bluuebunny/crossref_metadata_2025 huggingface dataset:
Prenatal tobacco smoke exposure and neurological impairment at 10 years of age among children born extremely preterm: a prospective cohort
Authors: Venkatesh KK , Leviton A , Fichorova RN , Joseph RM , Douglass LM , Frazier JA , Kuban KCK , Santos HP , Fry RC , O’Shea TM
Published: March 2021

Objective

To determine the association between prenatal tobacco smoke exposure and neurological impairment at 10 years of age among children born extremely preterm (<28 weeks of gestation).

Design

The Extremely Low Gestational Age Newborn (ELGAN) Study, a prospective cohort.

Setting

Ten‐year follow‐up of extremely preterm infants born at 14 US hospitals between 2002 and 2004.

Methods

Prenatal tobacco smoke exposure was defined as a mother’s report at enrolment of active (i.e. maternal) and passive smoking during pregnancy. Poisson regression with generalized estimating equations was used. Models adjusted for mother’s age, race/ethnicity, education, insurance, pre‐pregnancy body mass index, US region, multiple gestation and infant’s sex; and in sensitivity analysis, gestational age at delivery and clinical subtype of preterm birth, given their classification as intermediate and non‐confounding variables.

Main outcomes

Neurological impairment at 10 years, epilepsy, cerebral palsy and cognitive impairment.

Results

Of 1200 ELGAN study survivors, 856 were assessed at 10 years of age with neurological outcomes, of whom 14% (118/856) had active tobacco exposure during pregnancy and 24% (207/852) had passive tobacco exposure. Compared with children who were not exposed prenatally to tobacco, children exposed to active tobacco use during pregnancy had a higher risk of epilepsy (14% versus 5%; adjusted relative risk: 1.68, 95% CI 1.45–1.92). This risk remained after adjustment for gestational age at delivery and clinical subtype of preterm birth. Prenatal tobacco smoke exposure was not associated with other assessed neurological outcomes, including cerebral palsy and multiple measures of cognitive impairment.

Conclusions

Among children born extremely preterm, prenatal active tobacco smoke exposure was associated with an increased risk of epilepsy at 10 years of life.

Tweetable abstract

Among infants born before 28 weeks of gestation, prenatal active tobacco smoke exposure was associated with an increased risk of epilepsy at 10 years of life.
Use of icodextrin solution to evaluate peritoneal transport capacity
Authors: Pereira Lucas de J. , Guimarães Érica A. , Mohrbacher Sarah , Pereira Benedito J. , Elias Rosilene M. , Abensur Hugo
Published: March 2021

Peritoneal equilibration test (PET) is the gold standard for evaluating peritoneal transport, and measurement of the drain volume after 4‐h dwell time with glucose 4.25% is a simple means of evaluating failure of ultrafiltration. The study objective was to verify if the measurement of the volume drained after 4 h dwell of icodextrin at 7.5% (ICO), has a better correlation with the parameters of PET. Patients in a peritoneal dialysis program (N = 35) underwent three procedures: PET; determination of the drain volume after a 4‐h dwell with glucose 4.25%; and determination of the drain volume after a 4‐h dwell with ICO. Among patients who were classified as high transporters, the ultrafiltration volume was greater after ICO use. The ICO ultrafiltration volume correlated negatively with the ratio between the 4‐ and 0‐h dialysate glucose concentrations (D4/D0 ratio, r = −0.579; P = 0.002), correlating positively with the dialysate‐to‐plasma ratio for creatinine (D/PCr ratio, r = 0.474; P = 0.002). For ICO, the area under the receiver operating characteristic curve was 0.867 and 0.792 for the D/PCr and D4/D0 ratios (P < 0.0001 and P = 0.004, respectively), compared with 0.738 and 0.710 for glucose 4.25% (P = 0.020 and P = 0.041, respectively). A cut‐off volume of 141 mL discriminated high/high‐average transporters from low/low‐average transporters. Volume drained after ICO use better predicts peritoneal transport patterns than does that drained after the use of glucose 4.25%.
Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials
Authors: Sridharan K , Sivaramakrishnan G
Published: March 2021

Background

Corticosteroids, calcineurin inhibitors, vitamin D, photodynamic therapy, herbal drugs are some of the interventions tried in clinical trials for treating oral lichen planus. We carried out the present network meta‐analysis to compare the above‐mentioned interventions.

Methods

Electronic databases were searched for randomized clinical trials evaluating interventions in patients with symptomatic oral lichen planus. Clinical resolution, clinical score, pain resolution, pain score, and adverse effects were the outcomes evaluated.

Results

Fifty‐five (2831 patients) trials were included. Corticosteroids (OR: 13.6; 95% CI: 1.2, 155.4), pimecrolimus (OR: 14.7; 95% CI: 1.7, 125), purslane (OR: 18.4; 95% CI: 3.5, 97), and ozonized water/corticosteroids (OR: 52; 95% CI: 1.4, 1882.6) had better rates of clinical resolution compared to placebo. Corticosteroids (OR: 3.18; 95% CI: 1.2, 8.43), ozonized water/corticosteroids (OR: 9.9; 95% CI: 2.7, 36.2), aloe vera (OR: 13; 95%: 1.5, 111.8), pimecrolimus (OR: 18.8; 95% CI: 2, 177.4) and hyaluronic acid (OR: 24.8; 95% CI: 1.3, 457.6) were significantly associated with superior rates of pain resolution compared to placebo. Pimecrolimus and cyclosporine were associated with significantly higher risk of adverse effects than placebo.

