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Abstract Background and Aims Although the classification of secondary tricuspid regurgitation (STR) by atrial or ventricular aetiology (A-STR or V-STR) carries prognostic importance, the confounding effects of New York Heart Association (NYHA) class have not yet been elucidated. We aimed to correlate STR and NYHA classification with patient outcomes. Methods We studied 281 patients with severe STR who presented to 16 French hospitals between 2017 and 2019. Patients were separated into A-STR and V-STR categories using echocardiographic criteria (A-STR = tricuspid tenting height ≤10 mm, right mid-ventricular diameter ≤38 mm, and LVEF ≥ 50%). We tracked time to cardiovascular disease-related hospitalization or death, whichever came first. Results Of the patients 91/281 (32.7%) had A-STR, 164/281 (58.4%) had mixed/V-STR, and 25/281 (8.9%) could not be classified. Baseline age, labs, comorbidities and NYHA category (Class I–II = mildly symptomatic, Class III–IV = very symptomatic) did not differ between groups (P > 0.05). Although there were no differences in event-free survival among groups (70.7% vs. 65.9%, P = 0.59), this was confounded by NYHA class (P = 0.0104). Thus, among mildly symptomatic patients, estimated 5 year event-free survival was 76.4% in the A-STR group and 53.2% in the mixed/V-STR group (P < 0.05). Among very symptomatic patients, there was no difference in estimated event-free survival (39.4% vs. 17.2%, P > 0.05). Conclusions Though A-STR carries a more favourable prognosis in mildly symptomatic patients, this distinction is irrelevant in patients with advanced disease. Thus, the value of tricuspid valve intervention may become ‘too little, too late’ if A-STR is not promptly addressed. Atrial TR as more favourable prognosis except in advanced patients.

Art critic Jerry Saltz is regarded as a pioneer of online art criticism by the mainstream press, yet the Internet has been used as a platform for art discussion for over 30 years. There have been studies of independent print-based arts publishing, online art production and electronic literature, but there have been no histories of online art criticism. In this article, the author provides an account of the first wave of online art criticism (1980–1995) to document this history and prepare the way for thorough evaluations of the changing form of art criticism after the Internet.

This dissertation focuses on the ways that grassroots activists and urban gardeners in three United States cities have advocated for and organized the cultivation of urban land over the last half century. Since the 1970s, organized gardening activities have been sustained in many large cities across North America and beyond. However, community gardens continue to be viewed as temporary land uses in almost every case. Drawing on 55 interviews and thousands of pages of historical documents, I demonstrate how urban agriculture has come to be seen as a legitimate long-term land use in Milwaukee, Philadelphia, and Seattle in different ways that relate to key organizational decisions as well as to the local culture, economic conditions, and policy context. Comparing the cities’ cultural contexts, I highlight the importance of local civic conventions for organizational advocacy and social movement organizing by illustrating how civic conventions in the form of policy infrastructure have created important leverage points and interfaces between community-based organizations and the local government, while civic conventions in the form of widely shared ideas have been important to movement formation and mobilization. Comparing the political-economic conditions of each city, such as the availability of public resources and policy at larger scales of government, I demonstrate how the evolving role of gardens in the urban milieu has interacted with distinct growth strategies and political processes at work in each locale. In all three cities, the main garden organizations came to emphasize an economic framing—employment in Milwaukee, blight removal in Philadelphia, and neighborhood amenity creation in Seattle. I show how the different organizations’ economic frames have succeeded to varying degrees in convincing city officials that garden sites deserve long-term land access, funding, and other forms of public support. Even though all three frames have been effective in lengthening land tenure, however, economically focused arguments cohere with processes perpetuating inequality in urban environments, which has set the stage for present and future conflicts. Building on my qualitative historical analysis, I use a unique longitudinal dataset of organization-affiliated gardens to demonstrate how the different priorities emphasized by each city’s main garden organization are reflected in the changing locations of their gardens over time. I show how across the cases, specific sustained organizational priorities are connected to different outcomes in the proximity of gardens to low-income residents, immigrants, and people of color. As cities become increasingly important sites of contestation over governance and resource allocation in the 21st century, understanding how community-based organizations such as urban agriculture organizations interact with local government is critical—not only how these organizations secure resources from public sources, but also how they win policy victories in the face of elite opposition. In developing and defending community gardens, the urban agriculture organizations that are the focus of this dissertation provide instructive cases for understanding both the constraints imposed by organizational environments and the potential power that everyday people have to reshape land use patterns and urban systems.

