bluuebunny/crossref_metadata_2025 huggingface dataset:
Isolation, Extraction, Purification, and Molecular Characterization for Thermostable α-Amylase from Locally Isolated Bacillus Species in Sudan
Authors: Rakaz Maha A. , Hussien Mohammed O. , Ibrahim Hanan M.
Published: May 2021

The aim of this study was to isolate some soil bacteria strain that produced α-amylase and subsequent extraction and purification. One hundred soil samples were collected from different geographical areas in Khartoum State such as north Omdurman, Toti Island, and Soba. Samples were analyzed for starch hydrolyzing bacteria. Among several bacteria isolated, Bacillus cereus and Bacillus licheniformis were identified as active α-amylase producers. Both bacteria showed a large zone of clearance of 20 mm when grown on starch-agar plates. The identity was conducted using biochemical characterization and confirmed by sequencing their 16S-rDNA. The constitutive nature of amylase was proved by amplification of the amylase gene from the genome of B. licheniformis. The α-amylase activity from the spent medium of B. cereus and B. licheniformis was optimized at pH 8.0 and temperature of 45°C and 65°C, respectively. The α-amylase produced by both bacteria is alkalophilic and thermophilic. The experiments confirmed that B. licheniformis can be a good source of amylase for industrial applications in Sudan.
Cement Slurry Plugging Law and Optimal Plugging Flow Rate at a High Hydraulic Gradient
Authors: Su Peili , Jia Yifei , Liu Feng , Li Chong
Published: May 2021

With the continuous development of coal and rock mass engineering, water inrush grouting has become an urgent problem in engineering disaster management. Herein, a theoretical model of the optimal plugging flow rate was established, and a comparative theoretical analysis was performed based on the results of indoor model tests. The particle incipient velocity was defined as the optimal plugging flow rate. The effects of hydrodynamic velocity, water‐cement ratio, grouting pressure, and fracture aperture on the cement slurry grouting plugging were studied, and the optimal threshold of the plugging flow rate was obtained for theoretical model verification. Results showed that, at a high hydraulic gradient, the plugging effect of the grout was mainly affected by the hydrodynamic velocity, water‐cement ratio, and grouting pressure (listed in the order of importance). When the hydrodynamic velocity was low, the difference in the slurry deposition thickness was large under different water–cement ratios and pipe diameters. When the hydrodynamic velocity was increased, the influence of various factors on the slurry deposition thickness decreased. Through a comparative analysis of the experimental and theoretical values, the optimal plugging velocity of pure cement slurry was 0.5–0.55 m·s−1 under different conditions, and the error between the experimental and theoretical values was less than 0.1 m·s−1, which confirmed the rationality of the proposed model.
Combination of Joint Representation and Adaptive Weighting for Multiple Features with Application to SAR Target Recognition
Authors: Yu Liqun , Wang Lu , Xu Yongxing
Published: May 2021

For the synthetic aperture radar (SAR) target recognition problem, a method combining multifeature joint classification and adaptive weighting is proposed with innovations in fusion strategies. Zernike moments, nonnegative matrix factorization (NMF), and monogenic signal are employed as the feature extraction algorithms to describe the characteristics of original SAR images with three corresponding feature vectors. Based on the joint sparse representation model, the three types of features are jointly represented. For the reconstruction error vectors from different features, an adaptive weighting algorithm is used for decision fusion. That is, the weights are adaptively obtained under the framework of linear fusion to achieve a good fusion result. Finally, the target label is determined according to the fused error vector. Experiments are conducted on the moving and stationary target acquisition and recognition (MSTAR) dataset under the standard operating condition (SOC) and four extended operating conditions (EOC), i.e., configuration variants, depression angle variances, noise interference, and partial occlusion. The results verify the effectiveness and robustness of the proposed method.
Determination of Biochemical Contents of Fresh, Oven-Dried, and Sun-Dried Peels and Pulps of Five Apple Cultivars (Amasya, Braeburn, Golden Delicious, Granny Smith, and Starking)
Authors: Ergün Zeynep
Published: May 2021

This study aimed to investigate the biochemical compounds of five different apple cultivars (Amasya, Braeburn, Golden Delicious, Granny Smith, and Starking) grown in the same location and to reveal the differences between peel and pulp in the fresh, oven-dried, and sun-dried samples. Sugar and organic acid contents were analyzed through high-performance liquid chromatography. Besides, antioxidant activity, total flavonoid, and total phenolic contents were analyzed with a spectrophotometer. The results of these analyses showed that the compounds varied between peel and pulp and among fresh, oven-dried, and sun-dried samples. The largest level of total flavonoid was found in Amasya oven-dried peel, and the largest total phenol, antioxidant activity, fructose, and total sugar levels were observed in Amasya sun-dried peel. Moreover, the largest L-ascorbic acid was detected in Amasya oven-dried pulp. Granny Smith oven-dried pulp was rich in citric, succinic acids, and glucose. Braeburn sun-dried pulp, Golden Delicious oven-dried pulp, and Granny Smith sun-dried pulp contained the largest sucrose, malic acid, and total soluble solids levels, respectively. For data interpretation, t-test, ANOVA, Duncan’s test, Kruskal–Wallis H test, and principal component analysis were performed. The peel contained significantly higher total flavonoid, total phenol, and antioxidant activity than pulp. Moreover, among fresh, oven-dried, and sun-dried samples, total phenol, succinic acid, malic acid, and L-ascorbic acid significantly differed. As a whole, the pulp was rich in sugars. The results provide valuable information on the food quality parameters of five different apple cultivars. It was demonstrated that consuming apple with its peel is healthier (in terms of total flavonoid, total phenol, antioxidant activity parameters, and L-ascorbic acid), and drying (especially the sun-drying method) is an effective food storage method for apples.
Three-Dimensional Reconstruction of Huizhou Landscape Combined with Multimedia Technology and Geographic Information System
Authors: Zhou Zhenhong , Qingshan Zhu , Dongyi Liu , Weihong Tang
Published: May 2021

