bluuebunny/crossref_metadata_2025 huggingface dataset:
Current practices and challenges in adaptation of clinical guidelines: a qualitative study based on semistructured interviews
Authors: Song Yang , Ballesteros Monica , Li Jing , Martínez García Laura , Niño de Guzmán Ena , Vernooij Robin W M , Akl Elie A , Cluzeau Francoise , Alonso-Coello Pablo
Published: December 2021

Objective

This study aims to better understand the current practice of clinical guideline adaptation and identify challenges raised in this process, given that published adapted clinical guidelines are generally of low quality, poorly reported and not based on published frameworks.

Design

A qualitative study based on semistructured interviews. We conducted a framework analysis for the adaptation process, and thematic analysis for participants’ views and experiences about adaptation process.

Setting

Nine guideline development organisations from seven countries.

Participants

Guideline developers who have adapted clinical guidelines within the last 3 years. We identified potential participants through published adapted clinical guidelines, recommendations from experts, and a review of the Guideline International Network Conference attendees’ list.

Results

We conducted ten interviews and identified nine adaptation methodologies. The reasons for adapting clinical guidelines include developingde novoclinical guidelines, implementing source clinical guidelines, and harmonising and updating existing clinical guidelines. We identified the following core steps of the adaptation process (1) selection of scope and source guideline(s), (2) assessment of source materials (guidelines, recommendations and evidence level), (3) decision-making process and (4) external review and follow-up process. Challenges on the adaptation of clinical guidelines include limitations from source clinical guidelines (poor quality or reporting), limitations from adaptation settings (lacking resources or skills), adaptation process intensity and complexity, and implementation barriers. We also described how participants address the complexities and implementation issues of the adaptation process.

Conclusions

Adaptation processes have been increasingly used to develop clinical guidelines, with the emergence of different purposes. The identification of core steps and assessment levels could help guideline adaptation developers streamline their processes. More methodological research is needed to develop rigorous international standards for adapting clinical guidelines.
CCEDRRN COVID-19 Infection Score (CCIS): development and validation in a Canadian cohort of a clinical risk score to predict SARS-CoV-2 infection in patients presenting to the emergency department with suspected COVID-19
Authors: McRae Andrew D , Hohl Corinne M , Rosychuk Rhonda , Vatanpour Shabnam , Ghaderi Gelareh , Archambault Patrick M , Brooks Steven C , Cheng Ivy , Davis Philip , Hayward Jake , Lang Eddy , Ohle Robert , Rowe Brian , Welsford Michelle , Yadav Krishan , Morrison Laurie J , Perry Jeffrey
Published: December 2021

Objectives

To develop and validate a clinical risk score that can accurately quantify the probability of SARS-CoV-2 infection in patients presenting to an emergency department without the need for laboratory testing.

Design

Cohort study of participants in the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) registry. Regression models were fitted to predict a positive SARS-CoV-2 test result using clinical and demographic predictors, as well as an indicator of local SARS-CoV-2 incidence.

Setting

32 emergency departments in eight Canadian provinces.

Participants

27 665 consecutively enrolled patients who were tested for SARS-CoV-2 in participating emergency departments between 1 March and 30 October 2020.

Main outcome measures

Positive SARS-CoV-2 nucleic acid test result within 14 days of an index emergency department encounter for suspected COVID-19 disease.

Results

We derived a 10-item CCEDRRN COVID-19 Infection Score using data from 21 743 patients. This score included variables from history and physical examination and an indicator of local disease incidence. The score had a c-statistic of 0.838 with excellent calibration. We externally validated the rule in 5295 patients. The score maintained excellent discrimination and calibration and had superior performance compared with another previously published risk score. Score cut-offs were identified that can rule-in or rule-out SARS-CoV-2 infection without the need for nucleic acid testing with 97.4% sensitivity (95% CI 96.4 to 98.3) and 95.9% specificity (95% CI 95.5 to 96.0).

Conclusions

The CCEDRRN COVID-19 Infection Score uses clinical characteristics and publicly available indicators of disease incidence to quantify a patient’s probability of SARS-CoV-2 infection. The score can identify patients at sufficiently high risk of SARS-CoV-2 infection to warrant isolation and empirical therapy prior to test confirmation while also identifying patients at sufficiently low risk of infection that they may not need testing.

Trial registration number

NCT04702945.
Protocol for a prospective double-blind, randomised, placebo-controlled feasibility trial of octreotide infusion during liver transplantation
Authors: Fabes Jeremy , Ambler Gareth , Shah Bina , Williams Norman R , Martin Daniel , Davidson Brian R , Spiro Michael
Published: December 2021

Introduction

Liver transplantation is a complex operation that can provide significant improvements in quality of life and survival to the recipients. However, serious complications are common and include major haemorrhage, hypotension and renal failure. Blood transfusion and the development of acute kidney injury lead to both short-term and long-term poor patient outcomes, including an increased risk of death, graft failure, length of stay and reduced quality of life. Octreotide may reduce the incidence of renal dysfunction, perioperative haemorrhage and enhance intraoperative blood pressure. However, octreotide does have risks, including resistant bradycardia, hyperglycaemia and hypoglycaemia and QT prolongation. Hence, a randomised controlled trial of octreotide during liver transplantation is needed to determine the cost-efficacy and safety of its use; this study represents a feasibility study prior to this trial.

