bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of MenAfriVac on Meningococcal A Meningitis in Cameroon: A Retrospective Study Using Case-by-Case-Based Surveillance Data from 2009 to 2015
Authors: Gake Bouba , Babinne Graobe Bonaventure , Abdouraman Bouba , Satou Ngah Crescence , Aissatou Ahmadou , Gake Nelly-Michèle , Seukap Elise Claudine , Nchiwan Nukenine Elias , Etoundi Mballa Alain G. , Fonkoua Marie-Christine , Lombart Jean-Pierre
Published: September 2021

Meningococcal meningitis is a public health concern in Africa. Conjugated vaccine against serogroup A Neisseria meningitidis (MenAfriVac) was used in mass vaccination and was proved to have a good impact in the meningitis belt. There is a lack of information about the impact of this intervention in Cameroon after mass vaccination was undertaken. This study aimed at filling the gap in its unknown impact in Cameroon. A retrospective longitudinal study using biological monitoring data of case-by-case-based surveillance for meningitis was obtained from the National Reference Laboratories from 1 January 2009 to 20 September 2015. Immunization coverage data were obtained from Regional Public Health Delegations where immunizations took place. We compared the risks of vaccine serogroup occurrence before and after vaccinations and calculated the global impact using Halloran’s formula. Annual cases of meningitis A decreased gradually from 92 in 2011 to 34 in 2012 and then to 1 case in 2013, and since 2014, no cases have been detected. The impact was estimated at 14.48% (

p
=
0.41

) in 2012 and then at 98.63% (

p
<
0.0001

) after the end of vaccinations in 2013. This survey confirms the effectiveness of the MenAfriVac vaccine in Cameroon as expected by the WHO. The surveillance must be pursued and enhanced to monitor coming immunizations measures with multivalent conjugated vaccines for this changing threat.
Wavelet Analysis of Red Noise and Its Application in Climate Diagnosis
Authors: Zhang Zhihua
Published: September 2021

Signals are often destroyed by various kinds of noises. A common way to statistically assess the significance of a broad spectral peak in signals and the synchronization between signals is to compare with simple noise processes. At present, wavelet analysis of red noise is studied limitedly and there is no general formula on the distribution of the wavelet power spectrum of red noise. Moreover, the distribution of the wavelet phase of red noise is also unknown. In this paper, for any given real/analytic wavelet, we will use a rigorous statistical framework to obtain the distribution of the wavelet power spectrum and wavelet phase of red noise and apply these formulas in climate diagnosis.
A Hybrid AOA and TDOA-Based Localization Method Using Only Two Stations
Authors: Li Xiaolong , Xing Yi , Zhang Zhenkai
Published: September 2021

Target localization plays an important role in the application of radar, sonar, and wireless sensor networks. In order to improve the localization performance using only two stations, a hybrid localization method based on angle of arrival (AOA) and time difference of arrival (TDOA) measurements is proposed in this paper. Firstly, the optimization model for localization based on AOA and TDOA are built, respectively, in the sensor network. Secondly,the majorization-minimization (MM) method is employed to create surrogate functions for solving the multiple objective optimization problem. Next, the hybrid localization problem is solved by the projected gradient decent (PGD) method. Finally, the Cramer–Rao lower bound (CRLB) for the joint AOA and TDOA method is derived for the comparison. Simulations proved that the proposed method has improved localization performance using AOA and TDOA measurements from only two base stations.
[Retracted] The Functionalities and Clinical Significance of Tumor‐Infiltrating Immune Cells in Esophageal Squamous Cell Carcinoma
Authors: Zhang Jishuai , Wang Haifeng , Wu Haitao , Qiang Guangliang
Published: September 2021

Tumor‐infiltrating immune cells have been implicated in the tumorigenesis and progression of esophageal squamous cell carcinoma (ESCC). However, the functionalities and clinical significance of immune cells remain largely unveiled. In this study, the gene expression data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) were extracted. The relative infiltrating levels were estimated by single‐sample gene set enrichment analysis. Some cytotoxic immune cells were attenuated, and resting cytotoxic immune cells were accumulated in ESCC. Remarkably, we also observed that infiltrating levels of macrophage M2 and resting natural killer (NK) cells were increased in nonresponders of CRT, and T cells that had anticancer activities such as activated memory CD4 and T helper 2 (Th2) cells were significantly reduced in ESCC tissues of the nonresponders. Moreover, the high infiltrations of the resting natural killer (NK) and dendritic cell (DC) were observed to result in a shorter overall survival in ESCC. Consistently, high expression of immune checkpoint genes, CTLA4 and HAVCR2, was associated with poor prognosis. Furthermore, STAT5B, a key transcription factor, as well as its target genes, involved in the regulation of T cells, was significantly downregulated in ESCC, especially subgroup I, indicating that downregulation of STAT5B might be associated with reduced T cell‐mediated anticancer activity. In conclusion, the present study significantly improved our understanding of the regulatory roles of immune cells in ESCC.
EU-TIRADS-Based Omission of Fine-Needle Aspiration and Cytology from Thyroid Nodules Overlooks a Substantial Number of Follicular Thyroid Cancers
Authors: Solymosi Tamas , Hegedüs Laszlo , Bodor Miklos , Nagy Endre V.
Published: September 2021