Huizhou architecture is the most important Chinese ancient architecture. Being a traditional architecture, Huizhou architecture has always maintained a unique artistic style of elegance, simplicity, richness, and integration. Huizhou landscape is an essential embodiment of Huizhou culture. The landscape and pattern of Huizhou villages are the external manifestations of Huizhou culture symbols. This architecture needs to be preserved using multimedia technology and geographic information system. This paper uses these systems to extract the landscape image and develop three-dimensional Huizhou village’s modeling methods with automation, high efficiency, and low cost. It has realized the functions of landscape information query, high-dimensional measurement, terrain analysis, visibility analysis, and virtual roaming of Huipai village. This modeling has specific promotion effects on landscape spatial analysis, landscape planning, ecological protection, natural and cultural inheritance, and tourism development.
Efficacy of Novel Noncontrast Cardiac Magnetic Resonance Methods in Indicating Fibrosis in Hypertrophic Cardiomyopathy
Authors: Sharifian Maedeh , Rezaeian Nahid , Asadian Sanaz , Mohammadzadeh Ali , Nahardani Ali , Kasani Kianosh , Toloueitabar Yaser , Farahmand Ali Mohammad , Hosseini Leila
Published: May 2021

Objective. In hypertrophic cardiomyopathy (HCM), myocardial fibrosis is routinely shown by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) imaging. We evaluated the efficacy of 2 novel contrast-free CMR methods, namely, diffusion-weighted imaging (DWI) and feature-tracking (FT) method, in detecting myocardial fibrosis. Methods. This cross-sectional study was conducted on 26 patients with HCM. Visual and quantitative comparisons were made between DWI and LGE images. Regional longitudinal, circumferential, and radial strains were compared between LGE-positive and LGE-negative segments. Moreover, global strains were compared between LGE-positive and LGE-negative patients as well as between patients with mild and marked LGE. Results. All 3 strains showed significant differences between LGE-positive and LGE-negative segments (

P
<
0.001

). The regional longitudinal and circumferential strain parameters showed significant associations with LGE (

P
<
0.001

), while regional circumferential strain was the only independent predictor of LGE in logistic regression models (OR: 1.140, 95% CI: 1.073 to 1.207,

P
<
0.001

). A comparison of global strains between patients with LGE percentages of below 15% and above 15% demonstrated that global circumferential strain was the only parameter to show impairment in the group with marked myocardial fibrosis, with borderline significance (

P
=
0.09

). A review of 212 segments demonstrated a qualitative visual agreement between DWI and LGE in 193 segments (91%). The mean apparent diffusion coefficient was comparable between LGE-positive and LGE-negative segments (

P
=
0.51

). Conclusions. FT-CMR, especially regional circumferential strain, can reliably show fibrosis-containing segments in HCM. Further, DWI can function as an efficient qualitative method for the estimation of the fibrosis extent in HCM.
A Study on the Solutions of a Multiterm FBVP of Variable Order
Authors: Bouazza Zoubida , Etemad Sina , Souid Mohammed Said , Rezapour Shahram , Martínez Francisco , Kaabar Mohammed K. A.
Published: May 2021

In the present research study, for a given multiterm boundary value problem (BVP) involving the nonlinear fractional differential equation (NnLFDEq) of variable order, the uniqueness-existence properties are analyzed. To arrive at such an aim, we first investigate some specifications of this kind of variable order operator and then derive required criteria confirming the existence of solution. All results in this study are established with the help of two fixed-point theorems and examined by a practical example.
Suppression of DLBCL Progression by the E3 Ligase Trim35 Is Mediated by CLOCK Degradation and NK Cell Infiltration
Authors: Tan Xiyan , Cao Fuyang , Tang Feiyu , Lu Can , Yu Qiaoyan , Feng Songshan , Yang Zhanghuan , Chen Songming , He Xiang , He Jiang , Weng Liang , Sun Lunquan
Published: May 2021

The majority of diffuse large B-cell lymphoma (DLBCL) patients develop relapsed or refractory disease after standard ruxolitinib, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy, which is partly related to a dysregulated tumor immune microenvironment. However, how the infiltration of immune cells is appropriately regulated is poorly understood. Herein, we show that the E3 ubiquitin ligase Trim35 is expressed at low levels in human DLBCL tissues. We also show that overexpression of Trim35 suppresses DLBCL cell proliferation and correlates with inferior survival in DLBCL patients. Our mechanistic study shows that Trim35 functions as an E3 ligase to mediate the ubiquitination and degradation of CLOCK, a key regulator of circadian rhythmicity. High expression of Trim35 correlates with NK cell infiltration in DLBCL, partly due to the degradation of CLOCK. Consistently, patients with high expression of CLOCK show poor overall survival. Overall, these findings suggest that Trim35 suppresses the progression of DLBCL by modulating the tumor immune microenvironment, indicating that it may be a promising diagnostic and prognostic biomarker in DLBCL.
Genomics, Transcriptomics, and Minimal Residual Disease Detection: The Winning Team to Guide Treatment of Acute Lymphoblastic Leukemia
Authors: Segers Heidi , Cools Jan
Published: May 2021

