bluuebunny/crossref_metadata_2025 huggingface dataset:
A vocação modernista cultura e política na experiência intelectual do modernismo brasileiro
Authors: Martins Maro Lara
Published: August 2023

Este artigo tem como objeto a experiência intelectual modernista no Brasil da década de 1930. As principais contribuições para o campo do pensamento social brasileiro dizem respeito a reformulação do conceito de modernismo, levando em consideração amplo movimento de revisão teórica dentro da teoria sociológica, sua aplicação ao caso brasileiro e a construção de uma tipologia analítica para o estudo e interpretação da experiência intelectual modernista dos anos 1930. Para atingir esse objetivo analiso o modernismo a partir de quatro dimensões: técnica, estética, ética e política. A partir destas dimensões estabeleço as variáveis da produção e circulação das experimentações modernistas, especialmente nas relações dialógicas com o Estado brasileiro. Dessas situações posicionais em relação ao Estado e ao ideário político do corporativismo/nacionalismo proponho uma tipologia analítica para o estudo do modernismo brasileiro: modernismo central e modernismo periférico, modernismo heterônomo e modernismo radical.
Flk1 Deficiency and Hypoxia Synergistically Promote Endothelial Dysfunction, Vascular Remodeling, and Pulmonary Hypertension
Authors: Akiyama Tatsuya , Sadahiro Taketaro , Yamada Yu , Fujita Ryo , Abe Yuto , Nakano Koji , Honda Seiichiro , Ema Masatsugu , Kubota Yoshiaki , Sakai Satoshi , Hizawa Nobuyuki , Ieda Masaki
Published: August 2023

BACKGROUND:

The mechanisms underlying pulmonary hypertension (PH) remain largely unknown; further, why advanced vascular remodeling preferentially occurs in arterioles is yet to be answered. VEGF (vascular endothelial growth factor) regulates angiogenesis through Flk1 (fetal liver kinase 1) and Flt1 (fms-like tyrosine kinase 1) on endothelial cells (ECs), which may be related to PH pathogenesis. However, spatiotemporal expression patterns of Flk1 and Flt1 in the pulmonary vascular system and the role of endothelial Flk1 in PH development remain poorly understood.

METHODS:

We analyzed multiple reporter mice, including Flk1-GFP (green fluorescent protein) bacterial artificial chromosome transgenic (Tg), Flt1-DsRed bacterial artificial chromosome Tg, and Flk1-GFP/Flt1-DsRed double Tg mice, to determine the spatiotemporal expression of Flk1 and Flt1 in hypoxia-induced PH. We also used Cdh5
CreERT2
/Flk1
f/f
/Tomato (Flk1-KO [knockout]) mice to induce EC-specific Flk1 deletion and lineage tracing in chronic hypoxia.

RESULTS:

Flk1 was specifically expressed in the ECs of small pulmonary vessels, including arterioles. Conversely, Flt1 was more broadly expressed in the ECs of large- to small-sized vessels in adult mouse lungs. Intriguingly, Flk1
+
ECs were transiently increased in hypoxia with proliferation, whereas Flt1 expression was unchanged. Flk1-KO mice did not exhibit pulmonary vascular remodeling nor PH in normoxia; however, the arteriolar ECs changed to a cuboidal shape with protrusion. In hypoxia, Flk1 deletion exacerbated EC dysfunction and reduced their number via apoptosis. Additionally, Flk1 deletion promoted medial thickening and neointimal formation in arterioles and worsened PH. Mechanistically, lineage tracing revealed that neointimal cells were derived from Flk1-KO ECs. Moreover, RNA sequencing in pulmonary ECs demonstrated that Flk1 deletion and hypoxia synergistically activated multiple pathways, including cell cycle, senescence/apoptosis, and cytokine/growth factor, concomitant with suppression of cell adhesion and angiogenesis, to promote vascular remodeling.

CONCLUSIONS:

Flk1 and Flt1 were differentially expressed in pulmonary ECs. Flk1 deficiency and hypoxia jointly dysregulated arteriolar ECs to promote vascular remodeling. Thus, dysfunction of Flk1
+
ECs may contribute to the pathogenesis of advanced vascular remodeling in pulmonary arterioles.
Ameliorating Racial Disparities in Vascular Risk Factor Management With Aggressive Medical Management in the SAMMPRIS Trial
Authors: Almallouhi Eyad , Nelson Ashley M. , Cotsonis George , Harris William , Chimowitz Marc I. , Turan Tanya N.
Published: August 2023

BACKGROUND:

The WASID trial (Warfarin-Aspirin Symptomatic Intracranial Disease) and the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis) evaluated optimal management of symptomatic intracranial atherosclerotic stenosis. The aim of this retrospective, observational study was to determine whether aggressive medical management used in the SAMMPRIS trial ameliorated disparities in risk factor control between Black and non-Black patients.

METHODS:

The SAMMPRIS trial was a randomized controlled trial that enrolled patients with symptomatic intracranial atherosclerotic stenosis between November 2008 and April 2011. The frequency of risk factors at study entry (baseline) and mean levels of systolic blood pressure, diastolic blood pressure, LDL (low-density lipoprotein), hemoglobin A1c, and exercise level (quantified by physician-based assessment and counseling for exercise score) at baseline and at 1 year of follow-up were compared between Black (n=104) versus non-Black patients (n=347).

