bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Interlayer on Water Cut Rise in a Bottom Water Reservoir
Authors: Hu Yunpeng , Zhang Xiaoling , Ding Wei , Cheng Ziyun , Qu Liangchao , Su Penghui , Sun Chunliu , Zhang Wenqi
Published: August 2021

A bottom water reservoir is universal in all reservoirs in the world. In the exploitation process of the bottom water reservoir, because the reservoir is in complete contact with bottom water, the natural energy supply of the bottom water reservoir is sufficient. At the same time, in the production process, the pressure drop generated by the formation is mainly concentrated near the wellbore, which leads to a short period of waterless oil production, fast water breakthrough, and fast water cut rise, which seriously affects the overall recovery factor and increases the risk of oil filed exploitation. Since the distribution of an interlayer enhances the heterogeneity of the reservoir, it has a prominent impact on the flow of oil and water in the bottom water reservoir. However, people know little about the impact of the interlayer on the bottom water reservoir. In this paper, the mathematical model of two-phase flow in the bottom water reservoir with the interlayer is proposed, and the numerical solution of the model is obtained by a finite element method. The influence of the distribution of the interlayer on the water cut rising law of the bottom water reservoir is analyzed. The results show that the bottom water is blocked by the interlayer and its own gravity and the rising height of the bottom water is limited, so that the interlayer has a significant inhibitory effect on the coning of the bottom water. The closer the interlayer is to the oil-water interface, the faster the water cut will rise; the narrower the interlayer is, the faster the bottom water ridge will advance; when the width of the interlayer is the same as that of the reservoir, the water cone will not appear; the higher the permeability of the interlayer is, the faster the upper body of the water cut will be; when the permeability of the reservoir and the interlayer is over 1000, the influence of the interlayer on the water cut rise is not obvious; the thickness of the interlayer on the water cut rise law has little effect. Finally, through the case analysis, it is proposed that the new horizontal wells should be arranged in the position where the interlayer develops. The findings of this study can help for the better understanding of control laws of the interlayer on the bottom water and providing a crucial theoretical basis for the development of the bottom water reservoir.
Analysis of Risk Factors of Level V Lymphatic Metastasis for Papillary Thyroid Carcinoma with pN1b
Authors: Li Chuang , Meng Zhao-zhong , Qin Jian-wu , Qiu Xin-guang
Published: August 2021

Objective. To explore the risk factors of level V lymphatic metastasis in papillary thyroid carcinoma (PTC) patients with pN1b. Methods. Patients were selected if they presented with a suspicious level III or IV lymph node metastasis and underwent surgery by hemi or total thyroidectomy with a lymph node dissection (levels III, IV, VI, and VII). For these patients, if frozen section showed a positive level III or IV node, then levels II and V nodes were resected. Univariate analysis was performed using the chi-square test for some factors, including age, sex, tumor location, multifocal lesions, tumor size, local invasion of primary focus, status of cervical lymphatic metastasis, TNM staging, tumor deposits (independent tumor nodules), and the metastasis to more than 5 central lymph nodes. Then, the factors with statistical significance indicated by the above univariate analysis underwent multivariate analysis. Results. Univariate analysis indicated that the level V lymphatic metastasis was significantly associated with simultaneous metastases to levels II, III, and IV, simultaneous metastases to levels III and IV, and tumor deposits (all

p
<
0.05

), but it was not significantly associated with age, sex, tumor location, multifocal lesions, tumor size, local invasion of primary focus, other cervical lymphatic metastasis, TNM staging, and the metastases to more than 5 central lymph nodes (all

p
>
0.05

). Multivariate analysis suggested that the simultaneous metastases to levels III and IV and tumor deposits were the risk factors of level V lymphatic metastasis. Conclusion. The simultaneous metastases to levels III and IV and tumor deposits are independent risk factors of level V lymphatic metastasis. The patients with pN1b PTC who have simultaneous metastases to levels III and IV or/and tumor deposits may have the risk of level V lymph node metastasis.
The Assistive Device Situation for ALS Patients in Norway
Authors: Rolland Jenny Pernilla , Myrberget Mari-Anne , Meisingset Tore Wergeland
Published: August 2021

Aims. There are limited analytical descriptions of the assistive device situation in Norway for patients with ALS and other motor neuron diseases. This study is aimed at investigating how patients, caregivers, and healthcare professionals (occupational therapists and physiotherapists) experience the assistive device situation. Methods. Twenty-four interviews were conducted with patients with motor neuron disease, caregivers, and healthcare professionals involved in procurement and adaptation of assistive devices. Systematic text condensation was used to analyse the interviews. Results. The majority of patients and caregivers had positive experiences of follow-up by the specialist healthcare service. Several found follow-up by the primary health service to be deficient owing to inadequate expertise, continuity, and resources. Healthcare professionals reported having a proactive approach to identifying needs for assistive devices, but for various reasons, application processes were often delayed. Several patients indicated a reluctance to use assistive devices and were ambivalent regarding proactivity. The availability of assistive devices for some functional impairments was described as inadequate. Some patients felt there was too little focus on sexuality in the follow-up. The respondents had a number of suggestions for improving the assistive device situation. Conclusions. Multidisciplinary ALS teams are found to ensure follow-up expertise and continuity. Healthcare professionals wish to take a proactive approach to assistive devices, but a number of bureaucratic obstacles occur. The study findings are preliminary and should be validated through a prospective national quality registry for motor neuron diseases.
Study on the Shear Capacity of the Wet Joint of the Prefabricated Bridge Panel with a Special‐Shaped Shear Key
Authors: Feng Fan , Huang Fanglin , Zhou De , Wen Weibin , Tao Yong
Published: August 2021

