bluuebunny/crossref_metadata_2025 huggingface dataset:
Stroke Burden in Malaysia
Authors: Tan Kay Sin , Venketasubramanian Narayanaswamy
Published: March 2022

Malaysia is located in the heart of South East Asia with two land masses, Peninsular Malaysia and East Malaysia which are separated by the South China Sea. Stroke or cerebrovascular disease is Malaysia’s third leading cause of death. There were 47, 911 incident cases, 19,928 deaths, 443,995 prevalent cases, and 512,726 DALYs lost due to stroke in 2019. Successive national health and morbidity surveys from 2006 demonstrated a continuous rise in the prevalence of risk factors such as diabetes, hyperlipidaemia, and obesity. These risk factors are implicated in an increase in stroke incidence in those under 65 years of age, the largest increase of 53.3% and 50.4% in men and women, respectively, from the age strata of 35–39 years. The neurologist-to-patient ratio is 1:323,000 with the majority of neurologists working in urban centres. The healthcare system is provided predominantly by the public and private sectors. Concurrent use of traditional and complementary medicine is common and widely accepted. Challenges include delivering adequate care to rural communities, the low overall ischaemic stroke thrombolysis rates, and the high cost of thrombectomy devices for use in large vessel occlusions which have to be borne out-of-pocket by patients and their families. Effort is required to continue improving stroke care services in parallel with primary and secondary prevention strategies in the future, given the ageing population and the rising number of strokes in young adults nationally. Strategies include careful planning, inter-hospital cooperation, and increased allocation of resources from the government.
On the Electrophysiology and Mapping of Intramural Arrhythmic Focus
Authors: Anderson Robert D. , Rodriguez Padilla Jairo , Joens Christian , Masse Stephane , Bhaskaran Abhishek , Magtibay Karl , Niri Ahmed , Asta John , Lai Patrick , Azam Mohammed Ali , Vigmond Edward , Nanthakumar Kumaraswamy
Published: March 2022

Background:

Conventional mapping of focal ventricular arrhythmias relies on unipolar electrogram characteristics and early local activation times. Deep intramural foci are common and associated with high recurrence rates following catheter-based radiofrequency ablation. We assessed the accuracy of unipolar morphological patterns and mapping surface indices to predict the site and depth of ventricular arrhythmogenic focal sources.

Methods:

An experimental beating-heart model used Langendorff-perfused, healthy swine hearts. A custom 56-pole electrode array catheter was positioned on the left ventricle. A plunge needle was placed perpendicular in the center of the grid to simulate arrhythmic foci at variable depths. Unipolar electrograms and local activation times were generated. Simulation models from 2 human hearts were also included with grids positioned simultaneously on the endocardium-epicardium from multiple left ventricular, septal, and outflow tract sites.

Results:

A unipolar Q or QS complex lacks specificity for superficial arrhythmic foci, as this morphology pattern occupies a large surface area and is the predominant pattern as intramural depth increases without developing a R component. There is progressive displacement from the arrhythmic focus to the surface exit as intramural focus depth increases. A shorter total activation time over the overlying electrode array, larger surface area within initial 20 ms activation, and a dual surface breakout pattern all indicate a deep focus.

Conclusions:

Displacement from the focal intramural origin to the exit site on the mapping surface could lead to erroneous lesion delivery strategies. Traditional unipolar electrogram features lack specificity to predict the intramural arrhythmic source; however, novel endocardial-epicardial mapping surface indices can be used to determine the depth of arrhythmic foci.
Multiclass Arrhythmia Detection and Classification From Photoplethysmography Signals Using a Deep Convolutional Neural Network
Authors: Liu Zengding , Zhou Bin , Jiang Zhiming , Chen Xi , Li Ye , Tang Min , Miao Fen
Published: March 2022

Background

Studies have reported the use of photoplethysmography signals to detect atrial fibrillation; however, the use of photoplethysmography signals in classifying multiclass arrhythmias has rarely been reported. Our study investigated the feasibility of using photoplethysmography signals and a deep convolutional neural network to classify multiclass arrhythmia types.

Methods and Results

ECG and photoplethysmography signals were collected simultaneously from a group of patients who underwent radiofrequency ablation for arrhythmias. A deep convolutional neural network was developed to classify multiple rhythms based on 10‐second photoplethysmography waveforms. Classification performance was evaluated by calculating the area under the microaverage receiver operating characteristic curve, overall accuracy, sensitivity, specificity, and positive and negative predictive values against annotations on the rhythm of arrhythmias provided by 2 cardiologists consulting the ECG results. A total of 228 patients were included; 118 217 pairs of 10‐second photoplethysmography and ECG waveforms were used. When validated against an independent test data set (23 384 photoplethysmography waveforms from 45 patients), the DCNN achieved an overall accuracy of 85.0% for 6 rhythm types (sinus rhythm, premature ventricular contraction, premature atrial contraction, ventricular tachycardia, supraventricular tachycardia, and atrial fibrillation); the microaverage area under the microaverage receiver operating characteristic curve was 0.978; the average sensitivity, specificity, and positive and negative predictive values were 75.8%, 96.9%, 75.2%, and 97.0%, respectively.

Conclusions

This study demonstrated the feasibility of classifying multiclass arrhythmias from photoplethysmography signals using deep learning techniques. The approach is attractive for population‐based screening and may hold promise for the long‐term surveillance and management of arrhythmia.