Conclusion

Topical corticosteroids were the most effective drug class for treating oral lichen planus.
Gene mapping reveals the association between tyrosine protein kinase Abl1 and the silk yield of Bombyxmori
Authors: Luan Y. , Li C. , Zuo W. , Hu H. , Gao R. , Zhang B. , Tong X. , Lu C. , Dai F.
Published: March 2021

The Z chromosome of the silkworm contains a major gene that influences silk yield. This major locus on chromosome Z accounts for 35.10% of the phenotypic variance. The location and identification of the gene have been a focus of silkworm genetics research. Unfortunately, identification of this gene has been difficult. We used extreme phenotype subpopulations and selected from a backcross population, BC1M, which was obtained using the high‐yield strain 872B and the low‐yield strain IS‐Dazao as parents, for mapping the gene on the chromosome Z. The candidate region was narrowed down to 134 kb at the tip of the chromosome. BmAbl1 in this region correlated with silk gland development by spatiotemporal expression analysis. This gene was differentially expressed in the posterior silk glands of the high‐ and low‐yield strains. In BmAbl1, an insertion–deletion (indel) within the 10th exonic region and an SNP within the 6th intronic region were detected and shown to be associated with cocoon shell weight in 84 Bombyx mori strains with different yields. Nucleotide diversity analysis of BmAbl1 and its 50 kb flanking regions indicated that BmAbl1 has experienced strong artificial selection during silkworm domestication. This study is the first to identify the genes controlling silk yield in the major QTL of the Z chromosome using forward genetics.
Obesity in women: anaesthetic implications for peri‐operative and peripartum management
Authors: Tan H. S. , Habib A. S.
Published: March 2021

The prevalence, healthcare and socio‐economic impact of obesity (defined as having a body mass index of ≥ 30 kg.m‐2) are disproportionately higher in women than men. A combination of biological and social factors, including the adaptation of energy homeostasis to the increased demands of pregnancy and lactation and poor access to healthy foods or exercise facilities, contribute to the increasing prevalence of obesity in women. Obesity‐related physiological changes stem from mass loading and increased metabolism of adipose tissue, as well as secretion of bioactive substances from adipocytes leading to chronic low‐grade inflammation. As a result, obesity is associated with increased risks of: infertility; malignancy; sleep‐disordered breathing; cardiovascular disease; diabetes; and thromboembolism. Hence, obese women are at markedly increased risk of peri‐operative morbidity and mortality and require comprehensive evaluation and targeted comorbidity optimisation by a multidisciplinary team. In addition to routine obstetric challenges, pregnancy in women with obesity further exacerbates the above risks, making multidisciplinary management starting at pre‐conception even more important. Weight loss, lifestyle management and optimisation of comorbidity are the cornerstone of reducing obesity‐related risks. The anaesthetist plays a vital role within the multidisciplinary team by emphasising weight loss as part of pre‐operative comorbidity optimisation, formulation of individualised peri‐operative management plans, supervising postoperative care in the high dependency or intensive care settings and providing safe labour analgesia and careful peripartum management for obese parturients.
The effect of iron deficiency and anaemia on women’s health
Authors: Benson C. S. , Shah A. , Stanworth S. J. , Frise C. J. , Spiby H. , Lax S. J. , Murray J. , Klein A. A.
Published: March 2021

Iron deficiency and anaemia are global health problems and major causes of morbidity in women. Current definitions of anaemia in women are historic and have been challenged by recent data from observational studies. Menstrual loss, abnormal uterine bleeding and pregnancy put women at risk of developing iron deficiency which can result in severe fatigue, reduced exercise capacity and poor work performance. Iron deficiency and anaemia during pregnancy are associated with adverse maternal and fetal outcomes, including neurocognitive deficits in children born to iron‐deficient mothers. Both iron deficiency and anaemia are common in women undergoing surgery but their association with poor outcomes remains uncertain. The enduring burden of iron deficiency and anaemia in women suggests that current strategies for recognition, prevention and treatment are limited in their utility. Improvements in our understanding of iron homeostasis and the development of new iron preparations, which are better absorbed with fewer side‐effects, may improve therapeutic effectiveness of oral iron. Intravenous iron is efficacious for correcting anaemia rapidly but high‐quality data on patient‐centred outcomes and cost‐effectiveness are currently lacking. Many recommendations for the treatment of iron deficiency and anaemia in national guidelines are not supported by high‐quality evidence. There is a need for robust epidemiological data and well‐designed clinical trials. The latter will require collaborative working between researchers and patients to design studies in ways that incorporate patients’ perspectives on the research process and target outcomes that matter to them.
Pandemics and maternal health: the indirect effects of COVID‐19
Authors: Lucas D. N. , Bamber J. H.
Published: March 2021

