bluuebunny/crossref_metadata_2025 huggingface dataset:
Interventions to reduce acute paediatric hospital admissions: a systematic review
Authors: Dick Smita , MacRae Clare , McFaul Claire , Rasul Usman , Wilson Philip , Turner Stephen W
Published: August 2021

Background

Admission rates are rising despite no change to burden of illness, and interventions to reduce unscheduled admission to hospital safely may be justified.

Objective

To systematically examine admission prevention strategies and report long-term follow-up of admission prevention initiatives.

Data sources

MEDLINE, Embase, OVID SP, PsychINFO, Science Citation Index Expanded/ISI Web of Science, The Cochrane Library from inception to time of writing. Reference lists were hand searched.

Study eligibility criteria

Randomised controlled trials and before-and-after studies.

Participants

Individuals aged <18 years.

Study appraisal and synthesis methods

Studies were independently screened by two reviewers with final screening by a third. Data extraction and the Critical Appraisals Skills Programme checklist completion (for risk of bias assessment) were performed by one reviewer and checked by a second.

Results

Twenty-eight studies were included of whom 24 were before-and-after studies and 4 were studies comparing outcomes between non-randomised groups. Interventions included referral pathways, staff reconfiguration, new healthcare facilities and telemedicine. The strongest evidence for admission prevention was seen in asthma-specific referral pathways (n=6) showing 34% (95% CI 28 to 39) reduction, but with evidence of publication bias. Other pathways showed inconsistent results or were insufficient for wider interpretation. Staffing reconfiguration showed reduced admissions in two studies, and shorter length of stay in one. Short stay admission units reduced admissions in three studies.

Conclusions and implications

There is little robust evidence to support interventions aimed at preventing paediatric admissions and further research is needed.
Comparison of three intraosseous access devices for resuscitation of term neonates: a randomised simulation study
Authors: Keller Alon , Boukai Amit , Feldman Oren , Diamand Raz , Shavit Itai
Published: August 2021

Objectives

To compare the success rates and ease of use of three intraosseous (IO) access devices used in term neonates.

Design

A three-arm randomised controlled simulation study was conducted.

Setting

A simulation laboratory.

Participants

Seventy-two paediatric residents completing their emergency department rotation as part of their residency training, and 20 paediatric specialists.

Intervention

Using an animal bone model, the one-attempt success rate of the EZ-IO drill, the NIO-I needle and the Jamshidi needle was compared. Uncooked Cornish Hen bones were used because of their similarity in length and diameter to the bones of neonates. Participants were asked to record the perceived ease of use of their assigned device using a 5-point Likert Scale.

Main outcome measure

The main outcome was the visualisation of flow emerging from the distal end of the bone, and perceived ease of use of the three IO devices.

Results

The EZ-IO, NIO-I and Jamshidi groups included 30, 31 and 31 participants, respectively, with median (IQR) years of experience of 3 (2–5), 3 (2–6) and 4 (3–5) years. Participants had significantly lower one-attempt success rates with the EZ-IO drill than with the NIO-I and the Jamshidi needles (14 of 30 (46.7%) vs 24 of 31 (77.4%); p=0.016, and 14 of 30 (46.7%) vs 25 of 31 (80.7%); p=0.007, respectively). The median (IQR) ease-of-use score of the EZ-IO drill was higher than that of the NIO-I and Jamshidi needles (5 (4–5) vs 4 (4–5); p=0.008, and 5 (4–5) vs 4 (3–4); p=0.0004, respectively).

Conclusions

Although easier to use, the EZ-IO drill demonstrated lower success rates than the IO needles in establishing IO access on a neonatal bone model.
Rare case of type B insulin resistance in association with systemic lupus erythematosus: illustrating diagnostic and management challenges
Authors: Saqib Aaisha , Man Yik , Ismail Rayan , Kariyawasam Dulmini
Published: August 2021

A 42 year-old Caribbean woman with, known type 2 diabetes, was admitted with worsening fatigue, arthritis and rashes. She was diagnosed with multisystem systemic lupus erythematosus and was initially treated with systemic steroids. During this admission, she had persistently elevated capillary glucose levels with insulin requirements over 8 U/kg/day that still did not control her blood glucose levels. Due to her profound hyperglycaemia, serum samples of fasting insulin, C-peptide, paired with blood glucose were analysed, which confirmed significant hyperinsulinaemia. Further analysis confirmed the presence of insulin receptor antibodies consistent with type B insulin resistance.

She was started on intravenous cyclophosphamide (Euro-Lupus regimen) along with continuous glucose monitoring system. After completing her six cycles of cyclophosphamide, she no longer required insulin treatment. The goal of therapy for our patient with confirmed type B insulin resistance was to manage hyperglycaemia with high doses of insulin until autoantibodies were eliminated with immunosuppressive therapy.
Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
Authors: Robinson David Bryan Thomas , Luton Oliver , Mellor Katie , James Osian Penri , Hopkins Luke , Powell Arfon GMT , Hemington-Gorse Sarah , Harries Rhiannon L , Egan Richard J , Lewis Wyn G
Published: August 2021

Objectives

Stress and burn-out among surgical trainees has been reported most prevalent in core surgical trainees (CST) and female trainees in particular. This study aimed to identify factors perceived by CSTs to be associated with stress and burnout in those at risk.