RESULTS:

Significant differences at baseline in Black patients (listed first) versus non-Black patients were age (57.5 versus 61.0 years;
P
=0.004), hypertension (95.2% versus 87.5%;
P
=0.027), diabetes (52.9% versus 39.7%;
P
=0.017), mean diastolic blood pressure (82.4 versus 79.5 mm Hg;
P
=0.035), and mean physician-based assessment and counseling for exercise score (2.7 versus 3.3;
P
=0.002). The mean diastolic blood pressure and mean physician-based assessment and counseling for exercise scores at 1 year in Black versus non-Black patients were 74.7 versus 75.5 mm Hg (
P
=0.575) and 4.2 versus 4.1 (
P
=0.593), respectively. No disparities in other modifiable risk factors emerged at 1 year.

CONCLUSIONS:

Significant differences in important risk factors (physical activity and diastolic blood pressure) at baseline between Black and non-Black patients resolved at 1 year, suggesting that aggressive medical management may have an important role in ameliorating disparities in risk factor control between Black and non-Black patients.
Trichromatic vision in toads: evidence from preference for colour objects during mate choice
Authors: Kondrashev Sergei L.
Published: August 2023

Input of different spectral types of photoreceptors in amphibian colour vision has been assessed by studying the behaviour of male toads Bufo bufo and B. gargarizans in a laboratory. This method is based on the males’ innate reaction of approaching and clasping any visual object during the breeding season. A pair of colour stimuli made of paper or displayed on a LCD monitor has been selected to match the toad’s RGB colour space so that they differ by excitation of only a single spectral class of retinal photoreceptors. With pairwise presentation, the males are found to prefer a more ‘bluish’, or a less ‘reddish’, or a less ‘greenish’ stimulus from each pair. A microspectrophotometry of isolated rod and cone photoreceptors and an observation of behavioural responses in toads have revealed a trichromatic mesopic visual system based on a positive input from blue-sensitive photoreceptors and negative inputs from red-sensitive cones and green-sensitive rods. It is supposed that the observed colour preference and involvement of different chromatic mechanisms determine social interactions of anurans during mate choice.
The Necessity of a Polycentric Federal Democracy in Myanmar
Authors: Myint Tun
Published: August 2023

The military coup of February 1, 2021 ended Myanmar’s nominal transition to democracy. That transition had begun with the 2010 election under the military-drafted 2008 Constitution. The coup and post-coup Myanmar’s crises are the tip of the iceberg of a long endured political crisis about how to build an inclusive political system that respects the ethnic, cultural, and religious diversity of Burmese society at large. This article argues that the 2021 military coup itself may be a much-needed event for the future history of Burma: the coup has provoked resistance across ethnicity and religion to an unprecedented level.
Suffering and Spirituality in Myanmar Today: Hope amid the National Crisis
Authors: Geoffrion Timothy C.
Published: August 2023

Myanmar’s citizens have been devastated by the military coup on February 1, 2021, and by the ensuing violence, destruction, and chaos. As the people are struggling to cope with the horror and suffering, Christian faith and spirituality are playing significant roles for Myanmar Christians, albeit in different ways, depending on their personal spiritual preference (temperament) and theological perspective. This article explores the four major psycho-spiritual orientations (temperaments) using a paradigm developed by Dr. Corrine Ware: head spirituality (Type 1), heart spirituality (Type 2), mystical spirituality (Type 3), and social action spirituality (Type 4). In a separate section, ‘Hope amid Suffering’, I discuss how varying theological perspectives are producing at least three different kinds of hope (in terms of content and timing): hope for deliverance now; hope for deliverance later; and hope now and later. In short, Christian faith and spirituality are functioning as indispensable sources of hope amid great suffering.
Reading Romans 13:1–7 as a Hidden Transcript of Public Theology
Authors: Moe David Thang , Scott James C.
Published: August 2023

Romans 13:1–7 is a potential key text in determining the theological response of the churches in Myanmar to the 2021 coup. The text presents those who invoke its use with a dilemma that requires resolution and decision. Is it an oppressive text that justifies the coup and commands the church’s blind obedience to the coup-led state? Does Paul’s exhortation to be subject to the governing authorities’ (13:1) justify the line of the church’s uncritical obedience? Or does his description of the governing authorities as ‘servants for good’ (v.4) provide the basis for resistance to the coup conceived as adharma or untruth or evil? James Scott’s creative theory of hidden transcripts suggests that the text can be read as a script for a public theology that demands the church’s faithful disobedience to the coup. It invites a fresh reading of Paul being resistant to empire in a hidden and indirect way. Rom: 13.4 may then be placed in dialogue with Rom. 12:9 (‘resisting evil and loving good’). Through a hermeneutic of correspondence between Paul’s texts and contemporary protesters of the coup forms of everyday public resistance to the military power are disclosed. The text becomes a vehicle through which the goals of the resistance movement can be set in a biblical case for a public theology.
Viridantha minuscula (Tillandsioideae; Bromeliaceae), a new species from Guanajuato, Mexico
Authors: HERNÁNDEZ-CÁRDENAS RODRIGO ALEJANDRO , ESPEJO-SERNA ADOLFO , LÓPEZ-FERRARI ANA ROSA , VICCON-ESQUIVEL JOSÉ , SANDOVAL-MATA TECOATLAYOPEUH NELLY
Published: August 2023

