bluuebunny/crossref_metadata_2025 huggingface dataset:
PEMANFAATAN METODE KANO UNTUK PENENTUAN PRIORITAS VARIABEL PADA SISTEM MANAJEMEN KESELAMATAN KONSTRUKSI PROYEK DI SURABAYA
Authors: Joanly Edvan Benefisco , Andi Andi , Rahardjo Jani
Published: May 2023

Mengetahui tingginya angka kecelakaan kerja konstruksi di Indonesia, perlu dilakukan peningkatan penerapan SMKK (Sistem Manajemen Keselamatan Konstruksi). Mengingat, peningkatan penerapan SMKK menjadi salah satu hal yang dapat mempengaruhi kepuasan owner yang mempengaruhi rekomendasi, serta hubungan baik dengan owner. Oleh karena itu, diperlukan penelitian yang bertujuan untuk mengetahui variabel SMKK preferensi penerapan oleh kontraktor untuk mengetahui kebutuhan dan keinginan owner. Kuesioner disebarkan pada 24 proyek gedung tinggi di Surabaya. Data hasil kuesioner diolah dengan analisa kano untuk mengetahui variabel preferensi pada SMKK serta perbandingan owner dan kontraktor. Dari hasil analisa kano, didapatkan variabel preferensi one-dimensional, attractive, must-be, dan indifferent, serta hasil perbandingan owner dan kontraktor dimana ditemukan perbedaan pada setiap elemen SMKK kecuali elemen evaluasi kinerja keselamatan konstruksi.
Ideologia neoliberal, trabalho docente e educação: uma reflexão sobre a lógica hegemônica na educação básica paraibana
Authors: Franca Diego , Jezine Edineide , Santana de Araújo Rhoberta
Published: May 2023

A reestruturação do capitalismo implica novos arranjos produtivos flexíveis e formas de desregulamentação. Na era financeirizada, os capitais veem na educação um difusor da racionalidade instrumental. Este artigo é fruto dos aprofundamentos teóricos realizados durante o pós-doutorado em Educação (PPGE/UFPB), entre 2021 e 2022. Com base em dados secundários e nos documentos oficiais, analisou-se a ascensão neoliberal na Educação Básica paraibana a partir do método Materialista Histórico-Dialético, desnudando a ideologia imersa no currículo. Tal racionalidade hegemônica expressa uma estratégia que tende a moldar a escola e o currículo, inserindo elementos que legitimam sociabilidades do mercado e um mundo do trabalho precário.
Sobre os limites de uma crítica ontológica incompleta dos métodos em economia
Authors: Martins Siqueira Álvaro
Published: May 2023

O objetivo deste artigo é defender a importância de uma crítica ontológica a economia do mainstream. O artigo propõe que, apesar de correto na lógica de seu argumento, a crítica de Tony Lawson aos métodos dedutivistas não é capaz de explicar as razões para a existência e reprodução do mainstream. E se é assim, a crítica de Lawson não é ontológica. Pode-se afirmar que um projeto de reorientação geral da metodologia econômica é impossível caso a necessidade social que a requer permaneça intacta. A presente leitura tem por referências o realismo crítico e a crítica ontológica do capitalismo feita por Marx.
Novos arranjos judiciais e a Pedagogia Histórico-Crítica para jovens infratores
Authors: Francisco Julio Cesar
Published: May 2023

O presente artigo apresenta um inédito perfil de adolescentes em conflito com a lei, em um município do interior do estado de São Paulo, bem como faz algumas aproximações da Pedagogia Histórico-Crítica - PHC no campo da Justiça Juvenil. Os resultados revelam a predominância de jovens brancos, da classe trabalhadora, periféricos, entre 14 e 17 anos, envolvidos com roubo e tráfico de drogas. A Justiça Juvenil tem priorizado sentenças na comunidade. Na perspectiva da PHC, defende-se a necessidade de valorizar a auto-organização juvenil, a educação coletiva e o acesso ao saber escolar, na relação com o trabalho social dos educadores executores de medidas socioeducativas.
A crítica da pedagogia socialista ao construtivismo: uma análise a partir da Psicologia Histórico-Cultural
Authors: Carvalho Saulo Rodrigues , Melo Alessandro
Published: May 2023

Este artigo tem como objetivo apresentar a crítica da pedagogia socialista aos pressupostos construtivistas a respeito da aprendizagem dos indivíduos. O construtivismo como teoria psicológica defende a aprendizagem ativa da criança num processo de adaptação ao meio. Deste modo, tende a naturalizar a aprendizagem delegando ao ensino um papel secundário e negativo. Apresentado como uma teoria crítica à pedagogia tradicional foi adotado como uma solução pedagógica para os problemas educacionais, acumulados por anos de negligencia das políticas sociais e educacionais do país. Com base na Psicologia Histórico Cultural e na Pedagogia Histórico-Crítica, compreende-se que a aprendizagem está inserida no desenvolvimento histórico social da humanidade e, portanto, é resultado do acúmulo da experiência histórica do gênero humano e da sua produção social. De tal modo, conclui-se que a construção de uma pedagogia socialista prescinde da apropriação teórica dos pressupostos construtivistas, uma vez que relegam os fundamentos socioculturais da aprendizagem, desvalorizando o papel da escola e da docência no processo de ensino aprendizagem da criança
Freud e Marx: entre a crítica da religião e a crítica do Estado
Authors: Carneiro de Carvalho Mayra , Manso de Barros Rita Maria
Published: May 2023

