bluuebunny/crossref_metadata_2025 huggingface dataset:
Ginkgo Biloba Leaf Extract Attenuates Atherosclerosis in Streptozotocin-Induced Diabetic ApoE-/- Mice by Inhibiting Endoplasmic Reticulum Stress via Restoration of Autophagy through the mTOR Signaling Pathway
Authors: Tian Jinfan , Popal Mohammad Sharif , Liu Yanfei , Gao Rui , Lyu Shuzheng , Chen Keji , Liu Yue
Published: March 2019

Background. There is a crosstalk between endoplasmic reticulum stress (ERS) and autophagy, and autophagy could attenuate endoplasmic reticulum stress-mediated apoptosis. Ginkgo biloba leaf extract (GBE) exerts vascular protection functions. The purpose of the present study is to investigate the role of autophagy in diabetic atherosclerosis (AS) and the effect of GBE on autophagy and ERS. Methods. Network pharmacology was utilized to predict the targets and pathways of the active chemical compounds of Gingko biloba leaf to attenuate AS. ApoE-/- mice were rendered diabetic by intraperitoneal ingestion with streptozotocin combined with a high-fat diet. The diabetic mice were divided into five groups: model group, atorvastatin group, rapamycin group, and low- and high-dose GBE groups. Serum and tissue markers of autophagy or ERS markers, including the protein expression, were examined. Results. The mammalian target of rapamycin (mTOR) and NF-κB signaling pathways were targeted by the active chemical compounds of GBE to attenuate AS predicted by network pharmacology. GBE reduced the plaque area/lumen area and the plaque lipid deposition area/intimal area and inhibited the expressions of CD68, MMP2, and MMP9. Rapamycin and GBE inhibited the expression of mTOR and SQSTM1/p62 which increased in the aorta of diabetic mice. In addition, GBE reduced the expression of ERS markers in diabetic mice. GBE reduced the serum lipid metabolism levels, blood glucose, and inflammatory cytokines. Conclusion. Impaired autophagy and overactive endoplasmic reticulum stress contributed to diabetic atherosclerosis. mTOR inhibitor rapamycin and GBE attenuated diabetic atherosclerosis by inhibiting ERS via restoration of autophagy through inhibition of mTOR.
Medication-Related Osteonecrosis of the Jaws: Two Center Retrospective Cohort Studies
Authors: Petrovic Milan , Jelovac Drago B. , Antic Svetlana , Antunovic Marija , Lukic Nikola , Sabani Melvil , Mudrak Joerg , Jezdic Zoran , Pucar Ana , Stefanovic Aleksandar , Kuzmanovic Cedomir , Nikolic Danilo , Konstantinovic Vitomir
Published: March 2019

This retrospective cohort study aims to describe characteristics of patients with MRONJ, to identify factors associated with MRONJ development, and to examine variables associated with favourable outcome. Totally 32 patients were followed and observed: 21 females and 11 males, in the age range 35-84 in the period from 2009 to 2018. Clinical, radiological examination (Orthopantomograph and CBCT) and biopsy were performed in order to achieve diagnosis. Demographic and clinical variables were taken into consideration: sex, age, primary disease, medication type, mode of delivery, anatomic location, drug treatment duration, timing of tooth extraction, chemotherapy, presence of bone metastasis, aetiology of MRONJ, disease stage, and treatment modality. MRONJ developed under osteoporosis and malignant disease in 11 and 21 patients, respectively. MRONJ development was triggered by tooth extraction or trauma in 30 out of 32 cases, whereas the two patients developed MRONJ spontaneously. Stages I, II, and III were confirmed in 5 (16%), 18 (58%), and 9 (28%) patients, respectively. Mandible was affected in 23 (72%) patients. MRONJ was treated in our department by conservative and surgical modality. In this study we found that 65% of all patients were classified in the cured/improvement group and 35% in the stable/progression group. The female gender, osteoporosis as primary disease, oral regime intake, shorter period on BPs, earlier stage of disease, and specific anatomic localisation (frontal and premolar maxilla) were factors associated with better response to therapy and favourable clinical outcome. Comprehensive treatment protocol and further randomized studies are necessary for further improvements.
Prediction of Endometrial Hyperplasia and Cancer among Premenopausal Women with Abnormal Uterine Bleeding
Authors: Giannella Luca , Cerami Lillo Bruno , Setti Tiziano , Bergamini Ezio , Boselli Fausto
Published: March 2019

Objective. To create a prediction model including clinical variables for the prediction of premalignant/malignant endometrial pathology in premenopausal women with abnormal uterine bleeding (AUB). Methods. This is an observational retrospective study including 240 premenopausal women with AUB referred to diagnostic hysteroscopy. Based on the presence of endometrial hyperplasia (EH) or cancer (EC), the women were divided into cases (EH/EC) and controls (no EH/EC). Univariate, stepwise logistic regression and ROC curve analysis were performed. Results. 12 women had EH/EC (5%). Stepwise logistic regression analysis showed that EH/EC associated significantly with BMI ≥ 30 (OR=7.70, 95% CI 1.90 to 31.17), diabetes (OR=9.71, 95% CI 1.63 to 57.81), and a thickened endometrium (OR=1.20, 95% CI 1.08 to 1.34, criterion > 11 mm). The AUC was 0.854 (95% confidence intervals 0.803 to 0.896, p<0.0001). Considering the pretest probability for EH/EC of 5%, the prediction model with a positive likelihood ratio of 8.14 showed a posttest probability of 30%. The simultaneous presence of two or three risk factors was significantly more common in women with EH/EC than controls (50% vs. 6.6 and 25% vs. 0%, respectively, p<0.0001). Conclusion. When premenopausal vaginal bleeding occurs in diabetic obese women with ET > 11 mm, the percentage of premalignant/malignant endometrial pathology increases by 25%. It is likely that the simultaneous presence of several risk factors is necessary to significantly increase the probability of endometrial pathology.
Metformin Inhibits the Expression of Biomarkers of Fibrosis of EPCs In Vitro
Authors: Han Fei , Shu Jie , Wang Shunjun , Tang Can-e , Luo Fanyan
Published: March 2019

