bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid Coronary Revascularization: Perspective Current State After 25 Years of Start
Authors: Elassal Ahmed Abdelrahman , Al-Ebrahim Khalid , Makhdoom Adel Mohammad , Fatani Mazin , Ibrahim Mohamed
Published: April 2021

Hybrid coronary revascularization (HCR) represents a minimally invasive revascularization strategy in which the durability of the internal mammary artery to the left anterior descending artery graft is combined with percutaneous coronary intervention to treat remaining lesions. It first was introduced in the mid-1990s and aspired to bring together the “best of both worlds” – the excellent patency rates and survival benefits associated with the durable left internal mammary artery graft to the left anterior descending artery alongside the good patency rates of drug-eluting stents, which outlive saphenous vein grafts to non–left anterior descending vessels. Although in theory this is a very attractive revascularization strategy, several years later, only small randomized controlled trials comparing HCR with coronary artery bypass grafting has recently emerged in the medical literature, raising concerns regarding HCR’s role. In the current review, we discuss HCR’s rationale, the current evidence behind it, its limitations, and procedural challenges.
Perioperative Risk Factors Predisposing to Atrial Fibrillation After CABG Surgery
Authors: Omar Alaa , Ehab m elshihy  , Mahmoud singer  , David Zarif  , Omar dawoud
Published: April 2021

Objectives: To detect perioperative risk factors for atrial fibrillation (AF) after coronary artery bypass graft (CABG) and to assess the impact of AF on outcome and postoperative complications.
Methods: We undertook a prospective observational study of 1000 consecutive patients who underwent isolated CABG in Cairo University hospitals and other centers from March 2019 to November 2020. Patients were subsequently divided into 2 groups depending on the occurrence of postoperative AF. Preoperative, intraoperative, and postoperative risk factors were recorded for all patients, as well as postoperative mortality, complications, and hospital and intensive care unit (ICU) lengths of stay.
Results: Postoperative atrial fibrillation (POAF) occurred in 78 patients (7.8%), with significant risk factors of age (P = .001), low ejection fraction (P = .001), absence of preoperative beta-blocker use (P = .001), and presence of right coronary artery lesion (P = .003). The intraoperative significant risk factor was the absence of total coronary revascularization (P = .001). Postoperative significant risk factors were electrolyte imbalance (P = .001) and postoperative inotropes (P = .02). Patients with postoperative AF had increased risk of mortality (P = .001) and longer ICU (P = .001) and hospital (P = .001) stays.
Conclusion: The risk of POAF can be decreased by modifying perioperative adjustable risk factors, namely routinely using preoperative beta-blockers (unless contraindicated), achieving total coronary revascularization, avoiding postoperative electrolyte imbalance, and avoiding unnecessary use of inotropic support.
¿Cómo enseñar una segunda lengua en el aula? Beneficios asociados al enfoque AICLE
Authors: Bolarín-Martínez María José , Porto-Currás Mónica , Lova-Mellado María
Published: April 2021

y lenguas extranjeras (AICLE) favorece la construcción de un aprendizaje bilingüe, que aporta diferentes beneficios al alumnado. Objetivo. El objetivo de este trabajo reside en valorar si los cambios conceptuales, metodológicos y culturales que aporta la enseñanza de una segunda lengua mediante el enfoque AICLE conllevan, no solo una mejora del aprendizaje que realiza el alumnado, sino también una revisión y renovación de la práctica docente del personal implicado. Análisis. Con este fin, el artículo presenta una aproximación a la conceptualización del enfoque AICLE y un análisis detallado de las estrategias metodológicas que el profesorado debe emplear para facilitar la implementación de este enfoque en el aula. Conclusiones. La revisión de estas estrategias metodológicas permite resultados, conclusiones que para desarrollarlas en la práctica es necesario que el personal docente efectúe una reflexión profunda sobre la enseñanza que está realizando y los objetivos que pretende alcanzar. Si esta reflexión se genera y generaliza entre todo el profesorado participante en programas de enseñanza bilingües, se estarán consiguiendo muchos de los retos pedagógicos que desde hace décadas se reclaman a la educación obligatoria, y así, se permitiría tanto la renovación de la enseñanza de las lenguas como del sistema educativo en general.
ВІД СИНТЕЗУ ЕКОНОМІЧНИХ ТЕОРІЙ ДО ПОЛІТИЧНОГО КОНСЕНСУСУ: МОНЕТАРНО-ФІСКАЛЬНІ ДИЛЕМИ МАКРОЕКОНОМІЧНОЇ СТАБІЛІЗАЦІЇ В УМОВАХ КОРОНАКРИЗИ
Authors: РЕЗНІКОВА Наталія , ПАНЧЕНКО Володимир , ІВАЩЕНКО Оксана
Published: April 2021

