bluuebunny/crossref_metadata_2025 huggingface dataset:
An immunosuppressed 37-year-old woman with right atrial necrotising myocarditis
Authors: Carlson Sinead , Nangrahary Mary , Ong Jeremy SL
Published: April 2021

A 37-year-old immunocompromised woman was admitted with palpitations, fevers and myalgias. An echocardiogram demonstrated a mass in the right atrial walls and interatrial septum. Endovascular biopsy of the myocardium revealed neutrophilic necrotising myocarditis isolated to the right atrium. Multiple blood, urine and stool cultures were negative but a high anti-streptolysin O antibody titre was detected. The combination of these findings led to the working diagnosis of necrotising myocarditis. Without a positive culture, it was not possible to definitively state the cause of this condition. She was treated with intravenous antibiotics and continued to improve physically and biochemically on discharge.
Impact of the COVID-19 pandemic on anxiety and depression symptoms of young people in the global south: evidence from a four-country cohort study
Authors: Porter Catherine , Favara Marta , Hittmeyer Annina , Scott Douglas , Sánchez Jiménez Alan , Ellanki Revathi , Woldehanna Tassew , Duc Le Thuc , Craske Michelle G , Stein Alan
Published: April 2021

Objective

To provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low/middle-income countries (LMICs).

Design

A phone survey administered between August and October 2020 to participants of a population-based longitudinal cohort study established in 2002 comprising two cohorts born in 1994–1995 and 2001–2002 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We use logistic regressions to examine associations between mental health and pandemic-related stressors, structural factors (gender, age), and lifelong protective/risk factors (parent and peer relationship, wealth, long-term health problems, past emotional problems, subjective well-being) measured at younger ages.

Setting

A geographically diverse, poverty-focused sample, also reaching those without mobile phones or internet access.

Participants

10 496 individuals were approached; 9730 participated. Overall, 8988 individuals were included in this study; 4610 (51%) men and 4378 (49%) women. Non-inclusion was due to non-location or missing data.

Main outcome measures

Symptoms consistent with at least mild anxiety or depression were measured by Generalized Anxiety Disorder-7 (≥5) or Patient Health Questionnaire-8 (≥5).

Results

Rates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) (95% CI 38.63% to 43.12%; (29.49–33.74)), and lowest in Vietnam at 9% (9%) (95% CI 8.16% to 10.58%; (8.33–10.77)), mirroring COVID-19 mortality rates. Women were most affected in all countries except Ethiopia. Pandemic-related stressors such as health risks/expenses, economic adversity, food insecurity, and educational or employment disruption were risk factors for anxiety and depression, though showed varying levels of importance across countries. Prior parent/peer relationships were protective factors, while long-term health or emotional problems were risk factors.

Conclusion

Pandemic-related health, economic and social stress present significant risks to the mental health of young people in LMICs where mental health support is limited, but urgently needed to prevent long-term consequences.
Orphan nuclear receptor TLX promotes immunosuppression via its transcriptional activation of PD-L1 in glioma
Authors: Zhou Jiayi , Pei Xiaojuan , Yang Yingui , Wang Zhu , Gao Weijie , Ye Ran , Zhang Xiantong , Liu Jiangang , Liu Zhuohao , Yang Xinzhi , Tao Jingli , Gu Chunshan , Hu Wei , Chan Franky Lueng , Li Xin , Mao Jie , Wu Dinglan
Published: April 2021

Background

High-grade gliomas are rapidly progressing tumors of the central nervous system, and are associated with poor prognosis and highly immunosuppressive microenvironments. Meanwhile, a better understanding of PD-L1, a major prognostic biomarker for checkpoint immune therapy, regulation may provide insights for developing novel immunotherapeutic strategies for treating gliomas. In the present study, we elucidate the functional significance of the orphan nuclear receptor TLX in human glioma, and its functional role in immune suppression through regulation of PD-L1/PD-1 axis.

Methods

TLX and PD-L1 expression patterns, and their association with clinicopathological parameters and immune phenotypes of glioma were analysed using CIBERSORT algorithm and single-sample gene-set enrichment analysis from The Cancer Genome Atlas (n=695) and Chinese Glioma Genome Atlas (n=1018) databases. Protein expression and cellular localization of TLX, PD-L1, and PD-1, as well as the prevalence of cytotoxic tumor-infiltrating lymphocytes (TILs), and tumor-associated macrophages (TAMs), in the glioma immune microenvironment were analyzed via tissue microarray by immunohistochemistry and multiplex immunofluorescence. Glioma allografts and xenografts with TLX manipulation (knockdown/knockout or reverse agonist) were inoculated subcutaneously, or orthotopically into the brains of immunodeficient and immunocompetent mice to assess tumor growth by imaging, and the immune microenvironment by flow cytometry. PD-L1 transcriptional regulation by TLX was analyzed by chromatin immunoprecipitation and luciferase reporter assays.

Results

TLX and PD-L1 expression was positively associated with macrophage-mediated immunosuppressive phenotypes in gliomas. TLX showed significant upregulation and positive correlation with PD-L1. Meanwhile, suppression of TLX significantly inhibited in vivo growth of glioma allografts and xenografts (p<0.05), rescued the antitumoral immune response, significantly decreased the PD-L1+, and glioma-associated macrophage population, and increased cytotoxic lymphocyte infiltration (p<0.05). Mechanistically, TLX binds directly to CD274 (PD-L1) gene promoter and activates CD274 transcription.