Registration

URL:
www.chictr.org.cn
. Identifier: ChiCTR2000031170.
Practitioners’ Confidence and Desires for Education in Cardiovascular and Sudden Cardiac Death Genetics
Authors: Lopez Santibanez Jacome Laura , Dellefave‐Castillo Lisa M. , Wicklund Catherine A. , Scherr Courtney L. , Duquette Debra , Webster Gregory , Smith Maureen E. , Kalke Kerstin , Gordon Adam S. , De Berg Kristen , McNally Elizabeth M. , Rasmussen‐Torvik Laura J.
Published: March 2022

Background

Educating cardiologists and health care professionals about cardiovascular genetics and genetic testing is essential to improving diagnosis and management of patients with inherited cardiomyopathies and arrhythmias and those at higher risk for sudden cardiac death. The aim of this study was to understand cardiology and electrophysiology practitioners’ current practices, confidence, and knowledge surrounding genetic testing in cardiology and desired topics for an educational program.

Methods and Results

A one‐time survey was administered through purposive email solicitation to 131 cardiology practitioners in the United States. Of these, 107 self‐identified as nongenetic practitioners. Over three quarters of nongenetic practitioners reported that they refer patients to genetic providers to discuss cardiovascular genetic tests (n=82; 76.6%). More than half of nongenetic practitioners reported that they were not confident about the types of cardiovascular genetic testing available (n=60; 56%) and/or in ordering appropriate cardiovascular genetic tests (n=66; 62%). In addition, 45% (n=22) of nongenetic practitioners did not feel confident making cardiology treatment recommendations based on genetic test results. Among all providers, the most desired topics for an educational program were risk assessment (94%) and management of inherited cardiac conditions based on guidelines (91%).

Conclusions

This study emphasizes the importance of access to genetics services in the cardiology field and the need for addressing the identified deficit in confidence and knowledge about cardiogenetics and genetic testing among nongenetic providers. Additional research is needed, including more practitioners from underserved areas.
Representativeness of the GALACTIC‐HF Clinical Trial in Patients Having Heart Failure With Reduced Ejection Fraction
Authors: Mefford Matthew T. , Koyama Sandra Y. , De Jesus Justine , Wei Rong , Fischer Heidi , Harrison Teresa N. , Woo Pauline , Reynolds Kristi
Published: March 2022

Background

Randomized clinical trials in populations with heart failure with reduced ejection fraction may not be reflective of the general population with heart failure with reduced ejection fraction. Our study assessed the representativeness of the GALACTIC‐HF (Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure) patient population in Kaiser Permanente Southern California.

Methods and Results

We identified 9770 patients with a diagnosis of heart failure with reduced ejection fraction from 2014 to 2018 using electronic health records. Four mutually exclusive cohorts were created, including GALACTIC‐HF–ineligible cohorts: (1) not taking guideline‐directed medical therapy (GDMT) and (2) taking GDMT; and GALACTIC‐HF–eligible cohorts with: (3) ejection fraction (EF) ≤28% and (4) EF 29% to 35%. Patients were followed for 30‐day and 1‐year mortality and 30‐day, 180‐day, and 1‐year hospitalization. Overall, 3626 (37.1%) met GALACTIC‐HF inclusion criteria with EF ≤35%, and 2367 (65.3%) of those individuals had EF ≤28%. The risk of 1‐year mortality was lower among all cohorts versus the GALACTIC‐HF–ineligible cohort not taking GDMT (hazard ratio, 0.80 [95% CI, 0.70–0.91], 0.84 [95% CI, 0.72–0.98], and 0.62 [95% CI, 0.51–0.75] for the GALACTIC‐HF–ineligible cohort taking GDMT and GALACTIC‐HF‐eligible cohorts with EF ≤28% and 29%–35%, respectively). Compared with the GALACTIC‐HF–ineligible cohort not taking GDMT, the short‐term hospitalization risk at 30 and 180 days were similar for both GALACTIC‐HF–eligible cohorts and the hospitalization risk at 1 year was similar for the GALACTIC‐HF–eligible cohort with EF ≤28%.

Conclusions

A large portion of patients with heart failure with reduced ejection fraction with low EF met inclusion criteria for the GALACTIC‐HF trial and, despite being on GDMT, had hospitalization rates similar to those not taking GDMT, suggesting potential benefits from other innovative treatments.
Risk Factors, Subsequent Disease Onset, and Prognostic Impact of Myocardial Infarction and Atrial Fibrillation
Authors: Camen Stephan , Csengeri Dora , Geelhoed Bastiaan , Niiranen Teemu , Gianfagna Francesco , Vishram‐Nielsen Julie K. , Costanzo Simona , Söderberg Stefan , Vartiainen Erkki , Börschel Christin S. , Donati Maria Benedetta , Løchen Maja‐Lisa , Ojeda Francisco M. , Kontto Jukka , Mathiesen Ellisiv B. , Jensen Steen , Koenig Wolfgang , Kee Frank , de Gaetano Giovanni , Zeller Tanja , Jørgensen Torben , Tunstall‐Pedoe Hugh , Blankenberg Stefan , Kuulasmaa Kari , Linneberg Allan , Salomaa Veikko , Iacoviello Licia , Schnabel Renate B.
Published: March 2022

Background

Although myocardial infarction (MI) and atrial fibrillation (AF) are frequent comorbidities and share common cardiovascular risk factors, the direction and strength of the association of the risk factors with disease onset, subsequent disease incidence, and mortality are not completely understood.