Steel‐concrete composite beam has been widely applied in civil engineering, and the concrete during operation may crack due to the large shear force at the wet joint. A new concrete panel shear key with the boss is designed to strengthen the shear capacity of the wet joint part. Three different configurations of specimens are tested to study the shear capacity of the wet joint. These specimens include plain concrete specimens with shear keys, specimens with reinforcement and no shear key, and specimens with both shear keys and reinforcements. An experimental study is designed and conducted to verify the shear capacity of each specimen. The experimental results show that the ultimate shear capacity of the new wet joint structure is 73% higher than the conventional one. Meanwhile, the shear capacity of the new wet joint structure is theoretically predicted, and the finite element models are established to demonstrate the effectiveness of the experiment and the good performance of the new wet joint design.
A Case of Pulmonary Infarction Resembling Pneumonia during Immunosuppressive Treatment for Rheumatoid Arthritis
Authors: Kido Toshiki , Shinoda Koichiro , Tobe Kazuyuki
Published: August 2021

A 67-year-old woman with rheumatoid arthritis (RA) presented with fever and dyspnea. Chest radiography and computed tomography (CT) revealed pulmonary infiltrates with ground-glass opacities. We considered bacterial or pneumocystis pneumonia because she was immunocompromised due to RA treatment. However, she had tachycardia and elevated D-dimer levels. We performed contrast-enhanced CT and subsequently diagnosed her with pulmonary embolism (PE). Though PE is not usually accompanied by parenchymal pulmonary shadows, pulmonary infarction may cause pulmonary infiltrates that can be mistaken for pneumonia. As RA is a thrombophilic disease, clinicians should be aware of PE and pneumonia as differential diagnoses in such patients.
Plant-Extract-Mediated Synthesis of Metal Nanoparticles
Authors: Bao Yunhui , He Jian , Song Ke , Guo Jie , Zhou Xianwu , Liu Shima
Published: August 2021

Metal nanoparticles (MNPs) have been widely used in several fields including catalysis, bioengineering, photoelectricity, antibacterial, anticancer, and medical imaging due to their unique physical and chemical properties. In the traditional synthesis method of MNPs, toxic chemicals are generally used as reducing agents and stabilizing agents, which is fussy to operate and extremely environment unfriendly. Based on this, the development of an environment-friendly synthesis method of MNPs has recently attracted great attention. The use of plant extracts as reductants and stabilizers to synthesize MNPs has the advantages of low cost, environmental friendliness, sustainability, and ease of operation. Besides, the as-synthesized MNPs are nontoxic, more stable, and more uniform in size than the counterparts prepared by the traditional method. Thus, green preparation methods have become a research hotspot in the field of MNPs synthesis. In this review, recent advances in green synthesis of MNPs using plant extracts as reductants and stabilizers have been systematically summarized. In addition, the insights into the potential applications and future development for MNPs prepared by using plant extracts have been provided.
Integration of Wearable Smart Devices and Internet of Things Technology into Public Physical Education
Authors: Fu Dan , Chen Leqiu , Cheng Zhou
Published: August 2021

With the development of the Internet, virtual reality technology is manifested in various products through a more intuitive visual experience. As the carrier of virtual reality technology, according to many predictions, smart wearable devices will be the main development direction in the next few years; the era of intelligence also provides new requirements and new challenges for the education and teaching mode of ordinary colleges and universities. This paper aims to integrate wearable smart devices into public physical education, adopt comparative experiment method and data statistics method, and design and conduct teaching experiments with wearable smart devices based on the Internet of Things technology. The experimental class students’ shooting percentage score increased from 12.80 points to 21.43 points, calculated by SPSS. SPSS is “Statistical Products and Service Solutions” software. Initially, the full name of the software was “Statistical Software Package for Social Sciences.” However, with the expansion of the SPSS product service field and the increase of service depth, SPSS officially changed the English full name to “Statistical Products and Service Solutions” in 2000, which marked the strategic direction of SPSS which is making major adjustments. SPSS is the general term for a series of software products and related services for statistical analysis operations, data mining, predictive analysis, and decision support tasks launched by IBM. There are Windows and Mac OS X versions.

P
=
0.003
<
0.01

, which showed very obvious difference. At the same time, after the experiment, the comparison of the two groups of students’ skill scores showed that there is also a significant difference (

P
=
0.003
<
0.05

). A modern leap-forward teaching model that organically integrates wearable smart devices and public physical education is realized.
Discoloration and Degradation of Bamboo under Ultraviolet Radiation
Authors: Yu Haixia , He Shengliang , Zhang Wenfu , Zhan Mengyao , Zhuang Xiaowei , Wang Jin , Yu Wenji
Published: August 2021

Light is one of the most adverse factors for bamboo deterioration and causes surface degradation and discoloration. The study was carried out to initiate efficient and effective photodiscoloration to modify and enrich bamboo colors that may be applied to bamboo dyeing. Different types of bamboo samples commonly used in the industry were studied experimentally under two types of ultraviolet (UV) light. Effects of light sources, radiation time, and distances on discoloration and discoloration mechanism were systematically studied. For both UV 313 and high-pressure mercury light, the bamboo surface turned red-yellow, and color parameters including

