bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural, Optical and Optoelectrical Properties of CuAlSnS4 Thin Films
Authors: El Radaf I. M. , Al-Zahrani H. Y. S.
Published: March 2024

The present study used chemical deposition to deposit thin copper aluminum tin sulfide (CATS4) layers onto clean glass substrates. X-ray diffraction analysis was utilized to explore the crystalline structure of the CATS4 films, which refers to the CATS4 films having a cubic crystal structure. Energy-dispersive X-ray analysis showed the presence of Cu, Al, Sn, and S peaks in the CATS4 films, and their atomic ratio is close to 1:1:1:4. Spectrophotometric measurements of optical transmittance and reflectance spanning the 400–2500 nm spectral range were performed to describe the optical properties of the CATS4 layers. The CATS4 films demonstrated a direct energy gap transition between 1.42 and 1.31 eV. Further, increasing the layer thickness enhanced the refractive index and Urbach energy of the CATS4 films. The inspected CATS4 films showed better optoelectrical properties with increasing thickness, including improved optical conductivity, optical resistivity, optical carrier concentration, relaxation time, and optical mobility. Increasing the thickness of the CATS4 films increased their nonlinear optical indices. Additionally, the hot probe apparatus verified the p-type semiconducting characteristics of CATS4 films.
Glass Sintering Aid Effect on Magnetic and Dielectric Properties of YFeO3 Ceramics
Authors: Mohammed Sadik Ahmed , Dachuru Rama Sekhara Reddy
Published: March 2024

YFeO3 (YFO) and optimized glass wt% [0.5Li2O-0.5K2O-2B2O3 (LKBO) and BaO-Bi2O3-B2O3 (BBBO)] as a sintering aid in YFO ceramics were fabricated using fine powders prepared from sol-gel technique. Pure YFO and glass sintering aid added into YFO ceramics show orthorhombic crystal structure, confirmed by Rietveld refinement with the help of X-ray powder diffraction data. Scanning electron microscopy study revealed that the glass sintering aid added into YFO ceramics shows a higher average grain size than that of YFO ceramic. X-ray photoelectron spectroscopy was employed to confirm the presence of each atom/ion/element and their oxidation number in their respective samples. Using the Archimedes method, the density of the each ceramic sample was estimated. The BBBO glass sintering aid added into YFO exhibited a higher maximum magnetization value (2.82 emu g−1) compared to that of LKBO added into YFO (2.51 emu g−1) as well as pure YFO (1.53 emu g−1) ceramics. BBBO glass sintering aid added into YFO ceramic shows a higher dielectric constant, lower dielectric loss, and lower conductivity compared to LKBO added into YFO as well as pure YFO ceramics. In conclusion, improved magnetic and dielectric response of BBBO glasses added into YFO ceramic is a potential candidate for different dielectric-magnetic based applications.
Understanding the Relationship between Neighbourhood Built Environment and Older Adults’ Health from the Perspective of Housing Differentiation
Authors: Qin Bo , Choi Seungju , Dou Wangsheng , Hao Meizhu
Published: March 2024

Studies have revealed an association between the built environment and the health of older adults. However, few studies distinguish between the objective and perceived built environments and explore their associations with older adults’ health, especially when considering housing differentiation. Drawing on a survey of 426 older adults in ten residential neighbourhoods in Dongfeng Township, Beijing, this study employed structural equation modelling and the Kruskal–Wallis test to analyse the relationship between the built environment of different housing types and older adults’ health. The findings revealed that the objective and perceived environments were significantly associated with older adults’ health, with physical activity and social interactions as mediating factors. The perceived built environment mediates the relationship between the objective built environment and older adults’ health. Moreover, it was observed that the relationship between the built environment and older adults’ health varied depending on housing type, which is a crucial reflection of spatial non‐stationary in the relationship between health and environment. Therefore, the varying impacts of different housing types on older adults’ health should not be overlooked when developing planning and other policies for aging‐friendly cities.
Investigating the Impact of Automated Vehicles on the Safety and Operation of Low‐Speed Urban Networks
Authors: Karbasi Amir Hossein , Zheng Nan , O’Hern Steve
Published: March 2024

Automated vehicles (AVs) will appear on the road soon and will influence the properties of road traffic networks such as capacity and safety. While the impact of AV on traffic operations has been discussed extensively, most existing literature in this direction focuses on microscopic and mesoscopic levels. This study examines the effect of AVs on traffic flow operations and crash risks at a network scale. In addition, this study discusses the implications for designing and operating safe, low‐speed urban road networks. Simulation experiments were carried out in a grid road network with AVs and human‐driven vehicles operating in mixed flow conditions. To assess traffic performance, the macroscopic fundamental diagram (MFD) relationships were estimated, specifically focusing on speed‐density correlations. From this analysis, it was possible to extract key traffic performance indices such as capacity and critical speed. Using time‐to‐collision surrogate safety measures, macroscopic safety diagrams were generated which associate the level of congestion with the potential crash conflicts among vehicles at an aggregated spatial scale. Utilizing this knowledge, a novel multiobjective optimization based on the NSGA‐II algorithm was applied to identify the optimal trade‐off between efficiency and safety. The presence of AVs was found to have a positive impact on the capacity, critical density, and average speed on a system level, even in low‐speed scenarios. Moreover, AVs can result in increased critical density in the network, which suggests that the road system can serve more vehicles at its capacity, thus improving efficiency, while decreasing the number of conflicts. These findings are useful for both traffic planners and operators.
Current Status and Future Prospects of Small-Scale Household Biodigesters in Sub-Saharan Africa
Authors: Tolessa Amsalu
Published: March 2024