Infectious diseases can directly affect women and men differently. During the COVID‐19 pandemic, higher case fatality rates have been observed in men in most countries. There is growing evidence, however, that while organisational changes to healthcare delivery have occurred to protect those vulnerable to the virus (staff and patients), these may lead to indirect, potentially harmful consequences, particularly to vulnerable groups including pregnant women. These encompass reduced access to antenatal and postnatal care, with a lack of in‐person clinics impacting the ability to screen for physical, psychological and social issues such as elevated blood pressure, mental health issues and sex‐based violence. Indirect consequences also encompass a lack of equity when considering the inclusion of pregnant women in COVID‐19 research and their absence from vaccine trials, leading to a lack of safety data for breastfeeding and pregnant women. The risk‐benefit analysis of these changes to healthcare delivery remains to be fully evaluated, but the battle against COVID‐19 cannot come at the expense of losing existing quality standards in other areas of healthcare, especially for maternal health.
An update on the management of chronic pelvic pain in women
Authors: Vincent K. , Evans E.
Published: March 2021

Chronic pelvic pain represents a major public health problem for women and impacts significantly on their quality of life. Yet it is under‐researched and a challenge to manage. Women who suffer from chronic pelvic pain frequently describe their healthcare journey as long, via a variety of specialists and frustrating, with their pain often dismissed. Aetiological factors and associations are best conceptualised using the ‘three P’s’ model of predisposing, precipitating and perpetuating factors. This integrates the numerous biological, psychological and social contributors to the complex, multifactorial nature of chronic pelvic pain. Overall management involves analgesia, hormonal therapies, physiotherapy, psychological approaches and lifestyle advice, which like other chronic pain conditions relies on a multidisciplinary team approach delivered by professionals experienced and trained in managing chronic pelvic pain.
Mental disorder in pregnancy and the early postpartum
Authors: Cantwell R.
Published: March 2021

Perinatal mental illness is common, affecting up to 20% of women, but remains under‐recognised and under‐diagnosed. It may have adverse effects on pregnancy and neonatal outcomes, and mental disorder remains one of the leading causes of maternal death in the UK. Women with mental ill health face difficult decisions in balancing risks and benefits of treatment. Stigma related to mental disorder may lead to non‐engagement with maternity care. Some disorders bring specific challenges for anaesthetists working in maternity settings and it is vital that anaesthetists have knowledge of these disorders so they may offer care which is sensitive and appropriate.
Sarcopenia is a strong predictive factor of clinical and oncological outcomes following curative colorectal cancer resection
Authors: Chai Victor W. , Chia Marc , Cocco Anthony , Bhamidipaty Madhu , D'Souza Basil
Published: March 2021

Background

Skeletal muscle depletion and subsequent functional loss is common in gastrointestinal malignancy. Usual markers of nutritional status may not be part of routine workup. The predictive value of sarcopenia was assessed and compared with clinically utilized factors. The aim of this was to assess the association between computed tomography assessed sarcopenia with outcomes in colorectal cancer resection.

Methods

A total of 228 consecutive patients who underwent curative colorectal cancer resection were included. Skeletal muscle area was measured at L3, with pre‐defined gender‐specific cut‐offs applied to a height standardized index. Albumin, body mass index and Subjective Global Assessment scores were recorded alongside measures of comorbidity. Predictors of complications, mortality, and recurrence were identified through multivariate logistic regression.

Results

Computed tomography assessed sarcopenia was significantly associated with longer stays, complications, 30‐day mortality, readmissions and recurrence at 1 year. Specific associations with major, respiratory and cardiac complications were seen. It independently predicted overall complications (odds ratio 2.96, confidence interval 1.19–7.35 P = 0.019), recurrence at 1 year (odds ratio 8.00, confidence interval 1.45–44.21, P = 0.017) and an increase in comprehensive complication index of 14 (P = 0.002). Subgroup analysis found sarcopenia predicted overall complications in rectal surgery and major complications in colonic surgery. American Society of Anesthesiologists predicted complications but not major complications while cancer stage also predicted recurrence rates.

Conclusions

Sarcopenia presents an objective, available predictive factor that may be superior to current biochemical and clinical measures of nutritional and functional status. This study found it to be predictive of complication rates and recurrence after curative in colorectal cancer resection.
Fluorine Content of Fossil Human Bones Excavated from the SHIRAHO‐SAONETABARU Cave Site, ISHIGAKI Is., Okinawa, Japan, as a Chronological and Sedimentary Environmental Index
Authors: Yoshimura K. , Doi N. , Katagiri C. , Yoneda M.
Published: March 2021

The improved fluorine analysis method by ion chromatography was applied to the fossil human bones excavated from the Shiraho‐Saonetabaru Cave site on Ishigaki Island, which were dated back to the Late Pleistocene. This study presents the first systematic results on individual variation of F/P ratios of fossil bones using less than 1 mg samples. In addition to the burial period, the F/P ratio was governed by the local difference in seepage water circulation, because dripping water in a cave slowly flowed through the sediment and fluorine accumulated in the bone from the water. The F/P ratios provide a powerful tool for elucidating the burial situation and subsequent depositional environment. The average F/P ratio was well correlated with the 14C age of the samples. The present method can be practically applicable as a rough chronological classification of the Holocene and Pleistocene groups of human bones at this site. The only exception was the lower F/P values of the Pleistocene human skeleton belonging to Shiraho No. 4, which is thought to have been placed in a narrow space under the fallen rocks.
A consequentialist argument for considering age in triage decisions during the coronavirus pandemic
Authors: Altman Matthew C.
Published: March 2021