Summary: Cytogenetics supported by additional molecular analyses and minimal residual disease detection have been successfully combined to improve the outcome of childhood acute lymphoblastic leukemia (ALL). Results from the St. Jude Total Therapy Study 16 demonstrate that some of the recently identified ALL subtypes can further guide risk stratification.

See related article by Jeha et al., p. 326.
Successful Management of Internal Carotid Artery Transection Secondary to a Gunshot Wound and Subsequent Malignant MCA Syndrome
Authors: Cairns George , Belshaw Alex
Published: May 2021

There are over 100,000 strokes each year in the UK. A very small proportion of these can be attributed to gunshot wounds and subsequent surgical intervention. We present a rare case of a 24-year-old male patient admitted to the Emergency Department having sustained a gunshot wound to the left side of his neck. Initial imaging and surgical exploration revealed significant left-sided vertebral artery damage and a complete transection of the internal carotid artery. Following damage control surgery (DCS), the patient was admitted to ITU but had an acute neurological deterioration and was found to have suffered malignant middle cerebral artery (MCA) syndrome, requiring an urgent decompressive craniectomy. The patient’s National Institutes of Health Stroke Scale (NIHSS) at this stage was 26. After a prolonged ITU stay and repatriation to a local stroke unit for intensive therapies input, the patient walked out of the hospital independently on day 106, with an improved NIHSS of 3. This case report aims to highlight the rarity of an ischaemic stroke, secondary to the DCS required for a near fatal gunshot wound, along with the importance of timely recognition of an acute deterioration following artery ligation. Additionally, it aims to examine the lifesaving surgical management of malignant MCA syndrome and in turn the significance of the shared decision-making process between clinicians, the patient, and family members, due to the high rate of poor functional outcomes following this major surgery.
Cytomegalovirus-Associated Hemolytic Anemia in an Infant Born to a Mother with Lupus
Authors: Yamamoto Shunsuke , Shiraishi Akira , Ishimura Masataka , Motomura Yoshitomo , Yada Yutaro , Moriuchi Hiroyuki , Ohga Shouichi
Published: May 2021

A 31-day-old infant was admitted to the pediatric intensive care unit due to shock and anemia. The mother had systemic lupus erythematosus and direct antiglobulin test (DAT)-positive hemolytic anemia. The perinatal course of this infant and the mother was uneventful. Regular health check screenings revealed that activity, growth, and development were unremarkable at birth, 5, and 28 days of life. Passive immune hemolytic anemia due to neonatal lupus erythematosus was diagnosed based on a positive DAT for warm-type IgG antibodies, reticulocytosis, and lupus-specific antibodies at rehospitalization. It was complicated by cytomegalovirus (CMV) antigenemia. Umbilical cord blood and peripheral blood samples obtained from the infant at 5 days after birth were negative for CMV DNA. The infant was curatively treated by intensive care with repeated blood transfusions and antiviral therapy. This is the first report indicating that CMV infection exacerbates hemolytic anemia in patients with maternal red blood cell alloantibodies.
Detectable SARS-CoV-2 RNAemia in Critically Ill Patients, but Not in Mild and Asymptomatic Infections
Authors: Richter Enrico , Al Arashi Doaa , Schulte Bianca , Bode Christian , Marx Benjamin , Aldabbagh Souhaib , Schlüter Celina , Kümmerer Beate Mareike , Oldenburg Johannes , Funk Markus B. , Putensen Christian , Schmithausen Ricarda Maria , Hartmann Gunther , Eis-Hübinger Anna , Streeck Hendrik
Published: May 2021

Background: The SARS-CoV-2 pandemic has challenged many of our current routine practices in the treatment and care of patients. Given the critical importance of blood donation and transfusion we analyzed 92 blood samples of individuals infected with SARS-CoV-2 stratified by symptoms. Study Design and Methods: We therefore tested blood samples for SARS-CoV-2 via RT-PCR targeting the E gene. In addition, we tested each blood sample for anti-SARS-CoV-2 IgG antibodies via ELISA and performed plaque reduction neutralization tests. Results: SARS-CoV-2 RNA was absent in the blood of mild to asymptomatic patients (57 individuals) and only detectable in individuals with severe COVID-19 who were admitted to the intensive care unit (35 individuals) (n = 6/92 [6.5%]; p = 0.023 Fisher’s exact test). Interestingly, anti-spike IgG antibodies were not significantly higher in intensive care unit patients compared to mild patients, but we found that their neutralizing capacity was disproportionately increased (p < 0.001). Conclusion: Our observations support the hypothesis that there are no potential hazards from blood or plasma transfusion of SARS-CoV-2-positive individuals with mild flu-like symptoms and more importantly of asymptomatic individuals.
Porokeratosis of the Nail Unit: Case Series and Review
Authors: Yendo Tatiana Mina , Gabbi Tatiana Villas Boas , Nico Marcello Menta Simonsen
Published: May 2021

