bluuebunny/crossref_metadata_2025 huggingface dataset:
Major Adverse Cardiovascular Events Following Coronary Artery Stenting by History of Hypertensive Disorder of Pregnancy
Authors: Gunnarsson Omar Sigurvin , Pihlsgård Mats , Handmark Moa , Sarno Giovanna , Gonçalves Isabel , Timpka Simon
Published: October 2024

Background

A history of hypertensive disorders of pregnancy is associated with at least twice the risk of incident ischemic heart disease. Whether the long‐term outcome following treatment with coronary artery stenting is associated to the history of hypertensive disorders of pregnancy is unknown.

Methods and Results

We included 8364 women (age ≤65 years) undergoing first coronary artery stenting 2006 to 2022 following their first delivery in 1973 or later, linking nationwide data on percutaneous coronary intervention and delivery history. In total, 1122 women (13.4%) had a history of hypertensive disorders of pregnancy. The main outcome, a major adverse cardiovascular event, was defined as any incident myocardial infarction, ischemic heart disease, cardiac arrest, arrhythmias, angina pectoris, heart failure, cerebral infarction, or sudden death. During a median follow‐up time of 5 years, 258 women with a history of hypertensive disorders of pregnancy had a major adverse cardiovascular event, compared with 1465 women without a history of hypertensive disorders of pregnancy (23% versus 20.2%,
P
=0.028 for log‐rank test). Estimates adjusted for patient‐ and procedural characteristics in proportional hazards regression models suggested that the hazard rate increased only after 4–8 years of follow‐up (hazard ratio [HR], 1.36 [95% CI, 1.05–1.78]) and was primarily driven by women with history of gestational hypertension (HR, 2.15 [95% CI, 1.49–3.11]).

Conclusions

Women with a history of hypertensive disorders of pregnancy have an increased risk of a major adverse cardiovascular event following coronary artery stenting compared with other parous women. A history of hypertensive disorders of pregnancy warrants further attention in the secondary prevention setting of coronary artery disease.
Discernment of Holiness and Holy Persons
Authors: Kazarian Nicolas
Published: October 2024

In this essay, the author discusses some of the key aspects of the Eastern Orthodox understanding of holiness and holy persons. He highlights humanity’s vocation and destiny in theosis, Orthodox hagiology and the process of canonization, as well as iconography’s role in the discernment of holiness and holy persons.
A convenient and versatile culturomics platform to expand the human gut culturome of Lachnospiraceae and Oscillospiraceae
Authors: Plomp N. , Liu L. , Walters L. , Bus-Spoor C. , Khan M.T. , Sheridan P.O. , Veloo A.C.M. , Walker A.W. , Harmsen H.J.M. , Tsompanidou E.
Published: October 2024

The human gut microbiota is increasingly being recognised to play an important role in maintaining health. The families Lachnospiraceae and Oscillospiraceae in particular, are often reduced in disease states but are relatively poorly represented in culture collections. Cultured representatives are required to investigate the physiology and host interactions of gut microbes. Establishing cultured isolate collections can be laborious and expensive owing to the fastidious growth requirements of these organisms and the costs associated with taxonomic classification. This study proposes a culturomics platform combining a single basal culture medium with matrix-assisted laser adsorption/ionisation coupled to time-of-flight mass spectrometry (MALDI-TOF MS) for fast and reliable isolation and identification of hundreds of novel isolates. In this study, basal YCFA medium supplemented with either glucose, apple pectin, or porcine mucin was used to cultivate a total of 724 different isolates derived from only 11 different faecal samples from healthy volunteers, of which 389 isolates belonged to the Lachnospiraceae and Oscillospiraceae families. Moreover, 27 isolates could not be assigned to known species based on their 16S rRNA gene, 17 of which may even represent novel genera. To aid MALDI-TOF MS identification of gut bacteria, the commercial database was complemented with the MaldiGut database presented here, containing a collection of 132 different Main Spectrum Profiles, including the profiles of 125 Firmicutes species, 3 Bacteroidetes species, 3 Actinobacteria species, and one Verrucomicrobia species. The culturomics platform and MaldiGut database presented here will enable further expansion of the gut culturome, especially within the understudied Lachnospiraceae and Oscillospiraceae families.
Incidence and Outcomes of Pregnant Trauma Patients With Positive Urine Toxicology: A Southern California Multicenter Study
Authors: Clark Isabel , Nahmias Jeffry , Jebbia Mallory , Aryan Negaar , Lucas Alexa N. , Fierro Nicole , Dhillon Navpreet K. , Ley Eric J. , Smith Jennifer , Burruss Sigrid , Dahan Alden , Johnson Arianne , Ganske William , Biffl Walter L. , Bayat Dunya , Castelo Matthew , Wintz Diane , Schaffer Kathryn B. , Zheng Dennis J. , Tillou Areti , Coimbra Raul , Tuli Rahul , Santorelli Jarrett E. , Emigh Brent , Schellenberg Morgan , Inaba Kenji , Duncan Thomas K. , Diaz Graal , Tay-Lasso Erika , Zezoff Danielle C. , Grigorian Areg
Published: October 2024

