bluuebunny/crossref_metadata_2025 huggingface dataset:
The Prognostic Value of Left Atrial Global Longitudinal Strain and Left Atrial Phasic Volumes in Patients Undergoing Transcatheter Valve Implantation for Severe Aortic Stenosis
Authors: Weber Jonathan , Bond Kristine , Flanagan Joseph , Passick Michael , Petillo Florentina , Pollack Simcha , Robinson Newell , Petrossian George , Cao J. Jane , Barasch Eddy
Published: March 2021

Introduction: The changes and the prognostic implications of left atrial (LA) volumes (LAV), LA function, and vascular load in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) are less known. Methods: We enrolled 150 symptomatic patients (mean age 82 ± 8 years, 58% female, and pre-TAVI aortic valve area 0.40 ± 0.19 cm/m2) with severe AS who underwent 2D transthoracic echocardiography and 2D speckle tracking echocardiography at average 21 ± 35 days before and 171 ± 217 days after TAVI. The end point was a composite of new onset of atrial fibrillation, hospitalization for heart failure and all-cause death (major adverse cardiac events [MACE]). Results: After TAVI, indexed maximal LA volume and minimum volume of the LA decreased by 2.1 ± 10 mL/m2 and 1.6 ± 7 mL/m2 (p = 0.032 and p = 0.011, respectively), LA function index increased by 6.8 ± 11 units (p < 0.001), and LA stiffness decreased by 0.38 ± 2.0 (p = 0.05). No other changes in the LA phasic volumes, emptying fractions, and vascular load were noted. Post-TAVI, both left atrial and ventricular global peak longitudinal strain improved by about 6% (p = 0.01 and 0.02, respectively). MACE was reached by 37 (25%) patients after a median follow-up period of 172 days (interquartile range, 20–727). In multivariable models, MACE was associated with both pre- and post-TAVI LA global peak longitudinal strain (hazard ratio [HR] 0.75, CI 0.59–0.97; and HR 0.77, CI 0.60–1.00, per 5 percentage point units, respectively), pre-TAVI LV global endocardial longitudinal strain (HR 1.37, CI 1.02–1.83 per 5 percentage point units), and with most of the LA phasic volumes. Conclusion: Within 6 months after TAVI, there is reverse LA remodeling and an improvement in LA reservoir function. Pre- and post-TAVI indices of LA function and volume remain independently associated with MACE. Larger studies enrolling a greater diversity of patients may provide sufficient evidence for the utilization of these imaging biomarkers in clinical practice.
Monitoring of Erosive Tooth Wear with Intraoral Scanners In vitro
Authors: Witecy Corinna , Ganss Carolina , Wöstmann Bernd , Schlenz Moritz B. , Schlenz Maximiliane A.
Published: March 2021

Intraoral scanners (IOS) have been used to quantify tooth wear, but so far they have not been systematically validated for monitoring of tissue loss. The aim of this in vitro study was to investigate whether progression of tissue loss can be detected with an IOS and whether IOS values agree with those obtained with noncontacting profilometry (PRO) serving as a standard method. Model jaws were mounted in a phantom head positioned in a dental chair. Flattened areas were prepared on the non-load-bearing cusps of the first molars (model teeth; n = 16) in order to fix flat enamel samples with an experimental area and a reference area. After baseline PRO and IOS, the experimental enamel area was stepwise etched with 35% H3PO4 gel (4 × 30 s and 4 × 15 s). After each etching, PRO and IOS was performed and the vertical tissue loss between the reference and experimental areas was measured, each at the same 3 measurement points. Furthermore, cupped cusps were simulated by stepwise preparation of the load-bearing cusps of the model teeth with a spherical diamond bur, and the maximum vertical depth after each preparation step was measured only by IOS. Trios3 (3Shape, Denmark), Carestream CS3600 (Carestream, USA) and an optical profilometer (MicroProf, Fries, Germany) were used to measure the flat areas of the enamel samples, whereas only IOS were used to measure curved surfaces on the load-bearing cupped cusps of the model teeth. The IOS data were analyzed with an external software (GOM Inspect, Germany) and with the respective internal IOS software. PRO revealed a mean (±SD) tissue loss of 17.1 ± 4.7 µm after 30-s etching steps and 10.1 ± 5.1 µm after the 15-s etching steps. IOS and software types were able to detect the progression of tissue loss after each etching step (p ≤ 0.001 each); Bland-Altmann plots revealed good agreement with PRO regardless of the order of tissue loss, and no systematic difference was found. Increasing cupped lesion depths were detected by all IOS, with no significant differences between IOS and analysis methods. IOS were able to detect small amounts of tissue loss under simulated clinical conditions and seem to be a promising tool for monitoring even initial erosive tooth wear.
Covid-19 Interstitial Pneumonia: Histological and Immunohistochemical Features on Cryobiopsies
Authors: Doglioni Claudio , Ravaglia Claudia , Chilosi Marco , Rossi Giulio , Dubini Alessandra , Pedica Federica , Piciucchi Sara , Vizzuso Antonio , Stella Franco , Maitan Stefano , Agnoletti Vanni , Puglisi Silvia , Poletti Giovanni , Sambri Vittorio , Pizzolo Giovanni , Bronte Vincenzo , Wells Athol U. , Poletti Venerino
Published: March 2021

