bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Markers of Fibrosis and Heart Failure Incidence in Patients with Type 2 Diabetes Mellitus
Authors: Lebedev Denis A. , Lyasnikova Elena A. , Vasilyeva Elena Yu. , Likhonosov Nikolai P. , Sitnikova Maria Yu. , Babenko Alina Yu.
Published: November 2021

Type 2 diabetes mellitus (T2DM) and chronic heart failure (HF) have close association, and several biomarkers have been studied to better understand this association and improve prediction of HF in T2DM. Furthermore, in recent clinical trials, sodium glucose cotransporter 2 inhibitors (SGLT2i), glucose-lowering drugs, improved HF outcomes. The objective of the present study was to evaluate association between circulating biomarkers of fibrosis and incidence of HF with preserved ejection fraction (HFpEF) in patients with T2DM receiving sodium glucose cotransporter 2 inhibitors (SGLT2i). Materials and Methods. At baseline, transthoracic echocardiography and laboratory assessment of N-terminal fragment of the brain natriuretic peptide (Nt-proBNP), soluble suppression of tumorigenesis-2 (sST2), galectin-3 (Gal-3), C-terminal propeptide of procollagen type I (PICP), N-terminal propeptide of procollagen type III (PIIINP), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix proteinase-1 (TIMP-1) were done. After 3 years of follow-up, information about HF events (hospitalization for HF, established HF in outpatient department by a cardiologist) was obtained. Results. Seventy-two patients were included in the study. The mean age was 57 (49.7; 63.2) years; 44% were female. Most patients had T2DM for more than 4 years. All patients were overweight or had obesity, and 93% patients had arterial hypertension (AH). After 3 years of follow-up, HFpEF was established in 21% patients. Patients were divided into two groups according to the presence of HFpEF, and baseline characteristics were compared. Patients with HF were older and had longer diabetes and AH duration and higher Nt-proBNP, Gal-3, PIIINP, and PICP levels at baseline than patients without HF (all

p
<
0.05

).

Gal
−
3
>
10

 ng/ml (

OR
=
2.25

; 95% CI, 1.88–5.66;

p
=
0.01

) and

NT
−
pro
−
BNP
>
80

 pg/ml (

OR
=
2.64

; 95% CI, 1.56–4.44;

p
=
0.001

) were associated with increased risk of HF incidence.

Age
>
60

years, diabetes

duration
>
10

years, and presence of abdominal obesity were independent predictors of HFpEF as well. Conclusions. T2DM patients treated with SLGT2i, who developed HFpEF after 3 years of follow-up, had higher PICP, PIIINP, Gal-3, and NT-proBNP serum concentrations at baseline, and Gal-3 level was an independent predictor of HFpEF.
Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure: Primary Results of the SWISS-APERO Randomized Clinical Trial
Authors: Galea Roberto , De Marco Federico , Meneveau Nicolas , Aminian Adel , Anselme Frédéric , Gräni Christoph , Huber Adrian T. , Teiger Emmanuel , Iriart Xavier , Babongo Bosombo Flora , Heg Dik , Franzone Anna , Vranckx Pascal , Fischer Urs , Pedrazzini Giovanni , Bedogni Francesco , Räber Lorenz , Valgimigli Marco
Published: November 2021

Background:

No study has so far compared Amulet with the new Watchman FLX in terms of residual left atrial appendage (LAA) patency or clinical outcomes in patients undergoing percutaneous LAA closure.

Methods:

In the investigator-initiated SWISS APERO trial (Comparison of Amulet Versus Watchman/FLX Device in Patients Undergoing Left Atrial Appendage Closure), patients undergoing LAA closure were randomly assigned (1:1) open label to receive Amulet or Watchman 2.5 or FLX (Watchman) across 8 European centers. The primary end point was the composite of justified crossover to a nonrandomized device during LAA closure procedure or residual LAA patency detected by cardiac computed tomography angiography (CCTA) at 45 days. The secondary end points included procedural complications, device-related thrombus, peridevice leak at transesophageal echocardiography, and clinical outcomes at 45 days.

Results:

Between June 2018 and May 2021, 221 patients were randomly assigned to Amulet (111 [50.2%]) or Watchman (110 [49.8%]), of whom 25 (22.7%) patients included before October 2019 received Watchman 2.5, and 85 (77.3%) patients received Watchman FLX. The primary end point was assessable in 205 (92.8%) patients and occurred in 71 (67.6%) patients receiving Amulet and 70 (70.0%) patients receiving Watchman, respectively (risk ratio, 0.97 [95% CI, 0.80–1.16];
P
=0.713). A single justified crossover occurred in a patient with Amulet who fulfilled LAA patency criteria at 45-day CCTA. Major procedure-related complications occurred more frequently in the Amulet group (9.0% versus 2.7%;
P
=0.047) because of more frequent bleeding (7.2% versus 1.8%). At 45 days, the peridevice leak rate at transesophageal echocardiography was higher with Watchman than with Amulet (27.5% versus 13.7%,
P
=0.020), albeit none was major (ie, >5 mm), whereas device-related thrombus was detected in 1 (0.9%) patient with Amulet and 3 (3.0%) patients with Watchman at CCTA and in 2 (2.1%) and 5 (5.5%) patients at transesophageal echocardiography, respectively. Clinical outcomes at 45 days did not differ between the groups.

