bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac Fibroblasts Mediate a Sexually Dimorphic Fibrotic Response to β‐Adrenergic Stimulation
Authors: Peter Angela K. , Walker Cierra J. , Ceccato Tova , Trexler Christa L. , Ozeroff Christopher D. , Lugo Kimberly R. , Perry Amy R. , Anseth Kristi S. , Leinwand Leslie A.
Published: May 2021

Background

Biological sex is an important modifier of cardiovascular disease and women generally have better outcomes compared with men. However, the contribution of cardiac fibroblasts (CFs) to this sexual dimorphism is relatively unexplored.

Methods and Results

Isoproterenol (ISO) was administered to rats as a model for chronic β‐adrenergic receptor (β‐AR)‐mediated cardiovascular disease. ISO‐treated males had higher mortality than females and also developed fibrosis whereas females did not. Gonadectomy did not abrogate this sex difference. To determine the cellular contribution to this phenotype, CFs were studied. CFs from both sexes had increased proliferation in vivo in response to ISO, but CFs from female hearts proliferated more than male cells. In addition, male CFs were significantly more activated to myofibroblasts by ISO. To investigate potential regulatory mechanisms for the sexually dimorphic fibrotic response, β‐AR mRNA and PKA (protein kinase A) activity were measured. In response to ISO treatment, male CFs increased expression of β1‐ and β2‐ARs, whereas expression of both receptors decreased in female CFs. Moreover, ISO‐treated male CFs had higher PKA activity relative to vehicle controls, whereas ISO did not activate PKA in female CFs.

Conclusions

Chronic in vivo β‐AR stimulation causes fibrosis in male but not female rat hearts. Male CFs are more activated than female CFs, consistent with elevated fibrosis in male rat hearts and may be caused by higher β‐AR expression and PKA activation in male CFs. Taken together, our data suggest that CFs play a substantial role in mediating sex differences observed after cardiac injury.
Prognostic Value of Preoperative Absolute Lymphocyte Count in Children With Tetralogy of Fallot
Authors: Wu Xie , Luo Qipeng , Su Zhanhao , Li Yinan , Wang Hongbai , Yuan Su , Yan Fuxia
Published: May 2021

Background

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Absolute lymphocyte count (ALC) is a low‐cost and easy‐to‐obtain inflammatory indicator; however, its association with the prognosis of patients with TOF remains unknown. This study aimed to determine the prognostic value of preoperative ALC in children with TOF.

Methods and Results

This retrospective study included 707 patients aged <6 years who underwent corrective operations for TOF between January 2016 and December 2018 in Fuwai Hospital, China. The end points were mortality, extracorporeal membrane oxygenation placement, postoperative hospital stay >30 days, and severe postoperative complications; patients were grouped on the basis of prognosis: poor prognosis (n=76) and good prognosis (n=631). Univariable and multivariable logistic regression analyses were performed to identify the independent risk factors for poor prognosis, on which a risk scoring system was based. The receiver operating characteristic curve was used to assess model performance. Using another model without ALC, the effect of the addition of ALC was assessed. Results suggested that ALC was an independent factor with a cutoff point of 4.36×10
9
/L. The addition of ALC improved the area under the curve from 0.771 to 0.781 (
P
<0.001). To avoid reverse causality and further control for confounding factors, the patients were further divided on the basis of ALC level, and a propensity score matching was performed; 117 paired patients were identified for further analysis. Low ALC levels had an odds ratio of 3.500 (95% CI, 1.413–8.672).

Conclusions

Low preoperative ALC represents an independent predictor of poor prognosis in children with TOF.
Circulating Mature PCSK9 Level Predicts Diminished Response to Statin Therapy
Authors: Kuyama Naoto , Kataoka Yu , Takegami Misa , Nishimura Kunihiro , Harada‐Shiba Mariko , Hori Mika , Ogura Masatsune , Otsuka Fumiyuki , Asaumi Yasuhide , Noguchi Teruo , Tsujita Kenichi , Yasuda Satoshi
Published: May 2021

Background

Statin‐mediated efficacy of lowering low‐density lipoprotein (LDL) cholesterol varies in each individual, and its diminished response is associated with worse outcomes. However, there is no established approach to predict hyporesponse to statins. PCSK9 (proprotein convertase subxilisin/kexin type 9) is a serine‐protease associated with LDL metabolism, which circulates as mature and furin‐cleaved PCSK9. Since mature PCSK9 more potently degrades the LDL receptor, its evaluation may enable the identification of statin hyporesponders.

Methods and Results

We analyzed 101 statin‐naive patients with coronary artery disease who commenced a statin. PCSK9 subtypes at baseline and 1 month after statin use were measured by ELISA. Hyporesponse to statins was defined as a percent reduction in LDL cholesterol <15%. The relationship between each PCSK9 subtype level and hyporesponse to statins was investigated. Statins significantly lowered LDL cholesterol level (percent reduction, 40%±21%), whereas 11% of study participants exhibited a hyporeseponse to statins. Multivariable logistic regression analysis demonstrated that baseline mature PCSK9 level was an independent predictor for hyporesponse to statins even after adjusting clinical characteristics (mature PCSK9 per 10‐ng/mL increase: odds ratio [OR], 1.12; 95% CI, 1.01–1.24 [
P
=0.03]), whereas furin‐cleaved level was not (per 10‐ng/mL increase: OR, 1.37; 95% CI, 0.73–2.58 [
P
=0.33]). Receiver operating characteristic curve analysis identified mature PCSK9 level of 228 ng/mL as an optimal cutoff to predict hyporesponse to statins (area under the curve, 0.73 [sensitivity, 0.91; specificity, 0.56]).