Background: The pathogenetic steps leading to Covid-19 interstitial pneumonia remain to be clarified. Most postmortem studies to date reveal diffuse alveolar damage as the most relevant histologic pattern. Antemortem lung biopsy may however provide more precise data regarding the earlier stages of the disease, providing a basis for novel treatment approaches. Objectives: To ascertain the morphological and immunohistochemical features of lung samples obtained in patients with moderate Covid-19 pneumonia. Methods: Transbronchial lung cryobiopsy was carried out in 12 Covid-19 patients within 20 days of symptom onset. Results: Histopathologic changes included spots of patchy acute lung injury with alveolar type II cell hyperplasia, with no evidence of hyaline membranes. Strong nuclear expression of phosphorylated STAT3 was observed in >50% of AECII. Interalveolar capillaries showed enlarged lumen and were in part arranged in superposed rows. Pulmonary venules were characterized by luminal enlargement, thickened walls, and perivascular CD4+ T-cell infiltration. A strong nuclear expression of phosphorylated STAT3, associated with PD-L1 and IDO expression, was observed in endothelial cells of venules and interstitial capillaries. Alveolar spaces macrophages exhibited a peculiar phenotype (CD68, CD11c, CD14, CD205, CD206, CD123/IL3AR, and PD-L1). Conclusions: Morphologically distinct features were identified in early stages of Covid-19 pneumonia, with epithelial and endothelial cell abnormalities different from either classical interstitial lung diseases or diffuse alveolar damage. Alveolar type II cell hyperplasia was a prominent event in the majority of cases. Inflammatory cells expressed peculiar phenotypes. No evidence of hyaline membranes and endothelial changes characterized by IDO expression might in part explain the compliance and the characteristic pulmonary vasoplegia observed in less-advanced Covid-19 pneumonia.
Dermatomyositis: Double trouble – Case Report
Authors: Xanthouli Panagiota
Published: March 2021

Background: Each myositis-specific autoantibody (MSA) tends to have a distinct clinical presentation. Coexistence of MSAs do not commonly occur. If they do, it is unknown if there is an overlap of clinical features or prognostic implications. There are a few reported cases of overlap between these antibodies, mostly reported in patients with Japanese descent. Our aim for this case report is to turn more attention and interest for future MSA profile studies in the Hispanic population, which may hopefully spur better therapies if we realize the prognostic implications of certain myositis subsets including double-positive autoantibody syndromes. Case presentation: A 27-year-old Hispanic female was admitted to the medical intensive care unit due to acute hypoxemic respiratory failure secondary to acute respiratory distress syndrome (ARDS). She had failed conventional mechanical ventilation and was cannulated for venovenous extracorporeal membrane oxygenation (VV-ECMO) to manage her respiratory failure. She had erythematous scaly plaques on bilateral 3rd metacarpophalangeal joints on examination. Her autoimmune workup revealed positivity for both anti-PL-7(threonyl) and anti-melanoma differentiation-associated gene 5 (MDA5) autoantibodies. After extensive evaluation, it was concluded that she had rapidly progressive interstitial lung disease (RPILD) due to amyopathic dermatomyositis. Despite maximal medical management, she was ultimately transitioned to comfort care measures and expired. Conclusion: We would like to highlight the rarity of double antibody positive amyopathic dermatomyositis. This unique clinical presentation has only been reported in persons of Japanese descent. Our case is likely to be the first reported to occur in a person of Hispanic descent in the United States. The rarity of our case could stimulate further study of overlapping MSA to understand its varied presentations and prognoses including possible tendency toward a rapidly progressive ILD phenotype. Earlier detection of these clinical syndromes can lead to better outcomes for patients with RPILD. This case report could also herald an increased recognition and understanding of MSA profile in the Hispanic population in the USA.
Clinical and Radiological Follow-Up Results of Patients with Sequestered Lumbar Disc Herniation: A Prospective Cohort Study
Authors: Sucuoğlu Hamza , Barut Abdullah Yüksel
Published: March 2021

Purpose: The aim of the study was to assess radiological changes and clinical outcomes of patients with sequestered lumbar disc herniation (LDH) and evaluate the relationship between them. Methods: Patients diagnosed with sequestered LDH were followed up in 2 groups: operated (within the 1st month after diagnosis) and nonoperated. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores at baseline (V1) and 1st (V2), 3rd (V3), and 6th (V4) month visits were used for clinical evaluation. Radiological evaluation was performed by measuring the sequestered LDH level and herniation volume using magnetic resonance imaging (MRI) at V1 and V4. After the second MRI, patients in the nonoperated group were divided into 3 groups: nonregression (n = 6), partial regression (n = 22), and complete resolution (n = 27); patients were analyzed in 4 groups including the ones in the operated (n = 25) group. Results: Significant improvements were observed in VAS and ODI scores at V2 and V3 in all groups (p = 0.000) and at V4 in partial regression and complete resolution groups (p = 0.000). VAS and ODI score improvements at V2 and V3 were significantly higher in the operated group than in other groups (p = 0.000). At V4, there were no significant differences in VAS and ODI scores (p > 0.05) between the operated group and partial regression and complete resolution groups. Conclusion: Spontaneous regression was observed in the 6th month post-MRI in most of the nonoperated sequestered LDH patients with conservative treatment. Improvements in pain and disability scores were higher among the operated patients at the early stage, whereas they were not significantly different compared to patients with spontaneous regression at the 6th month.
Pretreatment Apparent Diffusion Coefficient Cannot Predict Histopathological Features and Response to Neoadjuvant Radiochemotherapy in Rectal Cancer: A Meta-Analysis
Authors: Surov Alexey , Pech Maciej , Powerski Maciej , Woidacki Katja , Wienke Andreas
Published: March 2021