Endothelial progenitor cells (EPCs) are a group of circulating cells with important functions in vascular repair and treatment of cardiovascular diseases. However, in patients with atrial fibrillation (AF), the number and function of EPCs reportedly are decreased. TGF-β is highly expressed in AF patients. In this study, we examined the effect of TGF-β1 on EPCs and the therapeutic outcome of metformin treatment on TGF-β1-induced EPCs. EPCs were induced with TGF-β1 at different concentrations (5 ng/ml, 10 ng/ml, and 20 ng/ml) for 48 h followed by western blot, qPCR, and immunofluorescence analyses to investigate changes in the levels of the fibrosis-related proteins, α-SMA, Col I, Col III, CTGF, and MMP-1. Live-dead cell staining was used to evaluate cell apoptosis. Compared with the control, TGF-β1 treatment significantly (p<0.05) enhanced the levels of α-SMA, Col I, Col III, CTGF, and MMP-1 in a dose-dependent manner. The most effective concentration of TGF-β1 (20 ng/ml) was then used to induce fibrosis biomarker expression in EPCs, followed by treatment with metformin at different concentrations (0.5, 1, and 2 mmol/l). Metformin treatment suppressed TGF-β-induced expression of all above factors, with the effect at 2 mmol/l being significant (p<0.05). Live-dead cell staining showed no difference among the control, TGF-β1-treated, and metformin-treated groups. In conclusion, our study showed that TGF-β1 induces the expression of fibrosis biomarkers in EPCs, which is attenuated by treatment with metformin. Thus, metformin may have therapeutic potential for improving EPC function in cardiovascular diseases.
Anaphylactic Degranulation of Mast Cells: Focus on Compound Exocytosis
Authors: Klein Ofir , Sagi-Eisenberg Ronit
Published: March 2019

Anaphylaxis is a notorious type 2 immune response which may result in a systemic response and lead to death. A precondition for the unfolding of the anaphylactic shock is the secretion of inflammatory mediators from mast cells in response to an allergen, mostly through activation of the cells via the IgE-dependent pathway. While mast cells are specialized secretory cells that can secrete through a variety of exocytic modes, the most predominant mode exerted by the mast cell during anaphylaxis is compound exocytosis—a specialized form of regulated exocytosis where secretory granules fuse to one another. Here, we review the modes of regulated exocytosis in the mast cell and focus on compound exocytosis. We review historical landmarks in the research of compound exocytosis in mast cells and the methods available for investigating compound exocytosis. We also review the molecular mechanisms reported to underlie compound exocytosis in mast cells and expand further with reviewing key findings from other cell types. Finally, we discuss the possible reasons for the mast cell to utilize compound exocytosis during anaphylaxis, the conflicting evidence in different mast cell models, and the open questions in the field which remain to be answered.
A Time‐Replacement Policy for Multistate Systems with Aging Components under Maintenance, from a Component Perspective
Authors: Huang Chao-Hui , Wang Chun-Ho
Published: March 2019

This study aims for multistate systems (MSSs) with aging multistate components (MSCs) to construct a time‐replacement policy and thereby determine the optimal time to replace the entire system. The nonhomogeneous continuous time Markov models (NHCTMMs) quantify the transition intensities among the degradation states of each component. The dynamic system state probabilities are therefore assessed using the established NHCTMMs. Solving NHCTMMs is rather complicated compared to homogeneous continuous time Markov models (HCTMMs) in determining reliability related performance indexes. Often, traditional mathematics cannot acquire accurate explicit expressions, in particular, for multiple components that are involved in designed system configuration. To overcome this difficulty, this study uses Markov reward models and the bound approximation approach to assess rewards of MSSs with MSCs, including such things as total maintenance costs and the benefits of the system staying in acceptable working states. Accordingly, we established a long‐run expected benefit (LREB) per unit time, representing overall MSS performance through a lifetime, to determine the optimal time to replace the entire system, at which time the LREB values are maximized. Finally, a simulated case illustrates the practicability of the proposed approach.
PD-1 Blockade Following Isolated Limb Perfusion with Vaccinia Virus Prevents Local and Distant Relapse of Soft-tissue Sarcoma
Authors: Smith Henry G. , Mansfield David , Roulstone Victoria , Kyula-Currie Joan N. , McLaughlin Martin , Patel Radhika R. , Bergerhoff Katharina F. , Paget James T. , Dillon Magnus T. , Khan Aadil , Melcher Alan , Thway Khin , Harrington Kevin J. , Hayes Andrew J.
Published: March 2019

Purpose:

The prevention and treatment of metastatic sarcoma are areas of significant unmet need. Immune checkpoint inhibitor monotherapy has shown little activity in sarcoma and there is great interest in identifying novel treatment combinations that may augment responses. In vitro and in vivo, we investigated the potential for an oncolytic vaccinia virus (GLV-1h68) delivered using isolated limb perfusion (ILP) to promote antitumor immune responses and augment response to PD-1 blockade in sarcoma.

Experimental Design: In an established animal model of extremity sarcoma, we evaluated the potential of locoregional delivery of a vaccinia virus (GLV-1h68) alongside biochemotherapy (melphalan/TNFα) in ILP. Complementary in vitro assays for markers of immunogenic cell death were performed in sarcoma cell lines.

Results:

PD-1 monotherapy had minimal efficacy in vivo, mimicking the clinical scenario. Pretreatment with GLV-1h68 delivered by ILP (viral ILP) significantly improved responses. Furthermore, when performed prior to surgery and radiotherapy, viral ILP and PD-1 blockade prevented both local and distant relapse, curing a previously treatment-refractory model. Enhanced therapy was associated with marked modulation of the tumor microenvironment, with an increase in the number and penetrance of intratumoral CD8+ T cells and expansion and activation of dendritic cells. GLV-1h68 was capable of inducing markers of immunogenic cell death in human sarcoma cell lines.

