bluuebunny/crossref_metadata_2025 huggingface dataset:
Thrombocytopenia after transcatheter aortic valve implantation: prognostic value and mechanisms
Authors: Roca Guerrero C , Brito J , Silva B , Carrilho-Ferreira P , Jorge C , Cardoso P , Corte-Real H , Bordalo A , Canas-Silva P , Pinto F , Bras-Rosario L
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Thrombocytopenia post transcatheter aortic valve implantation (TPPT) in its most severe manifestation is an independent predictor of mortality. However, mechanisms that favors TPPT remain unknown.

Purpose

To establish the prognostic value and risk factors of TPPT in a real-life population of patients treated with transcatheter aortic valve implantation (TAVI) in a tertiary hospital.

Methods

We analyzed retrospectively clinical, laboratory, echocardiographic and procedure-related variables from 203 consecutive patients, treated with TAVI between January 2019 and October 2021.

Results

This cohort had mean age of 82,3 ±5,9 years, 56% male, 83% hypertensive, 62% dyslipidemia, 35% diabetic, 20% chronic kidney disease, 22% chronic obstructive pulmonary disease, 32% coronary artery disease, 20% had previous ICP, 38% Atrial Fibrillation (AF), 18% peripheral arterial disease, 12% neurovascular disease, 23% history of cancer, 10% pacemaker carriers. 50% of TAVIs were balloon-expandable and 50% self-expandable. Mean procedure duration was 138 ±109min, size 26,6±3mm, contrast dose 233 ±88mL.

During in-hospital stay 192/203 patients had TPPT. Platelets before TAVI, 187.000 (IQR 148.000-222.000) Vs a minimum post-TAVI (PlqMin) of 135.000 (IQR 105.000-164.000); P<0,05. Platelet fall (DeltaPlq) 48.000 ±38.000. We observed a Minimum Kidney clearance (ClMin) 46 ±20,75mL/min/m2, a maximum ultrasensitive Troponin-T (Tr-TusMax) 250 ±450 pg/L, a Maximum C Reactive Protein (PCRMax) 6,68 ±6,4, and a Minimum Hemoglobin (HbMin) 9,8 ±1,7 g/dL. 31/203 (15,3%) patients were exitus at the end of follow-up.

We observed a non-lineal statistically significant association between TPPT quartiles and all-cause mortality (P<0,05): 21 exitus occurred in the extreme quartiles (1 and 4) while only 11 at the central ones (2 and 3).

DeltaPlq was associated with PCRMax (Pearson 0,25; P<0,001), CliMin (Pearson -0,23; P0,005), HbMin (Pearson -0,27; P 0,001), AF. The only protective factor for DeltaPlq was history of previous ICP. Among exitus patients PlqMin was observed later than in survivors (3,5 vs 2,2 days; P<0,05).

TPPT’s quartiles, previous ICP, time to PlqMin, HbMin, PCRMax and Tr-TusMax were the variables found to be independent associated with all-cause mortality (P<0,05).

Conclusions

The non-linear association between TPPT and mortality, the temporal relation between TPPT and mortality and the linear correlation between TPPT and HbMin and PCRMax suggest that late TPPT may have a mortality prognostic value through an increased risk of low Hb in the context of an increased inflammatory status. The fact that history of ICP was associated with les platelet fall suggests that revascularization, or ICP associated drug therapy, may confer protection against after TAVI mortality.
Evaluation of prognostic value of lung ultrasound in st-segment elevation myocardial infarction killip i
Authors: Carreras J , Simon-Ramon C , Vidal-Burdeus M , Rodriguez-Sotelo L , Giralt-Borrell T , Izquierdo-Marquisa A , Rivas-Lasarte M , Llao-Ferrando JI , Ariza-Sole A , Sionis A , Ribas-Barquet N , Vaquerizo-Montilla B
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Societat Catalana de Cardiologia (SCC)

Sociedad Española de Cardiología (SEC)

Introduction

About 80-90% of patients admitted for ST-segment elevation myocardial infarction (STEMI) present with no signs of heart failure at admission. Heart failure at admission is one of the most relevant prognostic factors in STEMI, whereas incidence and prognostic significance of HF developed during hospitalization is unclear. B-lines in lung ultrasound (LUS) provide useful diagnostic and prognostic information in heart failure patients with the potential to stratify the risk of complications in patients presenting with STEMI KKI.

Purpose

To assess the capacity of the lung ultrasound to predict heart failure developing or death during hospitalization in patients admitted for STEMI KKI

Methods

This is a prospective observational multicenter study. Consecutive patients admitted for STEMI KKI in four tertiary hospitals were included, exclusion criteria were patients with cardiac arrest at presentation, severe lung disease or hemodialysis. The LUS was carried out by an independent operator blinded to clinical data in the first 24 hours after admission. We counted B-lines using 8-scan site LUS protocol and divided patients in two groups : wet lung group (3 or more B-lines in at least one zone) and dry lung (no positive zone). The primary endpoint was a composite of clinical congestive heart failure, cardiogenic shock, or mortality during the index hospitalization.

Results

From June 2020 to November 2021, 221 patients STEMI KKI patients were included. Fifty-four patients (25,4%) had a wet lung according to the LUS. Seventeen patients (7,7%) presented the primary outcome (all of them developed congestive heart failure, 1 of them cardiogenic shock and 2 of them died during hospitalization). Fourteen in 54 wet-lung patients (25,9%) presented the primary outcome whereas only 3 in 167 (1,7%) of the dry-lung patients [relative risk of 14,4 (IC 95% 4,3-48,3)]. Patients who develop the primary outcome had no differences in NTproBNP at admission but had higher NTproBNP peak, higher troponin T peak, lower left ventricular ejection fraction and longer length of stay.