Conclusions

TLX contributes to glioma malignancy and immunosuppression through transcriptional activation of PD-L1 ligands that bind to PD-1 expressed on both TILs and TAMs. Thus, targeting the druggable TLX may have potential therapeutic significance in glioma immune therapy.
Depth of tumor implantation affects response to in situ vaccination in a syngeneic murine melanoma model
Authors: Carlson Peter M , Mohan Manasi , Rodriguez Matthew , Subbotin Vladimir , Sun Claire X , Patel Ravi B , Birstler Jen , Hank Jacquelyn A , Rakhmilevich Alexander L , Morris Zachary S , Erbe Amy K , Sondel Paul M
Published: April 2021

An important component of research using animal models is ensuring rigor and reproducibility. This study was prompted after two experimenters performing virtually identical studies obtained different results when syngeneic B78 murine melanoma cells were implanted into the skin overlying the flank and treated with an in situ vaccine (ISV) immunotherapy. Although both experimenters thought they were using identical technique, we determined that one was implanting the tumors intradermally (ID) and the other was implanting them subcutaneously (SC). Though the baseline in vivo immunogenicity of tumors can depend on depth of their implantation, the response to immunotherapy as a function of tumor depth, particularly in immunologically ‘cold’ tumors, has not been well studied. The goal of this study was to evaluate the difference in growth kinetics and response to immunotherapy between identically sized melanoma tumors following ID versus SC implantation. We injected C57BL/6 mice with syngeneic B78 melanoma cells either ID or SC in the flank. When tumors reached 190–230 mm3, they were grouped into a ‘wave’ and treated with our previously published ISV regimen (12 Gy local external beam radiation and intratumoral hu14.18-IL2 immunocytokine). Physical examination demonstrated that ID-implanted tumors were mobile on palpation, while SC-implanted tumors became fixed to the underlying fascia. Histologic examination identified a critical fascial layer, the panniculus carnosus, which separated ID and SC tumors. SC tumors reached the target tumor volume significantly faster compared with ID tumors. Most ID tumors exhibited either partial or complete response to this immunotherapy, whereas most SC tumors did not. Further, the ‘mobile’ or ‘fixed’ phenotype of tumors predicted response to therapy, regardless of intended implantation depth. These findings were then extended to additional immunotherapy regimens in four separate tumor models. These data indicate that the physical ‘fixed’ versus ‘mobile’ characterization of the tumors may be one simple method of ensuring homogeneity among implanted tumors prior to initiation of treatment. Overall, this short report demonstrates that small differences in depth of tumor implantation can translate to differences in response to immunotherapy, and proposes a simple physical examination technique to ensure consistent tumor depth when conducting implantable tumor immunotherapy experiments.
Structural performance of a medium-span RC three-sided culvert based on field measurements and numerical analyses
Authors: Ramadan Safwat H. , El Naggar M. Hesham
Published: April 2021

The structural performance and soil–structure interaction mechanism of a 7.3 m span, reinforced concrete (RC), three-sided culvert (TSC) with flat top slab are investigated through field monitoring and numerical analyses. The culvert was instrumented with six pressure cells and 14 strain gauges. Data were collected during and after construction. Two-dimensional finite element models were validated against the field measurements. The validated numerical models were then employed to evaluate the effects of the foundation soil condition (yielding or non-yielding) on the applied earth pressures along the culvert profile and the induced straining actions at the base of the culvert’s sidewall. Moreover, the structural performance of TSCs at the ultimate loading condition has been evaluated from the numerical model. The results indicate that for TSC supported on yielding foundation soil, significant bending moment develops at the sidewall base and that the assumption of hinged connection at the base is only realistic for the case of TSCs supported on rock (non-yielding foundation). In addition, the precast unit width was found to have minimal influence on the failure mechanism and the ductility of the precast unit. Finally, failure may occur at a lower backfill height for the non-yielding foundation case relative to the yielding foundation case.
Solutions of Pauli–Dirac equation in terms of Laguerre polynomials within perturbative scheme
Authors: Arda Altuğ
Published: April 2021

We search for first- and second-order corrections to the energy levels of the Pauli–Dirac equation within the Rayleigh–Schrödinger theory. We use some identities satisfied by the associated Laguerre polynomials to reach this aim. We give a list presenting analytical forms of some integrals including two associated Laguerre polynomials, or their derivatives.
Thermal and boundary layer flow analysis for MWCNT-SiO2 hybrid nanoparticles: An experimental thermal model
Authors: Song Ying-Qing , Hassan Mohsan , Khan Sami Ullah , Khan M. Ijaz , Qayyum Sumaira , Chu Yu-Ming , Nadeem Aamir
Published: April 2021

The nanomaterials, due to improved thermal consequences, intended the researcher’s attention in recent decade due to several engineering applications. The concept of boundary layer is quite necessitated in era of engineering like furnishing of different objects designs to control the drag force in case of flow of various working fluids. This theoretical nanofluid continuation aims to access the thermal aspects of hybrid nanomaterials in flow of non-Newtonian fluids confined by a moving belt. The hybrid characteristics of hybrid nanofluid are examined with multiple suspension of Silicon dioxide (SiO2) and multi-walled carbon nanotubes (MWCNTs) with base material ethylene glycol (EG) and water. The conservation laws and thermal features are incorporated to model the governing equations of hybrid nanofluid problem. The mathematical relations for model’s parameters are developed with applications of experimental modeling and justifications. The results in the form of velocity and temperature profiles for boundary layer regions are calculated with influence of different nanoparticles volume fractions and displaced by graphically. The altered developed pattern of momentum as well as thermal boundary layer thickness is accessed with associated boundary growth.
SEMI-SUPERVISED SPARSE REPRESENTATION CLASSIFICATION FOR SLEEP EEG RECOGNITION WITH IMBALANCED SAMPLE SETS
Authors: WUZHENG XIAOLEI , ZUO SHIGANG , YAO LI , ZHAO XIAOJIE
Published: April 2021