Δ
E

,

Δ
a

,

Δ
b

, and

C

rapidly increased first and then stabilized for long time, while

Δ
L

showed a similar trend, except for the final decrease. Compared with UV 313, high-pressure mercury lamp light was highly efficient and took less time to induce discoloration. Heat treatments darkened the bamboo color and slowed down photodiscoloration, and the higher temperature led to more photostability. The color change of bamboo scrimber under UV radiation was less and slower than that of untreated bamboo due to high density and heat treatment, and the dark carbonized scrimber changed less than that of the light carbonized scrimber. Relatively high contents of isovanillin, syringaldehyde, β-hydroxypropiovanillone, p-hydroxybenzaldehyde, and syringic acid were identified by GC-MS, and syringaldehyde, 2,6-dimethylbenzoquinone, and 3-hydroxy-4-methoxybenzoic acid were identified by HPLC-MS from a bamboo discoloration layer after high-pressure mercury lamp radiation. These products all contained a conjugated double bond and were conjectured to be degraded from lignin or aromatic extracts. Particularly, 2,6-dimethylbenzoquinone which contained a cyclohexenedione structure without benzene rings, was more chemically stable than other conjugated double bonds with benzene rings, and was supposed to be the final product (chromogenic group) during bamboo photodegradation. Untreated or light-colored bamboo under high-energy UV light initiated highly efficient and effective photodiscoloration, and UV light is recommended for being applied to industrial bamboo dyeing. Compared with traditional chemical dyeing, the photoinduced dyeing method has no chemical addition and is easy to operate and environmental-friendly.
Study on the Stability of Slopes Reinforced by Composite Vegetation Combined with a Geogrid under Rainfall Conditions
Authors: Hu Qizhi , Zhou Yong , Tao Gaoliang
Published: August 2021

The planting of shrubs and trees on geogrid‐reinforced slopes is an important ecological slope protection method that is frequently implemented in the rainy areas of southern China. First, this paper analyzes the soil‐fixing principle of the geogrid and root system and demonstrates the feasibility of using composite vegetation of shrubs and trees to reinforce the slope with a geogrid. Using the Yushi Expressway project in Guizhou, we conducted a stability analysis of slopes under different working conditions and different reinforcement modes. We determined that the ecological protection method of combining composite vegetation with a geogrid can effectively increase the stability of slopes. The maximum displacement of the ecological slope under rainfall conditions was reduced by 82% compared with the original slope, and the overall stability was improved by 35%. Four factors affect the slope stability: the depth of shrub reinforcement, depth of anchorage of trees, distribution of trees, and spacing of the geogrids. An orthogonal analysis considering these 4 factors with 3 levels was implemented. The following optimal combination was obtained to ensure ecological protection under rainfall conditions: a shrub reinforcement depth of 0.6 m, a tree anchorage depth of 3 m, a grid spacing of 0.4 m, and a top‐sparse and bottom‐dense tree distribution. The combined slope protection schematic was applied to the Yushi Expressway project in Guizhou, and a strong reinforced slope protection effect was observed.
A Combination of Coconut Fiber Suture and Tamarind Seed Gel with Dehydrated Human Amnion Membrane for Wound Surgery in Rats
Authors: Pothireddy Raghu Babu , Julius Angeline , Mathai Manu Thomas , Lakshmanan Ganesh , Hailemariam Beimnet Asfaw
Published: August 2021

Today, there are over 2,000 different biomaterials used for various medical applications, but none of these biomaterials are 100% compatible with all human beings. Coconut fiber is widely available but has not been tested as a safe natural alternative for sutures. Immature coconut fiber is nonabsorbable and is effective for cuts and open wounds when used in combination with dehydrated human amnion membrane (dHAM). Immature coconut fiber, tamarind seed polysaccharide (TSP), and dHAM were prepared to test their combinational effect on wound healing in rats. TSP enhanced cell viability, proliferation, and migration in human skin cells and cured wounds both individually and in combination with dHAM. An antibiotic‐free combination of the human amniotic membrane with intact epithelium, tamarind seed polysaccharide, and immature coconut fiber provided faster wound healing. Significantly higher wound healing was seen on the 11th day based on an initial 10 mm biopsy punch surgery in Wistar rats compared to control groups. Histological studies revealed thickened dermis edges with more neutrophil infiltration. Collagen deposition in the dermis was homogeneous across the excised skin tissue in the test group, again attesting to the utility of this procedure. This research signifies the use of TSP gel together with the amnion membrane representing a “smart patch” with wound healing potential, which would encourage further research on the smart patch made using a combination of plant and animal biological materials.
The Role of Heart Rate, Body Temperature, and Respiratory Rate in Predicting Anastomotic Leakage following Surgery for Rectal Cancer
Authors: Luo Jiajun , Wu Hongxue , Jiang Yue , Yang Yu , Yuan Jingwen , Tong Qiang
Published: August 2021

Objective. To explore the value of the heart rate, body temperature, and respiratory rate in the early prediction of anastomotic leakage after rectal cancer surgery. Methods. Clinical data from patients with rectal cancer who underwent anterior rectal resection in the Department of Gastroenterology, Renmin Hospital of Wuhan University, from January 2017 to December 2019 were collected and analyzed retrospectively. Based on the occurrence of anastomotic leakage after surgery, the patients were divided into two groups: those with and without anastomotic leakage. The quantitative values of the heart rate, body temperature, and respiration rate at day 7 postsurgery were compared between the two groups. The ROC curve was used to analyze their role in the early prediction of anastomotic leakage. Results. Among 441 patients with rectal cancer, 30 (6.81%) had clinical anastomotic leakage and were diagnosed at

