bluuebunny/crossref_metadata_2025 huggingface dataset:
Cysteine Pathogenic Variants of PMM2 Are Sensitive to Environmental Stress with Loss of Structural Stability
Authors: Yu Fan , Lin Li , Sun Jingmiao , Pan Jicheng , Liao Yixin , Pan Yunfan , Bai Guannan , Ma Liangjian , Mao Jianhua , Hu Lidan
Published: January 2023

Congenital disorders of glycosylation (CDG) are severe metabolic disorders caused by an imbalance in the glycosylation pathway. Phosphomannomutase2 (PMM2-CDG), the most prevalent CDG, is mainly due to the disorder of PMM2. Pathogenic variants in cysteine have been found in various diseases, and cysteine residues have a potential as therapeutic targets. PMM2 harbor six cysteines; the variants Cys9Tyr (C9Y) and Cys241Ser (C241S) of PMM2 have been identified to associate with CDG, but the underlying molecular mechanisms remain uncharacterized. Here, we purified PMM2 wild type (WT), C9Y, and C241S to investigate their structural characteristics and biophysical properties by spectroscopic experiments under physiological temperature and environmental stress. Notably, the variants led to drastic changes in the protein properties and were prone to aggregate at physiological temperature. Meanwhile, PMM2 was sensitive to oxidative stress, and the cysteine pathogenic variants led to obvious aggregate formation and a higher cellular apoptosis ratio under oxidative stress. Molecular dynamic simulations indicated that the pathogenic variants changed the core domain of homomeric PMM2 and subunit binding free energy. Moreover, we tested the potential drug targeting PMM2-celastrol in cell level and explained the result by molecular docking simulation. In this study, we delineated the pathological mechanism of the cysteine substitution in PMM2, which addressed the vital role of cysteine in PMM2 and provided novel insights into prevention and treatment strategies for PMM2-CDG.
Computed Tomography‐Based Prediction of Lumbar Pedicle Screw Loosening
Authors: Shu Li , Wang Xiaoyuan , Li Lei , Aili Abudunaibi , Zhang Rui , Liu Wenge , Muheremu Aikeremujiang
Published: January 2023

Objective. Pedicle screw loosening is one of the main complications after pedicle screw fixation. However, there are few reliable measures for prediction of screw loosening. The current study was carried out to find an effective method to use preoperative CT scanning as a predictor of screw loosening in the elderly patients and provide guidance for preoperative surgical planning. Methods. Patients who were treated with lumbar pedicle screw fixation procedure in our department for degenerative lumbar disorders between January 2015 and January 2021 were retrospectively included in the current study. CT scan attenuation of each vertebra was measured with Hounsfield units (HU). Screw loosening was determined in postoperatively X‐ray tests. One‐way analysis of variance (ANOVA) and receiver operating characteristic (ROC) curve analysis were carried out with IBMSPSS 24.00 software. Results. Screw loosening was observed in 44 of 215 patients (124 male, 91 female, average age 58.4 ± 7.6 years) during a mean follow‐up time of 19.0 ± 11.2 months (range 12‐32 months). No significant differences were found among the patients concerning patient gender, BMI, habit of smoking, and whether or not the patient had diabetes or suffered from spondylolisthesis (P > 0.05). The average HU value of lumbar vertebra was 122.4 ± 32.8 HU in the screw loosening group and 142.4 ± 38.2 HU in the control group, and the difference was significant (P < 0.01). ROC curve analysis revealed that the average HU value of L1‐L5 has a relatively larger area under the curve (AUC) of 0.689 (95% CI: 0.605‐0.773). With the sensitivity of 68% and specificity of 57%, a HU cut‐off value of ≤124 HU is a plausible cut‐off point to predict screw loosening. Conclusions. A prospective CT scan HU value‐based prediction can be used to decide whether or not to use screw augmentation methods. A cut‐off L1‐L5 average HU value of 124 HU can be used as an independent risk factor for screw loosening in instrumented lumbar vertebra. More predictive indexes should be involved to achieve higher sensitivity and specificity in future clinical practice.
Gait Function after High-Intensity Focused Ultrasound Thalamotomy for Essential Tremor: Searching for Technique Optimization
Authors: Sastre-Bataller Isabel , Campins-Romeu Marina , Marcos-Carrión Andrés , Gutiérrez-Martín Antonio , Conde-Sardón Rebeca , Losada-López Mireya , Santabárbara-Gómez José M. , León- Guijarro José L. , Belloch Vicente , Lozano Andrés M. , Martínez-Torres Irene
Published: January 2023

Introduction: Essential tremor (ET) is one of the most prevalent movement disorders in adults and may be highly disabling for some. Magnetic resonance image-guided high-intensity focused ultrasound (MRIgFUS) has been shown to control tremor efficaciously and with acceptable risk. To date, paresthesia and ataxia are the most common adverse effects (AE). Nevertheless, the impact of MRIgFUS thalamotomy on balance is not well established. Methods: Thirty-two patients underwent MRIgFUS for ET and completed 6 months of follow-up. Tremor severity and functional disability were assessed using the Essential Tremor Rating Scale and the Quality of Life in Essential Tremor Questionnaire. The Berg Balance Scale (BBS) was applied to objectively measure balance status. Results: All treatments were successful. The sonication target was 1–2 mm above the depth of the intercommissural line. Procedures lasted less the 2 h, with an average of 8 sonications per patient. Twenty-four patients were included in the tremor analysis. The hand tremor score was improved by 76% after 6 months of follow-up and 87% of patients self-reported marked improvement (≥75%). Disability scores showed marked improvement (78%), leading to a significant improvement in quality of life. At the final follow-up, 48% of the patients reported no side effects. When present, AE were generally transient and were considered mild in 96% of affected patients. Paresthesia and subjective feeling of unsteadiness were the most common persistent complaints (23% and 20%, respectively). Regarding objective ataxia, BBS scores remained stable throughout follow-up for most patients. Only 2 patients suffered a mild worsening of balance although no patients experienced moderate or severe ataxia. Conclusions: Subjective feeling of unsteadiness is one of the most frequent AE after MRIgFUS, although objective ataxia is infrequent and mild. Selecting the most appropriate lesion location and procedural parameters should increase treatment benefits while reducing side effects.
Weight Loss History and Its Association with Self-Esteem and Eating Behaviors in Adolescents and Young Adults with Obesity
Authors: Tolvanen Liisa , Christenson Anne , Eke Helén , Bonn Stephanie E. , Lagerros Ylva Trolle
Published: January 2023