Em O futuro de uma ilusão, Freud analisa a natureza psíquica das ideias religiosas como ilusões e questiona se a relação dos indivíduos com o Estado e demais instituições não seria de caráter igualmente ilusório,  aproximando-se de Marx que afirma ser a relação do Estado e do Direito com a sociedade, no capitalismo, mediada por ilusões geradas pela inversão constituinte da realidade social, que faz com que estas instâncias apareçam como autônomas, independentes e necessárias frente à própria sociedade que as constituiu como tais. Em uma investigação histórico-lógica da natureza do Estado e do Direito, revela-se seu caráter essencialmente classista e ideológico determinado pelo capitalismo.
Concepções de professores da Educação de Jovens e Adultos sobre o fracasso escolar: uma análise à luz da perspectiva crítica em psicologia escolar fundamentada no pensamento marxista
Authors: Proença Rebello de Souza Marilene , Amorim Checchia Ana Karina , Dos Santos Gonçalves Raphael , Barone Victor
Published: May 2023

Este artigo objetiva analisar concepções de professores da Educação de Jovens e Adultos sobre o fracasso escolar, à luz da perspectiva crítica em Psicologia Escolar e Educacional, fundamentada no pensamento marxista. Para tanto, foram realizadas entrevistas individuais com dois professores de uma unidade escolar pública do CIEJA e dois professores de um projeto filantrópico em uma escola particular para estudantes da EJA. Os professores concebem o fracasso escolar como um fenômeno social e historicamente constituído e revelam ideais freirianos, por meio dos quais se concebe a Educação como prática de liberdade, especialmente na dimensão da Educação de Jovens e Adultos, marcada pela presença da exclusão social subjacente ao fracasso escolar produzido em uma sociedade de classe
Atividade. Consciência. Personalidade [Aleksei Nikoláievitch Leontiev]
Authors: Da Silva Ferreira Asbahr Flávia
Published: May 2023

Resenha do livro Atividade. Consciência. Personalidade, de Aleksei Nikoláievitch Leontiev.
Da fragmentação à unidade psicofísica na prática pedagógica
Authors: Silva Flávia Gonçalves da , Almeida Sandro Henrique Vieira de
Published: May 2023

Este ensaio tem por objetivo tecer algumas considerações que possibilitem melhor compreensão do corpo e psiquismo como unidade psicofísica e quais implicações tais apontamentos podem trazer para a prática pedagógica. As reflexões teóricas deste texto partirão dos estudos da psicologia histórico-cultural, especialmente proposições de Vigotski sobre a análise dos fenômenos em unidades e os estudos de Luria sobre os sistemas funcionais, que tem como base epistemológica o materialismo histórico e dialético. Tal discussão é pertinente para superar a fragmentação na forma de compreender o indivíduo – corpo e psiquismo; biológico e social -  de tal modo a orientar práticas pedagógicas emancipadoras.
Psicologia, educação e marxismo
Authors: Tuleski Silvana Calvo , Magalhães Giselle Modé , Da Silva Messeder Neto Hélio , Mennocchi Lauren Mariana
Published: May 2023

O presente dossiê Psicologia, Educação e Marxismo parte do princípio da necessidade de especificarmos a qual psicologia nos referimos, quais os objetivos da educação que defendemos e a qual corrente do marxismo estas se vinculam. Não é qualquer psicologia, e não é qualquer educação que nos interessa, mas sim a articulação de ambas tendo em vista a superação da sociedade de classes, o que demanda uma análise histórica radical, portanto, ancorada nos princípios do materialismo histórico e dialético de Marx. Interessa-nos construir uma ciência concreta, que atenda aos interesses da classe trabalhadora, compreendendo suas particularidades geográficas, históricas, de gênero e raça. Esperamos, com este número da revista, termos reunido parte da diversidade de temáticas, áreas e concepções teóricas que permeiam o campo da psicologia, educação e marxismo no Brasil. Estamos certos/as de que ainda há muito o que se fazer para superarmos não só a crise da psicologia ou os rumos da educação no país, mas, principalmente, a sociedade capitalista, determinante, em grande medida, destas contradições e conflitos. Se o caminho para a construção de uma sociedade humana e justa é longo e árduo, somente podemos atravessá-lo de forma fraterna e verdadeiramente coletiva, como vislumbramos realizar no debate que aqui se apresenta.
Pregnancy Intention, Changes in Pregnancy Intention, and Pregnancy Incidence Among Female Nurses in North America
Authors: Wang Siwen , Minguez-Alarcon Lidia , Capotosto Melissa Perez , Mitsunami Makiko , Gaskins Audrey J. , Charlton Brittany M. , Hart Jaime E. , Rich-Edwards Janet W. , Chavarro Jorge E.
Published: May 2023

Importance

Pregnancy intention assessment is a key element of preconception and contraceptive care. The association between a single screening question and the incidence of pregnancy is unknown.

Objective

To prospectively evaluate the dynamics of pregnancy intention and pregnancy incidence.

Design, Setting, and Participants

This prospective cohort study (the Nurses’ Health Study 3) was conducted from June 1, 2010, to April 1, 2022, in 18 376 premenopausal, nonpregnant female nurses aged 19 to 44 years.

Main Outcomes and Measures

Pregnancy intention and pregnancy status were assessed at baseline and approximately every 3 to 6 months thereafter. Cox proportional hazards regression models were used to estimate the association between pregnancy intention and pregnancy incidence.

