bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-Dimensional Discrete Element Analysis of Crushing Characteristics of Calcareous Sand Particles
Authors: Lu Zucheng , Hou Heying , Jiang Pengming , Wang Qing , Li Tianxiang , Pan Zhuojie
Published: March 2022

Particle crushing is an important factor affecting the mechanical characteristics of calcareous sand, but at present, most of relative studying methods rely on physical experiments. In order to study the influence of particle crushing characteristics on the micromechanics of calcareous sand, the 14-fragment replacement method satisfying the Apollonian distribution is used to simulate the calcareous sand particles, and the fragment replacement method (FRM) is used to simulate the particle crushing. The three-dimensional discrete element model of calcareous sand particle crushing is established, and the development of relative crushing rate and the evolution laws of coordination number, porosity, and sliding contact ratio in triaxial consolidated drained shear test are analyzed. The results show that the three-dimensional model considering particle breakage can well reflect the micromechanical properties of the internal structure of the sample. The micromechanical response with and without particle crushing is quite different, which can be well reflected by the numerical test under high confining pressure. In addition, the modified relative crushing rate proposed by Einav based on the research of Hardin can better describe the relative crushing rate of calcareous sand under wide gradation and can provide a reference for the study of particle crushing characteristics of laboratory test of calcareous sand under wide gradation.
Ebosin Attenuates the Inflammatory Responses Induced by TNF-α through Inhibiting NF-κB and MAPK Pathways in Rat Fibroblast-Like Synoviocytes
Authors: Zhang Yang , Wang Lifei , Bai Liping , Jiang Rong , Wu Jianbo , Li Yuan
Published: March 2022

Tumor necrosis factor-α (TNF-α) lies at the apex of signal transduction cascades that results in induced destruction of joints in rheumatoid arthritis. It is therefore of great medicinal interest to modulate the cellular responses to TNF-α. Ebosin, a novel exopolysaccharide derived from Streptomyces sp, has been demonstrated to have remarkable therapeutic actions on collagen-induced arthritis in rats, while it also suppressed the production of IL-1β, TNF-α, and IL-6 at both mRNA and protein levels in cultured fibroblast-like synoviocytes. In order to further understand the potential mechanisms involved in the anti-inflammatory effects of ebosin at molecular level, we investigated the impact of it on the activation of MAPK and NF-κB pathways following TNF-α induced in fibroblast-like synoviocytes (FLS). The results showed that the phosphorylation levels of TNF-α-induced p38, JNK1, JNK2, IKKα, IKKβ, and IκB, as well as NF-κB nuclear translocation, were reduced significantly in FLS cells in response to ebosin. Furthermore, we proved that ebosin decreased the level of NF-κB in the nucleus and blocked the DNA-binding ability of NF-κB using electrophoresis mobility gel shift assay. Besides, low levels of matrix metalloproteinases (MMP-1 and MMP-3) and chemokines (interleukin-8 and RANTES) were found in TNF-α-stimulated fibroblast-like synoviocytes treated with ebosin. These results indicate that ebosin can suppress a range of activities in both MAPK and NF-κB pathways induced by TNF-α in rat fibroblast-like synoviocytes, which provides a rationale for examining the use of ebosin as a potential therapeutic candidate for rheumatic arthritis.
Comparative Study on the Clinical Efficacy and Safety of Acitretin and MTX in the Treatment of Pustular Psoriasis by TLR7/MyD88/CXCL16 Pathway
Authors: Lu Jiajing , Wang Yu , Li Ying , Gong Yu , Ding Yangfeng , Shi Yuling
Published: March 2022

Objective. To investigate the clinical efficacy and safety of acitretin and MTX with TLR7/MyD88/CXCL16 in the treatment of pustular psoriasis. Method. A total of 54 patients with pustular psoriasis were randomly divided into control group (

n
=
14

) and study group (

n
=
40

). MTX was used in the control group, and different doses of acitretin were used in the study group, which were divided into low-dose group (

n
=
13

), medium-dose group (

n
=
13

), and high-dose group (

n
=
14

). Symptom relief time, recurrence rate, GPPASI improvement rate, treatment response rate, BSA, DLQI score, and TLR7 and CXCL16 levels were compared among four groups. Result. The erythema, fever, and pustules disappeared in the low-dose group, the medium-dose group, and the high-dose group for a shorter time than control group, and it is shortest for the high-dose group. The low-dose, medium-dose, and high-dose groups had relatively lower recurrence rates at 1 month and 3 months (

P
<
0.05

). The improvement rates of GPPASI50 of the four groups (the control group, low-dose group, medium-dose group, and high-dose group in turn) were 71.4%, 78.3%, 80.2%, and 80.8%; GPPASI75 of the four groups were 73.5%, 74.3%, 79.4%, and 80.9%; and GPPASI90 were 12.9%, 13.1%, 13.4%, and 13.8%. After treatment, the BSA and DLQI scores of the four groups were reduced. The BSA and DLQI scores of the study group decreased more significantly, and the high-dose group had the most significant improvement (

P
<
0.05

). The incidence of adverse reactions in the four groups was 16.2%, 8.1%, 10.3%, and 14.7%, respectively. The high-dose group had a higher incidence of adverse reaction than the low-dose group (

P
<
0.05

). The effective rates of treatment of the four groups were 69.1%, 86.9%, 88.2%, and 91.9%, respectively. The study group had higher treatment efficiency than the control group, and the high-dose group had the highest treatment efficiency (

P
<
0.05

). After treatment, the level of serum TLR7 and CXCL16 was significantly reduced, but which in the study group decreased more significantly (

