bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 17392: Nano-Structural Analysis of Engrafted Human iPSC-Derived Cardiomyocytes in a Mouse Model of Myocardial Infarction Using APEX2
Authors: Hatani Takeshi , Funakoshi Shunsuke , Deerinck Thomas J , Bushong Eric A , Kimura Takeshi , Ellisman Mark H , Hoshijima Masahiko , Yoshida Yoshinori
Published: July 2021

Background:
Although many studies have shown the feasibility of
in vivo
cardiac transplantation of human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) in animal experiments, nano-structural confirmation of the engrafted iPSC-CMs including electron microscopy (EM) has not been accomplished, partly because identification of engrafted cells in EM has proven to be difficult. However, with a new genetically encoded probe, the monomeric 28-kDa peroxidase reporter 2 (APEX2), which withstands strong EM fixation can resolve this problem. Moreover, immaturity of iPSC-CMs is a critical problem. Especially, excitation-contraction coupling is one of the fundamental properties of cardiomyocytes, the absence of dyad formed between T-tubule and junctional portion of the sarcoplasmic reticulum is one of the major reasons of arrhythmogenic risks after transplantation. Using the APEX2 system, we evaluated morphological alteration of the engrafted iPSC-CMs in EM in a mouse model of myocardial infarction.

Methods:
We established human iPSC lines which stably expressed histone H2B-APEX2 (APEX2 iPSCs). After differentiating APEX2 iPSCs into CMs
in vitro
, purified cells were transplanted into NOG mouse hearts with myocardial infarction by direct injections into the myocardium. We evaluated the ultrastructure of engrafted iPSC-CMs using EM at 3 and 6 months after transplantation.

Results:
APEX2 did not give significant influences on cardiac differentiation
in vitro
and stably expressed in iPSC-CMs over 6 months
in vivo
. APEX2 reaction observed in EM clearly identified engrafted APEX2 iPSC-CMs surrounded by host CMs. The maturation of sarcomeric structure and mitochondria were evident, and T-tubules and dyads started to emerge in engrafted iPSC-CMs at 6 months after transplantation.

Conclusions:
We demonstrated that APEX2 is a versatile genetic reporter to trace cell fates in living animals over many months. We unequivocally demonstrated that T-tubules and dyads can be formed in iPSC-CMs after a substantially long period of engraftment. This method should be useful to many studies of stem cell-based cell replacement therapy, as it allows direct nano-scale structural characterization of engrafted cells in EM.
Abstract 100: Intravenous Calcium as a Pressor After Hypoxic Cardiac Arrest
Authors: Lampe Joshua W , Linqwister Alexander L , Welte William B , Gould Jeffrey R , Moodie Karen L , Kaufman Christopher L , Paradis Norman A
Published: July 2021

Background:
Resuscitation from hypoxic cardiac arrest presenting with pseudo-electromechanical dissociation (P-EMD) may be associated with hypotension after ROSC. This hypotension may be refractory to catecholamine pressors. Reversing hypotension is critical for stabilizing patients successfully resuscitated from P-EMD, so other therapeutic avenues should be explored.

Hypothesis:
The post-resuscitation phase after hypoxic pseudo-EMD cardiac arrest may be associated with hypocalcemia. The refractory hypotension may be responsive to intravenous calcium.

Methods:
Using our hypoxic pseudo-EMD swine model, we measured blood pressure, hemodynamics, and electrolytes after ROSC. In 12 animals with refractory hypotension we administered 37 boluses of intravenous calcium in the dosage range of 5 -20 mg. Physiological data were analyzed on a heartbeat by heartbeat basis. The midpoint of the calcium response was defined using change of curvature feature detection. Hemodynamic parameters were shifted such that the value at the midpoint was equal to zero. Comparisons were made between the average values in the time period 40-35 seconds before the bolus and 35-40 seconds after the bolus.

Results:
Of the 37 administered boluses, 34 manifested a reaction in the aortic blood pressure. Mean aortic pressure, systolic and diastolic pressures all increased due to the calcium bolus. Aggregating the timepoints in the range -40 s to -36 s and comparing with the timepoints in the range 36 s to 40 s shows that the mean aortic pressure increased 11.2 ± 0.6 mmHg, the systolic pressure increased 16.2 ± 0.8 mmHg, and the diastolic pressure increased 8.0 ± 0.5 mmHg.

Conclusions:
Resuscitation from hypoxic pseudo-EMD is often associated with hypotension and hypocalcemia. Administration of intravenous calcium is associated with an abrupt pressor-like response. Calcium as a therapeutic in this setting should be further studied.
Abstract 105: Accuracy of Team Perception of Performance With Actual CPR Quality Metrics in Children
Authors: Knight Lynda , Sweberg Todd , Mullan Pual , Sen Anita , Braga Matthew , Jani Priti , Su Felice , Balikai Shlipa , Kessler David , Roberts Joan , Donoghue Aaron , Wenger Jesse , Niles Dana , Nadkarni Vinay , Berg Marc
Published: July 2021

Background:
American Heart Association (AHA) recommends high quality CPR to promote optimal patient outcomes. Few reports compare team members’ perceptions of CPR quality with quantitative CPR data during actual pediatric CPR.

Hypothesis:
Self-reported team perception of CPR performance will not meet quantitative CPR metrics using AHA BLS guideline criteria.

