bluuebunny/crossref_metadata_2025 huggingface dataset:
Aplicação da Teoria do Cuidado Transpessoal de Jean Watson: uma década de produção brasileira
Authors: Favero Luciane , Meier Marineli Joaquim , Lacerda Maria Ribeiro , Mazza Verônica de Azevedo , Kalinowski Luísa Canestraro
Published: June 2009

Esta revisão sistemática objetivou descrever e analisar a aplicação da Teoria do Cuidado Transpessoal de Jean Watson nas pesquisas divulgadas em publicações de Enfermagem brasileiras dos últimos dez anos. O levantamento bibliográfico abrangeu 34 produções científicas selecionadas nas bases de dados eletrônicas MEDLINE (MEDLARS [Medical Literature Analysis and Retrieval System] On-line), LILACS (Literatura Latino Americana e do Caribe em Ciências da Saúde), BDENF (Base de dados de Enfermagem) e SciELO (Scientific Electronic Library On-line), que após aplicação dos critérios de inclusão estabelecidos, compuseram a amostra do estudo. Os resultados apontaram que a Região Sul concentra 61,8% das produções referidas ao tema de estudo, que ela pode ser aplicada nos níveis de atenção primária, secundária e terciária e que 64,7% das produções utilizam os fatores de cuidado propostos por Jean Watson em 1979. Emerge a necessidade de aprimoramento das pesquisas acerca da transformação ocorrida na Teoria do Cuidado Transpessoal, com abordagem do Processo Clinical Caritas, porém como são escassos os estudos referentes a esta temática, dificultam sua utilização prática.
Características analíticas de vinhos Merlot da Serra Gaúcha
Authors: Rizzon Luiz Antenor , Miele Alberto
Published: June 2009

A uva Merlot é uma cultivar originária da região de Bordeaux, França, uma das responsáveis pela notoriedade dos vinhos de Saint-Émilion e Pomerol. Na Serra Gaúcha, é a segunda vinífera tinta com maior área plantada. Na safra de 2007, a produção dessa uva alcançou 11.399t, representando 31% das uvas tintas viníferas processadas. O objetivo do trabalho foi avaliar a composição físico-química de vinhos Merlot elaborados na Serra Gaúcha, visando a sua identidade varietal, à caracterização regional e à formação de um banco de dados. Foram analisados 34 vinhos, safras 2000 a 2003, de 30 vinícolas. As análises foram realizadas na Embrapa Uva e Vinho, em Bento Gonçalves, RS. As determinações clássicas foram efetuadas por meio de métodos físico-químicos; os elementos minerais, por espectrofotometria de absorção atômica; e os compostos voláteis, por cromatografia gasosa. Os resultados mostram que os vinhos Merlot se enquadraram nos limites estabelecidos pela legislação brasileira. Foram observados valores elevados de matiz e baixos dos índices de cor avaliados a 520nm e 620nm, variáveis que participam do aspecto visual dos vinhos. Foram constatados teores elevados de acetato de etila e 1-propanol, compostos voláteis que influenciam as características sensoriais, e de K, que interfere na acidez e na conservação do vinho. A concentração de metanol também foi elevada.
Melanoníquia: importância da avaliação dermatoscópica e da observação da matriz / leito ungueal
Authors: Bilemjian Aline Perdiz de Jesus , Piñeiro-Maceira Juan , Barcaui Carlos Baptista , Pereira Francisco Burnier
Published: June 2009

Melanoníquia, do grego mélaina, negro, sombrio, resulta de uma deposição aumentada de melanina na lâmina ungueal originada a partir da matriz ungueal. Apresenta diversas causas, entre elas, o melanoma subungueal, por isso, seu diagnóstico etiológico torna-se essencial, devendo ser o mais precoce possível. Os autores apresentam dois pacientes com melanoníquias de natureza distinta e enfatizam o seu diagnóstico diferencial.
Educação superior bilíngue para surdos: o sentido da política inclusiva como espaço da liberdade: primeiras aproximações
Authors: Franco Monique
Published: June 2009

Este trabalho tem como objetivo apresentar um ensaio acerca da experiência em curso do Instituto Nacional de Surdos (INES), na implantação do Instituto Superior Bilíngue de Educação (ISBE). O diálogo com Hannah Arendt e a concepção de política como espaço da liberdade consubstanciam esta reflexão. Inicialmente, o recente contexto educacional dos surdos, com a aprovação do Decreto n.º 5.626/2005, que regulamenta a Lei n.º 10.436/2002, que oficializa a Língua Brasileira de Sinais (LIBRAS), é colocado em cena. Em seguida, traçam-se os elementos constitutivos básicos da recente construção da experiência de ensino superior bilíngue no INES/ISBE, com o curso de Pedagogia e os principais entraves a sua implantação. À guisa de reflexões finais, pretende-se indicar o sentido da política inclusiva no contexto de uma Política Cultural Bilíngue, enquanto abertura histórica de sentido possa representar um ensaio à liberdade.
Trajetória escolar do surdo no ensino superior: condições e possibilidades
Authors: Cruz José Ildon Gonçalves da , Dias Tárcia Regina da Silveira
Published: June 2009

