bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanism of Hypoxia‐Mediated Smooth Muscle Cell Proliferation Leading to Vascular Remodeling
Authors: Huang Xiaojuan , Akgün Elif Ece , Mehmood Khalid , Zhang Hui , Tang Zhaoxin , Li Ying
Published: December 2022

Vascular remodeling refers to changes in the size, contraction, distribution, and flow rate of blood vessels and even changes in vascular function. Vascular remodeling can cause cardiovascular and cerebrovascular diseases. It can also lead to other systemic diseases, such as pulmonary hypertension, pulmonary atherosclerosis, chronic obstructive pulmonary disease, stroke, and ascites of broilers. Hypoxia is one of the main causes of vascular remodeling. Prolonged hypoxia or intermittent hypoxia can lead to loss of lung ventilation, causing respiratory depression, irregular respiratory rhythms, and central respiratory failure. Animals that are unable to adapt to the highland environment are also prone to sustained constriction of the small pulmonary arteries, increased resistance to pulmonary circulation, and impaired blood circulation, leading to pulmonary hypertension and right heart failure if they live in a highland environment for long periods of time. However, limited studies have been found on the relationship between hypoxia and vascular remodeling. Therefore, this review will explore the relationship between hypoxia and vascular remodeling from the aspects of endoplasmic reticulum stress, mitochondrial dysfunction, abnormal calcium channel, disordered cellular metabolism, abnormal expression of miRNA, and other factors. This will help to understand the detailed mechanism of hypoxia‐mediated smooth muscle cell proliferation and vascular remodeling for the better treatment and management of diseases due to vascular remodeling.
Dibenzo[b,f][1,5]Diazocines/ZnO Organic/Inorganic Hybrid Photoanodes for Efficient Photo Electrochemical Water Splitting
Authors: Yana Sissembayeva , Cho Soo Kyung , Hwang Yoon-Hwae
Published: December 2022

In this study, we propose dibenzo[b,f][1,5]diazocine/ZnO organic/inorganic hybrid photoanode for application in the photoelectrochemical water splitting. The electrode consisting of inorganic ZnO nanorod (ZnO NR) array structures and organic diazocine derivative film with or without platinum nanoparticle (Pt NP) cocatalyst was examined. The morphology characterization was performed by FESEM. UV-vis absorbance spectra showed enhanced absorbance in the visible light spectrum for the hybrid sample. Photoluminescence analysis of a hybrid sample showed a significant decrease in charge recombination and enhanced charge separation. Photoelectrochemical measurements revealed an increase in current density for the organic/inorganic hybrid photoanode reaching 1.256 mA/cm2 at 1.23 V vs. RHE which is almost two times higher than bare ZnO NR arrays (0.716 mA/cm2 at 1.23 V vs. RHE). The addition of the Pt NP cocatalyst further enhanced the photocurrent density up to 1.636 mA/cm2. Therefore, proposed organic/inorganic hybrid photoelectrode is a promising candidate for the efficient solar water splitting.
Network Pharmacology and Molecular Docking Analysis of Shufeiya Recipe in the Treatment of Pulmonary Hypertension
Authors: Zhang Zeyu , Wang Xianliang , Wang Shuai , Jia Zhuangzhuang , Mao Jingyuan
Published: December 2022

Objective. This study is aimed at exploring the molecular mechanism of Shufeiya recipe in the treatment of pulmonary hypertension (PH) using network pharmacology and molecular docking analysis. Methods. Active components and their target proteins in the recipe were screened using the TCMSP database. PH‐related core proteins were screened using GeneCards, STRING database, and Cytoscape‐v3.8.2. Common proteins were obtained by intersection of the target proteins of these recipe active components and pH‐related core proteins. Rx64 4.0.2 software was used to perform GO functional enrichment analysis and KEGG pathway enrichment analysis on the common proteins to obtain pathway‐enriched proteins, and then core enriched proteins were further screened. We analyzed the relationship between the active components and pathway‐enriched proteins using Cytoscape‐v3.8.2. AutoDock Vina was used to dock their core proteins into the components. Results. Shufeiya recipe contained 67 active components. 61 common proteins of the target proteins of the active components and PH‐related core proteins were obtained. The treatment involved both functional and pathway regulations. The core pathway‐enriched proteins were prostaglandin G/H synthase 2 (PTGS2), epidermal growth factor receptor (EGFR), and RAC‐alpha serine/threonine‐protein kinase (AKT1), and their binding energies to the corresponding components were all less than ‐5 kJ•mol‐1. Conclusion. It was found that the main mechanism might be the active components acting on the core pathway‐enriched proteins to regulate related signaling pathways, thereby playing roles in anticoagulation, vasodilation, anti‐PASMC proliferation, promotion of PAECs apoptosis, inhibition of oxidative stress, and anti‐inflammatory effects.
Reliability Estimation of Low-Voltage Power Distribution Systems
Authors: Jabbari Mousa , Babaei Mohammad Mehdi , Moradi Hanifi Saber , Fallah Madvari Rohollah , Laal Fereydoon
Published: December 2022