Background: The use of illicit substances during pregnancy has increased 4-fold in the past two decades, negatively impacting both mother and fetus. The rate and clinical outcomes of substance use in pregnant trauma patients (PTPs) are not well studied. We sought to evaluate clinical outcomes of PTPs with positive urine toxicology, hypothesizing a higher rate of in-hospital maternal complications for PTPs with a positive urine toxicology ((+)Utox) compared to those testing negative ((−)Utox). Methods: PTPs (≥18 years old) were included in this multicenter retrospective study between 2016 and 2021. We included patients with known urine toxicology results and compared (+)Utox vs (−)Utox PTPs. Results: From 852 PTPs, 84 (9.8%) had a (+)Utox with the most common illicit substance being THC (57%) followed by methamphetamine (44%). (+)Utox PTPs had higher rates of blunt head injury (9.5% vs 4.2%, P = .028), extremity injury (14.3% vs 6.5%, P = .009), domestic violence (21.4% vs 5.9%, P < .001), suicide attempt (3.6% vs 0.3%, P < .001), and uterine contractions (46% vs 23.5%, P < .001). Abnormal fetal heart tracing, premature rupture of membranes and placental injury were similar between groups (all P > .05). The rate of maternal complications was similar in both groups (all P > .05). Conclusion: In this study, the rate of (+)Utox in PTPs was 9.8%. The (+)Utox group had similar rates of maternal complications but more commonly experienced uterine contractions which may be related to the physiology of drugs such as methamphetamines. PTPs with (+)Utox also more commonly were victims of domestic violence and suicide attempt, which merits further prevention research efforts.
The Federal Trade Commission’s Antitrust Lawsuit Against the Proposed Microsoft/Activision Merger: Déjà Vu with a Surprise Ending
Authors: Glass Victor , Tardiff Timothy
Published: October 2024

In 2018, the United States Department of Justice filed an antitrust lawsuit against the $80–100 billion merger between AT&T (a major cable provider) and Time Warner (a major content provider). The government predicted that the merged company would foreclose content to competitors, raise content prices, and slow innovation. The government lost the case because the court did not accept its theory that the merged company would enjoy increased bargaining leverage that would disadvantage competitors by offering the merged company’s content at increased consumer prices. In 2022, the Federal Trade Commission (FTC) offered a similar rationale in seeking to block the Microsoft/Activision Blizzard’s $68.7 billion merger. This paper compares and contrasts the two mergers, as well as three vertical merger cases that occurred around the same time of the closing of Microsoft/Activision, with the intent of highlighting the issues with assessing vertical mergers, with particular focus on online industries.
“They Are Taking the Sea from us” - Maritime Extractivism, Dispossession and Resistance in Rural and Ethnic Communities of the Colombian Caribbean
Authors: Márquez Pérez Ana Isabel
Published: October 2024

This article provides an overview of the impacts of the current Colombian extractivist development model on peasant, Afro-descendant, and Indigenous communities’ territorial seas ( maritorium) in the Colombian Caribbean. We reflect on the implications of a gradual penetration of concepts such as the blue economy in national public policy. The impacts of activities such as port infrastructure, oil drilling and mining, tourism and industrial fishing, are briefly analyzed, using examples gathered in different parts of the region where growing dispossession is evident. The article ends with a reflection on the various forms of resistance employed by these communities today to confront the plundering of their living spaces associated with coastlines and the sea.
Nonlinear model predictive dynamic positioning of a remotely operated vehicle with wave disturbance preview
Authors: Walker Kyle L. , Jordan Laura-Beth , Giorgio-Serchi Francesco
Published: October 2024

Exploiting preview information of disturbances within robot control is an effective method of handling state perturbations. For underwater vehicles operating in wave-dominated environments, disturbances significantly influence vehicle response and pose a threat to operational safety. In consideration of this, a complete end-to-end control architecture is developed in this work for disturbance rejection during station keeping tasks under wave perturbations, encompassing a nonlinear model predictive controller (NMPC) combined with a deterministic sea wave predictor (DSWP). The wave predictor exploits a continuous measurement of the wave elevation at a location upstream of the vehicle to form a forecast of the temporal evolution of the wave elevation at the vehicle location. The predicted wave parameters are then used to estimate the impending wave-induced hydrodynamic loading, enabling explicit consideration of accurate short-term disturbance forecasts within the controller, ensuring this preview is incorporated in the optimised control sequence. Experimental testing confirms the validity of the wave predictor, producing RMSE as low as 0.017 m. The proposed strategy is then simulated under various wave conditions, optimising control actions inclusive of the preview information. The NMPC outperforms a similar disturbance mitigating feed-forward controller, with average improvements of up to 52% and is found to perform best even with noisy, lower accuracy wave predictions, as well as with communication time delays, providing a high degree of robustness. This demonstrates the potential of the proposed control framework to effectively tackle disturbance mitigation of underwater vehicles subject to large magnitude wave disturbances, expanding the operational envelop of autonomous systems towards forbidding ocean environments.
Mapping the psoriasis research landscape: A comprehensive bibliometric analysis from 2012-2023
Authors: Garg Sneha , Chawla Muskan , Dixit Muskan , Sharma Arushal , Singh Manjinder , Singh Varinder , Ahmad Sheikh F , Attia Sabry M
Published: October 2024