Базуючись на ревізії змістовних положень неокласичного синтезу і нового макроекономічного консенсусу задля висвітлення особливостей інтерпретації їхніми адептами макроекономічних процесів, природи циклічних коливань і способів їх нівелювання та коригування, проведено аналіз урядових програм макроекономічної стабілізації обраних країн на предмет встановлення їх відповідності науковим підходам, що детермінують політичний вибір на користь застосування монетарних і/або фіскальних інструментів стимулювання економічної активності. Встановлено, що найбільш затребуваними в політичній площині стають висновки нового неокласичного синтезу (Нового макроекономічного консенсусу), який об'єднує новий кейнсіанський підхід і підхід реального ділового циклу, втім і вони коригуються в довільній формі, залежно від пріоритетності завдань, що ставить перед собою уряд (прагнення до досягнення повної зайнятості; стабілізація цін; економічне зростання і рівновага платіжного балансу; ефективне використання обмежених ресурсів), передбачають здебільшого короткостроковий горизонт планування, що ускладнює вихід із «зачарованого кола» економічної політики, коли її динамічний розвиток стає заручником потреби в постійній адаптації поведінки відповідно до мінливих умов, які вона сама своїм коригуванням і зумовлює. Виявлено, що в ситуації коронакризи питання боротьби з одночасними проявами шоків попиту і пропозиції,та зокрема безробіттям, визнаються за пріоритетні й прагнуть бути вирішеними за рахунок поєднання інструментарію монетарної та фіскальної політик, у тому числі й на засадах регуляторної конкуренції, яка реалізуєтьсязасобами неопротекціонізму, що визначається нами як сукупністьпринципів, інструментів і методів регуляторної політики держави у сфері міжнародної торгівлі, міжнародного руху капіталу і зарубіжних інвестицій, а також міжнародних валютно-фінансових і кредитних відносин, імперативом реалізації якої є стимулювання соціально-економічного розвитку та економічного зростання країни шляхом створення умов для підвищення економічної активності всіх суб’єктів господарювання.
СПЕЦІАЛІЗАЦІЯ АГРОПРОДОВОЛЬЧОГО ЕКСПОРТУ УКРАЇНИ: ТЕНДЕНЦІЇ, ДРАЙВЕРИ, ПЕРСПЕКТИВИ
Authors: ШУБРАВСЬКА Олена
Published: April 2021

Спеціалізація країн на світовому ринку є основою міжнародної торгівлі. Теоретичні засади глобальної спеціалізації сформовано концепціями міжнародної торгівлі, абсолютних і порівняльних переваг, альтернативних витрат. Експортну спеціалізацію України та її аграрного сектору визначають шість видів агропродовольчої продукції – кукурудза, пшениця, ячмінь, ріпак, соняшникові олія та макуха, які забезпечують майже третину загальнонаціонального і понад 70% агропродовольчого експорту держави. Отже, агропродовольчий експорт України є переважно сировинним і гіперспеціалізованим.Спеціалізація та інтернаціоналізація агропродовольчого виробництва і експорту України посилюються: зростають частки держави в загальносвітових обсягах експорту даних видів продукції, критично збільшується залежність вітчизняних аграріїв від імпорту багатьох видів виробничих ресурсів. Водночас частка імпортної складової в експорті Україною рослинницької продукції є порівняно невеликою.Сучасна модель глобальної агропродовольчої спеціалізації України вимагає коригування. Це необхідно як для збереження природно-ресурсного потенціалу аграрного виробництва, так і для забезпечення розвитку галузі в руслі сучасних загальносвітових соціально-економічних тенденцій. Для цього необхідно насамперед розширювати переліки виробленої сільгосппродукції і країн-імпортерів, активізувати залучення вітчизняних виробників до глобальних ланцюжків створення вартості, а також підвищувати частку продукції поглибленої переробки. Досягнення поставлених цілей зумовлює першочергову необхідність розвитку транспортно-логістичної інфраструктури та формування в державі ефективного інституційного середовища. Усе це має покращити умови ведення аграрного бізнесу і мотивувати його до дотримання природно-ресурсних обмежень і розвитку виробництв з глибокої переробки сільгоспсировини. Для збільшення кількості країн-імпортерів і розширення масштабів експорту вітчизняної агропродовольчої продукції потрібно також активізувати міждержавне торговельно-економічне співробітництво.
СИСТЕМА ТЕХНІЧНОГО ЗОРУ ДЛЯ ВИЗНАЧЕННЯ ВЗАЄМНОГО ПОЛОЖЕННЯ КОСМІЧНИХ АПАРАТІВ ПРИ ЗБЛИЖЕННІ ТА СТИКУВАННІ
Authors: Gubarev Vyacheslav , Volosov Viktor , Salnikov Nikolay , Shevchenko Vladimir , Melnychuk Sergiy , Maksymyuk Lyubov
Published: April 2021

Вступ. У країнах-лідерах космічної галузі інтенсивно ведуться роботи зі створення сервісних космічних апаратів для інспекції та обслуговування некооперованих космічних апаратів, які не оснащено спеціальними засобами для стикування. Застосування оптичних систем, так званих систем технічного зору, визначення положення дозволяють здійснити автоматичне зближення і стикування з некооперованим космічним апаратом.
Проблематика. На сьогодні проблема розпізнавання за відеозображенням взаємного положення космічних апаратів при зближенні і стикуванні, ще не має ефективного розв’язання. Під ефективністю розуміється виконання технічних вимог до бортової системи технічного зору за точністю та швидкодією при допустимих обсягах обчислень і збереження інформації. Тому актуальним є побудова системи технічного зору, створення відповідного математичного, алгоритмічного та програмного забезпечення з перевіркою запропонованих рішень у стендових випробуваннях. Систему призначено для автоматичного зближення і стикування з некооперованим космічним апаратом.
Мета. Розробка науково-технічних основ побудови системи технічного зору та методів розв’язання задачі визначення положення космічного апарата відносно некооперованого космічного апарата, створення математичного опису процесу зближення та стиковки, а також програмно-алгоритмічного забезпечення системи технічного зору, що задовольняє задані вимоги.
Матеріали й методи. Використано методи фільтрації та обробки цифрових зображень, комп’ютерної графіки, динаміки космічних апаратів, методи еліпсоїдального оцінювання стану нелінійних динамічних систем, методи розв’язування систем нелінійних рівнянь, методи теорії графів та навчання.
Результати. Створено математичне, алгоритмічне та програмно-технічне забезпечення системи технічного зору для визначення положення та орієнтації космічного апарата відносно некооперованого космічного апарата, придатне для практичного застосування.
Висновки. Проведені випробування системи технічного зору на стенді показали працездатність запропонованих науково-технічних рішень та можливість використання їх на практиці.
Policy in the IP Field in Academic Institutions and Higher Education Institutions
Authors: Parkhomenko N.M. , Yakubivskyi I.Ye. , Yurkevych Yurii
Published: April 2021

