bluuebunny/crossref_metadata_2025 huggingface dataset:
Levels of self‐determination in the ageing population with intellectual disabilities
Authors: Álvarez‐Aguado Izaskun , Vega Córdova Vanessa , Spencer González Herbert , González Carrasco Félix , Jarpa Azagra Marcela , Exss Cid Katherine
Published: September 2021

Accessible Summary

This study looks at the levels of self‐determination of people with intellectual disabilities aged 45 years or more.

Self‐determination involves skills to help make things they want happen in their own lives.

In people with intellectual disabilities over 45, self‐advocacy and self‐awareness skills could be strengthened.

Age, place of residence and support received by people with intellectual disabilities over 45, are some of the things that influence their self‐determination.

Background

Self‐determination is a key construct to guarantee the development of skills that allow people with disabilities to acquire control over their lives. However, people with intellectual disabilities may have premature ageing processes that make it difficult to exercise these skills. This study seeks to determine the self‐determination levels of 516 ageing adults with intellectual disabilities between the ages of 45 and 86 years.

Method

The data were collected with anad hocscale developed from the Functional Model of Self‐Determination.

Findings

The results show that competencies related to self‐advocacy and self‐knowledge greatly decreased, unlike making choices and solving problems. In addition, the severity of the disability, age, place of residence and type of support are identified as variables associated with levels of self‐determination.

Conclusions

There is a need to prioritise the acquisition and maintenance of skills related to self‐realisation as the basis for intervention proposals in self‐determination.
Pharmacokinetic, pharmacodynamic, and behavioural studies of deschloroketamine in Wistar rats
Authors: Štefková‐Mazochová Kristýna , Danda Hynek , Dehaen Wim , Jurásek Bronislav , Šíchová Klára , Pinterová‐Leca Nikola , Mazoch Vladimír , Krausová Barbora Hrčka , Kysilov Bohdan , Smejkalová Tereza , Vyklický Ladislav , Kohout Michal , Hájková Kateřina , Svozil Daniel , Horsley Rachel R. , Kuchař Martin , Páleníček Tomáš
Published: September 2021

Background and purpose

Deschloroketamine (DCK), a structural analogue of ketamine, has recently emerged on the illicit drug market as a recreational drug with a modestly long duration of action. Despite it being widely used by recreational users, no systematic research on its effects has been performed to date.

Experimental approach

Pharmacokinetics, acute effects, and addictive potential in a series of behavioural tests in Wistar rats were performed following subcutaneous (s.c.) administration of DCK (5, 10, and 30 mg·kg−1) and its enantiomersS‐DCK (10 mg·kg−1) andR‐DCK (10 mg·kg−1). Additionally, activity at humanN‐methyl‐d‐aspartate (NMDA) receptors was also evaluated.

Key results

DCK rapidly crossed the blood brain barrier, with maximum brain levels achieved at 30 min and remaining high at 2 h after administration. Its antagonist activity at NMDA receptors is comparable to that of ketamine withS‐DCK being more potent. DCK had stimulatory effects on locomotion, induced place preference, and robustly disrupted PPI. Locomotor stimulant effects tended to disappear more quickly than disruptive effects on PPI.S‐DCK had more pronounced stimulatory properties than itsR‐enantiomer. However, the potency in disrupting PPI was comparable in both enantiomers.

Conclusion and implications

DCK showed similar behavioural and addictive profiles and pharmacodynamics to ketamine, withS‐DCK being in general more active. It has a slightly slower pharmacokinetic profile than ketamine, which is consistent with its reported longer duration of action. These findings have implications and significance for understanding the risks associated with illicit use of DCK.
Inhibitor library screening identifies ispinesib as a new potential chemotherapeutic agent for pancreatic cancers
Authors: Murase Yoshiki , Ono Hiroaki , Ogawa Kosuke , Yoshioka Risa , Ishikawa Yoshiya , Ueda Hiroki , Akahoshi Keiichi , Ban Daisuke , Kudo Atsushi , Tanaka Shinji , Tanabe Minoru
Published: September 2021

Screening custom‐made libraries of inhibitors may reveal novel drugs for treating pancreatic cancer. In this manner, we identified ispinesib as a candidate and attempted to determine its clinical efficacy and the biological significance of its functional target Eg5 in pancreatic cancer. One hundred compounds in our library were screened for candidate drugs using cell cytotoxicity assays. Ispinesib was found to mediate effective antitumor effects in pancreatic cancer. The clinical significance of the expression of the ispinesib target Eg5 was investigated in 165 pancreatic cancer patients by immunohistochemical staining and in Eg5‐positive pancreatic cancer patient‐derived xenograft (PDX) mouse models. Patients with Eg5‐positive tumors experienced significantly poorer clinical outcomes than those not expressing Eg5 (overall survival; P < .01, recurrence‐free survival; P < .01). Ispinesib or Eg5 inhibition with specific siRNA significantly suppressed cell proliferation and induced apoptosis in pancreatic cancer cell lines. Mechanistically, ispinesib acted by inducing incomplete mitosis with nuclear disruption, resulting in multinucleated monoastral spindle cells. In the PDX mouse model, ispinesib dramatically reduced tumor growth relative to vehicle control (652.2 mm3 vs 18.1 mm3 in mean tumor volume, P < .01 by ANOVA; 545 mg vs 28 mg in tumor weight, P < .01, by ANOVA). Ispinesib, identified by inhibitor library screening, could be a promising novel therapeutic agent for pancreatic cancer. The expression of its target Eg5 is associated with poorer postoperative prognosis and is important for the clinical efficacy of ispinesib in pancreatic cancer.
COVID‐19 and home confinement: A study on fathers, father–child relationships and child adjustment
Authors: Trumello Carmen , Bramanti Sonia M. , Lombardi Lucia , Ricciardi Piera , Morelli Mara , Candelori Carla , Crudele Monia , Cattelino Elena , Baiocco Roberto , Chirumbolo Antonio , Babore Alessandra
Published: September 2021