An extensive investigation explores the complex terrain of psoriasis, a persistent inflammatory dermatological disorder that impacts between 1% and 3% of the worldwide populace. Acknowledging the intricate interplay between environmental, genetic, and immunological influences on the etiology of psoriasis, the study utilizes sophisticated bibliometric techniques to investigate patterns, gaps in knowledge, and emergent trends within the field. The study utilizes advanced bibliometric techniques to analyze patterns, gaps in knowledge, and emerging trends in the field while acknowledging the intricate interplay between environmental, genetic, and immune-related influences on the etiology of psoriasis. An examination of 18,765 documents from December 2012 to December 2023 was conducted using machine learning techniques and the Scopus database. The explanation for conducting analysis is rooted in its capacity to provide significant perspectives on the dynamic progression of psoriasis research. The study facilitates the identification of significant subject areas, exposes patterns in publication trends, emphasizes influential authors and journals, and outlines the worldwide contributions to the field. The study demonstrates a steady and progressive increase in publications, with significant contributions from the Journal of the American Academy of Dermatology, the British Journal of Dermatology, and the Journal of the European Academy of Dermatology and Venereology. Prominent scholars in research output, such as the United States, China, and Germany, as well as authors including Feldman, Wu, Griffiths, Puig, and Reich K., are identified. Biochemistry, genetics, and molecular biology come to the forefront as esteemed fields that make substantial contributions to the study of psoriasis alongside medicine. This research highlights the interdisciplinary aspects of psoriasis by uncovering knowledge hubs and international collaborations between authors and organizations. The findings highlight the global reach of research on psoriasis and the importance of international cooperation.
Plasma long non-coding RNAs as biomarkers for bone marrow infiltration and stage in diffuse large B-cell lymphoma
Authors: Abdelhafiz Ahmed Samir , Nabil Reem , Ghareeb Mohammed , Ibraheem Dalia , Ali Asmaa , Elshazly Samar S. , Soliman Asmaa Mohamed , Bakr Yasser M
Published: October 2024

We aimed to evaluate the expression profiles of five circulating lncRNAs (HOTAIR, MALAT-1, XIST, SNHG15, and H19) in DLBCL patients and explore potential associations between their expression and different clinicopathological features. Diffuse large B-cell lymphoma (DLBCL), the most common non-Hodgkin lymphoma (NHL), exhibits marked genetic and clinical heterogeneity, emphasizing the need for improved tools for risk stratification. Long non-coding RNAs (lncRNAs) emerged as regulators in different cellular processes and have been linked to cancer pathogenesis. Real-time quantitative PCR (qRT-PCR) was used to evaluate lncRNA expression in the plasma of 65 newly diagnosed adult DLBCL patients and 30 age-matched controls. HOTAIR expression was significantly elevated in DLBCL patients, while SNHG15 was significantly downregulated. Interestingly, both HOTAIR and SNHG15 demonstrated robust discriminatory power between DLBCL and healthy individuals, achieving area under the curve (AUC) values of 69% and 71%, respectively. H19 expression displayed a significant association with early-stage (stage I) DLBCL. While upregulated HOTAIR was a significant independent predictor of poor prognosis, high SNHG15 expression appeared to have a protective effect on mortality rates. Our findings suggest that circulating lncRNA expression patterns are promising tools as non-invasive biomarkers for diagnosis of DLBCL. Specific lncRNAs, such as HOTAIR, SNHG15, and H19, could offer potential for disease staging and patient prognosis. Long-term follow-up studies are recommended to further elucidate the interplay between these lncRNAs and survival rates, as well as their interactions with other genetic and pathological features of DLBCL.
Optimization of drilling parameters to minimize delamination in (PEKK/CFRP) thermoplastic polymer matrix composites for aerospace applications
Authors: İlhan Çağrı , Çavuş Yafes , Katmer Şükran , Şeker Ulvi
Published: October 2024

Composite materials have revolutionized the aerospace industry since their inception in the late 1980s, with advanced composites now comprising a substantial portion of modern airframes. This paper investigates the intricate relationship between drilling parameters and delamination in polymer matrix composites, focusing on the optimization of cutting speed and feed rate to minimize damage during drilling operations. Utilizing thermoplastic matrix composite, experiments were conducted to analyze the force, momentum, and delamination factors associated with varying drilling parameters. Through statistical analysis and regression modeling, the developed delamination factor equation demonstrates strong correlation and compatibility with measured data, with an average error of 1.2%. This robust framework offers practical strategies for optimizing drilling operations and improving composite performance, contributing to the ongoing advancement of aerospace technology. This research contributes to the advancement of aerospace technology by addressing a critical aspect of composite manufacturing for thermoplastic matrices, complementing existing knowledge on thermoset composites.
Between misfortune and misery, the Creole and the French language
Authors: Casimir Jean
Published: October 2024

The essays of Deborah Jenson and Chelsea Stieber point the way forward: a closer relationship amongst colleagues in the region, a deep analysis of the foundations that define us and our own way of progressing, as well as a careful look at the structures of national communities and their way of distancing themselves from this relatively hostile global universe. They retain the importance of the local language in getting closer to lived reality.
Health Insurance for Universal Health  Coverage in India
Authors: Datta Shreyasee , Bagli Supravat
Published: October 2024

