bluuebunny/crossref_metadata_2025 huggingface dataset:
391 First CARMAT implantation in Italy: a nurse’s experience
Authors: Pettillo Vincenzo , Artiola Gaetano
Published: December 2021

Aims

CARMAT is a new fully implantable device that simulates heart function. CARMAT has three characteristics that allow a physiological simulation that is at the top of biomedical engineering: it is blood-compatible for the use of bovine pericardium; it is pulsatile because it has hydraulic pumps that mimic systole and diastole; it is capable of self-regulating with the physiological needs of the patient. CARMAT has four biological valves that allow the intake of cardioaspirin avoiding the use of Coumadin and continuous blood draw. CARMAT also has two hybrid membranes with an internal part formed by bovine pericardium and an external polyurethane membrane; CARMAT has self-regulation sensors that adapt the system to the patient’s efforts. The operation is relatively simple because the rollers placed inside move the silicondressingstely and so it pushes the walls creating systole and diastole not synchronously as it normally happens but asynchronously, one ventricle at a time. Evaluation of the patient’s haemodynamics, monitoring of vital parameters, dressings of the drive-line, and psychological state.

Methods and results

Training in the field by the manufacturer due to the absence of material in literature. Since it was the first CARMAT implantation in Italy, we tried to combine experience with the clinical practice of other artificial hearts. The patient was weaned from anesthesia early and extubated; the patient did not show neurological damage. Psychologically, the artificial heart was accepted without any problems by the patient, the drive line had no infections, and the patient was discharged quickly.

Conclusions

The CARMAT system appears to be the one that best simulates the physiology of the heart because it involves fewer complications than other artificial hearts. This device is used as a bridge to transplant, but research and continuous studies tend to transform it as a therapy to end for patients who leave the transplant list and therefore the possibility of having a heart transplant.
783 The effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk during COVID-19 lockdown
Authors: Perrone Marco Alfonso , Padua Elvira , Pieri Massimo , Russo Carmelo , Iellamo Ferdinando , Parisi Attilio
Published: December 2021

Aims

The COVID-19 pandemic is a serious global health problem. In Italy, to limit the infections, the government ordered lockdown from March 2020. This measure, designed to contain the virus, led to serious limitations on the daily life of the individuals it affected, and in particular in the limitation of physical exercise. The aim of this study was to evaluate the effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk.

Methods and results

We enrolled 38 dyslipidaemic patients, 56% male, with an age range of 44–62 years, considered to be at high cardiovascular risk. All patients were prescribed statin drug therapy (atorvastatin 40 mg) and a vigorous physical activity program four times a week, 1 h per session. In addition, a personalized Mediterranean diet was prescribed to all the patients. Total cholesterol, LDL, HDL, and triglycerides were measured in patients at T0 before lockdown and at T1 during lockdown. Data showed a significant increase (P < 0.01) in total cholesterol (+6.8%) and LDL (+15.8%). Furthermore, the analysis of the data revealed a reduction in HDL (−3%) and an increase in triglycerides (+3.2%), although both were not significant (P > 0.05). Of the 14 patients who were all in perfect therapeutic range at T0, only 4 (28%) had LDL <70 mg/dL at T1.

Conclusions

Our study showed that the reduction in physical activity during lockdown led to an increase in LDL levels, and therefore, in the risk of ischaemic heart disease in dyslipidaemic patients with high cardiovascular risk.
149 Myocardial performance in opera singers
Authors: Stefani Laura , Corsi Marco , Orlandi Goffredo
Published: December 2021

Aims

Opera singers are subjected to continuous exercise in the cardiopulmonary district, however the impact on cardiac performance has not been studied in depth. In addition to the standard echo parameters, the deformation one offer the possibility to evaluate more clearly the myocardial performance. Objective was to verify the impact of singing in heart’s performance by the evaluation of traditional and particularly deformation parameters as strain, rotation, and twist.

Methods and results

A population of 17 OS (opera singers, aged 50 ± 5 years) (M/F: 7/9; 5 sopranos; 2 tenors; 2 contraltos; 2 basses) have been submitted to an echocardiographic evaluation (MLX8exp Release F100001) by standard 2D and deformation parameters (Figure 1). The data expressed as mean as SD were compared to an high level athletes (A) group (M 16) regularly trained. T-Student test for paired data was used and P < 0.05 was considered significant. All the 2D standard systo-diastolic parameters were within the normal range and the pulmonary pressure (PP) as well in both. In SO group were: LVDd: 47.31 ± 3.77 mm; LVSd: 30.48 ± 4.42 mm; E/A: 1.07 ± 0.32; RV: 27.63 ± 4.50 mm; in A group: LVDd: 50.81 ± 2.97 mm; LVSd: 31.44 ± 4.26 mm; E/A: 2.68 ± 1.67; RV: 27.63 ± 4.50 mm. As expected Cardiac mass index (CMI) was significantly greater in athletes, while the ejection fraction (EF) resulted to be higher in OS. Despite the deformation parameters were not different among the two groups, with the exclusion of GLS expressing a major value in athletes, on the contrary the rotational parameters resulted, in OS group similar to the athletes and in agreement with an high performance status.

