bluuebunny/crossref_metadata_2025 huggingface dataset:
“O falso Deus adora o verdadeiro": Pepetela e Camões em diálogo
Authors: Valle Diego Gomes do
Published: December 2022

O presente artigo analisa o conto “Grandes pássaros de asas abertas”, do angolano Pepetela, à luz da literatura comparada, uma vez que tal narrativa evoca o Canto V de Os lusíadas, de Camões, especialmente os feitos que antecedem e são desenvolvidos no famoso episódio do Gigante Adamastor. Munidos de um referencial teórico eclético, buscaremos evidenciar quais os pontos paródicos do conto, para que os pontos de crítica política fiquem evidentes. Nesse sentido, destacam-se o modo como a narrativa de Pepetela acompanha a dinâmica fabulativa do episódio camoniano em todos os seus momentos: a chegada dos portugueses, a tentativa de escambo, o embróglio com Veloso, o Gigante Adamastor e a disputa dos deuses. Desse modo, o próprio tratamento do maravilhoso, em ambas as obras, requer esclarecimentos. Almejamos oferecer uma abertura maior para a compreensão do conto, que se atualiza constantemente no conhecimento do canto da epopeia e também dos movimentos históricos e políticos.
Refrações de um olhar poético: o herói esparso de Luís Vaz de Camões
Authors: Soares Mafalda Sofia Borges
Published: December 2022

No âmbito do presente artigo, analisa-se o heroísmo que está patente n’Os Lusíadas, desconstruindo-se a ideia de que uma só figura de herói nessa obra se encontra. Demonstra-se que as descrições levadas a cabo por Luís de Camões não seguem à letra modelos greco-latinos, como o poderão ser a Odisseia, a Ilíada ou a Eneida, dado que os comportamentos heroicos retratados – ou desejados – se encontram esparsos por várias personagens (literárias e extraliterárias). Na senda desta refração do ideal heroico, o discurso poético revela-se plurifacetado e polissêmico, uma vez que o olhar épico – e mesmo lírico – sobre o passado serve de exemplo para – e de reflexão sobre – façanhas vindouras.
O plus ultra e o amor n'Os Lusíadas
Authors: Lachat Marcelo , Felipe Cleber Vinicius do Amaral
Published: December 2022

Este artigo analisa as forças centrífugas que organizam a epopeia de Camões, asseguram a vitória sobre os obstáculos representados ou referidos pelo Velho do Restelo, Gigante Adamastor e Baco, e coroam o desfecho da narração do poema, ocorrido na “ilha namorada”, quando Vasco da Gama e seus companheiros se unem às ninfas e consumam a simbiose entre homens e “aquáticas donzelas”, filhas do Oceano. Propõe-se uma leitura retórico-poética d’Os Lusíadas (1572), avessa aos critérios românticos, psicológicos, burgueses e ilustrados que naturalizam tabus e paradigmas incompatíveis com as práticas letradas portuguesas do século XVI.
Nitrites, Nitrates, and Cardiovascular Outcomes: Are We Living “La Vie en Rose” With Pink Processed Meats?
Authors: Srour Bernard , Chazelas Eloi , Fezeu Léopold K. , Javaux Guillaume , Pierre Fabrice , Huybrechts Inge , Hercberg Serge , Deschasaux‐Tanguy Mélanie , Kesse‐Guyot Emmanuelle , Touvier Mathilde
Published: December 2022

Background

Nitrates and nitrites are used as food additives in processed meats. They are also commonly ingested from water and several foods. Several short‐term clinical studies suggested beneficial effects of dietary nitrates on blood pressure, while deleterious effects on oxidative damage have been suggested in some experimental studies. However, there is a lack of evidence from longitudinal epidemiological studies linking foods and water‐originated and additives‐originated nitrites and nitrates, separately, to hypertension and cardiovascular diseases risk. We aimed to study these associations in a large population‐based cohort.

Methods and Results

Overall, 106 288 adults from the French NutriNet‐Santé cohort (2009–2022) were included. Associations between nitrites and nitrates intakes and hypertension and cardiovascular disease risks were assessed using multi‐adjusted Cox proportional hazard models. During follow‐up, 3810 incident cases of hypertension and 2075 cases of cardiovascular diseases were ascertained. Participants with higher intakes of additives‐originated nitrites (sodium nitrite in particular [European code e250]) had a higher hypertension risk compared with nonconsumers (hazard ratio, 1.19 [95% CI, 1.08–1.32],
P
=0.001, and 1.19 [95% CI, 1.08–1.32],
P
=0.002), respectively. No association was detected between foods and water‐originated nitrites, or nitrates with hypertension risk (all
P
values >0.3). We found no association between nitrites or nitrates and risks of cardiovascular diseases (all
P
values >0.2).