Background. The classification of nodules by Thyroid Imaging Reporting and Data Systems (TIRADS) is important in guiding management. Whether sensitivity in identifying thyroid cancers varies with thyroid cancer phenotype remains unclarified. Methods. The ultrasound (US) characteristics of nodules of 26,908 nodular goiter patients were recorded. Fine-needle aspiration cytology (FNA) was performed in all nodules >1 cm irrespective of US findings (n = 25,025) and in nodules between 5 mm and 10 mm with suspicious US characteristics (n = 1,883). Of the 3281 operated cases, 221, 30, and 23 were papillary (PTC), follicular (FTC), and medullary (MTC) cancers, respectively. The US-based indication of FNA, as defined by EU-TIRADS scores, combined with lesion size, was calculated. This study design is unique in avoiding the common selection bias when TIRADS’ sensitivity is tested in a cohort selected for FNA and surgery based on the same US characteristics on which TIRADS is based. Results. The EU-TIRADS score influences decision of FNA in the 10–20 mm range. In such nodules (n = 118), the number of suspicious features (marked hypoechogenicity, microcalcifications, irregular shape, and irregular border) per lesion was lower in FTC (0.7 ± 0.6) than in PTC (1.7 ± 1.0) or MTC (1.8 ± 0.7;

p
<
0.02

), resulting in EU-TIRADS scores of 4.1 ± 0.6, 4.8 ± 0.3, and 4.9 ± 0.2, respectively (

p
<
0.01

). The EU-TIRADS-based FNA indication rate was lower in FTC (55.5%) compared to PTC (85.0%) and MTC (88.9%) (

p
=
0.02

). Conclusions. EU-TIRADS-defined suspicious US features are less common in FTC than in PTC and MTC. Therefore, a substantial number of FTCs in the 10–20 mm range escape surgery.
Elimination of Radiation-Induced Senescence in the Brain Tumor Microenvironment Attenuates Glioblastoma Recurrence
Authors: Fletcher-Sananikone Eliot , Kanji Suman , Tomimatsu Nozomi , Di Cristofaro Luis Fernando Macedo , Kollipara Rahul K. , Saha Debabrata , Floyd John R. , Sung Patrick , Hromas Robert , Burns Terry C. , Kittler Ralf , Habib Amyn A. , Mukherjee Bipasha , Burma Sandeep
Published: September 2021

Glioblastomas (GBM) are routinely treated with ionizing radiation (IR) but inevitably recur and develop therapy resistance. During treatment, the tissue surrounding tumors is also irradiated. IR potently induces senescence, and senescent stromal cells can promote the growth of neighboring tumor cells by secreting factors that create a senescence-associated secretory phenotype (SASP). Here, we carried out transcriptomic and tumorigenicity analyses in irradiated mouse brains to elucidate how radiotherapy-induced senescence of non-neoplastic brain cells promotes tumor growth. Following cranial irradiation, widespread senescence in the brain occurred, with the astrocytic population being particularly susceptible. Irradiated brains showed an altered transcriptomic profile characterized by upregulation of CDKN1A (p21), a key enforcer of senescence, and several SASP factors, including HGF, the ligand of the receptor tyrosine kinase (RTK) Met. Preirradiation of mouse brains increased Met-driven growth and invasiveness of orthotopically implanted glioma cells. Importantly, irradiated p21−/− mouse brains did not exhibit senescence and consequently failed to promote tumor growth. Senescent astrocytes secreted HGF to activate Met in glioma cells and to promote their migration and invasion in vitro, which could be blocked by HGF-neutralizing antibodies or the Met inhibitor crizotinib. Crizotinib also slowed the growth of glioma cells implanted in preirradiated brains. Treatment with the senolytic drug ABT-263 (navitoclax) selectively killed senescent astrocytes in vivo, significantly attenuating growth of glioma cells implanted in preirradiated brains. These results indicate that SASP factors in the irradiated tumor microenvironment drive GBM growth via RTK activation, underscoring the potential utility of adjuvant senolytic therapy for preventing GBM recurrence after radiotherapy.

Significance:

This study uncovers mechanisms by which radiotherapy can promote GBM recurrence by inducing senescence in non-neoplastic brain cells, suggesting that senolytic therapy can blunt recurrent GBM growth and aggressiveness.
Organoids Derived from Neoadjuvant FOLFIRINOX Patients Recapitulate Therapy Resistance in Pancreatic Ductal Adenocarcinoma
Authors: Farshadi Elham Aida , Chang Jiang , Sampadi Bharath , Doukas Michail , Van 't Land Freek , van der Sijde Fleur , Vietsch Eveline E. , Pothof Joris , Koerkamp Bas Groot , van Eijck Casper H.J.
Published: September 2021

Purpose:

We investigated whether organoids can be generated from resected tumors of patients who received eight cycles of neoadjuvant FOLFIRINOX chemotherapy before surgery, and evaluated the sensitivity/resistance of these surviving cancer cells to cancer therapy.

Experimental Design:

We generated a library of 10 pancreatic ductal adenocarcinoma (PDAC) organoid lines: five each from treatment-naïve and FOLFIRINOX-treated patients. We first assessed the histologic, genetic, and transcriptional characteristics of the organoids and their matched primary PDAC tissue. Next, the organoids' response to treatment with single agents—5-FU, irinotecan, and oxaliplatin—of the FOLFIRINOX regimen as well as combined regimen was evaluated. Finally, global mRNA-seq analyses were performed to identify FOLFIRINOX resistance pathways.

Results:

All 10 patient-derived PDAC organoids recapitulate histologic, genetic, and transcriptional characteristics of their primary tumor tissue. Neoadjuvant FOLFIRINOX-treated organoids display resistance to FOLFIRINOX (5/5), irinotecan (5/5), and oxaliplatin (4/5) when compared with treatment-naïve organoids (FOLFIRINOX: 1/5, irinotecan: 2/5, oxaliplatin: 0/5). 5-Fluorouracil treatment responses between naïve and treated organoids were similar. Comparative global transcriptome analysis of treatment-naïve and FOLFIRINOX samples—in both organoids and corresponding matched tumor tissues—uncovered modulated pathways mainly involved in genomic instability, energy metabolism, and innate immune system.