Background

The purpose of this study was to explore fathers' adjustment and father–child relationships during the first peak of the coronavirus disease 2019 (COVID‐19) outbreak (April 2020). More particularly, the study analysed paternal perceptions of changes concerning familial economic conditions and children's psychological difficulties (viz., emotional problems and hyperactivity) during the lockdown produced by the current pandemic. Furthermore, we investigated the following correlates of fathers' parenting stress: socio‐demographic condition, paternal individual stress, anxiety, depression and changes in the father–child relationship during the outbreak.

Methods

A total of 102 fathers (mean age = 41.60 years; SD = 11.54) with minor children were recruited through an online survey and reported data about their socio‐economic condition, anxiety, and depressive levels, parenting stress, offspring's adjustment, and changes in their relationship with their children.

Results

As for the economic conditions, participants were equally distributed between those who did not perceive changes and those who perceived a worsening. With regard to changes in the child's psychological difficulties, results showed that levels of children's emotional problems and inattention/hyperactivity had significantly increased during the lockdown period. A multiple linear regression analysis highlighted that the principal predictor of paternal parenting stress was living in the regions most affected by the COVID‐19 pandemic, followed by high levels of paternal anxiety symptomatology and high levels of worsening of the relationship with the child during the pandemic.

Conclusions

Overall, our study suggests to consider the effects of COVID‐19 on fathers as well, as they have been rather overlooked by previous research that has mainly focused on mothers, and to plan specific interventions able to also take them into account.
Neuro‐COVID‐19
Authors: Shimohata Takayoshi
Published: September 2021

Neuromuscular manifestations of new coronavirus disease 2019 (COVID‐19) infection are frequent, and include dizziness, headache, myopathy, and olfactory and gustatory disturbances. Patients with acute central nervous system disorders, such as delirium, impaired consciousness, stroke and convulsive seizures, have a high mortality rate. The encephalitis/encephalopathy that causes consciousness disturbance and seizures can be classified into three conditions, including direct infection with the SARS‐CoV‐2 virus, encephalopathy caused by central nervous system damage secondary to systemic hypercytokinemia (cytokine storm) and autoimmune‐mediated encephalitis that occurs after infection. The sequelae, called post‐acute COVID‐19 syndrome or long COVID, include neuromuscular manifestations, such as anxiety, depression, sleep disturbance, muscle weakness, brain fog and cognitive impairment. It is desirable to establish diagnostic criteria and treatment for these symptoms. Vaccine‐induced thrombotic thrombocytopenia, Guillain–Barré syndrome, bilateral facial paralysis, encephalitis and opsoclonus‐myoclonus syndrome have been reported as adverse reactions after the COVID‐19 vaccine, although these are rare.
A high fat, sugar, and salt Western diet induces motor‐muscular and sensory dysfunctions and neurodegeneration in mice during aging: Ameliorative action of metformin
Authors: Hong Song , Nagayach Aarti , Lu Yan , Peng Hongying , Duong Quoc‐Viet A. , Pham Nicholas B. , Vuong Christopher A. , Bazan Nicolas G.
Published: September 2021

Aims

To explore the novel linkage between a Western diet combining high saturated fat, sugar, and salt (HFSS) and neurological dysfunctions during aging as well as Metformin intervention, we assessed cerebral cortex abnormalities associated with sensory and motor dysfunctions and cellular and molecular insights in brains using HFSS‐fed mice during aging. We also explored the effect of Metformin treatment on these mice.

Methods

C57BL/6 mice were fed with HFSS and treated with metformin from 20 to 22 months of age, resembling human aging from 56 to 68 years of age (an entry phase of the aged portion of lifespan).

Results

The motor and sensory cortexes in mice during aging after HFSS diet showed: (A) decreased motor‐muscular and sensory functions; (B) reduced inflammation‐resolving Arg‐1+ microglia; (C) increased inflammatory iNOs+ microglia and TNFα levels; (D) enhanced abundance of amyloid‐β peptide and of phosphorylated Tau. Metformin attenuated these changes.

Conclusion

A HFSS‐combined diet caused motor‐muscular and sensory dysfunctions, neuroinflammation, and neurodegeneration, whereas metformin counteracted these effects. Our findings show neuroinflammatory consequences of a HFSS diet in aging. Metformin curbs the HFSS‐related neuroinflammation eliciting neuroprotection.
Association of Bethesda category and molecular mutation in patients undergoing thyroidectomy
Authors: Mascarella Marco Antonio , Peeva Magdalena , Forest Veronique‐Isabelle , Pusztaszeri Marc Philippe , Avior Galit , Tamilia Michael , Mlynarek Alex M. , Hier Michael P. , Payne Richard J.
Published: September 2021

Objectives

The aim of this study was to ascertain the relationship between Bethesda category and molecular mutation of thyroid nodules in patients undergoing thyroidectomy.