Methods and Results

In pooled multivariable Cox regression analyses, we examined temporal relations of disease onset and identified predictors of MI, AF, and all‐cause mortality in 108 363 individuals (median age, 46.0 years; 48.2% men) free of MI and AF at baseline from 6 European population‐based cohorts. During a maximum follow‐up of 10.0 years, 3558 (3.3%) individuals were diagnosed exclusively with MI, 1922 (1.8%) with AF but no MI, and 491 (0.5%) individuals developed both MI and AF. Association of sex, systolic blood pressure, antihypertensive treatment, and diabetes appeared to be stronger with incident MI than with AF, whereas increasing age and body mass index showed a higher risk for incident AF. Total cholesterol and daily smoking were significantly related to incident MI but not AF. Combined population attributable fraction of cardiovascular risk factors was >70% for incident MI, whereas it was only 27% for AF. Subsequent MI after AF (hazard ratio [HR], 1.68; 95% CI, 1.03–2.74) and subsequent AF after MI (HR, 1.75; 95% CI, 1.31–2.34) both significantly increased overall mortality risk.

Conclusions

We observed different associations of cardiovascular risk factors with both diseases indicating distinct pathophysiological pathways. Subsequent diagnoses of MI and AF significantly increased mortality risk.
Brugada Syndrome: Different Experimental Models and the Role of Human Cardiomyocytes From Induced Pluripotent Stem Cells
Authors: Li Yingrui , Lang Siegfried , Akin Ibrahim , Zhou Xiaobo , El‐Battrawy Ibrahim
Published: March 2022

Brugada syndrome (BrS) is an inherited and rare cardiac arrhythmogenic disease associated with an increased risk of ventricular fibrillation and sudden cardiac death. Different genes have been linked to BrS. The majority of mutations are located in the
SCN5A
gene, and the typical abnormal ECG is an elevation of the ST segment in the right precordial leads V1 to V3. The pathophysiological mechanisms of BrS were studied in different models, including animal models, heterologous expression systems, and human‐induced pluripotent stem cell–derived cardiomyocyte models. Currently, only a few BrS studies have used human‐induced pluripotent stem cell–derived cardiomyocytes, most of which have focused on genotype–phenotype correlations and drug screening. The combination of new technologies, such as clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 (CRISPR associated protein 9)‐mediated genome editing and 3‐dimensional engineered heart tissues, has provided novel insights into the pathophysiological mechanisms of the disease and could offer opportunities to improve the diagnosis and treatment of patients with BrS. This review aimed to compare different models of BrS for a better understanding of the roles of human‐induced pluripotent stem cell–derived cardiomyocytes in current BrS research and personalized medicine at a later stage.
Renal Artery Stenting in Consecutive High‐Risk Patients With Atherosclerotic Renovascular Disease: A Prospective 2‐Center Cohort Study
Authors: Reinhard Mark , Schousboe Karoline , Andersen Ulrik B. , Buus Niels Henrik , Rantanen Jesper Moesgaard , Bech Jesper Nørgaard , Mafi Hossein Mohit , Langfeldt Sten , Bharadwaz Arindam , Hørlyck Arne , Jensen Mogens Kærsgaard , Jeppesen Jørgen , Olsen Michael Hecht , Jacobsen Ib Abildgaard , Bibby Bo Martin , Christensen Kent Lodberg
Published: March 2022

Background

The aim of this study was to prospectively evaluate the effects of renal artery stenting in consecutive patients with severe atherosclerotic renal artery stenosis and high‐risk clinical presentations as defined in a national protocol developed in 2015.

Methods and Results

Since the protocol was initiated, 102 patients have been referred for revascularization according to the following high‐risk criteria: severe renal artery stenosis (≥70%) with true resistant hypertension, rapidly declining kidney function, or recurrent heart failure/sudden pulmonary edema. At baseline, the mean 24‐hour ambulatory systolic blood pressure was 166.2 mm Hg (95% CI, 162.0–170.4), the defined daily dose of antihypertensive medication was 6.5 (95% CI, 5.8–7.3), and the estimated glomerular filtration rate was 41.1 mL/min per 1.73m
2
(95% CI, 36.6–45.6). In 96 patients with available 3‐month follow‐up data, mean 24‐hour ambulatory systolic blood pressure decreased by 19.6 mm Hg (95% CI, 15.4–23.8;
P<
0.001), the defined daily dose of antihypertensive medication was reduced by 52% (95% CI, 41%–62%;
P
<0.001), and estimated glomerular filtration rate increased by 7.8 mL/min per 1.73m
2
(95% CI, 4.5–11.1;
P
<0.001). All changes persisted after 24 months follow‐up. Among 17 patients with a history of hospitalization for acute decompensated heart failure, 14 patients had no new episodes after successful revascularization.

Conclusions

In this prospective cohort study, we observed a reduction in blood pressure and antihypertensive medication, an increase in estimated glomerular filtration rate, and a decrease in new hospital admissions attributable to heart failure/sudden pulmonary edema after renal artery stenting.

Registration

URL:
https://clinicaltrials.gov
. Identifier: NCT02770066.
Interpersonal Trauma and Risk of Incident Cardiovascular Disease Events Among Women
Authors: Thurston Rebecca C. , Chang Yuefang , Matthews Karen A. , Harlow Sioban , El Khoudary Samar R. , Janssen Imke , Derby Carol
Published: March 2022

Background

Traumatic experiences have been linked to risk for cardiovascular disease (CVD). Interpersonal violence is a trauma that is prevalent in women. Among midlife women followed up for 2 decades, we examined whether interpersonal violence (childhood abuse, adulthood abuse, or intimate partner violence [IPV]) was related to increased risk of subsequent clinical CVD events.