P
<
0.05

). Conclusion. The clinical effect of a high dose of acitretin on pustular psoriasis is remarkable. It can reduce the recurrence rate and improve the quality of life and clinical symptoms. Therefore, a high dose of acitretin is worth popularizing and applying.
Extraction of Psychological Effects of COVID‐19 Pandemic through Topic‐Level Sentiment Dynamics
Authors: Razzaq Abdul , Abbas Touqeer , Hashim Sarfraz , Qadri Salman , Mumtaz Imran , Saher Najia , Ul-Rehman Muzammil , Shahzad Faisal , Nawaz Syed Ali
Published: March 2022

The rapid increase in COVID‐19 cases has become the symbol of fear, anxiety, and panic among people around the globe. Mass media has played an active role in community education by addressing the health information of this pandemic. People interact by sharing their ideas and feelings through social media platforms. There is a considerable need to implement different measures and better perceive COVID‐19 pertinent facts and information by demystifying public sentiments. In this study, the Quarantine Life dataset of thousand tweets is based on #Quarantine, #Quarantine Days, #Quarantine Life, #My Pandemic Plan, and #Quarantine and Chill from January to September 2020 has been collected from Twitter. The extracted data have been scrubbed through preprocessing techniques. The sentiments and topics extracted from tweets have been analyzed through the TEXT BLOB, VADER, and AFFIN approach. Results show that people were distressed and fearful due to the COVID‐19 pandemic. However, most people enjoyed by playing games, watching movies, and reading books during the lockdown period. According to the present meta‐analysis, physical activity interventions are beneficial for patients with dementia in terms of cognition. The proposed framework illustrates the insight impact of COVID‐19 on human physiological and mainly focuses on the evaluation of sentiment dynamics at the topical level.
Upregulated miR-206 Aggravates Deep Vein Thrombosis by Regulating GJA1-Mediated Autophagy of Endothelial Progenitor Cells
Authors: Li Yan , Ge Jingping , Yin Yuanyuan , Yang Ruowen , Kong Jie , Gu Jianping
Published: March 2022

Background. Deep vein thrombosis (DVT) is the third most prevalent vascular disease worldwide. MicroRNAs (miRNAs) play regulatory roles in functions of endothelial progenitor cells (EPCs), which is becoming a promising therapeutic choice for thrombus resolution. Nevertheless, the role of miR-206 in EPCs is unclear. Methods. EPCs were isolated from the peripheral blood of patients with DVT. In DVT mouse models, DVT was induced by stenosis of the inferior vena cava (IVC). The levels of miR-206 and gap junction protein alpha 1 (GJA1) in EPCs and vascular tissues of DVT mice were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The proliferation, migration, apoptosis, and angiogenesis were tested by cell counting kit-8 (CCK-8) assay, Transwell assay, flow cytometry analysis, and in vitro tube formation assay. The levels of autophagy-related proteins as well as the level of GJA1 in EPCs and vascular tissues were evaluated by western blotting. DVT formation in vivo was observed through hematoxylin-eosin (HE) staining. The expression of thrombus resolution markers, CD34 molecule (CD34) and matrix metallopeptidase 2 (MMP2), in the thrombi was measured by immunofluorescence staining. Results. miR-206 overexpression inhibited proliferation, migration, and angiogenesis and promoted apoptosis of EPCs, while miR-206 knockdown exerted an opposite effect on EPC phenotypes. Downregulation of GJA1, the target of miR-206, abolished the influence of miR-206 on EPC phenotypes. Furthermore, silencing of miR-206 suppressed the autophagy of EPCs via upregulating GJA1. miR-206 knockdown repressed thrombus formation, enhanced the homing ability of EPCs to the thrombosis site, and facilitated thrombus resolution in DVT mouse models. Additionally, miR-206 was upregulated while GJA1 was downregulated in vascular tissues of DVT mice. miR-206 knockdown elevated GJA1 expression in vascular tissues of DVT mice. The expression of miR-206 was negatively correlated with that of GJA1 in DVT mice. Conclusion. miR-206 knockdown upregulates GJA1 to inhibit autophagy of EPCs and then promote EPC proliferation, migration, and angiogenesis, thereby enhancing EPC homing to thrombi and facilitating thrombus resolution.
A Potential Prognostic Biomarker for Glioma: Aldo-Keto Reductase Family 1 Member B1
Authors: Zhao Hulin , Dong Xuetao , Huang Tianxiang , Li Xueji
Published: March 2022

Aldo-keto reductase family 1 member B1 (AKR1B1) plays a vital role in tumor development and is involved in the tumor immune process. However, its role in glioma cell is poorly studied. This study’s aim was to assess the role of AKR1B1 in glioma through bioinformatics analysis. The AKR1B1 expression data and corresponding clinical data of glioma were collected from the Cancer Genome Atlas (TCGA) database. The R packages were used for data integration, extraction, analysis, and visualization. According to the median value of the risk score, all patients were divided into high-risk and low-risk groups to draw the Kaplan–Meier (KM) survival curves and to explore the level of immune infiltration. The expression of AKR1B1 was significantly elevated in glioma tissues compared to normal tissues (

P

 < 0.001). The high expression of AKR1B1 was significantly associated with WHO grade (