Many accidents always happen in the electricity distribution sector, which requires the use of control strategies in this field. Therefore, this study presented a risk assessment method based on a fuzzy Bayesian network (FBN) and William Fine method in low-voltage power distribution systems to reduce the structural uncertainties of the studies and examined the reliability of these systems to achieve proper performance in emergencies. The first step is to develop a fault tree (FT) and event tree (ET) in bow tie (BT) format. In this study, fuzzy theory and expert judgment were used to qualitatively analyze the root events affecting the system failure and determine the relevant probabilities. Then, deductive and inductive reasoning was done after determining the likelihood of basic events (BEs) and establishing the Bayesian network (BN). Then, the final risk was estimated using William Fine’s method and fuzzy logic. The results of a case study in a low-voltage power distribution system showed that there were 36 BEs and 20 intermediate events (IEs) for system failure, and the reliability of the system was obtained as 0.96654476 and 0.96654476 based on the FT and FBN, respectively. According to the results of BE25 (no installation of the earth) and BE18 (contact of metal objects with the live wire), the most critical events were based on FBN. The results showed that FBN simulation and its combination with static methods such as BT and William Fine provide a suitable method for the accurate identification of distribution systems. Therefore, the approach of the present study can help the decision makers and analysts of the electricity industry to prevent possible failures due to system changes.
Weapon Target Assignment Model for Small Unit Ground Combat Using Mixed Integer Nonlinear Program and Lagrangian Relaxation
Authors: Kim Yeonseung , Cho Jaeyoung , Han Sangwoo , Cho Namsuk
Published: December 2022

The importance of the weapon target assignment problem is increasing as weapon systems are expected to become intelligent and unmanned on the future battlefield. This study discusses the weapon-target assignment in small-scale ground force combat, which has not been addressed much in other studies. In ground combat, target assignment means the start of an engagement, so assignment should be made taking into account not only the probability of killing an enemy but also the probability of surviving friendly forces. We introduce the WTAG (WTA ground) model that reflects these characteristics and describes methodologies for solving the problem including mixed integer nonlinear problems and Lagrangian relaxation approaches. Our finding is that the algorithm presented can efficiently provide the bounds of the problem in a practical size.
Effects of Benson Relaxation Technique and Music Therapy on the Anxiety of Primiparous Women Prior to Cesarean Section: A Randomized Controlled Trial
Authors: Abarghoee Sedigheh Nosrati , Mardani Abbas , Baha Robabe , Aghdam Nasrin Fadaee , Khajeh Mahboobeh , Eskandari Fatemeh , Vaismoradi Mojtaba
Published: December 2022

Background and Aims. Primiparous women experience high levels of anxiety before cesarean section. Therefore, this research aimed to investigate the effects of the Benson Relaxation Technique (BRT) and Music Therapy (MT) on the anxiety of primiparous women prior to cesarean section. Methods. A randomized controlled trial was carried out on 105 women scheduled for cesarean section. They were randomly assigned into three groups: BRT, MT, and control (n = 35 per group). The women in the BRT and MT groups performed exercises and listened to music, respectively, for 20 minutes prior to cesarean section. The State Anxiety Inventory was used to measure the women’s anxiety in the groups before and after the intervention. Results. Within-group comparisons showed that the women in the BRT (t = 5.61,

p

 < 0.001, effect size (Cohen’s d) = 0.94) and MT (t = 3.83,

p

 = 0.001, d = 0.64) groups had significantly lower anxiety after the interventions compared to before the interventions. Also, between-group comparisons revealed that anxiety after the intervention was significantly lower in the BRT and MT groups compared to the control group (

p

 = 0.007). Conclusions. Although both of the BRT and MT helped with the reduction of anxiety among primiparous women before cesarean section, the BRT was shown more effective. These nonpharmacologic methods are safe and cost-effective and can improve well-being among women undergoing this invasive procedure. They can be used along with pharmacologic methods for reducing overreliance on medications.
Appraisal, Tangible, Self Esteem dan Belonging Support dalam Mempengaruhi Pencapaian Target Penjualan
Authors: Fitriana Fitriana
Published: December 2022

Sumber daya adalah hal yang tidak bisa dipisahkan dalam sebuah bisnis, baik berupa bahan baku, Sumber daya Manusia,keuangan, dsb. Sebuah bisnis dituntut untuk bisa menyediakan dan mengelolahnya secara efektif dan efisien terhadap sumber-sumber daya yang ada untuk tetap berjalannya kegiatan operasional sebuah usaha.

Dibutuhkan berbagai strategi dengan melihat dua sisi, baik secara Eksternal (ekonomi makro), maupun secara internal (ekonomi mikro). Berdasarkan survey yang dilakukan oleh SBA (Small Business Administration) dikatakan bahwa ditahun ke-5 angka prosentase bisnis yang bertahan hanya sekitar 45-50% (https://www.paper.id). Kondisi-kondisi tersebut tidak terlepas dari bagaimana sebuah manajemen itu dibangun. Karena manajemen yang bagus merupakan salah satu faktor yang mengantarkan sebuah bisnis mampu bertahan dan maju, begitupun sebuah manajemen harus memperhatikan sisi ekonomi makro yaitu bagaimana lingkungan diluar perusahaan ikut mempengaruhi pengambilan keputusan bagi seorang pemimpin perusahaan, seperti kebijakan fiskal yang diterapkan oleh pemerintah, kondisi politik, dsb. Selain itu hal yang tak kalah penting yang harus diperhatikan adalah pengelolaan sumber-sumber daya yang dimiliki oleh perusahaan secara optimal.

