Group-Based Trajectory Modeling A Retrospective Study To Assess Adherence To Direct Oral Anticoagulants or Warfarin Among Atrial Fibrillation Patients and Comorbid Hypertension, Diabetes Mellitus, and Hyperlipidemia: A Retrospective Study.

Background Poor adherence to oral anticoagulants is a significant problem in atrial fibrillation (AF), especially among patients with comorbid hypertension (HTN), diabetes mellitus (DM), and hyperlipidemia as it increases the risk for cardiac and thromboembolic events. Group-based trajectory modeling (GBTM) has been used to depict longitudinal patterns of adherence. Aim This primary objective was to describe adherence trajectory patterns of direct oral anticoagulants (DOACs) or warfarin among AF patients with HTN, DM, and hyperlipidemia using GBTM. The secondary objective was to report the clinical outcomes and concomitant drug use among DOAC/warfarin cohort Method This retrospective study was conducted among continuously enrolled Medicare Advantage Plan from January 2016-December 2019. AF patients were included in this study if they had comorbid HTN, DM, and hyperlipidemia with at least one pharmacy claim for warfarin/DOAC prescription. Monthly adherence to DOAC/warfarin was measured using proportion of days covered (PDC) and then modeled in a logistic GBTM to describe patterns of adherence. Patient’s demographic, clinical characteristics, and concomitant use of DOACs/warfarin with CYP3A4,P-gp inhibitors were measured and compared across trajectories. Results Among 317 patients, 137 (59.62%) and 79 (24.92%) were DOAC, and warfarin users, respectively. The trajectory model for DOACs included gradual decline in adherence (GD, 40.4%), adherent (38.8%), and rapid decline (RD, 20.8%). The trajectories for warfarin adherence included gradual decline (GD, 18.9%), adherence (59.4%), and gaps in adherence (GA, 21.7%). Conclusion Adherence to oral anticoagulants is suboptimal. Interventions tailored according to past adherence trajectories may be effective in improving patient’s adherence.

HOMEOSTASIS AND COMPENSATION AS LINGUISTIC PHENOMENA (COMPETITION OF ASPECT AND TENSE ON THE EXAMPLE OF SLAVIC LANGUAGES WITH SPECIAL REGARD TO POLISH)

The present paper deals with two universal linguistic phenomena, homeostasis and compensation. The author examines their function in relation to two categories, aspect and tense in the history of the Slavic languages. It is beyond doubt that one of the most important categories of the Slavic verb is aspect the origin of which may lie in the Proto-Indo-European language. The effects of its emergence as a verbal category were far-reaching and can be well traced in the history of the most Slavic languages. Taking a close look to the linguistic data, it seems quite obvious that the category of tense and aspect were closely related and did interact, creating different patterns in modern Slavic languages. A certain competition between the category of aspect and that of tense can already be observed in Old Slavic and also in Old Russian and Old Polish where tenses like the aorist and the imperfect were becoming increasingly obsolete. The perfect, on the contrary, has gained ground, while the pluperfect has almost completely fallen into disuse. In the further development, the aspectual opposition also extended to the future tenses thereby affecting the entire tense system. This scenario took place everywhere in the East and West Slavic languages with some nuanced differences. Consequently, in the aspect-tense system of the modern East and West Slavic languages the tendency of the category of aspect to prevail over the category of tense together with the gradual decline in the number of tenses seems to be quite clear. The South Slavic languages, however, have taken a slightly different path showing perhaps the most complex picture. Although the Serbian and Croatian languages have preserved the old tenses, their use is rather limited. In terms of their aspectual development, these languages are getting closer and closer to the Eastern and Western Slavic language groups. In contrast, in Bulgarian and Macedonian one can see an intricate interplay of the aspectual system and the developed tense system. In the case of the change of the different Slavic languages, the phenomenon of linguistic compensation can be observed in all cases on the example of aspect and tense categories as the main means of striving to maintain linguistic homeostasis. Keywords: linguistic homeostasis, compensation, aspect, tense, Old Slavic, Slavic languages, Polish

The Village of Psimolophou in Cyprus and the Latin Patriarchs of Jerusalem

Psimolophou is perhaps the best known village in medieval Cyprus, thanks to a document published by Jean Richard in 1947 that provides extensive and detailed information about the finances and organization of the fief, the people, and their obligations in the early fourteenth century. Less attention has been paid to the unusually well-documented vicissitudes of the fief, an important Templar property that after the dissolution came into the hands of the exiled Latin patriarchs of Jerusalem. The story presented below involves a long struggle over tithes, the diversion of the river going through the fief, and the gradual decline of patriarchal control over Psimolophou. It is told largely using sources discovered by Professor Richard himself in the 65 years following his 1947 publication, and two key documents are printed in an appendix.