Conclusions

These results do not support a protective role of nitrites or nitrates in cardiovascular health. Instead, they suggest a positive association between nitrites from food additives and hypertension risk, which needs confirmation in other large‐scale studies. These findings provide new evidence in the context of current discussions about updating regulations on the use of nitrites as food additives.
International Law and the Provocations of the Digital: The 2021 Annual Kirby Lecture in International Law
Authors: Johns Fleur
Published: December 2022

Based in Montevideo, and most recently valued at US$5 billion, the payments platform DLocal enables companies such as Booking.com, Amazon and Uber to transact in local currencies in 29 countries. It specializes in the “emerging economies” of Latin America, the Asia Pacific, the Middle East and North Africa. Among international lawyers, however, Montevideo is best known for another form of international infrastructure. That is the 1933 Montevideo Convention, or at least its first article, standardising the template of modern statehood. At the time, as scholars of international legal history have shown, this amounted to a radical reformatting of the fundamentals of international law, driven by semi-peripheral states, as part of a widespread effort of reconstructive codification after the Great War. Today, DLocal’s Montevideo is emblematic of a very different kind of international legal reformatting now underway. A digital logic, and associated circuits of value and aggregations of power, are becoming embedded—even predominant—in many of international law’s most routine operations. To shed light on this phenomenon, this lecture revisits each component of the Montevideo Convention’s well-known formula for statehood—permanent population; defined territory; government; and the conduct of international relations. Taking efforts of so-called digital humanitarianism as illustrative, it examines how each of these Montevideo properties is being rerouted and recomposed digitally, often in tension with an analog logic characteristic of law. And in the ensuing dislocations sometimes in evidence between analog and digital aspects of international legal work, it identifies some possibilities for collective reworking.
Can Polar Stratospheric Clouds Explain Arctic Amplification?
Authors: Dutta Deepashree , Sherwood Steven C. , Jucker Martin , Gupta Alex Sen , Meissner Katrin J.
Published: December 2022

Climate models underestimate the magnitude of Arctic warming in past warm climates, like the early Cretaceous and Paleogene periods, implying that certain physical processes might be missing or poorly represented. Previous studies suggest that a large increase in wintertime Arctic polar stratospheric clouds (PSCs) might have promoted Arctic amplification through additional greenhouse warming. High methane concentrations in warm climates might have increased stratospheric water vapor providing favorable conditions for PSCs. However, methane concentrations in past warm climates are extremely uncertain. Here, we revisit the PSC hypothesis by exploring PSC changes under very high methane levels, 4× preindustrial carbon dioxide, and strong polar-amplified surface warming, using a whole-atmosphere model with fully interactive chemistry. We find that with polar-amplified warming there is a large increase in Arctic outgoing longwave radiation (OLR) that reduces as the methane concentration is increased. PSCs increase monotonically with methane concentration. A large radiative cooling and an increase in water vapor in the stratosphere increases Arctic PSCs, which follow a power law with respect to relative humidity. Using a two-way partial radiative perturbation technique, we show that the OLR reduction due to PSCs is similar to the direct radiative forcing of methane for high methane levels. Thus, we find that PSCs could play an important role in Arctic warming in a warmer-than-present-day climate, but only if methane levels were higher than suggested by previous modeling studies for past warm climates.
Structural and Environmental Characteristics of Western Baiu Frontal Depressions
Authors: Tochimoto Eigo , Yanase Wataru
Published: December 2022

Baiu frontal depressions (BFDs) are the major cyclones that form and develop along baiu fronts. The structure and environment of BFDs are examined using the Japanese 55-year Reanalysis dataset. BFDs detected automatically were categorized into four groups based on the region where the BFDs peaked: the East China Sea (ES), off the south coast of the Japanese islands (SC), the Yellow Sea (YS), and the Sea of Japan (SJ). A BFD-centered composite analysis demonstrates that, for YS-BFDs and SJ-BFDs, compared to ES-BFDs and SC-BFDs, the strength of upper-level troughs is greater, and the upper-level troughs are closer, suggesting that the effect of upper-level troughs on BFD development is greater. BFDs for all categories are located in the region of cyclonic horizontal shear and have a horizontal trough running from southwest to northeast, favoring barotropic energy conversion. The BFD-centered composite analysis of the energy conversion terms demonstrates that the barotropic energy conversion of mean kinetic energy due to the environmental cyclonic horizontal shear to eddy kinetic energy contributes to BFD development, and the conversion of eddy available potential energy, which is generated mainly by the diabatic heating, is the major contributor to eddy kinetic energy.
The Influence of Motive Attributions for Destination Social Responsibility on Residents’ Empowerment and Quality of Life
Authors: Su Lujun , Yang Xiaojie , Swanson Scott R.
Published: December 2022

This research provides new insights into the link between destination social responsibility (DSR) and resident quality of life (QOL). A conceptual model is tested based on attribution theory and empowerment theory that investigates the impact that different DSR motive attributions can have on resident QOL, and the potential mediating role of empowerment. DSR actions attributable to intrinsic (extrinsic) motives by destination residents were found to demonstrate greater (lesser) empowerment and QOL. Empowerment was found to have a significant positive impact on QOL and to mediate the DSR motive attribution and resident QOL relationship. Examination of these initial findings suggest that intrinsic, relative to extrinsic, DSR motive attributions enhance resident empowerment through tourism and QOL under high involvement conditions. This relationship was not found to hold in low involvement tourism conditions. The paper concludes with a discussion of theoretical and managerial contributions, as well as study limitations and future research directions.
Resilient Regions in Brazil: Unfolding the Effects of COVID-19 From a Socioeconomic Perspective
Authors: Tupy Igor Santos , Silva Fernanda Faria , Diniz Gustavo Figueiredo Campolina , Montenegro Rosa Livia , de Queiroz Stein Alexandre , Ferraz Diogo
Published: December 2022