Introduction: Previous weight loss attempts in young people with obesity may have influenced their beliefs about themselves and contributed to maladaptive eating behaviors. Therefore, we aimed to investigate the association between previous weight loss with self-esteem and different eating behaviors in adolescents and young adults with obesity seeking specialty obesity care. Methods: We performed a cross-sectional study, where a total of 224 participants with obesity, aged 16–25, self-reported the amount and the frequency of previous weight loss of 5 kg or more. Self-esteem was assessed with Rosenberg’s Self-Esteem Scale and eating behavior with the Three-Factor Eating Questionnaire-Revised21. Linear regression was used to analyze associations between the amount of weight loss (no weight loss, 5–10 kg, and >10 kg) and the frequency of weight loss ≥5 kg (0, 1, and ≥2 times) with self-esteem and eating behaviors. Results: We found that both those who had lost 5–10 kg and those who had lost ≥5 kg twice or more, had statistically significantly higher cognitive restraint eating scores β = 7.03 (95% CI: 0.004–14.05) and β = 8.32 (95% CI: 1.20–15.43), respectively, compared to those who reported no previous weight loss. No other statistically significant associations were found. Conclusion: Previous weight loss in adolescents and young adults with obesity may be associated with a higher cognitive restraint eating behavior. Therefore, assessing weight loss history and eating behavior may be beneficial to better individualize obesity treatment.
Renal Cell Carcinoma in End-Stage Renal Disease: A Retrospective Study in Patients from Hungary
Authors: Semjén Dávid , Dénes Borbála , Somorácz Áron , Fintha Attila , Forika Gertrúd , Jenei Alex , Dobi Deján , Micsik Tamás , Eizler Kornélia Veronika , Giba Nándor , Sánta Fanni , Sejben Anita , Iványi Béla , Kuthi Levente
Published: January 2023

Introduction: End-stage renal disease (ESRD) and acquired cystic kidney disease (ACKD) are known risk factors for renal cell carcinoma (RCC). Hereby, the clinicopathological features of RCCs developed in ESRD were investigated. Methods: A database consisting of 34 tumors from 31 patients with ESRD among 2,566 nephrectomy samples of RCC was built. The demographic, clinical, and follow-up data along with pathological parameters were analyzed. The RCCs were diagnosed according to the current WHO Classification of Urinary and Male Genital Tumors. Results: Twenty-two tumors developed in men and 12 in women, with a median age of 56 years (range: 27–75 years). The causes of ESRD were glomerulonephritis (n = 7), hypertensive kidney disease (n = 6), autosomal dominant polycystic kidney disease (n = 6), chronic pyelonephritis (n = 4), diabetic nephropathy (n = 3), chemotherapy-induced nephropathy (n = 1), and undetermined (n = 4). ACKD complicated ESRD in 12 patients. The following histological subtypes were identified: clear cell RCC (n = 19), papillary RCC (n = 5), clear cell papillary tumor (n = 5), ACKD RCC (n = 3), and eosinophilic solid and cystic RCC (n = 2). The median tumor size was 31 mm (range: 10–80 mm), and 32 tumors were confined to the kidney (pT1-pT2). There was no tumor-specific death during the period of this study. Progression was registered in 1 patient. Conclusion: In our cohort, the most common RCC subtype was clear cell RCC (55%), with a frequency that exceeded international data appreciably (14–25%). The incidence of clear cell papillary tumor and ACKD RCC (14.7% and 8.5%) was lower than data reported in the literature (30% and 40%). Our results indicate a favorable prognosis of RCC in ESRD.
Hemodynamic Profiling and Prognosis in Cardiac Amyloidosis
Authors: Martens Pieter , Bhattacharya Sanjeeb , Longinow Joshua , Ives Lauren , Jacob Miriam , Valent Jason , Hanna Mazen , Tang W.H. Wilson
Published: January 2023

Background:

Little information is available on the prognostic relevance of cardiac hemodynamic cutoffs in cardiac amyloidosis (CA) and its subtypes.

Methods:

Consecutive patients diagnose with light chain-CA or transthyretin CA undergoing right heart catheterization were analyzed. Prognostic relevance of classic hemodynamic cutoffs of cardiac index (CI <2.2 L/min per m
2
), pulmonary capillary wedge pressure (>18 mm Hg), right atrial pressure (>8 mm Hg), and mean pulmonary artery pressure (≥25 mm Hg or pulmonary hypertension) with the combined end point of cardiac transplant/left ventricular assist device and death and heart failure admissions separately was assessed.