Sleep staging with supervised learning requires a large amount of labeled data that are time-consuming and expensive to collect. Semi-supervised learning is widely used to improve classification performance by combining a small amount of labeled data with a large amount of unlabeled data. The accuracy of pseudo-labels in semi-supervised learning may influence the performance of classifier. Based on semi-supervised sparse representation classification, this study proposed an improved sparse concentration index to estimate the confidence of pseudo-labels data for sleep EEG recognition considering both interclass differences and intraclass concentration. In view of class imbalance in sleep EEG data, the synthetic minority oversampling technique was also improved to remove mixed samples at the boundary between minority and majority classes. The results showed that the proposed method achieved better classification performance, in which the classification accuracy after class balancing was obviously higher than that before class balancing. The findings of this study will be beneficial for application in sleep monitoring devices and sleep-related diseases.
Nomenclature: how do we designate NPP taxa?
Authors: O'Keefe Jennifer M. K. , Nuñez Otaño Noelia B. , Bianchinotti M. Virginia
Published: April 2021

Identification and naming of fossil and subfossil organisms are not easy tasks. We are in the midst of a paradigm shift in how NPP taxa are named, driven in large part by (1) molecular clock taxonomic efforts in the past 25 years and (2) greater connectivity among scientific communities. Concurrent with this is the understanding that sometimes a name is not necessary, and identifying acronyms, pending further taxonomic work, or where fragmentary or synapomorphic remains cannot be assigned to their original taxon, are sufficient. The overarching goal of the paradigm shift is to maintain stability of the code and avoid increasing the number of names that refer to single taxa. The history and current state of nomenclature for non-pollen palynomorphs groups, highlighting recent developments with dinoflagellates and fungi, is given, and recommendations for a unified approach to NPP nomenclature through geological time are made.
Using Sub-character Level Information for Neural Machine Translation of Logographic Languages
Authors: Zhang Longtu , Komachi Mamoru
Published: April 2021

Logographic and alphabetic languages (e.g., Chinese vs. English) have different writing systems linguistically. Languages belonging to the same writing system usually exhibit more sharing information, which can be used to facilitate natural language processing tasks such as neural machine translation (NMT). This article takes advantage of the logographic characters in Chinese and Japanese by decomposing them into smaller units, thus more optimally utilizing the information these characters share in the training of NMT systems in both encoding and decoding processes. Experiments show that the proposed method can robustly improve the NMT performance of both “logographic” language pairs (JA–ZH) and “logographic + alphabetic” (JA–EN and ZH–EN) language pairs in both supervised and unsupervised NMT scenarios. Moreover, as the decomposed sequences are usually very long, extra position features for the transformer encoder can help with the modeling of these long sequences. The results also indicate that, theoretically, linguistic features can be manipulated to obtain higher share token rates and further improve the performance of natural language processing systems.
Arabic Diacritic Recovery Using a Feature-rich biLSTM Model
Authors: Darwish Kareem , Abdelali Ahmed , Mubarak Hamdy , Eldesouki Mohamed
Published: April 2021

Diacritics (short vowels) are typically omitted when writing Arabic text, and readers have to reintroduce them to correctly pronounce words. There are two types of Arabic diacritics: The first are core-word diacritics (CW), which specify the lexical selection, and the second are case endings (CE), which typically appear at the end of word stems and generally specify their syntactic roles. Recovering CEs is relatively harder than recovering core-word diacritics due to inter-word dependencies, which are often distant. In this article, we use feature-rich recurrent neural network model that use a variety of linguistic and surface-level features to recover both core word diacritics and case endings. Our model surpasses all previous state-of-the-art systems with a CW error rate (CWER) of 2.9% and a CE error rate (CEER) of 3.7% for Modern Standard Arabic (MSA) and CWER of 2.2% and CEER of 2.5% for Classical Arabic (CA). When combining diacritized word cores with case endings, the resultant word error rates are 6.0% and 4.3% for MSA and CA, respectively. This highlights the effectiveness of feature engineering for such deep neural models.
Nanostructuring of Iron Disulfide Cathode Materials for Enhanced Thermal Batteries
Authors: Di Benedetto Giuseppe L. , Morris Lauren A. , Swanson David B. , Wightman Brian D. , Carpenter Ryan R. , McMullan Charles W. , Dratler Richard M. , Sanchez Peggy A.
Published: April 2021

For the U.S. Department of Defense, high-performance power sources are a critical technology for current and future gun-fired munitions. Molten salt thermal batteries are the reserve power source of choice for many weapon systems due to their high power density, proven long shelf life, and capability to function across a wide range of operating environments. The incorporation of nanomaterials into thermal battery components offers the potential to produce batteries with performance improvements, such as higher voltages at increased current densities. In this study, nanoscale iron disulfide (FeS2) was synthesized using a fully scalable, high energy milling method, and characterized utilizing SEM, XRD, ICP-OES, BET surface area analysis, TGA-DSC, and other techniques. Nanostructured cathode mixtures containing the nanoscale FeS2 and LiCl-KCl eutectic salt electrolyte were pressed into electrode pellets. Their electrochemical performance was then characterized as compared to standard FeS2 cathode electrode pellets currently used in industry. Single cell thermal battery discharge testing, polarization type scans, and pulse load capability were used to compare cell performance for better understanding of best-use applications for these materials. Compared to control cells, the cells utilizing nanostructured cathodes provided higher power response, with respect to both voltage and runtime.
Impact of Molybdenum Doping on the Structural, Optical and Dielectric Properties of α-Al2−x MoxO3
Authors: Moustafa A. M. , Gad S. A. , Ward A. A.
Published: April 2021