Despite the age of the technology, sub-Saharan African (SSA) countries have numerous challenges that hinder biogas from being widely adopted. This review investigates the current gap between holistic use and the need for small-scale household biodigester adoption and effectiveness in rural and semiurban households of SSA. It reviews the present situation and potential of small-scale household digesters for sustainable future energy and biofertilizer use, with a focus on SSA. A literature survey was performed on small-scale household biogas digesters, and issues relating to the distribution, use, and implementation status with their implications on the future of small-scale household digesters in SSA were briefly reviewed. In recent years, the overall number of domestic biogas digesters installed across SSA countries has shown a significant increase due to the efforts of the National Domestic Biogas Programs such as the African Biogas Partnership Program with the Netherlands Development Organization and the Humanist Institute for Development Cooperation. However, based on an extensive literature review on small-scale household biodigesters in SSA, the study highlights that the success of biogas technology as a clean domestic cooking fuel has been relatively low. The findings of this review show that SSA countries still face a number of hurdles, the most significant of which can be boiled down to the need for technological advancement according to local context, social acceptance, and large initial investment costs. In order to overcome these obstacles and advance technological capability, social acceptance, financial benefits, and environmental impacts in order to improve its use and widespread dissemination as a renewable energy source, a highly effective organic fertilizer, and economic benefits for the betterment of SSA communities, more well-organized work and adequate research activities should be initiated and supported. The findings may be useful to researchers, practitioners, and policymakers who support/promote sustainable energy and waste management strategies in low-resource settings.
Physicochemical, Antioxidant, and Sensory Characteristics of Sponge Cake Fortified with Quinoa Flour, Oolong, and White Tea Powder
Authors: Ardeshir Anita , Fazeli Fatemeh , Khorshidian Nasim , Mohammadi Mehrdad
Published: March 2024

Nowadays, there is a growing demand for healthy foods enriched with various functional bioactive ingredients. Cakes are ready-to-eat baked products consumed worldwide and are suitable for the development of functional food products. In this study, a Box–Behnken design was used to investigate the effect of three independent variables, including oolong tea powder (OT, 0–20%), white tea powder (WT, 0–15%), and quinoa flour (QF, 0–40%), on the quality characteristics of sponge cake during 21 days of storage. Following the evaluation of the model, the optimum levels of ingredients for the preparation of sponge cake were 15% WT, 17.17% OT, and 24.97% QF. Total phenolic content of 52.09 mg gallic acid/100 g, antioxidant activity of 0.068 mg/mL, overall acceptability of 4.89, lightness of 47.94, and peroxide value of 0.68 mEq/kg were obtained under optimized conditions. The growth of molds and yeasts was prevented during storage time. The hardness, gumminess, and chewiness of the optimized sponge cake improved with increasing WT, OT, and QF levels in comparison to the control. Scanning electron micrographs showed a more porous structure in optimized cake samples. In conclusion, the utilization of OT, WT, and QF as phenolic compounds in sponge cake led to an increase in its nutritional value and improved shelf life.
Multiple Leap Maneuver Trajectory Design and Tracking Method Based on Prescribed Performance Control during the Gliding Phase of Vehicles
Authors: Zhang Taotao , Zhang Jun , Shen Sen , Chen Weiyi
Published: March 2024

A novel standard trajectory design and tracking guidance used in the multiple active leap maneuver mode for hypersonic glide vehicles (HGVs) is proposed in this paper. First, the dynamic equation and multiconstraint model are first established in the flight path coordinate system. Second, the reference drag acceleration-normalized energy (D-e) profile of the multiple active leap maneuver mode is quickly determined by the Newton iterative algorithm with a single design parameter. The range to go error is corrected by the drag acceleration profile update algorithm, and the drag acceleration error of the gliding terminal is corrected by the aerodynamic parameter estimation algorithm. Then, the reference drag acceleration tracking guidance law is designed based on the prescribed performance control method. Finally, the CAV-L vehicle model is used for numerical simulation. The results show that the proposed method can satisfy the design requirements of drag acceleration under multiple active leap maneuver modes, and the reference drag acceleration can be tracked precisely. The adaptability and robustness of the proposed method are verified by the Monte Carlo simulations under various combined deviation conditions.
Analysis of Filtered Multicarrier Modulation Techniques Using Different Windows for 5G and Beyond Wireless Systems
Authors: Debnath Sourav , Ahmed Samin , Alam S. M. Shamsul
Published: March 2024

In contemporary wireless communication systems, multicarrier modulation schemes have become widely adopted over single-carrier techniques due to their improved capacity to address challenges posed by multipath fading channels, leading to enhanced spectral efficiency. Orthogonal frequency division multiplexing (OFDM), a prevalent multicarrier scheme in 4G, is favored for its ease of implementation, interference resilience, and high data rate provision. But it falls short of meeting the requirements for 5G and beyond due to limitations such as out-of-band (OOB) emissions and cyclic prefixes. This paper introduces the filter bank multicarrier (FBMC) and universal filtered multicarrier (UFMC) with quadrature amplitude modulation (QAM) and phase shift keying (PSK) waveforms through Additive White Gaussian Noise channel (AWGN), Rayleigh fading channel and Rician channel. The objective of this paper is to enhance the performance of UFMC with reduced complexity through the new filtering approach for achieving optimal outcomes. The proposed scheme, incorporating Tukey filtering technique, demonstrates superior performance in reducing peak-to-average power ratio (PAPR) and improving bit error ratio (BER) compared to the original UFMC signal without necessitating additional power increments. Specifically, the UFMC system with Tukey filtering achieves a notable net gain of 5 dB. Simulation results demonstrate that utilizing various filter types in FBMC and UFMC systems, combined with QAM modulation, significantly reduces OOB emissions compared to conventional systems. In aspect to BER, Tukey window showed almost 10−6 at 15 dB SNR in UFMC which is better than FBMC.
m6A Modification Promotes EMT and Metastasis of Castration-Resistant Prostate Cancer by Upregulating NFIB
Authors: Shu Feng , Liu Hao , Chen Xiaohui , Liu Ye , Zhou Jiangli , Tang Lei , Cao Wanwei , Yang Shanshan , Long Yili , Li Rongna , Wang Hao , Wang Hongsheng , Jiang Guanmin
Published: March 2024