Introduction. Along with the creation of intangible objects, their effective introduction into production and other spheres of public relations to satisfy both the private interest of creators, the persons who have invested the funds in their creation, and the public interest acquire the particular importance.Problem Statement. The study of intellectual property policy in the activities of universities and research organizations now receives serious attention, in particular by institutions such as the World Intellectual Property Organization and the European Union.Purpose. The purpose of this research is to identify regulatory requirements and scientific approaches to the formulation of intellectual property policy of higher education establishments and R&D institutions of Ukraine, as well as proposing measures to improve the effectiveness of this policy.Materials and Methods. Analytical analysis of current regulations and scholarly research works in order to develop proposals for improving the effectiveness of intellectual property policy in the activities of higher education establishments and R&D institutions of Ukraine.Results. It is disputable that in the case of the conveyance of intellectual property rights as a contribution to the authorized capital of legal entities, such property rights “shall be held by a state-owned R&D institution or university, academies, institutes”. After all, if any assets are conveyed as a contribution to the authorized capital of a corporation, the titles to these assets are transferred to the corporation.Conclusions. The positive legislative trends in the educational field provide for strengthening the positions of education establishments and R&D institutions in terms of the commercialization of scholarly research and R&D results.
ІМЕРСИВНІ ТЕХНОЛОГІЇ В БІБЛІОТЕЦІ: ОРГАНІЗАЦІЯ ІННОВАЦІЙНОГО СЕРВІСУ ДЛЯ НАУКИ ТА ОСВІТИ
Authors: Granchak T.Yu. , Bondarenko V.I.
Published: April 2021

Вступ. Необхідність підвищення ефективності наукової діяльності, створення умов для продукування нових знань і обміну ними актуалізують вивчення когнітивного потенціалу імерсивних технологій.
Проблематика. Розкриття потенціалу імерсивних технологій для організації інноваційного бібліотечно-інформаційного сервісу сприяння розвитку науки і освіти.
Мета. Обґрунтування необхідності впровадження в практику наукових бібліотек імерсивних технологій з метою забезпечення інформаційно-технологічної підтримки наукових досліджень і освітньої діяльності, розробка теоретико-методологічних підходів до організації бібліотечного сервісу, побудованого на основі імерсивних технологій.
Матеріали й методи. Джерельну базу дослідження склали вебсайти наукових бібліотек, тематичні ресурси (портал Масачусетського технологічного інституту MIT Media Lab Research, сайти компаній-розробників програмного забезпечення та офіційні веб-сайти хакатонів віртуальної реальності), фахові публікації, що висвітлюють специфіку імерсивних технологій, досвід їх використання в наукових дослідженнях та в бібліотечній практиці. Використано системний, функціональний методи, методи спостереження, гіпотези в поєднанні з соціальнокомунікаційним методом.
Результати. Показано доцільність впровадження в практику наукових бібліотек імерсивних технологій як інноваційного інструменту інформаційно-технологічного забезпечення розвитку науки і освіти, акцентовано когнітивний потенціал імерсивних технологій, розроблено теоретико-методологічні засади організації комплексного бібліотечно-інформаційного сервісу, побудованого на використанні імерсивних технологій, висвітлено приклади ефективного використання останніх науковими бібліотеками.
Висновки. Позитивний ефект використання когнітивного потенціалу розширеної реальності в освітній практиці й наукових дослідженнях актуалізує розробку стратегій організації в наукових бібліотеках комплексного бібліотечно-інформаційного сервісу з надання доступу до імерсивних технологій.
Impact of Training on Perceived Stress of Parents with Intellectually Disabled Children
Authors:   RASS College of Special Education, Rashtriya Seva Samithi, Annamaiah Marg, Tirupati – 517502. A.P., India, Vankayala Nandini , . K. Anuradha ,   Department of Social Work, Sri Padmavati Mahila Visvavidyalayam, (Women’s University) Tirupati, A.P., India
Published: April 2021

The present study focuses on the perceived stress in 353 parents, whose Children with Intellectual disability underwent training in special education schools of (Bavitha Readiness Centres), Chittoor dist., Andhra Pradesh. The overall perceived stress (scale) score was measured through family assessment scheduled (FAS) developed by NIMHANS. The concerned mean scores were computed and compared at two stages of special training given to children i.e., at the time of joining and after two years of training with a paired t-test of significance. The overall findings reveal that the overall score, as well as its four sub–scales score of parent’s perceived stress, have been reduced after providing 2 years of special training to their Children with Intellectual disability as compared to joining the school (training).
Informal credit constraints and farmers’ health: an empirical study of China
Authors: Dong Xinyue , Yang Fan
Published: April 2021

ABSTRACT: Based on survey data of the income distribution and living conditions of urban and rural residents collected by the China Economic Monitoring and Analysis Center in 2014, we investigated the mechanisms related to informal credit constraints on farmer health and then empirically analyzed the impacts of such constraints. Results showed that, in general, informal credit constraints significantly negatively impact farmer health. Compared with farmers whose credit was not informally constrained, the probability of farmers who faced informal credit constraints describing their self-rated health as “very good” fell by 6.64%. After controlling for endogenous problems, this proportion rose to 28.87%. Correspondingly, the probability of describing self-rated health as “very bad” increased by 0.45%. After controlling for endogenous problems, this proportion rose to 0.81%. The robustness test showed that our conclusions are strongly robust. Informal credit constraints significantly positively impacted the number of days of illness in 2013 in the sample of farmers, which means farmers who suffered from informal credit constraints required more sick days than those who did not experience informal credit constraints in 2013. As far as we know, this is the first study on the impact of informal credit constraints on Chinese farmer health.
Temporalidades na vida e na autoformação de uma professora-pesquisadora
Authors: Dutra Marlene de Alencar , Therrien Jacques , Nóbrega-Therrien Silvia Maria
Published: April 2021

