Potential Factors Research Articles

Antiracist protest in Germany: (mediated) racism experiences and emotions as drivers of mobilization

ABSTRACT While antiracist protest has gained increasing prominence in Europe in recent years, the lack of representative data has so far prevented an assessment of the scope and drivers of antiracist protest outside of the United States. This paper addresses this gap drawing from a unique survey (N = 5003) on racism in Germany. Building upon sociological and social psychological theories of protest, the article explores the scope and role of key demographic, cognitive, and emotional factors for protest practice and protest potential. Our data suggests that antiracist protest is supported by considerable parts of German society and finds that mediated experiences of racism and emotional reactions matter as drivers of mobilization: those with and without a personal experience of racism are more likely to protest if they were told of racist experiences by others. This effect is even more pronounced if participants are emotionally affected by personal and mediated experiences of racism.

Nonlinearity in affect dynamics persists after accounting for the valence of daily-life events.

In recent years, increased attention has gone to studying nonlinear characteristics of affective time series. An example of such nonlinear features is multimodality-the presence of more than one mode in an affective time series-which might mark the presence of discrete-like transitions between one and another affective state. In an attempt to capture these nonlinear features, Loossens et al. (2020) proposed the Affective Ising Model (AIM) as a model of affect dynamics. This model was validated on daily-life data, but these data did not contain any information on potential environmental factors that might have influenced a participant's affective state. Unfortunately, this omission may have led to erroneously concluding that nonlinearity is a defining characteristic of the affective system, even when it is solely driven by extrinsic influences. To accommodate this limitation, we applied the AIM on daily-life data in which the valence of such external events was measured. Overall, we found that nonlinearity persisted after accounting for the valence of daily-life events, suggesting that nonlinearity is a defining characteristic of affect and should thus be accounted for. Interestingly, this effect was more pronounced for composite compared to single-item measures of affect. While in line with previous research, these results should be replicated in a larger, more representative sample. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of Adjuvant Radiotherapy Setting on Quality-of-Life in Head and Neck Squamous Cell Carcinoma.

To determine differences in post-treatment QoL across treatment settings in patients receiving adjuvant radiation therapy for head and neck squamous cell carcinoma (HNSCC). This was a prospective observational cohort study of patients with HNSCC initially evaluated in a head and neck surgical oncologic and reconstructive clinic at an academic medical center (AMC). Participants were enrolled prior to treatment in a prospective registry collecting demographic, social, and clinical data. Physical and social-emotional QoL (phys-QoL and soc-QoL, respectively) was measured using the University of Washington-QoL questionnaire at pre-treatment and post-treatment visits. A cohort of 177 patients, primarily male and White with an average age of 61.2 ± 11.2 years, met inclusion criteria. Most patients presented with oral cavity tumors (n = 132, 74.6%), had non-HPV-mediated disease (n = 97, 61.8%), and were classified as Stage IVa (n = 72, 42.8%). After controlling for covariates, patients treated at community medical centers (CMCs) reported a 7.15-point lower phys-QoL compared with those treated at AMCs (95% CI: -13.96 to -0.35, p = 0.040) up to 12 months post-treatment. Additionally, patients who were treated at CMCs had a 5.77-point (-11.86-0.31, p = 0.063) lower soc-QoL score compared with those treated at an AMC, which was not statistically significant. This study revealed that HNSCC patients treated with radiation at AMCs reported significantly greater phys-QoL in their first-year post-treatment compared to those treated at CMCs, but soc-QoL did not differ significantly. Further observational studies are needed to explore potential factors, including treatment planning and cancer resource engagement, behind disparities between AMCs and CMCs. 3 Laryngoscope, 134:3645-3655, 2024.