Conclusions

In patients admitted with STEMI KKI, presenting 3 or more B-lines at least at one lung zone in the LUS at first 24 hours after admission was strongly associated with worse prognosis during hospitalization.

LUS allows a better risk classification of patients and may potentially discriminate those with potential risk of complications during hospitalization from those with an excellent prognosis who can benefit from early discharge.
The biomarkers NSE and S100b have high predictive value regarding mortality in children resuscitated after cardiac arrest
Authors: Obling L , Bangshoej J , Liebetrau B , Wiberg S , Gjedsted J , Kjaergaard J , Hassager C , Wanscher M
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Children suffering from cardiac arrest (CA) have high mortality due to neurological injury and prognostication tools are sparse. The biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) are known to predict outcome in adult CA, but the use in children is not well investigated.

Purpose

To assess the predictive value of the biomarkers NSE and S100b in children resuscitated from CA the first 72 hours following admission.

Methods

In-hospital and out-of-hospital CA patients, age <18 and comatose at intensive care unit admission, were included consecutively at our hospital from 2011-2021 and analyses of NSE and S100b levels were made at three timepoints following admission: 12 to 24 hours, 24 to 48 hours and 48 to 72 hours. Patients were divided into groups of "survivors" and "non-survivors". The primary endpoint was 30-day mortality. Biomarker levels in the two groups were compared using the Mann-Whitney U test. Predictive value of NSE and S100b was determined by applying receiver operating characteristics (ROC) curves with area under the curves (AUC) presented for each timepoint.

Results

We included 32 resuscitated patients with 12 (38%) patients dying within 30 days from resuscitation, i.e. 20 (62%) patients surviving. 14 patients were male sex and the median age was 15 years (6-16) in survivors. In non-survivors 8 patients were male sex and the median age was 7 years (2-15). Significantly higher levels of NSE and S100b were found in non-survivors compared to survivors at all timepoints following CA (Figure 1). For NSE the ROC curves obtained AUC values of 0.91 (0.75-1.0), 0.97 (0.92-1.0) and 0.98 (0.93-1.0) for prediction of 30-day mortality at the three timepoints. AUCs for S100b were 0.93 (0.84-1.0), 0.94 (0.86-1.0) and 0.94 (0.85-1.0), respectively.

Conclusion

Levels of NSE and S100b in children resuscitated from CA are associated with 30-day mortality and both biomarkers appear to be strong predictors of mortality.
Changes of blood D-dimer level after COVID-19 in patients with coronary heart disease
Authors: Mukhitdinova O , Alyavi BA , Ubaydullaeva ZZ , Uzokov JK , Mukhamedova MG , Rakhimova DA , Nasirova GA , Orziev DZ
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Covid-19 was emerged in Wuhan and disseminated to the rest of the world. The virus may affect any kind of human organs. Aim of the study was to estimate the blood D-dimer level after Covid-19 in patients with coronary heart disease.

Methods

65 patients who were undergone Covid-19 (mild to moderate severity) without coronary heart disease (CHD; Group 1; aged 42-76 years, mean age 56.8±13.5 years) and 65 patients with CHD who was affected with Covid-19 (Group 2; aged 45-72 years, mean age 57.4±12.8 years) have been enrolled in this prospective study. Baseline characteristics were collected when first admitted to the hospital due to Covid-19, and follow-up characteristics were collected when they admitted to our hospital for the rehabilitation after undergoing Covid-19 in 3 months. Baseline and follow-up anthropometric, laboratory and instrumental data were assessed. All statistical analysis were performed by STATA software.

Results

Mean blood D-dimer level significantly reduced in both groups (from 864 ng/mL to 475 ng/mL in the first group, P<0.05 vs. from 812 ng/mL to 452 ng/mL in the Group 2, P<0.05), however there were not observed statistically significant changes when compared to groups, P>0.05. In the first group mean D-dimer level tended to be higher in men, with high fibrinogen level, and older patients. In the second group, D-dimer level tended to be higher in patients with higher body mass index (BMI) with high fibrinogen level. In the first group in 31% of patients was observed high level of D-dimer (>500 ng/mL) after 3 months whereas in the second group elevated D-dimer level maintained in 28% of patients.

Conclusion

Elevated blood D-dimer level are common after Covid-19, however concomitant CHD does not effect on it. Further studies are needed to reveal mechanisms of it.
Inflammatory profile of ACS reached by COPD in Algeria
Authors: Bouroubi O , Khelifi S , Belkadi L , Guendouz R , Zaabat N , Mehdioui H
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

As a common factor of both acute coronary syndrome (ACS) and chronic obstructive pulmonary disease (COPD), circulating biomarkers of inflammation may provide a link between these two diseases. The objective of this study was to explore the inflammatory profile of patients with COPD and ACS.

94 men with COPD according to GOLD criteria in stable clinical condition; are included prospectively in the study. Patients was divided into two groups with ACS and without ACS. The levels of circulating CRP, TNF-α and IL6 were determined for both groups.