The widespread use of androgen receptor (AR) signaling inhibitors has led to an increased incidence of AR-negative castration-resistant prostate cancer (CRPC), limiting effective treatment and patient survival. A more comprehensive understanding of the molecular mechanisms supporting AR-negative CRPC could reveal therapeutic vulnerabilities to improve treatment. This study showed that the transcription factor nuclear factor I/B (NFIB) was upregulated in patient with AR-negative CRPC tumors and cell lines and was positively associated with an epithelial-to-mesenchymal transition (EMT) phenotype. Loss of NFIB inhibited EMT and reduced migration of CRPC cells. NFIB directly bound to gene promoters and regulated the transcription of EMT-related factors E-cadherin (CDH1) and vimentin (VIM), independent of other typical EMT-related transcriptional factors. In vivo data further supported the positive role of NFIB in the metastasis of AR-negative CRPC cells. Moreover, N6-methyladenosine (m6A) modification induced NFIB upregulation in AR-negative CRPC. Mechanistically, the m6A levels of mRNA, including NFIB and its E3 ubiquitin ligase TRIM8, were increased in AR-negative CRPC cells. Elevated m6A methylation of NFIB mRNA recruited YTHDF2 to increase mRNA stability and protein expression. Inversely, the m6A modification of TRIM8 mRNA, induced by ALKBH5 downregulation, decreased its translation and expression, which further promoted NFIB protein stability. Overall, this study reveals that upregulation of NFIB, mediated by m6A modification, triggers EMT and metastasis in AR-negative CRPC. Targeting the m6A/NFIB axis is a potential prevention and treatment strategy for AR-negative CRPC metastasis.

Significance:

NFIB upregulation mediated by increased m6A levels in AR-negative castration-resistant prostate cancer regulates transcription of EMT-related factors to promote metastasis, providing a potential therapeutic target to improve prostate cancer treatment.
A Phase I Trial of Enzalutamide Plus Selective Glucocorticoid Receptor Modulator Relacorilant in Patients with Metastatic Castration-Resistant Prostate Cancer
Authors: Desai Kunal B. , Serritella Anthony V. , Stadler Walter M. , O'Donnell Peter H. , Sweis Randy F. , Szmulewitz Russell Z.
Published: March 2024

Purpose:

The majority of patients with metastatic prostate cancer who receive androgen-deprivation therapy and androgen receptor (AR) signaling inhibitors (ARSI) progress. Activation of the glucocorticoid receptor (GR) is associated with ARSI resistance. This single-arm phase I trial assessed safety and pharmacokinetic (PK) feasibility of a combined AR antagonist (enzalutamide) and selective GR modulator (relacorilant) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Patients and Methods:

This was a phase I trial (NCT03674814) of relacorilant and enzalutamide in patients with refractory mCRPC enrolled using a 6+3 design. The enzalutamide dose was kept constant at 120 mg/d with escalating doses of relacorilant based on safety and PK measures in cohorts of ≥6 patients. The primary objective was safety and establishment of pharmacologically active doses. Secondary objectives were related to antitumor activity.

Results:

Thirty-five patients with mCRPC were enrolled. Twenty-three were accrued across three dose cohorts in the dose-escalation phase, and 12 enrolled at the recommended phase II dose. The combination was generally well tolerated, safe, and achieved desirable enzalutamide PK. RP2D of 120 + 150 mg/d, respectively, was established. Median time on study was 2.2 months with four patients remaining on study for longer than 11 months. Four of 12 evaluable patients had a prostate-specific antigen (PSA) partial response.

Conclusions:

This is the first prospective trial combining an AR antagonist and a nonsteroidal selective GR modulator. The combination was safe and well tolerated with PSA response and prolonged disease control observed in a limited subset of patients. Further prospective trials are justified to evaluate efficacy and identify predictive biomarkers of response.
A Case Report of Pulmonary Edema Secondary to Large Volume Bowel Preparation in a High-Risk Patient with Multiple Cardiopulmonary Co-Morbidities
Authors: Fansiwala Kush , Prakash Preeti , Coe Christopher L. , Weiss Guy A.
Published: March 2024

Introduction: Polyethylene glycol 3,350 and electrolytes is a commonly prescribed bowel regimen for colonoscopy preparation with an overall excellent safety profile, though prior reports have demonstrated risk of volume overload. Case Presentation: A 55-year-old man with significant cardiopulmonary co-morbidities was admitted for acute hypoxic respiratory failure and subsequent evaluation for lung transplant. As part of his pretransplant evaluation, colon cancer screening was advised. Despite multiple days of bowel preparation, his stools contained sediment. Unfortunately, he developed pulmonary edema due to prolonged bowel preparation. Conclusion: While bowel preparation is considered generally safe, our case report highlights the importance of judicious use with monitoring in high-risk individuals.
Fecal Microbiota Transfer in Acute Graft-versus-Host Disease following Allogeneic Stem Cell Transplantation
Authors: Weber D. , Meedt Elisabeth , Poeck Hendrik , Thiele-Orberg Eric , Hiergeist Andreas , Gessner Andre , Holler Ernst
Published: March 2024