Conclusions:

Viral ILP augments the response to PD-1 blockade, transforming this locoregional therapy into a potentially effective systemic treatment for sarcoma and warrants translational evaluation.
Nested Stromal-Epithelial Tumor of the Liver: A Review
Authors: Geramizadeh Bita
Published: March 2019

Background: Nested stromal-epithelial tumor (NSET) is a rare liver tumor, which is most commonly seen in the pediatric age group. To the best of our knowledge, there has been no published review on this rare tumor in the English literature so far. Summary: In this review, we will discuss all the reported details of the published cases, including demography, clinical presentation, molecular histogenesis, imaging, gross pathology and histopathology, immunohistochemical findings, treatment modalities, and outcome of NSET of the liver. Key Message: Thirty-eight cases of NSET have been reported in the last 20 years in the English literature. This tumor produces a very large and calcified mass in the liver and characteristically can present as Cushing syndrome. NSET is a nonbiliary and nonhepatocytic tumor with biphasic differentiation into 2 components of epithelial and stromal cells. The epithelial cells are arranged as nests of mildly atypical epithelial cells with a few mitotic figures. The stromal component is composed of myofibroblasts and desmoplastic stroma which often shows ossification and calcification. Immunohistochemically, this tumor is positive for both epithelial and mesenchymal markers. The majority of the reported cases in the literature had benign behavior with an indolent course.
Melanocytoma of the Conjunctiva: Clinicopathologic Features of Three Cases
Authors: Herwig-Carl Martina C. , Loeffler Karin U. , Grossniklaus Hans E.
Published: March 2019

Background: Melanocytoma (magnocellular nevus) is a jet-black benign lesion histologically composed of polygonal tumor cells with small, inconspicuous nuclei and abundant cytoplasm. Melanocytomas in general are rare. Most cases occur in the optic nerve head. Conjunctival melanocytoma (magnocellular nevus) is extremely rare, and only 3 lesions of the ocular surface have been reported. Objectives: To describe the clinical and histological spectrum of conjunctival melanocytoma and discuss differential diagnoses of this rare lesion. Method: Four heavily pigmented conjunctival lesions were excised for slight tumor growth and histologically processed. The specimens were routinely stained with hematoxylin and eosin and periodic acid-Schiff. Sections were bleached and immunohistochemical stains were performed for CD68, HMB-45, S100, melanin, and Ki-67. Results: Histological examination revealed findings of a conjunctival melanocytoma in 3 cases. The fourth case was diagnosed histologically as a combined melanocytic lesion with a compound nevus and an inverted type A nevus. None of the lesions exhibited transition towards malignancy. The differential diagnoses included conjunctival melanoma, granular cell nevus, compound nevus with reactive changes, and blue nevus. Conclusions: Conjunctival melanocytic lesions suspicious for melanocytoma should be bleached to evaluate their cytologic features. CD68 can be helpful in identifying heavily pigmented melanomacrophages which may mimic a melanocytoma. As conjunctival melanocytomas are extremely rare, their pathogenesis may be different from that of other conjunctival nevi.
Urinary and Fecal Continence in 5-Year-Old Patients Who Underwent in utero Myelomeningocele Repair: A Prospective Study
Authors: Macedo Jr. Antonio , Cavalheiro Sérgio , Moron Antonio , Lobountchenko Tássia , Dini Felipe Silveira , Ottoni Sergio Leite , Garrone Gilmar , Ligori Riberto , Leal da Cruz Marcela
Published: March 2019

Introduction: After the successful results of in utero myelomeningocele (MMC) repair presented by the Management of Myelomeningocele Study, the concept of fetal surgery was introduced in our institution in 2011. Since then, we have been able to follow prospectively a group of patients with attention to urological care. In the present study, we were interested in estimating urinary and fecal continence in this new subset of patients. Material and Methods: We selected from our database patients aged 5 years or older for evaluation of urinary and fecal continence. We reviewed all charts and completed a questionnaire to study aspects of urinary and fecal continence. Results: We identified 14 patients, i.e., 4 (28.6%) males and 10 (71.4%) females. The mean age at MMC surgery was 25.6 gestational weeks. The uro­dynamic class was high-risk in 6 (42.9%), incontinent in 4 (28.6%), hypocontractile in 1 (7.1%), and normal in 3 (21.4%) patients. Three patients had undergone surgery (2 augmentations, i.e., 1 in association with a left colon ACE Macedo-Malone procedure and 1 mini-sling urethroplasty). Twelve patients underwent clean intermittent catheterization (CIC) (85.7%). Only 3 (21.4%) patients had no urinary leakage. Eleven patients (78.6%) used diapers. Eight patients (57.2%) underwent retrograde rectal irrigation and 11 (78.6%) complained of fecal loss. Eleven patients (78.6%) did not report an impact on their self-esteem. Conclusion: Despite the use of CIC in 85.7% of the cases, the continence rate in MMC patients operated on in utero was low and 78.6% of the patients used diapers. This data can be used to educate parents about future conditions of their 5-year-old children and may stimulate the debate regarding further attempts (surgical or not) to improve fecal and urinary continence.
Efeito agudo de uma sessão de treinamento de futsal na modulação autonômica cardíaca de jovens jogadores
Authors: Paludo Ana Carolina , Rabelo Felipe Nunes , Miloski Bernardo , Ronque Enio Ricardo Vaz , Serassuelo Junior Helio , Simões Antônio Carlos
Published: March 2019