The results showed that circulating biomarkers of inflammation are higher in the group of COPD patients with associated ACS. The rate of CRP g / l: 8.79 ± 17.12VS 8.83 ± 13.09 in the absence of ACS, TNFα pg / ml: 14.99 ± 28.88VS13.01 ± 16.40 and IL6 pg/ml: 32.66 ± 79.12 VS 23.79 ± 37.99.

Circulating cytokines are significantly associated with ACS, particularly the level of IL-6, which correlates with the presence of ACS in COPD. These results confirm the association between ACS and chronic inflammation of COPD. And that inflammation and more particularly circulating IL-6 seem strongly implicated in the pathophysiology of atherosclerotic remodeling in the COPD patient with ACS.
The impact of atmospheric pressure changes on patients with acute coronary syndrome
Authors: Cabeli A , Shuka N , Dado E , Hasimi E , Kondi L , Qordja M , Rrapo A , Berbiu E , Mance D , Simaku A , Begaj B , Dibra A
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Changes in atmospheric pressure act as a risk factor instability of atheromatous plaque and Acute Coronary Syndrome (ACS). Few studies have shown an association between atmosphere pressure, humidity, wind, sun rays, and cardiovascular disease.

Purpose

To evaluate the impact of atmospheric pressure on patients with Acute Coronary Syndrome.

Methods

This is a retrospective, observational, conducted in a single-center, in the period January-December 2018. We included patients with ACS, hospitalized in CCU, who performed emergency coronary angiography. The diagnosis of ACS was based on clinical, electrocardiographic, and laboratory findings. Data were collected retrospectively using patient records from archived files at the Statistics Center. Baseline demographic, clinical, and angiographic characteristics were collected. Data on atmospheric parameters, measured at the weather monitoring station, were obtained from the National Meteorological Service database (atmospheric pressure in each district of the country). The number of inhabitants for the respective districts is taken from the National Institute of Statistics.

Results

The number of patients involved was 1165. Significant changes in the average monthly values of atmospheric pressure were accompanied by a statistically significant increase in the number of cases with ACS, as occurred in March-April and October-November (p≤0.05). The highest number of ACS was in October 10.4%, whereas the lowest number was in January 10.6%, with a significant decreasing trend during May-June and the peak in October (p=0.04). A statistically significant relationship was observed between seasonal changes in atmospheric pressure with the number of cases with ACS. The autumn season prevails with 27.9% of the total cases, followed by the spring season with 25.6%, the summer season with 24.2%, and the winter season with 22.3%, (p = 0.04). Most cases in the cold period (November-March) occurred on days with statistically significant changes in Atmospheric Pressure.

Conclusion

The study notes an important relationship between seasonal, monthly changes in atmospheric pressure in relation to the frequency of cases with Acute Coronary Syndrome.
Embolic versus non- embolic acute coronary syndrome. Prognosis differences
Authors: Carmona-Carmona J , Martinez-Primoy IR , Martinez-Nunez R , Sayago-Silva I , Garcia-Rubira JC , Hidalgo-Urbano RJ
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Coronary embolism (CE) is a rare cause of acute coronary syndrome with current evidence from small case series. In our previous work (n=36), atrial fibrillation was the main risk factor and STEMI the most frequent presentation.

Objetives

In this analysis we compare severity characteristics, management and in-hospital prognosis between an embolic cohort versus a non-embolic one among patients with left anterior descending artery as culprit vessel.

Methods

Observational, retrospective descriptive study of patients admitted in our unit from July 2011 to march 2021 for ACS. The diagnosis of CE was established according to the National Cerebral Cardiovascular Center Criteria. Data were obtained from the ARIAM Andalucia Registry.

Results

646 Patients were analysed (19 embolic vs 627 non-embolic). There were no differences in ejection fraction (EF) (43±9% vs 44±10%, p>0.05) or Killip-Kimbal (KK) stage at admission moment (stage I more frequent in both groups) or use of inotropes or vasoactive drugs. Embolic cohort had more in-hospital complications: worse KK stage (p=0.001; KKII 23.5% vs 15.3%; KKIII 23.5% vs 5.9%), more thrombocytopenia (5.3% vs 0.8%, p=0.046) and higher hsTnT levels (p=0.000). There was more use of non-invasive mechanical ventilation in embolic group (21.1% vs 4.9%, p=0.002). Without differences in incidence of cardiac arrest, mechanical complications, bradycardia, hemorrhage or in-hospital dead.

Conservative management was more frequent in the embolic group. Percutaneous coronary intervention was the most frequent strategy in both cohorts (14.3% vs 3%; 85.6% vs 92.3%; p<0.05). At discharge, there were not significant differences in antithrombotic or anticoagulant therapy.

Conclusions

In our series the embolic group had worse KK stage and more need of non-invasive mechanical ventilation. They had no significant differences in EF, other mayor complications nor in-hospital mortality.
Prediction of late complications of acute myocardial infarction in diabetic patients
Authors: Koteliukh M
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Kharkiv national medical university

Background

The combination of acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM) is common in patients, and the prognosis is usually worse than in patients without type 2 DM. Late complications of AMI in the presence of type 2 DM have a negative impact on the viability of patients.

Purpose

To predict the development of late complications in patients with AMI and concomitant type 2 DM.

