bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemodynamic changes with pulmonary arterial hypertension targeted therapies: a meta-analysis of 3898 treatment-naive patients
Authors: Farmakis I , Baroutidou A , Patsiou V , Arvanitaki A , Doundoulakis I , Hobohm L , Zafeiropoulos S , Konstantinides S , D'alto M , Badagliacca R , Giannakoulas G
Published: November 2023

Background

Pulmonary arterial hypertension (PAH)-targeted therapies exert significant hemodynamic changes. We aimed to systematically synthesize these effects and explore the pulmonary pressure and flow changes in relation to the resistance changes.

Methods

We systematically searched PubMed, CENTRAL, and Web of Science for studies evaluating the hemodynamic effects (mean pulmonary artery pressure [mPAP], cardiac index/output [CI/CO], pulmonary vascular resistance [PVR]) of PAH-targeted therapies (comprising endothelin receptor antagonists [ERA], phosphodiesterase type 5 inhibitors [PDE5i], prostanoids [either i.v./s.c. or p.o./inh], riociguat, and selexipag) either in monotherapy or combinations as assessed by right heart catheterization (RHC) in treatment-naïve PAH patients. We performed a random-effects meta-analysis and used meta-regression to evaluate the contribution of mPAP % reduction and CI/CO % increase on the PVR % reduction across different treatment groups.

Results

We included 68 studies comprising 90 treatment groups and 4276 patients (age 47.3±13.2, 74% women). PVR reduction as a percentage of the pre-treatment value was more pronounced in the oral + prostanoid i.v./s.c. combination therapy (mean difference [MD] -50.0%, 95% confidence interval [CI] -60.8%; -39.2%), compared to oral combination therapy (MD -41.7%, 95% CI -47.6%; -35.8%), prostanoid i.v./s.c. monotherapy (MD -31.8%, 95% CI -37.6%; -25.9%), and oral monotherapy (MD -21.6%, 95% CI -25.4%; -17.8%) (Figure 1). The contribution of mPAP % reduction and of CI/CO % increase to the PVR % reduction was equally significant in all treatment groups (Figure 2). In the oral combination therapy group CI/CO % increase had superior contribution over mPAP % reduction (R2 90% vs R2 0%), but this difference was driven by an outlier study with n = 8 patients and after the exclusion of the outlier, the contribution of mPAP % reduction and of CI/CO % increase to the PVR % reduction was equally significant also in the oral combination group. The same results applied in a sensitivity analysis including only studies with idiopathic/heritable/drugs-induced/connective tissue disease-associated PAH patients.

Conclusion

Combination therapies, especially with the inclusion of parenteral prostanoids, lead to remarkable hemodynamic improvement in treatment-naïve PAH patients. The contribution of mPAP and CI/CO % changes to the overall PVR % reduction is equally significant.Figure 1Figure 2
Risk assessment according to the presence of left heart disease phenotype in pulmonary arterial hypertension patients: a multicenter cohort study
Authors: Toma M , Barbisan D , Lombardi C M , Airo E , Driussi M , Gentile P , Howard L , Moschella M , Di Poi E , Garascia A , Adamo M , Sinagra G , Lo Giudice F , Stolfo D , Ameri P
Published: November 2023

Introduction

Subclinical left heart disease (LHD) may impact the management of pulmonary arterial hypertension (PAH) [1].

Purpose

To evaluate the influence of a LHD phenotype on PAH risk stratification.

Methods

We retrospectively reviewed the data of consecutive PAH patients followed at 7 tertiary centers from 2001 to 2021, and selected those with all parameters available to determine risk of death by means of the COMPERA and COMPERA 2.0 scores, both at baseline and at the first disease reassessment including right heart catheterization. These subjects were classified as no-LHD or LHD according to the AMBITION trial criteria, i.e. absence or presence, respectively, of ≥ 3 among body mass index ≥ 30 kg/m2, systemic hypertension, diabetes mellitus, and coronary artery disease; and/or pulmonary vascular resistance between 3 and 3.75 WU or between 3.75 and 6.25 WU together with pulmonary artery wedge pressure (PAWP) between 13 and 15 mmHg [2,3]. The characteristics between the 2 groups were compared by chi-square test, T-test, or Mann-Whitney test, and Kaplan-Meier curves for overall survival by log-rank test.

Results

Of 286 patients included in the analysis, 57 (20%) had a LHD phenotype. The first complete reassessment was performed 7 ± 5 months after baseline. Compared with no-LHD, subjects with LHD were older, had more often cardiovascular comorbidities, and had higher E/e’ ratio, left atrial area and PAWP, but had lower brain natriuretic peptide concentrations and better right ventricular function and pulmonary hemodynamics (Figure 1). They were also less commonly treated with phosphodiesterase inhibitors or riociguat (54% vs 70%, P=0.03) and dual oral therapy (26% vs 43%, P=0.03), while they used more beta-blockers (47% vs 16%, P<0.001) and ACE inhibitors or angiotensin receptor blockers (40% vs 21%, P=0.004).

At baseline, the proportion of patients with low vs high risk was greater in LHD than in no-LHD with COMPERA, but not with COMPERA 2.0. Moreover, risk profile significantly improved during follow-up only in no-LHD with COMPERA, but in both groups with COMPERA 2.0 (Figure 1).