Conclusions

Baseline mature PCSK9 level >228 ng/mL is associated with hyporesponse to statins. This finding suggests that mature PCSK9 might be a potential determinant of hyporesponse to statins.
Sex Differences in the Associations of Visceral Adipose Tissue and Cardiometabolic and Cardiovascular Disease Risk: The Framingham Heart Study
Authors: Kammerlander Andreas A. , Lyass Asya , Mahoney Taylor F. , Massaro Joseph M. , Long Michelle T. , Vasan Ramachandran S. , Hoffmann Udo
Published: May 2021

Background

Men and women are labeled as obese on the basis of a body mass index (BMI) using the same criterion despite known differences in their fat distributions. Subcutaneous adipose tissue and visceral adipose tissue (VAT), as measured by computed tomography, are advanced measures of obesity that closely correlate with cardiometabolic risk independent of BMI. However, it remains unknown whether prognostic significance of anthropometric measures of adiposity versus VAT varies in men versus women.

Methods and Results

In 3482 FHS (Framingham Heart Study) participants (48.1% women; mean age, 50.8±10.3 years), we tested the associations of computed tomography–based versus anthropometric measures of fat with cardiometabolic and cardiovascular disease (CVD) risk. Mean follow‐up was 12.7±2.1 years. In men, VAT, as compared with BMI, had a similar strength of association with incident cardiometabolic risk factors (eg, adjusted odds ratio [OR], 2.36 [95% CI, 1.84–3.04] versus 2.66 [95% CI, 2.04–3.47] for diabetes mellitus) and CVD events (eg, adjusted hazard ratio [HR], 1.32 [95% CI, 0.97–1.80] versus 1.74 [95% CI, 1.14–2.65] for CVD death). In women, however, VAT, when compared with BMI, conferred a markedly greater association with incident cardiometabolic risk factors (eg, adjusted OR, 4.51 [95% CI, 3.13–6.50] versus 2.33 [95% CI, 1.88–3.04] for diabetes mellitus) as well as CVD events (eg, adjusted HR, 1.85 [95% CI, 1.26–2.71] versus 1.19 [95% CI, 1.01–1.40] for CVD death).

Conclusions

Anthropometric measures of obesity, including waist circumference and BMI, adequately capture VAT‐associated cardiometabolic and cardiovascular risk in men but not in women. In women, abdominal computed tomography–based VAT measures permit more precise assessment of obesity‐associated cardiometabolic and cardiovascular risk.
Impact of Uncontrolled Hypertension at 3 Months After Intracerebral Hemorrhage
Authors: Biffi Alessandro , Teo Kay‐Cheong , Castello Juan Pablo , Abramson Jessica R. , Leung Ian Y. H. , Leung William C. Y. , Wang Yujie , Kourkoulis Christina , Myserlis Evangelos Pavlos , Warren Andrew D. , Henry Jonathan , Chan Koon‐Ho , Cheung Raymond T. F. , Ho Shu‐Leong , Anderson Christopher D. , Gurol M. Edip , Viswanathan Anand , Greenberg Steven M. , Lau Kui‐Kai , Rosand Jonathan
Published: May 2021

Background

Survivors of intracerebral hemorrhage (ICH) are at high risk for recurrent stroke, which is associated with blood pressure control. Because most recurrent stroke events occur within 12 to 18 months of the index ICH, rapid blood pressure control is likely to be crucial. We investigated the frequency and prognostic impact of uncontrolled short‐term hypertension after ICH.

Methods and Results

We analyzed data from Massachusetts General Hospital (n=1305) and the University of Hong Kong (n=523). We classified hypertension as controlled, undertreated, or treatment resistant at 3 months after ICH and determined the following: (1) the risk factors for uncontrolled hypertension and (2) whether hypertension control at 3 months is associated with stroke recurrence and mortality. We followed 1828 survivors of ICH for a median of 46.2 months. Only 9 of 234 (4%) recurrent strokes occurred before 3 months after ICH. At 3 months, 713 participants (39%) had controlled hypertension, 755 (41%) had undertreated hypertension, and 360 (20%) had treatment‐resistant hypertension. Black, Hispanic, and Asian race/ethnicity and higher blood pressure at time of ICH increased the risk of uncontrolled hypertension at 3 months (all
P
<0.05). Uncontrolled hypertension at 3 months was associated with recurrent stroke and mortality during long‐term follow‐up (all
P
<0.05).

Conclusions

Among survivors of ICH, >60% had uncontrolled hypertension at 3 months, with undertreatment accounting for the majority of cases. The 3‐month blood pressure measurements were associated with higher recurrent stroke risk and mortality. Black, Hispanic, and Asian survivors of ICH and those presenting with severe acute hypertensive response were at highest risk for uncontrolled hypertension.
Risk Stratification of Patients With NonObstructive Coronary Artery Disease Using Resistive Reserve Ratio
Authors: Toya Takumi , Ahmad Ali , Corban Michel T. , Ӧzcan Ilke , Sara Jaskanwal D. , Sebaali Faten , Escaned Javier , Lerman Lilach O. , Lerman Amir
Published: May 2021

Background

Resistive reserve ratio (RRR), or the ratio of baseline to hyperemic microvascular resistance, has prognostic implications in predicting clinical outcomes in patients with obstructive coronary artery disease. However, its value in patients with angina or ischemia with nonobstructive coronary artery disease is unknown.