The effects of Molybdenum (Mo) doping on the structural, optical, and electrical properties of alumina α-Al2−xMoxO3, (x = 0.02–0.14) synthesized via solid-state reaction method have been studied. X-ray diffraction (XRD) analysis confirms of single-phase hexagonal corundum structure in the range 0.06–0.14. The influence of Mo doping on the structural parameters was estimated from XRD data by applying the Rietveld profile fitting method and Fourier-transform infrared spectroscopy. XRD results revealed that replacing Al with Mo does not affect the unit cell dimensions owing to that Mo occupy the vacant sites available in the crystal structure. The electron density map revealed strong positive peaks corresponding to the position occupied by (Al/Mo) and the intensity of these peaks increases with increasing Mo doping. Optical properties revealed that the energy bandgaps (Eg) increase with increasing MoO3, due to the difference in the ionic radius of Al+3 and Mo+3. The dielectric properties indicated that the values of ε′ and tan δ increased as molybdenum concentration increased as a result of the free charges build-up at the interfaces. It was found that tanδ peak lies in the region where DC-conductivity dominates which is a clear indication of the contribution of ionic conduction to the dielectric loss.
Pleth variability index may predict preload responsiveness in patients treated with nasal high flow: a physiological study
Authors: García-de-Acilu Marina , Pacheco Andrés , Santafé Manel , Ramos Francisco-Javier , Ruiz-Rodríguez Juan C. , Ferrer Ricard , Roca Oriol
Published: April 2021

This is the first study that analyzes the use of noninvasive plethysmographic variability index (PVi) for preload assessment in patients treated with nasal high flow (NHF). Its results showed that PVi might identify preload responders. Therefore, PVi may be used in the day-to-day clinical decision-making process in critically ill patients treated with NHF, helping to provide adequate resuscitation volume.
Hydrolyzed Karaya Gum: Gelatin Complex Coacervates for Microencapsulation of Soybean Oil and Curcumin
Authors: Nguyen Le My Lan , Le Thi Hang Nga , Nguyen Vinh Tien
Published: April 2021

This is the first report on utilizing hydrolyzed karaya gum (HKG) as a novel polyanion material for complex coacervation with gelatin A. With negative zeta potentials at pH > 2.5, HKG formed the complex coacervate with a maximum yield at pH 3.75 and 1 : 1 HKG:gelatin ratio. The optimal complex coacervates were used to encapsulate soybean oil containing curcumin using different shell:core ratios, homogenization speeds, concentrations of emulsifier, and drying techniques. Optical microscopy showed that increasing homogenization speed and Tween 80 concentration produced smaller and more uniform coacervate particles. Increasing the shell:core mass ratio from 1 to 4 resulted in a linear increase in encapsulation efficiencies for both soybean oil and curcumin. Accelerated peroxidation tests on the microcapsules showed enhanced protective effects against oil peroxidation when increasing shell:core ratios and using freeze-drying instead of oven-drying at 50 oC. In vitro release of curcumin in simulated gastric and intestinal fluids was faster when using freeze-drying and decreasing shell:core ratio. This study shows perspective novel applications of HKG in microencapsulating active ingredients for food and pharmaceutical industries.
Analysis and Experimental Study on Dynamic Behavior of Stepper-Actuated Dual-Axis Data Transmission Antenna
Authors: Zheng Zhaomingyue , Cheng Wei , Li Ming , Wang Guangyuan , Tan Limeng
Published: April 2021

The satellite-borne data transmission antenna is the main disturbing source of low-frequency microvibration of spacecraft, which immensely affects the image quality of remote sensing satellite. In this paper, the dynamic characteristics of flexible load driven by stepping motor on flexible boundary are studied. The dynamic equation of the stepping motor driven by current subdivision is simplified by linearization method. The dynamic model of flexible load driven by stepping motors on flexible boundary is established by using the Dynamic Substructure Method, and the analytical expression of microvibration of the data transmission antenna is given. The coupling relationship between the stepping motors and the flexible structure is analyzed by modal coordinate transformation. The microvibration model is verified by simulation and experiment, and the main causes and coupling factors of microvibration are explained. The results show that the model can accurately predict the microvibration of the satellite antenna and can be applied to the microvibration prediction in orbit. The reasonable selection of the working velocity of the stepping motors can effectively reduce the microvibration, which provides the basis for the design of the antenna control system.
Pyrocarbon Humeral Head in a Shoulder Hemiarthroplasty: Preliminary Results at 3 Years Follow-Up and Review of the Current Literature
Authors: Campos-Pereira Eva , Henrique-Barros Luís , Claro Rui
Published: April 2021