The role of health insurance in expanding Universal Health Coverage is to ease the access to healthcare services and reduce the risk of unexpected health expenditure burden. In order to examine this role, this article assesses the contribution of enrolment in health insurance on the utilisation of healthcare services and out-of-pocket expenditure for working-age Indians. Investigation into these two issues, addressing the self-selection/endogeneity problem in buying health insurance, is uncommon in the literature. Against this end, the probability of utilising healthcare services and the incurred out-of-pocket expenditure has been estimated using National Sample Survey (2017–2018) data in India. Empirical findings reveal evidence of endogeneity in health insurance enrolment for hospitalisation, which indicates the presence of self-selection in health insurance enrolment. Addressing the endogeneity problem, this study has found a higher probability of utilising hospitalisation and lower out-of-pocket expenditure among insured individuals than others. Socio-economic and demographic variables like household income, education, gender, religion and state of residence are important to determine the utilisation of healthcare facilities. On the other hand, while out-of-pocket expenditure incurred for hospitalisation significantly varies with age, gender, social caste, religion, working status, state of residence, nature of ailment and type of hospital, household income and health status have no significant effect on out-of-pocket expenditure. Poor people are less likely to be hospitalised, and compared to males, females have a higher probability of utilising healthcare services at their reproductive age. State-level health policies and health insurance schemes play a crucial role in determining health insurance participation and utilisation of health services.

JEL: C13, C21, C25, I10, I11, I13, I14, I18
Economic Openness and the Behaviour of Great Ratios in G20 Countries
Authors: Arjun  , Mishra Bibhuti Ranjan , Aneja Ranjan
Published: October 2024

Most of the macroeconomic models suggest that great ratios of economics should be stable in the long term. Keeping the theoretical consequences in mind, the present study investigates the order of integration of two great ratios, viz. consumption–output and investment–output ratios. The study employs both mean shift and trend shift unit root tests with a structural break to examine the stationarity property of great ratios. This article attempts to analyse the relationship between economic openness and the behaviour of great ratios. Results of the study indicate a balanced growth path for 10 out of 18 G20 countries considered in our analysis. Findings show that countries that have a deficit trade balance with surplus foreign direct investment are more likely to demonstrate a balanced growth path. The multivariate analysis shows evidence in support of the balanced growth hypothesis in 13 of the 18 G20 countries. Of the 18 countries analysed, 8 internationally open and 6 financially open countries provide support for the balanced growth path.

JEL: C20, E20, O50
Contextual Factors Predictive of Social-Emotional Functioning Among Children of Mothers With and Without Low Intellectual Functioning
Authors: Ang Janine , Zeitlin Wendy , Augsberger Astraea
Published: October 2024

This study used Future of Families Child and Wellbeing Study data to examine community, family, and maternal predictors of social-emotional outcomes for kindergarten-aged children of mothers with and without low intellectual functioning. Multivariate analysis of variance and multivariate regression explored relationships between maternal intellectual functioning, covariates, and outcomes. As poverty was an important covariate, predictive of outcomes, marginal analysis was used to understand the interaction between poverty and intellectual functioning on each of the outcomes. Children whose mothers had low intellectual functioning had poorer outcomes than their peers regarding positive, anxious/depressed, and withdrawn behaviors regardless of poverty level. This research supports prioritizing these children for early social-emotional education as they enter elementary school, as well as prioritizing their families for supportive interventions in community-based settings.
Simultaneous Endovascular Aortic Repair Expands Transcatheter Aortic Valve Replacement Eligibility to Patients With Hostile Aortic Pathology
Authors: Lu Jeffrey , Zambetti Benjamin , Plant Joshua , Gupta Anuj , Nagarsheth Khanjan , Toursavadkohi Shahab
Published: October 2024

Background

In recent years, Transcatheter Aortic Valve Replacement (TAVR) has become a primary modality of therapy in moderate-high risk patients with symptomatic aortic stenosis. Although clinicians remain vigilant about screening for both aortic stenosis, many patients still, nevertheless, often present only when they are symptomatic. Unfortunately, when isolated TAVR is performed in the context of hostile aortic pathology, it has been reported that patients suffer from higher rates of complications such as rupture, dissection, or death post-operatively.

Objectives

To explore the utility of a simultaneous TAVR and endovascular aortic repair in addressing symptomatic aortic stenosis in challenging patients with hostile aortic pathology.

Methods

Retrospective case series within a tertiary care hospital between May 2017 and December 2023.

Results

A total of 11 patients underwent simultaneous endovascular aortic repair and TAVR. TAVR was performed first in 9/11 (82%) of the procedures while endovascular aortic repair was performed first in 2/11 procedures (18%). The median age was 84 years old (IQR = 77-86 years old). The median LOS was 3 days (IQR = 2-10 days). The median procedure time was 155 minutes (IQR = 111-202 minutes) and the median contrast amount was 100 CC (IQR = 65-139 CC). 2 patients (18%) experienced post-operative complications. Both of these patients required re-intervention. This cohort of patients did not experience any mortality at 30 days related to pertinent complications or adverse MACE events. All patients were transferred to the PACU and ultimately discharged home.

Conclusions

Extending TAVR eligibility to high-risk patients with hostile aortic pathology through the implementation of simultaneous endovascular aortic repair, performed via the same access site, is an effective strategy for management of symptomatic aortic stenosis in the context of extensive cardiovascular co-morbidities.
Cardiovascular, autonomic symptoms and quality of life in children with hypermobile Ehlers–Danlos syndrome
Authors: Hertel Amanda K , Black William R , Lytch Ashley , Cramer Emily , Malloy Walton Lindsey , Jones Jordan T
Published: October 2024

Objectives:

Hypermobile Ehlers–Danlos syndrome is a connective tissue disorder characterized by joint hypermobility and other systemic manifestations. Cardiovascular, autonomic symptoms and dysautonomia are frequently reported in adults with hypermobile Ehlers–Danlos syndrome and have been shown to have a negative impact on quality of life. However, there is scant literature on autonomic symptoms in pediatric patients with hypermobile Ehlers–Danlos syndrome. This study aims to characterize cardiovascular symptoms and diagnoses in pediatric patients with hypermobile Ehlers–Danlos syndrome and evaluate the impact of autonomic symptoms on quality of life.