Viridantha minuscula from the state of Guanajuato, Mexico, is described and illustrated as new to science. The proposed taxon is compared to V. lepidosepala and V. tortilis, species with the most similarities. Images and a distribution map of the taxa involved are provided.
Chen, M.-J., Han, Y.-R., Hu, J.-X., Liu, Y.-J. & Huang, B. (2023) Tolypocladium rhizomatum sp. nov.: an endophytic species isolated from the rhizome of Polygonatum cyrtonema. Phytotaxa 606 (3): 201–210.
Authors: CHEN MING-JUN , HAN YI-REN , HU JIANG-XIN , LIU YU-JUN , HUANG BO
Published: August 2023

N/A
Ottia, a new ennomine genus of moth from Tajikistan (Lepidoptera: Geometridae)
Authors: VIIDALEPP JAAN , LINDT AARE
Published: August 2023

An ennomine species, described earlier as Plagodis ochraceata Viidalepp, 1988, is transferred from Plagodis Hübner, [1823]1816 to a genus of its own: Ottia ochraceata (Viidalepp, 1988) (gen. nov., comb. nov.). The morphology of the adult moth, of its male and female genitalia, phenology and spatial distribution are described and its taxonomic relationships are analyzed.
New records of predaceous midges in Bezzia Kieffer and Phaenobezzia Haeselbarth from Mexico with description of two new species of Bezzia (Diptera: Ceratopogonidae)
Authors: HUERTA HERÓN , SPINELLI GUSTAVO R. , JR WILLIAM L. GROGAN
Published: August 2023

Two new species of Bezzia Kieffer are described from Mexico, one in the gibbera group, B. (Bezzia) trujilloi sp. nov. from the state of Veracruz, and the other in the glabra group, B. (Homobezzia) breidenbaughi sp. nov. from Lagunas de Zempoala National Park nature reserve, state of Mexico. Two new country records of B. (Bezzia) mesotibialis Spinelli & Wirth from Veracruz and B. (Homobezzia) snowi Lane from Guerrero and Oaxaca, and the following new state records are also included: B. (B.) gibbera (Coquillett), B. (B.) hondurensis Spinelli & Wirth, B. (B.) punctipennis (Williston) from Veracruz; B. (H.) pulchripes Kieffer and Phaenobezzia maya Spinelli & Wirth from Yucatan; B. (H.) venustula (Williston) and Phaenobezzia fulvithorax (Malloch) from Guerrero; Phaenobezzia fulvithorax (Malloch) from Morelos and B. (H.) venustula (Williston) from Oaxaca. A key to Bezzia species from Mexico is also included.
The Moral Illicitness of Relying Solely on Neurological Criteria for the Determination of Death: A Catholic Response to “Brain Death”
Authors: Vacca Michael Arthur
Published: August 2023

This paper presents the biological, philosophical, and theological arguments against “brain death” or death determined strictly through neurological criteria. It is rooted in a realistic, Thomistic metaphysical and anthropological view of the human person and the objective reality of death. Part I of the paper reviews the medical evidence that the bodies of those declared brain death are alive and makes clear that the bodies of “brain dead” patients are not biologically analogous to severed body parts. Part II presents the philosophical and theological argument that it is impossible to be a live human being and not a person. Since then those declared brain dead are somatically alive, they are live human persons with the right to life and cannot be subject to the extraction of vital, unpaired organs, since this would violate the dead donor rule. Part III reviews why the Magisterium has not unconditionally approved the determination of death through neurological criteria, and why it would be within the competence of the Magisterium to preclude medical professionals from determining death strictly through neurological criteria. The paper argues that there should be a ban on all vital, unpaired organ donation from “brain dead” donors.
Tracheoesophageal Fistula as a Complication of Prolonged Ventilation in COVID-19: Description of Reconstruction and Review of the Literature
Authors: Walker Kendra N. , Carlson Kevin J. , Rubinstein Benjamin J. , Sinacori John T. , Mark Jonathan R.
Published: August 2023

Infection with COVID-19 pneumonia may necessitate intubation and mechanical ventilation. Viral inflammation and pressure necrosis may lead to scarring, stenosis, and in severe cases, fistula formation. Nonmalignant tracheoesophageal fistulas (TEF) represent a surgical challenge and may necessitate locoregional tissue transfer and tracheal resection to prevent recurrence and maintain airway patency. We present a case of TEF in a 63-year-old female secondary to prolonged mechanical ventilation in the setting of COVID pneumonia, detailing the clinical findings and surgical repair. Primary closure of the esophageal defect with pectoralis major muscle flap onlay and tracheal resection, with median sternotomy for access, provided successful intervention, allowing for subsequent tracheostomy decannulation and return to a complete oral diet. This case offers further evidence of the increased risk of airway complications in COVID-19 infection and provides otolaryngologists with an example of a rare surgical approach useful in management.
Clinical considerations for sarcopenia in older Colombian Afro-descendant and mestizo women
Authors: Monterrosa-Castro Álvaro , Prada-Tovar María , Monterrosa-Blanco Angélica
Published: August 2023

Objectives

To identify the frequencies of clinical suspicion of sarcopenia (CSS) and probable sarcopenia (PS) and their association with ethnic groups.