Design

A retrospective cohort of patients who underwent thyroidectomy following needle biopsy and molecular profile testing was performed.

Setting

Two tertiary care academic hospitals.

Participants

Consecutive patients with a dominant thyroid nodule who underwent both USFNA and molecular profile testing followed by thyroidectomy were included in the study.

Main Outcome and Measures

The main outcome was postoperative diagnosis of thyroid cancer and aggressivity of disease based on histopathological variants, nodal metastasis or extra‐thyroidal extension. Associations between Bethesda category, molecular mutation and postoperative pathology was assessed using descriptive analysis and chi‐square testing.

Results

Four hundred fifty‐one patients were included. 95.9% (93/97) of patients with a BRAFV600E mutation had a Bethesda category V or VI (p < .001), and all had confirmed thyroid cancer on postoperative pathology. Those with H, K or N RAS or EIF1AX mutations, gene expression profiling (GEP) or copy number alterations showed an association with Bethesda categories III and IV (p ≤ .01). Those with no identified molecular mutation had a lower incidence of aggressive thyroid cancer compared to those with an identified mutation (12.6% vs. 44.3%, p < .01).

Conclusion

BRAFV600E mutations were associated with thyroid cancer subtypes known to be more aggressive whereas RAS and EIF1AX mutations, copy number alterations, and GEP were related to Bethesda categories III and IV. These findings may help thyroid specialists better identify aggressive thyroid nodules associated with indeterminate Bethesda categories.
Predictors of right ventricular function improvement with sacubitril/valsartan in a real‐life population of patients with chronic heart failure
Authors: Correale Michele , Mazzeo Pietro , Magnesa Michele , Fortunato Martino , Tricarico Lucia , Leopizzi Alessandra , Mallardi Adriana , Mennella Raffaele , Tucci Salvatore , Brunetti Natale Daniele
Published: September 2021

Background

Observational studies have demonstrated that treatment with sacubitril/valsartan may improve left ventricular (LV) systolic and diastolic function in subjects with reduced LV ejection fraction (LVEF) in real‐world studies. Subjects with heart failure and reduced EF (HFrEF), however, are also characterized by an impaired right ventricular (RV) function. We therefore aimed to evaluate whether also RV function may improve after S/V therapy and possible predictors of RV improvement could be identified at echocardiography and tissue Doppler imaging.

Methods

Fifty consecutive patients (67 ± 8 years, LVEF 28 ± 6%, male 86%) with chronic HFrEF and NYHA class II‐III were followed up for 6 months after therapy with S/V. LV&RV function was assessed at baseline and after 6 months of therapy.

Results

After 6‐month therapy with S/V a significant improvement was shown in the following echocardiography parameters assessing RV function: PAsP (31 ± 11 vs. 35 ± 10 mmHg, p < 0.001), TAPSE (19 ± 3 vs. 18 ± 3 mm, p < 0.001), RV FAC (38 ± 7 vs. 34 ± 6 mm, p < 0.001), RV S’ (12 ± 2 vs. 10 ± 2 cm/s, p < 0.001), RV‐FW‐LS (−20 ± 5 vs. −18 ± 5%, p < 0.001), RV‐4Ch‐LS (−16 ± 5 vs. −14 ± 5%, p < 0.001). At multivariable analysis improvement in RV‐FW‐LS was associated to baseline levels of RV S’ (r 0.75, p < 0.01) and RAV (r –0.32, p < 0.05).

Conclusions

In a real‐world scenario, 6‐month therapy with S/V was associated with an improved RV function in HFrEF. RV function improvement may be predicted by assessing baseline RV S’ and right atrial volume values.
Understanding retail dynamics of a regionally important domestic bird market in Guangzhou, China
Authors: Fiennes Sicily , Zhang Mingxia , Sun Fuping , Lee Tien Ming
Published: September 2021

The prevailing methodology of noncontinuous wildlife market surveys contributes little to our understanding of the spatiotemporal variations of markets and their supply. Here, we investigate trends in bird trade in a large regional domestic market. Near‐continuous monthly surveys at a pet market in Guangzhou, China discovered over 95,000 individuals of 147 species between 2011 and 2013. We analyzed optimal survey frequency, finding that autumn is the best season to detect maximal species diversity. In a mixed‐effects model, we found that species‐specific purposes for trade controls the occurrence of species across shops in a market. A buffer analysis showed that 13 of the 15 most abundant species are distributed within 200 km of the market. However, hotspots of range overlap for wild‐caught, native species were found at great distances from the market within China and along China's borders. Identifying the location of theoretical trapping bottlenecks (areas where trapping levels are high) from this market data can help identify regions (e.g., southwest China) that are affected by trade, where local bird populations may be experiencing residual impacts from harvesting. Our results provide insights to improve methodologies for monitoring wildlife markets and identify priority regions for population surveys of in‐demand wild bird species.
User‐centered design features for digital health applications to support physical activity behaviors in solid organ transplant recipients: A qualitative study
Authors: Mathur Sunita , Janaudis‐Ferreira Tania , Hemphill Julia , Cafazzo Joseph A. , Hart Donna , Holdsworth Sandra , Lovas Mike , Wickerson Lisa
Published: September 2021

Introduction

Digital health tools may be effective in engaging solid organ transplant (SOT) recipients in physical activity (PA). This study examined the perspectives of SOT recipients regarding PA, and desired features for digital health tools.

Methods

Semi‐structured interviews were used to explore perspectives of SOT recipients about barriers and motivators to physical activity, and core features of a digital health tool to support PA. Interviews were analyzed via thematic analysis.