RESUMO Delineamos como objetivo deste estudo apreender as temporalidades na vida e na formação na itinerância aprendente de uma professora-pesquisadora como dimensão autoformadora pela narrativa de si. O aporte teórico está fundamentado nas formulações de autores como Pineau (1983, 1987, 2004, 2005, 2006, 2012), Josso (2004) e Souza (2006). Constituímos uma investigação descritiva, matizada pela abordagem (auto)biográfica, com estreitamento para uma pesquisa-formação. A narrativa de si, por uma professora-pesquisadora, tomada como corpus hermenêutico crítico, resulta de um movimento heurístico e reflexivo em uma comunidade de pesquisa. Em uma ecologia cognitiva constituinte e constituída no exercício autopoiético, pelo investimento (auto)biográfico em que apreendemos a narrativa de si no processo de reflexividade crítica, reconhecemos uma estrutura complexa das dinâmicas nas temporalidades da vida e da formação, em movimento de intercompreensão de fluxos e de circulações de conhecimentos e saberes. Esse desvelamento de uma pesquisa-formação em processos auto-organizáveis, coletivos e partilhados, levaram-nos a uma ação pesquisante em empreendimento dos sentidos e dos significados, para além das amarras academicistas, encontrando o tempo para a nossa autoformação, que nos coloca em um paradigma antropoformador na constituição identitária docente.
THE UBER DRIVER IS NOT AN ENTREPRENEUR
Authors: CASAGRANDE LUCAS , Zamora Martín A. M. , Oviedo Carlos F. T.
Published: April 2021

ABSTRACT Purpose: To analyze the conceptual relationship between entrepreneurship and the Uber driver since the company is the pinnacle of a new way of organizing work. It is argued here that, contrary to what is used in numerous articles and in the media, the Uber driver is not an “entrepreneur” but a precarious worker with flexible facilities. Originality/value: With the emergence of a new type of employment contract that is referenced in the labor relations of the company Uber, it becomes necessary to discuss the impacts of this new organization of labor. The conceptual discussion about the framework of the Uber driver is still incipient in the field. The research contributes to a better understanding of the discourse that the worker understood as an entrepreneur legitimizes exploitation. Design/methodology/approach: This is a theoretical-analytical article. Historical and theoretical literature was used to weave how the concept of entrepreneurship emerges historically and changes over time. Also, Uberized labor is compared to Taylorism and Toyotism. Findings: It demonstrates how the Uber driver cannot be considered an entrepreneur in any of the historical concepts. It is also demonstrated that the driver is a precarious employee, with flexible time and automated management, incorporating elements of the work organization of both Taylorism and Toyotism.
SUSTAINABLE CONSUMPTION: THEMATIC EVOLUTION FROM 1999 TO 20191
Authors: ARAÚJO ANGELICA C. M. , OLIVEIRA VERÔNICA M. , CORREIA SUZANNE E. N.
Published: April 2021

ABSTRACT Purpose: Analyze the thematic evolution of the research field on sustainable consumption from 1999 to 2019. Originality/value: The study advances the understanding of the development of the research field on sustainable consumption, analyzing the main publications and topics covered. Design/methodology/approach: Systematic literature review through a bibliometric study with analysis based on citations supported by the CitNetExplorer software, using core publication and clustering techniques. Two hundred sixty-four articles were analyzed. Findings: The most recent publications converge on the need to change the current patterns and levels of consumption and to engage dif- ferent stakeholders in participatory and co-creation processes. Also, the existence of five research clusters was identified, namely: 1. eco-efficiency with a focus on greening the market; 2. consumer behavior with an emphasis on encouraging the purchase of green products; 3. social nature of consumption that inserts the sociological perspective; 4. dynamic approach for considering the interdisciplinarity of the field; and 5. the role of education for sustainable consumption. The various themes found reveal contributions from different areas of knowledge and the importance of developing research that integrates the dynamics of the challenges to achieve sustainable consumption. We emphasize the need for an integrated approach due to the inherent complexity of the theme that involves economic, technological, political, social, psychological, and environmental aspects for governance in favor of sustainable consumption.
A CONSTRUÇÃO CURRICULAR DE UMA EDUCADORA DE CIÊNCIAS NA EJA: COMO A PRESENÇA DOS JOVENS AFETA A SUA PRÁTICA?
Authors: Resende Ana Carolina Costa , Cassab Mariana
Published: April 2021

RESUMO: A juvenilização é um processo que atinge há décadas a Educação de Jovens e Adultos (EJA), impondo desafios de diferentes ordens. O trabalho propõe entender como uma professora de Ciências desenvolve sua prática curricular em face da presença dos jovens. Ele se apoia em autores do campo do currículo, como Sacristán e Arroyo e constrói seu contexto de inteligibilidade, se movendo metodologicamente a partir da realização da história oral de vida e de observações de inspiração etnográfica às aulas da EJA. O trabalho conclui que os educandos centralizam a preocupação da professora no sentido de garantir seu interesse, aprendizagem e até mesmo presença na escola. Todavia, isso não significa que as juventudes se manifestam no fazer curricular como princípio estruturador. Há uma tensão em jogo que o estudo procura caracterizar.
MARCAS INSCRITAS NOS MUROS DA ESCOLA: IMAGENS, EDUCAÇÃO E VIDAS PRECÁRIAS
Authors: Ferrari Anderson , Castro Roney Polato de , Bastos Felipe
Published: April 2021

RESUMO Somos constantemente afetados por diferentes discursos que incitam o preconceito e a violência, presentes, muitas vezes, nas pequenas nuances do cotidiano, mas que também podem emergir explícitos, diretos e escancarados. O presente artigo toma duas pichações – uma de teor racista e outra de teor homofóbico –, feitas nos muros de uma escola pública de uma cidade do interior de Minas Gerais, como ponto de partida para problematizarmos, orientados pelas perspectivas foucaultianas e butlerianas, as imagens formadas nesses muros como potência de jogos de saber-poder e de transformação dos discursos e dos sujeitos.
PROTAGONISTAS PARA O MUNDO: MERCADO ESCOLAR E ASPIRAÇÕES DAS ELITES PELO ENSINO SUPERIOR
Authors: Caldeira Bruna de Figueiredo , Alves Maria Teresa Gonzaga
Published: April 2021