7
±
3
 
days

postsurgery. Within 7 days postsurgery, the heart rate, body temperature, and respiratory rate in the anastomotic leakage group were higher than those in the nonanastomotic leakage group. The differences in heart rate (1-5 d), body temperature (2-7 d), and respiratory rate (1-7 d) were statistically significant (

P
<
0.05

). The three ROC curves were drawn, respectively. The predictive value of the heart rate is greatest at days 2-3 postsurgery. The predictive value of the body temperature is greatest at days 4-6 postsurgery. The predictive value of the respiratory rate is best at days 1-4 postsurgery. Conclusion. The changes of vital signs (heart rate, body temperature, and respiratory rate) have a certain value in the early prediction of anastomotic leakage after rectal cancer surgery. Observation of postoperative vital signs at 7 days postsurgery is helpful for the early diagnosis of anastomotic leakage.
Evaluation of Seven Gap-Filling Techniques for Daily Station-Based Rainfall Datasets in South Ethiopia
Authors: Chinasho Alefu , Bedadi Bobe , Lemma Tesfaye , Tana Tamado , Hordofa Tilahun , Elias Bisrat
Published: August 2021

Meteorological stations, mainly located in developing countries, have gigantic missing values in the climate dataset (rainfall and temperature). Ignoring the missing values from analyses has been used as a technique to manage it. However, it leads to partial and biased results in data analyses. Instead, filling the data gaps using the reference datasets is a better and widely used approach. Thus, this study was initiated to evaluate the seven gap-filling techniques in daily rainfall datasets in five meteorological stations of Wolaita Zone and the surroundings in South Ethiopia. The considered gap-filling techniques in this study were simple arithmetic means (SAM), normal ratio method (NRM), correlation coefficient weighing (CCW), inverse distance weighting (IDW), multiple linear regression (MLR), empirical quantile mapping (EQM), and empirical quantile mapping plus (EQM+). The techniques were preferred because of their computational simplicity and appreciable accuracies. Their performance was evaluated against mean absolute error (MAE), root mean square error (RMSE), skill scores (SS), and Pearson’s correlation coefficients (R). The results indicated that MLR outperformed other techniques in all of the five meteorological stations. It showed the lowest RMSE and the highest SS and R in all stations. Four techniques (SAM, NRM, CCW, and IDW) showed similar performance and were second-ranked in all of the stations with little exceptions in time series. EQM+ improved (not substantial) the performance levels of gap-filling techniques in some stations. In general, MLR is suggested to fill in the missing values of the daily rainfall time series. However, the second-ranked techniques could also be used depending on the required time series (period) of each station. The techniques have better performance in stations located in higher altitudes. The authors expect a substantial contribution of this paper to the achievement of sustainable development goal thirteen (climate action) through the provision of gap-filling techniques with better accuracy.
Characteristics of Immune Memory and Effector Activity to Cancer-Expressed MHC Class I Phosphopeptides Differ in Healthy Donors and Ovarian Cancer Patients
Authors: Lulu Amanda M. , Cummings Kara L. , Jeffery Erin D. , Myers Paisley T. , Underwood Dennis , Lacy Rachel M. , Chianese-Bullock Kimberly A. , Slingluff Craig L. , Modesitt Susan C. , Engelhard Victor H.
Published: August 2021

Elevated immunity to cancer-expressed antigens can be detected in people with no history of cancer and may contribute to cancer prevention. We have previously reported that MHC-restricted phosphopeptides are cancer-expressed antigens and targets of immune recognition. However, the extent to which this immunity reflects prior or ongoing phosphopeptide exposures was not investigated. In this study, we found that preexisting immune memory to cancer-expressed phosphopeptides was evident in most healthy donors, but the breadth among donors was highly variable. Although three phosphopeptides were recognized by most donors, suggesting exposures to common microbial/infectious agents, most of the 205 tested phosphopeptides were not recognized by peripheral blood mononuclear cells (PBMC) from any donor and the remainder were recognized by only 1 to 3 donors. In longitudinal analyses of 2 donors, effector immune response profiles suggested active reexposures to a subset of phosphopeptides. These findings suggest that the immunogens generating most phosphopeptide-specific immune memory are rare infectious agents or incipient cancer cells with distinct phosphoproteome dysregulations, and that repetitive immunogenic exposures occur in individual donors. Phosphopeptide-specific immunity in PBMCs and tumor-infiltrating lymphocytes from ovarian cancer patients was limited, regardless of whether the phosphopeptide was expressed on the tumor. However, 4 of 10 patients responded to 1 to 2 immunodominant phosphopeptides, and 1 showed an elevated effector response to a tumor-expressed phosphopeptide. As the tumors from these patients displayed many phosphopeptides, these data are consistent with lack of prior exposure or impaired ability to respond to some phosphopeptides and suggest that enhancing phosphopeptide-specific T-cell responses could be a useful approach to improve tumor immunotherapy.
Comparison of Absorbable Packing versus No Packing in Wound Healing after Endoscopic Sinus Surgery: A Systematic Review and Pooled Analysis
Authors: Huang Zhenxiao , Zhou Bing
Published: August 2021