Results:

A total of 469 CA patients underwent right heart catheterization (light chain CA=42% and transthyretin CA=52%) of whom 69%, 64%, and 79% had elevated right atrial pressure, pulmonary capillary wedge pressure, and pulmonary hypertension, respectively. The classic hemodynamic cutoffs for right atrial pressure (hazard ratio, 1.26 [0.98–1.62]) and mean pulmonary artery pressure (hazard ratio, 1.28 [0.96–1.71]) did not identify patients at higher risk for adverse outcome; however, cutoffs of 14 mm Hg for right atrial pressure (hazard ratio, 1.59 [1.26–2.00]) and 35 mm Hg for mean pulmonary artery pressure (hazard ratio, 1.30 [1.01–1.66]) performed better to detect worse outcome (
P
<0.05 for both). Reduced CI occurred in 55% of patients and was the strongest variable associated with the risk for cardiac transplant/left ventricular assist device and death, heart failure admissions, and reduced functional capacity. Reduced CI independently predicted risk on top of the Mayo-score in light chain CA and National Amyloid Center score in transthyretin CA (
P
<0.05 for both). Patients with light chain CA had higher pulmonary capillary wedge pressure and lower stroke volume index but maintained CI through a higher heart rate.

Conclusions:

Hemodynamic variables are grossly abnormal in CA, but elevated filling pressures are prognostic at significantly higher threshold values than classic cutoff values. CI is the hemodynamic variable most strongly associated with outcome and functionality in CA.
Urinary cGMP (Cyclic Guanosine Monophosphate)/BNP (B-Type Natriuretic Peptide) Ratio, Sacubitril/Valsartan, and Outcomes in Heart Failure With Reduced Ejection Fraction: An Analysis of the PARADIGM-HF Trial
Authors: Butt Jawad H. , Ibrahim Wasyla , Dewan Pooja , Desai Akshay S. , Køber Lars , Prescott Margaret F. , Lefkowitz Martin P. , Rouleau Jean L. , Solomon Scott D. , Zile Michael R. , Packer Milton , Jhund Pardeep S. , McMurray John J.V.
Published: January 2023

Background:

The ratio of ucGMP (urinary cyclic guanosine monophosphate) to BNP (B-type natriuretic peptide) is thought to reflect the responsiveness of tissues to natriuretic peptides.

Methods:

We examined the relationship between ucGMP/BNP ratio and clinical outcomes, the effect of sacubitril/valsartan, compared with enalapril, on the ucGMP/BNP ratio, and the efficacy of sacubitril/valsartan on clinical outcomes according to baseline ucGMP/BNP ratio in PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure). ucGMP/BNP ratio was available at baseline (N=2031), 1 month (N=1959), and 8 months after randomization (N=1746). The primary outcome was a composite of heart failure hospitalization or cardiovascular death.

Results:

Compared with the lowest tertile of baseline ucGMP/BNP ratio, patients in the higher tertiles had a lower risk of the primary outcome (tertile 1, reference; tertile 2, hazard ratio 0.57 [95% CI, 0.45–0.71]; tertile 3, hazard ratio, 0.54 [0.43–0.67]). Compared with baseline, the ucGMP/BNP ratio at 1 month and 8 months after randomization was higher with sacubitril/valsartan than with enalapril: ratio of geometric mean ratios at 1 month, 1.38 (95% CI, 1.27–1.51) and 8 months, 1.32 (95% CI, 1.20–1.45), and this difference was consistent across tertiles of ucGMP/BNP ratio at baseline (
P
interaction
=0.19 and 0.91, respectively). The effect of sacubitril/valsartan, compared with enalapril, was consistent across tertiles of ucGMP/BNP ratio at baseline for all outcomes (
P
interaction
≥0.31).

Conclusions:

In patients with heart failure and reduced ejection fraction, higher ucGMP/BNP ratio was associated with better outcomes. Sacubitril/valsartan increased the ucGMP/BNP ratio, compared with enalapril, and the effect of sacubitril/valsartan on clinical outcomes was not modified by baseline ucGMP/BNP ratio.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique Identifier: NCT01035255.
Sex Differences in Associations Between Socioeconomic Status and Incident Hypertension Among Chinese Adults
Authors: Ma Han , Liu Fangchao , Li Jianxin , Chen Jichun , Cao Jie , Chen Shufeng , Liu Xiaoqing , Yang Xueli , Huang Keyong , Shen Chong , Yu Ling , Zhao Yingxin , Wu Xianping , Zhao Liancheng , Li Ying , Hu Dongsheng , Huang Jianfeng , Lu Xiangfeng , Gu Dongfeng
Published: January 2023

Background:

With rapid socioeconomic development and transition, associations between socioeconomic status (SES) and hypertension remained uncertain in China. We aimed to examine the health effects of SES on hypertension incidence and explore the sex differences among Chinese adults.

Methods:

We included 53 891 participants without hypertension from the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) project. SES was evaluated by education level, occupation prestige, and household monthly per capita income, and categorized into low, medium, and high groups. Hazard ratios and their 95% CIs were calculated using Cox proportional hazards regression models.

Results:

Compared with high SES, participants with medium SES (hazard ratio, 1.142 [95% CI, 1.068–1.220]) or low SES (hazard ratio, 1.166 [95% CI, 1.096–1.241]) had increased risks of incident hypertension in multivariate analyses. Interactions between SES and sex on hypertension were observed, with more pronounced adverse effects of lower SES among women. The corresponding hazard ratios (95% CIs) for low SES group were 1.270 (1.155–1.397) for women and 1.086 (0.999–1.181) for men. Effects of occupation prestige on hypertension were the strongest among SES factors.