Results

A total of 18 376 premenopausal, nonpregnant women (mean [SD] age, 32.4 [6.5] years) participated in the study. At baseline, 1008 women (5.5%) were trying to conceive, 2452 (13.3%) were contemplating pregnancy within 1 year, and the remaining 14 916 (81.2%) were neither trying to conceive nor thought they would be pregnant within 1 year. A total of 1314 pregnancies were documented within 12 months of pregnancy intention assessment. The cumulative incidence of pregnancy was 38.8% in women actively trying to conceive (median [IQR] time to pregnancy, 3.3 [1.5-6.7] months), 27.6% in women contemplating pregnancy (median [IQR] time to pregnancy, 6.7 [4.2-9.3] months), and 1.7% in women neither trying to conceive nor contemplating pregnancy (median [IQR] time to pregnancy, 7.8 [5.2-10.5] months) among those who became pregnant. Women who were actively trying to conceive were 23.1 times (95% CI, 19.5-27.4 times) and women who were contemplating pregnancy were 13.0 times (95% CI, 11.1-15.2 times) more likely to conceive within 12 months than women who were neither attempting nor contemplating pregnancy. Among women contemplating pregnancy at baseline who did not get pregnant during follow up, 18.8% were actively trying and 27.6% were not trying by 12 months. Conversely, only 4.9% of women neither trying to conceive nor contemplating pregnancy within 1 year at baseline changed pregnancy intention during follow up.

Conclusions and Relevance

In this cohort study of reproductive-aged nurses in North America, pregnancy intention was highly fluid among women who were contemplating pregnancy but relatively stable among women trying to conceive and women who were neither trying to conceive nor contemplating pregnancy. Pregnancy intention was strongly associated with pregnancy incidence, but the median time to pregnancy points to a relatively short time window to initiate preconception care.
The Role of Opioid Receptors in Cancer
Authors: Bhoir Siddhant , Uhelski Megan , Guerra‐Londono Juan Jose , Cata Juan P.
Published: May 2023

Opioids are one of the most potent drugs for treating moderate to severe pain. Despite irrefutable clinical application in chronic pain management, the long‐term use of opioids has been increasingly questioned due to undesired side effects that demand attention. Opioids such as morphine mediate clinically relevant effects primarily through the µ‐opioid receptor that go beyond their classical role as analgesics, causing potentially fatal side effects such as tolerance, dependence, and addiction. Furthermore, there is growing evidence that opioids affect immune system function, cancer progression, metastasis, and recurrence. Though a biological plausibility, the clinical evidence for the action of opioids on cancer is mixed, revealing a more complex picture as researchers struggle to establish a vital link between opioid receptor agonists, cancer progression, and suppression, or both. Thus, in light of the uncertainty of opioid effects on cancer, in this review, a focused overview of the role of opioid receptors in modulating cancer progression, their underlying signaling mechanisms, and the biological activity of opioid receptor agonists and antagonists is provided.
Tumor‐Specific Peroxynitrite Overproduction Disrupts Metabolic Homeostasis for Sensitizing Melanoma Immunotherapy
Authors: Yang Lijun , Wang Dianyu , Jia Haixue , Yang Cuihong , Zhang Yumin , Li Hui , Liu Jinjian , Liu Jianfeng
Published: May 2023

Tumor cells elicit metabolic reprogramming to establish an immunosuppressive tumor microenvironment (TME) for escaping from immunosurveillance. Therefore, interrupting the metabolic adaptation of tumor cells may be a promising strategy for TME immunomodulation, favoring immunotherapy. In this work, a tumor‐specific peroxynitrite nanogenerator APAP‐P‐NO is constructed that can selectively disrupt metabolic homeostasis in melanoma cells. Stimulated by melanoma‐characteristic acid, glutathione, and tyrosinase, APAP‐P‐NO can efficiently generate peroxynitrite through the in situ coupling of the produced superoxide anion and released nitric oxide. Metabolomics profiling reveals that the accumulated peroxynitrite induces a great decrease in metabolites in the tricarboxylic acid cycle. Meanwhile, the glycolysis‐produced lactate drops sharply both intracellularly and extracellularly under peroxynitrite stress. Mechanistically, peroxynitrite impairs the activity of glyceraldehyde‐3‐phosphate dehydrogenase in glucose metabolism through S‐nitrosylation. The metabolic alterations effectively reverse the immunosuppressive TME to evoke potent antitumor immune responses, including polarization of M2‐like macrophages to M1phenotype, reduction of myeloid‐derived suppressor cells and regulatory T cells, and restoration of CD8+ T cell infiltration. Combining APAP‐P‐NO with anti‐PD‐L1 achieves a significant inhibition against both primary and metastatic melanomas without systemic toxicities. Collectively, a tumor‐specific peroxynitrite overproduction approach is developed and the possible mechanism of peroxynitrite‐mediated TME immunomodulation is explored, providing a new strategy for facilitating immunotherapy sensitivity.
Improved Performance of Organic Thermoelectric Generators Through Interfacial Energetics
Authors: Petsagkourakis I. , Riera‐Galindo S. , Ruoko T.‐P. , Strakosas X. , Pavlopoulou E. , Liu X. , Braun S. , Kroon R. , Kim N. , Lienemann S. , Gueskine V. , Hadziioannou G. , Berggren M. , Fahlman M. , Fabiano S. , Tybrandt K. , Crispin X.
Published: May 2023

