bluuebunny/crossref_metadata_2025 huggingface dataset:
Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study
Authors: Vasan Ramachandran S. , Pan Stephanie , Xanthakis Vanessa , Beiser Alexa , Larson Martin G. , Seshadri Sudha , Mitchell Gary F.
Published: February 2022

Background:

Arterial stiffness increases with age and is associated with an increased risk of adverse outcomes on short-term follow-up (typically <10 years). Data regarding associations of arterial stiffness with health outcomes on longer-term follow-up are lacking.

Methods:

We evaluated 7283 Framingham Study participants (mean age 50 years, 53% women) who underwent assessment of carotid-femoral pulse wave velocity (a marker of arterial stiffness) via applanation tonometry at one or more routine examinations. We used time-dependent Cox proportional hazards regression models to relate carotid-femoral pulse wave velocity to the incidence of health outcomes (updating carotid-femoral pulse wave velocity and all covariates at serial examinations).

Results:

On long-term follow-up (median 15 years; minimum-maximum, 0–20), participants developed cardiometabolic disease (hypertension [1255 events]; diabetes [381 events]), chronic kidney disease (529 events), dementia (235 events), cardiovascular disease (684 events) and its components (coronary heart disease [314 events], heart failure [191 events], transient ischemic attacks or stroke [250 events]), and death (1086 events). In multivariable-adjusted models, each SD increment in carotid-femoral pulse wave velocity was associated with increased risk of hypertension (hazard ratio [HR], 1.32 [95% CI, 1.21–1.44]), diabetes (HR, 1.32 [95% CI, 1.11–1.58]), chronic kidney disease (1.19 [95% CI, 1.05–1.34]), dementia (HR 1.27 [95% CI, 1.06–1.53]), cardiovascular disease (HR, 1.20 [95% CI, 1.06–1.36]) and its components (coronary heart disease, HR 1.37 [95% CI, 1.13–1.65]; transient ischemic attack/stroke, HR, 1.24 [95% CI, 1.00–1.53]), and death (HR, 1.29 [95% CI, 1.17–1.43]). The association with heart failure was borderline nonsignificant (HR, 1.21 [95% CI, 0.98–1.51],
P
=0.08).

Conclusions:

Our prospective observations of a large community-based sample establish the long-term prognostic importance of arterial stiffness for multiple health outcomes.
Midfrontal Theta Transcranial Alternating Current Stimulation Facilitates Motor Coordination in Dyadic Human–Avatar Interactions
Authors: Boukarras Sarah , Özkan Duru Gun , Era Vanessa , Moreau Quentin , Tieri Gaetano , Candidi Matteo
Published: February 2022

Synchronous interpersonal motor interactions require moment-to-moment prediction and proactive monitoring of the partner's actions. Neurophysiologically, this is highlighted by an enhancement of midfrontal theta (4–7 Hz) oscillations. In this study, we explored the causal role of midfrontal theta for interpersonal motor interactions using transcranial alternating current stimulation (tACS). We implemented a realistic human–avatar interaction task in immersive virtual reality where participants controlled a virtual arm and hand to press a button synchronously with a virtual partner. Participants completed the task while receiving EEG-informed theta (Experiment 1) or beta (control frequency, Experiment 2) tACS over the frontal midline, as well as sham stimulation as a control. Results showed that midfrontal theta tACS significantly improved behavioral performance (i.e., reduced interpersonal asynchrony) and participants' motor strategies (i.e., increased movement times and reduced RTs), whereas beta tACS had no effect on these measures. These results suggest that theta tACS over frontal areas facilitates action monitoring and motor abilities supporting interpersonal interactions.
A Governance System that Supports City Diplomacy: The European Perspective
Authors: Kurz Peter
Published: February 2022

Although the concept of city diplomacy is not new, we are seeing exciting developments in the ways that cities work together to address local and global challenges. This article explores how the global political system must evolve to harness the full potential of a city diplomacy that is well-integrated into global governance. In order for city diplomacy’s promise to be unlocked, we must take action in four central areas: facilitating knowledge exchange between local, national and international governance; embracing networks as an integral part of global governance; systematically expanding municipal development co-operation; and revitalising the idea of a world charter of local self-government.
Rival Eco-Anxieties: Legacy of Soviet Water Management in the Syr Darya Basin
Authors: Roberts Flora J
Published: February 2022

This article focuses on the security and human rights implications of the water infrastructure legacy bequeathed to the Syr Darya river basin in the border area of the Ferghana Valley, by the Soviet period. Taking an environmental history approach, I consider the complex legacy of the system of ageing dams, irrigation canals, and reservoirs which for the most part were set in place between the 1950s and 1980s. Correcting the prevailing narrative that post-Soviet water tensions are often caused by the Soviet habit of disregarding borders and republican-level interests in designing water infrastructure, I show how Soviet water policy in the region fanned and exacerbated inter-republican tensions even while the national territorial divisions were ongoing. Current tensions are therefore not a response to a sudden and unexpected hardening of borders, but the fruit of much longer processes.
Exceptionalism at the Time of covid-19: Where Nationalism Meets Irrationality
Authors: Bortolotti Lisa , Murphy-Hollies Kathleen
Published: February 2022