Conclusions:

Resistance development in neoadjuvant FOLFIRINOX organoids, recapitulating their primary tumor resistance, suggests continuation of FOLFIRINOX therapy as an adjuvant treatment may not be advantageous for these patients. Gene-expression profiles of PDAC organoids identify targetable pathways involved in chemoresistance development upon neoadjuvant FOLFIRINOX treatment, thus opening up combination therapy possibilities.
Randomized Phase II Study of PARP Inhibitor ABT-888 (Veliparib) with Modified FOLFIRI versus FOLFIRI as Second-line Treatment of Metastatic Pancreatic Cancer: SWOG S1513
Authors: Chiorean E. Gabriela , Guthrie Katherine A. , Philip Philip A. , Swisher Elizabeth M. , Jalikis Florencia , Pishvaian Michael J. , Berlin Jordan , Noel Marcus S. , Suga Jennifer M. , Garrido-Laguna Ignacio , Cardin Dana Backlund , Radke Marc R. , Duong Mai , Bellasea Shay , Lowy Andrew M. , Hochster Howard S.
Published: September 2021

Purpose:

PARP inhibitors synergize with topoisomerase inhibitors, and veliparib plus modified (m) FOLFIRI (no 5-FU bolus) had preliminary activity in metastatic pancreatic cancers. This study evaluated the safety and efficacy of second-line treatment with veliparib and mFOLFIRI versus FOLFIRI (control) for metastatic pancreatic cancer.

Patients and Methods:

This randomized phase II clinical trial led by the SWOG Cancer Research Network enrolled patients between September 1, 2016 and December 13, 2017. The median follow-up was 9 months (IQR 1–27). BRCA1/2 and homologous recombination DNA damage repair (HR-DDR) genetic defects were tested in blood and tumor biopsies. Patients received veliparib 200 mg twice daily, days 1–7 with mFOLFIRI days 3–5, or FOLFIRI in 14-day cycles.

Results:

After 123 of planned 143 patients were accrued, an interim futility analysis indicated that the veliparib arm was unlikely to be superior to control, and the study was halted. Median overall survival (OS) was 5.4 versus 6.5 months (HR, 1.23; P = 0.28), and median progression-free survival (PFS) was 2.1 versus 2.9 months (HR, 1.39; P = 0.09) with veliparib versus control. Grade 3/4 toxicities were more common with veliparib (69% vs. 58%, P = 0.23). For cancers with HR-DDR defects versus wild-type, median PFS and OS were 7.3 versus 2.5 months (P = 0.05) and 10.1 versus 5.9 months (P = 0.17), respectively, with FOLFIRI, and 2.0 versus 2.1 months (P = 0.62) and 7.4 versus 5.1 months (P = 0.10), respectively, with veliparib plus mFOLFIRI.

Conclusions:

Veliparib plus mFOLFIRI did not improve survival for metastatic pancreatic cancer. FOLFIRI should be further studied in pancreatic cancers with HR-DDR defects.
Losartan Blocks Osteosarcoma-Elicited Monocyte Recruitment, and Combined With the Kinase Inhibitor Toceranib, Exerts Significant Clinical Benefit in Canine Metastatic Osteosarcoma
Authors: Regan Daniel P. , Chow Lyndah , Das Sunetra , Haines Laurel , Palmer Eric , Kurihara Jade N. , Coy Jonathan W. , Mathias Alissa , Thamm Douglas H. , Gustafson Daniel L. , Dow Steven W.
Published: September 2021

Purpose:

There is increasing recognition that progress in immuno-oncology could be accelerated by evaluating immune-based therapies in dogs with spontaneous cancers. Osteosarcoma (OS) is one tumor for which limited clinical benefit has been observed with the use of immune checkpoint inhibitors. We previously reported the angiotensin receptor blocker losartan suppressed metastasis in preclinical mouse models through blockade of CCL2–CCR2 monocyte recruitment. Here we leverage dogs with spontaneous OS to determine losartan's safety and pharmacokinetics associated with monocyte pharmacodynamic endpoints, and assess its antitumor activity, in combination with the kinase inhibitor toceranib.

Patients and Methods:

CCL2 expression, monocyte infiltration, and monocyte recruitment by human and canine OS tumors and cell lines were assessed by gene expression, ELISA, and transwell migration assays. Safety and efficacy of losartan-toceranib therapy were evaluated in 28 dogs with lung metastatic OS. Losartan PK and monocyte PD responses were assessed in three dose cohorts of dogs by chemotaxis, plasma CCL2, and multiplex cytokine assays, and RNA-seq of losartan-treated human peripheral blood mononuclear cells.

Results:

Human and canine OS cells secrete CCL2 and elicit monocyte migration, which is inhibited by losartan. Losartan PK/PD studies in dogs revealed that a 10-fold-higher dose than typical antihypertensive dosing was required for blockade of monocyte migration. Treatment with high-dose losartan and toceranib was well-tolerated and induced a clinical benefit rate of 50% in dogs with lung metastases.

Conclusions:

Losartan inhibits the CCL2–CCR2 axis, and in combination with toceranib, exerts significant biological activity in dogs with metastatic osteosarcoma, supporting evaluation of this drug combination in patients with pediatric osteosarcoma.