Design

An open-ended questionnaire was distributed to 79 CSTs and two researchers categorised responses independently, according to Michie’s model of workplace stress.

Setting

A UK regional postgraduate medical region (Wales).

Participants

Sixty-three responses were received; 42 males, 21 females. The response rate was 79.7%.

Results

Inter-rater reliability was good (k=0.792 (79.2%), p<0.001). The most common theme of Michie’s model related to CST stress and burnout was career development, with most statements associated with curriculum, examination and academic demands required to attain a CST certificate of completion of training, and higher surgical national training number appointment. This was closely followed by those intrinsic to the job with recurrent discussion around the difficulties balancing work perceived to be service provision (ward work and on-calls), outpatient clinic and operative experience. Conversely, the most common themes relevant to stress and burnout among female trainees were associated with relationships at work (primarily the male-dominated nature of surgery), extraorganisational factors (family–work life balance) and individual characteristics (personality and physiological differences).

Conclusion

CSTs’ perceptions regarding the causes of National Health Service related stress and burnout are numerous, and these findings provide a basis for the development of targeted stressor counter-measures to improve training and well-being.
The tumour microenvironment shapes innate lymphoid cells in patients with hepatocellular carcinoma
Authors: Heinrich Bernd , Gertz E Michael , Schäffer Alejandro A , Craig Amanda , Ruf Benjamin , Subramanyam Varun , McVey John C , Diggs Laurence P , Heinrich Sophia , Rosato Umberto , Ma Chi , Yan Chunhua , Hu Ying , Zhao Yongmei , Shen Tsai-Wei , Kapoor Veena , Telford William , Kleiner David E , Stovroff Merril K , Dhani Harmeet S , Kang Jiman , Fishbein Thomas , Wang Xin Wei , Ruppin E , Kroemer Alexander , Greten Tim F , Korangy Firouzeh
Published: August 2021

Objective

Hepatocellular carcinoma (HCC) represents a typical inflammation-associated cancer. Tissue resident innate lymphoid cells (ILCs) have been suggested to control tumour surveillance. Here, we studied how the local cytokine milieu controls ILCs in HCC.

Design

We performed bulk RNA sequencing of HCC tissue as well as flow cytometry and single-cell RNA sequencing of enriched ILCs from non-tumour liver, margin and tumour core derived from 48 patients with HCC. Simultaneous measurement of protein and RNA expression at the single-cell level (AbSeq) identified precise signatures of ILC subgroups. In vitro culturing of ILCs was used to validate findings from in silico analysis. Analysis of RNA-sequencing data from large HCC cohorts allowed stratification and survival analysis based on transcriptomic signatures.

Results

RNA sequencing of tumour, non-tumour and margin identified tumour-dependent gradients, which were associated with poor survival and control of ILC plasticity. Single-cell RNA sequencing and flow cytometry of ILCs from HCC livers identified natural killer (NK)-like cells in the non-tumour tissue, losing their cytotoxic profile as they transitioned into tumour ILC1 and NK-like-ILC3 cells. Tumour ILC composition was mediated by cytokine gradients that directed ILC plasticity towards activated tumour ILC2s. This was liver-specific and not seen in ILCs from peripheral blood mononuclear cells. Patients with high ILC2/ILC1 ratio expressed interleukin-33 in the tumour that promoted ILC2 generation, which was associated with better survival.

Conclusion

Our results suggest that the tumour cytokine milieu controls ILC composition and HCC outcome. Specific changes of cytokines modify ILC composition in the tumour by inducing plasticity and alter ILC function.
Viscous interaction and stability on dark matter Bose–Einstein condensation with modified Chaplygin gas
Authors: Mahichi E. , Amani Alireza , Ramzanpour M.A.
Published: August 2021

In this paper, viscous cosmological dynamics are studied in the presence of dark matter Bose–Einstein condensation by curved-FRW background. For this purpose, we use the BEC regime rather than normal dark matter (cold dark matter or barotropic dark matter) with the dark matter equation of state as [Formula: see text], which arises from the gravitational form. Therefore, we obtain the corresponding continuity equations with the existence of the universe components by considering an interacting model with modified Chaplygin gas. Afterward, we derive the energy density and the pressure of dark energy in terms of the redshift parameter. And then, by introducing a parametrization function and fitting it with 51 supernova data with the likelihood analysis, we find the cosmological parameters versus redshift parameter. In what follows, we plot the corresponding dynamic graphs proportional to redshift, and then we represent that the universe is currently undergoing an accelerated expansion phase. Finally, we explore the stability and the instability of the present model with the sound speed parameter.
Effects of food, kinship, and density on the longevity of spiderlings
Authors: Fischer Marta Luciane , Parolin Lays Cherobim , Neves Felipe Marcel , Villanueva-Bonilla German Antonio , Vasconellos-Neto João
Published: August 2021

