bluuebunny/crossref_metadata_2025 huggingface dataset:
The Potential Association between the Risk of Post-Surgical Adhesion and the Activated Local Angiotensin II Type 1 Receptors: Need for Novel Treatment Strategies
Authors: Tavakkoli Mahmood , Aali Saeed , Khaledifar Borzoo , Ferns Gordon A. , Khazaei Majid , Fekri Kiavash , Arjmand Mohammad-Hassan
Published: March 2021

Background: Post-surgical adhesion bands (PSABs) are a common complication after abdominal or pelvic surgeries for different reasons like cancer treatment. Despite improvements in surgical techniques and the administration of drugs or the use of physical barriers, there has only been limited improvement in the frequency of postoperative adhesions. Complications of PSAB are pain, infertility, intestinal obstruction, and increased mortality. The most important molecular mechanisms for the development of PSAB are inflammatory response, oxidative stress, and overexpression of pro-fibrotic molecules such as transforming growth factor β. However, questions remain about the pathogenesis of this problem, for example, the causes for individual differences or why certain tissue sites are more prone to post-surgical adhesions. Summary: Addressing the pathological causes of PSAB, the potential role of local angiotensin II/angiotensin II type 1 receptors (AngII/AT1R), may help to prevent this problem. Key Message: The objective of this article was to explore the role of the AngII/AT1R axis potential to induce PSAB and the therapeutic potential of angiotensin receptor blockers in the prevention and treatment of PSAB.
The Two Formyl Peptide Receptors Differently Regulate GPR84-Mediated Neutrophil NADPH Oxidase Activity
Authors: Mårtensson Jonas , Sundqvist Martina , Manandhar Asmita , Ieremias Loukas , Zhang Linjie , Ulven Trond , Xie Xin , Björkman Lena , Forsman Huamei
Published: March 2021

Neutrophils express the two formyl peptide receptors (FPR1 and FPR2) and the medium-chain fatty acid receptor GPR84. The FPRs are known to define a hierarchy among neutrophil G protein-coupled receptors (GPCRs), that is, the activated FPRs can either suppress or amplify GPCR responses. In this study, we investigated the position of GPR84 in the FPR-defined hierarchy regarding the activation of neutrophil nicotine adenine dinucleotide phosphate (NADPH) oxidase, an enzyme system designed to generate reactive oxygen species (ROS), which are important regulators in cell signaling and immune regulation. When resting neutrophils were activated by GPR84 agonists, a modest ROS release was induced. However, vast amounts of ROS were induced by these GPR84 agonists in FPR2-desensitized neutrophils, and the response was inhibited not only by a GPR84-specific antagonist but also by an FPR2-specific antagonist. This suggests that the amplified GPR84 agonist response is achieved through a reactivation of desensitized FPR2s. In addition, the GPR84-mediated FPR2 reactivation was independent of β-arrestin recruitment and sensitive to a protein phosphatase inhibitor. In contrast to FPR2-desensitized cells, FPR1 desensitization primarily resulted in a suppressed GPR84 agonist-induced ROS response, indicating a receptor hierarchical desensitization of GPR84 by FPR1-generated signals. In summary, our data show that the two FPRs in human neutrophils control the NADPH oxidase activity with concomitant ROS production by communicating with GPR84 through different mechanisms. While FPR1 desensitizes GPR84 and by that suppresses the release of ROS induced by GPR84 agonists, amplified ROS release is achieved by GPR84 agonists through reactivation of the desensitized FPR2.
The Role of Cell Blocks and Immunohistochemistry in Thyroid Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Bethesda Category
Authors: Abram Mikk , Huhtamella Roope , Kalfert David , Hakso-Mäkinen Heli , Ludvíková Marie , Kholová Ivana
Published: March 2021

Introduction: Thyroid cytology is a widely accepted tool in the clinical triaging of nodular lesions. Cell blocks (CBs) can help in the diagnosis of atypical lesions, namely, thyroid Bethesda category of Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS). Methods: In a series of 224 AUS/FLUS thyroid samples with CB, we studied CB cellularity and feasibility of 3 immunohistochemical markers (cytokeratin 19 [CK19], HBME-1, and galectin-3) apart and in combination. Results: The CBs were non-diagnostic in 34 cases. Twenty-four CBs contained <10 cells, 45 CBs 10–50 cells, and 121 CBs >50 cells. Notably, more cellularity was found in CBs performed by plasma-thrombin and in-house techniques (p < 0.001). The diagnostic accuracy to detect malignancy was 65.1% for CK19, 72.1% for HBME-1, and 70.3% for galectin-3. Conclusion: In conclusion, CB cellularity is essential for successful immunohistochemistry application and further diagnostic workup of AUS/FLUS cases.
WoundClot® Hemostatic Gauze Reduces Bleeding Time after Arterial Venous Fistula Decannulation
Authors: Kliuk-Ben Bassat Orit , Schwartz Doron , Zubkov Alexander , Gal-Oz Amir , Gorevoy Alexander , Romach Iris , Grupper Ayelet
Published: March 2021