See related commentary by Weiss et al., p. 571
Increased Choroidal Thickness in Morquio Syndrome
Authors: Magalhães Augusto , Vilares-Morgado Rodrigo , Cunha Ana Maria , Leão-Teles Elisa , Falcão Manuel , Carneiro Ângela , Falcão-Reis Fernando
Published: September 2021

The purpose of this clinical case report is to describe a case of mucopolysaccharidosis type IVA (MPS IVA), or Morquio syndrome, with increased choroidal thickness in enhanced-depth imaging optical coherence tomography (EDI-OCT) which can represent choroidal deposition of glycosaminoglycans (GAGs). A 21-year-old male with genetically confirmed diagnosis of MPS IVA was examined at our Pediatric Ophthalmology clinic as part of our follow-up protocol for MPS patients. His best-corrected visual acuity was 4/10 in his right eye (OD) and 6/10 in the left eye (OS). Mild diffuse corneal opacification was evident. Intraocular pressure was within normal range. Fundus examination and color fundus photography revealed no abnormalities. EDI-OCT revealed significantly increased choroidal thickness in his right eye and in his left eye, suggesting the presence of choroidal deposition of GAGs, despite absence of retinal or optic disc GAG deposition or other chorioretinal involvement. To our knowledge, this is the first case of MPS IVA described in the literature with suspected choroidal deposition of GAGs. With improved control of systemic features of MPS IVA, life expectancy of these patients has increased, allowing for more ocular manifestations to develop. The parallel development of technology in ophthalmology, such as the EDI-OCT, further contributes to the detection of these unprecedented ocular features in MPSs.
Optical Bench Analysis of 2 Depth of Focus Intraocular Lenses
Authors: Borkenstein Andreas F. , Borkenstein Eva-Maria , Luedtke Holger , Schmid Ruediger
Published: September 2021

Background: The aim of the study was to analyze the objective optical properties of 2 enhanced depth of focus (EDoF) intraocular lenses (IOLs) using optical bench analysis. Methods: This experimental study investigates 2 new EDoF IOLs, the Alcon AcrySof IQ Vivity and the Bausch & Lomb LuxSmart Crystal, on the optical bench, using OptiSpheric IOL PRO2 (Trioptics, Germany) in order to assess the optical quality according to ISO 11979 with ISO-2 Cornea. IOLs (power 22.0 D) were evaluated regarding modulation transfer function (MTF) at 50 lp/mm and Strehl ratio (SR) using a 3.0-mm and a 4.5-mm aperture. In addition, wavefront measurements were obtained using WaveMaster® IOL 2 device (Trioptics, Germany), and USAF targets were analyzed. Results: Centered: the MTF (mean) at 50 lp/mm (AcrySof IQ Vivity/LuxSmart Crystal) with 3.0 mm aperture was 0.250/0.257 and with 4.5 mm aperture 0.202/0.243. The SR (mean) with 3.0 mm aperture was 0.261/0.355 and with 4.5 mm aperture 0.176/0.206. Decentered by 1 mm: the MTF (mean) at 50 lp/mm (AcrySof IQ Vivity/LuxSmart Crystal) with 3.0 mm aperture was 0.266/0.247 and with 4.5 mm aperture 0.126/0.215. The SR (mean) with 3.0 mm aperture was 0.272/0.234 and with 4.5 mm aperture 0.133/0.183. Tilted by 5 degree: the MTF (mean) at 50 lp/mm (AcrySof IQ Vivity/LuxSmart Crystal) with 3.0 mm aperture was 0.221/0.360 and with 4.5 mm aperture 0.214/0.229. The SR (mean) with 3.0 mm aperture was 0.232/0.428 and with 4.5 mm aperture 0.225/0.229. The simulated visual function using USAF test targets showed corresponding qualitative results. Wavefront measurements proved a complex optical design. Higher order aberrations in the central part of the optics were modulated up to the 10th order to enhance the range of functional vision to near distance, leaving the peripheral parts of the optics aberration free or as aberration correcting. Conclusion: The diversity of EDOF IOLs, their optics, and their respective impact on the vision quality must be understood in order to select the appropriate IOL in each individual case. This analysis of new, innovative IOL optics based on increased negative spherical aberration may help the ophthalmic surgeon to select the IOL which meets the individual requirements of the patient for best postoperative outcomes. It seems that there is no perfect IOL that is equally suitable for all patients, but the right choice is an individual, customized approach dealing with patients’ expectations.
Arrhythmias Other Than Atrial Fibrillation in Those With an Irregular Pulse Detected With a Smartwatch: Findings From the Apple Heart Study
Authors: Perino Alexander C. , Gummidipundi Santosh E. , Lee Justin , Hedlin Haley , Garcia Ariadna , Ferris Todd , Balasubramanian Vidhya , Gardner Rebecca M. , Cheung Lauren , Hung Grace , Granger Christopher B. , Kowey Peter , Rumsfeld John S. , Russo Andrea M. , True Hills Mellanie , Talati Nisha , Nag Divya , Tsay David , Desai Sumbul , Desai Manisha , Mahaffey Kenneth W. , Turakhia Mintu P. , Perez Marco V. ,   on behalf of the Apple Heart Study Investigators
Published: September 2021

Background:

The Apple watch irregular pulse detection algorithm was found to have a positive predictive value of 0.84 for identification of atrial fibrillation (AF). We sought to describe the prevalence of arrhythmias other than AF in those with an irregular pulse detected on a smartwatch.

Methods:

The Apple Heart Study investigated a smartwatch-based irregular pulse notification algorithm to identify AF. For this secondary analysis, we analyzed participants who received an ambulatory ECG patch after index irregular pulse notification. We excluded participants with AF identified on ECG patch and described the prevalence of other arrhythmias on the remaining participant ECG patches. We also reported the proportion of participants self-reporting subsequent AF diagnosis.