Effects of compound emulsifiers on the characteristics and stability of nano-emulsions from pollock bones

To improve the stability of pollock bone broth, compound emulsifiers were employed and evaluated in nano-emulsions from pollock bones (PBNs). The microstructure, creaming index, particle size, zeta potential, and viscosity of PBNs were characterized and the stability of PBNs was investigated. It revealed that the concentration of compound emulsifiers is one of the principal factors for particle size, zeta potential, and viscosity of PBNs, and 0.9% of sodium caseinate and sucrose fatty acid ester (CS-SE) can make the PBN display good stability. Its particle size changed from 81.17 ± 1.33 nm to 19.62 ± 0.21 nm when the temperature ranged from 40 °C to 80 °C, and its creaming index could reach a maximum (90.83%) among all PBNs in 4 months of freeze-thaw assays. PBN stability could be improved by the compound emulsifier (CS-SE), which offers a theoretical basis for the application of pollock bone broth.

PTSD in autistic adults: Correlates of meeting DSM-5 criteria and predictors of professional diagnosis.

Although many autistic adults show high posttraumatic stress, PTSD is underdiagnosed in this population. This study aims to examine correlates of autistic adults screening positive for PTSD (PTSD +) and predictors of a professional PTSD diagnosis (Diagnosis +) in the PTSD + subgroup. Self-identified autistic adults (N = 677) completed an online survey on their demographic characteristics, mental health symptoms, and trauma history. T tests and chi-squares were used to compare subgroups, and logistic regression was used to predict diagnosis status. PTSD + participants were less likely to be employed or to identify as cisgender men, had more mental health symptoms and worse functional impairment, and had experienced a higher number of traumas and more interpersonal trauma. The same was true for Diagnosis + participants, who were also older and more likely to have a marginalized racial/ethnic identity. Among participants who were PTSD +, older age, being a woman or gender minority, being unemployed or on disability, having increased posttraumatic stress, having more co-occurring conditions, and having lower functional impairment predicted being Diagnosis +. The final model explained 35% of variance in diagnosis. PTSD is associated with significant impairment in autistic adults, but it often goes unrecognized. In particular, autistic cisgender men might be underdiagnosed with PTSD because of gendered stereotypes. High functional impairment may also increase barriers to obtaining an appropriate diagnosis. Future research should include participant treatment history as a potential factor. Clinicians should be aware of these potential signs of PTSD and diagnostic barriers when working with autistic clients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Low-carbon development of urban power grids in China: Quality assessment, obstacle analysis, and potential release

Urban power grid planning plays a pivotal role in the process of reducing carbon dioxide emissions from power grids. Traditional grey target models and analytic hierarchy processes fail to reflect the diversity of resource endowments in urban areas and cannot provide targeted solutions for carbon reduction strategies in urban power grids, representing a critical issue that urgently needs addressing. This paper introduces an enhanced grey target model based on the ‘source-grid-load’ system, establishes a quality evaluation index system for low-carbon development, and employs the Analytic Hierarchy Process - entropy weight method to account for the differentiated impacts of urban power grid partition resources. It conducts a comprehensive assessment of overall potential through multi-dimensional relative target centrality and identifies and examines key factors in low-carbon development potential using single-dimensional relative target centrality. The findings indicate that the refined grey target model, focusing on relative target centrality, effectively identifies areas with significant low-carbon development opportunities and assesses their developmental scope across various metrics, thereby providing strategic insights for carbon reduction planning in urban power grids under multi-objective decision-making conditions. This method will decrease CO2 emission by 21.38 % in 2030.

Let's get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Identity concealment thwarts psychological needs of authenticity and belonging, both of which are important for mental health and relationship building. Through the lens of minority stress theory and relational-cultural theory, the present study examined whether identity concealment in the workplace by psychology trainees is indirectly associated with greater burnout and poorer therapeutic relationship quality. To test this hypothesis, a parallel mediation analysis was conducted on data from 335 clinical and counseling psychology doctoral trainees with concealable stigmatized identities using Hayes's (2018) PROCESS macro. As expected, identity concealment at a practicum or internship site was negatively associated with authenticity and belonging, both of which were negatively associated with burnout and positively associated with therapeutic relationship quality. Furthermore, identity concealment was associated with lower therapeutic relationship quality and greater burnout indirectly through lower authenticity and lower belonging. Findings suggest trainees who engage in more identity concealment at their clinical training sites may be at increased risk for burnout and poorer relationships with clients due to limited opportunities for authenticity and belonging. Future research is encouraged to longitudinally examine the impact of identity concealment on professional burnout and relationships, as well as potential protective factors. Such knowledge can support the development of interventions and policies that foster safer, more welcoming work environments for trainees with concealable stigmatized identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Long non-coding RNAs PTENP1, GNG12-AS1, MAGI2-AS3 and MEG3 as tumor suppressors in breast cancer and their associations with clinicopathological parameters.