At the beginning of 2020, the world was left in an unprecedented state of shock by the COVID-19 pandemic. Brazil quickly became the epicenter of new cases of contamination, where the propagation of the virus was unrestrained, despite boasting one of the strongest Universal health coverage systems in Latin America. This paper has at least three empirical contributions to the literature about economic resilience and the COVID-19 pandemic. Firstly it is a critical issue regarding the “economics versus life” trade-off, which is an essential question for developing countries, given that policymakers must decide between policies to reduce the number of COVID-19 infections without damaging the economy. Secondly, our findings suggest that the early adoption of isolation measures applied in 2020, such as the financial aid and the vaccination have been effective in controlling the effects of the pandemic, especially in vulnerable microregions. Furthermore, it was verified that the Emergency financial aid was a fundamental policy in minimizing the economic impacts of the pandemic and allowing people to practice social distancing, contributing positively to the Employment Resilience Index and negatively related to the growth rate of deaths due to COVID-19. The contribution of our study is to measure an inverted U-shaped curve to demonstrate that policymakers must achieve a minimum of families to decrease the COVID-19 deaths. These contributions are essential and straightforward findings to lead policymakers' decisions in developing countries facing financial constraints in the public budget and population reticence about physical distancing, self-quarantine and vaccination.
Transitioning to Independent Nursing Practice during COVID-19: A Mixed Methods Study
Authors: Blanco Keli , Ely Elizabeth , DeAlmeida Katelyn , Bohr Nicole L.
Published: December 2022

The COVID-19 pandemic presented challenges to onboard and support new graduate nurses (NGNs). This study sought to explore the perceptions of nurses entering clinical practice during the COVID-19 pandemic. Using mixed methods, we investigated the experiences of NGNs entering the field during the pandemic and how a nurse residency program (NRP) adapted to meet their needs. Newly graduated nurses entering practice in November 2019 described their transition through nurse experience surveys and focus group discussions. Results from the quantitative data reported on compassion satisfaction, burnout, and exposure to secondary traumatic stress. The qualitative data mirrored these findings with the discovery of the following five themes: transitioning through an NRP, impact to nursing care, value of coworkers, coping, and professional growth. These findings illustrate the need to better support future practice transitions in times of disruption and change.
Prospects for Growth and Change: U.S. Metro Area Forecasts 2022–2032
Authors: Treyz Frederick R.
Published: December 2022

Since February 2020, severe economic disruption, policy responses, and behavioral shifts have created an uncertain economic future at the global, national, state, and local levels. In the context of this uncertainty, private and governmental decisions need the best available forecasts of long-term economic and demographic growth and change, and a regional economic modeling framework that allows model users to develop alternative forecasts. This commentary provides 10-year economic and population forecasts for the top 20 U.S. metropolitan areas, using REMI—a comprehensive economic/demographic forecasting model. While it focuses on metropolitan areas, the fundamental demographic and economic factors that guide the future of a region are the same. States, cities, and rural areas have underlying demographic and economic forces that will determine their destiny.
Overview of recent cases before the Court of Justice of the European Union (March –September 2022)
Authors: Melin Pauline , Sivonen Susanne
Published: December 2022

In this case note, nine judgments of the Court will be discussed. The first two judgments discussed concern the principle of equal treatment in relation to family benefits ( S v Familienkasse and Commission v Austria). Additionally, both the first and third judgments reported relate to the interpretation of the Citizenship Directive (Directive 2004/38) ( S v Familienkasse and VI). The other judgments on social security deal with the calculation of old-age pension ( CC) and the legislation applicable for flight and cabin crew ( INAIL and INPS) under Regulation 883/2004. The four remaining judgments are cases of discrimination on grounds of sex in the context of pensions ( KM v INSS and EB v BVAEB), on grounds of age ( A v HK Danmark and HK/Privat) and between temporary agency workers and ‘regular’ workers ( Luso Temp).
Using a condom or glove to improve pelvic exam visualization: A guide
Authors: Palsgaard Peggy , Yerrabelli Rahul S , Hojati Ashkhan , Whitmore Elsa
Published: December 2022

Objectives:

Pelvic exams are a cornerstone of gynecological care, necessary for both regular screenings and diagnostics. The collapse of lateral vaginal walls during a pelvic exam is a frequently encountered problem in clinical practice.

Methods:

Practitioners often utilize tools found in a typical clinical setting to counter this issue, such as a condom or glove over the speculum to prevent the lateral vaginal walls collapsing inward and obscuring cervical views.

Results:

These techniques have been passed down from mentor to mentee over the years, though scarcely described in literature. This article aims to provide instructions on how to use these two methods in clinical practice to improve pelvic exams for the practitioner and the patient.