Conclusions:

Amulet was not associated with a lower rate of the composite of crossover or residual LAA patency compared with Watchman at 45-day CCTA. Amulet, however, was associated with lower peridevice leak rates at transesophageal echocardiography, higher procedural complications, and similar clinical outcomes at 45 days compared with Watchman. The clinical relevance of CCTA-detected LAA patency requires further investigation.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03399851.
Development and Validation of a Predictive Model to Identify Patients With an Ascending Thoracic Aortic Aneurysm
Authors: Mori Makoto , Gan Geliang , Deng Yanhong , Yousef Sameh , Weininger Gabe , Daggula Krishna R. , Agarwal Ritu , Shang Michael , Assi Roland , Geirsson Arnar , Vallabhajosyula Prashanth
Published: November 2021

Background

Screening protocols do not exist for ascending thoracic aortic aneurysms (ATAAs). A risk prediction algorithm may aid targeted screening of patients with an undiagnosed ATAA to prevent aortic dissection. We aimed to develop and validate a risk model to identify those at increased risk of having an ATAA, based on readily available clinical information.

Methods and Results

This is a cross‐sectional study of computed tomography scans involving the chest at a tertiary care center on unique patients aged 50 to 85 years between 2013 and 2016. These criteria yielded 21 325 computed tomography scans. The double‐oblique technique was used to measure the ascending thoracic aorta, and an ATAA was defined as >40 mm in diameter. A logistic regression model was fitted for the risk of ATAA, with readily available demographics and comorbidity variables. Model performance was characterized by discrimination and calibration metrics via split‐sample testing. Among the 21 325 patients, there were 560 (2.6%) patients with an ATAA. The multivariable model demonstrated that older age, higher body surface area, history of arrhythmia, aortic valve disease, hypertension, and family history of aortic aneurysm were associated with increased risk of an ATAA, whereas female sex and diabetes were associated with a lower risk of an ATAA. The C statistic of the model was 0.723±0.016. The regression coefficients were transformed to scores that allow for point‐of‐care calculation of patients' risk.

Conclusions

We developed and internally validated a model to predict patients' risk of having an ATAA based on demographic and clinical characteristics. This algorithm may guide the targeted screening of an undiagnosed ATAA.
Graded Coronary Risk Stratification for Emergency Department Patients With Chest Pain: A Controlled Cohort Study
Authors: Mark Dustin G. , Huang Jie , Ballard Dustin W. , Kene Mamata V. , Sax Dana R. , Chettipally Uli K. , Lin James S. , Bouvet Sean C. , Cotton Dale M. , Anderson Megan L. , McLachlan Ian D. , Simon Laura E. , Shan Judy , Rauchwerger Adina S. , Vinson David R. , Reed Mary E. , Mark Dustin G , Huang Jie , Ballard Dustin W , Kene Mamata V , Sax Dana R , Chettipally Uli K , Lin James S , Bouvet Sean C , Cotton Dale M , McLachlan Ian D , Vinson David R , Rauchwerger Adina S , Reed Mary E
Published: November 2021

Background

Resource utilization among emergency department (ED) patients with possible coronary chest pain is highly variable.

Methods and Results

Controlled cohort study amongst 21 EDs of an integrated healthcare system examining the implementation of a graded coronary risk stratification algorithm (RISTRA‐ACS [risk stratification for acute coronary syndrome]). Thirteen EDs had access to RISTRA‐ACS within the electronic health record (RISTRA sites) beginning in month 24 of a 48‐month study period (January 2016 to December 2019); the remaining 8 EDs served as contemporaneous controls. Study participants had a chief complaint of chest pain and serum troponin measurement in the ED. The primary outcome was index visit resource utilization (observation unit or hospital admission, or 7‐day objective cardiac testing). Secondary outcomes were 30‐day objective cardiac testing, 60‐day major adverse cardiac events (MACE), and 60‐day MACE‐CR (MACE excluding coronary revascularization). Difference‐in‐differences analyses controlled for secular trends with stratification by estimated risk and adjustment for risk factors, ED physician and facility. A total of 154 914 encounters were included. Relative to control sites, 30‐day objective cardiac testing decreased at RISTRA sites among patients with low (≤2%) estimated 60‐day MACE risk (−2.5%, 95% CI −3.7 to −1.2%,
P
<0.001) and increased among patients with non‐low (>2%) estimated risk (+2.8%, 95% CI +0.6 to +4.9%,
P
=0.014), without significant overall change (−1.0%, 95% CI −2.1 to 0.1%,
P
=0.079). There were no statistically significant differences in index visit resource utilization, 60‐day MACE or 60‐day MACE‐CR.

Conclusions

Implementation of RISTRA‐ACS was associated with better allocation of 30‐day objective cardiac testing and no change in index visit resource utilization or 60‐day MACE.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03286179.
Sex Differences in Cardiovascular Outcomes of Older Adults After Myocardial Infarction
Authors: Kerola Anne M. , Palomäki Antti , Rautava Päivi , Nuotio Maria , Kytö Ville
Published: November 2021

Background

Evidence on the impact of sex on prognoses after myocardial infarction (MI) among older adults is limited. We evaluated sex differences in long‐term cardiovascular outcomes after MI in older adults.