Methods and Results

We included 1692 patients with nonobstructive coronary artery disease who underwent invasive coronary vasoreactivity testing. Abnormal coronary flow reserve (CFR, the ratio of hyperemic and baseline resting flow velocities) and RRR were defined as <2.5 and <2.62, respectively. The mortality rate was marginally higher in patients with abnormal CFR (428 patients [25%]) than those with normal CFR (38 [9%] versus 81 [6%];
P
=0.08), and was significantly higher in patients with abnormal RRR (716 patients [42%]) than those with normal RRR (70 [10%] versus 49 [5%],
P
=0.0002) over the median follow‐up of 11.3 years. Patients with abnormal CFR had marginally lower survival than those with normal CFR (log‐rank
P
=0.08). In contrast, patients with abnormal RRR had significantly lower survival than those with normal RRR (log‐rank
P
=0.001). Abnormal RRR was associated with shorter time to death even after adjustment for other covariates (adjusted hazard ratio, 1.63; 95% CI, 1.11–2.38;
P
=0.01).

Conclusions

In patients with no obstructive coronary artery disease, RRR was superior to CFR in predicting long‐term survival. An RRR <2.62 was associated with 1.6 times increased risk of death in patients with nonobstructive coronary artery disease. Indices of coronary microcirculatory resistive reserve comprising flow‐ and pressure‐derived values may reflect underlying microvascular pathology more faithfully than flow‐alone indices like CFR.
Temporal Trends, Clinical Characteristics, and Outcomes of Emergent Coronary Artery Bypass Grafting for Acute Myocardial Infarction in the United States
Authors: Patlolla Sri Harsha , Kanwar Ardaas , Cheungpasitporn Wisit , Doshi Rajkumar P. , Stulak John M. , Holmes David R. , Bell Malcolm R. , Singh Mandeep , Vallabhajosyula Saraschandra
Published: May 2021

Background

There are limited contemporary data on the use of emergent coronary artery bypass grafting (CABG) in acute myocardial infarction.

Methods and Results

Adult (aged >18 years) acute myocardial infarction admissions were identified using the National (Nationwide) Inpatient Sample (2000–2017) and classified by tertiles of admission year. Outcomes of interest included temporal trends of CABG use; age‐, sex‐, and race‐stratified trends in CABG use; in‐hospital mortality; hospitalization costs; and hospital length of stay. Of the 11 622 528 acute myocardial infarction admissions, emergent CABG was performed in 1 071 156 (9.2%). CABG utilization decreased overall (10.5% [2000] to 8.7% [2017]; adjusted odds ratio [OR], 0.98 [95% CI, 0.98–0.98];
P
<0.001), in ST‐segment–elevation myocardial infarction (10.2% [2000] to 5.2% [2017]; adjusted OR, 0.95 [95% CI, 0.95–0.95];
P
<0.001) and non–ST‐segment–elevation myocardial infarction (10.8% [2000] to 10.0% [2017]; adjusted OR, 0.99 [95% CI, 0.99–0.99];
P
<0.001), with consistent age, sex, and race trends. In 2012 to 2017, compared with 2000 to 2005, admissions receiving emergent CABG were more likely to have non–ST‐segment–elevation myocardial infarction (80.5% versus 56.1%), higher rates of noncardiac multiorgan failure (26.1% versus 8.4%), cardiogenic shock (11.5% versus 6.4%), and use of mechanical circulatory support (19.8% versus 18.7%). In‐hospital mortality in CABG admissions decreased from 5.3% (2000) to 3.6% (2017) (adjusted OR, 0.89; 95% CI, 0.88–0.89 [
P
<0.001]) in the overall cohort, with similar temporal trends in patients with ST‐segment–elevation myocardial infarction and non–ST‐segment–elevation myocardial infarction. An increase in lengths of hospital stay and hospitalization costs was seen over time.

Conclusions

Utilization of CABG has decreased substantially in acute myocardial infarction admissions, especially in patients with ST‐segment–elevation myocardial infarction. Despite an increase in acuity and multiorgan failure, in‐hospital mortality consistently decreased in this population.
Contemporary National Patterns of Eligibility and Use of Novel Cardioprotective Antihyperglycemic Agents in Type 2 Diabetes Mellitus
Authors: Nargesi Arash A. , Jeyashanmugaraja Gini P. , Desai Nihar , Lipska Kasia , Krumholz Harlan , Khera Rohan
Published: May 2021

Background

SGLT‐2 (sodium glucose transporter‐2) inhibitors and GLP‐1RAs (glucagon‐like peptide‐1 receptor agonists) effectively lowered cardiovascular risk in large clinical trials for patients with type 2 diabetes mellitus at high risk for these complications, and have been recommended by guidelines. To evaluate the contemporary landscape in which these recommendations would be implemented, we examined the use of these medications according to clinical guideline practice.