Conclusion:

Utilizing a condom or glove to prevent lateral vaginal wall collapse has the potential to improve pelvic exams for both practitioners and patients.
Study on the hotspots of urban tourism spaces based on Instagram-Worthy locations data: Taking Beijing as an example
Authors: Fan Lai , Zhang Dayu
Published: December 2022

As the mobile Internet emerges, numerous Instagram-worthy locations gradually constitute new spaces of urban tourism. For instance, the Xiaohongshu application, a community with shared content, has increasingly become a platform for people to share well-known tourist attractions, providing a new perspective for the study of the popularity of tourism spaces. On the basis of data of ticking off Instagram-worthy locations from the Xiaohongshu application, the present study aims to identify tourism hotspots in Beijing, analyze their spatial characteristics, and explore their evolution features from two dimensions of time and space. In addition, the emotional images of tourism hotspots in Beijing are interpreted by semantic analysis with an internal mechanism that influences those locations explored. The results of the study show that (1) the overall spatial structure of tourism hotspots in Beijing is C-shaped, which expands from the core area to the periphery with the feature of a circle layer. (2) under the influence of the COVID-19 pandemic, the spatial distribution center of tourism hotspots in Beijing is gradually shifting to the Southeast with the tendency of expanding to the surrounding suburbs. (3) the reception and serviceability of the tourist attractions have a significant influence on the popularity of tourism hotspots. To date, less research has been focused on the data of ticking off emerging Instagram-worthy locations like the Xiaohongshu application, and there is a dearth of the study related to in-depth excavation of the internal influencing mechanism of their popularity. This paper, therefore, under the interaction of virtual and reality, provides new ideas and methods for studying the popularity of urban tourist attractions.
Matriliny, Merchandise and Islam: A Study of the Keyis in the Coastal Belt of Tellicherry, North Malabar
Authors: Sebastian Aleena
Published: December 2022

As owners of extensive matrilineal joint households in the Tellicherry Coastal town (North Malabar, South India), Keyis upheld an urban-centred identity in the colonial period. Scattered around the coastal town of Tellicherry in Cannanore, the Keyis today form an economically diverse group. The socio-economic distinction of the Keyis from other Muslim merchants on the Coast, their consolidation of social organisation along the matrilineal line and their economic relations based in landlord –tenant relations are explored here. The nature of the transformation of economic relations and kinship practices among the Keyis in the colonial and post-colonial period puts forth interesting dimensions of their everyday practices as shaped by historic and region-specific socio-economic, legal and political conditions. By undertaking a historical and ethnographic examination of this kinship group, this paper explores Muslim communities and cultures through their pluralities and recommends a methodological shift towards the exploration of kinship practices to inform the current scholarship on the Anthropology of Islam and Kinship Studies.
Scientists benefit greatly from K-12 partnerships: the Panama Research Experiences for Teachers project
Authors: MacFadden Bruce J. , Vargas Vergara Claudia , Davey Bradford T.
Published: December 2022

Scientist-teacher partnerships are highly beneficial to K-12 STEM education. While much is known about the benefits for teachers in these partnerships, the corresponding benefits for scientists are less well known. With emphasis on the scientists’ perspective, here we describe our NSF RET (Research Experiences for Teachers) project consisting of five successive cohorts from 2012 to 2016. Coincident with a “once-in-a-century” expansion of the Panama Canal, the science research focused on the paleontology, evolutionary biology, and geology of this region to better understand the ancient Neotropical biota related to the Great American Biotic Interchange (GABI). In the field, scientists and teachers worked together collecting fossils and geological samples. Back in the K-12 classrooms, lesson plans related to their experiences were implemented and the teachers hosted scientist role-model visits. More than 30 scientists and 44 teachers participated in this Panama “GABI RET” project. Using a new validated survey developed during this project and focus groups, we explored the impact of this project, and in particular the perceived benefits accrued by the scientists. Our study confirmed that scientists felt they improved their communication skills, had a better appreciation for the K-12 teaching professions, greatly enjoyed working with the teachers, considered them colleagues, and many wanted to continue K-12 outreach as part of their careers. Overall, scientists perceived that they greatly benefited from these partnerships. In addition to describing their activities, they had numerous recommendations for similar partnerships in the future. For example, these include: (1) having more teachers participate in multiple cohorts, (2) continued opportunities for teachers to be involved in professional meetings, (3) ongoing webinars and face-to-face engagement, and (4) more diversity of racial and ethnic backgrounds, subjects taught, and regions represented. Although this case study was focused on the GABI RET, our results also potentially inform other projects that involve scientists’ education and outreach activities.
Mental healthcare-seeking behavior of women in Bangladesh: content analysis of a social media platform
Authors: Koly Kamrun Nahar , Tasnim Zarin , Ahmed Sharmin , Saba Jobaida , Mahmood Rudbar , Farin Faria Tasnim , Choudhury Sabrina , Ashraf Mir Nabila , Hasan M. Tasdik , Oloniniyi Ibidunni , Modasser Rifath Binta , Reidpath Daniel D.
Published: December 2022

Background

Mental health remains a highly stigmatized area of healthcare, and people often conceal their concerns rather than seek assistance or treatment. The Women Support Initiative Forum (WSIF) is a social media platform established in 2018 to provide expert and peer-led psychosocial support services to women of all ages in Bangladesh. The anonymous nature of the forum means that mental health concerns can be aired without fear of identification.