Devido ao número relativamente pequeno de surdos que frequentam o ensino superior, este estudo objetivou conhecer as suas condições nesse nível de ensino. Participaram da pesquisa sete surdos universitários, na faixa etária entre 22 e 39 anos. Os dados foram obtidos por meio de entrevistas individuais sucessivas, presenciais ou à distância, via internet, empregando o português falado, escrito ou a língua de sinais, com a mediação de intérprete. Realizaram-se dez entrevistas presenciais, gravadas e transcritas, e onze à distância, mediante e-mail e Messenger®. Os relatos foram analisados sob o ponto de vista sócio-antropológico, que entende os surdos como diferentes, linguística e culturalmente, pertencentes aos grupos minoritários e que frequentam, na maioria das vezes, uma escola organizada para ouvintes e padronizada. Os resultados apontam que as condições dos surdos no ensino superior são de dificuldades, de impedimentos, de abandono e de rejeição. Os surdos são obrigados a se responsabilizarem por sua aprendizagem, priorizando o trabalho extra classe para recuperação de notas. A escola se organiza de acordo com interesses e necessidades dos ouvintes, isto é: não há uma língua compartilhada com os alunos surdos, não há intérprete português-Libras, não há contexto bicultural, não há interlocução na escola. Concluiu-se que os surdos são capazes, produtivos, solidários e interessados em avançar no seu processo de escolarização, apesar dos empecilhos encontrados no interior do espaço escolar.
Fator V de Leiden na doença de Legg-Calvé-Perthes
Authors: Sanders Lia Lira Olivier , Braga Júnior Manuel Bomfim , Cima César Wagner Montenegro , Mota Rosa Maria Salani , Pardini Maria Inês de M. C. , Rabenhorst Sílvia Helena Barem
Published: June 2009

Trobofilias hereditárias têm sido implicadas na patogênese da doenca de Legg-Calvé-Perthes. Uma investigação do fator de risco hereditário mais comum para hipercoagulabilidade - a mutação no gene do fator V (fator V de Leiden) - foi conduzida em 20 pacientes com Legg-Calvé-Perthes e 214 controles sadios. A prevalência do fator V de Leiden foi maior nos pacientes com Legg-Calvé-Perthes que no grupo controle (30 vs. 1,87%). A razão de chances (odds ratio) para o desenvolvimento de Legg-Calvé-Perthes foi de 22,5 (p<0,05; intervalo de confiança: 5,68- 89.07). Estes dados sugerem, o fator V de Leiden como fator de risco hereditário para hipercoagulabilidade associada ao desenvolvimento da doença de Legg-Calvé-Perthes.
Nucleolar Organizer Region (NORs) in pseudocarcinomatous hyperplasia and squamous cell carcinoma of the oral mucosa
Authors: Altemani Albina Messias de Almeida Milani , Crespo Agrício , Cardinalli lzilda Aparecida , Norato Denise
Published: June 2009

Counts of nucleolar regions (NORs) demonstrated by a silver staining technique in paraffin sections, have been used to distinguish benign from malignant lesions. AgNORs were studied in 24 biopsies from oral cavity (5 cases of normal oral mucosa, 5 of pseudocarcinomatous hyperplasia and 14 of squamous cell carcinoma, subdivided according to degree of differentiation: 5 grade 1, 5 grade 2 and 4 grade 3) to find whether they were helpful in distinguishing pseudocarcinomatous hyperplasia due to chronic parasitic infections from squamous cell carcinoma. Two methods of counting AgNORs were used: (A) a simpler one which counts nucleolar clusters (AgNU) and satellite AgNORs and the other (B) counting all individual AgNORs, including those within AgNUs. In both methods the lowest mean values were observed for grade 3 carcinoma, while the highest belonged to grade 2 carcinoma. The simpler method (A) was the most useful because AgNU counts showed significant difference when pseudocarcinomatous hyperplasia was compared with grade 1 and 2 carcinomas, which are the most difficult to discriminate from it. However the overlapping of values render the technique of limited use in individual cases.
Maintenance treatment of diabetic patients, associating arterial obstructive tibio-peroneal disease
Authors: Wolosker Nelson , Rosoky Ruben Miguel Ayzin , Muraco Neto Baptista , Langer Berilo
Published: June 2009

When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II) was observed in 64 patients (91.5%), being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20%) of the patients, neuropathy in 22 (31%) and nephropathy in 8 patients (11.4%). All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%), presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%), trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%), injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%)(p<0,01). Studying the injury locals associated to the evaluation of the cases, we may observe that for injuries in the extreme digital, result is significantly better than in locals more nearly. When distal pulses are absent, there is no significant difference in the result of the treatment, being performed in distal injuries or in the more near ones (p>0,05)(Table IV).
The undetermined form of Chagas' heart disease: concept and forensic implications
Authors: Barretto Antonio Carlos Pereira , Ianni Barbara Maria
Published: June 2009

The undetermined form of Chagas' disease is diagnosed in asymptomatic subjects with a positive blood test for Chagas' disease, normal resting electrocardiogram, chest X-ray, barium esophageal and large bowel radiological studies. Other investigation methods are not recommended for identification of other organs damage lesions in this phase of the disease. When other methods of investigation were employed, cardiac and digestive abnormalities of small magnitude were detected without prognostic implications. These findings do not warrant frequent examinations of patients with undetermined form of the disease except for the electrocardiogram or if the patients report other clinical manifestations. The benign course of the disease does not preclude ability to work and the subjects should be considered apt for work in any profession.
Thromboembolism in chronic Chagas' heart disease
Authors: Braga João Carlos , Labrunie André , Villaça Fábio , Nascimento Ezilaine do , Quijada Luiz
Published: June 2009