Introduction: Decannulation of the arteriovenous fistula (AVF) after each hemodialysis session requires a precise compression on the needle puncture site. The objective of our study was to evaluate the bleeding time (BT) needed to achieve hemostasis using WoundClot, an innovative hemostatic gauze, and to assess whether its long-term use can improve AVF preservation. Methods: This is a prospective single center study. Initially, the time to hemostasis after AVF decannulation was compared between WoundClot and cotton gauze in 24 prevalent hemodialysis patients. Thereafter, the patients continued to use WoundClot for 12 months and were compared to a control group consisting of 25 patients using regular cotton gauze. Follow-up data included parameters of dialysis adequacy, AVF interventions, and thrombotic events. Results: WoundClot use shortened significantly the time needed for hemostasis. Mean venous BT decreased by 3.99 (±4.6) min and mean arterial BT by 6.38 (±4.8) min when using WoundClot compared to cotton gauze (p < 0.001). At the end of the study, dialysis adequacy expressed by spKt/V was higher in the WoundClot group compared to control (1.73 vs. 1.53, respectively, p = 0.047). Although patients in WoundClot group had a higher baseline BT, arterial and venous pressures did not differ between the groups after a median follow up of 10.8 months. AVF thrombosis rate was similar between the groups. Conclusions: WoundClot hemostatic gauze significantly reduced the time required for hemostasis after AVF decannulation and may be associated with better AVF preservation. We suggest using WoundClot for arterial BT longer than 15 min and for venous BT longer than 12.5 min.
Cumulative C-Reactive Protein Levels and Progression of Malnutrition in Dialysis Patients: A Longitudinal Study
Authors: Asai Kazuaki , Shibata Masanori , Ito Isao , Tawada Hisae , Taniguchi Shinkichi
Published: March 2021

Background/Aims: Malnutrition is a serious complication in dialysis patients that develops slowly but steadily. Cross-sectional studies may not adequately characterize this complication because not only the intensity but longitudinally cumulative effect should also be taken into consideration. Relationship between time-dependent changes in a nutritional marker, Geriatric Nutritional Risk Index (GNRI), and cumulative C-reactive protein (CRP) values was examined whether both intensity and duration of inflammation correlated with time-dependent progression and severity of malnutrition over 3 years, retrospectively. Methods: One hundred and sixty-four dialysis patients were examined over 3 years retrospectively. Based on analysis of clinical and laboratory findings over a period of 3 years, patients were divided into 2 groups: those with a >3.0 decrease in GNRI after 3 years (n = 84) and those in whom GNRI was unchanged (n = 80). Results: When comparing the 2 groups at 3 years, the GNRI-decreased group had 12% lower serum albumin (p < 0.001) and lower levels of creatinine (9%, p < 0.001), BUN (6%, p < 0.05), total cholesterol (6%, p < 0.05), and low-density lipoprotein cholesterol (10%, p < 0.01), which suggest onset of malnutrition. CRP levels, routinely measured twice a month in all patients, were summed to calculate the cumulative CRP. Cumulative CRP after 3 years was 57.6 ± 7.8 (mg/dL/3 years) in the GNRI-decreased group, which was significantly higher than that in the GNRI-unchanged group (38.6 ± 3.9; p < 0.05). Over 3 years, the GNRI-decreased group showed a time-dependent increase in cumulative CRP alongside a time-dependent decrease in the GNRI, producing an obvious mirror image; however, such inverse correlation was absent in the GNRI-unchanged group. Conclusion: A long-term perspective is needed in the management of malnutrition in dialysis patients because this complication develops progressively and is often irreversible when diagnosed. Cumulative CRP values may be useful in evaluating the degree of the progression of malnutrition in following up individual patients longitudinally.
Preventing Coronavirus Disease 2019 in Kidney Transplant Recipients: Where Should We Begin?
Authors: Riella Leonardo V. , Azzi Jamil R. , Cravedi Paolo
Published: March 2021

Context: Chronic immunosuppression is associated with an increased risk of opportunistic infections. Although kidney transplant recipients with coronavirus disease 2019 (COVID-19) have higher mortality than the general population, data on their risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are unknown. Subject of Review: A recent single-center screening study from the UK (Transplantation. 2021 Jan 1;105(1):151–7) showed that 89 (10.4%) of 855 consecutive kidney transplant recipients tested positive for SARS-CoV-2 antibodies. Risk factors for infection included a nonwhite background, diabetes, and a history of allograft rejection. Risk factors for mortality in individuals who developed COVID-19 were older age and receiving steroids. Second Opinion: This study shows that the rate of SARS-CoV-2 infection in kidney transplant recipients is similar to the one observed in the general population in the same area (13%), indicating that transplant recipients are not at increased risk of COVID-19. However, the investigators raise the interesting point that since transplant individuals were advised to shelter earlier than the general population, they may be in fact more susceptible. This statement is hard to substantiate, but the identification of specific risk factors for infection and poor outcomes is crucial to tailor strategies to prevent spread of the infection. This is particularly important, considering that kidney transplant recipients may be at increased risk of prolonged viral spread and in-host viral mutations, making them not just a particularly fragile population for COVID-19 but also a potentially major source of further contagions.
From BRCA1 to Polygenic Risk Scores: Mutation-Associated Risks in Breast Cancer-Related Genes
Authors: Woodward Emma R. , van Veen Elke M. , Evans D. Gareth
Published: March 2021