P

 < 0.001), IDH status (

P

 < 0.001), 1p/19q codeletion (

P

 < 0.001), primary therapy outcome (

P

 = 0.004), and age (

P

 < 0.05). Kaplan–Meier survival analysis found that OS (HR = 3.75,

P

 < 0.001), DSS (HR = 3.85,

P

 < 0.001), and PFI (HR = 2.76,

P

 < 0.001) were lower in patients with glioma with high AKR1B1 expression than in the group with low AKR1B1 expression. Based on GESA, six pathways (including interferon gamma signaling, signaling by interleukins, cell cycle checkpoints, cytokine receptor interaction, cell adhesion molecules (CAMs), and cell surface interactions) at the vascular wall were identified as significantly different between the two groups. Moreover, highly expressed AKR1B1 was associated with immune cell infiltration. AKR1B1 plays a key role in glioma progression and prognosis and, therefore, serves as a potential biomarker for prediction of patients’ survival.
Oncogenic and Tumor-Suppressive Functions of the RNA Demethylase FTO
Authors: Zuidhof Hidde R. , Calkhoven Cornelis F.
Published: March 2022

The epitranscriptome represents the more than 140 types of chemically varying and reversable RNA modifications affecting RNA fate. Among these, the most relevant for this review are the mRNA modifications N6-methyladenosine and N6,2′-O-dimethyladenosine. Epitranscriptomic mRNA biology involves RNA methyltransferases (so-called “writers”), RNA demethylases (“erasers”), and RNA-binding proteins (“readers”) that interact with methylation sites to determine the functional outcome of the modification. In this review, we discuss the role of a specific RNA demethylase encoded by the fat mass and obesity–associated gene (FTO) in cancer. FTO initially became known as the strongest genetic link for human obesity. Only in 2010, 16 years after its discovery, was its enzymatic function as a demethylase clarified, and only recently has its role in the development of cancer been revealed. FTO functions are challenging to study and interpret because of its genome-wide effects on transcript turnover and translation. We review the discovery of FTO and its enzymatic function, the tumor-promoting and suppressive roles of FTO in selected cancer types, and its potential as a therapeutic target.
Aberrant Activation of Cell-Cycle–Related Kinases and the Potential Therapeutic Impact of PLK1 or CHEK1 Inhibition in Uterine Leiomyosarcoma
Authors: Yoshida Kosuke , Yokoi Akira , Yamamoto Tomofumi , Hayashi Yusuke , Nakayama Jun , Yokoi Tsuyoshi , Yoshida Hiroshi , Kato Tomoyasu , Kajiyama Hiroaki , Yamamoto Yusuke
Published: March 2022

Purpose:

Uterine leiomyosarcoma is among the most aggressive gynecological malignancies. No effective treatment strategies have been established. This study aimed to identify novel therapeutic targets for uterine leiomyosarcoma based on transcriptome analysis and assess the preclinical efficacy of novel drug candidates.

Experimental Design:

Transcriptome analysis was performed using fresh-frozen samples of six uterine leiomyosarcomas and three myomas. The Ingenuity Pathway Analysis (IPA) was used to identify potential therapeutic target genes for uterine leiomyosarcoma. Afterward, our results were validated using three independent datasets, including 40 uterine leiomyosarcomas. Then, the inhibitory effects of several selective inhibitors for the candidate genes were examined using SK-UT-1, SK-LMS-1, and SKN cell lines.

Results:

We identified 512 considerably dysregulated genes in uterine leiomyosarcoma compared with myoma. The IPA revealed that the function of several genes, including CHEK1 and PLK1, were predicted to be activated in uterine leiomyosarcoma. Through an in vitro drug screening, PLK1 or CHEK1 inhibitors (BI-2536 or prexasertib) were found to exert a superior anticancer effect against cell lines at low nanomolar concentrations and induce cell-cycle arrest. In SK-UT-1 tumor-bearing mice, BI-2536 monotherapy remarkably suppressed tumorigenicity. Moreover, the prexasertib and cisplatin combination therapy inhibited tumor proliferation and prolonged the time to tumor progression.

Conclusions:

We identified upregulated expressions of PLK1 and CHEK1; their kinase activity was activated in uterine leiomyosarcoma. BI-2536 and prexasertib demonstrated a significant anticancer effect. Therefore, cell-cycle–related kinases may present a promising therapeutic strategy for the treatment of uterine leiomyosarcoma.
Attenuating Adaptive VEGF-A and IL8 Signaling Restores Durable Tumor Control in AR Antagonist–Treated Prostate Cancers
Authors: Maxwell Pamela J. , McKechnie Melanie , Armstrong Christopher W. , Manley Judith M. , Ong Chee Wee , Worthington Jenny , Mills Ian G. , Longley Daniel B. , Quigley James P. , Zoubeidi Amina , de Bono Johann S. , Deryugina Elena , LaBonte Melissa J. , Waugh David J.J.
Published: March 2022

Inhibiting androgen signaling using androgen signaling inhibitors (ASI) remains the primary treatment for castrate-resistant prostate cancer. Acquired resistance to androgen receptor (AR)-targeted therapy represents a major impediment to durable clinical response. Understanding resistance mechanisms, including the role of AR expressed in other cell types within the tumor microenvironment, will extend the clinical benefit of AR-targeted therapy. Here, we show the ASI enzalutamide induces vascular catastrophe and promotes hypoxia and microenvironment adaptation. We characterize treatment-induced hypoxia, and subsequent induction of angiogenesis, as novel mechanisms of relapse to enzalutamide, highlighting the importance of two hypoxia-regulated cytokines in underpinning relapse. We confirmed AR expression in CD34+ vascular endothelium of biopsy tissue and human vascular endothelial cells (HVEC). Enzalutamide attenuated angiogenic tubule formation and induced cytotoxicity in HVECs in vitro, and rapidly induced sustained hypoxia in LNCaP xenografts. Subsequent reoxygenation, following prolonged enzalutamide treatment, was associated with increased tumor vessel density and accelerated tumor growth. Hypoxia increased AR expression and transcriptional activity in prostate cells in vitro. Coinhibition of IL8 and VEGF-A restored tumor response in the presence of enzalutamide, confirming the functional importance of their elevated expression in enzalutamide-resistant models. Moreover, coinhibition of IL8 and VEGF-A resulted in a durable, effective resolution of enzalutamide-sensitive prostate tumors. We conclude that concurrent inhibition of two hypoxia-induced factors, IL8 and VEGF-A, prolongs tumor sensitivity to enzalutamide in preclinical models and may delay the onset of enzalutamide resistance.

