bluuebunny/crossref_metadata_2025 huggingface dataset:
Lupus Nephritis: The Significant Contribution of Electron Microscopy
Authors: Truong Luan , Seshan Surya V.
Published: July 2021

Background: Systemic lupus erythematosus (SLE) represents a principal prototype of a multisystemic autoimmune disease with the participation of both cell- and antibody-mediated mechanisms causing significant renal impairment. A renal biopsy diagnosis is the gold standard for clinical renal disease in SLE, which includes a broad range of indications. Summary: Renal disease in SLE can involve glomerular, tubulointerstitial, and/or vascular compartments, none of which are mutually exclusive. In most instances, the basic pathogenetic mechanism involves tissue deposition of immune complexes and/or cell-mediated mechanisms, identified by light microscopy, immunohistochemical methods, and electron microscopy (EM), evoking intraglomerular proliferative, inflammatory, and other tissue responses. These produce a spectrum of histologic lesions, depending on the participation of a wide range of clinical triggers, namely, genetic, serological, and immunological factors, correlating with their underlying pathogenetic potential. In addition to light and immunofluorescence microscopy, EM in this setting facilitates an accurate diagnosis, assesses disease activity, delineates subclasses, differentiates from primary forms of non-lupus renal lesions, identifies organized deposits, and rarely, identifies other forms of nonimmune complex lesions such as podocytopathies, amyloidosis, and thrombotic microangiopathy. Key Messages: EM findings that are distinctive for most of the renal lesions in SLE include immune complex and nonimmune complex diseases as well as overlapping entities. Routine ultrastructural examination not only provides significant diagnostic and prognostic information from both initial and repeat renal biopsies from lupus patients but also contributes toward the understanding of the underlying pathophysiology of the disease process.
Increased Hepatic Microvascular Density, Oxygenation, and VEGF in the Hypertrophic Lobe following Portal Vein Embolization in Rabbits
Authors: Uz Zühre , Ergin Bülent , Shen Lucinda , van Lienden Krijn P. , Rassam Fadi , Olthof Pim B. , Bennink Roel J. , Ince Can , van Gulik Thomas M.
Published: July 2021

Introduction: The microvascular events following portal vein embolization (PVE) are poorly understood despite the pivotal role of the microcirculation in liver regeneration and tumor progression. We aimed to assess the changes in hepatic microvascular perfusion and neo-angiogenesis after experimental PVE. Methods: PVE of the cranial liver lobes was performed in 12 New Zealand White rabbits divided into 2 groups of permanent (P-PVE) and reversible PVE (R-PVE), respectively. Hepatobiliary scintigraphy and CT were used to evaluate hepatic function and volume. Hepatic microcirculation was assessed using a handheld vital microscope (Cytocam) to measure microvascular density (total vessel density; TVD) before PVE, right after PVE, and 20 min after PVE, as well as at 14 days (D14 post-PVE) and 35 days (D35 post-PVE). Additionally, on D35, microvascular PO2 and liver parenchymal VEGF were assessed. Results: Eleven rabbits were included after PVE (R-PVE, n = 5; P-PVE, n = 6). TVD in the nonembo­lized (hypertrophic) lobes was higher than in the embolized (atrophic) lobes of the P-PVE group at D35 post-PVE (36.7 ± 7.2 vs. 23.4 ± 4.9 mm/mm2; p < 0.05). In the R-PVE group, TVD in the nonembolized lobes was not increased at D35. Function and volume were increased in the nonembolized lobes of the P-PVE group compared to the embolized lobes, but not in the R-PVE group. Likewise, the mmicrovascular PO2 and VEGF staining rate were higher in the nonembolized lobes of the P-PVE group at D35 post-PVE. Discussion/Conclusion: Successful volumetric and functional hypertrophy of the nonembolized lobe was accompanied by microvascular alterations featuring increased neo-angiogenesis, microvascular density, and microvascular oxygen pressure following P-PVE.
The Psychosocial Burden on Liver Transplant Recipients during the COVID-19 Pandemic
Authors: Weber Sabine , Rek Stephanie , Eser-Valeri Daniela , Padberg Frank , Reiter Florian P. , De Toni Enrico , Hohenester Simon , Zimny Sebastian , Rehm Markus , Guba Markus Otto , Gerbes Alexander L. , Denk Gerald
Published: July 2021

Introduction: Due to the coronavirus disease 19 (COVID-19) pandemic, multiple measures have been implemented including social distancing and curfews. Both the disease and measures might cause stress, particularly in persons at risk, such as liver transplant (LT) recipients. Here, we evaluated the impact on psychosocial well-being of LT recipients. Methods: Seventy-nine LT recipients and 83 nontransplanted controls participated in this study. Questionnaires comprising the WHO-five well-being index (WHO-5), the University of California at Los Angeles (UCLA) Loneliness Scale, and the preliminary COVID-19 Pandemic Mental Health Questionnaire (CoPaQ) were distributed among them. For the WHO-5 and UCLA Loneliness Scale, means of sum scores were compared between both groups, while a comparison on item level was conducted for the CoPaQ. Results: The general well-being was similar in LT recipients and controls (WHO-5: 64.0 ± 20.5% vs. 66.4 ± 17.3%), while the UCLA Loneliness Scale indicated a higher level of perceived social isolation (1.90 ± 0.51 vs. 1.65 ± 0.53, p = 0.001). The CoPaQ indicated higher risk perception regarding health issues, in particular concerning the fear of having severe consequences in case of a COVID-19 infection (3.1 ± 1.1 vs. 2.2 ± 1.3, p < 0.001), higher risk-avoiding behavior and stronger adherence to pandemic measures in LT recipients. Conclusion: During the COVID-19 pandemic, LT recipients displayed a higher risk perception, a more pronounced risk-avoiding behavior and a higher perception of loneliness, while the overall well-being was comparable to nontransplanted controls.
Solid Papillary Carcinoma and Encapsulated Papillary Carcinoma of the Breast: Clinical-Pathologic Features and Basement Membrane Studies of 50 Cases
Authors: Morgan Sarah , Dodington David , Wu Jessie M. , Turashvili Gulisa
Published: July 2021