Background: There has been huge progress over the last 30 years in identifying the familial component of breast cancer. Summary: Currently around 20% is explained by the high-risk genes BRCA1 and BRCA2, a further 2% by other high-penetrance genes, and around 5% by the moderate risk genes ATM and CHEK2. In contrast, the more than 300 low-penetrance single-nucleotide polymorphisms (SNP) now account for around 28% and they are predicted to account for most of the remaining 45% yet to be found. Even for high-risk genes which confer a 40–90% risk of breast cancer, these SNP can substantially affect the level of breast cancer risk. Indeed, the strength of family history and hormonal and reproductive factors is very important in assessing risk even for a BRCA carrier. The risks of contralateral breast cancer are also affected by SNP as well as by the presence of high or moderate risk genes. Genetic testing using gene panels is now commonplace. Key-Messages: There is a need for a more parsimonious approach to panels only testing those genes with a definite 2-fold increased risk and only testing those genes with challenging management implications, such as CDH1 and TP53, when there is strong clinical indication to do so. Testing of SNP alongside genes is likely to provide a more accurate risk assessment.
Association between knowledge and depression at rising time of COVID-19 in Bangladesh
Authors: Akhtar Sharmin , Ahmed Rubel , Chaity Arnaba Saha , Billah Mutasim
Published: March 2021

Novel coronavirus (nCoV) has created a new challenging situation all over the world. In Bangladesh, people are facing some difficulties to response the emergencies. There are so many people who are lacking of proper quarantine information and knowledge about prevention practices towards coronavirus disease 2019 (COVID-19). COVID-19 has created an experience of mental disorder like depression, anxiety, and stress. Although social media, newspaper, news, television has focused on this issue, still there is to be needed to identify the psychological effects like negative impact on our mind and behavioral changes during lockdown. An online survey of 248 respondents was conducted between April, 15 2020 and May, 15 2020. The aim of this study was to assess the relationship between higher knowledge of public regarding safety measures and depression among the adult population of Bangladesh during lockdown. This study focused on correlation between knowledge level and mental health condition like depression. About 50% respondents were felt high depression after the first announcement of lockdown in Bangladesh. Approximately 50% respondents stated that people of their locality were panicked, not panicked were 26.21% and the probability of getting panic were 23.79% due to COVID-19 during lockdown in Bangladesh. The respondents who had gathered a higher knowledge about precautions were associated with depression.
Effects of social media exposure on adolescent sexual attitudes and behavior: A systematic review
Authors: Fevriasanty Fransiska Imavike , Suyanto Bagong , Soedirham Oedojo , Sugihartati Rahma , Ahsan Ahsan
Published: March 2021

Aside from the role of family and peer groups, social media is also one of the major agents of sexual socialization in adolescents. Since it is relatively easy to connect to the internet these days, these people now have a wider access to pornographic content that could trigger them to engage in risky sexual behaviors. This review aimed to provide an analysis of the influence of social media exposure on adolescent’s sexual attitudes and behavior as well as describe limitations of the studies being reviewed. This study was based on several electronic databases namely Google Scholar, Science Direct, Proquest Health and Medical Complete, Proquest Science and Pscycholgy Journals, and PubMed, from 2011 to 2018, which revealed a total of 1351 research articles, with only 21 articles meeting the inclusion criteria and reviews. The result showed higher percentage of studies under reviewed mention the effect of social media exposure are related to sexual attitudes, behaviors, initiation and risks, as well as parental monitoring, academic achievement and gender. Conclusively, it is recommended to educate adolescents about the negative risks of social media exposure on sexual attitudes and behavior, as well as the importance of the role of parental monitoring of restrictions on sexualized media access.
Knowledge and quality of life among Indonesian students during the COVID-19 pandemic
Authors: Pribadi Prasojo , Lolita Lolita , Pangestuti Rayi Citra Ayu , Lutfiyati Heni , Mareti Silvia , Ikhsanudin Azis
Published: March 2021

The increasing of online coronavirus disease-2019 (COVID-19) information-sharing in digital media can contribute to the emergence of misinformation in public. Much insufficient knowledge will confuse public understanding and affect their quality of life. The study purposed to assess the knowledge and its influence on Indonesian students' quality of life during the COVID-19 crisis. A cross-sectional study was conducted between October and December 2020 by distributing online questionnaires. The data analysis was run through the Spearman correlation method by using SPSS version 21.0. A total of 200 respondents aged over 17 years were recruited using a snowball sampling technique. Most study respondents had insufficient knowledge about COVID-19, 23% of them had moderate knowledge, and only 17.5% had high knowledge. They obtained primary sources of COVID-19 information from social media platforms. The results showed that health science students have a better understanding than social science students (ρ<0.001). The level of knowledge has a significant associated with psychological domain (ρ=0.020), environmental domain (ρ=0.046), and overall quality of life (ρ=0.047). Thus, the media control center is vital to encounter valid information in providing better knowledge and quality of life during a pandemic.
Sex and Race‐Ethnic Disparities in Door‐to‐CT Time in Acute Ischemic Stroke: The Florida Stroke Registry
Authors: Polineni Sai P. , Perez Enmanuel J. , Wang Kefeng , Gutierrez Carolina M. , Walker Jeffrey , Foster Dianne , Dong Chuanhui , Asdaghi Negar , Romano Jose G. , Sacco Ralph L. , Rundek Tatjana ,   for the Florida Stroke Registry
Published: March 2021

Background

Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race‐ethnic and sex differences in door‐to‐CT (DTCT) ≤25 minutes in the FSR (Florida Stroke Registry).