Exceptionalism is the view that one group is better than other groups and, by virtue of its alleged superiority, is not subject to the same constraints. Here we identify national exceptionalism in the responses made by political leaders in the United States and the United Kingdom to the covid-19 pandemic in early 2020. First, we observe that responses appealed to national values and national character and were marked by a denial of the severity of the situation. Second, we suggest an analogy between national exceptionalism and unrealistic optimism, i.e., people’s tendency to make rosier predictions about their future than is warranted by the evidence due to illusions of superiority and control. Finally, we argue that, at the national level, exceptionalism gave rise to an assumption of invulnerability that made for slow responses to the pandemic, and at the individual level, it served as a justification of people’s failures to adopt safety behaviors.
3. Literary Activism
Authors: Orsini Francesca
Published: February 2022

Already a tradition several decades old, in the first decade after independence (in 1947) the short story emerged as the primary genre in Hindi, but also in other Indian literatures, to grapple with contemporary experiences and to learn about other Indian and world literatures. The short story was so popular that magazines solely devoted to the genre were launched, primary among them Kahānī (Short Story, 1954), established by Shripat Rai, one of the two sons of the hallowed Hindi-Urdu writer Premchand. Already since the 1940s, the Hindi literary field had been deeply polarised between the Progressive Writers’ Association, controlled in the early 1950s by a hardcore group of critics and writers, and those who protested the Progressives’ ideological emphasis. In the 1950s, this polarization became strengthened by Cold-War literary interventions and translated into two different visions of world literature: one clearly oriented towards China, the USSR, and Eastern Europe and a canon of communist or leftist writers from western countries (Howard Fast, Upton Sinclair, etc.); and another vision more open to and interested in writers from other countries. But the 1950s were also the first decade of Indian independence, and they saw magazines like Kahānī undertake literary activism in other ways, too, namely: (a) by emphasizing translations of contemporary writing in other Indian languages, which formed more than half of the magazine’s content; (b) by having at least one foreign short story in every issue; (c) by democratizing access to reading and encouraging “democratic” discussions of literature through the establishment of a “Kahani Club” and inviting readers to participate. This chapter explores and evaluates Kahānī’s literary activism in the context of the political polarization of Hindi and world literature in the early Cold War, of the relationship between Hindi and other Indian language literatures, and between them and English, and in relation to the work that the short story as a genre was called upon to perform.
Introduction
Authors: Orsini Francesca , Srivastava Neelam , Zecchini Laetitia
Published: February 2022

Much has been written on Cold War literature, though until recently mainly from within the national literary frameworks of primarily the USA, Soviet Russia, and China. But was the ‘rest’ of the literary world of Asia, Africa, and Latin America merely a battlefield for rival ideologies, falling under either American or Soviet influence? This book shows that such a perspective is not only acutely Eurocentric, it also does not do justice to the vitality of literary activism in the decolonizing world, and to the multiple ways by which Third World print cultures broke free from Cold War antagonisms, and from imperial superpowers. Decolonizing movements and Cold War propaganda produced mountains of printed materials—from illustrated news bulletins to cultural and literary magazines with limited and wide distribution, from book series to a wealth of translations. If magazines, meetings, festivals and translations were the pillars of Cold War culture, they all happened through or found their way into print: even meetings and festivals produced reports, dispatches, travelogues, and memoirs. Political solidarities encouraged other print forms as well: the manifesto and declaration, the testimony, the ‘letter from’, the poem, or the book review—often short, ‘portable’ forms that suited periodicals, rather than long forms like the novel. The Introduction discusses the keywords of the book--Cold War Print Cultures, Ideology, Form, and Third World—and the main print genres that the essays of this book discuss.
Supporting Mental Health at Work (Comment on “The Epidemic of Mental Disorders in Business”)
Authors: Pierce Lamar , Rider Christopher I.
Published: February 2022

Kensbock, Alkærsig, and Lomberg (KAL) (2022) address the important topic of employee mental health in organizations. For three reasons, we caution readers against embracing KAL’s proposition that employee mobility spreads mental disorders across organizations through a contagion process. First, we view harmful contagion as the least plausible of three theoretical mechanisms that imply similar empirical results. Second, despite detailed employment and healthcare data from Denmark, the empirical analysis does not distinguish harmful contagion from the alternative mechanisms. Third, KAL’s infectious disease metaphor and language risk further stigmatization of vulnerable populations with mental disorders. We offer suggestions for continuing research on healthy organizations.
Mirror, Mirror: Freud and the Reversible Self-Object Dyad
Authors: Paul Robert A.
Published: February 2022

Freud is often negatively contrasted with object relations and relational theorists for holding to a metapsychology in which drives are understood as innate and predetermined in their development, are thought to follow the pleasure principle in a “hydraulic” manner, and are not seen as influenced by real objects. While that theory is certainly one dimension of Freud’s thinking, it is paralleled by another, quite different model positing a “mirror” relation in which affectively charged reversible self-object dyads, as opposed to purely internal dynamics, are the constituent elements of mental life. This view, more compatible with theories placing greater emphasis on the constitutive role of self-object relations, may further the reconciliation of Freudian and object-relational theories.
Determinants and Potential of Seafood Trade: Evidence from a Transitional Economy
Authors: Dong Chung Van , Truong Hoan Quang
Published: February 2022

