bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Correlates of Serious Injuries among Adolescents in Mauritius
Authors: Mireku Dickson Okoree , Sarfo Jacob Owusu , Ansah Edward Wilson , Apaak Daniel , Armah Comfort
Published: December 2021

Introduction. Injuries are a major global health problem that affects teenagers in many countries. Though several studies have been done in many countries, little is known among adolescents in Mauritius. Therefore, our paper explored the prevalence and correlates of serious injuries among adolescents in Mauritius. Methods. We analysed the 2017 Global School-Based Student Health Survey (GSHS) data from Mauritius, using the Chi-square test and binomial logistic regression analysis with adjusted odds ratio (AOR) at 95% confidence interval (CI). Results. The prevalence of serious injuries among adolescents in Mauritius stood at 39.0%. Also, the predictors of serious injuries included sex (AOR = 0.70, CI = 0.58–0.81), physical attack (AOR = 0.47, CI = 0.39–0.57), being bullied (AOR = 0.48, CI = 0.48–0.70), suicide ideation (AOR = 0.65, CI = 0.49–0.85), hunger (AOR = 0.65, CI = 0.48–0.86), truancy from school (AOR = 0.77, CI = 0.63–0.93), marijuana use (AOR = 0.54, CI = 0.39–0.76), alcohol consumption (AOR = 0.64, CI = 0.70–0.98), and parental neglect (AOR = 0.83, CI = 0.70–0.98). Conclusion. The rate of injury among adolescents in Mauritius is moderately high, with sex, suicidal thought, hunger, truancy, drug use, and parental neglect as correlates. There is an urgent need for health promotion interventions at family, community, and school levels to deal with this level of serious injuries and the factors influencing such occurrences among these adolescents in Mauritius.
Recent Duplications Dominate VQ and WRKY Gene Expansions in Six Prunus Species
Authors: Zhong Yan , Wang Ping , Zhang Xiaohui , Cheng Zong-Ming
Published: December 2021

Genes encoding VQ motif-containing (VQ) transcriptional regulators and WRKY transcription factors can participate separately or jointly in plant growth, development, and abiotic and biotic stress responses. In this study, 222 VQ and 645 WRKY genes were identified in six Prunus species. Based on phylogenetic tree topologies, the VQ and WRKY genes were classified into 13 and 32 clades, respectively. Therefore, at least 13 VQ gene copies and 32 WRKY gene copies were present in the genome of the common ancestor of the six Prunus species. Similar small Ks value peaks for the VQ and WRKY genes suggest that the two gene families underwent recent duplications in the six studied species. The majority of the Ka/Ks ratios were less than 1, implying that most of the VQ and WRKY genes had undergone purifying selection. Pi values were significantly higher in the VQ genes than in the WRKY genes, and the VQ genes therefore exhibited greater nucleotide diversity in the six species. Forty-one of the Prunus VQ genes were predicted to interact with 44 of the WRKY genes, and the expression levels of some predicted VQ-WRKY interacting pairs were significantly correlated. Differential expression patterns of the VQ and WRKY genes suggested that some might be involved in regulating aphid resistance in P. persica and fruit development in P. avium.
A New Method of Identifying Graphite Based on Neural Network
Authors: Liu Guangjun , Xu Xiaoping , Yu Xiangjia , Wang Feng
Published: December 2021

The unique physical properties of graphite enable it to be applied in various fields of the national economy and people’s livelihood, which has very important industrial value. Many countries have listed graphite as a key mineral. To promote the transformation of the mining industry to informatization and intelligence, the realization of the intelligent recognition of graphite is particularly critical. Aiming at the problems of long time and low efficiency in manually identifying graphite, an improved AlexNet convolution neural network is proposed for graphite image recognition. First, we perform image preprocessing on the data set by means of random cropping, horizontal flipping according to probability, and normalization processing to achieve the purpose of data enhancement. Then we use the activation function ReLU6 to compress the dynamic range to make the algorithm more robust, using the batch standardization algorithm for normalization to speed up the convergence speed, modifying the size of the convolution kernel to enhance the generalization ability, and adding dropout regularization to the fully connected layer to further prevent overfitting. Finally, in the simulation experiment, compared with the existing method, the given method reduces the loss value and improves the average accuracy of identifying graphite.
Reconfigurable Intelligent Surface‐Based Space‐Time Block Transmission on 6G
Authors: Song Wei , Guan Bing
Published: December 2021

Reconfigurable intelligent surface (RIS) is considered to be a new technology with great potential and is being studied extensively and deeply. And the application extension of STBC in the RIS‐aided scheme provides a new train of thought for the research of channel coding. In this paper, we propose we extend the scheme of using the RIS to adjust the phase and reconfigure the reflected signal and propose the design of the RIS‐aided QO‐STBC scheme and the RIS‐aided QO‐STBC scheme with interference cancellation. Particularly in the RIS‐aided QO‐STBC scheme with interference cancellation, the design can achieve the transmission of the full rate and full diversity using an auxiliary reflection group to eliminate the influence of interference term. Also, the advantages and disadvantages of the schemes are analyzed in the paper, and the decoding algorithms with different complexity used in the proposed schemes are described. The simulation results show that the performance of the RIS‐aided QO‐STBC scheme with interference cancellation is better than that of the RIS‐aided QO‐STBC scheme and the RIS‐aided Alamouti scheme by about 5 dB and 7 dB at 10−3 BER because of diversity gain and coding gain.
Simplified Calculation Method for Seismic Active Earth Pressure of Translational Retaining Wall considering Soil Arching Effect
Authors: Wang Zheng-zhen , Kou Rang-cheng , Zhou Yong , Ma Tian-zhong
Published: December 2021