Methods and Results

Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator‐treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT ≤25. DTCT ≤25 was achieved in 56% of cases of suspected acute stroke, improving from 36% in 2010 to 72% in 2018. Women (odds ratio [OR], 0.90; 95% CI, 0.87–0.93) and Black (OR, 0.88; CI, 0.84–0.94) patients who had strokes were less likely, and Hispanic patients more likely (OR, 1.07; CI, 1.01–1.14), to achieve DTCT ≤25. In a secondary analysis among intravenous tissue plasminogen activator‐treated patients, 81% of patients achieved DTCT ≤25. In this subgroup, women were less likely to receive DTCT ≤25 (0.85, 0.77–0.94) whereas no significant differences were observed by race or ethnicity.

Conclusions

In the FSR, there was considerable improvement in acute stroke care metric DTCT ≤25 in 2018 in comparison to 2010. However, sex and race‐ethnic disparities persist and require further efforts to improve performance and reduce these disparities.
Treatment Intensification for Elevated Blood Pressure and Risk of Recurrent Stroke
Authors: Kim Beom Joon , Cho Yong‐Jin , Hong Keun‐Sik , Lee Jun , Kim Joon‐Tae , Choi Kang Ho , Park Tai Hwan , Park Sang‐Soon , Park Jong‐Moo , Kang Kyusik , Lee Soo Joo , Kim Jae Guk , Cha Jae‐Kwan , Kim Dae‐Hyun , Lee Byung‐Chul , Yu Kyung‐Ho , Oh Mi‐Sun , Kim Dong‐Eog , Ryu Wi‐Sun , Choi Jay Chol , Kim Wook‐Joo , Shin Dong‐Ick , Sohn Sung Il , Hong Jeong‐Ho , Lee Ji Sung , Lee Juneyoung , Han Moon‐Ku , Gorelick Philip B. , Bae Hee‐Joon
Published: March 2021

Background

It remains unclear whether physicians' attitudes toward timely management of elevated blood pressure affect the risk of stroke recurrence.

Methods and Results

From a multicenter stroke registry database, we identified 2933 patients with acute ischemic stroke who were admitted to participating centers in 2011, survived at the 1‐year follow‐up period, and returned to outpatient clinics ≥2 times after discharge. As a surrogate measure of physicians' attitude, individual treatment intensification (TI) scores were calculated by dividing the difference between the frequencies of observed and expected medication changes by the frequency of clinic visits and categorizing them into 5 groups. The association between TI groups and the recurrence of stroke within 1 year was analyzed using hierarchical frailty models, with adjustment for clustering within each hospital and relevant covariates. Mean±SD of the TI score was −0.13±0.28. The TI score groups were significantly associated with increased risk of recurrent stroke compared with Group 3 (TI score range, −0.25 to 0); Group 1 (range, −1 to −0.5), adjusted hazard ratio (HR) 13.43 (95% CI, 5.95–30.35); Group 2 (range, −0.5 to −0.25), adjusted HR 4.59 (95% CI, 2.01–10.46); and Group 4 (TI score 0), adjusted HR 6.60 (95% CI, 3.02–14.45); but not with Group 5 (range, 0–1), adjusted HR 1.68 (95% CI, 0.62–4.56). This elevated risk in the lowest TI score groups persisted when confining analysis to those with hypertension, history of blood pressure‐lowering medication, no atrial fibrillation, and regular clinic visits and stratifying the subjects by functional capacity at discharge.

Conclusions

A low TI score, which implies physicians' therapeutic inertia in blood pressure management, was associated with a higher risk of recurrent stroke. The TI score may be a useful performance indicator in the outpatient clinic setting to prevent recurrent stroke.
Consensus Transcriptional Landscape of Human End‐Stage Heart Failure
Authors: Ramirez Flores Ricardo O. , Lanzer Jan D. , Holland Christian H. , Leuschner Florian , Most Patrick , Schultz Jobst‐Hendrik , Levinson Rebecca T. , Saez‐Rodriguez Julio
Published: March 2021

Background

Transcriptomic studies have contributed to fundamental knowledge of myocardial remodeling in human heart failure (HF). However, the key HF genes reported are often inconsistent between studies, and systematic efforts to integrate evidence from multiple patient cohorts are lacking. Here, we aimed to provide a framework for comprehensive comparison and analysis of publicly available data sets resulting in an unbiased consensus transcriptional signature of human end‐stage HF.

Methods and Results

We curated and uniformly processed 16 public transcriptomic studies of left ventricular samples from 263 healthy and 653 failing human hearts. First, we evaluated the degree of consistency between studies by using linear classifiers and overrepresentation analysis. Then, we meta‐analyzed the deregulation of 14 041 genes to extract a consensus signature of HF. Finally, to functionally characterize this signature, we estimated the activities of 343 transcription factors, 14 signaling pathways, and 182 micro RNAs, as well as the enrichment of 5998 biological processes. Machine learning approaches revealed conserved disease patterns across all studies independent of technical differences. These consistent molecular changes were prioritized with a meta‐analysis, functionally characterized and validated on external data. We provide all results in a free public resource (
https://saezlab.shinyapps.io/reheat/
) and exemplified usage by deciphering fetal gene reprogramming and tracing the potential myocardial origin of the plasma proteome markers in patients with HF.