This study, by employing an augmented gravity model under the Poisson pseudo-maximum-likelihood (PPML) estimation, aims to scrutinise the determinants and potential of seafood exports from Vietnam—a transitional and emerging economy to the global market over the period of 2000–2018 at both aggregate and sectoral levels. With remarkable growth over the years, Vietnam has become the largest seafood exporter in Southeast Asia. The country’s seafood exports have been diversified in terms of export structure and export markets. The estimation results show that the size of economies and market development from importers are the main factors that are driving Vietnam’s total seafood exports. At the sectoral level, the magnitude of the effects of income per capita significantly differs among the subsectors of seafood. We find that the impacts of factors such as region, access to the World Trade Organization (WTO) and the free trade agreement (FTA) establishment on Vietnam’s seafood exports are heterogeneous. We found that there is still room for the expansion of Vietnam’s seafood exports to some market destinations. This article suggests a dynamic strategy to increase Vietnam’s seafood exports in the coming years.

JEL Codes: F1, F14, Q1
Intersectional Activism Among Black Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning Young Adults: The Roles of Intragroup Marginalization, Identity, and Community
Authors: Shaheed Janae , Cooper Shauna M. , McBride Margarett , Burnett Marketa
Published: February 2022

Research around the importance of activism for positive development has been primarily focused on a single identity, missing the ways in which race and sexual orientation intersect to influence the communities young adults advocate for. The current study assesses how Black lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) young adults’ experiences of discrimination, identity, and community predict involvement in intersectional activism (e.g., activism for LGBTQ communities of color). With a sample of 216 Black LGBTQ young adults from the Social Justice Sexuality project, we used hierarchical linear regression to examine relationships between intragroup marginalization, identity, community involvement, and intersectional activism. While all three constructs explained a significant variance in intersectional activism, only racial marginalization within the LGBTQ community and involvement in LGBTQ communities of color were positively associated with intersectional activism. These findings demonstrate that experiences of intragroup marginalization and connection to communities that center both race and sexual orientation may be important in fostering activism among Black LGBTQ young adults.
Lawyering While Black: Perceived Stress as a Mediator of Impostor Feelings, Race-Related Stress and Mental Health Among Black Attorneys
Authors: Cokley Kevin , Krueger Nolan , Garba Ramya , Bailey Marlon , Harris Keoshia , Hall Shaina , Coleman Carly , Archer Jennifer
Published: February 2022

Attorneys suffer from high rates of stress and mental health problems, and Black attorneys, who make up only five percent of all attorneys in the United States, are especially vulnerable due to underrepresentation and experiences of bias. The present study examined perceived stress as a mediator of the impostor phenomenon, race-related stress, and mental health among a sample of 142 Black attorneys (114 women, 25 men). Gender, age, impostor phenomenon, race-related stress, and perceived stress accounted for 51% and 57% of the variance in depression and anxiety, respectively. Perceived stress fully mediated the links between the impostor phenomenon and depression, cultural racism and depression, and impostor feelings and anxiety and partially mediated the link between cultural racism and anxiety. Results suggest that perceived stress is an important mechanism for understanding why the impostor phenomenon and race-related stress negatively impact the mental health of Black attorneys.
Nasopharyngeal Radiation-Induced Sarcoma: A Case Report
Authors: Su Wei-Hsiang , Lee Wen-Ying , Chang Shih-Lun
Published: February 2022

The primary treatment for nasopharyngeal carcinoma (NPC) is radiotherapy. In rare cases, patients with NPC treated with radiotherapy may develop radiation-induced sarcoma (RIS), a malignant tumor, in the field of previous radiation. The prognosis is poor, and complete surgical resection is the only potentially curative treatment. We report a case of radiation-induced nasopharyngeal sarcoma after radiotherapy for NPC with suspected lung and liver metastases in a 69-year-old woman.
Atypical Stevens–Johnson syndrome characterized by mucosal ulcerations of the pharynx and larynx: A case report and literature review
Authors: Dong Lei , Chen Xiumei , Song Xicheng
Published: February 2022

By summarizing and analyzing the diagnostic and treatment process of a case with atypical Stevens–Johnson syndrome (SJS) characterized by mucosal ulcerations of the pharynx and larynx, and reviewing related literature, we would like to remind that in the presence of unexplained mucosal lesions, atypical SJS should not be ignored.
Does Union Canvassing Affect Voter Turnout Under Conditions of Political Constraint? Empirical Evidence from Illinois
Authors: Li Weihao , Lamare J. Ryan , Bruno Robert
Published: February 2022