Aim: Our purpose was to perform a systemic literature review and meta-analysis regarding use of apparent diffusion coefficient (ADC) for prediction of histopathological features in rectal cancer (RC) and to prove if ADC can predict treatment response to neoadjuvant radiochemotherapy (NARC) in RC. Methods: MEDLINE library, EMBASE, Cochrane, and SCOPUS database were screened for associations between ADC and histopathology and/or treatment response in RC up to June 2020. Authors, year of publication, study design, number of patients, mean value, and standard deviation of ADC were acquired. The methodological quality of the collected studies was checked according to the Quality Assessment of Diagnostic Studies instrument. The meta-analysis was undertaken by using the RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated. Results: Overall, 37 items (2,015 patients) were included. ADC values of tumors with different T and N stages and grades overlapped strongly. ADC cannot distinguish RC with a high- and low-carcinoembryonic antigen level. Regarding KRAS status, ADC cannot discriminate mutated and wild-type RC. ADC did not correlate significantly with expression of vascular endothelial growth factor and hypoxia-inducible factor 1a. ADC correlates with Ki 67, with the calculated correlation coefficient: −0.52. The ADC values in responders and nonresponders overlapped significantly. Conclusion: ADC correlates moderately with expression of Ki 67 in RC. ADC cannot discriminate tumor stages, grades, and KRAS status in RC. ADC cannot predict therapy response to NARC in RC.
Biliary Cannulation in Endoscopic Retrograde Cholangiography: How to Tackle the Difficult Papilla
Authors: op den Winkel Mark , Schirra Jörg , Schulz Christian , De Toni Enrico N. , Steib Christian J. , Anz David , Mayerle Julia
Published: March 2021

Background: In the setting of a naïve papilla, biliary cannulation is a key step in successfully performing endoscopic retrograde cholangiography. Difficult biliary cannulation (DBC) is associated with an increased risk of post-ERCP pancreatitis and failure of the whole procedure. Summary: Recommendations for biliary cannulation can be divided into (a) measures to reduce the likelihood of a difficult papilla situation a priori and (b) rescue techniques in case the endoscopist is actually facing DBC. (a) Careful inspection of the papillary anatomy and optimizing its accessibility by scope positioning is fundamental. A sphincterotome in combination with a soft-tip hydrophilic guidewire rather than a standard catheter with a standard guidewire should be used in most situations. (b) The most important rescue techniques are needle-knife precut, double-guidewire technique, and transpancreatic sphincterotomy. In few cases, anterograde cannulation techniques are needed. To this regard, the EUS-guided biliary drainage followed by rendezvous is increasingly used as an alternative to percutaneous transhepatic biliary drainage. Key Messages: Biliary cannulation can be accomplished with alternative retrograde or less frequently by salvage anterograde techniques, once conventional direct cannulation attempts have failed. Considering recent favorable data for the early use of transpancreatic sphincterotomy, an adopted version of the 2016 European Society for Gastrointestinal Endoscopy (ESGE) algorithm on biliary cannulation is proposed.
Challenges and Opportunities for Real-World Evidence in Metastatic Luminal Breast Cancer
Authors: Lüftner Diana , Hartkopf Andreas D. , Lux Michael P. , Overkamp Friedrich , Tesch Hans , Titzmann Adriana , Pöschke Patrik , Wallwiener Markus , Müller Volkmar , Beckmann Matthias W. , Belleville Erik , Janni Wolfgang , Fehm Tanja N. , Kolberg Hans-Christian , Ettl Johannes , Wallwiener Diethelm , Schneeweiss Andreas , Brucker Sara Y. , Fasching Peter A.
Published: March 2021

Background: The therapeutic armamentarium for patients with metastatic breast cancer is becoming more and more specific. Recommendations from clinical trials are not available for all treatment situations and patient subgroups, and it is therefore important to collect real-world data. Summary: To develop recommendations for up-to-date treatments and participation in clinical trials for patients with metastatic breast cancer, the Prospective Academic Translational Research PRAEGNANT Network was established to optimize the quality of oncological care in the advanced therapeutic setting. The main aim of PRAEGNANT is to systematically record medical care for patients with metastatic breast cancer in the real-life setting, including the outcome and side effects of different treatment strategies, to monitor quality-of-life changes during therapy, to identify patients eligible for participation in clinical studies, and to allow targeted therapies based on the molecular structures of breast carcinomas. Key Messages: This article describes the PRAEGNANT network and sheds light on the question of whether the various end points from clinical trials can be transferred to the real-world treatment situation.
Asma neutrofílica en niños: Influencia de linfocitos Th17
Authors: Behrends Ilse A.
Published: March 2021