Methods

A total of 109 ST elevation myocardial infarction (STEMI) and 2 type DM patients were included. The patients were treated from 01 September 2018 till 31 December 2020. The study involved clinical assessment of the patient’s condition, C1q tumor necrosis factor - related protein 3 (CTRP3) and adropin quantification. Late complications of AMI were included atrial fibrillation, atrioventricular blockage, chronic heart failure 2-3 functional classes, aneurysm of the apex and ventricular, ejection fraction ≤49%. We measured serum-concentrations of CTRP 3 and adropin by enzyme immunoassay. Reference values of CTRP 3 were 315.85 (287.06 – 371.02) ng/ml and adropin – 23.58 (20.86 – 26.29) pg/ml. Qualitative data were presented as percentages; quantitative as median and interquartile range (25 and 75 percentiles). The nonparametric Mann-Whitney rank criterion was used to compare quantitative indicators. Binary logistic regression was used to build a model for predicting late complications in patients with AMI with type 2 DM.

Results

In total, 75 men (68.8%) and 34 women (31.2%) were included in the study. CTRP 3 levels on day 14 in patients with AMI and type 2 DM was determined 262.01 (225.32 – 288.84) ng/ml and adropin concentration on day 14 - 19.97 (16.35 – 20.99) pg/ml according to CTRP 3 reference values (p<0.05). No late complications were identified in 9 patients and 65 patients had late complications. The most important indicators for constructing the model were: CTRP3 quality, adropin quality, total cholesterol (TC), triglycerides on day 14 (TG), ejection fraction (EF) on day 14, low density lipoproteides (LDL) on day 14, the size of the left atrium on day 14 (LA). Binary logistic regression was used to obtain a mathematical model in order to determine the probability of developing late complications (P) of AMI: P=[1+ exp(-4.046×Adropin-2.714×CTRP3+6.270×TC-2.988×TG-0.288×EF-7.407×LDL-1.398×LA+19.259)]-1.The accuracy of the model was 94.6%.

Conclusion

This study showed that the use of a model to detect late complications of AMI may in the long term predict the development of uncomfortable cardiovascular events of AMI, accompanied by type 2 DM. Of course, the sample size was relatively small, which should be increased in the future to confirm the findings.
Longitudinal risk of death, hospitalizations for atrial fibrillation, and cardiovascular events following catheter ablation of atrial fibrillation: a cohort study
Authors: Ngo Linh , Woodman Richard , Denman Russell , Walters Tomos E , Yang Ian A , Ranasinghe Isuru
Published: May 2022

Aims

Population studies reporting contemporary long-term outcomes following catheter ablation of atrial fibrillation (AF) are sparse.

We evaluated long-term clinical outcomes following AF ablation and examined variation in outcomes by age, sex, and the presence of heart failure.

Methods and results

We identified 30 601 unique patients (mean age 62.7 ± 11.8 years, 30.0% female) undergoing AF ablation from 2008 to 2017 in Australia and New Zealand using nationwide hospitalization data. The primary outcomes were all-cause mortality and rehospitalizations for AF or flutter, repeat AF ablation, and cardioversion. Secondary outcomes were rehospitalizations for other cardiovascular events. During 124 858.7 person-years of follow-up, 1900 patients died (incidence rate 1.5/100 person-years) with a survival probability of 93.0% (95% confidence interval (CI) 92.6–93.4%) by 5 years and 84.0% (95% CI 82.4–85.5%) by 10 years. Rehospitalizations for AF or flutter (13.3/100 person-years), repeat ablation (5.9/100 person-years), and cardioversion (4.5/100 person-years) were common, with respective cumulative incidence of 49.4% (95% CI 48.4–50.4%), 28.1% (95% CI 27.2–29.0%), and 24.4% (95% CI 21.5–27.5%) at 10 years post-ablation. Rehospitalizations for stroke (0.7/100 person-years), heart failure (1.1/100 person-years), acute myocardial infarction (0.4/100 person-years), syncope (0.6/100 person-years), other arrhythmias (2.5/100 person-years), and new cardiac device implantation (2.0/100 person-years) occurred less frequently. Elderly patients and those with comorbid heart failure had worse survival but were less likely to undergo repeat ablation, while long-term outcomes were comparable between the sexes.

Conclusion

Patients undergoing AF ablations had good long-term survival, a low incidence of rehospitalizations for stroke or heart failure, and about half remained free of rehospitalizations for AF or flutter, including for repeat AF ablation, or cardioversion.
The Cultural Roots of Firm Entry, Exit and Growth
Authors: Erhardt Katharina , Haenni Simon
Published: May 2022

Can culture explain persistent differences in economic activity among individuals and across regions? A novel measure of cultural origin enables us to contrast entrepreneurial activity of individuals located in the same municipality, but whose ancestors lived just on opposite sides of the Swiss language border in the eighteenth century. Individuals with ancestry from the German-speaking side create 20% more firms than those with ancestry from the French-speaking side. These differences persist over generations and independent of the predominant culture at the current location. Yet, founder’s ancestry does not affect exit or growth of newly founded firms, suggesting that preferences are pivotal.
Demographic history differences between Hispanics and Brazilians imprint haplotype features
Authors: da Cruz Pedro Rodrigues Sousa , Ananina Galina , Secolin Rodrigo , Gil-da-Silva-Lopes Vera Lúcia , Lima Carmen Silvia Passos , de França Paulo Henrique Condeixa , Donatti Amanda , Lourenço Gustavo Jacob , de Araujo Tânia Kawasaki , Simioni Milena , Lopes-Cendes Iscia , Costa Fernando Ferreira , de Melo Mônica Barbosa
Published: May 2022