Target penjualan merupakan hal yang ingin dicapai oleh sebuah perusahaan, upaya yang bisa dilakukan adalah dengan melakukan pengelolaan/manajemen yang baik, antara lain menyiapkan tenaga penjualan yang profesional. Tenaga penjualan perlu dibangun dan ditingkatkan kinerjanya agar menghasilkan produktivitas yang optimal. Dalam membangun kinerja yang bagus, berpikir postif bukanlah hanya konsep, namun faktor yang krusial dalam meningkatkan kinerja. Pikiran positif yang dimiliki oleh karyawan akan bisa menyelamatkan keberlangsungan hidup sebuah perusahaan, sebaliknya jika tingkat berpikir positif rendah, maka karyawan bagi perusahaan bisa menjadi musuh dari dalam yang setiap saat bisa menghancurkan perusahaan. Agar karyawan tidak menjadi boomerang, maka manajemen perlu mengolah, memoles karyawan menjadi pribadi yang tangguh dalam menghadapi tantangan bisnis, salah satunya dengan memberi dukungan secara sosial, melalui appraisal, tangible, self esteem dan belonging support. Artikel ini merupakan artikel konseptual, yang menggambarkan bagaimana target penjualan bisa dicapai melalui produktivitas yang bagus,yang dibangun melalui pengoptimalan appraisal, tangible, self esteem dan belonging support dalam sebuah manajemen.
Interaction of Blood Pressure and Glycemic Status in Developing Cardiovascular Disease: Analysis of a Nationwide Real‐World Database
Authors: Suzuki Yuta , Kaneko Hidehiro , Yano Yuichiro , Okada Akira , Itoh Hidetaka , Matsuoka Satoshi , Yokota Isao , Imaizumi Takahiro , Fujiu Katsuhito , Michihata Nobuaki , Jo Taisuke , Takeda Norifumi , Morita Hiroyuki , Node Koichi , Yasunaga Hideo , Komuro Issei
Published: December 2022

Background

Hypertension and diabetes frequently coexist. However, little is known about the interaction between high blood pressure (BP) and hyperglycemia in the development of cardiovascular disease (CVD).

Methods and Results

We conducted an observational cohort study that included 3 336 363 patients (median age, 43 years old; men, 57.2%). People taking BP‐ or glucose‐lowering medications or those with prior history of CVD were excluded. We defined stage 1 hypertension as having systolic BP of 130 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg and stage 2 hypertension as having systolic BP of ≥140 mm Hg or diastolic BP of ≥90 mm Hg. We defined prediabetes as having fasting plasma glucose of 100 to 125 mg/dL and diabetes as having fasting plasma glucose of ≥126 mg/dL. Over a mean follow‐up period of 1185 ± 942 days, 5665 myocardial infarction, 52 475 angina pectoris, 25 436 stroke, 54 508 heart failure, and 12 932 atrial fibrillation events occurred. The BP and fasting plasma glucose categories additively increased the risk of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. However, the relative risk of stage 1 and stage 2 hypertension developing into CVD was attenuated with deteriorating glycemic status. Similarly, the relative risk of prediabetes and diabetes developing into CVD was attenuated with increasing BP. For example, the relative risk reduction of stage 2 hypertension for heart failure was 53.5% in individuals with normal fasting plasma glucose, 46.4% in those with prediabetes, and 37.2% in those with diabetes. The robustness of our findings was confirmed using a multitude of sensitivity analyses.

Conclusions

Although hypertension and hyperglycemia additively increase the risk of developing CVD, the relative contribution of hypertension to the development of CVD decreased with deteriorating glycemic status and that of hyperglycemia was attenuated with increasing BP. Our results indicate a potential interaction between hypertension and hyperglycemia in the development of CVD.
Epicardial Fat Volume, Cardiac Function, and Incident Heart Failure: The Rotterdam Study
Authors: Arshi Banafsheh , Aliahmad Hamid A. , Ikram M. Arfan , Bos Daniel , Kavousi Maryam
Published: December 2022

Background

Larger epicardial fat volume (EFV) has been associated with increased risks of cardiovascular disease and atrial fibrillation. Yet, evidence on the association of EFV with cardiac function and incident heart failure (HF) remains scarce.

Methods and Results

We included 2103 participants (mean age, 68 years; 54.4% women) from the prospective population‐based RS (Rotterdam Study) with computed tomography–based EFV and repeated echocardiography‐based assessment of left ventricular (LV) systolic and diastolic function. Linear mixed effects and Cox‐proportional hazard regression models, adjusted for cardiovascular risk factors, were used to assess the associations of EFV with repeated measurements of echocardiographic parameters and with incident HF. During a median follow‐up of 9.7 years, 124 HF events occurred (incidence rate, 6.37 per 1000 person‐years). For LV systolic function, 1‐SD larger EFV was associated with 0.76 (95% CI, 0.54–0.98) mm larger LV end‐diastolic dimension, 0.66 (95% CI, 0.47–0.85) mm larger LV end‐systolic dimension, and 0.56% (95% CI, −0.86% to −0.27%) lower LV ejection fraction. Interactions between EFV and time were small. For LV diastolic function, 1‐SD larger EFV was associated with 1.02 (95% CI, 0.78–1.27) mm larger left atrial diameter. Larger EFV was also associated with incident HF (hazard ratio per 1‐SD increase in EFV, 1.34 [95% CI, 1.07–1.68] per 1‐SD larger EFV).

Conclusions

We report an independent association between EFV with new‐onset HF in the general population. EFV seems to exert its influence on HF through different pathways contributing to deteriorations in systolic function and larger left atrial size in part, likely through mechanical restraint and hypertrophy.
Combination of Neutrophil‐to‐Lymphocyte and Platelet‐to‐Lymphocyte Ratios as a Novel Predictor of Cardiac Death in Patients With Acute Decompensated Heart Failure With Preserved Left Ventricular Ejection Fraction: A Multicenter Study
Authors: Tamaki Shunsuke , Nagai Yoshiyuki , Shutta Ryu , Masuda Daisaku , Yamashita Shizuya , Seo Masahiro , Yamada Takahisa , Nakagawa Akito , Yasumura Yoshio , Nakagawa Yusuke , Yano Masamichi , Hayashi Takaharu , Hikoso Shungo , Nakatani Daisaku , Sotomi Yohei , Sakata Yasushi ,   the OCVC‐Heart Failure Investigators
Published: December 2022

Background

Neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) are novel inflammation markers. Their combined usefulness for estimating the prognosis of patients with heart failure with preserved ejection fraction (HFpEF) admitted for acute decompensated heart failure remains elusive.