Conclusions

Even though technical and sampling variability confound the identification of differentially expressed genes in individual studies, we demonstrated that coordinated molecular responses during end‐stage HF are conserved. The presented resource is crucial to complement findings in independent studies and decipher fundamental changes in failing myocardium.
Chronic Kidney Disease Risk of Isolated Systolic or Diastolic Hypertension in Young Adults: A Nationwide Sample Based‐Cohort Study
Authors: Bae Eun Hui , Lim Sang Yeob , Jung Jin‐Hyung , Oh Tae Ryom , Choi Hong Sang , Kim Chang Seong , Ma Seong Kwon , Han Kyung‐Do , Kim Soo Wan
Published: March 2021

Background

Hypertension among young adults is common. However, the effect of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), or systolic and diastolic hypertension (SDH) among young adults on chronic kidney disease (CKD) development is unknown.

Methods and Results

From a nationwide health screening database, we included 3 030 884 participants aged 20 to 39 years who were not taking antihypertensives at baseline examination in 2009 to 2010. Participants were categorized as having normal blood pressure (BP), elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH. The primary outcome was incident CKD. A total of 5853 (0.19%) CKD events occurred. With normal BP as the reference, multivariable‐adjusted hazard ratios (HRs) (95% CIs) for CKD were 1.14 (95% CI, 1.04–1.26), elevated BP; 1.19 (95% CI, 1.10–1.28), stage 1 IDH; 1.24 (95% CI, 1.08–1.42), stage 1 ISH; 1.39 (95% CI, 1.28–1.51), stage 1 SDH; 1.88 (95% CI, 1.63–2.16), stage 2 IDH; 1.84 (95% CI, 1.54–2.19), stage 2 ISH; 2.70 (95% CI, 2.44–2.98), stage 2 SDH. The HRs for CKD were attenuated in the patients who were antihypertensive and began medication within 1 year of medical checkup than in those without antihypertensives.

Conclusions

Among Korean young adults, those with elevated BP, stage 1 IDH, stage 1 ISH, stage 1 SDH, stage 2 IDH, stage 2 ISH, and stage 2 SDH were associated with a higher CKD risk than those with normal BP. The CKD risk in ISH and IDH groups was similar but lower than that in the SDH group. Antihypertensives attenuated the risk of CKD in young adults with hypertension.
Prestroke Physical Activity and Adverse Health Outcomes After Stroke in the Atherosclerosis Risk in Communities Study
Authors: Mediano Mauro F. F. , Mok Yejin , Coresh Josef , Kucharska-Newton Anna , Palta Priya , Lakshminarayan Kamakshi , Rosamond Wayne D. , Matsushita Kunihiro , Koton Silvia
Published: March 2021

Background and Purpose:

The association of physical activity (PA) before stroke (prestroke PA) with long-term prognosis after stroke is still unclear. We examined the association of prestroke PA with adverse health outcomes in the ARIC study (Atherosclerosis Risk in Communities).

Methods:

We included 881 participants with incident stroke occurring between 1993 and 1995 (visit 3) and December 31, 2016. Follow-up continued until December 31, 2017 to allow for at least 1-year after incident stroke. Prestroke PA was assessed using a modified version of the Baecke questionnaire in 1987 to 1989 (visit 1) and 1993 to 1995 (visit 3), evaluating PA domains (work, leisure, and sports) and total PA. We used Cox proportional hazards models to quantify the association between tertiles of accumulated prestroke PA levels over the 6-year period between visits 1 and 3 and mortality, risk of cardiovascular disease, and recurrent stroke after incident stroke.

Results:

During a median follow-up of 3.1 years after incident stroke, 676 (77%) participants had adverse outcomes. Highest prestroke total PA was associated with decreased risks of all-cause mortality (hazard ratio, 0.78 [95% CI, 0.63–0.97]) compared with lowest tertile. In the analysis by domain-specific PA, highest levels of work PA were associated with lower risk for all-cause (hazard ratio, 0.77 [95% CI, 0.62–0.96]) and cardiovascular mortality (hazard ratio, 0.45 [95% CI, 0.29–0.70]), and highest levels of leisure PA were associated with lower all-cause mortality (hazard ratio, 0.72 [95% CI, 0.58–0.89]) compared with lowest tertile of PA. No significant associations for sports PA were observed.

Conclusions:

Higher levels of total prestroke PA as well as work and leisure PA were associated with lower risk of mortality after incident stroke. Public health strategies to increase lifetime PA should be encouraged to decrease long-term mortality after stroke.
The Confined Atom: James Clerk Maxwell on the Fundamental Particles and the Limits of Scientific Knowledge
Authors: Charalampous Charis
Published: March 2021

This paper distinguishes in Maxwell’s thought between “atomic molecules” and “ultimate atoms,” and arrives at a set of properties that characterize each type of atom. It concludes that Maxwell is a mathematical atomist, an approach that entails the notion that although it is impossible to observe the ultimate atoms as free particles, we can nevertheless study them as mathematical observables, on the caveat that mathematical formalism remains tied to phenomenalism and to theoretical interpretations of such phenomena as, for example, mass and force variations, gravitational pull, gas diffusion and viscosity, and heat conduction.
Two species of slow worm (Anguis fragilis, A. colchica) present in the Baltic region
Authors: Gvoždík Václav , Harca Zdeněk , Hánová Alexandra , Jablonski Daniel , Pupins Mihails , Čeirāns Andris , Paasikunnas Timo
Published: March 2021