Introduction: Solid papillary carcinoma (SPC) and encapsulated papillary carcinoma (EPC) of the breast are usually considered in situ lesions due to favorable prognosis, despite the variable presence of myoepithelial cells. We aimed to describe clinical-pathologic features including basement membrane (BM) studies in these tumors. Methods: Patients diagnosed with SPC and EPC in 2000–2019 were retrospectively identified. Microscopic slides and clinical history were reviewed. Immunohistochemical stains for BM and myoepithelial markers were performed. Results: Of 23 SPCs and 27 EPCs, there were 5/23 (21.7%) pure SPCs and 9/27 (33.3%) pure EPCs, while 4/23 (17.4%) and 12/27 (44.5%) were associated with ductal carcinoma in situ (DCIS), and 6/23 (26.1%) and 6/27 (22.2%) with invasive carcinoma, respectively; 8/23 (34.8%) SPCs were considered invasive. The median tumor size was 1.7 cm (range 0.1–16). All tumors were positive for hormone receptors and negative for HER2. Myoepithelial cells were absent in 20 tumors (40%) and focally present in 30 (60%). Collagen IV and laminin were negative in most invasive lesions, but they were expressed in 21/21 (100%) and 18/21 (85.7%) of EPCs without invasion, and 16/17 (94.1%) and 10/17 (58.8%) SPCs, including invasive SPCs, respectively. Lymph node involvement was identified in 3/26 (11.5%) patients, including micrometastasis in 1 EPC associated with DCIS, macrometastasis in 1 EPC associated with invasive carcinoma, and isolated tumor cells in 1 invasive SPC. Of 31 patients with outcome data (median follow-up 35 months, range 1–85), 2 (6.5%; 1 SPC, 1 EPC) developed local recurrence, both associated with invasive carcinoma. No distant recurrences or deaths were observed. Conclusions: Our study confirms favorable prognosis of SPCs and EPCs, with 2 local recurrences occurring in the presence of invasion. SPCs are more commonly associated with invasive carcinoma or considered invasive compared to EPCs (60.9 vs. 22.2%). The presence of BM material and lack of lymph node involvement in most cases indicates that the majority of these tumors may represent in situ lesions; however, some may behave as low-grade invasive malignancy with metastatic potential even in the absence of conventional invasion.
Small Neuroendocrine Tumors of the Whole Gastrointestinal Tract Performed Endoscopic or Surgical Resections Also Show Positive for Lymphovascular Invasion
Authors: Miyashita Haruna , Yamasaki Takuji , Akita Yoshihiro , Ando Yoshitaka , Maruyama Yuki , Nagata Yusuke , Miyazaki Ryosuke , Noguchi Masaaki , Sawada Ryoichi , Sakurai Toshiyuki , Kato Tomohiro , Sumiyama Kazuki , Suka Machi , Hamatani Shigeharu , Saruta Masayuki
Published: July 2021

Background and Aims: In gastrointestinal neuroendocrine tumors (GI-NETs), tumor size and grading based on cellular proliferative ability indicate biological malignancy but not necessarily clinically efficient prognostic stratification. We analyzed tumor size- and grading-based prevalence of lymphovascular invasion in GI-NETs to establish whether these are true biological malignancy indicators. Methods: We included 155 cases (165 lesions), diagnosed histologically with GI-NETs, that had undergone endoscopic or surgical resection. Patient age, sex, method of treatment, tumor size, invasion depth, lymphovascular invasion positivity according to Ki-67 index-based neuroendocrine tumor grading, distant metastases, and outcome were evaluated. The primary endpoints were the prevalence of lymphovascular invasion according to tumor size and grading. Results: Overall, 24.8% were positive for lymphovascular invasion. There was a high rate of lymphovascular invasion positivity even among grade 1 cases (22.8%). The rate of lymphovascular invasion was 3.4% for grade 1 cases <5 mm, with a lymphovascular invasion rate of 8.7% for those 5–10 mm. Lymphovascular invasion ≤10% required a tumor size ≤8 mm, and lymphovascular invasion ≤5% required a tumor size ≤6 mm. A cutoff of 6 mm was identified, which yielded a sensitivity of 79% and a specificity of 63%. Even small GI-NETs grade 1 of the whole GI tract also showed positive for lymphovascular invasion. Conclusions: GI-NETs ≤10 mm had a lymphovascular invasion prevalence exceeding 10%. The lymphovascular invasion impact in GI-NET development is incompletely understood, but careful follow-up, including consideration of additional surgical resection, is crucial in cases with lymphovascular invasion.
Serum Sortilin Is Associated with Coronary Artery Calcification and Cardiovascular and Cerebrovascular Events in Maintenance Hemodialysis Patients
Authors: Xu Jie , Shen Chan-Juan , Ooi Joshua D. , Tang Yang-Shuo , Xiao Zhou , Yuan Qiong-Jing , Zhong Yong , Zhou Qiao-Ling
Published: July 2021

