bluuebunny/crossref_metadata_2025 huggingface dataset:
Roda de conversa sobre medicamentos em um centro de atenção psicossocial em Salvador/BA: relato de experiência
Authors: Brandao Isabelle de Araujo , Oliveira Bruna Santos de , Alves João Batista de Brito Braga , Almeida Juliane Odette de Borba , Santos Dejoan da Cruz , Silva Ana Carolina Pinto da , Souza Márcio Costa , Conceição das Merces Magno Conceição das
Published: October 2022

Introdução: Considerando a Reforma Psiquiátrica e o desenvolvimento dos psicofármacos que mudaram o modo de produzir cuidado em saúde mental, por reduzirem a autonomia do sujeito, faz-se necessário discutir o uso racional da terapia medicamentosa, pois atualmente ocupa lugar central no tratamento dos usuários. Objetivo: Descrever a experiência das rodas de conversa sobre medicamentos e seu planejamento em um Centro de Atenção Psicossocial tipo II de Salvador/BA, a partir da vivência de profissionais residentes. Métodos: Trata-se de um relato de experiência de quatro residentes do Programa de Residência Multiprofissional em Saúde, da Universidade do Estado da Bahia, Núcleo de Saúde Mental, no período de abril a agosto de 2019. Resultados: Ao total foram realizadas nove rodas de conversa e nove reuniões de planejamento e avaliação, onde houve o estabelecimento de espaço protegido para os momentos de escuta e reflexão, promovendo maior segurança dos usuários para conversarem com seus profissionais de referência sobre seu projeto farmacoterapêutico. Conclusão: Foi possível observar melhor vinculação dos usuários e familiares com a unidade; discutir terapia medicamentosa, uso racional dos medicamentos com toda a equipe e fortalecer o SUS. Essa atividade acarretou também na ampliação da oferta do profissional farmacêutico no serviço.
Matemaattisen ongelmanratkaisun aktivoimat tunnereflektiot ja niiden fasilitointi alkuopetuksessa
Authors: Toikka Susanna , Eronen Lasse , Atjonen Päivi , Havu-Nuutinen Sari
Published: October 2022

Matematiikan ongelmanratkaisutilanteita voidaan hyödyntää tunnereflektion eli oppimiseen kohdentuvien tunteiden tarkastelun harjoittelemisessa. Tämä tutkimus tarkastelee, 1) millaisia oppimiseen kohdentuvia tunteita ongelmanratkaisutilanne aktivoi perusopetuksen ensimmäisen ja toisen vuosiluokan oppilaiden (N=23) ongelmanratkaisun sekä matematiikan ja sen opiskelun reflektioissa sekä 2) miten itsearviointitaitojen harjoitteluun kehitetty Arviointimaa-kuva fasilitoi oppilaiden tunnereflektioita. Tutkimuksen aineisto tuotettiin matemaattisella ongelmanratkaisu-tehtävällä sekä haastatteluilla. Ongelmanratkaisutilanne tarjosi alkuopetusikäisille luontevia mahdollisuuksia tunteiden moni-puoliselle ja ikäsidonnaiselle reflektoinnille. Haastattelukysymysten muoto vaikutti oppilaiden taitoon reflektoida; toisen vuosiluokan oppilaat reflektoivat ongelmanratkaisuprosessin herättämiä tunteita ensimmäisen luokan oppilaita monipuolisemmin. Eläytyminen Arviointimaahan fasilitoi tunne- ja metatunne-reflektioiden kuvaustapaa, sisältöä ja ilmaisua. Tutkimus vahvistaa, että ongelmanratkaisun, matematiikan ja sen opiskelun synnyttämien tunteiden kielentäminen tarjoaa alkuopetuksessa otollisen tilaisuuden reflektion harjoittelemiselle.
Evli Bireylerde Erken Dönem Uyumsuz Şemalar ve Sorun Çözme Becerilerinin Evlilik Doyumu İle İlişkisi
Authors: Üzerek İzel , Şarlak Deniz
Published: October 2022

Çalışmada erken dönem uyumsuz şemaların ve sorun çözme becerilerinin evlilik doyumu ile ilişkisinin incelenmesi amaçlanmıştır. Bu amaç doğrultusunda gönüllü 368 evli bireye Sosyo-demografik Form, Young Şema Kısa Form-3, Evlilikte Sorun Çözme, Evlilik Yaşamı ölçekleri uygulanmıştır. Katılımcıların %51.9’unu kadın, %41.8’i 31-40 yaş, %80.4’ü çalışmakta olduğu ve %39.9’unun evlilik süresi 1-5 yıl arasında değişmektedir. Katılımcıların %54.9’u çocuk sahibidir. Sorun çözme becerileri ile evlilik doyumu ile arasında pozitif yönde anlamlı bir ilişki bulunmuştur. Evlilik doyumu ile erken dönem uyumsuz şemalara ait alt boyutlar ve toplam puan arasında negatif yönde anlamlı bir ilişki saptanmıştır. Sorun çözme becerileri ile erken dönem uyumsuz şemalara ait toplam puan ve erken dönem uyumsuz şemalara ait alt boyutlar arasında negatif yönde anlamlı bir ilişki bulunmuştur. Erken dönem uyumsuz şemalara ait duygusal yoksunluk, sosyal izolasyon/güvensizlik ve tehditler karşısında dayanıksızlık şemalarının evlilik doyumu arasında negatif yönde anlamlı bir ilişki bulunmuştur. Erken dönem uyumsuz şemalar ve sorun çözme becerilerinin evlilik doyumu üzerinde etkili olduğu tespit edilmiştir. Çalışmanın, evlilik doyumu ile ilgili yapılacak gelecekteki araştırmalara katkı sağlaması hedeflenmektedir.
Management of Moderate-to-Severe Atopic Dermatitis in the Era of Targeted Treatments
Authors: Coates Sam
Published: October 2022