Implications:

Targeting hypoxia-induced signaling may extend the therapeutic benefit of enzalutamide, providing an improved treatment strategy for patients with resistant disease.
Intratumoral Electroporation of Plasmid Encoded IL12 and Membrane-Anchored Anti-CD3 Increases Systemic Tumor Immunity
Authors: Han Mia , Nguyen Bianca , Lee Jack Y. , Browning Erica , Zhang Jun , Mukhopadhyay Anandaroop , Gujar Ravindra , Salazar Jon , Hermiz Reneta , Svenson Lauren , Rolig Annah S. , Redmond William L. , Algazi Alain P. , Daud Adil I. , Canton David A. , Twitty Christopher G.
Published: March 2022

Intratumoral delivery of plasmid IL12 via electroporation (IT-tavo-EP) induces localized expression of IL12 leading to regression of treated and distant tumors with durable responses and minimal toxicity. A key driver in amplifying this local therapy into a systemic response is the magnitude and composition of immune infiltrate in the treated tumor. While intratumoral IL12 typically increases the density of CD3+ tumor-infiltrating lymphocytes (TIL), this infiltrate is composed of a broad range of T-cell subsets, including activated tumor-specific T cells, less functional bystander T cells, as well as suppressive T regulatory cells. To encourage a more favorable on-treatment tumor microenvironment (TME), we explored combining this IL12 therapy with an intratumoral polyclonal T-cell stimulator membrane-anchored anti-CD3 to productively engage a diverse subset of lymphocytes including the nonreactive and suppressive T cells. This study highlighted that combined intratumoral electroporation of IL12 and membrane-anchored anti-CD3 plasmids can enhance cytokine production, T-cell cytotoxicity, and proliferation while limiting the suppressive capacity within the TME. These collective antitumor effects not only improve regression of treated tumors but drive systemic immunity with control of nontreated contralateral tumors in vivo. Moreover, combination of IL12 and anti-CD3 restored the function of TIL isolated from a patient with melanoma actively progressing on programmed cell death protein 1 (PD-1) checkpoint inhibitor therapy.

Implications:

This DNA-encodable polyclonal T-cell stimulator (membrane-anchored anti-CD3 plasmid) may represent a key addition to intratumoral IL12 therapies in the clinic.
Venetoclax in Combination with Hypomethylating Agents for the Treatment of Treatment-Naive B/Myeloid Mixed-Phenotype Acute Leukemia and Relapsed/Refractory Acute Myeloid Leukemia: A Report of 3 Cases
Authors: Wang Na , He Jing , Liu Fang
Published: March 2022

B/myeloid mixed-phenotype acute leukemia (MPAL) is an uncommon and aggressive leukemia without well-established treatment guidelines and has an inferior outcome. Relapsed/refractory (R/R) acute myeloid leukemia (AML) that is ineligible for aggressive chemotherapy regimens and allogeneic hematopoietic stem-cell transplantation has an extremely poor prognosis. The novel regimen of venetoclax (VEN) combined with hypomethylating agents (HMAs) has a synergistic therapeutic effect and a tolerable safety profile, which has been officially approved by the US Food and Drug Administration (FDA) for newly diagnosed AML in adults who are 75 years or older or patients precluding intensive induction chemotherapy. For R/R and other rare types of AML, no consensus has been reached on the efficacy of VEN-HMA. In addition, there is no available report on treatment-naive B/myeloid MPAL with VEN-HMA. Herein, we present 3 cases of VEN-HMA in treatment-naive B/myeloid MPAL and R/R AML. Its potential efficacy is worthy of further exploration in future researches.
Homicide and Dementia: A Systematic Review
Authors: Sundakov-Krumins Tali Elsayed , Lubbe Sean , Wand Anne Pamela Frances
Published: March 2022

Background: Homicide by older offenders is rare and devastating. It likely occurs due to a complex interaction of personal, social, and environmental factors. Dementia is a progressive neurological condition which may amplify behavioural disturbances such as aggression. This systematic review aims to evaluate the factors associated with homicide committed by people with dementia in order to inform clinical practice. Summary: MEDLINE, PsychINFO, Embase, and PubMed databases were searched in accordance with PRISMA guidelines for empirical studies examining the characteristics and circumstances of people with dementia who committed homicides. Data on factors associated with the homicide were extracted and the quality of each study rated using standardized criteria. A total of 499 papers were screened and thirteen studies met the inclusion criteria. Study design included case reports (seven studies), case series (four studies), and two retrospective cohort studies, indicative of low levels of evidence. Sample sizes were 1–70. Study findings were predominantly descriptive. Quality ratings ranged from 50 to 100%. Factors associated with disinhibition such as dysexecutive syndrome, alcohol use, and delirium may predispose to severe impulsive aggression. Psychosis and personality pathology appeared to influence targeted assaults resulting in homicide by people with dementia. Victim vulnerability was also a key element. Key Messages: The current evidence examining risk factors for homicide committed by people with dementia is limited. However, there are common characteristics reported in these descriptive studies including psychiatric factors and cognitive states causing disinhibition. Recommendations for clinical practice include early assessment of older people with dementia and changed behaviours to allow management of comorbidities and reversible risk factors, alongside education, and advice to carers (who may be targets of aggression). Specialized geriatric forensic psychiatry services and care settings should be developed.
Association between Operative Time and Short-Term Radical Cystectomy Complications
Authors: Haeuser Lorine , Marchese Maya , Noldus Joachim , Kibel Adam S. , Carvalho Filipe , Preston Mark A. , Cooper Zara , Trinh Quoc-Dien , Mossanen Matthew
Published: March 2022