The interfacial energetics are known to play a crucial role in organic diodes, transistors, and sensors. Designing the metal‐organic interface has been a tool to optimize the performance of organic (opto)electronic devices, but this is not reported for organic thermoelectrics. In this work, it is demonstrated that the electrical power of organic thermoelectric generators (OTEGs) is also strongly dependent on the metal‐organic interfacial energetics. Without changing the thermoelectric figure of merit (ZT) of polythiophene‐based conducting polymers, the generated power of an OTEG can vary by three orders of magnitude simply by tuning the work function of the metal contact to reach above 1000 µW cm−2. The effective Seebeck coefficient (Seff) of a metal/polymer/metal single leg OTEG includes an interfacial contribution (Vinter/ΔT) in addition to the intrinsic bulk Seebeck coefficient of the polythiophenes, such that Seff = S + Vinter/ΔT varies from 22.7 µV K−1 [9.4 µV K−1] with Al to 50.5 µV K−1 [26.3 µV K−1] with Pt for poly(3,4‐ethylenedioxythiophene):p‐toluenesulfonate [poly(3,4‐ethylenedioxythiophene):poly(4‐styrenesulfonate)]. Spectroscopic techniques are used to reveal a redox interfacial reaction affecting locally the doping level of the polymer at the vicinity of the metal‐organic interface and conclude that the energetics at the metal‐polymer interface provides a new strategy to enhance the performance of OTEGs.
Developing Insoluble Polyoxometalate Clusters to Bridge Homogeneous and Heterogeneous Water Oxidation Photocatalysis
Authors: Hu Qiyu , Chen Shoushun , Wågberg Thomas , Zhou Hongshan , Li Shujun , Li Yiding , Tan Yilan , Hu Wenqi , Ding Yong , Han Xinbao
Published: May 2023

Cluster catalysts are attractive for their atomically precise structures, defined compositions, tunable coordination environments, uniform active sites, and their ability to transfer multiple electrons, but they suffer from poor stability and recyclability. Here, we report a general approach to the direct insolubilization of a water soluble polyoxometalate (POM) [{(B‐α‐PW9O34)Co3(OH)(H2O)2(O3PC(O)‐(C3H6NH3)PO3)}2Co]14− (Co7) and formation of a series of POM‐based solid catalysts with the counter‐cations Ag+, Cs+, Sr2+, Ba2+, Pb2+, Y3+, and Ce3+. They exhibit improved catalytic activities for visible‐light‐driven water oxidation following the trend CsCo7>SrCo7>AgCo7>CeIIICo7>BaCo7>YCo7>PbCo7. While CsCo7 exhibits mainly homogeneous catalysis, the others are predominantly heterogeneous catalysts. An optimal oxygen yield of 41.3 % and a high apparent quantum yield (AQY) of 30.6 % for SrCo7 is obtained, which is comparable to that of the parent homogeneous POM. Band gap structures, UV/Vis spectra, and real‐time laser flash photolysis experiments collectively suggest that easier electron transfer from the solid POM catalyst to the photosensitizer promotes photocatalytic water oxidation performance. These solid POM catalysts exhibit good stability, which is directly confirmed by a combination of Fourier‐transform infrared spectroscopy, electron microscopy, X‐ray diffraction patterns, Raman spectroscopy, X‐ray photoelectron spectroscopy, five cycles of tests, and poisoning experiments.
The spirit of time and the spirit of depth: Psychodynamic approaches in public mental health services in Israel
Authors: Lakh Elana
Published: May 2023

This article examines the interplay between psychodynamic psychotherapy and other approaches to psychotherapy in mental health services in Israel, describing the history of psychotherapy approaches, education and training, current dilemmas and service examples. Israel has a system of universal healthcare, education and social care which includes mental health services for all citizens and permanent residents. Mental health services and interventions are provided by psychiatrists, clinical psychologists, educational psychologists, social workers, clinical criminologists and creative arts therapists. Despite being public, accessibility is undermined by long waiting times, inequitable geographic distributions and cultural‐linguistic barriers. The interplay between approaches is clearly visible in public mental health services. Many therapists are trained primarily in psychodynamic approaches and receive psychodynamic‐oriented supervision. However, public services often cannot provide suitable conditions for psychodynamic oriented psychotherapy, and the therapists are required to adjust their interventions to treatment plans, reimbursement and reporting. This paper describes in detail two programs that implement psychodynamic approaches in the medical and education systems respectively. The first is “Lkol Nefesh” (“for every soul”) that provides long‐term intensive psychoanalytic psychotherapy for individuals suffering from severe mental disorders. The second is the system of creative arts therapies delivered in schools that provide psychotherapy as part of special education services. The paper concludes with a discussion of the influence of the spirit of time on psychotherapy, and the opposite tendencies evident in the state of affairs of psychodynamic psychotherapy in Israel.
Convergence properties concerning Lebesgue‐p norm of iterative learning control for a class of fractional differential systems
Authors: Li Lei
Published: May 2023

This paper investigates the monotonic convergence and speed comparison of first‐ and second‐order proportional‐α‐order‐integral‐derivative‐type (
type) iterative learning control (ILC) schemes for a linear time‐invariant (LTI) system, which is governed by the fractional differential equation with order
. By introducing the Lebesgue‐p (
) norm and utilizing the property of the Mittag‐Leffler function and the boundedness feature of the fractional integration operator, the sufficient condition for the monotonic convergence of the first‐order updating law is strictly analyzed. Therewith, the sufficient condition of the second‐order learning law is established using the same means as the first one. The obtained results objectively reveal the impact of the inherent attributes of system dynamics and the constructive mode of the ILC rule on convergence. Based on the sufficient condition of first/second‐order updating law, the convergence speed of first‐ and second‐order schemes is determined quantitatively. The quantitative result demonstrates that the convergence speed of second‐order law can be faster than the first one when the learning gains and weighting coefficients are properly selected. Finally, the effectiveness of the proposed methods is illustrated by the numerical simulations.
Life Sciences undergraduate students' preferences on online learning
Authors: Lee Zheng‐Wei
Published: May 2023