Prof Augustin opened the symposium by underlining how the management of patients with moderate-to-severe atopic dermatitis (AD) has become more dynamic over the past 2 years following the approval of the first biologic agent, dupilumab, in 2017. Prof Augustin explained that moderate-to-severe AD is a chronic Type II inflammatory disease that has significant effects on patients’ and caregivers’ lives. The multidimensional disease burden of AD, which includes signs and symptoms that impact physical, mental, social wellbeing, and quality of life (QoL), is proportional to disease severity and lack of disease control. Sustained control of moderate-to-severe AD is essential to limit the burden caused by the disease. In the second presentation, Dr Simpson emphasised the importance of pointing out to each patient that AD is a chronic disease that requires long-term management. When discussing goals and treatment options with each patient, the importance of sustainable disease management should be emphasised. He presented outcomes from recent clinical trials investigating the long-term efficacy and safety of targeted agents in patients with AD. In the final presentation, Dr de Bruin-Weller discussed the importance of real-world evidence when considering treatment options for patients with AD. Real-world evidence for the effectiveness and tolerability of treatments can be gleaned from a number of sources, including registry-based clinical experience, survey data, centre-based clinical experience, and case studies. Consideration of real-world evidence, alongside outcomes from randomised controlled trials, enables selection of the most appropriate treatment option for each patient.
Functional Mitral Regurgitation: If the Myocardium Is Guilty Do We Also Need to ‘Rehabilitate’ the Valve?
Authors: Pepe Martino , Paradies Valeria , Resta Fabrizio , Cafaro Alessandro , Bartolomucci Francesco , Masi Filippo , Quagliara Donato , Favale Stefano
Published: October 2022

Mitral regurgitation (MR) is the most frequent valvulopathy in the general population with an incidence that grows with age and is associated with a poor prognosis. Regardless of its primary cause, which can be both ischaemic and non-ischaemic cardiomyopathy, it finally activates a self-feeding process. Due to the complexity of mitral valve (MV) apparatus and its interaction with the myocardium, even the diagnosis could represent a challenge for physicians. Higher technological instruments such as 3D echocardiography and cardiac magnetic resonance could play an important role in the evaluation of MV. In this paper we reviewed the most salient aspects of functional MR pathophysiology as well as the current diagnostic methods. The management of functional mitral regurgitation (FMR) is even more challenging and controversial; the optimal approach, timing, and effectiveness of interventions are still debated. Treatment of FMR begins with optimal medical therapy for left ventricular dysfunction, including cardiac resynchronisation when indicated. While functional improvement after surgery is well established, the benefits in terms of survival are still questionable. Moreover, in patients with high perioperative risk there is a growing interest in emerging percutaneous techniques. Among a variety of medical, surgical, and percutaneous opportunities, authors support an accurate case-by-case evaluation to find a tailored and stepwise treatment according to anatomical features and patient comorbidities.
Cost-Effectiveness of a Novel Self-Apposing Stent in ST-Segment Elevation Myocardial Infarction (STEMI) in France
Authors: Annemans Lieven , Silvain Johanne , Montalescot Gilles
Published: October 2022

The objective was to calculate the cost-effectiveness profile of STENTYS compared to conventional bare and drug-eluting stents (DES). Stents are widely used in the treatment of patients with ST-segment elevation myocardial infarction (STEMI). However, several reports point to the prevailing risk of coronary events such as recurrent myocardial infarction, some of which are related to in-stent thrombosis, possibly explained by poorly apposed stents. 1-year results of the self-apposing stent, STENTYS, are promising regarding the incidence of fatal and non-fatal cardiovascular (CV) events. A model was developed to simulate costs and quality-adjusted life years (QALYs) over 1-5 years. In the first 12 months, a decision tree framework was used to define different CV outcomes for STEMI patients receiving a stent. After 12 months, outcomes were categorised in a Markov stage of the model as myocardial infarction (MI), other CV events, revascularisation, and death. Cost of comparative treatments and follow-up in relation to CV events were calculated from the French health insurance perspective. The results indicated, in the base case, over a time horizon of 5 years, that STENTYS bare metal stent (BMS) is dominant (less costly and more QALYs) against conventional DES. The STENTYS DES is dominant compared with conventional DES and very cost-effective versus BMS. The results were robust for different variations in the input variables. This first analysis of the cost-effectiveness of STENTYS showed that it is dominant or very costeffective as compared to conventional stents. Further comparative research and longer follow-up data are needed to expand on these results.
Circulating Haemoglobin Levels and the Risk of Atherosclerosis in Asian Indian Populations
Authors: Patel Jeetesh V. , Flinders Paul J. , Vyas Avni , Glover Imogen , Rajan Avithra J. , Prabhakaran Dorairaj , Bhatnagar Deepak , Srinath Reddy K. , Mackness Michael I. , Cruickshank J. Kennedy , Hughes Elizabeth A. , Durrington Paul N.
Published: October 2022