Methods:
Prospective data from an international pediatric (pediRES-Q) resuscitation collaborative from February 2016 to August 2017. A modified Team Emergency Assessment Measure framework for qualitative content analysis was used to assess data from “hot” debriefings (held soon after arrest) by language processing experts blinded to CPR data. Events without reported perception of CPR and quantitative CPR data were excluded. Comments regarding CPR perception were grouped as either Plus perceptions of performance (PPP) or Delta perceptions of performance (DPP). Grouped events were matched and compared to quantitative CPR data of chest compression (CC) fraction (CCF), rate, and depth as collected by CPR-recording defibrillators. Compliance with AHA BLS guidelines were defined as events with mean: CCF >60%, CC rate 100-120/min; and CC depth for infants <1yo, ~4 cm (3.6-4.4 cm.); children 1-18 yo, 5-≤6 cm.

Results:
Of 227 arrests, 108 (48%) hot debriefings were reported. Reported CPR perceptions with paired quantitative CPR data were available for 53/108 (49%) events; 32/53 (60%) PPP and 21/53 (39%) DPP. Event CPR metric summaries (median [IQR]) for PPP - CCF 0.87 [0.77, 0.93]; CC rate 116/min [108.5, 120]; CC depth age <1yo 2.35 [2.01, 3.0] cm; >1yr 4.2 [3.3, 5.05] cm. DPP - CCF 0.79 [0.69, 0.92]; CC rate 118/min [109,129]; CC depth < 1 yo 2.03 [1.95, 2.2] cm; >1yo 3.93 [3.3, 5.06] cm. PPP events, 28/32 (87%) met guideline criteria for CCF, 25/32 (78%) for CC rate; 6/32 (19%) for CC depth; and 4/32 (12%) met criteria for all 3 categories. For DPP events, 17/21 (80%) met guideline criteria for CCF; 15/21 (71%) for CC rate; and 3/21 (15%) for CC depth, and 2/21 (9%) met criteria for all 3 categories.

Conclusions:
Self-reported team perception of CPR quality does not match quantitative CPR metrics using AHA guideline criteria whether CPR was positively perceived or not, depth being main reason for non-compliance.
Abstract 106: Emergency Medical Response for Non-Hospitalized Patient Events in a Children’s Hospital
Authors: Hoffman Olivia L , Romano Jane , Kleinman Monica E
Published: July 2021

Introduction:
Hospital-based Code Blue (CB) teams are designed for hospitalized patients (HP) with unanticipated medical emergencies outside of an intensive care unit (ICU). At our pediatric institution, the same team responds to CB calls involving non-hospitalized patients (NHP) such as outpatients, visitors, and staff. The appropriate team composition for responses to NHP emergencies in a children’s hospital has not yet been studied.

Hypothesis:
There are significant differences between the characteristics of NHP and HP who require emergency medical response, and the majority of responses for NHP do not require advanced emergency or critical care.

Methods:
We analyzed a retrospective cohort of CB responses at a large, urban, academic children’s medical center over a one-year period (January 1 - December 31, 2017). Rapid response team (different from CB team) activations were excluded. We evaluated the demographic and clinical characteristics of NHP-related CB responses and compared them to HP-related CB responses.

Results:
The Code Blue team was activated 168 times, of which 135 (80.4%) were NHP-related and 33 (19.6%) were HP-related. Ninety-one (67.4%) of the NHP responses involved adults (age >18 years) compared to 6 (18.2%) of the HP. The CB team transferred 107 (79.3%) of the NHP to an emergency department, and 19 (75.6%) of the HP to an ICU for further care. The primary type of condition and most common critical interventions performed by the CB team are listed in the table below.

Conclusions:
Code blue activations in our children’s hospital more often involve NHP than HP. NHP responses are more likely to involve adults and infrequently require critical interventions. Use of a pediatric CB team for initial response to NHP events may be an unnecessary use of pediatric critical care resources. Future studies are warranted to evaluate the most effective CB team structure, training, and certification for NHP emergency responses.
Abstract 217: Cooling Beneficially Impacts Cardiac Performance on Arrest Survivors Undergoing Targeted Temperature Management
Authors: Chen Kevin , Schenone Aldo L , Gheyath Bashaer , Borges Nyal , Duggal Abhijit , Popovic Zoran , Menon Venu
Published: July 2021

Introduction:
Targeted temperature management (TTM) is a widely accepted neuroprotective strategy in the management of comatose cardiac arrest (CA) survivors. The beneficial impact of TTM on cardiac performance in this population remains debatable.

Hypothesis:
Mild cooling enhances cardiac performance in arrest survivors undergoing TTM.

Methods:
We reviewed prospectively collected data on all CA survivors undergoing TTM at our CICU between Jan15 and Jun17. Enrollment was restricted to cases with invasive hemodynamics (iHDs) available at TTM initiation, every 8 hrs at target temperature (32-34°C) and at rewarming completion (>36°C), unless precluded by mortality. Those with cooling initiated before admission and temperature of <36°C prior to iHDs were excluded. iHDs included temperature (Temp), heart rate (HR), mean blood pressure (MAP), right atrial pressure (RAP), pulmonary wedge pressure (PCWP), systemic vascular resistance (SVR) and Fick Cardiac Index (CI). Left and right ventricular stroke work indices were calculated (LVSWI & RVSWI).We also assessed changes induced by cooling, and overall improvements in cardiac performance and iHDs over time at completion of rewarming controlling for temp change using longitudinal data analysis.