At present, most seismic earth pressure theories have the limitations of complex derivation process and difficult solution. To solve these problems, considering the deflection of small principal stress caused by soil arching effect, the central arc soil arch was approximated to two inclined linear soil arches, which can greatly simplify the derivation process. Firstly, by improving the combination of differential thin‐layer element method and pseudostatic method, the theoretical formulas of seismic active earth pressure intensity, resultant force size, and resultant force action point under translation mode (T mode) were derived and were verified by experimental results. Then, the influence of soil internal friction angle, wall‐soil friction angle, and seismic coefficient on seismic active earth pressure theory was analyzed. The results show that the seismic active earth pressure is nonlinearly distributed, and the seismic horizontal coefficient has a greater influence than other influence factors. The theoretical results can provide reference for the seismic design of retaining wall.
Study on Development Risk of Overseas Transportation Infrastructure under the New Form Based on Interpretive Structure Model
Authors: Ou Liang , Ma Chongsen , Chen Yun , Zhang Jing
Published: December 2021

With the improvement of China’s comprehensive national strength, more and more construction enterprises began to undertake overseas construction projects. Under the premise of the epidemic situation and the increasingly severe international situation, it is of great significance to study the risk control of overseas transportation infrastructure construction. This paper constructs the risk influencing factor model of overseas transportation infrastructure development risk in the new form from six aspects, that is, decision‐making risk, design and planning risk, construction risk, operation risk, government risk, and force majeure, and uses the interpretative structure model and fuzzy comprehensive evaluation method. The key factors affecting the risk of overseas transportation foundation design and development are studied, and the adaptive solutions are put forward.
Correlation between Changes in Serum RBP4, hs-CRP, and IL-27 Levels and Rosuvastatin in the Treatment of Coronary Heart Disease
Authors: Wang Yali , Zhou Changrui , Yu Tianlian , Zhao Feng
Published: December 2021

Objective. To investigate the correlation between changes in serum RBP4, hs-CRP, and IL-27 levels and rosuvastatin in the treatment of coronary heart disease (CHD). Methods. One hundred and twenty patients with CHD admitted in our hospital were selected as the research object, including 60 patients with acute coronary syndrome as the ACS group, and 60 patients with stable angina as the SA group. Another 60 patients without CHD who were examined in our hospital at the same time were included in the non-CHD group. The patients with CHD were further divided into the control group (CG) (n = 42, with routine treatment) and the study group (SG) (n = 78, with routine treatment and rosuvastatin) to measure serum RBP4, hs-CRP, and IL-27 levels and analyze the correlation between each index and rosuvastatin in the treatment of CHD. Results. After retrospective analysis, no significant difference was found among the ACS group, the SA group, and the non-CHD group (

P

 > 0.05). As for serum RBP4, hs-CRP, and IL-27 levels, ACS group > SA group > non-CHD group, with obvious differences among groups (

P

 < 0.05). After Spearman correlation analysis, a positive correlation was observed between Gensini score and serum RBP4, hs-CRP, and IL-27 levels in patients with CHD (

P

 < 0.05). After treatment, serum RBP4, hs-CRP, and IL-27 levels were gradually reduced. At 4 weeks after treatment, serum RBP4, hs-CRP, and IL-27 levels of the CG and the SG were decreased conspicuously, and compared with the control, each index of the SG was obviously lower (

P

 < 0.05). Conclusion. Serum RBP4, hs-CRP, and IL-27 play an important role in the occurrence and development of CHD, with a positive correlation to the Gensini score, which can indicate the severity of cardiovascular disease to a certain extent. Meanwhile, rosuvastatin can remarkably reduce serum RBP4, hs-CRP, and IL-27 levels, which is of significance for prognosis.
Using the Internet of Things Mobile to Keep the User’s Back Straight While Sitting
Authors: Elshaweesh Omar , Wedyan Mohammad , Alturki Ryan , Ali Hashim
Published: December 2021

Spine and neck pain is the most common type of pain experienced by people whose work requires sitting for long hours during the day. Therefore, many of them resort to dealing with this matter in several ways, and these methods differ in their effectiveness and negative effects. In this paper, we designed a device to alert the user to the need to adjust their sitting and to generate an alert when they are sitting inappropriately. When trying this device, the results were promising and accurate in terms of the results of the sequential reading of the movement of the flexible sensor, which helps the system to give alerts at the right time in the event of curvature of the spine, in addition to the ease of use of this device.
The Effects of Sishen Wan on T Cell Responses in Mice Models of Ulcerative Colitis Induced by Dextran Sodium Sulfate
Authors: Li Ke , Dong Jiamin , Ge Dongyu , Li Mengjia , Ye Hehe , Wang Xudan , Wu Ying
Published: December 2021

Currently, it is unclear whether Sishen Wan (SSW) could modulate the balance of Th1 cells, Th17 cells, and Tregs and we evaluated the effects of SSW on T cell responses in mice models of ulcerative colitis (UC). The mice models of acute UC (4% dextran sodium sulfate (DSS), 8 days) and chronic UC (3% DSS, 16 days) with SSW were assayed. Colon tissues were collected for immunohistochemical analysis, enzyme linked immunosorbent assay (ELISA), and flow cytometry (FCM). The expressions of cytokines associated with Tregs, transcription factors of Th17 cells, the frequencies of Th1 cells, Th17 cells, and Tregs, and the functional plasticity of Th17 cells were detected. The frequency of IFN-γ+ T cells was not changed significantly with SSW treatment in acute DSS. In chronic models, the frequency of IFN-γ+ T cells was downregulated with SSW. Meanwhile, the levels of RORγt and the frequency of IL-17A+ Th17 cells showed no significant differences after SSW treatment. Despite no significant effect on the transdifferentiation of Th17 cells in chronic UC models, SSW transdifferentiated Th17 cells into IL-10+ Th17 cells and downregulated IFN-γ+ Th17 cells/IL-10+ Th17 cells in acute DSS. Moreover, there were no significant changes of cytokines secreted by Tregs in acute DSS after SSW treatment, but SSW facilitated the expressions of IL-10 and IL-35, as well as development of IL-10+ Tregs in chronic DSS. SSW showed depressive effects on the immunoreaction of Th17 cells and might promote the conversion of Th17 cells into IL-10+ Th17 cells in acute UC, while it inhibited the excessive reaction of Th1 cells, facilitated the development of Tregs, and enhanced the anti-inflammatory effects in chronic UC.
Early Insulin Resistance, Type 2 Diabetes, and Treatment Options in Childhood
Authors: Polidori Nella , Mainieri Francesca , Chiarelli Francesco , Mohn Angelika , Giannini Cosimo
Published: December 2021

