COVID-19 Pandemic
Authors: Ordonez Maricar , Bae Dayoung , Wong Melissa , Leventhal Adam M , Dai Hongying D , Cho Junhan
Published: November 2024

This study explores how discrimination experiences during the COVID-19 pandemic relate to anxiety and depressive symptoms in U.S. adults. Using a national representative intensive longitudinal survey, the study evaluates rapid subsequent changes in anxiety and depression when individuals undergo heightened discrimination beyond their usual experiences. The study used 23 survey timepoints, primarily with 2-week intervals, from the Understanding America Study (n=8,198). Time-varying and time-lagged associations between discrimination experiences and anxiety and depression were modeled using multi-level logistic random-effect repeated-measures regression models. The results showed that discrimination experiences were associated with moderate-to-severe anxiety and depressive symptoms, as well as more than one comorbid psychological distress symptom (adjusted Odds Ratios [AORs]=1.10 to 1.13). The association remained significant regardless of inter-individual differences in exposure to discrimination. Non-Hispanic Blacks, Asians, and other race/ethnicities exhibited stronger associations between discrimination and psychological distress (AORs=1.63 to 1.93) compared to Hispanic and White respondents (AORs=1.13 to 1.25). Our findings suggest that individuals experience a rapid deterioration in their emotional well-being when subjected to heightened levels of discrimination beyond their typical experiences.
PhosX: data-driven kinase activity inference from phosphoproteomics experiments
Authors: Lussana Alessandro , Müller-Dott Sophia , Saez-Rodriguez Julio , Petsalaki Evangelia
Published: November 2024

The inference of kinase activity from phosphoproteomics data can point to causal mechanisms driving signalling processes and potential drug targets. Identifying the kinases whose change in activity explains the observed phosphorylation profiles, however, remains challenging, and constrained by the manually curated knowledge of kinase–substrate associations. Recently, experimentally determined substrate sequence specificities of human kinases have become available, but robust methods to exploit this new data for kinase activity inference are still missing. We present PhosX, a method to estimate differential kinase activity from phosphoproteomics data that combines state-of-the-art statistics in enrichment analysis with kinases’ substrate sequence specificity information. Using a large phosphoproteomics dataset with known differentially regulated kinases we show that our method identifies upregulated and downregulated kinases by only relying on the input phosphopeptides’ sequences and intensity changes. We find that PhosX outperforms the currently available approach for the same task, and performs better or similarly to state-of-the-art methods that rely on previously known kinase–substrate associations. We therefore recommend its use for data-driven kinase activity inference.

Availability and implementation

PhosX is implemented in Python, open-source under the Apache-2.0 licence, and distributed on the Python Package Index. The code is available on GitHub (https://github.com/alussana/phosx).
R(+) propranolol decreases lipid accumulation in haemangioma-derived stem cells
Authors: Tan Jerry Wei Heng , Wylie-Sears Jill , Seebauer Caroline T , Mulliken John B , Francois Mathias , Holm Annegret , Bischoff Joyce
Published: November 2024

Infantile haemangioma (IH), often treated with propranolol, is a benign vascular tumour that undergoes a spontaneous involution to a fibrofatty residuum. We investigated how R(+) propranolol, the nonbeta blocker enantiomer of racaemic propranolol, affects lipid accumulation and adipogenesis in IH. This was motivated by our previous work showing that R(+) propranolol can block blood vessel formation in a preclinical model of IH. Our findings suggest a novel regulatory role for R(+) propranolol in modulating lipid accumulation in haemangioma stem cells. This highlights a novel role for R(+) propranolol in the involuting phase of IH and offers a strategy to reduce fibrofatty residua in IH.
Genome Streamlining: Effect of Mutation Rate and Population Size on Genome Size Reduction
Authors: Luiselli Juliette , Rouzaud-Cornabas Jonathan , Lartillot Nicolas , Beslon Guillaume
Published: November 2024