Online learning is implemented in response to emergency remote teaching during global pandemic. We conducted a survey on Life Sciences undergraduate students on their preferences on mode of lesson delivery, mode of learning and learning activities. Students across different study years responded in a similar order ranking blended learning delivery as highly favorable. The survey gathered insightful understandings on Life Sciences undergraduates' learning preferences on online learning which inform future purposeful learning design taking student's preferences into consideration.
Increasing the Selectivity of Light‐Active Antimicrobial Agents – Or How To Get a Photosensitizer to the Desired Target
Authors: Grimmeisen Michael , Jessen‐Trefzer Claudia
Published: May 2023

Photosensitizers combine the inherent reactivity of reactive oxygen species with the sophisticated reaction control of light. Through selective targeting, these light‐active molecules have the potential to overcome certain limitations in drug discovery. Ongoing advances in the synthesis and evaluation of photosensitizer conjugates with biomolecules such as antibodies, peptides, or small‐molecule drugs are leading to increasingly powerful agents for the eradication of a growing number of microbial species. This review article, therefore, summarizes challenges and opportunities in the development of selective photosensitizers and their conjugates described in recent literature. This provides adequate insight for newcomers and those interested in this field.
Computational Mechanistic Investigations of Biocatalytic Nitrenoid C−H Functionalizations via Engineered Heme Proteins
Authors: Zhang Yong , Chu Jia‐Min
Published: May 2023

Engineered heme proteins were developed to possess numerous excellent biocatalytic nitrenoid C−H functionalizations. Computational approaches such as density functional theory (DFT), hybrid quantum mechanics/molecular mechanics (QM/MM), and molecular dynamics (MD) calculations were employed to help understand some important mechanistic aspects of these heme nitrene transfer reactions. This review summarizes advances of computational reaction pathway results of these biocatalytic intramolecular and intermolecular C−H aminations/amidations, focusing on mechanistic origins of reactivity, regioselectivity, enantioselectivity, diastereoselectivity as well as effects of substrate substituent, axial ligand, metal center, and protein environment. Some important common and distinctive mechanistic features of these reactions were also described with brief outlook of future development.
Is a foreign accent a sign of bravery?
Authors: Mattar Mirabelle
Published: May 2023

Yale law professor Amy Chua once asked, “do you know what a foreign accent is? It's a sign of bravery.” As an immigrant with a foreign accent, I find this quote thought‐provoking and interesting to consider.
Unusual cause of cerebral calcifications in an 8‐year‐old girl
Authors: Boussetta Abir , Jellouli Manel , Maamouri Rym , Garagah Tahar
Published: May 2023

Key Clinical Message

Genetic counseling and genetic screening for hyperoxaluria should be recommended for children with urinary lithiasis for early management to avoid progression to oxalosis especially if there is a family history of lithiasis.

Primary hyperoxaluria type 1 (PH1) is caused by a deficiency of the liver peroxisomal enzyme alanine–glyoxylate aminotransferase (AGT) resulting in overproduction of calcium oxalates. In its later stage, a systemic deposit of calcium oxalates is observed. We present the case of an 8‐year‐old girl with exceptional neurological involvement secondary to this disease.
Left ventricular thrombus in a patient with recurrent ischemic stroke events—The role of echocardiography
Authors: Stylianou Vasiliki Vanesa , Tsampasian Vasiliki , Pavlou Marios , Georgiou Panagiota , Patestos Dimitrios , Kapetis Lorentzos , Vassiliou Vassilios S. , Eftychiou Christos , Tsielepis Michalis , Bazoukis George
Published: May 2023

Key Clinical Message

Cardiac ultrasound is recommended in investigating ischemic stroke events. There is increasing evidence that direct oral anticoagulants can be safely used instead of vitamin K antagonists in the setting of left ventricular thrombus.

Cardioembolic stroke is responsible for an increasing number of ischemic strokes. Compared to other causes of stroke, cardioembolic strokes affect a larger brain area. Left ventricular (LV) thrombi account for up to 10% of cardioembolic strokes. It is essential to identify patients at high risk of LV thrombus formation, such as patients with a history of myocardial infarction, patients with reduced ejection fraction, or patients with cardiomyopathies. We present a patient with an ischemic stroke, and the cardiac ultrasound revealed a reduced ejection fraction and the presence of LV thrombus at the apex. The patient had no prior history of cardiovascular diseases. Even in a resource‐limited setting, cardiac ultrasound is recommended to investigate stroke or transient ischemic attack events, especially in patients with a prior history of myocardial infarction. Although patients with LV thrombus should be treated with oral anticoagulants for at least 3 months, the role of direct oral anticoagulants and the optimal period of anticoagulation in this setting needs further investigation.
Biomarker‐Driven Developments in the Context of the New Regulatory Framework for Companion Diagnostics in the European Union
Authors: Verbaanderd Ciska , Trullás Jimeno Ana , Engelbergs Jörg , Zander Hilke , Reischl Ilona , Moreno Oliver Ana , Vamvakas Spiros , Vleminckx Camille , Bouygues Christelle , Girard Thomas , Day Francesca , Frias Zaide
Published: May 2023

