bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated Microfluidic Device for Enrichment and Identification of Circulating Tumor Cells from the Blood of Patients with Colorectal Cancer
Authors: Su Wentao , Yu Hao , Jiang Lei , Chen Wenwen , Li Hongjing , Qin Jianhua
Published: July 2019

Integrated device with high purity for circulating tumor cell (CTC) identification has been regarded as a key goal to make CTC analysis a “bench-to-bedside” technology. Here, we have developed a novel integrated microfluidic device that can enrich and identify the CTCs from the blood of patients with colorectal cancer. To enrich CTCs from whole blood, microfabricated trapping chambers were included in the miniaturized device, allowing for the isolation of tumor cells based on differences in size and deformability between tumor and normal blood cells. Microvalves were also introduced sequentially in the device, enabling automatic CTC enrichment as well as immunostaining reagent delivery. Under optimized conditions, the whole blood spiked with caco-2 cells passing through the microfluidic device after leukocyte depletion and approximately 73% of caco-2 cells were identified by epithelial cell adhesion molecule (EpCAM) staining. In clinical samples, CTCs were detectable from all patients with advanced colorectal cancer within 3 h. In contrast, the number of CTCs captured on the device from the blood of healthy donors was significantly lower than that from the patients, suggesting the utilization of the integrated device for further molecular analyses of CTCs.
Caristi-Type Fixed Point Theorem over Száz Principle in Quasi-Metric Space with a Graph
Authors: Chaira Karim , Eladraoui Abderrahim , Kabil Mustapha , Lazaiz Samih
Published: July 2019

The aim of this paper is to generalize Caristi’s fixed point theorem in a K-complete quasi-metric space endowed with a reflexive digraph by using Száz maximum principle. An example is given to support our main result.
The Parameter Space of Orbits of a Maximal Compact Subgroup Acting on a Flag Manifold
Authors: Ntatin B.
Published: July 2019

The orbits of a real form G of a complex semisimple Lie group GC and those of the complexification KC of its maximal compact subgroup K acting on Z=GC/Q, a homogeneous, algebraic, GC-manifold, are finite. Consequently, there is an open G-orbit. Lower-dimensional orbits are on the boundary of the open orbit with the lowest dimensional one being closed. Induced action on the parameter space of certain compact geometric objects (cycles) related to the manifold in question has been characterized using duality relations between G- and KC-orbits in the case of an open G-orbit and more recently lower-dimensional G-orbits. We show that the parameter space associated with the unique closed G-orbit in Z agrees with that of the other orbits characterized as a certain explicitly defined universal domain.
Laparoscopic Spleen-Preserving Distal Pancreatectomy (LSPDP) versus Open Spleen-Preserving Distal Pancreatectomy (OSPDP): A Comparative Study
Authors: Huang Jing , Yadav Dipesh Kumar , Xiong Chaojie , Sheng Ye , Zhou Xinhua’ , Cai Xiujun
Published: July 2019

Objective. To compare outcomes between laparoscopic spleen-preserving distal pancreatectomy (LSPDP) and open spleen-preserving distal pancreatectomy (OSPDP) for treatment of benign and low-grade malignant tumors of the pancreas and evaluate feasibility and safety of LSPDP. Methods. The clinical data of 53 cases of LSPDP and 44 cases of OSPDP performed between January 2008 and August 2018 were retrospectively analyzed. The clinical outcomes between the two groups were compared. Results. There was no significant difference in preoperative data between the two groups. However, the LSPDP group had statistically significant shorter operative time (145.3±55.9 versus 184.7±33.5, P=0.03) and lesser intraoperative blood loss (150.6±180.8 versus 253.5±76.2, P=0.03) than that of the OSPDP group. Moreover, the LSPDP group also had statistically significant earlier passing of first flatus (2.2±1.4 versus 3.1±1.9, P=0.01), earlier diet intake (2.3±1.8 versus 3.4±2.0, P=0.01), and shorter hospital stay (6.2±7.2 versus 8.8±9.3, 0.04) than that of the OSPDP group. However, postoperative pancreatic fistula (P=0.64) and total postoperative complications (P=0.59) were not significantly different between the groups. The rate of pancreatic fistula and total postoperative complications occurred in 62.5% and 64.5%, respectively, in LSPDP group and, similarly, 70% and 70.0%, respectively, in OSPDP group. Conclusion. This study confirms that LSPDP is safe, feasible, and superior to OSPDP in terms of operative time, intraoperative blood loss, hospital stay, and postoperative recovery. Hence, it is worth popularizing LSPDP for benign and low-grade malignant tumors of the pancreas.
Brain Lesion Segmentation Based on Joint Constraints of Low-Rank Representation and Sparse Representation
Authors: Ge Ting , Mu Ning , Zhan Tianming , Chen Zhi , Gao Wanrong , Mu Shanxiang
Published: July 2019

The segmentation of brain lesions from a brain magnetic resonance (MR) image is of great significance for the clinical diagnosis and follow-up treatment. An automatic segmentation method for brain lesions is proposed based on the low-rank representation (LRR) and the sparse representation (SR) theory. The proposed method decomposes the brain image into the background part composed of brain tissue and the brain lesion part. Considering that each pixel in the brain tissue can be represented by the background dictionary, a low-rank representation that incorporates sparsity-inducing regularization term is adopted to model the part. Then, the linearized alternating direction method with adaptive penalty (LADMAP) was selected to solve the model, and the brain lesions can be obtained by the response of the residual matrix. The presented model not only reflects the global structure of the image but also preserves the local information of the pixels, thus improving the representation accuracy. The experimental results on the data of brain tumor patients and multiple sclerosis patients revealed that the proposed method is superior to several existing methods in terms of segmentation accuracy while realizing the segmentation automatically.
Analysis and Building of Trading Platform of Construction 3D Printing Technology and Products
Authors: Yang Hongxiong , Zhu Kaozhi , Zhang Min
Published: July 2019

