bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 11859: Elevated Troponins and Ischemic Cardiomyopathy Are Predictive of Percutaneous Coronary Intervention in Patients With Pulmonary Embolism
Authors: Shahin Omar K , Gelman Samantha Z , Kubomoto Scott , Savoj Javad , Hanna George , Kaustubh Patankar
Published: March 2022

Introduction:
Pulmonary embolism is a common cause of myocardial strain. As such, patients with pulmonary embolism will have evidence of myocardial injury on laboratory assessment. This can be measured using a troponin assay. Of the patients who present with elevated troponins and pulmonary embolism, there is minimal evidence to guide the decision on whether a patient will benefit from left heart catheterization and coronary angiography. We sought to analyze troponin levels and risk factors for percutaneous coronary intervention (PCI) in a large dataset of patients hospitalized with pulmonary embolism.

Methods:
This was a retrospective study of 3929 patients who were admitted with pulmonary embolism in 2018 and 2019 at HCA Healthcare hospitals across the United States. Patients with other factors that could cause troponin elevation, such as a ST elevation myocardial infarction, chronic kidney disease, and sepsis, were excluded. Binary logistic regression model was utilized to examine risk factors for PCI.

Results:
Troponin I level was elevated in 68.9% (2707) of patients, 7.68% (208) of those patients with an elevated troponin had a left heart catheterization, and, of the patients that underwent a left heart catheterization, 26.92% (56) had PCI. The mean age of all subjects was 65.1 years and 52.4% of subjects were female. A total of 73.07% (2871) of subjects had coronary artery disease. Multivariable logistic regression showed maximum troponin value was associated with increased chance of PCI. For every ng/mL increase in troponin level, the odds of PCI increased by 2.5% (p=0.017). Patients with ischemic cardiomyopathy were 4.4-times more likely to have PCI than those without (p=0.010). Race, gender, and age were not significantly associated with risk of PCI.

Conclusions:
Elevated troponin is common in patients admitted with pulmonary embolism. In our dataset 7.7% of patients with elevated troponin received left heart catheterization and 26.9% of left heart catheterizations resulted in PCI. Higher troponin and known ischemic cardiomyopathy were independently associated with increased likelihood of PCI. Further analysis may help find additional factors to suggest which patients with elevated troponin should have left heart catheterization.
Abstract 11863: History of Paroxysmal Atrial Fibrillation is Associated With Earlier Recurrence After Initial Cardioversion Compared to New-Onset Persistent Atrial Fibrillation
Authors: Rutlen Christine , Mullen Cassie , Phan Francis , Raitt Merritt , DALOUK KHIDIR , Zarraga Ignatius , MacMurdy Karen , JESSEL PETER
Published: March 2022

Introduction:
Recurrence of atrial fibrillation (AF) after direct current cardioversion (DCCV) for persistent AF is common. A preceding history of paroxysmal AF before persistent AF may predispose to recurrence of AF after DCCV. However, whether the absence of paroxysmal AF before new-onset persistent AF (primary persistent AF) affects the recurrence of AF is currently poorly defined.

Hypothesis:
Patients with persistent AF and a preceding history of paroxysmal AF will have a higher rate of recurrence after DCCV compared to patients with primary persistent AF.

Methods:
Prospective clinical database at a Veterans Hospital was used to compare recurrence rates of AF after initial DCCV in patients with primary persistent AF to patients with a history of prior paroxysmal AF.

Results:
Among 484 patients who underwent initial cardioversion for persistent AF, 21% had a history of paroxysmal AF (n = 101). 80% of patients with a history of paroxysmal AF had a recurrence within one year, compared to 58% of patients with a history of primary persistent AF (p=0.0001). Those with a history of paroxysmal AF had a smaller left atrium, 4.47 cm, compared to those with primary persistent AF, 4.64 cm (p=0.04) and were more likely to be taking anti-arrhythmic drugs (AAD) at the time of DCCV (p=0.00002). Although those with prior paroxysmal AF were more likely to have a history of CKD (p=0.03), OSA (p=0.0004), and CVA (p=0.001), the presence of these respective comorbidities did not affect recurrence rates (p=0.3055, 0.8253, 0.1689).

Conclusions:
Patients with prior paroxysmal AF were more likely to have a recurrence of AF after DCCV compared to patients without a history of primary persistent AF, despite smaller left atriums and higher rates of AAD use. Although those with prior paroxysmal AF had higher prevalence of CKD, OSA, and CVA, the presence of these comorbidities was not predictive of recurrence.
Abstract 11877: Arrhythmogenic Right Ventricular Cardiomyopathy Patients with a Markedly Enlarged RV Compressing LV to Left Side Have an Atypical Distribution of Epsilon Waves and Elevated Plasma BNP
Authors: Funabashi Nobusada , Nakamura Kohki , sasaki takehio , Naito Shigeto , Kobayashi Yoshio
Published: March 2022

Introduction:
Epsilon waves on V1-3 leads are specific ECG findings in patients with arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC). 4D cardiac CT visualizes ARVC characteristics, such as fibro-fatty invasion into RV and left ventricular (LV) myocardium (RVM, LVM), an enlarged RV, reduced RV motion, and bulging.

Hypothesis:
We hypothesize that epsilon waves in V4-6 leads suggest LV invasion in ARVC. Alternatively, extreme RV enlargement may compress the LV and cause clockwise rotation; an enlarged RV may itself cause epsilon waves in V4-6 leads.

Methods:
Retrospective analysis of 17 patients (11 males, 57±17 yrs) with suspected ARVC undergoing cardiac CT and ECG, 9 of whom met 2010 ARVC task force criteria.