Introduction: The aim of this study was to examine the relationship between duration of surgical intervention and postoperative complications in radical cystectomy (RC). We hypothesized that the complication rate increases with longer operative time. Methods: We analyzed the National Surgical Quality Improvement Program database 2011–2017 to identify all patients who underwent RC. Clinicodemographic characteristics, operative time, and perioperative complications using the Clavien-Dindo Classification (CDC) were abstracted. We fit a generalized linear model with linear splines for operative time to analyze if the relationship between operative time and probability of complication changed over time. Results: A total of 10,520 RC patients were identified with a mean operative time of 5.5 h (standard deviation 2.03). In 55% and 18.2%, any complication and major complications (CDC ≥3) occurred within 30 days postoperatively, respectively. The spline regression model for any complication showed an almost linear relationship between the complication rate and operative time, ranging from 55% at 2.5 h to 82% at 10 h. For major complications, the model revealed the inflection point (knot) at 4.5 h, which corresponds to the lowest complication rate with 15%. Operative times at the extremes of the distribution had higher complication rates: 17.5% if <2.5 h and 28% if >10 h. Discussion/Conclusion: Operative time of RC is associated with postoperative complications. Though many factors impact the duration of surgery, surgeries that lasted between 4 and 5 h had trend toward the lowest complication rates. Attention to factors impacting operative time may allow surgeons to identify strategies for optimizing surgical care and reducing complications after RC.
Community-Based Findings of Magnitude of Type 2 Diabetes Mellitus among Adults in Selected Towns of Western Ethiopia
Authors: Feyisa Bikila Regassa , Mosisa Getu , Biru Bayise , Debelo Sidise , Dufera Mebrate
Published: March 2022

Background: The risk of diabetes mellitus (DM) is remarkably increasing globally, and it is alarmingly increasing in developing countries including Ethiopia, especially in urban residents. The present study was aimed at uncovering the magnitude of type 2 DM (T2DM) among adults residing in the selected towns of western part of Ethiopia. Methods: A community-based cross-sectional study design was conducted in towns of western Ethiopia from June 1 to June 30, 2019. Multistage and systematic random sampling techniques were employed. The data were collected using structured interviewer-administered questionnaire based on the World Health Organization STEPwise approach. Data were entered into EpiData 3.1, cleaned, and analyzed by the statistical package for social sciences software version 24. Descriptive statistics and logistic regression were used for the analysis. Results: The prevalence of T2DM was 7.0% (95% confidence interval [CI] 5.4–8.8) with 8.5% (95% CI 5.6–11.0) and 6.0% (95% CI 3.9–8.1) among males and females, respectively. Being married (AOR = 4.0, 95% CI 1.1–14.7) and divorced (AOR = 6.2, 95% CI 1.1–34.4), consumption of inadequate fruits and vegetables per day (AOR = 2.8, 95% CI 1.1–6.8), physical inactivity (AOR = 5.0, 95% CI 2.5–10.0), hypertension (AOR = 2.9, 95% CI 1.3–6.2), overweight (AOR = 2.3, 95% CI 1.1–4.9), and obesity (AOR = 19, 95% CI 4.5–50.1) were factors independently associated with T2DM. Conclusion: The prevalence of DM in the study area was found to be substantially higher than the national prevalence and other pocket studies in the country. Sociodemography and modifiable risk factors were affecting the prevalence of DM.
Long‐Term Cardiovascular Risk and Management of Patients Recorded in Primary Care With Unattributed Chest Pain: An Electronic Health Record Study
Authors: Jordan Kelvin P. , Rathod‐Mistry Trishna , Bailey James , Chen Ying , Clarson Lorna , Denaxas Spiros , Hayward Richard A. , Hemingway Harry , van der Windt Danielle A. , Mamas Mamas A.
Published: March 2022

Background

Most adults presenting with chest pain will not receive a diagnosis and be recorded with unattributed chest pain. The objective was to assess if they have increased risk of cardiovascular disease compared with those with noncoronary chest pain and determine whether investigations and interventions are targeted at those at highest risk.

Methods and Results

We used records from general practices in England linked to hospitalization and mortality information. The study population included patients aged 18 years or over with a new record of chest pain with a noncoronary cause or unattributed between 2002 and 2018, and no cardiovascular disease recorded up to 6 months (diagnostic window) afterward. We compared risk of a future cardiovascular event by type of chest pain, adjusting for cardiovascular risk factors and alternative explanations for chest pain. We determined prevalence of cardiac diagnostic investigations and preventative medication during the diagnostic window in patients with estimated cardiovascular risk ≥10%. There were 375 240 patients with unattributed chest pain (245 329 noncoronary chest pain). There was an increased risk of cardiovascular events for patients with unattributed chest pain, highest in the first year (hazard ratio, 1.25 [95% CI, 1.21–1.29]), persistent up to 10 years. Patients with unattributed chest pain had consistently increased risk of myocardial infarction over time but no increased risk of stroke. Thirty percent of patients at higher risk were prescribed lipid‐lowering medication.