Results

Participants included 21 SOT recipients (11 men, 10 women, 21‐78 years, 1.5‐16 years post‐transplant) from various organ groups (four heart, five kidney, five liver, three lung, and four multi‐organ). Barriers to PA included risk aversion, managing non‐linear health trajectories, physical limitations and lack of access to appropriate fitness training. Facilitators of PA included desire to live long and healthy lives, renewed physical capabilities, access to appropriate fitness guidelines and facilities. Desired features of a digital health tool included a reward system, affordability, integration of multiple functions, and the ability to selectively share information with healthcare professionals and peers.

Conclusions

SOT recipients identified the desired features of a digital health tool, which may be incorporated into future designs of digital and mobile health applications to support PA in SOT recipients.
Primary biliary cholangitis has the highest waitlist mortality in patients with cirrhosis and acute on chronic liver failure awaiting liver transplant
Authors: Singal Ashwani K. , Wong Robert J. , Jalan Rajiv , Asrani Sumeet , Kuo Yong‐Fang
Published: September 2021

Background

Data are sparse on etiology specific outcomes on waitlist (WL) and post‐transplant outcomes among patients with acute on chronic liver failure (ACLF).

Methods and results

In a retrospective cohort of 14,774 adults from United network for organ sharing (UNOS) database listed for Liver transplantation (LT) with cirrhosis and ACLF (January 2013–June 2019), 40% were due to alcohol‐associated liver disease (ALD), followed by hepatitis C virus (HCV) at 20%, non‐alcoholic steatohepatitis (19%), cryptogenic cirrhosis (7%), autoimmune hepatitis (5%), primary sclerosing cholangitis (PSC) at 3%, and 2% each for hepatitis B, primary biliary cholangitis (PBC), and metabolic etiology. Using competing risk analysis, cumulative risk of WL mortality was highest for PBC at 20.5% and lowest for PSC at 13.3%, P < .001. Compared with ALD as reference, WL mortality was higher for PBC (1.45 [1.16–1.82]), and similar for other etiologies, P < .001. Of this cohort, 9650 (65.3%) patients received LT, with 1‐year. patient survival of 91.6% for PBC, worst for cryptogenic cirrhosis (89.5%) and best for PSC and ALD (93.4%), P < .001.

Conclusion

Among listed candidates with ACLF, those with PBC have highest WL mortality 1‐year. post‐transplant survival was excellent among recipients for PBC. If these findings are validated in prospective studies, liver disease etiology should be considered for LT selection among patients in ACLF.
Violence‐related morbidity among people released from prison in Australia: A data linkage study
Authors: Willoughby Melissa , Keen Claire , Young Jesse T. , Spittal Matthew J. , Borschmann Rohan , Janca Emilia , Kinner Stuart A.
Published: September 2021

Introduction

People released from prison have an increased risk of morbidity, including from nonfatal violence. We examined the incidence and predictors of violence‐related morbidity after release from prison and investigated whether there are differences according to sex and Indigenous status.

Methods

Baseline data were collected from 1325 people within 6 weeks of release from prisons in Queensland, Australia, between 1 August 2008 and 31 July 2010. Data were linked to state‐wide health (ambulance, emergency department and hospital) and prison records, and national death records until 31 July 2012. Predictors were identified using a multivariable Andersen‐Gill model. Differences according to sex and Indigenous status were investigated using effect modification.

Results

A total of 225 (18.2%) people experienced 410 violence‐related events that were recorded in health records. The incidence was 12.8 per 100 person‐years [95% confidence interval (CI) 11.7, 14.1]. Risk factors for violence‐related morbidity included diagnosed mental illness [hazard ratio (HR) = 2.0, 95% CI 1.1, 3.8], substance use disorder (HR = 1.6, 95% CI 1.1, 2.3) or dual diagnosis (HR = 3.2, 95% CI 2.2, 4.8); high‐risk alcohol use (HR = 2.1, 95% CI 1.5, 2.8); being Indigenous (HR = 1.7, 95% CI 1.2, 2.5); and two or more prison releases (HR = 1.7, 95% CI 1.2, 2.6). Indigenous status modified the risk of violence‐related morbidity, with Indigenous men having twice the risk of non‐Indigenous men (HR = 1.9, 95% CI 1.3, 2.8).

Discussion and Conclusions

Approximately one in five people released from prisons in Queensland experienced violence‐related morbidity. Coordinated and continuous mental health and substance use treatment from prison to the community may reduce the risk of violence‐related morbidity in this population.
The rise of developmental biology in China
Authors: Huang Xun , Lin Xinhua , Liu Feng , Wu Gen , Yang Zhongzhou , Meng Anming
Published: September 2021

Developmental biology research in China started from experimental embryology, in particular from studies on aquatic and reptile animals. The recent growth of the developmental biology community in China parallels the increased governmental funding support and the recruitment of overseas talents. This flourishing field in China embraces the activities of developmental biology‐related societies, national meetings, key research initiatives and talented scientists. The first Development paper from China, published in 2000, marked the beginning of a new era. More recently, the second decade in the 21st century witnessed the blossoming of developmental biology research in China. Significant research spotlights, technical advances, and up‐and‐coming areas will be discussed in this overview.
Women's participation in disaster recovery after the 2005 Kashmir, Pakistan earthquake
Authors: Gul Shehla , McGee Tara K.
Published: September 2021