The positive effects of union canvassing on individual-level union member voter turnout within union-friendly environments have been well documented. Yet, whether unions increase turnout among their membership under constrained circumstances has remained unexamined. Furthermore, there is little consensus on whether union canvassing effects are generalizable to populations with heterogeneous political attributes and individual characteristics. This paper identifies the mechanisms that might explain how union canvassing can be effective under conditions characterized by anti-union legislative actions, adversarial judicial decisions, and right-wing populist rhetoric. We use canvassing and turnout data taken from the 2016 Democratic state and Cook County primary election in Illinois, and our results show that, despite constrained political circumstances relative to those found in previous studies, union canvassing achieved positive union membership turnout effects. This study also tests the moderating effects of individual political attributes (ideology and vote propensity) and voter characteristics (income and ethnicity). The most salient finding is that the effects are more potent for ideologically conservative registered Democrat voters, highlighting the imperative of recognizing the ideological heterogeneity among union members and suggesting specific resource allocation strategies under politically constrained conditions.
Democratic freedom as an aesthetic achievement: Peirce, Schiller and Cavell on aesthetic experience, play and democratic freedom
Authors: Räber Michael
Published: February 2022

In this essay, I reconsider the constitution of democratic freedom in aesthetic terms. My interest is in articulating a conception of aesthetic freedom that can be mapped onto a conception of democratic freedom. For this purpose, I bring together Charles Sanders Peirce’s ontology, which comprises fragments of an aesthetic theory, Friedrich Schiller’s concept of aesthetic play and Stanley Cavell’s democratic perfectionism. By providing a philosophical framework for constructing an aesthetics and politics that supports the recent aesthetic turn in political theory, which urges overcoming political theory’s excessive dependence on an epistemological theory of representation, and by proposing a modification to the turn’s heavy reliance on theories of affect, my reading of Peirce, Schiller and Cavell offers a new way to think about the political significance of the autonomy of aesthetic experience and affect for democratic freedom.
Diagnosis of malignant biliary obstruction: pondering over the ERCP, MRCP and histology
Authors: Rațiu Iulia , Lupușoru Raluca , Lungeanu Diana , Popescu Alina , Sporea Ioan , Goldiș Adrian , Dănilă Mirela , Miuțescu Bogdan , Moga Tudor , Barbulescu Andreea , Tăban Sorina , Dema Alis , Șirli Roxana
Published: February 2022

Objective

To compare the diagnostic accuracy of endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance pancreatography (MRCP) and histological examination for malignant biliary obstruction.

Methods

This retrospective study included patients admitted for biliary obstruction caused by biliary tree malignancy that underwent ERCP, MRCP and histological examination. Data were collected from the medical records. The primary endpoints were the area under the receiver operating characteristic (AUROC) curve value, sensitivity, specificity and overall diagnostic accuracy of the three procedures in terms of a final diagnosis of obstructive biliary malignancy; and the agreement between ERCP, MRCP and histological examination with the final diagnosis.

Results

A total of 160 patients were included in the study (85 males, 53.1%; mean ± SD age, 69.31 ± 10.96 years). Considering the final diagnosis, the performance of MRCP, ERCP and histology in assessing biliary tumours produced AUROC values of 0.88 (95% confidence interval [CI] 0.75, 0.90), 0.94 (95% CI 0.85, 0.99) and 0.80 (95% CI 0.70, 0.82), respectively. ERCP presented higher sensitivity, overall diagnostic accuracy and agreement with the final diagnosis than MRCP and histological examination.

Conclusion

These current data suggest that invasive methods such as ERCP with biopsy remain more reliable than non-invasive methods.
How to close the gaps between evidence and practice for perioperative opioids
Authors: Stevens Jennifer A , Findlay Bernadette R
Published: February 2022

Excellent resources are now available that distil the best evidence around opioid prescribing in the perioperative period, including the list of recommendations provided by the international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients. While some of the recommendations have been widely accepted as an essential part of postoperative practice, others have had slow and variable adoption. This article focuses on the items where theory and practice still diverge and suggests how best to close that gap. We must also remain mindful that while education is essential, it is on the lowest rung of implementation efficacy and, on its own, is a poor driver of behaviour change. Ongoing structural nudges and the use of local procedure-specific analgesic pathways will also be helpful in addressing the gap between evidence-based recommendations and practice.
Modeling Thermal Behavior of Mass Concrete Structures at Early Age
Authors: Alper Yikici Tahsin , Sezer Hayri , (Roger) Chen Hung-Liang
Published: February 2022

In this study, a three-dimensional (3D) mathematical model based on conduction heat transfer in a solid is developed to predict the temperature profile of large concrete elements during the hydration process at early ages. Four different concrete mix designs are tested in the laboratory and on site. Heat of hydration and activation energy of each concrete mix is determined in the laboratory and temperature dependent thermo-physical parameters are considered in the simulations. The transient 3D conduction heat transfer equation with a heat generation source term is discretized by using finite volume method. The mathematical model is validated with temperature-time histories measured from four 1.8 m cube concrete blocks that are cast on site. Results obtained from the 3D model show that variable thermal properties are considered to accurately predict the temperature gradients. According to the analysis, the numerical model demonstrates that it can produce accurate predictions for temperature analysis within the 1.8 m large concrete elements.
The cultural landscape and maritime identity of Szczecin: The past and present of a port city
Authors: Izdebska Karolina , Kozlowska Urszula
Published: February 2022