Methods and analysis

We describe a multicentre, double-blind, randomised, placebo-controlled feasibility study of continuous infusion of octreotide during liver transplantation surgery. We will recruit 30 adult patients at two liver transplant centres. A blinded infusion during surgery will be administered in a 2:1 ratio of octreotide:placebo. The primary outcomes will determine the feasibility of this study design. These include the recruitment ratio, correct administration of blinded study intervention, adverse event rates, patient and clinician enrolment refusal and completion of data collection. Secondary outcome measures of efficacy and safety will help shape future trials by assessing potential primary outcome measures and monitoring safety end points. No formal statistical tests are planned. This manuscript represents study protocol number 1.3, dated 2 June 2021.

Ethics and dissemination

This study has received Research Ethics Committee approval. The main study outcomes will be submitted to an open-access journal.

Trial sponsor

The Joint Research Office, University College London, UK.

Neither the sponsor nor the funder have any role in study design, collection, management, analysis and interpretation of data, writing of the study report or the decision to submit the report for publication.

Trial registration

The study is registered with ClinicalTrials.gov (NCT04941911) with recruitment due to start in August 2021 with anticipated completion in July 2022.

Clinical trials unit

Surgical and Interventional Group, Division of Surgery & Interventional Science, University College London.
TELO-SCOPE study: a randomised, double-blind, placebo-controlled, phase 2 trial of danazol for short telomere related pulmonary fibrosis
Authors: Mackintosh John A , Pietsch Maria , Lutzky Viviana , Enever Debra , Bancroft Sandra , Apte Simon H , Tan Maxine , Yerkovich Stephanie T , Dickinson Joanne L , Pickett Hilda A , Selvadurai Hiran , Grainge Christopher , Goh Nicole S , Hopkins Peter , Glaspole Ian , Reynolds Paul N , Wrobel Jeremy , Jaffe Adam , Corte Tamera J , Chambers Daniel C
Published: December 2021

Introduction

Recent discoveries have identified shortened telomeres and related mutations in people with pulmonary fibrosis (PF). There is evidence to suggest that androgens, including danazol, may be effective in lengthening telomeres in peripheral blood cells. This study aims to assess the safety and efficacy of danazol in adults and children with PF associated with telomere shortening.

Methods and analysis

A multi-centre, double-blind, placebo-controlled, randomised trial of danazol will be conducted in subjects aged >5 years with PF associated with age-adjusted telomere length ≤10th centile measured by flow fluorescence in situ hybridisation; or in children, a diagnosis of dyskeratosis congenita. Adult participants will receive danazol 800 mg daily in two divided doses or identical placebo capsules orally for 12 months, in addition to standard of care (including pirfenidone or nintedanib). Paediatric participants will receive danazol 2 mg/kg/day orally in two divided doses or identical placebo for 6 months. If no side effects are encountered, the dose will be escalated to 4 mg/kg/day (maximum 800 mg daily) orally in two divided doses for a further 6 months. The primary outcome is change in absolute telomere length in base pairs, measured using the telomere shortest length assay (TeSLA), at 12 months in the intention to treat population.

Ethics and dissemination

Ethics approval has been granted in Australia by the Metro South Human Research Ethics Committee (HREC/2020/QMS/66385). The study will be conducted and reported according to Standard Protocol Items: Recommendations for Interventional Trials guidelines. Results will be published in peer-reviewed journals and presented at international and national conferences.

Trial registration numbers

NCT04638517; Australian New Zealand Clinical Trials Registry (ACTRN12620001363976p).
The W mass and width measurement challenge at FCC-ee
Authors: Azzurri Paolo
Published: December 2021

The FCC-ee physics program will deliver two complementary top-notch precision determinations of the W boson mass, and width. The first and main measurement relies on the rapid rise of the W-pair production cross section near its kinematic threshold. This method is extremely simple and clean, involving only the selection and counting of events, in all different decay channels. An optimal threshold-scan strategy with a total integrated luminosity of $$12\,\mathrm{ab}^{-1}$$

12

ab

-
1

shared on energy points between 157 and 163 GeV will provide a statistical uncertainty on the W mass of 0.5 MeV and on the W width of 1.2 MeV. For these measurements, the goal of keeping the impact of systematic uncertainties below the statistical precision will be demanding, but feasible. The second method exploits the W-pair final state reconstruction and kinematic fit, making use of events with either four jets or two jets, one lepton and missing energy. The projected statistical precision of the second method is similar to the first method’s, with uncertainties of $$\sim 0.5$$

∼
0.5

(1) MeV for the W mass (width), employing W-pair data collected at the production threshold and at 240–365 GeV. For the kinematic reconstruction method, the final impact of systematic uncertainties is currently less clear, in particular uncertainties connected to the modeling of the W hadronic decays. The use and interplay of Z$$\gamma $$
γ
and ZZ events, reconstructed and fitted with the same techniques as the WW events, will be important for the extraction of W mass measurements with data at the higher 240 and 365 GeV energies.
Joy Arulraj Speaks Out on Non- Volatile Memory Database Systems
Authors: Winslett Marianne , Braganholo Vanessa
Published: December 2021