Thromboembolic episodes are particularly important in chronic Chagas' heart disease. Systemic and pulmonary embolic phenomena are important complications of the disease. Prophylaxis of the thromboembolic phenomena with anticoagulant therapy should be considered in several clinical forms of the disease. Further studies will have to address the stratification risk issue.
Abdominal mycobacterial infection in acquired immunodeficiency syndrome patients
Authors: Guidugli Ruggero Bernardo , Siqueira Sheila Aparecida Coelho , Senise Jorge de Figueiredo , Silva Anderson José da , Hamrick Paul , Figueiroa Nancy Rezende
Published: June 2009

The authors studied 12 patients with AIDS and abdominal mycobacteriosis hospitalized in the Hospital Ipiranga (São Paulo, Brazil), from June 1989 to January 1992. Diagnosis was confirmed by the histopathological examination of organ specimens collected during laparotomy, which, in most cases, was carried out due to an emergency situation. Observations included perforation of the ileum, seropurulent fluid involved and bloked by viscera, epiploon, and fibrin. Hepatoesplenomegaly was present in all patients and generalized granulomatous peritonitis was observed in more than 50%. A patient died in the immediate post-op period, four after an average period of 55 days in the hospital. A patient evolved with stercoral fistula and asked to be discharged. Six patients were discharged after an average hospitalization period of 27 days. The authors stress that in developing regions where tuberculosis incidence is high, a patient with AIDS and a painful and irritative abdominal picture should always lead to the hypothesis of mycobacteriosis.
Prognostic factors in 291 patients with pulmonary metastases submitted to thoracotomy
Authors: Rossi Benedito Mauro , Lopes Ademar , Kowalski Luiz Paulo , Regazzini Rosana Cardoso de Oliveira
Published: June 2009

Pulmonary metastases are among the most common sites for the spread of cancer, particularly with mesenchymal tumors. Despite improvements in cancer therapy, the prognosis remains poor, except for the highly selective group of patients who are considered eligible for surgical treatment and those with chemosensitive tumors. The main objective of this study was to evaluate survival results of 291 patients who underwent thoractomy due to pulmonary metastases between 1953 and 1986. The number of metastases ranged from a minimum of 1 to as many as 30. The type of resection depended on site, size, and number of pulmonary lesions: 154 wedge resections, 49 lobectomies, and 9 pneumectomies. The tumor was not resectable in the remaining 79 patients. Of the prognostic factors analyzed, only type of pulmonary resection (wedge vs. lobectomy vs. pneumectomy vs. unresectable) and disease free interval (DFI) between primary treatment and pulmonary metastases diagnosis ( <=6 months vs. 7-12 months vs. >12 months) were selected as independent predictors of the risk of death in multivariate analysis. A reduced model for bone tumors included disease free interval, sex and histology.
Perspectives on next‐generation technology for environmental sensor networks
Authors: Benson Barbara J , Bond Barbara J , Hamilton Michael P , Monson Russell K , Han Richard
Published: June 2009

Sensor networks promise to transform and expand environmental science. However, many technological difficulties must be overcome to achieve this potential. Partnerships of ecologists with computer scientists and engineers are critical in meeting these challenges. Technological issues include promoting innovation in new sensor design, incorporating power optimization schemes, integrating appropriate communication protocols, streamlining data management and access, using innovative graphic and statistical analyses, and enabling both scientists and the public to access the results. Multidisciplinary partnerships are making major contributions to technological advances, and we showcase examples of this exciting new technology, as well as new approaches for training researchers to make effective use of emerging tools.
Microbiological monitoring of acid mine drainage treatment systems and aquatic surroundings using real-time PCR
Authors: Han J. S. , Kim C. G.
Published: June 2009

In general, acid mine drainage (AMD) causes low pH and high metal concentrations in mining areas and surroundings. The aim of this research was to achieve microbiological monitoring for AMD and to assess whether mine water outflows have any ecological effects on the aqueous ecosystem receiving effluents from different types of treatment system. The water quality of aquatic sample was analyzed and the molecular biological diversity of the samples was assessed using 16S rRNA methods, which were implemented to determine which bacteria existed throughout various unit processes for different AMD treatment systems and their receiving water environments. Acidiphilium cryptum, a heterotrophic acidophile, was found at the AMD sites, and Rhodoferax ferrireducens, which can reduce iron using insoluble Fe(III) as an electron acceptor, was detected at many AMD treatment facilities and downstream of the treatment processes. Subsequently, quantitative real-time PCR was conducted on specific genes of selected bacteria. Surprisingly, obvious trends were observed in the relative abundance of the various bacteria that corresponded to the water quality analytical results. The copy number of Desulfosporosinus orientus, a sulfate reducing bacteria, was also observed to decrease in response to decreases in metals according to the downstream flow of the AMD treatment system.
Biological nitrogen and phosphorus removal in UCT-type MBR process
Authors: Lee H. , Han J. , Yun Z.
Published: June 2009