Loss of FVIII Expression by Possible Interlinked Immune and Cellular Stress Response in Hemophilia A Mice Treated with AAV Gene Therapy

Background Hemophilia A is an X-linked genetic disorder caused by a mutation in the gene for factor VIII (FVIII) protein that reduces the ability of blood to clot. Clinical drug trials have shown the potential of adeno-associated virus (AAV) gene therapy as a one-time treatment for hemophilia A that can produce sustained high levels of FVIII. However, a gradual decline in protein levels has been observed in patients after 2-4 years. The hypothesis being tested in the Herzog Lab is that an interlinked immune and cellular stress response could be causing the loss of expression. Methods Two groups of Hemophilia A mice were administered AAV therapy, with one group receiving recurrent doses of Rapamycin. Blood samples were taken at weeks 4, 8, 12 and 14. Mice were euthanized at weeks 4, 8, and 14, and their livers were harvested. qPCR was used to measure AAV copy numbers and FVIII mRNA at 4, 8, and 14 weeks. Cryosections of mice livers from weeks 4, 8, and 14 were stained with antibodies for FVIII protein and CD8. Results qPCR showed roughly half as much AAV copy numbers in the rapamycin group at all time points, and little difference in FVIII mRNA between the groups. There was also a large decrease in AAV copy numbers and FVIII mRNA in both groups between 8 and 14 weeks. Immunohistochemistry showed less CD8 and more FVIII signal in mice treated with rapamycin. Discussion Experiments are currently being performed to investigate the decline in AAV copy numbers and mRNA between weeks 8 and 14. The immunohistochemistry data shows a relationship between increased FVIII protein levels and decreased cellular immune response but does not explain the gradual decline in FVIII. Further investigation into FVIII expression following AAV gene therapy could lead to an effective one-time treatment for hemophilia A.

Egalitarianism to gender inequality: Cross-cultural exploration of gender relations, in economic systems

Gender inequality has generated a lot of debates among scholars across disciplines. Much of these studies have not explored a robust scholarship on the historical development of gender inequality by comparing different human societies and their subsistence strategies. This review study is designed to fill this gap, thereby contributing to corpus of literature on gender inequality in economic relations. As a historical research, the study uses secondary materials. These materials are mainly ethnographies of the societies under comparison. The study compares the roles of each of the gender categories in subsistence activities, in economic systems, to trace the sources of gender inequality in economic relations. Data available suggest egalitarian gender and economic relations. However, as societies evolved, there became a gradual decline in egalitarianism, leading to marked inequality. The inequality is relative to the complexity of social structure peculiar to the societies under review.

Quantification of Heavy Metals and Pesticide Residues in Widely Consumed Nigerian Food Crops Using Atomic Absorption Spectroscopy (AAS) and Gas Chromatography (GC)

More still needs to be learned regards the relative contamination of heavy metals and pesticide residues, particularly those found in widely consumed Nigerian food crops like cereals, vegetables, and tubers. In this current study, the heavy metals and pesticide residues detectable in widely consumed Nigerian food crops were respectively quantified using atomic absorption spectroscopy (AAS) and gas chromatography (GC). Specifically, the widely consumed Nigerian food crops included cereals (rice, millet, and maize), legume (soybean), tubers (yam and cassava), as well as leaf (fluted pumpkin, Amaranthus leaf, waterleaf, and scent leaf) and fruit vegetables (okro, cucumber, carrot, and watermelon). Results showed that the detected heavy metals included arsenic (As), cadmium (Cd), chromium (Cr), cobalt (Co), iron (Fe), lead (Pb), manganese (Mn), mercury (Hg), and nickel (Ni), whereas the pesticide residues included Aldrin, Carbofuran, g-chlordane, Chlorpyrifos, DichloroBiphenyl, Dichlorodiphenyldichloroethane (DDD), Dichlorodiphenyltrichloroethane (DDT), Dichlorvos, Endosulfan, Heptachlor, Hexachlorobenzene (HCB), Isopropylamine, Lindane, t-nonachlor, and Profenofos. Across the studied food crops, the concentrations of heavy metals and pesticides were varied, with different trends as they largely fell below the established maximum permissible limits, and with some exceptions. Our findings suggest there could be a somewhat gradual decline in the concentration of the heavy metals and pesticide residues of these studied food crops when compared to previously published reports specific to Nigeria. To help substantiate this observation and supplement existing information, further investigations are required into the concentration of these heavy metals and pesticide residues specific to these studied food crops at other parts of the country.