Welcome to this installment of the ACM SIGMOD Record's series of interviews with distinguished members of the database community. I'm Marianne Winslett, and today I have here with me Joy Arulraj, who won the 2019 ACM SIGMOD Jim Gray Dissertation Award for his thesis entitled The Design and Implementation of Non-volatile Memory Database Management Systems. Joy is now an Assistant Professor at Georgia Tech, and his PhD is from the Carnegie Mellon University, where he worked with Andy Pavlo, who won this same award in his time. So, Joy, welcome!
[Retracted] Expression of miR‐210, miR‐137, and miR‐153 in Patients with Acute Cerebral Infarction
Authors: Tian Hongtao , Zhao Yan , Du Chao , Zong Xiao , Zhang Xiuping , Qiao Xia
Published: December 2021

Aim. To explore the expression levels of miR‐210, miR‐137, and miR‐153 in patients with acute cerebral infarction. Material and Methods. 76 patients with acute cerebral infarction treated in our hospital from April 2016 to October 2017 were enrolled as the observation group. Another 64 normal patients were selected as the control group. The patients were divided into the death and survival groups based on 1‐year mortality of patients. qRT‐PCR was used to detect the expression of miR‐210, miR‐137, and miR‐153 in the serum of each group. Receiver operating characteristic (ROC) curve was employed to analyze the diagnostic value and predictive value of miR‐210, miR‐137 and miR‐153 death in patients. The correlation between miR‐210, miR‐137, and miR‐153 in the serum of the observation group was analyzed by Pearson’s test. Results. Levels of miR‐210 and miR‐137 in the observation group were significantly lower than those in the control group, while levels of miR‐153 in the observation group were significantly higher than those in the control group (all P < 0.05). The ROC curve of diagnosis of acute cerebral infarction showed that the area under curve of miR‐210 was 0.836, that of miR‐137 was 0.843, and that of miR‐153 was 0.842. The 1‐year survival rate was 71.05%. The 1‐year survival of the low‐expression group of miR‐210 and miR‐137 was significantly lower than that of the high‐expression group, while the 1‐year survival of the low‐expression group of miR‐153 was significantly higher than that of the high‐expression group (all P < 0.05). The ROC curve for predicting death showed that the area under curve of miR‐210 was 0.786, that of miR‐137 was 0.824, and that of miR‐153 was 0.858. Pearson’s correlation analysis showed that the expression of miR‐210 was positively correlated with that of miR‐137, while miR‐137 was negatively correlated with that of miR‐153 and miR‐210 was negatively correlated with that of miR‐153. Conclusion. miR‐210, miR‐137, and miR‐153 have a certain value in the diagnosis and prediction of 1‐year death of acute cerebral infarction and may be potential diagnostic and predictive indicators.
Late Lung Metastasis in a Patient with a Clear Cell Chondrosarcoma: An Indication for a Life-Long Follow-Up?
Authors: West Paulien , Jacobs Celine , Saerens Michael , Creytens David , Sys Gwen , Lapeire Lore
Published: December 2021

Background. Clear cell chondrosarcoma (CCCS) is a rare subtype of chondrosarcoma and comprises between 1.6% and 2.5% of all chondrosarcoma. They are known to be chemo- and radiotherapy resistant; surgical resection is therefore the therapy of choice. Methods. We present a 63-year-old woman with a progressive lung nodule 20 years after initial diagnosis and treatment of a clear cell chondrosarcoma of the right os naviculare. Results. On serial CT scans of the chest, an asymptomatic, slowly growing nodule in the left upper lung lobe was detected. CT-guided transthoracic biopsy of this nodule confirmed the diagnosis of a chondrosarcoma lung metastasis. Video-assisted thoracoscopic wedge resection was performed with complete removal of the nodule. The patient recovered well from surgery and remains in good health during further follow-up. Conclusion. Given the tendency of clear cell chondrosarcoma to recur and metastasize after extended periods of time, a long-term, possibly life-long follow-up and clinical surveillance is advisable in these patients.
T-Shaped Control Plate Effect on Flow past a Square Cylinder at Low Reynolds Numbers
Authors: Shahab Maryam , Ul-Islam Shams , Nazeer Ghazala
Published: December 2021