Methods and Results

All patients with MI ≥70 years admitted to 20 Finnish hospitals during a 10‐year period and discharged alive were studied retrospectively using a combination of national registries (n=31 578, 51% men, mean age 79). The primary outcome was combined major adverse cardiovascular event within 10‐year follow‐up. Sex differences in baseline features were equalized using inverse probability weighting adjustment. Women were older, with different comorbidity profiles and rarer ST‐segment–elevation MI and revascularization, compared with men. Adenosine diphosphate inhibitors, anticoagulation, statins, and high‐dose statins were more frequently used by men, and renin‐angiotensin‐aldosterone inhibitors and beta blockers by women. After balancing these differences by inverse probability weighting, the cumulative 10‐year incidence of major adverse cardiovascular events was 67.7% in men, 62.0% in women (hazard ratio [HR], 1.17; CI, 1.13–1.21;
P
<0.0001). New MI (37.0% in men, 33.1% in women; HR, 1.16;
P
<0.0001), ischemic stroke (21.1% versus 19.5%; HR, 1.10;
P
=0.004), and cardiovascular death (56.0% versus 51.1%; HR, 1.18;
P
<0.0001) were more frequent in men during long‐term follow‐up after MI. Sex differences in major adverse cardiovascular events were similar in subgroups of revascularized and non‐revascularized patients, and in patients 70 to 79 and ≥80 years.

Conclusions

Older men had higher long‐term risk of major adverse cardiovascular events after MI, compared with older women with similar baseline features and evidence‐based medications. Our results highlight the importance of accounting for confounding factors when studying sex differences in cardiovascular outcomes.
The Lives of Marx: Hägglund and Marx’s Philosophy after Pippin and Postone
Authors: Lazarus Michael
Published: November 2021

To make ‘philosophy worldly’ often requires an act of translation. In This Life, Martin Hägglund argues for the relevance of Marx to our contemporary lives. By way of a lively and sophisticated dialogue between philosophical interlocutors – including Hegel and Marx – Hägglund offers a compelling account of the relation between time, value and freedom. This Life translates current issues in academic philosophy into a popular register that does not reduce the complexity of the issues but shows what is at stake for our own lives. Hägglund provides a synthesis of Robert B. Pippin’s normative reading of Hegel and the value-form critical theory of Moishe Postone’s Marxism. Further, Hägglund’s vision of freedom outflanks the political limitations of Pippin’s Hegel and Postone’s Marx while retaining the power of their analyses. I assess his interpretation of Hegel and critically examine the concept of value operative in This Life, and frame this question in terms of value-form theory.
Pacific Islands Countries Declare Permanent Maritime Baselines, Limits and Boundaries
Authors: Freestone David , Schofield Clive
Published: November 2021

The Pacific Island countries are in the front line of adverse impacts from sea level rise. For the last decade the South Pacific Forum Members have been seeking ways to preserve their entitlements to their maritime zones and resources in the event of inundation of coasts and coastal features as a result of sea level rise. The issue was explored by the International Law Association in its 2018 Report and is being considered by a Study Group of the International Law Commission. This 2021 Declaration by the 18 Members of the South Pacific Forum purporting to fix permanently their maritime entitlements represents a major development in State practice for the region.
Legal Framework for Marine Oil Pollution from Ships in Thailand
Authors: Gamassa Pascal Kany Prud’ome
Published: November 2021

Marine oil pollution from ships has been a constant threat to Thai waters. This article examines the domestication of the provisions of relevant international conventions to which Thailand is a party regarding the prevention, preparedness, response and compensation of claimants of marine oil pollution damage. The current Thai legal framework does not provide for adequate protection of the marine environment. Thailand has not yet become a party to many relevant international conventions and does not provide adequate compensation to victims of marine oil pollution incidents. This article provides recommendations for the improvement of the legal framework of Thailand regarding these issues.
The NHS in Northern Ireland Post-Brexit: the Legal Position on Product Supply
Authors: Yusufi Hafsa , Hervey Tamara , Bloemink Astrid , Cavanagh Annie , Shaw Hannah
Published: November 2021

The UK left the European Union’s single market on 1 January 2021. A Withdrawal Agreement made special provision for Northern Ireland. However, ‘grace periods’ concerning supply of goods were agreed, delaying full application of the new rules. The Northern Ireland NHS is heavily reliant on supplies from Great Britain. If these supplies are disrupted, the quality of care offered to patients will diminish. This article shows the legal details of applicable law once the ‘grace periods’, which are currently securing supply, cease to apply. It reveals significant costs and uncertainties associated with supply of products to the NHS in Northern Ireland. The direction of travel, unless something changes, is that new products will reach patients later than in Great Britain, and there is a real possibility that some products become difficult or impossible for the NHS in Northern Ireland to source. The result will be reduced quality of patient care.
In the Footsteps of Galileo
Authors: de Ceglia Francesco Paolo , Lusito Fabio
Published: November 2021

