bluuebunny/crossref_metadata_2025 huggingface dataset:
ACTA2Expression Predicts Survival and Is Associated with Response to Immune Checkpoint Inhibitors in Gastric Cancer
Authors: Park Sunho , Karalis John D. , Hong Changjin , Clemenceau Jean R. , Porembka Matthew R. , Kim In-Ho , Lee Sung Hak , Wang Sam C. , Cheong Jae-Ho , Hwang Tae Hyun
Published: December 2022

Purpose:

We sought to identify biomarkers that predict overall survival (OS) and response to immune checkpoint inhibitors (ICI) for patients with gastric cancer.

Experimental Design:

This was a retrospective study of multiple independent cohorts of patients with gastric cancer. The association between tumor ACTA2 expression and OS and ICI response were determined in patients whose tumors were analyzed with bulk mRNA sequencing. Single-cell RNA sequencing (scRNA-seq) and digital spatial profiling data were used to compare tumors from patients with gastric cancer who did and did not respond to ICI.

Results:

Increasing tumor ACTA2 expression was independently associated with worse OS in a 567-patient discovery cohort [HR, 1.28 per unit increase; 95% confidence interval (CI), 1.02–1.62]. This finding was validated in three independent cohorts (n = 974; HR, 1.52 per unit increase; 95% CI, 1.34–1.73). Of the 108 patients treated with ICI, 56% of patients with low ACTA2 expression responded to ICI versus 25% of patients with high ACTA2 expression (P = 0.004). In an analysis of a publicly available scRNA-seq dataset of 5 microsatellite instability-high patients treated with ICI, the patient who responded to ICI had lower tumor stromal ACTA2 expression than the 4 nonresponders. Digital spatial profiling of tumor samples from 4 ICI responders and 5 ICI nonresponders revealed that responders may have lower ACTA2 expression in α-SMA–positive cancer-associated fibroblasts (CAF) than nonresponders (median: 5.00 vs. 5.50).

Conclusions:

ACTA2 expression is associated with survival and ICI response in patients with gastric cancer. ACTA2 expression in CAFs, but not in other cellular compartments, appears to be associated with ICI response.
Radiotherapy Induces Innate Immune Responses in Patients Treated for Prostate Cancers
Authors: Cheema Amrita K. , Li Yaoxiang , Ventimiglia Mary , Kowalczyk Keith , Hankins Ryan , Bandi Gaurav , Janowski Einsley-Marie , Grindrod Scott , Villagra Alejandro , Dritschilo Anatoly
Published: December 2022

Purpose:

Radiotherapy is a curative therapeutic modality used to treat cancers as a single agent or in combination with surgery and chemotherapy. Advanced radiotherapy technologies enable treatment with large fractions and highly conformal radiation doses to effect free-radical damage to cellular DNA leading to cell-cycle arrest, cell death, and innate immune response (IIR) stimulation.

Experimental Design:

To understand systemic clinical responses after radiation exposure, proteomic and metabolomic analyses were performed on plasma obtained from patients with cancer at intervals after prostate stereotactic body radiotherapy. Pathway and multivariate analyses were used to delineate molecular alterations following radiotherapy and its correlation with clinical outcomes.

Results:

DNA damage response increased within the first hour after treatment and returned to baseline by 1 month. IIR signaling also increased within 1 hour of treatment but persisted for up to 3 months thereafter. Furthermore, robust IIR and metabolite elevations, consistent with an early proinflammatory M1-mediated innate immune activation, were observed in patients in remission, whereas patients experiencing prostate serum antigen–determined disease progression demonstrated less robust immune responses and M2-mediated metabolite elevations.

Conclusions:

To our knowledge, these data are the first report of longitudinal proteomic and metabolomic molecular responses in patients after radiotherapy for cancers. The data supports innate immune activation as a critical clinical response of patients receiving radiotherapy for prostate cancer. Furthermore, we propose that the observed IIR may be generalized to the treatment of other cancer types, potentially informing multidisciplinary therapeutic strategies for cancer treatment.
An adjustment degree of fitting on fuzzy linear regression model toward manufacturing income
Authors: Ramly Nurfarawahida , Saifullah Rusiman Mohd , Ammar Shafi Muhammad , .S Suparman , Mohamad Hamzah Firdaus , Gurunlu Alma Ozlem
Published: December 2022

Regression analysis is a popular tool used in data analysis, whereas fuzzy regression is usually used for analyzing uncertain and imprecise data. In the industrial area, the company usually has problems in predicting the future manufacturing income. Therefore, a new approach model is needed to solve the future company prediction income. This article analyzed the manufacturing income by using the multiple linear regression (MLR) model and fuzzy linear regression (FLR) model proposed by Tanaka and Zolfaghari, involving 9 explanatory variables. In order to find the optimum of the FLR model, the degree of fitting (H) was adjusted between 0 to 1. The performance of three methods has been measured by using mean square error (MSE), mean absolute error (MAE) and mean absolute percentage error (MAPE). The analysis proved that FLR with Zolfaghari’s model with the degree of fitting of 0.025 outperformed the MLR and FLR with Tanaka’s model with the smallest error value. In conclusion, the manufacturing income is directly proportional to 6 independent variables. Furthermore, the manufacturing income is inversely proportional to 3 independent variables. This model is suitable in predicting future manufacturing income.
Social impact of disease parameters and damage accrual in patients with juvenile-onset systemic Lupus Erythematosus: a multicenter cross-sectional study
Authors: Tanigava Nicolas Yamada , Sakamoto Ana Paula , Franco André Silva , Sales Lucas Peixoto , Aikawa Nadia Emi , Terreri Maria Teresa , Pereira Rosa Maria Rodrigues
Published: December 2022