In this study, the influence of the T-shaped control plate on the fluid flow characteristics around a square cylinder for a low Reynolds numbers flow is systematically presented. The introduction of upstream attached T-shaped control plate is novel of its kind as T-shaped control plate used for the first time rather than the other passive control methods available in the literature. The Reynolds numbers (Re) are chosen to be Re = 100, 150, 200, and 250, and the T-shaped control plate of the same width with varying length is considered. A numerical investigation is performed using the single-relaxation-time lattice Boltzmann method. The numerical results reveal that there exists an optimum length of T-shaped control plate for reducing fluid forces. This optimum length was found to be 0.5 for Re = 100, 150, and 200 and 2 for Re = 250. At this optimum length, the fluctuating drag forces acting on the cylinder are reduced by 134%, 1375, 133%, and 136% for Re = 100, 150, 200, and 250, respectively. Instantaneous and time-averaged flow fields were also presented for some selected cases in order to identify the three different flow regimes around T-shaped control plate and square cylinder system.
The Effect of Letrozole Combined with Dydrogesterone for Endometriosis in China: A Meta‐Analysis
Authors: Sun Shumei , Zhang Hao , Zhong Peicheng , Xu Zhihong
Published: December 2021

Purpose. To discuss the effects of dydrogesterone combined with letrozole on the effectiveness, sex hormone levels, and serological indicators in patients with endometriosis. This study is registered with PROSPERO (CRD42020213172). Methods. We searched relevant randomized controlled trials (RCTs) through PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP Database. The standardized mean differences (SMDs), the mean differences (MDs), or odds ratios (ORs) with their 95% confidence intervals (95% CIs) were computed to be outcome indicators, including total effectiveness, Vascular Endothelial Growth Factor (VEGF) level, Carbohydrate Antigen 125 (CA125) level, Follicle‐Stimulating Hormone (FSH) level, Luteinizing Hormone (LH) level, estrogen (E2) level, progesterone (P) level, interleukin‐6 (IL‐6) level, and tumor necrosis factor‐a (TNF‐a) level. Results. A total of 19 RCTs involving 1,591 patients were included in this study. Our results showed that letrozole combined with dydrogesterone can significantly reduce the levels of VEGF (SMD ‐2.23, 95% CI ‐2.39 to ‐2.07; p < 0.00001), CA125 (MD ‐10.53, 95% CI ‐11.19 to ‐9.88; p < 0.00001), E2 (SMD ‐1.64, 95% CI ‐1.81 to ‐1.47; p < 0.00001), P (MD ‐5.11, 95% CI ‐6.26 to ‐3.96; p < 0.00001), IL‐6 (MD ‐4.41, 95% CI ‐5.16 to ‐3.67; p < 0.00001), and TNF‐a (MD ‐5.67, 95% CI ‐6.34 to ‐5.00; p < 0.00001) in patients with endometriosis compared with the control group. In addition, the results indicated that total effectiveness was significantly higher in the experiment group (OR 6.21, 95% CI 4.17 to 9.24; p < 0.00001) compared to the control. However, there was no significant difference between FSH and LH levels in both groups (p > 0.05). Conclusion. This combination therapy can effectively decrease the levels of VEGF, CA125, E2, P, IL‐6, and TNF‐a and increase the total effectiveness when comparing with the control group.
hsa_circ_0023305 Enhances Laryngeal Squamous Cell Carcinoma Progression and Modulates TRPM7 via miR‐218‐5p Sponging
Authors: Zhang Yi , Tian Kaisai , Zhou Enhui , Xue Xiaocheng , Yan Shiling , Chen Yixin , Qiao Peipei , Yang Liyun , Chen Xiaoping
Published: December 2021

Recently, circular RNAs have been shown to function as critical regulators of many human cancers. However, the circRNA mechanism in laryngeal squamous cell carcinoma (LSCC) remains elusive. Recent investigations using bioinformatics analysis revealed high expression of hsa_circ_0023305 in LSCC tissues compared to normal tissues. Furthermore, we discovered that hsa_circ_0023305 expression level was positively correlated to tumor/node/metastasis (TNM) stage as well as lymph node metastasis in LSCC. Moreover, higher hsa_circ_0023305 levels were correlated to poorer LSCC patient outcomes. Knockdown of hsa_circ_0023305 significantly inhibited LSCC cell proliferation, invasion, and migration abilities. Our team validated that hsa_circ_0023305 functioned as a miR‐218‐5p sponge from a mechanistic perspective, targeting the melastatin‐related transient receptor potential 7 (TRPM7) in LSCC cells. TRPM7 regulates a nonselective cation channel and promotes cancer proliferation and metastasis. Our data demonstrated that miR‐218‐5p was downregulated in LSCC and that miR‐218‐5p upregulation repressed LSCC proliferation and invasion both in vivo and in vitro. Additionally, we found that hsa_circ_0023305‐mediated upregulation of TRPM7 inhibited miR‐218‐5p and contributed to LSCC migration, proliferation, and invasion. In summary, these data propose a new mechanism by which the hsa_circ_0023305/miR‐218‐5p/TRPM7 network enhances LSCC progression.
For Whom the Bell Tolls? A Toll-Like Receptor 9 Agonist's Journey from Vaccine Adjuvant to Promising Agent in Anti–PD-1–Resistant Melanoma
Authors: Sullivan Ryan J.
Published: December 2021

Developing effective therapies in anti–PD-1–resistant melanoma is a key unmet need. The combination of pembrolizumab with the intralesional TLR9 agonist vidutolimod showed promise in this patient population with correlative analysis suggesting that patients with a “cold” tumor immune microenvironment may be the best patients to study further.