Italian scientific biopics experienced a period of extraordinary media hype in the 1970s, when some intellectuals personally committed to bringing the lives of the scientists of the past to television in order to discuss the relationship between knowledge and power in the present. Nevertheless, might we properly speak of “Italian-style” historical-scientific fictional drama? To answer this question, we will focus on Roberto Rossellini, Liliana Cavani and, above all, Lucio Lombardo Radice, a promoter, scientific consultant, author and presenter of, and sometimes even actor in, some of the most controversial of these scientific biopics. This article aims, first of all, to reconstruct this history, explaining the reasons for the success of the genre, starting in the 1960s, and the crisis it underwent in the 1980s; secondly, to ascertain the influences these ideological works exerted on choices, approaches and styles of the next generation of science historians and communicators.
Cryptic diversity and gene introgression of Moinidae (Crustacea: Cladocera) in Nigeria
Authors: Deng Zhixiong , Ni Yijun , Wang Jinhui , Ebido Chike Chukwuenyem , Odii Elijah Chibueze , Okoro Joseph Onyekwere , Blair David , Hu Wei , Yin Mingbo
Published: November 2021

The distribution and species/lineage diversity of freshwater invertebrate zooplankton is understudied in Sub-Saharan Africa. In the present study, we explored the lineage diversity and regional distribution of Moinidae (Crustacea: Cladocera) species in Southeast Nigeria. Three species of Moinidae were identified, based on morphology, in 11 of 32 Nigerian lakes examined. Their phylogenetic relationships were investigated based on mitochondrial dna sequences (cytochrome oxidase c subunit I gene; coi) and two nuclear internal transcribed spacer regions (its-1 and its-2). Three coi lineages were detected, corresponding to the morphological species. Two of the coi lineages are newly reported, but one coi lineage (and the haplotype found) is globally distributed, suggesting an ability of moinids to disperse over long distances. Interestingly, two individuals that were morphologically M. cf. macrocopa and had its alleles typical of that species had mtDNA sequences typical of M. cf. micrura. Additionally, one individual that corresponded morphologically to M. cf. macrocopa (and also had a mitochondrial sequence typical of M. cf. micrura) had one its-2 allele typical of that species and one typical of M. cf. micrura. This discordance between mtDNA and nuclear phylogenies suggests gene introgression and/or hybridization between different species within the genus. Our data shows the lineage distribution/diversity and the presence of gene introgression/interspecific hybridization among moinid species from a tropical region.
Histoire concrète de l’abstraction et histoire des mathématiques
Authors: Ehrhardt Caroline
Published: November 2021

Cet article propose de revenir sur le programme d’histoire concrète de l’abstraction proposé par Jean-Claude Perrot dans les années 1990, pour montrer quels en sont les apports pour l’histoire des mathématiques. En mettant l’accent sur les dynamiques sociales, culturelles et matérielles dans lesquelles s’élaborent les connaissances, ce programme fournit en effet des outils pour analyser non seulement les modalités de circulation des mathématiques, mais surtout les effets concrets des pratiques symboliques, souvent laissées de côtés dans les travaux historiens sur les sciences. Plus encore, le programme d’histoire concrète de l’abstraction constitue en objet d’histoire le processus qui permet aux traces matérielles des activités savantes passées et aux modalités de raisonnements qu’elles véhiculent de parvenir jusqu’à nous tout en transcendant leurs conditions initiales de production. Il offre ainsi un cadre analytique pour étudier le rapport des mathématiques au temps historique.
Introduction à la Genèse de l’Histoire (1945)
Authors: Febvre ( - ) Lucien
Published: November 2021

Ces pages dactylographiés ont été conçues par l’historien comme l’introduction d’un livre à écrire. Souvent ainsi, il traçait une ébauche qui tenait lieu ensuite d’introduction. Ici, il indique l’état d’une vaste enquête historiographique tout en récusant à la fois le tropisme historiographique et l’histoire des idées. Son attention au caractère concret des tâches des historiens, en leur temps, ouvre ici une perspective proprement épistémologique. Au passage il se démarque de la notion d’« outillage mental » tel qu’il l’avait employée ailleurs dans les mêmes années.
Comment l’histoire intellectuelle peut-elle servir une réforme de l’histoire économique et sociale ?
Authors: Brian Éric
Published: November 2021

Le projet intellectuel de Jean-Claude Perrot a été formé à l’occasion de la préparation de sa thèse sur la genèse de la ville de Caen. Au cours de cette enquête, il a mesuré les limites de l’histoire économique et sociale qui s’imposait alors comme modèle et les apports d’une histoire des connaissances économiques et sociales contemporaines des phénomènes étudiés. Cette vision d’ensemble a mûri pendant une trentaine d’années pour aboutir d’une part à des propositions neuves relatives à l’histoire intellectuelle et d’autre part à un programme historiographique qui conjuguerait ces deux dimensions. Ce programme a inspiré le « tournant critique » de la revue Les Annales (1989) et il a été exploré par ses continuateurs directs ou indirects. Finalement l’article opère une consolidation conceptuelle selon le principe analysé ailleurs par l’historien.
Modern Judeo-Provençal as Known from Its Sole Textual Testimony: Harcanot et Barcanot (Critical Edition and Linguistic Analysis)
Authors: Nahon Peter
Published: November 2021