Cannibalism is a behavioral characteristic found in a wide variety of animal groups. Although the rates of cannibalism can vary from one group to another, studies indicate that the main factors contributing to an increase in the frequency of such behavior are the availability of food, population density, the behavior and availability of victims, and environmental stress. We carried out different laboratory experiments to assess whether different factors such as the presence or absence of food among siblings and non-siblings, and at different densities among conspecific and heterospecific individuals, affect longevity of recently emerged Brazilian brown recluse (Loxosceles intermedia Mello-Leitão, 1934) and Chilean recluse (Loxosceles laeta (Nicolet, 1849)) spiderlings during periods of starvation. The results revealed that the survivorship of L. laeta during starvation was significantly higher than that of L. intermedia and that the addition of conspecific individuals increased survival rates by 1.5- and 1.6-fold, respectively. The tolerance of conspecifics differed between the two species, and generally, cannibalism was not observed, probably due to the risk of predation and limited consumption by weakened spiders, which coincided with the continued availability of endogenous vitelline reserves, thus indicating that the use of these spiderlings as a food resource may act to regulate starvation in more resistant spiders. The greater longevity and conspecific tolerance of L. laeta may be important factors contributing to the establishment of large populations of this spider in restricted areas, whereas for L. intermedia, hunger probably functions as a trigger for dispersal.
Vibration, synchronization and localization of three-bladed rotor: theoretical and experimental studies
Authors: Szmit Z.
Published: August 2021

Numerical and experimental methods in free and forced vibrations of the rotating structure consisting of the rigid hub and three flexible beams are considered. Firstly, the system of four mutually coupled dimensionless differential governing equations is presented and then forced response of the system as well as synchronization phenomenon are investigated. Next, the finite elements method is used to design the rotating structure and analyse complex dynamic response. During the numerical calculations symmetric, as well as de-tuned rotor are analyzed. Finally, results obtained from ordinary differential equations and numerical simulations are compared with experimental tests.
The Woods
Authors: Swearingen Kyoung , Swearingen Scott , Halac Fede Camara , Ammannagari Sruthi , Hall Matt
Published: August 2021

While loneliness in our real lives is increasingly recognized as having dire physical, mental, and emotional consequences, cooperative games have been shown to build empathy and provide positive social impact. In this paper, the authors present "The Woods," a local cooperative, mixed-reality game using augmented reality and 4-channel audio spatialization panning that provides players with face-to-face interactions in pursuit of a shared goal. This paper discusses the narrative, mechanical, and sonic components of the game, as well as the game's development process and the players' experiences. The goal of our team is to develop a narrative-driven AR game that promotes collaborative problem-solving and engages players in an emergent physical and digital experience.
Bad Mother / Good Mother
Authors: Rüst Annina
Published: August 2021

Bad Mother / Good Mother is an audiovisual performance that explores societal perceptions about ideal and non-ideal motherhood through sound and projected visuals. The sound comes from an amplified breast pump, while the visuals are projected on a single screen. In the performance, the artist plays the breast pump at different speeds. She plays it as a solo instrument and as part of an arrangement, and---at certain points in the performance---processes the breast pump sound using filters. This paper situates the performance within a discussion of how audiovisual performance can help express the relationship between gender and invisible labor.
Instruments of Vision
Authors: Bugdayci Irem , Dautel Anne-Heloise , Wuss Robert , Glynn Ruairi
Published: August 2021

In the age of ubiquitous visual technologies and systems, our perceptive apparatuses are constantly challenged, adapted, and shaped by instruments and machines, rendering the observing body as an active site of knowledge. Your Eye's Motion by Luna is an interactive installation that uses real-time eye-tracking to control a robotic creature named Luna (Figure 1). Materializing eye movements through a wondrous spectacle of light, motion, and color, the observer becomes conscious of her gaze enacted and extended by a robotic counterpart. Building on a diverse set of theories and understandings of vision from the fields of cybernetics, visual studies, embodied mind, and more, the project explores how our perceptual apparatuses and bodies are reconfigured in relation to machines and the environment to afford new ways of seeing. Once we see how observing bodies accommodate feedback from actions to cognition, we can uncover the embodied and affective potential of eye movement as an interface for robotics. The curiosity of Luna invests in this potential, articulating a unity between our embodied percepts and machinic environments to create a "vision machine."
Cangjie's Poetry
Authors: Zhang Weidi , Ren Donghao , Legrady George
Published: August 2021

This paper describes the conceptual background, artificial intelligent system design, and visualization strategies of an interactive art experience: Cangjie's Poetry. This artwork provides a conceptual response to the human-machine reality in the context of language, symbols, and semantic meanings. In the Cangjie's Poetry art installation, the intelligent system (Cangjie) constantly observes surroundings through the lens of a camera, writes poetry using its symbolic system based on its interpretation, and explains the evolving poem in natural language to audiences in real time. Due to the global pandemic of COVID-19, multiple presentation formats of this work were developed, which include in-person installation, virtual installation, and a special edition with pre-rendered video. This work prioritizes ambiguity and tension between machinic vision and human perception, the actual and the virtual, past and present.
Ming Shan Digital Experience
Authors: Henchoz Nicolas , Charvolin Margaux , Ribes Delphine , Défayes Lara , DuchÊne Cédric , Groves Emily , Sonderegger Andreas
Published: August 2021

The Ming Shan Digital Experience is an immersive installation designed to support meditation in the context of a new Taoist center. Its creation confronted current academic literature on digital technology for meditation with the practical and cultural requirements of Taoist practice. Quantitative and qualitative learnings show the effectiveness of multimodal biofeedback on individual and collective meditative experience. Now instated in the Taoist center, the installation opens new perspectives for combining digital technology with ancient practice.
Operando Analysis of Interphase Dynamics in Anode-Free Solid-State Batteries with Sulfide Electrolytes
Authors: Davis Andrew L. , Kazyak Eric , Liao Daniel W. , Wood Kevin N. , Dasgupta Neil P.
Published: August 2021