Methods and Results

A total of 2201 women, aged 42 to 52 years at baseline, underwent up to 16 in‐person visits over 22 years. Measures included questionnaires (including of childhood physical/sexual abuse, adult physical/sexual abuse, and IPV), physical measures, phlebotomy, and reported CVD events (myocardial infarction, stroke, heart failure, and revascularization). Death certificates were collected. Relationships between childhood abuse, adult abuse, and IPV with incident fatal/nonfatal CVD were tested in Cox proportional hazards models. Women with a childhood abuse history had increased risk for incident CVD (versus no abuse; hazard ratio [HR] [95% CI], 1.65 [1.12–2.44];
P
=0.01; adjusted for demographics and CVD risk factors); associations were strongest for childhood sexual abuse. Adult abuse was not significantly associated with CVD. Women with IPV had a doubling of risk for incident CVD in demographic‐adjusted models (versus no IPV; IPV: HR [95% CI], 2.06 [1.01–4.23];
P
=0.04; no partner: HR [95% CI], 1.79 [0.91–3.53];
P
=0.09); systolic blood pressure partially mediated relationships between IPV and CVD.

Conclusions

Childhood abuse, particularly sexual abuse, was associated with increased risk of CVD in women. IPV was associated with risk for CVD, with the higher systolic blood pressure among IPV‐exposed women important in these associations. Interpersonal violence prevention may contribute to CVD risk reduction in women.
Association of Socioeconomic Status With Outcomes and Care Quality in Patients Presenting With Undifferentiated Chest Pain in the Setting of Universal Health Care Coverage
Authors: Dawson Luke P. , Andrew Emily , Nehme Ziad , Bloom Jason , Biswas Sinjini , Cox Shelley , Anderson David , Stephenson Michael , Lefkovits Jeffrey , Taylor Andrew J. , Kaye David , Smith Karen , Stub Dion
Published: March 2022

BACKGROUND

This study aimed to assess whether there are disparities in incidence rates, care, and outcomes for patients with chest pain attended by emergency medical services according to socioeconomic status (SES) in a universal health coverage setting.

METHODS AND RESULTS

This was a population‐based cohort study of individually linked ambulance, emergency, hospital admission, and mortality data in the state of Victoria, Australia, from January 2015 to June 2019 that included 183 232 consecutive emergency medical services attendances for adults with nontraumatic chest pain (mean age 62 [SD 18] years; 51% women) and excluded out‐of‐hospital cardiac arrest and ST‐segment–elevation myocardial infarction. Age‐standardized incidence of chest pain was higher for patients residing in lower SES areas (lowest SES quintile 1595 versus highest SES quintile 760 per 100 000 person‐years;
P
<0.001). Patients of lower SES were less likely to attend metropolitan, private, or revascularization‐capable hospitals and had greater comorbidities. In multivariable models adjusted for clinical characteristics and final diagnosis, lower SES quintiles were associated with increased risks of 30‐day and long‐term mortality, readmission for chest pain and acute coronary syndrome, lower acuity emergency department triage categorization, emergency department length of stay >4 hours, and emergency department or emergency medical services discharge without hospital admission and were inversely associated with use of prehospital ECGs and transfer to a revascularization‐capable hospital for patients presenting to non‐percutaneous coronary intervention centers.

CONCLUSIONS

In this study, lower SES was associated with a higher incidence of chest pain presentations to emergency medical services and differences in care and outcomes. These findings suggest that substantial disparities for socioeconomically disadvantaged chest pain cohorts exist, even in the setting of universal health care access.
Understanding Physician and Patient Preferences for Thrombolysis in Ischemic Stroke Eligible for Endovascular Thrombectomy
Authors: Singh Nishita , Kashani Nima , Ganesh Aravind , Kenney Carol , Ben‐Israel David , Joundi Raed , Katsanos Aristeidis H. , Alrohimi Anas , Bala Fouzi , Shamy Michel , Tkach Aleksander , Swartz Richard H. , Buck Brian H. , Demchuk Andrew M. , Hill Michael D. , Thavorn Kednapa , Sajobi Tolulope , Almekhlafi Mohammed , Dowlatshahi Dar , Menon Bijoy K.
Published: March 2022

Background

In light of evidence from recent trials that endovascular thrombectomy (EVT) alone may potentially be noninferior to combined treatment, that is, with intravenous thrombolysis (IVT) with alteplase and EVT, we sought to understand physician and patient preferences around this issue.

Methods

We conducted a 2‐stage mixed methods study that included a structured, international, web‐based cross‐sectional survey among stroke physicians, and a focus group involving stroke survivors and caregivers. Demographic information was collected from all participants. The survey offered multiple choice questions and options to respond via free text which was analyzed quantitatively. The focus group was conducted online and analyzed qualitatively using a grounded theory approach.