Results:
46 arrest survivors with average age of 61 years, 65% male, 83% out-hospital arrest with a shockable rhythm (74%) were evaluated. HR decreased with cooling (p<0.001), to return to baseline after rewarming (p=0.6). MAP, SVR and PCWP decreased by cooling (p<0.001 for all), with sustained improvement after rewarming (p <0.001 for all). LVSWI increased with cooling (p<0.001), with return to baseline after rewarming (p=0.6). Similar findings were encountered with RAP and RVSWI.

Conclusion:
Mild cooling during TTM improves cardiac performance indices. At TTM completion, there is a sustained decrease in filling pressures without a change in LVSWI indicative of improved contractile performance during cooling.
Abstract 242: Incidence, Predictors, Causes, and Costs for 30-day Readmission After In-Hospital Cardiopulmonary Resuscitation Discharge in United States
Authors: Morita Yusuke , Haruna Tetsuya , Haruna Yoshisumi , Nakane Eisaku , Yamaji Yuhei , Hayashi Hideyuki , Hanyu Michiya , Inoko Moriaki
Published: July 2021

Background:
Readmissions after in-hospital cardiopulmonary resuscitation (ICPR) are common and contribute to increased health care utilization and costs. This is the first study to estimate the burden and patterns of 30-day readmission after ICPR from Nationwide Readmission Database (NRD).

Methods and Results:
Patients undergoing ICPR (International Classification of Diseases-Ninth Revision-Clinical Modification codes 99.60 and 99.63) between January and November 2014 from NRD were included. Incidence, predictors, causes, and costs of 30-day readmission were analyzed using discharge weights to obtain national estimates. Among estimated 27278 index admissions survived to hospital discharges after ICPR, 5439 (20.0%) were readmitted within 30 days. Length of stay (LOS) ≧15 days during index hospitalization (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.16-1.42), Medicare or Medicaid insurance (HR, 1.34; 95% CI, 1.19-1.51), heart failure (HR, 1.2; 95% CI, 1.1-1.32), and discharge of metropolitan teaching hospital (HR, 1.19; 95% CI, 1.07-1.33) were independent predictors of 30-day readmission. Among 5439 readmissions, Sepsis (13.7%), heart failure (10.8%), respiratory failure (6.4%), and cardiac dysrhythmias (5.2%) were the most common causes. Estimated total costs of readmission were $102 million and mean of $19122 ±30201, which is accounted for 25.7% of total episode of care (index+readmission). The mean LOS was 8.0 ±10.5 days. The patients with readmission revealed high mortality rate of 10.1%.

Conclusions:
Thirty-day readmissions after ICPR are frequent and are related to baseline comorbidities and hospital characteristics. Awareness of these predictors can help identify and target high-risk patients for interventions, to reduce readmissions and costs.
Abstract 27: Implications of Legislative Efforts on Layperson CPR Education
Authors: Alexander Tyler D , McGovern Shaun K , Leary Marion , Nadkarni Vinay , Abella Benjamin S , Blewer Audrey L
Published: July 2021

Introduction:
Although bystander CPR has been shown to increase rates of survival from out-of-hospital cardiac arrest, recent work has demonstrated low rates of layperson training across the US. In an attempt to increase layperson CPR training, states have passed legislation that mandates CPR training before high school graduation. No study has assessed the impact of this legislation on likelihood of CPR training.

Objectives:
We assessed whether an association existed between state mandated CPR training during high school and the likelihood of young adults being currently trained or ever trained in CPR. We hypothesized younger individuals in states with required CPR training by graduation would be more likely to be currently trained or ever trained in CPR.

Methods:
From 09/2015-11/2015, we conducted a nationwide cross-sectional study of the US adult population using random-digit telephone dialing (n=9,022). Data were weighted by state and assessed through univariate and multivariate analyses controlling for confounding variables. Individuals age 18-24 years old were considered “young” and healthcare workers were excluded in the analysis. Subjects in the five states whose mandatory training laws began in or before the 2013-2014 school year were considered.

Results:
Of the 9,022 participants, individuals were classified by whether they lived in state that mandated training (n=924) or did not (n=8,084). After accounting for confounding variables, 33% of all laypeople in states with mandated training were currently trained while 27% of laypeople in states without mandated training were currently trained (OR: 1.28, 95%CI: 1.07-1.48, p=0.01). Younger adults were 59% more likely to be currently trained in states with mandated training than in states without it (OR: 1.59, 95%CI 1.34-1.89, p<0.01). In addition, younger adults were also 48% more likely to be ever trained in states with mandated training (OR: 1.48, 95%CI: 1.02-2.10 p=0.04).

Conclusion:
Younger adults were more likely to be trained in states with laws mandating CPR training for high school graduation. In addition, younger adults were more likely to have ever been trained in states with laws requiring compulsory CPR training for high school graduation.
Abstract 300: Long-Term Survival, Quality of Life and Health Care Costs in the Survivors of Pre-Hospital Cardiac Arrest
Authors: Lin Hao Y , Yen Zui S , Lin Chih H , Yang Chih W , Hsieh Ming J , Fu Chia M , Ma Matthew H
Published: July 2021

Background:
Understanding the prognosis of out-of-hospital cardiac arrest (OHCA) patients is vital to informing resuscitation and advanced care planning decisions. However, short-term outcomes such as survival to hospital discharge do not account for post-arrest quality of life and medical costs.

Objective:
To investigate the survival time, long-term health-related quality of life, and health care costs of OHCA survivors.

