bluuebunny/crossref_metadata_2025 huggingface dataset:
O tratado de Andrea Pozzo e seus reflexos na talha dourada em Minas Gerais
Authors: Pedrosa Aziz José de Oliveira
Published: September 2023

A produção da talha dourada nas Minas Gerais do século18 foi possível pela pontual presença de artífices portugueses, que, de diversas regiões do Reino, migraram para o Brasil, diante das boas oportunidades de trabalhos de Arquitetura e ornamentação, nas igrejas que se erguiam na região de Minas. Muitos desses homens, entre arquitetos, entalhadores e demais profissionais que se dedicavam às artes e aos ofícios, foram os responsáveis pelos trabalhos de confecção da talha dourada, ornamentos necessários para deixar as igrejas com a devida decência para abrigar a fé de uma população em plena gênese de formação. Observe-se que foram, esses mesmos homens, os responsáveis por trazer as novidades artísticas vigentes na Europa Barroca para o interior das igrejas de Minas e aqui aclimatá-las, de acordo com as condições locais, tão divergentes do contexto europeu. Entretanto pouco se sabe sobre os modos pelos quais circularam na Capitania de Minas os modelos de Arquitetura e ornamentação, mas a descoberta de pequena biblioteca, sob a posse do entalhador José Coelho de Noronha, abre novos caminhos para debater o assunto, e traz a conhecimento reflexões de que, em Minas Gerais, durante o século 18, circularam tratados de Arquitetura. Assim, o presente artigo discute possibilidades de serem, alguns livros sob a posse de José Coelho de Noronha, os tratados de Arquitetura de Andrea Pozzo, que tiveram grande aceite e divulgação no mundo artístico europeu e, certamente, incidiram seus reflexos na Capitania de Minas.
A modernidade de Nova York segundo Rem Koohaas
Authors: Colosso Paolo
Published: September 2023

É relativamente aceito, entre diversos autores, que os trabalhos teóricos de Rem Koolhaas tratam de problemáticas importantes para a Arquitetura e para as grandes cidades, embora seu posicionamento seja bastante controverso. Sem tentar resolver as disputas a respeito da atual postura do arquiteto holandês, este artigo volta aos primeiros textos de Koolhaas, com o objetivo de identificar, no discurso ambivalente sobre a modernidade de Nova York, problemáticas relevantes para a teoria arquitetônica do último quartel do século 20. Em minha chave de leitura, isto implica ter em conta a seguinte questão: de que modo essa narrativa, ora estetizante, ora crítica, é capaz ou não de elucidar traços da cultura urbana das metrópoles sob regime de modernização ultraliberal. O percurso é dividido em dois momentos. No primeiro, analiso os textos de Koolhaas sobre o tema, salientando os seguintes pontos: i) a retícula urbana, como especulação em duplo sentido; ii) o arranha-céu nova-iorquino entendido em seus diversos aspectos: como cidades dentro da cidade, como extrusão das forças contraditórias da metrópole; iii) o Rockefeller Center, enquanto experiência arquitetônica coletiva e maior realização do urbanismo novaiorquino; por fim, elucido a posição ambivalente de Koolhaas diante dos eventos narrados. No segundo momento, analiso as perspectivas de Hal Foster e de Fredric Jameson acerca da posição de Koolhaas, destacando pontos que os autores consideram contribuições do arquiteto holandês.
Os projetos residenciais não-construídos de Vilanova Artigas em São Paulo
Authors: Tagliari Ana , Perrone Rafael Antonio Cunha , Florio Wilson
Published: September 2023

O presente artigo tem o objetivo de divulgar resultados da pesquisa realizada, entre 2009 e 2012, sobre os projetos residenciais não-construídos do arquiteto João Batista Vilanova Artigas (1915-1985), em São Paulo. O propósito da pesquisa é contribuir para a análise dos 39 projetos que não foram construídos, integrando este novo conhecimento ao conjunto da obra já amplamente conhecida do arquiteto, que é a obra construída. Organizamos e classificamos estes projetos por tipos formais, para análise individual e comparativa. A partir desta organização por tipos, foram identificados partidos arquitetônicos e características importantes de projeto. A investigação dos espaços internos das residências foi realizada por meio de desenhos diagramáticos e maquetes, permitindo visualizar a distribuição e a conexão espacial entre os espaços de diferentes setores. As maquetes foram construídas a partir de desenhos computacionais e da fabricação digital por corte a laser. Constatamos que a metodologia adotada nesta pesquisa contribui para o estudo de projetos não-construídos, análise, interpretação, síntese e avaliação.
Medidas de densidade e lacunaridade na discriminação da forma urbana: o caso das Zeis em Campina Grande, PB
Authors: Barros Filho Mauro Normando Macêdo , Simões Matheus Batista , Silva Yara Synthia Araújo
Published: September 2023