Methods and Results

We investigated 1026 patients registered in the Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction. Both NLR and PLR values were measured at the time of admission. Comorbidity burden was defined as the number of occurrences of 8 common comorbidities of HFpEF. The primary end point was cardiac death. The patients were stratified into 3 groups based on the optimal cut‐off values of NLR and PLR on the receiver operating characteristic curve analysis for predicting cardiac death (low NLR and PLR, either high NLR or PLR, and both high NLR and PLR). After a median follow‐up of 429 days, 195 patients died, with 85 of these deaths attributed to cardiac causes. An increased comorbidity burden was significantly associated with a higher proportion of patients with high NLR (>4.5) or PLR (>193), or both. High NLR and PLR values were independently associated with cardiac death, and a combination of both values was the strongest predictor (hazard ratio, 2.66 [95% CI, 1.51–4.70],
P
=0.0008). A significant difference was found in the rate of cardiac death among the 3 groups stratified by NLR and PLR values.

Conclusions

The combination of NLR and PLR is useful for the prediction of postdischarge cardiac death in patients with acute HFpEF.

Registration

URL:
ClinicalTrials.gov
; Unique identifier: UMIN000021831.
Initial Antihypertensive Regimens in Newly Treated Patients: Real World Evidence From the OneFlorida+ Clinical Research Network
Authors: Smith Steven M. , Winterstein Almut G. , Gurka Matthew J. , Walsh Marta G. , Keshwani Shailina , Libby Anne M. , Hogan William R. , Pepine Carl J. , Cooper‐DeHoff Rhonda M.
Published: December 2022

Background

Knowledge of real‐world antihypertensive use is limited to prevalent hypertension, limiting our understanding of how treatment evolves and its contribution to persistently poor blood pressure control. We sought to characterize antihypertensive initiation among new users.

Methods and Results

Using Medicaid and Medicare data from the OneFlorida+ Clinical Research Consortium, we identified new users of ≥1 first‐line antihypertensives (angiotensin‐converting enzyme inhibitor, calcium channel blocker, angiotensin receptor blocker, thiazide diuretic, or β‐blocker) between 2013 and 2021 among adults with diagnosed hypertension, and no antihypertensive fill during the prior 12 months. We evaluated initial antihypertensive regimens by class and drug overall and across study years and examined variation in antihypertensive initiation across demographics (sex, race, and ethnicity) and comorbidity (chronic kidney disease, diabetes, and atherosclerotic cardiovascular disease). We identified 143 054 patients initiating 188 995 antihypertensives (75% monotherapy; 25% combination therapy), with mean age 59 years and 57% of whom were women. The most commonly initiated antihypertensive class overall was angiotensin‐converting enzyme inhibitors (39%) followed by β‐blockers (31%), calcium channel blockers (24%), thiazides (19%), and angiotensin receptor blockers (11%). With the exception of β‐blockers, a single drug accounted for ≥75% of use of each class. β‐blocker use decreased (35%–26%), and calcium channel blocker use increased (24%–28%) over the study period, while initiation of most other classes remained relatively stable. We also observed significant differences in antihypertensive selection across demographic and comorbidity strata.

Conclusions

These findings indicate that substantial variation exists in initial antihypertensive prescribing, and there remain significant gaps between current guideline recommendations and real‐world implementation in early hypertension care.
Lipoprotein Subclasses Associated With High‐Risk Coronary Atherosclerotic Plaque: Insights From the PROMISE Clinical Trial
Authors: McGarrah Robert W. , Ferencik Maros , Giamberardino Stephanie N. , Hoffmann Udo , Foldyna Borek , Karady Julia , Ginsburg Geoffrey S. , Kraus William E. , Douglas Pamela S. , Shah Svati H.
Published: December 2022

BACKGROUND

More than half of major adverse cardiovascular events (MACE) occur in the absence of obstructive coronary artery disease and are often attributed to the rupture of high‐risk coronary atherosclerotic plaque (HRP). Blood‐based biomarkers that associate with imaging‐defined HRP and predict MACE are lacking.

METHODS AND RESULTS

Nuclear magnetic resonance–based lipoprotein particle profiling was performed in the biomarker substudy of the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial (N=4019) in participants who had stable symptoms suspicious for coronary artery disease. Principal components analysis was used to reduce the number of correlated lipoproteins into uncorrelated lipoprotein factors. The association of lipoprotein factors and individual lipoproteins of significantly associated factors with core laboratory determined coronary computed tomographic angiography features of HRP was determined using logistic regression models. The association of HRP‐associated lipoproteins with MACE was assessed in the PROMISE trial and validated in an independent coronary angiography biorepository (CATHGEN [Catheterization Genetics]) using Cox proportional hazards models. Lipoprotein factors composed of high‐density lipoprotein (HDL) subclasses were associated with HRP. In these factors, large HDL (odds ratio [OR], 0.70 [95% CI, 0.56–0.85];
P
<0.001) and medium HDL (OR, 0.84 [95% CI, 0.72–0.98];
P
=0.028) and HDL size (OR, 0.82 [95% CI, 0.69–0.96];
P
=0.018) were associated with HRP in multivariable models. Medium HDL was associated with MACE in PROMISE (hazard ratio [HR], 0.76 [95% CI, 0.63–0.92];
P
=0.004), which was validated in the CATHGEN biorepository (HR, 0.91 [95% CI, 0.88–0.94];
P
<0.001).