Objective: To analyze the role of serum sortilin in coronary artery calcification (CAC) and cardiovascular and cerebrovascular events (CCE) in maintenance hemodialysis (MHD) patients. Methods: One hundred eleven patients with MHD ≥3 months were included in this study. The general data, clinical features, hematological data, and medication history of the patients were recorded. Eighty-five cases were examined by vascular color Doppler ultrasound, cardiac color Doppler ultrasound, lateral lumbar radiography, and coronary artery calcification score. The patients were followed up for a median time of 45 months. The primary endpoint was CCE or death from a vascular event, and the role of sortilin in this process was analyzed. Results: Among 85 MHD patients, 51 cases (60.00%) had different degrees of CAC. There were significant differences in diabetes, dialysis time, serum phosphorus, calcium-phosphorus product, medical history of phosphate binders, sortilin, and carotid artery plaque between 4 different degrees of calcification groups (p < 0.05). Logistic regression analysis showed that diabetes (OR = 5.475; 95% CI: 1.794–16.71, p = 0.003), calcium-phosphorus product (OR = 2.953; 95% CI: 1.198–7.279, p = 0.019), and sortilin (OR = 1.475 per 100 pg/mL; 95% CI: 1.170–1.858, p = 0.001) were independent risk factors for CAC. During the follow-up, 28 cases of 111 patients (25.23%) suffered from CCE. There were significant differences in CCE between mild, moderate, and severe CAC groups and noncalcification groups (p < 0.05). Cox regression analysis showed that diabetes mellitus (HR 3.424; 95% CI: 1.348–8.701, p = 0.010), CAC (HR 5.210; 95% CI: 1.093–24.83, p = 0.038), and serum sortilin (HR = 8.588; 95% CI: 1.919–38.43, p = 0.005) were independent risk factors for CCE. Besides, we proposed a cutoff value of 418 pg/mL for serum sortilin level, which was able to predict the occurrence of CCE with 75.0% sensitivity and 71.9% specificity. The area under the curve was 0.778 (95% CI: 0.673–0.883). Conclusion: Sortilin is newly found to be independently associated with CAC and CCE in MHD patients.
Inflammatory Biomarkers as Promising Predictors of Prognosis in Cervical Cancer Patients
Authors: Domenici Lavinia , Tonacci Alessandro , Aretini Paolo , Garibaldi Silvia , Perutelli Alessandra , Bottone Pietro , Muzii Ludovico , Benedetti Panici Pierluigi
Published: July 2021

Introduction: Increasing evidence demonstrates a crucial role of inflammation in inducing and promoting several cancers. Pro-inflammatory upregulation of cytokines such as IL-6 has been implicated in cervical cancer development and progression through several mechanisms, for example, by inducing platelet production, activation, and aggregation. The aim of the study was to evaluate the effective prognostic impact of inflammatory biomarkers such as platelet count, platelet to lymphocyte ratio (PLR), and IL-6 in cervical cancer patients. Materials and Methods: Between 2016 and 2019, 108 out of 159 patients with cervical cancer have been enrolled. Cutoff level of pretreatment platelet count and PLR was identified by using the ROC curve. IL-6 tumoral and peritumoral expression was analyzed and stratified as low and high (low expression: 0 and +1; marked expression: +2 and +3). Results: Median follow-up duration was 30 months (range 16–44). Patients with higher platelet counts showed worse DFS and OS (DFS p < 0.001; OS p < 0.001). Cumulative rates of DFS and OS in patients with lower PLR were higher than in patients with higher values of PLR (DFS p = 0.032; OS p < 0.001). Survival analysis showed a better prognosis in patients with lower IL-6 expression (DFS p < 0.001; OS p < 0.001). Conclusion: Nowadays, causal relationship between inflammation, innate immunity, and cancer is more widely accepted. However, many of the molecular and cellular mechanisms mediating this relationship remain unresolved. Ongoing inflammatory response was associated with poor outcomes in cervical cancer patients. A higher pretreatment platelet count and PLR value associated with higher IL-6 tumoral expression could be used to predict poor prognosis in cervical cancer patients.
The Impact of Google Suites Amidst the New Normal
Authors: Mobo Froilan D.
Published: July 2021

The Novel Corona Virus has greatly made an impact in the global community and including business sectorial group. Sectoral business establishments were temporarily closed because of the strict quarantine protocol set by the Inter-Agency Task Force on COVID 19. Classes and Work were also suspended that is why we are experiencing delays in all transactions. The virus has shifted our global workforce into a cloud-based or virtual-based transaction because there are regulations that we need to follow regardless if that is private and public offices. Most of them used technological platform like Google Suites which includes office application and virtual transactions that will help our economy boost up.
21st-Century Skills of Social Studies Students: Basis for a Proposed Training Program
Authors: Jr Danilo V. Rogayan , Gallardo Carlisle B. , Lacaste Jerrica T. , Roque Darley Joyce A.
Published: July 2021