Sulfide solid electrolytes (SEs) show promise for Li metal solid-state batteries due to their high ionic conductivities and relative ease of manufacturing. However, many sulfide SEs suffer from limited electrochemical stability against Li metal electrodes. In this work, we use a suite ofoperandoanalytical techniques to investigate the dynamics of solid electrolyte interphase (SEI) formation and the associated effects on Li plating. We contrast a sulfide SE that forms an electrically insulating SEI (Li6PS5Cl) with an SE that forms an SEI with electrically conducting phases present (Li10GeP2S12). Using anode-free cell configurations, where the Li/SE interface is formed against a current collector, we perform complimentaryoperandovideo microscopy andoperandoX-ray photoelectron spectroscopy (XPS) experiments. The combination of these techniques allows for the interpretation of electrochemical voltage traces during Li plating. The electrically insulating nature of the SEI in Li6PS5Cl facilitates Li metal nucleation and plating after the initial SEI formation. In contrast, in cells that form an electronically conducting SEI, the onset of Li plating is suppressed, which is attributed to a low Faradaic efficiency from continuous SE decomposition. The insights in this study reveal how interphase dynamics control the transition from SEI formation to plating in anode-free solid-state batteries.
Innovative Applications of Computer-Assisted Technology in English Learning under Constructivism
Authors: Zhao Dan
Published: August 2021

In order to improve the effect of college English classroom teaching, this paper combines optical recognition to improve machine vision algorithms and uses computer optical vision technology to process teaching images. The system designed in this paper can be applied to philosophical teaching in college English classrooms. Moreover, the system can optimize teaching resources, manage teaching classrooms through the improved machine vision algorithm in this paper, and have a formative evaluation effect. In addition, taking into account the psychological activities of students in the classroom, this paper integrates the emotional recognition of college students in the construction of the system. Furthermore, it combines the actual teaching process to build a college English classroom teaching system based on constructivism. Finally, this paper designs an experiment to analyze the effect of the teaching model. From the research results, it can be known that the teaching system meets the demands of teaching.
Research on the Impact of Environmental Regulation on Enterprise Innovation from the Perspective of Official Communication
Authors: Feng Lili , Wang Lin , Zhou Wenjun
Published: August 2021

Many developing countries including China are implementing increasingly stringent environmental regulations to achieve sustainable development. However, we have limited understanding about whether environmental regulations promote enterprise innovation. To address this research gap, this study empirically analyzes the impact of environmental regulations which is represented by the China Environmental Protection Law (2015) on enterprise innovation and it explores the moderating effects of official communication on environmental regulations and corporate innovation. The Super-Slacks-Based Measure (Super-SBM) model and Multiple Nonlinear Regression model are used to analyze 34,074 samples in China’s A-share market during the 2015–2017 period. Our results show that, in general, a higher intensity of environmental regulations is more beneficial to incentivize enterprises to implement innovation. Meanwhile, there is an inverted U-type relationship between official communication and innovation of enterprises. Furthermore, at present, the average level of official communication in China is too high, which will weaken the role of environmental regulation in promoting enterprise innovation. Overall, this study can help us better understand the politics behind enterprise innovation in countries.
Vehicle State Estimation Based on Strong Tracking Central Different Kalman Filter
Authors: Liu Yingjie , Xu Qijiang , Sun Jingxia , Shen Fapeng , Cui Dawei
Published: August 2021

Vehicle active safety control was a key technology to avoid serious safety accidents, and accurate acquisition of vehicle states signals was a necessary prerequisite to achieve active vehicle safety control. Based on the purpose, a 3-DOF nonlinear vehicle dynamics model containing constant noise and a nonlinear tire model were established, and several vehicle key states were estimated by a strong tracking central different Kalman filter (CDKF). The conclusion showed that the proposed estimator had higher accuracy and less computation requirement than the CKF, CDKF, and UKF estimators. Numerical simulation and experiments indicated that the proposed vehicle state estimation method not only had higher estimation accuracy but also had higher real-time function.
Cellular Traffic Prediction Based on an Intelligent Model
Authors: Alsaade Fawaz Waselallah , Hmoud Al-Adhaileh Mosleh
Published: August 2021

The evolution of cellular technology development has led to explosive growth in cellular network traffic. Accurate time-series models to predict cellular mobile traffic have become very important for increasing the quality of service (QoS) with a network. The modelling and forecasting of cellular network loading play an important role in achieving the greatest favourable resource allocation by convenient bandwidth provisioning and simultaneously preserve the highest network utilization. The novelty of the proposed research is to develop a model that can help intelligently predict load traffic in a cellular network. In this paper, a model that combines single-exponential smoothing with long short-term memory (SES-LSTM) is proposed to predict cellular traffic. A min-max normalization model was used to scale the network loading. The single-exponential smoothing method was applied to adjust the volumes of network traffic, due to network traffic being very complex and having different forms. The output from a single-exponential model was processed by using an LSTM model to predict the network load. The intelligent system was evaluated by using real cellular network traffic that had been collected in a kaggle dataset. The results of the experiment revealed that the proposed method had superior accuracy, achieving R-square metric values of 88.21%, 92.20%, and 89.81% for three one-month time intervals, respectively. It was observed that the prediction values were very close to the observations. A comparison of the prediction results between the existing LSTM model and our proposed system is presented. The proposed system achieved superior performance for predicting cellular network traffic.
Complexity Analysis of New Future Video Coding (FVC) Standard Technology
Authors: Bouaafia Soulef , Khemiri Randa , Messaoud Seifeddine , Sayadi Fatma Elzahra
Published: August 2021