See related article by Ribas et al., p. 2998.
The rnc Gene Regulates the Microstructure of Exopolysaccharide in the Biofilm of Streptococcus mutans through the β-Monosaccharides
Authors: Lu Yangyu , Zhang Hongyu , Li Meng , Mao Mengying , Song Jiaqi , Deng Yalan , Lei Lei , Yang Yingming , Hu Tao
Published: December 2021

Streptococcus mutans is known as the crucial pathogen of human dental caries, owing to its contribution to the biofilm development via the capacity of synthesizing exopolysaccharide (EPS), which mainly compose of α-glycosidic bond and β-glycosidic bond. β-glycosidic bond is less flexible than α-glycosidic bond because of differences between their configurational properties. Previous studies have shown that the rnc gene is implicated in the EPS formation and the cariogenicity of S. mutans. However, the effects of rnc on the microstructure of EPS have been not well-understood yet. Here, we further investigated how the rnc gene worked to modulate microstructural properties of the extracellular polysaccharide of S. mutans using glycomics methods. The gas chromatography-mass spectrometer showed that the proportion of glucose was decreased in water-soluble EPS and galactose was absent in water-insoluble EPS from the S. mutans rnc-deficient strain (Smurnc), compared with the isogenic wild-type strain (UA159). The composition of functional groups and the displacement of hydrogen bond were analyzed by infrared radiation and 1H nuclear magnetic resonance, respectively. In addition, phenotypic modulation of the biofilm matrix was assessed by microscopy. We found that the EPS of UA159 and the rnc overexpression strain (Smurnc+) mainly consisted of β-glycosidic bonds. Conversely, the EPS of Smurnc were made up of mostly α-glycosidic bonds, leading to the attenuation of biofilm biomass and bacterial adhesion. Furthermore, the existence of β-glycosidic bond was verified by enzyme digestion. Collectively, the rnc gene modulates the conversion of β-glycosidic bonds, which may play important roles in regulating the micromolecule structure of the EPS matrix, thus affecting the characteristics of S. mutans biofilm. These data illustrate that β-glycosidic bonds mediated by rnc may be potential targets for the prevention and treatment of dental caries.
SoC-FPGA systems for the acquisition and processing of electroencephalographic signals
Authors: Oliva Matias Javier , García Pablo Andrés , Spinelli Enrique Mario , Veiga Alejandro Luis
Published: December 2021

Real-time acquisition and processing of electroencephalographic signals have promising applications in the implementation of brain-computer interfaces. These devices allow the user to control a device without performing motor actions, and are usually made up of a biopotential acquisition stage and a personal computer (PC). This structure is very flexible and appropriate for research, but for final users it is necessary to migrate to an embedded system, eliminating the PC from the scheme. The strict real-time processing requirements of such systems justify the choice of a system on a chip field-programmable gate arrays (SoC-FPGA) for its implementation. This article proposes a platform for the acquisition and processing of electroencephalographic signals using this type of device, which combines the parallelism and speed capabilities of an FPGA with the simplicity of a general-purpose processor on a single chip. In this scheme, the FPGA is in charge of the real-time operation, acquiring and processing the signals, while the processor solves the high-level tasks, with the interconnection between processing elements solved by buses integrated into the chip. The proposed scheme was used to implement a brain-computer interface based on steady-state visual evoked potentials, which was used to command a speller. The first tests of the system show that a selection time of 5 seconds per command can be achieved. The time delay between the user’s selection and the system response has been estimated at 343 µs.
Attitude and Knowledge Relationship with Sexual Behavior at Risk of Sexually Transmitted Infection (STI) in Male Adolescents in Indonesia (IDHS Data Analysis 2017)
Authors: Asiah Nur , Yohana Sondi Agnes , Parlina Nining , Jovanka Della Raymena
Published: December 2021

Introduction: Indonesia Population Demographic Survey in 2017 recorded that 8% of teenage boys and 2% of teenage girls admitted to having sexual intercourse. This certainly worries all of us who hope today's youth will be a demographic bonus. Sexual behavior is at risk of impacting the issue of Unwanted Pregnancy (KTD), abortion, Sexually Transmitted Infections (STIs), and the ongoing incidence of HIV and AIDS. Objective:  to confirm the relationship of attitudes and knowledge with risky sexual behavior in adolescent boys in Indonesia. Methods: This type of research is quantitative analytics using a cross-sectional design and sourced from secondary data of the Indonesian Health Demographic Survey 2017. The population in this study was 13,079 adolescent men aged 15-24, sampling 10,710 with saturated sampling techniques. Bivariate data analysis using the chi-square test (0.05). Results:  were obtained by adolescents with a positive attitude of 52.1%, knowledgeable 77.8%, and 13.1% risky sexual behavior. Test results showed there was an attitude relationship with risky sexual behavior with p-value = 0.000 and there was a knowledge relationship with risky sexual behavior with p-value = 0.000. Conclusions:  This study are expected to be used as input for the creation of risky sexual behavior prevention programs in adolescents and form the basis for the creation of an educational model related to adolescent reproductive health for parents and educational institutions.
El camino del medio: Barthes entre Benjamin y Adorno
Authors: Bohnhoff Leandro
Published: December 2021