Shoulder hemiarthroplasty is a viable option in young patients with an intact rotator cuff in order to preserve the native glenoid. To avoid the dreaded and expected wear of the glenoid in very active shoulders, implants with humeral head coated with a high resistant and elastic material—pyrolytic carbon—are now an option. The authors present the first pyrocarbon coated hemishoulder arthroplasty performed at our Orthopedic Department in a patient with osteonecrosis of the humeral head. At three years of follow-up, the patient is pain free and without limitations in his daily work. The Constant score was applied pre- and postoperatively, and an improvement of 32 points was reported. Larger cohorts with long-term follow-up are required to confirm our promising results.
Exosomes from LPS-Stimulated hDPSCs Activated the Angiogenic Potential of HUVECs In Vitro
Authors: Huang Xiangyu , Qiu Wei , Pan Yuhua , Li Jianjia , Chen Zhao , Zhang Kaiying , Luo Yifei , Wu Buling , Xu Wenan
Published: April 2021

Background. Exosomes from human dental pulp stem cells (hDPSCs) were indicated to play a positive role in vascular regeneration processes. But the angiogenic capabilities of exosomes from inflammatory hDPSCs and the underlying mechanism remain unknown. In this study, the inflammatory factor lipopolysaccharide (LPS) was used to stimulate hDPSCs, and exosomes were extracted from these hDPSCs. The proangiogenic potential of exosomes was examined, and the underlying mechanism was studied. Method. Exosomes were isolated from hDPSCs with or without LPS stimulation (N-EXO and LPS-EXO) and cocultured with human umbilical vein endothelial cells (HUVECs). The proangiogenic potential of exosomes was evaluated by endothelial cell proliferation, migration, and tube formation abilities in vitro. To investigate the proangiogenic mechanism of LPS-EXO, microRNA sequencing was performed to explore the microRNA profile of N-EXO and LPS-EXO. Gene Ontology (GO) analysis was used to study the functions of the predicted target genes. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was used to estimate the signaling pathways associated with the inflammation-induced angiogenesis process. Result. Compared to the uptake of N-EXO, uptake of LPS-EXO activated the angiogenic potential of HUVECs by promoting the proliferation, migration, and tube formation abilities in vitro. The mRNA expression levels of vascular endothelial growth factor (VEGF) and kinase-insert domain-containing receptor (KDR) in the LPS-EXO group were significantly higher than those in the N-EXO group. MicroRNA sequencing showed that 10 microRNAs were significantly changed in LPS-EXO. Pathway analysis showed that the genes targeted by differentially expressed microRNAs were involved in multiple angiogenesis-related pathways. Conclusion. This study revealed that exosomes derived from inflammatory hDPSCs possessed better proangiogenic potential in vitro. This is the first time to explore the role of exosomal microRNA from hDPSCs in inflammation-induced angiogenesis. This finding sheds new light on the effect of inflammation-stimulated hDPSCs on tissue regeneration.
List Edge Colorings of Planar Graphs without Adjacent 7-Cycles
Authors: Zhang Wenwen
Published: April 2021

In this paper, we get that

G

is edge-

k

-choosable (

k
=
max

10
,
Δ

G

) for planar graph

G

without adjacent 7-cycles.
An Evolutionary Approach to Clonally Complex Hematologic Disorders
Authors: Schwenger Emily , Steidl Ulrich
Published: April 2021

Emerging clonal complexity has brought into question the way in which we perceive and, in turn, treat disorders of the hematopoietic system. Former models of cell-intrinsic clonal dominance driven by acquisition of driver genes in a stereotypic sequence are often insufficient in explaining observations such as clonal hematopoiesis, and new paradigms are in order. Here, we review the evidence within the hematologic malignancy field and also borrow from perspectives rooted in evolutionary biology to reframe pathogenesis of hematologic disorders as dynamic processes involving complex interplays of genetic and nongenetic subclones and the tissue microenvironment in which they reside.

Significance:

Hematopoietic malignant and premalignant syndromes exhibit vast clonal diversity that is subject to selection imposed by the tissue microenvironment, as well as artificial selection by therapy. Tackling these disorders requires an appreciation of heterogeneity at both genetic and nongenetic levels, which can be borrowed from evolutionary biology principles. Models and drug development strategies that veer away from targeting solely dominant clones and, instead, embrace this complexity to outsmart it are required for long-term remission.
Prestenting Versus Nonprestenting on the Outcomes of Flexible Ureteroscopy for Large Upper Urinary Stones: A Systematic Review and Meta-Analysis
Authors: Chang Xueliang , Wang Yaxuan , Li Jingdong , Han Zhenwei
Published: April 2021

Introduction: The purpose of this article is to evaluate the efficacy and safety of prestenting (PS) versus non-PS (NPS) of flexible ureteroscopy (fURS) to treat large upper urinary stones. Methods: We conducted a systematic literature research of PubMed, Ovid, Scopus (up to August 2019), and citation lists to identify eligible studies. All studies comparing PS versus NPS of fURS were included. Data were analyzed using the Cochrane Collaboration’s Review Manager (RevMan) 5.3 software. Results: Overall, 7 studies including 3,145 patients (PS 1,408; NPS 1,737) were included in this article. PS group was associated with older age (weighted mean difference [WMD] 0.91 year; p < 0.001) and more male patients (odds ratio [OR] 1.34; p < 0.001). There were no statistical differences between PS and NPS in BMI (WMD 0.34 kg/m2; p = 0.13), stone size (WMD 0.13 mm; p = 0.77), and operative time (WMD 0.44 min; p = 0.86). Compared with NPS, PS showed better initial success rate (OR 4.04; p < 0.001) and higher SFR (OR 1.64; p < 0.001). There were no statistical differences for complications (OR 0.84; p = 0.42) and Clavien-Dindo score ≥3 complications (OR 1.04; p = 0.93). Conclusion: PS could improve initial success rate and avoid secondary general anesthesia for first ureteral access sheath failed patients. PS could provide better SFR than NPS in the treatment of large upper urinary stones with fURS.
Recommendations of the European Advisory Committee of Cytotechnology and European Federation of Cytology Societies for Training and Education of Cytotechnologists in Europe
Authors: Anic Veronika , Eide Maj Liv , Cochand-Priollet Beatrix , Vrdoljak Mozetic Danijela , Negri Giovanni , Vielh Philippe
Published: April 2021