Method

A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach.

Result

The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services.

Conclusion

The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
Elective egg freezing patients may benefit from increasing the maximal daily gonadotropin dose above 300IU
Authors: Orvieto Raoul , Aizer Adva , Saar-Ryss Bozhena , Marom-Haham Lilach , Noach-Hirsh Meirav , Haas Jigal , Nahum Ravit
Published: December 2022

Objective

Nowadays, patients attempting social/elective egg freezing has spread globally. Ovarian stimulation (OS) with high daily gonatotropin doses, are commonly offered to this group of patients, aiming to achieve the maximal oocytes cohort with minimum IVF cycle attempts. We aim to assess the IVF-ET outcome, and specifically the oocyte yield, of patients undergoing two successive IVF cycle attempts for elective egg freezing (EEF), and whether changing the daily gonadotropin dose in the second IVF cycle attempt, affect the outcome.

Patients and methods

All women admitted to our IVF unit for social/EEF, who underwent 2 consecutive IVF cycle attempts, with only those who used in the first attempt a starting daily gonadotropin dose of 300 IU were included. Ovarian stimulation characteristics, duration of OS, number of retrieved oocytes, number of mature oocytes were assessed and compared between the 1st and the 2nd IVF cycle attempts, and between the different daily gonadotropin doses and the oocyte yields in the 2nd cycle attempt (increase, decrease or no change).

Main outcome measures

Oocytes and mature oocytes yield in the 2nd as compared to the 1st IVF cycle attempt.

Results

A reduced oocyte yield in the 2nd cycle attempt was observed in those who highly responded in the 1st attempt, regardless the daily dose in the 2nd cycle attempt (whether it was increased, no change and decreased). Moreover, the proportion of patients with same or more oocytes in the 2nd IVF cycle attempt was significantly lower in patients with high peak E2 levels, compared to those with peak E2 levels < 9175 pmol/L. Among patients with high peak E2 (> 9175 pmol/L), those who achieved a lower oocytes yield in the 2nd IVF cycle attempt had lower basal Day-3 FSH/LH ratio (1.5 + 0.5 vs 1.8 + 0.8, p < 0.03) and higher oocyte (range: 7–28, median:10; vs range: 2–15, median:7) and mature oocytes yields. With a cut-off of 9 oocytes, 78.8% of those with > 9 oocytes and 61.8% of those with < 9 oocytes will achieve lower/higher oocytes yield in the 2nd IVF cycle attempt, respectively.

Conclusions

Ovarian stimulation with high daily gonatotropin doses (300 IU) should be offered to patients attempting social/EEF. Moreover, in their 2nd IVF cycle attempt, those with high peak E2 (> 9175 pmol/L) in the 1st attempt, and basal Day-3 FSH/LH ratio < 1.5 and/or more than 9 oocytes retrieved, should receive same OS protocol with no change in the daily gonadotropin dose.
Docetaxel suppressed cell proliferation through Smad3/HIF-1α-mediated glycolysis in prostate cancer cells
Authors: Peng Junming , He Zhijun , Yuan Yeqing , Xie Jing , Zhou Yu , Guo Baochun , Guo Jinan
Published: December 2022

Background

Tumor glycolysis is a critical event for tumor progression. Docetaxel is widely used as a first-line drug for chemotherapy and shown to have a survival advantage. However, the role of docetaxel in tumor glycolysis remained poorly understood.

Methods

The effect of Docetaxel in tumor glycolysis and proliferation were performed by CCK-8, Western blotting, real-time PCR, glucose, and lactate detection and IHC. ChIP and luciferase assay were used to analyze the mechanism of Docetaxel on Smad3-mediated HIF-1α transactivity.

Results

In this study, we showed that docetaxel treatment led to a significant inhibition of cell proliferation in prostate cancer cells through PFKP-mediated glycolysis. Addition of lactate, a production of glycolysis, could reverse the inhibitory effect of docetaxel on cell proliferation. Further analysis has demonstrated that phosphorylation of Smad3 (Ser213) was drastically decreased in response to docetaxel stimulation, leading to reduce Smad3 nuclear translocation. Luciferase and Chromatin immunoprecipitation (ChIP) analysis revealed that docetaxel treatment inhibited the binding of Smad3 to the promoter of the HIF-1α gene, suppressing transcriptional activation of HIF-1α. Moreover, ectopic expression of Smad3 in prostate cancer cells could overcome the decreased HIF-1α expression and its target gene PFKP caused by docetaxel treatment. Most importantly, endogenous Smad3 regulated and interacted with HIF-1α, and this interaction was destroyed in response to docetaxel treatment. What’s more, both HIF-1α and PFKP expression were significantly reduced in prostate cancer received docetaxel treatment in vivo.