Enhancing the 21st-century skills of learners will significantly help them become future-ready and globally-competent workforce in the global economy in the context of the fourth industrial revolution. This descriptive cross-sectional survey determined the 21st-century skills of junior high school learners as an input for a suggested train-ing program. A total of 120 seventh grade learners of a public sec-ondary school in Central Luzon, Philippines responded to the 21st-Century Skills Questionnaire (α=0.960). Results showed that the respondents have a moderate level of attainment of the 21st-century skills (M=3.46, SD=0.66). They moderately exhibit learning and innovation skills (LIS) (M= 3.32, SD=0.66), and highly exhibit information, media, and technology skills (IMTS) (M=3.53, SD=0.82), and life and career skills (LCS) (M=3.53, SD=0.74). Female students have higher overall 21st-century skills, and LIS than their male counterparts based on the independent sample t-test result. Furthermore, there is a significant correlation between LIS and IMTS (r=0.619, p=0.000), between LIS and LCS (r=0.560; p=0.000); and between IMTS and LCS (r=0.820; p=0.000). Learning institutions must adapt to the emerging Education 4.0 brought about by the new industrial era and the 21st-century society so that learners can thrive to the current and evolving challenges. A proposed training program is recommended for implementation to enhance the students’ 21st-century skills.
Through Pains and Gains: Measures of 21st Century Skills and Sense of Self-Efficacy of Alternative Learning System (ALS) Learners
Authors: Zulueta Ma. Cristina E. , Bag-ao Girlin , Bayucca Shallimar A. , Brombuela Glenn B. , Cajurao Garci Gil V. , Canlas Alden P. , Mendoza Maria Vanessa S. , Roque III Myron Willie B. , Sagun Angelita T. , Caparas Ma. Editha R.
Published: July 2021

For several years, illiteracy, poverty, and deprivation were the worst adversary of the Philippine Government. One of the greatly affected sec-tors of illiteracy and poverty is the education sector. The Department of Education (DepEd) has experienced large amounts of drop-outs and out-of-school youth and adults due to poverty. For the Department to alleviate this concern, the Alternative Learning System (ALS) was es-tablished. ALS offers basic schooling for all persons who wish to return to school in a way that fits their personal needs and situation. Hence, this study assessed and extrapolated ALS learners with their 21st-century skills and its correlation to their sense of self-efficacy. Using a descriptive-correlational design, the researchers wanted to establish a link between and among variables. The findings of the study revealed moderate acquisition of 21st-century skills among ALS’ learners. Their sense of self-efficacy was also noted to be high. Further analysis re-vealed that, ALS learners’ acquisition of 21st century skills significantly correlated to their sense of self-efficacy. It is recommended that ALS teachers should provide more activities that will further enhance and strengthen the local and global awareness of ALS learners. Also, possible extension of the study could be undertaken to draw the general picture of the ALS learners as to their skills and sense of self-efficacy.
The Research Capability of Secondary School Science Teachers
Authors: Tolentino Keneth S.
Published: July 2021

This paper described the perceived level of research capability of secondary school Science teachers in the basic education whereas a descriptive-correlational design was employed to determine the extent of relationship between research capability and profile of the 76 Science teachers from the Schools Division of Pampanga. A Re-search Capability Self-Assessment Scale Abrazado & Coronel (2016) was adopted to identify the level of research capability of the respondents, also a checklist was developed to identify the problems encountered by on their research undertakings. Most of the Science teachers did not yet pursue higher professional studies. Majority did not have the opportunity to attend research trainings; regarded with low research productivity. Science teachers had moderate research capability. Science teachers’ research capability had low level relationship with their profile in terms of educational attainment, research trainings and seminars attended, and research output. Lack of time, research trainings and research skills were the problems encountered. A sustainable research development program will aid Science teachers to develop and enhance their research capability.
Clients’ Satisfaction of the Therapeutic Community Modality Program: Ba-sis for the Development of Prototype Syllabus
Authors: Dausan Alrien F. , Virtudazo Francia S.
Published: July 2021

The study determined the Therapeutic Community (TC) clients’ satisfaction and assessment of the Therapeutic Community Modality Program rendered by the Parole and Probation Administration in the National Capital Region (NCR). The researchers-made survey questionnaire was administered to two (2) groups of respondents composed of 33 probation and parole personnel and 285 therapeutic community clients. The researchers-made survey questionnaire was validated by the four (4) experts in the field of therapeutic community modality program. The study revealed that the TC clients were satisfied on the Therapeutic Community Modality Program in all of the dimensions being assessed; however, there are indicators on clients’ satisfaction that obtained the lowest weighted mean that need to be addressed. On behav-ior management, there is a need for the TC implementers to reinforce community values and give emphasis on organizational structure. On the intellectual and spiritual aspects, educational activities and academic training must be intensified with focus on group activities that counter negative behavior to reinforce community values. On vocational and survival aspects, the TC program must incorporate vocational and livelihood training. The researchers conclude that the TC clients’ and TC personnel are satisfied to the Therapeutic Community Modality Program in terms of behavior management, intellectual and spiritual, vocational, and survival, and emotional and psychological aspects.
Progress testing as a pattern of excellence for the assessment of medical students’ knowledge: concepts, history, and perspective
Authors: Cecilio-Fernandes Dario , Bicudo Angélica Maria , Hamamoto Filho Pedro Tadao
Published: July 2021

Progress test has been created with the necessity of an assessment method align with problem-based learning. Although it was specifically created to overcome the limitations of traditional assessment for problem-based learning, nowadays is used by different type of curricula. In this paper, we first present the basic assumptions, the history, benefit and challenges of the progress test. Progress test overcomes many limitations of traditional assessment, such as validity and reliability. However, the implementation of progress test is a logistical challenge. In addition, we discuss the limitation of progress test when used as summative assessment, which may not always be aligned with constructivist theory. When adding feedback and methods of analysis that considers multiple testing, progress test is then align with constructivist theory. Finally, the use of progress test’s sub scores may lack validity because of the low number of items; thus, pass/fail decision should not be based on the sub scores, but only on general scores.
Perfil epidemiológico dos casos de histerectomia em um Hospital Universitário Terciário
Authors: Mesquita Yanne Carolline Silva , Wanderley Georgianna Silva , Chaves José Humberto Belmino , Wanderley Geordanna Silva
Published: July 2021