Background: Faced with changes in cytodiagnostics, cervical cancer screening programs, the introduction and application of new methods, the cytotechnological educational program requires the necessary changes and additions. Insufficient, uneven as well as inaccessible education of cytotechnologists in European countries was the basis for making these recommendations. Summary: The results of previous research and publications related to the currently available education of cytotechnologists in Europe, the needs and suggestions were given by the European Advisory Committee of Cytotechnology (EACC) and European Federation of Cytology Societies (EFCS) for optimal education of future generations of cytotechnologists were used in the preparation of these recommendations. The EACC and EFCS propose a 1-year education and training program divided into 3 modules: gynecological, nongynecological exfoliative, and fine-needle aspiration cytology. Training programs should be organized by an accredited university, preferably a combination of internal education in a cytology laboratory and theoretical education at the university. Cytopathologists and cytotechnologists with at least 5 years of work experience in cytodiagnostics should participate in education. Upon completion of the training program, the EACC and EFCS propose an official name: EFCS certified cytotechnologist. Key Messages: The EACC and EFCS believe that it is extremely important that these recommendations are recognized and implemented by institutions that provide education for cytotechnologists so that they can meet the growing requirements of the profession with their acquired knowledge and competencies.
O “Terceiro Setor na Saúde”: temas de investigação, atores, avanços e lacunas na gestão do Sistema Único de Saúde no prisma das Ciências Sociais e Humanas em Saúde
Authors: Barboza Renato , Ianni Áurea Maria Zöllner , Alves Olga Sofia Fabergé , Silva Alessandro Soares da
Published: April 2021

Analisou-se a produção científica sobre o “Terceiro Setor na Saúde”, a partir dos congressos promovidos pela Associação Brasileira de Pós Graduação em Saúde Coletiva (ABRASCO), entre 1995 e 2011, quanto à contribuição para o desenvolvimento do subcampo das Ciências Sociais e Humanas em Saúde, vinculado ao campo interdisciplinar da Saúde Coletiva.  Realizou-se um estudo exploratório, descritivo, retrospectivo de abordagem quantitativa, baseado nos Anais dos cinco congressos da ABRASCO. Identificaram-se 126 resumos, classificados em 12 temas de investigação. Quase um terço dos trabalhos evidenciaram a atuação dos movimentos sociais e das ações conduzidas por Organizações Não Governamentais no setor Saúde, ao passo que os temas que abordaram o exercício do controle social nos conselhos de saúde, o mix público-privado na saúde, a gestão/gerência das Organizações Sociais da Saúde, o voluntariado e o direito constitucional à saúde foram exíguos. Recomenda-se assim, a incorporação e manutenção desses temas com baixa visibilidade na produção científica, nas agendas de pesquisa em curso nos subcampos das Ciências Sociais e Humanas em Saúde e das Políticas, Planejamento e Gestão em Saúde, considerando a sua relevância para a gestão do Sistema Único de Saúde.
Oficinas Participativas como Ferramentas para a Avaliação de Impacto de Políticas Públicas: o estudo de caso do PIBIC/ICMBio no Brasil
Authors: Tozato Heloisa de Camargo , Bezerra Fernanda de Araújo , Albuquerque Elizabeth Maria Maia de , Bacellar Ana Elisa de Faria , Salzo Ivan , Jorge Rodrigo Silva Pinto , Ribeiro Katia Torres
Published: April 2021

As oficinas participativas são importantes para a avaliação de planos, programas e políticas públicas uma vez que permitem a identificação de uma diversidade de evidências a partir do diálogo entre atores-chave. A partir desta perspectiva, o presente artigo teve como objetivo descrever e analisar o processo de organização e desenvolvimento da oficina participativa realizada no âmbito do processo de avaliação de impacto de 10 anos de implementação do Programa Institucional de Bolsas de Iniciação Científica (PIBIC/ICMBio) do Instituto Chico Mendes de Conservação da Biodiversidade (ICMBio) no Brasil. A coleta de informações foi realizada a partir do desenvolvimento da metodologia da observação participante.  No presente estudo de caso, o diálogo estabelecido entre os sujeitos responsáveis pela concepção, gerenciamento e execução do PIBIC/ICMBio remete três pontos principais de reflexão. São eles: i) o apontamento de indicadores representativos, carregados de entendimento técnico, político, social, de conhecimento lógico e epistemológico para a avaliação do Programa; ii) o potencial do Programa como eixo de know-how para apoio à tomada de decisão para ações socioambientais no Brasil; e iii) às potenciais perdas no caso da inexistência futura do PIBIC/ICMBio, especialmente quanto à interrupção da pesquisa aplicada para a gestão e manejo da biodiversidade brasileira.
O Empoderamento Para a Mulher em Vulnerabilidade Social
Authors: Souza Karine Nogueira de
Published: April 2021