Methods and Results

In the National Health and Nutrition Examination Survey for 2017 to 2018, we defined compelling indications for SGLT‐2 inhibitors by the presence of atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease, and for GLP‐1RAs by the presence of established or high‐risk atherosclerotic cardiovascular disease, based on large clinical trials that have been incorporated in guideline recommendations of the American College of Cardiology and American Diabetes Association. We then evaluated use of these medications among patients with physician‐diagnosed type 2 diabetes mellitus. All analyses incorporated complex survey design to produce nationally representative estimates. A total 1104 of 9254 sampled individuals had type 2 diabetes mellitus, representing 10.6% (95% CI, 9.7%–11.6%) of the US population or 33.2 million adults nationally. Of these, 52.6% (95% CI, 47.7%–57.5%) had an indication for SGLT‐2 inhibitors, 32.8% (95% CI, 28.8%–37.2%) for GLP‐1RAs, and 26.6% (95% CI, 22.2%–31.7%) for both medications. During 2017 to 2018, 4.5% (95% CI, 2.4%–8.2%) were treated with SGLT‐2 inhibitors and 1.5% (95% CI, 0.7%–3.2%) with GLP‐1RAs. Atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease were not independently associated with SGLT‐2 inhibitor or GLP‐1RA use in patients with diabetes mellitus.

Conclusions

Despite a large number of patients being eligible for guideline‐recommended cardiorenal protective therapies, there are substantial gaps in the use of SGLT‐2 inhibitors and GLP‐1RAs, limiting their public health benefits.
Missions and the Construction of Gender in the Middle East
Authors: Gabry-Thienpont Séverine , Neveu Norig
Published: May 2021

The introduction to this special issue considers interdisciplinary approaches to the study of gender within missions to the Middle East, from the nineteenth century to the present. By highlighting the piecemeal nature of existing historical and anthropological research, it throws light on the transnational dynamics and gendered constructions of missionary activity, along with its nationalist dimensions. The studies presented here examine long-term gendered constructions of missionary activities in ways that encompass both femininities and masculinities, along with constructions of womanhood and manhood. By putting the question of gender at the heart of their works, the contributors to this special issue affirm the centrality of gendered approaches for understanding the social, cultural and religious relationships between missionaries and local peoples whom they encountered.
When the Physician Becomes an Apostle
Authors: Langhendries Maarten , Wils Kaat
Published: May 2021

Missionary medicine, especially healthcare offered by Catholic missions, is a rather neglected field in the study of colonial medicine. In addition, the potential of analytical tools such as the circulation of knowledge or attention for professional identities has not been fully explored yet. In this study of physicians in the Belgian Congo, we argue that a new professional identity – or persona – of the Catholic colonial doctor arose as a result of Catholic religious doctrine, missionary politics and biomedical developments. The persona of the mission’s main healthcare provider, with a strong commitment to curative medicine, was a metropolitan professional identity shaped by older missionary narratives. In colonial day-to-day reality, however, where tensions between physicians, missionaries and state officials abounded, this discursive identity proved difficult to maintain.
“Have You Ever Been Told That God Loves You?”
Authors: Aupiais Armand
Published: May 2021

This article focuses on the division of religious labour according to both gender and marital situation, based on an ethnographic survey in a Pentecostal church with a mixed membership in Istanbul (Turkey). Following the description of religious labour throughout its six areas, this research shows that celibacy is made relatively invisible inside the church, where the emphasis is on conjugality and family, while the latter bonds are de-emphasised in the outside world, where singles are at the forefront. “Love” appears as a multifaceted reality, encompassing not only justifications but the very output of religious labour, inside and outside the faith community.
American Missionaries in Egypt, Gender Relations, and the Professional and Social Formation of Women, 1854–1967
Authors: Sharkey Heather J.
Published: May 2021

This article considers the impact that the American Presbyterian mission in Egypt (1854–1967) exerted on American and Egyptian women, by expanding career opportunities and roles in church life and promoting new ideas about gender relations, sexuality, and family. It uses American women doctors and Egyptian Bible Women as case studies for female professionalism. Questioning the premise that influence moved one way, from American missionaries towards Egyptians, this study rejects triumphalist narratives about American progress in the gender domain; develops the story of missionary encounters as a bumpy two-way street; and shows how American and Egyptian women struggled to seize opportunities amid persistent gender discrimination. The article discusses the dearth of sources about these women, a shortfall that widens the gender gap in historical representation, requiring us to read between the lines.
Masculinity, Industrial Education and Fascism in Egypt
Authors: Turiano Annalaura
Published: May 2021

Starting from the premise that school is a ‘major site of masculinity formation’ (Connell, 1996), this article studies the construction of boyhood in the industrial schools of the Salesian mission in Egypt between 1900 and 1939. Analysis of the teaching tools and methods, and of the processes of conformity used in these schools run by Italian missionaries, reveals that they became forums for confrontation and negotiation between different models of masculinity. This article uses the case study of the Salesian schools to shed new light on the interconnections between missionary programmes, fascist imperialism and schooling strategies of the pupils and their families. Ultimately, it seeks to demonstrate how missionary schools contributed to the gendered construction of technical expertise and industrial education in Egypt.
The Right to Freedom of Thought in the United Kingdom
Authors: Cranmer Frank
Published: May 2021

The United Kingdom is bound by international obligations to uphold “the right to freedom of thought, conscience and religion” and domestic legislation reflects those obligations. The courts have held that to be protected, a belief must genuine, must not be a mere opinion, must attain a certain level of cogency, seriousness and importance and must be “worthy of respect in a democratic society”. How this plays out, however, in areas such as education, children’s rights and employment is highly sensitive to the specific facts of each case – which are often inconsistent, as the article explains. Much of the article examines the decisions of the courts in individual cases. It concludes with a discussion of the possible trajectory of domestic political debate at a time when there have been repeated calls for a “British Bill of Rights” and the Westminster Government is questioning more generally the constitutional role of the judiciary.
Colonic Endometriosis: A Study of Near Obstructing Sigmoid Endometrioma
Authors: Stevens Kaitlyn , Wasfie Tarik , Haus Carolyn F.
Published: May 2021