Introduction: Nasal packing after endoscopic sinus surgery (ESS) is controversial. The aim of this systematic review was to compare absorbable packing versus no packing in wound healing after ESS for the treatment of chronic rhinosinusitis. Data Source: English electronic databases, including Cochrane Library, EMBASE, MEDLINE, and PubMed, were searched, and only randomized controlled trials were included. Methods: The outcome measures were the presence of synechiae/adhesion formation, mucosal edema, crusting, granulation formation, and infection. The McNemar’s test was used for pooled analysis. Results: Four studies with 148 participants were included. The pooled analysis showed that absorbable packing may offer benefit in reducing adhesion at 6–8 weeks (odds ratio [OR]: 0.3864; 95% confidence interval [CI]: 0.2136–0.7235) and 12 weeks (OR: 0.2396, 95% CI: 0.08267–0.7709) postoperatively compared with no packing. There was no significant difference between the packed and the unpacked side at 2, 6–8, and 12 weeks after ESS in terms of presence of crusting, edema, and granulation formation. Conclusion: There is insufficient evidence to suggest that absorbable packing after ESS does not increase mucosal edema, granulation formation, and infection. However, the absorbable packing may be more effective than no packing for the prevention of mucosal adhesion after ESS. The use of absorbable nasal packing after ESS is recommended when used to reduce postoperative mucosal adhesion. More research in this area is clearly needed.
Legacy of a 10-Year Multidomain Lifestyle Intervention on the Cognitive Trajectories of Individuals with Overweight/Obesity and Type 2 Diabetes Mellitus
Authors: Hayden Kathleen M. , Neiberg Rebecca H. , Evans Joni K. , Luchsinger José A. , Carmichael Owen , Dutton Gareth R. , Johnson Karen C. , Kahn Steven E. , Rapp Stephen R. , Yasar Sevil , Espeland Mark A. ,   and the Action for Health in Diabetes (Look AHEAD) Research Group
Published: August 2021

Introduction: Weight loss and increased physical activity interventions are commonly recommended for individuals with type 2 diabetes (T2D) and overweight or obesity. We examined the impact of randomization to an intensive lifestyle intervention (ILI) on trajectories of cognitive function over 10 years in a cohort of participants in a randomized clinical trial who had T2D and overweight/obesity at baseline. Methods: Participants aged 45–76 years were enrolled in 2001–2004 and were randomized to the ILI or a diabetes support and education (DSE) condition. Cognitive function was assessed in 3,938 participants at up to 4 time points 8–18 years after randomization. General linear mixed effects models examined cognitive trajectories over time. Subgroup analyses focused on sex, individuals with baseline body mass index >30, those carrying the APOE ε4 allele, and those with a baseline history of cardiovascular disease (CVD). Results: Overall, there were no differences in the rate of cognitive decline by intervention arm. Subgroup analyses showed that participants who had a baseline history of CVD and were randomized to the ILI arm of the study performed significantly worse on the Stroop Color Word Test than those in the DSE arm. Discussion/Conclusions: The ILI did not result in preserved cognitive function or slower rates of cognitive decline in this cohort of individuals who had T2D and were overweight or obese at baseline.
Higher Enhancement Intrahepatic Nodules on the Hepatobiliary Phase of Gd-EOB-DTPA-Enhanced MRI as a Poor Responsive Marker of Anti-PD-1/PD-L1 Monotherapy for Unresectable Hepatocellular Carcinoma
Authors: Aoki Tomoko , Nishida Naoshi , Ueshima Kazuomi , Morita Masahiro , Chishina Hirokazu , Takita Masahiro , Hagiwara Satoru , Ida Hiroshi , Minami Yasunori , Yamada Akira , Sofue Keitaro , Tsurusaki Masakatsu , Kudo Masatoshi
Published: August 2021

Introduction: Immune checkpoint inhibitors (ICIs) are promising agents for the treatment of hepatocellular carcinoma (HCC). However, the establishment of noninvasive measure that could predict the response to ICIs is challenging. This study aimed to evaluate tumor responses to ICIs using the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI), which was shown to reflect Wnt/β-catenin activating mutation. Methods: A total of 68 intrahepatic HCC nodules from 18 patients with unresectable HCC and Child-Pugh class A liver function who received anti-programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) monotherapy were enrolled in this study. All patients had viable intrahepatic lesions evaluable using the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI within the 6 months prior to the treatment. The relative enhancement ratio was calculated, and the time to nodular progression (TTnP) defined as 20% or more increase in each nodule was compared between higher or hypo-enhancement HCC nodules. Then, the progression-free survival (PFS) and objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) were compared between patients with and without HCC nodules with higher enhancement on hepatobiliary phase images. Results: The median PFS was 2.7 (95% confidence interval [CI]: 1.4–4.0) months in patients with HCC nodules with higher enhancement (n = 8) and 5.8 (95% CI: 0.0–18.9) months in patients with hypointense HCC nodules (n = 10) (p = 0.007). The median TTnP of HCC nodules with higher enhancement (n = 23) was 1.97 (95% CI: 1.86–2.07) months and that of hypointense HCC nodules (n = 45) was not reached (p = 0.003). The ORR was 12.5% (1/8) versus 30.0% (3/10); the disease control rate was 37.5% (3/8) versus 70.0% (7/10), respectively, in patients with or without higher enhancement intrahepatic HCC nodules. Conclusion: The TTnP on HCC nodules with higher enhancement and the median PFS in patients who carried higher enhancement intrahepatic HCC nodules were significantly shorter than those in hypointense HCC nodules with anti-PD-1/PD-L1 monotherapy. The intensity of the nodule on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is a promising imaging biomarker for predicting unfavorable response with anti-PD-1/PD-L1 monotherapy in patients with HCC.
Evidence of a Causal Relationship between Serum Thyroid-Stimulating Hormone and Osteoporotic Bone Fractures
Authors: Soto-Pedre Enrique , Siddiqui Moneeza K. , Mordi Ify , Maroteau Cyrielle , Soto-Hernaez Jimena , Palmer Colin N.A. , Pearson Ewan R. , Leese Graham P.
Published: August 2021