Background: The lesions of porokeratosis (PK) lead to skin atrophy and scarring as long as they spread centrifugally. PK affecting the nail unit is seldom described. Objective: The aim was to revise the previously reported cases of ungual PK and to present 3 new cases. Methods: A PubMed search was performed with the keywords “nail” and “porokeratosis.” Previously reported cases as well as 3 new cases are depicted in tables. Results: Only 11 cases of ungual PK were found; 3 new cases have been added. All patients presented with typical lesions of PK (Mibelli, isolated, segmental, or ostial eccrine types) that happened to affect nails due to nail matrix or nail bed compromise, resulting in mild to severe nail scarring, including irreversible anonychia. The present 3 case series contrast with the previous single case reports. Conclusions: PK affecting the nails is exceedingly rare. Changes in nails affected by PK are irreversible, since, as on the skin, this is a chronic scarring process.
Flow Dynamic Analysis by Contrast-Enhanced Imaging Techniques of Medium Cutoff Membrane Hemodialyzer
Authors: Lorenzin Anna , Golino Gianlorenzo , de Cal Massimo , Pajarin Giordano , Savastano Sergio , Lupi Andrea , Sandini Alessandra , Fiorin Francesco , Ronco Claudio
Published: May 2021

Introduction: Medium cutoff (MCO) membranes represent an interesting innovation in the field of hemodialysis. Given the correlation between large (PM >25 kDa) middle molecules (LMM) and clinical outcomes, the possibility to broaden the spectrum of solutes removed in hemodialysis with MCO membranes introduces a new perspective for end-stage kidney disease patients. Due to low diffusion coefficients of LMM, the use of convection is required to maximize extracorporeal clearance. High convective rates are achieved with high-flux membranes in hemodiafiltration, a technique not available in the US. In case of the MCO membrane, remarkable clearances of LMM are achieved combining the permeability of the membrane with a significant amount of internal convection. The mechanism of filtration-backfiltration inside the dialyzer enables effective removal of LMM in a technique called expanded hemodialysis (HDx). Given such theoretical explanation, it is important to demonstrate the blood and ultrafiltration rheology inside the MCO dialyzer. Method: This study for the first time describes flow dynamic parameters and internal cross-filtration, thanks to specific radiology and nuclear imaging techniques. Results: Flow dynamic analysis of the blood and dialysate compartment confirms excellent distribution of velocities and an excellent matching of blood and dialysate. Average blood flow velocity allows for wall shear rates adequate to avoid protein stagnation at the blood membrane interface and increase in blood viscosity. Cross-filtration analysis demonstrates a remarkable filtration/backfiltration flux reaching values >30 mL/min at a blood flow of 300 mL/min and zero net filtration. Conclusion: The MCO dialyzer Theranova 400 appears to have a design optimized to perform expanded hemodialysis (HDx).
European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the Use of Minimally Invasive Treatments in Malignant Thyroid Lesions
Authors: Mauri Giovanni , Hegedüs Laszlo , Bandula Steven , Cazzato Roberto Luigi , Czarniecka Agnieszka , Dudeck Oliver , Fugazzola Laura , Netea-Maier Romana , Russ Gilles , Wallin Göran , Papini Enrico
Published: May 2021

The growing detection of papillary thyroid microcarcinomas (PTMCs) is paralleled by an increase in surgical procedures. Due to the frequent indolent nature, cost, and risk of surgery, active surveillance (AS) and ultrasound-guided minimally invasive treatments (MITs) are in suitable cases of incidental PTMC proposed as alternatives to thyroidectomy. Surgery and radioiodine are the established treatments for relapsing cervical differentiated thyroid carcinoma (DTC) metastases. But radioiodine refractoriness, risk of surgical complications, adverse influence on quality of life, or declining repeat surgery have led to AS and MIT being considered as alternatives for slow-growing DTC nodal metastases. Also, for distant radioiodine-refractory metastases not amenable to surgery, MIT is proposed as part of a multimodality therapeutic approach. The European Thyroid Association and the Cardiovascular and Interventional Radiological Society of Europe commissioned these guidelines for the appropriate use of MIT. Based on a systematic PubMed search, an evidence-based approach was applied, and both knowledge and practical experience of the panelists were incorporated to develop the manuscript and the specific recommendations. We recommend that when weighing between surgery, radioiodine, AS, or MIT for DTC, a multidisciplinary team including members with expertise in interventional radiology assess the demographic, clinical, histological, and imaging characteristics for appropriate selection of patients eligible for MIT. Consider TA in low-risk PTMC patients who are at surgical risk, have short life expectancy, relevant comorbidities, or are unwilling to undergo surgery or AS. As laser ablation, radiofrequency ablation, and microwave ablation are similarly safe and effective thermal ablation (TA) techniques, the choice should be based on the specific competences and resources of the centers. Use of ethanol ablation and high-intensity focused ultrasound is not recommended for PTMC treatment. Consider MIT as an alternative to surgical neck dissection in patients with radioiodine refractory cervical recurrences who are at surgical risk or decline further surgery. Factors that favor MIT are previous neck dissection, presence of surgical complications, small size metastases, and <4 involved latero-cervical lymph nodes. Consider TA among treatment options in patients with unresectable oligometastatic or oligoprogressive distant metastases to achieve local tumor control or pain palliation. Consider TA, in combination with bone consolidation and external beam radiation therapy, as a treatment option for painful bone metastases not amenable to other established treatments.
Analysis of Axial Length in Young Patients with Marfan Syndrome and Bilateral Ectopia Lentis by Z-Scores
Authors: Chen Ze-Xu , Chen Jia-Hui , Zhang Min , Chen Tian-Hui , Zheng Jia-Lei , Deng Michael , Ji Ying-Hong , Jiang Yong-Xiang
Published: May 2021