Background: Acute graft-versus-host disease (GvHD) is a major and sometimes lethal complication following allogeneic stem cell transplantation (aSCT). In the last 10 years, a massive loss of microbiota diversity with suppression of commensal bacteria and their protective metabolites has been identified as a major risk factor of GvHD. Summary: Since 2018, several studies have been published showing some efficacy of fecal microbiota transfer (FMT) in aSCT patients. FMT was used (1) to eliminate antibiotic resistant bacteria, (2) to restore microbiota diversity after hematopoietic recovery, or (3) in most cases to treat steroid-resistant GvHD. Overall response rates between 30 and 50% have been reported, but randomized trials are still pending. Newer approaches try to evaluate the role of prophylactic FMT in order to prevent GvHD and other complications. Although aSCT patients are heavily immunosuppressed, no major safety concerns regarding FMT have been reported so far. Key Message: FMT is a promising approach for modulation of GvHD after aSCT and should be further explored in randomized trials.
Safety and Feasibility of Single-Port Nephroscopy Combined with a Needle Electrode Technique to Treat Dorsal Simple Renal Cysts
Authors: Yang Hao , Wei Weiyang , Wang Qi , Li Linfeng , Lin Qisheng , Huang Hongxing , Huang Yaqiang
Published: March 2024

Introduction: The aim of this study was to explore the safety and feasibility of single-port nephroscopy combined with a needle electrode technique to unroof single dorsal simple renal cysts (SRCs). Methods: This was a retrospective analysis of the clinical data for 18 patients with single dorsal SRCs treated with single-port nephroscopy and a needle electrode technique at Zhongshan City People’s Hospital from August 2021 to August 2022. The basic information included the cyst condition, surgical methods and recurrence rate, and follow-up was conducted with CT imaging. Results: The surgery was successful in all 18 patients. The duration of surgery ranged from 24 to 46 min, with an average of 35.83 ± 1.62 min; the intraoperative bleeding volume ranged from 2 to 20 mL, with an average of 9.0 ± 1.3 mL; and the visual analog scale (VAS) score within 24 h after surgery ranged from 1 to 6 points, with an average of 2.72 ± 0.36 points. There were no significant postoperative complications, such as bleeding, urinary fistula, or infection. All drainage tubes were removed on the first day after surgery. After 1 year of postoperative follow-up, 1 patient experienced recurrence, for a recurrence rate of 5.6%. Conclusion: Single-port nephroscopy combined with a needle electrode technique is a safe, feasible, and effective minimally invasive surgical approach for treating single dorsal SRCs.
TABERNACL: Temporary Hemodynamic Stabilization In Vivo
Authors: Halaby Rim N. , Bruce Christopher G. , Yildirim D. Korel , Uzun Dogangun , Rogers Toby , Khan Jaffar M. , Jaimes Andi E. , Grant Laurie P. , Babaliaros Vasilis C. , Greenbaum Adam B. , Lederman Robert J.
Published: March 2024

BACKGROUND:

Acute aortic regurgitation is life-threatening with few nonsurgical options for immediate stabilization. We propose Trans-Aortic Balloon to Ease Regurgitation Applying Counter-Pulsation (TABERNACL), a simple, on-table temporary valve using commercially available equipment to temporize acute severe aortic regurgitation.

METHODS:

We hypothesize that an appropriately sized commercial balloon dilatation catheter—straddling the aortic annulus and connected to a counterpulsation console—can serve as a temporizing valve to restore hemodynamic stability in acute aortic regurgitation. We performed benchtop testing of valvuloplasty, angioplasty, and sizing balloons as counterpulsation balloons. TABERNACL was assessed in vivo in a porcine model of acute aortic regurgitation (n=8). We also tested a static undersized, continuously inflated transvalvular balloon as a spacer intended physically to obstruct the regurgitant orifice.

RESULTS:

Benchtop testing identified that Tyshak II and PTS sizing (NuMed Braun) balloon catheters performed adequately as temporary valves (ie, complete inflation and deflation with each cycle) and resisted fatigue, in contrast to others. When TABERNACL was used in the acute severe regurgitation animals, there was immediate hemodynamic improvement, with a significant 35% increase in diastolic aortic pressure by 16 mm Hg ([95% CI, 7–25]
P
=0.0056), 34% reduction in left ventricular end-diastolic pressure by −7 mm Hg ([95% CI, −10 to −5]
P
=0.0006), improvement in the aortic diastolic index by 0.28 ([95% CI, 0.18–0.39]
P
=0.0009), and reversal of electrocardiographic myocardial ischemia. As an alternative, static balloon inflation across the aortic valve stabilized regurgitation hemodynamics at the expense of a new aortic gradient and caused excessive ectopy from balloon movement in the left ventricular outflow tract.