CONCLUSIONS

Large and medium HDL subclasses and HDL size inversely associate with HRP features, and medium HDL subclasses inversely associate with MACE in PROMISE trial participants. These findings may aid in the risk stratification of individuals with chest pain and provide insight into the pathobiology of HRP.

REGISTRATION

URL:
https://clinicaltrials.gov
; Unique identifier: NCT01174550
Clinical Associations of Injuries Caused by Vasovagal Syncope: A Cohort Study From a Tertiary Syncope Unit
Authors: Tajdini Masih , Tavolinejad Hamed , Aminorroaya Arya , Aryan Zahra , Jalali Arash , Alaeddini Farshid , Sadeghian Saeed , Yadangi Somayeh , Vasheghani‐Farahani Ali , Kalhor Parvin , Bozorgi Ali
Published: December 2022

Background

Recent research has revealed that vasovagal syncope (VVS) leads to a high incidence of injuries; however, clinical associations of injury are not well‐established. We present data from an ongoing VVS cohort and aimed to determine characteristics associated with VVS‐related injury.

Methods and Results

Between 2017 and 2020, consecutive patients ≥18 years of age presenting to a tertiary syncope unit and diagnosed with VVS were included. Clinical characteristics relevant to syncope were obtained for the index episode. The outcome was incidence of injury during VVS, documented by clinical evaluation at the syncope clinic. Among 1115 patients (mean age, 45.9 years; 48% women), 260 injuries (23%) occurred. History of VVS‐related injuries (adjusted relative risk [aRR], 1.80 [95% CI, 1.42–2.29]), standing position (aRR, 1.34 [95% CI, 1.06–1.68]), and female sex (aRR, 1.30 [95% CI, 1.06–1.60]) were associated with injury, whereas recurrent VVS (aRR, 0.63 [95% CI, 0.49–0.81]) and syncope in the noon/afternoon (aRR, 0.70 [95% CI, 0.56–0.87]) and evening/night (aRR, 0.43 [95% CI, 0.33–0.57]) compared with morning hours were associated with lower risk. There was a trend for higher rates of injury with overweight/obesity (aRR, 1.23 [95% CI, 0.99–1.54]) and syncope occurring at home (aRR, 1.22 [95% CI, 0.98–1.51]). In a per‐syncope analysis considering up to 3 previous episodes (n=2518, 36% traumatic), syncope at home (aRR, 1.33 [95% CI, 1.17–1.51]) and absence of prodromes (aRR, 1.34 [95% CI, 1.09–1.61]) were associated with injury.

Conclusions

Patient characteristics, VVS presentations, the circumstances, and surroundings can determine the risk of injury. These associations of VVS‐related injury identify at‐risk individuals and high‐risk situations. Future prospective studies are needed to investigate potential strategies for prevention of post‐VVS injury in recurrent cases.
Disparate Cardiovascular Hospitalization Trends Among Young and Middle‐Aged Adults Within and Across Race and Ethnicity Groups in Four States in the United States
Authors: Akhabue Ehimare , Rua Melanie , Gandhi Poonam , Kim Jung Hyun , Cantor Joel C. , Setoguchi Soko
Published: December 2022

Background

Inpatient hospitalizations for cardiovascular disease (CVD) decreased nationally in the past decade. However, data are lacking on whether national declines represent trends within and across race and ethnicity populations from different US regions.

Methods and Results

Using State Inpatient Databases, Census Bureau and Behavioral Risk Factor Surveillance System data for Florida, Kentucky, New Jersey, and North Carolina, we identified all CVD hospitalizations and population characteristics for adults aged 18 to 64 years between January 1, 2009 and December 31, 2018. We calculated yearly CVD hospitalization rates for each state for the overall population, by sex, race, and ethnicity. We modeled yearly trends in age‐adjusted CVD hospitalization rate in each state using negative binomial regression. State base populations were similar by age (mean age: 40–42 years) and sex (50%–51% female) throughout the study period. There were 314 973 and 288 843 total CVD hospitalizations among the 4 states in 2009 and 2018, respectively. Crude hospitalization rates declined in all states (age 18–44 years NJ: −33.4%; KY: −17.0%; FL: −11.9%; NC: −11.2%; age 45–64 years NJ: −29.8%; KY: −20.3%; FL: −12.2%; NC: −11.6%) over the study period. In age‐adjusted models, overall hospitalization rates declined significantly in NJ −2.5%/y (95% CI, −2.9 to −2.1) and in KY −1.6%/y (−1.9 to −1.2) with no significant declining trend in FL and NC. Similar findings were present by sex. Among non‐Hispanic White populations, mean yearly decline in hospitalization rate was significant in all states except FL, with the greatest declines in NJ (−3.8%/y [−4.4 to −3.2],
P
values for state−year interaction <0.0001). By contrast, a significant declining trend was present for non‐Hispanic Black and Hispanic populations only in NJ (
P
values for state−year interaction <0.001). We found similar differences in trend between states in sensitivity analyses incorporating additional demographic and comorbid characteristics.

Conclusions

Decreases in CVD hospitalization rates in the past decade among nonelderly adults varied considerably by state and appeared largely driven by declines among non‐Hispanic White populations. Overall declines did not represent divergent trends between states within non‐Hispanic Black and Hispanic populations. Recognition of differences not just between but also within race and ethnicity populations should inform national and local policy initiatives aimed at reducing disparities in CVD outcomes.
Association of Incidentally Discovered Covert Cerebrovascular Disease Identified Using Natural Language Processing and Future Dementia
Authors: Kent David M. , Leung Lester Y. , Zhou Yichen , Luetmer Patrick H. , Kallmes David F. , Nelson Jason , Fu Sunyang , Puttock Eric J. , Zheng Chengyi , Liu Hongfang , Chen Wansu
Published: December 2022

Background

Covert cerebrovascular disease (CCD) has been shown to be associated with dementia in population‐based studies with magnetic resonance imaging (MRI) screening, but dementia risk associated with incidentally discovered CCD is not known.