Background: The global burden of coronary heart disease (CHD) is estimated to be the highest on the Indian subcontinent. The pathophysiology of this increased risk is complex, multifactorial, and its magnitude increases with migration from India to Britain. Haemoglobin disorders, which also frequent this ethnic group, have been linked to cardiovascular disease. We investigated the impact of migration and nutritional intake on haematological parameters amongst South Asians, with a focus on their relation to molecular indices of oxidative atherogenesis.
Methods: Haematology, diet, oxidised low-density lipoprotein (LDL), and serum paraoxonase activity were measured in 230 migrant Indian Gujaratis (Britain), and 305 matched contemporaries living in rural villages (India).
Results: Median levels of haemoglobin were higher amongst migrant men (14.5 µmol/l) compared to rural men (15.0 µmol/l, P=0.004) and higher in migrant women (12.7 µmol/l) compared to rural women (11.8 µmol/l, P<0.001). Irrespective of site, haemoglobin levels in South Asians were positively associated with high blood pressure, high serum cholesterol, low high density lipoprotein (HDL) cholesterol levels, and increased CHD risk scores (P<0.001). Haemoglobin concentrations were higher amongst migrants compared to rural contemporaries (P<0.001). In rural women, red cell volume was lower, and co-ordinated with lower levels of oxidised LDL compared with migrant women (P<0.001). On multivariate analysis, haemoglobin was independently associated with oxidised LDL (P=0.001) and paraoxonase activity (P=0.025).
Conclusion: Levels of haemoglobin were independently associated with indices of atherogenesis in our populations of rural and migrant Indians. Iron availability may underline the pathogenesis for the oxidative modification of LDL in this group.
Considering Tomorrow in Today’s Treatment Choice of Women Living with Psoriasis
Authors: Rowe Annie
Published: October 2022

This symposium explored the challenges of plaque psoriasis that are more prevalent in, or specific to, women, in terms of burden, treatment needs, and treatment options. This theme was introduced by Prof Augustin who described the social and emotional burden of plaque psoriasis and gender differences in relation to its impact and treatment expectations. Many areas, such as relationships, sexual activity, childbearing, and educational and career prospects can be affected in women, and as well as possible disease progression, need to be considered when discussing therapeutic options with the patient. Dr Egeberg outlined the certolizumab pegol (CZP) plaque psoriasis clinical trial programme. Three-year treatment results from the CIMPASI 1 and 2, and CIMPACT Phase III trials, showed that the clinical responses previously reported for moderate-to-severe plaque psoriasis with CZP 200 mg every other week (Q2W) or 400 mg Q2W for up to 48 weeks were well maintained over 3 years, with no new safety signals observed, underpinning the durability of the efficacy profile of CZP. Aligned with the unique Fc-free structure of CZP, clinical findings of no-to-minimal transfer of CZP from mother to infant or into breast milk, mean that CZP could be used during pregnancy if clinically needed and post-partum. Dr McBride described the profound life-impact of plaque psoriasis specifically in women and why it is essential to understand their needs and life goals when exploring treatment options. She discussed the importance of reviewing family planning and conception plans at every visit in case of changes in treatment needs. Immediate and future life plans, including the impact of pregnancy, childbirth, and the postpartum period, need to be considered when exploring treatment options with the patient. Women with plaque psoriasis face significant challenges and there is a need for long-term, effective treatments that are compatible with pregnancy and breastfeeding.
Advances and Latest Insights in Non-Biologic Systemic Therapeutic Agents in Psoriasis and Atopic Dermatitis
Authors: Boyes Bronwyn
Published: October 2022

Prof Peter van de Kerkhof, Radboud University Nijmegen Medical Centre, the Netherlands, discussed the very long history, particularly in Germany and the Netherlands, of dimethyl fumarate (a fumaric acid ester [DMF]) in treating psoriasis in adults. However, only recently, with a new DMF product registration in Europe, has clinical research escalated to investigate the most effective clinical use of this agent. Treatment strategies in patients with psoriasis should be personalised, with considerations of the disease, patient characteristics and preferences, as well as current and historical treatments. He presented a case scenario to highlight which patients might benefit most from DMF as a first-line systemic treatment for moderate-to-severe psoriasis. He further discussed the role of acitretin (a synthesised retinoic acid) as monotherapy in pustular psoriasis and erythrodermic psoriasis, and in combination for chronic plaque psoriasis. He concluded that in patients requiring systemic therapy with contraindications for immunosuppressive therapies, DMF and acitretin may provide a unique profile and treatment solution.
The representation of migrants in Spanish judicial decisions: using corpus data to refute hate speech
Authors: Pérez María José Marín , Almela Ángela
Published: October 2022

The phenomenon of immigration and its depiction in media texts have been examined profusely within the field of corpus-based discourse analysis ( Gabrielatos and Baker, 2008 ; Baker et al., 2013 ; and Blinder and Allen, 2016 ). This research seeks to present it as reflected in a corpus of 600 judicial decisions issued by Spanish courts in the years 2016 and 2017. This analysis was motivated by the rise of extreme right-wing parties in Europe in recent years. Such parties dehumanise immigrants and portray them as a threat to the welfare state. On first examination, the results appear to dissociate immigration and crime since a considerable percentage of the keywords obtained (about 20 percent) revolves around three major topoi (namely, ‘family’, ‘territory/access’ and ‘legal punishment’) and there is no evidence of any major offences or crimes amongst the top-ranking lexicon. The study of the collocate networks of the keywords within the category ‘legal punishment’ confirms our initial perception; in fact, out of twenty-one collocates, only the word delito (‘crime’) itself collocates with terms referring to typified crimes such as violencia (‘violence’). In parallel, the data were triangulated using the text-classification software UMUTextStats ( García-Díaz et al., 2018 ). The results of this second analysis also confirm our initial observations.
Reporting local cultures in the globalised world: how indigenised can English be in the free world?
Authors: Ali Sadia , Thompson Paul
Published: October 2022