Methods:
We conducted a prospective cohort study of all adult OHCA survivors of cardiac origin between 1 August 2016 and 31 December 2017 in a tertiary medical center in Taiwan. Chinese version of EuroQol-5D-5L (EQ-5D-5L) was used for measuring health-related quality of life at 1 month, 6 month and 1 year post-discharge. Survival and health care costs data were collected. Descriptive statistics and Wilcoxon Signed-Ranks Test were used for data analysis.

Results:
During the study period, 30 of 163 (18.4%) OHCA of presumed cardiac origin survived to hospital discharge. The mean age for the survivors was 59 years. Most survivors were male (83.3%), and received bystander cardiopulmonary resuscitation (73.3%) and defibrillation (86.7%) in the prehospital settings. Of 30 survivors, 23 patients were cerebral performance category score (CPC) of 1 or 2 and 7 were CPC of 3 or 4. The median hospital stay and estimated median survival time for CPC
1-2
and CPC
3-4
were 17 days, 8.8 years and 34 days, 0.4 years, respectively. The mean EQ-5D-5L visual analogue scale score and index score (utility) for 13 CPC
1-2
survivors followed at 6 month post discharge were 75.58 ± 13.31 and 0.856 ± 0.125, respectively, and were significantly higher than the scores (65.38 ± 15.47, 0.689 ± 0.114) at 1 month. The median health care costs of the index admission and 6 month post-discharge for CPC
1-2
survivors were NT$ 655,866 and NT$ 46,550, respectively.

Conclusion:
The survival time and health related quality of life for OHCA survivors with good neurologic outcome is good and improves over time. It pays to save those lives.
Abstract 321: XPro1595 Reduces the Severity of Post Resuscitation Myocardial Dysfunction in a Rat Model of Cardiac Arrest
Authors: Wang Changsheng , Yang Jin , Hu Zhangle , Guo Qinyue , Wu Xiaobo , Bradley Jennifer , Peberdy Mary Ann , Ornato Joseph , Dixon Kirsty , Tang Wanchun
Published: July 2021

Introduction:
Systemic inflammation plays a major role in the pathophysiology of myocardial dysfunction following cardiac arrest (CA), even after successful cardiopulmonary resuscitation (CPR). A major contributor is pro-inflammatory cytokine Tumor Necrosis Factor (TNF), which induces cardiac hypertrophy, cardiac dilation and reduced heart function. TNF activates two receptors: TNF receptor 1 (TNFR1) induces detrimental cardiac pathology (impedes heart function and reduces survival); and TNF receptor 2 (TNFR2) promotes heart health (improves heart function and survival). This distinction is important because traditional TNF inhibitors (e.g. Etanercept and Infliximab) block the activity of both TNF receptors, causing heart failure. In contrast, selectively inhibiting TNFR1 will likely improve heart function and animal survival following CA. XPro1595 is a novel biologic that selectively inhibits the soluble form of TNF from activating detrimental TNFR1, without interfering with the transmembrane form of TNF to active beneficial TNFR2.

Hypothesis:
XPro1595 selectively inhibits the activity of TNFR1 to reduce myocardial dysfunction following CA.

Methods:
Adult Sprague Dawley rats were anaesthetized and underwent CA (8 min VF, then 8 min CPR), or sham surgery (omit VF and CPR), with or without XPro1595 (10 mg/kg, I.V.), or vehicle treatment 10 min later. Ejection fraction (EF), cardiac index (CI), and myocardial performance index (MPI) were measured at baseline, and 2 and 4 hrs after ROSC. Sham + vehicle (n=5), CA + vehicle (n=5), CA + XPro1595 (n=5).

Results:
XPro1595 treatment significantly improved heart function following CA. For all parameters measured, XPro1595-treated CA animals showed significant improvement above vehicle-treated CA animals, but did not reach sham-operated levels (Fig. 1).

Conclusions:
Using XPro1595 to selectively inhibit soluble TNF from activating TNFR1 improves heart function following CA.
Abstract 342: The Relationship Between Time Interval From Collapse to Return of Spontaneous Circulation After Out-of-Hospital Cardiac Arrest and Neurologically Intact Survival
Authors: Nagao Ken , Tahara Yoshio , Nonogi Hiroshi , Yonemoto Naohiro , Gaieski David F , Ito Noritoshi , Hirose Hitoshi , Yagi Tsukasa , Chiba Nobutaka , Tachibana Eizo , Saku Keijiro , Simokawa Hiroaki
Published: July 2021

Background:
Early cardiopulmonary resuscitation (CPR) and early defibrillation are critical to survival from out-of-hospital cardiac arrest (OHCA). However, few studies have investigated the relationship between time interval from collapse to return of spontaneous circulation (ROSC) and neurologically intact survival.

Methods:
From the All-Japan OHCA Utstein Registry between 2005 and 2015, we enrolled adult patients achieving prehospital ROSC after witnessed OHCA, inclusive of arrest after emergency medical service responder arrival. The study patients were divided into two groups according to initial cardiac arrest rhythm (shockable versus non-shockable). The collapse-to-ROSC interval was calculated as the time interval from collapse to first achievement of prehospital ROSC. The primary endpoint was 30-day favorable neurological outcome after OHCA.