CONCLUSIONS:

TABERNACL improves hemodynamics and reduces coronary ischemia by electrocardiography in animals with acute severe aortic regurgitation. TABERNACL valves obstruct the diastolic regurgitant orifice without systolic obstruction. This may prove a lifesaving bridge to definitive valve replacement therapy.
Correlates of Plasma NT‐proBNP/Cyclic GMP Ratio in Heart Failure With Preserved Ejection Fraction: An Analysis of the RELAX Trial
Authors: Chiu Leonard , Agrawal Vineet , Armstrong David , Brittain Evan , Collins Sheila , Hemnes Anna R. , Hill Joseph A. , Lindenfeld JoAnn , Shah Sanjiv J. , Stevenson Lynne W. , Wang Thomas J. , Gupta Deepak K.
Published: March 2024

Background

Phosphodiesterases degrade cyclic GMP (cGMP), the second messenger that mediates the cardioprotective effects of natriuretic peptides. High natriuretic peptide/cGMP ratio may reflect, in part, phosphodiesterase activity. Correlates of natriuretic peptide/cGMP in patients with heart failure with preserved ejection fraction are not well understood. Among patients with heart failure with preserved ejection fraction in the RELAX (Phosphodiesterase‐5 Inhibition to Improve Clinical Status and Exercise Capacity in Heart Failure With Preserved Ejection Fraction) trial, we examined (1) cross‐sectional correlates of circulating NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide)/cGMP ratio, (2) whether selective phosphodiesterase‐5 inhibition by sildenafil changed the ratio, and (3) whether the effect of sildenafil on 24‐week outcomes varied by baseline ratio.

Methods and Results

In 212 subjects, NT‐proBNP/cGMP ratio was calculated at randomization and 24 weeks. Correlates of the ratio and its change were examined in multivariable proportional odds models. Whether baseline ratio modified the sildenafil effect on outcomes was examined by interaction terms. Higher NT‐proBNP/cGMP ratio was associated with greater left ventricular mass and troponin, the presence of atrial fibrillation, and lower estimated glomerular filtration rate and peak oxygen consumption. Compared with placebo, sildenafil did not alter the ratio from baseline to 24 weeks (
P
=0.17). The effect of sildenafil on 24‐week change in peak oxygen consumption, left ventricular mass, or clinical composite outcome was not modified by baseline NT‐proBNP/cGMP ratio (
P
‐interaction >0.30 for all).

Conclusions

Among patients with heart failure with preserved ejection fraction, higher NT‐proBNP/cGMP ratio associated with an adverse cardiorenal phenotype, which was not improved by selective phosphodiesterase‐5 inhibition. Other phosphodiesterases may be greater contributors than phosphodiesterase‐5 to the adverse phenotype associated with a high natriuretic peptide/cGMP ratio in HFpEF.

Registration Information

clinicaltrials.gov
. Identifier:
NCT00763867
.
Posttraumatic Stress Disorder After Spontaneous Coronary Artery Dissection: A Report of the International Spontaneous Coronary Artery Dissection Registry
Authors: Sumner Jennifer A. , Kim Esther S. H. , Wood Malissa J. , Chi Gerald , Nolen Jessica , Grodzinsky Anna , Gornik Heather L. , Kadian‐Dodov Daniella , Wells Bryan J. , Hess Connie N. , Lewey Jennifer , Tam Lori , Henkin Stanislav , Orford James , Wells Gretchen , Kumbhani Dharam J. , Lindley Kathryn J. , Gibson C. Michael , Leon Katherine K. , Naderi Sahar
Published: March 2024

Background

Myocardial infarction secondary to spontaneous coronary artery dissection (SCAD) can be traumatic and potentially trigger posttraumatic stress disorder (PTSD). In a large, multicenter, registry‐based cohort, we documented prevalence of lifetime and past‐month SCAD‐induced PTSD, as well as related treatment seeking, and examined a range of health‐relevant correlates of SCAD‐induced PTSD.

Methods and Results

Patients with SCAD were enrolled in the iSCAD (International SCAD) Registry. At baseline, site investigators completed medical report forms, and patients reported demographics, medical/SCAD history, psychosocial factors (including SCAD‐induced PTSD symptoms), health behaviors, and health status via online questionnaires. Of 1156 registry patients, 859 patients (93.9% women; mean age, 52.3 years) completed questionnaires querying SCAD‐induced PTSD. Nearly 35% (n=298) of patients met diagnostic criteria for probable SCAD‐induced PTSD in their lifetime, and 6.4% (n=55) met criteria for probable past‐month PTSD. Of 811 patients ever reporting any SCAD‐induced PTSD symptoms, 34.8% indicated seeking treatment for this distress. However, 46.0% of the 298 patients with lifetime probable SCAD‐induced PTSD diagnoses reported never receiving trauma‐related treatment. Younger age at first SCAD, fewer years since SCAD, being single, unemployed status, more lifetime trauma, and history of anxiety were associated with greater past‐month PTSD symptom severity in multivariable regression models. Greater past‐month SCAD‐induced PTSD symptoms were associated with greater past‐week sleep disturbance and worse past‐month disease‐specific health status when adjusting for various risk factors.

Conclusions

Given the high prevalence of SCAD‐induced PTSD symptoms, efforts to support screening for these symptoms and connecting patients experiencing distress with empirically supported treatments are critical next steps.