This study sought to learn how women participated in the recovery process after the Kashmir earthquake of October 2005 in Union Council Langarpura, Azad Kashmir state of Pakistan. Focus‐group discussions, semi‐structured interviews, and participant observations were conducted with a total of 48 participants. The results revealed that women played various important roles in the reproductive, productive, and community spheres, encompassing, inter alia, normal household responsibilities of cooking, cleaning, and caring for cattle, and non‐traditional tasks such as rebuilding the home. In addition, they participated in income‐generating activities such as carrying construction materials and water for daily wages, dairy farming, and working in fields and in the education and health sectors. Community endeavours, meanwhile, consisted of search and rescue, caring for the injured, collective cooking and food sharing, and supervising the reconstruction of public structures, including schools, roads, and water supply facilities, and establishing a sewing centre to provide vocational training to local women.
Fetal echocardiographic diagnosis of a triad with common embryological origins: Cervical aortic arch, retro‐aortic left innominate vein and coarctation of the aorta
Authors: Ramaswamy Prema , Harrington Jamie K.
Published: September 2021

Cervical aortic arch (CAA) and retro‐aortic innominate vein (RAIV) are rare entities which can be associated with one another in a structurally normal heart. Less well recognized is the fact, that a third entity may often be present as well, since aortic arch abnormalities are common in a CAA. Hence, these three entities (CAA, RAIV, and an arch anomaly – in this case a post‐ductal coarctation) may present as a triad. We present the first prenatal diagnosis of this rare triad which can be explained by common embryological origins which are discussed along with instructive aspects in diagnosis and management.
Hypothyroid cardiomyopathy: A reversible phenocopy of hypertrophic cardiomyopathy
Authors: Cianciulli Tomás F. , Morita Luis A. , Saccheri María C. , Zylberman Marcelo
Published: September 2021

We present the case of a 46‐year‐old patient with hypothyroidism secondary to Hashimoto's thyroiditis who was admitted with decompensation in the form of myxedema. A 2‐D echocardiogram shows a septal asymmetric hypertrophy, with low‐voltage QRS complex in the ECG and a bull's‐eye map of longitudinal strain with preserved apical strain with reduction of mid and basal strain that results in “cherry on the top” pattern, similar to the most frequent phenocopy of hypertrophic cardiomyopathy, as is the cardiac amyloidosis, and that, unlike this pathology, reverted after the patient reached the euthyroid state.
Accuracy and diagnostic performance of doppler echocardiography to estimate mean pulmonary artery pressure in heart failure
Authors: Björkman Alva , Lund Lars H. , Faxén Ulrika Ljung , Lindquist Per , Venkateshvaran Ashwin
Published: September 2021

Background

Multiple echocardiographic algorithms have been proposed to estimate mean pulmonary artery pressure (PAPM) and assess pulmonary hypertension (PH) likelihood. We assessed the accuracy of four echocardiographic approaches to estimate PAPM in heart failure (HF) patients undergoing near‐simultaneous right heart catheterization (RHC), and compared diagnostic performance to identify PH with recommendation‐advised tricuspid regurgitation peak velocity (TRVmax).

Methods

We employed four validated echocardiographic algorithms incorporating tricuspid regurgitation peak or mean gradient, pulmonary regurgitation peak gradient, and right ventricular outflow tract acceleration time to estimate PAPM. Echocardiographic estimates of right atrial pressure were incorporated in all algorithms but one. Association and agreement with invasive PAPM were assessed. Diagnostic performance of all algorithms to identify PH was evaluated and compared with the recommended TRVmax cut‐off.

Results

In 112 HF patients, all echocardiographic algorithms demonstrated reasonable association (r = .41–.65; p < 0.001) and good agreement with invasive PAPM, with relatively lower mean bias and higher precision observed in algorithms that incorporated tricuspid regurgitation peak or mean gradient. All methods demonstrated strong ability to identify PH (AUC = .70–.80; p < 0.001) but did not outperform TRVmax (AUC = .84; p < 0.001). Echocardiographic estimates of right atrial pressure were falsely elevated in 30% of patients.

Conclusions

Echocardiographic estimates demonstrate reasonable association with invasive PAPM and strong ability to identify PH in HF. However, none of the algorithms outperformed recommendation‐advised TRVmax. The incremental value of echocardiographic estimates of right atrial pressure may need to be re‐evaluated.
Immediate evaluation of global longitudinal strain at initiation of trastuzumab treatment in breast cancer patients
Authors: Banke Ann , Schou Morten , Ewertz Marianne , Dahl Jordi , Frederiksen Peter Hartmund , Videbæk Lars , Cold Søren , Møller Jacob E.
Published: September 2021

Background

Global longitudinal strain (GLS) is recommended to detect subclinical changes preceding reduced left ventricular ejection fraction (LVEF) in trastuzumab related cardiotoxicity. Since the possibility to detect signs of acute myocardial deterioration at treatment initiation is not clarified, the objective of this study was to assess changes in GLS and biomarkers within the first 2 weeks of trastuzumab treatment.

Methods

In a prospective cohort study, 45 patients with non‐metastatic breast cancer (age 54, LVEF 62.8%, GLS ‐19.9%, 40% hypertension) scheduled for trastuzumab treatment were included. Echocardiography and measurement of troponin and NT‐proBrain‐Natriuretic‐Peptide were conducted before initiation of trastuzumab, at days 3, 7, and 14 and after 3, 6, and 9 months.