En Roland Barthes por Roland Barthes (2018 [1975]), el crítico francés nos exhorta a leer su ensayo autobiográfico como dicho por un personaje de novela. Este es uno de los hitos donde se suele ubicar el comienzo del denominado "último Barthes", etapa marcada por una voluntad expresa de que su obra tienda a la novelización. Unos años después, en la Lección inaugural (2015 [1978]) dictada en 1977, se autofigura como un "sujeto incierto" por no haber escrito más que ensayos. El presente trabajo se propone leer la escritura de La cámara lúcida (2009 [1980]) en el horizonte de esa doble tensión. El polo novelístico de dicha tensión, además de las propias inquietudes de Barthes por el carácter eminentemente realista de toda literatura, nos permite preguntarnos el modo en que el libro barthesiano sobre la fotografía pone en juego la mímesis realista a través de ciertos aportes de Walter Benjamin (Cfr. 2007). Por otro lado, el polo ensayístico, que impulsaría a formular un pensamiento verdaderamente crítico, invoca la inquietud de leer la obra en su dimensión formal (en el sentido adorniano de la expresión [Cfr. 2013]). Ambas líneas de pesquisa iluminan el problema del medio o la mediación como eje central de la tensión entre novela y ensayo.
Aproximações semiológicas entre Barthes e Borges: o mito artificial em "Pierre Menard, autor do Quixote"
Authors: Berndt Jorge Antonio , Pezzini Paula Grinko
Published: December 2021

Ambas as escritas crítico-ensaísticas e ficcionais de Jorge Luis Borges questionam noções como cópia, originalidade, fonte e influência: em essência, a mitologia constituída em torno da Autoria. Publicado pela primeira vez em 1939, o conto “Pierre Menard, autor do Quixote” (2007) desmi(s)tifica o mito do autor ao arquitetar uma personagem que se propõe a reescrever Dom Quixote, o maior romance em língua espanhola. Contemporâneos, Borges na América Latina e Barthes na Europa, a separação geográfica, política e social não impediu correspondências interpretativas entre os autores no que se refere ao Texto. Em 1968, com a eclosão de “A morte do autor” (2012), Roland Barthes abala a concepção individualista do campo teórico ao tecer a personagem do escritor como uma criação moderna; e declara ser a morte do Autor o único subterfúgio que possibilita o nascimento do leitor. Visto que a acepção de Autoria é construída por um roubo de linguagem, é possível categorizá-la como mito, perpetuado e naturalizado ao longo da História. Sob essa perspectiva, e com base na metodologia de Mitologias (1972), o presente artigo explora se a morte de Cervantes, supostamente assassinado pelo Texto menardiano, produz um fenômeno artístico contramítico.
Filologia ativa: Barthes e Nietzsche
Authors: Nojiri Julia Bunemer
Published: December 2021

A presente tradução tem por objetivo contribuir para a divulgação de pesquisas acerca da influência germânica no pensamento de Roland Barthes: ainda que se tenha aí um amplo campo de estudos, esse está longe de se esgotar.
Isso, pois, como veremos adiante no artigo, tal pesquisa é uma empreitada em muitos sentidos, sendo um deles o mais óbvio – o fato de que Barthes não lia em alemão, coisa que ao passo que atiça a curiosidade do pesquisador é também um problema que pode enredá-lo, já que tal fato dificulta que se rastrei por onde passaram tais leituras, sempre traduzidas e mediadas.
Contudo, em certo sentido, pode-se dizer que se tem nesse problema a sua solução: compreender a influência dos escritos germânicos no bojo da cultura e da língua amadas por Barthes, fazendo-se necessárias as leituras de Derrida e Deleuze, especialmente no tocante aos estudos nietzschianos – e talvez o mais importante para sua solução, isso é, sermos barthesiano antes de tentarmos enquadrar Barthes, como o faz Shane Weller a seguir, repensando a relação de Nietzsche com Barthes no cerne do projeto barthesiano de libertação textual, obviamente barrando qualquer possibilidade de rastreamente teórico assertivo.
Para tanto, aqui optamos por manter o artigo o mais fidedigno possível ao original, de modo a ajudar o leitor, uma vez que isso se trata de uma tradução brasileira de um artigo inglês sobre a influência germânica no pensamento de um francês. Assim, em português fluente, aqui o leitor terá acesso à leitura de Shane Weller traduzida em léxico mais sóbrio e técnico, reproduzindo-se o original. Sobre as citações e referências feitas pelo autor, aqui se encontra seu equivalente em versão brasileira seguindo este padrão: tudo foi vertido do inglês, salvo as referências bibliográficas sem tradução brasileira. O uso do francês neste artigo foi mantido embora traduzido em notas de rodapé ou no próprio corpo do texto (também de modo a não nos afastarmos do autor nem aumentarmos as notas de rodapé), de maneira que todas as citações e referências que não se encontrarão aqui em português é devido ao fato de não estarem traduzidas, salvo O Prazer do texto, do qual optamos por fazer a nossa própria versão.
Ainda sobre as traduções brasileiras de Barthes, aqui usamos as versões de seus mais estabelecidos estudiosos, e quando as obras referenciadas eram inéditas em português ou não se encontravam no rol de seus estudiosos consagrados, optamos por tradução livre, devidamente indicada. E o mesmo vale para as obras de Nietzsche, Derrida e Deleuze.
Midlife Cardiorespiratory Fitness and the Development of Peripheral Artery Disease in Later Life
Authors: Keshvani Neil , Willis Benjamin , Leonard David , Gao Ang , DeFina Laura , McDermott Mary M. , Berry Jarett D. , Kumbhani Dharam J.
Published: December 2021