Conclusions

OS show an high myocardial performance as athletes. The data obtained are suggestive for a positive impact of regular training as an opera singers. Deformation parameters highlight the fitness status in this particular group. Classic music singing seems to have a training effect on the heart. Further studies will be necessary to confirm this hypothesis
582 Changes on diastolic and atrial functions following a single bout of two different exercise modalities in patients with hypertension and ischaemic heart disease
Authors: Caminiti Giuseppe , Perrone Marco , D’Antoni Valentino , Morsella Valentina , Catena Marco , Cascelli Giovanna , Iellamo Ferdinando , Volterrani Maurizio
Published: December 2021

Aims

Concurrent aerobic plus resistance exercise (RAE) and high intensive interval exercise (HIIE) are both effective on inducing post-exercise hypotension (PEH) in patients with hypertension. However central haemodynamic changes associated to PEH in hypertensive subjects with underlying ischaemic heart disease (IHD) have been poorly investigated. To compare the acute effects produced by these two exercise modalities on left ventricular diastolic function and left atrial function.

Methods and results

Twenty untrained male patients with history of hypertension and IHD under stable pharmacological therapy were enrolled. Each patient underwent three exercise sessions: RAE, HIIE, and a control session without exercise each lasting 45 min. Echocardiography examination was performed before and between 30 and 40 min from the end of the exercise sessions. In the first hour post exercise, BP values decreased in a similar way in RAE and HIIE and were unchanged after control. Compared to pre-session, E/E1 ratio increased after HIIE and remained unchanged after both RAE and control sessions (between-sessions P 0.002). PALS increased slightly after RAE (+1.4 ± 1.1%), decreased after HIIE (−4.6 ± 2.4%). and was unchanged after control. (between-sessions P 0.03). PACS was mildly increased after RAE, was reduced after HIIE, and was unchanged after control. Atrial volume was unchanged after both sessions. Left ventricular and left atrial stiffness increased significantly after HIEE while remained unchanged after RAE and control. Stroke volume and cardiac output increased after RAE, decreased after HIIE, and were unchanged after control.

Conclusions

Single sessions of RAE and HIIE determined similar PEHs in hypertensive subjects with IHD, while they evoked different central haemodynamic adjustments. Given its neutral effects of on diastolic and atrial functions, RAE seems more suitable for reducing blood pressure in hypertensive patients with IHD.
124 Tiny but useful transportable remote monitoring device during SARS-CoV-2 pandemic
Authors: Bozza Nicola , Loizzi Francesco , Carulli Eugenio , Carella Mariacristina , Latorre Maria , Achille Teresa , Tricarico Giuseppe , Soldato Nicolo , Amati Francesca , Favale Stefano
Published: December 2021

A 45-year-old woman, without cardiovascular risk factors and affected by chronic migraine, presented to the emergency department due to the onset of a typical chest pain. After performing an electrocardiogram she was promptly transported to the Cath lab, with the diagnosis of ST segment elevation myocardial infarction (STEMI), for urgent coronarography. A spontaneous dissection of the first obtuse marginal branch was detected which was treated with two drug eluting stents implantation. A day after the procedure, during a migraine crisis, at the continuous electrocardiographic monitoring it was registered a brief episode of complete atrioventricular block, which regressed spontaneously after a few minutes. For this reason, she underwent atropine test which resulted negative for AV conductance defects. No more episodes were recorded during the hospital stay, however it was decided to implant a loop recorder (Biotronik BIOMONITOR III) before the discharge. The patient received a remote monitoring device in order to allow a closer follow-up in course of the COVID-19-related lockdown, that caused a relevant reduction in the outpatients’ services. A few months later a sinusal pause of about 9 s was recorded with the emergence of an idioventricular rhythm at 25 b.p.m. When contacted by telephone the patient reported being hospitalized because of pulmonary complications of SARS-CoV-2 infection. She referred of being bedridden, without any cardiac monitor and of being asymptomatic for syncope. Thus, she was transferred to a Cardiology Unit dedicated to patients affected by SARS-CoV-2 disease, for further diagnostic investigations. This represents a case in which the remote monitoring technology resulted fundamental in the management of patients with implantable devices, in particular during COVID-19-related lockdown. However, it is at least as much important to encourage the patient to carry the transmitter with him, even in the case of unexpected events or hospitalizations, in order to gain access to all the information store in the CIED which might be useful to the diagnosis of the underlying disease. Biotronik has developed the smallest remote transmitter in commerce (CardioMessenger Smart) which is functional to this kind of use. Moreover, it has an automatic interrogation function which can send the alerts about the arrhythmic events quicker than the other brands and so it’s more practical in situations where the patient is hospitalized in non-cardiological units.
416 A very severe aortic stenosis secondary to radiation therapy for Hodgkin lymphoma: a case report
Authors: Carassia Claudia , Patti Giuseppe , Degiovanni Anna , Pastore Maria Concetta
Published: December 2021

Aims

Hodgkin lymphoma is a highly curable disease, with survival rates around 85% at 5 years, thanks to its treatment, mainly based on radiation therapy alone or in association with chemotherapy. However, radiation therapy carries the risk of long-term complications, mainly represented by secondary malignancies or cardiovascular diseases. Indeed, patients treated with radiation remain at increased risk of coronary artery disease, congestive heart failure, valve disease, pericardial disease and sudden death. In particular, radiation-induced valve disease has been reported in approximately 10% of treated patients, with the most common being aortic or mitral regurgitation, followed by aortic stenosis. We describe the case of a very severe aortic valve stenosis developed 35 years after radiotherapy for Hodgkin Lymphoma.