This article analyses the maritime cultural landscape of Szczecin, a port city connected by a river and a lagoon to the Baltic Sea, although at a considerable distance from the coast. The natural landscape does not have elements that are typically associated with the sea, but the local cultural landscape consists of many objects with maritime motifs and symbols (in particular monuments and other material elements). The study shows that the maritime cultural landscape of Szczecin can be divided into several categories: the cultural heritage connected with the German past, the communist period and present day. In each of these periods, the emphasis was placed on other functions of the cultural elements of the maritime landscape while maintaining its maritime identity. The authors used a variety of methods and research tools. This study was based on analysis of found documents. Visual data analysis was also used.
Analysis of circumferential oil film thickness for piston ring in twin-rotor piston engine under differential velocity motion of combined annular cylinder
Authors: Yang Congnan , Xu Haijun , Xu Xiaojun , Pan Dibo , Jiang Yue , Tang Yuanjiang , Yuan Lei
Published: February 2022

In this paper, a novel type of twin-rotor piston engine (TRPE) is proposed, and the circumferential oil film thickness for the piston ring in TRPE is analysed. Different from the integrated cylinder of a typical engine, the combined annular cylinder (CAC) of TRPE has unique structural composition and differential velocity motion characteristic, making the tribological performance more complicated. The main purpose of this paper is to reveal and explain the special tribological performance of TRPE, which has never been studied. Firstly, the special structural composition of CAC is introduced and the relative velocity between the piston ring and CAC wall at different circumferential positions of the piston ring is analysed. Then, based on the Greenwood-Trip asperity contact theory, radial and axial quasi-static equilibrium equations of the piston ring are both derived. The circumferential oil film thickness is calculated by solving the equilibrium equations and the two-dimensional average Reynolds equation within a cycle. Results indicate that there are significant differences in circumferential oil film thickness of the piston ring due to the special structure and motion of CAC, and the differences become greater as the output shaft speed increases. A long-time engine reverse towing experiment shows an obvious uneven wear phenomenon of the piston ring and CAC wall, which well validates the simulation results of the circumferential oil film thickness. The research work can be used as the basis of equal-wear design for the piston ring in TRPE with the help of surface texture technology, thereby greatly reducing the wear loss.
Microchannel flow and heat transfer enhancement via ribs arrangements
Authors: Ebaika Johnny Adukwu , Shuja S. Z. , Yilbas B. S. , Al-Qahtani H.
Published: February 2022

Enhanced heat transfer rates in microchannel flow remain challenging in terms of channel design, proper selection of carrier fluid, and setting the appropriate flow conditions. Introducing extended surfaces, such as ribs, in microchannel design, and the use of nanofluids enable to enhance the thermal performance of the flow system. In the present study, heat transfer characteristics in a microchannel flow incorporating the ribs arrangements on the channel wall are considered and the influence of the ribs location and carrier fluid on the thermal performance of the channel is examined. Temperature and velocity variations in the channel are predicted numerically and the findings of the Nusselt number are compared with that obtained from the experiments. The location of ribs along the channel wall is altered and the resulting variation of the Nusselt number and pressure drop along the microchannel is assessed. Al2O3 and TiO2 nanofluids are incorporated as a working fluid and water are also considered for the comparison. Temperature parameters are introduced to scale the rise of the maximum fluid temperature and temperature difference across the channel length. It is found that locating the ribs in the close region of the channel exit improves the Nusselt number by 25% and increases the pressure drop along the microchannel by 10% as compared to those corresponding to no-ribs arrangements. In addition, nanofluids improve the heat transfer rates and slightly alter the pressure drop across the microchannel.
Cryopreserved Stem Cells Incur Damages Due To Terrestrial Cosmic Rays Impairing Their Integrity Upon Long-Term Storage
Authors: Rocheteau P. , Warot G. , Chapellier M. , Zampaolo M. , Chretien F. , Piquemal F.
Published: February 2022

Stem cells have the capacity to ensure the renewal of tissues and organs. They could be used in the future for a wide range of therapeutic purposes and are preserved at liquid nitrogen temperature to prevent any chemical or biological activity up to several decades before their use. We show that the cryogenized cells accumulate damages coming from natural radiations, potentially inducing DNA double-strand breaks (DSBs). Such DNA damage in stem cells could lead to either mortality of the cells upon thawing or a mutation diminishing the therapeutic potential of the treatment. Many studies show how stem cells react to different levels of radiation; the effect of terrestrial cosmic rays being key, it is thus also important to investigate the effect of the natural radiation on the cryopreserved stem cell behavior over time. Our study showed that the cryostored stem cells totally shielded from cosmic rays had less DSBs upon long-term storage. This could have important implications on the long-term cryostorage strategy and quality control of different cell banks.
MGP Regulates Perivascular Adipose-Derived Stem Cells Differentiation Toward Smooth Muscle Cells Via BMP2/SMAD Pathway Enhancing Neointimal Formation
Authors: Ni Hui , Liu Chang , Chen Yuwen , Lu Yunrui , Ji Yongli , Xiang Meixiang , Xie Yao
Published: February 2022