Conclusions

Patients presenting to primary care with unattributed chest pain are at increased risk of cardiovascular events. Primary prevention to reduce cardiovascular events appears suboptimal in those at higher risk.
Use of Photovoice to Explore Pediatric Patients with Hypertrophic Cardiomyopathy and their Parents' Perceptions of a Heart‐Healthy Lifestyle
Authors: Sobierajski Frances , Storey Kate , Bird Melissa , Anthony Samantha , Pol Sarah , Pidborochynski Tara , Balmer‐Minnes Diana , Tharani Alliya Remtulla , Power Alyssa , Khoury Michael , Cunningham Chentel , Jeewa Aamir , Conway Jennifer
Published: March 2022

Background

Heart‐healthy lifestyles promote lifelong cardiovascular health. However, patients with hypertrophic cardiomyopathy are often advised to avoid strenuous exercise because of the risk of sudden cardiac death. Given these restrictions, this study explored youth and parent perceptions of a heart‐healthy lifestyle and the barriers and facilitators to this lifestyle.

Methods and Results

Youth and parents were purposefully recruited at 2 Canadian hospitals for this photovoice project. Participants were given cameras and took pictures of everyday heart‐healthy or heart‐unhealthy choices. Photos were discussed during one‐on‐one qualitative interviews with youth and parents separately to understand the photos’ meaning and significance. Inductive descriptive thematic analysis was employed. A total of 16 youth (median age, 14.4 years [range, 10.5–17.7 years]; 63% boys) and 16 parents (100% women) participated. A total of 15 youth were activity restricted. Data analysis revealed 7 categories organized into perceptions of healthy living (health is holistic and individualized) and factors influencing engagement in healthy living (self‐awareness, ownership and autonomy, feeling restricted and peer pressure, support from parents, and support from the cardiologist). Participants had a complex understanding of health and discussed the importance of physical, mental, and social well‐being. Youth used self‐awareness and taking responsibility as facilitators of healthy living. Healthy living was shaped by peers, parent role‐modeling, and cardiologist recommendations.

Conclusions

This study depicts the realities for youth with hypertrophic cardiomyopathy and can be used to inform the development of responsive interventions. Holistic, patient‐specific interventions may be more successful, and strategies such as shared decision making may be important to promote self‐awareness and autonomy.
Impact of an Automated Best Practice Alert on Sex and Race Disparities in Implantable Cardioverter‐Defibrillator Therapy
Authors: Thalappillil Alvin , Johnson Amber , Althouse Andrew , Thoma Floyd , Lee Jae , Estes N. A. Mark , Jain Sandeep , Lee Joon , Saba Samir
Published: March 2022

Background

Implantable cardioverter‐defibrillators (ICDs) are indicated in patients with severe left ventricular dysfunction, but many eligible patients do not receive them, especially women and Black patients. Our group had previously demonstrated that a best practice alert (BPA) improves overall rates of electrophysiology referrals and ICD implantations. This study examined the impact of a BPA by sex and race.

Methods and Results

This is a cluster randomized trial of cardiology (n=106) and primary care (n=89) providers who were randomized to receive (BPA, n=93) or not receive (No BPA, n=102) the alert and managed 1856 patients meeting primary prevention criteria for ICD implantation (965 BPA and 891 No BPA). After a median follow up of 34 months, 630 (34%) patients were referred to electrophysiology, and 522 (28%) patients received an ICD. Compared with the No BPA arm, patients in the BPA arm saw a modest differential increase in the rate of electrophysiology referrals at 18 months in men (+4%) compared with women (+7%) but a profound increase in Black patients (+16%) compared with White patients (+2%), thus closing the sex and race gaps. Similar trends were noted for rates of ICD implantation.

Conclusions

Use of a BPA improves rates of electrophysiology referrals and ICD implantations in all comers with severe cardiomyopathy and no prior ventricular arrhythmias but has a more pronounced impact in women and Black patients. The use of a BPA at the point of care is an effective tool in the fight against sex and race inequities in health care.
Demographic and Regional Trends of Mortality in Patients With Aortic Dissection in the United States, 1999 to 2019
Authors: Nazir Salik , Ariss Robert W. , Minhas Abdul Mannan Khan , Issa Rochell , Michos Erin D. , Birnbaum Yochai , Moukarbel George V. , Ramanathan P. Kasi , Jneid Hani
Published: March 2022

Background

Aortic dissection (AoD) is associated with high morbidity and mortality. However, the burden of AoD mortality is not well characterized, and contemporary data and mortality trends in different demographic and geographic subgroups have not been described.

Methods and Results

Trends in AoD mortality were assessed using a cross‐sectional analysis of the Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research database. Crude and age‐adjusted mortality rates (AAMR) per 1 million people with associated annual percent changes were determined. Joinpoint regression was used to assess trends in the overall sample and different demographic (sex, race and ethnicity, age) and geographic subgroups. Between 1999 and 2019, a total of 86 855 AoD deaths occurred within the United States. In the overall population, AAMR was 21.1 per 1 million in 1999 and 21.3 in 2019. After an initial decline in mortality, AAMR increased from 2012 to 2019, with an associated annual change of 2.5% (95% CI, 1.8–3.3). Men, older adults (aged ≥85 years), and non‐Hispanic Black or African American individuals had higher mortality rates than women, younger individuals, and other racial and ethnic individuals, respectively. Despite lower AAMRs throughout the study period, women experienced greater increases in AAMR from 2012 to 2019 compared with men. Similarly, non‐Hispanic Black or African American individuals had a pronounced increase in AAMR from 2012 to 2019.