Methods and Results

Individuals aged ≥50 years enrolled in the Kaiser Permanente Southern California health system receiving head computed tomography (CT) or MRI for nonstroke indications from 2009 to 2019, without prior ischemic stroke/transient ischemic attack, dementia/Alzheimer disease, or visit reason/scan indication suggestive of cognitive decline or stroke were included. Natural language processing identified incidentally discovered covert brain infarction (id‐CBI) and white matter disease (id‐WMD) on the neuroimage report;
white matter disease
was characterized as mild, moderate, severe, or undetermined. We estimated risk of dementia associated with id‐CBI and id‐WMD.

Among 241 050 qualified individuals,
natural language processing
identified 69 931 (29.0%) with id‐WMD and 11 328 (4.7%) with id‐CBI. Dementia incidence rates (per 1000 person‐years) were 23.5 (95% CI, 22.9–24.0) for patients with id‐WMD, 29.4 (95% CI, 27.9–31.0) with id‐CBI, and 6.0 (95% CI, 5.8–6.2) without id‐CCD. The association of id‐WMD with future dementia was stronger in younger (aged <70 years) versus older (aged ≥70 years) patients and for CT‐ versus MRI‐discovered lesions. For patients with versus without id‐WMD on CT, the adjusted HR was 2.87 (95% CI, 2.58–3.19) for younger and 1.87 (95% CI, 1.79–1.95) for older patients. For patients with versus without id‐WMD on MRI, the adjusted HR for dementia risk was 2.28 (95% CI, 1.99–2.62) for younger and 1.48 (95% CI, 1.32–1.66) for older patients. The adjusted HR for id‐CBI was 2.02 (95% CI, 1.70–2.41) for younger and 1.22 (95% CI, 1.15–1.30) for older patients for either modality. Dementia risk was strongly correlated with id‐WMD severity; adjusted HRs compared with patients who were negative for id‐WMD by MRI ranged from 1.41 (95% CI, 1.25–1.60) for those with mild disease on MRI to 4.11 (95% CI, 3.58–4.72) for those with severe disease on CT.

Conclusions

Incidentally discovered CCD is common and associated with a high risk of dementia, representing an opportunity for prevention. The association is strengthened when discovered at younger age, by increasing id‐WMD severity, and when id‐WMD is detected by CT scan rather than MRI.
Ross Procedure Versus Mechanical Versus Bioprosthetic Aortic Valve Replacement: A Network Meta‐Analysis
Authors: Yokoyama Yujiro , Kuno Toshiki , Toyoda Nana , Fujisaki Tomohiro , Takagi Hisato , Itagaki Shinobu , Ibrahim Michael , Ouzounian Maral , El‐Hamamsy Ismail , Fukuhara Shinichi
Published: December 2022

Background

The Ross operation appears to restore normal survival in young and middle‐aged adults with aortic valve disease. However, there are limited data comparing it with conventional aortic valve replacement. Herein, we compared outcomes of the Ross procedure with mechanical and bioprosthetic aortic valve replacement (M‐AVR and B‐AVR, respectively).

Methods and Results

MEDLINE and EMBASE were searched through March 2022 to identify randomized controlled trials and propensity score–matched studies that investigated outcomes of patients aged ≥16 years undergoing the Ross procedure, M‐AVR, or B‐AVR. The systematic literature search identified 2 randomized controlled trials and 8 propensity score–matched studies involving a total of 4812 patients (Ross: n=1991; M‐AVR: n=2019; and B‐AVR: n=802). All‐cause mortality was significantly lower in the Ross procedure group compared with M‐AVR (hazard ratio [HR] [95% CI], 0.58 [0.35–0.97];
P
=0.035) and B‐AVR (HR [95% CI], 0.32 [0.18–0.59];
P
<0.001) groups. The reintervention rate was lower after the Ross procedure and M‐AVR compared with B‐AVR, whereas it was higher after the Ross procedure compared with M‐AVR. Major bleeding rate was lower after the Ross procedure compared with M‐AVR. Long‐term stroke rate was lower following the Ross procedure compared with M‐AVR and B‐AVR. The rate of endocarditis was also lower after the Ross procedure compared with B‐AVR.

Conclusions

Improved long‐term outcomes of the Ross procedure are demonstrated compared with conventional M‐AVR and B‐AVR options. These results highlight a need to enhance the recognition of the Ross procedure and revisit current guidelines on the optimal valve substitute for young and middle‐aged patients.
Shrunken Pore Syndrome: A New and More Powerful Phenotype of Renal Dysfunction Than Chronic Kidney Disease for Predicting Contrast‐Associated Acute Kidney Injury
Authors: Zhang Li‐Wei , Luo Man‐Qing , Xie Xian‐Wei , You Zhe‐Bin , Zeng Ji‐Lang , Lin Mao‐Qing , Chen Li‐Chuan , Lin Kai‐Yang , Guo Yan‐Song
Published: December 2022

Background

Shrunken pore syndrome (SPS) as a novel phenotype of renal dysfunction is characterized by a difference in renal filtration between cystatin C and creatinine. The manifestation of SPS was defined as a cystatin C–based estimated glomerular filtration rate (eGFR) <60% of the creatinine‐based eGFR. SPS has been shown to be associated with the progression and adverse prognosis of various cardiovascular and renal diseases. However, the predictive value of SPS for contrast‐associated acute kidney injury (CA‐AKI) and long‐term outcomes in patients undergoing percutaneous coronary intervention remains unclear.