Perivascular adipose-derived stem cells (PV-ADSCs) could differentiate into smooth muscle cells (SMCs), participating in vascular remodeling. However, its underlying mechanism is not well explored. Our previous single-cell RNA-sequencing dataset identified a unique expression of matrix Gla protein (MGP) in PV-ADSCs compared with subcutaneous ADSCs. MGP involves in regulating SMC behaviors in vascular calcification and atherosclerosis. In this study, we investigated MGP’s role in PV-ADSCs differentiation toward SMCs in vitro and in vascular remodeling in vivo. PV-ADSCs were isolated from perivascular regions of mouse aortas. Quantitative reverse transcription–polymerase chain reaction (qRT-PCR), Western blot, and immunofluorescence confirmed higher MGP expression in PV-ADSCs. The MGP secretion increased along PV-ADSCs differentiation toward SMCs in response to transforming growth factor–beta 1 (TGF-β1). Lentivirus knockdown of MGP markedly promoted the bone morphogenetic protein 2 (BMP2) expression and phosphorylation of SMAD1/5/8 in PV-ADSCs, subsequently inhibiting its differentiation toward SMCs. Such inhibition could be partially reversed by further application of BMP2 inhibitors. On the contrary, exogenous MGP inhibited BMP2 expression and SMAD1/5/8 phosphorylation in PV-ADSCs, thereby promoting its differentiation toward SMCs. Transplantation of cultured PV-ADSCs, which was pretreated by MGP knockdown, in mouse femoral artery guide-wire injury model significantly alleviated neointimal hyperplasia. In conclusion, MGP promoted the differentiation of PV-ADSCs toward SMCs through BMP2/SMAD-mediated signaling pathway. This study offers a supplement to the society of perivascular tissues and PV-ADSCs.
A Prospective Trial Comparing Haploidentical Donor Transplantation With Cord Blood Versus HLA-Matched Sibling Donor Transplantation for Hematologic Malignancy Patients
Authors: Lu Wenyi , Jin Xin , Lyu Hairong , Bai Xue , Zhu Haibo , Li Xin , Xiao Xia , Meng Juanxia , Yuan Ting , Li Qing , Mu Juan , Lyu Cuicui , Jiang Yili , Wei Yunxiong , Xiong Xia , Zhang Meng , Zhao Mingfeng
Published: February 2022

Although haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT) has achieved similar survival to HLA-identical sibling donor (ISD) transplantation, the delayed hematopoietic engraftment as well as higher incidence of graft-versus-host-disease (GVHD), results in prolonged hospitalization, higher costs, and increased morbidity. In this study, a prospective, non-randomized clinical study was designed to evaluate the outcomes of patients who underwent HID HSCT supported by cord blood or ISD HSCT. Between May 2017 and November 2020, 113 patients were enrolled to undergo HID HSCT supported by cord blood (n=88) or ISD HSCT (n=25). The cumulative incidence of neutrophil and platelet engraftment at 30days was comparable in these two groups. Importantly, there was no significant difference in the cumulative incidence of grade II-IV aGVHD at 100days (20.5% [95% confidence interval [CI]: 12.2%–28.8%] versus 12.0% [95% CI: 0.2%–23.8%], P = 0.32) and cGVHD at 1 year (19.5% [95% CI: 11.2%–27.8%] versus 16.6% [[95% CI: 1.3%–31.9%] P = 0.70) between the two groups. Among the HID and ISD groups, the 2-year disease free survival was 76.8 and 80.0% ( P = 0.83), the 2-year overall survival was 82.4 and 88.0% ( P = 0.66), the 2-year GVHD-free, relapse-free survival was 68.9 and 75.3% ( P = 0.62), respectively. Our results indicate that HID transplantation supported by cord blood may offer a good alternative to ISD HSCT for patients with hematopoietic malignancies.

Trial registration:

Effect of co-infusion third party umbilical cord blood stem cells on haploidentical hematopoietic stem cell transplantation https://www.chictr.org.cn Reg. No. ChiCTR-OIN-17011426.
Fatal Sarcocystis calchasi–associated meningoencephalitis in 2 captive vulturine guineafowl
Authors: Gadsby Shelby , Garner Michael M. , Bolin Steven R. , Sanchez Carlos R. , Flaminio Kelly P. , Sim Richard R.
Published: February 2022

Two captive vulturine guineafowl ( Acryllium vulturinum) were presented with lethargy, hyporexia, weight loss, and progressive neurologic signs. One of the guineafowl was seropositive for Sarcocystis falcatula (1:50 dilution). Both guineafowl died within 5 d of presentation. Histologic examination revealed nonsuppurative meningoencephalitis with gliosis, associated with occasional schizonts in the neuropil. Using fresh-frozen brain tissue, PCR was performed to amplify the ITS1 RNA region and portions of the 18S ribosomal RNA gene (18S gene) and the 28S ribosomal RNA gene (28S gene). Analysis of nucleic acid sequences from the resulting amplicons indicated that Sarcocystis calchasi was the likely cause of disease. To our knowledge, S. calchasi–associated disease has not been reported previously in the order Galliformes.
Hospital Discharge During COVID-19: The Role of Social Resources
Authors: Schmutz Kirsten E. , Wallace Andrea S. , Bristol Alycia A. , Johnson Erin Phinney , Raaum Sonja E.
Published: February 2022

COVID-19 social distancing recommendations potentially disrupted support provided to patients after hospital discharge. The aim of this study was to use the Individual and Family Self-Management Theory to understand the effect the COVID-19 pandemic had on patients’ abilities to obtain and receive support after hospital discharge. Semi-structured interviews were conducted with 26 patients discharged from medical or surgical services. Qualitative description was used to identify salient themes. Most participants described little impact from COVID-19 on their ability to obtain and receive support from informal and formal resources. These experiences fell in contrast to one participant, whose changes in support dramatically affected her post-discharge experience. While social disruptions occurred for patients transitioning home after hospitalization during the COVID-19 pandemic, our findings indicate that strong pre-existing support networks are resilient and protective. All patients should be provided with resources on what to do if unexpected events occur post-discharge.