Objectives: To describe the frequency and investigate potential associations of unemployment, need of financial assistance and health-related quality of life in adult patients with Juvenile-onset Systemic Lupus Erythematosus (JSLE). Methods: In this multicenter cross-sectional study including JSLE adult patients, questionnaires were applied evaluating demographic characteristics, medical history, treatment, government financial assistance and work status, quality of life, economic classification, disease activity and damage accrual. Results: Sixty-nine JSLE patients from two Brazilian tertiary centers were included in this study. Twenty-eight (40.6%) patients were unemployed and 16 (23.2%) were receiving financial assistance or retirement. Work unemployment was associated only with higher damage scores (OR 1.95, 95% CI 1.14 to 3.35, p = 0.015), while the need of financial  assistance was associated with higher damage scores (OR 1.83, 95% CI 1.02 to 3.27, p = 0.042), longer disease duration (OR 1.15, 95% CI 1.01 to 1.32, p = 0.043) and worse economic score (OR 0.87, 95% CI 0.76 to 0.99, p = 0.036). Emotional health, body image perception and pain were the most compromised domains of quality of life but showed no correlation with disease parameters. Disease activity, on the other hand, was inversely associated with symptoms scores (ρ = -0.34, p = 0.004) and scores of adverse effects of medications (ρ = -0.27, p = 0.024). Conclusion: JSLE is a disease with severe outcomes and high social burden that profoundly impact patients during adulthood. Damage accrual is the main risk factor for both unemployment and need of financial assistance and its prevention must be central in the management of JSLE patients.
Endothelial injury in COVID-19 and septic patients
Authors: Hokama Larissa Tami , Souza Heraldo Possolo de
Published: December 2022

: Introduction: descriptions of the clinics presentation of COVID-19 and data from autopsies in deceased patients suggests that an important endothelial activation happens in COVID-19 evolution. Objectives: to determine the level of endothelial dysfunction and cytokines in sepsis and in COVID-19 and compare the extent of the endothelial activation and inflammation in both disease. Methods: patients were divided into three different groups: septic group, severe COVID-19 group and mild COVID-19 group. The septic group and severe COVID-19 group died from the respective disease and the mild group survived. The cytokines measured was: IFN-γ, TNF-α, IL-10, IL-1β and IL-4. The endothelial dysfunction markers measured was: E-Selectin, Tissue Factor (TF) and von Willebrand factor (vWF). Results: IL-10 level was higher in severe COVID-19 patients, when compared to the septic patients. No differences were observed in the level of the others cytokines. Between endothelial markers, E-Selectin was significantly higher in the septic group when compared to severe COVID-19 group; and TF was significantly higher in severe COVID-19 group when compared to the mild COVID-19 group. Conclusion: these two diseased evaluated, sepsis and COVID-19, presents a similar pattern of cytokines and endothelial dysfunction markers. These suggests that in COVID-19, the endothelium plays an important role in the pathophysiology of the disease and can be better evaluated as a therapeutic target.
Duodenopancreatectomy: influence of patient's intrinsic factors on results of pancreatic cancer surgical treatment
Authors: Freitas Álisson Carvalho de , Porath Heloisa , Rocha João Lucas Aleixes Sampaio , Goolkate Regina Maria , Ferreira Raphaella Paula , Reis Phillipe Geraldo Teixeira de Abreu
Published: December 2022

Introduction: Pancreatic cancer is the fourth leading cause of cancer death in Western countries, with a more prevalent incidence in the elderly (1). It presents itself as a neoplasm with high lethality and low survival, surgical resection being the only treatment with curative potential. However, pancreatoduodenectomy (Kausch-Whipple technique) is one of the most difficult surgeries in the gastrointestinal system, due to the great difficulty in accessing the pancreas and its proximity to various delicate and vital structures, requiring advanced knowledge by the surgeon (6). Objective: Evaluate the profile of patients with pancreatic cancer and factors that contribute to the surgical outcome and survival after curative pancreatoduodenectomy. Method: A descriptive retrospective cross-sectional study was carried out through the analysis of records of pancreatoduodenectomy in the period May 2005 – July 2015 at Hospital Erasto Gaertner (HEG) in Curitiba/PR. Variables were analyzed using Student's t-test, non-parametric Mann-Whitney U test, and chi-squared test with Fisher's correction. Survival and disease-free survival rates were evaluated using the Kaplan-Maier method with the log-rank test and survival predictors identified with Cox regression. The SPSS 23.0 and STATA 15 programs were used, with p value being lower than 0.05 considered statistically significant. Results: 98 pancreatoduodenectomy were evaluated and 46 were in male patients and 30 were in patients aged <60 years. Ca 19-9 levels were elevated in 29% of patients before surgery and elevated in 5% after surgery. Regarding the location of the tumor, 77% were pancreatic, 14% were duodenal papilla and 8% were biliary tract. Regarding tumor histology, 81 were adenocarcinoma, 6 were cholangiocarcinoma and 5 were other diagnoses; 29% were well differentiated, 53% moderately and 17% poorly differentiated. About staging, 21% T1, 23% T2, 36% T3 and 18% T4 were found. Factors such as local tumor extension, location of the lesion and surgery time do not show a significant influence on the surgical outcome of these patients. The main postoperative complications were fistula and evisceration. The mean overall survival after surgery at 5 years was 12.24% and this was seen to be significantly higher in the <60 years group (p < 0.01). Discussion and Conclusion: It was seen that pancreatic tumors present in more advanced stages at diagnosis and are more prevalent in the elderly. These characteristics negatively impact 5-year overall survival rates, as this is higher in patients older than 60 years. Early diagnosis remains a challenge for successful treatment with curative potential, and remains a key point for the survival of these patients, as it allows for better staging and better surgical results.
Evaluation of statural growth and puberty of children and adolescents with overweight and obesity
Authors: Souza Carolina Martins de , Yamamoto Tamara , Kochi Cristiane
Published: December 2022

