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Impact of anaemia and iron deficiency on outcomes in cardiogenic shock complicating acute myocardial infarction
No full textAims
Anaemia and iron deficiency (ID) are common comorbidities in cardiovascular patients and are associated with a poor clinical status, as well as a worse outcome in patients with heart failure and acute myocardial infarction (AMI). Nevertheless, data concerning the impact of anaemia and ID on clinical outcomes in patients with cardiogenic shock (CS) are scarce. This study aimed to assess the impact of anaemia and ID on clinical outcomes in patients with CS complicating AMI.
Methods and results
The presence of anaemia (haemoglobin <13 g/dl in men and <12 g/dl in women) or ID (ferritin <100 ng/ml or transferrin saturation <20%) was determined in patients with CS due to AMI from the CULPRIT-SHOCK trial. Blood samples were collected in the catheterization laboratory during initial percutaneous coronary intervention. Clinical outcomes were compared in four groups of patients having neither anaemia nor ID, against patients with anaemia with or without ID and patients with ID only. A total of 427 CS patients were included in this analysis. Anaemia without ID was diagnosed in 93 (21.7%), anaemia with ID in 54 study participants (12.6%), ID without anaemia in 72 patients (16.8%), whereas in 208 patients neither anaemia nor ID was present (48.9%). CS patients with anaemia without ID were older (73 ± 10 years, p = 0.001), had more frequently a history of arterial hypertension (72.8%, p = 0.01), diabetes mellitus (47.8%, p = 0.001), as well as chronic kidney disease (14.1%, p = 0.004) compared to CS patients in other groups. Anaemic CS patients without ID presence were at higher risk to develop a composite from all-cause death or renal replacement therapy at 30-day follow-up (odds ratio [OR] 3.83, 95% confidence interval [CI] 2.23–6.62, p < 0.001) than CS patients without anaemia/ID. The presence of ID in CS patients, with and without concomitant anaemia, did not increase the risk for the primary outcome (OR 1.17, 95% CI 0.64–2.13, p = 0.64; and OR 1.01, 95% CI 0.59–1.73, p = 0.54; respectively) within 30 days of follow-up. In time-to-event Kaplan–Meier analysis, anaemic CS patients without ID had a significantly higher hazard ratio (HR) for the primary outcome (HR 2.11, 95% CI 1.52–2.89, p < 0.001), as well as for death from any cause (HR 1.90, 95% CI 1.36–2.65, p < 0.001) and renal replacement therapy during 30-day follow-up (HR 2.99, 95% CI 1.69–5.31, p < 0.001).
Conclusion
Concomitant anaemia without ID presence in patients with CS at hospital presentation is associated with higher risk for death from any cause or renal replacement therapy and the individual components of this composite endpoint within 30 days after hospitalization. ID has no relevant impact on clinical outcomes in patients with CS.
Graphical Abstract
Impact of anaemia and iron deficiency on outcomes in cardiogenic shock due to acute myocardial infarction. CI, confidence interval; CS, cardiogenic shock; Hb, haemoglobin; HR, hazard ratio; ID, iron deficiency
Rapid in situ diversification rates in Rhamnaceae explain the parallel evolution of high diversity in temperate biomes from global to local scales
No full textThe macroevolutionary processes that have shaped biodiversity across the temperate realm remain poorly understood and may have resulted from evolutionary dynamics related to diversification rates, dispersal rates, and colonization times, closely coupled with Cenozoic climate change.
We integrated phylogenomic, environmental ordination, and macroevolutionary analyses for the cosmopolitan angiosperm family Rhamnaceae to disentangle the evolutionary processes that have contributed to high species diversity within and across temperate biomes.
Our results show independent colonization of environmentally similar but geographically separated temperate regions mainly during the Oligocene, consistent with the global expansion of temperate biomes. High global, regional, and local temperate diversity was the result of high in situ diversification rates, rather than high immigration rates or accumulation time, except for Southern China, which was colonized much earlier than the other regions. The relatively common lineage dispersals out of temperate hotspots highlight strong source-sink dynamics across the cosmopolitan distribution of Rhamnaceae.