Results:
A total of 69,208 adult patients achieving prehospital ROSC after witnessed OHCA were enrolled; 23,017(33.3%) the shockable arrest group and 46,191 (66.7%) the non-shockable arrest group. The shockable arrest group compared with the non-shockable arrest group had significantly shorter collapse-to-ROSC interval (16±10 min vs. 20±13 min, P<0.001) and significantly higher frequency of the favorable neurological outcome (54.9% vs. 15.3%, P<0.001). Frequencies of the favorable neurological outcome after shockable OHCA decreased to 1.2% to 1.5% with every minute that the collapse-to-ROSC interval was delayed (78% at 1 minute of collapse, 68% at 10 minutes, 44% at 20 minutes, 34% at 30 minutes, 16% at 40 minutes, 4% at 50 minutes and 0% at 60 minutes, respectively, P<0.001), and those after non-shockable OHCA decreased to 0.8% to 1.8% with every minute that the collapse-to-ROSC interval was delayed (40% at 1 minute of collapse, 26% at 10 minutes, 11% at 20 minutes, 5% at 30 minutes, 2% at 40 minutes, 0% at 50 minutes and 0% at 60 minutes, respectively, P<0.001).

Conclusions:
Termination of the collapse-to-ROSC interval to achieve neurologically intact survival after witnessed OHCA was 50 minutes or longer irrespective of initial cardiac arrest rhythm (shockable versus non-shockable), although the neurologically intact survival rate was difference between the two groups.
Abstract 358: Aortic Balloon Occlusion Augments the Efficacy of External Cardiopulmonary Resuscitation After Traumatic Cardiac Arrest in Swine
Authors: Xu Jiefeng , Shen Peng , Xia Senlin , Gao Yuzhi , Liu Shaoyun , Li Zilong , Zhang Mao
Published: July 2021

Introduction:
Following hemorrhage-induced traumatic cardiac arrest (TCA), the effectiveness of standard cardiopulmonary resuscitation (CPR) would be weakened or lost due to an inadequate circulating volume. Previous investigations demonstrated that aortic balloon occlusion (ABO) could control the bleeding and increase proximal organ perfusion during severe traumatic hemorrhage. In this study, we investigated the effect of ABO on the efficacy of CPR in a swine model of TCA.

Hypothesis:
ABO initiated during CPR would increase cardiac and cerebral perfusion so as to improve the outcomes of resuscitation after TCA in swine.

Methods:
Twenty-seven male domestic swine weighing 33±4 kg were utilized. Forty percent of estimated blood volume was removed within 20 mins. The animals were then subjected to 5 mins of untreated ventricular fibrillation and 5 mins of CPR. Coincident with the start of CPR, the animals were randomized to receive ABO (n=15) or control (n=12). Meanwhile, normal saline was intravenously infused at a speed of 0.7 ml/kg/min in all animals.

Results:
During CPR, significantly greater coronary perfusion pressure, regional cerebral oxygen saturation and end-tidal CO
2
were observed in animals treated with ABO when compared with the control group (Table). Consequently, the rate of resuscitation success was significantly higher in the ABO group than in the control group (15/15 vs. 9/12,
p
= 0.040). Additionally, shorter duration of CPR (5.1±0.5 vs. 7.5±4.5 min,
p
= 0.054) and less number of shocks (1.1±0.3 vs. 2.0±1.8,
p
= 0.058) were required for establishing spontaneous circulation in the ABO group compared to the control group.

Conclusion:
The implementation of ABO during CPR significantly increased cardiac and cerebral perfusion and improved the outcomes of resuscitation in TCA following massive hemorrhage.
Ambient Pollutants and Spontaneous Intracerebral Hemorrhage in Greater Boston
Authors: Wilker Elissa H. , Mostofsky Elizabeth , Fossa Alan , Koutrakis Petros , Warren Andrew , Charidimou Andreas , Mittleman Murray A. , Viswanathan Anand
Published: July 2021

Background and Purpose—

Associations between exposures to ambient air pollution and spontaneous intracerebral hemorrhage (ICH) have been inconsistent, and data on stroke subtypes are currently limited.

Methods—

We obtained information on all cases of deep or lobar hematomas from ICH patients who were admitted to the Massachusetts General Hospital in Boston, MA, between 2006 and 2011. We linked the date of admission with 1- to 7-day moving averages of fine particulate matter (PM
2.5
), black carbon, nitrogen dioxide, and ozone from area monitors. We conducted time-stratified bidirectional case-crossover analyses to assess associations between pollutants and stroke. We also investigated whether associations differed by hemorrhage location and type.

Results—

There were 577 cases of ICH (295 deep, 282 lobar). Overall, there was no evidence of elevated ICH risk after increases in PM
2.5
, black carbon, or nitrogen dioxide in the whole population. However, there was suggestion of heightened risk with higher levels of ozone for averages longer than 1 day although CIs were wide. In models stratified by ICH location, associations with ozone remained positive for patients with lobar (3-day moving average odds ratio, 1.62; 95% CI, 1.18–2.22) but not deep ICH (odds ratio, 0.88; 95% CI, 0.65–1.20). Larger estimates were observed among participants with a probable diagnosis of cerebral amyloid angiopathy (odds ratio, 2.23; 95% CI, 1.25–3.96).