Introduction: Childhood obesity is one of the main public health problems in Brazil and worldwide and is a risk factor for many other metabolic diseases. Furthermore, studies show that being overweight influences growth and puberty. Objectives: In females, being overweight is associated with the anticipation of puberty. However, in males, few studies have been done and they are controversial. Therefore, this study aimed to evaluate growth and puberty in overweight boys and girls. Methods: In this retrospective study, we analyzed the medical records of patients aged 5 to 19 years, overweight or obese, from the pediatric endocrinology clinic of the Irmandade de Misericórdia, Santa Casa de São Paulo. The data collected were: height (H) and weight, body mass index (BMI), expressed as z-scores (height SDS and BMI SDS, respectively). Pubertal staging was evaluated according to Tanner's criteria. Final height was considered when the growth rate was less than 2 cm/year and/or bone age was over 15 years. Results: Ninety girls were evaluated, with mean (SD) chronological age (CA) at puberty onset of 9.8 (1.2) years. Girls had higher stature compared to the family pattern, but their final height was equal to the genetic target. Eighty-two boys were evaluated, with a mean (SD) CA at puberty at 11.7 (1.2) years. Boys were above family height at the onset of puberty, but reduced height SDS during puberty evolution. There was a reduction in BMI SDS from beginning to end of puberty, different from what was observed in girls. Discussion: In this group evaluation, the onset of puberty occurred within the expected average age for a general population, in both genders, with no pubertal anticipation or delay being observed. Both groups showed taller stature compared to the familiar target at the beginning of puberty, however, they reached the end within the genetic pattern, suggesting that growth is accelerated in the prepubertal phase and then lowered during puberty. Furthermore, in girls, there was no difference between BMI SDS at the beginning and at the end of puberty, indicating that these patients do not show any worsening in weight after menarche. Boys, on the other hand, reduced BMI SDS during puberty, suggesting, therefore, that treatment should be individualized, since body composition is different according to gender.
Avaliação da implementação de uma capacitação relacionada à prevenção de lesão por pressão
Authors: Martins Maria Carolina Pinto , Silva Vanessa Abreu da , Almeida Angélica Olivetto de , Antunes Ivan Rogério , Roscani Alessandra Nazareth Cainé Pereira , Gasparino Renata Cristina
Published: December 2022

Objetivo: avaliar a implementação de um programa de capacitação para medidas de prevenção de lesão por pressão por meio de instrumentos validados. Metodologia: estudo quase-experimental desenvolvido em quatro etapas: validação de conteúdo de um instrumento de auditoria para a avaliação da implementação de medidas de prevenção de lesão por pressão; auditoria para a avaliação da implementação das medidas; intervenção educativa com validação de face de um questionário para avaliar a aprendizagem; repetição da auditoria dois meses após a intervenção educativa. Resultados: a validação alcançou porcentagem de concordância entre os especialistas superior a 0,9. Na primeira auditoria, a conformidade na implementação das medidas foi de 65,1%. A nota da avaliação de aprendizagem antes da intervenção foi 7,99 e, após, 8,45 (p<0,0001). Na segunda auditoria, a conformidade na implementação das medidas foi de 56,2%. Conclusão: a implementação de um programa de capacitação para medidas de prevenção de lesão por pressão contribuiu para aumentar o nível de conhecimento teórico dos participantes, entretanto, não houve a translação do conhecimento adquirido para a prática clínica. A validação dos instrumentos foi satisfatória.
Ansiedade e depressão em estudantes de medicina: estudo transversal
Authors: Nunes Joana Katya Veras Rodrigues Sampaio , Figueiredo Viviane Melo e Silva de , Santos João Vitor Soares , Mendes Natale Maria Lindoso da Silva , Figueiredo Neto José Albuquerque de
Published: December 2022