Registration

URL:https://www.clinicaltrials.gov; Unique identifier: NCT04496687.
Loss of Cardiac PFKFB2 Drives Metabolic, Functional, and Electrophysiological Remodeling in the Heart
Authors: Harold Kylene M. , Matsuzaki Satoshi , Pranay Atul , Loveland Brooke L. , Batushansky Albert , Mendez Garcia Maria F. , Eyster Craig , Stavrakis Stavros , Chiao Ying Ann , Kinter Michael , Humphries Kenneth M.
Published: March 2024

Background

Phosphofructo‐2‐kinase/fructose‐2,6‐bisphosphatase (PFK‐2) is a critical glycolytic regulator responsible for upregulation of glycolysis in response to insulin and adrenergic signaling. PFKFB2, the cardiac isoform of PFK‐2, is degraded in the heart in the absence of insulin signaling, contributing to diabetes‐induced cardiac metabolic inflexibility. However, previous studies have not examined how the loss of PFKFB2 affects global cardiac metabolism and function.

Methods and Results

To address this, we have generated a mouse model with a cardiomyocyte‐specific knockout of PFKFB2 (cKO). Using 9‐month‐old cKO and control mice, we characterized the impacts of PFKFB2 on cardiac metabolism, function, and electrophysiology. cKO mice have a shortened life span of 9 months. Metabolically, cKO mice are characterized by increased glycolytic enzyme abundance and pyruvate dehydrogenase activity, as well as decreased mitochondrial abundance and beta oxidation, suggesting a shift toward glucose metabolism. This was supported by a decrease in the ratio of palmitoyl carnitine to pyruvate‐dependent mitochondrial respiration in cKO relative to control animals. Metabolomic, proteomic, and Western blot data support the activation of ancillary glucose metabolism, including pentose phosphate and hexosamine biosynthesis pathways. Physiologically, cKO animals exhibited impaired systolic function and left ventricular dilation, represented by reduced fractional shortening and increased left ventricular internal diameter, respectively. This was accompanied by electrophysiological alterations including increased QT interval and other metrics of delayed ventricular conduction.

Conclusions

Loss of PFKFB2 results in metabolic remodeling marked by cardiac ancillary pathway activation. This could delineate an underpinning of pathologic changes to mechanical and electrical function in the heart.
Association Between Defibrillation Using LIFEPAK 15 or ZOLL X Series and Survival Outcomes in Out‐of‐Hospital Cardiac Arrest: A Nationwide Cohort Study
Authors: Meilandt Carsten , Qvortrup Mette , Bøtker Morten Thingemann , Folke Fredrik , Borup Lars , Christensen Helle Collatz , Milling Louise , Lauridsen Kasper G. , Løfgren Bo
Published: March 2024

Background

Defibrillation is essential for achieving return of spontaneous circulation (ROSC) following out‐of‐hospital cardiac arrest (OHCA) with shockable rhythms. This study aimed to investigate if the type of defibrillator used was associated with ROSC in OHCA.

Methods and Results

This study included adult patients with OHCA from the Danish Cardiac Arrest Registry from 2016 to 2021 with at least 1 defibrillation by the emergency medical services. We used multivariable logistic regression and a difference‐in‐difference analysis, including all patients with or without emergency medical services shock to assess the causal inference of using the different defibrillator models (LIFEPAK or ZOLL) for OHCA defibrillation. Among 6516 patients, 77% were male, the median age (quartile 1; quartile 3) was 70 (59; 79), and 57% achieved ROSC. In total, 5514 patients (85%) were defibrillated using LIFEPAK (ROSC: 56%) and 1002 patients (15%) were defibrillated using ZOLL (ROSC: 63%). Patients defibrillated using ZOLL had an increased adjusted odds ratio (aOR) for ROSC compared with LIFEPAK (aOR, 1.22 [95% CI, 1.04–1.43]). There was no significant difference in 30‐day mortality (aOR, 1.11 [95% CI, 0.95–1.30]). Patients without emergency medical services defibrillation, but treated by ZOLL‐equipped emergency medical services, had a nonsignificant aOR for ROSC compared with LIFEPAK (aOR, 1.10 [95% CI, 0.99–1.23]) and the difference‐in‐difference analysis was not statistically significant (OR, 1.10 [95% CI, 0.91–1.34]).

Conclusions

Defibrillation using ZOLL X Series was associated with increased odds for ROSC compared with defibrillation using LIFEPAK 15 for patients with OHCA. However, a difference‐in‐difference analysis suggested that other factors may be responsible for the observed association.
Introducing the Concept of Sanctuary Sites in Ischemic Stroke
Authors: Thirugnanachandran Tharani , Ma Henry , Donnan Geoffrey A. , Reutens David C. , Phan Thanh G.
Published: March 2024

BACKGROUND:

The topography of arterial territories has been defined using digital maps of supratentorial infarcts. Regions with a high probability of infarction (Pi) exist in the deep compartment due to a paucity of collaterals. However, less attention has been given to regions with a low Pi.

METHODS:

Using published digital maps, patients with cortical stroke and documented vessel occlusion were included. Infarcts from T
2
-weighted magnetic resonance images were segmented and registered onto a standard brain template (Montreal Neurological Institute 152). Segmented magnetic resonance images were averaged to yield the Pi at a voxel level. The overall Pi for the combined arterial territories was calculated to ensure that Pi was in the range of 0 to 1. Sanctuary sites were identified as regions with Pi <0.1.

RESULTS:

There were 154 patients (63% men; median age, 69 years; and interquartile range, 57–78 years). The magnetic resonance imaging scan used for segmentation was performed at a median interval of 35 (interquartile range, 3–66) days after stroke onset. Sanctuary sites were present in the frontal (gyrus rectus, the paracentral lobule, and orbitofrontal and precentral gyrus), parietal (postcentral, supramarginal, and angular gyrus, superior and inferior parietal lobule, and precuneus and posterior cingulate), and occipital cortex (cuneus, middle, and superior occipital gyrus).