Background: Type 2 diabetes (T2D) represents just the tip of the iceberg of the complex metabolic alterations associated with obesity and other clinical conditions associated to impaired adipose tissue storage. Summary: Available data have suggested the presence of a continuous spectrum of metabolic alterations developed in the progression from insulin resistance (IR) to T2D, most of which are likely preventable through the early characterization of all the multiple risk factors involved. Therefore, the complete characterization of the natural history of the disease and the major modifiable factors represents a milestone in the daily care of young subject at risk for the development of impaired glucose metabolism early in life. This review will focus on the main components defining the risk of IR and T2D in childhood with a specific focus on the main aspects of treatment options available in children and adolescents. Key messages: Impaired adipose tissue storage documented in obesity results in a continuous spectrum of metabolic alterations ranging from IR to T2DM. These metabolic alterations are mostly likely preventable through the early characterization of all the multiple risk factors involved. The complete characterization of the disease and of the major modifiable factors represent a milestone in the daily care of young subject at risk for the development of impaired glucose metabolism early in life.
Ten Famous Composers of the Romantic Era and Their Causes of Death
Authors: Pauwels Ernest K.J.
Published: December 2021

The musical composers in the Romantic Era (1800–1910) strived for compositions that expressed human life, including happiness, harmony, and despair. They lived in a period in which freedom of thought, expression of emotion, and inspiration by nature predominated. During this period, intensive trading with other parts of the world brought new microorganisms along, which made infections and epidemics very common. This article serves to address the cause of death and relevant biographic data of a number of well-known Romantic composers. Primarily, this review refers to clinically significant findings using reports that were retrieved from PubMed, Embase, and Google over the 19th, 20th, and 21st centuries till 14th June 2021. This text dwells on diseases and the cause of death of ten composers, namely Mozart, Beethoven, Chopin, Schubert, Schumann, Mendelssohn, Brahms, Liszt, Mahler, and Bruckner. It is evident that from the perspective of modern medicine, symptoms and forensic facts are not complete, but witnesses’ reports and recent medical research have provided passable and plausible clarity. Although many questions will remain unanswered, it appears that the diseases of these composers and their causes of death have their origins in alcohol abuses, age, epidemics (like tuberculosis), and syphilis.
Trayectorias y tensiones culturales en adolescentes migrantes residentes en Chile
Authors: Vera-Álvarez Nicolás , Riquelme-Sandoval Sandra
Published: December 2021

Las migraciones contemporáneas han desafiado significativamente el desarrollo de las parentalidades en el núcleo de la familia transnacional. Frente a este escenario, resulta de interés acercarnos a las trayectorias de adolescentes migrantes desde sus significados y experiencias, deconstruyendo lógicas adultocéntricas que han invisibilizado su capacidad de agencia y participación como sujetos protagónicos en las migraciones. Este estudio contó con la participación de adolescentes migrantes provenientes de Colombia, Haití y Venezuela, cuyas familias residen en Chile. A partir de entrevistas en profundidad, se realizó un análisis desde un enfoque constructivista de los principales resultados respecto a tensiones culturales vivenciadas por las y los adolescentes en el ámbito individual y familiar, a partir de las cuales desplegaron distintos mecanismos de resolución.
O Rádio de Gisela
Authors:   Universidade de São Paulo. Escola de Comunicações e Artes, Galvão Júnior Lourival da Cruz , Maluly Luciano Victor Barros ,   Universidade de São Paulo. Escola de Comunicações e Artes
Published: December 2021

O audiolivro O rádio de Gisela é formado por sete capítulos que detalham a formação do pensamento teórico e a trajetória acadêmica de Gisela Swetlana Ortriwano, docente e pesquisadora do Departamento de Jornalismo e Editoração da Escola de Comunicações e Artes da Universidade de São Paulo (CJE-ECA/USP) que se transformou em referência para os estudos sobre o rádio e do radiojornalismo no Brasil. A obra apresenta depoimentos de nove pessoas que conviveram com a docente ecana em diferentes momentosTotalizando 5 horas de conteúdo sonoro ilustrados no YouTube com fotos da docente ecana, o audiolivro O rádio de Gisela revela a vinda da família Ortriwano da Alemanha ao Brasil no pós-guerra; a vida estudantil de Gisela e o ingresso na USP; a carreira como docente e pesquisadora; a influência de intelectuais como Ciro Marcondes Filho e Walter Sampaio; a orientação a alunos na graduação e pós-graduação; as pesquisas, os livros publicados a atuação na Rádio USP; e, por fim, a dedicação ao ensino, à pesquisa e à extensão na Universidade de São Paulo. O rádio de Gisela oferece a alunos, professores e pesquisadores detalhes da carreira acadêmica e dos estudos de Gisela Swetlana Ortriwano que, por mais de três décadas, dedicou à vida ao CJE-ECA/USP.
Consciência crítica e emancipação cultural em legados (Sul) africanos da comunicação para a mudança social
Authors: Chasi Colin , Rodney-Gumede Ylva
Published: December 2021