A 41-year-old woman had a near-obstructing endometrioma involving the distal sigmoid colon treated with en bloc removal of the involved segment of colon and the adherent adnexa.
Living arrangements and intergenerational support among older Chinese: Does the gender of the co-resident adult children make a difference?
Authors: Yang Shuyan , Xie Lili , Li Ting
Published: May 2021

This study examines the effect of living arrangements on intergenerational support for older Chinese, using a nationally representative survey data of 9713 respondents (mean age = 70.18 years). The results of a generalised ordered logit and logit model showed that older adults living with a daughter received better instrumental and emotional support than those living with a son. The associations between residing with a daughter and the provision of intergenerational support varied between urban- and rural-dwelling older adults. The findings suggest that attention should be given to the gender perspective in gerontological social work practices and family support policies.
Enhancing social work education’s diversity-oriented perspective by integrating refugees into higher education: Experiences from the ‘refugee crisis’ in Germany
Authors: Borrmann Stefan
Published: May 2021

This note describes how integrating refugees into programs of social work education at universities and universities of applied sciences in Germany influenced the education provided, especially in rural areas where student bodies tend to be homogeneous groups. The refugees enrolled in social work courses changed those mostly homogeneous groups of students not only with their presence but moreover by introducing new perspectives on course content. As the changes prompted shifts in the global mindedness of fellow students and the teaching staff, the quality of the programs was enhanced.
Resisting politics of authoritarian populism during COVID-19, reclaiming democracy and narrative justice: Centering critical thinking in social work
Authors: Lee Eunjung , Johnstone Marjorie
Published: May 2021

Authoritarian populism that fosters deep hate of ‘Others’ and a desire for obedience and order, has attacked the fundamental principles of social work and democracy. During the global health crisis, another global pandemic – xeno or racism – is evoked to corroborate authoritarian populism. We critically analyze the dynamics of populism that shift the focus from ‘people’ to ‘problems’ and how it has been intensified during COVID-19. Using narrative justice as a guiding framework, we invite social workers to critically reflect on how this politics has impacted marginalized populations and injuries done to democracy and how social workers can contribute constructing social justice narratives.
Comparing the Slider Measure of Social Value Orientation with Its Main Alternatives
Authors: Bakker Dieko M. , Dijkstra Jacob
Published: May 2021

The Slider Measure of social value orientation (SVO) was introduced as an improvement from existing measures. We conduct an independent assessment of its suitability compared with the Ring Measure and the Triple Dominance Measure. Using a student sample, we assess the measures’ test-retest reliability (N = 88; using a longer time interval than previous studies) and sensitivity to random responses. Analyses pertaining to convergent validity, criterion validity, and the advantages of a continuous over a discrete measure are presented in the online appendix . Compared with alternatives, the Slider Measure has the highest test-retest reliability. However, it classifies random responses in an unbalanced way, assigning the vast majority of random responses to cooperative and individualistic, rather than altruistic and competitive, orientations. For all three measures, we propose improved ways of weeding out inconsistent responses.
Adverse birth outcomes and associated factors among mothers who delivered in Bale zone hospitals, Oromia Region, Southeast Ethiopia
Authors: Degno Sisay , Lencha Bikila , Aman Ramato , Atlaw Daniel , Mekonnen Ashenafi , Woldeyohannes Demelash , Tekalegn Yohannes , Hailu Sintayehu , Woldemichael Bedasa , Nigussie Ashebir
Published: May 2021

Objective

Adverse birth outcomes, which include stillbirth, preterm birth, low birthweight, congenital abnormalities, and stillbirth, are the leading cause of neonatal and infant mortality worldwide. We assessed adverse birth outcomes and associated factors among mothers who gave birth in Bale zone hospitals, Oromia, Southeast Ethiopia.

Methods

We used systematic random sampling in this cross-sectional study. We identified factors associated with adverse birth outcomes using bivariate analysis and multivariable logistic regression analysis.

Results

The proportion of adverse birth outcomes among participants was 21%. Of 576 births, 70 (12.2%) were low birthweight, 49 (8.5%) were preterm birth, 45 (7.8%) were stillbirth, and 18 (3.1%) infants had congenital anomalies. Inadequate antenatal care (adjusted odds ratio [AOR] = 6.58, 95% confidence interval [CI] 3.25–13.32), multiple pregnancy (AOR  =  4.74, 95% CI 1.55–14.45), premature rupture of membranes in the current pregnancy (AOR = 2.31, 95% CI 1.26–4.21), hemoglobin level  < 11 g/dL (AOR = 3.22, 95% CI 1.85–5.58), and mid-upper arm circumference less than 23 cm (AOR = 5.93, 95% CI 3.49–10.08) were all significantly associated with adverse birth outcomes.