A lab-scale UCT-type membrane bio-reactor (MBR) was operated for biological nitrogen (N) and phosphorus (P) removal simultaneously. In order to examine biological nutrient removal (BNR) characteristics of MBR, the lab unit was fed with a synthetic strong and weak wastewater. With strong wastewater, a simultaneous removal of N and P was achieved while application of weak wastewater resulted in a decrease of both N and P removal. Recycled nitrate due to the limited organic in weak wastewater operation probably caused a nitrate inhibition in anaerobic zone. In step feed modification with weak wastewater, both N and P removal capability recovered in the system, indicating that the allocation of COD for denitrification at anoxic zone was a key to increase the biological P removal. In addition, the analysis on the specific P uptake rate in anoxic zone demonstrated that denitrifying phosphorus accumulating organism (dPAO) played an important role to remove up to 40% of P along with N. The sludge production characteristics of UCT-type MBR were similar to ordinary activated sludge with BNR capability.
Atmospheric fluxes of nutrients onto Singapore Strait
Authors: Sundarambal P. , Balasubramanian R. , Tkalich P.
Published: June 2009

In view of recurring forest fires in Southeast Asia (SEA) on a large scale and the abundant rainfall in this tropical region, atmospheric fallout of airborne particles i.e. dry atmospheric deposition (DAD) and wet atmospheric deposition (WAD) of nutrients to the ocean surface are thought to be significant. Currently, limited data sets of atmospheric deposition (AD) exist for tropical ecosystems in the region. Furthermore, there is a lack of reliable experimental data on AD of nitrogen (N) & phosphorus (P) in tropical environments. It is therefore imperative to quantify the AD of macro-nutrients, N and P species in order to estimate their impacts on aquatic and terrestrial ecosystems. In this study, field measurements of nitrite, nitrate, ammonium, total N (TN), phosphate and total P (TP) were made, in both airborne particulate matter and precipitation, from January 2006 to July 2006 in Singapore. These measurements were done to characterize and estimate the difference between DAD and WAD fluxes of N & P to coastal waters. The estimated loadings from DAD and WAD (g/m2/year) of TN were 1.011±0.441 and 7.052±4.34 and those of TP were 0.187±0.16 and 0.532±0.524, respectively. This investigation represents a baseline study to access environmental effects of AD of nutrients on the coastal aquatic ecosystem.
Herbal pharmaceutical wastewater treatment by a pilot scale upflow anaerobic sludge blanket (UASB) reactor
Authors: Satyanarayan S. , Karambe A. , Vanerkar A. P.
Published: June 2009

Herbal pharmaceutical industry has grown tremendously in the last few decades. As such, literature on the treatment of this wastewater is scarce. Water pollution control problems in the developing countries need to be solved through application of cost effective aerobic/anaerobic biological systems. One such system—the upflow anaerobic sludge blanket (UASB) process which is known to be cost effective and where by-product recovery was also feasible was applied for treatment of a high strength wastewater for a period of six months in a pilot scale upflow anaerobic sludge blanket (UASB) reactor with a capacity of 27.44 m3. Studies were carried out at various organic loading rates varying between 6.26 and 10.33 kg COD/m3/day and hydraulic retention time (HRT) fluctuating between 33 and 43 hours. This resulted in chemical oxygen demand (COD), biochemical oxygen demand (BOD) and suspended solids (SS) removal in the range of 86.2%–91.6%, 90.0%–95.2% and 62.6%–68.0% respectively. The biogas production varied between 0.32–0.47 m3/kg COD added. Sludge from different heights of UASB reactor was collected and subjected to scanning electron microscopy (SEM). The results indicated good granulation with efficient UASB reactor performance.
Stem cell biology in traumatic brain injury: effects of injury and strategies for repair
Authors: Richardson R. Mark , Singh Amanpreet , Sun Dong , Fillmore Helen L. , Dietrich Dalton W. , Bullock M. Ross
Published: June 2009

Approximately 350,000 individuals in the US are affected annually by severe and moderate traumatic brain injuries (TBI) that may result in long-term disability. This rate of injury has produced ~ 3.3 million disabled survivors in the US alone. There is currently no specific treatment available for TBI other than supportive care, but aggressive prehospital resuscitation, rapid triage, and intensive care have reduced mortality rates. With the recent demonstration that neurogenesis occurs in all mammals (including man) throughout adult life, albeit at a low rate, the concept of replacing neurons lost after TBI is now becoming a reality. Experimental rodent models have shown that neurogenesis is accelerated after TBI, especially in juveniles. Two approaches have been followed in these rodent models to test possible therapeutic approaches that could enhance neuronal replacement in humans after TBI. The first has been to define and quantify the phenomenon of de novo hippocampal and cortical neurogenesis after TBI and find ways to enhance this (for example by exogenous trophic factor administration). A second approach has been the transplantation of different types of neural progenitor cells after TBI. In this review the authors discuss some of the processes that follow after acute TBI including the changes in the brain microenvironment and the role of trophic factor dynamics with regard to the effects on endogenous neurogenesis and gliagenesis. The authors also discuss strategies to clinically harness the factors influencing these processes and repair strategies using exogenous neural progenitor cell transplantation. Each strategy is discussed with an emphasis on highlighting the progress and limiting factors relevant to the development of clinical trials of cellular replacement therapy for severe TBI in humans.
Standard CMOS Fabrication of a Sensitive Fully Depleted Electrolyte-Insulator-Semiconductor Field Effect Transistor for Biosensor Applications
Authors: Shalev Gil , Cohen Ariel , Doron Amihood , Machauf Andrew , Horesh Moran , Virobnik Udi , Ullien Daniela , Levy Ilan
Published: June 2009