Genome streamlining, i.e. genome size reduction, is observed in bacteria with very different life traits, including endosymbiotic bacteria and several marine bacteria, raising the question of its evolutionary origin. None of the hypotheses proposed in the literature is firmly established, mainly due to the many confounding factors related to the diverse habitats of species with streamlined genomes. Computational models may help overcome these difficulties and rigorously test hypotheses. In this work, we used Aevol, a platform designed to study the evolution of genome architecture, to test 2 main hypotheses: that an increase in population size (N) or mutation rate (μ) could cause genome reduction. In our experiments, both conditions lead to streamlining but have very different resulting genome structures. Under increased population sizes, genomes lose a significant fraction of noncoding sequences but maintain their coding size, resulting in densely packed genomes (akin to streamlined marine bacteria genomes). By contrast, under an increased mutation rate, genomes lose both coding and noncoding sequences (akin to endosymbiotic bacteria genomes). Hence, both factors lead to an overall reduction in genome size, but the coding density of the genome appears to be determined by N×μ. Thus, a broad range of genome size and density can be achieved by different combinations of N and μ. Our results suggest that genome size and coding density are determined by the interplay between selection for phenotypic adaptation and selection for robustness.
Hidden price increases, product downsizing, and shrinkflation: a post-Keynesian macroeconomic perspective
Authors: Melmiès Jordan
Published: November 2024

This article takes a macroeconomic view of the industrial practice of marginally reducing the size/weight of goods or altering the content of goods or services without passing on the cost savings in prices. Although seldom a subject of academic study, this practice has come in for renewed attention with the recent return of inflation because it is one way of containing prices. Variously referred to as “hidden price increases,” “product downsizing,” or “shrinkflation,” it is part of a microeconomic strategy that has macroeconomic effects on both income distribution and consumer well-being.
Examining the joint effect of clinical quality, meaningful use of HIT and patient–caregiver interaction on mortality rates in US acute care hospitals
Authors: Elsaleiby Aber
Published: November 2024

Background

Healthcare quality has long been defined and assessed using different theories that outline care delivery as a product of clinical and non-clinical aspects. The clinical aspect is medicinal in nature, while the non-clinical symbolizes social and technological aspects of care. To the best of our knowledge, the joint effect of the clinical, social, and technological aspects of care on outcome quality of care has not been investigated in the literature. The current study empirically investigates, using the joint effect of the clinical, social, and technological care quality dimensions on mortality rates through analyzing longitudinal data from 3081 US hospitals.

Methods

Six-year data from 3081 acute care hospitals are collected and analyzed using econometric analysis with two-stage least square instrumental variable regression models.

Results

Hospitals that jointly focus on clinical, social, and technological care dimensions realize lower mortality rates. Combining clinical quality (CM) with either patient–caregiver interaction (PCI) or meaningful use of health infomration technology (MUHIT) reduces mortality rates. The lowest mortality rate is realized when hospitals combine CM, PCI, and MUHIT.

Conclusion

Our study provides empirical evidence on the importance of combining clinical and non-clinical care measures to reduce mortality rates in hospitals. Our results indicate that hospitals that combine dual quality dimensions, clinical quality with either PCI or MUHIT, can also realize improvement in mortality rates. However, the best outcome can be realized by focusing on the triple quality dimensions (CM, PCI, and MUHIT). The study provides pointers to healthcare professionals and policymakers on the impact of non-clinical care on the clinical–mortality link in hospitals.
Tort Law In America
Authors: White G Edward
Published: November 2024

Widely regarded as a standard in the field, G. Edward White’s Tort Law in America is a concise and accessible history of the way legal scholars and judges have conceptualized the subject of torts, the reasons why changes in certain rules and doctrines have occured, and the people who brought about these changes. Now in an expanded edition, Tort Law in America contains two new chapters - covering developments in American tort law over the past fifteen years - and a new preface. White approaches his subject from four perspectives: intellectual history, the sociology of knowledge, the phenomenon of professionalization in the late 19th and early 20th centuries in America, and the recurrent concerns of tort law since its emergence as a discreet field. He puts the intellectual history of this unique branch of law into a general picture of philosophy, sociology, and literature in what is not only a major work of legal scholarship but a tour de force for anyone interested in American intellectual history.
The Intellectual Origins of Torts in America
Authors: White G Edward
Published: November 2024

