bluuebunny/crossref_metadata_2025 huggingface dataset:
The hummingbird syrinx morphome: a detailed three-dimensional description of the black jacobin’s vocal organ
Authors: Monte Amanda , Cerwenka Alexander F. , Ruthensteiner Bernhard , Gahr Manfred , Düring Daniel N.
Published: July 2020

Background

The ability to imitate sounds depends on a process called vocal production learning, a rare evolutionary trait. In addition to the few mammalian groups that possess this ability, vocal production learning has evolved independently in three avian clades: songbirds, parrots, and hummingbirds. Although the anatomy and mechanisms of sound production in songbirds are well understood, little is known about the hummingbird’s vocal anatomy.

Results

We use high-resolution micro-computed tomography (μCT) and microdissection to reveal the three-dimensional structure of the syrinx, the vocal organ of the black jacobin (Florisuga fusca), a phylogenetically basal hummingbird species. We identify three features of the black jacobin’s syrinx: (i) a shift in the position of the syrinx to the outside of the thoracic cavity and the related loss of the sterno-tracheal muscle, (ii) complex intrinsic musculature, oriented dorso-ventrally, and (iii) ossicles embedded in the medial vibratory membranes.

Conclusions

The extra-thoracic placement of the black jacobin’s syrinx and the dorso-ventrally oriented musculature likely aid to uncoupling syrinx movements from extensive flight-related thorax constraints. The syrinx morphology further allows for vibratory decoupling, precise control of complex acoustic parameters, and a large motor redundancy that may be key biomechanical factors leading to acoustic complexity and thus facilitating the occurrence of vocal production learning.
Renal abnormalities and its associated factors among school-aged children living in Schistosoma mansoni endemic communities in Northwestern Tanzania
Authors: Kayange Neema M. , Mazuguni Nicholaus , Hokororo Adolfine , Muiruri Charles , Reis Karl , Kidenya Benson R. , Mazigo Humphrey D.
Published: July 2020

Background

In sub-Saharan Africa, renal abnormalities are a major public health concern, especially in children living inSchistosoma haematobiumendemic areas. However, there is a dearth of data on renal abnormalities among children living inSchistosoma mansoniendemic areas. The objective of the study was to assess the prevalence of renal abnormalities among school children in aSchistosoma mansoniendemic community in Northwestern Tanzania.

Methods

A cross-sectional study was conducted between January and March 2017 among school children aged 6–13 years, attending three primary schools located along the shoreline of Lake Victoria. A single urine sample was collected from each child and screened forS. mansoniusing circulating cathodic antigen and forS. haematobiumeggs using a urine filtration technique. A urine dipstick was used to screen for urine protein levels, creatinine levels, microalbuminuria, and red blood cells. Venous blood was obtained for estimation of creatinine level and for malaria diagnosis. The primary outcomes were the prevalence of renal abnormalities, defined by the presence of low estimated glomerular filtration rate (eGFR), proteinuria or microalbuminuria, and hematuria in urine.

Results

Of 507 children included in the final analysis, 49.9% (253/507) were male with a mean age of 8.51 ± 1.3 years. Overall, 64.0% (326/507) of the children were infected withS. mansoni, and 1.6% (8/507) of the children were infected withS. haematobium. A total of 71 (14%) of the children had proteinuria, 37 (7.3%) had hematuria, and 8 (1.6%) had a low estimated glomerular filtration rate (eGFR). Overall prevalence of renal abnormalities was 22.9%. Renal abnormalities (proteinuria) were associated withS. mansoniinfection (OR = 4.9, 95% CI 2.1–11.2,p< 0.001) and having red blood cells in urine (OR = 5.3, 95% CI 2.5–11.2,p< 0.001).

Conclusion

Twenty-two percent of school children who participated in this study had renal abnormalities associated withS. mansoniinfection. Given the high prevalence ofS. mansoni, longitudinal epidemiological surveillance is warranted to measure the burden of renal abnormalities and assess the impact of the praziquantel treatment on these abnormalities.
Migration arrest of chemoresistant leukemia cells mediated by MRTF-SRF pathway
Authors: Morimatsu Maho , Yamashita Erika , Seno Shigeto , Sudo Takao , Kikuta Junichi , Mizuno Hiroki , Okuzaki Daisuke , Motooka Daisuke , Ishii Masaru
Published: July 2020

Background

Dormant chemotherapy-resistant leukemia cells can survive for an extended period before relapse. Nevertheless, the mechanisms underlying the development of chemoresistance in vivo remain unclear.

Methods

Using intravital bone imaging, we characterized the behavior of murine acute myeloid leukemia (AML) cells (C1498) in the bone marrow before and after chemotherapy with cytarabine.

Results

Proliferative C1498 cells exhibited high motility in the bone marrow. Cytarabine treatment impaired the motility of residual C1498 cells. However, C1498 cells regained their migration potential after relapse. RNA sequencing revealed that cytarabine treatment promoted MRTF-SRF pathway activation. MRTF inhibition using CCG-203971 augmented the anti-tumor effects of chemotherapy in our AML mouse model, as well as suppressed the migration of chemoresistant C1498 cells.