While all-cause mortality was significantly different across baseline COMPERA and COMPERA 2.0 risk strata in no-LHD, either approach for risk stratification failed to discriminate LHD subgroups with different prognosis (Figure 2). However, both COMPERA and COMPERA 2.0 risk categories differentiated mortality in LHD at the first disease reassessment (log-rank P <0.001, not shown).

Conclusions

This study suggests that the performance of risk stratification scores COMPERA and COMPERA 2.0 in PAH subjects with a LHD phenotype is limited, although the former may retain value during follow-up. Alternative tools may be needed for prognostication in this patient subset.
Incidence of chronic thromboembolic pulmonary Hypertension after acute pulmonary embolism in real-world practice
Authors: Hobohm L , Below M , Farmakis I T , Barco S , Munzel T , Konstantinides S , Keller K , Paschke L M
Published: November 2023

Background

Recently a large prospective multicentre observational cohort study demonstrated a 2-year cumulative CTEPH incidence of 2.3% after acute PE with a standardized and pre-defined follow-up plan. Thus, we sought to investigate the prevalence and incidence of CTEPH diagnosis after acute PE in real-world practice in a twelve-year observational period.

Methods

This study is based on nationwide ambulatory billing claims (VDA) and drug prescription (AVD) data of all residents with statutory health insured (SHI) in Germany from 2010 to 2019 (approx. 73 million in 2019).

Results

We identified 573,972 patients with acute PE in the German ambulatory care system between 2010 and 2019. The majority of patients were women (57.4%) and had a median age of 71 years. Prevalence of CTEPH increased during this twelve-year observational period from 0.4% in 2010 to 0.7% in 2019. Overall, a CTEPH diagnosis was made in 2556 (0.4%) patients after acute PE during a follow-up of 30 quarters (90 months). The majority of CTEPH cases (17.7%) were diagnosed in the first quarter after the index PE event. The incidence rate after the first quarter was calculated as 0.08%. The cumulative incidence after two years (8th quarter) was calculated as 0.37% and after the complete follow-up time (90 months) as 0.76% (Figure 1). Patients with CTEPH diagnosis during follow-up had considerably more often a diagnosis of acute right ventricular dysfunction at the index PE event compared to patients without CTEPH during follow-up (14.9% vs. 8.3%; ARR +6.67%). Regarding predisposing risk factors for CTEPH, especially hypothyreodism and consecutive levothyroxine application were more often present in patients with acute PE and CTEPH diagnosis during follow-up opposed to those without (18.9% vs. 16.8%; ARR +2.11%).

Conclusions

In conclusion, our study provides a comprehensive view of incidence of CTEPH after acute PE in real-word practice. The low rate of CTEPH incidence after acute PE indicate a limited awareness regarding CTEPH and lack of standardized follow-up for patients with acute PE in real-world practice, which may lead to a considerable under-diagnosis of CTEPH in Germany. On the basis of these data, a better implantation of existing clinical evaluation strategies for follow-up after acute PE seems indicated.Cumulative Incidence CTEPH
The aortic root in young adults
Authors: Chatrath N , Bhatia R , Fyyaz S , Forster J , Marwaha S , Scrocco C , Jayaratne N , Ensam B , Androulakis E , Al-Turaihi S , Sharma S , Tome Esteban M , Papadakis M
Published: November 2023

Background

Aortic size varies between individuals and is influenced by age, gender, body size and blood pressure. There are numerous studies aimed at defining normative aortic root measurements, but the vast majority of these are in older adults, or limited by a small sample size.

Purpose

To screen a large number of young individuals (≤35 years) to understand the rate of aortic growth, validate current guideline cut-offs for aortic root measurements in this age group and compare findings in males versus females.

Methods

Individuals ≥ 16 years old who attended a voluntary, nationwide cardiac screening programme for young individuals (aged 14-35) were offered and consented for an additional focused transthoracic echocardiogram of the aorta. Individuals with a known cardiac abnormality or genetic syndrome (for example Marfan’s) were excluded. Images were obtained in the parasternal long axis view with measurements of the sinus of Valsalva (SOV), sinotubular junction (STJ) and ascending aorta (AA) at end-diastole from inner-edge to inner-edge in line with British Society of Echocardiography (BSE) guidance[1]. Measurements were indexed to height (in metres). Mean SOV, STJ and AA measurements were plotted against age and comparisons were made between males and females.

Results

1153 patients were recruited. 11 were excluded to a bicuspid aortic valve (BAV), leaving 1142 subjects in the final analysis. 88% (1004) were Caucasian. The aortic measurements are shown in table 1. Males had a significantly larger SOV, STJ and AA than females (p<0.001). However, when indexed to height, only the SOV was significantly larger. All mean aortic root measurements fell within the normative range for each gender as specified by current BSE guidance[1].

Mean aortic root measurements at each year of age are shown in figure 1. There was a weakly positive correlation coefficient between age and aortic diameter (r=0.33 at SOV, r=0.31 at STJ, r=0.39 at AA) which, coupled with the lines of best-fit in figure 1, suggest there is slow but continual aortic growth from the age of 16.