Introduction: Marfan syndrome (MFS) is characterized by ectopia lentis (EL) and elongated axial length (AL). The characteristics of AL in young patients with MFS and bilateral EL before the lens surgery are not fully understood. Methods: This study reviewed MFS patients under 20 years old with bilateral EL from January 2015 to October 2020. The Z-scores were introduced in terms of the number of standard deviations from the mean of age-matched normative data. Using Z-scores, the distribution of AL and influence factors were evaluated. The correlations between AL and other biometrics were analyzed. Results: We reviewed 183 patients and enrolled both eyes. The mean age was 8.44 ± 4.69 years. About 36% of the patients were children under 6 years old. The median AL increased from 23.16 mm under 5 years old to 26.20 mm in the 16–20 age group, and when plotted, the trend presented a logarithmic curvature (R2 = 0.145, p < 0.001). The median Z-AL score was 1.24. One-third of eyes had Z-score <0. About 20% of the patients had AL difference over 1 mm between the right and left eyes, and the right one had longer Z-AL scores (p = 0.013). The eye complicated with megalocornea (10, 7.04%) had larger Z-AL scores (4.72 ± 3.51 vs. 1.10 ± 2.25, p = 0.002). A positive correlation was found between Z-AL and Z-corneal curvature radius (r = 0.265, p < 0.001). Conclusion: Young patients with bilateral EL but small AL should not be excluded from MFS without systematic examination. The age-adjusted Z-score will facilitate further study of the individual variations in AL across different ages.
Lung'Ie, lunge no: método para aprender lung'Ie
Authors:   Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão, Agostinho Ana Lívia , Araujo Gabriel Antunes de ,   Universidade de São Paulo. Faculdade de Filosofia, Letras e Ciências Humanas
Published: May 2021

O lung’Ie é uma língua crioula de base portuguesa falada na República Democrática de São Tomé e Príncipe (STP). Também conhecido, especialmente na literatura científica, como principense ou crioulo da Ilha do Príncipe, o lung’Ie, ou “língua da Ilha”, é chamado lingw’Ie ou lungw’Ie por seus falantes. As gramáticas prévias do lung’Ie não servem como instrumentos para uso pedagógico propriamente dito, pois são descrições científicas e não foram formatadas como material didático. Além disso, a primeira tem o alemão como língua-veículo e, a segunda, o inglês. A obra ora apresentada tem como língua-veículo o português, língua oficial de São Tomé e Príncipe, empregada na escolarização básica e fundamental e língua materna da maior parte da população. Assim, pela primeira vez, temos um material linguístico acessível aos habitantes da Ilha do Príncipe. As versões em português dos diálogos e textos de cultura podem apresentar variação linguística e diferir da norma escolar padrão. O conteúdo deste método pedagógico está dividido em quatro partes: lições, apêndices, índices e glossário.
Nutrizes usuárias de drogas e o desfecho da amamentação: estudo de coorte
Authors: Ribeiro Silmara de Fátima Teixeira , Fernandes Rosa Aurea Quintella
Published: May 2021

Objetivo: conhecer o desfecho do aleitamento materno de mães usuárias de drogas lícitas e ilícitas, verificar a gravidade da dependência e relacionar com o tempo de aleitamento. Método: estudo de coorte com 108 mulheres. Utilizou-se o Alcohol Smoking and Substance Involvement Screening Test para estabelecer a dependência a drogas. A manutenção da amamentação foi avaliada no 7°, 15° e 30° dias de nascimento. Para avaliar a continuidade do aleitamento materno, utilizou-se análise de sobrevivência de Kaplan-Meier e de Cox. Resultados: a maconha teve escore de uso abusivo para 42,6% das mães e a cocaína para 37%. A média de aleitamento foi de 28,8 dias. O uso abusivo de tabaco e álcool representou, respectivamente, 6,6 e 11 vezes mais risco de descontinuar a amamentação. Não foi possível estabelecer a mesma relação para maconha e cocaína. Conclusão: as mães usuárias de drogas praticaram o aleitamento exclusivo, mesmo aquelas que consomem maconha e cocaína de modo abusivo. O consumo de drogas, mesmo lícitas, representa um risco para o desmame precoce.
Idosos atendidos em um Serviço de Urgência e Emergência Psiquiátrica
Authors: Cordeiro Mayara Giuli dos Santos , Otani Márcia Aparecida Padovan , Goulart Flávia Cristina , Pinheiro Osni Lazaro , Marin Maria José Sanches , Lazarini Carlos Alberto
Published: May 2021