Clinical Trial Registration

This study is a part of a parent study: Social Needs and Resources in the Evaluation and Enhancement of Discharge Support. The trial registry is clinicaltrials.gov, number NCT04248738. Initial release was 1/27/2020 and the first participant was enrolled on 2/4/2020. Link to the information on the registry: https://clinicaltrials.gov/ct2/show/NCT04248738
Efficacy of Liposomal Bupivacaine for Sternotomy Pain After Cardiac Surgery: A Retrospective Analysis
Authors: Patel Janki , Medas Ryan , Donnelly Julianne , Mullins Brandon
Published: February 2022

Background:

Multimodal analgesia is a cornerstone of postoperative pain management. Different formulations of local anesthetics are available. Data to support these treatment options are limited.

Objective:

To determine the efficacy of liposomal bupivacaine compared with bupivacaine or ropivacaine in patients undergoing sternotomy for coronary artery bypass graft (CABG) and/or valve surgery.

Methods:

Single-center, retrospective, observational study at a community teaching hospital. Patients included were 18 years of age or older undergoing CABG and/or valve surgery via median sternotomy and received either liposomal bupivacaine or an active comparator. The primary outcome was opioid utilization in morphine milligram equivalent (MME) from 0 to 72 hours.

Results:

A total of 376 patients were included, 223 in the liposomal bupivacaine arm and 153 in the active comparator arm. There was no difference in the MME use from 0 to 72 hours among patients in the liposomal bupivacaine group compared with the comparator group (114.2 mg [75.55] vs 107.6 mg [68.4], P = 0.38). After Bonferroni correction, there was no difference in pain scores at individual time points. At 24- and 48-hour post-op, pain scores were higher with liposomal bupivacaine at 4.4 (2.7) vs 3.5 (2.8) ( P = 0.01) and 3.1 (2.9) vs 2.4 (2.6) ( P = 0.02).

Conclusion and Relevance:

Based on these findings and previous studies, liposomal bupivacaine should not be routinely used for CABG and/or valve surgery through a median sternotomy given lack of superiority. This helps inform surgical practice to the role of anesthetics as part of the multimodal analgesia regimen.
Safety and Efficacy of an Intensive Care Insulin Infusion Protocol Targeting a Blood Glucose of 140 to 180 mg/dL
Authors: Chatley Michelle M. , Thuyns Michael R.
Published: February 2022

Background

Despite multiple guideline recommendations of a goal blood glucose of 140 to 180 mg/dL in critically ill patients, no insulin infusion protocols (IIPs) targeting this range have been validated and published in the literature.

Objective

The purpose of this study is to determine the safety and efficacy of an IIP targeting a blood glucose of 140 to 180 mg/dL in critically ill patients, with the ultimate goal of validating such a protocol.

Methods

This retrospective chart review uses data of critically ill patients admitted from August 2018 to December 2018. Patient data from August 2017 to December 2017 served as a historical comparator to further assess safety outcomes. Percent of blood glucose readings within goal was the primary outcome measurement. Relevant clinical variables, insulin requirements, hypoglycemic events, and protocol adherence were also recorded.

Results

A total of 88 insulin infusions were included in analysis, 34 of which served as a historical comparator. In the IIP targeting a blood glucose 140 to 180 mg/dL, once blood glucose levels decreased below 180 mg/dL, 54% of blood glucose readings were within goal (140-180 mg/dL) and 73% of blood glucose readings were within a “clinically acceptable” range (110-180 mg/dL). The number of hypoglycemic events decreased from 70 in the historical comparator group to 4 in the current IIP ( P < .0001).

Conclusion and relevance

This IIP is both safe and effective at targeting a blood glucose of 140 to 180 mg/dL and could be used at other institutions to achieve satisfactory glycemic control.
Observed Apixaban Anti-Xa Levels in Obese Patients
Authors: Harkness Weston , Pipitone Olivia , Joss Jacqueline , Schiedler Michael , Shagavah Santon , Moore Ryan , Hsing Jeff
Published: February 2022

Background:

Recent guidelines suggest that, for venous thromboembolism (VTE), standard doses of apixaban are appropriate in patients with body mass index (BMI) >40 kg/m2 or >120 kg. Atrial fibrillation (AF) is excluded from this recommendation.

Objective:

The goals of our study were to measure and describe anti-Xa levels of patients with a BMI ≥40 kg/m2 and/or a weight ≥120 kg with a clinical indication of AF or VTE who were treated with apixaban, and to determine whether BMI or weight are associated with anti-Xa levels in this population.