This study offers a linguistic description of the idiom of the Jews of the Comtat Venaissin (“Judeo-Provençal”) at the end of the 18th century, based on a critical edition of the only relevant document illustrating this language, a theatrical play in verse entitled Harcanot et Barcanot. The introduction provides a philological inventory of all known sources of “Judeo-Provençal.” The critical and variorum edition of the text, accompanied by linear glosses in English, is followed by a commentary comprising a glossary and analysis of all relevant linguistic features. It reveals, inter alia, that this language possessed words pertaining to the linguistic repertoire of French Jews since the Middle Ages; as for the phonetic features of the Jewish dialect of Provençal, their etiology is to be found in the history of the communities. The study concludes with a reassessment of the nature of linguistic variation in the dialect of the Jews of Provence.
Immunoglobulin Light Chain Amyloidosis Presenting as Inferior Vena Cava Thrombosis
Authors: Axentiev Anna , Rozik Marina , Slama Eliza , Setya Viney
Published: November 2021

Immunoglobulin light chain (AL) amyloidosis is a rare disease characterized by the deposition of misfolded extracellular proteins within various body tissues resulting in dysfunction of the cardiac, renal, gastrointestinal, hematologic, and nervous systems, among others. Systemic AL amyloidosis often presents with a constellation of vague symptoms such as fatigue, dyspnea, and abdominal pain. Untreated AL amyloidosis with cardiac involvement is rapidly fatal with a median survival of 6 months. In this report, we will highlight the case of a 43-year-old female who presented with generalized abdominal symptoms and fatigue. She was found to have extensive inferior vena cava (IVC) thrombosis extending into the renal veins bilaterally in the setting of nephrotic range proteinuria, new onset arrhythmia, diastolic heart failure, gastrointestinal, and autonomic dysfunction. She received systemic thrombolytic therapy for the IVC and renal vein thrombosis. The multiorgan involvement led us to consider the possibility of amyloidosis. Abdominal fat pad biopsy was performed as part of the diagnostic effort. The abdominal fat pad biopsy did not reveal AL amyloidosis. Ultimately, the diagnosis of systemic AL amyloidosis was made on the basis of pathology from luminal biopsies obtained during outpatient esophagogastroduodenoscopy that was performed days prior to her admission. Unique to our case is the patient presentation with extensive thrombotic disease of the IVC and renal veins. It is important to understand the disease process, presenting signs and symptoms as well as diagnostic essentials based on current literature in order to minimize the morbidity and mortality of this rare disease.
Survival With Surgery Is Superior to Survival Without Surgery in Breast Cancer Patients Aged 85 years or Older: A Retrospective Study
Authors: Enomoto Katsuhisa , Fukumoto Satsuki , Mori Satoshi , Nozaki Fumi , Hara Yukiko , Tada Keiichiro
Published: November 2021

Background

Surgical treatment of breast cancer patients aged 85 years or older is still controversial.

Methods

A series of surgically treated breast cancer patients aged 85 years or older was evaluated. The clinicopathological features and outcomes of these patients were compared with the features and outcomes of breast cancer patients in the same age group who were managed without surgery.

Results

A total of 45 patients (75%) received surgical treatment, and 15 patients (25%) were managed without surgery. Significantly more patients treated by surgery underwent systemic treatment than patients managed without surgery ( P = .003). The 5-year disease-free survival rate of patients treated by surgery was 80.7% (95% confidence interval: 66.2–98.5%), which was significantly higher than that of the patients managed without surgery ( P = .001).

Conclusions

The surgical treatment of breast cancer patients aged 85 years or older is warranted. This outcome was achieved with the use of hormonal therapy.
Toward a Just Leadership Learning Ecology: A CHAT-IT Analysis of the Highlander Idea
Authors: Chang Ethan , Glass Ronald David
Published: November 2021

Purpose: This paper conceptualizes a just leadership learning ecology through an analysis of one nontraditional site of leadership preparation: the Highlander Research and Education Center (originally founded as the Highlander Folk School). Methodology: Drawing on cultural historical activity theory (CHAT) and institutional theory (IT), we examine the core design and pedagogy of Highlander, which co-founder, Myles Horton, referred to as the “Highlander idea.” Findings: We illustrate how a residential learning and living environment, norms of epistemic humility and democratic decision making, and horizontal teaching and learning roles fostered social justice leadership. This just leadership learning ecology reflected institutions present at the time of Highlander's founding, including cultural scripts rooted in prophetic Christianity, class consciousness, and unfolding social movements in Appalachia and the South. Implications: Our analysis of Highlander extends recent efforts to re-envision the how and who of leadership preparation and addresses the observed lack of coherence within this subfield.
Intraspeaker Priming across the New Zealand English Short Front Vowel Shift
Authors: Villarreal Dan , Clark Lynn
Published: November 2021

A growing body of research in psycholinguistics, corpus linguistics, and sociolinguistics shows that we have a strong tendency to repeat linguistic material that we have recently produced, seen, or heard. The present paper investigates whether priming effects manifest in continuous phonetic variation the way it has been reported in phonological, morphological, and syntactic variation. We analyzed nearly 60,000 tokens of vowels involved in the New Zealand English short front vowel shift (SFVS), a change in progress in which trap/dress move in the opposite direction to kit, from a topic-controlled corpus of monologues (166 speakers), to test for effects that are characteristic of priming phenomena: repetition, decay, and lexical boost. Our analysis found evidence for all three effects. Tokens that were relatively high and front tended to be followed by tokens that were also high and front; the repetition effect weakened with greater time between the prime and target; and the repetition effect was stronger if the prime and target belonged to (different tokens of) the same word. Contrary to our expectations, however, the cross-vowel effects suggest that the repetition effect responded not to the direction of vowel changes within the SFVS, but rather the peripherality of the tokens. We also found an interaction between priming behavior and gender, with stronger repetition effects among men than women. While these findings both indicate that priming manifests in continuous phonetic variation and provide further evidence that priming is among the factors providing structure to intraspeaker variation, they also challenge unitary accounts of priming phenomena.
Individual Observer Differences in the Use of Form and Motion to Perceive the Actor’s Sex in Biological Motion Displays
Authors: Hiris Eric , Conway Sean , McLoughlin William , Yang Gaokhia
Published: November 2021