Neste artigo, reconhecemos o pensamento freiriano como fundamental para a articulação de um dos quatro principais fluxos de influência às abordagens sul-africanas de comunicação e mudança social. Sabelo Ndlovu-Gatsheni (2017) afirmou que os estudos universitários na África têm três influências civilizacionais: “As próprias ricas culturas/ tradições da África, as culturas/tradições islâmicas e as culturas/tradições ocidentais” (p. 54). Este relato da influência da conscientização freiriana sobre a filosofia e as práticas do movimento Consciência Negra, originário da África do Sul na década de 1960, chama a atenção para o pensamento do Consciência Negra, considerado um marco fundamental nos estudos de comunicação e mudança social.
Comunicação libertadora no século XXI
Authors: Lima Venício A. de
Published: December 2021

Paulo Freire tem alguma contribuição a oferecer ao campo de estudos da comunicação nos nossos dias? Neste artigo, fazemos uma exaustiva leitura da obra de Freire, desde a sua visão da natureza humana, que inclui a comunicação como realidade existencial e ontológica, passando pela comunicação nas suas dimensões relacional e política. Fazemos também um levantamento das manifestações de Freire sobre comunicação após a publicação dos textos fundadores; da posição crítica de estudiosos da comunicação no Brasil e no exterior e, finalmente, oferecemos uma avaliação da contribuição de Freire na perspectiva de sua prática da liberdade alongada para a pesquisa da comunicação no século XXI.
A difusão geográfica inicial da COVID-19 no Brasil e a aeromobilidade
Authors: Barros Gabriel Teixeira
Published: December 2021

Esse artigo investiga o fenômeno da difusão geográfica inicial da Covid-19 no Brasil, procurando contribuir com a formulação de políticas públicas para a contenção pandêmica. Para tanto, foi dividido em três partes: primeiramente, dados dos boletins epidemiológicos do Brasil, da Argentina e do Equador desde o início de sua divulgação até o dia 20/04/2020 foram transformados em mapas e analisados à luz de suas respectivas políticas de contenção, em comparação com China e Cingapura. Depois, em escala nacional, as analisam-se dados de 25/02/2020 a 03/08/2020, por município, comparados ao fluxo aéreo dominante de passageiros (IBGE, 2013). Na terceira parte, discute-se a relação entre a aeromobilidade e a modernidade líquida. Concluímos que uma suas primeiras ações de um protocolo de contenção pandêmica emergencial deveria ser o fechamento dos aeroportos, principalmente os de São Paulo, tanto para voos internacionais como nacionais, pois isso atrasaria consideravelmente a rede de difusão da doença.
Formação de leitores literários na Amazônia brasileira: da escuta à leitura silenciosa
Authors: Oliveira Andreia dos Santos
Published: December 2021

Por compreender a leitura como direito fundamental da humanidade, tenho desenvolvido projetos que garantam o acesso de crianças aos textos literários. O artigo em tela objetiva relatar duas dessas ações extensionistas desenvolvidas em dois projetos de leitura, cujo objetivo central foi contribuir com a formação de leitores literários em duas cidades do estado de Rondônia, Amazônia brasileira. As ações ocorreram a partirda problematização: Como garantir o acesso aos textos literários ao maior número possível de crianças fora do ambiente escolar? Para isso, recorri à leitura de autores cujos argumentos se dão em defesa da necessidade do contato das crianças pequenas com o texto literário, a exemplo de Candido (2004), Bajard (1994, 2014), Arena e Arena (2015), Lima e Girotto (2015), Petit (2010), entre outros. Em seguida, elaborei e desenvolvi duas ações extensionistas. Os resultados apontam a importância de mediadores de leitura promovendo a interação entre a criança e o livro, por meio da escuta e da leitura silenciosa.
Páginas paisagens luso-brasileiras em movimento: um projeto permanente de leitura
Authors: Alves Ida
Published: December 2021

Trata-se, neste artigo, da descrição detalhada de um projeto de leitura emexecução on line no portal do Real Gabinete Português de Leitura, Rio de Janeiro, em parceria com o PPG Estudos de Literatura da Universidade Federal Fluminense, Fundação Calouste Gulbenkian e FAPERJ. O foco do projeto é apresentar ao leitor umcorpus de textos literários brasileiros e portugueses, do século XVI à atualidade, sendo a paisagem natural ou urbana o eixo principal de análise e comentário. A aplicação do projeto e sua ressonância visam motivar a leitura de obras literárias de língua portuguesa, em perspectiva interdisciplinar, utilizando hiperlinks e imagens, com divulgação global em ambiente virtual e acesso aberto em rede. O acervo de “páginas” aumenta de acordo com as colaborações recebidas de docentes e pesquisadores nacionais e estrangeiros. Ao final do artigo, é feita breve avaliação da contribuição desse projeto aplicado para formação de leitores no ensino fundamental e médio.
Livros e canções: diálogos entre literatura e música
Authors: Siqueira Joelma Santana , Passos Victor Augusto da Costa
Published: December 2021

O artigo apresenta um relato reflexivo sobre o primeiro ano de um projeto de extensão intitulado “Livros e Canções”, um programa de rádio apresentado semanalmente em uma emissora universitária. A partir do reconhecimento da importância da canção na cultura brasileira (Wisnik, 2004), do diálogo entre cultura erudita e popular (Bosi, 1992) e das emissoras de rádio universitárias a serviço da sociedade e contra os monopólios da informação (Deus, 2003), buscou-se apresentar diversas aproximações entre a cultura erudita e a cultura popular para o público ouvinte.
Ensino remoto em tempos de pandemia: leitura e produção de textos para crianças e jovens
Authors: Valenzuela Sandra Trabucco , Ruiz Regina Celia
Published: December 2021