The emergence of Torts as an independent branch of law came strikingly late in American legal history. Although William Blackstone and his eighteenth-century contemporaries, in their efforts to classify law, identified a residual category of noncriminal wrongs not arising out of contract, Torts was not considered a discrete branch of law until the late nineteenth century. The first American treatise on Torts appeared in 1859; Torts was first taught as a separate law school subject in 1870; the first Torts casebook was published in 1874. A standard explanation for the emergence of an independent identity for Torts late in the nineteenth century is the affinity of tort doctrines, especially negligence, to the problems produced by industrialization. The process by which Torts emerged as a discrete branch of law was more complex, however, and less dictated by the demands of industrial enterprise than the standard account suggests. Changes associated with industrial enterprise did provide many more cases involving strangers, a phenomenon that played a part in the emergence of Torts as an independent branch of law. But even this new increase in cases in which the litigants had had no prior relationship would not have been sufficient had it not come at a time when legal scholars were prepared to question and discard old bases of legal classification. The emergence of Torts as a distinct branch of law owed as much to changes in jurisprudential thought as to the spread of industrialization.
The Impact of Legal Science on Tort Law, 1880-1910
Authors: White G Edward
Published: November 2024

In the early and middle years of the nineteenth century, the college student, particularly if he received his education at one of the traditional northern centers of higher learning, was exposed to philosophies of learning that increasingly appeared incongruous with the outside world. From 1820 to 1850, an education at one of the leading northern universities or colleges consisted of one’s learning basic rules of conduct, being exposed to classical literature and mathematics, developing one’s moral character, and preparing oneself to occupy a position of high status in a homogeneous, stable, stratified society.’ Yet while this process of education was taking place, primarily through formal lectures and recitations, American life seemed to be moving in different directions. Egalitarian political ideologies had begun to clash with extant status and occupational privileges, and those privileges had begun gradually and irregularly to crumble.” “Romantic” literature and popular folklore were celebrating the ability of the individual to transcend his social environment. The barriers to entry of professional guilds had become a subject of legislative attack.4 Advances in the technology of transportation held out the promise that Americans could change their lives simply by changing their locations.”
The Impact of Realism on Tort Law, 1910-1945
Authors: White G Edward
Published: November 2024

The emergence of the Realist movement in American jurisprudence appears, in retrospect, to have been tinged with ironies. Leading participants in the movement disclaimed any striking theoretical unity or coherence in Realism and took pains to disassociate their own jurisprudential positions from those of purportedly Realist colleagues. Some self-styled Realists even went so far as to deny that Realism was a. jurisprudential theory at all, locating its essence in its methodology. Yet few of the specific methodological innovations associated with Realism gained widespread acceptance in legal education or jurisprudential scholarship, while others were conspicuously ridiculed. At the same time, the theoretical underpinnings of Realism did become staples of American jurisprudential thought, and by 1940 the acceptance of Realism in leading American law schools was so widespread that no competing jurisprudential attitude could have been said to occupy a position of comparable influence. Realists, for the most part, professed little interest in substantive legal doctrine, claiming that process and procedure constituted the gist of law making. Yet the significant doctrinal changes that occurred in tort law and other private law areas during the years of Realism’s hegemony can be seen to reflect the intellectual assumptions of the Realists.
The Twentieth Century Judge As Torts Theorist: Cardozo
Authors: White G Edward
Published: November 2024

Thus far the attention of this study has focused primarily on the contributions of academics. Preceding chapters have argued that legal scholars, influenced by intellectual assumptions comparable to those made by scholars in other disciplines, created a “subject” of Torts, attempted to shape its doctrinal superstructure to conform to a conception of law as a science, and then, having abandoned that conception, attempted to reshape tort doctrines to reflect the insights of early twentieth-century reformist thought. In each of the chapters judges and courts have been discussed, but not given central treatment, and where interactions between academic thought and judicial decisions have been examined, emphasis has been placed primarily on academic sources. The preceding chapters have indicated, however, that nineteenth and early twentieth-century tort law was not exclusively the product of academic thought. The corpus of tort law between 1850 and 1930, of course, primarily consisted of judicial decisions. The significance of academic thought in those years lay in its subtle, sometimes almost imperceptible, modification of judicial decisions through intellectual analysis and synthesis.
Entering the Twenty-First Century
Authors: White G Edward
Published: November 2024