The author develops a theory showing how archival technicity impacts art historical thinking. She describes an example of a web-based art critcal/contextual platform and indicates the prevalent theme of performativity in art history as per today's web-based archival imperative.

Ko fiAnnan is ringing the alarm bells about the rich world's lack of action for Africa. He reports feeble progress in meeting Gleneagles aid commitments (In 2005, G8 pledged $50bn for Africa. Now the reality, April 25).

Assessment of diet in large epidemiological studies can be costly and time consuming. An automated dietary assessment system could potentially reduce researcher burden by automatically coding food records. myfood24 (Measure Your Food on One Day) an online 24-h dietary assessment tool (with the flexibility to be used for multiple 24 h-dietary recalls or as a food diary), has been developed for use in the UK population. Development of myfood24 was a multi-stage process. Focus groups conducted with three age groups, adolescents (11–18 years) (n = 28), adults (19–64 years) (n = 24) and older adults (≥65 years) (n = 5) informed the development of the tool, and usability testing was conducted with beta (adolescents n = 14, adults n = 8, older adults n = 1) and live (adolescents n = 70, adults n = 20, older adults n = 4) versions. Median system usability scale (SUS) scores (measured on a scale of 0–100) in adolescents and adults were marginal for the beta version (adolescents median SUS = 66, interquartile range (IQR) = 20; adults median SUS = 68, IQR = 40) and good for the live version (adolescents median SUS = 73, IQR = 22; adults median SUS = 80, IQR = 25). Myfood24 is the first online 24-h dietary recall tool for use with different age groups in the UK. Usability testing indicates that myfood24 is suitable for use in UK adolescents and adults.

Abstract Context The clinical phenotype of multiple endocrine neoplasia type 4 (MEN4) is undefined due to a limited number of published cases. Knowledge on disease manifestation in MEN4 is essential for developing prevention programs and treatment. Objective To expand current knowledge of the MEN4 phenotype including assessment of penetrance. Design This is a case report and a brief review of previously published MEN4 cases. Patients We report a large Danish family with multiple cases of endocrine tumors that segregated with a pathogenic variant in the CDKN1B gene. Main Outcome/Result The medical history of the proband included primary hyperparathyroidism and Cushing disease. Genetic analysis identified a pathogenic variant in CDKN1B (c.121_122delTT, p.Leu41Asnfs*83). Among the family members, another 12 individuals were identified as carriers of the same variant, which segregated with development of endocrine tumors. Hypercalcemia due to primary hyperparathyroidism occurred in all 13 of the available carriers of the genetic variant, and 4 patients also had functioning or nonfunctioning pituitary adenomas, whereas 1 patient had a metastatic neuroendocrine tumor (carcinoid). Loss-of-heterozygosity was detected in two of five parathyroid adenomas, supporting that CDKN1B acts as a tumor suppressor gene. Thirty cases representing 16 different CDKN1B variants have previously been reported, and these cases presented primarily with primary hyperparathyroidism and functioning and nonfunctioning pituitary tumors. Conclusion Hypercalcemia due to primary hyperparathyroidism and pituitary tumors are common in MEN4. Gastrointestinal neuroendocrine tumors appear to be less prevalent in MEN4 than in MEN1. This study shows the clinical phenotype of a pathogenic variant that associates with MEN4 and provides an overview of previous MEN4 cases.

OBJECTIVES: The growing care demands of an aging population and a smaller workforce is a big societal problem. Therefore, knowledge on how to organize eldercare work without hampering workers` health is needed. We aimed to investigate if workers` daily number of residents cared for over 14 months is associated with low-back pain in eldercare workers. METHODS: We included 513 eldercare workers from 122 wards. In each ward, we gathered quarterly data over 14 months on the number of residents, workers, and work schedules and calculated the daily numbers of residents each worker cared for. Workers reported intensity and days with low-back pain via monthly text messages over 14 months. Using generalized linear mixed models adjusted for confounders, we investigated the association between the number of residents workers cared for daily and low-back pain among those workers. RESULTS: In 3-month periods over 14 months, caring for ≥1 resident per day was associated with a 4% [95% confidence interval (CI) 1.02–1.07] increased risk of more days with low-back pain, and a 2% (95% CI 1.00–1.03) increase in low-back pain intensity among workers. CONCLUSIONS: Eldercare workers are at a higher risk of experiencing low-back pain during periods when they care for a greater number of residents each day. Maintaining a consistent number of residents and workload for workers over a 14-month period could serve as an effective organizational strategy to prevent low-back pain.