Conclusions—

Exposure to ozone may be associated with incidence of lobar ICH, especially among those who have confirmed or probable cerebral amyloid angiopathy.
Negotiation in the Contact Zone: Reading Joseph and Aseneth from a Postcolonial Perspective
Authors: Jun Sunhee
Published: July 2021

In Joseph and Aseneth, religious difference is the decisive boundary that separates Aseneth (gentile) and Joseph (Jew). Therefore, Aseneth’s conversion is essential to cross over this boundary in the narrative. In this respect, one may see Joseph and Aseneth as a colonizing text that seems to romanticize Aseneth’s conversion. However, colonial realities never result one-sidedly from the intention of the powerful; they are full of ambiguity, ambivalence, and hybridity. Utilizing the postcolonial concept of contact zone, this article deals with which negotiations between the disparate groups occur in the contact zone, and consequently what unexpected changes happen after the encounter. The union of the two groups in Joseph and Aseneth is characterized as an ambiguous relation rather than as a unilateral assimilation. Aseneth becomes a shelter for anyone who is in danger beyond the religious boundary by redefining the identity given by the angel, City of Refuge.
The Past Time Uses of the Imperfect in the Aramaic of Daniel
Authors: Carver Daniel E.
Published: July 2021

In the Aramaic of Daniel, the imperfect expresses past situations 29 times. Scholars have long wrestled with these past time uses, and although important contributions have been made along the way, one of the most salient semantic issues that arise with these uses—the semantic intersection of imperfective aspect and telicity—has been overlooked. This study addresses this issue directly by providing a linguistic analysis of the past imperfective uses of the imperfect that describes their semantics in light of situation aspect and (un)boundedness. This study also describes the past modal use of the imperfect, and offers a linguistic explanation for how the imperfect acquired such a use. Ultimately, this study provides a linguistic analysis of the past time uses of the imperfect that fosters more artful and nuanced readings of the text in light of its semantic and functional sophistication.
4. Social Groups and Adapted Minds
Authors: Boyer Pascal
Published: July 2021

Contacts between people from different groups engage a variety of human competencies and motivations, from high-level representations of social categories to visceral responses when confronted with strangers, from cognitive appraisal of conflict to a desire to exclude or even attack “others.” There is a correspondingly diverse set of fields and subfields in psychology and the social sciences focusing on such specific topics as racial prejudice, in-group bias, ethnic identity, xenophobia, and nationalism. In this article, we propose a model that cuts across boundaries between these different fields to describe and explain fundamental aspects of intergroup relations. We propose that many aspects of intergroup relations should be construed as different manifestations of a coalitional psychology. We describe coalitional psychology as a set of evolved mechanisms designed to garner support from conspecifics, organize and maintain alliances, and increase an alliance’s chance of success against rival coalitions. In this perspective, the core psychological mechanisms are the same, independent of whether the alliance in question is formed as ethnic (based on perceived similarity and common origin), racial (based on ethnicity combined with phenotypic similarity), regional, or political, and so forth.
5. How People Think about the Economy
Authors: Boyer Pascal
Published: July 2021

The domain of “folk-economics” consists in explicit beliefs about the economy held by laypeople, untrained in economics, about such topics as, for example, the causes of the wealth of nations, the benefits or drawbacks of markets and international trade, the effects of regulation, the origins of inequality, the connection between work and wages, the economic consequences of immigration, or the possible causes of unemployment. These beliefs are crucial in forming people’s political beliefs and in shaping their reception of different policies. Yet, they often conflict with elementary principles of economic theory and are often described as the consequences of ignorance, irrationality, or specific biases. As we will argue, these past perspectives fail to predict the particular contents of popular folk-economic beliefs and, as a result, there is no systematic study of the cognitive factors involved in their emergence and cultural success. Here we propose that the cultural success of particular beliefs about the economy is predictable if we consider the influence of specialized, largely automatic inference systems that evolved as adaptations to ancestral human small-scale sociality. These systems, for which there is independent evidence, include free-rider detection, fairness-based partner choice, ownership intuitions, coalitional psychology, and more. Information about modern mass-market conditions activates these specific inference systems, resulting in particular intuitions, for example, that impersonal transactions are dangerous or that international trade is a zero-sum game. These intuitions in turn make specific policy proposals more likely than others to become intuitively compelling, and, as a consequence, exert a crucial influence on political choices.
6. Detecting Mental Disorder
Authors: Boyer Pascal
Published: July 2021

How do people detect mental dysfunction? What is the influence of cultural models of dysfunction on this detection process? The detection process as such is not usually researched as it falls between the domains of cross-cultural psychiatry (focusing on the dysfunction itself) and anthropological ethno-psychiatry (focusing on cultural models of sanity and madness). I provide a general model for this ‘‘missing link’’ between behavior and cultural models, grounded in empirical evidence for intuitive psychology. Normal adult minds entertain specific intuitive expectations about mental function and behavior, and by implication they infer that specific kinds of behavior are the result of underlying dysfunction. This suggests that there is a ‘‘catalogue’’ of possible behaviors that trigger that intuition, hence a limited catalogue of possible symptoms that feed into culturally specific folk-understandings of mental disorder. It also suggests that some mental dysfunctions, as they do not clearly violate principles of intuitive psychology, are ‘‘invisible’’ to folk-understandings. This perspective allows us to understand the cultural stability and spread of particular views of madness. It also suggests why certain types of mental disorder are invisible to folk-understandings.
The influence of variability in meridional over turning on global ocean circulation
Authors: Hu Aixue , Meehl Gerald A. , Rosenbloom Nan , Molina Maria J. , Strand Warren. G.
Published: July 2021