Introdução: A prevalência de depressão e ansiedade entre universitários vem aumentando nas faculdades de medicina, e o sexo feminino é apontado como um possível fator predisponente ao esgotamento mental. Este estudo visa elucidar fatores associados, bem como a prevalência de sintomas depressivos e ansiosos em estudantes de medicina, contribuindo no estabelecimento de medidas de prevenção e tratamento para futuros médicos. Métodos: Estudo transversal envolvendo 812 estudantes de medicina. Foram aplicados questionários sobre dados sociodemográficos, o Inventário de Depressão de Beck - (BDI-II) e o Inventário de Ansiedade de Beck – (BAI). A análise estatística foi realizada no programa SPSS 22. A normalidade foi testada pelo teste de Shapiro-Wilk e as correlações foram avaliadas pelo teste de correlação de Spearman. Resultados: Foi observada uma prevalência de 34,2% de depressão entre os estudantes, considerando sintomas leves, moderados e graves. Em relação à ansiedade, o nosso estudo observou a prevalência de 46,3%. Entre os participantes com ansiedade, 56,4% apresentaram sintomas de depressão, sendo 22,6% mulheres; 50,3% dos alunos com depressão apresentaram sintomas de ansiedade, sendo 19,6% mulheres. Após análise com regressão logística, os sintomas de depressão estiveram relacionados à ansiedade (OR: 4,3; IC95%: 2,6-6,8; p < 0,001) e ao sexo feminino (OR: 1,7; IC95%: 1,04-2,6; p = 0,0320). Os sintomas de ansiedade, após ajuste de regressão logística, estiveram associados à depressão (OR: 4,3; IC95%: 2,7-6,8; p < 0,001) e ao sexo feminino (OR: 1,6; IC95%: 1,04-2,4; p = 0,039). Conclusão: Neste estudo as estudantes do sexo feminino, foram mais propensas a desenvolver ansiedade e depressão. No entanto, mais estudos são necessários para determinar se esse fenômeno se deve a mecanismos fisiológicos femininos ou a fatores sociais e culturais da sociedade patriarcal.
Automated didactic prototype of pulmonary ventilation exhibits a simulation of intrathoracic pressure variations during diaphragmatic function
Authors: Pereira Raphael José , Lopes Vitor Mainenti Leal , Hohl Rodrigo , Mourão-Júnior Carlos Alberto , Nagato Akinori Cardozo
Published: December 2022

The movement of air from the environment to the alveoli is a vital and complex phenomenon that occurs due to variations in intrathoracic and airway pressures in relation to the atmosphere. The construction of didactic prototypes can minimize the abstraction required in these in vivo phenomena. In this study, we automated a didactic prototype of pulmonary ventilation already described in literature to simulate and exhibit variations in intrathoracic pressure during diaphragmatic function. A pulmonary ventilation (PV) prototype was produced with recyclable materials, and automated by adapting a pressure sensor in the system to generate pressure curves as a function of time during the simulation of diaphragmatic function. The automated plunger’s downward traction induced by the servomotor (such as diaphragmatic) reduced the pressure inside the bottle (intrathoracic), and this variation can be observed graphically on a computer interface while the balloon was expanded, and atmospheric air invaded its interior. Conclusion: The incorporation of technology into a simple PV prototype allowed a safe and simulated demonstration of how the diaphragm induces the variation of the intrathoracic pressure in relation to the atmosphere concomitantly with the pulmonary deformation that occurs during inspiration and exhalation.
Promoção de saúde cardiovascular na infância e na adolescência: uma revisão da literatura
Authors: Mainardes Vanessa Tramontim , Canizella Gabriela Parice , Ramos Marina Garcia , Yamamoto Renato Minoru
Published: December 2022

A aterosclerose é hoje reconhecida como doença que se inicia precocemente, na infância. Entre os principais fatores de risco modificáveis para as doenças cardiovasculares (DCV) na idade adulta, encontram-se dois distúrbios da nutrição e do metabolismo que também podem incidir na infância e na adolescência, a dislipidemia e a obesidade. O objetivo foi determinar se existe uma associação positiva entre a adoção de hábitos saudáveis de vida e a melhoria da saúde cardiovascular na infância e na adolescência, expressa pela redução da gordura corpórea e das dislipidemias. Este estudo é uma revisão sistemática da literatura na faixa etária dos 2 aos 19 anos de idade, avaliando publicações do período de 2011 a 2021, em língua inglesa, espanhola ou portuguesa. A intervenção analisada foi a promoção de hábitos saudáveis de vida, incluindo a atividade física regular e a adoção de práticas alimentares adequadas. Seguindo o anagrama PICO, a pergunta orientadora escolhida foi: a promoção de hábitos saudáveis de vida resulta em melhoria da saúde cardiovascular na infância e na adolescência, indicada pela redução de gordura corpórea e pelo controle das dislipidemias? Dos 362 artigos inicialmente identificados nos portais de pesquisa, 350 foram excluídos e 12 foram selecionados para a análise final. A adoção de hábitos saudáveis de vida conduziu à melhoria da saúde cardiovascular, expressa pela redução da gordura corpórea. No caso das dislipidemias, houve discordância entre os autores e não foi possível concluir se a promoção de hábitos saudáveis de vida protege as crianças e os adolescentes contra esses distúrbios metabólicos. A participação da família e das escolas foram estratégias desenvolvidas nos estudos que alcançaram a melhoria da saúde cardiovascular entre as crianças e os adolescentes. Os autores observaram a necessidade de estudos de intervenção realizados durante períodos mais longos para implementar futuras medidas de melhoria da saúde cardiovascular que se mantenham até a idade adulta, a partir da faixa etária pediátrica.
O sublime ecfrástico dos vídeos musicais: um travelling literário a partir da letra
Authors: Silveira Francisco Ricardo Cipriano
Published: December 2022