Conclusions:

Our study provided the compelling evidence from China that lower SES was associated with incident hypertension and women were more susceptible. These findings will have substantial implications on future hypertension prevention and management, especially among women. Sex-specific approaches are warranted to reduce socioeconomic disparities.
Improvement in Blood Pressure Control in Safety Net Clinics Receiving 2 Versions of a Scalable Quality Improvement Intervention: BP MAP A Pragmatic Cluster Randomized Trial
Authors: Fontil Valy , Modrow Madelaine Faulkner , Cooper‐DeHoff Rhonda M. , Wozniak Gregory , Rakotz Michael , Todd Jonathan , Azar Kristen , Murakami Linda , Sanders Margaret , Chamberlain Alanna M. , O'Brien Emily , Lee April , Carton Thomas , Pletcher Mark J.
Published: January 2023

Background

Uncontrolled blood pressure (BP) remains a leading cause of death in the United States. The American Medical Association developed a quality improvement program to improve BP control, but it is unclear how to efficiently implement this program at scale across multiple health systems.

Methods and Results

We conducted BP MAP (Blood Pressure Measure Accurately, Act Rapidly, and Partner With Patients), a comparative effectiveness trial with clinic‐level randomization to compare 2 scalable versions of the quality improvement program: Full Support (with support from quality improvement expert) and Self‐Guided (using only online materials). Outcomes were clinic‐level BP control (<140/90 mm Hg) and other BP‐related process metrics calculated using electronic health record data. Difference‐in‐differences were used to compare changes in outcomes from baseline to 6 months, between intervention arms, and to a nonrandomized Usual Care arm composed of 18 health systems. A total of 24 safety‐net clinics in 9 different health systems underwent randomization and then simultaneous implementation. BP control increased from 56.7% to 59.1% in the Full Support arm, and 62.0% to 63.1% in the Self‐Guided arm, whereas BP control dropped slightly from 61.3% to 60.9% in the Usual Care arm. The between‐group differences‐in‐differences were not statistically significant (Full Support versus Self‐Guided=+1.2% [95% CI, −3.2% to 5.6%],
P
=0.59; Full Support versus Usual Care=+3.2% [−0.5% to 6.9%],
P
=0.09; Self‐Guided versus Usual Care=+2.0% [−0.4% to 4.5%],
P
=0.10).

Conclusions

In this randomized trial, 2 methods of implementing a quality improvement intervention in 24 safety net clinics led to modest improvements in BP control that were not statistically significant.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03818659.
Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review
Authors: Enard Kimberly R. , Coleman Alyssa M. , Yakubu R. Aver , Butcher Briona C. , Tao Donghua , Hauptman Paul J.
Published: January 2023

Background

Prior research suggests an association between clinical outcomes in heart failure (HF) and social determinants of health (SDoH). Because providers should identify and address SDoH in care delivery, we evaluated how SDoH have been defined, measured, and evaluated in studies that examine HF outcomes.

Methods and Results

Following Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines, databases were searched for observational or interventional studies published between 2009 and 2021 that assessed the influence of SDoH on outcomes. Selected articles were assessed for quality using a validated rating scheme. We identified 1373 unique articles for screening; 104 were selected for full‐text review, and 59 met the inclusion criteria, including retrospective and prospective cohort, cross‐sectional, and intervention studies. The majority examined readmissions and hospitalizations (k=33), mortality or survival (k=29), and success of medical devices and transplantation (k=8). SDoH examined most commonly included race, ethnicity, age, sex, socioeconomic status, and education or health literacy. Studies used a range of 1 to 9 SDoH as primary independent variables and 0 to 7 SDoH as controls. Multiple data sources were employed and frequently were electronic medical records linked with national surveys and disease registries. The effects of SDoH on HF outcomes were inconsistent because of the heterogeneity of data sources and SDoH constructs.

Conclusions

Our systematic review reveals shortcomings in measurement and deployment of SDoH variables in HF care. Validated measures need to be prospectively and intentionally collected to facilitate appropriate analysis, reporting, and replication of data across studies and inform the design of appropriate, evidence‐based interventions that can ameliorate significant HF morbidity and societal costs.
Differential Associations of Cystatin C Versus Creatinine‐Based Kidney Function With Risks of Cardiovascular Event and Mortality Among South Asian Individuals in the UK Biobank
Authors: Chen Debbie C. , Lees Jennifer S. , Lu Kaiwei , Scherzer Rebecca , Rutherford Elaine , Mark Patrick B. , Kanaya Alka M. , Shlipak Michael G. , Estrella Michelle M.
Published: January 2023

Background

South Asian individuals have increased cardiovascular disease and mortality risks. Reliance on creatinine‐ rather than cystatin C–based estimated glomerular filtration rate (eGFRcys) may underestimate the cardiovascular disease risk associated with chronic kidney disease.