The new In Vitro Diagnostic Regulation (EU) 2017/746 (IVDR) introduces important changes in the EU legal framework for companion diagnostics (CDx), including a new risk‐based classification system for in vitro diagnostic tests (IVDs), a first legal definition for CDx and enhanced involvement of notified bodies in the conformity assessment and certification process of CDx. The IVDR also establishes an important link between the assessment of a CDx and the corresponding medicinal product by requiring the notified body to seek a scientific opinion from the medicines regulator on the suitability of the CDx for use with the concerned medicinal product(s) before issuing an IVD certificate. Whereas the IVDR aims at establishing a robust regulatory framework for IVDs, it is also associated with several challenges, such as insufficient capacity of notified bodies and readiness of manufacturers. To ensure timely access for patients to essential IVDs, a progressive roll‐out for this new legislation has been introduced. In addition, the new consultation process for CDx requires increased collaboration and alignment of assessments performed by the different stakeholders involved in this process. The European Medicines Agency (EMA) and notified bodies are currently building experience based on the first CDx consultation procedures that have been submitted from January 2022 onward. In the current article, we describe the new European regulatory framework for certification of CDx and highlight several challenges for medicine and CDx co‐development. In addition, we briefly touch upon the interplay between the Clinical Trial Regulation (EU) No. 536/2014 (CTR) and the IVDR.
Macronutrient composition of sea otter diet with respect to recolonization, life history, and season in southern Southeast Alaska
Authors: LaRoche Nicole L. , King Sydney L. , Fergusson Emily A. , Eckert Ginny L. , Pearson Heidi C.
Published: May 2023

The sea otter (Enhydra lutris) population of Southeast Alaska has been growing at a higher rate than other regions along the Pacific coast. While good for the recovery of this endangered species, rapid population growth of this apex predator can create a human‐wildlife conflict, negatively impacting commercial and subsistence fishing. Previous foraging studies throughout the sea otter range have shown they will reduce invertebrate prey biomass when recolonizing an area. The goal of this study was to examine and quantify the energy content of sea otter diets through direct foraging observations and prey collection. Our study area, Prince of Wales Island in southern Southeast Alaska, exhibits a gradient of sea otter recolonization, thus providing a natural experiment to test diet change in regions with different recolonization histories. Sea otter prey items were collected in three seasons (spring, summer, and winter) to measure caloric value and lipid and protein content. We observed 3523 sea otter dives during the spring and summer. A majority of the sea otter diet consisted of clams. Sea otters in newly recolonized areas had lower diet diversity, higher energetic intake rates (EIR, kcal/min), and prey had higher energy content (kcal/g). Females with pups had the highest diet diversity and the lowest EIR. Sea otter EIR were higher in the fall and winter vs. spring and summer. Sea cucumber energy and lipid content appeared to correspond with times when sea otters consumed the highest proportion of sea cucumbers. These caloric variations are an important component of understanding ecosystem‐level effects sea otters have in the nearshore environment.
A systematic review and meta‐analysis of nonpharmacological interventions for children and adolescents with selective mutism
Authors: Hipolito Gino , Pagnamenta Emma , Stacey Helen , Wright Emily , Joffe Victoria , Murayama Kou , Creswell Cathy
Published: May 2023

Background

Selective mutism (SM) is an anxiety disorder that often starts in early years with serious and lasting consequences. Nonpharmacological interventions are commonly seen as the preferred first treatment. This systematic review identifies outcome measures used and outcomes achieved for nonpharmacological interventions for children and adolescents with SM.

Methods

Systematic searches were conducted using 13 electronic databases and hand searches, including peer‐reviewed and grey literature since 1992.

Results

Twenty‐five studies were identified. While specific measures varied, all studies reported an outcome measure for speaking behaviour and 18 used a measure of anxiety. Few studies reported measures of SM remission (k = 6), well‐being (k = 6), academic impact (k = 2), or quality of life (k = 1). Within subject outcomes for nonpharmacological interventions were variable for improvements in speaking behaviours (very small to large positive effects) and reduction in anxiety symptoms (very small negative to large positive effects). Only five randomised controlled trials (RCTs) were included in the meta‐analysis. Three studies compared a combined systems/behavioural approach with waitlist controls indicating a significant and large effect (Hedges g = 1.06, p < .0001, 95% CI: 0.57–1.56) on improved speaking behaviour. Two of these RCTs showed a large effect for SM remission favouring the intervention (Risk Ratio = 4.25, p = .1774, 95% CI: 0.52–34.84) but this did not reach statistical significance. Non‐significant outcomes for two RCTs with active controls (Hedges g = 0.55, p < .2885, 95% CI: −0.47 to 1.57) showed considerable heterogeneity in approach and outcomes, one with large and one with negligible effects.

Conclusion

Despite the considerable impairment caused by SM, there has been little systematic evaluation of non‐pharmacological interventions. Although combined systems/behavioural interventions are promising, further systematic evaluations are urgently needed to inform treatment approaches. Cross‐study measurement harmonisation is required to promote learning from all studies, including wider clinical and economic outcomes.

Clinical Trial Registration

Not applicable.
Optical profilometry for forensic bloodstain imaging
Authors: Vale Brayden , Orr Amanda , Elliott Colin , Stotesbury Theresa
Published: May 2023

Understanding the physical, chemical and biological changes that occur during the drying of a bloodstain is important in many aspects of forensic science including bloodstain pattern analysis and time since deposition estimation. This research assesses the use of optical profilometry to analyze changes in the surface morphology of degrading bloodstains created using three different volumes (4, 11, and 20 μL) up to 4 weeks after deposition. We analyzed six surface characteristics, including surface average roughness, kurtosis, skewness, maximum height, number of cracks and pits, and height distributions from the topographical scans obtained from bloodstains. Full and partial optical profiles were obtained to examine long‐term (minimum of 1.5‐h intervals) and short‐term (5‐min intervals) changes. The majority of the changes in surface characteristics occurred within the first 35 min after bloodstain deposition, in agreement with current research in bloodstain drying. Optical profilometry is a nondestructive and efficient method to obtain surface profiles of bloodstains, and can be integrated easily into additional research workflows including but not limited to time since deposition estimation.