Conclusion

These findings extended the essential role of docetaxel and revealed that docetaxel inhibited cell proliferation by targeting Smad3/HIF-1α signaling-mediated tumor Warburg in prostate cancer cells.
Early and midterm outcomes of a bentall operation using an all-biological valved BioConduit™
Authors: Botea Roxana , Lavie-Badie Yoan , Goicea Alexandru , Porterie Jean , Marcheix Bertrand
Published: December 2022

Objectives

To analyze the midterm results of aortic root replacement using the valved, all biological, No React®, BioConduit™.

Methods

From 2017 to 2020, we prospectively followed 91 consecutive patients who underwent a Bentall procedure with a BioConduit™ valved graft in our institution. The primary outcomes were aortic bioprosthetic valve dysfunction and mortality according to Valve Academic Research Consortium 3 (VARC3).

Results

Mean age was 70 ± 10 years and 67 patients (74%) were men. Ascending aortic aneurysm (72%), aortic valve regurgitation (51%) or stenosis (20%) and acute endocarditis (14%) were the main indications for surgery. Seventy-four patients (81.3%) were followed up at 1 year. The perioperative mortality was 8% (n = 8), the early, 1 year, mortality was 2% (n = 2) and the midterm mortality, at 4 years of follow up, was 4% (n = 3). Ten patients fulfilled the criteria for hemodynamic valve deterioration at 1 year (13%) and 14 for a bioprosthetic valve failure during the entire follow-up (17%).

Conclusions

We are reporting early and midterm results of Bentall procedures with the all-biological, valved, No-React® BioConduit™. To our knowledge, this is the first study reporting an early and midterm unexpectedly high rate of non-structural prosthetic hemodynamic deterioration. The rate of endocarditis and atrioventricular disconnections remain similar to previous studies.
Response to commentary ‘long COVID-19/post-COVID condition in children: do we all speak the same language?
Authors: Trapani Gianfranco , Verlato Giuseppe , Bertino Enrico , Maiocco Giulia , Vesentini Roberta , Spadavecchia Alessia , Dessì Angelica , Fanos Vassilios
Published: December 2022

Here we present the Authors’ answer to the Letter written by Dr. Garazzino and Colleagues with reference to our article “Long COVID-19 in children: an Italian cohort study”.
Flower-like meristem conditions and spatial constraints shape architecture of floral pseudanthia in Apioideae
Authors: Baczyński Jakub , Celep Ferhat , Spalik Krzysztof , Claßen-Bockhoff Regine
Published: December 2022

Background

Pseudanthia are multiflowered units that resemble single flowers, frequently by association with pseudocorollas formed by enlarged peripheral florets (ray flowers). Such resemblance is not only superficial, because numerous pseudanthia originate from peculiar reproductive meristems with flower-like characteristics, i.e. floral unit meristems (FUMs). Complex FUM-derived pseudanthia with ray flowers are especially common in Apiaceae, but our knowledge about their patterning is limited. In this paper, we aimed to investigate both the genetic and morphological basis of their development.

Results

We analysed umbel morphogenesis with SEM in six species representing four clades of Apiaceae subfamily Apioideae with independently acquired floral pseudanthia. Additionally, using in situ hybridization, we investigated expression patterns of LEAFY (LFY), UNUSUAL FLORAL ORGANS (UFO), and CYCLOIDEA (CYC) during umbel development in carrot (Daucus carota subsp. carota). Here, we show that initial differences in size and shape of umbel meristems influence the position of ray flower formation, whereas an interplay between peripheral promotion and spatial constraints in umbellet meristems take part in the establishment of specific patterns of zygomorphy in ray flowers of Apiaceae. This space-dependent patterning results from flower-like morphogenetic traits of the umbel which are also visible at the molecular level. Transcripts of DcLFY are uniformly distributed in the incipient umbel, umbellet and flower meristems, while DcCYC shows divergent expression in central and peripheral florets.

Conclusions

Our results indicate that umbels develop from determinate reproductive meristems with flower-like characteristics, which supports their recognition as floral units. The great architectural diversity and complexity of pseudanthia in Apiaceae can be explained by the unique conditions of FUMs—an interplay between expression of regulatory genes, specific spatio-temporal ontogenetic constraints and morphogenetic gradients arising during expansion and repetitive fractionation. Alongside Asteraceae, umbellifers constitute an interesting model for investigation of patterning in complex pseudanthia.
Protocol for development and validation of postpartum cardiovascular disease (CVD) risk prediction model incorporating reproductive and pregnancy-related candidate predictors
Authors: Wambua Steven , Crowe Francesca , Thangaratinam Shakila , O’Reilly Dermot , McCowan Colin , Brophy Sinead , Yau Christopher , Nirantharakumar Krishnarajah , Riley Richard ,   on behalf of the MuM-PreDiCT Group
Published: December 2022

Background

Cardiovascular disease (CVD) is a leading cause of death among women. CVD is associated with reduced quality of life, significant treatment and management costs, and lost productivity. Estimating the risk of CVD would help patients at a higher risk of CVD to initiate preventive measures to reduce risk of disease. The Framingham risk score and the QRISK® score are two risk prediction models used to evaluate future CVD risk in the UK. Although the algorithms perform well in the general population, they do not take into account pregnancy complications, which are well known risk factors for CVD in women and have been highlighted in a recent umbrella review.