This paper presents a corpus-based analysis of English newspaper reportage in two South Asian countries, Pakistan (where English was introduced through colonisation) and Afghanistan (which has not been colonised), and their comparison with British newspaper reportage. The objective of this study is to analyse linguistic variation between the cultural press reportage (cpr) of the selected countries and to see which variety of English, Pakistani or Afghan, resembles British English the most. To achieve this objective, three English newspapers from each country were selected for the compilation of a specialised corpus which was analysed with reference to the five textual dimensions introduced by Biber (1988 , 2006 ). This research is significant as no previous study has attempted to find the differences and similarities between the Englishes used in a formerly colonised country and a country that was never part of the British Empire. The comparison indicates that Pakistani cpr is close to British cpr, while Afghan cpr is different. In terms of Biber’s five textual dimensions, Afghan cpr is more informational, narrative, explicit and abstract, and less non-argumentative in comparison with British and Pakistani cpr.
Operation Heron: latent topic changes in an abusive letter series
Authors: Busso Lucia , Petyko Marton , Atkins Sarah , Grant Tim
Published: October 2022

The paper presents a two-part forensic linguistic analysis of an historic collection of abuse letters, sent to individuals in the public eye and individuals’ private homes between 2007 and 2009. We employ the technique of structural topic modelling (stm) to identify distinctions in the core topics of the letters, gauging the value of this relatively under-used methodology in forensic linguistics. Four key topics were identified in the letters, ‘Politics A’ and ‘B’, ‘Healthcare’ and ‘Immigration’, and their coherence, correlation and shifts in topic were evaluated. Following the stm, a qualitative corpus linguistic analysis was undertaken, coding concordance lines according to topic, with the reliability between coders tested. This coding demonstrated that various connected statements within the same topic tend to gain or lose prevalence over time, and ultimately confirmed the consistency of content within the four topics identified through stm throughout the letter series. The discussion and conclusions to the paper reflect on the findings and also consider the utility of these methodologies for linguistics and forensic linguistics in particular. The study demonstrates real value in revisiting a forensic linguistic dataset such as this to test and develop methodologies for the field.
Risk factors for intravesical recurrence after radical nephrourethrectomy in upper urinary tract urothelial tumors: retrospective single-center study
Authors: Kargı Taner , Ekşi Mithat
Published: October 2022

Objective: We examined factors predicting metachronous recurrence of bladder cancer in our series of patients who underwent radical nephroureterectomy (RNU) for upper system urothelial carcinoma (UTUC). Material and Methods: Patients with UTUC-induced RNU in our center from September 2009 to March 2020 were included in the study. Patients were classified as having and not having an intravesical recurrence (IVR), and the factors predicting recurrence were evaluated. Results: A total of 50 patients were included in the study. IVR was developed in 19 (38%) of 50 patients, with a mean follow-up of 39.5 ± 25.3 months. There was no significant difference between the two groups in demographic characteristics, admission hemoglobin, glomerular filtration rate, and degree of hydronephrosis in preoperative ureterorenoscopy and cytology positivity history (p>0.05). The IVR (+) group had significantly more previous history of bladder cancer (35.5% vs. 52.6%, p=0.019, respectively). While the number of patients with ureteral tumors was 10 (32.3%) in the IVR (-) group, it was 9 (47.4%) in the IVR (+) group, and it was significantly higher. There are 28 (56%) patients with T2-T4 pathology in the entire patient group, and the rate is significantly greater in the IVR (+) group (63.2% vs. 51.6%, p=0.038, respectively). Conclusion: Caution should be exercised for metachronous bladder cancer recurrence in patients with a previous history of bladder cancer, especially in ureteral and high pathological T-stage UTUCs.
A STUDY ON MODELING OF CONFLICT AND AGREEMENT WITH GAME THEORY
Authors: ÇAPIN Haşim , KONCA Şükran
Published: October 2022

Game theory is a mathematical approach to analyze the state of competition between players. The foundations of this theory go back about 170 years, and the main development of the subject is based on the last 55 years. In this study, the effect of game theory on political elections and political behaviors has been examined. The Nash equilibrium is investigated by creating a mathematical model of the gains and losses that two political parties obtain in the elections according to the coalition formation status of two political parties by using the Prisoners' Dilemma game model in cooperative and non cooperative games.
ON $D_4$ INVARIANTS OF POLYNOMIAL ALGEBRAS
Authors: FINDIK Şehmus , ÖĞÜŞLÜ Nazar Şahin
Published: October 2022

Let $D_4$ be the dihedral group of order $8$. In the present study, we give generators of the algebra of $D_4$ invariants in the polynomial algebra with four generators over a field of characteristic zero.
HIGH-PERFORMANCE NETWORK APPLICATION FOR CREATING PERSONALIZED VIDEOS AND AUDIOS USING MLT
Authors: Heinrich Marius
Published: October 2022

Nowadays, many marketing campaigns are based on personalized marketing, so a solution should be found for the core problem, namely the creation of this content. More and more software solutions are based on proprietary products where the licenses for commercial use are unclear. A solution has now been found for this, which is made available to all people as open source technology. The concept is based on the Media Lovin’ Toolkit which is a framework written in C++ that uses XML files to create finished videos that have previously been designed in a conventional editor. In the XML file, however, the most diverse parameters can be changed before processing, which makes this framework a perfect problem solver.
Climate Risk Decision-making: Translation of Decision Support into Policy
Authors: Mackie Erik , Connon Irena L.C. , Workman Mark , Gilbert Alyssa , Shuckburgh Emily
Published: October 2022