Breast cancer is the most commonly occurring cancer worldwide and is the main cause of death from cancer in women. Novel biomarkers are highly warranted for this disease. Evaluation of novel long non-coding RNAs biomarkers for breast cancer. The study comprised the analysis of the expression of 71 candidate lncRNAs via screening, six of which (four underexpressed, two overexpressed) were validated and analyzed by qPCR in tumor tissues associated with NST breast carcinomas, compared with the benign samples and with respect to their clinicopathological characteristics. The results indicated the tumor suppressor roles of PTENP1, GNG12-AS1, MEG3 and MAGI2-AS3. Low levels of both PTENP1 and GNG12-AS1 were associated with worsened progression-free and overall survival rates. The reduced expression of GNG12-AS1 was linked to the advanced stage. A higher grade was associated with the lower expression of PTENP1, GNG12-AS1 and MAGI2-AS3. Reduced levels of both MEG3 and PTENP1 were linked to Ki-67 positivity. The NRSN2-AS1 and UCA1 lncRNAs were overexpressed; higher levels of UCA1 were associated with multifocality. The results suggest that the investigated lncRNAs may play important roles in breast cancer and comprise a potential factor that should be further evaluated in clinical studies.

Optimizing erectile function evaluation pattern in postoperative pelvic fracture-urethral injury patients: introducing PFUI pEF PROM.

To establish a psychometric validated pelvic fracture-urethral injury postoperative erectile function patient reported outcome measure (PFUI pEF PROM). We also aim to explore PFUI patients' potential classification and suitable postoperative erectile function assessment pattern. A total of 93 PFUI patients who treated by excisionandprimaryanastomotic (EPA) urethroplasty from January 2020 to August 2022 were enrolled to this study. Patients who had intercourse completed the IIEF-5, those who had sexual stimulation other than intercourse finished PFUI pEF PROM, and those who performed both completed the IIEF-5, and PFUI pEF PROM. Erection Hardness Score (EHS) was completed by all patients. This PROM was performed psychometric validation and used to find PFUI patients potential classification through latent class analysis. Then, we determined the cut-off value though receiver-operating characteristic (ROC) curve and performed univariate analysis subgroups feature. The PFUI pEF PROM demonstrated high reliability and validity with a Cronbach's alpha of 0.928. It correlated significantly with IIEF-5 (r = 0.550, p < 0.001) and EHS (r = 0.909, p < 0.001). The latent class analysis identified three patient subgroups, with 14.5 as the subgroup cut-off value. Urethral stricture length, IIEF-5, and EHS score were identified as influence factors for maximal erection potential. An assessment pattern combining IIEF-5, EHS, and the PFUI pEF PROM covered 92.5% of patients. This PROM effectively addresses the current limitation in assessing erectile function in PFUI patients. This study provides a promising tool for stratified assessment, prediction erection recovery, and treatment guidance in the PFUI Erectile dysfunction field.

Efficacy of intraoperative visual evoked potential amplitude reduction in predicting visual outcome after extended endoscopic endonasal resection of craniopharyngiomas.