A densidade urbana tem sido uma das principais medidas utilizadas para caracterizar a forma nas cidades, mas não é a única. A lacunaridade é uma propriedade de objetos fractais que permite diferenciar texturas urbanas em imagens de satélite. Este artigo busca avaliar a capacidade de ambas as medidas em discriminar a forma urbana das Zonas Especiais de Interesse Social (ZEIS) em relação às demais áreas da cidade (Não-ZEIS). A análise da densidade foi realizada partir dos indicadores do Spacematrix e a análise da lacunaridade a partir da aplicação do algoritmo de caixas deslizantes em diferentes escalas. Os valores obtidos com essas medidas em ZEIS e Não-ZEIS de Campina Grande foram comparados entre si, com o uso de técnicas de análise discriminante, considerando diferentes distâncias entre essas áreas na cidade. Ao avaliar os resultados, verifica-se que lacunaridade e densidade são medidas complementares que podem auxiliar na (re)formulação de zoneamentos e índices urbanísticos. Ambas revelam que as ZEIS tendem a ser morfologicamente mais semelhantes às Não-ZEIS mais próximas do que mais distantes. No entanto, a lacunaridade demonstrou ser mais eficiente que a densidade em discriminar as ZEIS das Não-ZEIS, além de ser uma medida mais facilmente aplicável que a densidade.
Legislação e desenho de paisagens: uma leitura da rua Aurora no Recife a partir da paisagem urbana histórica
Authors: Silva Milena Torres de Melo , Carneiro Ana Rita Sá
Published: September 2023

O presente artigo discute a ação da legislação no desenho de paisagens a partir do caso da Rua da Aurora, uma das frentes d’água do centro histórico da cidade do Recife, sob a ótica da Paisagem Urbana Histórica associada ao conceito de palimpsesto. Com base na investigação histórica e documental de legislações, mapas cartográficos e fotografias, faz-se uma leitura de quatro tempos dessa paisagem: (i) Tempo 1: o início dos aterros e a consolidação da Rua da Aurora; (ii) Tempo 2: a fase das modernizações; (iii) Tempo 3: o período preservacionista e (iv) Tempo 4: a época dos arranha – céus. A análise das legislações municipais e estaduais nesses quatro tempos históricos permitiu compreender o papel que essas normativas tiveram como impulsionadoras e guias das modificações e consolidações, revelando desenhos de paisagens na Rua da Aurora.
The “Tunneled Sandwich” Technique for Preserving the Buccal Tissue Volume After Immediate Implantation: A Retrospective Report of 10 Cases
Authors: Bilhan Hakan , Friedmann Anton
Published: September 2023

Tooth loss or extraction is associated with significant reduction in alveolar ridge volume, extensively expressed in the anterior zone, and immediate implant placement is insufficient to overcome this problem. The proposed approach combined immediate implant placement with buccal tissue enhancement by applying a crosslinked collagen matrix hydrated with crosslinked hyaluronic acid (xHyA). All 10 cases presented with a retained but narrow buccal socket wall, so immediate implant placement with the “tunneled sandwich” technique was performed after tooth extraction. The tunneled sandwich technique helped create a subperiosteal pouch for insertion of the collagen matrix buccal to the alveolar bone crest. The implants healed transmucosally by receiving either a gingiva former or an immediate temporary restoration. Ten sites in 10 patients demonstrated stable, noninflamed peri-implant conditions and suitable ridge volume at the implant neck and achieved high pink esthetic scores 6 months after implant loading. The tunneled sandwich technique is a suitable method to preserve buccal volume, which biologically and esthetically contributes to favorable long-term results.
Altered Smooth Muscle Cell Histone Acetylome by the SPHK2/S1P Axis Promotes Pulmonary Hypertension
Authors: Ranasinghe A. Dushani C.U. , Holohan Maggie , Borger Kalyn M. , Donahue Deborah L. , Kuc Rafael D. , Gerig Martin , Kim Andrew , Ploplis Victoria A. , Castellino Francis J. , Schwarz Margaret A.
Published: September 2023

BACKGROUND:

Epigenetic regulation of vascular remodeling in pulmonary hypertension (PH) is poorly understood. Transcription regulating, histone acetylation code alters chromatin accessibility to promote transcriptional activation. Our goal was to identify upstream mechanisms that disrupt epigenetic equilibrium in PH.

METHODS:

Human pulmonary artery smooth muscle cells (PASMCs), human idiopathic pulmonary arterial hypertension (iPAH):human PASMCs, iPAH lung tissue, failed donor lung tissue, human pulmonary microvascular endothelial cells, iPAH:PASMC and non-iPAH:PASMC RNA-seq databases, NanoString nCounter, and cleavage under targets and release using nuclease were utilized to investigate histone acetylation, hyperacetylation targets, protein and gene expression, sphingolipid activation, cell proliferation, and gene target identification. SPHK2 (sphingosine kinase 2) knockout was compared with control C57BL/6NJ mice after 3 weeks of hypoxia and assessed for indices of PH.