The history of tort law in America has revealed the multifaceted and elusive character of the subject. From its origins the field of torts has been defined by its residual status. It has been conceived as a field of civil actions, but not encompassing those arising out of contract; a field separate from criminal law, but often overlapping it. A field broad enough to encompass industrial accidents and slander suits, misrepresentations about the goodwill of a business, and suits by grandparents for the anguish caused by their fear for the safety of their grandchildren; but narrow enough to aspire to comprehensive principles of liability. A field in which class actions for damage brought by the release of toxic chemicals, with their extensive public policy implications, coexist with cases where a child slips on a patch of ice in a neighbor’s yard. A field, in short, combining cases that resemble the classic actions of private law-one plaintiff suing one defendant as a result of a single incident that caused harm and damage-with cases raising issues of risk distribution and allocation among multiple enterprises in an industrial society. An area of law that has periodically sought to determine whether its primary purpose should be admonitory, to deter and punish activity that creates substantial risks to others, or compensatory, to provide injured persons redress from their injuries.
Marginalia and the Reception of French Bibles
Authors: Holt Mack P.
Published: November 2024

This chapter explores readers’ markings in French vernacular Bibles published between 1530—the date of the first complete Bible published in French in Antwerp—and 1600. Using a data sample of nearly five hundred French Bibles, this research shows that Catholic readers were just as likely as Protestant readers to read Scripture in their own language rather than in Latin. Second, it shows that most readers of both confessions did not read the Bible in a linear fashion from Genesis to Revelation. Third, the distribution of readers’ marks suggest that readers were much less interested in theology and doctrine than in the human interaction with the divine. Finally, owning and reading the Bible in the vernacular was more a sign of belonging to a community of readers than a means of theological understanding. Thus, reading the Bible was as much about belonging as it was about believing.
The Ethiopic Bible and the Reformation in Europe
Authors: Daniels David D.
Published: November 2024

The Ethiopic or Ge’ez Bible was a significant version of the Bible that was printed during the Reformation era. As a text of antiquity, the Ethiopic Bible possessed authority as an ancient version of the sacred Scriptures and an ancient vernacular translation of Greek texts of the Bible. The Reformers debated the degree of authority it possessed. In that period, the Ethiopic Bible and its tradition of biblical interpretation was printed, translated, circulated, cited, and debated. Ethiopians participated as editors, co-editors, translators, and interpreters of the Ethiopic Bible during the Reformation in Europe. Rather than being nonexistent, inconsequential, or ancillary to the Reformation, the Ethiopic Bible and its tradition of biblical interpretation was prominent and contributed to the confessional debates of the era.
Humanist Textual Criticism and Lorenzo Valla’s Annotationes
Authors: den Haan Annet
Published: November 2024

The Annotationes Novi Testamenti, written by the Italian humanist Lorenzo Valla (1407–57), is a philological commentary on the Latin translation of the New Testament. It represents a new way of studying the text of the Bible, rooted in Renaissance Humanism. It is innovative in its use of Greek sources, its focus on correct Latin, and its approach to the authority of Scripture and its translations. This chapter will explore how Valla’s work can be seen as a milestone in the history of the Reformation and the history of biblical criticism as a scholarly discipline, particularly because of its influence on Desiderius Erasmus (1466–1536). At the same time, exploring the context in which Valla worked allows us to qualify the subversive nature of his scholarship, since it demonstrates that his approach to the Bible was shared by other scholars and supported at the highest level of the church.
Balthasar Hubmaier (1480–1528)
Authors: Eccher Stephen Brett
Published: November 2024

Balthasar Hubmaier holds a fascinating place in the historiography of Anabaptist studies. As this chapter argues, Hubmaier’s unique vision for reform that emerged at Waldshut and Nikolsburg was shaped by the reformer’s Anabaptist biblicism. Although his Reformation journey began as a Catholic priest, the influence of Renaissance Humanism birthed in the reformer a commitment to the Bible’s authority (sola Scriptura) and led him to embrace an evangelical understanding of the gospel. The more he read the Bible though his emerging lens of biblicism, which was characterized by a simple, straightforward reading of the biblical text with a desire to reinstitute an apostolic church model, the more he believed deeper changes were needed. And while Hubmaier affirmed such reforms were required according to Scripture, those correctives eventually led to his execution in 1528.
Philip Melanchthon (1497–1560)
Authors: Wengert Timothy J.
Published: November 2024

No other sixteenth-century interpreter of Scripture had a more wide-ranging influence than Philip Melanchthon (1497–1560). His books on Greek grammar, on rhetoric, and on dialectics set the stage for scholarly discussion of texts. His commentaries demonstrated how this method might be employed. His many works on Romans, Colossians, and Proverbs helped to focus scholarly discussion and debate for both friend and foe. His Loci communes and other summaries of doctrine helped define for Lutherans and others the very center of the Bible. He influenced an entire generation of exegetes who followed him in Wittenberg. Far from neglecting Scripture and its meaning, Melanchthon may be said to have championed a new approach to the text, using the very latest tools from the humanities and the very central categories of the Reformation.
Predestination (Rom. 8–9; Eph. 1)
Authors: Rouwendal Pieter L.
Published: November 2024