Background: The pathogenetic mechanims of neutrophilic asthma are not well understood now. Whether T helper (Th)17-mediated immunity contributes to the pathogenesis of neutrophilic asthma in human is still under investigation. The aim of this study was to explore the relationship between Th17-mediated immunity and airway inflammation in childhood neutrophilic asthma. Methods: Twenty-eight children with exacerbated asthma and without using any glucocorticoids were divided into three groups: eosinophilic asthma (EA, n  =  12) group, neutrophilic asthma (NA, n  =  10) group and paucigranulocytic asthma (PGA, n  =  6) group according to the induced sputum cytology. Ten healthy children were recruited as healthy control (HC, n  =  10) group. Peripheral Th17 and Th2 cells, and the expression of Ki-67 in peripheral Th17 cells were detected by flow cytometry. The mRNA expression of retinoic acid-related orphan receptor γt (RORγt) in peripheral blood mononuclear cells (PBMCs) was detected by qRT-PCR. The concentrations of IL-17, IL-8 and IL-5 in sputum, as well as IL-17 in plasma and culture supernatant of activated PBMCs were measured by ELISA. Results: The percentage of Th17 cells in peripheral Th cells, and the concentrations of IL-17, IL-8 in sputum, as well as IL-17 in culture supernatant of activated PBMCs were all increased in NA group, and positively correlated with neutrophil level in sputum and with each other. Also, the mRNA expression of RORγt in PBMCs and Ki-67 positivity in peripheral Th17 cells were both increased in NA group. The percentage of Th2 cells in peripheral Th cells, and the concentration of IL-5 in sputum were both increased in EA group, and positively correlated with eosinophil level in sputum and with each other. Conclusions: Both Th17- and Th2-mediated immunity are involved in the pathogenesis of childhood asthma. There is predominance of Th17-mediated immunity and Th17 cells proliferation in childhood neutrophilic asthma.
A Refinement of Clinical Tumor Marker Monitoring: Why Not Use an Inverse Value of Doubling Time?
Authors: Zaleskis Gintaras , Bosas Paulius , Ulys Albertas , Dabkevičiene Daiva , Dobrovolskiene Neringa , Hudson Bret Andrew , Pašukoniene Vita
Published: March 2021

Objectives: The aim of this study was to compare prostate-specific antigen (PSA) kinetics – half-life time (HT), doubling time (DT), and elimination rate PSA (ePSA) in prostate cancer (PCa) monitoring. Implementation of ePSA in clinical practice could help simplify patient monitoring in the remission phase. Materials and Methods: A total of 49 PCa patients were examined by their PSA tests before prostatectomy and after 30 days, 91 days, and 24 months. Conventional PSA rate of change parameters (HT and DT) were compared to a new clinically understandable ePSA parameter. Results: We observed that implementation of inverse value (ePSA) rather than HT or DT has distinct advantages: (1) values are valid when PSA is unchanged (ePSA equals zero), (2) the concept of ePSA can be easily understood, as it is a growth fraction, (3) ePSA fluctuates within a narrow range and is thus easy to interpret, and (4) there are no mathematical flaws (no positive skewing). Conclusion: Exploring ePSA norm as ≤0% could help spot biochemical recurrence in a timely manner. Primary health care providers tend to use an irrelevant PSA threshold, that is, 4.0 ng/mL, in postoperative follow-up. The delayed referrals of patients in remission might be reduced if ePSA testing is adopted.
Role of Peroral Endoscopic Myotomy in Geriatric Patients with Achalasia: A Systematic Review and Meta-Analysis
Authors: Zhong Chunyu , Huang Shu , Xia Huifang , Tan Shali , Lü Muhan , Peng Yan , Tang Xiaowei
Published: March 2021

Background: Peroral endoscopic myotomy (POEM) is a particularly attractive intervention for achalasia. Presently, POEM has been reported to be effective and safe for achalasia in geriatric patients. Herein, this systematic review was conducted to explore the role of POEM in geriatric patients with achalasia. Method: PubMed, Embase, and Cochrane Library were searched to identify studies evaluating the clinical outcome of POEM in geriatric patients with achalasia during January 2009 to October 2020. The primary outcomes were technical and clinical success. Secondary outcomes included postoperative Eckardt score, lower esophageal sphincter (LES) pressure, adverse events, and clinical reflux. Results: There were 7 studies with a total of 469 geriatric patients, and the pooled technical success of POEM treatment was 98.1% (95% confidence interval [CI], 95.1–99.3%), and the pooled clinical success was 92.5% (95% CI, 89.3–94.8%). After POEM, the Eckardt score significantly decreased by 6.09 points (95% CI, 5.44–6.74, p < 0.00001), and the LES pressure significantly reduced by 13.53 mm Hg (95% CI, 5.14–21.91, p = 0.002). The pooled adverse events rate was 9.0% (95% CI, 4.3–17.9%), and the post-POEM clinical reflux rate was 17.4% (95% CI, 12.9–23.2%). Conclusion: Our current study demonstrated that POEM was an effective and safe technique for achalasia in geriatric patients.
Renal Involvement in Mediterranean Spotted Fever: Clinical and Histopathological Data
Authors: Baltadzhiev Ivan , Zaprianov Zaprian , Baltadjiev Atanas
Published: March 2021