Future Video Coding (FVC) is a modern standard in the field of video coding that offers much higher compression efficiency than the HEVC standard. FVC was developed by the Joint Video Exploration Team (JVET), formed through collaboration between the ISO/IEC MPEG and ITU-T VCEG. New tools emerging with the FVC bring in super resolution implementation schemes that are being recommended for Ultra-High-Definition (UHD) video coding in both SDR and HDR images. However, a new flexible block structure is adopted in the FVC standard, which is named quadtree plus binary tree (QTBT) in order to enhance compression efficiency. In this paper, we provide a fast FVC algorithm to achieve better performance and to reduce encoding complexity. First, we evaluate the FVC profiles under All Intra, Low-Delay P, and Random Access to determine which coding components consume the most time. Second, a fast FVC mode decision is proposed to reduce encoding computational complexity. Then, a comparison between three configurations, namely, Random Access, Low-Delay B, and Low-Delay P, is proposed, in terms of Bitrate, PSNR, and encoding time. Compared to previous works, the experimental results prove that the time saving reaches 13% with a decrease in the Bitrate of about 0.6% and in the PSNR of 0.01 to 0.2 dB.
Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Authors: Ni Liyuan , Huang Xiaoquan , Jiang Siyu , Ma Lili , Luo Jianjun , Chen Shiyao
Published: August 2021

Background. Transjugular intrahepatic portosystemic shunt (TIPS) is suggested as the salvage therapy for gastroesophageal variceal bleeding in cirrhosis. However, rebleeding might occur in some patients after TIPS. Currently, there is a lack of evidence in the endoscopic management of recurrent bleeding in these patients. Aims. To evaluate the efficacy of endoscopic treatment in cirrhotic patients with recurrent bleeding after TIPS. Methods. Cirrhotic patients with gastroesophageal varices who received endoscopic treatment for recurrent bleeding after TIPS were included. Results. 6 patients were enrolled in this study. The median age of the patients was 47 years (range 27 to 65 years), and the duration of follow-up time was 346 (17-773) days. Stent stenosis or occlusion was found in 5 out of 6 patients after TIPS. Salvage endoscopic treatment, including esophageal variceal ligation (EVL), gastric variceal cyanoacrylate injection, esophageal variceal sclerotherapy, and balloon-occluded retrograde transvenous obliteration- (BRTO-) assisted endoscopic cyanoacrylate injection. Among included patients, 2 died shortly after EVL (14 and 19 days) due to variceal bleeding. Among other 4 patients, 2 had rebleeding episodes at 422 and 789 days, respectively. Conclusion. Endoscopic treatment may be an option for recurrent bleeding after TIPS in selected patients. Further studies are needed to carefully define the indication and efficacy of this option.
Stability of Perturbed Set Differential Equations Involving Causal Operators in Regard to Their Unperturbed Ones considering Difference in Initial Conditions
Authors: Yakar Coșkun , Talab Hazm
Published: August 2021

We investigate the stability of solutions of perturbed set differential equations with causal operators in regard to their corresponding unperturbed ones considering the difference in initial conditions (time and position) by utilizing Lyapunov functions and Lyapunov functionals.
The Dawn of Myeloid-Derived Suppressor Cells: Identification of Arginase I as the Mechanism of Immune Suppression
Authors: Gabrilovich Dmitry I.
Published: August 2021

A study published in Cancer Research in 2004 by Rodriguez and colleagues identified the existence of arginase-producing myeloid cells in tumors distinct from macrophages. They demonstrated the role of arginase in negative regulation of T-cell function in vivo. This was one of the first reports implicating cells, which later were named myeloid-derived suppressor cells (MDSC), in T-cell suppression in vivo and linking this effect with arginase activity and expression. This work was important in advancing the field of MDSC research and helped to bring these cells to the forefront of cancer immunology.

See related article by Rodriguez et al., Cancer Res 2004;64:5839–49
Large Metastatic Cardiac Tumor from Ascending Colon Cancer with Autopsy
Authors: Tomiyama Takashi , Shijimaya Takuya , Sano Yasuki , Kobayashi Sanshiro , Fukui Toshiro , Ishida Mitsuaki , Naganuma Makoto
Published: August 2021