Predestination was a doctrine much debated among Protestants. Interpretations of Romans 8 and 9, for example, differed, and these differences were accompanied by dogmatic disputes, for in the sixteenth century the distinction between exegesis and dogmatics was not yet great. Thereby, it is difficult to ascertain whether the difference in interpretation determined the dogmatic dispute, or vice versa. This chapter offers an overview of the distinct positions within the Lutheran and Reformed traditions of the sixteenth century, in conjunction with related doctrines such as justification and atonement. Ongoing reflection by later Protestants on the problems raised by the doctrine of predestination led to more nuanced opinions. Scholasticism did not lead to a hardening of the doctrine, but on the contrary to a moderation.
Trinity (Heb. 1:3; John 1)
Authors: Woo Kenneth J.
Published: November 2024

This chapter examines diverse exegetical approaches to the doctrine of the Trinity during the Reformation period, focusing on various interpretations of John 1 and Heb. 1:3. Protestant commitments to the authority of Scripture alone and to literal exegesis over against allegorical approaches produced new ways of articulating traditional Christian teaching. Anti-Trinitarian thinkers offered exegetical arguments that not only rejected traditional language of divine “persons,” “substance,” and “essence” as unbiblical, but further asserted the radical oneness of God, denying that Scripture teaches God’s triunity. Leading Lutheran and Reformed figures responded to anti-Trinitarian arguments by showing how patristic Trinitarian formulations, while not explicitly biblical, are nevertheless consistent with the literal sense of both the Old and New Testaments. This chapter highlights how such exegetical arguments also served the less obvious concern of reinforcing communal boundaries around a distinctive theological identity contrasted against not only Rome and Radicals, but also fellow Protestants.
Genetic diversity of the major cat allergen, Fel d 1
Authors: Cleveland Clifford W , Davis Brian W , Khatri Kriti , Pomés Anna , Chapman Martin D , Brackett Nicole F
Published: November 2024

Cat allergy affects ∼15% of the US population and can cause severe symptoms, including asthma. The major cat allergen, Fel d 1, drives IgE antibody responses. We conducted a comparative analysis of Fel d 1 genes, CH1 and CH2, and investigated structural features of Fel d 1 homologs across the family Felidae. The CH1 and CH2 domestic cat DNA references were used to identify homologous sequences in domestic and exotic cat genomes. Variability of these sequences within or across cat species was analyzed. Comprehensive alignments of Fel d 1 sequences and homologs from 276 domestic or exotic cats identified >100 unique, dissimilar substitutions in the protein sequences across Felidae. Selective pressure analyses of 37 exotic cat species revealed that Fel d 1 experienced positive selection, or greater variability over time, in CH1 and CH2. Linear regression of the mean pairwise identities of Fel d 1 DNA or protein sequences indicated that the genes largely reflected the evolution of Felidae. The Fel d 1 genes are highly variable (41 and 58% of the amino acid residues encoded by CH1 and CH2, respectively), suggesting that the biological function of Fel d 1, which is currently unknown, may vary among cat species and/or that Fel d 1 may be nonessential for cats. This is supported by Fel d 1 homology to nonessential proteins and recent evidence of healthy cats with CRISPR-edited CH2 genes. Fel d 1 variability could confer an evolutionary advantage for cats by allowing the allergen to bind different physiological ligands.
Efficacy of L-Ornithine L-Aspartate (LOLA) as an Adjunct to Branched Chain Amino Acids (BCAA) Enriched Solutions on Clinical Outcomes in ICU Patients with Hepatic Encephalopathy: A Randomized Controlled Trial
Authors: Fawaz Ahmed Ahmed Aly , Abdelhakam Sara Mahmoud , Esmat Ibrahim Mamdouh , Mohamed Noha Refaat , Ashoor Tarek Mohamed , Ebrahim Elsayed Ahmed Elsayed
Published: November 2024

Background

Hepatic encephalopathy or portosystemic encephalopathy is a syndrome describing a spectrum of potentially reversible neuropsychiatric abnormalities, occurring as a complication of severe acute or chronic liver insufficiency, large portal-systemic shunts, or both.