Results

A significant deterioration in LVEF from 62.8% (SD±3.6) to 58.4% (SD±4.1) (p < 0.0001), GLS from ‐19.9 (SD±2.1) to ‐18.1 (SD±2.5) (p = 0.004), s’ (p < 0.0001), e’ septal (p = 0.008), and s’ RV (p < 0.0001) occurred at 9 months and was preceded by significant changes in these parameters within the first 14 days. After 14 days, 12 patients (27%) had a ≥10% deterioration in GLS, which was associated with significantly lower LVEF at 55.2% (SD±4.1) at 9 months compared to patients with < 10% early deterioration in GLS (LVEF = 59.5% (SD±3.5) (p = 0.001)). No difference in plasma concentrations of biomarkers was observed between the two groups.

Conclusion

In this study deteriorations in key echocardiographic parameters within normal limits were detected during the first 2 weeks of trastuzumab treatment, and an early ≥10% deterioration in GLS was associated with a lower LVEF at 9 months.
Prenatally diagnosed left atrial appendage aneurysm with various postnatal imaging investigations: A case report
Authors: Sasaki Takeshi , Kawasaki Yuki , Murakami Yosuke , Fujino Mitsuhiro , Nakamura Kae , Yoshida Yoko , Suzuki Tsugutoshi , Nishigaki Kyoichi , Ehara Eiji
Published: September 2021

A congenital left atrial appendage aneurysm (LAAA) is a rare cardiac malformation, that is, usually diagnosed in adulthood. It is rarely diagnosed prenatally. In most cases, surgical resection is recommended soon after the diagnosis has been made due to the risk of arrhythmia and thrombotic events. The present report describes a case of LAAA that was prenatally diagnosed and was asymptomatic postnatally. Imaging revealed the relation of the cardiac and airway structures around the LAAA in detail. The patient underwent surgical resection of the LAAA successfully at 7 months of age and is currently healthy at 5 years of age.
Myocardial work and left ventricular contractile reserve during stress echocardiography: An angiographic validation
Authors: Edwards Natalie F. A. , Scalia Gregory M. , Putrino Anthony , Appadurai Vinesh , Sabapathy Surendran , Anderson Bonita , Chamberlain Robert , Khandheria Bijoy K. , Chan Jonathan
Published: September 2021

Objective: This study sought to determine the contractile reserve (CR) response to exercise stress echocardiography (ESE) quantified by the novel parameter, non‐invasive myocardial work (MW), in subjects with angiographically proven coronary artery disease (CAD).

Methods: CR was measured by the relative change in ejection fraction (EF), global longitudinal strain (GLS) and MW indices from rest to peak exercise in 304 patients referred for clinically indicated ESE. Positive ESE patients proceeded to coronary angiography and further risk stratified based on either percutaneous or surgical intervention.

Results: CRGLS and global work index (CRGWI) significantly decreased with exercise induced ischemia and angiographically proven significant CAD (CRGLS −1.6±3.5%; CRGWI −8.6±511 mm Hg% decrement, p < 0.001) compared to non‐ischemic patients (CRGLS 1.4±2.2%; CRGWI 398±404 mm Hg% improvement). Global constructive work (CRGCW) was significantly higher (p < 0.0001) in non‐ischemic (818±457 mm Hg%) and blunted in ischemic patients (208±550 mm Hg%). CRGCW (AUC .81; 95%CI:.75–.86) demonstrated the most association for inducible ischemia followed by CRGLS (AUC .75; 95%CI:.69–.80), CRGWI (AUC .73, 95%CI:.67–.79) and CREF (AUC .71; 95%CI:.65–.77, p < 0.001). Subgroup analysis showed patients requiring surgical revascularization demonstrated a significantly lower CRGWE (−11.5±7.6%, p < 0.05) as a result of reduced CRGCW (281±573 mm Hg%, p < 0.05) and increased global wasted work (CRGWW, 289±151 mm Hg%, p = 0.09).

Conclusion: Multivessel disease requiring surgical revascularization have the greatest reduction in CR. MW may potentially improve detection of ischemia and further risk stratification during ESE to maximize the benefits of revascularization.
An indolent cause of high‐output heart failure in end‐stage kidney disease—Application of the Nicoladoni‐Israel‐Branham test: A case report
Authors: Ogugua Fredrick , Herzog Charles A. , Sahadevan Meena , Davies Scott , Shroff Gautam R.
Published: September 2021

Background

A hemodynamically significant arteriovenous fistula (AVF) in end‐stage kidney disease (ESKD) causes a high flow state, resulting in pathologic cardiovascular remodeling, and deserves timely clinical recognition.

Case

A 55‐year‐old woman with history of ESKD with deceased donor kidney transplant with failing graft function and baseline creatinine of 2.8 mg/dl presented to the clinic with nocturnal cough, orthopnea, dyspnea on exertion and pedal edema. Physical exam was notable for large, aneurysmal right brachial AVF. Transthoracic echocardiography (TTE) revealed left ventricular (LV) enlargement and hypertrophy and elevated cardiac output (CO) of 10 L/min, raising a clinical concern for high‐output heart failure.

Decision making

A non‐invasive assessment of the hemodynamic significance of the AVF was performed using a TTE. During temporary occlusion of the AVF, it was determined that about 27% of the resting CO was attributed to the AVF, suggesting hemodynamic significance. Nicoladoni‐Israel‐Branham sign was negative as there was no change in patient's heart rate, but this was potentially attributed to beta‐blockade and chronic loading conditions. She underwent AVF banding and 2‐month later her presenting symptoms resolved, and a TTE showed a decrease in resting CO of 7.6 L/min with normalization of LV size.