Result:
All 9 patients had epsilon waves ; 5 had fibro-fatty invasion into the LVM. We divided the 9 into 5 groups by CT: 1) markedly enlarged RV compressing the LV to the left side with fibro-fatty changes exclusively in RVM (N=1); 2) similar findings in both RVM and LVM (N=2); 3) moderately enlarged RV without compression of the LV to the left side and fibro-fatty changes exclusively in RVM (N=3); 4) the same in both RVM and LVM (N=2); 5) severe mitral valve regurgitation, a markedly enlarged LV, and a fibro-fatty change in both RVM and LVM (N=1). The patient in group (gp) 1 showed epsilon waves in V1-6 leads, patients in gp 2 had epsilon waves in V1-6 (N=1), and V3-5 (N=1) leads; patients in gp 3 had epsilon waves in V1-4 (N=2), and V1-3 (N=1) leads, patients in gp 4 had epsilon waves in V1-3 (N=1), and V1, 2 (N=1) leads; finally, the patient in gp 5 had epsilon waves in V4-6 leads. Plasma BNP levels were significantly greater in patients in gp 1 & 2 than gp 3 & 4 (1255±838 vs 80±52 pg/ml, P=0.016).

Conclusions:
ARVC patients with a markedly enlarged RV compressing the LV to the left side (gp 1,2) had a broad (V1-6) or different range (V3-5) distribution of epsilon waves and significantly elevated plasma BNP independent of fibro-fatty invasion of the LV, different from typical ARVC (gp 3,4).
Abstract 11878: Atrial Fibrillation is Correlated With Brain Atrophy in Regions Associated With Alzheimer Disease
Authors: Kim Hosung , Matloff William J , Zhao Lu , Arzouni Nibal , Tanaka Nina , Heckbert Susan R , Kwon Younghoon , Toga Arthur W
Published: March 2022

Introduction:
Atrial fibrillation (AF) has been associated with neurocognitive impairment. The broad effects of AF on the brain, however, remain to be clarified. We investigated using data from the UK Biobank (UKB) whether an automated electrocardiography (ECG) diagnosis of AF or atrial flutter (AFL) is associated with imaging-based markers of brain atrophy, including volume, thickness, and white matter microstructure, in brain regions associated with Alzheimer Disease (AD).

Methods:
We studied a subset of 48,705 UKB study participants with available brain magnetic resonance imaging (MRI) and cognitive function test data. AF/AFL were determined by either automatic ECG interpretation or history by self-reported and hospital-visit derived data. Participants were classified into four groups: 1) no history or ECG detection of AF/AFL; 2) history of AF/AFL but no AF/AFL on ECG; 3) no history of AF/AFL but AF/AFL on ECG; and 4) history of AF/AFL and AF/AFL on ECG. The following brain MRI measurements were obtained: mean bilateral hippocampal volume, fornix fractional anisotropy (FA), and an AD cortical thickness signature. The AD cortical thickness signature was computed as the average of thickness values in various frontal and temporal cortices involved in AD progression.

Results:
A total of 17,723 participants aged 46-81 (mean age 64 years, 52.2% female) with group sizes of 17182, 307, 100, and 134 (groups 1-4 respectively) were included. Compared to participants with no AF/AFL (group 1), hippocampal volume was significantly smaller in the two groups with AF/AFL on ECG (groups 3 and 4; 97.5 and 95.8 mm
3
smaller; p<0.005). No difference in the volume was found between groups 1 and 2. This pattern of group differences was similar for both fornix FA and the AD cortical thickness signature. A post-hoc analysis for the cognitive function variables showed that scores on the matrix pattern and symbol digit substitution cognitive tests were lower for participants with AF/AFL on ECG (groups 3+4) than those without AF/AFL (groups 1), each with a beta estimate of -0.16 standard deviations (p<0.05).

Conclusion:
AF/AFL on ECG at time of brain imaging, but not AF/AFL history, is associated with brain atrophy and disrupted white matter microstructure in AD-associated regions.
Abstract 11880: Outcomes of Transcatheter Rheumatic Mitral Valve Repair
Authors: Elzeneini Mohammed , ASHRAF HASSAN , Assaf Yazan , Mahmoud Ahmad , Elbadawi Ayman , Elgendy Islam Y , Anderson R D , Jneid Hani
Published: March 2022

Introduction:
The aim of this analysis was to investigate if mitral transcatheter edge-to-edge repair (TEER) presents a safe and effective option for patients with severe symptomatic rheumatic mitral regurgitation.

Hypothesis:
Mitral TEER in rheumatic valvular disease (RVD) is challenging due to leaflet thickening and calcification but is performed in select cases. Limited data exists on its outcomes.

Methods:
We queried the Nationwide Readmissions Database for hospitalizations for mitral TEER in the United States between 2016 and 2018. Propensity score weighted regression analysis was conducted to evaluate the association of RVD with in-hospital outcomes and 90-day readmissions after mitral TEER.

Results:
A total of 18,240 mitral TEER procedures were included in analysis, including 1,779 (10%) in patients with RVD. Mitral TEER in patients with RVD was associated with no difference in overall in-hospital mortality compared to patients without RVD (odds ratio [OR] 1.47, 95% confidence interval [CI] 0.94-2.30, p 0.089). However, RVD was associated with higher in-hospital acute myocardial infarction (OR 1.65, 95%CI 1.07-2.56), acute kidney injury (OR 1.58, 95%CI 1.30-1.94), ventricular arrhythmia (OR 1.50, 95%CI 1.12-2.01), high-degree heart block (OR 1.67, 95%CI 1.25-2.23) and conversion to open surgical repair or replacement (OR 2.53, 95%CI 1.02-6.30). Mitral TEER in RVD was also associated with higher 90-day all-cause readmission (hazard ratio [HR] 1.19, 95% CI 1.04-1.47, p 0.012), although there was no difference in heart failure readmission or readmission for surgical repair/replacement.