Aim of the Work

To assess the efficacy of LOLA as an adjunct to BCAA enriched solutions on reversal of HE or improvement of HE by two grades (according to West Havens Criteria) and mental state grade after 5 days of treatment in ICU patients.

Patients and Methods

This study is randomized Controlled Trial, the study was conducted on patients with grade III / IV hepatic encephalopathy who will be admitted to internal medicine ICU of Ain Shams university hospitals

Results

The need for vasopressor support with mean duration of therapy (11 (16.9%) in group I and 22 (33.3%) in group II), the need for renal replacement therapy (RRT) during ICU stay (7 (10.8%) in group I and 17 (25.8%) in group II), length of hospital stay (19.4±3.0 24.8±4.1), and length of ICU stay (11.8±3.4 in group I and 17.2±3.9 in group II) were all assessed in our trial and found to be significantly lower in patients receiving LOLA infusion, in our trial, all these effects occurred more frequently in group I, suggesting that they might be related to LOLA (P > 0.05), our clinical trial was conducted to assess the efficacy of LOLA plus BCAA and conventional therapy in overt hepatic encephalopathy patients against BCAA and conventional therapy alone. Results support the efficacy of LOLA proven by its capability of the reversal of hepatic encephalopathy and better short-term survival rates.

Conclusion

The results of this prospective double-blind controlled trial demonstrate the efficacy of L-ornithine L-aspartate (LOLA) as an adjunct to branched-chain amino acids (BCAA) and conventional therapy in patients with overt hepatic encephalopathy (HE). Patients receiving LOLA showed significant improvements in neurological function, including higher Glasgow Coma Scale scores, and a remarkable reduction in HE grades, with almost 90% experiencing either improvement or resolution of HE.
Mirtazapine vs Sumatriptan in the Treatment of Postdural Puncture Headache Following Obstetric Surgery Under Spinal Anesthesia
Authors: Gad Alla Raouf Ramzy , Esmat Ibrahim Mamdouh , Ashoor Tarek Mohamed , Hasseb Ahmad Mahmoud , MaherAbdel Kader Sadek Ahmed
Published: November 2024

Background

Postdural puncture headache (PDPH) is a potential complication after spinal anesthesia caused by traction on pain-sensitive structures from low cerebrospinal fluid pressure (intracranial hypotension) following a leak of cerebrospinal fluid at the puncture site. Symptoms of this condition include a bilateral frontal or occipital headache that is worse in the upright position, along with nausea, neck pain, dizziness, visual changes, tinnitus, hearing loss, or radicular symptoms in the arms.

Objective

To compare the efficacy of mirtazapine with that of sumatriptan in the treatment of postdural puncture headache after obstetric surgery under spinal anesthesia.

Patients and Methods

This clinical study was carried out at Ain Shams University Hospitals from 15 November 2021 to 15 September 2023. 210 women were enrolled in the study and underwent obstetric surgery under spinal anesthesia.

Results

In this study, Mirtazapine and Sumatriptan significantly relieved PDPH and its associated symptoms. This improvement was evident after 72 hours of administration of the drugs in both groups. Clinically significant drop of VAS for headache to < 4 was reached in both study groups; So, both treatments showed similar effectiveness from the sixth hour onwards.

Conclusion

The current study concluded that Mirtazapine was as effective as sumatriptan in treatment of postdural puncture headache after caesarean sections under spinal anesthesia with the superiority of Mirtazapine in its associated anti emetic effects.
Comparison between Ultrasound Guided Quadratus Lumborum Block and Caudal Block in Children Undergoing Lower Abdominal Surgeries
Authors: Abdel-Naby Ahmed Mohamed , Salama Mohamed R , El-Gendy Hanaa A , Talaat Sahar M
Published: November 2024

Background

Caudal epidural anesthesia is a widely used popular technique for postoperative analgesia. The caudal approach of the epidural space is done through the sacral hiatus. A success rate of 96% was reported, however it can cause complications such as needle trauma, infection, hematoma, inadvertent subarachnoid or intravascular injection of local anesthetic. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. The quadratus lumborum block is also known as the abdominal truncal block. Ultrasound-guided quadratus lumborum block is a technique that was developed to provide visceral and somatic analgesia during abdominal procedures, and it can provide perioperative analgesia for all age groups, including pediatric patients undergoing abdominal surgery.