Conclusions

Approximately one in five study participants had adverse birth outcomes. Increasing antenatal care uptake, ferrous supplementation during pregnancy, and improving the quality of maternal health services are recommended.
18F-FDG PET/CT features of ureteral metastases from breast cancer: a case report
Authors: Huang Yuanbi , He Huajie , Wei Wei , Li Qiguang , Long Xian , Li Yongpeng , Chen Rongchao , Yi Xianlin
Published: May 2021

Breast cancer metastasis to the ureter is rare. Fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/computed tomography (CT) is widely used to identify primary lesions of metastatic tumours, however, 18F-FDG PET/CT imaging features of ureteral metastasis from breast cancer are rarely reported. Herein, the case of a 46-year-old woman with recurrent left flank pain for 5 months, who was admitted to the Cancer Hospital of Guangxi Medical University and Guangxi Cancer Research Institute, is described. She had undergone right radical mastectomy 5 years previously and had received tamoxifen treatment for 5 years. Assessment by 18F-FDG PET/CT revealed tumours on the ureter presenting as a long segmental lesion, radioactive concentrations, and a low maximum standardized uptake value (SUVmax), with no radioactive concentrations in the urine and no significant change in the ureteral contour. The severity of the ureteral lesion was not consistent with the severity of hydronephrosis. A tumour biopsy was performed laparoscopically, and postoperative pathological examination confirmed a primary breast cancer tumour. The patient did not consent to treatment and was lost to follow-up.
Evaluation of urine SARS-COV-2 RT-PCR as a predictor of acute kidney injury and disease severity in patients with critical COVID-19
Authors: de Souza Sérgio Pinto , Silveira Marcelo Augusto Duarte , Souza Bruno Solano de Freitas , Cabral Julia Barros , de Melo Erica Batista dos Santos Galvão , Nonaka Carolina Kymie Vasques , Coelho Fernanda Oliveira , da Hora Passos Rogério
Published: May 2021

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began as an outbreak in Wuhan, China and has spread rapidly across the globe. Although most infections are mild, patients with severe and critical COVID-19 infections face deterioration of respiratory function and may also have extrapulmonary manifestations, mostly affecting the kidney, digestive tract, heart, and nervous system. Here, we prospectively evaluated the presence of SARS-CoV-2 genetic material using reverse-transcription polymerase chain reaction in urine samples obtained from patients with COVID-19 receiving critical care. Among 51 included patients, we found higher serum creatinine levels, a longer hospital stay, and more frequent need for dialysis in urine-positive patients. These findings could suggest that, in predisposed patients, a direct viral cytopathic effect may contribute to a more severe disease phenotype.
Guidelines of the International Headache Society for clinical trials with neuromodulation devices for the treatment of migraine
Authors: Tassorelli Cristina , Diener Hans-Christoph , Silberstein Stephen D , Dodick David W , Goadsby Peter J , Jensen Rigmor H , Magis Delphine , Pozo-Rosich Patricia , Yuan Hsiangkuo , Martinelli Daniele , Hoek Thomas van den , Deen Marie , Ashina Messoud , Terwindt Gisela M
Published: May 2021

Background

Although the European Medicines Agency and the US Food and Drug Administration have cleared several devices that use neuromodulation to provide clinical benefits in the acute or preventive treatment of migraine, the Clinical Trials Committee of the International Headache Society has not developed guidelines specifically for clinical trials of neuromodulation devices. In recognition of the distinct needs and challenges associated with their assessment in controlled trials, the Committee provides these recommendations for optimizing the design and conduct of controlled trials of neuromodulation devices for the acute and/or preventive treatment of migraine.

Methods

An international group of headache scientists and clinicians with expertise in neuromodulation evaluated clinical trials involving neuromodulation devices that have been published since 2000. The Clinical Trials Committee incorporated findings from this expert analysis into a new guideline for clinical trials of neuromodulation devices for the treatment of migraine.

Results

Key terms were defined and recommendations provided relative to the assessment of neuromodulation devices for acute treatment in adults, preventive treatment in adults, and acute and preventive treatment in children and adolescents. Ethical and administrative responsibilities were outlined, and a bibliography of previous research involving neuromodulation devices was created.

Conclusions

Adoption of these recommendations will improve the quality of evidence regarding this important area in migraine treatment.
Simulation of the Impacts of a Zero-Emission Zone on Freight Delivery Patterns in Rotterdam
Authors: de Bok Michiel , Tavasszy Lóránt , Kourounioti Ioanna , Thoen Sebastiaan , Eggers Larissa , Nielsen Victor Mayland , Streng Jos
Published: May 2021

As part of a broader vision for emission-free city logistics, the city of Rotterdam plans to introduce a zero-emission zone in combination with urban consolidation centers (UCCs) on the outskirts of the city to generate a shift to zero-emission vehicles. For the design of this zero-emission zone, several research questions arise that require a systematic analysis of the impacts of the transition scenarios on freight demand patterns, the use and market shares of new (zero-emission) vehicles, and the impacts of truck flow and emissions. As a case study, we implemented heterogenous transition scenarios for each logistic segment into the Tactical Freight Simulator from the HARMONY project and analyzed the systemwide impacts. This model is multiagent, empirical, and shipment based and simulates long-term tactical choices (distribution channel choice, shipment size and vehicle type choice, sourcing) and short-term tactical choices (tour formation, delivery times). Results showed that the impact of UCCs is not trivial: we observed a small increase in vehicle kilometers traveled overall of +0.25%, which can be attributed to the rerouting of shipments through the UCCs. Calculations confirmed that emissions reduced dramatically, by 90%, inside the zero-emission zone. At the city scale this corresponds to a reduction of almost 10%, as most freight-related traffic is generated by the port and involves long-haul heavy goods vehicle transport that does not enter the city center. At a regional level, impact reduction was very small. More measures are needed if more ambitious reductions in emissions are to be achieved.
Futures of a ‘halved sustainability’: Critical comments on Frank Adloff and Sighard Neckel’s research program
Authors: Brand Karl-Werner
Published: May 2021