INTRODUÇÃO:A histerectomia é o segundo procedimento operatório mais frequente em mulheres na idade reprodutiva, sendo superada apenas pela cesariana. É um tratamento cirúrgico de remoção parcial ou total do útero, indicado para diversas patologias do assoalho pélvico feminino. Trata-se de uma cirurgia irreversível, com alteração da integridade corporal e com implicações na identidade sexual feminina. OBJETIVO: descrever o perfil clínico-epidemiológico das pacientes que passaram pela histerectomia, a fim de avaliar a tendência de indicações cirúrgicas adotadas. MATERIAL E MÉTODOS: A presente pesquisa se trata de um estudo descritivo, comparativo e transversal, realizado com base em dados secundários, coletados de laudos histológicos e prontuários médicos de mulheres submetidas à histerectomia total no Hospital Universitário Professor Alberto Antunes (HUPAA), Maceió-AL, na série histórica de 2009 a 2018. RESULTADOS: A faixa etária de 41-50 anos correspondeu a 43,8% das pacientes que passaram pela histerectomia. A miomatose uterina, em conformidade com o que demonstra a literatura, representou 60,3% das indicações. Os sintomas relacionados a alterações menstruais foram os principais citados. A Ultrassonografia pélvica, considerada padrão ouro para diagnóstico dos miomas uterinos, foi o exame complementar mais utilizado. CONCLUSÃO: Os dados coletados, de maneira geral, entram em consonância com a literatura disponível. Contudo, ainda existem casos em que é preciso uma melhor investigação para a indicação correta da histerectomia.
Laboratório de habilidades e simulação clínica em época de Covid-19: possibilidades e recomendações práticas
Authors: Costa Raphael Raniere de Oliveira , Mata Ádala Nayana de Sousa , Almeida Rodrigo Guimarães dos Santos , Coutinho Verónica Rita Dias , Alves Leandro Yukio Mano , Mazzo Alessandra
Published: July 2021

Este artigo teve por objetivo refletir sobre as possibilidades do laboratório de habilidades e simulação clínica enquanto espaço potencial para o treino e desenvolvimento de competências e habilidades no ensino em saúde, além de compartilhar estratégias para o planejamento docente e para o uso desses espaços em tempos de pandemia pela COVID-19. Estudo descritivo, exploratório e qualitativo realizado a partir da consulta a protocolos de recomendações sanitárias, diretrizes/planejamento de universidades públicas nacionais e internacionais para o retorno das atividades acadêmicas práticas em cursos da área da saúde e a opinião de especialistas em simulação clínica. São compartilhadas orientações específicas e comuns considerando os tipos de simulação propostas, estratégias de apoio às experiências clínicas simuladas, além de diretrizes sanitárias. Trata-se de recomendações que devem ser discutidas e adaptadas conforme as diferentes realidades, atualização de diretrizes sanitárias dos órgãos de saúde e educação, além do monitoramento do comportamento da pandemia causada pelo coronavírus em todo o mundo.
Thrombus Structural Composition in Cardiovascular Disease
Authors: Alkarithi Ghadir , Duval Cédric , Shi Yu , Macrae Fraser L. , Ariëns Robert A.S.
Published: July 2021

Thrombosis is a major complication of cardiovascular disease, leading to myocardial infarction, acute ischemic stroke, or venous thromboembolism. Thrombosis occurs when a thrombus forms inside blood vessels disrupting blood flow. Developments in thrombectomy to remove thrombi from vessels have provided new opportunities to study thrombus composition which may help to understand mechanisms of disease and underpin improvements in treatments. We aimed to review thrombus compositions, roles of components in thrombus formation and stability, and methods to investigate thrombi. Also, we summarize studies on thrombus structure obtained from cardiovascular patients and animal models. Thrombi are composed of fibrin, red blood cells, platelets, leukocytes, and neutrophil extracellular traps. These components have been analyzed by several techniques, including scanning electron microscopy, laser scanning confocal microscopy, histochemistry, and immunohistochemistry; however, each technique has advantages and limitations. Thrombi are heterogenous in composition, but overall, thrombi obtained from myocardial infarction are composed of mainly fibrin and other components, including platelets, red blood cells, leukocytes, and cholesterol crystals. Thrombi from patients with acute ischemic stroke are characterized by red blood cell- and platelet-rich regions. Thrombi from patients with venous thromboembolism contain mainly red blood cells and fibrin with some platelets and leukocytes. Thrombus composition from patients with myocardial infarction is influenced by ischemic time. Animal thrombosis models are crucial to gain further mechanistic information about thrombosis and thrombus structure, with thrombi being similar in composition compared with those from patients. Further studies on thrombus composition and function are key to improve treatment and clinical outcome of thrombosis.
In Vivo Characterization of Endogenous Cardiovascular Extracellular Vesicles in Larval and Adult Zebrafish
Authors: Scott Aaron , Sueiro Ballesteros Lorena , Bradshaw Marston , (辻千里)  , Power Ann , Lorriman James , Love John , Paul Danielle , Herman Andrew , Emanueli Costanza , Richardson Rebecca J.
Published: July 2021

Objective:

Extracellular vesicles (EVs) facilitate molecular transport across extracellular space, allowing local and systemic signaling during homeostasis and in disease. Extensive studies have described functional roles for EV populations, including during cardiovascular disease, but the in vivo characterization of endogenously produced EVs is still in its infancy. Because of their genetic tractability and live imaging amenability, zebrafish represent an ideal but under-used model to investigate endogenous EVs. We aimed to establish a transgenic zebrafish model to allow the in vivo identification, tracking, and extraction of endogenous EVs produced by different cell types.