CONCLUSIONS:

We propose that following vessel occlusion, there are cortical regions with a low Pi, which we termed sanctuary sites. The anatomic basis for this observation is the compensatory capacity of leptomeningeal collaterals.
RUSSIA'S RECENT MIDDLE EAST ENGAGEMENTS: HITTING MULTIPLE BIRDS WITH A SINGLE STONE
Authors: Baran Muhsin
Published: March 2024

During the early post-Cold War period, the global order witnessed a significant shift, with Western liberal democracy emerging as the predominant force. However, this ascent of the United States in pursuit of global dominance gave rise to a Security Dilemma, fostering the emergence of alternative powers in various regions worldwide. Among these, Russia has played a prominent role, notably in the Middle East. This study seeks to examine Russia's historical and contemporary objectives in the Middle East, analyzing its political, economic, and security pursuits. Through the lens of the "Security Dilemma," the article underscores Russia's transformation into a potent regional counterbalance to Western influence in various respects. The article concludes that the sustainability of Russia's gains depends on the fluid Middle East landscape, the continuation of Putin's leadership, and the influence of potential Western sanctions.
The Asymmetric Effects of Consumer Confidence on Credit Card Spending in Turkey
Authors: İlhan Ali
Published: March 2024

This paper analyzes the asymmetric effects of consumer confidence on personal credit card expenditures in Turkey. To this end, the impact of the consumer confidence index on real credit card spending is investigated from January 2013 to June 2023 using the threshold generalized method of moments (GMM). The linear GMM model findings indicate that consumer confidence increases real credit card expenditures. Furthermore, when the threshold GMM model is estimated using the annual percentage change of the consumer confidence index as a threshold variable, the coefficients differ across low- and high-confidence regimes. More specifically, the consumer confidence index has a statistically significant positive impact on credit card expenditure in the low-confidence regime but not in the high-confidence regime. This indicates that the optimistic expectations of economic units in a low-confidence environment may stimulate credit card spending.
Complete checklist of Burmese (Myanmar) amber taxa 2023
Authors: ROSS ANDREW J.
Published: March 2024

This is a list of all known taxa described or recorded from Burmese (Myanmar) amber from the published literature up to the end of 2023. Data from previously published checklists have been merged, the higher taxonomy has been updated and the total numbers of taxa have been checked and corrected. A total of 2,805 species have been described or recorded from Cretaceous amber of Myanmar.
Actinopyga spinea Cherbonnier, 1980 (Holothuroidea: Holothuriida:Holothuriidae), new addition to the holothuroid fauna of Pakistan
Authors: ALI QADEER MOHAMMED , SHAIKH IQRA , THANDAR AHMED , AHMED QURATULAN
Published: March 2024

We here in report on the first record of Actinopyga spinea from the intertidal zone from Balochistan, Pakistan in the northern Arabian Sea. Its taxonomic characters, habitat and distribution are described.
Heterotopic Ossification of the Abdomen: A Rare Sequela Following Trauma and Damage Control Laparotomy
Authors: Cherfan Patrick , Cobler-Lichter Michael D. , Kronenfeld Joshua P. , Weiss Zoe , Byers Patricia M.
Published: March 2024

Heterotopic ossification (HO) of the abdomen is a rare yet highly morbid complication following blunt and penetrating trauma requiring damage control laparotomy. We present the case of a 22-year-old man, 20 months after life-threatening motor vehicle crash with major vascular injury requiring multiple abdominal surgeries. The patient was initially treated at a community hospital and subsequently developed a chronic left lower quadrant enterocutaneous fistula, accompanied by a gradually worsening diffuse abdominal pain. He was referred to our tertiary care center with extensive skin breakdown and an inability to control the fistula despite numerous wound care consultations. He also had severe abdominal deformities due to HO in the abdominal wall, peritoneum, paraspinal muscles, and parapelvic regions. As HO is largely underreported, it is crucial to refer those patients, once medically stabilized, to tertiary care centers for surveillance and possible treatment when symptomatic.
Interpersonal Violence and Social Determinants of Health
Authors: Sawyers Robyn G. , Tackett Nichole , McMandon Allie A. , Mack Thomas J , Evangelista Meagan E. , Bendyk Heather , Lombardozzi Kristine A.
Published: March 2024

Social determinants of health (SDOH) influence patient outcomes and risk assessment. This study focuses on interpersonal violence, trauma outcomes, and SDOH. We hypothesized patients with lower SDOH experience worse trauma outcomes and present from higher-risk communities. Demographics, SDOH, and outcomes for patients admitted to surgical trauma suffering interpersonal violence were collected and analyzed. Home addresses were plotted, identifying areas of need compared with Area Deprivation Index (ADI). Only 18.8% of patients had documented SDOH, yielding small sample size. Analysis revealed no statistically significant associations ( P < .05) between SDOH and trauma outcomes, including ICU length of stay and stress concern ( P = .0804). Heat mapping revealed several hot spots across our catchment area, correlating with higher-ranked ADIs and increased deprivation. This study demonstrated SDOH can bring value in determining patient risk, emphasizing resource dedication to documenting these factors. Home addresses in conjunction with ADIs can ascertain areas for resource allocation within communities.
Trans-Carotid Artery Revascularization Versus Carotid Endarterectomy in Patients With Carotid Artery Disease: Systematic Review and Meta-analysis of 30-day Outcomes
Authors: Loufopoulos Georgios , Manaki Vasiliki , Tasoudis Panagiotis , Karela Nina-Rafailia , Sénéchaud Christophe , Giannopoulos Argirios , Ktenidis Kiriakos , Spanos Konstantinos
Published: March 2024