Optical profilometry is a non‐contact tool to scan bloodstains in ambient conditions

Drying phases are observable in small drip bloodstains

Significant surface morphology changes occur within 35 min after deposition
Local orthogonality dimension
Authors: Attias Inon , Haviv Ishay
Published: May 2023

An orthogonal representation of a graph over a field is an assignment of a vector to every vertex of , such that for every vertex and whenever and are adjacent in . The locality of the orthogonal representation is the largest dimension of a subspace spanned by the vectors associated with a closed neighborhood in the graph. We introduce a novel graph parameter, called the local orthogonality dimension, defined for a given graph and a given field , as the smallest possible locality of an orthogonal representation of over . This is a local variant of the well‐studied orthogonality dimension of graphs, introduced by Lovász, analogously to the local variant of the chromatic number introduced by Erdös et al. We investigate the usefulness of topological methods for proving lower bounds on the local orthogonality dimension. Such methods are known to imply tight lower bounds on the chromatic number of several graph families of interest, such as Kneser graphs and Schrijver graphs. We prove that graphs for which topological methods imply a lower bound of on their chromatic number have local orthogonality dimension at least over every field, strengthening a result of Simonyi and Tardos on the local chromatic number. We show that for certain graphs this lower bound is tight, whereas for others, the local orthogonality dimension over the reals is equal to the chromatic number. More generally, we prove that for every complement of a line graph, the local orthogonality dimension over coincides with the chromatic number. This strengthens a recent result by Daneshpajouh, Meunier, and Mizrahi, who proved that the local and standard chromatic numbers of these graphs are equal. As another extension of their result, we prove that the local and standard chromatic numbers are equal for some additional graphs, from the family of Kneser graphs. We also study the computational aspects of the local orthogonality dimension and show that for every integer and a field , it is NP‐hard to decide whether the local orthogonality dimension of an input graph over is at most . We finally present an application of the local orthogonality dimension to the index coding problem from information theory, extending a result of Shanmugam, Dimakis, and Langberg.
Rudolph Hermann Lotze's philosophically informed psychology
Authors: Vagnetti Michele
Published: May 2023

This essay deals with four main topics: the notion of philosophical psychology; the idea that physical events and mental events cannot be compared to one another; psychophysical mechanism; and the theory of local signs. These are all key elements in the Medicinische Psychologie of Rudolph Hermann Lotze (1817‒1881). By philosophical psychology, Lotze understands not only the collection of experimental data regarding physiological and mental states but also their philosophical processing outlining an interpretation of the real nature of the mind‒body connection. Within this framework, Lotze introduces the psychophysical mechanism as based on a key philosophical idea: mind and body are incomparable, but, nevertheless, they are in reciprocal relation (Wechselwirkung). In virtue of said special relation, movements that take place in the mental sphere of reality are transferred or translated in the bodily sphere and vice versa. This rearrangement (Umgestaltung) from one sphere of reality to the other is termed by Lotze “transformation to equivalent.” Through the concept of equivalence, Lotze supports the idea that the mind and the body form an organic whole. However, psychophysical mechanisms should not be seen as not a fixed series of physical changes followed by an equally fixed series of mental changes: physical changes are “read,” organized, and then transformed by the mind into something purely mental. This, in turn, produces new mechanical force and more physical changes. Lotze's legacy and long‐term impact is finally read against the background of his contributions.
Oxymatrine ameliorates rheumatoid arthritis by regulation of Tfr/Tfh cell balance viatheTLR9‐MyD88‐STAT3 signaling pathway
Authors: Cao Gan , Mao Zhuhan , Niu Tengyao , Wang Peipei , Yue Xiaoqi , Wang Xuemei , Ma Ailing , Zhang Yanli
Published: May 2023

Background

Oxymatrine (OMT) is one of the authentic Chinese herbal medicines which has rich and complex active ingredients. however,the relevant potential targets of oxymatrine on rheumatoid arthritis and the mechanism remains unreported. The aim of this study was to determine the regulation of oxymatrine on rheumatoid arthritis using a collagen‐induced arthritis (CIA) mice models and blood samples from RA patients.

Results

Our results indicated that Tfr cells in RA patients express low levels of Blimp‐1 and CTLA‐4. Oxymatrine treatment of CIA mice alleviated joint swelling, reduced the arthritis score, and improved joint damage. While flow cytometry results showed that oxymatrine treatment reduced Tfh cells and B cells, and increased Tfr cells in the spleen of CIA mice. In addition, oxymatrine treatment significantly down‐regulated the expression of TLR9（Toll‐like Receptors 9), IL‐21, MyD88, STAT3, p‐STAT3, and CXCR5 in the synovial tissues of CIA mice, and up‐regulated the expression of Foxp3, Blimp‐1, and CTLA‐4.