RESUMO Este artigo analisa a adequação do mercado escolar às aspirações de acesso ao Ensino Superior pelas elites no contexto da expansão desse nível de ensino. Utiliza dados de um estudo exploratório sobre onze colégios privados frequentados por estudantes das elites de Belo Horizonte, Minas Gerais, e um estudo de caso em um desses colégios. Os resultados mostraram que os colégios vêm adequando suas propostas pedagógicas, com destaque para a internacionalização e a promoção do protagonismo dos seus estudantes para o mundo, reforçando os elementos de distinção das elites no espaço social. O estudo de caso identificou alterações nas aspirações dos estudantes e o refinamento de suas estratégias de acesso ao Ensino Superior com o crescente interesse pelo ingresso em instituições privadas elitizadas.
Autocuidado na perspectiva de trabalhadoras sexuais para enfretamento e prevenção à pandemia do SARS-CoV-2
Authors: Couto Pablo Luiz Santos , Rodrigues Vanda Palmarella , Boery Rita Narriman Silva de Oliveira , Correia Andresa Teixeira Santos , Vilela Alba Benemérita Alves
Published: April 2021

Objetivo: Analisar a noção de autocuidado e ações adotadas por trabalhadoras sexuais no enfretamento e prevenção à COVID-19. Método: Estudo descritivo, qualitativo, apoiado na teoria de Enfermagem do Autocuidado. Realizou-se entrevista em profundidade com 30 trabalhadoras sexuais, do Alto Sertão Produtivo Baiano, entre os meses de setembro e outubro de 2020. As respostas foram submetidas à análise de conteúdo semântica/lexical possibilitada pelo software IRAMUTEQ. Resultados: Evidenciou-se quatro classes temáticas que revelaram como elas entendem o autocuidado e o implementa no seu cotidiano: o autocuidado como meio de ter bem-estar e qualidade de vida; valorização do dinheiro como um meio para fazer autocuidado; a tentativa de se proceder com a prevenção à COVID, ainda que seja difícil para muitas; consideração de que o cuidado si perpassa pelo cuidado com os outros. Conclusão: Para as participantes o autocuidado envolve o cuidado consigo mesma para a prevenção da COVID-19 e o cuidado com outro (familiares ou colegas de trabalho). Entretanto, o dinheiro obtido por meio do serviço sexual, constitui-se um facilitador para adoção do autocuidado, visto que há a negligência do Estado quanto ao atendimento às demandas e necessidades desse grupo social vulnerável.
Regulation of Rat Mesangial Cell Migration by Platelet-Derived Growth Factor, Angiotensin II, and Adrenomedullin
Authors: KOHNO MASAKAZU , YASUNARI KENICHI , MINAMI MIEKO , KANO HIROAKI , MAEDA KENSAKU , MANDAL ANIL K. , INOKI KEN , HANEDA MASAKAZU , YOSHIKAWA JUNICHI
Published: April 2021

This study sought to determine whether platelet-derived growth factor (PDGF) and angiotensin II (AngII) stimulate migration of cultured rat glomerular mesangial cells. After finding that this was so, the effects of adrenomedullin (ADM) and cAMP-elevating agents on basal and stimulated mesangial cell migration were examined. Two isoforms of PDGF, AB and BB, stimulated migration in a concentration-dependent manner between 1 and 50 ng/ml, while the AA isoform lacked significant effect. AngII modestly but significantly stimulated migration in a concentration-dependent manner between 10-7 and 10-6 mol/L. Rat ADM significantly inhibited the PDGF BB- and AngII-stimulated migration in a concentration-dependent manner between 10-8 and 10-7 mol/L. Inhibition by rat ADM was accompanied by an increase in cellular cAMP. cAMP agonists or inducers such as 8-bromo cAMP, forskolin, and prostaglandin I2 also significantly reduced the stimulated migration. H 89, a protein kinase A (PKA) inhibitor, attenuated the inhibitory effect of ADM, and a calcitonin gene-related peptide (CGRP) receptor antagonist, human CGRP (8-37), abolished the inhibitory effects of rat ADM. These results suggest that PDGF AB and BB as well as AngII stimulate rat mesangial cell migration and that ADM can inhibit PDGF BB- and AngII-stimulated migration, at least in part through cAMP-dependent mechanisms likely to involve specific ADM receptors with which CGRP interacts. The adenylate cyclase/cAMP/PKA system may be involved in the migration-inhibitory effect of ADM in these cells.
Heme Oxygenase-1 Induction Attenuates Inducible Nitric Oxide Synthase Expression and Proteinuria in Glomerulonephritis
Authors: DATTA PRASUN K. , KOUKOURITAKI SEVASTI B. , HOPP KATHLEEN A. , LIANOS ELIAS A.
Published: April 2021