Methods

This cross-sectional study categorized 700 women into Afro-descendant and mestizo ethnic groups. Calf circumference, muscle strength, and gait speed were measured. CSS was assessed using a sarcopenia risk scale and the measurement of calf circumference; the muscle strength of the dominant hand was used to establish PS. Unadjusted logistic regressions assessed associations between CSS/PS and ethnicity. Two adjusted logistic regression models included relevant covariates.

Results

CSS and PS were identified in 10.4% to 20.7% and 7.8% to 14.1% of study participants, respectively. Compared with mestizos, Afro-descendants had a more favorable sarcopenia risk score, greater calf circumference, and greater muscle strength and were associated with a lower risk for CSS (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06–0.28 and OR: 0.12, 95% CI: 0.07–0.21) and PS (OR: 0.12, 95% CI: 0.05–0.30 and OR: 0.11, 95% CI: 0.06–0.21).

Conclusion

Compared with mestizos, CSS and PS were less frequent among Afro-descendants, who had 87% to 88% lower probability of CSS and 88% to 89% lower probability of PS.
Modeling the Influence of Smartphone Distraction and Pedestrian Characteristics on Pedestrian Road Crossing Behavior
Authors: Yadav Ankit Kumar , Pawar Nishant Mukund , Velaga Nagendra R.
Published: August 2023

With the increase in the use of technology, smartphone distraction has become a significant pedestrian safety issue. Research on pedestrian smartphone distraction has been conducted mainly in western countries, and there is a scarcity of research in low- and middle-income countries (LMICs). This study is the first attempt to investigate the effect of smartphone distraction on pedestrians’ road crossing behavior in India. We conducted a survey of pedestrians, with 560 respondents (63.4% males), about their demographics and walking characteristics, pedestrian behavior (violations, errors, lapses, aggressive behaviors, and positive behaviors), and smartphone distraction. The associations of smartphone distraction and pedestrian characteristics with pedestrians’ road crossing behavior were identified by developing structural equation models (SEMs). The strongest influence of smartphone distraction was found to be on violations (factor loading = 0.50), followed by errors (factor loading = 0.44), lapses (factor loading = 0.41), and aggressive behaviors (factor loading = 0.37). No significant effect of smartphone distraction was observed on the positive behaviors. Male pedestrians were more likely to commit violations, errors, lapses, and aggressive behaviors, whereas female pedestrians showed more positive behaviors. Older pedestrians showed more positive behavior than young pedestrians. Pedestrians who walk at high speeds tend to engage in a high number of violations. Pedestrians with a crash history were more likely to commit violations and show aggressive behaviors than those with no prior crash experience. The study findings can aid policymakers in understanding the smartphone distraction habits of pedestrians, which are required to design behavior-based road safety interventions.
Promoting Self-Regulation Progress and Knowledge Construction in Blended Learning via ChatGPT-Based Learning Aid
Authors: Wu Ting-Ting , Lee Hsin-Yu , Li Pin-Hui , Huang Chia-Nan , Huang Yueh-Min
Published: August 2023

This study combines ChatGPT, Apple’s Shortcuts, and LINE to create the ChatGPT-based Intelligent Learning Aid (CILA), aiming to enhance self-regulation progress and knowledge construction in blended learning. CILA offers real-time, convergent information to learners’ inquiries, as opposed to traditional Google search engine that provide divergent information. By addressing questions promptly, CILA minimizes interruptions during the performance phase of self-regulation progress. The tool records learners’ questions and answers, aiding self-reflection in self-regulation progress. We evaluated self-regulation progress using motivation, engagement, and self-efficacy as indicators. Findings show that CILA’s intervention effectively improves self-regulation progress and knowledge construction, offering benefits over divergent information in blended learning contexts with respect to amotivation, intrinsic motivation, and behavioral engagement. This research highlights the potential of incorporating large language models like ChatGPT in educational settings to support teachers and students.
Analysis of the causes of severe side wear of the high rail on metro curves by numerical simulation and field investigation
Authors: Wang Shenghua , Wen Bingguang , Ren Dexiang , Ding Yaqi , Wen Zefeng , Dong Dawei , Tao Gongquan
Published: August 2023

Two of the Shanghai metro lines suffered from severe side wear on the high rail, not only in sharp curves but also in large curves, and the service life of some rails on sharp curves was reduced by approximately 50% compared with the last rail replacement. Features and evolution rules for the rail side wear and the wheel flange wear were determined by field measurements and long-term monitoring. A rail wear prediction model, verified in our previous work, is used to reveal the influence of factors on rail wear. The results indicate that the poor lubrication condition at the rail gauge face is the main cause of severe side wear of the high rail, and the use of wheel profiles with low conicity and the loss of profile curvature of low rail profiles caused by the untimely maintenance also increase the side wear of the high rail. The service life of the high rail could be greatly extended by some countermeasures, such as repairing the worn shape of the low rail and repairing/improving the wayside lubrication system.
Designing deformable Girehs based on historical authenticity
Authors: Azizpour Shoubi Aref , Nazarzadeh Ansaroudi Farnaz , Nazarzadeh Ansaroudi Elnaz , Faghih Dinevari Najmeh
Published: August 2023