Construction 3D printing technology has been rapidly developed, but in the usual life, there are still many people who have not heard of or used construction 3D printing products, and many people want to buy Construction 3D printing products, but there is no channel. Therefore, through the questionnaire survey of potential customers, from the willingness of potential customers, the influencing factors of construction 3D printing technology product trading platform are analyzed, and the PLD‐SEM model is established. The potential customers are analyzed in the 3D printing technology product trading platform, with more attention to factors, including product categories, prices, trading platform customization features, and excellent network capabilities. Finally, the 3D printing technology product trading platform was designed, and the customer management module, construction 3D printing technology product information management module, construction 3D printing technology product retrieval module, and transaction information management were proposed. Building a fully functional 3D printing technology product trading platform that can attract more potential customers provides customers with a channel to understand and purchase 3D printing products and helps solve the current 3D printing technology products difficult to promote and trade problem.
The Effect of Oxidation on the Far-Field Scattering of Aluminium Patch Antennae from Visible to UV
Authors: McArthur Duncan , Papoff Francesco
Published: July 2019

In this paper we evaluate the effect of oxidation on the total power scattered in the far field by a 60nm radius Al sphere in the presence of a substrate comprised of either Al or silica (SiO2). Using an effective medium approach to model the Al particle with an outer layer of alumina (Al2O3), we find that the UV peak of total energy scattered in the far field shifts towards longer wavelengths for volume fractions of Al2O3 up to 20%. When particles with these volume fractions are held above an Al substrate, enhancement of two orders of magnitudes of the far-field power radiated by a dipole in the gap can be observed. For larger volume fractions of Al2O3, the total intensity of light scattered is significantly reduced.
Assessment of the Concentration of Bone Metabolism Markers: Sclerostin and FGF-23 in Children with Idiopathic Nephrotic Syndrome Treated with Glucocorticosteroids
Authors: Pukajło-Marczyk Agnieszka , Jakubowska Anna , Bargenda-Lange Agnieszka , Kiliś-Pstrusińska Katarzyna , Zwolińska Danuta
Published: July 2019

Recurring nature of idiopathic nephrotic syndrome (INS) and steroid dependence imply a long-term treatment with glucocorticosteroids (GCSs), which increases the risk of bone metabolism disorders. The search for new markers of that process is essential. The aims of this study were to assess the concentrations of sclerostin (Scl) and fibroblast growth factor-23 (FGF-23) in the plasma of children with INS and compare Scl and FGF-23 to existing markers of bone metabolism, mainly parathyroid hormone (PTH). The study involved 70 children, 50 with INS and 20 healthy children. Patients with INS were divided into 4 groups depending on the number of relapses and applied therapy. Significantly higher concentrations of FGF-23 and Scl were found in all patient groups with INS compared to the control group, and increase in the concentrations of examined parameters depending on the number of NS relapses was showed. In patients from the group with numerous relapses, higher concentrations of FGF-23 and Scl in the relapse phase than those in the remission phase were found. We observed positive correlation in these proteins with parathyroid hormone. Positive correlation of FGF-23 and Scl in the examined group was noted. Children having relapsing INS treated with steroids have higher levels of Scl and FGF-23 that can indicate the bone metabolism disorders. The significance of these observations requires further research.
Manejo de la osteomielitis de la mano: revisión a propósito de un caso clínico
Authors: Salas González Soledad Alejandra , Ruiz Riquelme Pablo , Urrutia Hoppe Esteban
Published: July 2019

La Osteomielitis de Mano es una infección poco frecuente, pero que puede asociarse a una gran morbilidad y largas estadías hospitalarias. Además, en pacientes con Diabetes Mellitus suele presentarse de forma más grave y avanzada complejizando su manejo. Los pilares de tratamiento de la osteomielitis son la antibioterapia y cirugía. El tratamiento antibiótico se evalúa caso a caso, ajustándose según los patógenos, siendo la vía de administración y duración aún temas controversiales. La agresividad del manejo quirúrgico depende de varios factores, pudiendo ayudar en esta decisión la clasificación de Cierny y Mader. El siguiente reporte de caso pretende discutir el manejo y tratamiento de la osteomielitis de mano basado en la literatura actual.
Mapeo del proceso clínico de pacientes con ideación suicida activa que consultan en el Centro de Salud Familiar “San Alberto Hurtado” en Chile
Authors: Gómez Cannobbio Constanza , González Gutiérrez Constanza , Hasbún Zegpi Catalina , Santander Barría María Jesús , Beca Jofré Paulina , Bittner Salgado Marcela , Rojas González Pamela
Published: July 2019