In glomerulonephritis, there is intraglomerular activation of inducible nitric oxide synthase (iNOS) leading to high output production of nitric oxide (NO). This can result in supraphysiologic amounts of NO and cause oxidative injury. It is unknown whether mechanisms of cellular defense against NO-mediated injury exist. Induction of the heme catabolizing enzyme heme oxygenase-1 (HO-1), which generates biliverdin, carbon monoxide (CO), and iron (Fe), may provide such a mechanism, as CO and Fe are two negative modulators of iNOS activity and expression. This study assessed whether upregulation of HO-1 by a specific inducer, hemin, negatively modulates iNOS expression and activity in anti-glomerular basement membrane antibody-mediated glomerulonephritis. Glomerular HO-1 expression in nephritic animals was upregulated by treatment with hemin (30 μmol/kg body wt). iNOS and HO-1 mRNA expression were assessed by reverse transcription-PCR of glomerular total RNA from nephritic animals or nephritic animals pretreated with hemin. iNOS activity in glomeruli was measured by assessing conversion of [14C] L-arginine to [14C] L-citrulline. HO-1 protein levels in glomeruli were assessed by Western blot analysis. The effect of hemin treatment on monocyte/macrophage infiltration was assessed by enumeration of ED-1-positive cells in nephritic glomeruli. iNOS and HO-1 were coinduced in nephritic glomeruli. Hemin treatment of nephritic animals resulted in upregulation of glomerular HO-1 levels and a two- to threefold reduction in glomerular iNOS mRNA levels. iNOS activity in glomeruli was significantly reduced in hemin-treated nephritic animals in which proteinuria was also attenuated without a change in monocyte/macrophage infiltration. Hemin (100 to 200 μM) also reduced iNOS protein levels and enzyme activity in cultured mesangial cells stimulated with cytokines. These studies demonstrate that in glomerular immune injury, hemin treatment upregulates glomerular HO-1 with an attendant downregulation of iNOS expression, and thus points to regulatory interaction between the two systems. The beneficial effect of hemin treatment on proteinuria could be linked to downregulation of iNOS.
Pentosan Polysulfate Decreases Proliferation and Net Extracellular Matrix Production in Mouse Mesangial Cells
Authors: ELLIOT SHARON J. , STRIKER LILIANE J. , STETLER-STEVENSON WILLIAM G. , JACOT TERRY A. , STRIKER GARY E.
Published: April 2021

Glomerulosclerosis is characterized by extracellular matrix accumulation and is often associated with mesangial cell proliferation. Heparin-like molecules have been shown to decrease glomerulosclerosis in vivo, although their cellular site and mechanism of action is still unclear. In this study, a line of glomerular mesangial cells derived from normal mice was used to determine whether pentosan polysulfate (PPS) inhibited proliferation and altered extracellular matrix turnover. Cells treated with PPS showed a decrease in cell number beginning 24 h after treatment, which was maintained for 5 d. For matrix accumulation and degradation studies, cells were treated for 5 d and collagen types I and IV protein were measured by enzyme-linked immunosorbent assay as well as matrix metalloproteinases (MMP) measured by zymography. Collagen types I and type IV were significantly decreased in the media (P < 0.0001) and cell layer (P < 0.005) after treatment with PPS but not after treatment with heparin. By zymography, MMP-2 was significantly increased after treatment with PPS (P < 0.001) and heparin (P < 0.05). PPS and heparin also decreased MMP-9 (P < 0.001) after treatment. Reverse zymography showed the presence of tissue inhibitors of metalloproteinases (TIMP)-1 and -2 in control mesangial cells. Treatment with PPS and heparin increased TIMP-1. In addition, TIMP-3 was found in the medium of treated but not control cells. In conclusion, PPS alters extracellular matrix turnover through the induction of MMP-2 and alterations in the TIMP profile and may be useful in decreasing progressive glomerulosclerosis.
Ganglioside GM2-Activator Protein and Vesicular Transport in Collecting Duct Intercalated Cells
Authors: MUNDEL THOMAS M. , HEID HANS W. , MAHURAN DON J. , KRIZ WILHELM , MUNDEL PETER
Published: April 2021

This study describes the molecular characterization of an antigen defined by an autoantibody from a woman with habitual abortion as GM2-activator protein. The patient showed no disorder of renal function. Accidentally with routine serum screening for autoantibodies, an immunoreactivity was found in kidney collecting duct intercalated cells. Three distinct patterns of immunostaining of intercalated cells were observed: staining of the apical pole, basolateral pole, and diffuse cytoplasmic labeling. Ultrastructurally, the immunoreactivity was associated with “studs,” which represent the cytoplasmic domain of the vacuolar proton pump in intercalated cells. This pump is subjected to a shuttling mechanism from cytoplasmic stores to the cell membrane, which exclusively occurs in intercalated cells. Peptide sequences of a 23-kD protein purified from rat kidney cortex showed complete identity with corresponding sequences of GM2-activator protein. In the brain, GM2-activator protein is required for hexosaminidase A to split a sugar from ganglioside GM2. Because neither ganglioside GM2 nor GM1 (its precursor) is present in significant amounts in the kidney, the previous finding that this tissue contains the highest level of activator protein in the body was confusing. In this study, a novel role for GM2-activator protein in intercalated cells is proposed, and possible roles in the shuttling mechanism are discussed.
Osteopontin Expression in Fetal and Mature Human Kidney
Authors: HUDKINS KELLY L. , GIACHELLI CECILIA M. , YAN CUI  , COUSER WILLIAM G. , JOHNSON RICHARD J. , ALPERS CHARLES E.
Published: April 2021

Osteopontin is a secreted phosphoprotein that is expressed by normal kidney, and has been associated with a number of functions including cell adhesion, migration, signaling, and biomineralization. Although there is a vast literature detailing osteopontin localization in various rodent models of both development and disease, this article presents the first comprehensive description of osteopontin localization in human kidney. In this study, immunohistochemistry, immunoelectron microscopy, in situ hybridization, and Northern blotting are used to analyze osteopontin protein and mRNA expression in human fetal and normal mature renal tissue. Osteopontin is expressed in the human embryonic renal tubular epithelium beginning on approximately day 75 to 80 of gestation. In the fetal kidney, osteopontin can also be seen occasionally expressed in the ureteric buds and in some interstitial cells. As localized at the protein and mRNA level, the tubular expression of osteopontin increases with increasing gestational age and persists into adulthood. In the normal adult kidney, osteopontin is localized primarily to the distal nephron and is strongly expressed by the thick ascending limb of the loops of Henle. Osteopontin expression can also be observed in some collecting duct epithelium. In cases that exhibit foci of interstitial fibrosis and an associated influx of interstitial macrophages, osteopontin expression is significantly upregulated in all tubular segments, including proximal tubules.
Prominence of Cell-Mediated Immunity Effectors in “Pauci-Immune” Glomerulonephritis
Authors: CUNNINGHAM MALCOLM A. , HUANG XIAO RU , DOWLING JOHN P. , TIPPING PETER G. , HOLDSWORTH STEPHEN R.
Published: April 2021