Conclusions:
Mitral TEER might be a reasonable option for carefully selected patients with RVD at very high surgical risk who also have favorable anatomy.
Abstract 11882: The Relationship Between Day-to-Day Variability in Home Blood Pressure and Multiple Organ Function
Authors: Kubozono Takuro , Akasaki Yuichi , Kawasoe Shin , Ojima Satoko , Kawabata Takeko , Kuwahata So , Takenaka Toshihiro , Ikeda Yoshiyuki , Ohishi Mitsuru
Published: March 2022

Introduction:
Blood pressure variability (BPV) is associated with the prognosis of cardiovascular disease. Continuous home BP measurements can be used to assess day-to-day BPV. Day-to-day BPV is associated with poor cognitive function, and the onset and progression of dementia. However, it is not clear how BPV is related to various organs.

Hypothesis:
Day-to-day BPV is related to various organ functions.

Methods:
Three hundred sixty-six participants (136 male, mean age: 71±9 years) who were participated in the community-based health checkup survey in Tarumizu city. All participants measured home blood pressure using HEM-9700T (OMRON Healthcare, Kyoto, Japan). Day-to-day variability of systolic blood pressure were evaluated by coefficient of variation (CV) of home systolic blood pressure in morning during one month. CV was categorized into quartiles. NT-pro BNP and high-sensitivity (hs-)troponin T as cardiac biomarkers were measured. Liver stiffness and renal function were evaluated by Fibrous-4 (Fib4) index and estimated glomerular filtration rate (eGFR), respectively. NT-pro BNP and hs-troponin T were divided by median value. Fib4 index greater than 2.67 and eGFR less than 60 mL/min/1.73 m2 were defined as high Fib4 index and high eGFR.

Results:
Mean CV was 6.0±1.7%. In logistic analysis adjusted age, gender and receiving antihypertensive medication, the odds ratios for high eGFR and high Fib4 index were higher in the higher quartiles, and only the fourth quartile was an independently associated factor. Moreover, for high NT-pro BNP levels, it was an independent factor in all three quartiles of CV. In contrast, for high troponin T levels, no associations were found for all quartiles of CV (Figure).

Conclusion:
Day-to-day BPV is independently associated with NT-pro BNP, eGFR and Fib4 index, but not with hs-troponin T.
Risk Stratification Guided by the Index of Microcirculatory Resistance and Left Ventricular End-Diastolic Pressure in Acute Myocardial Infarction
Authors: Maznyczka Annette M. , McCartney Peter J. , Oldroyd Keith G. , Lindsay Mitchell , McEntegart Margaret , Eteiba Hany , Rocchiccioli J. Paul , Good Richard , Shaukat Aadil , Robertson Keith , Malkin Christopher J. , Greenwood John P. , Cotton James M. , Hood Stuart , Watkins Stuart , Collison Damien , Gillespie Lynsey , Ford Thomas J. , Weir Robin A.P. , McConnachie Alex , Berry Colin
Published: March 2022

Background:

The index of microcirculatory resistance (IMR) of the infarct-related artery and left ventricular end-diastolic pressure (LVEDP) are acute, prognostic biomarkers in patients undergoing primary percutaneous coronary intervention. The clinical significance of IMR and LVEDP in combination is unknown.

Methods:

IMR and LVEDP were prospectively measured in a prespecified substudy of the T-TIME clinical trial (Trial of Low Dose Adjunctive Alteplase During Primary PCI). IMR was measured using a pressure- and temperature-sensing guidewire following percutaneous coronary intervention. Prognostically established thresholds for IMR (>32) and LVEDP (>18 mm Hg) were predefined. Contrast-enhanced cardiovascular magnetic resonance imaging (1.5 Tesla) was acquired 2 to 7 days and 3 months postmyocardial infarction. The primary end point was major adverse cardiac events, defined as cardiac death/nonfatal myocardial infarction/heart failure hospitalization at 1 year.

Results:

IMR and LVEDP were both measured in 131 patients (mean age 59±10.7 years, 103 [78.6%] male, 48 [36.6%] with anterior myocardial infarction). The median IMR was 29 (interquartile range, 17–55), the median LVEDP was 17 mm Hg (interquartile range, 12–21), and the correlation between them was not statistically significant (
r
=0.15;
P
=0.087). Fifty-three patients (40%) had low IMR (≤32) and low LVEDP (≤18), 18 (14%) had low IMR and high LVEDP, 31 (24%) had high IMR and low LVEDP, while 29 (22%) had high IMR and high LVEDP. Infarct size (% LV mass), LV ejection fraction, final myocardial perfusion grade ≤1, TIMI (Thrombolysis In Myocardial Infarction) flow grade ≤2, and coronary flow reserve were associated with LVEDP/IMR group, as was hospitalization for heart failure (n=18 events;
P
=0.045) and major adverse cardiac events (n=21 events;
P
=0.051). LVEDP>18 and IMR>32 combined was associated with major adverse cardiac events, independent of age, estimated glomerular filtration rate, and infarct-related artery (odds ratio, 5.80 [95% CI, 1.60–21.22]
P
=0.008). The net reclassification improvement for detecting major adverse cardiac events was 50.6% (95% CI, 2.7–98.2;
P
=0.033) when LVEDP>18 was added to IMR>32.