Conclusion

Oxymatrine can alleviate rheumatoid arthritis by regulating the TLR9‐MyD88‐STAT3 signaling pathway to maintain immune balance between Tfr‐Tfh cells. © 2023 Society of Chemical Industry.
Astragaloside IV promotes keratinocyte proliferation and migration through upregulating lncRNA H19 recruited ILF3 to enhance the stability of CDK4 mRNA
Authors: Wang Dan‐Dan , Zhang Li‐Ze , Pang Cheng‐Jian , Ye Jian‐Zhou
Published: May 2023

Skin is the first line of the body to resist pathogen invasion. A potentially fatal infection may result from problems with wound healing. Small molecule drugs like astragaloside IV (AS‐IV) show pro‐healing activities, but the mechanisms are not fully understood. Using real‐time quantitative PCR and a western blot assay, the amount of gene expression was evaluated. The proliferation and migration of keratinocytes were determined by MTS and wound healing assay, respectively. The binding of lncRNA H19 to RBP protein ILF3 and the binding of ILF3 protein to CDK4 mRNA were confirmed by RNA immunoprecipitation. Treatment with AS‐IV enhanced the expression of lncRNA H19, ILF3, and CDK4 and improved the proliferation and migration of keratinocytes HaCaT. Additionally, apoptosis of keratinocytes was attenuated by AS‐IV. Further studies showed that both lncRNA H19 and ILF3 were important for AS‐IV‐mediated keratinocyte growth and migration. In addition, lncRNA H19 recruited ILF3 to increase CDK4 mRNA level and enhanced cell proliferation. We discovered a lncRNA H19/ILF3/CDK4 axis that is activated by AS‐IV to promote keratinocyte migration and proliferation. These results elucidate the mechanism of action of AS‐IV and justify its application in further application in wound healing treatment.
The Transverse Turbinate Line: A Reliable Landmark for the Maxillary Sinus Natural Ostium
Authors: Comer Julia C. , Hess Andrew O. , Rarey Kyle E. , Justice Jeb M. , Collins William O. , Lobo Brian C.
Published: May 2023

Objectives

Approximating the maxillary sinus natural ostium's (MSNO) natural position during anterograde surgery is challenging, as only a single visual “landmark,” the maxillary line, is routinely offered to guide the identification of the MSNO in three‐dimensional space. Despite almost 40 years of endoscopic sinus surgery (ESS) experience in North America, maxillary recirculation and discontinuity between the natural and surgical ostia are commonly encountered during revision ESS. Consequently, we feel an additional visual landmark would assist in localizing the MSNO with or without image guidance. In this study, we aim to provide a second reliable landmark in the sinonasal cavity.

Methods

We present a cadaveric anatomical landmark series that provides a second visual landmark for the MSNO, which we have labeled the transverse turbinate line (TTL): a 2‐millimeter zone of confidence for the craniocaudal positioning of the MSNO that can be combined with the anteroposterior (AP) landmark of the maxillary line.

Results

In our study, 40 cadaveric sinuses were dissected, and the TTL was found to correspond consistently with the zone between the superior and inferior aspects of the MSNO.

Conclusion

We anticipate that this second relational landmark may decrease the time required for anterograde access to the MSNO in trainees, increase the accuracy of identification, and translate to lower long‐term recirculation and maxillary surgery failure rates.

Level of Evidence

NA Laryngoscope, 133:3285–3291, 2023
Formulation for wave propagation in dissipative media and its application to absorbing layers in elastoplastic analysis using mathematical programming
Authors: Wang Liang , Zhang Xue , Tinti Stefano
Published: May 2023

In this article, we propose a new solution scheme for modeling elastoplastic problems with stress wave propagation in dissipative media. The scheme is founded on a generalized Hellinger–Reissner (HR) variational principle. The principle renders the discretized boundary‐value problem into an equivalent second‐order cone programming (SOCP) problem that can be resolved in mathematical programming using the advanced optimization algorithm—the interior point method. In such a way, the developed method not only inherits admirable features of the SOCP‐based finite element method in solving elastoplastic problems but also enables the enforcement of absorbing layers (i.e., Caughey absorbing layer), which is essential in modeling stress wave propagation problems, to absorb wave energy. The proposed scheme is validated via the comparison between analytical and numerical results for seismic wave propagation in dissipative media. Its application to elastoplastic dynamic problems with stress wave propagation is also illustrated to demonstrate its efficiency.
The Role of Nasal Endoscopy in the Preoperative Evaluation of Nasal Airway Obstruction
Authors: Gardiner Lauren A. , Goyal Lindsey K. , McCoy Jennifer L. , Gillman Grant S.
Published: May 2023

Objective

To examine the prevalence and nature of nasal endoscopic findings in patients referred for structural nasal obstruction, and analyze how such findings influence the preoperative evaluation or operative plan.

Study Design

Cross‐sectional study.

Setting

University‐based academic otolaryngology practice.

Methods

Nasal endoscopy was performed by a single surgeon and the exam findings were documented. Patient demographics, variables in the patient history, Nasal Obstruction Symptom Evaluation scores, and an Ease‐of‐Breathing Likert Scale were tested for associations with findings on endoscopy.

Results

A total of 82 of 346 patients (23.7%) had findings on rigid nasal endoscopy not appreciable on anterior rhinoscopy. Prior nasal surgery (p = .001) and positive allergy testing (p = .013) were significantly associated with findings on nasal endoscopy. Endoscopic findings prompted additional preoperative studies in 50 (14.5%) patients, and a change in the operative plan in 26 (7.5%) patients.

Conclusion

In patients referred for surgical management of nasal obstruction, findings on nasal endoscopy otherwise undetected with anterior rhinoscopy are most common in but certainly not limited to those with prior nasal surgery or allergic rhinitis. Routine nasal endoscopy should be considered for all patients being evaluated for nasal airway surgery. These results may benefit future updates of the clinical consensus statements regarding the role of nasal endoscopy in the evaluation of nasal valve compromise and septoplasty.