Methods

A 60-years-old woman with history of Hodgkin Lymphoma treated with radiotherapy 35 years ago, no cardiovascular risk factors, complained progressive fatigue and worsening dyspnoea. She was referred to our centre from a spoke centre for congestive heart failure caused by aortic stenosis. At her arrival, we performed a transthoracic echocardiography finding a very-severe aortic stenosis (mean gradient 97 mmHg, AVA 0.3 cm2), a moderate functional mitral regurgitation and an important hypertrophy suspected of infiltrative pattern. No coronary artery disease was found at coronary angiography. Furthermore, she underwent a cardiac magnetic resonance showing a moderate left ventricular dilatation and hypertrophy with areas of non-ischaemic late gadolinium enhancement, significant for myocardial fibrosis with no specific pattern of infiltration. She was treated with surgical aortic valve replacement with biological prosthesis (Inspiris Resilia 21) with good results at the discharge echocardiography.

Discussion

Cardiovascular toxicity is nowadays the most common non-malignancy cause of death in radio-treated cancer survivors. At the level of the valvular apparatus, radiation damage is expressed with fibrosis of the myocardium and of the valvular endothelium, leading to thickening and calcification especially of the left-sided valves. Radio-treated patients have a 50% cumulative incidence of cardiovascular diseases at 40 years after treatment, and a clinically-relevant valve disease is found in approximately 6% of radio-treated patients at 20 years.

Conclusions

Thus, an early identification of the disease in a subclinical state is crucial. Nevertheless, there is still no consensus on the timing and the modality of cardiovascular screening after radiation therapy. Moreover, an elevated cardiovascular risk profile was found to be directly related to cardiotoxicity; this underlines the importance of identification and aggressive treatment of cardiovascular risk factors. Radiation dose reduction and the use of shields may further reduce the incidence of late cardiovascular complications in these patients.
763 Feasibility and reliability of a comprehensive three-dimensional transesophageal echocardiography screening process for transcatheter mitral valve replacement
Authors: Piroli Francesco , Boccellino Antonio , Ingallina Giacomo , Rolando Marco , Melillo Francesco , Ancona Francesco , Stella Stefano , Biondi Federico , Denti Paolo , Castiglioni Alessandro , Agricola Eustachio
Published: December 2021

Aims

The planning of transcatheter mitral valve replacement (TMVR) requires cardiac imaging assessment to establish patient eligibility according to mitral valve anatomy, device characteristics and risk of left ventricular outflow tract (LVOT) obstruction. In this setting, computed tomography (CT) is considered the reference method. Although recent studies demonstrated that three-dimensional transesophageal echocardiographic (3D-TEE) assessment of mitral anatomy presents a good agreement compared to CT, its potential role in the TMVR planning has never been fully evaluated. To test feasibility and reliability of a comprehensive 3D-TEE screening in candidates for TMVR.

Methods

We performed a single-centre retrospective observational study including 59 consecutive patients referred to our centre for TMVR due to high surgical risk, who performed a pre procedural CT and 3D-TEE screening. The measurements of mitral annulus (MA), native LVOT and predicted Neo-LVOT, assessed with CT and 3D-TEE were collected in order to evaluate their concordance in the assessment of TMVR eligibility. The final suitability decision was given by the valve manufacturer based on CT measurements and then compared with the screening results obtained with 3D-TEE evaluation. 3D-TEE measurements were obtained with a post processing analysis using a novel automated software platform (3mensio Structural Heart 10.1 - 3mSH, Pie Medical Imaging, Bilthoven, Netherlands).

Results

Excellent correlation was found between 3D-TEE and CT measurements for MA area (r =0.85), antero-posterior diameters (r= 0.81), native LVOT (r=0.82) and Neo-LVOT areas (r=0.95) (all P-values <0.0001). Among 59 patients screened, 17 did not undergo the intervention because were found ineligible due to small predicted neo-LVOT, too small or too large MA area. Among the 42 patients with a successful screening, 32 underwent TMVR and all of them showed a correct implantation and no LVOT obstruction at post procedural echocardiographic evaluation. An almost perfect agreement among CT and 3D-TEE was found in assessing the eligibility for TMVR implantation (Cohen kappa 0.82, P<0.001). Interobserver and intraobserver agreements were found excellent for the parameters appraised with ICCs >0.80.

Conclusions

3D-TEE appraisements of MA dimensions, native LVOT and Neo-LVOT are feasible in patients candidate for TMVR, showing good correlations with CT measurements and high accuracy to predict TMVR screening success.
13 Isolated exercise-induced pulmonary hypertension is associated with clinical worsening and poor immunological control in HIV patients
Authors: Madonna Rosalinda , Fabiani Silvia , Morganti Riccardo , Forniti Arianna , Mazzola Matteo , Menichetti Francesco , De Caterina Raffaele
Published: December 2021

Aims

Exercise-induced pulmonary hypertension (Ex-PH) may represent the earliest sign of pulmonary arterial hypertension (PAH) in human immunodeficiency virus (HIV) patients. We investigated its association with clinical and immunological status, virologic control, and response to antiviral therapy.