Conclusions

Despite an initial decline in AoD mortality, the mortality rate has been increasing from 2012 to 2019, with pronounced increases among women and non‐Hispanic Black or African American individuals.
County‐Level Trends in Hypertension‐Related Cardiovascular Disease Mortality—United States, 2000 to 2019
Authors: Vaughan Adam S. , Coronado Fátima , Casper Michele , Loustalot Fleetwood , Wright Janet S.
Published: March 2022

Background

Amid stagnating declines in national cardiovascular disease (CVD) mortality, documenting trends in county‐level hypertension‐related CVD death rates can help activate local efforts prioritizing hypertension prevention, detection, and control.

Methods and Results

Using death certificate data from the National Vital Statistics System, Bayesian spatiotemporal models were used to estimate county‐level hypertension‐related CVD death rates and corresponding trends during 2000 to 2010 and 2010 to 2019 for adults aged ≥35 years overall and by age group, race or ethnicity, and sex. Among adults aged 35 to 64 years, county‐level hypertension‐related CVD death rates increased from a median of 23.2 per 100 000 in 2000 to 43.4 per 100 000 in 2019. Among adults aged ≥65 years, county‐level hypertension‐related CVD death rates increased from a median of 362.1 per 100 000 in 2000 to 430.1 per 100 000 in 2019. Increases were larger and more prevalent among adults aged 35 to 64 years than those aged ≥65 years. More than 75% of counties experienced increasing hypertension‐related CVD death rates among patients aged 35 to 64 years during 2000 to 2010 and 2010 to 2019 (76.2% [95% credible interval, 74.7–78.4] and 86.2% [95% credible interval, 84.6–87.6], respectively), compared with 48.2% (95% credible interval, 47.0–49.7) during 2000 to 2010 and 66.1% (95% credible interval, 64.9–67.1) for patients aged ≥65 years. The highest rates for both age groups were among men and Black populations. All racial and ethnic categories in both age groups experienced widespread county‐level increases.

Conclusions

Large, widespread county‐level increases in hypertension‐related CVD mortality sound an alarm for intensified clinical and public health actions to improve hypertension prevention, detection, and control and prevent subsequent CVD deaths in counties across the nation.
YENİLENEBİLİR ENERJİ BAĞLAMINDA ÇEVRE VE EKONOMİK BÜYÜME İLİŞKİSİ: OECD ÜLKELERİ ÖRNEĞİ
Authors: ÇETİNTAŞ Yağmur , AYDIN Celil
Published: March 2022

Bu çalışmada, OECD ülkelerinde, yenilenebilir enerji bağlamında çevre kirliliği ve ekonomik büyüme ilişkisi, 1995-2018 dönemi için Yumuşak Geçişli Panel Regresyon (YGPR) modeli kullanılarak incelenmiştir. Analiz sonuçlarına göre, yenilenebilir enerji kullanımının enerji tüketimi içerisindeki payı olarak belirlenen eşik değişkenine dair değerin, %7,825 olduğu tespit edilmiştir. Bu bağlamda yenilenebilir enerji kullanımının enerji tüketimi içerisindeki payının eşik seviyesinin altında olduğu durumda ekonomik büyüme çevreyi olumsuz etkileyerek çevre kirliliğini artırırken, eşik seviyesinin üstünde gerçekleştiği durumda ise olumlu etkileyerek çevre kirliliğini azaltmaktadır. Dolayısıyla çevre kirliliğinin azalması adına, yenilenebilir enerji kullanımının yaygınlaşması çözüm niteliği taşımaktadır. Buna istinaden politika yapıcılarının hem enerji kullanımının üzerinde durması hem de teşvik etmesi oldukça önem arz etmektedir.
Transnational Governance and the Urban Politics of Nature-Based Solutions for Climate Change
Authors: Tozer Laura , Bulkeley Harriet , Xie Linjun
Published: March 2022

Multiple visions for how urbanism can respond to the climate crisis and foster sustainability have emerged on the international agenda, including the ecocity, low-carbon city, smart city, and resilient city. These competing visions have been joined by one deploying “nature-based solutions.” We examine how nature-based solutions are emerging as a linchpin holding together the nature and climate agendas and what this means for where and by whom nature-based solutions are forming part of transnational urban governance. We argue that this field is animated by four frames connecting urban nature and climate: nature for resilience, nature for mitigation, the integrated benefits of nature, and nature first. Diverse actors, from conservation organizations to design firms to transnational municipal networks, draw on these frames and adopt new governance arrangements such that what it means to govern climate in the city is shifting. How this emerging nature–climate governance complex is structured will generate new momentum for governing urban nature over the coming decade.
Turkey
Authors: Özcan Turgut Aycan , Ataol Eylül
Published: March 2022

As complex international commercial relations developed, the practice of arbitration became more popular around the world. In this context, arbitration practices on a local basis have been shaped accordingly. The purpose of this study is to give general information about the international and domestic legislation in Turkey in the field of arbitration. Within this context, it evaluates the rules to be applied to international and national arbitration proceedings in Turkey by taking into account the effect of UNCITRAL model law on the evolution of national arbitration legislation of Turkey.
Clinical application of nano-biomedical composite materials in treatment and nursing
Authors: Jiang Lijuan , Yu Aiyun , Sun Meiling
Published: March 2022

Nano-biocomposite materials are widely used in the treatment and nursing of gynecological tumors. Nanobiocomposite materials can be loaded with anti-tumor drugs to achieve the targeted effect of gynecological tumor treatment. In this article, the nano-biomedical composite gold nanostar
particles loaded with the anti-tumor drug doxorubicin hydrochloride (DOX) are incubated with ovarian cancer cells and treated simultaneously by radiotherapy and chemotherapy. Studies have found that radiotherapy or chemotherapy alone has a weaker effect on the survival rate of ovarian cancer
cells. Suppose an ovarian cancer cell complex loaded with nano-biomedical composite gold nanostar particles loaded with the anti-tumor drug DOX. In that case, the cell survival rate is significantly reduced after radiotherapy and chemotherapy. Nanobiomedical composite gold nanostar particles
can play a synergistic role in the radiotherapy and chemotherapy of gynecological ovarian cancer tumors. They can improve the efficiency of ovarian cancer treatment clinically.
“The Situation Sounds Sketchy”: Institutional Rule-Breaking and a Qualitative Case for Quantifying Culture
Authors: Kelly Chelsea Rae
Published: March 2022