O objetivo do presente estudo foi avaliar o efeito de uma sessão de treinamento de futsal na modulação autonômica cardíaca (pré versus pós) de jovens atletas. Foram avaliados nove atletas de futsal do sexo masculino da categoria Sub 20 de um clube profissional do estado de São Paulo- Brasil (idade:18,9 ±0,9 anos, massa corporal:73,1±6,0 kg e estatura: 179,0 ±0,1 cm). A sessão de treinamento caracterizou-se como técnico/tática. A modulação autonômica cardíaca foi analisada pelos índices da variabilidade da frequência cardíaca (VFC) avaliada com registro contínuo da frequência cardíaca (Polar Team2 Pro) 15 minutos antes e após a sessão de treinamento, sendo os dados posteriormente exportados para o programa Kubios (2.0) para o cálculo dos índices: MRR, RMSSD, LFlog e HFlog. A carga de treino foi avaliada pelos métodos de PSE, TRIMP e PSE da sessão (sPSE). As mudanças pré e pós foram avaliadas pelo o teste t de Student e a variação percentual (P com variação percentual foi: 10,7; 26,9; 4,2 e 11,3%, respectivamente, para os índices MRR, RMSSD, LFlog e HFlog. Variação percentual do índice LFlog apresentou correlação significativa (P sessão (r=0,694). Conclui-se que uma única sessão de treinamento de futsal foi capaz de gerar mudanças significativas na modulação autonômica cardíaca de jovens jogadores de futsal, com uma variação de 4,2% a 26,9%. Essa variação esta positivamente correlacionada com a carga de treino. Essas informações podem auxiliar a comissão técnica no planejamento das sessões de treino, no monitorando das cargas de treinamento.
Health-related quality of life and leisure physical activity during pregnancy
Authors: Hirasawa Ana Claudia , Romero Simone Cristina Scarpa , Kurashima Carolina Harumi , Gelie Florence Cousson , Takito Monica Yuri
Published: March 2019

The practice of physical activity during pregnancy plays an important role related to improvement how women perceive their health status. The aim of this study was to investigate the relationship between perceived quality of life during pregnancy and the practice of physical activity during leisure time. It is a cross-sectional study of 187 postpartum women. A retrospective questionnaire was administered to obtain information regarding pregnancy, being evaluated the pattern of physical activity and health status. To evaluate the aspects related to quality of life we used the SF-12 questionnaire. The statistical analysis were t-test, chi-square and multiple linear regression analysis. From the results it was observed that mothers who were active during pregnancy considered their good or excellent health compared do non active (p=0.005, 35.9% and 15.5% respectively). Active women had higher mental component when compared to those who did not practice (p=0.035). There was a relationship between mental component with the private health service, income, education level, disease and presence of a partner. The physical component was related to maternal age, low birth weight, obesity, and smoking during pregnancy. Despite univariate analysis showed a positive association between physical activity during leisure time and the mental component of quality of life related to health, this association lost significance when included age and care health sectors. Longitudinal studies should be developed to measure effects of physical activity in quality of life.
Utilização de diferentes métodos para a determinação da idade óssea em jovens
Authors: Pinto Vanessa Carla Monteiro , Souza Francisco Emílio Simplício de , Simões Thaisys Blanc dos Santos , Mortatti Arnaldo Luis , Dantas Paulo Moreira Silva , Cabral Breno Guilherme de Araújo Tinôco
Published: March 2019

O estudo tem como objetivo correlacionar os resultados da idade óssea em meninos e meninas em diferentes métodos. Na metodologia para verificar a idade óssea, foram realizadas aferições de estatura, diâmetros de úmero e fêmur, perímetro corrigido de braço, dobra tricipital, idade cronológica para compor o modelo matemático, e raio-x de mão e punho para utilização do método de Grave e Brown (1976). No tratamento estatístico realizado no programa SPSS 20.0 utilizando estatística descritiva, correlação de Pearson e diferença significativa entre os métodos. As correlações obtiveram resultados positivos para meninos e meninas, respectivamente, com resultados entre raio x e idade cronológica (M=0,84/F=0,53), modelo matemático (M=0,85/F=0,56) e estatura (M=0,80/F=0,28), assim como entre o modelo matemático e estatura (M=0,95/ F=0,84) e idade cronológica (M=0,95/F=0,76). Concluímos, desta forma, existir correlação entre os métodos, não existindo diferença significativa entre os mesmos, destacando assim o modelo matemático por ser um método prático e de fácil aplicação para uso no meio esportivo.
A ESPECIFICIDADE DOS AFETOS DIRECIONADOS A OUTROS SERES AFETIVOS NO LIVRO III DA ÉTICA DE ESPINOSA
Authors: Hoste Vinicius Xavier
Published: March 2019

O livro III da Ética de Espinosa se dedica a definição dos afetos. Dentro dessa definição o outro desempenha um papel importantíssimo, mesmo se, inicialmente, ele parece estar ausente. Espinosa começará sua definição falando de afetos direcionados a coisas e não necessariamente a outros sujeitos afetivos. Todavia, isso não significa que o outro não seja importante para a teoria de Espinosa, pelo contrário, a partir da proposição 21 desse livro ele faz sua aparição, trazendo novos elementos à teoria dos afetos e, principalmente, apontando para uma via de mão dupla, mostrando-nos que, se por um lado, as relações interpessoais podem ser de amor, por outro, o ódio estará presente, ou seja, essa relação pode se revelar tanto harmoniosa quanto conflitante. É justamente esse o caminho que gostaríamos de iluminar neste artigo, explicitando assim como a entrada do outro na teoria dos afetos de Espinosa lhe confere novas nuances, novos caminhos, novas possibilidades.
ÊTRE APTE CHEZ SPINOZA : ENTRE REFUS DE LATÉLÉOLOGIE CLASSIQUE ET AUTO-ORGANISATION
Authors: Legeay Vincent
Published: March 2019