Girehs are an important esthetic tool in Islamic architecture. The introduction of deformable Girehs can be considered as a significant solution in the areas of flexibility and authenticity in contemporary architecture. By investigating the configurations of different Girehs based on their configurational authenticity, the present study presents a method to make the studied Girehs deformable. The presented methodology can be generalized for all types of Girehs. The deployment of Girehs in a constant perimeter and the generation of new authentic Gireh with deformable configuration are among the main features of the proposed method. The method is based on the PIC methodology, which uses the change in the angle of the Gireh elements in underlying generative tessellation based on the family of the Gireh (acute, median, obtuse). The fixed points of the deformable Girehs are positioned in the midpoints of the sides of the underlying polygons. Also, to address the issue of the increased lengths of the elements and integrated movement, telescope elements and scissor structure have been used.
Empathy and ethical sensitivity among intensive and critical care nurses: A path analysis
Authors: Sharifnia Amir Masoud , Green Heidi , Fernandez Ritin , Alananzeh Ibrahim
Published: August 2023

Background

Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses’ empathy and ethical sensitivity. Evidence in the literature indicates that nurses’ emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity.

Aim

To investigate the relationship between nurses’ empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis.

Research design

Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis.

Participants and research context

Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021.

Ethical considerations

The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki.

Findings

Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity.

Conclusions

Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses.
Prognosis Analysis of Delayed Call Time for Chest Pain in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Direct Percutaneous Coronary Intervention
Authors: Yang Yangyang , Zhang Yuanzhuo , Ren Lei
Published: August 2023

To describe the impact of delayed call time for chest pain in the salvage of ST-segment elevation myocardial infarction (STEMI) patients and its associated independent risk factors, and to identify risk factors associated with cumulative morbidity and mortality in STEMI patients at 4 years after percutaneous coronary intervention (PCI). Retrospective analysis of 398 patients diagnosed with STEMI and treated with emergency PCI within 24 hours of symptom onset in Fuyang People's Hospital from April 2018 to April 2021. The enrolled patients were divided into ≤60 minutes group (193 cases), and > 60 minutes group (205 cases), according to the delayed call time of patients with chest pain. Analysis of basic clinical data, rescue time, and major cardiovascular adverse events in the 2 groups. Multifactorial logistic regression analysis of independent correlates of delayed chest pain calls and Cox proportional risk regression modeling of risk factors for cumulative morbidity and mortality at 4 years after surgery. Compared to the delayed call time ≤ 60 minutes group, the > 60 minutes group had a higher proportion of females, a history of diabetes, rural remote areas, and farmer occupation ( P < .05). Binary logistic regression analysis shows the history of diabetes and female as independent risk factors for delayed call time >60 minutes for chest pain. In the delayed call time ≤60 minutes group, the time from symptom onset-to-balloon (S0-to-B) and from symptom onset-to-first medical contact (SO-to-FMC) were smaller than in the delayed call time >60 minutes group ( P < .05). The sum of postinfarction angina and major cardiovascular adverse events was lower in the group with delayed call time ≤60 minutes than in the group with delayed call time >60 minutes ( P < .05). The Kaplan-Meier survival curve and the survival curve without the occurrence of major adverse cardiovascular events were statistically significant in both groups ( P < .05). Multifactorial Cox regression analysis showed that delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III were all risk factors for cumulative morbidity and mortality at 4 years after PCI in patients with STEMI. Delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III are all risk factors for cumulative morbidity and mortality in STEMI patients at 4 years after PCI. Reducing the delayed call time for chest pain can improve the long-term prognosis of patients.
Public discourse on refugees in social media: A case study of the Netherlands
Authors: Sutkutė Rūta
Published: August 2023

Social media websites, such as Facebook and Twitter, are starting to become places where people present and evaluate various events. Moreover, these websites influence value perception of their users and readers. The article discusses the refugee crisis in Europe and initiatives like ‘Refugees Welcome Netherlands’ and ‘Refugees Not Welcome Netherlands’ that have been launched to help or oppose refugees. It aims to analyse the formation of the discourse on refugee integration in social media in the Netherlands and its impact on individuals’ attitudes towards refugees. The article uses statistics, images and social media posts to provide deeper insights on the topic. The study also highlights Dutch government’s approach to refugees and their integration and Government’s concern about growing intolerance towards immigrants. The study is relevant to shed light on how political decisions and public opinion condition refugee integration processes in the host society.
PTEN in triple-negative breast carcinoma: protein expression and genomic alteration in pretreatment and posttreatment specimens
Authors: Chen Hui , Ding Qingqing , Khazai Laila , Zhao Li , Damodaran Senthil , Litton Jennifer K. , Rauch Gaiane M. , Yam Clinton , Chang Jeffrey T. , Seth Sahil , Lim Bora , Thompson Alastair M. , Mittendorf Elizabeth A. , Adrada Beatriz , Virani Kiran , White Jason B. , Ravenberg Elizabeth , Song Xingzhi , Candelaria Rosalind , Arun Banu , Ueno Naoto T. , Santiago Lumarie , Saleem Sadia , Abouharb Sausan , Murthy Rashmi K. , Ibrahim Nuhad , Routbort Mark J. , Sahin Aysegul , Valero Vicente , Symmans William Fraser , Tripathy Debu , Wang Wei-Lien , Moulder Stacy , Huo Lei
Published: August 2023

Background:

Recent advances have been made in targeting the phosphoinositide 3-kinase pathway in breast cancer. Phosphatase and tensin homolog (PTEN) is a key component of that pathway.