Conclusion

Despite adult height being reached by the age of 16 in most individuals, the aorta continues to grow beyond this age. This study further highlights the importance of indexing aortic measurements to height, and validates that the current BSE guideline cut-offs for aortic root measurements can be applied to young individuals.
The impact of endovascular aneurysm repair for ruptured abdominal aortic aneurysms: a single center experience
Authors: Kobayashi Y , Kawakami A , Osawa I
Published: November 2023

Background

Treatment of ruptured abdominal aortic aneurysms (rAAAs) is still burdened by high morbidity and mortality, despite improvements in 30-day mortality, recently reported at around 30-35%. Although endovascular aortic repair (EVAR) offers encouraging results in elective setting, the evidence supporting its use as the primary treatment for patients with rAAAs remains controversial. Endovascular approach for rAAA has been increasing worldwide. According to some recent studies, rEVAR is associated with diminished 30-day mortality, but its superiority in long-term results in terms of mortality and morbidity is still to be defined.

Purpose

We review our single center experience of EVAR for all patients who had rAAA over 8 years.

Methods

A retrospective review of data extracted from medical records identified 82 consecutive patients with rAAA who were underwent endovascular repairs from January 2014 to December 2021. We used EVAR first protocol for all patients. Under local anesthesia, percutaneous puncture of both common femoral arteries and left brachial artery is performed. Endovascular balloon control (EBC) is placed at T12 or L1 through the left brachial artery. Induction of general anesthesia can then be obtained. Then it can be done EVAR in the usual fashion. The primary end point was to assess the rAAA-related mortality in the immediate postoperative period, within 1, 3 and 5 years after EVAR; secondary endpoints included the following: length of stay, rAAA-related postoperative complications such as acute limb ischemia, myocardial infarction, renal and respiratory failure, abdominal compartment syndrome and rAAA-related re-interventions.

Results

EVAR was performed in all patients. There were no patients who converted to open surgical repair. The average age of the patients was 77 years, and 76% were male. 64% were sent from other hospitals, and 60% presented with severe hypotension. Anatomically, 52 cases, or 63%, were considered ineligible for EVAR. EBC were used in 72%. In early results, 12% of patients required dialysis due to acute kidney injury, and 9% required prolonged intubation with tracheotomy. Abdominal compartment syndrome occurred in 8%. Perioperative deaths occurred in 10 patients (12.1%), all within 48 hours after surgery. In late outcomes, mean follow-up was 1100. No new complications were seen after the 30-day period. Endovascular reinterventions took place in 11%. The average time to re-intervention was 372 days, with the majority of cases taking less than a year. The overall survival rates at 1, 3, and 5 years were 71.9%, 66.3%, and 66.3%, respectively.

Conclusions

EVAR for rAAA is associated with lower perioperative and long-term mortality with our protocol. This single-center experience suggests genuine concerns and impediments to the adoption of an ‘‘EVAR-first’’ policy for all rAAAs.
Cardiological hypertensive emergencies: real word data compared to guidelines indications
Authors: Maloberti A , Andrian E , Leidi F , Monticelli M , Galasso M , Colombo V , Giannattasio C
Published: November 2023

Background

The 2018 ESH guidelines have revised the therapeutic goals of cardiological Hypertensive Emergencies (HE) with an indication for a more intensive (target < 140/90 mmHg) and rapid (immediate) Blood Pressure (BP) reduction. Cardiac acute organ damage during HE includes acute myocardial infarction, pulmonary edema, unstable angina pectoris and aortic dissection. However, how much these indications have been applied in clinical practice to date it’s unknown.

Aims

The first purpose of our study is to analyze the prevalence and clinical characteristics of cardiological HE in our institution. The second purpose is to compare the year before the release of the 2018 guidelines (2017) with the subsequent years (2019) trying to verify adherence to guidelines.

Methods

This is a single-center retrospective study conducted at a hospital. All patients aged ≥ 18 years with Systolic BP≥ 180 mmHg and/or a Diastolic BP ≥ 120 mmHg with Cardiological Emergency were enrolled. From the Emergency Department (ED) data clinical, anamnestic, blood pressure, symptoms, drug treatment and target achievement were registered.

Results

Patients with BP > 180/120 mmHg in 2017 were 706 out of a total of 73795 accesses (0.96%) and 601 over 67273 (0.89%) in 2019. 246 (34.84%) in 2017 were HE of which 144 (58.53%) were cardiological: aortic dissection 1 (0.69%), acute coronary syndrome 52 (36.11%), acute pulmonary edema 35 (24.30%), cardiac decompensation 91 (63.19%). During 2019 similar figures were founded with 286 (47.58%) HE of which 286 (47.58%) were cardiological: aortic dissection 2 (1.43%), acute coronary syndrome 43 (30.93%), acute pulmonary edema 20 (14.39%), cardiac decompensation 76 (54.68%). The reduction in BP obtained in ED was significantly greater in 2017 than in 2019 (44.7±31.4 vs 35.4±24.5 mmHg, p = 0.011) with a lower target reaching in 2019 (28.9 vs 51.4%, p<0.001). Pulmonary edema is the cardiological HE on which a greater pressure reduction is obtained and therefore in which the target set by the guidelines is more frequently reached.