RESULTS:

We identified that Human PASMCs are vulnerable to the transcription-promoting epigenetic mediator histone acetylation resulting in alterations in transcription machinery and confirmed its pathological existence in PH:PASMC cells. We report that SPHK2 is elevated as much as 20-fold in iPAH lung tissue and is elevated in iPAH:PASMC cells. During PH pathogenesis, nuclear SPHK2 activates nuclear bioactive lipid S1P (sphingosine 1-phosphate) catalyzing enzyme and mediates transcription regulating histone H3K9 acetylation (acetyl histone H3 lysine 9 [Ac-H3K9]) through EMAP (endothelial monocyte activating polypeptide) II. In iPAH lungs, we identified a 4-fold elevation of the reversible epigenetic transcription modulator Ac-H3K9:H3 ratio. Loss of SPHK2 inhibited hypoxic-induced PH and Ac-H3K9 in mice. We discovered that pulmonary vascular endothelial cells are a priming factor of the EMAP II/SPHK2/S1P axis that alters the acetylome with a specificity for PASMC, through hyperacetylation of histone H3K9. Using cleavage under targets and release using nuclease, we further show that EMAP II–mediated SPHK2 has the potential to modify the local transcription machinery of pluripotency factor KLF4 (Krüppel-like factor 4) by hyperacetylating KLF4 Cis-regulatory elements while deletion and targeted inhibition of SPHK2 rescues transcription altering Ac-H3K9.

CONCLUSIONS:

SPHK2 expression and its activation of the reversible histone H3K9 acetylation in human pulmonary artery smooth muscle cell represent new therapeutic targets that could mitigate PH vascular remodeling.
Two new endemic Begonia species named after historical landmarks of Ilocos Sur, Philippines
Authors: CALARAMO MICHAEL AGBAYANI , RUBITE ROSARIO RIVERA , LIN CHE-WEI
Published: September 2023

Two new species of Begonia endemic to the Philippines are described from the province of Ilocos Sur, Northwestern Luzon: Begonia tiradpassensis (B. sect. Baryandra) from Tirad Pass, and Begonia bessangpassensis (B. sect. Petermannia) from the subsummit of Bessang Pass Natural Monument/Landmark. Based on IUCN Red List list criteria, B. tiradpassensis & B. bessangpassensis are provisionally assessed to be threatened, as they are confined to small populations with anthropogenic disturbance surrounding their distribution area. The discovery of these species highlights the conservation importance of two historical landmarks, Tirad Pass and Bessang Pass, which have left an indelible mark on Philippine history.
Polystemma stevensii (Apocynaceae, Asclepiadoideae), a new species from Michoacán, Mexico
Authors: HERNÁNDEZ-BARÓN GERALD MATUS , JUÁREZ DIANA ISABEL TRUJILLO , STEINMANN VICTOR W.
Published: September 2023

Polystemma stevensii, a new species from Michoacán, Mexico, is described and illustrated. It grows in tropical deciduous forest in the Balsas Depression at elevations from 350 to 750 m. Polystemma stevensii is similar to P. viridiflorum but differs by having a gynostegial corona with five lobes fused at the base to form a discontinuous flat ring (vs. not forming a discontinuous flat ring), an internal corona with two deltate lobes (vs. with one ligulate lobe), and globose style head (vs. flat style head). A distribution map of the new species and a key to determine the Polystemma species of Michoacán are provided. Following IUCN Red List guidelines, it is assigned a preliminary category of endangered, EN B1ab(i,ii,iii)+2ab(i,ii,iii). Polystemma now includes eight species, of which five are endemic to Mexico.
Immune-Checkpoint Inhibitor-Related Myocarditis: Where We Are and Where We Will Go
Authors: Vergara Andrea , De Felice Marco , Cesaro Arturo , Gragnano Felice , Pariggiano Ivana , Golia Enrica , De Pasquale Antonio , Blasi Ettore , Fimiani Fabio , Monda Emanuele , Limongelli Giuseppe , Calabrò Paolo
Published: September 2023

Immune checkpoint inhibitors (ICIs) are specific monoclonal antibodies directed against inhibitory targets of the immune system, mainly represented by programmed death-1 (PD1) ligand-1 (PD-L1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4), thus enabling an amplified T-cell–mediated immune response against cancer cells. These drugs have significantly improved prognosis in patients with advanced metastatic cancer (e.g., melanoma, non-small cell lung cancer, renal cell carcinoma). However, uncontrolled activation of anti-tumor T-cells could trigger an excessive immune response, possibly responsible for multi-organ damage, including, among others, lymphocytic myocarditis. The incidence of ICIs-induced myocarditis is underestimated and the patients affected are poorly characterized. The diagnosis and management of this condition are mainly based on expert opinion and case reports. EKG and ultrasound are tests that can help identify patients at risk of myocarditis during treatment by red flags, such as QRS complex enlargement and narrowing of global longitudinal strain (GLS). Therapy of ICI-related myocarditis is based on immunosuppressors, monoclonal antibodies and fusion proteins. A future strategy could involve the use of microRNAs. This review considers the current state of the art of immune-related adverse cardiovascular events, focusing on histological and clinical features, diagnosis and management, including current treatments and future pharmacological targets.
The Best-Case Heuristic: Relative Optimism in Relationships, Politics, and a Global Health Pandemic
Authors: Sjåstad Hallgeir , Van Bavel Jay
Published: September 2023