Admixture is known to greatly impact the genetic landscape of a population and, while genetic variation underlying human phenotypes has been shown to differ among populations, studies on admixed subjects are still scarce. Latin American populations are the result of complex demographic history, such as 2 or 3-way admixing events, bottlenecks and/or expansions, and adaptive events unique to the American continent. To explore the impact of these events on the genetic structure of Latino populations, we evaluated the following haplotype features: linkage disequilibrium, shared identity by descent segments, runs of homozygosity, and extended haplotype homozygosity (integrated haplotype score) in Latinos represented in the 1000 Genome Project along with array data from 171 Brazilians sampled in the South and Southeast regions of Brazil. We found that linkage disequilibrium decay relates to the amount of American and African ancestry. The extent of identity by descent sharing positively correlates with historical effective population sizes, which we found to be steady or growing, except for Puerto Ricans and Colombians. Long runs of homozygosity, a particular instance of autozygosity, was only enriched in Peruvians and Native Americans. We used simulations to account for random sampling and linkage disequilibrium to filter positive selection indexes and found 244 unique markers under selection, 26 of which are common to 2 or more populations. Some markers exhibiting positive selection signals had estimated time to the most recent common ancestor consistent with human adaptation to the American continent. In conclusion, Latino populations present highly divergent haplotype characteristics that impact genetic architecture and underlie complex phenotypes.
Dose–Response Association Between Physical Activity (Daily MIMS, Peak 30-Minute MIMS) and Cognitive Function Among Older Adults: NHANES 2011–2014
Authors: Zheng Peixuan , Pleuss James D , Turner Dusty S , Ducharme Scott W , Aguiar Elroy J
Published: May 2022

Background

The purpose of this study was to determine the dose–response association between habitual physical activity (PA) and cognitive function using a nationally representative data set of U.S. older adults aged ≥60 years.

Methods

We used data from the 2011–2014 National Health and Nutrition Examination Survey (n = 2 441, mean [SE] age: 69.1 [0.2] years, 54.7% females). Cognitive function was assessed using the digit symbol substitution test (DSST) and animal fluency test (AFT). Habitual PA was collected using a triaxial accelerometer worn on participants’ nondominant wrist. PA was expressed as 2 metrics using monitor-independent movement summary (MIMS) units: the average of Daily MIMS (MIMS/day) and peak 30-minute MIMS (Peak-30MIMS; the average of the highest 30 MIMS min/d). Sample weight-adjusted multivariable linear regression was performed to determine the relationship between each cognitive score and MIMS metric while adjusting for covariates.

Results

After controlling for covariates, for each 1 000-unit increase in Daily MIMS, DSST score increased (β-coefficient [95% CIs]) by 0.67 (0.40, 0.93), whereas AFT score increased by 0.13 (0.04, 0.22); for each 1-unit increase in Peak-30MIMS, DSST score increased by 0.56 (0.42, 0.70), whereas AFT score increased by 0.10 (0.05, 0.15), all p < .001. When including both MIMS metrics in a single model, the association between Peak-30MIMS and cognitive scores remained significant (p < .01), whereas Daily MIMS did not.

Conclusions

Our findings suggest that higher PA (both daily accumulated and peak effort) is associated with better cognitive function in the U.S. older adult population.
Social Norms About Handling Financial Challenges  in Relation to Health-Protective Capacity Among  Low-Income Older Adults
Authors: Samuel Laura J , Wright Rebecca , Taylor Janiece , Roberts Lavigne Laken C , Szanton Sarah L
Published: May 2022

Background and Objectives

Despite evidence linking financial challenges to poor health among older adults, effective interventions are lacking. This study examined the experience of living with financial challenges, useful strategies to handle them, and social norms that may constrain options and decision-making.

Research Design and Methods

This two-staged qualitative study recruited low-income older adults from the United States Baltimore City area. First, semistructured individual interviews examined older adults’ experiences and strategies used to handle financial challenges. Then, vignette-based focus groups examined relevant social norms. Transcripts were coded, and hierarchical themes were described using thematic analysis.

Results

Two themes were generated. First, the social norms relevant to financial challenges share a common underlying assumption of personal responsibility. Second, social norms about personal responsibility are inconsistent with the experiences of older adults facing financial challenges, who typically lack control over their situation and face structural barriers to preventing and handling financial challenges. Differences between statements related to norms and personal responsibility were found across six subthemes, including how finances should be handled to prevent financial challenges, the causes of financial challenges, asking for help from community resources, navigating community resources, getting help from family, and cutting back to handle financial challenges.

Discussion and Implications

The disconnect between social norms and the reality of financial challenges among older adults may explain why so many older adults cut back to the point of foregoing necessities. There is an urgent need to strengthen the social safety net and remove normative barriers to services.
Large-scale discovery of non-conventional peptides in grape (Vitis vinifera L.) through peptidogenomics
Authors: Pei Mao-Song , Liu Hai-Nan , Wei Tong-Lu , Yu Yi-He , Guo Da-Long
Published: May 2022

Non-conventional peptides (NCPs), which are peptides derived from previously unannotated coding sequences, play important biological roles in plants. In this study, we used peptidogenomic methods that integrated mass spectrometry (MS) peptidomics and a six-frame translation database to extensively identify NCPs in grape. In total, 188 and 2021 non-redundant peptides from the Arabidopsis thaliana and Vitis vinifera L. protein database at Ensembl/URGI and an individualized peptidogenomic database were identified. Unlike conventional peptides, these NCPs derived mainly from intergenic, intronic, upstream ORF, 5′UTR, 3′UTR, and downstream ORF regions. These results show that unannotated regions are translated more broadly than we thought. We also found that most NCPs were derived from regions related to phenotypic variations, LTR retrotransposons, and domestication selection, indicating that the NCPs have an important function in complex biological processes. We also found that the NCPs were developmentally specific and had transient and specific functions in grape berry development. In summary, our study is the first to extensively identify NCPs in grape. It demonstrated that there was a large amount of translation in the genome. These results lay a foundation for studying the functions of NCPs and also provide a reference for the discovery of new functional genes in grape.
Constitutional design for dynamic democracies: A framework for analysis
Authors: Nwokora Zim
Published: May 2022