Despite mounting evidence and warnings of current and future climate risks, climate policy in the UK and globally falls far short of achieving the required reductions in greenhouse gas emissions needed to stave off the risks posed by climate change, and limit global warming to 1.5C. The science on climate risk is strong, but the policy response is currently lacking in effectiveness. Why are the plethora of climate risk assessments and decision support tools available to decision-makers not always translating into effective policy action on climate risk? What are the challenges, complexities and uncertainties associated with this translational process, and how can we improve the research translation pipeline in order to achieve more effective decision-making on climate policy? These are some of the key questions that this UK Universities Climate Network report aims to address, through a combination of literature review, case study assessment and input from stakeholder workshops.
The regulation of totipotency transcription: Perspective from in vitro and in vivo totipotency
Authors: Xu Haiyan , Liang Hongqing
Published: October 2022

Totipotency represents the highest developmental potency. By definition, totipotent stem cells are capable of giving rise to all embryonic and extraembryonic cell types. In mammalian embryos, totipotency occurs around the zygotic genome activation period, which is around the 2-cell stage in mouse embryo or the 4-to 8-cell stage in human embryo. Currently, with the development of in vitro totipotent-like models and the advances in small-scale genomic methods, an in-depth mechanistic understanding of the totipotency state and regulation was enabled. In this review, we explored and summarized the current views about totipotency from various angles, including genetic and epigenetic aspects. This will hopefully formulate a panoramic view of totipotency from the available research works until now. It can also help delineate the scaffold and formulate new hypotheses on totipotency for future research works.
Methodological approaches to assess climate vulnerability and cumulative impacts on coastal landscapes
Authors: Olivares-Aguilar Isabel C. , Sánchez-Dávila Gabriel , Wildermann Natalie Elizabeth , Clark Dana , Floerl Lisa , Villamizar Estrella , Matteucci Silvia D. , Muñoz Sevilla Norma Patricia , Nagy Gustavo J.
Published: October 2022

Natural and human-induced hazards and climatic risks threaten marine and coastal ecosystems worldwide, with severe consequences for these socio-ecological systems. Therefore, assessing climate vulnerability (exposure, sensitivity and adaptive capacity) and the cumulative environmental impacts of multiple hazards are essential in coastal planning and management. In this article, we review some approaches used in climate vulnerability assessment and marine and coastal cumulative environmental impacts to learn about state-of-the-art on the subject. Besides, we qualitatively evaluated the climatic vulnerability of five coastal regions of Venezuela using the IPCC concept of Reasons for Concern (RFCs) to determine their level of climatic exposure. We also assessed the cumulative environmental impact of multiple stressors on marine and terrestrial ecosystems using a well-known impact assessment method partially modified to explore the feasibility of this model in data-poor areas. However, we found no standardization of the methodologies used in evaluating Coastal Climate Vulnerability or Cumulative Environmental Impacts in coastal landscapes or frameworks that operationally link them with socio-ecological systems. Most studied coastal regions are at risk from at least three RFCs, loss of unique ecosystems (RFC1), risks associated with extreme events (RFC2) and risks associated with global aggregate impacts (RFC4). Furthermore, the assessment showed that areas with accumulated impact cover about 10 percent ranging from moderate to high in urban areas, growth zones, industrial oil settlements, port areas and aquaculture areas with fishing activity. Moreover, areas with moderate to low cumulative impact cover half of the study area, dominated by uninhabited regions and vegetation of the thorny scrub and coastal grassland types. Therefore, we consider it essential to implement regional climate risk management that incorporates these assessments into the ordinance in countries that are particularly vulnerable to climate change, such as Venezuela, which has an extensive line of low-lying coastlines (where 60% of the country's population lives) and coastal regions with harsh climates and poor economic conditions. Finally, we present the scope and limitations of implementing these evaluations and highlight the importance of incorporating them into regional strategies for adaptation to climate change.
Differentiating between cardiac amyloidosis and hypertrophic cardiomyopathy on non-contrast cine-magnetic resonance images using machine learning-based radiomics
Authors: Jiang Shu , Zhang Lianlian , Wang Jia , Li Xia , Hu Su , Fu Yigang , Wang Xin , Hao Shaowei , Hu Chunhong
Published: October 2022

Objectives

This study aimed to determine whether texture analysis (TA) and machine learning-based classifications can be applied in differential diagnosis of cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) using non-contrast cine cardiac magnetic resonance (CMR) images.

Methods

In this institutional review board-approved study, we consecutively enrolled 167 patients with CA (n = 85), HCM (n = 82), and 84 patients with normal CMR served as controls. All cases were randomized into training [119 patients (70%)] and validation [48 patients (30%)] groups. A total of 275 texture features were extracted from cine images. Based on regression analysis with the least absolute shrinkage and selection operator (LASSO), nine machine learning models were established and their diagnostic performance determined.

Results

Nineteen radiomics texture features derived from cine images were used to differentiate CA and HCM. In the validation cohort, the support vector machine (SVM), which had an accuracy of 0.85, showed the best performance (MCC = 0.637). Gray level non-uniformity (GLevNonU) was the single most effective feature. The combined model of radiomics texture features and conventional MR metrics had superior discriminatory performance (AUC = 0.89) over conventional MR metrics model (AUC = 0.79). Moreover, results showed that GLevNonU levels in HCM patients were significantly higher compared with levels in CA patients and control groups (P < 0.001). A cut-off of GLevNonU ≥ 25 was shown to differentiate between CA and HCM patients, with an area under the curve (AUC) of 0.86 (CI:0.804–0.920). Multiple comparisons tests showed that GLevNonU was significantly greater in LGE+, relative to LGE-patient groups (CA+ vs. CA- and HCM+ vs. HCM-, P = 0.01, 0.001, respectively).