Results:

Among 419 297 participants enrolled in the Apple Heart Study, 450 participant ECG patches were analyzed, with no AF on 297 ECG patches (66%). Non-AF arrhythmias (excluding supraventricular tachycardias <30 beats and pauses <3 seconds) were detected in 119 participants (40.1%) with ECG patches without AF. The most common arrhythmias were frequent PACs (burden ≥1% to <5%, 15.8%; ≥5% to <15%, 8.8%), atrial tachycardia (≥30 beats, 5.4%), frequent PVCs (burden ≥1% to <5%, 6.1%; ≥5% to <15%, 2.7%), and nonsustained ventricular tachycardia (4–7 beats, 6.4%; ≥8 beats, 3.7%). Of 249 participants with no AF detected on ECG patch and patient-reported data available, 76 participants (30.5%) reported subsequent AF diagnosis.

Conclusions:

In participants with an irregular pulse notification on the Apple Watch and no AF observed on ECG patch, atrial and ventricular arrhythmias, mostly PACs and PVCs, were detected in 40% of participants. Defining optimal care for patients with detection of incidental arrhythmias other than AF is important as AF detection is further investigated, implemented, and refined.
Prognostic Impact of Home Blood Pressures for Adverse Cardiovascular Outcomes and Mortality in Patients With Resistant Hypertension: A Prospective Cohort Study
Authors: Cardoso Claudia R.L. , Salles Gil F.
Published: September 2021

Home blood pressure (HBP) monitoring has been increasingly used in hypertension management. We aimed to evaluate the prognostic importance of HBP parameters in patients with resistant hypertension in relation to office and ambulatory blood pressures (BPs). Three hundred thirty-three patients with resistant hypertension performed 24-hour ambulatory and HBP monitoring at baseline and were followed up for a median of 5.6 years. Primary outcomes were total cardiovascular events, major adverse cardiovascular events, and all-cause and cardiovascular mortality. Associations between HBPs (total mean, morning and evening BPs, analyzed as continuous and as dichotomical variables) and outcomes were assessed by multivariable-adjusted Cox analyses. Improvement in risk discrimination with HBP was evaluated by
C
statistics and the Integrated Discrimination Improvement index. During follow-up, there were 48 cardiovascular events (42 major adverse cardiovascular events) and 43 all-cause deaths (26 cardiovascular). Continuous HBP parameters were associated with significantly higher risks of all adverse outcomes, with hazard ratios varying from 1.7 to 2.1, after adjustments for office and ambulatory BPs. In dichotomical analyses, uncontrolled HBP was associated with significantly higher risks of all outcomes, except for the evening HBP. Morning HBP was associated with the highest risks. HBP parameters improved risk discrimination, with increases in
C
statistics of up to 0.044 and relative Integrated Discrimination Improvements up to 42%, equivalent to those obtained from ambulatory BPs, except for all-cause and cardiovascular mortalities, in which ambulatory BPs provided greater improvements than HBPs. In conclusion, higher/uncontrolled HBP levels are predictive of adverse cardiovascular outcomes and mortality and improve risk discrimination in patients with resistant hypertension.

Graphic Abstract:

An online
graphic abstract
is available for this article.
Mendelian Randomization Focused Analysis of Vitamin D on the Secondary Prevention of Ischemic Stroke
Authors: Chan Yap-Hang , Schooling C. Mary , Zhao Jie , Au Yeung Shiu-Lun , Hai Jo Jo , Thomas G. Neil , Cheng Kar-Keung , Jiang Chao-Qiang , Wong Yuen-Kwun , Au Ka-Wing , Tang Clara S. , Cheung Chloe Y.Y. , Xu Aimin , Sham Pak-Chung , Lam Tai-Hing , Lam Karen Siu-Ling , Tse Hung-Fat
Published: September 2021

Background and Purpose:

Experimental studies showed vitamin D (Vit-D) could promote vascular regeneration and repair. Prior randomized studies had focused mainly on primary prevention. Whether Vit-D protects against ischemic stroke and myocardial infarction recurrence among subjects with prior ischemic insults was unknown. Here, we dissected through Mendelian randomization any effect of Vit-D on the secondary prevention of recurrent ischemic stroke and myocardial infarction.

Methods:

Based on a genetic risk score for Vit-D constructed from a derivation cohort sample (n=5331, 45% Vit-D deficient, 89% genotyped) via high-throughput exome-chip screening of 12 prior genome-wide association study–identified genetic variants of Vit-D mechanistic pathways (
rs2060793
,
rs4588
, and
rs7041
; F statistic, 73;
P
<0.001), we performed a focused analysis on prospective recurrence of myocardial infarction (MI) and ischemic stroke in an independent subsample with established ischemic disease (n=441, all with prior first ischemic event; follow-up duration, 41.6±14.3 years) under a 2-sample, individual-data, prospective Mendelian randomization approach.

Results:

In the ischemic disease subsample, 11.1% (n=49/441) had developed recurrent ischemic stroke or MI and 13.3% (n=58/441) had developed recurrent or de novo ischemic stroke/MI. Kaplan-Meier analyses showed that genetic risk score predicted improved event-free survival from recurrent ischemic stroke or MI (log-rank, 13.0;
P
=0.001). Cox regression revealed that genetic risk score independently predicted reduced risk of recurrent ischemic stroke or MI combined (hazards ratio, 0.62 [95% CI, 0.48–0.81];
P
<0.001), after adjusted for potential confounders. Mendelian randomization supported that Vit-D is causally protective against the primary end points of recurrent ischemic stroke or MI (Wald estimate: odds ratio, 0.55 [95% CI, 0.35–0.81]) and any recurrent or de novo ischemic stroke/MI (odds ratio, 0.64 [95% CI, 0.42–0.91]) and recurrent MI alone (odds ratio, 0.52 [95% CI, 0.30–0.81]).