Five European slow worms (Anguis) have mostly parapatric distributions. Two species, A. fragilis and A. colchica, are widely distributed across the western and eastern parts of the genus range. Their contact zone runs from the north-eastern Balkans, through Pannonia to northern Central Europe. In northern Poland, the contact zone has been located approximately between the North and East European Plains. Here, we present the first mitochondrial and nuclear DNA data from Finland and the coastal Baltics. We demonstrate that A. fragilis enters the East European Plains, where it is presumably distributed along the Baltic coast. Our data indicate that A. colchica is present more inland and to the north of Riga. The genetic structure suggests three independent postglacial colonization events in the Baltics (two by A. colchica). The presence of the two species, A. fragilis and A. colchica, should be considered by the conservation legislations of Lithuania, Latvia and Russia.
Conceptualizing and Measuring Political Inequality in a Cross-National Perspective
Authors: Choi Gwangeun
Published: March 2021

It is widely believed that economic inequality significantly affects political inequality, and vice versa. However, there has been a lack of empirical evidence about this relationship, particularly, in cross-national comparative research. This is largely because cross-national measures of political inequality are underdeveloped. To fill this gap, this study introduces a new way of conceptualizing and measuring political inequality and constructs the Political Inequality Index (PII), which is mainly based on objective indicators. Additionally, the Political Power Inequality Index (PPII) based on subjective indicators is presented as an alternative measure. This research then explores the features of these measures and investigates the impact of economic inequality on political inequality with the measures. The dynamic panel data analysis controlling for endogeneity provides little evidence that income inequality has a significant effect on political inequality, however.
Muḥammad al-Ṣūfī, the Prophet Muḥammad, and Ibn al-Fāriḍ
Authors: Homerin† Emil
Published: March 2021

Muḥammad Ibn al-Shihābī al-Ṣūfī composed mystical poems in praise of the prophet Muḥammad, basing much of his verse on the poems of Ibn al-Fāriḍ. While he was not the first to imitate Ibn al-Fāriḍ, Ibn al-Shihābī may have been the first Arabic poet to use consistently a Persian style signature verse (takhalluṣ). This article offers a critical Arabic edition, English translation, and analysis of several of his poems, with a particular focus on his signature verses, which add insights into Ibn al-Shihābī’s life, religious beliefs, and vocation as a Sufi eulogist of the Prophet.
Rūmī’s Mathnawī, Book Two
Authors: Moqaddam Sassan Zand , Nourian Mehdi
Published: March 2021

Early in Mathnawī Book Two appears a heavily-debated hemistich: “An interval was needed in order that the blood might turn to milk.” Here Rūmī uses three distinct means to introduce the notion of “Transfiguration of the Senses”: a religious conceit; an allegory – in fact, a common Persian-language proverb; and a brief explanation of Ḥusām al-Dīn’s spiritual ascension. Lacking familiarity with Rūmī’s symbolic language and the transfigurational concept he wishes to introduce, commentators have been unable to reconcile the proverb with the account of Ḥusām al-Dīn’s ascension. To further complicate the issue, Aflākī attributes the delay to the grief of the recently widowed Ḥusām al-Dīn. Here, using textual, contextual and intertextual analysis, we decode Rūmī’s symbolic language and explain “The Transfiguration of the Senses,” as well as Ḥusām al-Dīn’s role as its catalyst. Our findings also lead to a revised chronology of Ḥusām al-Dīn’s spiritual journey and his relationship with Rūmī.
Re-envisioning Caribbean Costa Rica
Authors: Narváez Benjamín N.
Published: March 2021

While West Indians constituted a much larger immigrant group in the port of Limón, Costa Rica and its environs, Chinese also migrated there during the late nineteenth and early twentieth centuries. In hopes of maintaining their culture and in response to the prejudice they faced, both groups formed their own tightknit transnational subcommunities. Nevertheless, they also interacted with each other. These interactions ranged from tension and conflict on the one hand, to routine, peaceful interaction and even collaboration on the other. In particular, class differences and the marginalization these groups experienced combined to produce this complex relationship. Tension and conflict often emerged due to both sides hoping to move up the social ladder and because of the economic power that many Chinese held as shopkeepers and lenders. Nevertheless, as groups experiencing social marginalization and living in proximity to each other, they could develop neutral or positive social and economic relationships.
Ecological Civilizationalism: Greater Educational Cooperation and Sustainable Development under the bri
Authors: Peters Michael A. , Green Benjamin
Published: March 2021

Ecological Civilization (EC) represents a constituted effort on the part of China to utilize its developing regional linkages to promote a form of globalization that places the bioeconomy as a foundational core of sustainable global development. This article first outlines how China, through a unique form of state-centric globalization-through-regionalism, has continued to develop cooperative networks based on global trade, infrastructure, and educational exchanges. Second, signaling a fundamental shift within the higher education (HE) landscape, we outline that the Belt and Road Initiative (BRI), and its ever-increasing number of open and inclusive university partnerships, represents a rich avenue for people-to-people exchange within a third-space for scientific collaboration. Third, within both a shifting HE landscape (and the scholarly push to engage with a new postdigital scientific/philosophical paradigm) China’s pursuit of EC constitutes a form of biodigitalism which conceptualizes the bioeconomy as a pursuit of technological advancement that preserves and strengthens humanity’s intimate relationship with the natural world. Finally, we argue that building a BRI-ESD community undergirded by the biodigital ecopedagogy of EC will provide both the curriculum and educational space to more fully enact UNESCO’s ESD 2030 framework.
Shaping “The Belt and Road Initiative” International Higher Education
Authors: Li Jian
Published: March 2021