One of the central problems of social-theoretical sustainability studies is their high degree of arbitrariness. To increase the transparency of these studies, this article outlines a frame of reference for a systematic comparison of theoretical sustainability approaches that intends to clarify their thematic focus, theoretical premises, implicit assumptions and blind spots. This frame of reference will then be applied to the research program ‘Futures of Sustainability: Modernization, Transformation, Control’ directed by Frank Adloff and Sighard Neckel at the University of Hamburg.
Intimate Partner Violence and its Mental Health Implications Amid COVID-19 Lockdown: Findings Among Nigerian Couples
Authors: Ojeahere Margaret Isioma , Kumswa Sahmicit Kankemwa , Adiukwu Frances , Plang Janet Punyit , Taiwo Yetunde Folake
Published: May 2021

Intimate partner violence (IPV) has been identified as a global health problem with increasing mental health consequences. During the COVID-19 pandemic lockdown in Nigeria, couples were compelled to spend more time together, regardless of their pre-existing challenges. Our study aims to determine the prevalence of IPV, its forms, and mental health implications among Nigerian households amid the COVID-19 lockdown. A cross-sectional study was implemented which used the snowball sampling technique to recruit 474 participants across 31 states in Nigeria. A semi-structured online questionnaire was distributed using the WhatsApp platform. The relationship between IPV, its forms, and associated factors were analyzed using descriptive analysis and logistic regression with significant value at p ≤ .05 and confidence interval of 95%. Majority (98.1%) of the participants had at least a college degree and 90.1% were employed. Overall prevalence of IPV ranged from 7.2% to 13.5%. Using the lockdown as the landmark, higher prevalence was found before than during the lockdown across physical, emotional, financial, and sexual forms of IPV. Emotional form had the highest prevalence both before and during the lockdown with 11.4% and 3.8% respectively. Furthermore, 22.6% of participants reported that the lockdown affected their mental health. Hopelessness, feelings of failure, being irritable, and constantly under strain were psychological symptoms significantly associated with IPV amid the lockdown. Decreased prevalence of IPV were found in the early phase of the pandemic, suggesting that couples can experience less partner violence during periods of confinement. Our study supports existing evidence that forms of IPV have negative mental health consequences on abused partners.
The longitudinal interplay between personal values and subjective well-being: A registered report
Authors: Grosz Michael P , Schwartz Shalom H , Lechner Clemens M
Published: May 2021

A large body of cross-sectional research on personal values and subjective well-being has inspired theories of the interplay between personal values and subjective well-being. In this registered report, we investigated which of these theories fit best with the longitudinal associations between values and cognitive and affective subjective well-being. We hypothesized that openness-to-change values have a causal effect on subjective well-being and that subjective well-being, in turn, has a causal effect on openness-to-change values. We analyzed 12 waves of a German panel study ( N = 9,723) with random intercept cross-lagged panel models (RI-CLPM). Partly consistent with our hypotheses, all four six-month cross-lagged effects and one of four 18-month cross-lagged effects from openness-to-change values to subjective well-being and vice versa were statistically significant. Neither openness-to-change values nor subjective well-being appeared to be causally predominant over the other. Additional exploratory analyses yielded little evidence for cross-lagged effects from conservation, self-transcendence, and self-enhancement to subjective well-being or vice versa. Overall, our findings are compatible with theorized bidirectional influences between openness-to-change values and subjective well-being. Time-varying confounders might provide an alternative explanation for the cross-lagged associations that we could not rule out. We conclude with directions for further theory-driven research on the values–subjective well-being interface.
Donations and the Overhead Ratio Are Related Even When Donors Do Not Bother About Efficiency
Authors: Jegers Marc
Published: May 2021

Empirical research on donor behavior infers from donations being negatively related to overhead ratios (or indicators based on these ratios) that donors give more to more “efficient” organizations. This relation is proved to be at least partly driven by a purely mechanical link between donations and overhead ratios, which therefore should be isolated when studying empirically the behavioral effect of overhead ratio–based indicators on donors’ giving decisions.
A numerical study on the internal heat leak mechanisms in a variable property three-stream heat exchanger
Authors: Shafiei-alamooti Yasser , Ashrafizadeh Ali
Published: May 2021

Heat leakage mechanisms need to be addressed in the thermal analysis of multi-stream heat exchangers due to their effects on the intended heat transfer between the streams. In this paper, multi-dimensional heat transfers between various fluid streams and also between the fluid and solid parts of a three-stream plate-fin heat exchanger is numerically modeled considering the variation of thermo-physical properties of both solid and fluid parts. All internal heat leak mechanisms, i.e. longitudinal heat conduction, transverse bypass through fins, and heat transfer reversal in a stream are taken into consideration. The distribution of longitudinal heat conduction along the stream’s separating plates (plates) is also explored. It is shown that the longitudinal heat conduction depends strongly on the variation of properties in some flow arrangements. For such cases, the plates experience areas with relatively low temperature, and a new longitudinal heat conduction, mainly induced by property variation, is identified and presented. This induced longitudinal conduction is close to 1% of the maximum heat exchange between the streams in this study. Another interesting result is that the longitudinal temperature distribution in the plates does not necessarily follow the temperature distribution along the nearby streams due to the entrance effects and unbalanced heat capacity rates. Numerical results show that property variations affect all of the thermal leakage phenomena and, therefore, need to be considered in the modeling and thermal analysis of multi-stream heat exchangers.
Cross-sectional study of plasma Axl, ferritin, IGFBP4 and sTNFR2 as biomarkers of disease activity in childhood-onset SLE: A study of the Pediatric Nephrology Research Consortium
Authors: Soliman Samar A , Haque Anam , Mason Sherene , Greenbaum Larry A , Hicks M John , Mohan Chandra , Wenderfer Scott E
Published: May 2021