Methods and Results

Among 7738 South Asian UK BioBank participants without prevalent heart failure (HF) or atherosclerotic cardiovascular disease, we investigated associations of 4 eGFRcys and creatinine‐based estimated glomerular filtration rate categories (<45, 45–59, 60–89, and ≥90 mL/min per 1.73 m
2
) with risks of all‐cause mortality, incident HF, and incident atherosclerotic cardiovascular disease. The mean age was 53±8 years; 4085 (53%) were women. Compared with creatinine, cystatin C identified triple the number of participants with estimated glomerular filtration <45 (n=35 versus n=113) and 6 times the number with estimated glomerular filtration 45 to 59 (n=80 versus n=481). After multivariable adjustment, the eGFRcys 45 to 59 category was associated with higher risks of mortality (hazard ratio [HR], 2.38 [95% CI, 1.55–3.65]) and incident HF (sub‐HR [sHR], 1.87 [95% CI, 1.09–3.22]) versus the eGFRcys ≥90 category; the creatinine‐based estimated glomerular filtration rate 45 to 59 category had no significant associations with outcomes. Of the 7623 participants with creatinine‐based estimated glomerular filtration rate ≥60, 498 (6.5%) were reclassified into eGFRcys <60 categories. Participants who were reclassified as having eGFRcys <45 had higher risks of mortality (HR, 4.88 [95% CI, 2.56–9.31]), incident HF (sHR, 4.96 [95% CI, 2.21–11.16]), and incident atherosclerotic cardiovascular disease (sHR, 2.29 [95% CI, 1.14–4.61]) versus those with eGFRcys ≥90; those reclassified as having eGFRcys 45 to 59 had double the mortality risk (HR, 2.25 [95% CI, 1.45–3.51]).

Conclusions

Among South Asian individuals, cystatin C identified a high‐risk chronic kidney disease population that was not detected by creatinine and enhanced estimated glomerular filtration rate–based risk stratification for mortality, incident HF, and incident atherosclerotic cardiovascular disease.
Cardioprotective Actions of a Glucagon‐like Peptide‐1 Receptor Agonist on Hearts Donated After Circulatory Death
Authors: Kadowaki Sachiko , Siraj M. Ahsan , Chen Weiden , Wang Jian , Parker Marlee , Nagy Anita , Steve Fan Chun‐Po , Runeckles Kyle , Li Jing , Kobayashi Junko , Haller Christoph , Husain Mansoor , Honjo Osami
Published: January 2023

Background

Heart transplantation with a donation after circulatory death (DCD) heart is complicated by substantial organ ischemia and ischemia–reperfusion injury. Exenatide, a glucagon‐like peptide−1 receptor agonist, manifests protection against cardiac ischemia–reperfusion injury in other settings. Here we evaluate the effects of exenatide on DCD hearts in juvenile pigs.

Methods and Results

DCD hearts with 15‐minutes of global warm ischemia after circulatory arrest were reperfused ex vivo and switched to working mode. Treatment with concentration 5‐nmol exenatide was given during reperfusion. DCD hearts treated with exenatide showed higher myocardial oxygen consumption (exenatide [n=7] versus controls [n=7], over 60–120 minutes of reperfusion,
P
<0.001) and lower cardiac troponin‐I release (27.94±11.17 versus 42.25±11.80 mmol/L,
P
=0.04) during reperfusion compared with controls. In working mode, exenatide‐treated hearts showed better diastolic function (dp/dt min: −3644±620 versus −2193±610 mm Hg/s,
P
<0.001; Tau: 15.62±1.78 versus 24.59±7.35 milliseconds,
P
=0.02; lateral
e
′ velocity: 11.27 ± 1.46 versus 7.19±2.96,
P
=0.01), as well as lower venous lactate levels (3.17±0.75 versus 5.17±1.44 mmol/L,
P
=0.01) compared with controls. Higher levels of activated endothelial nitric oxide synthase (phosphorylated to total endothelial nitric oxide synthase levels: 2.71±1.16 versus 1.37±0.35,
P
=0.02) with less histological evidence of endothelial damage (von Willebrand factor expression: 0.024±0.007 versus 0.331±0.302, pixel/μm,
P
=0.04) was also observed with exenatide treatment versus controls.

Conclusions

Acute treatment of DCD hearts with exenatide limits myocardial and endothelial injury and improves donor cardiac function.
Body Composition and Risk of Vascular‐Metabolic Mortality Risk in 113 000 Mexican Men and Women Without Prior Chronic Disease
Authors: Gnatiuc Friedrichs Louisa , Wade Rachel , Alegre‐Díaz Jesus , Ramirez‐Reyes Raúl , Garcilazo‐Ávila Adrián , Gonzáles‐Carballo Carlos , Santacruz‐Benitez Rogelio , Chiquete Erwin , Herrington William , Collins Rory , Peto Richard , Clarke Robert , Berumen Jaime , Emberson Jonathan R. , Kuri‐Morales Pablo , Tapia‐Conyer Roberto
Published: January 2023

Background

Body‐mass index is the sum of fat mass index (FMI) and lean mass index (LMI), which vary by age, sex, and impact on disease outcomes. We investigated the separate and joint relevance of FMI and LMI with vascular‐metabolic causes of death in Mexican adults.

Methods and Results

A total of 113 025 adults aged 35 to 74 years and free from diabetes or other chronic diseases when recruited into the Mexico City Prospective Study were followed for 19 years. Cox models estimated sex‐specific death rate ratios from vascular‐metabolic causes after adjustment for confounders and exclusion of the first 5 years of follow‐up. To account for the strong correlation between FMI and LMI, additional models estimated rate ratios associated with “residual FMI” and “residual LMI” (ie, the residuals from linear regression analyses of FMI on LMI, or vice versa). In both sexes, higher FMI and LMI were associated with higher risks of vascular‐metabolic mortality. For a given (ie, fixed) level of LMI, the rate ratio (95% CI) for vascular‐metabolic mortality per 1 kg/m
2
higher residual FMI strengthened and was higher in women (1.52 [1.38–1.68]) than in men (1.19 [1.13–1.25]). By contrast, for a given level of FMI, higher residual LMI was inversely associated with vascular‐metabolic mortality (rate ratio per 1 kg/m
2
0.67 [0.56–0.80] in women and 0.94 [0.90–0.98] in men).