Com o objetivo de apresentar as representações sociais sobre empoderamento, este artigo é resultado de uma pesquisa realizada com mulheres chefes de família em situação de vulnerabilidade social, no município de São Paulo, SP, Brasil. Para coleta de dados utilizamos entrevista semiestruturada e questionário de associação livre, tendo na teoria das Representações Sociais de Serge Moscovici a sustentação teórico metodológica. Participaram 30 mulheres que vivenciam situações de vulnerabilidade social, na faixa etária entre 18 a 55 anos, mães de três filhos ou mais. O estudo identificou diferenças importantes nas representações sociais apresentadas de acordo com a faixa etária das mulheres participantes do estudo. Como resultado temos, que a representação social sobre o empoderamento se ancora na necessidade de maior informação sobre os direitos, pertencimento e igualdade social.
Laços Comunitários e Estigma: um estudo sobre o Programa Minha Casa Minha Vida
Authors: Silva Douglas Cardoso da
Published: April 2021

Este estudo buscou identificar elementos que caracterizam as relações entre os moradores do Programa Minha Casa Minha Vida (PMCMV), com o objetivo de compreender melhor qual a concepção dos moradores a respeito da sua vizinhança e avaliar se a dinâmica de implementação do programa favorece a construção de laços comunitários duradouros. A pesquisa foi desenvolvida a partir dos pressupostos da observação participante, privilegiando o discurso dos moradores, em conjuntos habitacionais localizados na cidade de Mogi das Cruzes. Constatou-se que entre eles prevalece uma concepção estigmatizada a respeito dos vizinhos, e a percepção negativa formulada sobre o grupo do qual fazem parte parece ser traço demasiadamente profundo. Os elementos utilizados para identificar os vizinhos, e a si próprios, estão relacionados, principalmente, com os estigmas da pobreza. A percepção de qualidades comuns partilhadas é depreciativa, e as relações entre eles se estabelecem de maneira sobretudo hostil, quando não violenta. A conclusão a que se chegou é que a dinâmica do PMCMV não favorece a construção de entendimentos e relações de outra ordem. Dessa forma, os moradores parecem vivenciar uma experiência de maior fragilidade, pois sua inserção no programa implica uma ruptura com os laços construídos em suas antigas moradias, gerando um processo de desenraizamento; por outro lado, a dinâmica que rege a implementação do programa parece não oferecer condições apropriadas para a construção de uma comunidade e a consolidação de relações fraternas e consistentes. É preciso reconhecer o mérito do PMCMV pela construção em massa de moradias para a população de baixa renda, contudo, é de fundamental importância analisar de que maneira as famílias são atendidas pelo programa.
Motivação no Setor Público como Ferramenta Estratégica de Gestão: desafios e reflexões
Authors: Carvalho José Natanael Fontenele de , Silva Anayana de Sousa
Published: April 2021

A motivação humana sempre foi um grande desafio para as organizações, principalmente no que se refere a instituições públicas. A presente pesquisa tem como objetivo explorar a importância da motivação dentro das organizações públicas e como esta pode contribuir para o aperfeiçoamento dos resultados destas instituições. O estudo desenvolveu-se através de uma revisão bibliográfica sobre as principais teorias motivacionais e análise de pesquisas já realizadas sobre motivação no setor público. Reflexões acerca do tema indicam que fatores motivacionais intrínsecos, como a relevância e essência do trabalho, têm grande importância na motivação dos servidores, e dependendo do contexto pessoal do servidor, até mais do que fatores motivacionais extrínsecos, como remunerações, salários e benefícios. Dessa forma, pode-se afirmar que fatores motivacionais intrínsecos tem grande influência sobre os resultados organizacionais. Essa pesquisa contribui com os estudos sobre motivação no serviço público ao avaliar o impacto que os fatores motivacionais extrínsecos e intrínsecos têm sobre os níveis de satisfação profissional e consequentemente dos resultados das organizações públicas.
Association Between Genetic Variation in Blood Pressure and Increased Lifetime Risk of Peripheral Artery Disease
Authors: Levin Michael G. , Klarin Derek , Walker Venexia M. , Gill Dipender , Lynch Julie , Hellwege Jacklyn N. , Keaton Jacob M. , Lee Kyung M. , Assimes Themistocles L. , Natarajan Pradeep , Hung Adriana M. , Edwards Todd L. , Rader Daniel J. , Gaziano J. Michael , Davies Neil M. , Tsao Philip S. , Chang Kyong-Mi , Voight Benjamin F. , Damrauer Scott M. ,   on behalf of the VA Million Veteran Program
Published: April 2021

Objective:

We aimed to estimate the effect of blood pressure (BP) traits and BP-lowering medications (via genetic proxies) on peripheral artery disease.

Approach and Results:

Genome-wide association studies summary statistics were obtained for BP, peripheral artery disease (PAD), and coronary artery disease. Causal effects of BP on PAD were estimated by 2-sample Mendelian randomization using a range of pleiotropy-robust methods. Increased systolic BP (SBP), diastolic BP, mean arterial pressure (MAP), and pulse pressure each significantly increased risk of PAD (SBP odds ratio [OR], 1.20 [1.16–1.25] per 10 mm Hg increase,
P
=1×10
−24
; diastolic BP OR, 1.27 [1.18–1.35],
P
=4×10
−11
; MAP OR, 1.26 [1.19–1.33],
P
=6×10
−16
; pulse pressure OR, 1.31 [1.24–1.39],
P
=9×10
−23
). The effects of SBP, diastolic BP, and MAP were greater for coronary artery disease than PAD (SBP ratio of OR [ROR], 1.06 [1.0–1.12],
P
=
0.04; MAP ratio of OR, 1.15 [1.06–1.26],
P
=8.6×10
−4
; diastolic BP ratio of OR, 1.21 [1.08–1.35],
P
=6.9×10
−4
). Considered jointly, both pulse pressure and MAP directly increased risk of PAD (pulse pressure OR, 1.26 [1.17–1.35],
P
=3×10
−10
; MAP OR, 1.14 [1.06–1.23],
P
=2×10
−4
). The effects of antihypertensive medications were estimated using genetic instruments. SBP-lowering via β-blocker (OR, 0.74 per 10 mm Hg decrease in SBP [95% CI, 0.65–0.84];
P
=5×10
−6
), loop diuretic (OR, 0.66 [0.48–0.91],
P
=0.01), and thiazide diuretic (OR, 0.57 [0.41–0.79],
P
=6×10
−4
) associated variants were protective of PAD.