Methods:

As part of a longitudinal study, a consecutive sample of 70 patients with Ehlers–Danlos syndromes were recruited at routine clinical care visits. Medical history was reviewed, demographics were obtained, and patient-reported outcomes were completed by the patients.

Results:

The average age of 70 patients was 15.8 years, and the majority were females (89%) and Caucasian (89%). The most common cardiovascular diagnoses were orthostatic intolerance (59%), dysautonomia (47%), and postural orthostatic tachycardia syndrome (21%). Most patients had an echocardiogram (77%), that was normal (82%). No patients had mitral valve prolapse, and only one patient had mild aortic root dilation (2%). Patient-reported outcomes revealed decreased quality of life associated with autonomic symptoms.

Conclusions:

This study shows that most children with hypermobile Ehlers–Danlos syndrome have cardiovascular and autonomic symptoms, which have a negative impact on quality of life. Few patients with hypermobile Ehlers–Danlos syndrome have structural abnormalities on echocardiogram, which suggests that the cardiovascular symptoms experienced by patients are not due to structural cardiovascular disease and possibly reflective of autonomic pathology, though further studies will need to confirm this. This study confirms that cardiovascular and symptoms are prevalent and have a dramatic impact on quality of life in pediatric and young adult patients diagnosed with hypermobile Ehlers–Danlos syndrome.
Paid, Owned and Earned Media Research: A Mixed Review, Reflections and Agendas for Future Research
Authors: Vasan Sudharshini , Rao Akshat Aditya , Priya Samant Shant , Gupta Nimit
Published: October 2024

This study aims to advance the understanding of POEM (paid, owned and earned media) literature through a mixed-review approach, comprising bibliometric and thematic analyses. VOSviewer was used for the bibliometric analysis of 816 articles from the Scopus database, while thematic analysis identified five themes and 17 sub-themes. The major thematic clusters are (a) brand communication and engagement via social media; (b) dynamics of media engagement and marketing strategies; (c) advertising, cross-channel synergy and branding; (d) mediated diplomacy and advertising literacy; and (e) the role of different media types in brand communication. This study presents the current state of research in POEM marketing and provides actionable recommendations for marketing practitioners and policymakers. Practitioners can use these findings to adapt and integrate emerging communication strategies, while policymakers can develop guidelines to enhance marketing practices and regulatory frameworks. Additionally, the study outlines five future research directions: (a) the integration of AI technologies, (b) ethical considerations, (c) cross-media synergy, (d) interdisciplinary approaches and (e) robust research methodologies.
Predictors of Tdap vaccine acceptance in pregnancy before and after delivery
Authors: Toubiyan David , Fogel Joshua , Jacobs Allan J.
Published: October 2024

Background:

Tdap vaccine receipt in the immediate postpartum period has not been well studied.

Objectives:

We study factors associated with Tdap vaccine receipt during both pregnancy and the immediate postpartum period.

Design:

Retrospective study of 2844 pregnant patients that delivered.

Methods:

Factors from demographics, medical history, previous obstetric history, prenatal care, and previous vaccination history were included.

Results:

39.7% of patients received the Tdap vaccine, 39.5% received the Tdap vaccine prior to delivery, and 20.8% received the Tdap vaccine between delivery and discharge. Increased age (relative risk ratio (RRR): 0.98, 95% CI: 0.96, 0.99, p = 0.01) and lower number of prenatal care visits of fewer than 11 (RRR: 0.51, 95% CI: 0.41, 0.64, p < 0.001) were associated with decreased likelihood of vaccine receipt before delivery. Spanish language (before: RRR: 2.35, 95% CI: 1.69, 3.25, p < 0.001; after: RRR: 1.68, 95% CI: 1.13, 2.49, p = 0.01) and South Asian languages (before: RRR: 1.55, 95% CI: 1.03, 2.32, p = 0.04; after: RRR: 1.69, 95% CI: 1.06, 2.69, p = 0.03) had similar patterns for increased likelihood of Tdap vaccine receipt before and after delivery. Race/ethnicity of Hispanic (RRR:1.84, 95% CI: 1.31, 2.59, p = 0.001), Asian (RRR:1.65, 95% CI: 1.22, 2.22, p = 0.001), and receipt of influenza vaccine during current pregnancy (RRR: 1.58, 95% CI: 1.31, 1.91, p < 0.001) were associated with increased likelihood before delivery.