Conclusions:

Genetically predicted lowering in Vit-D level is causal for the recurrence of ischemic vascular events in persons with prior ischemic stroke or MI.
Rebelling against the Ruler: Egyptian Youth and Azhari Scholars’ Authority after the 2011 Uprising
Authors: Amin Nareman
Published: September 2021

Scholars have investigated statements by Azhari ʿulamāʾ (religious scholars) about the legality of protest in Egypt in 2011 and 2013 and their use of fiqh al-wāqiʿ, a jurisprudential method by which jurists consider social and political realities when issuing legal opinions. These studies focus on Islamic legal theory but do not examine the social implications of the legal. Based on textual analysis of televised statements by ʿulamāʾ and interviews with young Muslim Egyptians, I argue that, although some jurists discouraged the laity from joining the 2011 protests, religious youth were not deterred from protesting. Additionally, laypeople who are not well-versed in Islamic law grew suspicious of the shifting opinions of ʿulamāʾ on the legal status of protest, as happened in 2013. In the aftermath of the 2011 and 2013 movements, the moral capital of several Azhari scholars decreased as did the moral-legal purchase of the fatwās they issued.
‘No Ideas but in Things’: The Responsibility to Protect as Assemblage
Authors: MacLennan Jack Adam
Published: September 2021

This article establishes the need to engage with the Responsibility to Protect (R2P) as an assemblage in order to reckon with how material influences shape its politics. Through an analysis of the 2011 United States and North Atlantic Treaty Organization intervention in Libya, the paper illustrates how particular tools and techniques influence R2P. The example shows how the original impetus of the intervention was mediated and translated by the particular collection of elements brought together to realise the intervention in Libya. Rather than argue this illustrates how R2P is defined by specific techniques, the article situates and then builds upon the extant literature by labelling R2P as an assemblage. In this way the article highlights how material influences and the importance of mediation are missed in the extant literature. Further, it concludes by arguing for a more productive research agenda that foregrounds empirical engagements with specific practices in order to develop the current literature.
Othering within the Islamist Spectrum: Ennahda and the Political Salafists in Tunisia
Authors: Lorch Jasmin , Chakroun Hatem
Published: September 2021

While research on Islamist moderation has paid considerable attention to cross-ideological cooperation, it has barely explored whether and how the moderation of Islamist parties is related to interactions inside the Islamist spectrum. We attempt to bridge this gap by using othering as a theoretical-analytical lens with which to analyze the interplay between Ennahda’s moderation and the party’s relations to the political Salafists in Tunisia. We argue that the discursive act of othering the political Salafists has helped Ennahda construct itself both as a moderate, democratic actor representing the ‘true’ version of Tunisian Islam and as an effective and reliable political force. Moreover, while the concept of othering has barely been systematically applied to intra-Islamist relations, we show that it constitutes a fine-grained tool with which to study Islamist moderation in the context of intra-Islamist competition.
Radicalizing Life after Death: Dostoevskii’s ‘Bobok: Zapiski odnogo litsa’ (‘Bobok: Notes of a Certain Person’) and Petrushevskaia’s Nomer Odin, ili V sadakh drugikh vozmozhnostei (Number One, or in the Gardens of Other Opportunities)
Authors: Tigountsova Inna F. I.
Published: September 2021

The focus of this article is on Dostoevskii’s story “Bobok” [“Bobok,” 1873] and Petrushevskaia’s novel Nomer Odin, ili V sadakh drugikh vozmozhnostei [Number One, or In the Gardens of Other Opportunities, 2004]. These dialogical narratives explore the theme of life after death; they portray death as a transition to life that includes several stages, and focus on the process of dying, living in a different form, and dying again. I discuss how these radical views on death are expressed in “Bobok” and Nomer Odin (with some reference to Dostoevskii’s Zapiski iz podpol’ia [Notes from Underground, 1864] and Petrushevskaia’s Vremia: Noch’ [Time: Night, 1992]): from the “getting naked” (“zagolimsia,” “obnazhimsia”) preached and practised by the decaying corpses in Dostoevskii’s text, to transitions between different stages after death in Petrushevskaia’s novel, such as metempsychosis, as well as tropes used to denote these transitions.
Identification key of Ctenopoda (Cladocera, Holopedidae, Sididae) taxa from Brazil with remarks on taxonomy and geographic distribution
Authors: SOUSA FRANCISCO DIOGO R. , ELMOOR-LOUREIRO LOURDES M. A.
Published: September 2021

Using literature and field sampling data, we found that Brazilian fauna of the order Ctenopoda (Cladocera, Branchiopoda) was composed of twelve species, including the locally endemic Holopedium amazonicum and Sarsilantona behningi. In Brazil, Diapahanosoma (Neodiaphanosoma) bergamini was reported out of its type locality for the first time. Ctenopoda species were reported in all Hydrographic Regions in Brazil, however, the sampling effort was clearly distinct between many areas. These findings suggest the necessity of new faunal surveys in several parts of Brazil.
Platylomia kohimaensis n. sp.—a new cicada species (Hemiptera: Cicadidae) from the Naga Hills in the Eastern Himalayas
Authors: HAJONG SUDHANYA RAY , LIMATEMJEN
Published: September 2021

A new cicada species, Platylomia kohimaensis n. sp., belonging to the Platylomia radha group is described from the Naga Hills in the eastern Himalayas. It is a dusk singing, large-sized cicada that calls for a short window during the evening twilight hours. Timbalisation is in the form of a continuous and regular cackling. Photographs of adult male and female along with genitalia illustration and distribution map are provided. A sonogram along with Acoustic Identification Card is also provided.
Turbulence in The Marine Boundary Layer and Air Motions Below Stratocumulus Clouds at the ARM Eastern North Atlantic Site
Authors: Ghate Virendra P. , Cadeddu Maria P. , Zheng Xue , O’Connor Ewan
Published: September 2021