Background

Data are sparse on the prospective associations between physical activity and incidence of lower extremity peripheral artery disease (PAD).

Methods and Results

Linking participant data from the CCLS (Cooper Center Longitudinal Study) to Medicare claims files, we studied 19 023 participants with objectively measured midlife cardiorespiratory fitness through maximal effort on the Balke protocol who survived to receive Medicare coverage between 1999 and 2009. The study aimed to determine the association between midlife cardiorespiratory fitness and incident PAD with proportional hazards intensity models, adjusted for age, sex, body mass index, and other covariates, to PAD failure time data. During 121 288 person‐years of Medicare follow‐up, we observed 805 PAD‐related hospitalizations/procedures among 19 023 participants (21% women, median age 50 years). Lower midlife fitness was associated with a higher rate of incident PAD in patients aged 65 years and older (low fit [quintile 1]: 11.4, moderate fit [quintile 2 to 3]: 7.8, and high fit [quintile 4 to 5]: 5.7 per 1000 person years). After multivariable adjustment for common predictors of incident PAD such as age, body mass index, hypertension, and diabetes, these findings persisted. Lower risk for PAD per greater metabolic equivalent task of fitness was observed (hazard ratio [HR], 0.93 [95% CI, 0.90–0.97];
P
<0.001). Among a subset of patients with an additional fitness assessment, each 1 metabolic equivalent task increase from baseline fitness was associated with decreased risk of incident PAD (HR, 0.90 [95% CI, 0.82–0.99];
P
=0.03).

Conclusions

Cardiorespiratory fitness in healthy, middle‐aged adults is associated with lower risk of incident PAD in later life, independent of other predictors of incident PAD.
Real‐Time Arrhythmia Detection Using Hybrid Convolutional Neural Networks
Authors: Bollepalli Sandeep Chandra , Sevakula Rahul K. , Au‐Yeung Wan‐Tai M. , Kassab Mohamad B. , Merchant Faisal M. , Bazoukis George , Boyer Richard , Isselbacher Eric M. , Armoundas Antonis A.
Published: December 2021

Background

Accurate detection of arrhythmic events in the intensive care units (ICU) is of paramount significance in providing timely care. However, traditional ICU monitors generate a high rate of false alarms causing alarm fatigue. In this work, we develop an algorithm to improve life threatening arrhythmia detection in the ICUs using a deep learning approach.

Methods and Results

This study involves a total of 953 independent life‐threatening arrhythmia alarms generated from the ICU bedside monitors of 410 patients. Specifically, we used the ECG (4 channels), arterial blood pressure, and photoplethysmograph signals to accurately detect the onset and offset of various arrhythmias, without prior knowledge of the alarm type. We used a hybrid convolutional neural network based classifier that fuses traditional handcrafted features with features automatically learned using convolutional neural networks. Further, the proposed architecture remains flexible to be adapted to various arrhythmic conditions as well as multiple physiological signals. Our hybrid‐ convolutional neural network approach achieved superior performance compared with methods which only used convolutional neural network. We evaluated our algorithm using 5‐fold cross‐validation for 5 times and obtained an accuracy of 87.5%±0.5%, and a score of 81%±0.9%. Independent evaluation of our algorithm on the publicly available PhysioNet 2015 Challenge database resulted in overall classification accuracy and score of 93.9% and 84.3%, respectively, indicating its efficacy and generalizability.

Conclusions

Our method accurately detects multiple arrhythmic conditions. Suitable translation of our algorithm may significantly improve the quality of care in ICUs by reducing the burden of false alarms.
Bilateral Transcutaneous Electrical Nerve Stimulation Improves Upper Limb Motor Recovery in Stroke: A Randomized Controlled Trial
Authors: Chen Peiming , Liu Tai-Wa , Kwong Patrick W.H. , Lai Claudia K.Y. , Chung Raymond C.K. , Tsoh Joshua , Ng Shamay S.M.
Published: December 2021

Background:

Recent evidence has shown bilateral transcutaneous electrical nerve stimulation (Bi-TENS) combined with task-oriented training (TOT) to be superior to unilateral transcutaneous electrical nerve stimulation (Uni-TENS)+TOT in improving lower limb motor functioning following stroke. However, no research explored the effect of Bi-TENS+TOT in improving upper limb motor recovery. This study aimed to compare Bi-TENS+TOT with Uni-TENS+TOT, Placebo transcutaneous electrical nerve stimulation (Placebo-TENS)+TOT, and no treatment (Control) groups in upper limb motor recovery.