Approach and Results:

Using a membrane-tethered fluorophore reporter system, we show that EVs can be fluorescently labeled in larval and adult zebrafish and demonstrate that multiple cell types including endothelial cells and cardiomyocytes actively produce EVs in vivo. Cell-type specific EVs can be tracked by high spatiotemporal resolution light-sheet live imaging and modified flow cytometry methods allow these EVs to be further evaluated. Additionally, cryo electron microscopy reveals the full morphological diversity of larval and adult EVs. Importantly, we demonstrate the utility of this model by showing that different cell types exchange EVs in the adult heart and that ischemic injury models dynamically alter EV production.

Conclusions:

We describe a powerful in vivo zebrafish model for the investigation of endogenous EVs in all aspects of cardiovascular biology and pathology. A cell membrane fluorophore labeling approach allows cell-type specific tracing of EV origin without bias toward the expression of individual protein markers and will allow detailed future examination of their function.
Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association
Authors: Kernan Walter N. , Viera Anthony J. , Billinger Sandra A. , Bravata Dawn M. , Stark Susan L. , Kasner Scott E. , Kuritzky Louis , Towfighi Amytis ,   on behalf of the American Heart Association Stroke Council; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; and Council on Peripheral Vascular Disease
Published: July 2021

Primary care teams provide the majority of poststroke care. When optimally configured, these teams provide patient-centered care to prevent recurrent stroke, maximize function, prevent late complications, and optimize quality of life. Patient-centered primary care after stroke begins with establishing the foundation for poststroke management while engaging caregivers and family members in support of the patient. Screening for complications (eg, depression, cognitive impairment, and fall risk) and unmet needs is both a short-term and long-term component of poststroke care. Patients with ongoing functional impairments may benefit from referral to appropriate services. Ongoing care consists of managing risk factors such as high blood pressure, atrial fibrillation, diabetes, carotid stenosis, and dyslipidemia. Recommendations to reduce risk of recurrent stroke also include lifestyle modifications such as healthy diet and exercise. At the system level, primary care practices can use quality improvement strategies and available resources to enhance the delivery of evidence-based care and optimize outcomes.
There Once Was a Really Bad Poet, It Was Automated but You Didn’t Know It
Authors: Wang Jianyou , Zhang Xiaoxuan , Zhou Yuren , Suh Christopher , Rudin Cynthia
Published: July 2021

Limerick generation exemplifies some of the most difficult challenges faced in poetry generation, as the poems must tell a story in only five lines, with constraints on rhyme, stress, and meter. To address these challenges, we introduce LimGen, a novel and fully automated system for limerick generation that outperforms state-of-the-art neural network-based poetry models, as well as prior rule-based poetry models. LimGen consists of three important pieces: the Adaptive Multi-Templated Constraint algorithm that constrains our search to the space of realistic poems, the Multi-Templated Beam Search algorithm which searches efficiently through the space, and the probabilistic Storyline algorithm that provides coherent storylines related to a user-provided prompt word. The resulting limericks satisfy poetic constraints and have thematically coherent storylines, which are sometimes even funny (when we are lucky).
Chrysostom’s Homily on the Word Koimeterion and on the Cross: A Translation and Commentary
Authors: Friel David M.
Published: July 2021

Chrysostom’s homily De coemeterio et de cruce (CPG 4337) was delivered during a full eucharistic synaxis on Good Friday in a cemetery outside the gates of late-fourth-century Antioch. It demonstrates both rhetorical and theological prowess. Chrysostom consoles his hearers by likening death to sleep and reflecting on the cemetery as a “sleeping place” (koimeterion). The text is notable for its theology of physical space, its conception of liturgical anamnesis, and its presentation of the Christus Victor atonement motif. The homily also highlights the liturgical role of the Holy Spirit, especially by alluding to the eucharistic epiclesis, and it chastises the congregation for their poor behavior during the communion rite. This article presents the homily’s full text in Greek with English translation, followed by a commentary that probes its major themes and liturgical aspects.
Basic regulatory effects and clinical value of metalloproteinase-14 and extracellular matrix metalloproteinase inducer in diabetic retinopathy
Authors: Li Shuyan , Lu Shiheng , Zhang Lei , Liu Shasha , Wang Lei , Lin Kai , Du Jialun , Song Meixia
Published: July 2021