Conclusion

Machine learning-based classifiers can accurately differentiate between CA and HCM on non-contrast cine images. The radiomics-MR combined model can be used to improve the discriminatory performance. TA may be used to assess myocardial microstructure changes that occur during different stages of cardiomyopathies.
Hydrogen sulfide against preeclampsia exposure-induced oxidative mitochondrial damage in HTR-8/SVneo cells
Authors: Wang Xianli , Yu Shaokun , Jian Yuting , Pan Hongmin , Guo Jiannan , Wu Jian , Guo Wei
Published: October 2022

Extravillous trophoblast invasion disorder caused by oxidative stress is involved in the pathogenesis of preeclampsia (PE). In order to identify whether hydrogen sulfide (H2S) can prevent oxidative stress injury in extravillous trophoblasts. HTR-8/SVneo cells were detected by H2S inhibiting H2O2 induced oxidative mitochondrial damage. Reactive oxygen species (ROS) were detected, as well as malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD). JC-1 detected the potential of the mitochondrial membrane in this experiment. Then to detect the expression level of the apoptosis-inducing protein B-cell lymphoma-2 (Bcl-2) associated X protein (Bax), caspase 3, p53, p-p53, the apoptosis-inhibiting protein Bcl-2, PRAP, and the mitochondria fission protein Drp1, p-Drp1. CCK-8 assay, it was demonstrated that cell proliferation in the NaHS group was significantly higher than that in the Mod group, indicating that H2S may induce cell proliferation. Transwell assay elucidated that cell invasion in the NaHS group was recovered compared to the Mod group. ROS concentration no matter in cells or mitochondria was decreased by NaHS, which we could get from the comparison between the Mod group, PAG group, and NaHS group. The concentration of MDA was significantly lower in the NaHS group, and the concentration of SOD was extremely high in the NaHS group. Utilized JC-1 to detect mitochondrial membrane potential and found that cells from the NaHS group had a stable potential while cells from the Mod group and PAG group partly lost their potential, which could demonstrate that NaHS could maintain mitochondrial membrane potential. The western blot results revealed that p-Drp1 had a significant decline in the NaHS group, which means mitochondria fission was decreased in the NaHS group. The expression level of Bax and caspase 3 was significantly lower than in the Mod group and PAG group, and the expression level of Bcl-and PRAP was significantly higher in the NaHS group. That could prove that NaHS protect HTR-8/SVneo cell by inhibiting cell apoptosis. These promising results show that H2S elicits its effects on cell apoptosis by decreasing ROS concentration, maintaining mitochondrial membrane stability, and promoting apoptosis-inhibiting protein expression in cells.
Comparative analysis of instantaneous wave-free ratio and quantitative real-time myocardial contrast echocardiography for the assessment of myocardial perfusion
Authors: Liang Li , Zhu Yongxiang , Li Fangfang , Guo Kai , Chang Shang , Li Qian , Zhang Yaojun , Li Dongye
Published: October 2022

Background and hypothesis

The field of coronary artery physiology is developing rapidly and changing the practice of interventional cardiology. A new functional evaluation technique using the instantaneous wave-free ratio (iFR) has become an alternative to fractional flow reserve. Future research studies need to determine whether physiological indicators play a role in evaluating myocardial perfusion in the catheter room.

Materials and methods

Thirty-eight patients scheduled for coronary angiography and iFR evaluation underwent a real-time myocardial contrast echocardiography (RT-MCE) examination at rest. The myocardial perfusion parameters (A, β, and A × β) on the myocardial perfusion curve were quantitatively analyzed using Q-Lab software. Coronary angiography and iFR assessment were completed within 1 week after the RT-MCE examination in all patients. Correlation analysis was used to identify iFR- and MCE-related indicators. The sensitivity and specificity of iFR in the quantitative detection of coronary microcirculation were obtained.

Results

The correlation coefficients between iFR and A, β, and A × β were 0.81, 0.66, and 0.82, respectively. The cut-off value for iFR was 0.85 for microvascular ischemia detection, while the sensitivity and specificity for the diagnosis of myocardial perfusion were 90.7 and 89.9%, respectively. The receiver operating characteristic (ROC) curve area for iFR was 0.946 in the segments related to myocardial blood flow.

Conclusion

The iFR is an effective tool for detecting myocardial microcirculation perfusion, with satisfactory diagnostic performance and a demonstrated role in physiological indices used for the perfusion assessment.
Reconstructing rainfall using dryland dunes: Assessing the suitability of the southern Kalahari for unsaturated zone hydrostratigraphies
Authors: Stone Abi , Zeng Yijian , Yu Lianyu , van der Ploeg Martine , Wanke Heike
Published: October 2022