Over time, a constitution may become suboptimal for the political system that it is meant to support and yet remain in place, largely unchanged. Thus, we might ask how a constitution might be designed to remain ideal for a democracy as it evolves, and indeed whether this is even possible. This practical dilemma has not been rigorously analyzed in the literature on constitutional design, however, because this research agenda has tended to downplay the potential for democracies to transform over time. To remedy this gap, this article sketches an explicitly temporal approach to design, which takes account of a wide range of political system dynamics. The framework contributes insights into the various ways that constitutional structures can be designed to operate over time; the alignment between these setups and different political system dynamics; and the means by which a constitutional design process might be reconfigured to give more weight to the prospect of fundamental political change.
Reporting of patient safety incidents in minimally invasive thoracic surgery: a national registered thoracic surgeons experience for improvement of patient safety
Authors: Bottet Benjamin , Rivera Caroline , Dahan Marcel , Falcoz Pierre-Emmanuel , Jaillard Sophie , Baste Jean-Marc , Seguin-Givelet Agathe , de la Tour Richard Bertrand , Bellenot Francois , Rind Alain , Gossot Dominique , Thomas Pascal-Alexandre , D’Journo Xavier Benoit
Published: May 2022

OBJECTIVES

The reporting of patient safety incidents (PSIs) occurring in minimally invasive thoracic surgery (MITS) is crucial. However, previous reports focused mainly on catastrophic events whereas minor events are often underreported.

METHODS

All voluntary reports of MITS-related PSIs were retrospectively extracted from the French REX database for ‘in-depth analysis’. From 2008 to 2019, we retrospectively analysed and graded events according to the WHO classification of PSIs: near miss events, no harm incidents and harmful incidents. Causes and corrective measures were analysed according to the human-technology-organization triad.

RESULTS

Of the 5145 cardiothoracic surgery PSIs declared, 407 were related to MITS. Among them, MITS was performed for primary lung cancer in 317 (78%) and consisted in a lobectomy in 249 (61%) patients. PSIs were: near miss events in 42 (10%) patients, no harm incidents in 81 (20%) patients and harmful incidents in 284 (70%) patients (mild: n = 163, 40%; moderate: n = 78, 19%; severe: n = 36, 9%; and deaths: n = 7, 2%). Human factors represented the most important cause of PSIs with 267/407 (65.6%) cases, including mainly vascular injuries (n = 90; 22%) and non-vascular injuries (n = 43; 11%). Pulmonary arteries were the most affected site with 57/91 cases (62%). In all, there were 7 deaths (2%), 53 patients required second surgery (13%) and 30 required additional lung resection (7%).

CONCLUSIONS

The majority of reported MITS -related PSIs were non-catastrophic. Human factors were the main cause of PSIs. Systematic reporting and analysis of these PSIs will allow surgeon and his team to avoid a large proportion of them.
Non-equilibrium growth of a binary alloy
Authors: Fowler A C
Published: May 2022

We present an interpretation of the phase diagram for a binary alloy from the point of view of reaction dynamics. We consider a model system in which the two-component liquid phase is an ideal solution, but the solid phase can be non-ideal, with its non-ideality increasing with reducing temperature. We show how a ‘batch’ model for the evolution of the two-component solid–liquid system, in which the interfacial growth rates are proportional to free energy differences, leads to a set of four differential equations, whose equilibria correspond to the familiar solidus and liquidus curves. In addition, we explain how the transitions between them depend on the bifurcation structure of the solutions. We show that locally stable mixed-phase solutions can exist below the eutectic temperature, thus providing an alternative explanation for the observation of super-cooled liquids, and we also explain why complete solidification ‘normally’ occurs below the eutectic temperature, despite the fact that this temperature has no intrinsic dynamic significance, being simply a value at which two completely different equilibrium states happen to share a common liquid concentration.
Antitrust and Innovation Competition
Authors: Spulber Daniel F
Published: May 2022

Innovation competition presents challenges for antitrust law and enforcement policy. Innovation has generated changes in the nature of competition as firms introduce new transaction techniques, product designs, and production processes. Innovation competition is driving the ‘Business Revolution’ in retail, wholesale, manufacturing, services, and financial technology. Transaction innovation in online platforms and multi-sided markets has raised antitrust concerns about anticompetitive conduct, vertical restraints, consumer privacy, and barriers to entrepreneurship. The article argues that although antitrust policy makers recognize the importance of innovation competition, they need to update their economic frameworks. Antitrust policy makers need to move beyond traditional analysis based on the twin frameworks of perfect competition and imperfect competition. The article provides an introduction to the emerging Economics of Technology & Innovation and examines some implications for antitrust policy. First, antitrust policy should shift its focus from price competition without technological change to address non-price aspects of innovation competition. Secondly, antitrust policy should apply economic analysis that recognizes the critical role of Intellectual Property and technology standards in innovation competition. Thirdly, antitrust policy toward horizontal and vertical mergers should consider developments in the economic analysis of innovation competition.
Influence of hempseed cake inclusion on growth performance, carcass characteristics, feeding behavior, and blood parameters in finishing heifers
Authors: Winders Thomas M , Serum Eric M , Smith David J , Neville Bryan W , Mia Golam K , Amat Samat , Dahlen Carl R , Swanson Kendall C
Published: May 2022

