Search Results (4)

Background: Concurrent atherosclerosis (AS) in peripheral arteries may worsen the prognosis of ischemic cerebrovascular disease (ICVD) patients. Although cervicocephalic atherosclerotic burden (AB) has demonstrated strong risk stratification capabilities, whether peripheral arterial evaluation provides incremental prognostic value remains unclear. This study aimed to determine whether cervicocephalic–peripheral AB (CPAB) improves risk stratification in ICVD patients. Methods: This prospective cohort study consecutively included acute ICVD patients. AB scores for intracranial, cervical, renal, and lower extremity arteries were assigned as 0 (no stenosis), 1 (significant stenosis in one segment), or 2 (significant stenosis in ≥2 segments). The total score (range 0–8) was trisected into low, medium, and high CPAB levels. The primary endpoint was a composite of ischemic stroke, acute coronary syndrome, and vascular death. Model performance was evaluated using Harrell’s C and Somers’ D. Results: Among 403 patients (mean follow-up: 9.6 ± 5.4 months), 41 primary endpoints occurred, and 21 (5.2%) were lost to follow-up. Of 382 patients analyzed, 30.6% had significant peripheral AS. Patients with concurrent peripheral-cervicocephalic AS had a higher risk of vascular events (p = 0.001) than those with single-territory AS. CPAB was independently associated with the primary endpoint (HR = 2.22, p < 0.001) and stroke recurrence (HR = 1.90, p = 0.013). While cervicocephalic AB also independently predicted outcomes, the CPAB-based multivariate Cox model had improved discriminative performance (Harrell’s C = 0.678 vs. 0.653 for primary endpoint, p = 0.02; 0.646 vs. 0.634 for stroke recurrence, p = 0.03). Conclusions: Peripheral AS is common in ICVD patients and contributes independently to vascular risk. The CPAB score, which integrates atherosclerotic burden from both cervicocephalic and peripheral territories, could improve prognostic stratification compared to single-territory or cervicocephalic AB alone, supporting comprehensive multiterritorial AS assessment to guide risk-based management strategies. Full article

Due to their multiple sources and structures, big spatial data require adapted tools to be efficiently collected, summarized and analyzed. For this purpose, data are archived in data warehouses and explored by spatial online analytical processing (SOLAP) through dynamic maps, charts and tables. Data are thus converted in data cubes characterized by a multidimensional structure on which exploration is based. However, multiple sources often lead to several data cubes defined by heterogeneous dimensions. In particular, dimensions definition can change depending on analyzed scale, territory and time. In order to consider these three issues specific to geographic analysis, this research proposes an original data cube metamodel defined in unified modeling language (UML). Based on concepts like common dimension levels and metadimensions, the metamodel can instantiate constellations of heterogeneous data cubes allowing SOLAP to perform multiscale, multi-territory and time analysis. Afterwards, the metamodel is implemented in a relational data warehouse and validated by an operational tool designed for a social economy case study. This tool, called “Racines”, gathers and compares multidimensional data about social economy business in Belgium and France through interactive cross-border maps, charts and reports. Thanks to the metamodel, users remain independent from IT specialists regarding data exploration and integration. Full article

Background and objectives: Polyvascular atherosclerosis is frequent and associated with a high cardiovascular risk, although the mechanisms regulating the atherosclerosis extent to single or multiple arterial territories are still poorly understood. Inflammation regulates atherogenesis and soluble CD40 ligand (sCD40L) is an inflammatory mediator associated with the presence of single-territorial atherosclerosis. We assessed whether the sCD40L expression is associated with the atherosclerosis extent to single or multiple arterial territories and with the atherosclerosis severity in different territories. Materials and Methods: We prospectively enrolled 94 participants with no atherosclerosis (controls, n = 26); isolated coronary atherosclerosis (group 1, n = 20); coronary and lower extremity (LE) atherosclerosis (group 2, n = 18); coronary and carotid atherosclerosis (group 3, n = 12); and coronary, LE, and carotid atherosclerosis (group 4, n = 18). Serum sCD40L levels were quantified. Results: The sCD40L levels (ng/mL, mean (standard deviation)) were 4.0 (1.5), 5.6 (2.6), 7.2 (4.2), 5.9 (3.7), and 5.1 (2.4) in controls and groups 1 to 4, respectively (ANOVA p = 0.012). In nonrevascularized patients, the sCD40L levels were significantly higher in group 2 than in group 1 and were correlated with the number of LE diseased segments. Prior LE bypass surgery was associated with lower sCD40L levels. Coexistence of coronary and LE atherosclerosis was independently associated with the sCD40L levels. Conclusions: The sCD40L levels were increased in stable atherosclerosis, particularly in polyvascular coronary and LE atherosclerosis. The number of LE diseased segments and prior LE revascularization were associated with sCD40L expression. To our knowledge, these are novel data, which provide insights into the mechanisms underlying multi-territorial atherosclerosis expression. sCD40L may be a promising noninvasive tool for refining the stratification of the systemic atherosclerotic burden. Full article

Pantanal is one of the largest wetlands in the world. In its southern portion, it hosts significant beef cattle ranching, having a herd of 4,832,200 head of cattle in 2016 (IBGE, 2018). Yet it presents intra-regional differences and complementarities. This article discusses such current territory definition, focusing on cattle ranching in Pantanal, considering its forms of occupation, agents, and its intra-regional flow of cattle. This recognition is essential for the identification of the arrangements developed in the territory, its temporal dynamics and spatial strategies, assuming different forms of interaction with the environment. In order to identify multiple livestock territories and their logics of action, data grouped into four dimensions were considered: (i) agents, (ii) product, (iii) space used, and (iv) flows and circulation, approached in different scales (farms, municipal and units of landscape floodplain/plateau). The analyzes show different forms of domination and territorial appropriation, continuous and discontinuous, permanent and temporary. Mapping of cattle territories in the South Pantanal identified a scenario of multiterritoriality. While maintaining its “nursery” profile, it presents more intensive arrangements with the rearing and fattening phases. New territorialities represented by external agents and the fragmentation of old properties has genereted a new mapping of the “used spaces” for cattle breeding and posed new challenges for the maintenance of the traditional cattle production systems in the region. Full article