Conclusions

The recommendation for a more intense and rapid BP reduction in cardiological HE seems to be not accepted from ED clinicians that persist to reduce BP accordingly to previous guidelines.
Bayesian inversion for modelling 3-D density structures in the eastern margin of Bayan Har block and its tectonic implications
Authors: Li Honglei , Chen Shi , Zhang Bei , Li Yongbo , Zhuang Jiancang
Published: November 2023

Recently, the eastern margin of the Tibetan plateau has experienced three moderate earthquakes. Deep crustal structure is a critical factor for understanding the seismotectonic environment and deformations in this region. Although several multidisciplinary geophysical approaches have been used to develop crustal structure models for this area, substantial inconsistencies still persist in the results due to the intricate structural properties of crust. In this study, we introduce a novel approach to construct a 3-D crustal model with assimilated density structure (MADS) at a resolution of 0.2° × 0.2° × 5 km. This model is built by integrating data from various source, including multisource gravity anomalies and diverse available crustal structure reference models. We use a model-assimilated gravity inversion process with Bayesian parameter optimization. First, we combine the terrestrial gravity profiles data set with published global gravity field models to create a data set rich in reliable high-frequency anomaly information. Secondly, we incorporate three reference models derived from different seismological methods as prior constraints for our model. These models encompass seismic tomography, surface wave dispersion and receiver function data. We optimize the hyper-parameters of these constraints using the Bayesian criterion. The results demonstrate that the MADS not only captures significant changes in the crustal density but also discerns subtle variations in the upper and middle crust, thereby providing detailed insights into the morphologies of major faults. For instance, the central section of the Longmenshan fault is revealed as a high-angle deep thrust feature, while the frontal section of the Longmenshan fault appears as a low-angle mid-deep thrust feature, and the Xianshuihe fault exhibits a vertical deep subduction feature. Additionally, our findings indicate a correlation between the locations of moderate-to-large earthquakes in this region and the high density-gradient zones or asperities with high density within MADS. We believe that the insights into density characteristics offered by the new MADS model can shed light on the study of asperities associated with recent moderate earthquakes and enhance our understanding of deformation in this region.
The Galactic distribution of pulsar scattering and the τ–DM relation
Authors: He Qiuyi , Shi Xun
Published: November 2023

Interstellar radio wave scattering leads to flux density fluctuations and pulse broadening of pulsar signals. However, Galactic distribution and the structure of the scattering medium are still poorly understood. Pulsar pulse broadening data available for a relatively large number of pulsars is well suited for such investigations. We collected an up-to-date sample of publicly available pulsar scattering data and introduced a new quantity – the reduced scattering strength $\tilde{\tau }$ to study the Galactic distribution of pulsar scattering in the Milky Way. We show that the current observations are dominated by two distinct pulsar populations: a local and an inner-Galactic one separated by $\tilde{\tau }=10^{-5.1}$ s cm6 pc−1. The stronger electron density fluctuations associated with the inner-Galactic population naturally explain the observed steepening of pulsar scattering time τ–dispersion measure relation. We measure an inner disc region with $3\, {\rm kpc}\ \lt\ \rm r\ \lt\ 5.5\, {\rm kpc}$ from the Galactic centre to have a scattering scale height of about 0.28 kpc, supporting a correlation between interstellar radio scattering and structures associating with the ionized gas and stellar activities.
The ALMA REBELS survey: obscured star formation in massive Lyman-break galaxies at z
= 4–8 revealed by the IRX–β and M⋆ relations
Authors: Bowler R A A , Inami H , Sommovigo L , Smit R , Algera H S B , Aravena M , Barrufet L , Bouwens R , da Cunha E , Cullen F , Dayal P , De Looze I , Dunlop J S , Fudamoto Y , Mauerhofer V , McLure R J , Stefanon M , Schneider R , Ferrara A , Graziani L , Hodge J A , Nanayakkara T , Palla M , Schouws S , Stark D P , van der Werf P P
Published: November 2023

We investigate the degree of dust obscured star formation in 49 massive (log10(M⋆/M⊙) > 9) Lyman-break galaxies (LBGs) at z = 6.5–8 observed as part of the Atacama Large Millimeter/submillimeter Array (ALMA) Reionization Era Bright Emission Line Survey (REBELS) large program. By creating deep stacks of the photometric data and the REBELS ALMA measurements we determine the average rest-frame ultraviolet (UV), optical, and far-infrared (FIR) properties which reveal a significant fraction (fobs = 0.4–0.7) of obscured star formation, consistent with previous studies. From measurements of the rest-frame UV slope, we find that the brightest LBGs at these redshifts show bluer (β ≃ −2.2) colours than expected from an extrapolation of the colour–magnitude relation found at fainter magnitudes. Assuming a modified blackbody spectral energy distribution (SED) in the FIR (with dust temperature of $T_{\rm d} = 46\, {\rm K}$ and βd = 2.0), we find that the REBELS sources are in agreement with the local ‘Calzetti-like’ starburst Infrared-excess (IRX)–β relation. By re-analysing the data available for 108 galaxies at z ≃ 4–6 from the ALMA Large Program to Investigate C+ at Early Times (ALPINE) using a consistent methodology and assumed FIR SED, we show that from z ≃ 4–8, massive galaxies selected in the rest-frame UV have no appreciable evolution in their derived IRX–β relation. When comparing the IRX–M⋆ relation derived from the combined ALPINE and REBELS sample to relations established at z < 4, we find a deficit in the IRX, indicating that at z > 4 the proportion of obscured star formation is lower by a factor of ≳ 3 at a given a M⋆. Our IRX–β results are in good agreement with the high-redshift predictions of simulations and semi-analytic models for z ≃ 7 galaxies with similar stellar masses and star formation rates.
Role of adipose-derived stem cells in healing surgically induced trauma of the rat’s tunica albuginea
Authors: Sharqawi Abdallah , Mansour Mona F , Elatrash Gamal A , Ismail Ezzat A , Ralph David , El-Sakka Ahmed I
Published: November 2023

Background

Injection of adipose-derived stem cells (ADSCs) into the injured tunica albuginea (TA) may prevent fibrosis, restore the balance between pro- and antifibrotic pathways, and potentially mitigate erectile dysfunction caused by abnormal TA healing.