Microfabricated semiconductor devices are becoming increasingly relevant for detection of biological and chemical components. The integration of active biological materials together with sensitive transducers offers the possibility of generating highly sensitive, specific, selective and reliable biosensors. This paper presents the fabrication of a sensitive, fully depleted (FD), electrolyte-insulator-semiconductor field-effect transistor (EISFET) made with a silicon-on-insulator (SOI) wafer of a thin 10-30 nm active SOI layer. Initial results are presented for device operation in solutions and for bio-sensing. Here we report the first step towards a high volume manufacturing of a CMOS-based biosensor that will enable various types of applications including medical and enviro nmental sensing.
A Quality-refinement Process for Medical Imaging Applications
Authors: Maleike D. , Nolden M. , Kenngott H.-G. , Meinzer H.-P. , Wolf I. , Neuhaus J.
Published: June 2009

Objectives: To introduce and evaluate a process for refinement of software quality that is suitable to research groups. In order to avoid constraining researchers too much, the quality improvement process has to be designed carefully. The scope of this paper is to present and evaluate a process to advance quality aspects of existing research prototypes in order to make them ready for initial clinical studies. The proposed process is tailored for research environments and therefore more lightweight than traditional quality management processes.

Methods: Focus on quality criteria that are important at the given stage of the software life cycle. Usage of tools that automate aspects of the process is emphasized. To evaluate the additional effort that comes along with the process, it was exemplarily applied for eight prototypical software modules for medical image processing.

Results: The introduced process has been applied to improve the quality of all prototypes so that they could be successfully used in clinical studies. The quality refinement yielded an average of 13 person days of additional effort per project. Overall, 107 bugs were found and resolved by applying the process.

Conclusions: Careful selection of quality criteria and the usage of automated process tools lead to a lightweight quality refinement process suitable for scientific research groups that can be applied to ensure a successful transfer of technical software prototypes into clinical research workflows.
What Is Autism Spectrum Disorder?
Authors: Voelker Rebecca
Published: April 2024

This JAMA Patient Page describes autism spectrum disorder (ASD) and its signs and symptoms, diagnosis, and therapy options.
Reconsidering and Measuring Patient Access in Medicaid
Authors: Sommers Benjamin D. , Tipirneni Renuka
Published: April 2024

This JAMA Forum discusses the ways that policymakers can use different metrics that are more meaningful to patients when measuring patient access to treatment in the Medicaid program.
Postoperative Hypofractionated Intensity-Modulated Radiotherapy With Concurrent Chemotherapy in Cervical Cancer
Authors: Cho Won Kyung , Park Won , Kim Sang-Won , Lee Kang Kyu , Ahn Ki Jung , Choi Jin Hwa
Published: April 2024

Importance

Prospective data assessing the safety of hypofractionated (40 Gy in 16 fractions) radiotherapy (RT) among patients who receive postoperative concurrent chemoradiotherapy for cervical cancer are lacking.

Objective

To evaluate the acute toxic effects of hypofractionated pelvic intensity-modulated radiotherapy (IMRT) with concurrent chemotherapy among women with cervical cancer who underwent radical hysterectomy.

Design, Setting, and Participants

The POHIM-CCRT (Postoperative Hypofractionated Intensity-Modulated Radiation Therapy With Concurrent Chemotherapy in Cervical Cancer) study was designed as a multicenter, phase 2 nonrandomized controlled trial that accrued and followed up patients from June 1, 2017, to February 28, 2023. In total, 84 patients were enrolled from 5 institutions affiliated with the Korean Radiation Oncology Group. Eligible patients experienced lymph node metastasis, parametrial invasion, or positive resection margins after radical hysterectomy for treatment of confirmed cervical cancer.

Intervention

Postoperative pelvic radiation using hypofractionated IMRT with 40 Gy in 16 fractions to the whole pelvis combined with concurrent chemotherapy.

Main Outcomes and Measures

The primary end point was incidence of acute grade 3 or higher gastrointestinal tract, genitourinary, and hematologic toxic effects (based on the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0) in the evaluable population during RT or within 3 months after RT completion.

Results

Of 84 patients enrolled, 5 dropped out prior to RT, and data from 79 patients were analyzed. The patients’ median (IQR) age was 48 (42-58) years, and the median (IQR) tumor size was 3.7 (2.7-4.5) cm. Of these patients, 31 (39.7%) had lymph node metastasis, 4 (5.1%) had positive resection margins, and 43 (54.4%) had parametrial invasion. Grade 3 or higher acute toxic effects occurred in 2 patients (2.5% [90% CI, 0%-4.8%]). After a median (IQR) follow-up of 43.0 (21.1-59.0) months, the 3-year disease-free survival rate was 79.3%, and the overall survival rate was 98.0%.

Conclusions

Findings from this nonrandomized control trial indicated that postoperative pelvic irradiation combined with concurrent chemotherapy using hypofractionated IMRT with 40 Gy in 16 fractions was safe and well-tolerated in women with cervical cancer. Studies assessing long-term toxic effects and oncological outcomes with longer follow-up periods are needed.