Aim of the Work

The aim of this study was to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing lower abdominal surgeries under general anesthesia.

Patients and Methods

This prospective randomized controlled double-blind study was carried out on eighty patients between 6-12 years old and undergoing lower abdominal surgeries. Patients were equally categorized into two groups which are quadratus lumborum block group (40 patients) received general anesthesia followed by ultrasound- guided Quadratus Lumborum block (0.3 ml/Kg of 0.25% Bupivacaine) and caudal block group (40 patients) received general anesthesia followed by caudal block (0.5 ml/Kg of 0.25% Bupivacaine).

Results

VAS score measurements showed no statistically significant difference at baseline, after 1 hr, 18h and 24h postoperative, while VAS score measurements were significantly lower in QLB group than Caudal block group after 2h, 4h, 6h and 12h postoperative. Intraoperative HR and MAP measurements were insignificantly different between both groups. Postoperative HR and MAP measurements were insignificantly different at baseline, after 18h and 24h. Postoperative HR2 measurements were significantly lower in QLB group than Caudal block group after 1h, 2h, 4h, 6h, 12h, 18h and 24h. Time to first analgesic request was significantly higher in QLB group than caudal block group. Total paracetamol consumption was significantly lower in QLB group than caudal block group. Hospital stay was insignificantly different between both groups, also hypotension was reported to be significantly lower in QLB group than caudal block group. There were few cases that experienced postoperative nausea and vomiting in both groups but there was no statistically significant difference in PONV between the two groups.

Conclusion

Performing QLB (anterior approach) is recommended for pediatric analgesia in lower abdominal surgeries as it is more effective in decreasing total paracetamol consumption, pain scores, and prolonging postoperative analgesia time more than caudal block.
Evaluation of Leg Wrapping for Prevention of Postspinal Hypotension in Cesarean Section under Spinal Anesthesia
Authors: Hasan Alaa Eid Mohamed , Taha Sameh Salem Hefni , Eldin Abdel Aziz Farouk Kamal , Abdel salam Aya Fathy
Published: November 2024

Background

Hypotension is one the most common intra-operative complications associated with spinal anesthesia. Its incidence in cesarean section has been estimated to be as high as 50-60 %.

Objective

To evaluate the efficiency of leg wrapping with crepe bandage for the prevention or attenuation of post-spinal hypotension and it’s adverse effects in cesarean section patients.

Patients and Methods

A total of 60 women scheduled for cesarean section under spinal anesthesia were included in the study, divided into 30 patients in each group.

Results

The preemptive use of leg wrapping significantly reduced the incidence of post spinal hypotension in obstetric patients. The minimum Heart Rate throughout the operation was significantly higher in wrapped leg group. Nausea and vomiting were significantly less frequent in wrapped leg group. No statistical significant difference between the study groups regarding birth weight, APGAR1, APGAR-5 and NICU admission. Furthermore, this method reduced vasopressor consumption.

Conclusion

the leg wrapping technique was a reliable method in decreasing the incidence of the commonest complications occurring after spinal anesthesia in obstetric patients: hypotension, bradycardia, nausea and vomiting. Recommendations: further studies with larger samples and more advanced leg compression equipments should be considered
Comparison of Ultrasound Guided Transversus Abdominis Plane Block versus Intravenous Patient Controlled Analgesia for Post-Operative Analgesia in Patients Undergoing Lower Abdominal Surgeries under Spinal Anesthesia
Authors: Mohammed Kamel Baheya Hesham , Ibrahim Sherif Farouk , Kamal Abo Seif Eman Mohamed , Hassan Hala Said
Published: November 2024

Background

poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics.

Aim of the Work

to compare the efficacy of TAP block versus PCA with IV morphine to provide prolonged post-operative analgesia; secondary objective is to identify the side effects of both techniques as post-operative analgesia

Patients and Methods

The study was conducted on 40 randomly chosen patients aged 21 to 70 years in both sexes, American Society of Anesthesiologists (ASA) class I or II scheduled for elective lower abdominal surgeries under spinal anesthesia in Ain Shams University Hospitals after approval of the medical ethical committee.

Results

TAP block is given in the volume of 20 mL bilaterally, it is as effective as intravenous Morphine PCA in pain treatment, but with less systemic side effect Also TAP block delay using of postoperative additional analgesia, however PCA analgesic effect last longer, less invasive technique and easier to be used while TAP require hand skills and limited to 24 hours analgesia only.