This study examined the basic regulatory effects and clinical value of metalloproteinase-14 and extracellular matrix metalloproteinase inducer in diabetic retinopathy. Seventy-four patients with diabetic retinopathy (study group/diabetic retinopathy (DR) group) and 48 healthy people
(control group) were included in this study. Venous blood of subjects in the two groups was collected and the plasma levels of EMMPRIN, MMP-14, VEGF, and MMP-9 were determined by enzyme-linked immunosorbent assay. The value of applying plasma EMMPRIN and MMP-14 for predicting the prognosis
of DR was evaluated using a receiver operating characteristic (ROC) curve with a 1-year follow-up. Human umbilical vein endothelial cells (HUVECs) were cultured in high-glucose conditions. EMMPRIN and MMP-14 mRNA levels were determined by RT-qPCR, EMMPRIN and MMP-14 protein levels were determined
by Western blotting, apoptosis was determined by flow cytometry, and the level of angiogenesis was recorded. The levels of EMMPRIN and MMP-14 in the DR group were increased compared with those in the control group. Plasma EMMPRIN was positively correlated with plasma MMP-9 and plasma VEGF,
and its area under the curve (AUC) for predicting 1-year adverse outcome of DR was 0.676. Plasma MMP-14 was also positively correlated with plasma MMP-9 and plasma VEGF, and its AUC for predicting 1-year adverse outcome of DR was 0.650. EMMPRIN and MMP-14 were upregulated in high-glucose-induced
HUVECs. Downregulation of EMMPRIN resulted in downregulation of MMP-14, and downregulation of MMP-14 and EMMPRIN resulted in decreased apoptosis and angiogenesis of HUVECs. These findings suggest that EMMPRIN promotes endothelial cell apoptosis and angiogenesis in DR through MMP-14, and that
plasma EMMPRIN and MMP-14 can help predict the short-term prognosis of DR.
Study of zinc oxide nanoparticles on epithelial-mesenchymal transition and toxicity of spontaneous monocyte-mediated cytotoxity-7721 cells
Authors: Wang Luoluo , Ruan Yi , Wu Xiang , Zhou Xinhua
Published: July 2021

To explore the method of studying zinc oxide nanoparticles on the epithelial-mesenchymal transition and toxicity of liver cancer SMMC-7721 cells. Human liver cancer SMMC-7721 cells is stored in 90% FBS+10% DMSO liquid nitrogen. ZnO suspension was prepared, cell viability was assessed
using MTT assay, cell apoptosis was analyzed by flow cytometry, and EMT-related proteins were detected by western blotting. Results showed LDH activity increased continuously with the increase in ZnO nanoparticle concentration and exposure time (P < 0.001). Both ATP and SOD activities
gradually decreased with the increase in ZnO nanoparticle concentration and exposure time (both P < 0.001). The MTT assay revealed that with the increase in ZnO dose, the proliferation of SMMC-7721 liver cancer cells decreased gradually (P < 0.001), and with the continuous
increase in exposure time to ZnO nanoparticles, the reproductive viability of these cells also continued to decline (P < 0.001). The apoptosis rate of SMMC-7721 liver cancer cells increased with the increase in ZnO dose (P < 0.001). Flow cytometry results demonstrated that
the apoptosis rate of SMMC-7721 liver cancer cells increased with the continuous prolongation of treatment time (P < 0.001). Western blotting experiments revealed that the concentrations of vimentin, Snail, N-cadherin, and Slugn proteins in SMMC-7721 cells increased significantly,
whereas those of E-cadherin and ZO-1 decreased significantly, with the increase in ZnO dose (both P < 0.001). Therefore, ZnO nanoparticles can induce apoptosis of SMMC-7721 liver cancer cells, inhibit cell proliferation and EMT, and can be used as a new nanoparticle carrier for potential
treatment of liver cancer.
Research progress of ceramic particles reinforced Al-based composites with micro-nano-scale and high volume fraction
Authors: He Wenjing , Fan Caihe , Ao Hong , Dai Nanshan , Hu Zeyi , Shen Tong
Published: July 2021

Al-based composites reinforced by high volume fraction ceramic particles have attracted much attention because of their high specific strength, high specific modulus, good wear resistance, and low thermal expansion properties. The preparation technology, advantages, and disadvantages
of Al-based composites reinforced by high ceramic content are reviewed in this study. The research status of the microstructure and mechanical properties of Al-based composites reinforced by high ceramic particles content is summarized. The effects of ceramic content and preparation technology
on the properties of Al-based composites are described. The strengthening mechanism of micro-nano-scale ceramic particles in composites is also expounded. The development trend of micro-nano-scale high content ceramic particle-reinforced Al-based composites is prospected.
Fabrication of AgOx/Graphene-Based Acetaminophen Sensor
Authors: Luk Hsiang-Ning , Yeh Yu-Wen , Wu Ren-Jang , Chavali Murthy
Published: July 2021

In this work, we prepared AgOx/Graphene composite material as the working electrode; the acetaminophen is determined by the electrochemical method. Using cyclic voltammetry electrochemical sensing method determined the current signal of acetaminophen (0.98 μM–15.6 μM)
with electrolyte phosphate-buffer solution. When the voltage was operated as 0.42 V, an oxidation peak appeared in the linear concentration range and the least mean square was obtained R2 = 0.9922, and the detection limit was calculated as 0.26 μM. Using a differential
pulse voltammetry electrochemical-sensing method, we determined the current signal of various acetaminophen concentrations (0.98 μM–7.8 μM). When the voltage is 0.33 V, R2 = 0.9996, and the detection limit is 0.15 μM. The material was characterized
by TEM and XRD. It was also confirmed that Ag2O and Ag coexist (AgOx) on the surface of graphene, which facilitates the oxidation-reduction reaction of acetaminophen on the electrode.
Cloud-dependent piecewise assimilation based on a hydrometeor-included background error covariance and its impact on regional Numerical Weather Prediction
Authors: Meng Deming , Chen Yaodeng , Li Jun , Wang Hongli , Wang Yuanbing , Sun Tao
Published: July 2021