Methods

We conducted an observational cohort study at a single health care system in Oregon, USA. Patients meeting enrollment criteria were recruited and had peak and trough apixaban anti-Xa levels drawn.

Results

Of 55 patients enrolled, 5 (9%) had peak anti-Xa levels below the reference range and 3 (6%) had trough anti-Xa levels below the reference range. BMI did not significantly correlate with peak or trough anti-Xa levels (r = −0.10, p = 0.45 and r = −0.14, p = 0.31). Weight had a moderate, negative correlation with peak anti-Xa levels (r = −0.42, p = 0.002) and a weak, negative correlation with trough anti-Xa levels (r = −0.32, p = 0.02).

Conclusions and Relevance

This study provides evidence that anti-Xa levels among obese patients are not substantially different from patients with nomral BMI and weight. This supports recent ISTH guidance for standard dosing of apixaban for VTE patients with BMI >40 kg/m2 or weight >120 kg and provides additional evidence that the standard dosing may also be appropriate in patients with AF.
Stigma, lost opportunities, and growth: Understanding experiences of caregivers of persons with mental illness in Tamil Nadu, India
Authors: Dijkxhoorn Mirjam A. , Padmakar Archana , Bunders Joske F. G. , Regeer Barbara J.
Published: February 2022

This study aimed to address gaps in understanding of the lived experiences of caregivers of persons with mental illness in low-income countries. It was conducted among caregivers of persons with mental illness making use of a free non-governmental clinic in and around Chennai, India. The study adopted a qualitative methodology, with semi-structured interviews and life history exercises (n = 29) and six focus group discussions with caregivers (n = 21) and mental health professionals and community-based workers (n = 39). The experiences of caregivers were analyzed in the framework of “The Banyan model of caregiving,” which identifies six phases. Major themes in caregivers’ experience were: embarrassment and losing honor; fear; awareness; stigma and social exclusion; and reduced social interaction and loneliness. Posttraumatic growth considered as the result of caregiver experiences was found to consist mainly of personal growth and focusing on positive life experiences. Lost opportunities particular to the context of Tamil Nadu were described as the inability to get married, obtaining less education than desired, and loss of employment. Siblings faced lower levels of burden, while elderly mothers experienced especially high levels of burden and lack of happiness in life. Caregiver gains were identified as greater compassion for other people with disabilities, resulting in a desire to help others, as well as increased personal strength and confidence. Understanding the nuances of the caregiving experiences over time can provide a framework to devise more fine-tuned support structures that aim to prevent reductions in social interaction and lost opportunities, and improve a sense of meaning, in order to assist caregivers to continue providing care for their relatives with mental illness in a context with scarce mental health resources.
A fast supervised density-based discretization algorithm for classification tasks in the medical domain
Authors: Aristodimou Aristos , Diavastos Andreas , Pattichis Constantinos S
Published: February 2022

Discretization is a preprocessing technique used for converting continuous features into categorical. This step is essential for processing algorithms that cannot handle continuous data as input. In addition, in the big data era, it is important for a discretizer to be able to efficiently discretize data. In this paper, a new supervised density-based discretization (DBAD) algorithm is proposed, which satisfies these requirements. For the evaluation of the algorithm, 11 datasets that cover a wide range of datasets in the medical domain were used. The proposed algorithm was tested against three state-of-the art discretizers using three classifiers with different characteristics. A parallel version of the algorithm was evaluated using two synthetic big datasets. In the majority of the performed tests, the algorithm was found performing statistically similar or better than the other three discretization algorithms it was compared to. Additionally, the algorithm was faster than the other discretizers in all of the performed tests. Finally, the parallel version of DBAD shows almost linear speedup for a Message Passing Interface (MPI) implementation (9.64× for 10 nodes), while a hybrid MPI/OpenMP implementation improves execution time by 35.3× for 10 nodes and 6 threads per node.
Pure hybrid nanofibers made of 4,4′-bis(triethoxysilyl)-1,1′-biphenyl and the way of their production
Authors: Máková Veronika , Kulhánková Johana , Nikendey Holubová Barbora , Plecháček Tomáš
Published: February 2022

Nanofibers bring everyday challenges to modern material science. Different types of fibrous materials made of organic and/or inorganic components are well known worldwide and find applications in various fields of industry and everyday life, covering optoelectronics, energetics, sensors, catalysis, filtration and/or medicine. However, their combination in the form of hybrid nanofibers is a part of science that has not been fully discovered yet. Hybrid organic-inorganic organosilane nanofibers bring completely new, unique and extraordinary properties given by the interconnection of organic and inorganic components via strong covalent bonds between silicon and carbon. Herein, we briefly present the patented process leading to the preparation of the first purely hybrid organic-inorganic organosilane nanofibers composed of organo-bis-silylated precursor based on 4.4′-bis(triethoxysilyl)-1.1′-biphenyl, which were successfully prepared by a sol–gel process combined with electrospinning techniques. These hybrid nanofibers were prepared without using various types of additives such as organic polymers and/or surfactants, which are commonly used as support during the preparation of other types of nanofibers.