Conclusions

These results provide novel insight into the role of cell migration arrest on the development of chemoresistance in AML, as well as provide a strong rationale for the modulation of cellular motility as a therapeutic target for refractory AML.
Regulatory lymphocytes: the dice that resolve the tumor endgame
Authors: Pati Subhadip , Chowdhury Anandi , Mukherjee Sumon , Guin Aharna , Mukherjee Shravanti , Sa Gaurisankar
Published: July 2020

A large number of cancer patients relapse after chemotherapeutic treatment. The immune system is capable of identifying and destroying cancer cells, so recent studies have highlighted the growing importance of using combinatorial chemotherapy and immunotherapy. However, many patients have innate or acquired resistance to immunotherapies. Long-term follow-up in a pooled meta-analysis exhibited long-term survival in approximately 20% of patients treated with immune checkpoint inhibitors or the adoptive transfer of chimeric T cells. It has been reported that high levels of immunoregulatory cells in cancer patients contribute to immunotherapy resistance via immunosuppression. Among the most important regulatory cell subtypes are the CD4+T-regulatory cells (Tregs), identified by their expression of the well-characterized, lineage-specific transcription factor FOXP3. In addition to CD4+Tregs, other regulatory cells present in the tumor microenvironment, namely CD8+Tregs and IL10-producing B-regulatory cells (Bregs) that also modulate the immune response in solid and lymphoid tumors. These cells together have detrimental effects on tumor immune surveillance and anti-tumor immunity. Therefore, targeting these regulatory lymphocytes will be crucial in improving treatment outcomes for immunotherapy.
A real-world analysis of patient-reported outcomes in patients with migraine by preventive treatment eligibility status in the US and Europe
Authors: Ford Janet H. , Foster Shonda A. , Nichols Russell M. , Tockhorn-Heidenreich Antje , Ye Wenyu , Jackson James , Cotton Sarah
Published: July 2020

Background

Migraine has a severe impact on health-related quality of life (HRQoL) affecting physical, emotional, and social aspects of daily living of an individual. Preventive treatment has been demonstrated to improve HRQoL by reducing the frequency of migraine headache days.

Methods

The study used data from 2017 Adelphi Migraine Disease Specific Program, which is a cross-sectional survey of physicians and their consulting patients with migraine in the United States (US) and five European countries (EU [Germany, France, UK, Italy and Spain]). Objectives were to evaluate patient-reported outcome (PRO) measures in the following two subgroups and by region (US and EU): (i) patients who are eligible for migraine preventive treatment (≥4 migraine headache days/month), and (ii) patients who are non-eligible for preventive treatment (< 4 migraine headache days/month). Patient-reported outcome measures that were assessed included the following: Migraine-Specific Quality-of-Life Questionnaire Version 2.1, Migraine Disability Assessment Scale (MIDAS), European Quality of Life-5 Dimensions-5 Levels version, and Work Productivity and Activity Impairment.

Results

In total, 5462 patients (US = 1373; EU = 4089) were included in the study (preventive eligible: US = 584; EU = 1942; preventive non-eligible: US = 789; EU = 2147). In the US and EU, preventive eligible patients were significantly more likely to have worse disability as measured by MIDAS than non-eligible patients; preventive eligible patients also had significantly greater functional impairment, worse health utility, and overall greater work impairment (p < 0.0001). Among patients who were preventive eligible, a larger proportion of patients in the US reported that migraine forced them to reduce the number of hours worked as compared with the EU population (29.0% vs 24.7%).

Conclusion

Patients who were preventive eligible (≥4 migraine headache days/month) demonstrated greater burden of disease across multiple PRO measures; trends were similar across the US and the five EU countries.
Biological control chance and limitation within integrated pest management program in Afghanistan
Authors: Falahzadah Mohammad Hussain , Karimi Javad , Gaugler Randy
Published: July 2020

Integrated pest management (IPM) has recognized as a sustainable method for pest prevention, monitoring, and control. The purpose of this review article focused on biological control potential and challenges in Afghanistan. Biological control is beginning to increase in Afghanistan, in large part due to the establishment of graduate studies in entomology in 2008. Afghan farmers have restricted knowledge about agrochemicals and mostly use a few conventional chemical pesticides and fertilizers. The development and registration of biological agents as an alternative is a more recent movement. Only a single parasitoid agent and three microbial products were registered or pending registration for commercial use on various crops. Products based on Trichogramma brassicae (Bezdenko 1968) for lepidopteran pests, Trichoderma viride against soil-borne pathogens including Rhizoctonia solani, Macrophomina phaseolina, and Fusarium species are most widely spread. Also, T. viride, Cydia pomonella granulovirus, and Helicoverpa zea nucleopolyhedrovirus registered in 2015. Pesticide registration is the responsibility of the Afghan Ministry of Agriculture, Irrigation and Livestock, with the assistance of the Pesticides Division of Plant Protection and Quarantine Department in coordination with the Ministry of Public Health. The pesticide management board of the National Environmental Protection Agency has not yet signed the membership of the World Trade Organization (WTO) or the International Plant Protection Convention (IPPC). Currently, only one foreign company, the National Horticulture and Livestock Project (NHLP), produces microbial pesticides. However, it promised that two more other companies, the Center for Agricultural Bioscience International and the Afghanistan Agriculture Inputs Projects, will start production shortly. This is a review of the brief history of biological control of pests, with a view on current challenges of pest control practices as well the status of the market and the registration procedures for biocontrol agents, along with challenges and opportunities for the development of biocontrol in Afghanistan.
Biological characteristics and efficacy of Bacillus thuringiensis var. thuringiensis against the cotton leaf roller, Syllepte derogata (Fabricius, 1775) (Lepidoptera: Crambidae)
Authors: Gahramanova Gulnar , Mamay Mehmet , Mammadov Zulfi
Published: July 2020