Most ethics guidelines for distributing scarce medical resources during the coronavirus pandemic seek to save the most lives and the most life‐years. A patient’s prognosis is determined using a SOFA or MSOFA score to measure likelihood of survival to discharge, as well as a consideration of relevant comorbidities and their effects on likelihood of survival up to one or five years. Although some guidelines use age as a tiebreaker when two patients’ prognoses are identical, others refuse to consider age for fear of discriminating against the elderly. In this paper, I argue that age is directly relevant for maximizing health benefits, so current ethics guidelines are wrongly excluding or deemphasizing life‐stage in their triage algorithms. Research on COVID‐19 has shown that age is a risk factor in adverse outcomes, independent of comorbidities. And limiting a consideration of life‐years to only one or five years past discharge does not maximize health benefits. Therefore, based on their own stated values, triage algorithms for coronavirus patients ought to include life‐stage as a primary consideration, along with the SOFA score and comorbidities, rather than excluding it or using it merely as a tiebreaker. This is not discriminatory because patients ought to have equal opportunity to experience life‐stages. The equitable enforcement of that right justifies unequal treatment based on age in cases when there is a scarcity of life‐saving resources. A consideration of life‐stage would thus allow healthcare workers to responsibly steward public resources in order to maximize lives and life‐years saved.
Using feathers to map continental‐scale movements of waterbirds and wetland importance
Authors: Brandis Kate J. , Mazumder Debashish , Gadd Patricia , Ji Boyu , Kingsford Richard T. , Ramp Daniel
Published: March 2021

Waterbirds are highly mobile, moving over large distances to access resources. Although consistent migration routes are observed in highly seasonal and predictable environments, movement patterns to utilize ephemeral resources in dryland environments are largely unknown. This makes conservation planning and water policy challenging as the relative importance of widely dispersed wetlands is difficult to rank. We addressed this challenge by combining a citizen science project with the novel application of X‐ray fluorescence of feathers to detect continental scale movement of waterbirds using elemental signatures. By doing so, we gained important insight into the movements of 24 waterbird species, including the significance of the Murray–Darling basin as a key source of waterbirds across the continent. Our approach highlights the benefits of elemental signatures to identify key areas of habitat use and priorities for wetland management.
Evolutionary process modeling with Bayesian inference of Spodoptera frugiperda ballooning and walking dispersal in Bt and non‐Bt cotton plant mixtures
Authors: Malaquias José Bruno , Godoy Wesley Augusto Conde , Caprio Michael A. , Pachú Jéssica Karina da Silva , de Sousa Ramalho Francisco , Omoto Celso , Ferreira Claudia Pio
Published: March 2021

Transgenic crops expressing Bacillus thuringiensis Berliner (Bt) have been cultivated throughout the world as a great technological tool for developing integrated pest management. We hypothesized that artificial landscapes containing Bt and non‐Bt cotton plants (Gossypium hirsutum L., Malvaceae) at small scales could influence dispersal by ballooning of Spodoptera frugiperda (JE Smith) (Lepidoptera: Noctuidae). We also simulated how ballooning dispersal combined with walking movement could impact resistance evolution in various scenarios of plant mixtures involving non‐Bt and Bt cotton plants with high‐dose and low‐dose events. The ballooning frequency of Cry1F‐resistant larvae in a treatment with non‐Bt cotton as a natal plant and Bt cotton in adjacent sites was two‐fold lower compared to when Bt cotton was the natal plant and non‐Bt cotton was in the adjacent sites. Our model results suggested that the higher rate of walking movement associated with ballooning promoted faster resistance evolution in low‐dose events, and contamination of Bt cotton fields with non‐Bt cotton plants in a high‐dose event showed the longest time to resistance. Therefore, a high rate of walking movement associated with ballooning negatively impacted the time for resistance to evolve in low‐dose events.
Large vessel cardioembolic stroke and embolic stroke of undetermined source share a common profile of matrix metalloproteinase‐9 level and susceptibility vessel sign length
Authors: Alhazmi Hanan , Bani‐Sadr Alexandre , Bochaton Thomas , Paccalet Alexandre , Da Silva Claire Crola , Buisson Marielle , Amaz Camille , Ameli Roxana , Berthezene Yves , Eker Omer Faruk , Ovize Michel , Cho Tae‐Hee , Nighoghossian Norbert , Mechtouff Laura
Published: March 2021

Background

Embolic stroke of undetermined source (ESUS) accounts for up to 25% of ischemic strokes. Identification of biomarkers that could improve the prediction of stroke subtype and subsequently of stroke prevention still remains a major issue.

Methods

The HIBISCUS‐STROKE cohort includes ischemic stroke patients with large vessel occlusion treated with mechanical thrombectomy following admission magnetic resonance imaging. Presence and length of susceptibility vessel sign (SVS) were assessed by gradient‐recalled echo T2*‐weighted imaging. Matrix metalloproteinase‐9 (MMP‐9) was measured on sera collected at admission. A multiple logistic regression model was performed to detect independent markers distinguishing cardioembolic (CE) from large‐artery atherosclerosis (LAA) subtype.