Aim

To assess the potential role of ADSC injection on structural, ultrastructural, functional, and molecular changes in surgically induced trauma of the rat’s TA.

Methods

Forty adult male albino Wistar rats were divided into 5 groups of 8 rats each: group 1, sham; group 2, injury to TA without treatment; group 3, injury to TA and suture repair; group 4, injury to TA and injection of ADSCs without suture repair; group 5, injury to TA followed by injection of ADSCs and suture repair.

Outcomes

After 6 weeks, all groups were subjected to functional, histologic, and ultrastructural examination and molecular expression of healing growth factors.

Results

The intracavernous pressure (ICP; mean ± SD) was 114 ± 2, 32 ± 2, 65 ± 2, 68 ± 2, and 111 ± 2 mm Hg in groups 1 to 5, respectively. There were significant differences in ICP between each of groups 3 to 5 and group 2 (P < .05), and groups 3 and 4 each had significant differences with group 1 (P < .05). No significant difference in ICP occurred between groups 3 and 4 (P > .05). There were significant histologic and ultrastructural alterations in tunical tissues from group 2; however, these changes were markedly less in group 5 in terms of lower levels of fibrotic changes, elastosis, and superior overall neuroendothelial expression. Groups 3 and 4 showed improved structural and ultrastructural parameters when compared with group 2. Group 5 demonstrated lower levels of transforming growth factor β1 and basic fibroblast growth factor expression.

Clinical Implications

This experimental model may encourage administration of ADSCs to prevent the deleterious effects of trauma to the TA.

Strengths and Limitations

Injecting ADSCs can improve the healing process and erectile dysfunction in a rat model following TA injury, and combining ADSC injection with surgical suturing resulted in superior outcomes. The main limitation was the absence of long-term ICP measurements and a longer follow-up period that may provide further insight into the chronic phase of the healing process.

Conclusion

ADSC injection may prevent structural, ultrastructural, functional, and molecular alterations in surgically induced trauma of the rat’s TA and enhance the effect of tunical suturing after trauma.
Mini Crestal Sinus Lift With Bone Grafting and Simultaneous Insertion of Implants in Severe Maxillary Conditions as an Alternative to Lateral Sinus Lift: Multicase Study Report of Different Techniques
Authors: Rosa Alessio , Ranieri Nicola , Miranda Michele , Mehta Vini , Fiorillo Luca , Cervino Gabriele
Published: November 2023

The present study evaluates the efficacy and clinical outcomes of crestal sinus lift techniques used to elevate the sinus floor simultaneously with bone grafting and implant placement as a possible and reproducible alternative to lateral sinus lift. Patients underwent different crestal sinus elevation techniques. The heterologous biomaterial was used as graft material, and multiple implants were placed simultaneously after sinus augmentation. Radiographic and clinical examinations were performed during follow-up. All procedures were successfully performed without any apparent perforation of the Schneider membrane. The sinus floor was augmented with an average height of 5 mm (range: 2.8–7.4 mm). The implants healed smoothly with healing screws. Peri-implant marginal bone was stable with a mean follow-up of 50 months (range: 33–71 mo). No complications were observed during the follow-up. Based on the limited data collected in this study, the new crestal sinus elevation approach can effectively raise the sinus floor and reduce the incidence of postoperative complications. Other cases with long-term follow-up are needed to confirm and improve this crestal sinus lift technique.
MAGNESIUM SULFATE AMELIORATES HISTONE-INDUCED COAGULATION DYSFUNCTION AND LUNG DAMAGE IN MICE
Authors: Zhong Tao , Zhang Jiaqi , Chen Shanjia , Chen Sainan , Deng Ke , Guan Jianbin , Yang Jingjing , Lv Ronggui , Liu Zhifeng , Liu Yong , Chang Ping , Liu Zhanguo
Published: November 2023