L’article entend montrer qu’à partir d’une conceptualité classique, héritée de Descartes, Spinoza parvient à contrer l’argument cartésien de liberté et l’argument aristotélicien du finalisme par une structure théorique impossible à classifier à son époque, faisant penser à une tentative de formaliser l’auto-organisation comme le fondement de l’intentionnalité. À partir d’une analyse du texte spinoziste et sa compréhension de la contrainte, l’article entend montrer que la reprise d’un certain nombre de notions et de termes entourant ce thème ont été redisposés par Spinoza afin de solutionner un problème nouveau, invisible avant lui.
ALGUNS ELEMENTOS DE ESPINOSA NAS FILOSOFIAS DE MARX E DELEUZE
Authors: Maeso Benito , De França Marcos Antônio
Published: March 2019

A partir da leitura comparada de trechos dos Cuadernos Spinozade Karl Marx e de Espinosa: filosofia prática,de Gilles Deleuze, o trabalho busca encontrar nestes autores elementos do pensamento espinosano, principalmente do Tratado Teológico-Políticoe excertos da Ética. Tais conexões parecem mais visíveis nos conceitos de materialismo e na relação homem-natureza. Se, conforme Marx, o concreto é a síntese de múltiplas determinações, o que relaciona-se com a ideia deleuziana da determinação da diferença como diferença de si e da História como contingência, como isso se articularia com um conceito caro a Espinosa como o de que as transformações na realidade referem-se a determinações internas da própria realidade material, abdicando-se de um imperativo moral externo como eixo destas mudanças, ou seja, a causalidade imanente e não-transcendente dos processos? Para que estes conceitos tenham pontos de contato, de que forma o materialismo, a natureza e a liberdade devem ser entendidos?
AS DOUTRINAS DO "HEN KAI PAN": GIORDANO BRUNO E ESPINOSA NA LEITURA DE F. H. JACOBI
Authors: Martone Juliana Ferraci
Published: March 2019

As denominadas filosofias do hen kai pantiveram um papel determinante no pensamento alemão do século XVIII e XIX, em boa parte devido ao tratamento que lhes foi dado por F. H. Jacobi em Sobre a doutrina de Espinosa em cartas ao senhor Moses Mendelssohn (1785). Espinosa e Giordano Bruno são os grandes representantes desse modo de pensar, e suas filosofias inauguram uma nova articulação entre causa e razão, mundo e Deus. Jacobi identifica em ambos o modelo da máxima coerência intelectual que uma filosofia pode alcançar, um monismo imanente cuja consistência lógica não pode ser combatida no interior do sistema com as armas da metafísica pura. Por outro lado, é no princípio indeterminado, comum a essas doutrinas, que Jacobi verá a confirmação de uma danosa tendência da história da filosofia que culmina no idealismo de Fichte e na filosofia do jovem Schelling, isto é, na união entre natureza naturada e naturante no eu.
DA VERDADEIRA THEOLOGIA MYSTICA
Authors: Pinheiro Ulysses
Published: March 2019

Tradução do texto "Da verdadeira Theologia Mystica", de G. W. Leibniz.
Barriers between community screening for visual problems and treatments in a tertiary center
Authors: Ferreira Gabriel De Almeida , Rezende Marcelo Abrão , Meneghim Roberta Lilian Fernandes de Sousa , Schellini Silvana Artioli
Published: March 2019

OBJECTIVE: To evaluate the effectiveness of mobile ophthalmic unit screenings and to investigate barriers between community care and resolution of the problem at a tertiary center. METHODS: This prospective study evaluated a convenience sample from 10 municipalities in São Paulo State, Brazil. Patients were assessed in the municipality by a mobile ophthalmic unit and underwent a complete ophthalmic consultation. Patients were referred as warranted to a tertiary hospital. RESULTS: The mobile ophthalmic unit screened 1,928 individuals and 714 (37%) were referred. The mean age of the referred patients was 57.12 (SD = 19.5) years with best corrected visual acuity of 0.37 (SD = 0.36) logMAR. Forty-seven (6.6%) patients were blind and 185 (26.5%) were visually impaired. Cataracts (44.7%) and pterygium (14.7%) accounted for most referrals. Of those referred, 67.1% presented to the tertiary center. The diagnosis by the mobile ophthalmic unit corresponded to the one by the tertiary center in 88.5% of the cases. There were a significantly higher number of blind and visually impaired persons among those who presented to the hospital. There was a significantly greater attendance among patients living in more distant municipalities from the reference center with a higher number of inhabitants and a greater number of ophthalmologists in the cities of origin (p < 0.05, all comparisons). Complete treatment was performed in 65.6% of patients, and loss to follow-up was the main cause of incomplete treatment in 50.7% of patients. A total of 313 cataract surgeries were performed, which reduced the number of blind patients from 20 to 2 and of visually impaired individuals from 87 to 2 (p < 0.001). CONCLUSIONS: Only 37% of the patients assessed by a mobile ophthalmic unit required referral to a tertiary hospital. Among the referred patients, 67.1% presented to the hospital, and complete resolution after treatment was approximately 65.5%. There was a significant improvement in visual acuity and a reduction in the prevalence of blindness and visual impairment postoperatively.
Prevalence and Significance of an Early Repolarization Electrocardiographic Pattern and Its Mechanistic Insight Based on Cardiac Magnetic Resonance Imaging in Patients With Acute Myocarditis
Authors: Oka Eiichiro , Iwasaki Yu-ki , Maru Yujin , Fujimoto Yuhi , Hagiwara Kanako , Hayashi Hiroshi , Yamamoto Teppei , Yodogawa Kenji , Hayashi Meiso , Shimizu Wataru
Published: March 2019

Background:

An early repolarization electrocardiographic (ER-ECG) pattern is caused by various pathophysiological conditions and is reported to be a predictor of life-threatening ventricular tachyarrhythmias. However, little evidence has been reported on the prevalence and significance of the ER-ECG pattern in acute myocarditis. This study aimed to investigate the prevalence and significance of the ER-ECG pattern and its mechanistic insight based on the cardiac magnetic resonance findings in patients with acute myocarditis.