Conclusion

This case highlights several teaching points. Firstly, in patients with ESKD, a large AVF can contribute to a high CO state resulting in maladaptive cardiovascular remodeling. Secondly, TTE evaluation of the hemodynamic contribution of an AVF can be performed with the application of the Nicoladoni‐Israel‐Branham sign. Finally, some experts recommend pre‐emptive banding or ligation of AVF after successful kidney transplantation as this has been shown to have symptomatic and cardiovascular benefits.
Rare presentation of transposition of great arteries and total anomalous pulmonary venous connection in an 18‐year‐old
Authors: Chatterjee Debika , Gangopadhyay Debasree , Narayan Pradeep
Published: September 2021

Transposition of great arteries (TGA) in association with total anomalous Pulmonary venous connection (TAPVC) is a rare anomaly, that is seldom reported in adulthood. While both the conditions are life threatening on their own, in combination they compensate for each other and can often present after weeks or months after birth. Transthoracic Echocardiography (TTE) can reliably diagnose this anomaly. Cardiac MRI can also be used to confirm the diagnosis. We describe a rare combination of TGA and TAPVC in an 18‐year‐old patient.
Comprehensive analytical approaches reveal species‐specific search strategies in sympatric apex predatory sharks
Authors: Calich Hannah J. , Rodríguez Jorge P. , Eguíluz Víctor M. , Hammerschlag Neil , Pattiaratchi Charitha , Duarte Carlos M. , Sequeira Ana M. M.
Published: September 2021

Animals follow specific movement patterns and search strategies to maximize encounters with essential resources (e.g. prey, favourable habitat) while minimizing exposures to suboptimal conditions (e.g. competitors, predators). While describing spatiotemporal patterns in animal movement from tracking data is common, understanding the associated search strategies employed continues to be a key challenge in ecology. Moreover, studies in marine ecology commonly focus on singular aspects of species' movements, however using multiple analytical approaches can further enable researchers to identify ecological phenomena and resolve fundamental ecological questions relating to movement. Here, we used a set of statistical physics‐based methods to analyze satellite tracking data from three co‐occurring apex predators (tiger, great hammerhead and bull sharks) that predominantly inhabit productive coastal regions of the northwest Atlantic Ocean and Gulf of Mexico. We analyzed data from 96 sharks and calculated a range of metrics, including each species' displacements, turning angles, dispersion, space‐use and community‐wide movement patterns to characterize each species' movements and identify potential search strategies. Our comprehensive approach revealed high interspecific variability in shark movement patterns and search strategies. Tiger sharks displayed near‐random movements consistent with a Brownian strategy commonly associated with movements through resource‐rich habitats. Great hammerheads showed a mixed‐movement strategy including Brownian and resident‐type movements, suggesting adaptation to widespread and localized high resource availability. Bull sharks followed a resident movement strategy with restricted movements indicating localized high resource availability. We hypothesize that the species‐specific search strategies identified here may help foster the co‐existence of these sympatric apex predators. Following this comprehensive approach provided novel insights into spatial ecology and assisted with identifying unique movement and search strategies. Similar future studies of animal movement will help characterize movement patterns and also enable the identification of search strategies to help elucidate the ecological drivers of movement and to understand species' responses to environmental change.
Oil price shocks, protest, and the shadow economy: Is there a mitigation effect?
Authors: Ishak Phoebe W. , Farzanegan Mohammad Reza
Published: September 2021

In this study, we look at how oil price shocks affect the incidence of protests in a country and how the size of a country's shadow economy influences this relationship. Using panel data from 144 countries, from the period of 1991–2015, we find evidence that negative oil price shocks significantly increase protests in countries with small shadow economies. The effect dissipates as the size of the shadow economy increases and eventually vanishes in countries with a shadow economy representing more than 35% of gross domestic product. Our analysis departs from existing literature by emphasizing the moderating role of a shadow economy on the effects of negative oil shocks on the incidence of protests in oil‐dependent economies. The results are robust to various specifications and their broader implications are discussed.
Rapid colonisation post‐displacement contributes to native fish resilience
Authors: Alford Samantha L. , Walters Annika W.
Published: September 2021

Native freshwater fish are experiencing global declines. Determining what drives native fish resilience to disturbance is crucial to understanding their persistence in the face of multiple stressors. Fish colonisation ability may be one factor affecting population resilience after disturbance. We conducted displacement experiments in headwater streams in Wyoming, USA, to evaluate mottled sculpin (Cottus bairdii) and mountain sucker (Catostomus platyrhynchus) colonisation ability. Specifically, we (1) determined whether fish could colonise sites rapidly after displacement, (2) evaluated site‐level factors affecting colonisation, and (3) compared species‐level differences in movement and colonisation capabilities. Mountain sucker recovered to pre‐displacement abundances within 6–11 weeks, but mottled sculpin were still at slightly reduced abundances. For both species, the majority of colonists were unmarked new individuals and size–structure was similar to pre‐displacement size–structure. Fish colonisation was best predicted by pre‐displacement abundance and an interaction between per cent riparian cover and species identity. The slower colonisation rate of mottled sculpin may relate to movement ability as average daily movement rate and movement extent were significantly greater for mountain sucker. Our results demonstrate that colonisation is one mechanism allowing fish populations to be resilient in the face of disturbance and that species' traits provide insight into fish colonisation capabilities. Experimental approaches provide mechanistic insight into colonisation dynamics, enhancing our understanding of native fish resilience in degraded stream ecosystems and their response to restoration actions.
Using quizzes to provide an effective and more enjoyable dental education: A pilot study
Authors: Pereira Andresa Costa , Dias da Silva Marco Antonio , Patel Upen S. , Tanday Ajit , Hill Kirsty B. , Walmsley Anthony Damien
Published: September 2021

Introduction

Increasingly, dental education is using digital strategies to deliver teaching; however, not all of these learning materials are engaging and effective.