Conclusions:

IMR and LVEDP in combination have incremental value for risk stratification following primary percutaneous coronary intervention.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02257294.
Saphenous Vein Graft Failure: From Pathophysiology to Prevention and Treatment Strategies
Authors: Xenogiannis Iosif , Zenati Marco , Bhatt Deepak L. , Rao Sunil V. , Rodés-Cabau Josep , Goldman Steven , Shunk Kendrick A. , Mavromatis Kreton , Banerjee Subhash , Alaswad Khaldoon , Nikolakopoulos Ilias , Vemmou Evangelia , Karacsonyi Judit , Alexopoulos Dimitrios , Burke M. Nicholas , Bapat Vinayak N. , Brilakis Emmanouil S.
Published: March 2022

Saphenous vein grafts (SVGs) remain the most frequently used conduits in coronary artery bypass graft surgery (CABG). Despite advances in surgical techniques and pharmacotherapy, SVG failure rates remain high, often leading to repeat coronary revascularization. The no-touch SVG harvesting technique (minimal graft manipulation with preservation of vasa vasorum and nerves) reduces the risk of SVG failure, whereas the effect of the off-pump technique on SVG patency remains unclear. Use of buffered storage solutions, intraoperative graft flow measurement, careful selection of the target vessels, and physiological assessment of the native coronary circulation before CABG may also reduce the incidence of SVG failure. Perioperative aspirin and high-intensity statin administration are the cornerstones of secondary prevention after CABG. Dual antiplatelet therapy is recommended for off-pump CABG and in patients with a recent acute coronary syndrome. Intermediate (30%–60%) SVG stenoses often progress rapidly. Stenting of intermediate SVG stenoses failed to improve outcomes; hence, treatment focuses on strict control of coronary artery disease risk factors. Redo CABG is associated with higher perioperative mortality compared with percutaneous coronary intervention (PCI); hence, the latter is preferred for most patients requiring repeat revascularization after CABG. SVG PCI is limited by high rates of no-reflow and a high incidence of restenosis during follow-up. Drug-eluting and bare metal stents provide similar long-term outcomes in SVG PCI. Embolic protection devices reduce no-reflow and should be used when feasible. PCI of the corresponding native coronary artery is associated with better short- and long-term outcomes and is preferred over SVG PCI, if technically feasible.
T2* Placental Magnetic Resonance Imaging in Preterm Preeclampsia
Authors: Ho Alison E.P. , Hutter Jana , Jackson Laurence H. , Seed Paul T. , Mccabe Laura , Al-Adnani Mudher , Marnerides Andreas , George Simi , Story Lisa , Hajnal Joseph V. , Rutherford Mary A. , Chappell Lucy C.
Published: March 2022

Placental dysfunction underlies the cause of pregnancies complicated by preeclampsia. The use of placental magnetic resonance imaging to provide an insight into the pathophysiology of preeclampsia and thus assess its potential use to inform prognosis and clinical management was explored. In this prospective observational cohort study, 14 women with preterm preeclampsia and 48 gestation-matched controls using 3-Tesla magnetic resonance imaging at median of 31.6 weeks (interquartile range [IQR], 28.6–34.6) and 32.2 weeks (IQR, 28.6–33.8), respectively, were imaged. The acquired data included T2-weighted images and T2* maps of the placenta, the latter an indicative measure of placental oxygenation. Placentae in women with preeclampsia demonstrated advanced lobulation, varied lobule sizes, high granularity, and substantial areas of low-signal intensity on T2-weighted imaging, with reduced entire placental mean T2* values for gestational age (2 sample
t
test, t=7.49) correlating with a reduction in maternal PlGF (placental growth factor) concentrations (Spearman rank correlation coefficient 0.76) and increased lacunarity values (t=3.26). Median mean T2* reduced from 67 ms (IQR, 54–73) at 26.0 to 29.8 weeks’ gestation to 38 ms (IQR, 28–40) at 34.0 to 37.9 weeks’ gestation in the control group. In women with preeclampsia, median T2* was 23 ms (IQR, 20–23) at 26.0 to 29.8 weeks’ gestation and remained low (22 ms [IQR, 20–26] at 34.0–37.8 weeks’ gestation). Histological features of maternal vascular malperfusion were only found in placentae from women with preeclampsia. Placental volume did not differ between the control group and women with preeclampsia. Placental magnetic resonance imaging allows both objective quantification of placental function in vivo and elucidation of the complex mechanisms underlying preeclampsia development.
Stroke Acute Management and Outcomes During the COVID-19 Outbreak
Authors: Fuentes Blanca , Alonso de Leciñana María , García-Madrona Sebastián , Díaz-Otero Fernando , Aguirre Clara , Calleja Patricia , Egido José A. , Carneado-Ruiz Joaquín , Ruiz-Ares Gerardo , Rodríguez-Pardo Jorge , Rodríguez-López Ángela , Ximénez-Carrillo Álvaro , de Felipe Alicia , Ostos Fernando , González-Ortega Guillermo , Simal Patricia , Gómez Escalonilla Carlos I. , Gómez-Porro-Sánchez Pablo , Desanvicente Zayrho , Reig Gemma , Gil-Núñez Antonio , Masjuán Jaime , Díez-Tejedor Exuperio
Published: March 2022

Background and Purpose:

The coronavirus disease 2019 (COVID-19) outbreak has added challenges to providing quality acute stroke care due to the reallocation of stroke resources to COVID-19. Case series suggest that patients with COVID-19 have more severe strokes; however, no large series have compared stroke outcomes with contemporary non–COVID-19 patients. Purpose was to analyze the impact of COVID-19 pandemic in stroke care and to evaluate stroke outcomes according to the diagnosis of COVID-19.

Methods:

Retrospective multicenter cohort study including consecutive acute stroke patients admitted to 7 stroke centers from February 25 to April 25, 2020 (first 2 months of the COVID-19 outbreak in Madrid). The quality of stroke care was measured by the number of admissions, recanalization treatments, and time metrics. The primary outcome was death or dependence at discharge.

Results:

A total of 550 acute stroke patients were admitted. A significant reduction in the number of admissions and secondary interhospital transfers was found. COVID-19 was confirmed in 105 (19.1%) patients, and a further 19 patients were managed as suspected COVID-19 (3.5%). No differences were found in the rates of reperfusion therapies in ischemic strokes (45.5% non–COVID-19, 35.7% confirmed COVID-19, and 40% suspected COVID-19;
P
=0.265). However, the COVID-19 group had longer median door-to-puncture time (110 versus 80 minutes), which was associated with the performance of chest computed tomography. Multivariate analysis confirmed poorer outcomes for confirmed or suspected COVID-19 (adjusted odds ratios, 2.05 [95% CI, 1.12–3.76] and 3.56 [95% CI, 1.15–11.05], respectively).