Introducción: el suicidio es un fenómeno complejo y prevalente. En Chile, los centros de atención primaria pesquisan pacientes con ideación suicida activa y los derivan a centros terciarios, pero el proceso es complejo y poco fluido.El objetivo de este trabajo fue mapear el proceso clínico que siguen los pacientes con ideación suicida activa derivados desde el Centro de Salud Familiar Áncora San Alberto Hurtado en Santiago, Chile.  Métodos: se realizaron reuniones con los principales protagonistas y se recolectaron protocolos de manejo. Se graficaron los procesos clínicos según la edad del paciente, identificando nudos, brechas y quiebres. Resultados: los pacientes menores de 15 años son derivados al servicio de urgencia pediátrica en el Complejo Asistencial Dr. Sótero del Río, donde son evaluados por un psiquiatra infanto-juvenil, quien determina si son dados de alta para continuar seguimiento en el nivel secundario o son hospitalizados. Los pacientes mayores de 15 años son referidos al servicio de urgencia psiquiátrica del Complejo Asistencial Barros Luco Trudeau para ser evaluados por un psiquiatra, quien evalúa si requieren seguimiento a nivel secundario u hospitalización. En este último caso, son derivados nuevamente al Hospital Sótero del Río. Se identificaron nudos, brechas y quiebres que dificultan la atención y seguimiento de los pacientes. Conclusión: existen condiciones que afectan el proceso clínico de pacientes con ideación suicida activa derivados desde un centro de atención primaria, y es fundamental reparar las dificultades identificadas para ofrecer a la población una atención en salud mental eficiente.
Infected transcartilaginous ear piercings. A case report and review of the literature.
Authors: Rodríguez Gutiérrez Javier Ignacio , Thöne Natalie , Duque Benavides Josefina , Brañes Fierro Rocío
Published: July 2019

Background: transcartilaginous perforations have become a prominent practice among adolescents and young adults in recent years, which are associated with an increased risk of complications since it is frequently performed without sterile technique and by unqualified individuals. The transgression of the integrity of the skin and cartilage of the ear favors infections such as cellulitis, chondritis, perichondritis or abscesses that can cause serious deformities. Methods: we present a clinical case compatible with a perichondritis secondary to ear perforations with three abscesses.Results: the three abscesses were drained with sterile technique and successfully managed with outpatient antibiotic treatment. In relation to the pathophysiology, the trauma in the auditory pavilion produces the extraction of the adjacent perichondrium, causing devascularization of the cartilage and microfractures, which together with the transgression of the skin, increase the susceptibility to infection. In addition, subpericardial bleeding and inflammatory reaction decrease the blood supply, which limits the immune response and the effectiveness of antibiotics. In some cases, incision and drainage are required. The signs of perichondritis include pain, swelling, and erythema of the skin. Clinically, perichondritis can be differentiated from cellulitis of the pinna, in that the first usually does not involve the earlobe. The fluctuating swelling leads us to an abscess. Conclusions: the administration of broad-spectrum antibiotics should be immediately administered and include coverage for Pseudomonas aeruginosa since it is responsible for the majority of post-perforation cartilage infections (up to 95% of cases). Due to the increase of post-perforation infectious complications, all physicians should be familiar with its diagnosis and treatment.
Serum Urate, Genetic Variation, and Prostate Cancer Risk: Atherosclerosis Risk in Communities (ARIC) Study
Authors: Wang Anqi , Barber John R. , Tin Adrienne , De Marzo Angelo M. , Kottgen Anna , Joshu Corinne E. , Platz Elizabeth A.
Published: July 2019

Background:

Evidence is mounting that intraprostatic inflammation influences prostate cancer development. Uric acid crystals depositing in the prostate could result in injury and inflammation, increasing prostate cancer risk.

Methods:

Included were 6,574 men ages 45–64 years who enrolled in the Atherosclerosis Risk in Communities study in 1987 to 1989. We used Cox proportional hazards regression to estimate the association of serum urate concentration alone and to improve accuracy, jointly with a genetic risk score (GRS, N = 4,983) derived from variants predictive of urate concentration, with prostate cancer (N = 813) risk.

Results:

Serum urate concentration or joint categories of urate concentration and GRS were not associated with prostate cancer risk (Ptrend for quartiles = 0.3). Results were generally similar by race and after excluding users of medications that influence uric acid.

Conclusions:

Serum urate alone and with a urate-associated GRS were not associated with prostate cancer risk.

Impact:

It is unlikely that circulating urate concentration influences prostate cancer development.
Mechanisms of Innate and Acquired Resistance to Anti-EGFR Therapy: A Review of Current Knowledge with a Focus on Rechallenge Therapies
Authors: Parseghian Christine M. , Napolitano Stefania , Loree Jonathan M. , Kopetz Scott
Published: July 2019

Innate and acquired resistance to anti-EGFR therapy (EGFRi) is a major limitation in the treatment of metastatic colorectal cancer (mCRC). Although RAS genes are the most commonly mutated innate and acquired oncogenes in cancer, there are a number of other mechanisms that limit the effectiveness of EGFRi. Patients with innate resistance have been found to contain BRAFV600E mutations, and possibly MET, MEK, PIK3CA, PTEN, and HER2 alterations. Meanwhile, BRAFV600E mutations may also be involved in acquired resistance to EGFRi, in addition to EGFR ectodomain mutations, MET alterations, and possibly HER2 amplification. In addition, paracrine effects and cell-fate mechanisms of resistance are being increasingly described as contributing to acquired resistance. Utilization of circulating tumor DNA has been paramount in monitoring the dynamic nature of acquired resistance and has helped to guide treatment decisions, particularly in the EGFRi rechallenge setting. Herein, we provide an in-depth review of EGFRi-resistance mechanisms and describe the current therapeutic landscape in the hopes of identifying effective rechallenge strategies.
Mismatch Repair–Proficient Colorectal Cancer: Finding the Right TiME to Respond
Authors: Willis Jason A. , Overman Michael J. , Vilar Eduardo
Published: July 2019

New approaches are required for addressing the important and unmet need to expand the benefits of checkpoint blockade to patients with mismatch repair proficient colorectal cancer. Systematic profiling of the tumor immune microenvironment provides insights into potential mechanisms of resistance, predictive biomarkers, and novel combinatorial strategies for overcoming resistance.