This systematic review and meta-analysis compared trans-carotid artery revascularization (TCAR) as an alternative approach to carotid endarterectomy (CEA) in patients with carotid artery disease. An electronic search was conducted using PubMed, Scopus, and Cochrane databases including comparative studies with patients who underwent either TCAR or CEA. This meta-analysis is according to the recommendations of the PRISMA statement. Eight studies met our eligibility criteria, incorporating 7,606 and 7,048 patients in the TCAR and CEA groups, respectively. Thirty-day mortality (odds ratio [OR]: 0.94, 95% confidence interval [CI]: 0.56–1.56, P = .81) and stroke (OR: 0.92, 95%CI 0.70–1.22, P = .57) were similar between the two groups, with low heterogeneity. The odds of myocardial infarction (OR: 1.79, 95% CI: 1.18–2.71, P = .01) and cranial nerve injury were significantly higher in patients undergoing CEA compared with TCAR (OR: 4.11, 95% CI: 2.59–6.51, P < .001). The subgroup analysis according to symptomatic pre-intervention status revealed no statistically significant difference regarding 30-day mortality (symptomatic OR: 0.91, 95% CI: 0.40–2.07, P = .82, asymptomatic OR: 0.93, 95% CI: 0.46–1.86, P = .83) and stroke (symptomatic OR: 0.88, 95% CI:0.47–1.64, P = .68, asymptomatic OR: 0.93, 95% CI: 0.64–1.35, P = .70). TCAR offers an alternative treatment for patients with carotid artery stenosis with comparable to CEA mortality and stroke rates during a 30-day post-operative period.
Peasant Resistance in Times of Economic Affluence: Lessons From Paraguay
Authors: Duarte Recalde Liliana Rocío , Feierherd Germán , Mangonnet Jorge , Murillo María Victoria
Published: March 2024

Contrary to the established belief that low agricultural prices fuel peasant rebellion, our study investigates the surge in peasant unrest during a period of high agricultural prices. The transition to capital-intensive agriculture, characterized by reduced labor demand and heightened entry barriers, prompts landowners to expand into the agricultural frontier during periods of price increases. In these frontier regions, the soils, while comparatively less suitable, become economically viable for commercial agriculture when crop prices are high. This scenario sets the stage for heightened collective resistance, particularly where organizational capacities and subsistence communities provide peasants with symbolic and material resources to resist land encroachment. We provide evidence of this argument by using unique municipal-level data from Paraguay between 2000 and 2014, a period of rising yet fluctuating prices. Our study shows how the interplay between technological advancements in agriculture and global market forces reshape the geography of peasant rebellion.
Shape-shifting: How boundary objects affect meaning-making across visual, verbal, and embodied modes
Authors: Nathues Ellen , van Vuuren Mark , Endedijk Maaike D , Wenzel Matthias
Published: March 2024

Boundary objects help collaborators create shared meaning and coordinate their work across differences. Acknowledging the complex dynamics of such processes, we propose a multimodal alternative to studies’ traditionally static view of boundary objects and ask: How do boundary objects “shape-shift”? How do they emerge in varying forms across visual, verbal, and embodied modes, and in what ways does this “shape-shifting” affect meaning-making? Adopting a “strong” multimodal lens, we show how boundary objects expand in form as collaborative work proceeds through shifting shapes both across and within modes. We also show how they contract over time, reemerging exclusively in some and not other shapes, often in simplified forms. These dynamics both enable and constrain meaning-making. Expanding shapes of the boundary object allow collaborators to develop rich shared understandings. Contracting shapes, in turn, condense meaning-making into efficient communication among those familiarized with the object, yet obscure meaning-making for newcomers who cannot make sense of its contracted shapes. Our study sheds new light on boundary objects’ multimodal nature and demonstrates how objects’ shifting shapes affect meaning-making. More generally, we offer a rich empirical account of how modes enmesh in practice, unveiling their processual and inseparable complexion.
The correlation between self-reported sleep quality, anxiety levels, and balance confidence among university students
Authors: Avcı Nizamettin Burak , Çınar Betül Çiçek
Published: March 2024

Recently, the incidence of poor sleep quality and anxiety levels has increased among university students. The psychological and physical factors that students commonly experience may also correlate with their ability to balance confidently during daily activities. This study aimed to examine the relationship between sleep quality, anxiety levels, and balance confidence among university students. A total of 217 participants, aged between 18 and 25 years, with no hearing loss or vestibular/balance disorder, no metabolic, neurological, or psychiatric diseases, and no sleep apnea, were included in the study. The Activities-Specific Balance Confidence Scale, Pittsburgh Sleep Quality Index, and Beck Anxiety Inventory were used. Anxiety level and poor sleep quality were negatively correlated with balance confidence ( r = −.323 for anxiety, r = −.293 for sleep quality, p < .001). In addition, a moderate positive correlation was observed between sleep quality and anxiety level ( r = .504, p < .001). Participants with good sleep quality had higher balance confidence scores than those with poor sleep quality ( p < .001). Similarly, those with mild anxiety levels had higher balance confidence scores than those with moderate or high anxiety levels ( p = .03). Poor sleep quality, an increase in anxiety, and a decline in balance confidence were interrelated among university students. These findings can aid the development of interventions to improve sleep quality, anxiety levels, and balance confidence among university students, thereby improving their health and wellbeing.