As the hemp industry continues to develop in the United States, there is an increasing interest in feeding byproducts of industrial hemp production to livestock. A completely randomized design experiment using crossbred finishing heifers (initial body weight [BW] ± SE = 494 ± 10 kg) was conducted to determine the effects of feeding hempseed cake in a corn-based finishing diet (10% forage) formulated to meet or exceed ruminally degradable and metabolizable protein requirements on growth performance, carcass characteristics, feeding behavior, and plasma parameters. Dietary treatments were the inclusion of 20% (dry matter [DM] basis) of dried corn distillers grains plus solubles (DDGS, n = 16) or hempseed cake (HEMP, n = 15). Cattle were housed in two pens, had ad libitum access to feed and water, and individual intakes and feeding behavior were monitored using the Insentec feeding system. Cattle were fed treatment diets for 111 d, and every 14 d BW were measured and blood samples were collected. Blood plasma was analyzed for glucose, urea nitrogen, and individual amino acids, and results were analyzed using repeated-measures analysis in SAS. Final BW, average daily gain, gain:feed, and hot carcass weight decreased (P ≤ 0.05) by 2.3%, 7.7%, 7.7%, and 2.6%, respectively, in heifers fed the HEMP diet than in heifers fed the DDGS diet. Net energy for maintenance and gain (Mcal/kg of feed, DM basis), estimated based on heifer intake and performance, were greater (P = 0.02) for the DDGS diet than for the HEMP diet. All other performance and carcass characteristics were not different (P ≥ 0.20) between treatments. Heifers fed the HEMP diet had greater (P < 0.05) plasma urea nitrogen concentration in samples from each collection day compared with heifers fed the DDGS diet, although there was a treatment-by-day interaction (P < 0.01) because of variability in the magnitude of treatment differences over time. Plasma glucose concentration was not influenced (P = 0.17) by dietary treatment. Plasma concentrations of total amino acids, nonessential amino acids, and essential amino acids were not different between treatments (P ≥ 0.09), although there were several interactions between treatment and day (P ≤ 0.04) for individual amino acids. These data suggest that hempseed cake has a lower net energy for maintenance and gain relative to DDGS when adequate metabolizable protein is supplied, while still providing adequate nutrition to support the acceptable performance of finishing cattle.
Body weight of newborn and suckling piglets affects their intestinal gene expression
Authors: Villagómez-Estrada Sandra , Pérez José F , Melo-Durán Diego , Gonzalez-Solè Francesc , D’Angelo Matilde , Pérez-Cano Francisco J , Solà-Oriol David
Published: May 2022

Modern hyperprolific sows must deal with large litters (16–20 piglets) which reduce piglet birthweight with a concomitant increase in the proportion of small and intrauterine growth retarded piglets. However, larger litters do not only have a greater variation of piglet weights, but also a greater variation in colostrum and milk consumption within the litter. To further understand the impact that body weight has on piglets, the present study aimed to evaluate the degree of physiological weakness of the smallest piglets at birth and during the suckling period (20 d) compared to their middle-weight littermates through their jejunal gene expression. At birth, light piglets showed a downregulation of genes related to immune response (FAXDC2, HSPB1, PPARGC1α), antioxidant enzymes (SOD2m), digestive enzymes (ANPEP, IDO1, SI), and nutrient transporter (SLC39A4) (P < 0.05) but also a tendency for a higher mRNA expression of GBP1 (inflammatory regulator) and HSD11β1 (stress hormone) genes compared to their heavier littermates (P < 0.10). Excluding HSD11β1 gene, all these intestinal gene expression differences initially observed at birth between light and middle-weight piglets were stabilized at the end of the suckling period, when others appeared. Genes involved in barrier function (CLDN1), pro-inflammatory response (CXCL2, IL6, IDO1), and stress hormone signaling (HSD11β1) over-expressed compared to their middle-weight littermates (P < 0.05). In conclusion, at birth and at the end of suckling period, light body weight piglets seem to have a compromised gene expression and therefore impaired nutrient absorption, immune and stress responses compared to their heavier littermates.
Contracts and Induced Institutional Change
Authors: Harstad Bård , Mideksa Torben
Published: May 2022

We study agents’ incentives to form horizontal coalitions before a principal offers vertical contracts. When a vertical contract generates negative externalities on other agents, the agents may collude in order to obtain better deals; when one contract benefits other agents, the agents may decentralize, instead. Contractually induced institutional changes always harm the principal and the negative effect can outweigh the direct effects of the contracts, making the contracts counterproductive. The model is tractable and sufficiently flexible to be relevant for applications such as regulation of pollution, payments for forest conservation, and mergers between firms in a supplier–franchisee relationship. (JEL D86, H23, H87, Q58).
Parallel Appearance of Polyglutamine and Transactivation-Responsive DNA-Binding Protein 43 and Their Complementary Subcellular Localization in Brains of Patients With Spinocerebellar Ataxia Type 2
Authors: Koyano Shigeru , Yagishita Saburo , Tada Mikiko , Doi Hiroshi , Uchihara Toshiki , Tanaka Fumiaki
Published: May 2022