Conclusion:

Prenatal Tdap vaccination is the best way to prevent infection with B. pertussis. Postpartum Tdap vaccination provides some protection for those declining prenatal vaccination. We recommend that clinicians recognize that there are different patterns for Tdap vaccine receipt before and after delivery and tailor Tdap vaccine counseling based on these patterns.
Performance analysis of wire-electrochemical discharge cutting of glass material
Authors: Yadav Pallvita , Chikane Pruthviraj
Published: October 2024

The present study investigated the feasibility of micro-cutting in glass material by using Electrochemical Discharge Machining (ECDM) Process. Glass possesses outstanding properties that make it a versatile with widely used in a diverse range of applications. Because of its tendency to fracture brittle during machining, glass is typically processed in its liquid or viscous state to manufacture precise and high-quality parts. Machining glass with good dimensional accuracy is a challenging task due to its fragile nature. Therefore, researchers have recognized the very appropriate technique for machining glasses with precision. The Wire-Electrochemical Discharge Machining (WECDM) has been identified as the most economical and efficient technique for fabricating micro slits in thin glass samples. In the present work, an in-house setup for WECDM was developed and the feasibility of the developed configuration was examined. Two different thicknesses of glass specimen have been considered for experimentation for checking the quality of cut and it is found that thinner specimen possesses good quality cut. The regression model has been developed to find a relationship between input and response parameters. The developed regression model was reasonably well fitted with the observed values where applied voltage 55V, 15% by wt. electrolyte concentration and 70% duty cycle were the most influencing parametric combinations among others. Further mixed electrolytes have shown excellent performance up to a certain concentration in terms of Material Removal Rate (MRR). This study reveals that optimal capillary action, influenced by surface tension and electrolyte concentration, is crucial for consistent sparking and efficient material removal in WECDM.
Zuranolone for the Treatment of Postpartum Depression
Authors: St. Onge Erin , Patel Priti , Whitner Chardae
Published: October 2024

Objective

To review the safety, efficacy, and tolerability of zuranolone for the treatment of postpartum depression.

Data Sources:

A literature search was conducted through PubMed using the following terms: zuranolone, postpartum depression, perinatal depression, SAGE-217, and allopregnanolone analogue.

Study Selection and Data Extraction

Articles describing the pharmacology, pharmacokinetics, efficacy, safety, and/or tolerability of zuranolone were included in this review.

Data Synthesis

Zuranolone is an allopregnanolone analogue that works through modulation of the GABAA receptor. Clinical trials have demonstrated that compared with placebo, zuranolone is effective in treating patients with postpartum depression. Common adverse events associated with zuranolone include fatigue, somnolence, headache, dizziness, diarrhea, sedation, upper respiratory tract infection, and nausea.

Conclusions:

Pharmacotherapeutic options to treat postpartum depression include selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, with the medication brexanolone (the first allopregnanolone analogue) reserved for severe postpartum depression. Zuranolone, the newest medication in its class, is without the same limitations as brexanolone, thus affording providers an additional easy-to-use option for treating postpartum depression.
Acetamiprid elicits oxidative stress, pro-inflammatory response, and cellular proliferation in human bronchial epithelial cells in vitro and in silico: alleviative implications of the mixture of heat-killed Lactobacillus strains
Authors: Arafa Samah S. , Elnoury Heba A. , Badr El-Din Sahar , Abdel Sattar Shimaa , Sakr Mohamed A. , Ghanem Sahar K. , Ahmed Omnia S. , Khalil Doaa M. , Ghorab Mohamed A. , Salama Rasha A. , Abdelkader Afaf
Published: October 2024

Background

Acetamiprid (ACE), a neonicotinoid insecticide, has been extensively used to control pests in agricultural and industrial environments. It has been reported that ACE is detrimental to the lungs. Nevertheless, the extent to which the activation of oxidative stress, inflammation, and cellular proliferation contributes to the pulmonary toxicity induced by ACE exposure remains insufficiently understood. This study explored the mechanism of toxicological consequences after ACE exposure in bronchial epithelial cells (BEAS-2B cells). The research also examined the potential ameliorative effects of the mixture of heat-killed Lactobacillus delbrueckii and Lactobacillus fermentum (HKL) on the toxicities of ACE.

Results

Following 14 days of exposure to ACE at 0.5 and 1 μM, oxidative stress was induced, as evidenced by the decreased levels of reduced glutathione, catalase, glutathione peroxidase, and superoxide dismutase, along with increased levels of malondialdehyde. Also, ACE exposure results in overexpression and raised protein levels of the IL-25, NF-κB1, NF-κB2, IL-33, TSLP, and NF-κB target genes, which induce inflammatory responses. In addition, ACE boosted Ki-67-positive BEAS-2B cells. The molecular docking of ACE with target genes and their proteins demonstrated a potent binding affinity, further supported by the presence of hydrophobic contacts, electrostatic interactions, and hydrogen bonds. The post-treatment of HKL following the ACE (1 μM) exhibited its antioxidant, anti-inflammatory, and antiproliferative activities in suppressing ACE-induced toxicity.

Conclusions

Our research revealed that ACE toxicity in BEAS-2B cells is caused by driving oxidative stress, pro-inflammatory response, and cellular proliferation. This study would give us a strategy to alleviate ACE-induced lung impairment by heat-killed probiotic supplements. As a result, dietary supplements that contain these microorganisms may potentially be beneficial in countries with high levels of pesticide contamination.
The future of AI clinicians: assessing the modern standard of chatbots and their approach to diagnostic uncertainty
Authors: Huang Ryan S. , Benour Ali , Kemppainen Joel , Leung Fok-Han
Published: October 2024

Background

Artificial intelligence (AI) chatbots have demonstrated proficiency in structured knowledge assessments; however, there is limited research on their performance in scenarios involving diagnostic uncertainty, which requires careful interpretation and complex decision-making. This study aims to evaluate the efficacy of AI chatbots, GPT-4o and Claude-3, in addressing medical scenarios characterized by diagnostic uncertainty relative to Family Medicine residents.