Objective:

To understand the changes in PTEN expression over the course of the disease in patients with triple-negative breast cancer (TNBC) and whether PTEN copy number variation (CNV) by next-generation sequencing (NGS) can serve as an alternative to immunohistochemistry (IHC) to identify PTEN loss.

Methods:

We compared PTEN expression by IHC between pretreatment tumors and residual tumors in the breast and lymph nodes after neoadjuvant chemotherapy in 96 patients enrolled in a TNBC clinical trial. A correlative analysis between PTEN protein expression and PTEN CNV by NGS was also performed.

Results:

With a stringent cutoff for PTEN IHC scoring, PTEN expression was discordant between pretreatment and posttreatment primary tumors in 5% of patients ( n = 96) and between posttreatment primary tumors and lymph node metastases in 9% ( n = 33). A less stringent cutoff yielded similar discordance rates. Intratumoral heterogeneity for PTEN loss was observed in 7% of the patients. Among pretreatment tumors, PTEN copy numbers by whole exome sequencing ( n = 72) were significantly higher in the PTEN-positive tumors by IHC compared with the IHC PTEN-loss tumors ( p < 0.0001). However, PTEN-positive and PTEN-loss tumors by IHC overlapped in copy numbers: 14 of 60 PTEN-positive samples showed decreased copy numbers in the range of those of the PTEN-loss tumors.

Conclusion:

Testing various specimens by IHC may generate different PTEN results in a small proportion of patients with TNBC; therefore, the decision of testing one versus multiple specimens in a clinical trial should be defined in the patient inclusion criteria. Although a distinct cutoff by which CNV differentiated PTEN-positive tumors from those with PTEN loss was not identified, higher copy number of PTEN may confer positive PTEN, whereas lower copy number of PTEN would necessitate additional testing by IHC to assess PTEN loss.

Trial registration:

NCT02276443.
Immune dysregulation and potential targeted therapy in myelodysplastic syndrome
Authors: Zhang Xiaoying , Yang Xingcheng , Ma Ling , Zhang Yicheng , Wei Jia
Published: August 2023

Myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematological diseases and a high risk for transformation to acute myeloid leukemia (AML). The identification of key genetic alterations in MDS has enhanced our understanding of the pathogenesis and evolution. In recent years, it has been found that both innate and adaptive immune signaling are activated in the hematopoietic niche of MDS with aberrant cytokine secretion in the bone marrow microenvironment. It is also clear that immune dysregulation plays an important role in the occurrence and progression of MDS, especially the destruction of the bone marrow microenvironment, including hematopoiesis and stromal components. The purpose of this review is to explore the role of immune cells, the immune microenvironment, and cytokines in the pathogenesis of MDS. Insights into the mechanisms of these variants may facilitate the development of novel effective treatments to prevent disease progression.
Inversion position testing in concussed athletes
Authors: Tsuruike Masaaki , Hirose Norikazu , Nishime Robert S.
Published: August 2023

Context

No prior study has examined inversion position testing in individuals who have experienced sports related concussions.

Objective

To investigate whether the inversion position testing (IPT) would un-mask symptoms in asymptomatic concussed collegiate athletes during the return to play progression assessment.

Design

Case-Control Study.

Setting

Athletic Training Room.

Participants

One hundred and thirty-nine collegiate student athletes were randomly recruited from 12 different sports belonging to National Collegiate Athletic Association Division I Conference.

Main outcome measure(s)

A baseline concussion symptom questionnaire was administered. Of the 139, 122 participants without any of the suspicious symptoms related to concussions were examined using the Concussion Symptom Inventory (CSI) in connection with IPT. Also, the 18 concussed athletes underwent the IPT when any symptom subsided.

Results

Eighteen of the 122 (16.2%) non-concussed athletes showed some post-IPT symptoms, while 5 of 12 (41.7%) concussed athletes showed some post-IPT symptoms in the baseline test. For the latter, neither the interaction ( P = 0.08) nor difference in the total CSI score was observed either from pre- to post-IPT ( P = 0.14) or between the baseline and post-concussion ( P = 0.96).

Conclusion

This study demonstrated that symptoms could be exacerbated by the IPT in concussed athletes even when their original symptoms had subsided prior to the testing. The IPT exacerbated post-concussive symptoms may depend on a number of days required for post-concussive symptoms to subside. The innovative instrument of IPT may prove effective in clarifying the degree to which post-concussive symptoms have subsided.