Results

A total of 147 patients were included, of them the etiology was distributed as follows: 86 (58.5%) CE, 26 (17.7%) LAA, and 35 (23.8%) ESUS. The optimal cutoff for differentiating CE from LAA subtype was 14.5 mm for SVS length (sensitivity, 79.7%; specificity, 72.7%) and 1110 ng/ml for admission MMP‐9 level (sensitivity, 85.3%; specificity, 52.2%). Multivariate analysis revealed that current smoking (odds ratio [OR] 0.07, 95% confidence interval [CI] 0.01–0.93), tandem occlusion (OR 0.01, 95% CI 0.01–0.21), SVS length (OR 0.78, 95% CI 0.63–0.97), and admission MMP‐9 level (OR 0.99, 95% CI 0.99–1.00) were inversely associated with CE subtype. SVS length and MMP‐9 level did not differ between ESUS and CE subtypes.

Conclusion

SVS length and admission MMP‐9 level may improve the prediction of CE subtype whose profile is close to ESUS, thus suggesting a common cardiac embolic source.
Effectiveness of a resistance exercise program for lower limbs in chronic renal patients on hemodialysis: A randomized controlled trial
Authors: Exel Ana Luiza , Lima Paulo Soares , Urtado Christiano Bertoldo , Dibai‐Filho Almir Vieira , Vilanova Claudia Lucio , Sabino Elaine Fávaro Pípi , Cunha Thúlio Marquez , de Farias‐Filho Flávio Teles , de Miranda Claudio Torres , da Silva Robinson Sabino , Bassi‐Dibai Daniela
Published: March 2021

Introduction

Physical inactivity in hemodialysis patients is associated with increased mortality. The objective of this study was evaluated the effect of an intradialytic resistance exercise program on chronic kidney disease (CKD) patients on hemodialysis.

Methods

One hundred seven patients were included in the study. They were aged 18–60 years, of both sexes, had undergone hemodialysis treatment for at least 1 year, sedentary. Patients were randomly divided into two groups: stretching (STG) and resistance exercise (REG). Intervention programs were performed for 8 weeks, three times a week. The evaluations were performed before and after the training programs. The primary outcome was functional capacity using the 6‐minute walk test (6MWT). Secondary outcomes were peripheral muscle strength, respiratory muscle strength, spirometric respiratory function, and laboratory data.

Findings

Comparisons between groups revealed the following clinically relevant results in favor of REG: lower limb muscle strength (mean difference [MD] = −1.99, 95% confidence interval [CI] = −2.77 to −1.21; d = −0.53), distance walked in the 6MWT (MD = −26.27, 95% CI = −45.40 to −7.14; d = −0.46), creatinine (MD = −1.52, 95% CI = −2.49 to −0.54; d = −0.66), and calcium (MD = −0.44, 95% CI = −0.78 to −0.10; d = −0.49).

Discussion

CKD patients on hemodialysis have reduced functional capacity compared to healthy sedentary individuals. In turn, this reduction appears to be associated with a lower survival rate and affects the performance of their daily living activities. Thus, resistance exercise performed in the intradialytic phase is an effective therapeutic strategy for CKD patients, mainly because it increases functional capacity and lower limb muscle strength.
CLASS OR COMMUNITY? MARX, THE RUSSIAN COMMUNE, AND CONTEMPORARY CRITICAL THEORY
Authors: MACÍAS VÁZQUEZ ALFREDO , ALONSO GONZÁLEZ PABLO , PARGA DANS EVA
Published: March 2021

This article explores the relationship between class and community through a discussion of peasant struggles and the commune during the Russian Revolution. Doing so, we show how Marx's class‐oriented reflections on community can help us to understand the role that the peasantry plays (or should play) in processes of social transformation. This enables us, first, to understand the relevance of communal forms for Marx, who believed that communitarian ways of life were crucial for overcoming a value‐based society. It is, in fact, a mistake to divide Marx's intellectual trajectory into two periods: a categorical Marx, who authored Capital and critically analyzed the classical theory of value, and a phenomenological, empirical Marx, who in the last years of his life abandoned writing Capital and focused instead on studying the Russian peasantry. Second, it enables us to discuss new externalist visions, such as postcolonial and decolonial theories, which postulate that the subordination of contemporary peasant communities is rooted in epistemology, culture, and local power relations. These theories are related to the old social‐democratic canon, which conceives of social classes as preconstituted entities and of capital as a parasitic externality that is incommensurable with social dynamics. The experience of the Russian peasantry calls into question all externalist and ontological perspectives.
SEAGULLS! ON MARTIN HÄGGLUND'S THIS LIFE: SECULAR FAITH AND SPIRITUAL FREEDOM
Authors: Wurgaft Benjamin Aldes
Published: March 2021

In this review essay, I examine Martin Hägglund's This Life: Secular Faith and Spiritual Freedom, a book that argues on behalf of democratic socialism on the basis of an atheistic confrontation with the fact of our mortality. Hägglund's book includes readings of Søren Kierkegaard, Karl Ove Knausgaard, Karl Marx, and Martin Luther King Jr. and is best assessed as a literary and philosophical, rather than historical, study of the relation between mortality and social action. Simply put, Hägglund believes that, from the standpoint of an atheistic confrontation with our mortality, our time itself should be our ultimate measure of value. He furthermore believes that democratic socialism is the political and economic form that most naturally follows from this, allowing us to honor, defend, and enhance one another's mortal time and freedom to make choices—and that, by comparison with atheism, religion offers only the false coin of otherworldly salvation. Although sympathizing with Hägglund's existential and political orientations, I criticize his account of religion, which I find to be historically weak. But I also criticize his approach to the problem of valuation, or the issue of how we make choices in relation to our limited time. Whereas Hägglund believes that mortal creatures like ourselves must make choices in a spirit of commitment—the “secular faith” of his subtitle—I observe that, despite our mortality, we humans make our choices in a variety of psychological states, and that asking us to occupy only one such state—one of zealous resolve—actually undermines our “spiritual freedom,” another one of Hägglund's key terms.
Impact of more conservative European Society of Cardiology guidelines on the management of patients with acute chest pain
Authors: Kienbacher Calvin L. , Fuhrmann Verena , van Tulder Raphael , Havel Christof , Schreiber Wolfgang , Rasoul‐Rockenschaub Susanne , Wrba Thomas , Herkner Harald , Laggner Anton N. , Roth Dominik
Published: March 2021