Methods

Questions with diagnostic uncertainty were extracted from the Progress Tests administered by the Department of Family and Community Medicine at the University of Toronto between 2022 and 2023. Diagnostic uncertainty questions were defined as those presenting clinical scenarios where symptoms, clinical findings, and patient histories do not converge on a definitive diagnosis, necessitating nuanced diagnostic reasoning and differential diagnosis. These questions were administered to a cohort of 320 Family Medicine residents in their first (PGY-1) and second (PGY-2) postgraduate years and inputted into GPT-4o and Claude-3. Errors were categorized into statistical, information, and logical errors. Statistical analyses were conducted using a binomial generalized estimating equation model, paired t-tests, and chi-squared tests.

Results

Compared to the residents, both chatbots scored lower on diagnostic uncertainty questions (p < 0.01). PGY-1 residents achieved a correctness rate of 61.1% (95% CI: 58.4–63.7), and PGY-2 residents achieved 63.3% (95% CI: 60.7–66.1). In contrast, Claude-3 correctly answered 57.7% (n = 52/90) of questions, and GPT-4o correctly answered 53.3% (n = 48/90). Claude-3 had a longer mean response time (24.0 s, 95% CI: 21.0-32.5 vs. 12.4 s, 95% CI: 9.3–15.3; p < 0.01) and produced longer answers (2001 characters, 95% CI: 1845–2212 vs. 1596 characters, 95% CI: 1395–1705; p < 0.01) compared to GPT-4o. Most errors by GPT-4o were logical errors (62.5%).

Conclusions

While AI chatbots like GPT-4o and Claude-3 demonstrate potential in handling structured medical knowledge, their performance in scenarios involving diagnostic uncertainty remains suboptimal compared to human residents.
Cardiac MRI in infarct-like myocarditis: transmural extension of late gadolinium enhancement is associated with worse outcomes
Authors: Isaak Alexander , Wirtz Johannes , Kravchenko Dmitrij , Mesropyan Narine , Bischoff Leon M. , Bienert Simon , Weinhold Leonie , Pieper Claus C. , Attenberger Ulrike , Öztürk Can , Zimmer Sebastian , Kuetting Daniel , Luetkens Julian A.
Published: October 2024

Objectives

To assess the prognostic value of cardiac MRI (CMR) parameters for the occurrence of major adverse cardiac events (MACE) in patients with infarct-like myocarditis.

Methods

In this retrospective single-center study, patients with CMR-confirmed acute myocarditis with infarct-like presentation were identified (2007–2020). Functional and structural parameters were analyzed including late gadolinium enhancement (LGE). The primary endpoint was the occurrence of MACE up to 5 years after discharge.

Results

In total, 130 patients (mean age, 40 ± 19 years; 97 men, 75%) with infarct-like myocarditis were included. CMR was conducted a median of 3 days (interquartile range [IQR], 1–5) after symptom onset. MACE occurred in 18/130 patients (14%) during a median follow-up of 19.3 months (IQR, 4.5–53). The median extent of LGE was 7% (IQR, 4–10). LGE affected the subepicardium in 111/130 patients (85%), the midwall in 45/130 patients (35%), and both the subepicardium and midwall in 27/130 patients (21%). Transmural extension of non-ischemic LGE lesions was observed in 15/130 patients (12%) and septal LGE in 42/130 patients (32%). In univariable Cox regression analysis, a significant association was found between the occurrence of MACE and both, quantified LGE extent and transmural LGE pattern. In multivariable analysis, transmural extension of LGE was an independent predictor for MACE (hazard ratio, 6.34; 95% confidence interval: 2.29–17.49; p < 0.001). Patients with the transmural extension of LGE had a shorter event-free time on Kaplan–Meier analysis (log-rank p < 0.001).

Conclusions

MACE occurred in 14% of patients with infarct-like myocarditis during follow-up. A transmural extension of non-ischemic LGE was associated with a worse long-term prognosis.

Critical relevance statement

CMR-based assessment of transmural extension of non-ischemic LGE holds the potential to serve as an easily assessable marker for risk stratification in patients with infarct-like myocarditis.

Key Points

The prognostic value of CMR was studied in patients with infarct-like myocarditis.

The extent of LGE and transmural extension were linked to adverse cardiac events.

Transmural non-ischemic LGE can serve as an easily assessable prognostic marker.