Trial Registration

ClinicalTrials.gov Identifier: NCT03239613
Progressive Cheek Swelling in an Older Woman
Authors: Lim Kelvin Yong Jie , Cheong Ee Cherk , Lim Ming Yann
Published: April 2024

An 87-year-old woman presents with sudden-onset worsening right facial swelling and pain and generalized maxillary alveolar hyperplasia. What is your diagnosis?
Severe Hypoplasia of Paranasal Sinuses and Turbinates
Authors: Saro-Buendía Miguel , Gómez-Gómez Maria José , Armengot-Carceller Miguel
Published: April 2024

This case report describes a patient in their 40s with a history of bronchiectasis, azoospermia, and epididymal cysts who presented with bilateral nasal obstruction.
Structural and functional insights into the enzymatic activities of lipases from Burkholderia stagnalis and Burkholderia plantarii
Authors: Kataoka Saori , Kawamoto Sayuri , Kitagawa Sayuri , Kugimiya Wataru , Tsumura Kazunobu , Akutsu Yukie , Kubota Tomomi , Ishikawa Kazuhiko
Published: April 2024

Lipases with high interesterification activity are important enzymes for industrial use. The lipase from Burkholderia stagnalis (BsL) exhibits higher interesterification activity than that from Burkholderia plantarii (BpL) despite their significant sequence similarity. In this study, we determined the crystal structure of BsL at 1.40 Å resolution. Utilizing structural insights, we have successfully augmented the interesterification activity of BpL by over twofold. This enhancement was achieved by substituting threonine with serine at position 289 through forming an expansive space in the substrate‐binding site. Additionally, we discuss the activity mechanism based on the kinetic parameters. Our study sheds light on the structural determinants of the interesterification activity of lipase.
The impact of automatic tube current modulation related settings of a modern GE CT scanner on image quality and patient dose; details do matter
Authors: Tsalafoutas Ioannis A. , AlKhazzam Shady , Kharita Mohammed Hassan
Published: April 2024

Purpose

To investigate the operation principles of the automatic tube current modulation (ATCM) of a modern GE healthcare CT scanner, and the impact of related settings on image quality and patient dose.

Material & Methods

A dedicated phantom (Mercury 4.0) was scanned using two of the most frequently used clinical scanning protocols (chest and abdomen‐pelvis). The preset protocol settings were used as starting points (reference conditions). Scan direction, scan mode (helical vs. axial), total beam width, tube potential (kVp), and ATCM settings were then modified individually to understand their impact on radiation dose and image quality. Regarding the ATCM settings, the SmartmA minimum and maximum mA limits, and the noise index (NI) values were varied. As surrogates of patient dose, the CTDIvol and DLP values of each scan were used. As surrogates of image quality were used the image noise and the detectability index (d’) of five different materials (air, solid water, polystyrene, iodine, and bone) embedded in the Mercury phantom calculated with the ImQuest software.

Results

The scanning direction did not have any effect on ATCM curves, unlike what has been observed in CT scanners from other manufacturers. Total beam width does matter, however, the SmartmA limit settings and kVp selection had the greatest impact on image quality and dose. It was seen that improper minimum mA limit settings practically invalidated the ATCM operation. In contrast, when full modulation was allowed without restrictions, noise standard deviation, and detectability index became much more consistent across the wide range of phantom diameters. For lower kVp settings an impressive dose reduction was observed that requires further investigation.

Conclusion

SmartmA is a tool that if not properly used may increase the patient doses considerably. Therefore, its settings should be carefully adjusted for each preset different clinical protocol.
Polarization Saturation in Multilayered Interfacial Ferroelectrics
Authors: Cao Wei , Deb Swarup , Stern Maayan Vizner , Raab Noam , Urbakh Michael , Hod Oded , Kronik Leeor , Shalom Moshe Ben
Published: April 2024

Van der Waals polytypes of broken inversion and mirror symmetries  have been recently shown to exhibit switchable electric polarization even at the ultimate two‐layer thin limit. Their out‐of‐plane polarization has been found to accumulate in a ladder‐like fashion with each successive layer, offering 2D building blocks for the bottom‐up construction of 3D ferroelectrics. Here, it is demonstrated experimentally that beyond a critical stack thickness, the accumulated polarization in rhombohedral polytypes of molybdenum disulfide saturates. The underlying saturation mechanism, deciphered via density functional theory and self‐consistent Poisson–Schrödinger calculations, point to a purely electronic redistribution involving: 1. Polarization‐induced bandgap closure that allows for cross‐stack charge transfer and the emergence of free surface charge; 2. Reduction of the polarization saturation value, as well as the critical thickness at which it is obtained, by the presence of free carriers. The resilience of polar layered structures to atomic surface reconstruction, which is essentially unavoidable in polar 3D crystals, potentially allows for the design of new devices with mobile surface charges. The findings, which are of general nature, should be accounted for when designing switching and/or conductive devices based on ferroelectric layered materials.
Harvesting Multicolor Photoluminescence in Nonaromatic Interpenetrated Metal–Organic Framework Nanocrystals via Pressure‐Modulated Carbonyls Aggregation
Authors: Xiao Zhihao , Shan Shuo , Wang Yixuan , Zheng Haiyan , Li Kuo , Yang Xinyi , Zou Bo
Published: April 2024