Results

A total of 225 physicians (67% men) from 44 countries completed the survey. Most participants (70%) were between 31 and 50 years of age. Survey results showed that in current practice, 90% respondents would offer IVT to patients with large vessel occlusion stroke eligible for both IVT and EVT. When asked if their practice would change in light of recent trials, 63% responded no. When asked about the appropriate timing for IVT in the setting of large vessel occlusion stroke with EVT availability, 56% preferred to administer IVT immediately, 21% were willing to defer the decision for 30 minutes from groin puncture, and 8% were willing to defer for 60 minutes from groin puncture to assess if reperfusion was achieved with EVT. A total of 61% participants would choose to use tenecteplase over alteplase as the preferred drug for IVT if both drugs are backed by evidence. The focus group identified a need to better understand patient characteristics that may benefit from EVT‐only or combined strategies. The focus group also identified the need for more data to inform physician decision making.

Conclusions

Most physicians surveyed prefer IVT before EVT in patients with acute ischemic stroke attributable to large vessel occlusion, although there was some uncertainty around this issue. The need for further studies, including data on IVT with tenecteplase and among various patient subgroups to inform decision making, was apparent from both the survey and the patient focus group.
Association of the
RNF213
p.R4810K Variant With the Outer Diameter of Cervical Arteries in Patients With Ischemic Stroke
Authors: Yamaguchi Eriko , Yoshimoto Takeshi , Ogura Shiori , Saito Kozue , Saito Satoshi , Hattori Yorito , Wasida Kazuo , Nishimura Kunihiro , Toyoda Kazunori , Koga Masatoshi , Ihara Masafumi
Published: March 2022

Background

We investigated the impact of the p.R4810K variant of
RNF213
(ring finger protein 213) gene, a susceptibility gene of moyamoya disease in East Asia, on the outer diameter of cervical parts of carotid and vertebral arteries (VAs).

Methods

We examined consecutive Japanese patients with ischemic stroke who underwent carotid ultrasonography between 2015 and 2019. Patient background and the carotid ultrasonography‐measured outer diameter of extracranial cervical arteries, including the common carotid artery, internal carotid artery, external carotid artery, and cervical VA, were compared between variant carriers and noncarriers. Outer diameters of each artery were defined as the mean distance from far to near wall adventitia of right and left target arteries using carotid ultrasonography. The average diameter of both cervical portions of common carotid arteries, internal carotid arteries, external carotid arteries, and the dominant side diameter of both cervical VAs were used.

Results

Of the 617 adult patients (204 women; median age, 74 years) analyzed, 26 (4.2%) carried the
RNF213
p.R4810K variant. Variant carriers were significantly younger (
P
<0.01) and had more frequent steno‐occlusion of the M1 segment of the middle cerebral artery (
P
<0.01). Multivariate logistic regression analysis showed that variant carriers had significantly smaller mean diameters in the common carotid artery (7.25 versus 8.22 mm; adjusted odds ratio [aOR] per 1 mm decrease, 2.94; 95% CI, 1.69–5.00), cervical internal carotid artery (4.99 versus 5.55 mm; aOR, 1.66; 95% CI, 1.03–2.70), and cervical VA (3.55 versus 4.10 mm; aOR, 2.56; 95% CI, 1.33–4.76) than noncarriers. Mean diameters of the common carotid artery (aOR, 3.44; 95% CI, 2.08–5.88) and cervical internal carotid artery (aOR, 2.04; 95% CI, 1.23–3.33) and the dominant diameter of the cervical VA (aOR, 3.23; 95% CI, 1.72–5.88) were also smaller in variant carriers even when the analysis was restricted to patients without bilateral steno‐occlusion in target vessels or intracranial arteries distal to target vessels.

Conclusion

RNF213
p.R4810K variant carriers have smaller cervical arterial outer diameters in both anterior and posterior circulations than noncarriers with ischemic stroke.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02251665.
New species and records of Phanoperla (Plecoptera: Perlidae) from southwestern China
Authors: WANG YINGYING , LI WENLIANG , LI WEIHAI
Published: March 2022

A species of Phanoperla, P. wangi sp. nov., is described from Yunnan Province, China as new to science and compared with related species. Phanoperla himalayana Zwick, 1977, P. vietnamensis Zwick, 1986, and P. wieng Sivec & Stark, 2010 are reported as new records from China.
“The Benefit Of Positron Emission Tomography/Computed Tomography In Stage I And Stage II Melanomas With High-Risk Decisiondx-Melanoma Scores”
Authors: Williams Andrew , Hamilton Owen , Likar Carly , Thomay Alan , Garland-Kledzik Mary
Published: March 2022

Introduction

Early detection of melanoma is instrumental as the 5-year survival decreases from 93.3% to <50% when metastases are present. 1 - 3 Distinguishing which patients require closer follow-up can be difficult for melanoma patients. Developments by Castle Biosciences’ (Friendswood, TX) DecisionDx-Melanoma (DDx-M) use 31 melanoma associated genes to stratify melanomas into 4 classes with 1A having lowest risk of morbidity and mortality and 2B the highest. 5 We assessed the benefit of providing additional 18FDG-PET-CT and brain MRI to genetically high-risk patients who may have otherwise been overlooked.

Methods

297 patients at our institution had biopsies sent for DDx-M between 2014 and 2021. Patients found to have Class 2 melanomas received additional screening with yearly 18FDG-PET-CT scans and brain MRIs. Patients with Class 2 DDx-M scores and negative SLNB were included in the study. 66 met inclusion criteria and received imaging.

Results

Within 3 years of follow-up, 8/66 (12.1%) patients had metastases detected by 18FDG-PET-CT scans. No patients with stage IA or IB went on to develop metastases.