Objetivo: caracterizar os idosos atendidos em um Serviço de Urgência e Emergência Psiquiátrica quanto ao perfil  sociodemográfico, diagnóstico psiquiátrico, prescrição de medicamentos e conduta médica e avaliar suas associações com o sexo. Método: estudo transversal, quantitativo, em que os dados foram obtidos a partir dos prontuários de pacientes atendidos no referido serviço, entre julho/2015 e junho/2016. A variável independente foi o sexo e as dependentes foram: idade; procedência; informante; tratamento psiquiátrico anterior; diagnóstico; medicamentos prescritos e conduta. Resultados: nos 152 prontuários analisados, observam-se idade prevalente entre 60 a 69 anos, maioria de mulheres, procedência do município local e comparecimento com acompanhante. Os diagnósticos prevalentes são a esquizofrenia e os transtornos mentais e comportamentais decorrentes do uso de substâncias psicoativas. As medicações prescritas com maior frequência são da classe dos antipsicóticos e anti-histamínicos, seguidas dos ansiolíticos/sedativos. O critério de Beers considera a prescrição de medicamentos do grupo dos benzodiazepínicos, antipsicóticos e anti-histamínicos inapropriada para idosos. A principal conduta foi a alta, sem encaminhamento a outro serviço. Conclusão: embora haja incentivo do Ministério da Saúde, com a criação de novas políticas de saúde mental, muitos profissionais mantêm o modelo de atendimento baseado na queixa e conduta, dificultando a reabilitação  psicossocial dos pacientes.
Binge drinking e fatores associados em indígenas da etnia Karipuna
Authors: Castelo-Branco Fernanda Matos Fernandes , Vargas Divane de
Published: May 2021

Objetivo: identificar a prevalência do uso em binge em indígenas Karipuna e verificar a associação desse uso com variáveis sociodemográficas, clínicas e comportamentais da amostra. Método: trata-se de um estudo transversal realizado com 230 indígenas de 12 aldeias Karipuna em Oiapoque. Obteve-se o rastreio do uso em binge por meio da Questão-Chave. Coletaram-se os dados entre maio e dezembro de 2017. Realizaram-se, a priori, a análise de frequência das variáveis envolvidas no estudo e, na sequência, o teste qui-quadrado e o modelo de regressão logística. Resultados: revela-se que a prevalência do uso em binge foi de 24,8% de uma a três vezes; de 20,4% de quatro a seis vezes; de 12,2%  de sete a dez vezes e de 9,6% em mais de dez vezes. Associaramse os seguintes fatores: estudante (OR=2,99); migração da aldeia de origem (OR=2,22); uso de preservativo (OR=2,62) e relações sexuais após o consumo de álcool (OR=1,61).Conclusão: alerta-se que o uso ocasional de risco de álcool demanda consideração, bem como o conhecimento das particularidades da população ora investigada, a fim de estabelecer controle, planejamento de recursos terapêuticos para que se alcancem resultados efetivos nas ações planejadas e principalmente nas que são adotadas na prática a fim ...
Treinamento em transtornos mentais comuns na enfermaria: uso de metodologias ativas na construção do cuidado
Authors: Machado Marília Girão de Oliveira , Sampaio Cynthia Lima
Published: May 2021

Objetivo: analisar a percepção de enfermeiras atuantes em leitos psiquiátricos de um hospital geral sobre a realização de um treinamento em saúde mental com a utilização de metodologias ativas. Método: pesquisa do tipo descritiva, exploratória, com abordagem qualitativa, realizada em um hospital geral de grande porte, com cinco enfermeiras, no período de junho a novembro de 2019. A coleta de dados consistiu em duas etapas: realização e avaliação do treinamento. Para a realização do treinamento, utilizaram-se metodologias ativas, com foco na aprendizagem baseada em problemas e problematização. A avaliação do treinamento foi realizada por meio de entrevista  semiestruturada, elaborada segundo o modelo proposto por Kirkpatrick, e os dados analisados por meio da análise de conteúdo temática de Bardin. Resultados: os enfermeiros consideraram o treinamento positivo e desenvolveram habilidades como abordagem terapêutica, escuta ativa e mudança de comportamento. Conclusão: o treinamento foi eficaz na construção do conhecimento, promovendo transformações e reflexões significativas na aprendizagem de enfermeiros, além de contribuir com a produção de habilidades e atitudes na área de saúde mental, valorizando a aprendizagem significativa.
Eugenia pokkudanii (Myrtaceae): a new species from Sky Islands of Nelliyampathy, Kerala, India

Authors: MANOHARAN MAYA AMMATHIL , PRABHUKUMAR KONICKAL MAMBETTA , JOSE SOJAN , V Suresh
Published: May 2021

Eugenia pokkudanii, a new species of Myrtaceae from high ranges of the Western Ghats, Palakkad District, Kerala is described and illustrated here. The species shows similarities with Eugenia discifera and Eugenia indica but is distinct from them by the shape, size and indumentum of leaves, petioles, pedicels, calyces, petals and bracteoles. Detailed description, distribution and conservation notes are provided with photographs and illustration.
Taxonomic revision of the genus Psoricoptera Stainton, 1854 (Lepidoptera: Gelechiidae: Gelechiinae) from China, with descriptions of three new species
Authors: ZHENG MEILING , LI HOUHUN
Published: May 2021