Conclusions:

This study confirms that patients with COVID-19 have more severe strokes and poorer outcomes despite similar acute management. A well-established stroke care network helps to diminish the impact of such an outbreak in stroke care, reducing secondary transfers and allowing maintenance of reperfusion therapies, with a minor impact on door-to-puncture times, which were longer in patients who underwent chest computed tomography.
Mobile Stroke Units Facilitate Prehospital Management of Intracerebral Hemorrhage
Authors: Cooley S. Regan , Zhao Henry , Campbell Bruce C.V. , Churilov Leonid , Coote Skye , Easton Damien , Langenberg Francesca , Stephenson Michael , Yan Bernard , Desmond Patricia M. , Mitchell Peter J. , Parsons Mark W. , Donnan Geoffrey A. , Davis Stephen M. , Yassi Nawaf ,   on behalf of the Melbourne Mobile Stroke Unit Collaboration, Smith Karen , Bernard Stephen , Cadilhac Dominique A. , Kim Joosup , Bladin Christopher F. , Crompton Douglas E. , Dewey Helen M. , Sanders Lauren M. , Wijeratne Tissa , Cloud Geoffrey C. , Brooks Duncan M. , Asadi Hamed , Thijs Vincent , Chandra Ronil V. , Ma Henry , Phan Thanh , Bivard Andrew , Dowling Richard J. , Yassi Nawaf
Published: March 2022

Background and Purpose:

Mobile stroke units (MSUs) improve reperfusion therapy times in acute ischemic stroke (AIS). However, prehospital management options for intracerebral hemorrhage (ICH) are less established. We describe the initial Melbourne MSU experience in ICH.

Methods:

Consecutive patients with ICH and AIS treated by the Melbourne MSU were included. We describe demographics, proportions of patients receiving specific therapies, and bypass to comprehensive/neurosurgical centers. We also compare operational time metrics between patients with MSU-ICH and MSU-AIS.

Results:

During a 2-year period, the Melbourne MSU managed 49 patients with ICH, mean (SD) age 74 (12) years, median (interquartile range) National Institutes of Health Stroke Scale 17 (12–20). Intravenous antihypertensives were the commonest treatment provided (46.9%). Bypass of a primary center to a comprehensive center with neurosurgical expertise occurred in 32.7% of patients with MSU-ICH compared with 20.5% of patients with MSU-AIS. Compared with patients with MSU-AIS, patients with MSU-ICH had faster onset-to-emergency-call, and onset-to-scene-arrival times at the median and 75th percentiles.

Conclusions:

MSUs can facilitate ultra-early ICH diagnosis, management, and triage.
PERCEIVED ORGANIZATIONAL SUPPORT AND HAPPINESS AT WORK: THE ROLE OF PSYCHOLOGICAL CAPITAL
Authors: ÖZDEMİR Burak
Published: March 2022

Building on the tenets of social exchange theory and conservation of resources theory this study investigates the mediating role of psychological capital between organizational support and happiness at work. Data were collected from 207 white-collar workers of multiple organizations in Turkey. The findings indicate that perceived organizational support has moderate effect on happiness at work (work engagement, job satisfaction, affective commitment). Further, psychological capital mediates the relationship between perceived organizational supoort and work engagement. As a result, this study revealed that employees who perceive high levels of organizational support are more likely to generate positive psychological resources, which should lead to better work engagement. The findings of this study extend the social exchange theory and conservations of resource theory.
SAĞLIK SEKTÖRÜ ÇALIŞANLARINDA İŞ YÜKÜ, İŞ TATMİNİ VE TÜKENMİŞLİK DURUMUNUN İNCELENMESİ
Authors: ATALAY Muhammet , ÇAKIREL Yasin
Published: March 2022

COVID-19 salgınının başından itibaren hastanelerin ve çalışanlarının yoğunluğu artmıştır. Bu araştırma sağlık çalışanlarının iş yükü, iş tatmini ve tükenmişlik durumlarının ve aralarındaki ilişkilerin birlikte incelendiği bir çalışmadır. Bu amaçla kamu hastanelerindeki 202 sağlık çalışanına yönelik anket uygulanmıştır. Elde edilen bulgulara göre, iş yükü ile tükenmişlik arasında orta düzeyde aynı yönde; iş yükü ile iş tatmini arasında ortaya yakın düzeyde zıt yönde, tükenmişlik ile iş tatmini arasında ise orta düzeyde zıt yönde anlamlı ilişki bulunmaktadır. Öte yandan iş tatmininin, iş yükünün tükenmişliğin alt boyutu olan kişisel başarıda düşme hissine olan etkisinde tam aracılık; duygusal tükenmeye ve duyarsızlaşmaya olan etkisinde ise kısmi aracılık rolü üstlendiği bulunmuştur. Ayrıca bulgular, COVID-19 ile ilgili bölümlerde görev yapan çalışanlarda iş yükü, tükenmişlik, duygusal tükenme ve duyarsızlaşma düzeylerinin daha yüksek; iş tatmini ve içsel tatmin düzeylerinin ise daha düşük olduğunu göstermektedir. Sonuçlar, sağlık çalışanlarının salgın nedeniyle doğal olarak artan iş yükünün etkisiyle işte tatmin durumlarının azaldığını, bunun da artan tükenmişliğe neden olduğunu ortaya koymaktadır.
İŞ GÖRÜŞMELERİNDE YAPAY ZEKA
Authors: KAMBUR Emine
Published: March 2022