In four experiments covering three different life domains, participants made future predictions in what they considered the most realistic scenario, an optimistic best-case scenario, or a pessimistic worst-case scenario ( N = 2,900 Americans). Consistent with a best-case heuristic, participants made “realistic” predictions that were much closer to their best-case scenario than to their worst-case scenario. We found the same best-case asymmetry in health-related predictions during the COVID-19 pandemic, for romantic relationships, and a future presidential election. In a fully between-subject design (Experiment 4), realistic and best-case predictions were practically identical, and they were naturally made faster than the worst-case predictions. At least in the current study domains, the findings suggest that people generate “realistic” predictions by leaning toward their best-case scenario and largely ignoring their worst-case scenario. Although political conservatism was correlated with lower covid-related risk perception and lower support of early public-health interventions, the best-case prediction heuristic was ideologically symmetric.
A self-care process model for patients with chronic noncommunicable diseases
Authors: Milavec Kapun Marija , Rajkovič Vladislav , Šušteršič Olga , Rajkovič Uroš
Published: September 2023

Self-care of patients with chronic noncommunicable diseases is an essential component of contemporary healthcare. The purpose of this paper is to present a novel self-care process model and place it in the broader context of professional care. The extended Event-driven Process Chain approach to process modelling was used, focusing on a detailed overview of sequences of events, connections and activities and other elements/building blocks. A self-care process model was designed. The model is divided into two parts. The first part represents the self-care process when patients are able to manage their symptoms and be independent. The second part includes the process when patients are unable to perform self-care and/or need professional support. By identifying the essential elements of this process and incorporating them into the patients' care process, we can ensure that professional support for self-care creates a dynamic balance in the patients’ ecosystems. Patients with chronic noncommunicable diseases need to make timely decisions about individual aspects of their health and seek professional help. In this way, an optimal level of health and well-being of patients can be achieved. Focusing on the patients’ self-care process could also reduce treatment costs and improve the quality of life of patients. The novel designed model of the process of self-care, with all its essential elements, can be supported by digital technology, especially in the decision-making process and needs to become an important part of healthcare and long-term care systems.
Social representations of citizenship among Argentine adolescents: Between civic engagement, rights and nationality
Authors: Bruno Daniela Silvana , Barreiro Alicia
Published: September 2023

Citizenship as an object of study goes beyond the mere recognition of formal rights and responsibilities and includes cultural and social practices in different spheres. In this sense, the exercise of citizenship is linked to different forms of political participation. Recent studies show that young people are distanced from traditional political participation and prefer alternative civic practices. Within this framework, the present study aims to investigate the social representations of citizenship of Argentinean adolescents ( N = 32) aged between 16 and 18. To this end, participants were asked to elaborate a narrative about their experiences with citizenship in the framework of semi-structured interviews guided according to the Piagetian clinical method. The results obtained allow the construction of four analytical categories intended to describe how these adolescents represent citizenship: civic engagement, rights, nationality and voting. It is concluded that there is a plurality of social representations of this object, and it is necessary to elucidate their development, maintenance and transformation processes in future research.
The Impacts of Guanxi: Drug Policing Under Police Professionalisation in China
Authors: Shi Haitao
Published: September 2023

Guanxi is a ubiquitous, intricate, and enduring characteristic of Chinese society and permeates virtually every aspect of Chinese life. Drug policing is no exception. This study attempts to clarify the concept of guanxi and illustrate how guanxi affects police professionalisation in China through observing drug policing conducted by two Anti-Drug Squads and one Anti-Drug Corps in Jixiang City in China and interviewing 25 anti-drug police officers. Thematic analysis was employed to analyse the data. This article defines guanxi as a long-term, interpersonal, and transmittable relationship that is connected by ganqing (affective bonds) and renqing (instrumental bonds). It involves mianzi (face and reputation) maintenance and social reciprocity. It highlights the importance of the Guanxi Base, which has often been omitted in previous literature. It argues that guanxi may result in unfair police management and give rise to renqing cases that undermine police professionalisation and the rule of law. Furthermore, it is argued that police professionalisation may bring about some resistance to political interference, particularly when it violates the law. However, guanxi operates smoothly within legal boundaries during drug policing.
Misdiagnosis of pancreatic tuberculosis as a pancreatic cystic neoplasm – A case report
Authors: Lakmal Kasun , Jayarajah Umesh , Chandraguptha Minidu Ravinda , Nandasena Malith , Pathirana Aloka
Published: September 2023

Pancreatic tuberculosis is an extremely rare condition. Its non-specific clinical and radiological findings resemble pancreatic malignancy. Here, we report a case of pancreatic tuberculosis that presented with abdominal pain and dyspeptic symptoms for 2 months and was misdiagnosed as a pancreatic cystic neoplasm. Abdominal magnetic resonance imaging showed a well-demarcated exophytic lesion with multiple T2 high signals small cystic areas in the anterior superior part of the head of the pancreas measuring 23 × 20 × 28 mm. This patient has undergone laparotomy and excision of the pancreatic mass. Histological examination revealed granulomatous inflammation of a lymph node with caseation, which was pathognomonic of tuberculosis. She was treated for tuberculosis for 6 months and has become symptom free. The diagnosis of pancreatic tuberculosis could be misleading and should be considered when dealing with pancreatic masses in countries with high incidence.
Fast bilateral weighted least square for the detail enhancement of COVID-19 chest X-rays
Authors: Bian Wenyan , Yang Yang
Published: September 2023

Background

X-ray is an effective measure in the diagnosis of coronavirus disease 2019. However, it suffers from low visibility and poor details. A plausible solution is to decompose the captured images and enhance the details. The bilateral weighted least square model can be an effective tool for this task. However, it is highly computationally expensive.