Conclusions

In this study, higher residual FMI was more strongly associated with vascular‐metabolic mortality in women than in men. Conversely, higher residual LMI was inversely associated with vascular‐metabolic mortality, particularly in women.
Morphological Characteristics of Ruptured Brain Aneurysms: A Systematic Literature Review and Meta‐Analysis
Authors: Sanchez Sebastian , Hickerson Meredith , Patel Rishi R. , Ghazaleh Dana , Tarchand Ranita , Paranjape Geeta S. , Pope Holly , Ortega‐Gutierrez Santiago , Pederson John M. , Hasan David , Raghavan Madhavan L. , Samaniego Edgar A.
Published: January 2023

Background

It is unclear what morphological features of brain aneurysms are better at predicting risk of rupture. We conducted a meta‐analysis to analyze the best morphological determinants of rupture status.

Methods

The Nested Knowledge platform was used to perform a search of articles reporting on aneurysm size, aspect ratio (AR), size ratio (SR), ellipticity index, nonsphericity index, and undulation index. The mean differences between ruptured and unruptured aneurysms were used to calculate effect sizes.

Results

A total of 63 studies with 13 025 aneurysms were included: 6966 ruptured aneurysms and 6059 unruptured aneurysms. Ruptured aneurysms had a larger size (
P
<0.001), AR (
P
<0.001), SR (
P
<0.001), ellipticity index (
P
=0.049), and nonsphericity index (
P
=0.049) compared with unruptured aneurysms. The mean size of ruptured aneurysms was 6.1 mm (95% CI, 5.6–6.5). The size of ruptured and unruptured aneurysms was similar in the anterior cerebral artery (
P
=0.28), anterior communicating artery (
P
=0.31), and basilar artery (
P
=0.51). The mean AR of ruptured aneurysms was 1.5 (95% CI, 1.4–1.6), and the mean SR was 2.3 (95% CI, 2.1–2.5). For mirror aneurysms, the mean AR was 1.2 (95% CI, 1.2–1.5), and the mean SR was 2.2 (95% CI, 2.1–2.5).

Conclusions

Size is not significantly different between ruptured and unruptured aneurysms located in the anterior cerebral artery, anterior communicating artery, and basilar artery. SR is significantly different between ruptured and unruptured aneurysms in all locations. A mean AR of 1.5 and SR of 2.3 are the thresholds associated with ruptured aneurysm status.
A revision of Gerrhopilus inornatus (Squamata: Gerrhopilidae) reveals a multi-species complex
Authors: KRAUS FRED
Published: January 2023

Melanesian blindsnakes of the genus Gerrhopilus have been little collected or researched. I examined specimens assigned in museums to Gerrhopilus inornatus and found considerable morphological diversity among them that indicates the presence of multiple species. I redescribe G. inornatus (Boulenger) based on the holotype and one additional specimen, and I describe six new species among specimens currently subsumed under that name from Papua New Guinea: Gerrhopilus flavinotatus sp. nov., Gerrhopilus lorealis sp. nov., Gerrhopilus papuanorum sp. nov., Gerrhopilus polyadenus sp. nov., Gerrhopilus slapcinskyi sp. nov., and Gerrhopilus wallachi sp. nov. Each species is currently known from only 1–3 specimens, and all but two are known only from single localities. In addition to traditional information on scale counts, habitus, and color patterns, I found the numbers and distributions of epidermal glands among the head shields to be especially useful for discriminating among species. The number of recognized Melanesian Gerrhopilus has increased tremendously in recent years, but the region has been poorly sampled for these snakes, and it is to be expected that additional species will be identified at such time as surveys can more effectively target these cryptic snakes.
You Have to Send the Right Message: Examining the Influence of Protective Action Guidance on Message Perception Outcomes across Prior Hazard Warning Experience to Three Hazards
Authors: Fischer Laura , Huntsman David , Orton Ginger , Sutton Jeannette
Published: January 2023

A long-term goal for warning-message designers is to determine the most effective type of message that can instruct individuals to act quickly and prevent loss of life and/or injury when faced with an imminent threat. One likely way to increase an individual’s behavioral intent to act when they are faced with risk information is to provide protective action information or guidance. This study investigated participant perceptions (understanding, believing, personalizing, deciding, milling, self-efficacy, and response efficacy) in response to the National Weather Service’s experimental product Twitter messages for three hazard types (tornado, snow squall, and dust storm), with each message varying by inclusion and presentation of protective action information placed in the tweet text and the visual graphic. We also examine the role of prior hazard warning experience on message perception outcomes. To examine the effects, the experiment used a between-subjects design in which participants were randomly assigned to one hazard type and received one of four warning messages. Participants then took a post-test measuring message perceptions, efficacy levels, prior hazard warning experience, and demographics. The results showed that, for each hazard and prior hazard experience level, messages with protective action guidance in both the text and graphic increase their understanding, belief, ability to decide, self-efficacy, and response efficacy. These results reinforce the idea that well-designed messages that include protective action guidance work well regardless of hazard type or hazard warning experience.