Land Governance in Fifth Schedule Areas: A Critical Analysis of Chhattisgarh State

The governance of land is central to the political economy of development. In India, The schedule areas are demarcated primarily for the development of adivasis who are officially classified as Scheduled Tribes (STs)/and protection of culture through special legal and administrative provisions in the form of fifth and sixth schedule. The article aims to understand and analyse the land governance in the areas of Fifth Schedule with specific reference to the Chhattisgarh State. It explores the role of Governor in preventing the land alienation. The main data sources include the agriculture census, diversion of forest land for the development projects including the mining along with cases of PESA and FRA using a process tracing methodology. The gradual decline in the size of average land holdings indicates the failure of land governance. There is a need to clear the legal ambiguity between the provisions of Fifth Schedule with particular reference to the role of Governor to establish peace and good governance.

LOSING MY CODE: AN AUTOETHNOGRAPHY ON LANGUAGE ATTRITION

Learning a new language is one of the privileges that a person can get when moving from one place to another and staying there for a longer time. In this paper, I will discuss my journey that resulted to gradual decline of my L1 (First language), Polillohing Tagalog, which is a variety of the Tagalog language, in the Philippines. The result of migration, acquisition of other languages, and exposure to different speaking environment had led me to continuously decline my first language. Using the auto-ethnographic type of writing a research, I reflected on my experiences which lead me to language attrition. Auto-ethnographic research is when the researcher is the participant of the story narrating his experience on the culture and phenomenon of the researched topic.

Total anti-SARS-CoV-2 antibodies measured 6 months after Pfizer-BioNTech COVID-19 vaccination in healthcare workers

Background: This study aimed at monitoring the kinetics of serum total anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antibodies in a cohort of healthcare workers after voluntary vaccination with Pfizer-BioNTech coronavirus disease 2019 (COVID-19).Methods: The study population consisted of 787 healthcare workers (mean age 44±12 years; 66% females), who received two 30 μg doses of Pfizer-BioNTech COVID-19 vaccine, 3 weeks apart. Venous blood was drawn before the first vaccine dose, immediately before the second vaccine dose, and then at 1, 3 and 6 months after the second vaccine dose. Serological testing employed the total anti-SARS-CoV-2 antibodies measurement with Roche Elecsys Anti-SARS-CoV-2 S chemiluminescent immunoassay.Results: The median serum levels of total anti-SARS-CoV-2 antibodies reached the peak (1762 KU/L) 1 month after the second vaccine dose, but tended to progressively decline at the 3-month (1086 KU/L) and 6-month (802 KU/L) follow-up points. Overall, the values after 3- and 6-months were 37% and 57% lower than the corresponding concentrations measured at the peak. No healthcare worker had total anti-SARS-CoV-2 antibodies below the method-dependent cut-off. The decline compared to the peak was more accentuated in baseline seropositive persons than in those who were baseline seronegative (74% vs. 52%) cohort. The 6-month post-vaccination anti-SARS-CoV-2 antibodies in subjects aged <65 years remained over 2-fold higher than that measured in those aged ≥65 years (813 vs. 343 KU/L). Conclusions: Gradual decline of total anti-SARS-CoV-2 antibodies occurred 6 months after Pfizer-BioNTech COVID-19 vaccination, though values remained higher than the method-dependent cut-off, with no case of seronegativization.

The Waqf Estates of Pānḍūa: Historical Analysis (from Fifteenth to Twentieth Centuries)

In its first section, the article examines the creation of two major Sufi institutions, the khanqāhs of Shaikh Jalāluddīn Tabrīzī (d. 1225) known as Badi dargā h and Shaikh Nūr Quṭb Ālam (d. 1410) as Chhotī dargā h. Further, for the smooth functioning and maintenance, the rulers of Ilyas Shahi dynasty and other independent rulers of Bengal endowed rent-free lands to the respective khanqāhs presently known as Bāis Hazārī and Shash Hazārī waqf estates. The present study also attempts to look into a more comprehensive and detailed analysis of the sanads concerning with these grants were confirmed and continued by the Mughal emperors, Nawab Nazims of Bengal and British officials that testify to the importance of the place during the pre-colonial times. The extensive property enjoyed by the mutawallis of these dargā hs continued till date. The focus of the article in its second section, on the historical changes of these waqf estates basing on official records from these institutions, court proceedings of the litigations, historical works by the mutawallis and other connected histories. This examination is followed by a discussion of the gradual decline of these institutions and subsequent patronage for the education and other measures of welfare for the society.