Cotton (Gossypium hirsutumL.) is an important fiber crop cultivated in > 50 countries of the world. The cotton leaf rollerSyllepte derogata(Fabricius, 1775) (Lepidoptera: Crambidae) is considered as an invasive and widespread species in many geographic regions of the world and pose significant damages to cotton crop. This study reported the first record ofS. derogataand its biological characteristics in Azerbaijan. The results indicated thatS. derogatawas only observed on cotton crop from the Absheron region of the country. The larvae only attacked on cotton leaves and did not damage the reproductive organs (i.e., bolls).S. derogatacompleted one generation in 31–42 days in the Absheron region. Larvicidal efficacy ofBacillus thuringiensisvar.thuringiensis(Btt) againstS. derogatawas also tested under laboratory and field conditions. Three differentBttconcentrations (0.3, 0.4, 0.5 g/l) were tested against 2nd and 4th larval instars ofS. derogata. The 0.5 g/l concentration ofBttcaused 72.88% larval mortality under field conditions. However, under laboratory conditions, 0.3, 0.4, and 0.5 g/l concentrations caused 50, 66.67, and 100% mortality of the 2nd instar larvae on the 7th day, respectively. The 0.5 g/l suspension ofBttproved the most effective againstS. derogata; therefore, it can be recommended for the management ofS. derogatain the infested region of the country. This study further warns thatS. derogatacould spread to the other cotton-producing regions of the country; thus, an effective early warning and rapid response system must be developed for the pest in the country.
Early disability in ambulatory patients with multiple sclerosis: optical coherence tomography versus visual evoked potentials, a comparative study
Authors: Thabit Mohamed N. , Farouk Mahmoud Mohamed , Awni Martha , Mohamed Al-Amir Bassiouny
Published: July 2020

Background

Multiple sclerosis (MS) is a common cause of neurological disabilities in adults and commonly affects the visual pathway. The objective of this study is to assess and compare the sensitivity of visual evoked potentials (VEP) and optical coherence tomography (OCT) as measures of early disability in ambulatory patients with MS.

Methods

Forty-four patients with MS with Expanded Disability Status Scale (EDSS) of ≤ 4.5 (ambulatory patients) and 14 healthy controls participated in this study. Patients were classified into 3 groups according to EDSS. Patients with EDSS of 0–1.5 formed the “No disability,” patients with EDSS of 2–3 formed the “Minimal to mild disability,” and finally patients with EDSS of 3.5–4.5 formed the “Moderate to significant disability” groups. N75/P100 amplitude, P100 latency, retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer complex (GCLC) thickness were measured.

Results

Patients showed significantly lower N75/P100 amplitude, higher P100 latency, lower RNFL, and GCLC thicknesses compared to controls. However, there were non-significant changes in P100 latency, N75/P100 amplitude, and GCLC thickness among the 3 groups for both patients with and without history of optic neuritis (ON). On contrary, RNFL thickness was significantly different between the three groups for both patients with and without history of ON. Factorial ANOVA revealed non-significant disability × History of ON interaction.

Conclusion

Compared to VEP parameters, RNFL thickness was a sensitive correlate with the various degrees of early disability in fully ambulatory patients with MS whatever the history of ON.
Anxiety disorders in children with high intellectual potential
Authors: Kermarrec Solenn , Attinger Laurie , Guignard Jacques-Henri , Tordjman Sylvie
Published: July 2020

Background

Several studies have reported anxiety disorders in children with high intellectual potential (HIP). However, there are discrepant results possibly as a result of methodological biases (different/absent definitions of HIP, small sample sizes, non-validated/adapted/specific tools for assessing anxiety and a single observational source).

Aims

To examine more thoroughly the relationships between HIP and anxiety in large samples of children using clear definitions of HIP, different observational sources and specific assessments of anxiety.

Method

Children with HIP (n= 211, total IQ ≥130) were compared with children without HIP (n= 397, total IQ <130) for anxiety using different observational sources (child psychiatric diagnosis, parental evaluation and child's self-evaluation). Intellectual functioning was assessed using the Wechsler Intelligence Scale.

Results

There were significantly more children with HIP who had anxiety disorders than children without HIP based on the child psychiatric diagnosis. Moreover, based on the child's self-evaluation, children with a high Verbal Comprehension Index (VCI ≥130) were significantly more anxious than children with a VCI <130, whereas children with a high Perceptual Reasoning Index (PRI ≥130) were significantly less anxious than children with a PRI <130. Finally, there was no significant relationship between levels of intellectual functioning and anxiety according to parental observation.

Conclusions

The results highlight the importance of using multiple observational sources and conducting analyses on different dimensions of intellectual functioning (such as VCI and PRI), rather than only on the composite total IQ score. High verbal potential might be a factor of vulnerability for anxiety, whereas high perceptual reasoning might be a protective factor. Further studies are necessary to understand better the mechanisms underlying these results.
Randomized, Parallel Group, Open-Label Bioequivalence Trial of Intramuscular Pegaspargase in Patients With Relapsed Acute Lymphoblastic Leukemia
Authors: Nookala Krishnamurthy Manjunath , Narula Gaurav , Gandhi Khushboo , Awase Ankita , Pandit Ruta , Raut Sunil , Singh Ritu , Gota Vikram , Banavali Shripad Dinanath
Published: July 2020

PURPOSE

Pegylated asparaginase is comparatively safer than native asparaginase in the management of acute lymphoblastic leukemia (ALL). However, the high price and nonavailability in low- and middle-income countries limits its use. In 2014, the first generic of pegaspargase (Hamsyl) was approved in India for use as a second-line treatment option for ALL. The aim of this study was to assess whether the generic pegaspargase (the test product) was bioequivalent with the reference product (Oncaspar).