Time-series of dryland rainfall over 100–1000 s of years are scarce but are needed to underpin improved predictions under future climate change. Dryland sand dunes are established Quaternary geomorphic archives, which also contain pore moisture as part of the unsaturated zone (USZ), with chemical tracers that provide a novel proxy for palaeomoisture. Chloride depth profiles, converted using a mass balance approach to temporal records, are known as hydrostratigraphies. Evaporative enrichment of meteoric chloride occurs in the near-surface zone and the established signature gets transported vertically via infiltration. This study explores the potential for this approach for southern Kalahari vegetated linear dunes comparing twelve (10–12 m deep) hydrostratigraphies across space and sampled in different years (2011, 2013, and 2016). Three further profiles sampled close to an interdune pan demonstrate that additional chloride is added locally to the dune closest to the pan. The remaining hydrostratigraphies show variable trends, with four broad groupings, leading us to suggest this region is unsuitable for this approach. Insights into this variable behavior were sought from simulating liquid and vapor flux using STEMMUS (Simultaneous Transfer of Energy, Mass and Momentum in Unsaturated Soil). Simulations suggest the mixing zone can reach 10 m thick, which helps account for the variation in hydrostratigraphies. Heterogeneity may also arise from spatially-heterogenous receipt of convective rainfall events and non-uniform vegetation cover. Furthermore, the vegetated nature of the landscape leads to less uniform moisture movement within the dune sands. We call for future applications to include site-specific insights into moisture dynamics.
Riverine microplastic contamination in southwest Germany: A large-scale survey
Authors: Schrank Isabella , Löder Martin G. J. , Imhof Hannes K. , Moses Sonya R. , Heß Maren , Schwaiger Julia , Laforsch Christian
Published: October 2022

Microplastic (MP) contamination of freshwater ecosystems is still in the focus of research and public attention, as aquatic environments have a high ecological, economic, and recreational value. We now know that rivers do not only function as pathways of MPs into oceans but may also act as temporary MP sinks. However, due to methodological differences, the comparability of studies on MP contamination of rivers is still limited. To compare MP contamination between different river systems, to analyze if there is a constant increase in MP contamination from the upper to the lower course of the river, and to investigate if there are distinct MP distribution patterns, we set up a large-scale survey. We chose two large river systems, the Rhine and Danube catchments with their tributaries and sampled 23 rivers of different sizes at 53 sampling locations in southwest Germany. Surface water sampling, sample processing, and analysis were performed with the same methodology to obtain comparable results on MP number, polymer type, and particle’s size and shape. Fully quantitative data were generated down to 300 µm by using a manta trawl net with a 300-µm mesh size for sampling. Nevertheless, we also included the non-quantitative sampled fraction of particles down to a size of 20 µm in our FTIR analysis after plastic-friendly sample purification by enzymatic oxidative treatment. Plastic concentrations recorded in surface water at the sampling locations ranged from 0.7 to 354.9 particles/m³. Concerning all samples, the number of particles increased toward lower size classes (61.0 ± 34.2% below 300 µm), and fragments were the prevailing shape (90.7 ± 13.6%). Polyethylene (49.2 ± 25.9%) and polypropylene (33.2 ± 22.6%) were the most frequent polymer types. Our survey did not reveal distinct MP distribution patterns or a constant increase of MP abundance within river courses in the investigated river systems. Next, to provide a large-scale dataset of microplastic contamination in surface waters of southwest Germany, our study shows that a representative sampling of MPs in rivers is challenging. MP particles are not homogeneously distributed in rivers, and this indicates that spatial and temporal changes in MP abundance should always be considered in MP monitoring approaches.
Health career exploration through science, technology, engineering, and mathematics pipeline programming
Authors: Brew Ranelle L. , Pokorski Emily , Scheidel Tess , Scherf Brian , Agee Kathy , DeJong Pamela
Published: October 2022

Developing effective programs that aim to generate student interest in the pursuit of a career in healthcare is vital to avoid shortages among the workforce. As the American population ages, the country will continue to experience a higher demand for healthcare-trained individuals and services. Exposing racially diverse students to career options and the educational requirements early can serve as a pipeline for increasing interest in obtaining careers in healthcare professions overall. Program formatting resembles “summer camps” as it provides students with educational opportunities outside of the typical school curriculum. These summer camp designed “programs” have been an effective method of increasing interest because it can provide hands-on exposure to healthcare careers, an opportunity to job shadow, and tour local healthcare facilities. Summer camps aimed to fill the gaps and increase interest in healthcare careers for underrepresented minority students. The literature identifies a few exploration camps across the United States, each with a data collection method unique to the program. This study examines the impact a summer health exploration camp can have on student efficacy and the effectiveness of generating student interest, in diverse populations, in the pursuit of a health-related career.
Integrated analysis of fibroblasts molecular features in papillary thyroid cancer combining single-cell and bulk RNA sequencing technology
Authors: Li Wei , Liu Zhiyong , Cen Xiaoxia , Xu Jing , Zhao Suo , Wang Bin , Zhang Wei , Qiu Ming
Published: October 2022

Background

Papillary thyroid cancer (PTC) is the most common pathological type of thyroid cancer with a high incidence globally. Increasing evidence reported that fibroblasts infiltration in cancer was correlated with prognostic outcomes. However, fibroblasts related study in thyroid cancer remains deficient.

Methods

Single-cell sequencing data of PTC were analyzed by Seurat R package to explore the ecosystem in PTC and identify fibroblasts cluster. The expression profiles and prognostic values of fibroblast related genes were assessed in TCGA dataset. A fibrosis score model was established for prognosis prediction in thyroid cancer patients. Differentially expressed genes and functional enrichment between high and low fibrosis score groups in TCGA dataset were screened. The correlation of immune cells infiltration and fibrosis score in thyroid cancer patients was explored. Expression levels and prognostic values of key fibroblast related factor were validated in clinical tissues another PTC cohort.