Objective

To evaluate the performance of 4 plasma protein markers for detecting disease activity in childhood-onset systemic lupus erythematosus (SLE) patients.

Methods

Eighty-three consecutive pediatric patients fulfilling ≥4 ACR criteria for SLE and twenty-five healthy controls were prospectively recruited for serological testing of 4 protein markers identified by antibody-coated microarray screen, namely Axl, ferritin, IGFBP4 and sTNFR2. SLE disease activity was assessed using SLEDAI-2000 score. Fifty-seven patients had clinically active SLE (SLEDAI score ≥4, or having a flare).

Results

The plasma concentrations of Axl and ferritin were significantly higher in patients with active SLE than inactive SLE. Plasma Axl levels were significantly higher in active renal versus active non-renal SLE patients. Levels of Axl, ferritin and IGFBP4 correlated significantly with SLEDAI scores. Levels of Axl, IFGBP4 and sTNFR2 inversely correlated with plasma complement C3 levels. Only plasma Axl and ferritin levels correlated with degree of proteinuria. These markers were more specific, but less sensitive, in detecting concurrent SLE activity than elevated anti-dsDNA antibody titer or decreased C3. Ferritin and IGFBP4 levels were more specific for concurrent active lupus nephritis than anti-dsDNA or C3. Plasma ferritin was the best monitor of global SLE activity, followed by C3 then Axl, while both Axl and C3 were best monitors of clinical lupus nephritis activity.

Conclusion

In childhood-onset SLE patients, plasma ferritin and Axl perform better than traditional yardsticks in identifying disease activity, either global or renal. The performance of these plasma markers should be explored further in longitudinal cohorts of SLE patients.
Reconceptualizing contemporary energy markets
Authors: Lawrence Andrew
Published: May 2021

This article provides a conjunctural synopsis of both empirical trends and new approaches to analytically and normatively assessing energy markets. The preceding eras of coal and oil entailed not only differing technologies but also historically distinct political geographies, modes of production, and characteristic commodities and systems of value. They also coincided with and helped reinforce several misleading assumptions: of ‘pure’, ‘stateless’ energy markets; of scarcity as a defining feature of all economies; of unlimited growth and of market equilibrium. These assumptions tended to reinforce established approaches to energy markets that were insufficiently historically grounded, abstracted from social, political and ecological relations, and – with particular reference to oil – premised on zero-sum geostrategic calculations of interest. They are inadequate to, or misleading about, fossil fuel markets, and do not adequately address such recent phenomena as unprecedented levels of financialization of the global economy with an unprecedented intensity of ecological crisis entailing, most prominently, global warming. These factors undermine the prior assumptions in several respects: it is not scarcity, but rather abundance of greenhouse gas emissions that is of paramount concern; this in turn necessarily implies that unlimited growth is neither possible nor desirable; and furthermore, that ecological degradation has fundamentally displaced the analytical plausibility of market equilibrium, no less than its normative appeal. An exercise in reconceptualizing energy markets is therefore one that should explore not only what was misperceived and what has changed but also what needs to change in order to restore economic, political and ecological sustainability.
The Politics of Transnational Advocacy Against Chinese, Indian, and Brazilian Extractive Projects in the Global South
Authors: Shipton Leah , Dauvergne Peter
Published: May 2021

Activists in the global South have been navigating two powerful trends since the mid-1990s: intensifying state repression and rising investment in extractive projects from the emerging economies of Brazil, Russia, India, China, and South Africa (BRICS). In this context, this article explores the underlying forces determining the formation, endurance, and power of BRICS–South transnational advocacy networks (TANs) opposed to BRICS-based corporate extraction in the global South. By analyzing activism against Chinese, Indian, and Brazilian extractive projects in Ecuador, Ethiopia, and Mozambique, respectively, the research reveals the critical importance of domestic politics and civil society characteristics in both the BRICS and host states for shaping BRICS–South TANs, including which groups assume leadership, the extent of cross-national cooperation, and the role of nonprofits headquartered in the global North. The findings uncover core reasons for the variable resiliency and capacity of BRICS–South TANs, opening up new avenues of research and offering valuable insights for activists and policymakers.
Course Internationalization Through Virtual Exchange: Students’ Reflections About “Seeing the World Through the Lens That is Soccer”
Authors: Coche Roxane
Published: May 2021

Virtual exchange (VE) is an emergent but promising trend in course internationalization, which consists of using technology to interact and work with another class located in another city/country to develop digital skills and intercultural competence. After a VE project was implemented in a sports-related communication course, students reflected on their experience in a short paper or a video. This case study is a qualitative analysis of these 17 reflections. Despite some complications, students indicated they learned much about cultural differences and would be keen to repeat the VE experience.