PATIENTS AND METHODS

This study was an open-label, parallel-group, comparative pharmacokinetic study in pediatric patients with relapsed ALL receiving their first dose (1,000 IU/m2) of pegaspargase administered intramuscularly. Patients were randomly assigned 1-to-1 to either the test or the reference product. The 2 formulations were considered equivalent if the 90% CIs for area under the plasma asparaginase activity–time curve (AUC0-t) geometric mean test-to-reference ratio was within 75% to 133%.

RESULTS

Twenty-nine patients (6-18 years of age) were enrolled in this study, of whom 24 completed the study criteria and were considered for safety analysis (5 patients were ineligible for the assessment). Three patients were excluded from analysis, because of presence of anti-asparaginase antibodies, leaving 21 patients who were considered for bioequivalence pharmacokinetics data. The point estimate of AUC0-t for the test-to-reference ratio was 95.05 (90% CI, 75.07% to 120.33%). Maximum plasma concentration, trough concentrations (day 14), half-life, volume of distribution, drug clearance, and changes in the asparagine and glutamine levels were not significantly different between products. Adverse events were comparable in both groups.

CONCLUSION

Generic and reference pegaspargase had equivalent pharmacokinetics with comparable safety. This could be a safe and cost-effective alternative for patients with ALL, especially in low- and middle-income countries.
Management of Tracheoesophageal Fistula Repair With Cardiac Dextroposition and Right Lung Agenesis: A Case Report
Authors: Zhou Eric P. , Lee Rebecca E.
Published: July 2020

Tracheoesophageal fistulae (TEF) commonly occur as part of the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal, and limb abnormalities (VACTERL) association. However, pulmonary agenesis is not typically seen with TEF. We report the anesthetic management of a TEF repair in a 33-week-old, 1.6-kg, monochorionic diamniotic twin with right lung agenesis, intrauterine growth restriction, and cardiac dextroposition. Due to the unique position of the heart, the patient periodically lost complete cardiac output during the exposure and repair of the esophagus.
Aerosol Box 2.0: Adjustments and Improvements Made in Mexico for Intubating Patients During the Coronavirus Disease 2019 Pandemic
Authors: López Hernández Mercedes Nicté , Álvarez Reséndiz Gerardo Esteban , Galván Talamantes Yazmin , Lagarda Cuevas Juan , Wilson-Manríquez Eduardo A. , Calva Ruiz Diana Stephanie , Ham Armenta Cristian Irvin
Published: July 2020

In January 2020, a global pandemic was declared by the World Health Organization authorities for coronavirus disease 2019 (COVID-19). Since then, we have looked for ways to avoid transmission with mitigation measures and social distancing. However, areas with a high incidence of COVID-19 have struggled to maintain adequate supplies of personal protective equipment (PPE) essential for health workers. Many innovations have been proposed to assist providers including barriers to use during airway management. We present adaptations to previously described intubation or “aerosol” boxes.
Discussion, Dream, Art, People
Authors: Sellar Tom
Published: July 2020

In this article, Tom Sellar, the editor of Theater for sixteen years, reflects on the five-decade legacy of the magazine. Sellar’s personal retrospective looks both backward and forward, from Theater’s polemical beginnings in the late 1960s and his own encounters with the magazine as a student in the 1980s to the political exigencies of the present day and the demands this moment makes on the future of theater and criticism. As Sellar writes, Theater’s early radical spirit has not left the magazine’s mission: “Part muse, part archive, part mirror, Theater has held tightly to … its permanent stance that the theater can provide a vessel for transformation, bringing altered consciousness and maybe a better society.” Tracing this history, Sellar illuminates how Theater, as a journal and a reflection of its object of inquiry, has responded to the evolving idea of a public — a sphere that has narrowed and expanded, fractured and recombined over the past half century.
Strange Eventful History
Authors: Rogoff Gordon
Published: July 2020

Theater magazine founding editor Gordon Rogoff puts the history of the American theater over the last five decades under a critical retrospective lens, examining how shifting political, social, and economic conditions have shaped theater as both industry and art form. Rogoff ’s essay mixes memory with polemic and humor with outrage while attempting to untangle the threads of high art and big business that have held up and ensnared the art of theater across the last half century.
Nephron-Sparing Surgery for Adult Xp11.2 Translocation Renal Cell Carcinoma at Clinical T1 Stage: A Multicenter Study in China
Authors: Liu Ning , Qu Feng , Shi Qiancheng , Zhuang Wenyuan , Ma Wenliang , Yang Zhenhao , Sun Jing , Xu Wei , Zhang Lihua , Jia Ruipeng , Xu Linfeng , Zhao Xiaozhi , Li Xiaogong , Zhang Gutian , Guo Hongqian , Li Dongmei , Gan Weidong
Published: July 2020

Purpose

To evaluate the oncologic efficacy and feasibility of nephron-sparing surgery (NSS) in adult Xp11.2 translocation renal cell carcinoma (RCC).