Objective: We aimed to validate the association of genome-wide association study (GWAS)-identified loci and polygenic risk score with serum thyroid-stimulating hormone (TSH) concentrations and the diagnosis of hypothyroidism. Then, the causal relationship between serum TSH and osteoporotic bone fracture risk was tested. Methods: A cross-sectional study was done among patients of European Caucasian ethnicity recruited in Tayside (Scotland, UK). Electronic medical records (EMRs) were used to identify patients and average serum TSH concentration and linked to genetic biobank data. Genetic associations were performed by linear and logistic regression models. One-sample Mendelian randomization (MR) was used to test causality of serum TSH on bone fracture risk. Results: Replication in 9,452 euthyroid individuals confirmed known loci previously reported. The 58 polymorphisms accounted for 11.08% of the TSH variation (p < 1e−04). TSH-GRS was directly associated with the risk of hypothyroidism with an odds ratio (OR) of 1.98 for the highest quartile compared to the first quartile (p = 2.2e−12). MR analysis of 5,599 individuals showed that compared with those in the lowest tertile of the TSH-GRS, men in the highest tertile had a decreased risk of osteoporotic bone fracture (OR = 0.59, p = 2.4e−03), while no difference in a similar comparison was observed in women (OR = 0.93, p = 0.61). Sensitivity analysis yielded similar results. Conclusions: EMRs linked to genomic data in large populations allow replication of GWAS discoveries without additional genotyping costs. This study suggests that genetically raised serum TSH concentrations are causally associated with decreased bone fracture risk in men.
Symptomatic Nephroptosis of the Transplant: First Report of Diagnostic Workup and Successful Minimal-Invasive Treatment
Authors: Nikitin Elena , Huber Johannes , Thomas Christian , Putz Juliane
Published: August 2021

The symptomatic nephroptosis of a kidney transplant is a rare and potentially fatal complication and requires fast diagnosis and treatment. In this report, we describe a case in which intermittent symptomatic hydronephrosis and an increase of the creatinine levels were the leading symptoms of nephroptosis. Moreover, we describe the diagnostic procedures and the successful minimal-invasive treatment. To our knowledge, this is the first report of a symptomatic transplant nephroptosis with consecutive intermittent hydronephrosis and without complications of perfusion solved with a minimal-invasive approach.
Varied Presentation and Importance of MR Neurography of the Common Fibular Nerve in Slimmer’s Paralysis
Authors: Shields Lisa B.E. , Iyer Vasudeva G. , Shields Christopher B. , Zhang Yi Ping , Rao Abigail J.
Published: August 2021

Slimmer’s paralysis refers to a common fibular nerve palsy caused by significant and rapid weight loss. This condition usually results from entrapment of the common fibular nerve due to loss of the fat pad surrounding the fibular head. Several etiologies of common fibular nerve palsy have been proposed, including trauma, surgical complications, improperly fitted casts or braces, tumors and cysts, metabolic syndromes, and positional factors. We present 5 cases of slimmer’s paralysis in patients who had lost 32–57 kg in approximately 1 year. In 2 cases, MR neurogram of the knee demonstrated abnormalities of the common fibular nerve at the fibular head. Two patients underwent a common fibular nerve decompression at the fibular head and attained improved gait and sensorimotor function. Weight loss, diabetes mellitus, and immobilization may have contributed to slimmer’s paralysis in 1 case. Awareness of slimmer’s paralysis in patients who have lost a significant amount of weight in a short period of time is imperative to detect and treat a fibular nerve neuropathy that may ensue.
Large Artery Stiffness: A Companion to the 2015 AHA Science Statement on Arterial Stiffness
Authors: Rey-García Jimena , Townsend Raymond R.
Published: August 2021

Large artery stiffness (LAS) has proven to be an independent risk factor for cardiovascular disease and mortality. Nevertheless, the position of current hypertension guidelines regarding the usefulness of assessing LAS differs across different continents. In general, European Guidelines recognize pulse wave velocity (PWV) as a marker of target organ damage but do not recommend its systematic use in general population. Asian guidelines consider PWV as a recommended test at diagnosis of hypertension, in contrast to North American guidelines that do not state any position about its usefulness. However, PWV predicts cardiovascular events, and several studies have shown that it improves risk classification adjusting for established risk factors especially for intermediate-risk patients. Finally, some advances have been made related to treatments affecting LAS. Dietary interventions such as sodium restriction and exercise-based interventions have a modest effect in reducing LAS. Pharmacological interventions, such as statins, or more recent advances with mineralocorticoid blocker seem to have a beneficial effect. Last, controversial effects of renal denervation on LAS have been found. Our goal here is to update the reader on LAS on these areas since the 2015 American Heart Association Scientific Statement.
A cor e a forma da literatura russa na Irlanda: refrações
Authors:   Universidade de São Paulo. Faculdade de Filosofia, Letras e Ciências Humanas, Mutran Munira H.
Published: August 2021