Discussion

18FDG-PET-CT scans detect metastases in < 3% of the time when all stage I and II patients are scanned; however, by using DDx-M in our screening protocols, we achieved a detection rate of 12.1%. 6 , 7 These patients went on to receive treatment and would have otherwise progressed undetected, leading to higher morbidity and mortality.

Conclusion

We suggest all patients with initial stage II or above melanomas receive a DDx-M score and those with class 2 receive yearly 18FDG-PET-CT/brain MRI imaging.
One-step extraction of ramie cellulose fibers and reutilization of degumming solution
Authors: Lin Guyu , Tang Qi , Huang He , Yu Chongwen , Yu Jianyong , Li Zhaoling , Ding Bin
Published: March 2022

Ramie cellulose fibers are common natural fibers with high strength and outstanding biodegradability. However, there are interconnected gummy components covering raw ramie, which need to be removed to extract separated fibers. Here, an effective and environmentally friendly extraction approach using deep eutectic solvent (DES) was developed. The whole degumming technique can be completed in a one-step boiling process at 160°C for 2.5 h. This new method exhibited the capability to remove most non-cellulosic contents without sacrificing the physical properties or chemical structures of cellulose in comparison with the traditional alkaline method. Besides, the DES can be reutilized many times while still maintaining sufficient degumming efficiency. Some by-products in the degumming solution, such as lignin and polysaccharides, can be successfully separated, beneficially realizing recycling economy and sustainable development. The DES degumming method provides an alternative and practical method for ramie fiber extraction.
Effect of different cure systems on natural rubber/nanocellulose nanocomposites in rheological, physical-mechanical, aging, and mechanical properties
Authors: Honorato Luciana Ribeiro , Visconte Leila Lea Yuan , Nunes Regina Célia Reis
Published: March 2022

The effect of different crosslink structures was studied in nanocomposites obtained by co-precipitation of natural rubber (NR) latex and aqueous solution of cellulose xanthate for obtaining nanocellulose. Cure systems characterized as conventional (CV), semi-efficient (SEV), and efficient (EV) were used in compositions of NR and also in natural rubber/cellulose (NR/CEL) nanocompositions with 15 phr of cellulose. The characterization of the developed compositions was based on rheological, physical-mechanical, aging, and mechanical properties. The obtained results allowed the conclusion that cellulose is a reinforcing filler as it promoted a significant increase in all these properties, that were sensitive to the cure systems used and protects NR from accelerated aging. The experimental results are presented and discussed also by Payne effect, entropy (ΔS), and Gibbs free energy (ΔG) to enable an understanding on cellulose distribution throughout NR influenced by the different cure systems.
What does it mean to be susceptible to influence? A brief primer on peer conformity and developmental changes that affect it
Authors: Laursen Brett , Faur Sharon
Published: March 2022

Peer influence is a twofold process that entails a behavior by an agent of influence that elicits conformity from the target of influence. Susceptibility describes the likelihood that conformity will occur. This review focuses on factors that shape susceptibility to peer influence. We argue that conformity has two distinct sources. In some instances, conformity is a product of characteristics of the target of influence, operationalized as stable individual difference variables. Trait-like attributes associated with susceptibility to peer influence include conformity dispositions, social goals, resource acquisition strategies, vulnerabilities, and maturational status. In other instances, conformity is a product of the context in which the target is situated, operationalized as impermanent individual difference variables. State-like circumstances associated with susceptibility to peer influence include conditions of uncertainty, personal attributes that differ from the partner or group, perceived benefits of impression management, unmet social needs, and social referents and beliefs about their behavior. Empirical illustrations are provided. We close with a discussion of developmental changes hypothesized to impact variations in susceptibility to peer influence.
When We’re Asked to Change: The Role of Suppression and Reappraisal in Partner Change Outcomes
Authors: Sisson Natalie M. , Wang Grace A. , Le Bonnie M. , Stellar Jennifer E. , Impett Emily A.
Published: March 2022

Receiving a request to change from a romantic partner can evoke intense emotional responses that hinder change progress and conflict resolution. As such, investigating how those being asked to change (i.e., change targets) regulate their emotions through key intrapersonal strategies (i.e., suppression and reappraisal) will lend crucial insight into promoting change success. Utilizing laboratory-interaction (Study 1; N = 111 couples) and experience-sampling methods (Study 2; N = 2178 weekly reports from an 8-week diary), we assessed targets’ regulation strategies, change progress, and the extent to which they met their partner’s ideals. Preregistered analyses demonstrated that targets’ use of suppression was not linked to better or worse change outcomes. However, targets’ use of reappraisal was linked to better change outcomes as rated by both partners. Additional analyses revealed that targets’ suppression was linked to targets meeting their partner’s ideals more in the short term but less over time, whereas targets’ reappraisal was linked to targets meeting their partner’s ideals more in both the short term and over time. These findings highlight reappraisal as a key strategy for promoting successful partner change.
Salmonella spondylodiscitis and epidural abscess successfully treated with unilateral biportal endoscopic discectomy and debridement: a rare case report
Authors: Hsu Ta-Li , Yang Chia-Jui , Pao Jwo-Luen
Published: March 2022