A metastatic cardiac tumor from colon cancer is an exceedingly rare clinical feature associated with a poor prognosis without therapeutic intervention; however, such cases may be frequently encountered in clinical practice, especially among the elderly. We report a case of synchronous double cancer of the prostate and ascending colon with metastases to multiple organs, including a large cardiac tumor. A 71-year-old Japanese man had prostate cancer with neck and para-aortic metastasis. He visited our hospital with complaints of fatigue and a positive fecal occult blood test result. Colonoscopy findings revealed the presence of a tumor in the ascending colon, and contrast-enhanced CT revealed a tumor in the heart, which was possibly due to metastasis from the ascending colon. The patient received palliative care and declined anticancer treatment. He died due to respiratory failure 3 months after the first diagnosis but did not show critical arrhythmia until death. Autopsy revealed the presence of a large mass in the right ventricle with tumor embolism of the right coronary artery. The cardiac mass was pathologically consistent with metastasis from the colon. In case of colorectal cancer with cardiac metastasis involving poor prognosis or performance status, best supportive care without any therapeutic intervention could be the optimal treatment for the quality of the remaining time.
As diferentes concepções de natureza na sociedade ocidental: da physis ao desenvolvimento sustentável
Authors: Camargo Diogenes Rafael de , Silvestri Kátia Vanessa Tarantini
Published: August 2021

Mediante às proposições de desenvolvimento sustentável, recursos naturais e sustentabilidade, deve se compreender a natureza em um contexto polivalente permeado pelos discursos políticos, científicos, sociais, artísticos e filosóficos. De abordagem qualitativa, o procedimento metodológico fez revisão sistemática acerca do conceito physis na história da filosofia objetivando traçar 1. um percurso semântico até a função desenvolvimento sustentável, 2. propor uma inflexão às proposições de desenvolvimento sustentável e, 3. evitar ambiguidades dos termos homem e humano. Para tanto, fundamenta-se a revisão sistemática em Heidegger (1989; 2017), Deleuze e Guattari (2016), Loureiro (2012), Montibeller-Filho (2008), Unger (2006), Guattari (2006), Singer (2000). A pesquisa desenvolvida mostrou que após as grandes catástrofes sociais e ambientais que o mundo assistiu na primeira metade do século XX, ocorreu a emergência de muitas correntes ambientalistas. Algumas dessas correntes partiram de um viés propagandista e ideológico oficial pelo qual se propagaram os sistemas discursivos mais bem estruturados e, um pouco mais estagnados na dinâmica entre supra e infraestrutura, utilizando o discurso ambiental. Este que começava a brotar na sociedade, como ferramenta de garantia da manutenção de uma hegemonia econômica e política contribuiu historicamente para o abismo da dicotomia Homem versus Natureza.
O debate sobre o trabalho e exercício profissional do arquiteto-urbanista brasileiro
Authors: Mello Bruno Cesar Euphrasio de , Kuhn Eugenia Aumond , Rorato Geisa Zanini
Published: August 2021

Este artigo apresenta os resultados do levantamento exploratório da literatura sobre o trabalho e o exercício profissional do arquiteto e urbanista, bem como uma pequena amostra do debate mais recente sobre a questão realizado pela categoria no Brasil e no mundo. Percebe-se que o tema tem ganhado relevância nas discussões no âmbito da organização da classe; entretanto, a isso não corresponde uma maior da pesquisa científica ou do debate acadêmico, já que os textos existentes são dispersos e nem sempre tomam como centro de sua atenção o trabalho e o exercício de suas atribuições.
Effects of Exercise and Weight Loss on Proximal Aortic Stiffness in Older Adults With Obesity
Authors: Brinkley Tina E. , Leng Iris , Bailey Margie J. , Houston Denise K. , Hugenschmidt Christina E. , Nicklas Barbara J. , Hundley W. Gregory
Published: August 2021

Background:

Obesity may accelerate age-related increases in aortic stiffness. Although aerobic exercise training generally has favorable effects on aortic structure and function, exercise alone may not be sufficient to improve aortic stiffness in older adults with obesity. We determined the effects of aerobic exercise training with and without moderate- to high-caloric restriction (CR) on the structure and function of the proximal aorta in 160 older (65–79 years) men and women with obesity (body mass index=30–45 kg/m
2
).

Methods:

Participants were randomly assigned to 1 of 3 groups: aerobic exercise training only (treadmill 4 days/week for 30 minutes at 65% to 70% of heart rate reserve; n=56), aerobic exercise training plus moderate CR (n=55), or aerobic exercise training plus more intensive CR (n=49) for 20 weeks. Aortic pulse wave velocity, aortic distensibility, and other measures of aortic structure and function were assessed by cardiovascular magnetic resonance imaging. Pearson correlation coefficients were examined to assess associations between changes in proximal aortic stiffness and changes in fitness, fatness, and other potential confounders.

Results:

Weight loss in the aerobic exercise training plus moderate CR (−8.0 kg [95% CI, −9.17 to −6.87]) and aerobic exercise training plus more intensive CR (−8.98 kg [95% CI, −10.23 to −7.73) groups was significantly greater compared with the aerobic exercise training–only group (−1.66 kg [95% CI, −2.94 to −0.38];
P
<0.017 for both). There were significant treatment effects for descending aorta distensibility (
P
=0.008) and strain (
P
=0.004) and aortic arch pulse wave velocity (
P
=0.01) with the aerobic exercise training plus moderate CR group having a 21% increase in distensibility (
P
=0.016) and an 8% decrease in pulse wave velocity (
P
=0.058). None of the aortic stiffness measures changed significantly in the aerobic exercise training–only or aerobic exercise training plus more intensive CR groups, and there were no significant changes in any other measure of aortic structure or function in these groups. Overall, increases in aortic distensibility were correlated with improvements in body weight and body fat distribution, but these associations were not statistically significant after adjustment for multiple comparisons.