Marine stratocumulus clouds are intimately coupled to the turbulence in the boundary layer and drizzle is known to be ubiquitous within them. Six years of data collected at the Atmospheric Radiation Measurement (ARM)’s Eastern North Atlantic site are utilized to characterize turbulence in the marine boundary layer and air motions below stratocumulus clouds. Profiles of variance of vertical velocity binned by wind direction (wdir) yielded that the boundary layer measurements are affected by the island when the wdir is between 90° and 310° (measured clockwise from North where air is coming from). Data collected during the marine conditions (wdir<90 or wdir>310) showed that the variance of vertical velocity was higher during the winter months than during the summer months due to higher cloudiness, wind speeds, and surface fluxes. During marine conditions the variance of vertical velocity and cloud fraction exhibited a distinct diurnal cycle with higher values during the nighttime than during the daytime. Detailed analysis of 32 cases of drizzling marine stratocumulus clouds showed that for a similar amount of radiative cooling at the cloud top, within the sub-cloud layer 1) drizzle increasingly falls within downdrafts with increasing rain rates, 2) the strength of the downdrafts increases with increasing rain rates, and 3) the correlation between vertical air motion and rain rate is highest in the middle of the sub-cloud layer. The results presented herein have implications for climatological and model evaluation studies conducted at the ENA site, along with efforts of accurately representing drizzle-turbulence interactions in a range of atmospheric models.
Laing Versus Szasz: Antagonists, Kindred Spirits, or a Misconstrued Rivalry?
Authors: Balbuena Francisco
Published: September 2021

In the mid-1970s, as the role of institutional psychiatry was being debated, Thomas S. Szasz directed a severe and unexpected critique at the work of Ronald D. Laing, after which there arose an acrimonious debate between Szasz and supporters of Laing in the Philadelphia Association (PA). (Laing himself conspicuously declined to respond to Szasz). This clash of views was initiated by Szasz in The New Review (TNR), which prompted a series of rebuttals from those working alongside Laing in the PA. Pivotal to this dispute were contrasting ideas on how to guide people from breakdown to sanity and the roles to be played by professionals and institutions in engaging with them. The main purpose of this article is to evaluate whether Laing (seen through lens of his then-associates in the PA) and Szasz were “antagonists,” whether they shared a kindred spirit in their view of the psychiatric establishment, or whether their perceived differences on how to treat psychic sufferers stemmed from misrepresentations created by themselves or others. My conclusion is that, even though Laing and Szasz shared an interest in changing conventional psychiatric practice and the mode of understanding and treating psychic suffering, each side misconstrued the position of the other.
Career Confidential: Teacher annoyed that parents copy principal on their emails to her
Authors: Fagell Phyllis L.
Published: September 2021

In this advice column, Phyllis Fagell answers educators’ questions about their professional dilemmas. This month, a teacher is frustrated that parents are copying the principal when sending emails. Another teacher is anxious about COVID exposure as school reopens and wants to opt out of lunch duty.
A new path planning method based on sparse A* algorithm with map segmentation
Authors: Zhaoying Li , Ruoling Shi , Zhao Zhang
Published: September 2021

Due to the complexity of map modeling, the massive computation and high redundancy of the traditional A* algorithm will greatly reduce the efficiency of pathfinding, resulting in huge performance consumption. Meanwhile, limited by neighborhood search strategy in grid map, the traditional A* algorithm is actually unable to achieve the optimal path in the global sense. To solve these problems, this paper proposes an improved A* algorithm based on graph preprocessing. First, the free space on the map was decomposed into several polygon regions using the improved convex decomposition method based on Maklink. Then, each region was coded into feature nodes according to A* algorithm. Finally, an optimal region passage was found based on the principle of A* algorithm, in which the global optimal path solution was obtained. Compared with the traditional A* algorithm and other classical path planning algorithms, the proposed algorithm has significant advantages in planning speed, path cost, stability, and completeness.
Finite-time extended dissipative filtering for nonlinear Markovian jump systems with unknown transition rates and time-varying delays
Authors: Wang Yao , Guo Jun , Liu Guobao , Lu Junwei , Li Fangyuan
Published: September 2021

The problem of finite-time filtering for nonlinear Markovian jump systems subject to extended dissipativity with unknown transition rates and time-varying delays is investigated in this paper. Firstly, by constructing novel Lyapunov-Krasovskii functionals and utilizing delay partitioning method, the error system is proved to be stochastically finite-time bounded and extended dissipative. Secondly, in virtue of linear matrix inequalities approach, the desired mode-dependent filter is obtained. Finally, two simulations are illustrated for the purpose of demonstrating the less conservativeness and effectiveness of the proposed method.
TikTok Tonsils
Authors: Sulibhavi Anita , Isaacson Glenn
Published: September 2021

There has been a subjective increase in the number of patients presenting for tonsil stones to our pediatric otolaryngology clinic. This may be related to frequent viewing of videos on the social media application, TikTok, pertaining to tonsil stones.
Communicating Through a Pandemic: Insights on Crisis Communication from Steel Authority of India Limited, Rourkela Steel Plant
Authors: Chattaraj Dipak , Mohanty Seemita , Satpathy Archana
Published: September 2021