Results

Fibroblasts were highly infiltrated in PTC and could interact with other type of cells by single-cell data analysis. 34 fibroblast related terms were differentially expressed in thyroid tumor tissues. COX regression analysis suggested that the constructed fibrosis score model was an independent prognostic predictor for thyroid cancer patients (HR = 5.17, 95%CI 2.31-11.56, P = 6.36E-05). Patients with low fibrosis scores were associated with a significantly better overall survival (OS) than those with high fibrosis scores in TCGA dataset (P = 7.659E-04). Specific immune cells infiltration levels were positively correlated with fibrosis score, including monocytes, M1 macrophages and eosinophils.

Conclusion

Our research demonstrated a comprehensive horizon of fibroblasts features in thyroid cancer microenvironment, which may provide potential value for thyroid cancer treatment.
Distinguishing the lipid profile of GCK-MODY patients and its correlation with hsCRP levels
Authors: Ping Fan , Fu Junling , Xiao Xinhua
Published: October 2022

Aims

Glucokinase–maturity-onset diabetes of the young (GCK-MODY) is the most common monogenic diabetes in China. We have previously reported on the low levels of high-sensitivity C-reactive protein (hsCRP) in patients with GCK-MODY. In this study, we further explored the correlation between the serum lipid profiles and hsCRP levels of patients with different types of diabetes. We also proposed to determine the possible mechanism of macrovascular protection in GCK genetic variants.

Methods

The serum lipid profiles of the GCK-MODY group (n = 50) were compared with those of the hepatocyte nuclear factor-1 alpha (HNF1A)-MODY group (n = 19), the type 1 diabetes (T1D) group (n = 50), and the type 2 diabetes (T2D) group (n = 54). The associations between the lipid compositions and the hsCRP levels in each group were also explored.

Results

Elevated levels of high-density lipoprotein cholesterol (HDL-C) were found in the GCK-MODY group (1.5 ± 0.27) compared with the T1D (1.2 ± 0.47, p < 0.01) and T2D (1.3 ± 0.3, p < 0.01) groups. On the other hand, a significantly lower LDL-C level (2.4 ± 0.69) in the GCK-MODY group compared with the T1D (2.7 ± 0.72, p < 0.01) and T2D (2.9 ± 0.68, p < 0.01) groups was also noted. A lower ratio of triglyceride to HDL-C (TG/HDL) and a lower hsCRP level were also found in the GCK-MODY group [TG/HDL = 0.38 (0.25–0.52), hsCRP = 0.2 mg/L (0.16–0.37)] compared with the T1D group [(TG/HDL = 0.56 (0.39–1.29), hsCRP = 0.56 mg/L (0.39–1.29), p < 0.01] and the T2D group [(TG/HDL = 1.6 (1.1–2.68), hsCRP = 1.11 mg/L (0.66–2.34), p < 0.01]. Although patients with HNF1A-MODY showed similar hsCRP levels [0.17 (0.08–0.52), p > 0.05] compared with the patients in the GCK-MODY group, they had higher TG levels [1.01 (0.66–1.76), p < 0.05] and TG/HDL ratios [0.84 (0.56–1.31), p < 0.05]. Analysis of the correlations between the hsCRP levels and lipid profiles of each group confirmed that the LnhsCRP (natural logarithm-transformed hsCRP level) was positively correlated with the LnTG (natural logarithm-transformed TG) (r = 0.352, p = 0.011) and the Ln(TG/HDL) ratio (r = 0.283, p = 0.047) only in individuals with GCK-MODY.

Conclusions

Individuals harboring GCK variants have the characteristics of protective lipid profiles manifested as a higher level of HDL-C and a lower level of LDL-C compared with type 1 and 2 diabetes milletus (T1DM and T2DM, respectively) patients. In addition, lower ratios of TG/HDL were found to be associated with the inhibition of secretion of hsCRP, even when adjusted for the HbA1c levels in patients with GCK-MODY. It is suggested that the protective effect of macrovascular complications in GCK-MODY patients might partly be due to their unique lipid profiles associated with the suppression of inflammation.
Prognostic model for the exemption of adjuvant chemotherapy in stage IIIC endometrial cancer patients
Authors: Yang Xi-Lin , Yang Feng-Leng , Kou Ling-Na , Wu Da-Jun , Xie Cong
Published: October 2022

Background

This study aimed to develop a nomogram to predict the survival for stage IIIC endometrial cancer (EC) patients with adjuvant radiotherapy (ART) alone and personalize recommendations for the following adjuvant chemotherapy (ACT).

Methods

In total, 746 stage IIIC EC patients with ART alone were selected from the Surveillance, Epidemiology, and End Results (SEER) registry. Cox regression analysis was performed to identify independent risk factors. A nomogram was developed accordingly, and the area under the receiver operating characteristic curve (AUC) and C-index were implemented to assess the predictive power. The patients were divided into different risk strata based on the total points derived from the nomogram, and survival probability was compared between each risk stratus and another SEER-based cohort of stage IIIC EC patients receiving ART+ACT (cohort ART+ACT).

Results

Five independent predictors were included in the model, which had favorable discriminative power both in the training (C-index: 0.732; 95% CI: 0.704–0.760) and validation cohorts (C-index: 0.731; 95% CI: 0.709–0.753). The patients were divided into three risk strata (low risk <135, 135 ≤ middle risk ≤205, and high risk >205), where low-risk patients had survival advantages over patients from cohort ART+ACT (HR: 0.45, 95% CI: 0.33–0.61, P < 0.001). However, the middle- and high-risk patients were inferior to patients from cohort ART+ACT in survival (P < 0.001).

Conclusion

A nomogram was developed to exclusively predict the survival for stage IIIC EC patients with ART alone, based on which the low-risk patients might be perfect candidates to omit the following ACT. However, the middle- and high-risk patients would benefit from the following ACT.