Conclusions:

In older adults with obesity, combining aerobic exercise with moderate CR leads to greater improvements in proximal aortic stiffness than exercise alone.

Registration:

URL:
https://clinicaltrials.gov
; Unique identifier: NCT01048736.
Long Noncoding RNA
Tug1
Promotes Angiotensin II–Induced Renal Fibrosis by Binding to Mineralocorticoid Receptor and Negatively Regulating MicroR-29b-3p
Authors: Zhang Juhong , Zhang Yuqing , Gao Jing , Wang Meihui , Li Xiaoting , Cui Zhaoqiang , Fu Guosheng
Published: August 2021

Inappropriately activation of renin-angiotensin-aldosterone system induced renal fibrosis is characterized by partial epithelial-to-mesenchymal transition. Previously, we have indicated that miR-29b-3p in inhibiting partial epithelial-to-mesenchymal transition by negatively regulating extracellular matrix gene expression in the kidney. Despite the critical role of miR-29b-3p in fibrosis, the molecular mechanisms by which miR-29b-3p is regulated under the condition of profibrotic stimuli are largely unknown. Our aim is to search for the long noncoding RNA that mediated sponge regulatory on miR-29b-3p, and whether the long noncoding RNA could be activated by renin-angiotensin-aldosterone system and its consequent effects on renal fibrosis. Bioinformatics analysis predicted that
Tug1
might directly bound to miR-29b-3p and function as a competing endogenous RNA. Dual-luciferase reporter assay, fluorescence in situ hybridization, and real-time polymerase chain reaction were performed to indicate that
Tug1
interact with miR-29b-3p in a sequence-specific manner. Decreased
Tug1
led to an increase in extracellular matrix measured by Western blot, and this effect was enhanced by miR-29b-3p measured by real-time polymerase chain reaction and Western blot, suggesting cross-regulation between the RNAs. Bioinformatics analysis predicted that mineralocorticoid receptor might bind to long noncoding RNA
Tug1
. Notably, mineralocorticoid receptor antagonism reduced
Tug1
expression in the presence or absence of angiotensin II or aldosterone measured by real-time polymerase chain reaction, and RNA immunoprecipitation assays confirmed that the mineralocorticoid receptor directly bound to
Tug1
. Finally, we confirmed that
Tug1
expression was enhanced in fibrotic compared with nonfibrotic human renal biopsy samples using RNA-in situ hybridization. Our findings provide novel insights into the molecular mechanism of Ang II–induced renal fibrosis and identify the
Tug1
–miR-29b-3p axis as an important target of MR activation.
Characteristics and Outcomes of Early Recurrent Myocardial Infarction After Acute Myocardial Infarction
Authors: Nair Raunak , Johnson Michael , Kravitz Kathleen , Huded Chetan , Rajeswaran Jeevanantham , Anabila Moses , Blackstone Eugene , Menon Venu , Lincoff A. Michael , Kapadia Samir , Khot Umesh N.
Published: August 2021

Background

We aimed to understand the characteristics and outcomes of patients readmitted with a recurrent myocardial infarction (RMI) within 90 days of discharge after an acute myocardial infarction (early RMI).

Methods and Results

We analyzed the timing of reinfarction, etiology, and outcome for all patients admitted with an early RMI within 90 days of discharge after an acute myocardial infarction between January 1, 2010 and January 1, 2017. We identified 6626 admissions for acute myocardial infarction (index myocardial infarction) which led to 168 cases of RMI within 90 days of discharge. The mean patient age was 65.1±13.1 years, and 37% were women. The 90‐day probability of readmission with an early RMI was 2.5%. Black race, medical management, higher troponin T, and shorter length of stay were independent predictors of early RMI. Medically managed group had a higher risk for early RMI compared with percutaneous coronary intervention (
P
=0.04) or coronary artery bypass grafting (
P
=0.2). Predominant mechanisms for reinfarction were stent thrombosis (17%), disease progression (12%), and unchanged coronary artery disease (11%). At 5 years, the all‐cause mortality rate for patients with an early RMI was 49% (95% CI, 40%–57%) compared with 22% (95% CI, 21%–23%) for patients without an early RMI (
P
<0.0001).

Conclusions

Early RMI is a life‐threatening condition with nearly 50% mortality within 5 years. Stent‐related events and progression in coronary artery disease account for most early RMI. Medication compliance, aggressive risk factor management, and care transitions should be the cornerstone in preventing early RMI.
Proteomic Profiling of Exosomes From Hemorrhagic Moyamoya Disease and Dysfunction of Mitochondria in Endothelial Cells
Authors: Wang Xia , Han Cong , Jia Yangjie , Wang Jiayu , Ge Wei , Duan Lian
Published: August 2021

Background and Purpose:

Moyamoya disease (MMD) is a rare steno-occlusive and slowly progressing cerebrovascular disorder. The detailed mechanism of the underlying pathogenesis is still blurry.

Methods:

Tandem Mass Tag-labeled quantitative proteomics was performed on serum-derived exosomes (SDEs) extracted from adult patients diagnosed with pure ischemic MMD or hemorrhagic MMD and healthy controls. Then mouse brain vascular endothelial cell (EC), human umbilical vein EC, neuroblastoma cell, and human hepatocyte cell were treated with exosomes, and changes of the protein expression in mouse brain vascular EC cells were identified.