Spinal epidural abscess (SEA) is a rare but severe infection with potentially devastating consequences. Epidural abscesses caused by Salmonella serogroup C2 are even rarer and tend to be more invasive with multidrug resistance. Early diagnosis, effective use of antibiotics and surgical intervention are the mainstay strategies for managing SEA, especially for more virulent and multidrug-resistant Salmonella infections. This case report presents a rare case of an elderly and fragile woman with Salmonella spondylodiscitis and an extensive epidural abscess, which were successfully treated with intravenous antibiotics and unilateral biportal endoscopic (UBE) debridement and drainage through four small surgical incisions. After surgery, her fever subsided, she regained consciousness and her low back pain dramatically improved. Follow-up magnetic resonance imaging showed complete resolution of the epidural abscess. At 6 months after surgery, the patient regained muscle strength, ambulated with a walker and had no recurrence of the infection. The UBE technique can effectively eradicate infection while minimizing surgery-related risks and complications. A multidisciplinary team is required to achieve a good outcome.
Maximum Profit Facility Location and Dynamic Resource Allocation for Instant Delivery Logistics
Authors: Rajesh Chauhan Darshan , Unnikrishnan Avinash , Boyles Stephen D.
Published: March 2022

Increasing e-commerce activity, competition for shorter delivery times, and innovations in transportation technologies have pushed the industry toward instant delivery logistics. This paper studies a facility location and online demand allocation problem applicable to a logistics company expanding to offer instant delivery service using unmanned aerial vehicles or drones. The problem is decomposed into two stages. During the planning stage, the facilities are located, and product and battery capacity are allocated. During the operational stage, customers place orders dynamically and real-time demand allocation decisions are made. The paper explores a multi-armed bandit framework for maximizing the cumulative reward realized by the logistics company subject to various capacity constraints and compares it with other strategies. The multi-armed bandit framework provides about 7% more rewards than the second-best strategy when tested on standard test instances. A case study based in Portland Metro Area showed that multi-armed bandits can outperform the second-best strategy by more than 20%.
Capital, Caste, and Patriarchy: Theory of Marriage Formation in India
Authors: Srivastava Abhilasha , Willoughby John
Published: March 2022

This article presents a theory of marriage formation in India and grounds it with primary qualitative data. India presents a unique case for interrogating the institution of marriage because here, violent kinship-based patriarchy and the neoliberal promises of individual freedom and choice coexist. This article draws on literatures from Marxist, Feminist political economy, economic anthropology, and the political economy of caste to contend that a synthesis of Social Reproduction Theory and Ambedkarite theory of caste and Brahminical Patriarchy presents a better theoretical framework to critically examine the relationship between market and nonmarket social relations in India. We argue that in India, marriage is an institution that provides the essential legitimizing framework for the reproduction of social order, as well as the social relations of class, caste, and gender. Empirical analysis shows that Brahminical Patriarchy amalgamates with social relations of neoliberal capital within the institution of marriage to create new forms of regressive social norms and oppressions. This study also complicates the neat distinction between market and nonmarket relations and, in extension, between economic and social realms of life.

JEL Classification: B54, B14, Z13, J12
The Role of Generic Price Look-Up Code in WIC Benefit Redemptions
Authors: Zhang Junzhou , Zhang Qi , Tang Chuanyi , Park Kayoung , Harrison Kristina , McLaughlin Patrick W. , Stacy Brian
Published: March 2022

One of the most significant recent changes in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is that the Healthy, Hunger-Free Kids Act of 2010 mandated the conversion of the program to an electronic benefit transfer (EBT) system by October 1, 2020. This mandate has led to some technical challenges and policy issues. Focusing on the adoption of a generic price look-up (PLU) code, an important EBT mechanism intended to facilitate the redemption of fresh produce, this research examines how different mapping approaches in using the generic PLU code are associated with WIC participants’ cash value benefit redemption. Using the redemption data of 121,021 Virginia WIC participants in 2015, the first year after the full implementation of the EBT system in Virginia, the authors identified three groups of WIC participants based on their exposure to the generic PLU code. Results show that WIC participants who had ever been exposed to the generic code tended to have a significantly higher fruit and vegetable redemption rate than those who had never experienced the generic code. The authors also conducted a qualitative study to provide insights regarding the potential mechanism underlying the hypothesized relationships. Relevant policy implications and future research directions are discussed.
Differential Associations between Guilt and Shame Proneness and Religious Coping Styles in a Diverse Sample of Young Adults
Authors: Ladis Ilana , Abrams Dylan , Calkins Cynthia
Published: March 2022

Positive religious coping is linked with better mental health outcomes following physical and sexual abuse while negative religious coping is associated with poorer outcomes. Religious coping styles may be linked with dispositional tendencies to experience guilt or shame. This study compared the associations between guilt and shame proneness and religious coping styles and tested whether abuse history moderated these relationships. We conducted a cross-sectional study with 425 college students ( n = 145 with physical and/or sexual abuse history, n = 280 with no abuse history). Participants completed questionnaires assessing positive and negative religious coping style, as well as two dimensions of guilt proneness and shame proneness. Structural equation models were fitted to examine associations between guilt proneness and shame proneness, and positive and negative religious coping, respectively, accounting for abuse history as a binary moderator. Across the full sample, positive religious coping was positively associated with guilt repair (i.e., the tendency to engage in reparative behaviors following one’s wrongdoing), guilt negative behavior evaluation (i.e., the tendency to feel bad about how one acted in a given scenario), and shame withdrawal (i.e., the tendency to try and avoid unpleasant situations in which one has done something wrong), and negatively associated with shame negative self-evaluation (i.e., the tendency to make internal, negative self-attributions about one’s wrongdoing). Negative religious coping was positively associated with shame withdrawal and, for participants with no abuse history, shame negative self-evaluation. Results suggest that positive religious coping is more closely related to guilt proneness, and negative religious coping to shame proneness. Additional research with longitudinal designs and more defined abuse history subgroups is needed.
Practical Approaches to Antipsychotic-Associated Corrected QT Interval Prolongation in Patients With Serious Mental Illness: A Review of Cases
Authors: Cunha Alexandra L. , Schwartz Shaina E. , Cooper Julie B.
Published: March 2022