Method

In this article, we propose an efficient algorithm for the bilateral weighted least square model. We approximate the bilateral weight with the bilateral grid and then incorporate it into the optimization model. This significantly reduces the number of variables in the linear system. Therefore, the model can be efficiently solved. We employ the proposed algorithm to decompose the input X-rays into base and detail layers. The detail layers are then boosted and added back to the input to derive the detail-enhanced results.

Results

The subjective results indicate that our method achieves higher contrast than the best-performing method ([Formula: see text], [Formula: see text], [Formula: see text]). Furthermore, our method is highly efficient. It takes 0.92  s to process a 720P color image on an Intel i7-6700 CPU. The objective results derive from the chi-square test indicate that subjects hold more positive attitudes toward our detail-enhanced images than the original X-ray images ([Formula: see text], [Formula: see text], [Formula: see text]).

Conclusion

We have conducted extensive experiments to evaluate the proposed image detail enhancement method. It can be concluded that (1) our method could significantly improve the visibility of the X-ray images. (2) our method is fast and effective, thus facilitating real applications.
Multimorbidity transitions and the associated healthcare cost among the Finnish adult population during a two-year follow-up
Authors: Wikström Katja , Linna Miika , Reissell Eeva , Laatikainen Tiina
Published: September 2023

Background

Ageing of the population increases the prevalence and coexistence of many chronic diseases; a condition called multimorbidity. In Finland, information on the significance of multimorbidity and its relation to the sustainability of healthcare is scarce.

Aim

To assess the prevalence of multimorbidity, the transitions between patient groups with and without multiple diseases and the associated healthcare cost in Finland in 2017–2019.

Methods

A register-based cohort study covering all adults ( n = 3,326,467) who used Finnish primary or specialised healthcare services in 2017. At baseline, patients were classified as ‘non-multimorbid’, ‘multimorbid’ or ‘multimorbid at risk’ based on the recordings of a diagnosis of interest. The costs were calculated using the care-related patient grouping and national standard rates. Transition plots were drawn to observe the transition of patients and costs between groups during the two-year follow-up.

Results

At baseline, 62% of patients were non-multimorbid, 23% multimorbid and 15% multimorbid at risk. In two years, the proportion of multimorbid patients increased, especially those at risk. Within the multimorbid at-risk group, total healthcare costs were greatest (€5,027 million), accounting for 62% of the total healthcare cost of the overall patient cohort in 2019. Musculoskeletal diseases, cardiometabolic diseases and tumours were the most common and expensive chronic diseases contributing to the onset of multimorbidity.

Conclusion

Multimorbidity is causing a heavy burden on Finnish healthcare. The estimates of its effect on healthcare usage and costs should be used to guide healthcare planning.
Relationship between Foreign Portfolio Investment and Exchange Rate: The Case of India Using VECM Testing Approach
Authors: Jacob Tom , Raphael Rincy , Antony Andria
Published: September 2023

India attracts a large sum of foreign investments every year. These foreign investments have a remarkable impact on Indian economy. Real economy is assumed to be affected by foreign investment through its constituents like exchange rate, foreign exchange reserves, economic growth, etc. Exchange rate movements are also believed to affect the foreign portfolio investment, especially foreign institutional investment coming to the country. The unit root test is applied to determine stationary of the time series data. Vector error correction model is applied to determine the dynamics of the relationship between foreign investment and exchange rate. The result shows that foreign portfolio investment, foreign direct investment, index of industrial production, interest rate and wholesale price index have a positive impact on the exchange rate (REER), that is, Indian rupee appreciates whereas import has negative impact on exchange rate in India that is, Indian rupee depreciates. In short, foreign portfolio investment in India may lead to rupee appreciation with several other currencies and their selling and disinvestment may lead to its depreciation.
Impact of Job Burnout on Performance: A Study Among Hospital Employees of J&K, India
Authors: Bhat Mohd. Abass , Tariq Shagufta
Published: September 2023

This study aims to examine the impact of job burnout on work performance in the hospitals of Jammu and Kashmir (J&K). A total of 304 employees from various hospitals in J&K provided data for the study. Analysis was carried out based on the questionnaire responses. Various statistical tools and techniques were used to understand the perceptual aspects of data and analysis using PLS-SEM. Further convergent and discriminant validity was established, leading to reliable hypothesis testing using structural equation modelling for testing causal relationships among the constructs. The intricacy among job burnout dimensions (independent variable) and employee performance (dependent variable) reveals that antecedents of job burnout are negatively associated with employee performance. In other words, emotional exhaustion, depersonalisation and reduction in personal accomplishment hamper employees’ performance at the workplace. However, emotional exhaustion was found to be the most important dimension of job burnout, affecting employees’ performance.
“Seeing is believing”: myth or maxim? Mimics of pathology on paediatric chest imaging studies
Authors: Warraich Sara , Bush Andrew , Semple Thomas
Published: September 2023

Appreciating the importance of correct interpretation of radiological studies, the need for space for further education and experience, and the recognition that interpretative errors often occur, we present below a case series highlighting situations where all may not be as it first appears.
Neither backlash nor convergence: dynamics of intra-couple childcare division during the Covid-19 pandemic in Germany
Authors: Boll Christina , Müller Dana , Schüller Simone
Published: September 2023