Yapay zeka, organizasyonların insan sermayesine nasıl ulaştığını, onu nasıl seçtiğini ve çektiğini önemli ölçüde etkileme potansiyeline sahiptir. Organizasyonlar da işe alım süreçlerinde yapay zeka destekli teknolojileri kullanmaktadır. Ancak, adayların yapay zeka destekli iş başvuru sistemlerini nasıl gördükleri ve bu durumun başvuruda bulunma olasılıklarını etkileyip etkilemediği hakkında oldukça az şey bilinmektedir. Bu çalışmada da genel olarak iş başvuru sürecinde yapay zeka kullanımına yönelik tutumlar ortaya çıkarılmaya çalışılmıştır. Bu tutumun teknoloji kullanım becerisi ile iş görüşmelerinde yapay zeka arasındaki ilişkiye aracılık edip etmediği, başvuru sürecinde oldukça etkili duygusal durum olan anksiyetenin düzenleyici rolü olup olmadığı araştırılmıştır. Hayes (2013) tarafından geliştirilen Process Makro ile yapılan analizler neticesinde teknoloji kullanım becerisinin, iş görüşmelerinde yapay zekaya yönelik düşünceleri etkilediği, yapay zekaya yönelik tutumun, teknoloji kullanım becerisi ile iş görüşmelerinde yapay zeka arasındaki ilişkiye aracılık ettiği tespit edilmiştir. Ayrıca teknoloji kullanım becerisinin, iş görüşmelerinde yapay zeka üzerindeki etkisinde cinsiyetin düzenleyici rolü olduğu ve teknoloji kullanım becerisinin, yapay zekaya yönelik tutum vasıtasıyla iş görüşmelerinde yapay zeka üzerindeki dolaylı etkisinde anksiyetenin düzenleyici etkisi olduğu tespit edilmiştir.
ÇOKLU REGRESYON, ARIMA VE YAPAY SİNİR AĞI YÖNTEMLERİ İLE TÜRKİYE ELEKTRİK PİYASASINDA FİYAT TAHMİN VE ANALİZİ
Authors: ARSLAN Burak , ERTUĞRUL İrfan
Published: March 2022

Türkiye’de EPİAŞ aracılığıyla işletilen ve operasyon süreçlerinden birisi olarak elektrik piyasalarında arza çıkan her birim elektrik için arz ve talep dengesine göre piyasa takas fiyatı oluşmaktadır. Piyasa takas fiyatı saatlik olarak oluşmakta katılımcılara ve halka açık olarak şeffaf platformlarda bildirilmektedir. Bu çalışmada R istatistik paket programı kullanılarak çoklu regresyon yöntemi ve yapay sinir ağı modelleri; Eviews paket programı ile ise ARIMA yöntemi kullanılarak geçmiş piyasa fiyatının analizi ve tahmini gerçekleştirilmiştir. Çoklu regresyon ve yapay sinir ağları yöntemleri ile piyasa fiyatını doğrudan etkileyen etmenler bağımsız değişkenler olarak ele alınmıştır. ARIMA yönteminde ise verinin geçmiş değerleri referans olarak alınarak analizler gerçekleştirilmiştir. Çalışmada kullanılan analiz yöntemleri sonucunda en iyi performansın sırasıyla yapay sinir ağları, çoklu regresyon yöntemi ve ARIMA yönteminden elde edildiği belirlenmiştir.
Empowering Women in the Lessons of Rabbanit Yemima Mizrahi
Authors: Yemini Bat-Zion
Published: March 2022

This paper examines the rhetoric used by Rabbanit Yemima Mizrahi in her weekly Torah portion lectures to women, in which she applies a feminine point of view. For eighteen years, Rabbanit Mizrahi has used her unique rhetorical style to attract a faithful, diverse audience of Jewish women in Israel and abroad. This study investigates her rhetoric in fifty videotaped lectures and presents five of her rhetorical tools: metaphor and simile, puns, syntactical-rhetorical repetition, humor, and slang. The study also examines how her rhetoric attracts women from all walks of life, irrespective of their level of religious observance, age, and socio-cultural background, and without proselytizing. Moreover, she uses her rhetoric in a direct way, avoiding any type of authoritative distance, to transmit a message of sisterhood through empowerment of women as she interprets the Torah portion.
Professional Ethics of Community Rabbis and Religious Scholars in Judaism
Authors: Rashi Tsuriel
Published: March 2022

This article represents a first attempt to collect and analyze texts written by halakhic authorities throughout the generations that deal with the professional ethics of rabbis and religious scholars. From these texts, we understand that the ideal rabbi embodies a combination of professionalism, humility, and a shouldering of his responsibilities as a religious leader. Respectful and dignified conduct when he engages with his community is the mark of his professional vocation. I also look at the appropriate relationship between a community and its rabbi, from his appointment through the way he fulfills his obligations and the circumstances around his parting from his congregation.
Consistency in the ICJ’s Approach to the Standard of Proof: An Appraisal of the Court’s Flexibility
Authors: Farnelli Gian Maria
Published: March 2022

Taking steps from Judge Higgins’ invitation to the ICJ “mak[ing] clear what standards of proof it requires to establish what sorts of facts”, the contribution addresses the Court’s case law with a view to verifying the degree of consistency in its practice. The study comes in three parts. First, the absence of rules on the standard of proof in litigation before the ICJ is addressed, and the Court’s inherent power to choose the standard of proof is upheld. Second, the ICJ case law is addressed from which a highly flexible approach to the standard of proof is inferred. In particular, a two-tier approach in the matter is highlighted with regard to cases in which all the disputing parties appear, whereas the Court appears to follow a single-tier analysis in cases of non-appearance. Lastly, some concluding remarks are provided, highlighting the accordance of such a flexible approach with general principles of procedural law.
The Role of Human Rights in International Investment Arbitration: Arguments Raised by the Parties and Procedural Implications
Authors: Papanastasiou Thomas-Nektarios
Published: March 2022