The Atlantic Meridional Overturning circulation (AMOC) is an important global scale circulation and changes in AMOC can induce significant regional and global climate impacts. Here we study the stability of AMOC and its influence on global ocean circulation and the surface climate though analyzing a set of sensitivity experiments using the Community Climate System Model version 1 (CESM1). Results show that a collapsed AMOC can induce changes in global ocean circulation, such as reduced (or reversed) Bering Strait transport, weakened Indonesia throughflow and Agulhas current, but strengthened Drake Passage transport. It also changes the global wind pattern and surface temperature, such as a seesaw-like surface temperature change between Northern and Southern Hemispheres, a weakening of Indian-Australia summer monsoon, a southward shift of the Southern ocean westerlies, etc. We also found that AMOC and the Pacific deep meridional overturning circulation (or PMOC) do not form a natural seesaw under modern day climate and geography. A collapsed AMOC (active PMOC) is not stable under modern conditions if there is no additional freshwater (salt) input in the subpolar North Atlantic (Pacific), suggesting that the modern mean state of AMOC (PMOC) does not depend on local haline forcing although its variability and changes do.
Causal Mapping for Strategy Execution: Pitfalls and Applications
Authors: MacLennan Andrew F. , Markides Constantinos C.
Published: July 2021

Organizations can attempt to improve strategy implementation by developing strategy execution maps, which aim to translate strategic objectives into specific activities and provide sufficient clarity to inform employees’ decisions and actions. However, managers often encounter pitfalls, both in framing the process and in developing maps. This article suggests how to overcome these pitfalls, describes several applications of causal maps to further enhance strategy execution, and illustrates strategy execution maps for organizations with distinctive strategies.
Political trust in a multilevel polity: patterns of differentiation among more and less politically sophisticated citizens
Authors: Proszowska Dominika , Jansen Giedo , Denters Bas
Published: July 2021

Differentiation in political trust attitudes occurs when citizens distinguish between different political institutions in terms of their trustworthiness. This article explores patterns of citizens’ (non-)differentiation between the local, national and European Union governance levels with regard to political trust. With unique Dutch data, we find that trust evaluations of each pair of governments (local–national/national–European Union/local–European Union) follows a distinct pattern. This suggests that citizens: (1) form more than one political trust attitude; and (2) use different cognitive mechanisms (like cognitive proximity and subjective rationality) to make sense of the political complexities in multilevel governance systems. Although general patterns found at the population level were largely reproduced at the subgroup level, that is, low and high political sophistication groups produced similar patterns of (non-)differentiation, highly politically sophisticated citizens tended to differentiate more – they are more likely to evaluate each governance level ‘on its own merits’. Our results are especially relevant in an era of declining trust, where governments want to regain citizens’ trust but are very much in the dark about which government level (if any) is the main culprit.

Points for practitioners

Citizens, particularly those with higher political interest, more exposure to political information and higher education, tend to differentiate in their trust orientations towards different governments. This suggests that citizens, to some extent, judge different governments in the multilevel system ‘on their own merits’. Therefore, politicians and public managers confronted with declining trust in their jurisdiction should seriously consider whether such a negative trend might not reflect citizens’ dissatisfaction with their governments’ lack of responsiveness to the specific demands of its citizens.
Psychometric Suitability of Adaptations to the Special Judo Fitness Test for Athletes With Visual Impairment
Authors: Kons Rafael L. , Franchini Emerson , Bragança Jaime R. , Detanico Daniele
Published: July 2021

This study aimed to test the reliability, sensitivity, construct and logical validity of an adapted Special Judo Fitness Test (SJFT) for judo athletes with visual impairment . Twenty judo athletes with visual impairments performed both the adapted SJFT with tactile and sonorous stimuli (experimental conditions) and the typically administered SJFT (standard condition). We used analyses of variance (ANOVAs) with repeated-measures to compare the groups’ SJFT performances, and one-way ANOVAs to compare different visual ability classes of athletes (B1, B2 and B3). We used t-tests to compare SJFT variables between elite and sub-elite groups. We set statistical significance for all tests at p < 0.05. The standard SJFT showed excellent test-retest reliability for number of throws and overall index (ICC = 0.91–0.95), and both sonorous and tactile sensitivity adaptations of the SJFT showed medium sensitivity for detecting performance changes. The number of throws and SJFT index were higher with the sonorous adaptation of the test, compared to the tactile and standard versions ( p < 0.001). Athletes who were blind (B1) presented similar performances to athletes who were partially sighted (B2 and B3) only on the SJFT with the sonorous stimulus. Moreover, only the sonorous SJFT adaptation discriminated between the performances of elite and sub-elite athletes ( p < 0.001). In conclusion, both SJFT adaptations showed excellent reliability and medium sensitivity on test-retest, but, only the SJFT with the sonorous stimulus seemed valid for assessing judo athletes with varying degrees of visual impairment, and only the sonorous stimulus SJFT discriminated elite from sub-elite athletes.
Transportation Barriers to Successful Reentry among Returning Citizens: A Qualitative Interpretive Meta-synthesis
Authors: Nordberg Anne , Davis Jaya B. , Leat Sara R. , Mattingly Stephen , Keaton Craig , Mitchell Michael B.
Published: July 2021