Introduction: Extracellular histones have been determined as significant mediators of sepsis, which can induce endothelial cell injury and promote coagulation activation, and ultimately contribute to multiorgan failure. Evidence suggests that magnesium sulfate (MgSO4) exerts a potential coagulation-modulating activity; however, whether MgSO4 ameliorates histone-induced coagulation dysfunction and organ damage remains unclear. Methods: To measure circulating histone levels, blood specimens were collected from septic patients and mice, and the relationship between circulating histone levels, coagulation parameters, and Mg2+ levels in sepsis was investigated. Furthermore, to explore the possible protective effects of MgSO4, we established a histone-induced coagulation model in mice by intravenous histone injection. The survival rate of mice was assessed, and the histopathological damage of the lungs (including endothelial cell injury and coagulation status) was evaluated using various methods, including hematoxylin and eosin staining, immunohistochemistry, immunofluorescence, electron microscopy, and quantitative polymerase chain reaction. Results: The circulating histone levels in septic patients and mice were significantly associated with several coagulation parameters. In septic patients, histone levels correlated negatively with platelet counts and positively with prothrombin time and D-dimer levels. Similarly, in cecal ligation and puncture mice, histones correlated negatively with platelet counts and positively with D-dimer levels. Interestingly, we also observed a positive link between histones and Mg2+ levels, suggesting that Mg2+ with anticoagulant activity is involved in histone-mediated coagulation alterations in sepsis. Further animal experiments confirmed that MgSO4 administration significantly improved survival and attenuated histone-mediated endothelial cell injury, coagulation dysfunction, and lung damage in mice. Conclusion: These results suggest that therapeutic targeting of histone-mediated endothelial cell injury, coagulation dysfunction, and lung damage, for example, with MgSO4, may be protective in septic individuals with elevated circulating histone levels.
Collagen receptor GPVI-mediated platelet activation and pro-coagulant activity aggravates inflammation and aortic wall remodelling in abdominal aortic aneurysm
Authors: Feige T , Bosbach A , Krott KJ , Mulorz J , Chatterjee M , Ortscheid J , Krüger E , Krüger I , Ibing W , Grandoch M , Wagenhäuser MU , Schelzig H , Elvers M
Published: November 2023

Platelets play an important role in cardio- and cerebrovascular diseases. Abdominal aortic aneurysm (AAA) is a highly lethal, atherosclerotic-related disease with characteristic features of progressive dilatation of the abdominal aorta and degradation of the vessel wall accompanied by chronic inflammation. Platelet activation and pro-coagulant activity play a decisive role in the AAA pathology as they might trigger AAA development in both mice and men. The present study investigated the impact of the major platelet collagen receptor glycoprotein (GP)VI in cellular processes underlying AAA initiation and progression. Genetic deletion of GPVI offered protection of mice against aortic diameter expansion in experimental AAA. Mechanistically, GPVI deficiency resulted in decreased inflammation with reduced infiltration of neutrophils and platelets into the aortic wall. Further, remodelling of the aortic wall was improved in absence of GPVI, indicated by reduced MMP2/9 and OPN plasma levels and an enhanced α-SMA content within the aortic wall, accompanied by reduced cell apoptosis. As a result, an elevation in intima/media thickness and elastin content were observed in GPVI-deficient PPE mice, coursing a significantly reduced aortic diameter expansion and reduced aneurysm incidence. In AAA patients, enhanced plasma levels of soluble GPVI and fibrin, besides fibrin accumulation within the intraluminal thrombus (ILT) suggested that GPVI might serve as a biomarker and mediator in fibrin-supported stabilization of the ILT. In conclusion, our results emphasize the potential need for a GPVI-targeted anti-platelet therapy to reduce AAA initiation and progression, as well as to protect AAA patients from aortic rupture.

Translational perspective

Abdominal aortic aneurysm (AAA) is an atherosclerotic-related, cardiovascular disease (CVD) with high mortality. The impact of platelets in different cellular processes underlying AAA initiation and progression remains unclear.Therefore, we analysed the role of the major platelet collagen receptor GPVI in the pathogenesis of AAA. Results from platelet depleted mice and patients with AAA revealed a significant contribution of GPVI to the inflammatory response and remodelling process of the aorta. Further, elevated accumulation of fibrin, a recently identified ligand of GPVI in the intraluminal thrombus (ILT) and in the plasma of AAA patients, suggests that GPVI binding to fibrin plays a role in ILT formation and probably stabilization of the abdominal aorta. Furthermore, increased levels of sGPVI suggest that GPVI might serve as a clinical biomarker for AAA. Thus, therapeutic targeting of GPVI-mediated platelet activation might be an effective anti-thrombotic strategy for AAA patients.
An assessment of flash flood susceptibility in Golestan province, Iran, using multiple computational approaches
Authors: Hosseini Sabzevari Sayed Arash , Mehdipour Haleh , Aslani Fereshteh
Published: November 2023

Purpose

Golestan province in the northern part of Iran has been affected by devastating floods. There has been a significant change in the pattern of rainfall in Golestan province based on an analysis of the seven heaviest rainfall events in recent decades. Climate change appears to be a significant contributing factor to destructive floods. Thus, this paper aims to assess the susceptibility of this area to flash floods in case of heavy downpours.

Design/methodology/approach

This paper uses a variety of computational approaches. Following the collection of data, spatial analyses have been conducted and validated. The layers of information are then weighted, and a final risk map is created. Fuzzy analytical hierarchy process, geographic information system and frequency ratio have been used for data analysis. In the final step, a flood risk map is prepared and discussed.

Findings

Due to the complex interaction between thermal fluctuations and precipitation, the situation in the area is further complicated by climate change and the variations in its patterns and intensities. According to the study results, coastal areas of the Caspian Sea, the Gorganrood Basin and the southern regions of the province are predicted to experience flash floods in the future. The research criteria are generalizable and can be used for decision-making in areas exposed to flash flood risk.