We plan to develop a robust CVD risk prediction model to assess the additional value of pregnancy risk factors in risk prediction of CVD in women postpartum.

Methods

Using candidate predictors from QRISK®-3, the umbrella review identified from literature and from discussions with clinical experts and patient research partners, we will use time-to-event Cox proportional hazards models to develop and validate a 10-year risk prediction model for CVD postpartum using Clinical Practice Research Datalink (CPRD) primary care database for development and internal validation of the algorithm and the Secure Anonymised Information Linkage (SAIL) databank for external validation. We will then assess the value of additional candidate predictors to the QRISK®-3 in our internal and external validations.

Discussion

The developed risk prediction model will incorporate pregnancy-related factors which have been shown to be associated with future risk of CVD but have not been taken into account in current risk prediction models. Our study will therefore highlight the importance of incorporating pregnancy-related risk factors into risk prediction modeling for CVD postpartum.
Info-pollution: a word of caution for the neurosurgical community
Authors: Narvaez-Rojas Alexis , Arnaout Mohamed M. , Hoz Samer S. , Agrawal Amit , Lee Angel , Moscote-Salazar Luis Rafael , Deora Harsh
Published: December 2022

The medical-patient relationship is facing pollution of information all over the internet, for physician and patients is becoming tougher to keep updated with the highest quality of information. During the last 20 years multiple evaluation tools have been developed trying to find the best tool to assess high-quality information, to date DISCERN tool represents the most widely spread. Information can be found on the surface internet and in the deep web, constituting the biggest chunk of the internet, informing and controlling the quality of information is a formidable task. PubMed and Google Scholar are the most important tools for a physician to find information, although multiple others are available; awareness must be raised over improving current strategies for data mining high-quality information for the patients and the healthcare community.
Sympathetic innervation of human and porcine spleens: implications for between species variation in function
Authors: Kirkland Logan G. , Garbe Chloe G. , Hadaya Joseph , Benson Paul V. , Wagener Brant M. , Tankovic Sanjin , Hoover Donald B.
Published: December 2022

Background

The vagus nerve affects innate immune responses by activating spleen-projecting sympathetic neurons, which modulate leukocyte function. Recent basic and clinical research investigating vagus nerve stimulation to engage the cholinergic anti-inflammatory pathway (CAP) has shown promising therapeutic results for a variety of inflammatory diseases. Abundant sympathetic innervation occurs in rodent spleens, and use of these species has dominated mechanistic research investigating the CAP. However, previous neuroanatomical studies of human spleen found a more restricted pattern of innervation compared to rodents. Therefore, our primary goal was to establish the full extent of sympathetic innervation of human spleens using donor tissue with the shortest procurement to fixation time. Parallel studies of porcine spleen, a large animal model, were performed as a positive control and for comparison.

Methods

Human and porcine spleen tissue were fixed immediately after harvest and prepared for immunohistochemistry. Human heart and porcine spleen were stained in conjunction as positive controls. Several immunohistochemical protocols were compared for best results. Tissue was stained for tyrosine hydroxylase (TH), a noradrenergic marker, using VIP purple chromogen. Consecutive tissue slices were stained for neuropeptide Y (NPY), which often co-localizes with TH, or double-labelled for TH and CD3, a T cell marker. High-magnification images and full scans of the tissue were obtained and analyzed for qualitative differences between species.

Results

TH had dominant perivascular localization in human spleen, with negligible innervation of parenchyma, but such nerves were abundant throughout ventricular myocardium. In marked contrast, noradrenergic innervation was abundant in all regions of porcine spleen, with red pulp having more nerves than white pulp. NPY stain results were consistent with this pattern. In human spleen, noradrenergic nerves only ran close to T cells at the boundary of the periarterial lymphatic sheath and arteries. In porcine spleen, noradrenergic nerves were closely associated with T cells in both white and red pulp as well as other leukocytes in red pulp.

Conclusion

Sympathetic innervation of the spleen varies between species in both distribution and abundance, with humans and pigs being at opposite extremes. This has important implications for sympathetic regulation of neuroimmune interactions in the spleen of different species and focused targeting of the CAP in humans.
Predictors of peritoneal metastasis of gastric origin
Authors: ElKordy Mohamed Atef , Soliman Rady Mansour , ElTohamy Mahitab Ibrahim , Mohamed Dalia Negm Eldin , Mustafa Ahmed Morsi
Published: December 2022

Background

Gastric adenocarcinoma is one of the most aggressive forms of cancer. Despite marked advancements in radiological techniques, peritoneal deposits are still only discovered during laparotomies in a significant number of cases. The role of surgery in the management of metastatic gastric cancer is very limited, reducing the value of conducting laparotomies. In addition, conducting laparoscopies for the purposes of properly staging every case of gastric cancer is difficult, especially in healthcare systems with limited resources. It is thus crucial to investigate all possible predictors of peritoneal metastasis of gastric cancer, with the aim of reserving the use of laparoscopies to cases known to have high incidences of peritoneal metastasis despite negative radiological results.