See related article by Llosa et al., p. 5250
Predictive Potential of Head and Neck Squamous Cell Carcinoma Organoids
Authors: Hill Sarah J. , D'Andrea Alan D.
Published: July 2019

In this issue of Cancer Discovery, Driehuis and colleagues establish culture conditions for the rapid, efficient, and long-term expansion of healthy human oral mucosa and head and neck squamous cell carcinoma (HNSCC) tumor organoids. The HNSCC tumor organoids provide a functional platform for analyzing tumor cell phenotype, tumorigenic potential, and drug and radiotherapy response, and they have a potential role in clinical decision-making.

See related article by Driehuis et al., p. 852.
Lymphoma Chemotherapy: Hungry Macrophages Strike the Final Blow
Authors: Duval Florent , De Palma Michele
Published: July 2019

Macrophages modulate tumor response to chemotherapy; in this issue, Lossos and colleagues show that high-dose alkylating agents instigate a synthetic lethal program in lymphoma cells that is independent of DNA damage and involves recruitment and priming of macrophages for antibody-mediated tumor phagocytosis. These findings implicate chemotherapy-elicited macrophages as critical effectors of lymphoma clearance during biological therapy.

See related article by Lossos et al., p. 944.
Recharacterizing Tumor-Infiltrating Lymphocytes by Single-Cell RNA Sequencing
Authors: Zhang Lei , Zhang Zemin
Published: July 2019

T cells are central players in cancer immunotherapy. Despite much concentrated effort on the study of tumor-infiltrating lymphocytes (TIL), such as T cells, a series of fundamental properties that include heterogeneity, clonal expansion, migration, and functional state transition remain elusive. Advances of single-cell sequencing have enabled the detailed characterization of immune cells in tumors and have vastly improved our understanding of less-defined cell subsets. Here, we discuss the current strategies for uncovering the heterogeneity of TILs, and how the deep transcriptome coupled with T-cell receptor analysis enhances the understanding of detailed properties of T-cell subsets. We further discuss the identification of novel T-cell markers with therapeutic or prognosis potentials, and highlight distinct T-cell properties among different cancer indications.
Prenatal Diagnosis of 4q Terminal Deletion and Review of the Literature
Authors: Tidrenczel Zsolt , Tardy Erika P. , Pikó Henriett , Sarkadi Edina , Böjtös Ildikó , Demeter János , Simon Judit , Kósa János P. , Beke Artúr
Published: July 2019

Terminal deletion of chromosome 4 (4q deletion syndrome) is a rare genetic condition that is characterized by a broad clinical spectrum and phenotypic variability. Diagnosis of the distinct condition can be identified by conventional chromosome analysis and small deletions by novel molecular cytogenetic methods such as microarray comparative genome hybridization (aCGH). Prenatal diagnosis is challenging; to date 10 cases have been described. We report a prenatally diagnosed case of de novo 4q deletion syndrome confirmed by conventional karyotyping and FISH due to an elevated combined risk for Down syndrome and prenatal ultrasound findings. aCGH validated the diagnosis and offered exact characterization of the disorder. Cytogenetic and microarray results described a 4q32.1qter terminal deletion of the fetus. Prenatal ultrasound detected multiple nonstructural findings (micrognathia, choroid plexus cysts, echogenic fetal bowel, short femur, and cardiac axis deviation). Pregnancy was terminated at 20 weeks. In addition to the index patient, we reviewed the 10 prenatally published cases of 4q deletion syndrome in the literature and compared these with our results. We summarize the patients' characteristics and prenatal clinical findings. Alterations of maternal serum biochemical factors, an elevated combined risk for trisomies, and distinct ultrasonographic findings can often be observed in cases of prenatal 4q deletion syndrome and may facilitate the otherwise difficult prenatal diagnosis.
Patterns of Gestational Weight Gain in Women with Overweight or Obesity and Risk of Large for Gestational Age
Authors: Zheng Wei , Huang Wenyu , Zhang Zhi , Zhang Li , Tian Zhihong , Li Guanghui , Zhang Weiyuan
Published: July 2019