Methods and results

In 32 consecutive HIV patients with either low (n = 29) or intermediate probability (n = 3) of PH at rest, we evaluated the association of isolated Ex-PH with: time to HIV diagnosis; CD4+ T-cell count; clinical progression to acquired immunodeficiency syndrome (AIDS); development of resistance to antiretroviral therapy (ART); HIV RNA levels; time to beginning of ART; current use of protease inhibitors; combination of ART with boosters (ritonavir or cobicistat); immuno-virologic response to ART; and ART discontinuation. Isolated Ex-PH at stress echocardiography (ESE) was defined as absence of PH at rest and systolic pulmonary arterial pressure (sPAP) >45 mmHg or a > 20 mmHg increase during low-intensity exercise cardiac output (<10 l/min). In our cohort, 22% (n = 7) of the enrolled population developed Ex-PH which was inversely related to CD4+ T-cell count (P = 0.047), time to HIV diagnosis (P = 0.014) and time to onset of ART (P = 0.041). Patients with Ex-PH had a worse functional class than patients without Ex-PH (P < 0.001). Ex-PH and AIDS showed a trend (P = 0.093) to a direct relationship. AIDS patients had a higher pulmonary vascular resistance compared to patients without Ex-PH (P = 0.020) at rest echocardiography.

Conclusions

The presence of isolated Ex-PH associates with a worse clinical status and poor immunological control in HIV patients. Assessment of Ex-PH by ESE may help identify subgroups of HIV patients with a propensity to develop subclinical impairment of pulmonary circulation following poor control of HIV infection.
810 Incidence and determinants of permanent pacemaker implantation after transcatheter aortic valve replacement
Authors: Bellantoni Antonio , Sorrentino Sabato , Boccuto Fabiola , Carabett Nicole , Giordano Salvatore , Cacia Michele Antonio , Polimeni Alberto , Leo Isabella , Varano Ylenia , Augusto Florinda Maria , Mongiardo Annalisa , De Rosa Salvatore , Indolfi Ciro , Spaccarotella Carmen
Published: December 2021

Aims

conduction disturbances requiring pacemaker implantation (PPM) are among the most common complications in patients undergoing transcatheter aortic valve replacement (TAVR). Introduction in clinical practice of a new generation of TAVR devices is contributing to a significant reduction in procedural complications. However, limited data is available regarding PPM implantation after TAVR with the latest available devices. Accordingly, in this analysis we aimed to investigate the incidence and risk factors for new permanent pacemaker implantation after TAVR according to the type and diameter of valve implanted.

Methods

Patients who underwent TAVR at our Institution from September 2008 to November 2020 were included in this analysis. Out of 407, 38 (9.3%) were excluded because they already presented a PPM/ICD, received only balloon angioplasty or for procedural unsuccess. The independent association between baseline clinical and procedural variables and the occurrence of PPM implantation was investigated with cross-sectional logistic regression analysis.

Results

Out of 368 TAVR procedures included in the final analysis, 89 (24.2%) required in-hospital PPM implantation. No differences were observed for age and common cardiovascular risk factors between groups. Among procedural variables, patients requiring PPM had lower left ventricular ejection fraction (LVEF) and experienced a longer intensive care unit stay. Valve types used were Corevalve n = 98 (26.6%) (first-generation devices), Evolute R, n = 191 (51.9%), Evolute Pro, n = 3 (1.1%), Portico n = 2 (0.5 %), or Sapien 3, n = 73 (19.8%) (second-generation devices). Clinical and procedural correlates of PPM implantation were depicted in Figure. Of note, compared to the first generation of self-expandable devices, the second generation is associated with a lower risk of PPM implantation, albeit non-significant for the subgroup of second generation self-expandable devices. Finally, valve diameter was also an independent predictor of PPM implantation

Conclusions

PPM was required in 24.2% of patients who underwent TAVR with first- and second-generation balloon or self-expandable valves. For instance, in our population, second-generation TAVR devices were associated with a lower risk of PPM implantation compared to the previous generation. However, further investigations are warranted to assess the impact of new implantation techniques and valve technology on such an important outcome.
816 UNA Diagnosi . . . Incidentale
Authors: Bava Annita , Nadia Aricò Concetta , Caridi Rocco , Rodà Filippo , Franzutti Claudio , Scappatura Giuseppe , Grillone Nadine , Rao Massimo
Published: December 2021

Hypertrophic cardiomyopathy (HCM) is the most frequent genetic disease of the myocardium, with a prevalence of 1:500 cases in the general population. The salient feature is a hypertrophy, symmetrical or not, of the walls of the left ventricle (mainly the septum, but also less typical locations, such as the apex or the infero-lateral wall), not linked to abnormal load conditions. HCM is mostly an autosomal dominant inherited disease with incomplete penetrance and variable expressivity, mainly linked to mutations in genes coding for sarcomeric proteins. Several studies have shown an up-regulation of the ACE-2 gene, perhaps indicative of a compensatory anti-hypertrophic and anti-fibrotic response of the myocardium, in hypertrophic cardiomyopathy. Being the ACE-2 receptor target of the Sars-CoV-2 virus, these patients may have an increased risk of infection and a worse outcome.