The proliferation of temperate environments since the Oligocene may have provided the ecological opportunity for rapid in situ diversification of Rhamnaceae across the temperate realm. Our study illustrates the importance of high in situ diversification rates for the establishment of modern temperate biomes and biodiversity hotspots across spatial scales
Reminders of an agentic ingroup buffer disease uncontrollability
No full textChronic illness has negative impacts beyond those on physical health. In particular, because it is often experienced as uncontrollable, chronic illness might reduce people's general sense of personal control and, subsequently, personal well-being. Drawing on recent theory and research, we proposed and tested in four experiments (Ntotal = 1323) a potential buffer to these negative effects: thinking about an agentic social ingroup in one's life. In Study 1, patients suffering from a chronic illness that was either high or low in medical disease controllability were asked either to think about an agentic ingroup or a personal issue. Low perceived disease-related control was associated with low perceived personal control only when participants' personal self, but not when their ingroup, was salient. In three follow-up vignette studies, we asked participants to take the perspective of a person who suffered from a health problem of low medical disease controllability and attended a self-help group that was described as either high or low in agency. The findings supported the predicted buffering effect: participants who reflected on a target suffering from a low control disease thought that the target would experience more personal control when the agentic (vs. the nonagentic) self-help group was salient. These findings suggest ingroups can serve as a source of personal control in the context of health-related threats to the extent that they are perceived as agentic. Thus, focusing on agentic properties of (health-related) ingroups might be a promising novel strategy when designing effective group-based interventions to cope with chronic illness
Plant diversity and soil legacy independently affect the plant metabolome and induced responses following herbivory
No full textPlant and soil biodiversity can have significant effects on herbivore resistance
mediated by plant metabolites. Here, we disentangled the independent effects of plant
diversity and soil legacy on constitutive and herbivore-induced plant metabolomes
of three plant species in two complementary microcosm experiments. First, we
grew plants in sterile soil with three different plant diversity levels. Second, single
plant species were grown on soil with different plant diversity-induced soil legacies.
We infested a subset of all plants with Spodoptera exigua larvae, a generalist leaf-
chewing herbivore, and assessed foliar and root metabolomes. Neither plant diversity
nor soil legacy had significant effects on overall foliar, root, or herbivore-induced
metabolome composition. Herbivore-induced metabolomes, however, differed
from those of control plants. We detected 139 significantly regulated metabolites
by comparing plants grown in monocultures with conspecifics growing in plant or
soil legacy mixtures. Moreover, plant–plant and plant–soil interactions regulated
141 metabolites in herbivore-induced plants. Taken together, plant diversity and soil
legacy independently alter the concentration and induction of plant metabolites, thus
affecting the plant's defensive capability. This is a first step toward disentangling
plant and soil biodiversity effects on herbivore resistance, thereby improving our
understanding of the mechanisms that govern ecosystem functioning
Platformization as a Structural Dimension for Public Service Media in Germany: The funk Content Network and the New Interstate Media Treaty
No full textAs social media is constantly gaining in importance, public service media (PSM) is forced to create content that fits the environment of social media platforms (SMPs). In Germany, the content network funk by the ARD and ZDF represents a change in the thinking of PSM and policy makers. Since platformization affects PSM institutionally and structurally, German media regulators are addressing platformization in the context of the new Interstate Media Treaty. The article aims to discuss the treaty’s orientation toward digital platforms and SMPs as it attempts to subject them to the control of local state media authorities. Algorithms and data-driven content curation are policed in terms of transparency and non-discrimination, and to ensure that public value content is not marginalized. To enforce this, I would argue, the treaty has to acknowledge the importance of platformization as a structural prerequisite that enables PSM to serve its public demand
Prevalence of TERT Promoter Mutations in Orbital Solitary Fibrous Tumors
No full textThe orbital manifestation of a solitary fibrous tumor (SFT) is exceptionally rare and poses
specific challenges in diagnosis and treatment. Its rather exceptional behavior among all SFTs
comprises a high tendency towards local recurrence, but it rarely culminates in metastatic disease.