Objective: Mediterranean spotted fever (MSF) is a tick-borne rickettsial infection endemic to the Mediterranean coastline countries. As a result of growing tourism, imported cases have been registered in many nonendemic countries and regions. We present clinical laboratory parameters and histopathological data on renal impairment in patients with MSF. The study meets our goal of identifying kidney involvement and detecting renal damage in people with MSF. Subjects and Methods: Three hundred fifty patients with MSF with a diagnosis confirmed by immunofluorescence analysis were tested for serum urea, creatinine, and albumin. Fifty-five patients with malignant form of MSF were divided into 2 groups: 19 fatalities and 36 survivors. The percentage of patients with acute renal failure (ARF) was compared in both groups. Results: Subjects with elevated urea and creatinine levels increased from 5.21 to 3.47% in mild to 48.78 and 29.26% in severe MSF, respectively. Loss of serum albumin also increased from mild to severe MSF. Renal impairment comprised 60% of the cohort of 55 patients with malignant MSF: 89.4% in the group of deaths and almost twice less in the survivors. ARF developed in 84.2% of fatal cases and was >2 times less in survivors. Postmortem light microscopy of renal samples of 9 fatal cases revealed perivascular mononuclear inflammatory infiltrates, vasculitis with fibrinoid necrosis, acute tubular necrosis, interstitial edema, hemorrhage, and thrombosis. Conclusion: Renal pathology associated with MSF rickettsial infection consists of systemic small vessel vasculitis and vascular injury, leading to ARF in the most severe cases.
Steroidogenic Activity in Unresected Adrenals Associated With Surgical Outcomes in Primary Aldosteronism
Authors: Nakai Kazuki , Tsurutani Yuya , Inoue Kosuke , Matsui Seishi , Makita Kohzoh , Yamazaki Yuto , Sasano Hironobu , Makita Noriko , Nangaku Masaomi , Saito Jun , Omura Masao , Nishikawa Tetsuo
Published: March 2021

In patients with primary aldosteronism diagnosed with unilateral lesions through adrenal venous sampling, excess aldosterone occasionally persists after adrenalectomy. We investigated whether aldosterone values from unresected adrenals would be associated with postoperative outcomes. Overall, 102 primary aldosteronism patients, who underwent segmental adrenal venous sampling and unilateral adrenalectomy, were assessed for biochemical success (as outlined in the PASO [Primary Aldosteronism Surgical Outcomes] Study) at 1 year after surgery by using the saline infusion test. We divided patients into the biochemical complete or incomplete success group. Eighty-seven and 15 patients had complete and incomplete biochemical success, respectively. The biochemical incomplete group, compared with the biochemical complete group, had higher maximum aldosterone in tributary veins (11 000 versus 7030 pg/mL,
P
=0.006), maximum aldosterone/cortisol in tributary veins (18.05 versus 9.13,
P
<0.001), aldosterone in the central vein (9260 versus 5800 pg/mL,
P
=0.011), and aldosterone/cortisol in the central vein (13.67 versus 8.08,
P
<0.001) of the unresected adrenal gland. In logistic regression analyses, maximum aldosterone/cortisol in tributary veins had the highest area under the curve (0.780). Aldosterone/cortisol in the central vein had a nearly equivalent area under the curve (0.775). The lateralization index showed no significant differences between the groups. The clinical incomplete group similarly had higher aldosterone and aldosterone/cortisol in the unresected adrenal gland than did the clinical complete group. Therefore, steroidogenic activity in unresected adrenals (eg, absolute aldosterone value and aldosterone/cortisol) were associated with surgical outcomes. Our results may aid clinicians in determining the surgical application for primary aldosteronism.
Blood Pressure Levels in Young Adulthood and Midlife Stroke Incidence in a Diverse Cohort
Authors: Gerber Yariv , Rana Jamal S. , Jacobs David R. , Yano Yuichiro , Levine Deborah A. , Nguyen-Huynh Mai N. , Lima Joao A.C. , Reis Jared P. , Zhao Lihui , Liu Kiang , Lewis Cora E. , Sidney Stephen
Published: March 2021

We examined the longitudinal association between blood pressure (BP) and stroke incidence in young and middle-aged adults. BP measured during 9 examinations of the CARDIA study (Coronary Artery Risk Development in Young Adults) from 1985-1986 to 2015-2016 was used to classify participants (n=5079) according to the 2017 Hypertension Clinical Practice Guidelines. We used the highest BP obtained through the third examination (1990–1991) to define baseline BP categories; time-dependent categories (accounting for change in BP over time) were determined incorporating follow-up measurements. BP groups at ages 30 and 40 years were also defined. Stroke events were adjudicated until 2018. Mean age at baseline was 29.8 years. Stroke occurred in 100 participants. Stroke incidence (per 100 000 person-years) was higher (
P
<0.001) in Black (120 [95% CI, 95–149]) versus White (29 [95% CI, 18–46]) participants. After adjustment with Cox models for sociodemographic and cardiovascular risk factors, stage 2 hypertension was associated with a higher risk of stroke at baseline (hazard ratio, 3.72 [95% CI, 2.12–6.54]), as a time-dependent variable (hazard ratio, 5.84 [95% CI, 3.43–9.95]), at age 30 (hazard ratio, 4.14 [95% CI, 2.19–7.82]) and at age 40 (hazard ratio, 5.59 [95% CI, 3.35–9.31]), compared with normal BP. Elevated BP and stage 1 hypertension showed more modest increases in risk. As a continuous variable, systolic BP ≥90 mm Hg at age 40 was directly associated with stroke risk. These findings call for primordial prevention strategies to reduce population BP levels among young and middle-aged adults, particularly in Black young adults given ≈4-fold higher stroke incidence, including within values traditionally considered to be normal.
Universal Dependencies
Authors: de Marneffe Marie-Catherine , Manning Christopher D. , Nivre Joakim , Zeman Daniel
Published: March 2021

Universal dependencies (UD) is a framework for morphosyntactic annotation of human language, which to date has been used to create treebanks for more than 100 languages. In this article, we outline the linguistic theory of the UD framework, which draws on a long tradition of typologically oriented grammatical theories. Grammatical relations between words are centrally used to explain how predicate–argument structures are encoded morphosyntactically in different languages while morphological features and part-of-speech classes give the properties of words. We argue that this theory is a good basis for crosslinguistically consistent annotation of typologically diverse languages in a way that supports computational natural language understanding as well as broader linguistic studies.
Africa from Post-Colonialism to Multilateralism
Authors: Hrubec Marek
Published: March 2021