Objective: Timing of gestational weight gain (GWG) may influence perinatal outcomes differently. This study aimed to find associations of latent GWG patterns with risk of large for gestational age (LGA) in women with overweight or obesity. Methods: A total of 4,438 women with overweight or obesity were included in the analyses. Latent trajectories of GWG associated with LGA were identified by trajectory analysis. GWG, risk of LGA and early pregnancy factors were compared between these identified groups. Results: This study identified four distinct GWG trajectory groups associated with LGA, each group including, respectively, 78.6, 19.0, 1.4, and 0.9% of the participants. Group 1 presented a typical curve with lower GWG in early pregnancy and relatively higher GWG in mid- and late pregnancy. Women in group 2 showed sustained high GWG and high LGA prevalence than women in group 1 (48.24 vs. 21.56%, p < 0.0001). A catch-up in GWG after low weight gain did not result in significantly higher risk of LGA in group 3 compared to group 1. On the other hand, a rapid GWG in the first two-thirds of pregnancy followed by a strict weight control was associated with elevated risk of LGA in group 4 than group 1 (62.50 vs. 21.56%, p < 0.0001). Conclusions: Women affected by overweight or obesity combined with high GWG in early mid-pregnancy were at elevated risk of LGA. Early clinical recognition of a poor GWG trajectory will enable early intervention in high-risk groups.
Meckel-Gruber Syndrome: A Case Who Lived for 5 Months
Authors: Aydin Ozturk Pinar , Asena Muhammet , Katar Salim , Ozturk Unal
Published: July 2019

The Meckel-Gruber syndrome is a rare, congenital, and lethal malformation characterized by typical manifestations such as encephalocele, polycystic kidneys, and polydactyly. Herein, we present a case of a patient with the typical triad as well as facial, ocular, liver, and genital abnormalities who lived for almost 5 months.
Antimicrobial Resistance Patterns in Methicillin-Resistant Staphylococcus aureus from Patients Hospitalized during 2015–2017 in Hospitals in Poland
Authors: Kot Barbara , Wierzchowska Kamila , Piechota Małgorzata , Grużewska Agata
Published: July 2019

Objective: The aim of this study was to determine antimicrobial resistance profiles of methicillin-resistant Staphylococcus aureus (MRSA) isolates from clinical samples from patients hospitalized during 2015–2017 in hospitals of ­Masovian district in Poland. Materials and Methods: Antimicrobial resistance of 112 MRSA isolates was tested with a disc diffusion method. Isolates were examined for methicillin resistance using a 30 µg cefoxitin disk. Resistance was confirmed by PCR detection of the mecA gene. PCR was also used to determine spa gene polymorphism in X-region. Results: A large number of MRSA isolates showed resistance to levofloxacin (83.9%), ciprofloxacin (83%), erythromycin (77.7%) and clindamycin (72.3%). A lower number of MRSA isolates showed resistance to tetracycline (10.7%), amikacin (14.2%), gentamicin and trimethoprim with sulfamethoxazole (8.0%). None of the MRSA isolates were resistant to linezolid and teicoplanin. Among MRSA isolates, 92.9% were multidrug-resistant (MDR). Resistance to erythromycin, clindamycin, ciprofloxacin and levofloxacin was the most common resistance pattern among MDR MRSA isolates. The highest number of isolates was resistant to 4 groups of antimicrobials (53.8%). The number of drugs to which MRSA isolates were resistant in 2017 was significantly higher than that in 2016 (p = 0.002). The size polymorphism analysis of X fragment of the spa gene revealed high genetic diversity of the investigated group MRSA isolates. Conclusion: This study demonstrates that in the hospital environment, MRSA isolates can quickly acquire new antimicrobial resistance determinants and that knowledge of current resistance patterns is important for the effective treatment of infections caused by MDR MRSA.
Socialização legal de crianças e adolescentes: revisão da literatura e desafios de pesquisa
Authors: Rodrigues Herbert , Gomes Aline Morais Mizutani , Oliveira Renan Theodoro de , Piccirillo Debora , Brito Rafael Cardoso de
Published: July 2019

Este artigo visa apresentar a socialização legal como um campo de investigação que busca compreender a maneira pela qual as crianças e os adolescentes desenvolvem suas noções sobre autoridades, regras e leis. Trata-se de uma revisão da literatura dividida em dois segmentos centrais: um balanço teórico das chamadas abordagens tradicionais e uma síntese dos estudos recentes sobre a temática da socialização legal. Além disso, o artigo sinaliza alguns desafios de pesquisa que podem contribuir para o entendimento desse processo no contexto brasileiro.
A produção do fato da transformação do adolescente: uma análise dos relatórios utilizados na execução da medida socioeducativa de internação
Authors: Gisi Martins de Almeida Bruna
Published: July 2019

O enquadramento legal definido pelo Estatuto da Criança e do Adolescente para a institucionalização de adolescentes autores de atos infracionais estabelece que a decisão sobre o tempo de duração da internação deve ser produzida ao longo do processo de execução da medida socioeducativa. Partindo de uma pesquisa realizada com as instituições responsáveis pela execução da medida de internação em São Paulo (Fórum Brás e Fundação CASA), o objetivo deste artigo é analisar o processo de construção dessa decisão nos relatórios produzidos pelas equipes técnicas nas unidades de internação para fundamentar a decisão judicial sobre a liberação do adolescente. O contexto prático de elaboração e recepção dos relatórios foi utilizado como esquema interpretativo para análise dos procedimentos empregados para produzir a razoabilidade da decisão de liberar o adolescente da unidade. A análise sugere que os três formatos desses relatos – relatórios inicial, de acompanhamento e conclusivo – exibem organizações típicas e empregam procedimentos que contribuem para a produção do fato da transformação do adolescente como efeito da medida.
Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association
Authors: Rychik Jack , Atz Andrew M. , Celermajer David S. , Deal Barbara J. , Gatzoulis Michael A. , Gewillig Marc H. , Hsia Tain-Yen , Hsu Daphne T. , Kovacs Adrienne H. , McCrindle Brian W. , Newburger Jane W. , Pike Nancy A. , Rodefeld Mark , Rosenthal David N. , Schumacher Kurt R. , Marino Bradley S. , Stout Karen , Veldtman Gruschen , Younoszai Adel K. , d’Udekem Yves ,   On behalf of the American Heart Association Council on Cardiovascular Disease in the Young and Council on Cardiovascular and Stroke Nursing
Published: July 2019