Using unique (bi)monthly panel data (IAB-HOPP) covering the immediate postlockdown period from June to August 2020, as well as the subsequent period up until the second lockdown in January/February 2021, we investigate opposing claims of widening/closing the gender gap in parental childcare during the Covid-19 pandemic in Germany. We consider prepandemic division as a reference point and provide dynamics rather than snapshots. Our results suggest a slight initial shift toward a more egalitarian division that, however, faded out in subsequent months. Starting from a fairly “traditional” prepandemic childcare division, the lockdown stimulus was not nearly strong enough to level the playing field. Subgroup analysis differentiating between individual lockdown-specific work arrangements shows that the drivers of the observed shift were mothers with relatively intense labor market participation who cannot work from home. Fathers’ work arrangement instead did not play a significant role. We conclude that the shift emerged out of necessity rather than opportunity, which makes it likely to fade once the necessity vanishes. Further, a shift is observed only if fathers were to some extent involved in childcare prepandemic, which points to the crucial role of initial conditions.
Management of respiratory failure in immune checkpoint inhibitors-induced overlap syndrome: a case series and review of the literature
Authors: Cuenca John A. , Hanmandlu Ankit , Wegner Robert , Botdorf Joshua , Tummala Sudhakar , Iliescu Cezar A. , Nates Joseph L. , Reddy Dereddi R.
Published: September 2023

Background

Checkpoint inhibitor-induced overlap syndrome ([OS] myocarditis, and myositis with or without myasthenia gravis) is rare but life-threatening.

Cases presentation

Here we present a case series of four cancer patients that developed OS. High troponinemia raised the concern for myocarditis in all the cases. However, the predominant clinical feature differed among the cases. Two patients showed marked myocarditis with a shorter hospital stay. The other two patients had a prolonged ICU stay due to severe neuromuscular involvement secondary to myositis and myasthenia gravis. Treatment was based on steroids, plasmapheresis, intravenous immunoglobulin, and immunosuppressive biological agents.

Conclusion

The management of respiratory failure is challenging, particularly in those patients with predominant MG. Along with intensive clinical monitoring, bedside respiratory mechanics can guide the decision-making process of selecting a respiratory support method, the timing of elective intubation and extubation.
A radiomics model fusing clinical features to predict microsatellite status preoperatively in colorectal cancer liver metastasis
Authors: Wang Xuehu , Liu Ziqi , Yin Xiaoping , Yang Chang , Zhang Jushuo
Published: September 2023

Purpose

To study the combined model of radiomic features and clinical features based on enhanced CT images for noninvasive evaluation of microsatellite instability (MSI) status in colorectal liver metastasis (CRLM) before surgery.

Methods

The study included 104 patients retrospectively and collected CT images of patients. We adjusted the region of interest to increase the number of MSI-H images. Radiomic features were extracted from these CT images. The logistic models of simple clinical features, simple radiomic features, and radiomic features with clinical features were constructed from the original image data and the expanded data, respectively. The six models were evaluated in the validation set. A nomogram was made to conveniently show the probability of the patient having a high MSI (MSI-H).

Results

The model including radiomic features and clinical features in the expanded data worked best in the validation group.

Conclusion

A logistic regression prediction model based on enhanced CT images combining clinical features and radiomic features after increasing the number of MSI-H images can effectively identify patients with CRLM with MSI-H and low-frequency microsatellite instability (MSI-L), and provide effective guidance for clinical immunotherapy of CRLM patients with unknown MSI status.
Synergy-based functional electrical stimulation and robotic-assisted for retraining reach-to-grasp in stroke: a study protocol for a randomized controlled trial
Authors: Zhou Huan-xia , Hu Jun , Yun Rui-sheng , Zhao Zhong-zhi , Lai Ming-hui , Sun Li-hui-zi , Luo Kai-liang
Published: September 2023

Background

Stroke survivors have long-term upper limb impairment, which impacts the quality of life (QOL) and social reintegration, but there is lack of effective therapeutic strategies and novel technologies. Customized multi-muscle functional electrical stimulation (FES) based on the muscle synergy of healthy adults and robotic-assisted therapy (RAT) have been proved efficacy respectively. Synergy-based FES combined with RAT can be a novel and more effective therapy for upper limb recovery of stroke survivors from the perspective of synergistic enhancement. However, few studies have examined the effectiveness of combined synergy-based FES and RAT, especially for motor control evaluated by reach-to-grasp (RTG) movements. The main objective of the following research protocol is to evaluate the effectiveness and efficacy, as well as adoptability, of FES-RAT and FES or RAT rehabilitation program for upper limb function improvement after stroke.

Methods

This will be an assessor-blinded randomized controlled trial involving a 12-week intervention and a 6-month follow-up. Stratified randomization will be used to equally and randomly assign 162 stroke patients into the FES + conventional rehabilitation program (CRP) group, RAT + CRP group and FES-RAT + CRP group. Interventions will be provided in 5 sessions per week, with a total of 60 sessions. The primary outcome measurements will include the Fugl-Meyer Assessment and Biomechanical Assessment of RTG movements. The secondary outcome measurements will include quality of life and brain neuroplasticity assessments by MRI. Evaluations will be performed at five time points, including at baseline, 6 weeks and 12 weeks from the start of treatment, and 3 months and 6 months following the end of treatment. A two-way analysis of variance with repeated measures will be applied to examine the main effects of the group, the time factor and group-time interaction effects.