O presente trabalho visa apresentar dois relatos de experiência a respeito do ensino da literatura e produção de textos, dentro do contexto transitório gerado pela pandemia provocada pelo Coronavírus. Crianças e jovens, no mundo inteiro, tiveram suas aulas presenciais suspensas, havendo a necessidade de adequação por parte de todos os envolvidos no processo ensino-aprendizagem ao ensino remoto — em especial dos professores —, adaptando as atividades para que estas funcionassem no novo modelo. O tema “morte” passou a compor parte do cotidiano e, desse modo, abordar um assunto tão difícil e que estava tão presente suscitou a necessidade de reflexões dentro das salas de aula virtuais. Promover a leitura e a produção de textos no contexto da pandemia trouxe a necessidade de estimular diálogos com os leitores, estabelecendo discussões sobre o significado da morte, sobre a dor e a saudade. Com foco nessas preocupações, o trabalho docente proposto para alunos do primeiro semestre do ensino superior, numa instituição pública do Estado de São Paulo, foi a produção de contos baseados em imagens criadas pelo fotógrafo senegalês Alun.be, em seu projeto imagético inspirado na África, que une o mundo virtual e a cultura africana, num processo de integração entre o passado mítico e o presente, pontuado pela tecnologia. Por sua vez, alunos do Ensino Fundamental II da rede particular de ensino da cidade de São Paulo produziram textos verbais e não-verbais, após reflexões e debates promovidos pela leitura de livros de Odilon Moraes, Viriato Correa e Beatriz Martín Vidal, estabelecendo relações que dialogam com questões existenciais em evidência no contexto atual. Pierre Lévy, Nelly Novaes Coelho, Didi-Huberman e Roland Barthes ofereceram os caminhos que iluminam as práticas concretizadas durante este período de aulas síncronas, voltadas para a formação do leitor e produção de textos.
Editorial
Authors: Thomaz Nathalia Xavier , Cunha Maria Zilda da , Reis Célia Maria Domingues da Rocha
Published: December 2021

Créditos

Sumário 

Editorial
Transgressão e utopia: Fausto na estética de Ernst Bloch
Authors: Rodrigues Ubiratane de Morais
Published: December 2021

O objetivo deste artigo é apresentar a transgressão como uma categoria dialética fundamental da filosofia de Ernst Bloch. Para isso, partimos da interpretação original de Bloch sobre o Fausto de Goethe. A relação estabelecida entre Filosofia e Literatura nas análises do Fausto revela que a conceituação de Fausto como figura-modelo da transgressão é a pedra angular, na literatura, capaz de movimentar uma reflexão estética sobre as potencialidades utópicas da arte.
Abstract 10906: Association of Serum Magnesium Level on Emergency Department Arrival and Favorable Neurologic Outcome After Out-of-Hospital Cardiac Arrest
Authors: Kim Jooyeong , Sung Jin Kim , Park Jonghak , Ahn Sejoong , Song Juhyun , Cho Hanjin ,   Korean Cardiac Arrest Rsch Consortium
Published: December 2021

Introduction:
Electrolyte disturbances are associated with sudden cardiac arrest based on several cohort studies. However little is known about the association between serum magnesium(S-Mg) level at ED arrival and survival of out-of-hospital cardiac arrest (OHCA) patients.

Hypothesis:
We hypothesized S-Mg level at ED arrival is associated with favorable neurologic outcome of OHCA patients.

Methods:
This is an observational study using Korean Cardiac Arrest Research Consortium (KoCARC) data from October 2015 to June 2020. EMS treated OHCA patients over 18 years old who survived to ICU admission were included. Those without S-Mg level were excluded. Exposure is S-Mg level at emergency department (ED) arrival and outcome was favorable neurologic outcome (cerebral performance category 1 or 2) at hospital discharge. S-Mg was categorized into three groups; Low group; 0-1.7mg/dl, Normal group;1.7-2.3mg/dl, High group; over 2.3mg/dl). Multivariable logistic regression was performed to calculate adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) for outcome.

Results:
From total 10,897 OHCA patients, 2,789 patients survived to ICU admission and 1,370 patients had initial S-Mg result. Favorable neurologic outcome was 27.4% in low group, 55.7% in normal group and 23.0% in high group. After adjusting potential confounders in multivariable logistic analysis, compared to the normal group, AOR was 0.28 (95% CI 0.11-0.75) at low group and 0.43 (95% CI 0.23-0.82) at high group.

Conclusion:
Low (S-Mg less than 1.7 mg/dl) or high (S-Mg over 2.3mg/dl) S-Mg level measured initially at ED arrival for OHCA patients was associated with worse neurologic outcome compared to normal S-Mg level (S-Mg 1.7-2.3mg/dl). Based on this study, further study is needed to investigate the optimized S-Mg level for OHCA patient under resuscitation.
Abstract 11617: Personalizing Outcomes After Child Cardiac Arrest (POCCA): A Preliminary Biomarker Report
Authors: Fink Ericka L , Kochanek Patrick M , Panigrahy Ashok , Beers Sue R , Berger Rachel P , BAYIR HULYA , Wang Chunyan , Pineda Jose , Topjian Alexis A , maddux aline , Willyerd Frederick , Hunt Elizabeth A , Chung Melissa G , Newth Christopher , Smith Lincoln , Doughty Leslie , Diddle J Wesley , Piantino Juan , Walson Karen H , Balakrishnan Binod , Friess Stuart , Siems Ashley , Clark Robert M , Fabio Anthony ,   POCCA Investigators
Published: December 2021