This raises the question of prognostic factors in orbital SFTs (oSFTs). Telomerase reverse transcriptase
(TERT)-promoter mutations have previously been linked to an unfavorable prognosis in SFTs of
other locations. We analyzed the prevalence of TERT promoter mutations of SFTs in the orbital
compartment. We performed a retrospective, descriptive clinico-histopathological analysis of nine
cases of oSFTs between the years of 2017 and 2021. A TERT promoter mutation was present in one
case, which was classified with intermediate metastatic risk. Local recurrence or progress occurred
in six cases after primary resection; no distant metastases were reported. Multimodal imaging
repeatedly showed particular morphologic patterns, including tubular vascular structures and ADC
reduction. The prevalence of the TERT promoter mutation in oSFT was 11%, which is similar to the
prevalence of extra-meningeal SFTs of the head and neck and lower than that in other extra-meningeal
compartments. In the present study, the TERT promoter mutation in oSFT manifested in a case with
an unfavorable prognosis, comprising aggressive local tumor growth, local recurrence, and eye loss
Synthesis, Structure and Magnetic Properties of Some Copper(II) Complexes Supported by Pendant Calix[4]arene Ligands
No full textThe synthesis and characterization of three new calix[4]arene ligands bearing two pendant acylhydrazone arms and some of their Cu2+ complexes, namely [Cu(L1-2H)(MeOH)] (3), [Cu(L1’-H)(Cl)(2-hydroxy-1-naphthaldehyde)] (4), [Cu2(L2-2H)2] (5) and [Cu4(L3-2H)2(OH)2(ClO4)2] (6) are described. The ligands are obtained by simple imine condensation reactions between calix[4]arene-1,3-bis-acyl-hydrazides and the corresponding carbaldehydes. The Cu2+ ions are always situated in 5-membered chelate rings, either in a deprotonated −O−CR=N−N=CHR (enolate) or a neutral O=CR−NH−N=CHR (keto) form. In 3 and 4 a 5-membered chelate ring is formed through interaction of the Cu2+ ion with the naphtholato group. Additional MeOH, chlorido or naphthaldehyde ligands complete the planar (3) or square pyramidal (4) coordination spheres. The thiophenes in 5 do not interact with the Cu2+ ions and dimerization of [CuL] entities occurs to produce centrosymmetric 2 : 2 complexes with four-coordinated Cu2+ ions. In 6, two dinuclear [Cu2(L3-2H)(OH)] subunits are connected by μ1,3-bridging ClO4− ions. The magnetic properties of polycrystalline samples of 5 and 6 were studied by variable temperature magnetic susceptibility measurements. The χ′′(T) vs T plots indicate antiferromagnetic exchange interactions. The exchange interactions in 6 (J=−4.8 cm−1) were found to be stronger than in 5 (J=−0.54 cm−1). This is also supported by broken symmetry DFT calculations
Socioeconomic Downward Mobility and Support for the AfD in Germany - An Empirical Analysis
No full textThe Causal Cookbook: Recipes for Propensity Scores, G-Computation, and Doubly Robust Standardization
No full textRecent developments in the causal-inference literature have renewed psychologists’ interest in how to improve causal conclusions based on observational data. A lot of the recent writing has focused on concerns of causal identification (under which conditions is it, in principle, possible to recover causal effects?); in this primer, we turn to causal estimation (how do researchers actually turn the data into an effect estimate?) and modern approaches to it that are commonly used in epidemiology. First, we explain how causal estimands can be defined rigorously with the help of the potential-outcomes framework, and we highlight four crucial assumptions necessary for causal inference to succeed (exchangeability, positivity, consistency, and noninterference). Next, we present three types of approaches to causal estimation and compare their strengths and weaknesses: propensity-score methods (in which the independent variable is modeled as a function of controls), g-computation methods (in which the dependent variable is modeled as a function of both controls and the independent variable), and doubly robust estimators (which combine models for both independent and dependent variables). A companion R Notebook is available at github.com/ArthurChatton/CausalCookbook. We hope that this nontechnical introduction not only helps psychologists and other social scientists expand their causal toolbox but also facilitates communication across disciplinary boundaries when it comes to causal inference, a research goal common to all fields of research
The cumulative niche approach: A framework to assess the performance of ecological niche model projections
No full textEcological Niche Models (ENMs) are often used to project species distributions within alien ranges and in future climatic scenarios. However, ENMs depend on species-environment equilibrium, which may be absent for actively expanding species. We present a novel framework to estimate whether species have reached environmental equilibrium in their native and alien ranges. The method is based on the estimation of niche breadth with the accumulation of species occurrences. An asymptote will indicate exhaustive knowledge of the realised niches. We demonstrate the CNA framework for 26 species of mammals, amphibians, and birds. Possible outcomes of the framework include: (1) There is enough data to quantify the native and alien realised niches, allowing us to calculate niche expansion between the native and alien ranges, also indicating that ENMs can be reliably projected to new environmental conditions. (2) The data in the native range is not adequate but an asymptote is reached in the alien realised niche, indicating low confidence in our ability to evaluate niche expansion in the alien range but high confidence in model projections to new environmental conditions within the alien range. (3) There is enough data to quantify the native realised niche, but not enough knowledge about the alien realised niche, hindering the reliability of projections beyond sampled conditions. (4) Both the native and alien ranges do not reach an asymptote, and thus few robust conclusions about the species’ niche or future projections can be made. Our framework can be used to detect species’ environmental equilibrium in both the native and alien ranges, to quantify changes in the realised niche during the invasion processes, and to estimate the likely accuracy of model projections to new environmental conditions