Originality/value

The unique feature of this paper is that it evaluates flash flood risks and predicts flood-prone areas in the northern part of Iran. Furthermore, some interventions (e.g. remapping land use and urban zoning) are provided based on the socioeconomic characteristics of the region to reduce flood risk. Based on the generated risk map, a practical suggestion would be to install and operate an integrated rapid flood warning system in high-risk zones.
The sociodemographic determinants of stress level among the parents of preterm infants
Authors: Russo Concetta , Decataldo Alessandra , Fiore Brunella
Published: November 2023

Purpose

Introduction: The birth of a preterm child requires hospitalization in a neonatal intensive care unit (NICU), which is a very stressful experience for parents. Aim: To determine the stress level of parents of preterm babies admitted to intensive and sub-intensive units in two hospitals in Northern Italy and its association with their sociodemographic variables and the clinical conditions of their newborns.

Design/methodology/approach

The sampling was non-probabilistic and included parents of preterm babies admitted to intensive and/or sub-intensive care for at least 10 days. Instruments: (1) information deduced from the clinical record of preterm newborns; (2) sociodemographic determinants of parents' well-being deduced from a questionnaire; (3) parental stress scale: neonatal intensive care unit (PSS:NICU), which measures the perception of parents about stressors from the physical and psychological environment of the NICU.

Findings

Results: A total of 104 parents of 59 hospitalized preterm babies participated in the study. The average parental stress level was 1.87 ± 0.837. The subscale score that got higher was parent-infant relationship subscale. Concerning the infant characteristics, the birth weight of the babies and the length of their hospitalization affected the parents' stress level. Looking at parents' sociodemographic characteristics instead, the greater predictors were gender, age and occupational social class.

Originality/value

The parental role alteration caused by infant premature birth and consequent hospitalization is a major stressor for parents and in particular for mothers. The variables that resulted positively associated with higher stress in parents of preterm infants hospitalized are specific parental characteristics, including not adequately or previously studied ones, and infant characteristics.
Using digital twin to enhance Sim2real transfer for reinforcement learning in 3C assembly
Authors: Mu Weiwen , Chen Wenbai , Zhou Huaidong , Liu Naijun , Shi Haobin , Li Jingchen
Published: November 2023

Purpose

This paper aim to solve the problem of low assembly success rate for 3c assembly lines designed based on classical control algorithms due to inevitable random disturbances and other factors,by incorporating intelligent algorithms into the assembly line, the assembly process can be extended to uncertain assembly scenarios.

Design/methodology/approach

This work proposes a reinforcement learning framework based on digital twins. First, the authors used Unity3D to build a simulation environment that matches the real scene and achieved data synchronization between the real environment and the simulation environment through the robot operating system. Then, the authors trained the reinforcement learning model in the simulation environment. Finally, by creating a digital twin environment, the authors transferred the skill learned from the simulation to the real environment and achieved stable algorithm deployment in real-world scenarios.

Findings

In this work, the authors have completed the transfer of skill-learning algorithms from virtual to real environments by establishing a digital twin environment. On the one hand, the experiment proves the progressiveness of the algorithm and the feasibility of the application of digital twins in reinforcement learning transfer. On the other hand, the experimental results also provide reference for the application of digital twins in 3C assembly scenarios.

Originality/value

In this work, the authors designed a new encoder structure in the simulation environment to encode image information, which improved the model’s perception of the environment. At the same time, the authors used the fixed strategy combined with the reinforcement learning strategy to learn skills, which improved the rate of convergence and stability of skills learning. Finally, the authors transferred the learned skills to the physical platform through digital twin technology and realized the safe operation of the flexible printed circuit assembly task.
Secondary sneaker market: Investigating the motives, activities, resources and capabilities of the triadic framework
Authors: Slaton Kelcie , Pookulangara Sanjukta
Published: November 2023

Purpose

The purpose of this study was to investigate the elements of the triadic framework (e.g. consumer motives, activities, resources and capabilities) and their influence on consumer attitudes and the theory of reasoned action (TRA) elements of subjective norms and eventual purchase intention of secondary sneakers.

Design/methodology/approach

The framework draws from two models, the triadic framework for collaborative consumption and the TRA. Data was collected using an online survey, which consisted of demographic questions and reliable scales. The hypothesized relationships were tested through structural equation modeling.

Findings

The findings indicate that reducing risks and the customer activity of providing information was significant in influencing consumers' attitudes. However, the customer motives of economic and environmental as well as technical skills were not significant in influencing attitudes.

Practical implications

This study attempts to inform secondary and full-priced retailers offering used products strategies to provide the best experience to millennial and generation Z consumers to ensure they can attract and retain them.

Originality/value

It can be stated with a high degree of certainty that sneaker resale remains one of the most permanent trends in the market today with sneaker resale is significantly outperforming the broader ecommerce ecosystem suggesting more research into the motivations of secondary sneaker consumption.
Institutional work for IFRS adoption: the case of IFRS 17 insurance contract for Islamic insurance in Malaysia
Authors: Wahyuni Ersa Tri , Azhar Zubir , Fajriati Novy
Published: November 2023

Purpose

The global insurance industry has implemented International Financial Reporting Standards (IFRS) 17 insurance contracts effective from January 1, 2023. The Islamic insurance (Takaful) industry would find itself at a crossroads if IFRS 17 should also be adopted for Takaful contracts. This paper aims to explore the process of IFRS 17 adoption for Takaful contracts in Malaysia and the implementation of the standard in the early adoption year.

Design/methodology/approach

Applying a qualitative approach, this study uses a literature review search and interviews to analyze deeper into the adoption process in Malaysia. Using institutional work, this paper analyses the process timeline, the actors and their roles and actions in the adoption process. The authors interviewed 12 informants from different backgrounds comprising the national standard setters, preparers and the IFRS 17 consultants.