It has been 50 years since Francis Fontan pioneered the operation that today bears his name. Initially designed for patients with tricuspid atresia, this procedure is now offered for a vast array of congenital cardiac lesions when a circulation with 2 ventricles cannot be achieved. As a result of technical advances and improvements in patient selection and perioperative management, survival has steadily increased, and it is estimated that patients operated on today may hope for a 30-year survival of >80%. Up to 70 000 patients may be alive worldwide today with Fontan circulation, and this population is expected to double in the next 20 years. In the absence of a subpulmonary ventricle, Fontan circulation is characterized by chronically elevated systemic venous pressures and decreased cardiac output. The addition of this acquired abnormal circulation to innate abnormalities associated with single-ventricle congenital heart disease exposes these patients to a variety of complications. Circulatory failure, ventricular dysfunction, atrioventricular valve regurgitation, arrhythmia, protein-losing enteropathy, and plastic bronchitis are potential complications of the Fontan circulation. Abnormalities in body composition, bone structure, and growth have been detected. Liver fibrosis and renal dysfunction are common and may progress over time. Cognitive, neuropsychological, and behavioral deficits are highly prevalent. As a testimony to the success of the current strategy of care, the proportion of adults with Fontan circulation is increasing. Healthcare providers are ill-prepared to tackle these challenges, as well as specific needs such as contraception and pregnancy in female patients. The role of therapies such as cardiovascular drugs to prevent and treat complications, heart transplantation, and mechanical circulatory support remains undetermined. There is a clear need for consensus on how best to follow up patients with Fontan circulation and to treat their complications. This American Heart Association statement summarizes the current state of knowledge on the Fontan circulation and its consequences. A proposed surveillance testing toolkit provides recommendations for a range of acceptable approaches to follow-up care for the patient with Fontan circulation. Gaps in knowledge and areas for future focus of investigation are highlighted, with the objective of laying the groundwork for creating a normal quality and duration of life for these unique individuals.
Arterial Remodeling and Dysfunction in the ZSF1 Rat Model of Heart Failure With Preserved Ejection Fraction
Authors: Leite Sara , Cerqueira Rui J. , Ibarrola Jaime , Fontoura Dulce , Fernández-Celis Amaya , Zannad Faiez , Falcão-Pires Inês , Paulus Walter J. , Leite-Moreira Adelino F. , Rossignol Patrick , López-Andrés Natalia , Lourenço André P.
Published: July 2019

Background:

The interplay between the stiffened heart and vessels has long been viewed as a core mechanism in heart failure with preserved ejection fraction, but the incremental vascular molecular remodeling mechanisms from systemic arterial hypertension to heart failure with preserved ejection fraction remain poorly investigated. Our aim was to characterize central arterial remodeling and dysfunction in ZSF1 obese rats and to compare it with hypertensive ZSF1 lean and healthy Wistar-Kyoto controls.

Methods and Results:

Twenty-week-old male ZSF1 obese (n=9), lean (n=9), and Wistar-Kyoto rats (n=9) underwent left ventricular pressure-volume loop evaluation and synchronous acquisition of ascending aortic flow and pressure. Aortic rings underwent functional evaluation, histology, and molecular biology studies. Although mean arterial pressure, characteristic aortic impedance, and reactivity to phenylephrine were similarly increased in hypertensive ZSF1 lean and obese, only ZSF1 obese showed impaired relaxation and upward-shifted end-diastolic pressure-volume relationships despite preserved systolic function indexes, denoting heart failure with preserved ejection fraction. ZSF1 obese phenotype further showed decreased aortic compliance, increased wave reflection, and impaired direct NO donor and endothelial-mediated vasodilation which were accompanied on structural and molecular grounds by aortic media thickening, higher collagen content and collagen/elastin ratio, increased fibronectin and α-5 integrin protein expression and upregulated TGF (transforming growth factor)-β and CTGF (connective tissue growth factor) levels.

Conclusions:

Functional, molecular, and structural disturbances of central vessels and their potentially underlying pathways were newly characterized in experimental heart failure with preserved ejection fraction rendering the ZSF1 obese rat model suitable for preclinical testing.
Conserved
NPPB
+ Border Zone Switches From MEF2- to AP-1–Driven Gene Program
Authors: van Duijvenboden Karel , de Bakker Dennis E.M. , Man Joyce C.K. , Janssen Rob , Günthel Marie , Hill Matthew C. , Hooijkaas Ingeborg B. , van der Made Ingeborg , van der Kraak Petra H. , Vink Aryan , Creemers Esther E. , Martin James F. , Barnett Phil , Bakkers Jeroen , Christoffels Vincent M.
Published: July 2019

Background:

Surviving cells in the postinfarction border zone are subjected to intense fluctuations of their microenvironment. Recently, border zone cardiomyocytes have been specifically implicated in cardiac regeneration. Here, we defined their unique transcriptional and regulatory properties, and comprehensively validated new molecular markers, including
Nppb
, encoding B-type natriuretic peptide, after infarction.