Com o videoclipe de Bachelorette respectivo a uma canção de Björk a servir de moldura, procura-se estudar em que medida o formato de arte da imagem em movimento em causa – o dos vídeos musicais – está assentado numa presença de estatuto idiossincrático, mas também variado, das artes verbais. Isto é, qual a especificidade e a diversidade literárias dos vídeos musicais partindo da passagem da letra a canção videografada e da identificação de diferentes tipologias de inscrição da literatura neles? Para tal efeito, a diversidade remete para casos tais quais lyric videos, vídeos que representam tecnologias de escrita ou vídeos interativos em que a palavra escrita tem destaque. Por seu turno, a tentativa de uma especificidade constrói-se em torno de uma metáfora. Esta compara uma ideia de viagens em transportes motorizados a um tipo de écfrase característico da transição letra-vídeo nos videoclipes, a um “sublime ecfrástico” que atua enquanto gancho conceptual.
Artes cênicas e interdisciplinaridade: o interartístico em questão
Authors: Lesage Marie-Christine , Sardá Daniela Nienkötter , Santos Guilherme Soares dos
Published: December 2022

Neste artigo, a autora faz uma distinção conceitual entre a interdisciplinaridade teórica e a interdisciplinaridade das práticas artísticas. Com efeito, existem duas maneiras de encarar a interdisciplinaridade: no âmbito dos saberes teóricos e da epistemologia, e do ponto de vista das práticas artísticas. A interdisciplinaridade, no sentido estrito, é um confronto de disciplinas constituídas, de metodologias e de teorias provenientes de horizontes epistemológicos diferentes. Por isso, importa diferenciar esta última do encontro de várias artes no interior da representação teatral ou da performance, que é da alçada do interartístico. A criação interartística, por sua vez, remete mais especificamente a processos de criação fundados em diálogos complexos entre diversas práticas que preservam a sua autonomia, o que deve, ainda, ser distinguido do fato de que a arte do teatro recorra a diferentes meios. A noção de interartístico busca, antes de tudo, designar a praxis, a qual — trata-se de uma hipótese — tenderia a se afastar do modelo de encenação.
As guardiãs das tradições religiosas: a representatividade das nochês em Os Tambores de São Luís e na poesia Comando Doce
Authors: Silva Welida Maria Gouveia , Oliveira Rubenil da Silva
Published: December 2022

Este artigo propõe analisar comparativamente as nochês — mulheres negras, sacerdotisas e líderes — nos terreiros de Mina e Candomblé, respectivamente, na Casa das Minas e na Casa Jitolu de Os tambores de São Luís (MONTELLO, 2005) e a poesia Comando Doce (ILÊ AIYÊ, 2009). Ambas as obras destacam as sacerdotisas como guardiãs das tradições religiosas de matriz africana, sujeitos identitários e políticos que utilizam a religião como meio de resistência e de preservação cultural. Assim, busca-se, através deste estudo bibliográfico, evidenciar também o protagonismo feminino negro nos terreiros jeje-nagôs, oriundo dos povos iorubás, e o matriarcado como sistema de poder estrutural dessas comunidades. Além disso, este estudo mostra como a religião, com seus símbolos e rituais, continua sendo uma forma de resistência à dominação branca. Portanto, percebe-se que as mulheres têm papel fundamental na construção e na manutenção das comunidades religiosas e que os terreiros não são apenas lugares de orações, mas de preservação das tradições, dos costumes, da cultura e identidade negra.
Telemedicina no Brasil: ameaças à proteção de dados pessoais em decorrência da flexibilização da pandemia e da regulamentação precária
Authors: Oliveira Diogo Luís Manganelli
Published: December 2022

O presente trabalho analisou os riscos envolvidos na utilização dos recursos de telessaúde e telemedicina, autorizados durante a pandemia de covid-19, sem um correspondente amadurecimento com relação aos requisitos necessários para garantir a segurança dos dados pessoais e dados pessoais sensíveis de seus usuários, seja pela recente entrada em vigor da Lei n. 13.709/2018, seja pela incipiente criação da Autoridade Nacional de Proteção de Dados, que ainda caminha no sentido de se estruturar organicamente. Sob o lume da metodologia civil-constitucional capitaneada por Perlingieri, o artigo destacou a necessidade de que os requisitos tecnológicos abarcados nas relações privadas sejam devidamente adequados aos valores intrínsecos àqueles delineados no texto constitucional, tendo as normas de direito civil como importante vetor na garantia de tal aplicação. A partir de pesquisa qualitativa, valendo-se de fontes indiretas, inclusive legislação estrangeira, e análise à luz da metodologia dedutiva, elencou-se uma série de considerações para a aplicação de recursos da telemedicina no Brasil de maneira adequada e em sintonia com a proteção de dados pessoais de seus cidadãos.
GLP-1 Receptor Agonists for the Reduction of Atherosclerotic Cardiovascular Risk in Patients With Type 2 Diabetes
Authors: Marx Nikolaus , Husain Mansoor , Lehrke Michael , Verma Subodh , Sattar Naveed
Published: December 2022