Methods and Results

We retrospectively observed 5050 consenting patients from January 2012 to December 2018. Serum cystatin C and creatinine were measured and applied to corresponding 2012 and 2021 Chronic Kidney Disease Epidemiology Collaboration equations, respectively, to calculate the eGFR. Chronic kidney disease (CKD) was defined as a creatinine‐based eGFR <60 mL/min per 1.73 m
2
without dialysis. CA‐AKI was defined as an increase in serum creatinine ≥50% or 0.3 mg/dL within 48 hours after contrast medium exposure. Overall, 649 (12.85%) patients had SPS, and 324 (6.42%) patients developed CA‐AKI. Multivariate logistic regression analysis indicated that SPS was significantly associated with CA‐AKI after adjusting for potential confounding factors (odds ratio [OR], 4.17 [95% CI, 3.17–5.46];
P
<0.001). Receiver operating characteristic analysis indicated that the cystatin C–based eGFR:creatinine‐based eGFR ratio had a better performance and stronger predictive power for CA‐AKI than creatinine‐based eGFR (area under the curve: 0.707 versus 0.562;
P
<0.001). Multivariate logistic analysis revealed that compared with those without CKD and SPS simultaneously, patients with CKD and non‐SPS (OR, 1.70 [95% CI, 1.11–2.55];
P
=0.012), non‐CKD and SPS (OR, 4.02 [95% CI, 2.98–5.39];
P
<0.001), and CKD and SPS (OR, 8.62 [95% CI, 4.67–15.7];
P
<0.001) had an increased risk of CA‐AKI. Patients with both SPS and CKD presented the highest risk of long‐term mortality compared with those without both (hazard ratio, 2.30 [95% CI, 1.38–3.86];
P
=0.002).

Conclusions

SPS is a new and more powerful phenotype of renal dysfunction for predicting CA‐AKI than CKD and will bring new insights for an accurate clinical assessment of the risk of CA‐AKI.
Lexical Glosses in Cambridge, University Library, Kk. 3.18
Authors: Afros Elena
Published: December 2022

Cambridge, University Library, Kk.3.18, the latest extant copy of the Old English Bede, is a remarkably reader-oriented manuscript. Consistently punctuated, rubricated, and furnished with the list of chapter headings, chapter numbers, and continuous running titles, it is easy to read and navigate. Complementing these signposts are lexical interlinear glosses. Many of them are dialectally unmarked variants of Anglian and obsolete/obsolescent vocabulary as well as nonce formations. Another subset consists of the alternatives to the words that were probably familiar to the late Anglo-Saxon audience. These additions enhance the translation similarly to the multiple psalter glosses. The third group corrects copying errors by supplying a reading found in other manuscripts. On the whole, these glosses offer an apparatus that facilitates a better understanding of Bede’s Latin composition and its Old English translation. In addition, they provide invaluable information about the development of the Early English lexicon and the scribes’ active repertoire and linguistic preferences.
Gregorius in Schweden
Authors: Quak Arend
Published: December 2022

The Linköping Legendary contains amongst other texts an Old Swedish translation of the well-known medieval German legend of Gregory on the Stone. This text was translated into Swedish around 1525 in the monastery of Vadstena. In this article the Swedish translation is compared with the Middle High and Middle Low German originals. This comparison makes it highly probable that the translation was based on the 1478 Low German edition of the ‘Der Heiligen Leben’, also known as the ‘Passional’, by Lucas Brandis. Some differences between the Swedish translation and its exemplar can be explained as mistakes in understanding the Low German original.
Gender and Race Demographics of Fellowships After General Surgery Training in the United States: A Five-Year Analysis in Applicant and Resident Trends
Authors: Mueller Lauren , Morenas Rohan , Loe Mallory , Toraih Eman , Turner Jacquelyn
Published: December 2022

Introduction

The gender and minority gap in general surgery residency is narrowing; however, literature lacks comprehensive data regarding the demographics of fellowship programs following general surgery training.

Methods

Data from 2017 to 2021 for gender, ethnicity, and surgical subspecialty are publicly available from the ERAS database and ACGME yearly data reports. Cochran-Armitage trend tests were used to determine statistical significance in trends for female and minority applicants and trainees.

Results

The overall trend of female applicants to surgical specialties remained stagnant. However, female applicants to vascular surgery increased significantly from 25% to 35% (P = .045). There was no significant increase in female trainees in any surgical specialties evaluated. Furthermore, the overall trend of minority applicants to surgical specialties also remained stagnant, except for pediatric surgery, which showed significantly fewer minority applicants. Despite pediatric surgery having fewer applicants, minority trainees in this specialty increased significantly from 8% to 19% (P = .008).

Conclusion

Several current initiatives, such as intentional mentorship, are being reported to promote diverse and equal representation among female and minority applicants and trainees. However, the current overall margin of increase in diversity among surgical specialty applicants and trainees is minimal, indicating that continued efforts are needed to diversify surgical specialty training programs.
Evaluation of Detected Medication Errors Within the Operating Room at an Academic Medical Center
Authors: Wolf Mark , Rolf Justin , Nelson Dylan , Smith Devlin , Hess Elizabeth
Published: December 2022