A 47-year-old man, with no known comorbidities, was hospitalized in our Emergency Medicine Department for bilateral Sars-CoV-2 pneumonia. Noninvasive mechanical ventilation c-PAP (FiO2 60%, PEEP 7.5 cmH20) was started for hypoxemic respiratory failure and an ECG showed diffuse ventricular repolarization abnormalities suggestive of left overload (asymmetric negative T waves V4 to V6, in I, II and aVL, flat in aVF. Figure 1), with a deep Q wave in III. The patient was asymptomatic for chest pain and equivalents and D-dimer and indices of myocardionecrosis were normal. Echocardiographic evaluation was performed, with evidence of marked asymmetric concentric hypertrophy of the left ventricle (interventricular septum: 16 mm), without significant anomalies in segmental kinetics, noteworthy valvulopathies and pericardial effusion. The family and personal medical history were negative for syncope, sudden cardiac death and resuscitated cardiac arrest and the estimated risk of sudden cardiac death at five years (HCM Risk-SCD) was <4% (1.33%). The diagnostic hypothesis of non-obstructive hypertrophic cardiomyopathy was advanced. During hospitalization, ECG monitoring showed no sustained ventricular arrhythmias and the patient remained asymptomatic for dyspnoea, chest pain and equivalents. Subsequent echocardiograms showed no new changes. A progressive weaning from oxygen support was carried out and, after thirty days, the patient was discharged to home fiduciary isolation, with optimal cardiological therapy and indication to study with cardiac magnetic resonance to the negativization of the nasal swab for Sars-CoV-2. MRI, performed about two months later, confirmed the suspicion of hypertrophic cardiomyopathy, with no signs of late enhancement in T1-weighted sequences (Figure 2). The patient was then referred to a genetic study and cardiological follow-up, still in progress. 816 Figure 1816 Figure 1
Deep Conservation of Histone Variants in Thermococcales Archaea
Authors: Stevens Kathryn M , Hocher Antoine , Warnecke Tobias
Published: December 2021

Histones are ubiquitous in eukaryotes where they assemble into nucleosomes, binding and wrapping DNA to form chromatin. One process to modify chromatin and regulate DNA accessibility is the replacement of histones in the nucleosome with paralogous variants. Histones are also present in archaea but whether and how histone variants contribute to the generation of different physiologically relevant chromatin states in these organisms remains largely unknown. Conservation of paralogs with distinct properties can provide prima facie evidence for defined functional roles. We recently revealed deep conservation of histone paralogs with different properties in the Methanobacteriales, but little is known experimentally about these histones. In contrast, the two histones of the model archaeon Thermococcus kodakarensis, HTkA and HTkB, have been examined in some depth, both in vitro and in vivo. HTkA and HTkB exhibit distinct DNA-binding behaviors and elicit unique transcriptional responses when deleted. Here, we consider the evolution of HTkA/B and their orthologs across the order Thermococcales. We find histones with signature HTkA- and HTkB-like properties to be present in almost all Thermococcales genomes. Phylogenetic analysis indicates the presence of one HTkA- and one HTkB-like histone in the ancestor of Thermococcales and long-term maintenance of these two paralogs throughout Thermococcales diversification. Our results support the notion that archaea and eukaryotes have convergently evolved histone variants that carry out distinct adaptive functions. Intriguingly, we also detect more highly diverged histone-fold proteins, related to those found in some bacteria, in several Thermococcales genomes. The functions of these bacteria-type histones remain unknown, but structural modeling suggests that they can form heterodimers with HTkA/B-like histones.
Rates of Protein Evolution across the Marsupial Phylogeny: Heterogeneity and Link to Life-History Traits
Authors: Luzuriaga-Neira Agusto R , Alvarez-Ponce David
Published: December 2021

Despite the importance of effective population size (Ne) in evolutionary and conservation biology, it remains unclear what factors have an impact on this quantity. The Nearly Neutral Theory of Molecular Evolution predicts a faster accumulation of deleterious mutations (and thus a higher dN/dS ratio) in populations with small Ne; thus, measuring dN/dS ratios in different groups/species can provide insight into their Ne. Here, we used an exome data set of 1,550 loci from 45 species of marsupials representing 18 of the 22 extant families, to estimate dN/dS ratios across the different branches and families of the marsupial phylogeny. We found a considerable heterogeneity in dN/dS ratios among families and species, which suggests significant differences in their Ne. Furthermore, our multivariate analyses of several life-history traits showed that dN/dS ratios (and thus Ne) are affected by body weight, body length, and weaning age.
Malleable monuments and comparative cultural property law: The Balbo monument between the United States and Italy
Authors: Caponigri Felicia
Published: December 2021