Patients with type 2 diabetes are at high risk for development of cardiovascular disease, including myocardial infarction, stroke, heart failure, and cardiovascular death. Multiple large cardiovascular outcome trials with novel glucose-lowering agents, namely SGLT2i (SGLT2 inhibitors) and GLP-1 RA (GLP-1 receptor agonists), have demonstrated robust and significant reductions of major adverse cardiovascular events and additional cardiovascular outcomes, such as hospitalizations for heart failure. This evidence has changed the landscape for treatment of patients with type 2 diabetes. Both diabetes and cardiology guidelines and professional societies have responded to this paradigm shift by including strong recommendations to use SGLT2i and/or GLP-1 RA, with evidence-based benefits to reduce cardiovascular risk in high-risk individuals with type 2 diabetes, independent of the need for additional glucose control. GLP-1 RA were initially developed as glucose-lowering drugs because activation of the GLP-1 receptor by these agents leads to a reduction in blood glucose and an improvement in postprandial glucose metabolism. By stimulating GLP-1R in hypothalamic neurons, GLP-1 RA additionally induce satiety and lead to weight loss. Data from cardiovascular outcome trials demonstrated a robust and consistent reduction in atherothrombotic events, particularly in patients with established atherosclerotic cardiovascular disease. Despite the consistent evidence of atherosclerotic cardiovascular disease benefit from these trials, the number of patients receiving these drugs remains low. This overview summarizes the experimental and clinical evidence of cardiovascular risk reduction offered by GLP-1 RA, and provides practical information on how these drugs should be implemented in the treatment of type 2 diabetes in the cardiology community.
The Development and Validation of the English Writing Enjoyment Scale
Authors: Jin Yinxing
Published: December 2022

To develop the English Writing Enjoyment Scale, I surveyed 30 Chinese-as-First-Language university students of English (Group 1) through a self-narrative inquiry that included but was not limited to psychological, motivational, behavioral, cognitive, and physiological factors. Using a grounded theory approach to analyzing the participants’ self-reports, I extracted 30 thematic categories. From the 11 categories that were most often endorsed, I developed the English Writing Enjoyment Scale and subjected it next to other psychometric analyses using three other groups of larger samples of university students. This included first a Principal Components Analysis (Group 2: n = 220) and then a Confirmatory Factor Analysis (Group 3: n = 357) that narrowed the instrument to 9-items with satisfactory internal reliability and construct validity. Finally, I conducted correlational analyses between this instrument and four other measures in and outside second language acquisition research (Group 4: n = 62). I discuss these findings and their implications and outline directions for further research.
The Quest for Competitive Advantage: The Role of Technology Depth and Breadth at the Customer Interface
Authors: Bhattacharyya Som Sekhar , Sahay Arvind , Sahay Arunaditya
Published: December 2022

Technology is becoming pivotal for firms while interacting with customers. While extensive research exists on how deployment of firm resources, such as technology, leads to competitive advantage (CA), research on the interaction between technology-led firm capabilities deployed at firm customer interaction and CA is limited. We theorize regarding a more effective approach to manage technology by looking at the effects of firm technology resource and capability deployment by a firm in the context of managing different dimensions of TRU at the firm–customer interface. We do so by considering two firm capabilities, namely, technology resource breadth utilization (TRBU) and technology resource depth utilization (TRDU). We use low involvement purchase (LIP) customer purchase context during three customer purchase stages, namely, pre-purchase, purchase and post-purchase to provide structure to the logic. We then build arguments on the relationship between the level of deployment of TRDU and TRBU and attainment of CA under different conditions. We propose testable propositions between TRBU and TRDU levels with CA attained and posit different kinds of relationship like positive, negative and inverted U-shaped relationships having inflexion points to contribute to the theorization in this area.
Jumping over the paywall: Strategies and motivations for scholarly piracy and other alternatives
Authors: Segado-Boj Francisco , Martín-Quevedo Juan , Prieto-Gutiérrez Juan-José
Published: December 2022

Despite the advance of the Open Access (OA) movement, most scholarly production can only be accessed through a paywall. We conduct an international survey among researchers (N  =  3304) to measure the willingness and motivations to use (or not use) scholarly piracy sites, and other alternatives to overcome a paywall such as paying with their own money, institutional loans, just reading the abstract, asking the corresponding author for a copy of the document, asking a colleague to get the document for them, or searching for an OA version of the paper. We also explore differences in terms of age, professional position, country income level, discipline, and commitment to OA. The results show that researchers most frequently look for OA versions of the documents. However, more than 50% of the participants have used a scholarly piracy site at least once. This is less common in high-income countries, and among older and better-established scholars. Regarding disciplines, such services were less used in Life & Health Sciences and Social Sciences. Those who have never used a pirate library highlighted ethical and legal objections or pointed out that they were not aware of the existence of such libraries.
Background check: Spatiality and relationality in Nancy Fraser's expanded conception of capitalism
Authors: Conroy William
Published: December 2022

Nancy Fraser's recent work on the hidden abodes of capitalism has quickly become a critical point of reference for those concerned with the racialized, gendered, and ecological conditions of capitalist reproduction. With that in view, this article seeks to extend Fraser's conceptualization through a sympathetic critique of her approach to capitalism's foreground/background nexus. After situating Fraser's project in relation to Marx (and his own engagement with capitalism's background conditions of possibility), it argues that (1) Fraser fails to adequately theorize how capitalist crisis is produced and resolved in space and (2) that Fraser obscures the relational-dialectical constitution of her own hidden abodes. This article then develops an alternative theoretical approach to capitalism's foreground/background relationship, based on a synthetic reading of Fraser's framework and the work of geographer Jason W. Moore. Finally, it closes with some brief reflections on the implications of this theorization for contemporary socialist politics.
Systematic Review of the Economics of School-Based Interventions for Dating Violence and Gender-Based Violence
Authors: Kiff Fraizer , Shaw Naomi , Orr Noreen , Rizzo Andrew. J. , Chollet Annah , Young Honor , Rigby Emma , Hagell Ann , Berry Vashti , Bonell Chris , Melendez-Torres G. J. , Farmer Caroline
Published: December 2022