Aim

To evaluate the perception and knowledge retention of undergraduate dental students after using two different digital learning tools: quizzes and PDF.

Methods

Thirty‐three students from a Dental School in the United Kingdom took part in the research. They received learning material derived from the Prosthodontic (Kennedy classification) or Paediatric dentistry content (Tooth classification). The same content was delivered in two different formats: quiz game (n = 17) and PDF file (n = 16). The PDF file had ten images and their classifications, whilst the quiz had the same images with a question about the classification, along with alternatives (single best answer).

Results

All students gave similar performances on the knowledge assessment; however, their perception about the learning material differed. Students using quizzes (88%) agreed that they were fun and an interesting way of learning, while only 37.5% had this opinion about PDF material (p = .002). When using quizzes, learners were more motivated and confident. They would frequently recommend quizzes to other colleagues; however, the use of PDF was not suggested as frequently (p = .039). As a learning strategy, 100% of the students using quizzes wanted more of the same to study other dental subjects. This was not the case with the PDF format (p = .005).

Conclusion

Despite quizzes and PDF files resulting in a similar understanding of dental subjects, learners prefer quizzes to supplement their studies. Educators should consider using this interactive digital tool to engage students, instead of PDF files.
Outcome data from >10 000 multiple myeloma patients in the Danish and Swedish national registries
Authors: Blimark Cecilie Hveding , Vangsted Annette Juul , Klausen Tobias W. , Gregersen Henrik , Szabo Agoston Gyula , Hermansen Emil , Wålinder Göran , Knut‐Bojanowska Dorota , Zang Chenyang , Turesson Ingemar ,   the Real‐World Evidence Group within the Nordic Myeloma Study Group (NMSG)
Published: September 2021

Objective

We describe real‐world evidence (RWE) from the nationwide Swedish and Danish registries that provide important information on incidence and outcome in multiple myeloma (MM).

Method

First line treatment data on more than 10.000 MM patients from Denmark and Sweden between 2005–2018 are presented. Key results from research conducted within the Swedish and Danish myeloma registries are summarized, describing subgroups of patients with comorbidity, myeloma complications, and early relapse.

Results

We show that national guidelines, generated on results from randomized clinical trials (RCTs) are rapidly implemented and improve overall survival (OS). We find that both the incidence of MM and the median age at diagnosis is higher in national registries compared to results from referral centres, indicating a more complete coverage. This highlights the need of validation of prognostic scoring systems and indices in e.g., SMM and high‐risk MM in a real‐ world‐population. We show that these subgroups are unlikely to be captured in RCTs with narrow inclusion and exclusion criteria, that they have worse survival, and are in need of new treatment approaches.

Conclusion

National registries that include all MM patients are an important source of knowledge on epidemiology, treatment and outcome with implications for the planning of MM care. Despite the introduction of new and better treatments, rapidly implemented in our countries, our registries uncover subgroups of patients that still have inferior outcome. Our RWE can help to identify important research questions to be studied in further clinical trials also in patients currently not included in RCTs.
Dysfunction of oligodendrocyte inwardly rectifying potassium channel in a rat model of amyotrophic lateral sclerosis
Authors: Peric Mina , Nikolic Ljiljana , Andjus Pavle R. , Bataveljic Danijela
Published: September 2021

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease caused by the death of motor neurons in the spinal cord and the brain. Although this disease is characterized by motoneuron degeneration, non‐neuronal cells such as oligodendrocytes play an important role in the disease onset and progression. The aim of our study was to examine functional properties of oligodendrocytes in the SOD1G93A rat model of ALS with a particular focus on the inwardly rectifying potassium channel Kir4.1 that is abundantly expressed in these glial cells and plays a role in the regulation of extracellular K+. First, we demonstrate that the expression of Kir4.1 is diminished in the spinal cord oligodendrocytes of the SOD1G93A rat. Moreover, our data show an elevated number of dysmorphic oligodendrocytes in the ALS spinal cord that is indicative of a degenerative phenotype. In order to assess physiological properties of oligodendrocytes, we prepared cell cultures from the rat spinal cord. Oligodendrocytes isolated from the SOD1G93A spinal cord display similar ramification of the processes as the control but express a lower level of Kir4.1. We further demonstrate an impairment of oligodendrocyte functional properties in ALS. Remarkably, whole‐cell patch‐clamp recordings revealed compromised membrane biophysical properties and diminished inward currents in the SOD1G93A oligodendrocytes. In addition, the Ba2+‐sensitive Kir currents were decreased in ALS oligodendrocytes. Altogether, our findings provide the evidence of impaired Kir4.1 expression and function in oligodendrocytes of the SOD1G93A spinal cord, suggesting oligodendrocyte Kir4.1 channel as a potential contributor to the ALS pathophysiology.