Recent research has shown that the perception of biological motion may be influenced by aspects of the observer’s personality. In this study, we sought to determine how participant characteristics (including demographics, response inhibition, autism spectrum quotient, empathy, social anxiety, and motion imagery) might influence the use of form and motion to identify the actor’s sex in biological motion displays. We varied the degree of form and motion in biological motion displays and correlated 76 young adult participants’ performances for identifying the actor’s sex in these varied conditions with their individual differences on variables of interest. Differences in the separate use of form and motion cues were predictive of participant performance generally, with use of form most predictive of performance. Female participants relied primarily on form information, while male participants relied primarily on motion information. Participants less able to visualize movement tended to be better at using form information in the biological motion task. Overall, our findings suggest that similar group level performances across participants in identifying the sex of the actor in a biological motion task may result from quite different individual processing.
National trends and cost of litigation in UK National Health Service (NHS): a specialty-specific analysis from the past decade
Authors: Lane Jenni , Bhome Rahul , Somani Bhaskar
Published: November 2021

Background and aims

Medical litigation claim and costs in UK are rising. This study aims to analyse the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19.

Methods

Data were procured from National Health Service (NHS) Resolution. Number of claims, total litigation costs and cost per claim were ascertained for each financial year. The data collected also includes the number of claims and average amount per claim per speciality during the years 2009–2019 (2009/2010 to 2018/2019 financial years).

Results

The total annual cost of NHS litigation is currently £3.6 billion(2018/2019). Damages make up the greatest proportion of costs(£1.5 billion). Surgical specialties have the greatest number of claims annually(2847) but Obstetrics has the greatest total litigation(£1.9 billion) and cost per claim(£2.6 million). Number of claims, total costs and cost per claim are significantly greater in 2018/2019 than in 2009/2010.

Conclusions

Addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.
Editorial – Medical litigation in the 21st century
Authors: Webber Robyn
Published: November 2021

The possibility of a medical negligence claim lies at the back of many doctors’ minds. But which specialties see the greatest and fewest claims, and what are the potential costs to the NHS of a successful claim? In their article, Dr Lane et al. analyse 10 years’ NHS litigation data, broken down by specialty, number of claims, and the attendant cost of those claims which were successful. Litigation in the ‘post Montgomery’ era is considered along with some of the common factors which may lead to a patient or their family taking legal action.
Urban resilience
Authors: Glaeser Edward L
Published: November 2021

Will COVID-19 end the urban renaissance that many cities have experienced since the 1980s? This essay selectively reviews the copious literature that now exists on the long-term impact of natural disasters. At this point, the long-run resilience of cities to many forms of physical destruction, including bombing, earthquakes and fires, has been well-documented. The destruction of human capital may leave a longer imprint, but cities have persisted through many plagues over the past millennia. By contrast, economic and political shocks, including deindustrialisation or the loss of capital city status, can enormously harm an urban area. These facts suggest that the COVID-19 pandemic will only significantly alter urban fortunes if it is accompanied by a major economic shift, such as widespread adoption of remote work, or political shifts that could lead businesses and the wealthy to leave urban areas. The combination of an increased ability to relocate with increased local redistribution or deterioration of local amenity levels, or both, could recreate some of the key attributes of the urban crisis of the 1970s.
On the move in the (post)colonial metropolis: The Paris Metro in Francophone African and Afrodiasporic fiction
Authors: Toivanen Anna-Leena
Published: November 2021

Literary texts convey the complexities of the urban experience in a tangible way. While there is a wide body of work on literary representations of Paris, the role of public transport as part of the (postcolonial) urban experience has not received much attention. This article sets out to analyse the meanings of the mobile public space comprising the Paris Metro in Francophone African and Afrodiasporic literary texts from the mid-20th century to the 2010s. The reading demonstrates how the texts represent the public space of the Metro as a symbol of modernity, a space of disappointment and alienation, an embodiment of social inequalities and as a site of convivial encounters and claims of agency. Through this analysis, the article highlights the role of literature in elucidating the intertwinement of mobility, public space and postcolonial urbanity.
The Influence of Social Support, Help-Seeking Attitudes and Help-Seeking Intentions on Older Australians’ use of Mental Health Services for Depression and Anxiety Symptoms
Authors: Bretherton Susan Jane
Published: November 2021