Dating and relationship violence (DRV) and gender-based violence (GBV) among children and young people incur a high cost to individuals and society. School-based interventions present an opportunity to prevent DRV and GBV early in individuals’ lives. However, with school resources under pressure, policymakers require guidance on the economics of implementing interventions. As part of a large systematic review funded by the National Institute for Health and Care Research (NIHR), we searched for economic evaluations and costing studies of school-based interventions for DRV and GBV. No formal economic evaluations were identified. Seven studies reporting costs, cost savings, or resource use for eight interventions were identified. The largest costs of implementing interventions were related to staff training and salaries but savings could be made by implementing interventions on a large scale. The potential cost savings of avoided DRV and GBV far outweighed the costs of implementation.
Primordial Brains and Bodies: How Neurobiological Discourses Shape Policing Experiences
Authors: Keesman Laura Danique
Published: December 2022

This article demonstrates how the broader social development to understand behaviour and personhood as shaped by neurobiology forms a predominant narrative among police officers. Drawing on an ethnography of the Dutch police force and 73 interviews with officers, I examine first how they use neurobiological terms to describe and account for their embodied sensations as well as civilian behaviour. Second, I describe the functions these narratives have, that is, why officers use them. Finally, I show how neurobiological discourses are learned and (re)produced during training. Results indicate that officers invoke neurobiology both as facilitator of and explanation for action. The latter raises questions as to what extent neurobiological discourse obscures police responsibility and accountability. A more thorough understanding of how neurobiological discourses are used to understand and account for actions is relevant, given the growing pressures on public professionals to legitimise their work.
Sense of mastery and attitude towards illness: Examining longitudinal benefits of a medical specialty camp for youth with sickle cell disease
Authors: Gillard Ann , Gagnon Ryan , Pashankar Farzana , Balsamo Lyn , Grafft Natalie , Miranda Jacqueline , Boruchov Donna , Neri Caitlin , Sprinz Philippa , Longyear Christine
Published: December 2022

Medical specialty camps can play an important role in the positive development of psychosocial outcomes for children and youth with sickle cell disease (SCD). This study examined how sense of mastery and attitude towards illness outcomes changed over 6 months for 100 campers aged 8–16 years with SCD. The outcomes were measured twice before and twice after camp. Latent growth curve modeling was used to analyze data. Results showed no changes in the outcomes for this study population. Implications for future research designs, populations, and outcomes are discussed, as are implications for communications about camp, and policy and practice.
Introvert EFL learners’ listening comprehension and metacognitive awareness: A mixed-method study
Authors: Taghizade Motahare , Bozorgian Hossein , Abadikhah Shirin
Published: December 2022

Listening is regarded as an essential skill for language learning, and metacognitive intervention has been utilized widely to facilitate this skill for learners in recent years. Besides metacognitive factors, the impact of personality traits such as introversion/extroversion has been emphasized in the field of language teaching. This study investigated the effect of the metacognitive intervention on upper-intermediate introvert English as a foreign language (EFL) learners’ listening comprehension and metacognitive awareness. Upper-intermediate introvert EFL learners ( N = 59) were randomly assigned to an experimental ( N = 29) and a control group ( N = 30). The experimental group received metacognitive intervention through a pedagogical cycle for eight sessions, while the control group followed their conventional approach without a pedagogical cycle. Participants in both groups took International English Language Testing System (IELTS) listening tests and completed a Metacognitive Awareness Listening Questionnaire (MALQ) before and after the intervention. Subsequently, 20 learners from the experimental group were randomly chosen and interviewed to decode their attitudes toward the intervention. Results suggested that metacognitive intervention led to a significant improvement in introvert EFL learners’ listening comprehension and metacognitive awareness. The results of the qualitative data analysis also revealed that the learners benefited from the metacognitive intervention in various areas, such as improvement in listening comprehension, becoming able to identify their strengths and weaknesses, decreasing anxiety, and increasing concentration, self-confidence, and motivation.
Null objects in Polish heritage language acquisition in contact with German
Authors: Sopata Aldona , Rinke Esther , Flores Cristina
Published: December 2022

Aims and objectives:

This study investigates the acquisition of referential expressions for direct objects by child heritage speakers of Polish living in Germany. Our main research questions are how object expression develops in bilingual children and whether their path or pace of acquisition differs from monolingual children.

Methodology:

We investigate the use of referential expressions in an elicited production task. In all, 39 Polish-German bilingual children participated in the test.

Data and analysis:

We compare the data of four age groups of bilingual children – 3- to 4-year-olds, 5- to 6-year-olds, 7- to 8-year-olds, and 9- to 10-year-olds – to each other and to monolingual children at the respective ages. For the analysis of participants’ responses, we ran a generalized linear mixed model (GLMM) with a multinominal dependent variable.

Findings:

The results show that child heritage language (HL) speakers of Polish display knowledge of semantic and pragmatic constraints of object realization from early stages on. However, from age 5 and up to age 9 to 10, they still produce high rates of inappropriate null objects and show a deceleration in the development of this knowledge, compared to monolingual children. This protracted development is attributed to reduced input in the HL, mainly due to the enrolment in the majority language school.

Originality:

This study is the first to investigate the development of referential expressions for direct objects in child heritage speakers of Polish in the age span 3 to 10 years.