This article deals with a differentiation of the historical phases of African trajectories in the global context from independence to the present day in order to overcome colonialism and global capitalism. It explains how to understand the historical trajectories from post-colonialism to unilateralism, multilateralism, and finally, the potential of polylateralism. It focuses on the problems and tendencies of advancement in Africa, mainly in sub-Saharan Africa, in order to indicate a potential model for the social, political, economic, and cultural arrangement of relations for the recognition of people in Africa in global interactions.
Oh Britannia: Great Britain’s Exit from the European Union and Its Impact on Globalism and Nationalism
Authors: Williams John P.
Published: March 2021

Globalization unleashed trends such as the free movement of capital, people, and goods; trickle-down economics, and diminished stature of nation-states. While largely embraced by most countries in the WTO, a growing tension within the European Union to push back went largely ignored until recently. Britain’s exit represents such a push back, a rejection of a single banking system, a single budget, and a single political entity. This article examines the historic 2016 British referendum that saw 52 percent of voters favor England leaving the EU. This research serves four purposes: one, to identify the origins of this important referendum as well as the positions of both its supporters and detractors; two, to analyze the fallout of the vote and its impact on other European nations; three, to correlate the results of this referendum and the rise of populist parties on the left and right in the EU; and four, to discuss briefly what the future holds for globalism.
Taxonomic changes and new species in Malagasy Euphorbia (Euphorbiaceae)
Authors: HAEVERMANS THOMAS , HETTERSCHEID WILBERT L. A.
Published: March 2021

Several species of Malagasy Euphorbia are described and compared to related species in their respective sections, along with identification keys for morphologically close relatives and distribution maps: Euphorbia agatheae, Euphorbia atimovatae, Euphorbia fuscoclada, Euphorbia graciliramulosa, Euphorbia kalambatitrensis, Euphorbia linguiformis, Euphorbia mahaboana, Euphorbia makayensis, Euphorbia multibrachiata, Euphorbia parvimedusae, Euphorbia perrierioides, Euphorbia rigidispina, Euphorbia spannringii, Euphorbia tsihombensis. New synonyms and new combinations and statuses are proposed, such as Euphorbia antsingiensis and Euphorbia crassa, and a lectotype is selected for Euphorbia rangovalensis.
Description of the male of Pterorthochaetes yunnanensis Ballerio, 2014 (Coleoptera: Scarabaeoidea: Hybosoridae: Ceratocanthinae)
Authors: JIANG RI-XIN , BALLERIO ALBERTO , LIU HAO-YI , WANG SHUO
Published: March 2021

The ceratocanthine genus Pterorthochaetes Gestro, 1898 (Coleoptera: Scarabaeoidea: Hybosoridae) includes about 26 valid species and occurs from the eastern Himalaya (Nepal and India) and southern China to northern Australia (Queensland) and Vanuatu Islands (Paulian 1978, 1987; Ballerio 1999, 2006, 2013, 2014).
Nothobranchius nikiforovi, a new species of seasonal killifish from the lower Matandu drainage in south-eastern coastal Tanzania (Cyprinodontiformes: Nothobranchiidae)
Authors: NAGY BÉLA , WATTERS BRIAN R. , RASPOPOVA ALEXANDRA A.
Published: March 2021

Nothobranchius nikiforovi, a new species known from seasonal habitats in the lower Matandu drainage in south-eastern coastal Tanzania is described. It is distinguished from all other congeners, except N. eggersi, by males presenting two colour phenotypes: the blue phenotype having a bright iridescent light blue to blue-green body, with narrow red-brown scale margins creating irregular reticulated pattern, forming chevron-shaped crossbars on the posteroventral portion of body and light blue median fins with red-brown dotted pattern; the red phenotype has a dark red head, light blue dorsal and anal fins proximally and medially, dark red distally, with dark red stripes parallel to the fin rays, and a plain dark red caudal fin. Nothobranchius nikiforovi differs from N. eggersi by male colour pattern, the blue phenotypes having median fins with dark grey distal portion, some of the rays of dorsal and anal fins with white tips (vs. median fins with distinct slender white distal band), and the caudal fin lacking a spotted pattern (vs. dots arranged into irregular curved stripes); the red phenotype with golden stripe between the nape and dorsal-fin origin (vs. light-blue stripe), the dorsal and anal fins with a plain red distal portion and lacking a light distal band (vs. with distinct narrow white distal band), the pelvic fin lacking a distal band (vs. with distinct slender light blue to white distal band), and some morphometric differences. Phylogenetic analyses also support the genetic distinction of the new species from its closest known relative, N. eggersi, and confirm its position in the N. guentheri species group within the Adiniops subgenus.
Rediscovery of the rare Mediterranean marine cave stenopodid shrimp Odontozona addaia Pretus, 1990, 30 years after its original description (Crustacea: Decapoda: Stenopodidea)
Authors: CHEVALDONNÉ PIERRE , PRETUS JOAN Ll.
Published: March 2021