Still standing in situ today, the Balbo monument in Chicago has presented an especially monumental challenge for the Chicago community, including members of the Italian American community in Chicago. This article considers the laws which regulate cultural heritage in the separate territories of Italy and the United States, cultural property law and historic preservation law, respectively, in light of archival research on the behind-the-scenes maneuvers of the Balbo monument’s installation. In certain circumstances, historic property is not the same as cultural property, even though historic property and cultural property may at times overlap. Identity may more greatly inform one category over another through the law’s terminology, connections to place, and resulting historical connections. The central proposal of this article is that some monuments, as they are defined with reference to history under the law, seem so specific to certain histories and historical narratives that they might be meant to be, perhaps counterintuitively, malleable monuments. Despite their characterization as historic property or cultural property, malleable monuments should, can, and, at times, already do, proverbially bend to our shifting and evolving notions of identity as they are inevitably tied to our histories. In Italy, “malleable” may mean tangible monuments with changing symbolism and cultural significance; in the United States, “malleable” may mean embodied symbolism and cultural significance with the impermanence of tangible monuments. Permanence is not definitive of malleable monuments’ existence; rather, impermanence is. Recognizing the complexity of what it means to be Italian in America today through the Balbo monument, the article concludes, may mean accepting the Balbo monument as a malleable monument.
Physical Activity Levels in Hospitalized Adults With Burn Injuries
Authors: Plaza Anita , Adsett Julie , Byrnes Angela , McRae Prue
Published: December 2021

Physical activity behavior has not been previously described in hospitalized adults with burn injuries. This prospective, cross-sectional study used a standardized behavioral mapping protocol to observe patient behavior related to physical activity over a 12-hour period on one weekday in a quaternary referral specialist burn center. Structured observations were recorded for each of four domains: 1) patient location, 2) position, 3) activity performed, and 4) the presence of others. Observations were summarized across all participants as median (interquartile range [IQR]) proportion of time. Participants (n = 17) were predominantly male (82%) with a mean age of 44.3 (SD 15.2) years, a mean burn size of 34.9% (SD 26.7) TBSA, and a median hospital length of stay of 18 (IQR 6–49) days at time of observation. Participants spent a median of 83% (IQR 73–93) of time in their bedroom, 92% (IQR 68–97) of time in or on their bed and a median of 5% (IQR 3–13) of time mobilizing. Exercise accounted for 10% (IQR 8–17) of activity-related observations. A median of 68% (IQR 39–83) of time was spent alone. Results suggest time spent engaging in physical activity is low. Further studies are required to investigate motivators and barriers to performing physical activity in this population. This will consequently inform the development and implementation of appropriate strategies to improve physical activity behavior in this cohort.
Differential attenuation in star-forming galaxies at 0.3 ≲ z ≲ 1.5 in the SHARDS/CANDELS field
Authors: Rodríguez-Muñoz L , Rodighiero G , Pérez-González P G , Talia M , Baronchelli I , Morselli L , Renzini A , Puglisi A , Grazian A , Zanella A , Mancini C , Feltre A , Romano M , Vidal García A , Franceschini A , Alcalde Pampliega B , Cassata P , Costantin L , Domínguez Sánchez H , Espino-Briones N , Iani E , Koekemoer A , Lumbreras-Calle A , Rodríguez-Espinosa J M
Published: December 2021

We use a sample of 706 galaxies, selected as [O ii]λ3727 ([O ii]) emitters in the Survey for High-z Absorption Red and Dead Sources (SHARDS) on the CANDELS/GOODS-N field, to study the differential attenuation of the nebular emission with respect to the stellar continuum. The sample includes only galaxies with a counterpart in the infrared and log10(M*/M⊙) > 9, over the redshift interval 0.3 ≲ z ≲ 1.5. Our methodology consists in the comparison of the star formation rates inferred from [O ii] and  Hα emission lines with a robust quantification of the total star-forming activity (SFR TOT) that is independently estimated based on both infrared and ultraviolet (UV) luminosities. We obtain $f\, =\, E(B-V)_{\mathrm{stellar}}$/E(B − V)nebular = 0.69$^{0.71}_{0.69}$ and 0.55$^{0.56}_{0.53}$ for [O ii] and  Hα, respectively. Our resulting f-factors display a significant positive correlation with the UV attenuation and shallower or not-significant trends with the stellar mass, the SFRTOT, the distance to the main sequence, and the redshift. Finally, our results favour an average nebular attenuation curve similar in shape to the typical dust curve of local starbursts.
Theoretical analysis on pulsar timing of a millisecond pulsar around a binary black hole
Authors: Wu Xiao-Jun , Yuan Ye-Fei , Kumar Rajiv , Luo Yan
Published: December 2021

The merging binary black holes (BBHs) have been detected by the ground gravitational-wave observatories, but it is very difficult to detect BBHs before their mergers. Since millisecond pulsars (MSPs) are remarkable precise ‘clocks’ in Universe, they could be used to detect the hidden BBHs, if they exist in systems of BBHs. Doing so, we construct a triple system which consists of a BBH and a third outer MSP. The theoretical studies have shown that the inner binary could cause additional time residuals (i.e. R$\ddot{o}$mer delay) on the orbit of the outer MSP, which can be used to detect inner BBHs. Using N-body simulations, in this paper, we calculate such time residuals, and analyse the periodic signals of them by Fast Fourier Transform, which allow us to explore the effects of the parameters of the inner BBHs. Specifically, we assume that the triple system is coplanar and stable; the distance from the earth is ∼1 kpc; the mass of each black hole is $10\, {\rm M}_\odot$. We find that the amplitude of the time residual increases with the semimajor axis and eccentricity of the inner BBH. Moreover, we find that there are several prominent and characteristic periodic signals for different parameters of the inner BBHs. With the help of the analytic results, we find these frequencies are due to different orders of the eccentricities of both the inner and outer binaries. Thus, in principle, we can use these frequencies to determine the parameters of the inner BBHs.
Dynamic queuosine changes in tRNA couple nutrient levels to codon choice in Trypanosoma brucei
Authors: Dixit Sameer , Kessler Alan C , Henderson Jeremy , Pan Xiaobei , Zhao Ruoxia , D’Almeida Gabriel Silveira , Kulkarni Sneha , Rubio Mary Anne T , Hegedűsová Eva , Ross Robert L , Limbach Patrick A , Green Brian D , Paris Zdeněk , Alfonzo Juan D
Published: December 2021