Patients and Methods

Seventy patients with Xp11.2 translocation RCC and 273 with conventional RCC from five institutions in Nanjing were retrospectively studied. All patients were older than 18 years and were categorized into clinical T1 (cT1) stage using preoperative imaging. Using the preoperative imaging and electronic medical records, anatomical and pathological features were collected and analyzed.

Results

Among patients with Xp11.2 translocation RCC, 18/36 (50.0%) with cT1a and 12/34 (35.3%) with cT1b tumors underwent NSS. The respective proportions in the conventional RCC group were 121/145 (83.4%) and 93/128 (72.7%). Among cT1a tumors, the Xp11.2 translocation RCCs tended to be adjacent to the collecting system, sinus, and axial renal midline compared with conventional RCCs. Patients with Xp11.2 translocation RCCs who underwent NSS had comparable progression-free survival (PFS) and overall survival to radical nephrectomy (RN) patients (P > 0.05). Among cT1b tumors, surgical margin positivity and pelvicalyceal, vascular, and region lymphatic involvement were more likely to occur in the Xp11.2 translocation RCCs (P < 0.05). Patients with Xp11.2 translocation RCC who underwent RN had a more favorable PFS than those who underwent NSS (P = 0.048). However, multivariate analysis of PFS did not identify surgical method as a risk factor (P = 0.089).

Conclusions

Among adults with Xp11.2 translocation RCC, NSS can be an alternative for patients with cT1a tumor but should be performed with more deliberation in patients with cT1b tumors.
The impact of the introduction of artificial intelligence in radiology and its potential legal implications in the UK and Ireland
Authors: Anderson Toni , Torreggiani William C , Munk Peter L , Mallinson Paul I
Published: July 2020

Artificial intelligence (AI) has been defined as a branch of computer science dealing with the capability and simulation of a machine to imitate intelligent human behaviour. Diagnostic radiology, being a computer-based service, is unsurprisingly at the forefront of the discussion of the use of AI in medicine. There are however differing schools of thought regarding its use; namely, will AI eventually replace the radiologist? Or indeed will it ever be fully capable of replacing radiology as a speciality, but rather be used as an aid to the profession whereby a human’s input will always be required?

Furthermore, what will the legal implications of AI in radiology mean to the profession? Who will be liable for missed diagnoses? Is it possible that the introduction of AI to radiology will in fact make the profession busier?
A luz de um vermelho entardecer: os protestos no Chile a partir da fotografia de Susana Hidalgo
Authors: Lazaro Fernanda
Published: July 2020

Este artigo tem por objetivo investigar uma relação de retroalimentação entre a formação de uma nova percepção temporal na sociedade chilena e a construção discursiva da popular fotografia de Susana Hidalgo sobre a chamada La marcha más grande de Chile. Como ferramentas teórico-metodológicas, proponho um diálogo entre a Análise Multimodal de Discurso de Kress e Van Leeuwen (2006) e as categorias de espaço de experiência e horizonte de expectativa de Reinhart Koselleck (2006). O artigo conclui que a evocação do passado ditatorial na fala do presidente Sebastian Piñera foi decisiva para a formação de uma nova concepção de futuro e, portanto, de uma nova concepção de tempo presente, representados na fotografia.
Primórdios batistas no Brasil: abertura de igrejas e formação da equipe missionária (1881-1886)
Authors: Alves Pedro Henrique
Published: July 2020

O objetivo desse artigo é caracterizar a inserção de missionários batistas estadunidenses no Brasil e elucidar as estratégias e escolhas de tal grupo para o estabelecimento de igrejas batistas no país. O texto, partindo da chegada no Brasil de uma equipe missionária batista enviada pela Convenção Batista do Sul dos Estados Unidos, desenvolve o processo de aproximação do grupo com a população brasileira, a expansão das igrejas por algumas capitais e a constituição de um primeiro grupo de congregações batistas no Brasil.
Educação para a emancipação: O território quilombola como “lugar de memória” e identidade étnico-cultural
Authors: Lacerda Nayara Ferreira
Published: July 2020

Neste artigo, nosso objetivo é refletir sobre a importância do território para as comunidades quilombolas do Brasil e como a educação escolar dentro de seus territórios pode ser um instrumento que auxilia para a afirmação da identidade quilombola. Os territórios quilombolas são lugares compostos de uma singularidade histórica e cultural e sua população enfrenta lutas emblemáticas para o reconhecimento de seus direitos, seja no âmbito da educação, da cultura ou na defesa de suas terras. Levando em consideração a trajetória de exclusão dos povos quilombolas ao longo de séculos da história do Brasil, acreditamos que a educação nestes lugares deve ser fundamentada em princípios de autonomia e respeito a identidade.
A agenda das políticas educacionais no Brasil: a Lei nº 11.645/08
Authors: Dantas Maisa Cristina Torres
Published: July 2020

O presente artigo tem como objetivo entender como a temática indígena nas escolas passa a ser uma ideia relevante, a ponto de se tornar uma pauta de agenda das políticas públicas de educação brasileira. Para realizar esta análise, utilizam-se os conceitos do modelo teórico de Múltiplos Fluxos, elaborado pelo cientista político John W. Kingdon (2003). O autor faz apontamentos sobre fatores relevantes no processo de definição da agenda governamental. Este modelo teórico serve de auxílio para o presente artigo, que pretende ser um exercício de análise de formulação de políticas públicas na área de educação.
A participação política na “era Lula” revisitada: Novas agendas de pesquisa
Authors: Pedroso Rafael Teodoro
Published: July 2020