Background: Medication errors are preventable events that lead to inappropriate medication use and potential patient harm. This is especially prevalent within the operating room (OR) where one practitioner is involved in the entire medication-use process. Despite recent implementation of BD Pyxis™ Anesthesia ES, Codonics Safe Label System, and Epic One Step at the University of Kentucky Healthcare (UKHC) to prevent medication errors, errors continue to be reported. Curatolo et al found human error was the most frequent cause of medication error within the OR. Clumsy automation may be an explanation for this, which imposes burdens and promotes work arounds. This study endeavors to assess potential medication errors via chart review to identify risk reduction strategies. Methods: This a single-center retrospective cohort review of patients admitted to a UK HealthCare Main Operating Room, defined OR1A-OR5A and OR7A-OR16A, who were administered medications from 8/1/2021 to 9/30/2021. Results: Over a 2-month period, 145 cases were conducted at UK HealthCare. Of the 145 cases, 98.6% (n = 143) involved a medication error and 93.7% (n = 136) of the errors involved a high-alert medication. The top 5 classes of drugs involved in errors were all high-alert medications. Lastly, 46.6% (n = 67) of cases had documentation that Codonics was utilized. In addition to analyzing medication errors, the financial analysis found that $3154.04 in drug cost was lost in the study period. When extrapolating these results to all BD™ Pyxis Anesthesia Machines at UK HealthCare, $107 237.36 of drug cost is potentially lost per year. Conclusions: These findings add to previous data that have described the increased rate of medication errors when conducting chart review rather than rely on self-reported data. In this study, 98.6% of all cases involved a medication error. In addition, these findings provide additional insight in the increased use of technology within the operating room despite medication errors still occurring. These results can be applied to like institutions to critically evaluate anesthesia workflow to determine risk reduction strategies.
An experimental multi-instrumental approach to understand the size effect on the damage propagation of plain-woven CFRP composites under shear loading
Authors: Ali Hafiz Q , Khan Raja M A , Tabrizi Isa E , Yildiz Mehmet
Published: December 2022

Damage propagation and failure mechanisms in woven carbon fiber composites are complex due to their anisotropic nature and are affected by the percentage of constituents of the composite materials named fiber, matrix, and void. The “size effect” that relies on these parameters can be influenced by the volume fraction percentages of these constituents and composite manufacturing parameters. This research introduces a multi-instrumental structural health monitoring approach to understand damage progression due to the size effect under the Iosipescu configuration. Acoustic emission (AE) signals are classified via a K-means clustering algorithm to distinguish the damage activities based on their frequencies. It is shown that both size effect and void content are relatable based on cumulative AE energy jumps attributed to the accumulation of micro-damages inside these laminates. The thermal variations observed by passive infrared thermography are associated with the nonlinear response of the shear behavior. The outcomes of the thermal analysis are depicted to show the relationship between damage progress and laminate thickness. The digital image correlation analysis is performed to measure the full-field strain measurement during the testing. The correspondence of material thickness with elastic shear behavior is investigated via a comparison of shear strain maps.
Discrimination Based on Physical Attractiveness: Causes and Consequences A Critical Perspective
Authors: Maheshwari Bhawana
Published: December 2022

The consequences of physical attractiveness (PA) are ubiquitous, however not often become a topic of discussion. The consequences, in general, are attributed to preference or discrimination without much deliberation. There is a very thin line between the two. The study makes an attempt to distinguish between preference and discrimination based on PA. In an organizational context, this distinction seems warranted since PA does impact work-related outcomes. The distinction was addressed by examining published studies between 1970 and 2021 on PA in the management and economics field of research. The study highlights when and how preference turns into discrimination and furthers discusses the causes of such discrimination. The causes are equivalent to antecedents; the antecedent to being physically attractive is mostly genes. The antecedents to the discrimination are the attributions that we have associated with being physically attractive. The study highlights these attributions and the reasons for these attributions. To completely understand a phenomenon, it is essential to understand what causes it. Therefore, this study tries to understand what causes discrimination based on PA. The study has implications for diversity and inclusion literature and practice. It also adds to the literature on PA.
Comparing the Effects of Tourists’ Perceptions of Residents’ Emotional Solidarity and Tourists’ Emotional Solidarity on Trip Satisfaction and Word-of-Mouth Intentions
Authors: Lai Ivan Ka Wai , Wong Jose Weng Chou
Published: December 2022

This study aims to examine the effect of tourists’ perceptions of residents’ emotional solidarity with tourists on their trip satisfaction and word-of-mouth intentions toward a destination, taking into consideration the moderating effect of visitation frequency. It also aims to compare the impacts of tourists’ perceptions of residents’ emotional solidarity and the impacts of tourists’ perceptions of their emotional solidarity with residents. The results indicate that residents’ welcoming nature and emotional closeness as perceived by tourists have significant effects on tourists’ satisfaction and word-of-mouth intentions, while perceived residents’ sympathetic understanding does not. Visitation frequency significantly moderates the effects of perceptions of residents’ welcoming nature and emotional closeness on satisfaction. For tourists’ emotional solidarity, their sympathetic understanding has a significant effect on word-of-mouth intentions, and no moderating effect exists. This study has implications for exploring the differences in how tourists both receive from and offer to residents in terms of emotional solidarity.
Negotiating queer voices: How five south African queer music educators negotiate their professional identity
Authors: Pilkington Carl Ian
Published: December 2022

Forced to navigate and negotiate their positionality and subjectivity, queer music educators confront unique challenges in heteronormative schooling environments. This minority group is often associated with the music industry. Still, upon entering an educational context, they navigate and negotiate their identity, specifically the tension between their queer selves and the heteronormative requirements of their teaching context. This article analyses the narratives of five queer music educators situated in a South African context. Being a queer music educator myself, I used a relational approach, the Listening Guide, to listen for the contrapuntal voices that come to the fore when my participants reflected on their professional identity negotiation as music educators. The participants developed various strategies to negotiate their professional identity, with some reporting on its negative impact on effective teaching. This article suggests that heteronormativity in music education should be challenged to allow for an inclusive and affirming space for queer music educators and students.