This study investigated the influence of predisposing factors (social support, help-seeking attitudes and help-seeking intentions) on older Australian adults’ use of mental health services for depression and/or anxiety symptoms. Participants were 214 older Australian adults (61% female; aged between 60 and 96 years; M  =  75.15 years, SD  =  8.40 years) who completed a self-report questionnaire that measured predisposing factors and lifetime mental health service use for depression and/or anxiety symptoms. Higher levels of social support predicted non-use of mental health services. When this relationship was serially mediated by help-seeking attitudes and help-seeking intentions, it predicted mental health service use for depression and/or anxiety. Older adults are less likely to seek help for depression and/or anxiety symptoms unless members of their social support network encourage positive help-seeking attitudes, which lead to positive help-seeking intentions and the subsequent use of mental health services.
Organic pore heterogeneity and its formation mechanisms: Insights from the Lower Cretaceous lacustrine Shahezi shale in the Songliao Basin, NE China
Authors: Fenglin Gao , Chengxi Wang , Yan Song , Qinghong Hu , Chengxiang Wan , Fengyang Xiong , Zhuo Li , Joachim Moortgat
Published: November 2021

Pores associated with organic matter are well known to play a significant role in shale gas capacities. However, an extremely high heterogeneity of organic pores often impacts our evaluation of reservoir quality. In this work, we analyze the formation mechanisms of the heterogeneity based on positioning observation method using a combination of field emission scanning electron microscopy and optical microscopy. These analyses were conducted on six lacustrine shale samples at the gas window in the Lower Cretaceous Shahezi shale, which is located in the Changling Fault Depression of Songliao Basin. The results reveal that organic pore heterogeneity is mainly attributed to four controlling factors. (a) One is different hydrocarbon generation potentials among different macerals. The degree of pore development from high to low is solid bitumen, vitrinite, and inertinite. The content of carbon by the weight percentage of solid bitumen, vitrinite, and inertinite is in the opposite order, which reflects that the different hydrocarbon generation potential of each maceral is the dominant factor. (b) Another one is the remnants of primary pores in organic matter with plant cell structures. Well preserved telinite, fusinite, and semi-fusinite show cell structures, and the cells that are not completely compressed or not fully filled retain the original residual pores. (c) The third one is evolutional differences of individual solid bitumen. Not all solid bitumen developed organic pores, which is mainly attributed to the difference of solid bitumen reflectance in different solid bitumen particles. The solid bitumen reflectance of porous solid bitumen is mostly distributed between 1.6% and 2.0%, in which oil cracking to gas is dominant and porous residual solid bitumen subsequently forms. The solid bitumen reflectance of non-porous solid bitumen peaks in 1.2–1.6%, which is in the stage of kerogen transformation and oil generation with rare pore development. (d) The last one is the catalysis of clay minerals. All organoclay complexes develop abundant sponge-like pores due to catalysis during the transformation from smectite to illite. A high content of illite in the mixed layers I/S increases the specific catalytic activities, promoting the organic matter and solid bitumen to further generate hydrocarbon and form pores. Most organic–inorganic mixtures develop pores also because of catalysis from inorganic minerals.
Effects of Mindfulness-Based Interventions on Depressive Symptoms, Anxiety, Stress, and Quality of Life in Family Caregivers of Persons Living with Dementia: A Systematic Review and Meta-analysis
Authors: Han Areum
Published: November 2021

Objective: This systematic review and meta-analysis examined effects of mindfulness-based interventions (MBIs) on depressive symptoms, anxiety, stress, and quality of life in family caregivers of people with dementia. Methods: A comprehensive search was conducted within the PubMed, CINAHL, PsycINFO, and SCOPUS databases to identify relevant randomized controlled trials (RCTs). Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the types of control groups and MBIs. Results: 15 RCTs met the eligibility criteria. Meta-analyses showed medium to large effects of MBIs on depressive symptoms, anxiety, stress, and quality of life at the immediate posttest. Small to large effects of MBIs were found at follow-up. Conclusions: Future high-quality studies involving different types of MBIs and delivery modes are needed to better understand effects of MBIs on family caregivers of people with dementia and examine effective intervention features.
From “Sea Turtles” to “Grassroots Ambassadors”: The Chinese Politics of Outbound Student Migration
Authors: Liu Jiaqi M.
Published: November 2021

International student migration/mobility (ISM) has long come under the spotlight in migration and education studies. Previous research has focused primarily on inbound students in Western host countries, with much less attention on sending countries’ policies. Based on evidence from interviews, ethnography, and policy analysis in China, the world’s largest source country of student migrants, I argue that outbound student migration can be integrated into the home country’s broader diaspora politics to serve economic, governmental, and geopolitical policy objectives. These diverse, sometimes-clashing, interests are predicated upon China’s domestic politics and global positioning. To establish a conceptual bridge between ISM and diaspora studies, I depart from the mobility paradigm’s emphases on neoliberalism and de-regulation and, instead, foreground nation-states’ changing, yet-unabating, interests in regulating and strategizing about overseas students. I find that following decades of prioritizing the economic and governmental impacts of student returnees ( haigui, or colloquially “sea turtles”) in boosting the domestic economy and maintaining political stability, China now attaches growing importance to student migrants’ geopolitical value as “grassroots ambassadors” ( minjian dashi) in expanding China’s global influence and enhancing its national image abroad. This geopolitics-focused national reorientation, however, may not be well received by student migrants themselves or fully implemented by street-level migration bureaucrats. By examining tensions between the central Chinese state, student migrants, and frontline local officials, this article sheds new light on ISM as a dynamic policy arena where state ambitions crosscut individual desires and national grand plans are confronted with flexible local improvisation.
Re-Norwood operation using femoral artery cannulation
Authors: Asai Hidetsugu , Cao Yuchen , Ikarashi Jin , Arai Yosuke , Ebuoka Noriyoshi , Tachibana Tsuyoshi
Published: November 2021