Significance Statement

Preventing injury and/or loss of life during a hazardous event is a prime concern for disaster communicators. The study provides insights to practitioners on how to effectively communicate protective actions to audiences with varying familiarity with the hazard through Twitter posts. We experimented with tweet message design and content for three hazards: tornado, snow squall, and dust storm, to find that posts that include protective action guidance in both the text and image increase participant perceptions that they could perform the suggested protective actions, regardless of hazard type or hazard warning experience. Given our findings, practitioners should consider including protective action guidance in message text and graphic to warn members of the public with varied prior warning experience.
Ongoing Remote Work, Returning to Working at Work, or in between during COVID-19: What Promotes Subjective Well-Being?
Authors: Fan Wen , Moen Phyllis
Published: January 2023

The COVID-19 pandemic precipitated a massive turn to remote work, followed by subsequent shifts for many into hybrid or fully returning to the office. To understand the patterned dynamics of subjective well-being associated with shifting places of work, we conducted a nationally representative panel survey (October 2020 and April 2021) of U.S. employees who worked remotely at some point since the pandemic (N = 1,817). Cluster analysis identified four patterned constellations of well-being based on burnout, work–life conflict, and job and life satisfaction. A total return to office is generally more stressful, leading to significantly lower probabilities of being in the optimal low stress/high satisfaction constellation by Wave 2, especially for men and women without care obligations. Remote and hybrid arrangements have salutary effects; moving to hybrid is especially positive for minority men and less educated men, although it disadvantages White women’s well-being.
Mapping homicide by 3-D modelling of bloodstain patterns at crime scene
Authors: Kislov Maksim A , Chauhan Mohit , Khanna Sunil K , Leonov Sergei V , Leonova Elena N , Nagornov Mikhail N , Berezovsky Berezovskiy D , Lomakin Yurij V , Bychkov Alexey A , Stepanov Sergey A , Krupin Konstantin N , Sergeevna ZM
Published: January 2023

Background

Three-dimensional (3-D) modelling can be a useful technical aid and we used it to reconstruct a homicide scene to corroborate the statement of an eyewitness. 3-D modelling of the bloodstain was conducted by Micro Smith Poser 11 and Autodesk 3-Ds Max software. The technique was found to be easily understandable by the police and judiciary in the interpretation of the sequence of the events of the crime. It refuted the eye-witness's account of the actions of the accused who was charged with murder and allowed collection, storage and retrieval of the patho-anatomic information about the deceased.

Conclusion

The checks on the accuracy of statements given by eye-witnesses that can be provided by 3-D modelling may change the outcome of criminal investigations in future.
Religious representation and performative citizenship: The civic dimensions of Shia lamentation rituals in Barcelona
Authors: Astor Avi , Martínez-Cuadros Rosa , Albert-Blanco Víctor
Published: January 2023

In diasporic contexts, religious representatives play a key role as cultural ambassadors for their respective communities and religions. This article examines religious representation as a form of civic engagement among Shia Muslims who have assumed representational responsibilities in Barcelona. Our study focuses on their interactions with municipal authorities and the wider public amid the planning, organization, and enactment of public lamentation processions. We show how public rituals provide representatives of Barcelona’s main Shia community with a platform for ‘performative citizenship’ practices like claiming rights and demonstrating their deservingness of inclusion in the neighborhood, city, and nation. Yet, different representatives have engaged in distinct styles of representation and performative citizenship. In explaining these differences, we draw attention to how their respective migration trajectories, historical experiences, and sociostructural location have contributed to certain pressures, forms of positional awareness, and practical dispositions that account for their inclinations toward different approaches to civic engagement.
Empirical intravenous aciclovir therapy in a suspected case of acute encephalitis
Authors: Divyashree Krishna , Singh Harpreet , Suri Vikas , Bhalla Ashish
Published: January 2023

Herpes simplex encephalitis is the most common cause of sporadic viral encephalitis worldwide but presents as a diagnostic challenge at many settings due to its non-specific symptoms, which can be easily mistaken for systemic infection or metabolic encephalopathy. It has diverse range of presentations from fever, altered sensorium, nausea, vomiting, meningismus to seizures, neurological deficits and coma in advanced stages. It is associated with significant morbidity and mortality if treatment is delayed or inadequate. We here discuss a case of Herpes simplex virus (HSV) encephalitis which rapidly progressed to result in irreversible neurological insult due to delayed diagnosis and treatment.
Controlling for inequality in neuropsychological assessment: using Crawford and Howell’s (1998) single-case methodology with norms from demographically homogeneous groups of South Africans
Authors: Ferreira-Correia Aline , Cockcroft Kate
Published: January 2023

The practice of neuropsychological assessment in South Africa is complicated by the lack of norms that are representative of clients’ educational and linguistic experiences. In an attempt to address this challenge, we argue that Crawford and Howell’s Single-Case Methodology in Neuropsychology is a good option for the neuropsychological investigation of cases that are not well represented by the available norms. This research design and inferential statistical method compares the scores of one case to the performance of a carefully matched sample of modest size. In order that practitioners and researchers might use this methodology, we provide a set of norms for South Africans with specific demographic profiles on a range of well-researched and commonly used neuropsychological tests. We provide an illustrative case study to demonstrate the application of Crawford and Howell’s Single-Case Methodology, which shows how the selection of an appropriately matched norm (control) group is an effective way to reduce test biases for individuals who are not represented by the original test norms.
Developing a missiology for ministry to nomads
Authors: Hibbert Evelyn , Williamson Lance , Williamson Barbara
Published: January 2023