The majority of patients with rapidly progressive crescentic glomerulonephritis show histologic features of extensive necrosis and focal and segmental proliferation with fibrin production, but little or absent Ig deposition in the glomerulus. This subcategory of the disease, labeled “pauci-immune” glomerulonephritis, has recently been shown to be associated with the presence of antineutrophil cytoplasmic antibody in the patient's circulation (but not within the glomerulus). The absence of the effectors of humoral immunity at the site of renal injury led to this investigation of the contribution of cell-mediated immunity to the glomerular injury in this form of glomerulonephritis. In 15 patients presenting acutely with pauci-immune glomerulonephritis, CD3-positive T cells (3.7 ± 2.5 [mean ± SD] cells per glomerular cross section, [c/gcs]), CD45RO-positive T cells (2.7 ± 1.9 c/cgs), macrophages (7.3 ± 6.1 c/gcs), fibrin (3+), and endothelial-associated tissue factor were demonstrated to be prominent in glomeruli. These mediators were absent in a group of 12 patients with thin basement membrane disease and only occasionally observed in a group of eight patients with “humorally mediated” (noncrescentic) glomerulonephritis. Thus, in pauci-immune glomerulonephritis, there is the development of significant cell-mediated immunity with activated T cells, macrophages, tissue factor, and fibrin at the site of glomerular injury, suggesting that this glomerular disease is most likely a manifestation of T cell-directed cognate immune injury.
The Intrarenal Vascular Lesions Associated with Primary Antiphospholipid Syndrome
Authors: NOCHY DOMINIQUE , DAUGAS ERIC , DROZ DOMINIQUE , BEAUFILS HELENE , GRÜNFELD JEAN-PIERRE , PIETTE JEAN-CHARLES , BARIETY JEAN , HILL GARY
Published: April 2021

Even 10 yr after the identification of the antiphospholipid syndrome (APS), renal involvement in the course of APS is still relatively unrecognized, and is probably underestimated. The association of anticardiolipin antibodies and/or lupus anticoagulant with the development of a vaso-occlusive process involving numerous organs is now confirmed. In a multicenter study, 16 cases of “primary” APS (PAPS) were found and followed for 5 yr or more, all with renal biopsy. In all 16 cases of PAPS, there was a vascular nephropathy characterized by small vessel vaso-occlusive lesions associated with fibrous intimal hyperplasia of interlobular arteries (12 patients), recanalizing thrombi in arteries and arterioles (six patients), and focal cortical atrophy (10 patients). In combination, these led to progressive destruction of the kidney, accelerated by acute glomerular and arteriolar microangiopathy in five patients. Focal cortical atrophy is a distinctive lesion, present in 10 biopsies, and likely represents the histologic and functional renal analogue to the multiple cerebral infarcts detected on imaging studies. The clinical hallmark of this vascular nephropathy in PAPS is systemic hypertension, only variably associated with renal insufficiency, proteinuria, or hematuria. The ensemble of histologic renal lesions defined in this study should aid in the separation of the lesions found in cases of secondary APS, especially systemic lupus erythematosus, into those lesions related to APS and those related to the underlying disease.
“The FSGS Factor”
Authors: SHARMA MUKUT , SHARMA RAM , MCCARTHY ELLEN T. , SAVIN VIRGINIA J.
Published: April 2021

A circulating causative factor has been postulated in focal segmental glomerulosclerosis (FSGS). It has been shown that serum or plasma from some FSGS increases glomerular albumin permeability (Palb) in vitro. Palb greater than 0.5 (i.e., FS activity) is associated with recurrence after transplantation. Specimens from 15 FSGS patients were studied to document the presence of a permeability factor, to isolate this factor, to characterize its biochemical properties, and to show its effect in vivo. Total lipids were extracted by chloroform/methanol (2:1); FS activity was absent from total lipid extract. Chylomicrons and lipoproteins were removed from the plasma with dextran sulfate, followed by sequential precipitation of proteins at 50 and 70% ammonium sulfate saturation. FS activity was retained in the 70% ammonium sulfate supernatant and exhibited a 100-fold purification. FS activity was lost after heating at 100°C for 10 min or after protease digestion. Under nondenaturing conditions, electrophoresis of the FSGS 70% supernatant showed a prominent low molecular weight band that was not evident in the 70% supernatant from normal plasma. Dialysis and centrifugation-based membrane ultrafiltration of the FSGS factor indicated a molecular size between 30 and 50 kD. Injection of the 70% FSGS supernatant into rats caused a threefold increase in urine protein in collections from 6 to 24 h after injection. No increase in proteinuria occurred in rats injected with 70% supernatant from normal individuals. It is concluded that the FSGS factor is a low molecular weight protein with the potential to increase Palb in vitro and to cause proteinuria in vivo.
Intranephron Distribution and Regulation of Endothelin-Converting Enzyme-1 in Cyclosporin A-Induced Acute Renal Failure in Rats
Authors: NAKAYAMA YUSHI , NONOGUCHI HIROSHI , KIYAMA SHIGERU , IKEBE MIKA , TASHIMA YUKA , SHIMADA KOHEI , TANZAWA KAZUHIKO , TOMITA KIMIO
Published: April 2021