This article focuses on human rights arguments raised in investment arbitration, and examines their role in the adjudication of investment disputes. It is indicated that the rejection of human rights arguments is not necessarily based on the inapplicability of human rights claims to the investment arbitration process. As shown in several cases, arbitral tribunals refused to accept human rights arguments, mainly because the parties to the dispute failed to demonstrate any relevance or impact of their claim on the investment at stake. Still, no solid legal reasoning can be noticed when tribunals rejected the relevance of human rights. Nevertheless, even if the current legal framework does not favour further involvement of human rights-based claims, we observe several developments in the treaty making practices. Such practices seek to “harmonize” human rights concerns with the international investment regime by introducing corporate social responsibility (CSR) standards or by including specific provisions relating to human rights.
Symphony or Cacophony? Orchestrating Federal Mechanics toward Covid-19 Response in the United States and Germany
Authors: Tonti Lauren
Published: March 2022

Governance is a critical upstream tool in public health emergency preparedness, for it provides structure to emergency response. Pandemics, singular public health emergencies, pose challenges to inherently fragmented federal governance systems. Understanding and utilizing the facilitators of response embedded within the system is critical. In its examination of how contemporary federal systems addressed fragmentation in the face of the Covid-19 pandemic, this article uses two mitigation measures, community masking and vaccination administration to compare elements of federal system mechanics in the United States and Germany’s respective pursuits of public health goals. With particular focus on federal-state power-sharing, it analyzes the division and application of federal-state authority, therein examining mechanisms of executive expediency, as well as the cooperation of multilevel actors. Comparing the jurisdictions identifies inter-federal coordination, availability of exigency mechanisms, and federal guidance as facilitators of public health goal achievement.
The Relationship between the Cīvaravastu of the Mūlasarvāstivāda Vinaya and Chapter 36 of Yijing’s Nanhai jigui neifa zhuan
Authors: Wu Juan
Published: March 2022

This paper reconsiders the long-held view that Chapter 36 of the Nanhai jigui neifa zhuan or “Record of the Inner Law Sent Home from the South Seas” written by the Chinese pilgrim Yijing is a translation of a long passage from the Cīvaravastu of the Mūlasarvāstivāda Vinaya. Through comparing Chapter 36 with the Gilgit Sanskrit text of the Cīvaravastu, the Tibetan translation of the Cīvaravastu, and Yijing’s translation of the Mūlasarvāstivāda Vinayasaṃgraha, this paper reveals, on the one hand, significant differences between Chapter 36 and the extant versions of the Cīvaravastu, and, on the other hand, substantial overlap between Chapter 36 and Yijing’s translation of the Vinayasaṃgraha. It argues that Chapter 36 was not translated from the Cīvaravastu (or at least not from a version of the Cīvaravastu identical with or similar to the Gilgit Sanskrit version), but rather seems to have been composed by Yijing through drawing largely (though not entirely) from the Vinayasaṃgraha. This paper therefore demonstrates anew that Yijing’s travel record cannot be simply taken as his eyewitness report of Buddhist monastic practices in ancient India.
Manifestation of Belief and the “Liberal” Law of Religion: Why It Is Time to Rethink the Status-Quo?
Authors: Bacquet Sylvie
Published: March 2022

Manifestation of belief is a key component of religious freedom, however in modern pluralist states there are inherent conflicts between practices of the more religious minorities and those of the secular majority. In attempting to mediate those conflicts judges have been faced with the sensitive task of determining the extent to which a particular symbol or practice is worthy of protection by the law. The case law arising from this process has produced some inconsistencies and has shown that not all symbols are equal before the law. As a matter of practice, the law of religion is based on liberal values which tend to favour faith based on orthodoxy over orthopraxy. This article argues that the time has come for a remodelling of the current approach to manifestation of religion and belief and puts forward a holistic approach which considers religion as an element of identity and as such ascribed rather than merely a life choice. It explores the possibility of a modification of current legal tests which would give way to this approach. The argument is considered from three different perspectives namely the emphasis on autonomy within the “liberal law of religion,” the religious vs. secular binary present within the courts’ approach and the difficulty of defining religion and belief.
“Useful” Knowledge and Moral Education in Zanzibar Between Colonial and Islamic Reform, 1916–1945
Authors: Bolton Caitlyn
Published: March 2022

The introduction of colonial schooling in Zanzibar was aimed at improving economic productivity, drawing on an exchange of educational theory with the American South to ensure a labor supply for the post-emancipation plantation economy. Yet colonial officials faced a key problem: students did not attend, preferring instead to continue studying in Qur’anic schools, institutions roundly derided by colonial officials. To secure attendance, colonial officials engaged local Muslim leaders to create an Islamic studies syllabus. While reflecting transnational Islamic reformist trends, this syllabus ultimately backfired as local parents protested its lack of moral content. Based on research in the Zanzibar National Archives, this article recounts the tensions and overlap between colonial officials, Islamic leaders connected to transnational discourses of reform, and local Muslim parents over what constitutes truly “useful” knowledge. It argues that colonial education was not particularly successful in forming students into the hard-working agricultural subjects it envisioned. It was successful, however, in orienting public institutions towards economic progress, and shifting public discourses on morality and religion to suit that goal.
The Fawātih Al-Suwar: A Critique of Classical Categories and New Typology
Authors: Zahid Moh.
Published: March 2022