Objective

Early diagnosis or rule‐out of acute coronary syndrome (ACS) is a key competence of emergency medicine. Changes in the NSTE‐ACS guidelines of the European Society of Cardiology (ESC) in 2015 and 2020 both warranted a henceforth more conservative approach regarding high‐sensitivity troponin t (hsTnt) testing.

We aimed to assess the impact of more conservative guidelines on the frequency of early rule‐out and prolonged observation with repeated hsTnt testing at a high‐volume tertiary care emergency department.

Patients and Methods

We conducted a pre‐ and post‐changeover analysis 3 months before and 3 months after transition from less (hsTnt cut‐off 30 ng/L, 3‐hour rule‐out) to more conservative (hsTnt cut‐off 14 ng/L, 1‐hour rule‐out) guidelines in 2015, comparing proportions of patients requiring repeated testing.

Results

We included 5442 cases of symptoms suspicious of acute cardiac origin (3451 before, 1991 after, 2370 (44%) female, age 55 (SD 19) years). The proportion of patients fulfilling early‐rule out criteria decreased from 68% (2348 patients) before to 60% (1195 patients) with the 2015 guidelines (P < .01). Those requiring repeated testing significantly (P < .01) increased from 22% (743 patients) to 25% (494 patients). Positive results in repeated testing significantly (P = .02) decreased from 43% (320 patients) to 37% (181 patients). Invasive diagnostics were performed in 91 patients (2.6%) before and in 75 patients (3.8%) after (P = .02) the guideline revision.

Conclusion

The implementation of the more conservative 2015 ESC guidelines led to a minor rise in prolonged observations because of an increase in negative repeated testing and to an increase in invasive procedures.
Metabolic regulators of enigmatic inflammasomes in autoimmune diseases and crosstalk with innate immune receptors
Authors: Jimenez‐Duran Gisela , Triantafilou Martha
Published: March 2021

Nucleotide‐binding domain and leucine‐rich repeat receptor (NLR)‐mediated inflammasome activation is important in host response to microbes, danger‐associated molecular patterns (DAMPs) and metabolic disease. Some NLRs have been shown to interact with distinct cell metabolic pathways and cause negative regulation, tumorigenesis and autoimmune disorders, interacting with multiple innate immune receptors to modulate disease. NLR activation is therefore crucial in host response and in the regulation of metabolic pathways that can trigger a wide range of immunometabolic diseases or syndromes. However, the exact mode by which some of the less well‐studied NLR inflammasomes are activated, interact with other metabolites and immune receptors, and the role they play in the progression of metabolic diseases is still not fully elucidated. In this study, we review up‐to‐date evidence regarding NLR function in metabolic pathways and the interplay with other immune receptors involved in GPCR signalling, gut microbiota and the complement system, in order to gain a better understanding of its link to disease processes.
Issues, challenges, and a proposed theoretical core of agile software development research
Authors: Baham Corey , Hirschheim Rudy
Published: March 2021

Over the last two decades, agile software development (ASD) has garnered much attention in both research and practice. Several ASD methods and techniques have been developed and studied. In particular, researchers have provided several theoretical perspectives on ASD and contributed rich insights to the ASD practice. Still, despite calls for a more unified theoretical understanding of ASD, a theoretical core of ASD has not been identified. This paper offers a theoretical core of ASD research, clarifying what is essential and what is less essential for IS agility, hoping to spark a scholarly discussion, and provides implications of such a core for understanding method tailoring.
The school bus routing problem with student choice: a bilevel approach and a simple and effective metaheuristic
Authors: Calvete Herminia I. , Galé Carmen , Iranzo José A. , Toth Paolo
Published: March 2021

The school bus routing problem (SBRP) involves interrelated decisions such as selecting the bus stops, allocating the students to the selected bus stops, and designing the routes for transporting the students to the school taking into account the bus capacity constraint, with the objective of minimizing the cost of the routes. This paper addresses the SBRP when the reaction of students to the selection of bus stops is taken into account, that is, when students are allowed to choose the selected bus stop that best suits them. A bilevel optimization model with multiple followers is formulated, and its transformation into a single‐level mixed integer linear programming (MILP) model is proposed. A simple and effective metaheuristic algorithm is also developed to solve the problem. This algorithm involves solving four MILP problems at the beginning, which can be used to obtain tight upper bounds of the optimal solution. Extensive computational experiments on SBRP benchmark instances from the literature show the effectiveness of the proposed algorithm in terms of both the quality of the solution found and the required computing time.
Spawning, embryogenesis, settlement, and post‐settlement development of the gorgonian Plexaura homomalla
Authors: Tonra Kaitlyn J. , Wells Christopher D. , Lasker Howard R.
Published: March 2021