Thirty years after its first finding and description, the marine cave stenopodid shrimp Odontozona addaia is here reported for the second time. The new localities, particular marine caves of southern France, are more than 300 km apart from the type locality in the Balearic Islands. First live in situ photographs are provided, and the morphological intraspecific variability is detailed by comparing the new specimens to the types. DNA sequences were also obtained for comparison with other Odontozona species. Based on both morphology and molecular analysis, closest relatives of O. addaia appear to be the western Atlantic Odontozona meloi and the eastern Mediterranean Odontozona minoica, although their detailed relationships remain unresolved.
Three new species and two new records of Helochares (Hydrobaticus) MacLeay, 1871 from China (Coleoptera: Hydrophilidae: Acidocerinae)
Authors: DONG XUE , BIAN DONGJU
Published: March 2021

Helochares (Hydrobaticus) MacLeay, 1871 is the largest subgenus of Helochares Mulsant, 1844. The Chinese fauna of Helochares (Hydrobaticus) is still poorly known. Five species are recognized, including three herein described as new: Helochares (Hydrobaticus) hainanensis sp. n. (Hainan); H. wuzhifengensis sp. n. (Jiangxi); H. tengchongensis sp. n. (Yunnan). Helochares minor d’Orchymont, 1925 and H. nipponicus Hebauer, 1995 are recorded from China for the first time. Descriptions, diagnoses, and illustrations of the new species are given. Habitus and aedeagus photos of the new record species are provided.
A review of the genus Tzustigmus Finnamore (Hymenoptera: Crabronidae: Pemphredoninae) from India with the description of a new species
Authors: RAJAN TESSY , KUMAR P. GIRISH , SURESHAN P.M.
Published: March 2021

The genus Tzustigmus Finnamore (Crabronidae: Pemphredoninae) from India is reviewed and a modified key to the world species is provided. A new species T. sahyadriensis Tessy, Girish Kumar & Sureshan sp. nov., from Kerala is described and illustrated.
On the authorship and publication dates of the nomina Theraphosa and Theraphosidae (Araneae: Mygalomorphae)
Authors: SHERWOOD DANNIELLA , BLICK THEO , GABRIEL RAY , LUCAS SYLVIA M.
Published: March 2021

The family Theraphosidae is the most speciose in the infraorder Mygalomorphae Pocock, 1892 with over one thousand described species (World Spider Catalog 2021). The taxonomy of the group has been subjected to considerable attention in modern times, with a focus on delineation based predominantly on genital organ and stridulatory organ morphology which has shown promise, both alongside molecular methods (where possible) and as a stand-alone line of evidence, in stabilising the group (e.g. Hamilton et al. 2016; Fabiano-da-Silva et al. 2020; see also Sherwood 2020). The predominant reference to the family is as Theraphosidae Thorell, 1870 with almost as many references to Theraphosidae Thorell, 1869. This non-congruence of dates is because Tord Tamerlan Teodor Thorell (1830–1901) had his important work On European Spiders published in two parts during its publication by the Royal Society of Upsala in its journal Nova Acta Regiae Societatis Scientiarum Upsaliensis. The first half (pages 1–108 and the supplement I–XIII) was published in 1869 whereas pages 109–242 (despite being dated on the cover page as 1869) were published in 1870 (see Roewer 1942; Bonnet 1945; World Spider Catalog 2021). In the second part, the secretary of the society notes: “L’auteur avait proposé comme titre du présent mémoire: Remarks on Synonyms of European Spiders, preceded by some observations on Zoological Nomenclature and a Review of the European Genera of Spiders; mais, la partie, insérée dans le Tome VII, étant seule présentée à la Société des Sciences le 13 Fevr. 1869, il a été nécessaii’e d’y conformer le titre.” [= The author proposed as the title of this memoir: Remarks on Synonyms of European Spiders, preceded by some observations on Zoological Nomenclature and a Review of the European Genera of Spiders; but, the part, inserted in Volume VII, being the only one presented to the Société des Sciences on 13 Feb. 1869, it was necessary to conform the title to it.].
Comments on “Is Copytus Skogsberg, 1939 (Crustacea: Ostracoda) a neocytherideid? With description of a new family and two new species” by Coimbra, Bergue & Ramos (2020)
Authors: KÜLKÖYLÜOĞLU OKAN
Published: March 2021

Most recently, Coimbra et al. (2020) published an article in this journal (Zootaxa, 4729 (2): 177–194) questioning the taxonomic position of the genus Copytus Skogsberg, 1939 (Crustacea, Ostracoda) along with proposing it as the type genus of their new family (Copytidae Coimbra et al., 2020), and erecting two new species that were listed by previous authors as Copytus sp. 1 and Copytus sp. 2. The main diagnostic characteristics of their new proposed family (and the genus Copytus) are the hinge type and muscle scars on the carapace and/or valves (see lines 6–8 from the bottom, p. 179 in Coimbra et al. 2020). They also underlined that (p. 179) “...this study is based exclusively on the morphology of the animals’ hard parts”. While the authors considered another genus (Neocopytus) proposed by Külköylüoğlu, Colin & Kılıç (2007) of the family Neocytherididae as invalid, they interestingly transferred some species of Neocopytus to Copytus as species of their new family (Coimbra et al. 2020). Herein, my point with the comments listed below is to clarify that, when possible, both soft and hard parts should be considered in taxonomy, and such an integrated approach clearly indicates that Neocopytus is a valid and taxonomically useful genus.
The Dual Meanings of Artifacts: Public Culture, Food, and Government in the “What’s Cooking, Uncle Sam?” Exhibition
Authors: Petre Elizabeth A. , Lee David Haldane
Published: March 2021