The article is trying to criticize the old and to propose a new fawātiḥ al-suwar variety grouping from two perspectives, namely sentence structure and message of the verse. Fawātiḥ al-suwar (the opening of surah) is essential in the structure of surah in the Holy Quran. Its beauty and urgency have been attracting classic Islamic scholars who group them in ten varieties. However, the grouping seems inaccurate because it mixes the sentence structure and the message. This is a library-method study with fawātiḥ al-suwar as the material object of study. The Quran’s verses from which data were obtained vary from one simple sentence to some compound, even complex sentences. Each verse constitutes four elements, namely: sentence, clause, phrase, and word. The study reveals that ten inventory varieties set by the scholars were inaccurate due to ambiguous point of view between the sentence structure and the implied message on the first verse of every surah.
Prevalence of burnout in medical students in Guatemala: Before and during Covid-19 pandemic comparison
Authors: Ruiz Roxanna , Fernandes Diego Asturias , Vásquez Allan , Trigueros Andrea , Pemberton Max , Gnanapragasam Sam N , Torales Julio , Ventriglio Antonio , Bhugra Dinesh
Published: March 2022

Burnout is a syndrome consisting of physical, emotional, and mental exhaustion along with depersonalization and poor sense of personal accomplishment. Often related to work conditions. Several recent studies from around the world have shown high rates of burnout among medical students in different countries. In Guatemala City, we decided to assess levels of burnout in 2017 and then again in December 2020. In the first wave from one private medical school, we had a total of 159 respondents (response rate of 56.7%) and 132 (48.5%) in the second wave. Not surprisingly rates of burnout were higher during the pandemic even though response rate is lower. Surprisingly we found that rates of depersonalization had not increased, and levels of personal accomplishment had. These findings present a mixed picture of levels of burnout in Guatemala City. Further qualitative research is indicated to explore cultural differences in order to set up appropriate and suitable intervention strategies.
Design of the MVT RBF neural network robotic manipulator control system based on model block approximation
Authors: Xiaoliang Yuan , Jun Liu , Shouyong Xie
Published: March 2022

Due to the uncertain dynamic characteristics, the requirements for robotic manipulator control are increasingly complex. The traditional radial basis function (RBF) neural network has a good generalization ability, but its redundant and tedious training process cannot meet the “Intelligent” control requirement of robotic manipulator. This study designs a new valve-regulated memristive RBF neural network, which adopts the model block approximation control strategy to estimate the three coefficient matrices of the robotic manipulator and uses the memristor with voltage threshold (MVT) as an electronic synapse to provide connections between neurons for the neural network and store information. This study adopts the design idea of software hardening and replaces the updated neural network weight with the change of the memristance value in the MVT network (crossed array), which can effectively improve the control performance of the traditional RBF neural network and can also provide analytical data for the fault detection of the subsequent control system. A simulation analysis is conducted with a single-joint robotic manipulator as the control object, and the results verify the rationality and feasibility of the proposed control algorithm.
The sociomaterial force theory of identity
Authors: Sullivan Daniel , Schmitt Harrison J. , Goad Alexis N.
Published: March 2022

Foundational theories in social psychology tend to focus on the individual’s phenomenological experience, and to conceive of the environment and the individual as discrete entities. To overcome the ontological and epistemological limitations of such perspectives, we propose a theory rooted in culturally oriented existential philosophy. This sociomaterial force theory of identity emphasizes the reciprocal, historically contingent relationship between broad social and material forces on one hand, and processes of social and individual identity on the other. To concretize the framework, we compare it to current theories (social identity theory and social representations theory) and apply it to a qualitative case study of differences in how religious group members narrate the suffering brought on by natural disaster. We propose the theory can contribute to a more historical, dynamic, and truly interdisciplinary psychology, and would be especially useful for integrating multilevel data on the experience of a particular social group at a specified historical period.
One-way coupled numerical model utilizing Viscoelastic Maxwell model for MR damper
Authors: Parlak Zekeriya , Şahin İsmail , Parlak Nezaket
Published: March 2022

Describing the hysteresis behavior of magnetorheological (MR) shock absorber significantly facilitates the developers before manufacturing and control processes. However, most of the models developed to describe the phenomenon have been required experimental data of the manufactured absorber. In this study, the hysteresis behavior for a shock absorber has been characterized by developing a three-dimensional coupled numerical model that adapts Viscoelastic Maxwell Model to momentum equations of fluid flow. The viscosity of the MR fluid, which depends on the magnetic flux density, has been calculated with the Herschel-Bulkley model at each node of the fluid domain, coupled with the magnetic field analysis. The hysteresis relationship between force and velocity has been obtained from time-dependent CFD analyses on the deformed grid. It has been observed that the hysteresis behavior of the MR shock absorber has been attained with a good agreement when the data obtained from the developed numerical model are compared with the experimental data. In addition, besides estimating the hysteresis widths in the force-velocity curves, all effects and changes in time in the flow domain have been observed thanks to the model.
Fractional-order viscoelastic modeling of the magnetic field dependent transmissibility response of MRE isolator
Authors: Kiran Katari , Poojary Umanath R , Gangadharan KV
Published: March 2022

In the present study, a modeling approach to estimate the parameters of the MRE isolator model with respect to the frequency-response curve is presented. To concur the response of the isolator over wide frequency range, fractional order based Kelvin Voigt model comprised of three parameters and the fractional Zener model having four parameters are proposed. An isolator operating in shear-mode is developed, and its performance is evaluated through the transmissibility tests. The parameters of the model are identified by minimizing the error between the transmissibility response from the MRE isolator model and the experimental results. A polynomial function is used to generalize the variation of these parameters with respect to the input current. The response predicted by the MRE isolator models confirms that both fractional Kelvin Voigt and fractional Zener modeling approaches are effective in portraying the transmissibility response. The fractional Zener MRE isolator model is more accurate and can reproduce the experimentally determined magnitude and phase response of the transmissibility with an accuracy greater than 91.5% and 84.87% respectively. On the contrary, the fractional Kelvin Voigt model is simpler in form, and it effectively reproduced the magnitude of the transmissibility response with an accuracy higher than 86.35% and the phase response greater than 83.77%.