São apresentados os principais resultados, oriundos de uma literatura recente e relativamente variada, acerca de movimentos sociais, organizações da sociedade civil e ativismos à direita nos governos Lula. A ambição de explicar os ciclos de protestos ocorridos de 2013 a 2015 no Brasil tem levado pesquisadores a olhar para fenômenos sociais à direita nos anos que antecedem esse período. Embora nenhum deles tenha se voltado especificamente para os anos de 2002 a 2010, é possível, reunindo os seus trabalhos, apresentar alguns resultados a esse respeito. Essa leva de estudos pode ser agrupada em três frentes: (1) análise de eventos protesto; (2) análise de atores; (3) análise da produção de descontentes e redes de ativismo.
Análise comparativa do processo de registro oficial de praguicidas no Brasil com outros em nível internacional: revisão narrativa da literatura
Authors: Moura Alan Carvalho Caetano , Machado Fernanda Ferreira , Costa Anna Carolina de Moura , Sanches Cristina , Chequer Farah Maria Drumond
Published: July 2020

Objetivo: comparar o processo de registro oficial de praguicidas no Brasil com o da China, Canadá, Estados Unidos da América (EUA) e União Europeia. Métodos: a revisão narrativa da literatura baseou-se na pesquisa de atos normativos sobre praguicidas nos sites oficiais dos Ministérios e do Governo do Brasil, dos EUA, da China, do Canadá e da Comissão Europeia, utilizando-se os termos: “agrotóxicos”, “registro de agrotóxicos” e “legislação sobre agrotóxicos” e suas respectivas traduções para o inglês. Para fins de comparação, lançou-se mão da metodologia de análise exploratória, resumindo e organizando os dados coletados. Resultados: no Brasil, o pedido de registro é avaliado por órgãos de três Ministérios (da Agricultura, da Saúde e do Meio ambiente), enquanto na China essa responsabilidade é centralizada num único órgão do Ministério da Agricultura. Brasil e EUA apresentam o maior prazo para concessão de registro, de 6 a 10 anos. A taxa de registro mais alta é cobrada nos EUA e a mais baixa, no Brasil. Nesse país, não há encargos para manutenção, nem prazo para reavaliação do praguicida. Enquanto nos EUA e Canadá a validade máxima dos registros é de 15 anos. Conclusão: apesar de existirem normas que impedem o registro de praguicidas com potenciais riscos à saúde, isenções de taxas e não periodicidade de reavaliação do registro contribuem para o uso descontrolado desses produtos no Brasil.
As implicações da COVID-19 no sistema cardiovascular: prognóstico e intercorrências
Authors: Martins Jaqueline Dantas Neres , Sardinha Daniele Melo , Silva Roseli Reis da , Lima Karla Valéria Batista , Lima Luana Nepomuceno Gondim Costa
Published: July 2020

Objetivo: descrever as implicações da COVID-19 no sistema cardiovascular: prognósticos e intercorrências. Método: trata-se de uma revisão integrativa da literatura, realizada nas bases de dados, Science Direct, National Library of Medicine National Institutes of Health dos EUA (PUBMED), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Collaboration e Medical Literature Analysis and Retrieval System Online (MEDLINE) com os descritores, Cardiovascular System; Cardiovascular Diseases; Coronary Disease, e a palavra-chave Covid-19. Incluíram-se estudos originais, relatos de casos, revisões sistemáticas na série temporal 2019-2020. Resultados: a busca resultou em 13 artigos, todos na língua inglesa, emergindo os pontos-chave: potencialização das complicações cardiovasculares pela infecção por COVID-19; aumento da mortalidade de origens cardiovasculares influenciadas pela infecção por COVID-19. Conclusão: o envolvimento do sistema cardiovascular no COVID-19 pode determinar a gravidade da doença, potencializado na presença de fatores de riscos cardiovasculares, repercutindo em complicações que necessitam de tratamento intensivo e morte. De maneira geral, todos os pacientes com COVID-19 são passíveis de ter comprometimento cardiológico, fato que pode depender de antecedentes mórbidos pessoais, resposta inflamatória e liberadores bioquímicos.
Academia’s Big Five: a normative taxonomy for the epistemic responsibilities of universities
Authors: Peels Rik , van Woudenberg René , de Ridder Jeroen , Bouter Lex
Published: July 2020

This paper proposes a normative taxonomy by which universities can express the extent to which they meet five core epistemic responsibilities. Epistemic responsibilities are responsibilities that have to do with the attainment of knowledge and understanding. The core epistemic responsibilities, which we call the Big Five, are to (1) foster research integrity, (2) teach for intellectual virtue, (3) address the big questions of life, (4) give humanistic inquiry and education a proper place, and (5) serve society. The paper characterizes the Big Five in some detail and explains why they are core epistemic responsibilities of universities. The paper concludes by describing the steps that should be taken in order to test, amend, and implement the taxonomy.
Current practice in systematic reviews including the ‘PICO for each synthesis’ and methods other than meta-analysis: protocol for a cross-sectional study
Authors: Cumpston Miranda S. , McKenzie Joanne E. , Thomas James , Brennan Sue E.
Published: July 2020

Introduction: Systematic reviews are used to synthesise research and inform decision making by clinicians, consumers and policy makers. The synthesis component of systematic reviews is often narrowly considered as the use of statistical methods to combine the results of studies, primarily meta-analysis. However, synthesis can be considered more broadly as a process beginning with: (i) defining the groupings of populations, interventions and outcomes to be compared (the ‘PICO for each synthesis’); (ii) examining the characteristics of the available studies; and (iii) applying synthesis methods from among multiple options. To date, there has been limited examination of approaches used in reviews to define and group PICO characteristics and synthesis methods other than meta-analysis.