Blood-based brain injury biomarkers show promise to prognosticate outcome for children resuscitated from cardiac arrest. The objective of this multicenter, observational study was to validate promising biomarkers to accurately prognosticate outcome at 1 year. Early brain injury biomarkers will be associated with outcome at one year for children with cardiac arrest. Fourteen centers in the US enrolled children aged < 18 years with in- or out-of-hospital cardiac arrest and pediatric intensive care unit admission if pre-cardiac arrest Pediatric Cerebral Performance Category score was 1-3. Glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal esterase L1 (UCHL1), neurofilament light (NfL), and Tau protein concentrations were measured in samples drawn post-arrest day 1 using Quanterix Simoa 4-Plex assay. The primary outcome was unfavorable outcome at one year (Vineland Adaptive Behavioral Scale < 70). Of 164 children enrolled, 120 children had evaluable data (n=50 with unfavorable outcome). Children were median (interquartile range) 1 (0-8.5) years of age, 41% female, and 60% had asphyxia etiology. Of children with unfavorable outcome, 93% had unwitnessed arrests and 43 died. While all 4 day 1 biomarkers were increased in children with unfavorable vs. favorable outcome at 1-year post-arrest, NfL had the best univariate area under the receiver operator curve to predict 1 year outcome at 0.731. In a multivariate logistic regression, NfL concentration trended toward significance on day 1 and was associated with unfavorable outcome at 1-year on days 2 and 3 (day 1: Odds Ratio [95% Confidence Interval] 1.004 [1.000-1.008], p=.062; day 2: 1.005 [1.002-1.008], p=.003, and day 3: 1.002 [1.001-1.004], p=.003, respectively). UCHL1 was associated with outcome on days 2: 1.005 [1.002-1.009], p=.003 and 3: 1.001 [1.000-1.002], p=.019) and Tau trended toward association with outcome on days 2: 1.003 [1.000-1.005], p=.08) and 3: 1.001 [1.000-1.002], p=.077. Brain injury biomarkers predict unfavorable outcome post-pediatric cardiac arrest. Accuracy of biomarkers alone and together with other prognostication tools should be evaluated to predict long term child centered outcomes post-cardiac arrest.
Abstract 12398: Cardiopulmonary Resuscitation Duration Determines Phenotype of Post-Arrest Brain Injury
Authors: Coppler Patrick J , CALLAWAY Clifton W , Elmer Jonathan ,   Pittsburgh Post Cardiac Arrest Service
Published: December 2021

Introduction:
Patients resuscitated from out-of-hospital cardiac arrest (OHCA) have variable severity of brain injury. Signatures of severe injury on brain imaging and EEG including diffuse cerebral edema and burst suppression with identical bursts (BSIB). Current therapies for these patterns of injury are inadequate and patient outcomes are poor.

Hypothesis:
We hypothesize distinct phenotypes of brain injury are associated with increasing CPR duration.

Methods:
We identified from our prospective registry OHCA patients treated between January 2010 to July 2019. We abstracted CPR duration, best neurological examination < 6 hours from OHCA, initial brain CT grey-to-white ratio (GWR), and initial EEG pattern. We defined cerebral edema as GWR <1.20. We defined BSIB according to American Clinical Neurophysiology Society guidelines. We considered four phenotypes on presentation: awake; comatose with neither BSIB nor cerebral edema; BSIB; and cerebral edema. BSIB and cerebral edema were considered as non-mutually exclusive outcomes. We compared duration of CPR across groups using Kruskal-Wallis tests with Bonferroni correction for multiple hypothesis testing. We report the probability of presenting phenotype at the median CPR duration for each group using local regression.

Results:
We included 2,721 patients, of whom 582 (21%) were awake, 1,428 (52%) had coma without BSIB or edema, 372 (14%) had BSIB and 356 (13%) had cerebral edema. Only 47 (2%) had both BSIB and edema. Median CPR duration was 16 [IQR 8-28] minutes overall. Median CPR duration increased in a stepwise manner across groups: awake 6 [3-12] minutes; comatose without BSIB or edema 16 [9-27] minutes; BSIB 21 [14-30] minutes; cerebral edema 32 [22-46] minutes (all P <0.001). The probability of observing each phenotype at the median CPR duration for each was: awake (0.42); comatose without BSIB or edema (0.72); BSIB (0.34); cerebral edema (0.29).

Conclusions:
The brain injury phenotype is related to CPR duration, which is a surrogate for severity of ischemic injury. The sequence of most likely brain injury phenotype with progressively longer CPR duration is awake, coma without BSIB or edema, BSIB, and finally cerebral edema.
Abstract 12990: The Association of Modifiable Mechanical Ventilation Settings, Blood Gas Changes and Survival After Extracorporeal Cardiopulmonary Resuscitation
Authors: Tonna Joseph , Selzman Craig , Bartos Jason , Ou Zhining , Jo Yeonjung , Becker Lance B , Youngquist Scott T , Thiagarajan Ravi R , Johnson Michael , Rycus Peter , Keenan Heather ,   for the Extracorporeal Life Support Organization (ELSO) Member Cntrs
Published: December 2021

Introduction:
Gas exchange during ECMO can occur independent of the lungs through ECMO, enabling a wider range of ventilator settings and blood gas values. Yet it is not known if potentially modifiable mechanical ventilation parameters or blood gas values are associated with survival for patients who receive ECPR.

Hypothesis:
To determine associations between ventilation parameters, blood gas values, and survival.

Methods:
Cohort analysis among 7,488 ECPR patients ≥18yrs of age from the Extracorporeal Life Support Organization (ELSO) Registry from 2008 - 2019. We examined the association between mechanical ventilation parameters on-ECMO with case-mix adjusted hospital survival. We used generalized estimating equation logistic regression, accounting for center level variation.