Over 600,000 individuals return to United States communities from prison each year. Transportation has been identified as a major barrier to successful reentry. Applying qualitative interpretive meta-synthesis to achieve a deep understanding of reentry transportation obstacles, 11 articles with 362 male and female participants were identified. Two themes emerged from our analysis: (1) “Transportation connects complex obligations,” highlighting the critical role that transportation plays in the successful navigation of post-release conditions; and (2) “Transportation deficiencies exacerbate vulnerability,” revealing how transportation factors intertwine with structural issues to increase precarity.
Confirmation Bias and the Persistence of Misinformation on Climate Change
Authors: Zhou Yanmengqian , Shen Lijiang
Published: July 2021

A web-based two (preexisting position: correct vs. incorrect) by two (message type: scientific information vs. misinformation) by three (messages) mixed design experimental study was conducted to test confirmation bias as a mechanism underlying the persistence of misinformation on climate change and to examine attitude certainty as a moderator of confirmation bias. Data collected with Qualtrics panels demonstrated robust confirmation bias in message and source perceptions, empathy, and perceived message effectiveness when individuals encountered messages consistent with their preexisting position on climate change, which in turn strengthened their preexisting position. The patterns of biased message processing and post-message position polarization were more extreme among climate change deniers. Attitude certainty significantly intensified polarization of position on climate change.
Decolonizing Our Feminist/ized Revolutions: Enfleshed Praxis from Southwest Colombia
Authors: Motta Sara C.
Published: July 2021

An initial mapping of the decolonial feminisms emergent in Buenaventura and Cali, Southwest Colombia, in the Afro-Colombian and indigenous political Escuela de Mariposas de Alas Nuevas and Círculo de Hombres, Cali, shows that they move within and beyond a politics and epistemology of representation in a return to the enfleshed as territories of transformatory wisdoms and the embrace of ancestrality and feminist spirituality.

Un mapeo inicial de los feminismos decoloniales surgidos en Buenaventura y Cali, en el suroeste de Colombia, dentro de las agrupaciones políticas afrocolombianas e indígenas Escuela de Mariposas de Alas Nuevas y Círculo de Hombres, Cali, muestra que se mueven dentro y fuera de una política y epistemología de representación y ejercen un retorno a lo encarnado como territorios de sabidurías transformadoras a la vez que abrazan la ancestralidad y la espiritualidad feminista.
In the Labyrinths of Dependent Urbanization: Rescue and Perspectives
Authors: Tonin Vitor Hugo
Published: July 2021

At their peak, theories of underdevelopment and dependency guided social research in the most varied dimensions of life. The rapid increase in urban inequality was one of the main drivers of criticism of capitalist development in peripheral countries and gave rise to analyses of dependent urbanization. This interpretation was interrupted in the late 1970s with the crisis of dependency theory, the main reason for which was the political defeat of the continent’s new left. This rescue of this analytical matrix and its combination with current Marxist studies of the capitalist production of the city offer a more precise categorization of underdevelopment and greater refinement in dealing with levels of abstraction. It is now feasible to better situate existing links between dependency and urban development and thus to establish a dialogue with recent analytical contributions on urban development. This dialogue opens a path for the theoretical and methodological evolution of urban studies in peripheral countries.

Em seu auge as teorias do subdesenvolvimento e dependência orientaram as investigações sociais nas mais variadas dimensões da vida. O acelerado aumento da desigualdade urbana foi um dos principais impulsionadores da crítica ao desenvolvimento capitalista nos países periféricos e deu origem às análises da urbanização dependente. Essa construção foi interrompida no final da década de 1970 com a crise da teoria da dependência cuja principal razão identificamos na derrota política da nova esquerda no continente. O resgate dessa matriz analítica e seu encontro com os atuais estudos marxistas da produção capitalista da cidade oferece atualmente uma categorização mais precisa do subdesenvolvimento e maior refinamento no trato dos níveis de abstração. Torna-se possível localizar melhor as mediações existentes entre a dependência e o urbano e, com isso, estabelecer um diálogo com as recentes contribuições analíticas sobre o urbano. Deste diálogo abre-se uma alameda para a evolução teórica-metodológica dos estudos urbanos nos países periféricos.
Why Multibusiness Corporations Split: CEO Strategizing as the Ecosystem Evolves
Authors: Burgelman Robert A. , Snihur Yuliya , Thomas Llewellyn D. W.
Published: July 2021

We investigate why CEOs of multibusiness corporations decide to engage in a corporate split that spawns multiple independent, smaller, but more adaptive, entities. Through an in-depth examination of the dynamic forces that led CEO Meg Whitman to split HP, we propose that the company’s evolving business ecosystem led to the divergence of the consumer-oriented and enterprise-oriented business models in the corporate portfolio. We document the interplay between inter–business model complementarity and intra–business model complexity and how this vicious cycle, in combination with increasing capital market pressure, led to the CEO decision to split and her public justification for this momentous move. Our combined longitudinal interpretative and realist process-tracing approach generates one of the first conceptual frameworks to integrate insights from the ecosystem and corporate divestiture literatures.
Navigating the Gap: Children’s Experiences of Home and School Life Following Maternal Death
Authors: Holmgren Helle
Published: July 2021

This article is the second reporting on the findings from a study of the experiences of families following the death of a parent. Four Danish families consisting of four fathers and seven children were interviewed about their experiences following the death of the mother in the family. The results presented here focus on the experiences of the children. Using thematic analysis assisted by the qualitative data analysis software NVivo 12 Pro, two overall themes were found, “Life in the Home” and “Life Outside the Home.” The children experienced a clear dichotomy between the two lifeworlds post-loss and found it difficult navigating between the two. The recommendations offered for an improvement of the care for bereaved children are based on the children’s own advice.