O livro convida o leitor a mergulhar nos dois universos literários – o irlandês e o russo. À primeira vista, esses dois universos poderiam parecer bem distantes um do outro, mas, na verdade, como nos mostra a pesquisadora, eles se interligam, relacionam-se e comunicam-se com uma intensidade surpreendente. A autora analisa numerosos exemplos de adaptação e “domesticação” de textos literários russos na literatura irlandesa e, associando o rigor da pesquisa com fluidez e elegância de estilo, consegue criar um painel representativo amplo e multifacetado das “refrações” que acontecem no processo do diálogo dos escritores irlandeses com os russos. Talvez a palavra “refração” seja uma escolha mais poética para descrever todas as formas de intertextualidade que existem nesse diálogo, pois, declara a autora: “Minha escolha recaiu em ‘refração’ por ser definida como o desvio que sofrem os raios de luz, do calor ou do som ao passar de um meio para outro”.
Das regras
Authors: Souza Dheyne de
Published: August 2021

Texto de criação literária.
O vício de falar comigo mesma – Março de 1977 e Outubro de 1979
Authors: Guimarães Rochelle de Sousa
Published: August 2021

Tradução de trechos extraídos do primeiro volume dos "Cadernos" (Taccuini), organizados com o título "O vício de falar comigo mesma" (Il vizio di parlare a me stessa), de Goliarda Sapienza, artista, escritora e atriz italiana.
Impossibilidade encobridora: uma leitura de “As grandes punições”, de Clarice Lispector
Authors: Ferreira Mariana Borrasca
Published: August 2021

O presente artigo traz uma análise da crônica “As grandes punições”, de Clarice Lispector, publicada no Jornal do Brasil em 4 de novembro de 1967 e disponível no livro A descoberta do mundo, texto de notas autobiográficas em que uma narradora, adulta, relata episódio de sua infância e sua relação com o amigo Leopoldo. O estudo do texto toma por base o conceito psicanalítico de “lembrança encobridora”, teoria desenvolvida por Sigmund Freud em “Lembranças encobridoras” (1899), trabalho no qual ele aborda o tema das memórias de infância, afirmando que, em alguns casos, tais lembranças, aparentemente triviais, podem revelar conteúdo afetivo de grande significação.
Stela do Patrocínio: tecendo uma figura cindida de si
Authors: Cassiano Bruna , Fernandes Hildália
Published: August 2021

Neste trabalho, buscamos analisar fragmentos do “falatório” de Stela do Patrocínio, narradora de Reino dos bichos e dos animais é o meu nome (2001), discutindo a especificidade do seu modo de abordar os afetos que a atravessavam. Vislumbramos, antes de tudo, apresentar e difundir as palavras, o legado de Stela, uma mulher simultaneamente única e plural. O seu valor recobre a existência de várias mulheres negras que, como ela, findaram “quebrando” mediante a um sistema racista que ceifa a saúde da população negra historicamente. Mesmo em condições insalubres, a sua intelectualidade, notável no olhar crítico que lançava à sociedade e suas instituições, irrompia insurgentemente. Para a feitura do trabalho, partimos do método da colcha de retalhos (hooks, 2019), entrelaçando diversos trechos da obra em foco às considerações de Grada Kilomba (2019), Beatriz Nascimento (1989), Audre Lorde (2019) e bell hooks (2019). Dessa maneira, organizamos este artigo em três partes: em um primeiro momento, apresentamos a autora e o contexto de produção do corpus em análise; na sequência, discutimos sobre a perda e busca da imagem no falatório de Stela do Patrocínio e, por fim, abordamos a relação entre quimeras narrativas (CYRULNIK, 2009) e banzo (NUNES, 2019) no discurso da narradora.
Clarice e Carolina: a salvação pela escrita
Authors: Bijotti Mariana Silva
Published: August 2021

Motivado, principalmente, pelo breve encontro entre Clarice Lispector e Carolina Maria de Jesus, e o diálogo que esse encontro entre as duas proporcionou, este artigo tem como propósito comparar brevemente duas narrativas: A paixão segundo G.H. e Quarto de despejo. A partir do viés da metalinguagem nas duas autoras, é possível notar como a atividade da escrita serve para salvar essas duas vidas (de G.H. e até de Clarice, como ela afirma na crônica “Escrever”, e também de Carolina). As narrativas dessas duas mulheres parecem ser essenciais para sua sobrevivência em meio à experiência e descoberta do cotidiano desigual, ora a partir do conhecimento do outro, o desvalido (em G.H.), ora a partir da sua própria vivência nas classes mais pobres da sociedade (nos diários de Carolina). Desta forma, partindo do reconhecimento de suas diferenças (principalmente sociais), o que se quer aqui mostrar é como as duas obras parecem ter um eixo temático comum: a da escrita como necessária à sobrevivência das experiências.
Naidna de Souza: a palavra des-a-linha, atravessa a margem e brinca sobre a encruzilhada
Authors: Pontes Ana Carolina Pedrosa
Published: August 2021