Objectives: To identify and describe current practice in systematic reviews in relation to structuring the PICO for each synthesis and methods for synthesis when meta-analysis is not used.

Methods: We will randomly sample 100 systematic reviews of the effects of public health and health systems interventions published in 2018 and indexed in the Health Evidence and Health Systems Evidence databases. Two authors will independently screen studies for eligibility. One author will extract data on approaches to grouping and defining populations, interventions and outcomes, and the rationale for the chosen groups; and the presentation and synthesis methods used (e.g. tabulation, visual displays, statistical synthesis methods such as combining P values, vote counting based on direction of effect). A second author will undertake independent data extraction for a subsample of reviews. Descriptive statistics will be used to summarise the findings. Specifically, we will compare approaches to grouping in reviews that primarily use meta-analysis versus those that do not.

Conclusion: This study will provide an understanding of current practice in two important aspects of the synthesis process, enabling future research to test the feasibility and impact of different methodological approaches.
Recent Developments in Tuberculous Meningitis Pathogenesis and Diagnostics
Authors: Cresswell Fiona V , Davis Angharad G. , Sharma Kusum , Basu Roy Robindra , Ganiem Ahmad Rizal , Kagimu Enock , Solomons Regan , Wilkinson Robert J. , Bahr Nathan C , Thuong Nguyen Thuy Thuong ,   Tuberculous Meningitis International Research Consortium
Published: July 2020

The pathogenesis of Tuberculous meningitis (TBM) is poorly understood, but contemporary molecular biology technologies have allowed for recent improvements in our understanding of TBM. For instance, neutrophils appear to play a significant role in the immunopathogenesis of TBM, and either a paucity or an excess of inflammation can be detrimental in TBM. Further, severity of HIV-associated immunosuppression is an important determinant of inflammatory response; patients with the advanced immunosuppression (CD4+ T-cell count of <150 cells/μL) having higher CSF neutrophils, greater CSF cytokine concentrations and higher mortality than those with CD4+ T-cell counts > 150 cells/μL. Host genetics may also influence outcomes with LT4AH genotype predicting inflammatory phenotype, steroid responsiveness and survival in Vietnamese adults with TBM. Whist in Indonesia, CSF tryptophan level was a predictor of survival, suggesting tryptophan metabolism may be important in TBM pathogenesis. These varying responses mean that we must consider whether a “one-size-fits-all” approach to anti-bacillary or immunomodulatory treatment in TBM is truly the best way forward. Of course, to allow for proper treatment, early and rapid diagnosis of TBM must occur. Diagnosis has always been a challenge but the field of TB diagnosis is evolving, with sensitivities of at least 70% now possible in less than two hours with GeneXpert MTB/Rif Ultra. In addition, advanced molecular techniques such as CRISPR-MTB and metagenomic next generation sequencing may hold promise for TBM diagnosis. Host-based biomarkers and signatures are being further evaluated in childhood and adult TBM as adjunctive biomarkers as even with improved molecular assays, cases are still missed. A better grasp of host and pathogen behaviour may lead to improved diagnostics, targeted immunotherapy, and possibly biomarker-based, patient-specific treatment regimens.
Metformin as adjunctive therapy for dengue in overweight and obese patients: a protocol for an open-label clinical trial (MeDO)
Authors: Nguyen Nguyet Minh , Chanh Ho Quang , Tam Dong Thi Hoai , Vuong Nguyen Lam , Chau Nguyen Thi Xuan , Chau Nguyen Van Vinh , Phong Nguyen Thanh , Trieu Huynh Trung , Luong Thi Hue Tai , Cao Thi Tam , Dinh The Trung , Duyen Huynh Thi Le , Van Ninh Thi Thanh , Nguyen Than Ha Quyen , Rivino Laura , Gallagher Peter , Jones Nick K. , Geskus Ronald B. , Kestelyn Evelyne , Yacoub Sophie
Published: July 2020

Background:  Dengue is a disease of major global importance. While most symptomatic infections are mild, a small proportion of patients progress to severe disease with risk of hypovolaemic shock, organ dysfunction and death.  In the absence of effective antiviral or disease modifying drugs, clinical management is solely reliant on supportive measures. Obesity is a growing problem among young people in Vietnam and is increasingly recognised as an important risk factor for severe dengue, likely due to alterations in host immune and inflammatory pathways. Metformin, a widely used anti-hyperglycaemic agent with excellent safety profile, has demonstrated potential as a dengue therapeutic in vitro and in a retrospective observational study of adult dengue patients with type 2 diabetes.  This study aims to assess the safety and tolerability of metformin treatment in overweight and obese dengue patients, and investigate its effects on several clinical, immunological and virological markers of disease severity.

Methods: This open label trial of 120 obese/overweight dengue patients will be performed in two phases, with a metformin dose escalation if no safety concerns arise in phase one. The primary endpoint is identification of clinical and laboratory adverse events.  Sixty overweight and obese dengue patients aged 10-30 years will be enrolled at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam. Participants will complete a 5-day course of metformin therapy and be compared to a non-treated group of 60 age-matched overweight and obese dengue patients.