Patterns of population biology and community structure can be studied by looking closely at the ontogeny and reproductive biology of reef‐building organisms. This knowledge is particularly important for Caribbean octocorals, which seem to be more resilient to long‐term environmental change than scleractinian corals and provide some of the same ecological services. We monitored the development of the black sea rod, Plexaura homomalla, a common, widely distributed octocoral on shallow Caribbean reefs, from eggs to three‐polyp colonies over the course of 10 weeks. Gametes were collected ex situ on St. John, U.S. Virgin Islands, during spawning events that occurred 3–6 days after the July full moon. Cleavage started 3.0 hr after fertilization and was holoblastic, equal, and radial. Embryos were positively buoyant until becoming planulae at 3 days after fertilization. Planulae were competent to settle 4 days after fertilization. Symbiodiniaceae began infecting polyps ~8 days after fertilization. Overall, development was typical for Caribbean octocorals, except for an increase in the number of embryos between 3.5 and 6.0 hr after fertilization.
Interfacial reactions between B2O3 and spark plasma sintered Yb2Si2O7
Authors: Guarriello Rachel , Hoglund Eric , Heinrich Helge , Opila Elizabeth
Published: March 2021

Reactions between boria (B2O3) and Yb2Si2O7 were studied via a series of idealized interfacial “well” tests. Boria oxidizes out of SiC/SiC ceramic matrix composites (CMCs) where BN is used as a fiber/matrix interphase and boron‐rich inclusions often serve as aids in the melt infiltration process. Borate phases are highly reactive and can react with the rare earth silicates currently being utilized as environmental barrier coatings (EBCs) for these CMC systems. Ytterbium disilicate substrates for these well tests are prepared via spark plasma sintering. The well is then drilled into the substrates and filled with a boria glass plug. Exposures in a stagnant‐air box furnace show that the boria is reacting with the disilicate via a substitution reaction leaving YbBO3 and amorphous silica glass as the product phases. This phase was characterized with scanning electron microscopy and elemental dispersive spectroscopy (SEM/EDS), micro‐focus X‐ray diffraction, and selected‐area electron diffraction (SAED). Inductively coupled plasma optical emission spectroscopy (ICP‐OES) was also used to analyze water‐soluble glassy phases left on the surface of the substrates post‐exposure, indicating that the boron content of the glass was decreasing with both increasing exposure times and temperatures. There are few data on the borate product phase properties, however the results of this study suggest that the boria formed via oxidation from the SiC/BN/SiC composites could be detrimental to the performance of Yb2Si2O7 environmental barrier coatings via formation of the borate phase and silica.
Economic implications of access to daylight and views in office buildings from improved productivity
Authors: MacNaughton Piers , Woo May , Tinianov Brandon , Boubekri Mohamed , Satish Usha
Published: March 2021

Previous research has found significant impacts of daylight and views on the cognitive function of office workers. In this study, we use scores on decision‐making performance to estimate the annual economic potential of optimizing daylighting and views in U.S. offices. Cognitive scores were compared against over 100,000 previous test scores to obtain the distributional shift in cognitive performance when working in an office with optimized daylighting and views as opposed to an office with traditional blinds. These changes in performance were then compared to compensation data from the Bureau of Labor Statistics. Office workers shifted on average from the 52nd percentile to 65th percentile, equivalent to a $11,809 difference in salary per person per year. When conservatively accounting for the number of employees working within 15 ft of a window with blinds, optimizing daylight and views in U.S. offices has the potential to generate $352B ($240B–$464B), or 1.7% of the 2018 U.S. gross domestic product (GDP), in additional productivity. These findings suggest that building developers, architects and tenants should give additional attention to daylight design and façade technology as they consider new building construction, renovation and leasing options.
Predictors of permanent pacemaker insertion after TAVR: A systematic review and updated meta‐analysis
Authors: Mahajan Sugandhi , Gupta Rahul , Malik Aaqib H. , Mahajan Pranav , Aedma Surya K. , Aronow Wilbert S. , Mehta Sanjay S. , Lakkireddy Dhanunjaya R.
Published: March 2021

Objectives

The aim of this analysis was to evaluate the predictors associated with increased risk of permanent pacemaker implantation (PPMI) following transcatheter aortic valve replacement (TAVR).

Background

While TAVR has evolved as the standard of care for patients with severe aortic stenosis, conduction abnormalities leading to the need for PPMI is one of the most common postprocedural complications.

Methods

A systematic literature search was performed to identify relevant trials from inception to May 2020. Summary effects were calculated using a DerSimonian and Laird random‐effects model as odds ratio with 95% confidence intervals for all the clinical endpoints.

Results

Thirty‐seven observational studies with 71 455 patients were identified. The incidence of PPMI following TAVR was 22%. Risk was greater in men and increased with age. Patients with diabetes mellitus, presence of right bundle branch block, baseline atrioventricular conduction block, and left anterior fascicular block were noted to be at higher risk. Other significant predictors include the presence of high calcium volume in the area below the left coronary cusp and noncoronary cusp, use of self‐expandable valve over balloon‐expandable valve, depth of implant, valve size/annulus size, predilatation balloon valvuloplasty, and postimplant balloon dilation.