Findings

The adoption process of IFRS 17 in Malaysia is an interplay between the accounting standard setter, the government and the industry associations who are the major actors in the process. These actors have different roles and contributions, but they work together to accomplish a single vision, adopting IFRS 17 for all. There is an interplay between actors to disrupt the accounting practice and involved in creating various institutional work to ensure the concerns of Takaful practitioners are well addressed. This research also found that the companies faced significant challenges in applying the standard in the early months of implementation.

Research limitations/implications

This paper contributes to the literature by providing an explanation and examples of the IFRS adoption for Shariah transactions. The story of Malaysia can become a case study for other countries that are still deciding on adopting IFRS 17, especially for the Islamic insurance industry.

Practical implications

The story of Malaysia can become a case study for other countries that are still deciding on adopting IFRS 17, especially for the Islamic insurance industry.

Originality/value

This paper contributes to the literature on the debate of the application of IFRS to Shariah transactions by using institutional work theory as a framework.
“You get good at becoming secretive, at hiding it.” Shame and loneliness: the mental health impacts of skin picking disorder
Authors: Isibor Marta , Sagan Olivia
Published: November 2023

Purpose

The purpose of this paper is to report on a study into the lived experience of skin picking disorder (SPD) and to explore the psychological impact of the disorder.

Design/methodology/approach

Researchers employed a qualitative phenomenological approach, using Interpretative phenomenological analysis (IPA).

Findings

The study found that the sense of shame, common among participants, led to self-stigma, hiding, concealing and avoidance. Shame of SPD also interplayed with and compounded the shame of loneliness.

Research limitations/implications

Limitations included a lack of a longitudinal component to the work. This is deemed important, as both the SPD and the experience of loneliness can shift over time as circumstances change, and individuals develop strategies for coping or, conversely, experience a worsening of the condition and the shame, loneliness and social isolation it can induce.

Practical implications

This study draws attention to the complex nature of both SPD and loneliness. It highlights how those living with the disorder are reluctant to seek help, resulting in low rates of treatment access and distrust in health providers.

Social implications

As SPD is little understood, it can be erroneously deemed a “choice”; seldom discussed as a condition, it can lead to exclusion and withdrawal. The sense of shame of both appearance and behaviour interplays with and compounds the shame of loneliness and can force the individual into a further cycle of withdrawal and isolation.

Originality/value

While research suggests SPD should be acknowledged as a public health issue, research and literature is still relatively limited, and there are no qualitative phenomenological studies as yet that report on the lived experience of SPD.
Learning-driven strategic renewal: systematic literature review
Authors: Maharani Ida Ayu Kartika , Sukoco Badri Munir , Usman Indrianawati , Ahlstrom David
Published: November 2023

Purpose

This paper aims to systematically review and synthesize existing research on learning-driven strategic renewal and examines the findings to elucidate the dimensions, antecedents, mechanisms and consequences associated with learning-driven strategic renewal, thereby addressing gaps in the existing literature.

Design/methodology/approach

This research covers learning-driven strategic renewal from 1992 to 2022, using hybrid snowball sampling techniques and Boolean searches on the Scopus and Web of Science databases to extract 49 papers.

Findings

This review proposes an organizing framework for learning-driven strategic renewal, building upon existing literature. The framework identifies various dimensions of the process, including antecedents, mechanisms and consequences. The antecedents are categorized into individual, organizational and external factors. The mechanisms for learning-driven strategic renewal were explored within the context of Crossan’s established 4I framework, which serves as a lens for emphasizing the balance between exploratory and exploitative learning. Within this framework, intuiting, interpreting, integrating and institutionalizing are the four “Is” that guide the renewal process. These mechanisms require a robust system to enforce the prescribed processes effectively, thereby contributing to long-term firm performance and sustainability.

Research limitations/implications

Despite using search terms similar to those in existing literature on strategic renewal, the scope and depth of this study may be limited. Further research may benefit from bibliometric screening or more refined inclusion criteria.

Originality/value

While there has been extensive research into both organizational learning and strategic renewal, no coherent framework links them. This study fills this gap by building a framework that identifies connections between these two concepts, providing valuable insights that may be used to foster successful strategic renewal efforts. The review offers valuable knowledge and understanding of the subject matter, serving as useful guidance for effectively driving renewal initiatives within organizations.
Ethics without borders: solidarity and difference in inter‐community dialogue
Authors: Egorova Yulia
Published: November 2023

The article offers an ethnographically embedded analysis of a UK‐based Jewish‐Muslim inter‐community network to contribute to anthropological research into the ethical efforts that groups seen as polarized invest in negotiating boundaries of difference. The article makes two sets of arguments. First, it suggests that sometimes such groups have to negotiate not one but several ‘borders across difference’ and follow diverse ethical routes to navigate them depending upon how they conceptualize these borders. Second, it shows that in negotiating different sets of boundaries, network members often use techniques that at first glance appear to be artificial or even superficial in that they build on formal rules and/or contain no promise of achieving a consensus on issues important for the participants. However, I argue that these seemingly superficial efforts could still be seen as ethical endeavours underpinned by a strong commitment to inter‐group solidarity and that they could be best understood as what Ruth Sheldon has described in her recent intervention in the ethics of Jewish ethnography as the movement between surface and depth.