Results:

Proteomics analysis results showed that 859 shared proteins were detected in SDEs from ischemic and hemorrhagic MMD patients with 231 differently expressed compared with healthy controls. Bioinformatic analysis revealed dysregulated cell growth and maintenance and indicated disturbed actin dynamics in MMD, with CFL1 (Cofilin-1) and ACTR2/3 (actin-related protein 2/3; also known as ARP2/3) downregulated in ischemic and hemorrhagic patients’ SDEs. We also found immunity dysfunction in hemorrhagic MMD. Following treatment with MMD SDEs, mouse brain vascular EC cells showed significantly higher levels of proliferation and more ethynyl-2-deoxyuridine-positive cells compared with the healthy control group, while there were no obvious changes in the human umbilical vein EC and human hepatocyte cell. Interestingly, we also found that SDEs from ischemic MMD promoted neuroblastoma cell proliferation. Proteomic analysis of mouse brain vascular EC cells suggested that SDEs from hemorrhagic MMD patients induced dysfunction of the mitochondria in cerebrovascular ECs.

Conclusions:

This study highlighted potential molecular mechanisms underlying the pathogenesis of MMD patients, thereby providing new therapeutic strategies for MMD.
Text Mining Islamic Law
Authors: Lange Christian , Latif Maksim Abdul , Çelik Yusuf , Lyklema A. Melle , van Kuppevelt Dafne E. , van der Zwaan Janneke
Published: August 2021

Digital humanities has a venerable pedigree, stretching back to the middle of the twentieth century, but despite noteworthy pioneering contributions it has not become a mainstream practice in Islamic Studies. This essay applies humanities computing to the study of Islamic law. We analyze a representative corpus of works of Islamic substantive law (furūʿ al-fiqh) from the beginnings of Islamic legal jurisprudence to the early modern period (2nd/8th-13th/19th c.) using several computational tools and methods: text-reuse network analysis based on plain-text annotations and html tags, clustered frequency-based analysis, word clouds, and topic modeling. Applying machine-guided distant reading to Islamic legal texts over the longue-dureé, we study (1) the role of the Qurʾān, (2) patterns of normative qualifications (aḥkām), and (3) the distribution of topics in our corpus. In certain instances the analysis confirms claims made in the scholarly literature on Islamic law, in other instances it corrects such claims.
Micrometeorological Aspects of Spraying within a Surface Inversion
Authors: Grace Warwick , Tepper Graeme
Published: August 2021

Pesticide applications during surface inversions can lead to spray drift causing severe damage up to several kilometers off-target. Current regulations in Australia prohibit spray application of certain agricultural chemicals when hazardous surface inversions exist. This severely limits spray opportunities. Surface inversions can be classified as weakly or strongly stable. In the weakly stable case, moderate to strong turbulent mixing is not supportive of long-distance concentrated drift. In the very stable case, weak turbulent mixing can support the transport of high concentrations of fine material over long distances. A review of the literature and our analyses indicate that if the turbulence, as measured by the standard deviation of the vertical wind speed σw, is greater than about 0.2 m s−1 then turbulence-driven mixing and dispersion is moderate to strong and conversely if σw is less than about 0.2 m s−1 then turbulence-driven mixing and dispersion is weaker (an order of magnitude). The concept of maximum downward heat flux as a natural division between the regimes is applied within Monin–Obukhov stability theory, and it is shown that the observed mean σw of 0.2 m s−1 aligns with the ridge line of maximum heat flux in stable conditions. The level of turbulence in the weakly stable regime is comparable to the turbulence typically observed in near-neutral conditions that are recommended under current guidelines as suitable for spraying and is therefore seen as an acceptable prerequisite to avoid nondispersive spraying conditions.
Biomarkers of Coronary Microvascular Dysfunction in Patients With Microvascular Angina: A Narrative Review
Authors: Sucato Vincenzo , Corrado Egle , Manno Girolamo , Amata Francesco , Testa Gabriella , Novo Giuseppina , Galassi Alfredo R
Published: August 2021

The current gold standard for diagnosis of coronary microvascular dysfunction (CMD) in the absence of myocardial diseases, whose clinical manifestation is microvascular angina (MVA), is reactivity testing using adenosine or acetylcholine during coronary angiography. This invasive test can be difficult to perform, expensive, and harmful. The identification of easily obtainable blood biomarkers which reflect the pathophysiology of CMD, characterized by high reliability, precision, accuracy, and accessibility may reduce risks and costs related to invasive procedures and even facilitate the screening and diagnosis of CMD. In this review, we summarized the results of several studies that have investigated the possible relationships between blood biomarkers involved with CMD and MVA. More specifically, we have divided the analyzed biomarkers into 3 different groups, according to the main mechanisms underlying CMD: biomarkers of “endothelial dysfunction,” “vascular inflammation,” and “oxidative stress.” Finally, in the last section of the review, we consider mixed mechanisms and biomarkers which are not included in the 3 major categories mentioned above, but could be involved in the pathogenesis of CMD.
Book review: Eiichiro Azuma, In Search of Our Frontier Japanese America and Settler Colonialism in the Construction of Japan’s Borderless Empire
Authors: Tankha Brij
Published: August 2021

Eiichiro Azuma, In Search of Our Frontier Japanese America and Settler Colonialism in the Construction of Japan’s Borderless Empire (University of California Press, 2019), $75.