Interpenetrated metal–organic frameworks (MOFs) with nonaromatic ligands provide a unique platform for adsorption, catalysis, and sensing applications. However, nonemission and the lack of optical property tailoring make it challenging to fabricate smart responsive devices with nonaromatic interpenetrated MOFs based on ligand‐centered emission. In this paper, the pressure‐induced aggregation effect is introduced in nonaromatic interpenetrated Zn4O(ADC)4(Et3N)6 (IRMOF‐0) nanocrystals (NCs), where carbonyl groups aggregation results in O─O distances smaller than the sum of the van der Waals radii (3.04 Å), triggering the photoluminescence turn‐on behavior. It is noteworthy that the IRMOF‐0 NCs display an ultrabroad emission tunability of 130 nm from deep blue (440 nm) to yellow (570 nm) upon release to ambient conditions at different pressures. The eventual retention of through‐space n–π* interactions in different degrees via pressure treatment is primarily responsible for achieving a controllable multicolor emission behavior in initially nonemissive IRMOF‐0 NCs. The fabricated multicolor phosphor‐converted light‐emitting diodes based on the pressure‐treated IRMOF‐0 NCs exhibit excellent thermal, chromaticity, and fatigue stability. The proposed strategy not only imparts new vitality to nonaromatic interpenetrated MOFs but also offers new perspectives for advancements in the field of multicolor displays and daylight illumination.
Computational‐Design Enabled Wearable and Tunable Metamaterials via Freeform Auxetics for Magnetic Resonance Imaging
Authors: Wu Ke , Zhu Xia , Bifano Thomas G. , Anderson Stephan W. , Zhang Xin
Published: April 2024

Metamaterials hold significant promise for enhancing the imaging capabilities of magnetic resonance imaging (MRI) machines as an additive technology, due to their unique ability to enhance local magnetic fields. However, despite their potential, the metamaterials reported in the context of MRI applications have often been impractical. This impracticality arises from their predominantly flat configurations and their susceptibility to shifts in resonance frequencies, preventing them from realizing their optimal performance. Here, a computational method for designing wearable and tunable metamaterials via freeform auxetics is introduced. The proposed computational‐design tools yield an approach to solving the complex circle packing problems in an interactive and efficient manner, thus facilitating the development of deployable metamaterials configured in freeform shapes. With such tools, the developed metamaterials may readily conform to a patient's knee, ankle, head, or any part of the body in need of imaging, and while ensuring an optimal resonance frequency, thereby paving the way for the widespread adoption of metamaterials in clinical MRI applications.
In Situ X‐Ray Techniques Unraveling Charge Distribution Induced by Halogen Bonds in Solvates of an Iodo‐Substituted Squaraine Dye
Authors: Ye Xiaoyu , Gutenthaler‐Tietze Jonathan , Wu Ruoxuan , Xia Guomin , Xu Shidang , Liu Bin , Chen Yi‐Hung , Karaghiosoff Konstantin
Published: April 2024

The importance of halogen bonds (XBs) in the regulation of material properties through a variation in the electrostatic potential of the halogen atom is not attracted much attention. Herein, this study utilizes in situ single crystal X‐ray diffraction and synchrotron‐based X‐ray techniques to investigate the cooling‐triggered irreversible single‐crystal‐to‐single‐crystal transformation of the DMF solvated iodo‐substituted squaraine dye (SQD‐I). Transformation is observed to be mediated by solvent‐involved XB formation and strengthening of electrostatic interaction between adjacent SQD‐I molecules. By immersing a DMF solvate in acetonitrile a solvent exchange without loss of long‐range ordering is observed. This is attributed to conservation of the molecular charge distribution of SQD‐I molecules during the process. The different solvates can be used in combination for temperature‐dependent image encryption. This work emphasizes the changes caused by XB formation to the electrostatic potentials of halogen containing molecules and their influence on material properties and presents the potential utility of XBs in the design of soft‐porous crystals and luminescent materials.
Predictive soil health indicators across a boreal forest to agricultural conversion gradient
Authors: Benalcazar P. , Kolka R. , Diochon A. C. , Schindelbeck R. R. , Sahota T. , McLaren B. E. , Stanovick John
Published: April 2024

A changing climate offers new opportunities to expand agriculture in northern latitudes, and understanding forest‐to‐agriculture land conversion impacts is critical to ensure soil sustainability. Using the Comprehensive Assessment of Soil Health (CASH) framework, we identified a minimum suite of indicators with little collinearity to reliably predict soil impacts during the conversion of boreal forest to agriculture and a time since conversion gradient (forest, <10 years, >10 and <50 years, and >50 years since conversion). We sampled paired forest and agricultural sites and used multiple linear regression to assess 16 indicators and found four‐ and six‐indicator models predicted the CASH score with varying but reasonable accuracy depending on conversion class. Organic matter, water aggregate stability, and pH were consistent predictors across all classes, as well as one or more micronutrients. The CASH framework appears to be more suitable for agricultural soils and as time since conversion proceeds.
Multifunctional Additives to Realize Dendrite‐Free Lithium Deposition in Carbonate Electrolytes toward Low‐Temperature Li Metal Batteries
Authors: Jiang Jinlong , Li Meng , Liu Xiaoyu , Yi Jin , Jiang Yong , Wu Chao , Liu Huakun , Zhao Bing , Li Wenrong , Sun Xueliang , Zhang Jiujun , Dou Shixue
Published: April 2024