Methods:

Transgenic reporter mice were used to identify the
Nppb
-positive border zone after myocardial infarction. Transcriptome analysis of remote, border, and infarct zones and of purified cardiomyocyte nuclei was performed using RNA-sequencing. Top candidate genes displaying border zone spatial specificity were histologically validated in ischemic human hearts. Mice in which
Nppb
was deleted by genome editing were subjected to myocardial infarction. Chromatin accessibility landscapes of border zone and control cardiomyocyte nuclei were assessed by using assay for transposase-accessible chromatin using sequencing.

Results:

We identified the border zone as a spatially confined region transcriptionally distinct from the remote myocardium. The transcriptional response of the border zone was much stronger than that of the remote ventricular wall, involving acute downregulation of mitochondrial oxidative phosphorylation, fatty acid metabolism, calcium handling, and sarcomere function, and the activation of a stress-response program. Analysis of infarcted human hearts revealed that the transcriptionally discrete border zone is conserved in humans, and led to the identification of novel conserved border zone markers including
NPPB
,
ANKRD1
,
DES
,
UCHL1, JUN
, and
FOXP1
. Homozygous
Nppb
mutant mice developed acute and lethal heart failure after myocardial infarction, indicating that B-type natriuretic peptide is required to preserve postinfarct heart function. Assay for transposase-accessible chromatin using sequencing revealed thousands of cardiomyocyte lineage-specific MEF2-occupied regulatory elements that lost accessibility in the border zone. Putative injury-responsive enhancers that gained accessibility were highly associated with AP-1 (activator protein 1) binding sites. Nuclear c-Jun, a component of AP-1, was observed specifically in border zone cardiomyocytes.

Conclusions:

Cardiomyocytes in a discrete zone bordering the infarct switch from a MEF2-driven homeostatic lineage-specific to an AP-1–driven injury-induced gene expression program. This program is conserved between mouse and human, and includes
Nppb
expression, which is required to prevent acute heart failure after infarction.
Early Onset Hypertension Is Associated With Hypertensive End-Organ Damage Already by MidLife
Authors: Suvila Karri , McCabe Elizabeth L. , Lehtonen Arttu , Ebinger Joseph E. , Lima Joao A.C. , Cheng Susan , Niiranen Teemu J.
Published: July 2019

Early onset hypertension confers increased risk for cardiovascular mortality in the community. Whether early onset hypertension also promotes the development of target end-organ damage (TOD), even by midlife, has remained unknown. We studied 2680 middle-aged CARDIA study (Coronary Artery Risk Development in Young Adults) Study participants (mean age 50±4 years, 57% women) who underwent up to 8 serial blood pressure measurements between 1985 and 2011 (age range at baseline 18–30 years) in addition to assessments of echocardiographic left ventricular hypertrophy, coronary calcification, albuminuria, and diastolic dysfunction in 2010 to 2011. Age of hypertension onset was defined as the age at first of 2 consecutively attended examinations with blood pressure ≥140/90 mm Hg or use of antihypertensive medication. Participants were divided in groups by hypertension onset age (<35 years, 35–44 years, ≥45 years, or no hypertension). While adjusting for TOD risk factors, including systolic blood pressure, we used logistic regression to calculate odds ratios for cases (participants with TOD) versus controls (participants without TOD) to examine the relation of hypertension onset age and hypertensive TOD. Compared with normotensive individuals, hypertension onset at age <35 years was related to odds ratios of 2.29 (95% CI, 1.36–3.86), 2.94 (95% CI, 1.57–5.49), 1.12 (95% CI, 0.55–2.29), and 2.06 (95% CI, 1.04–4.05) for left ventricular hypertrophy, coronary calcification, albuminuria, and diastolic dysfunction, respectively. In contrast, hypertension onset at age ≥45 years was not related to increased odds of TOD. Our findings emphasize the importance of assessing age of hypertension onset in hypertensive patients to identify high-risk individuals for preventing hypertensive complications.
Meaning Frames: The Structure of Problem Frames and Solution Frames
Authors: Haase Louise Møller , Laursen Linda Nhu
Published: July 2019

In recent years, focus on the designer's ability to frame wicked problems has underlined the important positioning of the designer as a key player in the early phases of innovation. However, further clarification and development of the theory and terminology of framing are needed in order to understand and support the rather complex framing process that the design team engages in during the early phases of innovation. There is a need to understand how design teams move from an overall framing of the wicked problem, in literature termed the “ problem frame,” to creating a meaningful solution. Through in-depth case studies of the framing processes at five design companies, we learn how designers use the overall problem frame as a stepping-stone to constructing a set of “ solution frames” in order to move toward a meaningful solution that integrates different perspectives. Together with the problem frame these sets of additional solution frames constitute an overall framing of the meaningful product—a “ meaning frame.” This overall meaning frame clarifies and sets the boundaries, the values and goals, and the criteria for evaluation of a proposed solution. As such, the study sheds light on the otherwise hidden reasoning process of framing toward a meaningful solution, rather than framing the problem, which a majority of current literature discusses.
Toward Design Orientation and Integration: Driving Design from Awareness to Action
Authors: Nusem Erez , Matthews Judy , Wrigley Cara
Published: July 2019