Através do poema “Linhas”, de Naidna de Souza (2015), nossa leitura é guiada para pensarmos na sua poesia e produção de discurso, interseccionada por exclusões de gênero, raça, classe, e, sobretudo, pela experiência de sofrimento mental. Naidna é poeta, performer e pintora, frequenta o dispositivo Centro de Convivência da Rede de Saúde Mental, substitutiva aos manicômios, que se estabelece enquanto política pública no município de Belo Horizonte/ MG. Mesmo depois da Lei da Reforma Psiquiátrica e da consolidação do Movimento Nacional da Luta Antimanicomial, retrocessos importantes têm se imposto às garantias de direitos nacionais no campo da saúde mental. Pensamos na poesia como produção de devir, enquanto agenciamento de vidas (DELEUZE, 1977) e narrativas que se vulnerabilizam historicamente a partir da ideologia eugênica, da necropolítica (MBEMBE, 2016) e dos biopoderes (FOUCAULT, 1979), que se reorganizam sistemicamente como projeto de Estado. A vivência da arte e linguagem se fazem na tentativa de rasurar as violências e violações. A poesia de Naidna de Souza se estabelece enquanto portal de enunciação, que opera através da reexistência (SOUZA, 2009), no sentido discursivo coletivo e comunitário, afirmando a vida de um grupo narrativo que se encontra na ressignificação da encruzilhada (PONTES, 2019).
Luto-19
Authors: Pacheco Ana
Published: August 2021

Conto de Ana Pacheco
Antologia de poemas
Authors: Dias Ayana Moreira , Marinho Cecilia Silva Furquim , Morais Maira Luana , Mendes Mariana Diniz
Published: August 2021

Nesta edição da revista Opiniães, “Vozearia, literatura brasileira feminina em coro”, nós, da equipe editorial, achamos significativo apresentar os poemas num único arquivo, privilegiando sua natureza de coro, onde um grupo de pessoas cantam juntas num mesmo palco, uma mesma partitura. Aqui, a ideia de partitura não é a de promover um canto em uníssono, mas a de sobrepor cantos vários, cantos díspares, que se relacionam de alguma forma numa enunciação e num espaço comum. A chamada favoreceu a escrita de mulheres e de pessoas pertencentes ao grupo LGBTQIA, em afinidade com o dossiê, que procura contestar a prevalência de grupos historicamente privilegiados no fazer literário. Dessa forma, conseguimos compor uma pequena antologia que, a despeito dessa afinidade, celebram suas diferenças, na medida em que reúne pessoas de idades, origens e posições diferentes, tanto na vida profissional como na vida literária. Temos poetas graduadxs, mestres, mestrandxs, doutores, doutorandxs, professorxs de Universidade. Com larga experiência na produção de poesia no formato livro (autores com 3 ou mais livros publicados) e poetas com menos publicações ou mesmo inéditos. E, na medida em que cada poeta, ao compartilhar seu poema, compartilha também os outros dezessete poetas que habitam o mesmo arquivo, esperamos que esses cantos ressoem multiplicados na experiência dos leitores.
Large-Scale Screening for Monogenic and Clinically Defined Familial Hypercholesterolemia in Iceland
Authors: Björnsson Eythór , Thorgeirsson Guðmundur , Helgadóttir Anna , Thorleifsson Guðmar , Sveinbjörnsson Garðar , Kristmundsdóttir Snaedís , Jónsson Hákon , Jónasdóttir Aðalbjörg , Jónasdóttir Áslaug , Sigurðsson Ásgeir , Guðnason Thórarinn , Ólafsson Ísleifur , Sigurðsson Emil L. , Sigurðardóttir Ólöf , Viðarsson Brynjar , Baldvinsson Magnús , Bjarnason Ragnar , Danielsen Ragnar , Matthíasson Stefán E. , Thórarinsson Björn L. , Grétarsdóttir Sólveig , Steinthórsdóttir Valgerður , Halldórsson Bjarni V. , Andersen Karl , Arnar Davíð O. , Jónsdóttir Ingileif , Guðbjartsson Daníel F. , Hólm Hilma , Thorsteinsdóttir Unnur , Sulem Patrick , Stefánsson Kári
Published: August 2021

Objective:

Familial hypercholesterolemia (FH) is traditionally defined as a monogenic disease characterized by severely elevated LDL-C (low-density lipoprotein cholesterol) levels. In practice, FH is commonly a clinical diagnosis without confirmation of a causative mutation. In this study, we sought to characterize and compare monogenic and clinically defined FH in a large sample of Icelanders.

Approach and Results:

We whole-genome sequenced 49 962 Icelanders and imputed the identified variants into an overall sample of 166 281 chip-genotyped Icelanders. We identified 20 FH mutations in
LDLR
,
APOB
, and
PCSK9
with combined prevalence of 1 in 836. Monogenic FH was associated with severely elevated LDL-C levels and increased risk of premature coronary disease, aortic valve stenosis, and high burden of coronary atherosclerosis. We used a modified version of the Dutch Lipid Clinic Network criteria to screen for the clinical FH phenotype among living adult participants (N=79 058). Clinical FH was found in 2.2% of participants, of whom only 5.2% had monogenic FH. Mutation-negative clinical FH has a strong polygenic basis. Both individuals with monogenic FH and individuals with mutation-negative clinical FH were markedly undertreated with cholesterol-lowering medications and only a minority attained an LDL-C target of <2.6 mmol/L (<100 mg/dL; 11.0% and 24.9%, respectively) or <1.8 mmol/L (<70 mg/dL; 0.0% and 5.2%, respectively), as recommended for primary prevention by European Society of Cardiology/European Atherosclerosis Society cholesterol guidelines.

Conclusions:

Clinically defined FH is a relatively common phenotype that is explained by monogenic FH in only a minority of cases. Both monogenic and clinical FH confer high cardiovascular risk but are markedly undertreated.