Executive Summary

The year 2020 will go down in the annals of history as the year of COVID-19, the year the whole world was left devastated. Even in 2021, countries are being ravaged by the virus, with no immediate end in sight. In fast-moving and uncertain situations, leaders face many questions for which they might not have any answers ( Argenti, 2020 ). Therefore, the question is how leaders can manage the communication environment with clarity, consistency and empathy during this period of extreme disruption ( Glinska, 2020 ). Crisis communication is generally defined as the accumulation and dissemination of information during crisis situations to alleviate the severity of the crisis. This study outlines and analyses the communication strategies and measures adopted by the management of one of the biggest manufacturing industries of the country, the Steel Authority of India Limited, Rourkela Steel Plant (RSP), during this ongoing COVID-19 crisis. A survey on the efficacy of the communication measures adopted by the management was conducted on 345 employees. The results showed a high level of support for all the implemented communication measures. Yet employees at the junior level articulated a need for better communication exchange with the top management. They perceived their voices as going unheard and sought additional communication channels connecting them to the highest authority. Considering the feedback received from the employees, additional communication measures were adopted. RSP’s Mass Contact Exercise was revived in an online format. A mobile app was developed containing all information and guidelines that an employee would need regarding precautions, prevention, testing and treatment of COVID-19. Quick and clear communication at every juncture let RSP tide through arguably the toughest pandemic period. Thus, it should always be ensured that appropriate communication channels are effectively implemented for vital information to reach every corner of the organization.
Health System-Level Evaluation of Tele-Mental Health Services Among Children and Adolescents in Ontario, Canada
Authors: Toulany Alene , Kurdyak Paul , Gandhi Sima , Fu Longdi , Grewal Seena , Kulkarni Chetana , Saunders Natasha , Vigod Simone , Guttmann Astrid , Chiu Maria , Pignatiello Antonio
Published: September 2021

Objective

To describe the characteristics of children and adolescents receiving tele-mental health services in Ontario, Canada and examine access to a psychiatrist, in-person or via tele-mental health services, following a mental health and addictions (MHA)-related emergency department (ED) visit or hospitalization.

Method

Using linked health and administrative data, we described two cohorts: (1) children and adolescents (1–18 years) who used a provincial tele-mental health programme from January 1, 2013 to March 31, 2017, comparing their MHA-related service use (outpatient, ED, hospitalization) in the 1 year prior to and the 1 year following initial consultation; (2) children and adolescents with high mental health service needs, defined as those with an incident MHA-related ED visit or hospitalization between January 1, 2013 and December 31, 2016, examining their 1-year follow-up with telemedicine and other health care utilization.

Results

In the first cohort, 7,216 children and adolescents (mean age 11.8 [±3.8] years) received tele-mental health services. The proportion of MHA-related ED visits [15.1% pre vs. 12.6% post (test statistic 23.57, P < 0.001)] or hospitalizations [10.2% pre vs. 8.7% post (test statistic 11.96, P < 0.001)] declined in the year following tele-mental health consultation, while local psychiatry visits increased [8.4% pre vs. 17.0% post (test statistic 298.69, P < 0.001)]. In the second cohort ( n = 84,033), only 1.5% received tele-mental health services, 40.7% saw a psychiatrist in-person, and 32.5% received no MHA-related outpatient care in follow-up.

Conclusions

Tele-mental health services were rarely used in Ontario, even among high-needs children and adolescents, despite their association with increased access to care and less need for acute mental health care.
State of the Art Stroke Imaging: A Current Perspective
Authors: McDonough Rosalie , Ospel Johanna , Goyal Mayank
Published: September 2021

Acute stroke is a widespread, debilitating disease. Fortunately, it also has one of the most effective therapeutic options available in medicine, endovascular treatment. Imaging plays a major role in the diagnosis of stroke and aids in appropriate therapy selection. Given the rapid accumulation of evidence for patient subgroups and concurrent broadening of therapeutic options and indications, it is important to recognize the benefits of certain imaging technologies for specific situations. An effective imaging protocol should: 1) be fast, 2) easily implementable, 3) produce reliable results, 4) have few contraindications, and 5) be safe, all with the goal of providing the patient the best chance of achieving a favorable outcome. In the following, we provide a review of the currently available imaging technologies, their advantages and disadvantages, as well as an overview of the future of stroke imaging. Finally, we offer a perspective.
Sustainable bioproducts through thermoplastic processing of wheat gluten and its blends
Authors: Guna Vijaykumar , Touchaleaume Francois , Saulnier Benjamin , Grohens Yves , Reddy Narendra
Published: September 2021

Proteins are unique biopolymers extensively used for food and non-food applications. In addition to animal proteins such as poultry feathers that are generated as byproducts, plant proteins such as wheat gluten and soy proteins are also available in large quantities at reasonable cost. Since proteins are inherently non-thermoplastic, they cannot generally be processed by thermal treatments. Further, most proteins do not dissolve in common solvents either. Hence, most of the non-food applications of plant proteins require extensive chemical and physical modifications which increases cost and also reduces the biodegradability of the products developed. However, studies have shown that proteins including wheat gluten and keratin can become thermoplastic under specific conditions, when adequate pressure, heat and moisture are applied. Similarly, proteins can be made thermoplastic after physical or chemical modifications or by using plasticizers and compatibilizers. Based on such modifications, completely biodegradable composites with proteins as matrix and natural fibers as reinforcement and even all protein composites have been developed. Proteins as matrix offer new avenues to obtain sustainable, green composites with unique properties. Wheat gluten is a novel protein that has many distinct properties and characteristic behavior. Wheat gluten has been used for several non-food applications mostly by dissolving and solution casting which is a cumbersome process and restricted to only a few types of materials that can be developed. Alternatively, wheat gluten has been made thermoplastic using chemical, physical modifications or a combination of both. Several organic and inorganic additives, crosslinkers and plasticizers have also been added to ensure thermoplastic processing of wheat gluten and to obtain products with properties suitable for commodity applications. In this review, we discuss the processes and possibility of converting wheat proteins into thermoplastic products and as matrix for composites and the properties and applications of the wheat gluten based thermoplastics.