Results:
Case-mix adjusted patient-level mechanical ventilation parameters and blood gas values on-ECMO varied across individual hospitals, including arterial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), and changes in these values from pre-ECMO to on-ECMO. Increasing absolute on-ECMO PaO2 (OR 0.88 [95% CI 0.86, 0.9]; p<0.001), and relative increases in PaO2 from pre- to on-ECMO (OR 0.91 [0.89,0.93]; p<0.001) were both associated with decreased survival. Relative increases in pre- to on-ECMO PaCO2 (OR 1.31 [1.14, 1.1.54]; p<0.001) were associated with improved survival. Decreasing peak inspiratory pressure (OR 0.77, per 5 centimeters of water (cmH2O) [0.72, 0.81]; p<0.001) and fraction of inspired oxygen (OR 0.94, per 5% [0.92, 0.96]; p<0.001) were both associated with improved survival.

Conclusions:
Mechanical ventilation parameters of ECPR patients varies across hospitals. Potentially modifiable parameters and blood gas values are associated with survival and should be the focus of future research.
Abstract 13434: Chronic Total Occlusions in Refractory Cardiac Arrest Patients
Authors: Kral Ales , Belohlavek Jan , Rob Daniel , Smalcova Jana
Published: December 2021

Introduction:
Coronary artery disease (CAD) is the most frequent cause of cardiac arrest (CA) in adults. Coronary chronic total occlusions (CTOs) are associated with an increased risk CA and predict future malignant arrhythmias in CA survivors. Nevertheless, the prevalence of CTOs in patients with CA and especially refractory CA is poorly characterized. We sought to evaluate the frequency and characteristics of CTOs in refractory CA patients included in the Prague-OHCA study.

Methods:
From 256 patients with refractory CA randomized in the Prague-OHCA study, coronary angiography (CAG) was performed in 181 subjects. Of the 128 patients with significant CAD (defined as more than 50% diameter stenosis in at least one major coronary vessel), 14 had a different primary cause of CA, leading to a study cohort of 114 patients with CAD as the primary cause of CA. 41 patients had at least one coronary CTO, whereas 73 patients had significant CAD without CTOs. Clinical, angiographic parameters, initial management and outcome was compared between the CTO and non-CTO groups.

Results:
Patients in the CTO cohort were older (59 ±12 versus 54 ±11 years, p = 0.015) and had shorter CA durations (45 ± 25 versus 55 ± 24 minutes, p = 0.03) as compared to patients in the non-CTO cohort. The CTO cohort presented less frequently with an acute coronary syndrome (ACS) (51 versus 89%, p < 0.0001) and had a higher prevalence of multi-vessel disease (89 versus 51%, p < 0.0001), as compared to the non-CTO cohort. Acute index PCI was performed less frequently in the CTO group (61 versus 86%, p = 0.002). Patients in the CTO group experienced more frequent neurologic recovery (51 versus 32%, p = 0.04), whereas cardiac recovery (63 versus 51%, p = 0.19) and six month mortality (51 versus 59%, p = 0.43) did not differ between the CTO and non-CTO group.

Conclusions:
CTOs represent a frequent cause of refractory CA. Patients with refractory CA due to CTOs were older with a high prevalence of multi-vessel disease and presented less frequently with an ACS, as compared to patients with significant CAD without CTOs. The observed more frequent neurologic recovery in the CTO cohort is presumably due to shorter CA durations in these patients. Mid- and long-term prognosis did not differ between the CTO and non-CTO cohort.
Is Blood Pressure Lowering in the Very Elderly With Previous Stroke Associated With a Higher Risk of Adverse Events?
Authors: Tharmaratnam Damien , Karayiannis Christopher C. , Collyer Taya A. , Arima Hisatomi , McClure Leslie A. , Chalmers John , Anderson Craig S. , Benavente Oscar R. , White Carole L. , Algra Ale , Moran Chris , Phan Thanh G. , Wang Wei C. , Srikanth Velandai , Tharmaratnam Damien , Karayiannis Christopher C. , Collyer Taya A. , Arima Hisatomi , McClure Leslie A. , Chalmers John , Anderson Craig S. , Benavente Oscar R. , White Carole L. , Algra Ale , Moran Chris , Phan Thanh G. , Wang Wei C. , Srikanth Velandai
Published: December 2021

Background

We investigated whether blood pressure lowering for secondary prevention is associated with a reduction in recurrent stroke risk and/or a higher risk of adverse events in very elderly compared with younger trial participants.

Methods and Results

This is a random effects meta‐analysis of randomized controlled trials of blood pressure lowering for secondary stroke prevention to evaluate age‐stratified (<80, ≥80 years) risk of adverse events. Ovid‐MEDLINE was searched for trials between 1970 and 2020. Summary‐level data were acquired including outcomes of stroke, cardiovascular events, mortality, and adverse events. Seven trials were included comprising 38 596 participants, of whom 2336 (6.1%) were aged ≥80 years. There was an overall reduction in stroke risk in the intervention group compared with controls (risk ratio [RR], 0.90 [95% CI, 0.80, 0.98], I
2
=49%), and the magnitude of risk reduction did not differ by age subgroup (<80, ≥80 years). There was no increase in the risk of hypotensive symptoms in the intervention group for patients aged <80 years (RR, 1.19 [95% CI, 0.99], 1.44, I
2
=0%), but there was an increased risk in those ≥80 years (RR, 2.17 [95% CI, 1.22], 3.86, I
2
=0%). No increase was observed in the risk of falls, syncope, study withdrawal, or falls in either age subgroup.