Discussion

The results of the study protocol will provide high quality evidence for integrated synergy-based FES and RAT, and synergy-based FES alone and guide the design of more effective treatment methods for stroke rehabilitation.

Trial registration

ChiCTR2300071588.
Alternating electric fields can improve chemotherapy treatment efficacy in blood cancer cell U937 (non-adherent cells)
Authors: Homami Elham , Goliaei Bahram , Shariatpanahi Seyed Peyman , Habibi-Kelishomi Zahra
Published: September 2023

Background

Recent achievements in cancer therapy are the use of alternating electrical fields at intermediate frequencies (100–300 kHz) and low intensities (1–3 V/cm), which specifically target cell proliferation while affecting different cellular activities depending on the frequency used.

Methods

In this article, we examine the effect of electric fields on spherical suspended cells and propose the combination of Daunorubicin, a chemotherapy agent widely used in the treatment of acute myeloid leukemia, with electric field exposure. U937 cells were subjected to an electric field with a frequency of 200 kHz and an intensity of 0.75 V/cm, or to a combination of Daunorubicin and electric field exposure, resulting in a significant reduction in cell proliferation. Furthermore, the application of an electric field to U937 cells increased Daunorubicin uptake.

Results

Apoptosis and DNA damage were induced by the electric field or in conjunction with Daunorubicin. Notably, normal cells exposed to an electric field did not show significant damage, indicating a selective effect on dividing cancer cells (U937). Moreover, the electric field affects the U937 cell line either alone or in combination with Daunorubicin. This effect may be due to increased membrane permeability.

Conclusions

Our findings suggest that the use of electric fields at intermediate frequencies and low intensities, either alone or in combination with Daunorubicin, has potential as a selective anti-cancer therapy for dividing cancer cells, particularly in the treatment of acute myeloid leukemia. Further research is needed to fully understand the underlying mechanisms and to optimize the use of this therapy.
Infertility-related stress and its relationship with emotional divorce among Iranian infertile people
Authors: Shayesteh-Parto Fatemeh , Hasanpoor-Azghady Seyedeh Batool , Arefi Soheila , Amiri-Farahani Leila
Published: September 2023

Background

Infertility affects different aspects of couples’ lives, so it may cause problems in couples’ emotional relationships by increasing marital conflicts. This study aimed to determine Infertility-related stress and its relationship with emotional divorce among Iranian infertile people.

Methods

We conducted a cross-sectional observational study on 200 infertile people. The research environment was one of the well-equipped infertility centers in Tehran, Iran. Continuous sampling was employed. The data collection tools included a general information form, the Fertility Problem Inventory (FPI), and the Emotional Divorce Scale (EDS).

Results

The findings revealed a significant direct relationship between infertility-related stress and all its subscales with emotional divorce in both infertile women and men. In infertile women, the most concern was the need for parenthood, while the lowest concerns were the relationship and sexual concerns. Multiple linear regression analysis indicated that social and relationship concerns predicted 44% of emotional divorce, with social concern being the more influential factor. In infertile men, the need for parenthood was the most significant concern, while relationship and social concerns were less prominent. Multiple linear regression analysis showed that relationship concern predicted 50% of emotional divorce in infertile men. In both infertile men and women, social and relationship concerns explained 45% of the variance in emotional divorce. Among these two variables, relationship concern had a more impact in predicting emotional divorce. Also, there was no statistically significant difference between women and men regarding infertility-related stress and its subscales, except for sexual concern.

Conclusion

The study highlights the importance of the need for parenthood as a main concern among infertile individuals. Increased infertility-related stress and its subscales contribute to higher levels of emotional divorce among this population. Additionally, relationship concern was the lowest concern in infertile people. But it significantly predicts emotional divorce among infertile individuals.
Triple therapy for Helicobacter pylori eradication and the risk of hypoglycemia in patients with diabetes: a population-based cohort study
Authors: Chang Anne , Chang Anna , Chen Wan-Ting , Chan Lung , Hong Chien-Tai , Chien Li-Nien
Published: September 2023