Postoperative visual outcome is a major concern of neurosurgeons for patients with craniopharyngiomas. The current study aimed to investigate the value of visual evoked potential (VEP) amplitude reduction (N75-P100 and P100-N145) for predicting postoperative visual dysfunction (POVD) and refining current warning criteria for VEP monitoring. Data from 96 patients who underwent the extended endoscopic endonasal approach for craniopharyngiomas between October 2020 and November 2021 were retrospectively reviewed. VEP amplitude reduction ratios were calculated and compared between patients with POVD and those without. Subsequently, the critical threshold values of VEP amplitude reduction ratios for predicting POVD were obtained through receiver operating characteristic curve analysis. Finally, multivariate binary logistic regression analysis was applied to evaluate the effect of potential factors on the probability of experiencing POVD. Both N75-P100 and P100-N145 amplitude reduction ratios were significantly higher in patients with POVD (p < 0.001 for both). The threshold value of the N75-P100 amplitude reduction ratio for predicting POVD was 51.76% with an area under the curve (AUC) of 0.816 (p < 0.001), while the threshold value of the P100-N145 amplitude reduction ratio was 38.80% with an AUC of 0.738 (p < 0.001). Both N75-P100 and P100-N145 amplitude reduction ratios were identified as independent predictors for POVD via multivariate analysis (p < 0.001 and p = 0.018, respectively). Both N75-P100 and P100-N145 amplitude reduction ratios showed great potential to be indicators for POVD in patients with craniopharyngiomas. Regarding warning criteria for VEP monitoring, the authors recommend that both N75-P100 and P100-N145 amplitude reduction should be considered, with early warning criteria of a 50% reduction for N75-P100 amplitude and/or a 40% reduction for P100-N145 amplitude.

Factors of Job Stress among university teachers in Pakistan A conceptual review

University teaching is universally known for its stressful nature. The university teachers are exposed to various stressors at work as a result of which their working performance is affected. The current study has conceptually reviewed the different factors of Job Stress among university teachers in Pakistan by using non-systematic narrative review technique. Following review of existing literature, the findings of current study revealed nine potential factors as determinants of Job Stress among university teachers in Pakistan. These factors were related to both intra and extra organizational environments of universities in Pakistan. This study concludes that university teaching is a stressful profession in Pakistan. The problem of Job Stress should be managed both at individual and institutional levels. Individually the academic staff members should get awareness about causes and consequences of Job Stress. At institutional level the management of universities should provide Stress free conducive environment, so that university teachers could be saved from the devastating effects of Job Stress.Â

Exploring Physical Educators' Self-Efficacy to Teach Students With Disabilities in General Physical Education.

The purpose of this study was to explore the ways in which in-service physical education teachers construct their self-efficacy beliefs toward teaching students with disabilities in general physical education classes. Using a qualitative descriptive approach situated within self-efficacy theory, data were collected via semistructured audio-recorded interviews with 16 in-service physical educators. Three interrelated themes were constructed: (a)The more I do it, the better I feel: the importance of professional experiences; (b)I've learned from others: the influence of colleagues; and (c)Being in the general educational setting is a challenge: the impact of contextual factors. Findings supported the influence of the four sources of self-efficacy (i.e.,mastery experience, vicarious experience, social persuasion, and affective and physiological state), in addition to potential contextual factors (i.e.,class sizes and availability of hands-on support), impacting participants' self-efficacy to teach students with disabilities in general physical education classes.

Correlations between Visual Temporal Resolution and Individual Alpha Peak Frequency: Evidence that Internal and Measurement Noise Drive Null Findings.

The brain organizes the continuous flow of sensory input by parsing it into discrete events. In the case of two flashes separated by a brief ISI, for example, perception may be of a single flash or two distinct flashes, depending on the ISI but also on the speed of processing. A number of studies have reported evidence that participants with a higher EEG peak alpha frequency are able to detect the presence of two flashes separated by short intervals, whereas those with slower alpha report only one flash. Other studies have not found this correlation. We investigated potential factors that might mask the relationship between individual alpha frequency and visual perception. We recorded resting-state EEG from a large sample of participants (n = 50) and measured the temporal resolution of visual perception with the two-flash fusion task. We found that individual alpha frequency over posterior channels predicted the two-flash fusion threshold, in line with previous studies, but this correlation was significant only when taking into account the steepness of the psychophysical curve of the two-flash task. Participants with a relatively shallow psychophysical curve, likely reflecting high sensory and/or decision noise, failed to show this relationship. These findings replicate previous reports of a correlation between alpha frequency and visual temporal resolution, while also suggesting that an explanation of two-flash fusion performance that neglects the role of internal noise might be insufficient to account for all individual differences.