Re-Norwood operation is technically difficult to perform and is a high risk procedure due to the underlying hypocardiac function. Herein, we describe our successful re-Norwood operation approach in a 6-month old infant with persistent severe cyanosis and aortic re-coarctation. Our procedure was performed using femoral artery cannulation to protect cerebrospinal and lower body perfusion. Safe reopening of the chest was achieved, despite strong adhesions due to prior surgeries. Our repair and anastomosis techniques are described in detail. Cardiac circulation and function improved post-surgery. The patient was maintained on anti-heart failure drug therapy after surgery while awaiting a Glenn procedure.
Probiotic supplementation: A prospective approach in the treatment of COVID-19
Authors: Nayebi Atiyeh , Navashenaq Jamshid Gholizadeh , Soleimani Davood , Nachvak Seyyed Mostafa
Published: November 2021

Background: Despite strategies based on social distancing, the coronavirus disease 2019 (COVID-19) expands globally, and so far, many attempts have been made to achieve effective treatment for patients with COVID-19. This disease infects the lower respiratory tract and may lead to severe acute respiratory syndrome coronavirus (SARS-CoV). COVID-19 also can cause gastrointestinal infections. Therefore, COVID-19 patients with gastrointestinal symptoms are more likely to be complicated by SARS-CoV. In this disease, acquired immune responses are impaired, and uncontrolled inflammatory responses result in cytokine storms, leading to acute lung injury and thrombus formation. Probiotics are living microorganisms that contribute to the health of the host if administered in appropriate doses. Aim: This study aimed to provide evidence to show the importance of gut dysbiosis in viral disease, especially COVID-19. Therefore, we have focused on the impact of probiotics consumption on preventing severe symptoms of the disease. Methods: We have entirely searched SCOPUS, PubMed, and Google Scholar databases to collect evidence regarding the relationship between probiotics and viral infections to expand this relationship to the COVID-19. Results: It has been shown that probiotics directly counteract SARS-CoV in the gastrointestinal and respiratory tracts. Moreover, probiotics suppress severe immune responses and prevent cytokine storms to inhibit pathologic inflammatory conditions in the body via modulation of immune responses. Conclusion: According to available evidence based on their antiviral and respiratory activities, using probiotics might be an adjuvant therapy to reduce the burden and severity of this disease.
An analysis of the impact of school closings on gifted services: Recommendations for meeting gifted students’ needs in a post-COVID-19 world
Authors: Wolfgang Charlton , Snyderman Daniel
Published: November 2021

Gifted support services were directly impacted by the COVID-19 shutdown in Spring 2020. This qualitative research study consisting of parents ( n = 110) and gifted support teachers ( n = 53) explored the impact on gifted students’ services and instruction. Utilizing surveys, open-ended response questions, and in-depth interviews, teachers and parents shared their thoughts and perceptions about challenge, enrichment, and students’ social-emotional health throughout the shutdown. Data analysis found that gifted services were directly impacted by the COVID-19 shutdown and parents and teachers shared that challenge and enrichment were lacking. However, data collected also showed that there is much potential to meet students’ academic and social-emotional needs virtually. Utilizing the data collected, a model was created to help teachers, parents, and school districts provide challenge, enrichment, and acceleration, as well as address social-emotional concerns in a virtual environment.
Sedation and analgesia requirements during venovenous extracorporeal membrane oxygenation in acute respiratory distress syndrome patients
Authors: Ren Xingshu , Ai Yuhang , Zhang Lina , Zhao Chunguang , Li Li , Ma Xinhua
Published: November 2021

Introduction:

The purpose of this study is to describe sedation and analgesia management, and identify the factors associated with increased demand for medication in acute respiratory distress syndrome (ARDS) patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO).

Methods:

This retrospective, single-center study included consecutive adult ARDS patients who received VV-ECMO for at least 24 hours from January 2018 to December 2020 in a comprehensive intensive care unit. The electronic medical records were retrospectively reviewed to collect data.

Results:

Forty-two adult patients meeting the inclusion criteria were included in the study. Midazolam, sufentanil, and remifentanil were main sedatives and analgesics used in the patient population. The morphine equivalents, representative of the demand for opioids, was 512.9 (IQR, 294.5, 798.2) mg/day. The midazolam equivalents, representative of benzodiazepine requirement, was 279.6 (IQR, 208.8, 384.5) mg/day. The levels of serum creatinine, total bilirubin, lactic acid, SOFA score, and APACHE Ⅱ score at cannulation were found to be associated with opiate or benzodiazepine requirements. Multiple linear regression analysis revealed a linear correlation between midazolam equivalents and morphine equivalents (p < 0.001). In addition, there was a negative linear correlation between Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and midazolam equivalents (p = 0.024).

Conclusions:

The sedation and analgesia requirements of ARDS patients receiving VV-ECMO often increase simultaneously. More large-scale studies are needed to confirm the risk factors for increased sedation and analgesia needs in patients supported on VV-ECMO.