Conclusion

Fourteen factors were found to be associated with increased risk of PPMI after TAVR, suggesting early identification of high‐risk populations and targeting modifiable risk factors may aid in reducing the need for this post TAVR PPMI.
Atrial fibrosis and substrate based characterization in atrial fibrillation: Time to move forwards
Authors: Quah Jing X. , Dharmaprani Dhani , Tiver Kathryn , Lahiri Anandaroop , Hecker Teresa , Perry Rebecca , Selvanayagam Joseph B. , Joseph Majo X. , McGavigan Andrew , Ganesan Anand
Published: March 2021

Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia in clinical practice. However, current therapeutic interventions for atrial fibrillation have limited clinical efficacy as a consequence of major knowledge gaps in the mechanisms sustaining atrial fibrillation. From a mechanistic perspective, there is increasing evidence that atrial fibrosis plays a central role in the maintenance and perpetuation of atrial fibrillation. Electrophysiologically, atrial fibrosis results in alterations in conduction velocity, cellular refractoriness, and produces conduction block promoting meandering, unstable wavelets and micro‐reentrant circuits. Clinically, atrial fibrosis has also linked to poor clinical outcomes including AF‐related thromboembolic complications and arrhythmia recurrences post catheter ablation. In this article, we review the pathophysiology behind the formation of fibrosis as AF progresses, the role of fibrosis in arrhythmogenesis, surrogate markers for detection of fibrosis using cardiac magnetic resonance imaging, echocardiography and electroanatomic mapping, along with their respective limitations. We then proceed to review the current evidence behind therapeutic interventions targeting atrial fibrosis, including drugs and substrate‐based catheter ablation therapies followed by the potential future use of electro phenotyping for AF characterization to overcome the limitations of contemporary substrate‐based methodologies.
Pancreatitis severity in mice with impaired CFTR function but pancreatic sufficiency is mediated via ductal and inflammatory cells‐Not acinar cells
Authors: Trapp Simon , Aghdassi Ali A. , Glaubitz Juliane , Sendler Matthias , Weiss Frank Ulrich , Kühn Jens Peter , Kromrey Marie‐Luise , Mahajan Ujjwal M. , Pallagi Petra , Rakonczay Zoltán , Venglovecz Viktória , Lerch Markus M. , Hegyi Peter , Mayerle Julia
Published: March 2021

Mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR) are an established risk factor for cystic fibrosis (CF) and chronic pancreatitis. Whereas patients with CF usually develop complete exocrine pancreatic insufficiency, pancreatitis patients with CFTR mutations have mostly preserved exocrine pancreatic function. We therefore used a strain of transgenic mice with significant residual CFTR function (CFTRtm1HGU) to induce pancreatitis experimentally by serial caerulein injections. Protease activation and necrosis were investigated in isolated acini, disease severity over 24h, pancreatic function by MRI, isolated duct stimulation and faecal chymotrypsin, and leucocyte function by ex vivo lipopolysaccharide (LPS) stimulation. Pancreatic and lung injury were more severe in CFTRtm1HGU but intrapancreatic trypsin and serum enzyme activities higher than in wild‐type controls only at 8h, a time interval previously attributed to leucocyte infiltration. CCK‐induced trypsin activation and necrosis in acini from CFTRtm1HGU did not differ from controls. Fluid and bicarbonate secretion were greatly impaired, whereas faecal chymotrypsin remained unchanged. LPS stimulation of splenocytes from CFTRtm1HGU resulted in increased INF‐γ and IL‐6, but decreased IL‐10 secretion. CFTR mutations that preserve residual pancreatic function significantly increase the severity of experimental pancreatitis—mostly via impairing duct cell function and a shift towards a pro‐inflammatory phenotype, not by rendering acinar cells more susceptible to pathological stimuli.
ARID1B/SUB1‐activated lncRNA HOXA‐AS2 drives the malignant behaviour of hepatoblastoma through regulation of HOXA3
Authors: Liu Gongbao , Liu Baihui , Liu Xiangqi , Xie Lulu , He Jiajun , Zhang Jingjing , Dong Rui , Ma Duan , Dong Kuiran , Ye Mujie
Published: March 2021

It has been becoming increasingly evident that long non‐coding RNAs (lncRNAs) play important roles in various human cancers. However, the biological processes and clinical significance of most lncRNAs in hepatoblastoma (HB) remain unclear. In our previous study, genome‐wide analysis with a lncRNA microarray found that lncRNA HOXA‐AS2 was up‐regulated in HB. Stable transfected cell lines with HOXA‐AS2 knockdown or overexpression were constructed in HepG2 and Huh6 cells, respectively. Our data revealed knockdown of HOXA‐AS2 increased cell apoptosis and inhibited cell proliferation, migration and invasion in HB. Up‐regulation of HOXA‐AS2 promoted HB malignant biological behaviours. Mechanistic investigations indicated that HOXA‐AS2 was modulated by chromatin remodelling factor ARID1B and transcription co‐activator SUB1, thereby protecting HOXA3 from degradation. Therefore, HOXA‐AS2 positively regulates HOXA3, which might partly demonstrate the involvement of HOXA3 in HOXA‐AS2‐mediated HB carcinogenesis. In conclusion, HOXA‐AS2 is significantly overexpressed in HB and the ARID1B/HOXA‐AS2/HOXA3 axis plays a critical role in HB tumorigenesis and development. These results might provide a potential new target for HB diagnosis and therapy.