TIM3 and CTLA4 immune checkpoint polymorphisms are associated with acute myeloid leukemia in Saudi Arabia

ABSTRACT Background Immune checkpoints are receptors on the surface of T cells that function crucially in suppressing the immune response, and they are implicated in autoimmunity and cancer diseases. Aim The present study aimed to investigate the relationship between functional single nucleotide polymorphisms (SNPs) of two immune checkpoint molecules, CTLA-4 and TIM-3, and acute myeloid leukemia (AML) in a Saudi population. Methods Two SNPs in CTLA-4 (rs231775, A > G) and TIM-3 (rs10515746, A > C) were genotyped in 229 subjects, including 98 patients and 131 healthy controls, from the Saudi population using TaqMan assay methods. Differential expression of these two genes was performed using in silico analysis. Results An association was found between polymorphisms in TIM-3 (OR: 6.01; 95% CI: 3.99–9.05, P < 0.0001) and the risk of AML. Inversely, the rs231775 SNP in the CTLA-4 gene was found to protect against AML in allelic, dominant, and additive models (P < 0.05). A significantly higher expression of TIM-3 in the blood of individuals with AML was observed. Conclusion This is the first study focusing on single nucleotide polymorphisms (SNPs) for CTLA-4 and TIM-3 in acute myeloid leukemia patients in a Saudi community and could be a potential new prognostic factor for this disease.

Impacts of cross‐border equity portfolio flow and central bank transparency on financial development: The role of economic freedom and international bonds

AbstractWe investigate the effects of international equity portfolio diversification and central bank independence on financial development using panel data from 49 countries from 2001 to 2016. We find that international equity portfolio diversification improves financial development. We correspondingly examine potential factors through which international equity portfolio diversification may impact financial development and find that central bank transparency provides an important channel for improving financial development. We further find that the relationship between international equity portfolio diversification and financial development is sensitive to economic freedom. Concerning sequencing, we find that foreign equity and debt flow are complementary to financial system development. Our results are robust to endogeneity using the exogenous shock of the 2008 financial crisis. This study offers new empirical evidence on the relationship between international capital and financial development.

Towards healthy cities: Modeling restorative potential of urban environments by coupling LiDAR-derived 3D metrics with panorama-based online survey

With the growing concern for the psychological well-being of urban dwellers, there has been a recognized need to explore the role of green environments in facilitating mental restorative benefits from the demands of city life. However, a significant gap exists in quantitatively modeling the restorative potential of urban environments, especially in terms of comprehensive 3D characteristics beyond mere greenery. This research gap has hindered our understanding of how to plan and design urban spaces that promote mental health. To bridge this gap, we conducted a study using Singapore as a case study to model the restorative potential for landscape planning and design by integrating LiDAR-derived 3D metrics, outcomes of an online survey, and a machine learning-based regularized regression model. We first collected data from 100 scenes, including both residential neighborhoods and urban parks, by extracting point cloud information from LiDAR scans for calculating a diverse set of 41 3D spatial metrics. Alongside these objective measurements, we conducted an online survey (N = 1500) using the Perceived Restorativeness Scale (PRS) where respondents evaluated the restorative potential of these scenes presented as interactive panoramic images. We subsequently utilized a regularized regression technique based on machine learning by conducting K-fold cross-validation (K = 10) with 1251 tests to identify the feature metrics significantly contributing to restorative potential. Our findings highlighted the importance of the green volumetric ratio as the most significant positive factor for restorative potential. Additionally, the results on the metrics of grey horizontal diversity and grey cluster number indicated a positive impact of unregulated and unaggregated grey components on restorative potential. The results on green horizontal diversity suggested that a uniform and concentrated spatial arrangement of greenery is a positive predictor, while other factors like front-background ratio, colorfulness, and slope variation also positively influenced restorative potential. In essence, our study not only provides novel insights but also introduces innovative methods for quantitatively assessing and characterizing the quality of urban environments that enhance psychological well-being. These findings inform the practical planning and design strategies aimed at fostering healthy and sustainable urban spaces.