Methods:

Thirty patients (23 men; 39.2±19.1 years) with a diagnosis of acute myocarditis by a clinical presentation between March 2011 and April 2018 were retrospectively evaluated. The patients were divided into 2 groups depending on the presence of an ER-ECG pattern on admission.

Results:

Nine cases had an ER-ECG pattern, which was defined as terminal QRS notching or slurring with an amplitude of >0.1 mV in at least 2 inferior or lateral leads (early repolarization [ER] group), whereas the remaining 21 cases had broad ST-segment elevation or pathological Q waves (non-ER group). The cardiac troponin T level was significantly higher in the non-ER group than ER group (3.2±4.3 versus 0.9±1.2 ng/mL;
P
=0.036). The ECG changes returned to baseline along with the normalization of the cardiac biomarkers. Nine of the 21 non-ER group patients, but none of the 9 ER group patients, developed a fulminant course and lethal ventricular tachyarrhythmias. T2-weighted cardiac magnetic resonance showed high-intensity signals over the entire transmural left ventricle in the non-ER group, whereas they were localized to the left ventricular epicardium in the ER group.

Conclusions:

The ER-ECG pattern in acute myocarditis was transient and reversible and was not associated with a worse prognosis. Inflammation/swelling localized to the left ventricular epicardium because of acute myocarditis might provide a mechanistic insight into the ER-ECG pattern.
Glycemic Markers and Subclinical Cardiovascular Disease: The Jackson Heart Study
Authors: Echouffo-Tcheugui Justin B. , Chen Haiying , Kalyani Rita R. , Sims Mario , Simpson Sean , Effoe Valery S. , Correa Adolfo , Bertoni Alain G. , Golden Sherita H.
Published: March 2019

Background

We investigated the associations of glycemic markers (HbA
1C
[hemoglobin A
1C
], fasting plasma glucose, and insulin resistance—homeostasis model assessment of insulin resistance) with subclinical cardiovascular disease (CVD) among blacks.

Methods

We included 4303 community-dwelling blacks (64% women; mean age, 54.5 years) without prevalent CVD. Subclinical CVD was defined as ≥1 of the following: any coronary artery calcification (CAC), elevated carotid intima-media thickness (cIMT), left ventricular (LV) hypertrophy, LV ejection fraction <50%, and peripheral artery disease (ankle-brachial index, <0.90). Estimates of cross-sectional associations of glycemic markers (fasting plasma glucose, HbA
1C
, and homeostasis model assessment of insulin resistance) with subclinical CVD measures were adjusted for traditional CVD risk factors.

Results

Each 1% increment in HbA
1C
was associated with higher odds of CAC, abnormal cIMT, and subclinical CVD (all
P
<0.001). Adjusted mean values of LV mass (LVM), LVM index, relative wall thickness, CAC, and cIMT were increasingly abnormal with worsening HbA
1C
categories (all
P
<0.05). Each 10-mg/dL increase in fasting plasma glucose was associated with higher odds of LV hypertrophy, CAC, abnormal cIMT, and subclinical CVD (all
P
<0.005). Adjusted mean values of LVM, LVM index, relative wall thickness, CAC, ankle-brachial index, and cIMT were more abnormal across categories of worsening fasting plasma glucose (all
P
<0.05). Each unit increment in log-transformed homeostasis model assessment of insulin resistance conferred a higher odd of having LV hypertrophy (
P
<0.01). Across quartiles of homeostasis model assessment of insulin resistance, we observed progressively abnormal adjusted mean values of LVM, LVM index, relative wall thickness, and ankle-brachial index (all
P
<0.01).

Conclusions

Among blacks, glycemic markers were differentially associated with various measures of subclinical CVD.
Dapagliflozin and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus and Previous Myocardial Infarction
Authors: Furtado Remo H.M. , Bonaca Marc P. , Raz Itamar , Zelniker Thomas A. , Mosenzon Ofri , Cahn Avivit , Kuder Julia , Murphy Sabina A. , Bhatt Deepak L. , Leiter Lawrence A. , McGuire Darren K. , Wilding John P.H. , Ruff Christian T. , Nicolau Jose C. , Gause-Nilsson Ingrid A.M. , Fredriksson Martin , Langkilde Anna Maria , Sabatine Marc S. , Wiviott Stephen D.
Published: March 2019

Background:

Sodium glucose transporter-2 inhibitors reduce the risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus and a history of atherosclerotic cardiovascular disease. Because of their baseline risk, patients with previous myocardial infarction (MI) may derive even greater benefit from sodium glucose transporter-2 inhibitor therapy.

Methods:

DECLARE-TIMI 58 (Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58) randomized 17 160 patients with type 2 diabetes mellitus and either established atherosclerotic cardiovascular disease (n=6974) or multiple risk factors (n=10 186) to dapagliflozin versus placebo. The 2 primary end points were composite of MACE (cardiovascular death, MI, or ischemic stroke) and the composite of cardiovascular death or hospitalization for heart failure. Those with previous MI (n=3584) made up a prespecified subgroup of interest.