The incidence of type 2 diabetes mellitus has risen globally, from 108 million cases in 1980 to 422 million cases in 2014. Although controlling glycemic levels in patients with diabetes is crucial, insulin and sulfonylureas can cause hypoglycemic episodes and even potentially fatal events such as comas, seizures, life-threatening arrhythmias, and myocardial infarctions. Several antibiotics have been documented to cause hypoglycemic episodes; the use of antibiotics along with insulin or sulfonylureas might further increase the risk of hypoglycemia. Therefore, researchers must determine which antibiotics carry a risk of inducing severe hypoglycemic events. The prevalence of H. pylori infection remains high in most countries, and the infection is often treated with triple therapy involving amoxicillin, clarithromycin, and a proton pump inhibitor (PPI). Several case reports have reported that hypoglycemia can occur when used with patients who also take diabetes medication. Therefore, we hypothesized that patients with diabetes have an increased risk of hypoglycemic episodes when being treated with triple therapy for H. pylori infection. By analyzing medical records from Taiwan’s National Health Insurance Research Database, we found a significant association between hypoglycemia and triple therapy treatment for diabetic patients with peptic ulcer disease. Prescribing triple therapy to patients with diabetes and peptic ulcers significantly increased the risk of a hypoglycemic episode (adjusted odds ratio [aOR] = 1.75, 95% confidence interval [CI]: 1.64 to 1.88, P < 0.001). Similarly, the highest aOR (5.77, 95% CI 4.82 to 6.92) was found in patients with diabetes and peptic ulcers who had hypoglycemic episodes within 30 days after triple therapy treatment. Many patients with diabetes require H.pylori eradication for peptic ulcer treatment, and vigilance toward the risk of hypoglycemia in this population is thus necessary.
Predicting mortality among patients with severe COVID-19 pneumonia based on admission vital sign indices: a retrospective cohort study
Authors: Udompongpaiboon Piyaphat , Reangvilaikul Teeraphat , Vattanavanit Veerapong
Published: September 2023

Background

Coronavirus disease 2019 (COVID-19) pneumonia remains a major public health concern. Vital sign indices—shock index (SI; heart rate [HR]/systolic blood pressure [SBP]), shock index age (SIA, SI × age), MinPulse (MP; maximum HR–HR), Pulse max index (PMI; HR/maximum HR), and blood pressure–age index (BPAI; SBP/age)—are better predictors of mortality in patients with trauma compared to traditional vital signs. We hypothesized that these vital sign indices may serve as predictors of mortality in patients with severe COVID-19 pneumonia. This study aimed to describe the association between vital sign indices at admission and COVID-19 pneumonia mortality and to modify the CURB-65 with the best performing vital sign index to establish a new mortality prediction tool.

Methods

This retrospective study was conducted at a tertiary care center in southern Thailand. Adult patients diagnosed with COVID-19 pneumonia were enrolled in this study between January 2020 and July 2022. Patient demographic and clinical data on admission were collected from an electronic database. The area under the receiver operating characteristic (AUC) curve analysis was used to assess the predictive power of the resultant multivariable logistic regression model after univariate and multivariate analyses of variables with identified associations with in-hospital mortality.

Results

In total, 251 patients with COVID-19 pneumonia were enrolled in this study. The in-hospital mortality rate was 27.9%. Non-survivors had significantly higher HR, respiratory rate, SIA, and PMI and lower MP and BPAI than survivors. A cutoff value of 51 for SIA (AUC, 0.663; specificity, 80%) was used to predict mortality. When SIA was introduced as a modifier for the CURB-65 score, the new score (the CURSIA score) showed a higher AUC than the Acute Physiology and Chronic Health Evaluation II and CURB-65 scores (AUCs: 0.785, 0.780, and 0.774, respectively) without statistical significance.

Conclusions

SIA and CURSIA scores were significantly associated with COVID-19 pneumonia mortality. These scores may contribute to better patient triage than traditional vital signs.
Updated recommendations on the therapeutic role of extracorporeal shock wave therapy for peyronie’s disease: systematic review and meta-analysis
Authors: Wang Xiaofeng , Liu Hongquan , Tang Gonglin , Wu Gang , Chu Yongli , Wu Jitao , Cui Yuanshan
Published: September 2023

Background

The therapeutic role of extracorporeal shockwave therapy (ESWT) for Peyronie’s disease (PD) has been controversial in a long term. We aimed to further evaluate the therapeutic effect of ESWT for PD on the basis of available high-quality studies.

Methods

The PubMed, CENTRAL and Embase databases were searched for articles published from January 1st, 2000 to December 31, 2022. Only randomized controlled trials (RCTs) using ESWT to treat PD were included. Meta-analysis and forest plots were carried out using Review Manager 5.4.1 software, and outcomes were reviewed by 2 authors independently. Using the Risk of Bias assessment form (ROB-2) by Cochrane Collaboration for quality assessment. PRISMA 2020 guidelines were used in this article to achieve the quantitative and qualitative synthesis of data.

Results

A total of four RCTs were included. 151 patients in the ESWT group and 150 patients in the control group. The meta-analysis results showed that ESWT could significantly reduce plaque size (OR 2.59, 95%CI 1.15 to 5.85, P = 0.02) and relieve pain (MD -1.55, 95%CI -2.46 to -0.64, P = 0.0008); but it has no significant effect on reducing the penile curvature (OR 1.93, 95%CI 0.87–4.26, P = 0.11) and improving sexual function (MD 2.6, 95%CI -1.63 to 6.83, P = 0.23), there is also no significant difference in complication rates between groups (OR 2.94, 95%CI 0.66 to 13.03, P = 0.16). The risk of bias of results is low. The limitations of this study are that the number of included studies is too small, some experimental outcomes are missing, and the expression of outcomes is not unified.

Conclusions

For PD, ESWT can be considered as a safe short-term treatment, which can reduce plaque size and relieve pain, but cannot improve penile curvature and sexual function. Its long-term efficacy remains to be discussed.

Registration number

PROSPERO (ID: CRD42023436744).