In 2011, “What’s Cooking, Uncle Sam? The Government’s Effect on the American Diet” (WCUS) was exhibited at the Lawrence F. O’Brien Gallery of the National Archives Building in Washington, DC. Afterward, it toured the country, visiting the Centers for Disease Control and Prevention’s (CDC) David J. Sencer Museum in Atlanta, the National Constitution Center in Philadelphia, and the Kansas Museum of History in Topeka. The exhibition website states that WCUS was “made possible” by candy corporation Mars, Incorporated. WCUS featured over a 100 artifacts tracing “the Government’s effect on what Americans eat.” Divided into four thematic sections (Farm, Factory, Kitchen, and Table), WCUS moves from agrarianism, through industrial food production and into mess halls, cafeterias, and individual kitchens. Photos, documents, news clippings, and colorful propaganda posters portray the government as a benevolent supporter of agriculture, feeder of soldiers and children, and protector of consumer health and safety. Visitors are positioned as citizens in an ideological mélange of paternalism and patriotism. In this rhetorical walk-through of the exhibition, we consider the display of archival materials for purposes of positioning, in consideration of past and present issues of diet and governance. Making explicit unstated assumptions, we claim that, although propagandistic artifacts take on different meanings to those viewing them decades later as memorabilia, they maintain their ideological flavor.
Diagnosis of Retrolingual Obstruction during Drug-Induced Sleep Endoscopy versus Polysomnography with Nasopharyngeal Tube in Patients with Obstructive Sleep Apnea
Authors: Qiao Jian , Qin Jie , Xing Dengxiang , Li Shuhua , Wu Dahai
Published: March 2021

Objective:

To compare the retrolingual obstruction during drug-induced sleep endoscopy (DISE) with the retrolingual obstruction during polysomnography with nasopharyngeal tube (NPT-PSG).

Methods:

A cross-sectional study of 77 consecutive patients with moderate and severe obstructive sleep apnea (OSA) was conducted. After 15 patients were excluded from the study for not completing DISE or NPT-PSG successfully, 62 patients were included in this study. Retrolingual sites of obstruction grade 2 determined by DISE according to the VOTE (velum, oropharynx lateral wall, tongue base, and epiglottis) classification were considered as retrolingual obstruction, while apnea-hypopnea index (AHI) ≥ 15 events/hour determined by NPT-PSG was considered as retrolingual obstruction. The extent of agreement between DISE and NPT-PSG findings was evaluated using unweighted Cohen’s kappa test.

Results:

The 62 study participants (11 moderate OSA, 51 severe OSA) had a mean (SD) age of 39.8 (9.9) years, and 58 (94%) were men. No statistically significant differences between included and excluded patients were observed in patient characteristics. The extent of agreement in retrolingual obstruction between DISE and NPT-PSG was 80.6% (Cohen k = 0.612; 95% CI, 0.415-0.807).

Conclusion:

Retrolingual obstruction requiring treatment showed good agreement between DISE and NPT-PSG, suggesting that NPT-PSG may also be a reliable method to assess the retrolingual obstruction.
The Use of Theory of Linear Mixed-Effects Models to Detect Fraudulent Erasures at an Aggregate Level
Authors: Peng Luyao , Sinharay Sandip
Published: March 2021

Wollack et al. (2015) suggested the erasure detection index (EDI) for detecting fraudulent erasures for individual examinees. Wollack and Eckerly (2017) and Sinharay (2018) extended the index of Wollack et al. (2015) to suggest three EDIs for detecting fraudulent erasures at the aggregate or group level. This article follows up on the research of Wollack and Eckerly (2017) and Sinharay (2018) and suggests a new aggregate-level EDI by incorporating the empirical best linear unbiased predictor from the literature of linear mixed-effects models (e.g., McCulloch et al., 2008). A simulation study shows that the new EDI has larger power than the indices of Wollack and Eckerly (2017) and Sinharay (2018). In addition, the new index has satisfactory Type I error rates. A real data example is also included.
A structural social work approach to oral health care in Nepal
Authors: Spero Laura , Werkmeister Rozas Lisa
Published: March 2021

Structural social work (SSW) is a critical theory that frames poverty, violence, and disease as the product of oppressive social structures. SSW concepts were applied to a rural dentistry project in Nepal. Delivery of oral health care in Nepal is influenced by capitalist, colonialist, and scientific-modernist ideologies that disadvantage the rural poor. Jevaia Oral Health Care operationalizes SSW principles of tension relief, consciousness-raising, collectivization, and power-brokering, but is limited in tackling structural problems around etiological aspects of oral disease. SSW offers useful and important practice strategies for improving oral health care in Nepal.
Expanded Public Works Programme Participants: Transitioning to Tourism in South Africa
Authors: Glen Niki , Mearns Kevin F
Published: March 2021

The Expanded Public Works Programme (EPWP) was developed in South Africa as a strategy for job creation amongst poor people. However, this desired outcome of EPWP is often not achieved. This research follows an action research approach to analyse the potential of two organisations to collectively help overcome development gaps and improve living, learning and working conditions for EPWP participants. A new framework is proposed that will support all collaborating organizations to achieve their common objectives of overcoming poverty and unemployment and providing opportunities in rural areas for vulnerable people to earn an income. The research assesses the opportunities for collaboration between the organizations to help create business opportunities in tourism once participants exit the EPWP programme. This study included some primary data collection and adds new insights to the body of knowledge that deals with effectiveness of EPWP programmes in achieving objectives of poverty alleviation and job creation.