Results:

In patients with previous MI (n=3584), dapagliflozin reduced the relative risk of MACE by 16% and the absolute risk by 2.6% (15.2% versus 17.8%; hazard ratio [HR], 0.84; 95% CI, 0.72–0.99;
P
=0.039), whereas there was no effect in patients without previous MI (7.1% versus 7.1%; HR, 1.00; 95% CI, 0.88–1.13;
P
=0.97;
P
for interaction for relative difference=0.11;
P
for interaction for absolute risk difference=0.048), including in patients with established atherosclerotic cardiovascular disease but no history of MI (12.6% versus 12.8%; HR, 0.98; 95% CI, 0.81–1.19). There seemed to be a greater benefit for MACE within 2 years after the last acute event (
P
for interaction trend=0.007). The relative risk reductions in cardiovascular death/hospitalization for heart failure were more similar, but the absolute risk reductions tended to be greater: 1.9% (8.6% versus 10.5%; HR, 0.81; 95% CI, 0.65–1.00;
P
=0.046) and 0.6% (3.9% versus 4.5%; HR, 0.85; 95% CI, 0.72–1.00;
P
=0.055) in patients with and without previous MI, respectively (
P
interaction for relative difference=0.69;
P
interaction for absolute risk difference=0.010).

Conclusions:

Patients with type 2 diabetes mellitus and previous MI are at high risk of MACE and cardiovascular death/hospitalization for heart failure. Dapagliflozin appears to robustly reduce the risk of both composite outcomes in these patients. Future studies should aim to confirm the large clinical benefits with sodium glucose transporter-2 inhibitors we observed in patients with previous MI.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01730534.
Effect of a Walnut Diet on Office and 24-Hour Ambulatory Blood Pressure in Elderly Individuals
Authors: Domènech Mónica , Serra-Mir Mercè , Roth Irene , Freitas-Simoes Tania , Valls-Pedret Cinta , Cofán Montserrat , López Anna , Sala-Vila Aleix , Calvo Carlos , Rajaram Sujatha , Sabaté Joan , Ros Emilio
Published: March 2019

Nut consumption lowers blood cholesterol and is associated with reduced cardiovascular disease, but effects on blood pressure (BP) are inconsistent. We assessed the 2-year effects of a walnut diet versus a control diet on office BP and 24-hours ambulatory BP in free-living elders participating in the Walnuts and Healthy Aging study, a randomized trial testing the effects of walnuts at ≈15% energy on age-related disorders. In a prespecified analysis, we enrolled 305 participants, of whom 236 (75%) completed the study (65% women; age, 69 years; 60% with mild hypertension). Walnuts were well tolerated, and compliance was >98%. Mean baseline office BP was 128/79 mm Hg. Adjusted changes from baseline in mean office systolic BP were −4.61 mm Hg (95% CI, −7.43 to −1.79 mm Hg) in the walnut group and −0.59 mm Hg (−3.38 to 2.21 mm Hg) in controls (
P
=0.051). Respective changes in mean systolic 24-hour ambulatory BP were −3.86 mm Hg (CI, −5.45 to −2.26 mm Hg) and −2.00 mm Hg (CI, −3.58 to −0.42 mm Hg;
P
=0.111). No changes in diastolic BP were observed. In participants in the upper tertile of baseline 24-hour ambulatory systolic BP (>125 mm Hg), mean 2-year systolic 24-hour BP was −8.5 mm Hg (CI, −12 to −5.0 mm Hg) in the walnut group and −2.5 mm Hg (CI, −6.3 to 1.3 mm Hg) in controls (
P
=0.034). During the trial, participants in the walnut group required less uptitration of antihypertensive medication and had better overall BP regulation than controls. Walnut consumption reduces systolic BP in elderly subjects, particularly in those with mild hypertension.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier:
NCT01634841
.
Reduced Intracerebral Hemorrhage and Perihematomal Edema Volumes in Diabetics on Sulfonylureas
Authors: Irvine Hannah , Male Shailesh , Robertson Jetter , Bell Caitlin , Bentho Oladi , Streib Christopher
Published: March 2019

Background and Purpose—

Sulfonylurea medications have been linked to reduced brain edema and improved outcome following ischemic stroke, but their effects on primary intracerebral hemorrhage (pICH) have not been thoroughly explored. Increasing ICH volume and perihematomal edema (PHE) volume are predictors of poor outcome in pICH. We investigated whether preexisting sulfonylurea use influenced ICH volume, PHE volume, and discharge disposition in patients with type 2 diabetes mellitus presenting with pICH.

Methods—

We performed a retrospective chart review of all diabetic patients presenting with pICH to 2 tertiary academic centers from 2006 to 2016. All patients with diabetes mellitus, pICH, admission computed tomography scan, and sulfonylurea use on admission were included in our study. For each case, 2-matched controls (admission date, age, hematoma location [deep versus lobar], use of antiplatelet, or anticoagulant) with diabetes mellitus and pICH were consecutively selected. ICH and PHE volumes were measured via region of interest analysis on admission computed tomography. To mitigate the influence of ICH volume on PHE, the PHE/ICH surface area ratio was calculated. Hospital discharge disposition was determined via chart abstraction. We used the Wilcoxon rank-sum test and Fisher exact test to compare cases and controls.

Results—

Of 317 patients screened, 21 sulfonylurea cases and 42-matched controls met criteria for study inclusion. Sulfonylurea cases had significantly lower admission ICH volumes (median, 4 mL; interquartile range [IQR], 2–30 versus median, 25 mL; IQR, 6–60;
P
=0.011), PHE volumes (median, 4 mL; IQR, 0.9–24 versus median, 17; IQR, 6–37;
P
=0.0095), and PHE/ICH surface area ratios (median, 0.28; IQR, 0.1–0.4 versus median, 0.43; IQR, 0.3–0.6;
P
=0.013) as compared with controls. Sulfonylureas were associated with improved discharge disposition (
P
=0.0062).