Every type of nucleic acid in cells undergoes programmed chemical post-transcriptional modification. Generally, modification enzymes use substrates derived from intracellular metabolism, one exception is queuine (q)/queuosine (Q), which eukaryotes obtain from their environment; made by bacteria and ultimately taken into eukaryotic cells via currently unknown transport systems. Here, we use a combination of molecular, cell biology and biophysical approaches to show that in Trypanosoma brucei tRNA Q levels change dynamically in response to concentration variations of a sub-set of amino acids in the growth media. Most significant were variations in tyrosine, which at low levels lead to increased Q content for all the natural tRNAs substrates of tRNA-guanine transglycosylase (TGT). Such increase results from longer nuclear dwell time aided by retrograde transport following cytoplasmic splicing. In turn high tyrosine levels lead to rapid decrease in Q content. Importantly, the dynamic changes in Q content of tRNAs have negligible effects on global translation or growth rate but, at least, in the case of tRNATyr it affected codon choice. These observations have implications for the occurrence of other tunable modifications important for ‘normal’ growth, while connecting the intracellular localization of modification enzymes, metabolites and tRNAs to codon selection and implicitly translational output.
A Machine Learning Approach to Identify Predictors of Frequent Vaping and Vulnerable Californian Youth Subgroups
Authors: Fu Rui , Shi Jiamin , Chaiton Michael , Leventhal Adam M , Unger Jennifer B , Barrington-Trimis Jessica L
Published: December 2021

Introduction

Machine learning presents a unique opportunity to improve electronic cigarette (vaping) monitoring in youth. Here we built a random forest model to predict frequent vaping status among Californian youth and to identify contributing factors and vulnerable populations.

Methods

In this prospective cohort study, 1281 ever-vaping twelfth-grade students from metropolitan Los Angeles were surveyed in Fall and in 6-month in Spring. Frequent vaping was measured at the 6-month follow-up as nicotine-containing vaping on 20 or more days in past 30 days. Predictors (n = 131) encompassed sociodemographic characteristics, substance use and perceptions, health status, and characteristics of the household, school, and neighborhood. A random forest was developed to identify the top ten predictors of frequent vaping and interactions by sociodemographic variables.

Results

Forty participants (3.1%) reported frequent vaping at the follow-up. The random forest outperformed a logistic regression model in prediction (C-Index = 0.87 vs. 0.77). Higher past-month nicotine concentration in vape, more daily vaping sessions, and greater nicotine dependence were the top three of the ten most important predictors of frequent vaping. Interactions were found between age and perceived discrimination, and between age and race/ethnicity, as those who were younger than their classmates and either reported experiencing discrimination frequently or identified as Asian or Native American/Pacific Islander were at increased risk of becoming frequent vapers.

Conclusions

Machine learning can produce models that accurately predict progression of vaping behaviors among youth. The potential association between frequent vaping and perceived discrimination warrants more in-depth analyses to confirm if discrimination constitutes a cause of increased vaping.

Implications

This study demonstrates the utility of machine learning in predicting status of frequent vaping over 6 months and understanding predictors and nuanced intersectionality by sociodemographic attributes. The high performance of the random forest model has practical implications for a personalized risk calculator that supports vaping prevention program. Public health officials need to recognize the importance of social factors that contribute to frequent vaping, particularly perceived discrimination. Youth subpopulations, including younger high school students and Asians or Native Americans/Pacific Islanders, might require specially designed interventions to help prevent habit-forming in vaping.
Product Life Cycles in Corporate Finance
Authors: Hoberg Gerard , Maksimovic Vojislav
Published: December 2021

We develop a novel 10-K text-based model of product life cycles and examine firm investment policies. Conditioning on the life cycle substantially improves the power of q to explain investment and reveals a natural ordering of investments over the life cycle. While R&D and CAPX sensitivity are high early in the cycle, acquisitions arise as products mature, and divestitures and product extension investments arise as products decline. q-sensitivities that condition on the life cycle can vary by as much as 400% from traditional sensitivities. The life cycle framework further reveals an enriched relationship between competition, investment, and corporate profits.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Coresidence and Well-Being among Adult Child Caregivers in Urban China: Impacts of the Domain-Specific Caregiver Burden
Authors: Mao Weiyu , Lou Vivian W Q , Li Mengting , Chi Iris
Published: December 2021