This study aims to exploring the “The Belt and Road” international higher education. This research uses a qualitative method to explore the learning perceptions of 22 international students from South-Asian countries studying in Chinese learning programs at three Chinese higher education institutions. The findings argue that the international students from South-Asian countries’ various attitudes towards the learning and teaching approaches as well as their communications with international classmates, Chinese students and teachers all shaped their learning perceptions of learning Chinese. Moreover, the findings reveal those international students’ cognitive (e.g., thoughts, beliefs, and ideas), affective (e.g., feelings and emotions) and conative (e.g., tendency or disposition) learning perceptions as parts of their psychological mechanisms interacted with institutional or cross-cultural contexts. This study also highlights the importance of making sense of these complexities to understand international students’ learning perceptions. The implications of stimulating their learning perceptions are also discussed.
Understanding Education on China’s Belt and Road Initiative: A Cultural Political Economy Approach
Authors: Xu Bowen
Published: March 2021

The Chinese Belt and Road Initiative (bri) is a state-driven development campaign that promote economic integration and infrastructure building across Eurasia and beyond, aiming to reconnect countries and revive the prosperity of the historical Silk Road region. Since its inception in 2013, there has been a growing literature surrounding the initiative, yet the studies of education within the bri context remain relatively under-researched. This paper aims to explore such connection by undertaking the task through a combination of policy review, semi-structured interviews, and empirical fieldwork data. It adopts a Cultural Political Economy theoretical framework to analyzes how education policy and practice has been positioned, constructed, and coordinated in relation to the wider cultural political economy in assisting the bri planning and development. Against the background of China’s resurgence as a global power and its ambition in reinvigorating the Silk Road, I argue that the strategic positioning of education into the bri represents a constructive force in imagining, empowering, and materializing the New Silk Road Project. This reveals education and its multifaced properties in promoting cultural outreach, fulfilling political obligation, and accelerating economic growth in line with the overall bri building.
The Macro-Level Education Policy in “The Belt and Road” Strategy: A Policy Text Analysis
Authors: Xue Eryong , Tian Shixu , Li Jian
Published: March 2021

This study concentrates on examining the macro-level education policy in “The Belt and Road” strategy. In particular, the policy text analysis of the macro-level education policy in “The Belt and Road” Strategy, the policy implementation analysis of the macro-level education policy in “The Belt and Road” Strategy, and the policy challenges analysis of the macro-level education policy in “The Belt and Road” Strategy have been offered in this study. In addition, the conclusion, suggestions and remarks have been provided in the last section.
China’s Approaches Fighting against Covid-19: Online Learning for Students
Authors: Qin Yiming
Published: March 2021

In early 2020, almost all schools were closed in China due to the Covid-19 pandemic. This article offers a snapshot of China’s improvisational approaches of online learning adopted shortly after the outbreak of Covid-19 in the early 2020 with a system-wide policy of “No Lesson Suspended”. It captures three major approaches of online learning in the context of such a policy. It is also concluded that online learning has resulted in varied outcomes for students, teachers and parents, which play profound and multidimensional roles in educational equality and quality. Additionally, several hidden challenges are identified for critical reflections on the improvement of online education in the future.
The genus Carex (Cyperaceae) in Armenia

Authors: KOOPMAN JACOB , ALEKSANYAN TARON , ALEKSANYAN ALLA , FAYVUSH GEORGE , OGANESIAN MARINA , VITEK ERNST , WIĘCŁAW HELENA
Published: March 2021

In this paper we present an updated checklist, key and maps for all the currently known Carex taxa present in Armenia. The present work is based on the revision of the vouchers in herbaria ERE, W and MW, extensive literature search, and field research carried out in 2015–2019. As a result, 71 species of Carex are known from Armenia. Besides, the first Carex hybrid in Armenia has been found and provided here with a binomial name.
A taxonomic note of Pterocephalus (Caprifoliaceae) from N Iran

Authors: RANJBAR MASSOUD , RANJBAR ZAHRA
Published: March 2021

Pterocephalus ramianensis (Caprifoliaceae) is described and illustrated as a new species from Golestan Province, north Iran. This species is morphologically and micromorphologically well-differentiated from P. plumosus. The characters that distinguish this new species from P. plumosus are provided along with a key to the Iranian annual species in Pterocephalus.
Begonia ×dinglensis, a natural hybrid of Philippine Begonia section Baryandra, as evidenced by morphological, phylogenetic and cytological data
Authors: NAKAMURA KOH , RUBITE ROSARIO RIVERA , KONO YOSHIKO , MACABASCO JELENE V. , TALAÑA ARLENE D. , ALEJANDRO GRECEBIO J. D. , HO MENG-JUNG , YANG HSUN-AN , CHUNG KUO-FANG , PENG CHING-I
Published: March 2021

Here we describe a natural hybrid of Philippine Begonia from Bulabog Puti-an National Park in Dingle, Iloilo, Panay Island. The hybrid, named Begonia ×dinglensis after its place of origin, grows on moist, coralline-rock slopes at 200 m elevation. Morphological, molecular, and cytological evidence support its origin from natural hybridization between Philippine endemics B. camiguinensis and B. nigritarum.
Cortinarius jiaoheensis (Cortinariaceae), a new species of Cortinarius subgenus Telamonia section Flexipedes, from northeast China
Authors: LUO YING , BAU TOLGOR
Published: March 2021