Conclusions:

Higher BP is likely to cause PAD. BP-lowering through β blockers, loop diuretics, and thiazide diuretics (as proxied by genetic variants) was associated with decreased risk of PAD. Future study is needed to clarify the specific mechanisms by which BP influences PAD.
Cost-Effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops
Authors: Bryant Kelsey B. , Moran Andrew E. , Kazi Dhruv S. , Zhang Yiyi , Penko Joanne , Ruiz-Negrón Natalia , Coxson Pamela , Blyler Ciantel A. , Lynch Kathleen , Cohen Laura P. , Tajeu Gabriel S. , Fontil Valy , Moy Norma B. , Ebinger Joseph E. , Rader Florian , Bibbins-Domingo Kirsten , Bellows Brandon K.
Published: April 2021

Background:

In LABBPS (Los Angeles Barbershop Blood Pressure Study), pharmacist-led hypertension care in Los Angeles County Black-owned barbershops significantly improved blood pressure control in non-Hispanic Black men with uncontrolled hypertension at baseline. In this analysis, 10-year health outcomes and health care costs of 1 year of the LABBPS intervention versus control are projected.

Methods:

A discrete event simulation of hypertension care processes projected blood pressure, medication-related adverse events, fatal and nonfatal cardiovascular disease events, and noncardiovascular disease death in LABBPS participants. Program costs, total direct health care costs (2019 US dollars), and quality-adjusted life-years (QALYs) were estimated for the LABBPS intervention and control arms from a health care sector perspective over a 10-year horizon. Future costs and QALYs were discounted 3% annually. High and intermediate cost-effectiveness thresholds were defined as <$50 000 and <$150 000 per QALY gained, respectively.

Results:

At 10 years, the intervention was projected to cost an average of $2356 (95% uncertainty interval, –$264 to $4611) more per participant than the control arm and gain 0.06 (95% uncertainty interval, 0.01–0.10) QALYs. The LABBPS intervention was highly cost-effective, with a mean cost of $42 717 per QALY gained (58% probability of being highly and 96% of being at least intermediately cost-effective). Exclusive use of generic drugs improved the cost-effectiveness to $17 162 per QALY gained. The LABBPS intervention would be only intermediately cost-effective if pharmacists were less likely to intensify antihypertensive medications when systolic blood pressure was ≥150 mm Hg or if pharmacist weekly time driving to barbershops increased.

Conclusions:

Hypertension care delivered by clinical pharmacists in Black barbershops is a highly cost-effective way to improve blood pressure control in Black men.
Composing by Laypeople: A Broader Perspective Provided by Arithmetic Operation Grammar
Authors: Kramann Guido
Published: April 2021

Many existing approaches to teaching laypeople to compose are based, to a certain extent, on simply hiding the theoretical background. This is done, for example, by offering ready-made musical events that can be combined in any way to organize them in time. A different approach is taken in the work presented here. As an alternative to classical music theory, with all its complications, the generative composition method Arithmetic Operation Grammar (AOG) is used, which is much easier to learn. This approach has been taken in the conviction that the leaner theory on which it is based, in combination with the compact symbolic representation of entire compositions, can make a significant contribution to bringing forward the “everyday creativity” in the field of ubiquitous music. Furthermore, in the field of sonification, AOG offers the possibility of sonifying data that do not inherently include time as an ordering parameter. To prove practical use of this approach, AOG is combined with a user interface that is more suitable for adults as a target group and another one that is more appropriate for primary school children.
Sonification and Animation of Multivariate Data to Illuminate Dynamics of Geyser Eruptions
Authors: Barth Anna , Karlstrom Leif , Holtzman Benjamin K. , Paté Arthur , Nayak Avinash
Published: April 2021

Sonification of time series data in natural science has gained increasing attention as an observational and educational tool. Sound is a direct representation for oscillatory data, but for most phenomena, less direct representational methods are necessary. Coupled with animated visual representations of the same data, the visual and auditory systems can work together to identify complex patterns quickly.

We developed a multivariate data sonification and visualization approach to explore and convey patterns in a complex dynamic system, Lone Star Geyser in Yellowstone National Park. This geyser has erupted regularly for at least 100 years, with remarkable consistency in the interval between eruptions (three hours) but with significant variations in smaller scale patterns between each eruptive cycle. From a scientific standpoint, the ability to hear structures evolving over time in multiparameter data permits the rapid identification of relationships that might otherwise be overlooked or require significant processing to find. The human auditory system is adept at physical interpretation of call-and-response or causality in polyphonic sounds. Methods developed here for oscillatory and nonstationary data have great potential as scientific observational and educational tools, for data-driven composition with scientific and artistic intent, and towards the development of machine learning tools for pattern identification in complex data.