This study investigated the relationship between coresidence and the well-being of adult child caregivers and examined the domain-specific caregiver burden as the cognitive appraisal pathway in such a relationship in the context of urban China. Data on adult child caregivers (N = 334) came from a regionally representative study using the Family Caregivers for the Frail and Very Elderly survey in 2010, in Shanghai, China. Multistage random sampling was used to collect data. The 24-item Chinese version of the Caregiver Burden Inventory was used to assess five domains of caregiver burden: time dependence, developmental, physical, social, and emotional. Well-being outcomes included depressive symptoms and self-rated health. Path analyses were used to estimate direct and indirect effects on caregiver well-being outcomes. Social burden was found to mediate the relationship between coresidence and caregiver well-being outcomes. Through the intermediary pathway of domain-specific cognitive appraisal, particularly caregiver social burden, coresidence with the care recipient exerts negative influences on caregiver well-being. Healthcare professionals, such as social workers providing support and services to caregivers, should understand the importance of assessing domain-specific burden and incorporate tailored intervention strategies to prevent or reduce social burden, especially among coresident adult child caregivers.
A Longitudinal Examination of the Relationship between Religious Service Attendance and Young Adult Substance Use
Authors: Wu Shiyou , Hodge David R , Wu Qi , Marsiglia Flavio F , Chen Weitao
Published: December 2021

Young adulthood is a time of increased substance use. To better understand the effects of potential protective factors, this study explores the relationship between four types of religious service attendance during emerging adulthood and six measures of young adult substance use. Study data were abstracted from waves I (time 1 [T1]) and IV (time 2 [T2]) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) surveys (N = 14,800). Logistic regression was conducted to calculate the odds of using each substance with the results weighted to produce nationally representative estimates. Analysis revealed that service attendance was generally associated with a lower likelihood of lifetime and recent use across all measures examined at T2. Relative to the reference group (nonattenders at T1 and T2), the protective effects were largest for the consistent attendance group (attenders at T1 and T2), followed by the adult attendance group (nonattenders at T1, attenders at T2), and then the childhood attendance group (attenders at T1, nonattenders at T2). The results suggest that diverse attendance types may exert a protective influence on adult substance use. Practitioners might explore attendance options in clinical settings in a client-centered manner.
Piedmont and X-Trusts: ‘what are protectors for?’
Authors: Renouf Mark , Flavin Marcus
Published: December 2021

The authors consider the contrasting approaches of the Royal Court of Jersey and the Supreme Court of Bermuda in construing the proper ambit of protector’s powers to veto or consent to a proposed distribution. In the Piedmont and Riviera case, the Royal Court adopted a wider view of the proper role of the protectors, with a duty to take their own view on the substantive proposals, while in Bermuda, at almost exactly the same time, the Supreme Court, considering very similar powers, took the view that the role of protectors when making decisions of this kind was more akin to that of the court on a blessing application, focussed on the Trustee’s decision-making process, and limited to a ‘watchdog’ role.
Analyses of Wheat Yellow Rust Populations Reveal Sexual Recombination and Seasonal Migration Pattern of Puccinia striiformis f. sp. tritici in Gangu, Northwestern China
Authors: Huang Miaomiao , Liu Taiguo , Cao Shiqin , Yuen Jonathan , Zhan Jiasui , Jia Qiuzhen , Gao Li , Liu Bo , Chen Wanquan , Berlin Anna
Published: December 2021

Puccinia striiformis f. sp. tritici is the causal agent of wheat yellow rust with records of regular and severe epidemics in China. This study explored the population dynamics of the yellow rust pathogen in Gangu, northwestern China. In Gangu, the Weihe River runs from west to east and divides Gangu into three regions: North and South mountain, with the valley in between. To study the genetic structure of the pathogen in local populations, samples were collected over 3 years from the three regions at different altitudes both within and between the wheat cropping seasons. A total of 811 P. striiformis f. sp. tritici isolates were successfully genotyped using 16 simple sequence repeat markers. The results suggest that P. striiformis f. sp. tritici can survive year-round in Gangu. The P. striiformis f. sp. tritici populations migrated among the regions, and the migration pattern was not related to altitude. The oversummering populations in the North and South mountain regions were genetically different from each other; and the P. striiformis f. sp. tritici populations collected from the lower altitude in the valley had no relationship with any of the populations collected in the spring or fall, indicating that they too have a different origin. Signatures of random mating were found in the populations collected in both North and South mountain regions, but not in the valley populations.
Nursing considerations for transgender men
Authors: Guelbert Christopher
Published: December 2021

Caring for transgender men requires adequate knowledge about gender transitioning. This article discusses surgical procedures, hormonal therapy, and other nursing actions related to transgender patients' physical and psychological health, privacy, and health promotion.
Preoperative evaluation of geriatric patients undergoing liver transplantation
Authors: Akhtar Shamsuddin
Published: December 2021

Purpose of review

As the population of the world is aging the number of geriatric patients undergoing liver transplantation (LT) is also increasing. They pose a unique challenge for the caregivers, as they have age-related physiological changes, multiple comorbidities and cirrhosis-related pathologies.

Recent findings

Twenty-two percent of patients who undergo LT are older than 65 years. Many patients suffer from nonalcoholic steatohepatitis (NASH), hepatocellular carcinoma and hepatitis-C virus. Incidence of NASH tends to increase with age, obesity, diabetes and metabolic syndrome. Elderly patients require comprehensive cognitive, cardiac and pulmonary evaluation prior to LT. Cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension and frailty are of specific concern.

Proportion of elderly patients who are undergoing LT continues to increase. These patients require comprehensive cardiopulmonary and frailty evaluation. Consensus-based practice advisories need to be developed to standardize preoperative evaluation of geriatric patients awaiting LT.