A new Cortinarius species in subgenus Telamonia section Flexipedes, Cortinarius jiaoheensis, is described based on morphological characteristics and molecular data. It is characterized by small basidiomata, with the surface of the pileus completely covered by woolly squamules, and ellipsoid to obovoid ellipsoid basidiospores. This species produces basidiomata in the autumn and is currently known only from northeast China.
Understanding and Regulating Cell-Matrix Interactions Using Hydrogels of Designable Mechanical Properties
Authors: Yang Jiapeng , Zhang Yu , Qin Meng , Cheng Wei , Wang Wei , Cao Yi
Published: March 2021

Similar to natural tissues, hydrogels contain abundant water, so they are considered as promising biomaterials for studying the influence of the mechanical properties of extracellular matrices (ECM) on various cell functions. In recent years, the growing research on cellular mechanical response has revealed that many cell functions, including cell spreading, migration, tumorigenesis and differentiation, are related to the mechanical properties of ECM. Therefore, how cells sense and respond to the extracellular mechanical environment has gained considerable attention. In these studies, hydrogels are widely used as thein vitromodel system. Hydrogels of tunable stiffness, viscoelasticity, degradability, plasticity, and dynamical properties have been engineered to reveal how cells respond to specific mechanical features. In this review, we summarize recent process in this research direction and specifically focus on the influence of the mechanical properties of the ECM on cell functions, how cells sense and respond to the extracellular mechanical environment, and approaches to adjusting the stiffness of hydrogels.
Co-Delivery of Paclitaxel and siRNA with pH-Responsive Polymeric Micelles for Synergistic Cancer Therapy
Authors: Shi Liuqi , Feng Huayang , Li Zhanrong , Shi Jun , Jin Lin , Li Jingguo
Published: March 2021

Due to the complex physiological characteristics of tumors, chemotherapy or gene therapy alone cannot completely kill tumor cells. Therefore, combining chemotherapy with gene therapy for combination therapy is the key to solving this problem. However, there are still significant challenges
in how to simultaneously deliver and rapidly release the drugs and siRNA into cancer cells. In this work, a triblock copolymer was synthesized to co-deliver siRNA and paclitaxel to tumor cells. This system has an acid-sensitive subsurface layer, which can not only load siRNA to prevent premature
drug release but also has good controlled release performance. In vitro experiments showed that polymeric vectors can efficiently deliver siRNA and paclitaxel simultaneously into tumor cells for rapid release within the tumor cells. This study reveals that this novel polymeric micelle
is a suitable vector for the codelivery of chemotherapeutic drugs and siRNA to cancer cells, representing an important advance in nanotechnology, nanomedicine, drug delivery, and cancer therapy.
IMDAA: High Resolution Satellite-era Reanalysis for the Indian Monsoon Region
Authors: Rani S. Indira , T Arulalan , George John P. , Rajagopal E. N. , Renshaw Richard , Maycock Adam , Barker Dale M. , Rajeevan M.
Published: March 2021

A high resolution regional reanalysis of the Indian Monsoon Data Assimilation and Analysis (IMDAA) project is made available to researchers for deeper understanding of the Indian monsoon and its variability. This 12 km resolution reanalysis covering the satellite-era from 1979 to 2018 using 4D-Var data assimilation method and the UK Met Unified Model is presently the highest resolution atmospheric reanalysis carried out for the Indian monsoon region. Conventional and satellite observations from different sources are used, including Indian surface and upper air observations, of which some were not used in any previous reanalyses. Various aspects of this reanalysis, like quality control and bias correction of observations, data assimilation system, land surface analysis, and verification of reanalysis products, are presented in this paper. Representation of important weather phenomena of each season over India in the IMDAA reanalysis verifies reasonably well against India Meteorological Department (IMD) observations and compares closely with ERA5. Salient features of the Indian summer monsoon are found to be well represented in the IMDAA reanalysis. Characteristics of major semi-permanent summer monsoon features (e.g., Low-level Jet and Tropical Easterly Jet) in IMDAA reanalysis are consistent with ERA5. The IMDAA reanalysis has captured the mean, inter-annual, and intra-seasonal variability of summer monsoon rainfall fairly well. IMDAA produces a slightly cooler winter and a hotter summer than the observations; the reverse for ERA5. IMDAA captured the fine-scale features associated with a notable heavy rainfall episode over complex terrain. In this study, the fine grid spacing nature of IMDAA is compromised due to the lack of comparable resolution observations for verification.
Comments on “Global and Regional Entropy Production by Radiation Estimated from Satellite Observations”
Authors: Gibbins Goodwin , Haigh Joanna D.
Published: March 2021

A recent paper by Kato and Rose reports a negative correlation between the annual mean entropy production rate of the climate and the absorption of solar radiation in the CERES SYN1deg dataset, using the simplifying assumption that the system is steady in time. It is shown here, however, that when the nonsteady interannual storage of entropy is accounted for, the dataset instead implies a positive correlation; that is, global entropy production rates increase with solar absorption. Furthermore, this increase is consistent with the response demonstrated by an energy balance model and a radiative–convective model. To motivate this updated analysis, a detailed discussion of the conceptual relationship between entropy production, entropy storage, and entropy flows is provided. The storage-corrected estimate for the mean global rate of entropy production in the CERES dataset from all irreversible transfer processes is 81.9 mW m−2 K−1 and from only nonradiative processes is 55.2 mW m−2 K−1 (observations from March 2000 to February 2018).