Key words

Concussion, College athletes, Inversion position, Symptoms.
Analysis of Reported Adverse Events Associated With the Use of Functional Lumen Imaging Probe Devices in the Esophagus and Stomach: An FDA MAUDE Database Study
Authors: Jaber Fouad , Johnson Willie Mohammed , Wilson Natalie , Alsakarneh Saqr , Mohamed Mouhand , Ahmed Khalid , Patel Nicole , Hanson Brian , Abdallah Mohamed , Bilal Mohammad
Published: August 2023

The endoscopic Functional Lumen Imaging Probe (FLIP) devices are used to evaluate pressure changes, diameter, and volume of the esophagus. We used the FDA’s MAUDE database to collect post-marketing surveillance data on these devices from January 2009 to September 2022. Forty-Five device-related events and thirty-six patient-related adverse events were analyzed. The most common device issue for the diagnostic FLIP device was therapeutic/diagnostic failure (n = 6), while the most frequent issue with the therapeutic FLIP device was adverse events without an identified device or use problem (n = 11). Patient-related adverse events were extremely rare with the diagnostic FLIP and the most common patient-related adverse event with the therapeutic FLIP was perforation (n = 11). Endoscopists need to be mindful of these potential technical issues and adverse events while using these devices.
Impact of exacerbation history on long-term efficacy of dupilumab in patients with asthma
Authors: Corren Jonathan , Katelaris Constance H. , Castro Mario , Maspero Jorge F. , Humbert Marc , Halpin David M.G. , Altincatal Arman , Pandit-Abid Nami , Soler Xavier , Radwan Amr , Jacob-Nara Juby A. , Deniz Yamo , Rowe Paul J.
Published: August 2023

Background

The phase 3 QUEST (NCT02414854) and TRAVERSE (NCT02134028) studies demonstrated the efficacy of dupilumab 200/300 mgversusplacebo every 2 weeks for 52 weeks (QUEST) and dupilumab 300 mg up to an additional 96 weeks (TRAVERSE) in patients ≥12 years of age with uncontrolled, moderate-to-severe asthma. Overall, safety was consistent with the known dupilumab safety profile. Thispost hocanalysis assessed long-term dupilumab efficacy for up to 3 years by exacerbation history.

Patients and methods

Unadjusted annualised severe exacerbation rates (AER) and change from parent study baseline (PSBL) in pre-bronchodilator forced expiratory volume in 1 s (FEV1) and 5-item Asthma Control Questionnaire (ACQ-5) score were assessed in patients with PSBL eosinophils ≥150 cells·µL−1or fractional exhaled nitric oxide ≥20 ppb and 1 (n=624), 2 (n=344), or ≥3 (n=311) exacerbations in the year before enrolment in QUEST.

Results

In all three groups, dupilumab treatment progressively reduced AER range to 0.17–0.30 during TRAVERSE (Weeks 48–96), increased pre-bronchodilator FEV1range by 0.28–0.49 L by Week 96 and improved asthma control (reduced ACQ-5 score range by 1.51–2.03 by Week 48). For patients who first received dupilumab upon TRAVERSE enrolment, AER decreased, and lung function and asthma control improved rapidly, as was observed upon initiation of dupilumab in QUEST. Dupilumab was efficacious regardless of exacerbation history.

Conclusion

For patients with uncontrolled, moderate-to-severe asthma with elevation of at least one type 2 biomarker, dupilumab treatment provides sustained, long-term reduction of exacerbation rates and improvements in lung function and asthma control irrespective of exacerbation history.
Comparison of day surgery between varicose veins with and without superficial venous thrombosis below knee: a propensity score-matched analysis
Authors: Xu Jiatang , Xu Xiaolin , Tian Jing , Huang Minyi , Xia Zuqi , Luo Xianghui , Zheng Junmeng , Huang Kai
Published: August 2023

Objectives

Development of endovenous treatment and sclerotherapy technology makes it feasible for clinicians to treat varicose veins (VV) through day surgery (DS). Superficial venous thrombosis (SVT) of lower extremities is a common complication of VV. This study aimed to investigate whether the existence of SVT below knee affect the safety and efficacy of DS for VV patients.

Methods

This is a single-center retrospective study. Clinical data of 593 VV patients was retrospectively analyzed. Raw data were matched by the using of propensity score matching model. Operation time, technical failure, postoperative DVT, skin burns, saphenous nerve injury, subcutaneous induration, and bleeding were compared between the groups. Also, we compared VV recurrence, SVT formation, DVT events and the change of VCSS score with 12 months.

Results

Fifty-nine patients complicated with SVT below knee were matched with 118 patients had VV only. Perioperative and follow-up outcomes were similar in both groups except for the number of incisions (median = 6 [5, 7] VS median = 4 [4, 5], P < 0.001). Both groups experienced a great decrease in VCSS score.

Conclusion

We systematically compared the clinical outcomes of DS in VV patients. Our results indicate DS is safe and effective for patients with VV, whether accompanied by SVT below the knee.

Trial registration

The ClinicalTrials.gov identifier for this trial is NCT05380895 (retrospectively registered).
MAGIC (maternal glucose in pregnancy) understanding the glycemic profile of pregnancy, intensive CGM glucose profiling and its relationship to fetal growth: an observational study protocol
Authors: Scott Eleanor M , Murphy Helen R. , Myers Jenny , Saravanan Ponnusamy , Poston Lucilla , Law Graham R
Published: August 2023

Background

Continuous glucose monitoring (CGM) provides the most objective method of assessing glucose in daily life. Although there have been small, short-term physiologic studies of glucose metabolism in ‘healthy’ pregnant women a comprehensive, longitudinal description of changes in glucose over the course of pregnancy and how glucose dysregulation earlier in pregnancy relates to traditional third trimester screening for gestational diabetes, fetal growth and pregnancy outcomes is lacking. This study aims to characterise longitudinal changes in glycemia across gestation using CGM, in order to understand the evolution of dysglycemia and its relationship to fetal growth.