The Chinese fauna of Psoricoptera Stainton, 1854 included two described species prior to this study. In the present paper we describe three new species: P. curva sp. nov., P. minutignatha sp. nov. and P. proximikawabei sp. nov. P. speciosella Teich, 1893 is recorded from China for the first time. The total number of Psoricoptera species in China is brought to six. The female of P. latignathosa is described for the first time. Photographs of adults and genitalia are provided, along with a key to the Chinese species. A Neighbor-Joining (NJ) tree is provided for species identification and association of the sexes.
Novel Use of the Buccal Fat Pad for Sinocutaneous Fistulae Closure and a Review of Reconstructive Options
Authors: Pool Christopher , Goyal Neerav , Lighthall Jessyka G.
Published: May 2021

Background:

Sinocutaneous fistulae (SCF) are abnormal communications between the paranasal sinuses and the overlying skin. They may be difficult to manage due to facial geometry, scar contraction, and poor tissue vascularity. We describe a novel use of the buccal flap and review the literature to examine management options for this disease process.

Methods:

A PubMed/MEDLINE literature search was performed for studies published between January 1, 1950 and April 29, 2020 that describe management strategies for SCF. The clinical record, imaging, and operative reports were reviewed of the case in which the buccal fat flap was used in reconstruction.

Results:

A total of 359 articles were retrieved. After removing duplicate articles, non-English studies, animal studies, duplicate articles and studies that mentioned SCF without specific mention of management strategies, 51 articles were reviewed. Management paradigms throughout the articles include (1) removal of infection, (2) ensuring patency of sinus outflow tracts, (3) tensionless multilayered closure using well vascularized tissue, and (4) prevention or minimization of future risk factors for fistula formation.

Conclusion:

This article informs surgeons on reconstructive options for sinocutaneous fistulae including a novel description of the buccal fat flap.
Electronic Health Records’ Support for Primary Care Physicians’ Situation Awareness: A Metanarrative Review
Authors: Savoy April , Patel Himalaya , Murphy Daniel R. , Meyer Ashley N. D. , Herout Jennifer , Singh Hardeep
Published: May 2021

Objective

Situation awareness (SA) refers to people’s perception and understanding of their dynamic environment. In primary care, reduced SA among physicians increases errors in clinical decision-making and, correspondingly, patients’ risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)’ SA during clinical decision-making.

Method

We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP–EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs’ clinical decision-making and care management for adults. Then, we mapped findings to an established SA framework to classify external factors (individual, task, and system) affecting PCPs’ levels of SA (1–Perception, 2–Comprehension, and 3–Projection) and identified SA barriers.

Results

From 1504 articles identified, we included and synthesized 19 studies. Study designs were largely noninterventional. Studies described EHR workflow misalignments, usability issues, and communication challenges. EHR information, including lab results and care plans, was characterized as incomplete, untimely, or irrelevant. Unmet information needs made it difficult for PCPs to obtain even basic SA, Level 1 SA. Prevalent barriers to PCPs developing SA with EHRs were errant mental models, attentional tunneling, and data overload.

Conclusion

Based on our review, EHRs do not support the development of higher levels of SA among PCPs. Review findings suggest SA-oriented design processes for health information technology could improve PCPs’ SA, satisfaction, and decision-making.
The Human Salivary Proteome Wiki: A Community-Driven Research Platform
Authors: Lau W.W. , Hardt M. , Zhang Y.H. , Freire M. , Ruhl S.
Published: May 2021

Saliva has become an attractive body fluid for on-site, remote, and real-time monitoring of oral and systemic health. At the same time, the scientific community needs a saliva-centered information platform that keeps pace with the rapid accumulation of new data and knowledge by annotating, refining, and updating the salivary proteome catalog. We developed the Human Salivary Proteome (HSP) Wiki as a public data platform for researching and retrieving custom-curated data and knowledge on the saliva proteome. The HSP Wiki is dynamically compiled and updated based on published saliva proteome studies and up-to-date protein reference records. It integrates a wide range of available information by funneling in data from established external protein, genome, transcriptome, and glycome databases. In addition, the HSP Wiki incorporates data from human disease–related studies. Users can explore the proteome of saliva simply by browsing the database, querying the available data, performing comparisons of data sets, and annotating existing protein entries using a simple, intuitive interface. The annotation process includes both user feedback and curator committee review to ensure the quality and validity of each entry. Here, we present the first overview of features and functions the HSP Wiki offers. As a saliva proteome–centric, publicly accessible database, the HSP Wiki will advance the knowledge of saliva composition and function in health and disease for users across a wide range of disciplines. As a community-based data- and knowledgebase, the HSP Wiki will serve as a worldwide platform to exchange salivary proteome information, inspire novel research ideas, and foster cross-discipline collaborations. The HSP Wiki will pave the way for harnessing the full potential of the salivary proteome for diagnosis, risk prediction, therapy of oral and systemic diseases, and preparedness for emerging infectious diseases.