Discussion:  Previously observed antiviral and immunomodulatory effects of metformin make it a promising dengue therapeutic candidate in appropriately selected patients. This study will assess the safety and tolerability of adjunctive metformin in the management of overweight and obese young dengue patients, as well as its effects on markers of viral replication, endothelial dysfunction and host immune responses. 

Trial registration: ClinicalTrials.gov: NCT04377451 (May 6th 2020).
The Happy Dental Nurse
Authors: O'Neill Hayley
Published: July 2020

Hayley O'Neill reveals how she plugged a gap in the market with a fun learning pack for trainee dental nurses and their mentors
Extent of infectious SARS-CoV-2 aerosolisation as a result of oesophagogastroduodenoscopy or colonoscopy
Authors: Hussain Abdulzahra , Singhal Tarun , EL-Hasani Shamsi
Published: July 2020

Background

COVID-19 has caused an unprecedented pandemic and medical emergency that has changed routine care pathways. This article discusses the extent of aerosolisation of severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, as a result of oesophagogastroduodenoscopy and colonoscopy.

Methods

PubMed and Google Scholar were searched for relevant publications, using the terms COVID-19 aerosolisation, COVID-19 infection, COVID-19 transmission, COVID-19 pandemic, COVID-19 and endoscopy, Endoscopy for COVID-19 patients.

Results

A total of 3745 articles were identified, 26 of which were selected to answer the question of the extent of SARS-CoV-2 aerosolisation during upper and lower gastrointestinal endoscopy. All studies suggested high infectivity from contact and droplet spread. No clinical study has yet reported the viral load in the aerosol and therefore the infective dose has not been accurately determined. However, aerosol-generating procedures are potentially risky and full personal protective equipment should be used.

Conclusions

As it is a highly infectious disease, clinicians treating patients with COVID-19 require effective personal protective equipment. The main routes of infection are direct contact and droplets in the air and on surfaces. Aerosolisation carries a substantial risk of infection, so any aerosol-producing procedure, such as endoscopy, should be performed wearing personal protective equipment and with extra caution to protect the endoscopist, staff and patients from cross-infection via the respiratory system.
Nutritional Therapy In Ischemic Stroke Patients With Type 2 Diabetes Mellitus : A Case Report
Authors: Muhaswitri Cipuk , Andayani Diyah Eka , Mesiano Taufik
Published: July 2020

Introduction: The prevalence of stroke in Indonesia increased from 8.3 per 1000 population in 2007 to 12.1 per 1000 population in 2013, based on Riset Kesehatan Dasar (RISKESDAS) 2013. Diabetes mellitus (DM) is an independent risk factor and can be modified. Hyperglycemia that occurs in the acute phase of stroke is associated with an increase in mortality and poor clinical outcome after stroke. Moreover, stroke patients are at risk of developing hypoalbuminemia due to poor intake and the presence of a chronic inflammatory process.
Methods: A 66-year-old female patient with third recurrent ischemic stroke, history of uncontrolled DM, conciousness based on GCS is E3M5Vaphasia, Nasogastric tube (NGT) was inserted and there was a right facial nerve paralysis and bilateral hemiparesis . Nutritional status of patient is obese-1. During follow up period, the patient's blood glucose level ranged from 194 g/dl-345 g/dl. Nutrition therapy is given with a target of 1350 kcal (32 kcal/kg). Its composition consists of 15% protein, 25% fat and 60% carbohydrate (preferred complex carbohydrates), in the form of DM-specific formula containing inulin and monounsaturated fatty acid (MUFA). This nutritional therapy was administrated six times per day via enteral pathway, followed by the administration of micronutrients of vitamins C, B and folic acid.
Result: During follow up period, the patient tolerated well with the diet. After the 14 days hospitalization, there was improvement of blood glucose level (<200 g/dL). Albumin level increases from 2.5 g/dL to 2.9 g/dl by the nutritional therapy containing protein more than 1.2 g/kg/day.
Conclusion: Administering a diet with the recommended composition and formula helps control hyperglycemia and improve hypoalbuminemia in patients that can improve the patient's clinical condition.
Improvement in optical fiber bundle-based imaging using synchronized fiber motion
Authors: Momsen Neil C. , Rouse Andrew R. , Gmitro Arthur F.
Published: July 2020

Image quality in fiber bundle-based imaging systems is inherently limited by the size and spacing of the individual fiber cores. The fiber bundle limits the achievable spatial resolution and superimposes a fixed pattern of signal variability across the image. To overcome these limitations, piezoelectric tubes were used to synchronously dither the fiber bundle on both ends. Experimental results using the dithering approach with a commercial fiber bundle showed a substantial decrease in fixed pattern noise and an increase in spatial resolution.
Real-time 3D thermoacoustic imaging and thermometry using a self-calibration technique
Authors: Tamimi Ehab A. , Xin Hao , Witte Russell S.
Published: July 2020

Thermoacoustic (TA) imaging is a modality where pulsed microwaves are used to generate ultrasound waves in tissue, which are highly correlated with temperature. This study uses a self-calibration approach to improve the estimation of temperature using 3D real-time TA thermometry in porcine tissue during localized heating. The self-calibration method estimated temperatures at eight embedded thermocouple locations with a normalized root-mean-square error of

3.25

±

2.08

%

. The results demonstrate that the method has the suitable accuracy and resolution to provide feedback control for breast cancer ablation therapy.