Musculoskeletal and tendinous details of selected anomalies in the locomotor system of anurans.

Previous studies on anuran anomalies predominantly examine isolated cases or focus on external and skeletal features. Our study analyzes a comprehensive sample collected from 1991 to 2017, examining the muscle-tendon system in 24 anuran species across adult, juvenile, and metamorphic stages. This extensive sample size allows us to investigate consistent anomaly patterns across different developmental stages and anuran families, exploring potential common developmental or genetic factors. Our detailed anatomical examination, encompassing musculature, tendons, and skeletal structures, revealed that 21% of the specimens displayed anomalies, a noteworthy finding considering the extensive sample size and duration of the studied sample. Of these anomalies, 17% affected the locomotor system, predominantly in the upper limbs. Key anomalies included, forelimbs and hindlimbs brachydactyly, rotation in forelimbs, partial kyphotic lordosis, and scoliosis. Notably, the digit 4 in the forelimbs and digits 4 and 5 in the hindlimbs were particularly susceptible to teratogenic effects, indicating possible prolonged exposure during development. Our study also uncovered combinations of anomalies and identified a phenotype similar to Poland syndrome. The findings validate the "Logic of Monsters" (LoMo theory) by Alberch, although the name itself may not be deemed appropriate, showing that developmental disruptions in tetrapods are not random but follow distinct sequences and patterns. The name, while unfortunate, accurately reflects the unusual nature of these developmental anomalies. This contributes to the evolving "Evo-Devo-Path" framework, highlighting the study's importance in understanding developmental disruptions in tetrapods.

Characterization of cell cycle, inflammation, and oxidative stress signaling role in non-communicable diseases: Insights into genetic variants, microRNAs and pathways

Non-Communicable Diseases (NCDs) significantly impact global health, contributing to over 70% of premature deaths, as reported by the World Health Organization (WHO). These diseases have complex and multifactorial origins, involving genetic, epigenetic, environmental and lifestyle factors. While Genome-Wide Association Study (GWAS) is widely recognized as a valuable tool for identifying variants associated with complex phenotypes; the multifactorial nature of NCDs necessitates a more comprehensive exploration, encompassing not only the genetic but also the epigenetic aspect. For this purpose, we employed a bioinformatics-multiomics approach to examine the genetic and epigenetic characteristics of NCDs (i.e. colorectal cancer, coronary atherosclerosis, squamous cell lung cancer, psoriasis, type 2 diabetes, and multiple sclerosis), aiming to identify novel biomarkers for diagnosis and prognosis. Leveraging GWAS summary statistics, we pinpointed Single Nucleotide Polymorphisms (SNPs) independently associated with each NCD. Subsequently, we identified genes linked to cell cycle, inflammation and oxidative stress mechanisms, revealing shared genes across multiple diseases, suggesting common functional pathways. From an epigenetic perspective, we identified microRNAs (miRNAs) with regulatory functions targeting these genes of interest. Our findings underscore critical genetic pathways implicated in these diseases. In colorectal cancer, the dysregulation of the “Cytokine Signaling in Immune System” pathway, involving LAMA5 and SMAD7, regulated by Hsa-miR-21-5p, Hsa-miR-103a-3p, and Hsa-miR-195-5p, emerged as pivotal. In coronary atherosclerosis, the pathway associated with “binding of TCF/LEF:CTNNB1 to target gene promoters” displayed noteworthy implications, with the MYC factor controlled by Hsa-miR-16-5p as a potential regulatory factor. Squamous cell lung carcinoma analysis revealed significant pathways such as “PTK6 promotes HIF1A stabilization,” regulated by Hsa-let-7b-5p. In psoriasis, the “Endosomal/Vacuolar pathway,” involving HLA-C and Hsa-miR-148a-3p and Hsa-miR-148b-3p, was identified as crucial. Type 2 Diabetes implicated the “Regulation of TP53 Expression” pathway, controlled by Hsa-miR-106a-5p and Hsa-miR-106b-5p. In conclusion, our study elucidates the genetic framework and molecular mechanisms underlying NCDs, offering crucial insights into potential genetic/epigenetic biomarkers for diagnosis and prognosis. The specificity of pathways and related miRNAs in different pathologies highlights promising candidates for further clinical validation, with the potential to advance personalized treatments and alleviate the global burden of NCDs.