Patients and methods

This is a case control study that included all cases of gastric adenocarcinoma that had presented to the National Cancer Institute–Cairo University between January 2018 and December 2019. The ‘cases’ group encompassed all gastric adenocarcinoma patients who were found to have peritoneal metastasis, whilst the ‘control’ group included those patients who were apparently metastasis-free. Comparisons were made between the two groups in terms of demographics, tumor characteristics, and results of laboratory tumor marker investigations.

Results

Patients with peritoneal metastasis were statistically significantly younger than those who had no apparent metastasis (mean ± SD 51.4 ± 12.5 and 56.2 ± 12.6 respectively;P= 0.020). Significant associations were found between a finding of peritoneal metastasis and (i) a middle tumor site (P= 0.002); (ii) tumor thickening morphology (P< 0.001); (iii) undifferentiated histopathology (P= 0.040); (iv) tumor grade III (P< 0.001); (v) lower lymphocyte counts of < 1.9/ml (P= 0.030); and (vi) high levels of CA 19-9 of > 37 units/ml (P= 0.032).

Conclusion

Tumor pathological criteria, including tumor site, degree of differentiation, shape, and grading, as well as laboratory findings of low lymphocytic counts and high levels of CA 19-9 appear to be reliable predictors of the presence of peritoneal metastasis from a gastric adenocarcinoma.
Novel distance measures of hesitant fuzzy sets and their applications in clustering analysis
Authors: Liao Fuping , Li Wu , Zhou Xiaoqiang , Liu Gang
Published: December 2022

Distance and similarity measures are very important in clustering, pattern recognition, decision-making and other scientific fields. For the existing hesitant fuzzy distance, most of them do not consider the hesitance degree. Even if the hesitance degree is considered, only the degree of dispersion or the number of hesitant fuzzy values are considered. Aiming at these shortages, a new hesitance degree is defined, which has better accuracy and applicability. Then, some hesitant fuzzy distance measures based on the proposed hesitance degree are proposed, which can overcome some shortcomings of the existing distance measures. Finally, the new hesitant fuzzy distance is applied to the hierarchical hesitant fuzzy k-means clustering algorithm, and an illustration example is given to illustrate the effectiveness of the proposed method.
Opioid sparing effect of intravenous dexmedetomidine in orthopaedic surgery: a retrospective analysis
Authors: Donatiello Valerio , Alfieri Aniello , Napolitano Andrea , Maffei Vincenzo , Coppolino Francesco , Pota Vincenzo , Passavanti Maria Beatrice , Pace Maria Caterina , Sansone Pasquale
Published: December 2022

Background

Dexmedetomidine is a highly selective alpha-2 receptor agonist without any effect on the GABA receptor. It provides an excellent sedative and analgesic profile with few side effects. We report our experience with dexmedetomidine use during orthopaedic surgery under locoregional anaesthesia to ensure adequate sedation and optimal postoperative pain control.

Methods

In this retrospective analysis, we included 128 patients who underwent orthopaedic surgery between January 2019 and December 2021. All patients received the same local anaesthetic dose of 20 ml of ropivacaine 0.375% + mepivacaine 0.5% for axillary and supraclavicular block and 35 ml of ropivacaine 0.375% + mepivacaine 0.5% for triple nerve block (femoral, obturator and sciatic nerve). The cohort was divided into two groups based on sedation drugs used during surgery (dexmedetomidine, or group D, vs midazolam, or group M). All patients received postoperative 24-h analgesia consisting of 60 mg of ketorolac, 200 mg of tramadol and 4 mg of ondansetron. The primary outcome measured how many patients in the two groups required an analgesic rescue dose of pethidine and the time to first pethidine administration. To reduce confounding, we included patients in two groups with non-statistically different demo-anamnestic parameters and who received the same dose of intraoperative local anaesthetic and postoperative analgesia.

Results

The number of patients in group D who did not require a rescue dose of analgesia was significantly greater than in group M (49 vs 11, p < 0.001). Time-to-first postoperative opioid administration did not show a fundamental difference between the two groups under examination (523.75 ± 131.55 min vs 564 ± 117.84 min). Total opioid consumption was higher in the M group than in the D group (3529.8 ± 30.36 μg vs 1864.8 ± 31.59 μg, p 0.075), with a mean opioid consumption significantly higher in the M group than in the D group (26.26 ± 42.8 μg vs 69.21 ± 46.1 μg, p < 0.001): D group received 62.06% less opioid than M group.

Conclusions

The continuous infusion of dexmedetomidine during orthopaedic surgery performed under locoregional anaesthesia has been shown to increase the analgesic effect of local anaesthetics and reduce the consumption of major opioids in the postoperative period. Dexmedetomidine offers a unique ability to supply sedation and analgesia without respiratory depression, having a wide safety margin and an excellent sedative capacity. It does not increase the rate of postoperative complications.