Nomads are sometimes referred to as the last to reach. Their remoteness and marginalization make it challenging for missionaries to live with them. Their different mindsets and values require different approaches than those used to reach sedentary peoples. Major advocates for mission to nomads, David Phillips and Malcolm Hunter, have advocated for a different paradigm of mission and church that reflects nomads’ way of life. Relatively little has been written about missionary work among nomads in recent decades. In 2018, 37 national and expatriate missionaries to nomads were interviewed. The interview data were compared with the experience of missionaries recorded in the literature. Alongside making disciples, missionaries to nomads are involved in a wide range of activities, including caring for nomads’ animals. In this article we outline what missionaries to nomads today are doing and the major challenges they face. We affirm the need for a specific missiological focus on ministry to nomadic peoples and suggest some essential areas for its development.
Domain-Specific Greed
Authors: Weiß Martin , Schulze Julian , Krumm Stefan , Göritz Anja S. , Hewig Johannes , Mussel Patrick
Published: January 2023

Greed, the insatiable and excessive desire and striving for more even at the expense of others, may be directed toward various goods. In this article, we propose that greed may be conceptualized as a domain-specific construct. Based on a literature review and an expert survey, we identified 10 domains of greed which we operationalized with the DOmain-SPEcific Greed (DOSPEG) questionnaire. In Study 1 ( N = 725), we found support for the proposed structure and convergent validity with related constructs. Bifactor-(S-1) models revealed that generic greed is differentially related to the greed domains, indicating that generic greed primarily captures a striving for money and material things. In the second study ( N = 591), we found that greed domains had incremental validity beyond generic greed with regard to corresponding criteria assessed via self- and other-reports. We conclude that greed can be conceptualized as a domain-specific construct and propose an onion model reflecting this structure.
Exploring the Role of Resilience and Optimism during the COVID-19 Pandemic in Older European Adults
Authors: Lee Sunwoo
Published: January 2023

This study examined how resilience and optimism were related to psychological well-being among older European adults during the early pandemic. The study used data sampled from the Eurofound COVID-19 survey conducted in 27 European countries during the first lockdown (April 2020). The study sample included 10,674 older adults (mean age = 69.71 ± 5.15, 68.6% women, 87.3% retired). Using structural equation modeling, the relationship between pandemic adversities, resilience, optimism, and well-being was investigated. Results indicated that resilience and optimism in part mediated the association between adversities and psychological well-being. Resilience and optimism have the potential to help older adults cope with stressful life events and other adversities. Future studies should more precisely explore the role of resilience and optimism, its formation, and the protective mechanisms that promote the psychological well-being of older adults.
The Role of Confidence and Knowledge in Intentions to (Not) Seek Care for Hypertension: Evidence From a National Survey
Authors: Bruine de Bruin Wändi , Okan Yasmina , Krishnamurti Tamar , Huffman Mark D.
Published: January 2023

Background

Hypertension (high blood pressure) is a modifiable risk factor for cardiovascular disease. However, patients may lack confidence in their understanding of what constitutes normal/healthy blood pressure, potentially affecting intentions to seek necessary care. The American Heart Association defines normal/healthy blood pressure as <120/80 mm Hg, with a 130/80 mm Hg threshold for hypertension diagnosis.

Methods

Our US sample ( N = 6,592) included 1,342 adults with hypertension alone and 795 with hypertension and relevant comorbidities (heart disease, kidney disease, and diabetes mellitus). We assessed confidence in understanding blood pressure numbers, knowledge of thresholds for normal/healthy blood pressure (“normal or healthy blood pressure is below . . .”; counting 120–130/80 mm Hg as correct), and intentions to seek care for randomly assigned blood pressure readings of 142/91 (stage 2 hypertension), 132/69 (stage 1 hypertension), or 118/78 mm Hg (normal/healthy blood pressure).

Results

Among nonhypertensive participants, 55% expressed confidence in their understanding of blood pressure numbers, but only 36% knew the upper thresholds for normal/healthy blood pressure. Among participants with hypertension alone, 78% were confident while 47% were knowledgeable. Among participants with hypertension and comorbidities, 81% were confident and 40% were knowledgeable. Participants who were confident (v. not) were more likely to express intentions to act on stage 2 hypertension readings but less likely to express intentions to act on stage 1 readings, even after adjustment for knowledge, hypertension diagnosis, and sociodemographics.

Limitations

Confidence, knowledge, and intentions were each measured with 1 question.

Conclusions

Independent of knowledge, confidence was associated with greater willingness to act on stage 2 hypertension readings but reduced willingness to act on stage 1 hypertension readings. Interventions aiming to improve hypertension care-seeking behavior should improve confidence in accurate knowledge.

Highlights

Hypertension or high blood pressure is a major risk factor for heart disease. Most Americans do not know that normal/healthy blood pressure levels are ≤120/80 mm Hg, yet they are confident that they know this information. Inappropriate confidence in understanding of blood pressure numbers undermines intentions to seek care for stage 1 hypertension blood pressure readings.
Trans-arterial embolization for intractable primary postpartum hemorrhage caused by arterial aneurysms with arteriovenous fistulas in the lower vagina bilaterally: a case report
Authors: Wu Cheng-Hsien , Wu Patricia Wanping , Wong Yon-Cheong , Chueh Ho-Yen
Published: January 2023

Failure of conservative management for controlling postpartum hemorrhage (PPH) is not uncommon, particularly when PPH is caused by vascular lesions. Awareness of this possibility and initiating timely trans-arterial embolization (TAE) are essential for improving the outcome. Herein, we describe the case of a 34-year-old woman presenting with arterial aneurysms with arteriovenous fistulas in the lower vagina bilaterally, which caused intractable PPH. Conservative management failed to resolve the PPH; however, TAE successfully controlled the bleeding, and the patient recovered smoothly. Knowledge of this possible etiology for intractable PPH is crucial for timely TAE. This case report aims to highlight the pivotal role of TAE in detecting and treating this unusual cause of PPH.