Treatment of extramammary Paget's disease with imiquimod in a real-life setting: a multicenter retrospective analysis in Spain.

Topical imiquimod has shown to be an effective treatment for EMPD, although available evidence supporting its use is based on case reports and small series of patients. To investigate the therapeutic outcomes and analyze potential clinico-pathological factors associated with imiquimod response in a large cohort of EMPD patients. Retrospective chart review of 125 EMPD patients treated with imiquimod at 20 Spanish tertiary-care hospitals. During the study period, patients received 134 treatment regimens with imiquimod, with 70 (52.2%) cases achieving complete response (CR), 41 (30.6%) partial response and 23 (17.2%) no response. The cumulative CR rates at 24 and 48 weeks of treatment were 46.3% and 71.8%, respectively, without significant differences between first-time and previously treated EMPD. Larger lesions (≥6 cm; p = 0.038) and EMPD affecting >1 anatomical site (p = 0.002) were significantly associated with a worse treatment response. However, the CR rate did not differ significantly by the number of treatment applications (≤4 vs. > 4 times/week; p = 0.112). Among patients who achieved CR, 30 (42.9%) developed local recurrences during a mean follow-up period of 36 months, with an estimated 3 and 5-year recurrence free-survival of 55.7% and 36.4%, respectively. Imiquimod appears as an effective therapeutic alternative for both first-line and previously treated EMPD lesions. However, a less favorable therapeutic response could be expected in larger lesions and those affecting >1 anatomical site. Based on our results, a 3-4 times weekly regimen of imiquimod with a treatment duration of at least 6 months could be considered an appropriate therapeutic strategy for EMPD patients.

Impact of Renal Congestion in Patients With Secondary Mitral Regurgitation After Mitral Transcatheter Edge-to-Edge Repair.

Renal congestion is a potential prognostic factor in patients with heart failure and recently, assessment has become possible with intrarenal Doppler ultrasonography (IRD). The association between renal congestion assessed by IRD and outcomes after mitral transcatheter edge-to-edge repair (TEER) is unknown, so we aimed to clarify renal congestion and its prognostic implications in patients with mitral regurgitation (MR) who underwent TEER using MitraClip system.Methods and Results: Patients with secondary MR who underwent TEER and were assessed for intrarenal venous flow (IRVF) by IRD were classified according to their IRVF pattern as continuous or discontinuous. Of the 105 patients included, 78 patients (74%) formed the continuous group and 27 (26%) were the discontinuous group. Kaplan-Meier analysis revealed significant prognostic power of the IRVF pattern for predicting the composite outcome of all-cause death and heart failure rehospitalization (log-rank P=0.0257). On multivariate Cox regression analysis, the composite endpoint was independently associated with the discontinuous IRVF pattern (hazard ratio, 3.240; 95% confidence interval, 1.300-8.076; P=0.012) adjusted using inverse probability of treatment weighting. IRVF patterns strongly correlated with clinical outcomes without changes in renal function. Thus, they may be useful for risk stratification after mitral TEER for patients with secondary MR.