Endothelin-1 (ET-1) is thought to play a significant role in acute renal failure induced by cyclosporin A (CsA). The cDNA sequence encoding endothelin-converting enzyme-1 (ECE-1), which produces the active form of ET-1 from big ET-1, was recently reported. To elicit the role of ECE-1 in the glomerular and tubular dysfunction induced by CsA, the effects of CsA on mRNA and protein expression of ECE-1 in rat kidney and on mRNA expression of prepro-ET-1 and ET A- and B-type receptors in glomeruli were studied. ECE-1 mRNA was detected in glomeruli and in whole nephron segments. ECE-1 mRNA expression was downregulated in all nephron segments at 24 h after CsA injection. Protein levels were also downregulated in glomeruli and in the outer and inner medulla. CsA rapidly increased prepro-ET-1 mRNA expression in glomeruli at 30 to 60 min after injection; this rapid increase was followed by an increase in plasma ET-1 levels. These increases were followed by decreased expression of ECE-1, ET A-type receptor, and ET B-type receptor mRNA at 6 h after injection, and serum creatinine levels were increased at 24 h after CsA injection. It is suggested that downregulation of glomerular and tubular ECE-1 expression may be caused by increased ET-1 synthesis in CsA-induced acute renal failure.
Asymmetric Dimethylarginine Plasma Concentrations Differ in Patients with End-Stage Renal Disease
Authors: KIELSTEIN JAN T. , BÖGER RAINER H. , BODE-BÖGER STEFANINE M. , SCHÄFFER JÜRGEN , BARBEY MARK , KOCH KARL M. , FRÖLICH JÜRGEN C.
Published: April 2021

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial nitric oxide (NO) synthase. Its concentration is elevated in patients with end-stage renal disease (ESRD), in part because it is excreted via the kidneys. In this study, the plasma concentrations of ADMA, symmetric dimethylarginine, and L-arginine were determined in relation to plasma nitrate levels (as an index of NO formation) for a group of 80 patients with ESRD. The effects of two treatment methods, i.e., hemodialysis (HD) and peritoneal dialysis (PD), and the role of the presence of atherosclerotic disease were evaluated. Forty-three patients receiving HD and 37 patients receiving PD were compared with healthy control subjects. Plasma L-arginine and dimethylarginine levels were determined by HPLC, using precolumn derivatization with o-phthaldialdehyde. Plasma nitrate levels were determined by gas chromatography-mass spectrometry. Predialysis ADMA concentrations in HD-treated patients were approximately sixfold higher than those in the control group (6.0 ± 0.5 versus 1.0 ± 0.1 μmol/L; P < 0.05). Plasma nitrate concentrations were significantly lower in HD-treated patients, which suggests that ADMA may inhibit NO synthase. In contrast, plasma ADMA levels and nitrate concentrations in PD-treated patients were similar to those in control subjects. Plasma L-arginine concentrations were not significantly decreased in patients with ESRD. ADMA concentrations were significantly decreased 5 h after HD, compared with baseline values. ADMA levels were significantly higher in HD-treated patients with manifest atherosclerotic disease than in HD-treated patients without atherosclerotic disease (7.31 ± 0.70 versus 3.95 ± 0.52 μmol/L; P < 0.05). This study confirms that ADMA is accumulated in ESRD. PD-treated patients exhibit significantly lower ADMA levels than do HD-treated patients. Accumulation of ADMA may be a risk factor for the development of endothelial dysfunction and cardiovascular disease in patients with ESRD.
Quantifying the Effect of Changes in the Hemodialysis Prescription on Effective Solute Removal with a Mathematical Model
Authors: CLARK WILLIAM R. , LEYPOLDT JOHN K. , HENDERSON LEE W. , MUELLER BRUCE A. , SCOTT MERI KAY , VONESH EDWARD F.
Published: April 2021

One potential benefit of chronic hemodialysis (HD) regimens of longer duration or greater frequency than typical three-times-weekly schedules is enhanced solute removal over a relatively wide molecular weight spectrum of uremic toxins. This study assesses the effect of variations in HD frequency (F: per week), duration (T: min per treatment), and blood/dialysate flow rates (Q
B/Q
D: ml/min) on steady-state concentration profiles of five surrogates: urea (U), creatinine (Cr), vancomycin (V), inulin (I), and β2-microglobulin (β2M). The regimens assessed for an anephric 70-kg patient were: A (standard): F = 3, T = 240, Q
B = 350, Q
D = 600; B (daily/short-time): F = 7, T = 100, Q
B = 350, Q
D = 600; C/D/E (low-flow/long-time): F = 3/5/7, T = 480, Q
B = 300, Q
D = 100. HD was simulated with a variable-volume double-pool model, which was solved by numerical integration (Runge-Kutta method). Endogenous generation rates (G) for U, Cr, and β2M were 6.25, 1.0, and 0.17 mg/min, respectively; constant infusion rates for V and I of 0.2 and 0.3 mg/min, respectively, were used to simulate middle molecule (MM) G values. Intercompartment clearances of 600, 275, 125, 90, and 40 ml/min were used for U, Cr, V, I, and β2M, respectively, For each solute/regimen combination, the equivalent renal clearance (EKR: ml/min) was calculated as a dimensionless value normalized to the regimen A EKR, which was 13.4, 10.8, 6.6, 3.7, and 4.8 ml/min for U, Cr, V, I, and β2M, respectively. For regimens B, C, D, and E, respectively, these normalized EKR values were U: 1.04, 0.96, 1.58, and 2.22; Cr: 1.03, 1.08, 1.80, and 2.55; V: 1.06, 1.32, 2.21, and 3.12; I: 1.05, 1.54, 2.57, and 3.62; β2M: 1.00, 1.27, 1.73, and 2.19. The extent of post-HD rebound (%) was highest for regimens A and B, ranging from 16% (urea) to 50% (inulin), and lowest for regimen E, ranging from 6% (urea) to 28% (β2M). The following conclusions can be made: (1) Relative to a standard three-times-weekly HD regimen of approximately the same total (weekly) treatment duration, a daily/short-time regimen results in modest (3 to 6%) increases in effective small solute and MM removal. (2) Relative to a standard three-times-weekly HD regimen, a three-times-weekly low-flow/long-time regimen results in comparable effective small solute removal and progressive increases in MM and β2M removal. A daily low-flow/long-time regimen substantially increases the effective removal of all solutes.