As respondents assess the cultural normalcy of social events, they employ both affective and cognitive criteria. Does this event feel normal? Does this event make sense? While these related questions often have the same answer, we know little about the assessment process under circumstances of signal mismatch. Using qualitative and quantitative data from two experimental studies, this research separately evaluates the effects of deflection level (is this event affectively normative) and institutional concordance (do the components of this event obey the guiding parameters of social institutions) in the assessment of social events. Online-administered surveys gathered data for a 3-condition experiment in an undergraduate sample ( N = 74) and a 4-condition experiment in a non-undergraduate quasi-nationally representative sample ( N = 507). Results from linear mixed models and ANOVAs show that (1) both concordance and low deflection are significant predictors of event assessment ratings, (2) when controlling for concordance, event deflection level remains a statistically significant predictor, and (3) deflection and concordance have a significant and positive interaction effect. Qualitative data patterns and a visualization of predicted probabilities from a multinomial logit model further suggest that (4) cognitive work in respondents’ assessments—transforming high-deflection events into low-deflection events through contextualized reinterpretations in accord with institutional domain parameters—follow affect control theory principles. This research strengthens understanding of and predictive abilities concerning social responses to culturally contextualized events.
Introducing and Exploring the Extremist Cybercrime Database (ECCD)
Authors: Holt Thomas J. , Chermak Steven M. , Freilich Joshua D. , Turner Noah , Greene-Colozzi Emily
Published: March 2022

This study uses open source, public information to examine nation-state and non-nation-state ideologically motivated cyberattacks performed against US targets from 1998 to 2018. We created the Extremist Cyber Crime Database (ECCD) that includes scheme, offender and target codebooks to address gaps in existing research and better inform policymakers. We describe our open source collection procedures, the type of information uncovered, and how we assessed their quality and reliability. We highlight our findings, compare these extremist cyber-crimes to extremist real world violence, and discuss their conceptual and policy implications.
From Being Figured to Figuring the World: Identity Work in Young Girls’ Aspirations
Authors: Mani Reema
Published: March 2022

This article shows the significance of college-going aspiration in the future identities of young girls and the sources of such influence in their worlds. Using the figured worlds theory, the paper analyzes the process and implications of these young girls’ college-going aspirations. Drawing on interviews and observations with nineteen young girls living in urban India, the study shows that their response to the normative good girl figure gives them a chance of going to college. Their imagined identity is linked to values and communicative competence, and their figuring shows their investment in their own cultural transformation.
Kiyoshi Miki as a Precursor of Humanistic Psychology: Utopia and Eupsychia
Authors: Muramoto Shoji
Published: March 2022

This article explores the relevance of the life and works of Kiyoshi Miki (1897–1945), a Japanese philosopher, to Maslovian humanistic psychology. Although Miki and Maslow differ in many respects, they shared a few common points that are important to examine. In his early articles, Miki equated philosophy with confessions of the soul and argued that individuality was impossible within the traditional framework of logic. His first main work on Pascal’s anthropology was an attempt to assimilate and synthesize the German existential/hermeneutic and the French moralist traditions he had learned in Europe in the early 1920s. Despite pioneering works by Wilhelm Reich and Erich Fromm, humanistic psychology has not exhausted the potentialities of Marxism. Maslow and other intellectuals sympathetic to this materialist philosophy were mutually disappointed. However, Maslow’s enlightened or eupsychian management may be an important step toward social revolution, compensating for a missing psychological viewpoint in traditional Marxism. Miki’s hermeneutic approach to this ideology offers two important points relevant to humanistic psychology: his concept of basic experience—later called Pathos—as the basis of any ideology, and the distinction between dialectic and organicism. His last years, during the War and fascism, raise important questions regarding what talented, self-actualizing intellectuals can do without freedom of speech and expression under a totalitarian and authoritarian regime. Finally, this article addresses how well Miki’s concept of utopia—on which he wrote an essay in the context of a dark age—corresponds to Maslow’s idea of eupsychia.
Still With Me? Assessing the Persisting Relationship to a Deceased Loved-One - Validation of the “Continuing Bonds Scale” in a German Population
Authors: Hopf Dora , Eckstein Monika , Ditzen Beate , Aguilar-Raab Corina
Published: March 2022

Continuing the bond (CB) to a deceased loved one plays a clinically significant role in grief. We validated the Continuing Bonds Scale (CBS) examining externalized CB (illusions and hallucinations) versus internalized CB (use of the deceased as a secure base) in relation to risk factors of complicated grief and bereavement-related adjustment. Data from 364 bereaved German participants on CBS, Inventory of Complicated Grief (ICG), and Posttraumatic Personal Growth Inventory (PPGI) entered an exploratory factor analysis. This yielded a two-factor-solution representing externalized and internalized CB ( KMO = .89, χ2 = 2100.5, df = 120). Both factors demonstrated high internal consistency (Cronbach's α = .87). ICG and PPGI highly correlated with externalized and internalized CB. Cause of death and feelings of responsibility were associated with externalized CB. In the future, the use of the CBS could help predict problems in grief processing and consequently implement early interventions.