Significance:

The study relates the higher rates of null objects in the bilingual production to the varying degrees of exposure to the HL during language development. Deceleration in the pace of object acquisition by the HL speakers at the age of 5 to 6 years is attributed to a prolonged stage of acquisition of integrating rules of syntactic and pragmatic knowledge.
Optimisation of electric vehicle with the in-wheel motor as a dynamic vibration absorber considering ride comfort and motor vibration based on particle swarm algorithm
Authors: Zhao Pingping , Fan Zhimin
Published: December 2022

Compared with other electric vehicles, the ride comfort of the electric vehicle with the in-wheel motor as a dynamic vibration absorber has significantly improved. However, the in-wheel motor is used as a dynamic vibration absorber, aggravating the motor vibration, thus affecting motor performance and life. In addition, the space inside the wheel is limited, so the vibration displacement of the motor relative to the hub needs to be constrained. In fact, the literature on ride comfort of the electric vehicle with the in-wheel motor as a dynamic vibration absorber has hardly considered motor vibration. So, this article comprehensively investigates the ride comfort and motor vibration of this electric vehicle. Firstly, the vibration model of the electric vehicle with the in-wheel motor as a dynamic vibration absorber is established. Then, the optimisation model of this electric vehicle is founded. Next, the multi-objective particle swarm optimisation algorithms based on adaptive grid and crowding distance are used to optimise the model, and these two algorithms are compared. The optimal solutions in three typical cases are obtained. Finally, the vibration responses of this electric vehicle model before and after optimisation, the traditional electric vehicle model, and the in-wheel motor drive electric vehicle model are compared in case 1. The results show that all vibration responses are improved to different degrees after optimisation; the algorithm based on crowding distance can seek out the optimal solutions faster, but it takes longer to complete the whole optimisation process.
Age-dependent Electroencephalogram Characteristics During Different Levels of Anesthetic Depth
Authors: Li Feixiang , Dang Yaoyao , Zhang Xuan , Chen Huimin , Lu Yuechun , Yu Yonghao
Published: December 2022

Objective The monitoring of anesthetic depth based on electroencephalogram derivation is not currently adjusted for age. Here we analyze the influence of age factors on electroencephalogram characteristics. Methods Frontal electroencephalogram recordings were obtained from 80 adults during routine clinical anesthesia. The characteristics of electroencephalogram with age and anesthesia were observed during four kinds of anesthesia. Results The slow wave power, δ power, Bispectral Index (BIS) and approximate entropy can be used to distinguish different states of anesthesia (P < 0.05). In the deep and very deep anesthesia states, δ power decreased with age (P < 0.0001). In the very deep anesthesia state, θ power decreased with age (P < 0.05). In the deep and very deep anesthesia states, α power decreased with age (P = 0.0002). In the light and deep anesthesia states, β power decreased with age (P = 0.003). In the deep anesthesia state, γ power decreased with age (P = 0.002). In the very deep anesthesia state, permutation entropy increased significantly with age (P = 0.0001). In the very deep anesthesia state, BIS value increased with age (P = 0.006). The slow wave power, approximate entropy, and sample entropy did not show age-dependent changes. Conclusions The influence of age should be considered when using BIS and δ power to monitor the depth of anesthesia, while the influence of age should not be considered when using slow wave power and approximate entropy to monitor the depth of anesthesia.
Cognitive assemblages: The entangled nature of algorithmic content moderation
Authors: Crosset Valentine , Dupont Benoît
Published: December 2022

This article examines algorithmic content moderation, using the moderation of violent extremist content as a specific case. In recent years, algorithms have increasingly been mobilized to perform essential moderation functions for online social media platforms such as Facebook, YouTube, and Twitter, including limiting the proliferation of extremist speech. Drawing on Katherine Hayles’ concept of “cognitive assemblages” and the Critical Security Studies literature, we show how algorithmic regulation operates within larger assemblages of humans and non-humans to influence the surveillance and regulation of information flows. We argue that the dynamics of algorithmic regulation are more liquid, cobbled together and distributed than it appears. It is characterized by a set of shifting human and machine entities, which mix traditional surveillance methods with more sophisticated tools, and whose linkages and interactions are transient. The processes that enable the consolidation of knowledge about risky profiles and contents are, therefore, collective and distributed among humans and machines. This allows us to argue that the cognitive assemblages involved in content moderation become a cobbled space of preemptive calculation.
Missense VKOR mutants exhibit severe warfarin resistance but lack VKCFD via shifting to an aberrantly reduced state
Authors: Li Shuang , Sun Jie , Liu Shixuan , Zhou Fengbo , Gross Michael L. , Li Weikai
Published: December 2022

Missense vitamin K epoxide reductase (VKOR) mutations in patients cause resistance to warfarin treatment but not abnormal bleeding due to defective VKOR activity. The underlying mechanism of these phenotypes remains unknown. Here we show that the redox state of these mutants is essential to their activity and warfarin resistance. Using a mass spectrometry-based footprinting method, we found that severe warfarin-resistant mutations change the VKOR active site to an aberrantly reduced state in cells. Molecular dynamics simulation based on our recent crystal structures of VKOR reveals that these mutations induce an artificial opening of the protein conformation that increases access of small molecules, enabling them to reduce the active site and generating constitutive activity uninhibited by warfarin. Increased activity also compensates for the weakened substrate binding caused by these mutations, thereby maintaining normal VKOR function. The uninhibited nature of severe resistance mutations suggests that patients showing signs of such mutations should be treated by alternative anticoagulation strategies.