Conclusion

In lower abdominal surgery, when TAP block is given in the volume of 40 mL, it is as effective as intravenous PCA in pain treatment. Compared with intravenous PCA, TAP block can be considered as a more preferable method because it can avoid the systemic actions of morphine.
Effect of Intravenous Infusion of Ketamine versus Fentanyl on Intraoperative and Postoperative Analgesia in Patients Undergoing Posterior Lumbar Fusion Surgery: A Blind Randomized Study
Authors: Refai Ahmed Essam Alaa , Abdellatif Ayman Ahmad , Mohamed Mohamed Abdelwareth
Published: November 2024

Background

Use of opioids for perioperative analgesia is associated with sedation, respiratory depression and postoperative nausea and vomiting. N-methyl-D-aspartate receptor antagonist such as ketamine has both analgesic and antihyperalgesic properties.

Objective

Comparison between intravenous infusion of ketamine and fentanyl in patients undergoing posterior lumbar fusion surgery on postoperative analgesia.

Patients and Methods

A total of 60 patients who underwent elective posterior lumbar fusion were enrolled and divided into two equal groups; ketamine and fentanyl groups, with the same inclusion and exclusion criteria. Baseline vital parameters, adequacy of ventilation, surgical time from skin incision to skin closure, heart rate, mean arterial pressure, and pulse oximetry, total consumption of isoflurane, Visual Analogue Scale, total morphine consumption and sedation score (Ramsay sedation score) and occurrence of any complication were recorded.

Results

Postoperative VAS score was statistically significant higher in fentanyl compared to ketamine group, however, we reported statistically significant higher median of sedation score in fentanyl group. Our study showed statistically significant higher frequency of propofol 100mg and morphine 5mg consumption in fentanyl comparing to ketamine group.

Conclusion

Patients undergoing posterior lumbar fusion surgery, ketamine has potent postoperative analgesic effect with less opioid consumption and need for rescue sedation compared with fentanyl.
Role of Interleukin 6 and C-Reactive Protein Levels in Predicting the Need for Mechanical Ventilation in COVID 19 Patients
Authors: Mahmoud Mohamed Sidky , Anis Sherif George , Amer Akram Mohamed , Hamed Abdelhak Hadeer Ashraf
Published: November 2024

Background

COVID-19 is caused by coronavirus; first discovered in China 2019, COVID-19 infection shows symptoms ranging from influenza like symptoms; fever, sore throat, headache, cough and dyspnea to marked respiratory distress manifestations like dyspnea, hypoxia, tachypnea and disturbed conscious level lastly to death

Objective

As severe symptoms are related to increased inflammatory markers. So the aim is to assess the correlation between levels of IL6, CRP and other inflammatory markers as predictors and the need for mechanical ventilation.

Methods

A retrospective analytical cohort study was performed on twenty-five patients admitted to critical care department with COVID-19 positive reverse transcription polymerase chain reaction (PCR) over last 3 years. Patients’ data collected from the critical care department port- Fouad hospital and Ain Shams University Hospital. Labs and vital signs were collected at day 0 and day 3 of admission and patients were divided into two groups.

Results

The higher the levels of IL6 and CRP the more severe are the symptoms. The study showed higher IL6 levels in group II with (mean 238±169.79) as compared to group I (mean 49.18 ± 56.18) with significant p value 0.001. CRP in mechanically ventilated patients (group II) showed higher values (mean 176.54±51.69) than other patients who didn’t need mechanical ventilation (mean 69.42±23.56). with significant p value < 0.001. Variables found to be statistically significant related to outcome. The values correlate well with the need to mechanical ventilation, as the higher the CRP and IL-6 value the increased need to mechanical ventilation. It also correlates with longer length of stay in intensive care unit and increasing mortality of high-risk group.

Conclusion

Through studying the levels of IL-6 and CRP in patients admitted to ICU due to COVID-19 infection; who were classified to 2 groups the first needed mechanical ventilation and the other group did not, it was noticed that higher levels of IL-6 and CRP are strong predictors for the need of mechanical ventilation with cut off value 120 for CRP and 151 for IL-6. They also were a strong predictor for mortality and increased ICU -LOS, as the higher levels of circulating inflammatory markers and cytokine (cytokine storm) was associated with a higher risk of mortality and increase LOS in ICU.