Conclusions—

In patients with diabetes mellitus and pICH, sulfonylurea use predicted lower ICH and PHE volumes, lower relative PHE, and improved discharge disposition. Given the paucity of treatment options for pICH, further study of sulfonylureas is warranted.
Differential Impact of Risk Factors on Stroke Occurrence Among Men Versus Women in West Africa
Authors: Akpalu Albert , Gebregziabher Mulugeta , Ovbiagele Bruce , Sarfo Fred , Iheonye Henry , Akinyemi Rufus , Akpa Onoja , Tiwari Hemant K. , Arnett Donna , Wahab Kolawole , Lackland Daniel , Abiodun Adeoye , Ogbole Godwin , Jenkins Carolyn , Arulogun Oyedunni , Akpalu Josephine , Obiako Reginald , Olowoyo Paul , Fawale Michael , Komolafe Morenikeji , Osaigbovo Godwin , Obiabo Yahaya , Chukwuonye Innocent , Owolabi Lukman , Adebayo Philip , Sunmonu Taofiki , Owolabi Mayowa ,   on behalf of SIREN Team as part of H3Africa Consortium
Published: March 2019

Background and Purpose—

The interplay between sex and the dominant risk factors for stroke occurrence in sub-Saharan Africa has not been clearly delineated. We compared the effect sizes of risk factors of stroke by sex among West Africans.

Methods—

SIREN study (Stroke Investigative Research and Educational Networks) is a case-control study conducted at 15 sites in Ghana and Nigeria. Cases were adults aged >18 years with computerized tomography/magnetic resonance imaging confirmed stroke, and controls were age- and sex-matched stroke-free adults. Comprehensive evaluation for vascular, lifestyle, and psychosocial factors was performed using validated tools. We used conditional logistic regression to estimate odds ratios and reported risk factor specific and composite population attributable risks with 95% CIs.

Results—

Of the 2118 stroke cases, 1193 (56.3%) were males. The mean±SD age of males was 58.1±13.2 versus 60.15±14.53 years among females. Shared modifiable risk factors for stroke with adjusted odds ratios (95% CI) among females versus males, respectively, were hypertension [29.95 (12.49–71.77) versus 16.1 0(9.19–28.19)], dyslipidemia [2.08 (1.42–3.06) versus 1.83 (1.29–2.59)], diabetes mellitus [3.18 (2.11–4.78) versus 2.19 (1.53–3.15)], stress [2.34 (1.48–3.67) versus 1.61 (1.07–2.43)], and low consumption of green leafy vegetables [2.92 (1.89–4.50) versus 2.00 (1.33–3.00)]. However, salt intake and income were significantly different between males and females. Six modifiable factors had a combined population attributable risk of 99.1% (98.3%–99.6%) among females with 9 factors accounting for 97.2% (94.9%–98.7%) among males. Hemorrhagic stroke was more common among males (36.0%) than among females (27.6%), but stroke was less severe among males than females.

Conclusions—

Overall, risk factors for stroke occurrence are commonly shared by both sexes in West Africa favoring concerted interventions for stroke prevention in the region.
Y KUŞAĞI PERSPEKTİFİNDEN MUHASEBE MESLEĞİ: İKTİSADİ VE İDARİ BİLİMLER FAKÜLTESİ ÖĞRENCİLERİNE YÖNELİK BİR ARAŞTIRMA
Authors: AKBAŞ Halil Emre , BOZKURT Serdar , DEMİRHAN Ayşe , YAZICI Kübra
Published: March 2019

Muhasebe mesleğinin yalnızca kayıt
tutmaktan ibaret olmadığının anlaşılması ile muhasebenin önemi gittikçe
artmıştır.  Günümüzde muhasebe çıktıları
işletme sahiplerinin, yöneticilerinin ve paydaşların kararlarını etkileyen en
önemli unsurlardan biridir. Bu alanda çalışanların genellikle İktisadi ve İdari
Bilimler Fakültesi mezunu olduğu düşünüldüğünde öğrenimine devam etmekte olan Y
kuşağındaki lisans öğrencilerinin gelecekte bu meslekte yer almaları
muhtemeldir. Bu bağlamda çalışmanın temel amacı, Y kuşağında yer alan lisans
öğrencilerinin muhasebe mesleğine yönelik algılarının incelenmesidir. Ayrıca
öğrencilerin demografik özelliklerine göre muhasebe mesleği algılarının farklı
olup olmadığının incelenmesi de araştırmanın alt amacını oluşturmaktadır. Bu
doğrultuda, bir devlet üniversitesinde İktisadi ve İdari Bilimler Fakültesinde
okuyan ve Y kuşağında yer alan 125 öğrenci ile anket çalışması
gerçekleştirilmiştir. Araştırma sonucunda; öğrencilerin muhasebe mesleği
algısının cinsiyete göre farklılık gösterdiği belirlenmiştir. Ancak muhasebe
meslek algısının öğrencilerin bölümüne, bulundukları sınıfa ve muhasebe
alanında çalışma durumuna göre farklılık göstermediği tespit edilmiştir.
SAĞLIK HARCAMALARI-GELİR DAĞILIMI İLİŞKİSİNE YÖNELİK EKONOMETRİK BİR ANALİZ
Authors: ŞANTAŞ Gülcan , DEMİRGİL Bünyamin , ŞANTAŞ Fatih
Published: March 2019

Bu
çalışma, Türkiye’de sağlık harcamalarının gelir dağılımı üzerindeki etkisinin
incelenmesi amacıyla gerçekleştirilmiştir. Çalışma, 1980-2017 dönemini
kapsamaktadır. Çalışmada Gini katsayısı bağımlı değişken ve kamu sağlık
harcamalarının GSYH’ye oranı ise bağımsız değişkendir. Çalışmada seriler
arasında eşbütünleşme ilişkisi bulunduğu belirlenmiştir. ARDL sınır testi
yaklaşımına göre, kamu sağlık harcamalarında meydana gelen %1’lik bir artış,
uzun dönemde Gini katsayısını %0,03 oranında azaltmaktadır. Toda Yamamoto
nedensellik testine göre sağlık harcamalarından gelir dağılımı eşitsizliğine
doğru bir nedensellik ilişkisi bulunmaktayken gelir dağılımı eşitsizliğinden
sağlık harcamalarına doğru bir nedensellik ilişkisi bulunmadığı belirlenmiştir.