Conclusions

Very elderly people in secondary prevention trials of blood pressure lowering have an increased risk of hypotensive symptoms, but with no statistical increase in the risk of falls, syncope, or mortality. However, evidence is lacking for frail elderly with multiple comorbidities who may be more vulnerable to adverse effects of blood pressure lowering.
COVID‐19 and Anticoagulation for Atrial Fibrillation: An Analysis of US Nationwide Pharmacy Claims Data
Authors: Hernandez Inmaculada , Gabriel Nico , He Meiqi , Guo Jingchuan , Tadrous Mina , Suda Katie J. , Magnani Jared W.
Published: December 2021

Background

Adherence to oral anticoagulation (OAC) is critical for stroke prevention in atrial fibrillation. However, the COVID‐19 pandemic may have disrupted access to such therapy. We hypothesized that our analysis of a US nationally representative pharmacy claims database would identify increased incidence of lapses in OAC refills during the COVID‐19 pandemic.

Methods and Results

We identified individuals with atrial fibrillation prescribed OAC in 2018. We used pharmacy dispensing records to determine the incidence of 7‐day OAC gaps and 15‐day excess supply for each 30‐day interval from January 1, 2019 to July 8, 2020. We constructed interrupted time series analyses to test changes in gaps and supply around the pandemic declaration by the World Health Organization (March 11, 2020), and whether such changes differed by medication (warfarin or direct OAC), prescription payment type, or prescriber specialty. We identified 1 301 074 individuals (47.5% women; 54% age ≥75 years). Immediately following the COVID‐19 pandemic declaration, we observed a 14% decrease in 7‐day OAC gaps and 56% increase in 15‐day excess supply (both
P
<0.001). The increase in 15‐day excess supply was more marked for direct OAC (69% increase) than warfarin users (35%;
P
<0.001); Medicare beneficiaries (62%) than those with commercial insurance (43%;
P
<0.001); and those prescribed OAC by a cardiologist (64%) rather than a primary care provider (48%;
P
<0.001).

Conclusions

Our analysis of nationwide claims data demonstrated increased OAC possession after the onset of the COVID‐19 pandemic. Our findings may have been driven by waivers of early refill limits and patients’ tendency to stockpile medications in the first weeks of the pandemic.
Cardiovascular Effects of Autologous Bone Marrow–Derived Mesenchymal Stromal Cell Therapy With Early Tacrolimus Withdrawal in Renal Transplant Recipients: An Analysis of the Randomized TRITON Study
Authors: Meucci Maria Chiara , Reinders Marlies E. J. , Groeneweg Koen E. , Bezstarosti Suzanne , Ajmone Marsan Nina , Bax Jeroen J. , De Fijter Johan W. , Delgado Victoria
Published: December 2021

Background

After renal transplantation, there is a need of immunosuppressive regimens that effectively prevent allograft rejection while minimizing cardiovascular complications. This substudy of the TRITON trial evaluated the cardiovascular effects of autologous bone marrow–derived mesenchymal stromal cells (MSCs) in renal transplant recipients.

Methods and Results

Renal transplant recipients were randomized to MSC therapy, infused at weeks 6 and 7 after transplantation, with withdrawal at week 8 of tacrolimus or standard tacrolimus dose. Fifty‐four patients (MSC group=27; control group=27) underwent transthoracic echocardiography at weeks 4 and 24 after transplantation and were included in this substudy. Changes in clinical and echocardiographic variables were compared. The MSC group showed a benefit in blood pressure control, assessed by a significant interaction between changes in diastolic blood pressure and the treatment group (
P
=0.005), and a higher proportion of patients achieving the predefined blood pressure target of <140/90 mm Hg compared with the control group (59.3% versus 29.6%,
P
=0.03). A significant reduction in left ventricular mass index was observed in the MSC group, whereas there were no changes in the control group (
P
=0.002). The proportion of patients with left ventricular hypertrophy decreased at 24 weeks in the MSC group (33.3% versus 70.4%,
P
=0.006), whereas no changes were noted in the control group (63.0% versus 48.1%,
P
=0.29). Additionally, MSC therapy prevented progressive left ventricular diastolic dysfunction, as demonstrated by changes in mitral deceleration time and tricuspid regurgitant jet velocity.

Conclusions

MSC strategy is associated with improved blood pressure control, regression of left ventricular hypertrophy, and prevention of progressive diastolic dysfunction at 24 weeks after transplantation.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03398681.
Allen Ginsberg’s Jeremiad
Authors: Murray Caleb
Published: December 2021

“Howl” continues to capture popular and academic imaginations. This article explores the categorical fault lines between modernist and postmodernist epistemologies as they are applied to Ginsberg’s poetic project. Reframing “religion” in postmodern terms, this article argues that even dominative categories and processes might be refashioned and deployed in the service of emancipatory and (counter)normative ethics and politics.
Once More on the Dating of the “Royal” Five Brothers’ Burial Mound No. 8
Authors: Monakhov Sergei Yu.
Published: December 2021

Burial-mound No. 8 in the necropolis of the Elizavetovskoye fortified settlement. The dates assigned to 14 amphorae found in the dromos are constantly argued over by scholars. When traditional methods of chronology are used, it emerges that some of the amphorae should be assigned to the 350s BC, and others to the 330s–320s BC. Recently N.F. Fedoseev attempted to explain this difference in dating of various stamps by stating that the two burials had been laid out in the burial-mound at different times and that, as a result, the amphorae had also been placed in the dromos at different times. Analysis of the assemblage of amphorae against a background of new sources has made it possible to assume with confidence that both burials in the burial-chamber of the Five Brothers’ Burial-mound No. 8 had been of the same date and that this spectacular monument should be dated to the second half of the 350s BC or to the 350/340s BC.
Preliminary Report on Archaeological Excavations in Sophtades, Cyprus: Pre-Byzantine Pottery
Authors: Licheli Vakhtang , Gagoshidze Giorgi , Kasradze Merab
Published: December 2021

The article is devoted to the materials found during the excavations of St. George Church located in the southern part of Cyprus, near the village of Softades. In the cultural layers inside of this church, pottery belonging to the Roman period, Iron Age and Late Bronze Age has been discovered. It is discussed in this article.