Database URL: https://salivaryproteome.nidcr.nih.gov/
Feeling Film: Time, Space, and the Third Image
Authors: Hockley Luke
Published: May 2021

This article explores what it means to feel film. It does so through an exploration of the interconnections between Bergson, Deleuze, and Jung. Central to the argument is the ontological status of the image in these different philosophical and psychological traditions. In particular, image is seen as an encapsulation of coming into being, or what Bergson terms durée. To feel film is to engage with its therapeutic capacity to bring us into being. In the consulting room and in the cinema, this process is embodied and in some way created either between client and therapist or viewer and screen. The elusive present moment is the site at which the past permeates the present, creating as it does feeling toned entry into the process of becoming. Jung thought of this as central to individuation and Bergson as central to being. Feeling film from this perspective becomes a way of finding ourselves in both the world of the film and in our individual psyche.
A General Panel Model for Unobserved Time Heterogeneity with Application to the Politics of Mass Incarceration
Authors: Duxbury Scott W.
Published: May 2021

Panel data analysis is common in the social sciences. Fixed effects models are a favorite among sociologists because they control for unobserved heterogeneity (unexplained variation) among cross-sectional units, but estimates are biased when there is unobserved heterogeneity in the underlying time trends. Two-way fixed effects models adjust for unobserved time heterogeneity but are inefficient, cannot include unit-invariant variables, and eliminate common trends: the portion of variance in a time-varying variable that is invariant across cross-sectional units. This article introduces a general panel model that can include unit-invariant variables, corrects for unobserved time heterogeneity, and provides the effect of common trends while also allowing for unobserved unit heterogeneity, time-varying coefficients, and time-invariant variables. One-way and two-way fixed effects models are shown to be restrictive forms of this general model. Other restrictive forms are also derived that offer all the usual advantages of one-way and two-way fixed effects models but account for unobserved time heterogeneity. The author uses the models to examine the increase in state incarceration rates between 1970 and 2015.
Mission and Principalities and Powers Reconsidered
Authors: Fensham Charles J.
Published: May 2021

This article examines the implications for public witness of the Pauline notion of principalities and powers with reference to Bosch, Newbigin, Bevans and Schroeder, Acolatse, Wink, Barth, and Moltmann. It critiques popular contemporary ideas of “spiritual warfare” in light of the relevant Pauline texts and theological arguments. It examines the theological idea that the source of evil lies in godlessness and how this idea illuminates the concept of principalities and powers for contemporary Christian practice. It argues that it is the mission of the church to publicly bear witness and to evangelize the principalities and powers in both personal and systemic forms while maintaining a humble but firm trust in the liberating work of Christ.
Answer Similarity Analysis at the Group Level
Authors: Eckerly Carol
Published: May 2021

Answer similarity indices were developed to detect pairs of test takers who may have worked together on an exam or instances in which one test taker copied from another. For any pair of test takers, an answer similarity index can be used to estimate the probability that the pair would exhibit the observed response similarity or a greater degree of similarity under the assumption that the test takers worked independently. To identify groups of test takers with unusually similar response patterns, Wollack and Maynes suggested conducting cluster analysis using probabilities obtained from an answer similarity index as measures of distance. However, interpretation of results at the cluster level can be challenging because the method is sensitive to the choice of clustering procedure and only enables probabilistic statements about pairwise relationships. This article addresses these challenges by presenting a statistical test that can be applied to clusters of examinees rather than pairs. The method is illustrated with both simulated and real data.
A Signal Detection Model for Multiple-Choice Exams
Authors: DeCarlo Lawrence T.
Published: May 2021

A model for multiple-choice exams is developed from a signal-detection perspective. A correct alternative in a multiple-choice exam can be viewed as being a signal embedded in noise (incorrect alternatives). Examinees are assumed to have perceptions of the plausibility of each alternative, and the decision process is to choose the most plausible alternative. It is also assumed that each examinee either knows or does not know each item. These assumptions together lead to a signal detection choice model for multiple-choice exams. The model can be viewed, statistically, as a mixture extension, with random mixing, of the traditional choice model, or similarly, as a grade-of-membership extension. A version of the model with extreme value distributions is developed, in which case the model simplifies to a mixture multinomial logit model with random mixing. The approach is shown to offer measures of item discrimination and difficulty, along with information about the relative plausibility of each of the alternatives. The model, parameters, and measures derived from the parameters are compared to those obtained with several commonly used item response theory models. An application of the model to an educational data set is presented.
Core Cardiology Training Symposium (COCATS) Standards and Board Certifications: Implications for Fellows-in-Training Seeking Employment
Authors: Betageri Omkar , Winchester David
Published: May 2021

The Core Cardiology Training Symposium (COCATS) standards are recommendations endorsed by the American College of Cardiology to assist cardiology fellowship program training directors in curricular design. In addition to seeking COCATS standards as evidence of proficiency in cardiovascular skills, Fellows-In-Training (FITs) often pursue board certifications to maximize their hiring potential. The costs and barriers with COCATS standards and board certification processes are not insignificant, however the degree to which the job marketplace demands them has not been well characterized. The intent of this investigation study was to estimate the demand for COCATS standards and board certification in cardiology job advertisements. We conducted a cross-sectional survey of job listings on the American College of Cardiology’s “Cardiology Careers” page, to establish how often advanced COCATS standards and certifications are requested. Of a total of 314 total cardiology job postings (including 133 academic positions), only eight (2.5%) job postings explicitly noted COCATS standards. Aside from American Board of Internal Medicine subspecialty certification, only 8.60% required certification in another cardiology related board certification. Despite the perception that COCATS standards and subspecialty certifications are vital to the cardiology job application process, our analysis suggests that few job postings require them. Concern regarding COCATS standards and subspecialty certification of FITs may be out of proportion to the relevance of these achievements on the current job market.