Spinocerebellar ataxia type 2 (SCA2) is caused by mutations in the ATXN2 gene in which toxic effects are triggered by expanded polyglutamine repeats within ataxin-2. SCA2 is accompanied by motor neuron degeneration as occurs in amyotrophic lateral sclerosis (ALS). We investigated the distribution patterns of ataxin-2 and transactivation-responsive DNA-binding protein 43 (TDP-43), a major disease-related protein in ALS, in the CNS of 3 SCA2 patients. Phosphorylated TDP-43 (pTDP-43)-positive lesions were widely distributed throughout the CNS and generally overlapped with 1C2 (expanded polyglutamine)-immunoreactive lesions. This distribution pattern is different from the pattern in limbic-predominant age-related TDP-43 encephalopathy. In SCA2, double immunostaining of TDP-43 and 1C2 in motor neurons revealed 3 staining patterns: cytoplasmic 1C2 and nuclear TDP-43, nucleocytoplasmic 1C2 and nuclear TDP-43, and nuclear 1C2 and cytoplasmic TDP-43, which reflect the early, active, and final stages of pathological change, respectively. The translocation of TDP-43 from the nucleus to the cytoplasm along with the translocation of 1C2 in the opposite direction indicates that nuclear accumulation of the disease-specific protein ataxin-2 affects the intracellular dynamics of TDP-43. Such a close interrelationship between mutant ataxin-2 and TDP-43 in the cell might account for the similarity of their distribution in the CNS of patients with SCA2.
New Hands in US Public Lands Management: The Role and Influence of Nonagency Partners in Forest Service Stewardship Agreements
Authors: Cowan Emery R , Grimm Kerry E , Davis Emily Jane , Nielsen Erik A , Waltz Amy E M
Published: May 2022

The USDA Forest Service (USFS) is increasingly turning to partnership tools such as stewardship agreements (SAs) to accomplish land management objectives. In these arrangements, nonagency partners (partners) often bring resources, capabilities, and preferences that can influence management processes and activities. We explored the nature of partner influence in SAs through interviews with USFS and partner staff in four SA case studies in Arizona, California, and New Mexico. Interviewees perceived that partners influenced project prioritization; implementation pace, scope, and approach; and SA participants’ ways of working. Influence was linked to partners’ involvement in SA project selection; contribution of resources, expertise, and capabilities; and assumption of some project implementation responsibilities. USFS-partner relationships also appeared to encourage partnership-oriented approaches beyond the original project. Our research suggests SA partners are uniquely influential in the implementation of USFS management activities and recommends additional exploration of SAs in the context of collaborative implementation.
Middle mediastinal cavernous hemangioma: a case report of clinical, pathologic and radiologic features
Authors: Turner Darren , Nwatu Daniel , Kodia Karishma , Huerta Carlos Theodore , Villamizar Nestor R , Briski Lawrence , Nguyen Dao M
Published: May 2022

Benign vascular tumors of the mediastinum are rare, representing only 0.5% of all mediastinal masses. Given their rare presentation, they are infrequently considered in the workup of a middle mediastinal mass. We present a unique case describing the clinical, imaging and pathologic characteristics of a middle mediastinal cavernous hemangioma which was initially misdiagnosed as a bronchogenic cyst and ultimately required surgical resection with the use of veno-venous extracorporeal membrane oxygenation.
Covert gastroduodenal intussusception: a case report
Authors: Al-Roubaie Aymen , Withanage Indrajith
Published: May 2022

Gastroduodenal intussusception is extremely rare and usually symptomatic in adults. Authors here report a case of a 99-year-old female with a gastroduodenal intussusception with no obstructive signs and symptoms or an obvious leading point showed on imaging modality. The index case presented with a three-day history of upper abdominal pain radiated to the back and right shoulder. Examination was unremarkable except for mild tenderness in the epigastric and right hypochondrial areas. A diagnosis of a small gastroduodenal intussusception was made by abdominal CT scan. The patient and family refused gastroscopy. Therefore, a conservative approach was followed, and the patient was discharged home on analgesia after two days of admission in the surgical ward.
Combination treatment by the cervical approach with mediastinal drainage and continuous saline irrigation for descending necrotizing mediastinitis type IIb: a three-case series
Authors: Ohashi Takuya , Kawago Mitsumasa , Ota Fuminori , Hirai Yoshimitsu , Kiyoi Megumi , Miyasaka Miwako , Yata Yumi , Kawaji Mari , Fusamoto Aya , Iguchi Hideto , Nakanishi Hitomi , Nakaya Takahito , Fujiwara Yuki , Nishimura Yoshiharu
Published: May 2022

Descending necrotizing mediastinitis (DNM) is a severe, life-threatening disease and requires prompt treatment. The primary treatment for DNM is cervical and mediastinal drainage in addition to antibiotic treatment. However, the most appropriate drainage approach and the effectiveness of additional treatment remain unclear. In this study, we performed cervical and mediastinal drainage for three patients with type IIB DNM using the cervical approach alone. Continuous saline irrigation was administered as additional treatment. There is little evidence for the use of saline irrigation for DNM. We propose that this combination treatment may be more effective and has the potential to improve patient prognosis. In our report, the average drainage duration was 13 days, and the average hospital stay was 30 days. Furthermore, both drainage duration and hospital stay were shorter than those in previously reported cases. Our case series provides valuable insight into the use of combination treatment to treat DNM.