Method/design

A multi-centre, prospective, observational, cohort study of 500 healthy pregnant women, recruited in the first trimester of pregnancy. Masked CGM will be performed for a 14-day period on five occasions across pregnancy at ~ 10–12, 18–20, 26–28, 34–36 weeks gestation and postnatally. Routinely collected anthropometric and sociodemographic information will be recorded at each visit including: weight, height, blood pressure, current medication. Age, parity, ethnicity, smoking will be recorded. Blood samples will be taken at each visit for HbA1c and a sample stored. Details on fetal growth from ultrasound scans and the OGTT results will be recorded. Maternal and neonatal outcomes will be collected. CGM glucose profiling is the exposure of interest, and will be performed using standard summary statistics, functional data analysis and glucotyping. The primary maternal outcome is clinical diagnosis of GDM. The primary neonatal outcome is large for gestational age (LGA) (> 90th centile defined by customised birthweight centile). The relationship of glucose to key secondary maternal and neonatal outcomes will be explored.

Discussion

This study will ascertain the relationship of maternal dysglycemia to fetal growth and outcomes. It will explore whether CGM glucose profiling can detect GDM before the OGTT; or indeed whether CGM glucose profiling may be more useful than the OGTT at detecting LGA and other perinatal outcomes.

Trial registration

ISRCTN 15,706,303 https://www.isrctn.com/ISRCTN15706303 Registration date: 13th March 2023.
The effect of psychological interventions targeting overweight and obesity in school-aged children: a systematic review and meta-analysis
Authors: Baygi Fereshteh , Djalalinia Shirin , Qorbani Mostafa , Larrabee Sonderlund Anders , Kousgaard Andersen Merethe Kirstine , Thilsing Trine , Heitmann Berit Lilienthal , Nielsen Jesper Bo
Published: August 2023

Background

Multi-component psychological interventions may mitigate overweight and obesity in children and adolescents. Evidence is, however, scattered on the effectiveness of such interventions. This study aims to review the available evidence on the effectiveness of multi-component psychological interventions on anthropometric measures of school-aged children with overweight or obesity.

Methods

We systematically searched international databases/search engines including PubMed and NLM Gateway (for MEDLINE), Web of Science, SCOPUS, and Google Scholar up to November 2022 for relevant articles pertaining to psychological weight-loss interventions targeting school-aged children. Two reviewers screened and extracted pertinent data. The quality of included studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials. Random effect meta-analysis was used to calculate, and pool standardized mean differences (SMD). We distinguished between intervention and maintenance effects. Intervention effects were defined as the mean change in outcome measurement detected between baseline and post-treatment. Maintenance effects were defined as the mean change in outcome measurement between post-treatment and last follow-up.

Results

Of 3,196 studies initially identified, 54 and 30 studies were included in the qualitative and quantitative syntheses, respectively. Most studies reported on group-based interventions. The significant effects of intervention on BMI z-score (SMD -0.66, 95% CI: -1.15, -0.17) and WC (SMD -0.53, 95% CI: -1.03, -0.04) were observed for interventions that centered on motivational interviewing and cognitive behavioral therapy, respectively. Mean BMI and WC did not differ significantly between post-treatment and last follow-up measurement (maintenance effect), indicating that an initial weight loss obtained through the intervention period could be maintained over time.

Conclusions

Findings indicate that motivational interviewing and cognitive behavioral therapy as interventions to reduce BMI z-score (generalized obesity) and waist circumference (abdominal obesity) are effective and durable. However, detailed analyses on individual components of the interventions are recommended in future effectiveness studies.
Sickness absence due to mandatory COVID-19 certificates in the workplace
Authors: Wanger Susanne , Weber Enzo
Published: August 2023

Background

As vaccines for COVID-19 became available, many countries introduced an obligation in 2021 for employees to prove their COVID-19 status at work, known in Germany as the 3G rule (vaccinated, recovered, tested). In view of the controversial debate, there was concern that employees might try to avoid providing mandatory COVID-19 certificates by taking sick leave. The aim of this study was to investigate whether mandatory COVID-19 tests in the workplace led to such an evasive response.

Method

For an empirical panel analysis, we collected data from official sources and combined aggregated health insurance data on sick leave, epidemiological data on laboratory-confirmed COVID-19 infections, and vaccination rates for the German states from September 2021 to January 2022. We used a regional panel data analysis to estimate the impact of the mandatory COVID-19 certificates at the workplace on workers’ sick leave. The regional vaccination rate reflected differences in treatment intensity.

Results

This study contributes to the limited evidence on the potential impact of introducing mandatory COVID-19 certificates at the workplace on sickness absence rates. In fact, our results showed that after controlling for infection rates, a one percentage point lower vaccination rate led to a 0.021 percentage point increase in the sickness absence rate when the 3G rule came into effect. This effect was measured with high statistical precision. In addition, in robustness checks, we controlled for a number of other possible influencing factors that may have affected sickness behaviours, such as time-varying labour market situations. However, the results remained robust.

Conclusions

The results of our empirical panel analysis implied that mandatory COVID-19 certificates in the workplace led to evasive responses and to additional days of sick leave of a relevant magnitude. Testing obligations were meant to help contain the epidemic. However, when introducing controversial obligations, it is important to consider evasive responses and to design the rules appropriately and communicate them convincingly.