Li metal is recognized as one of the most promising anode candidates for next‐generation high specific energy batteries. However, the fragile solid electrolyte interface (SEI) and heterogeneous Li plating/stripping in carbonate electrolyte severely encumber its practical application. Here, the heptafluorobutyramide (HFT) and lithium nitrate (LiNO3) are proposed to synergistically construct a robust SEI layer with excellent Li+ transport kinetics. The HFT can promote the dissolution of LiNO3 in carbonate electrolyte due to the strong cooperation. The results of theoretical calculations, in situ Raman and X‐ray photoelectron spectroscopy with deep Ar‐ion etching demonstrate that HFT and NO3− will be preferentially reduced to a Li3N/LiF‐rich composite structure on the surface of Li metal. Particularly, after the addition of additives, the first solvent shell is converted from solvent‐dominated to anion‐dominated structure, and thus a significantly lower Li‐ion desolvation barrier is presented. Consequently, the Coulombic efficiency (CE) of Li||Cu half cells using the designed carbonate electrolyte can reach 97.1%. The full cells matched with LiFePO4 and LiNi0.8Co0.1Mn0.1O2 (NCM 811) can deliver high‐capacity retention over 100% at −20°C. This work provides an effective strategy for the regulation of solvation structure and the construction of high‐performance Li metal batteries.
From Back to Stage: Superior Cycling Stability of 2LiBH4−MgH2 Enabled by Anion Tuning
Authors: Ma Zhongliang , Zang Jiahe , Hu Wenqiang , Wang Qisen , Sun Zhonghui , Fang Fang , Song Yun , Sun Dalin
Published: April 2024

2LiBH4−MgH2 (Li‐RHC) is a potential hydrogen storage candidate with a capacity of 11.5 wt.%. However, its further application is severely limited by the long nucleation induction period and poor reversibility of end‐product. Unlike the traditional focus on the catalytical role of cation, herein, a new perspective of previously ignored anion tuning has been proposed, in which S2− bridges the reversible conversion between Li2S and MgS during de‐/hydrogenation cycling of Li‐RHC. Such conversion not only enhances the migration of Li+, leading to the rapid destabilization of B─H bonds without obvious nucleation period of MgB2, but also improves the cycling stability of Li‐RHC with capacity retention over 90% even after 50 cycles. The universal of this anion modulation has been verified, along with the matching criteria of the corresponding transition metal cation. The results highlight the contribution of anion, push anion modulation from back to stage and eventually broaden the selection of catalysts for Li‐RHC.
Association between low handgrip strength and incontinence among Chinese middle‐aged and older people: A cross‐sectional study
Authors: Li Lin , Chen Feilong , Li Xiaoyan , Gao Yiyuan , Wang Ning , Xu Tao
Published: April 2024

Objective

Incontinence seriously affects the lives of middle‐aged and older people. Pelvic floor muscle assessment is very important for incontinence, and handgrip strength can be used as an auxiliary diagnostic tool. Our study aims to find new cutoff points of handgrip strength as early indicators of incontinence and analyze the association between low handgrip strength and incontinence among Chinese middle‐aged and older people.

Methods

Participants were recruited from the 2015 China Health and Retirement Longevity Study. Receiver operating characteristic (ROC) curves were used to find the handgrip strength cutoff point. Logistic regression analysis was performed to explore other incontinence‐related risk factors.

Results

The study included 10,229 middle‐aged and older people. Compared with normal handgrip strength participants, medium strength participants had 1.510 [men, 95% confidence interval (CI) = 1.017–2.243] and 1.792 (women, 95% CI = 1.294–2.480) times greater risk of incontinence, and low strength participants had 2.420 (men, 95% CI = 1.787–3.277) and 1.516 (women, 95% CI = 1.130–2.032) times greater risk of incontinence. Trend test results showed that the risk of incontinence increased with decreasing handgrip strength in middle‐aged and older people.

Conclusions

Our study suggests that handgrip strength < 31 kg in men and < 20.5 kg in women is significantly associated with higher risk of incontinence in Chinese middle‐aged and older people. The risk of incontinence increases with decreasing handgrip strength. Handgrip strength should be measured in routine physical examinations in middle‐aged and older people for timely assessment and intervention in incontinence.
Worm‐like ordered mesoporous carbon from liquefied wood: Morphological manipulation by varying hydrothermal temperature
Authors: Li Yang , Wu Zhenwei , Liu Yanhong , Zhang Kun , Luo Sha , Li Wei , Liu Shouxin
Published: April 2024

The hydrothermal/soft templating method is an effective way to synthesize ordered mesoporous carbon (OMC), yet the mechanism of this strategy is not well illustrated. Herein, a hydrothermal temperature‐controlled approach is developed to precisely synthesize OMCs with well‐defined morphologies from liquefied wood (LW). As the hydrothermal temperature increases from 130 to 210°C, the hydrophilicity of the hydrophilic blocks decreases accompanied by the increase of the relative volume of the hydrophobic block, resulting in the packing parameter p of micelles changing from p ≤ 1/3 to 1/3 < p < 1/2, which transforms the micelle's structure from spherical to cylindrical. Additionally, accelerated nucleation occurred with the increased hydrothermal temperature. When the rate of nucleation is matched to the self‐assembly of the composite micelles, the composite micelles grow into worm‐like morphology and an ordered p6m mesostructure. This hydrothermal temperature‐controlled strategy provides a straightforward and effective approach for synthesizing OMCs with various morphologies from LW, addressing the previously insufficiently elucidated micelle formation mechanism in the hydrothermal/soft templating method.