Background: There is no consensus for assessment and management of patients with serious mental illness (SMI) who are at risk for cardiac morbidity and mortality due to antipsychotic-associated QTc prolongation. Objective: The objective of this review was to assess methods for risk scoring, QT correction calculation, and clinical management in SMI patients with antipsychotic-associated QTc prolongation. Methods: A search was performed in PubMed for case reports that described QTc prolongation in adult patients with schizophrenia or bipolar disorder prescribed an antipsychotic. Reports published in North America between 2000 and 2020 were eligible. The Mayo, Tisdale, and RISQ-PATH scoring tools were applied to cases to categorize risk level. Results: Seventeen cases were included. Most patients were prescribed a second-generation antipsychotic for schizophrenia, with baseline and maximum QTc values of 429 milliseconds and 545 milliseconds, respectively. The Mayo scoring tool identified 17 (100%) cases as “high risk,” Tisdale identified 9 (53%) cases as “moderate risk” and 7 (41%) cases as “low risk,” while RISQ-PATH identified 9 (53%) cases as “not low risk” and 8 (47%) cases as “low risk.” Three cases reported the QT correction formula utilized (18%). The most common intervention to address antipsychotic-associated QTc prolongation was switching to a different antipsychotic (35%). Approximately one third of patients experienced Torsades de Pointes. Conclusion: There is a lack of standardization for antipsychotic-associated QTc prolongation risk assessment and management in patients with SMI. This review provides real-world data representing actual clinical practice.
Free vibration analysis of a circular cylindrical shell using a new four-variable refined shell theory
Authors: Johari Vahid , Hassani Ali , Talebitooti Roohollah , Kazemian Mehdi
Published: March 2022

A theory is proposed to study the vibrations of homogenous isotropic circular cylindrical shells based on a developed plate vibration theory. By proposing a novel distribution of the shear stress and strain across the thickness of the shell, the arguments are adjusted such that the transverse shear strains and stresses equal zero at the shell surfaces. Due to the existing curvature in the circumferential direction, the defined shear stress and strain distributions consider a change in the position of the neutral plane toward the center of curvature. In the presented Two-Separated Lateral Displacement (TSLD) theory, the lateral displacement is defined by two bending and shear parts to provide an analytical model, referred to as the four-variable refined plate theory. The similarity to classical theory and involving only four unknowns are significant features of the introduced theory. The TSLD theory is verified against the available data in the literature. It is shown that the provided stress and stress distributions lead to more accurate results, especially in moderately thick cylinders. The proposed theory is remarkably more precise than classical shell theory and First-order Shear Deformation Theory (FSDT). Results of the TSLD theory are as accurate as the Higher-Order Shear Deformation Theory (HOST12) for the higher frequency parameters and more thick shells, while the TSLD theory implementation is much simpler than the HOST12.
A model of strength degradation for glass fiber reinforced polymer composite laminates under fatigue loading
Authors: Ma Qiang , Song Jiangbei , Tang Ting , An Zongwen
Published: March 2022

In order to overcome the shortcoming of traditional strength modeling of glass fiber reinforced polymer (GFRP) composite laminates that require a large amount of strength test data, a strength degradation model on the account of residual stiffness degradation data is proposed. First, fatigue damage growth can be described by the gradual reduction of the stiffness and strength, and damage expressed by the two degradation methods are equivalent. Second, according this assumption, the connection between the two damage indices is established, and then a four parameters strength degradation model is obtained. Finally, the proposed model is validated by the applying experimental data of GFRP laminates, and the precision of proposed model is contrasted with other four models. Verification results indicate that if the residual stiffness degradation data is known, the residual strength degradation law can be predicted by a small number of residual strength tests and the presented model has better applicability and higher fitting accuracy.
Effects of process parameters on machining forces and surface roughness during turning 304L steel using SiO2 nanofluid
Authors: Karimpour Hadi , Abedini Vahid , Hajialimohammadi Alireza
Published: March 2022

The use of cutting fluids in machining processes plays an important role in minimizing cutting temperature, cutting forces, and machining cost In this paper, a study has been performed to model and optimize the process parameters involved in the turning operation of alloy steel AISI-304L (4306) with SiO2 nanofluids using the minimum quantity lubrication (MQL) method. The effects of spindle speed, feed rate, and flow rate in three levels have been investigated on the surface roughness and the machining forces using the response surface method (RSM). The results show the feed rate has the most effect on output responses. The minimum level of the feed rate and the maximum level of the flow rate and the spindle speed results in the optimum value for the surface roughness and machining forces. Also, a comparison between lubricating with and without nanoparticles show addition of nanoparticles improves the cutting forces and surface roughness due to the increase of the thermal conductivity coefficient of cutting fluids. The use of SiO2 nanoparticles in cutting fluid decreases the surface roughness by 48.5% and the cutting force by 12.3% compared to pure cutting fluid in the same condition.