Graphical Abstract
Beyond resorption: osteoclasts as drivers of bone formation
Authors: Xiang Qianfeng , Li Lei , Ji Wei , Gawlitta Debby , Walboomers X Frank , van den Beucken Jeroen J.J.P.
Published: October 2024

Emerging evidence illustrates that osteoclasts (OCs) play diverse roles beyond bone resorption, contributing significantly to bone formation and regeneration. Despite this, OCs remain mysterious cells, with aspects of their lifespan—from origin, fusion, alterations in cellular characteristics, to functions—remaining incompletely understood. Recent studies have identified that embryonic osteoclastogenesis is primarily driven by osteoclast precursors (OCPs) derived from erythromyeloid progenitors (EMPs). These precursor cells subsequently fuse into OCs essential for normal bone development and repair. Postnatally, hematopoietic stem cells (HSCs) become the primary source of OCs, gradually replacing EMP-derived OCs and assuming functional roles in adulthood. The absence of OCs during bone development results in bone structure malformation, including abnormal bone marrow cavity formation and shorter long bones. Additionally, OCs are reported to have intimate interactions with blood vessels, influencing bone formation and repair through angiogenesis regulation. Upon biomaterial implantation, activation of the innate immune system ensues immediately. OCs, originating from macrophages, closely interact with the immune system. Furthermore, evidence from material-induced bone formation events suggests that OCs are pivotal in these de novo bone formation processes. Nevertheless, achieving a pure OC culture remains challenging, and interpreting OC functions in vivo faces difficulties due to the presence of other multinucleated cells around bone-forming biomaterials. We here describe the fusion characteristics of OCPs and summarize reliable markers and morphological changes in OCs during their fusion process, providing guidance for researchers in identifying OCs both in vitro and in vivo. This review focuses on OC formation, characterization, and the roles of OCs beyond resorption in various bone pathophysiological processes. Finally, therapeutic strategies targeting OCs are discussed.
An Insight into developmental changes in reasoning skills among Indian Preschoolers: A cross-sectional study using a story-based approach
Authors: Prasanna Aparna , Bajaj Gagan , Anakkathil Anil Malavika , Bhat Jayashree S
Published: October 2024

Background: Considering the importance of exploring the development of reasoning skills during preschool period and the suitability of using a culturally linguistically relevant story-based approach for the same, the present research intended to profile the reasoning skills in typically developing Indian preschool children between 36 and 72 months using a story-based approach. The specific objectives were to determine the test-retest and inter-rater reliability of reasoning tasks within an existing story-based cognitive-communicative assessment tool and to use this tool to assess the reasoning skills of typically developing Indian preschool children. Method: Reasoning tasks across explanation, prediction and inference domains were evaluated for its psychometric properties and administered to 63 typically developing Indian preschool children attending English medium schools in Mangalore. The preschoolers were equally divided into three age groups. The responses obtained across the age groups were analyzed quantitatively and qualitatively. Results: The developed tasks were confirmed to have good psychometric properties like test-retest and inter-rater reliability. The age comparisons of reasoning abilities using one-way ANOVA suggested an increase in reasoning abilities with age during the preschool period. The qualitative analysis further suggested that with increasing age, the nature of reasoning changed from content-based reasoning to reasoning based on prior knowledge which was integrated with the story content. Conclusion: The study describes reasoning skill development using a story-based task in Indian preschoolers. The study findings further provide clinical and educational implications to assess and foster reasoning abilities among preschoolers.
Preterm birth: associated risk factors in the tertiary care center
Authors: Fernandes Sweety Jousline , Jose Tessy Treesa , Noronha Judith Angelitta , Karkada Sushmitha
Published: October 2024

The study aimed at identifying the prevalence of preterm labor and the associated risk factors. Design A quantitative approach using a retrospective case-control study. Setting Tertiary care hospital of Udupi district Karnataka. Population or Sample Women delivered in tertiary care Hospital of Udupi district, Karnataka, were the sample; among them, the cases (250) were the records of the women who had delivered before 37 weeks of gestation, and controls (500) were the records of women who delivered after 37 weeks of gestation and without any complications. Method The study was conducted using a retrospective case-control design by reviewing the case records of women who had delivered in a tertiary care hospital. Main Outcome Measures Women delivered in tertiary care Hospital of Udupi district, Karnataka, and their inpatient records were assessed for risk factors during the antenatal and delivery periods. Results The study revealed that the prevalence of preterm labor was 356 (14.86%) Out of 2402 deliveries. Among them, only 250 were assessed. It was significantly correlated with age, place of residence, degree of education, occupation, marital status, gravid para, number of deliveries, type of deliveries, gap between births, blood type, and religion. Pregnant women who had been exposed or had a risk for preterm labor included those who had been diagnosed with pregnancy-induced hypertension, medication during pregnancy, history of abortion, intense physical labor, and conception dates older than 30 years. Conclusion The preterm labor prevalence can be minimized if the modifiable risk factors are in control. Non-modifiable risk factors require keen supervision. Thus, health professionals must be alert to all modifiable and non-modifiable risk factors.
Z badań nad najstarszą heraldyką panów z Prószkowa
Authors: Wójcik Marek
Published: October 2024

Rodzina Pruszkowskich, jedna z najmożniejszych rodzin wywodzących się z Prószkowa na Opolszczyźnie, jest dobrze znana badaczom. Pierwszych jej przedstawicieli spotykamy na przełomie XIII i XIV w., ale największą karierę zrobili dopiero po 1526 r. w służbie Habsburgów. W 1560 r. Pruszkowscy zostali włączeni przez cesarza Ferdynanda I do grona czeskich baronów, uzyskując status wolnych panów stanowych (Freiherren). Otrzymali przy tej okazji nowy herb. Jego wizerunek nie budzi w historiografii wątpliwości. Od lat trwa natomiast spór o wygląd herbu używanego przez rodzinę w okresie średniowiecza. Sięgając po wszelkie dostępne dziś źródła o charakterze heraldycznym (pieczęcie, herbarze, zabytki sepulkralne, list herbowy), autor podejmuje trud ustalenia jego najbardziej prawdopodobnego kształtu.