Design is increasingly recognized as offering strategic value to business in driving innovation, and has assisted organizations in balancing the needs of several stakeholders while maintaining competitiveness. However, for organizations which are not design-oriented, realizing outcomes through design can present a complex challenge. This paper presents the findings of a two-year action research project, and contributes a method for building an appetite for design, developing an awareness of the value design can offer, and for taking action within organizational constraints. Outcomes include enhanced perception of design methods, a clearer understanding of stakeholders, and the contribution of a framework for integrating design in organizations yet unfamiliar with the value of design.
Design Activism in an Indonesian Village
Authors: Crosby Alexandra
Published: July 2019

Many design practices in Indonesia combine a sense of urgency around environmental crises with very local forms of community organizing and alternative economies. Located in the village of Kandangan in an agricultural area of Central Java are two organizations called Magno and Spedagi, as well as a cluster of other design activist projects. This paper aims to bring some of these practices and projects into broader discussions about design activism and sustainability, while resisting the urge to define design activism as a global movement.
Variable Selection for Nonparametric Learning with Power Series Kernels
Authors: Matsui Kota , Kumagai Wataru , Kanamori Kenta , Nishikimi Mitsuaki , Kanamori Takafumi
Published: July 2019

In this letter, we propose a variable selection method for general nonparametric kernel-based estimation. The proposed method consists of two-stage estimation: (1) construct a consistent estimator of the target function, and (2) approximate the estimator using a few variables by [Formula: see text]-type penalized estimation. We see that the proposed method can be applied to various kernel nonparametric estimation such as kernel ridge regression, kernel-based density, and density-ratio estimation. We prove that the proposed method has the property of variable selection consistency when the power series kernel is used. Here, the power series kernel is a certain class of kernels containing polynomial and exponential kernels. This result is regarded as an extension of the variable selection consistency for the nonnegative garrote (NNG), a special case of the adaptive Lasso, to the kernel-based estimators. Several experiments, including simulation studies and real data applications, show the effectiveness of the proposed method.
Modern Muslim Subjectivities: Religion and Multiple Modernities within Islam
Authors: Jung Dietrich
Published: July 2019

This article presents the overarching theoretical framework and some tentative findings of the Modern Muslim Subjectivities Project (MMSP). It discusses some of its conceptual tools and presents strategies for studying the role of religion in modern Muslim subjectivity formation. The core rationale of this research program is to explore the role of religious traditions in the construction of modern forms of Muslim subjectivity and social order. It investigates the ways in which Muslims have imagined specifically Islamic modernities in combination with non-religious and globally relevant cultural scripts. In criticizing the alleged Western origin and secular nature of modernity, the MMSP aims at making original contributions both to conceptual discussions of modernity in the study of religions and to our knowledge of modern Muslim societies.
Daily Ritual, Mission, and the Transformation of the Self: the Case of Tablighi Jamaat
Authors: Pieri Zacharias
Published: July 2019

Tablighi Jamaat (TJ) is Islam’s largest movement, with estimates of up to 80 million Muslims taking part in its activities. Having originated on the Indian subcontinent, TJ has expanded to have a strong presence across the globe. Traditionally, TJ is known for bringing lapsed Muslims back to a stricter understanding of Islam and the recommendation that its male (and to an increasing extent also its female) members spend a certain portion of time each year working on the “path of Allah” — that is, on missionary activities. Tablighi leaders are conscious that participation in the movement impacts not only those who are the targets of missionary activity but also those who are doing the missionizing, having a powerful effect upon the formation of selfhoods. TJ also emphasizes the importance of imitating the Prophet Muhammad, and members are encouraged to ritualize every aspect of their life in accordance with the Prophet’s example. The ritualization of everyday practices, a focus on purity and mission, combined with textual (re)interpretation, contribute to individual and collective identity construction among members of TJ. For TJ, the formation of modern Muslim selfhoods is of vital importance, as they believe that an identity centered on an authentic form of Islam can protect Muslims in a fast-changing world.
An Islamic University in the West and the Question of Modern Authenticity
Authors: Sinclair Kirstine
Published: July 2019

The aim of this article is to discuss how Islamic universities in the West facilitate and condition the formation of modern Muslim subjectivities in minority contexts, with an emphasis on the institutions as providers of guidelines for good, Muslim minority life. This is done through a case study of Cambridge Muslim College in the UK. Its values and aims are explored through interviews with the founder and dean, faculty members and students, and through participatory observation. Cambridge Muslim College sees itself as a mediator between Islamic traditions and modern Muslims in the West, and as responsible for engaging in the development of both Muslim minorities and the wider society within which it operates. The questions guiding the study are the following: What role do Islamic universities play in shaping modern Muslim subjectivities in the West? How does Cambridge Muslim College combine understandings of authenticity with preparing their students for professional careers in Britain? The study shows that the understanding of authenticity that is encouraged by college dean Shaykh Abdal Hakim provides an important tool for the students as they strive to form meaningful selves and careers in contemporary Britain. Thus, references to authentic Islam is used to support the development of both working and moral modern subjects.
Attitudinal Pleasure in Plato’s Philebus
Authors: Sommerville Brooks A.
Published: July 2019

This paper addresses two interpretive puzzles in Plato’s Philebus. The first concerns the claim, endorsed by both interlocutors, that the most godlike of lives is a pleasureless life of pure thinking. This appears to run afoul of the verdict of the earlier so-called ‘Choice of Lives’ argument that a mixed life is superior to either of its ‘pure’ rivals. A second concerns Socrates’ discussion of false pleasure, in which he appears to be guilty of rank equivocation. I argue that we can solve both puzzles by attributing to Plato an account of pleasure as a species of intentional attitude.