The background error covariance (B) behaves differently and needs to be carefully defined in cloudy areas due to larger uncertainties caused by models’ inability to correctly represent complex physical processes. This study proposes a new cloud-dependent B strategy by adaptively adjusting the hydrometeor-included B in the cloudy areas according to the cloud index (CI) derived from the satellite-based cloud products. The adjustment coefficient is determined by comparing the error statistics of B for the clear and cloudy areas based on the two-dimensional geographical masks. The comparison highlights the larger forecast errors and manifests the necessity of using appropriate B in cloudy areas. The cloud-dependent B is then evaluated by a series of single observation tests and three-week cycling assimilation and forecasting experiments. The single observation experiments confirm that the cloud-dependent B allows cloud dependency for the multivariate analysis increments and alleviates the discontinuities at the cloud mask borders by treating the CI as an exponent. The impact study on regional numerical weather prediction (NWP) demonstrates that the application of the cloud-dependent B reduces analyses and forecasts bias and increases precipitation forecast skills. Diagnostics of a heavy rainfall case indicate that the application of the cloud-dependent B enhances the moisture, wind, and hydrometeors analyses and forecasts, resulting in more accurate forecasts of accumulated precipitation. The cloud-dependent piecewise analysis scheme proposed herein is extensible, and a more precise definition of CI can improve the analysis, which deserves future investigation.
The mediating effect of brain-derived neurotrophic factor levels on childhood trauma and psychiatric symptoms in patients with first-episode schizophrenia
Authors: Wang Leilei , Yin Yi , Zhou Yanfang , Huang Junchao , Zhang Ping , Chen Song , Fan Hongzhen , Cui Yimin , Luo Xingguang , Tan Shuping , Wang Zhiren , Li Chiang-Shan R , Tian Baopeng , Tian Li , Elliot Hong L , Tan Yunlong
Published: July 2021

Background:

Previous studies have implicated childhood trauma and abnormal brain-derived neurotrophic factor in the pathogenesis of schizophrenia. Here, we explored whether brain-derived neurotrophic factor levels mediated the relationship between childhood trauma and psychopathological symptoms in patients with first-episode schizophrenia.

Methods:

Patients with first-episode schizophrenia ( n = 192) and healthy controls ( n = 136) were enrolled. Childhood traumatic experiences and psychopathology were assessed by Childhood Trauma Questionnaire and Positive and Negative Syndrome Scale, respectively. Enzyme-linked immunosorbent assay was used to quantify brain-derived neurotrophic factor levels.

Results:

The patients with first-episode schizophrenia experienced more severe childhood trauma and had lower serum brain-derived neurotrophic factor levels than healthy controls. Emotional abuse and Childhood Trauma Questionnaire total score showed positive correlation with Positive and Negative Syndrome Scale positive, general psychopathological subscore and total score. Emotional neglect showed positive correlation with Positive and Negative Syndrome Scale positive subscore. Physical neglect was positively associated with Positive and Negative Syndrome Scale negative subscore. Emotional neglect and Childhood Trauma Questionnaire total score were negatively correlated with serum brain-derived neurotrophic factor levels. The serum brain-derived neurotrophic factor levels mediated the relationship between both Childhood Trauma Questionnaire total score and Positive and Negative Syndrome Scale total score and negative symptoms in the patients. The brain-derived neurotrophic factor levels also mediated the relationship between emotional neglect and Positive and Negative Syndrome Scale total score in the patients.

Conclusion:

Childhood trauma might contribute to the clinical symptoms of schizophrenia by affecting brain-derived neurotrophic factor levels. Perhaps we can prevent schizophrenia by reducing childhood traumatic experiences.
Culturally competent, safe and equitable clinical care for Ma¯ori with bipolar disorder in New Zealand: The expert critique of Ma¯ori patients and Wha¯nau
Authors: Haitana Tracy , Pitama Suzanne , Cormack Donna , Clark Mau Te Rangimarie , Lacey Cameron
Published: July 2021

Objective:

Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system.

Methods:

A qualitative Kaupapa Māori Research methodology was used. A total of 24 semi-structured interviews were completed with Māori patients with bipolar disorder and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data.

Results:

Three themes were evident from participants’ critique of clinical components of the health system. Theme 1 established that the efficacy of clinical care for bipolar disorder was dependent on Māori patients and whānau having clear pathways through care, and being able to access timely, consistent care from clinically and culturally competent staff. Theme 2 identified the influence of clinical culture in bipolar disorder services, embedded into care settings, expressed by staff, affecting the safety of clinical care for Māori. Theme 3 focused on the need for bipolar disorder services to prioritise clinical work with whānau, equip staff with skills to facilitate engagement and tailor care with resources to enhance whānau as well as patient wellbeing.

Conclusion:

The standard of clinical care for Māori with bipolar disorder in New Zealand does not align with practice guidelines, Māori models of health or clinical frameworks designed to inform treatment and address systemic barriers to equity. Research also needs to explore the role of structural and organisational features of the health system on Māori patient and whānau experiences of care.
Keeping it in the family: Cultural socialization among Haitian American families
Authors: Etienne Vadricka Y.
Published: July 2021

The broad areas of ethnic and racial socialization have been studied as essential aspects of immigrant and African American families. Yet, there has been less understanding of how these processes intersect, specifically within second-generation Black immigrant families. This article draws on 41 interviews and 10 months of ethnographic fieldwork to explore how ethnically-identified Haitian American parents transmit ethnicity and prepare their children to navigate systems of racial oppression. Findings demonstrate how these processes operate concurrently within second-generation Black immigrant families amidst parental motivation for transmitting ethnicity across generations and the realities of raising Black children in a majority-minority city.