Methods:

This is a 4-group parallel design. One hundred and twenty subjects were given either Bi-TENS+TOT, Uni-TENS+TOT, Placebo-TENS+TOT, or Control without treatment in this randomized controlled trial. Twenty 60-minute sessions were administered 3× per week for 7 weeks. The outcome measure was the Fugl-Meyer Assessment of Upper Extremity, which was assessed at baseline, after 10 sessions (mid-intervention) and 20 sessions (post-intervention) of intervention, and at 1- and 3-month follow-up.

Results:

Patients in the Bi-TENS+TOT group showed greater improvement in the Fugl-Meyer Assessment of Upper Extremity scores than Uni-TENS+TOT (mean difference, 2.13;
P
=0.004), Placebo-TENS+TOT (mean difference, 2.63;
P
<0.001), and Control groups (mean difference, 3.11;
P
<0.001) at post-intervention. Both Bi-TENS+TOT (mean difference, 3.39;
P
<0.001) and Uni-TENS+TOT (mean difference, 1.26;
P
=0.018) showed significant within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores. Patients in the Bi-TENS+TOT group showed earlier within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores at mid-intervention than Uni-TENS+TOT. These improvements were maintained at the 3-month follow-up assessment.

Conclusions:

Bi-TENS combined with TOT is an effective therapy for improving upper limb motor recovery following stroke.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03112473.
Deepening a Sense of Being Taiwanese
Authors: Yeh Shu-ling , Chang Ying-Cheng
Published: December 2021

This paper examines how the Amis, the largest indigenous community in Taiwan, draw on their Catholic faith to understand what it means to be Taiwanese. For over a century, the Amis were treated as marginalised citizens by the Japanese colonial government and the Han-Chinese Kuomintang under Chiang Kai-shek and Chiang Ching-kuo. Their predicament changed when political priorities shifted from cultural assimilation to multiculturalism after 1987. Successive Taiwanese governments since then have actively sought to incorporate indigenous culture as a core part of Taiwanese identity. Focusing on how the Amis intertwined their adopted Catholic notions and practices with pre-Christian ideas, social structure, and rituals, this paper demonstrates the ways in which the Amis carve out a place for themselves in wider Taiwanese society. It adds to ongoing discussions about the relationship between conversion and cultural transformation in Oceania by arguing that Catholicism empowered the Amis to deepen their sense of belonging to the island republic and, for the first time, assert themselves fully as Taiwanese.
Archaeology of Early Chinese Settlement in Southeast Asia
Authors: Miksic John
Published: December 2021

Little historical information is available about early Chinese settlement in Southeast Asia. By the 15th century several Chinese settlements of significant size had formed, but they vanished by the time the Portuguese reached the region. This article surveys the historical literature on these early overseas Chinese settlements, and summarizes the contributions which archaeology can make to clarifying the timing and nature of the process.
New species of Rineloricaria (Siluriformes: Loricariidae) from the Paranaíba River basin, Brazil
Authors: DA COSTA-SILVA GUILHERME JOSÉ , OLIVEIRA CLAUDIO , DA COSTA E SILVA GABRIEL DE SOUZA
Published: December 2021

Rineloricaria is a genus of armored catfish encompassing 67 valid species that are widely distributed throughout the Neotropical region. A new species of Rineloricaria is described from the Paranaíba River, Upper Paraná River basin, southeastern Brazil. Rineloricaria rodriquezae sp. n. is distinguished from its congeners by the combination of the following characters: caudal-fin color pattern with basal dark spot and subterminal dark bar on branched rays interspersed with a hyaline area; five series of lateral plates with two keeled in the mid-dorsal series around the insertion of the first ray of dorsal fin; and unbranched caudal-fin ray extended as long filaments.
Contributions of a Professional Development Course to Language Teacher Identity Development: Critical Incidents in Focus
Authors: Nazari Mostafa , De Costa Peter I.
Published: December 2021

Despite the widely recognized significance of critical incidents (CIs) in teachers’ professional learning, little research has investigated the role of CIs in language teacher identity development. This study attempts to fill this gap by exploring the contributions of a Telegram-based professional development course—framed around CI storying—to the language teacher identity development process of a group of teachers. Data were collected from 10 teachers before, during, and after the course. Data analyses indicated that, before the course, CIs negatively influenced the teachers’ agency and emotions. Participation in the course contributed, however, to the teachers’ enhanced agency and greater emotion regulation. In addition, the course afforded the teachers an opportunity to experience further professional socialization and collegial engagement. Our findings revealed that during the course, the teachers developed greater expertise in storying their CIs and discussed higher order issues relevant to the multiplicity of identity as connected to sociocultural-educational dimensions. These findings suggest that emotions and agency are two significant identity aspects that are profoundly influenced by and influence CIs. Our article closes with a discussion of the implications of embedding CIs in professional development courses to help teachers (re)construct their identities.
Return of Benefit to Society of Publicly Funded Innovations to Combat COVID-19
Authors: Yu Helen
Published: December 2021

In response to the COVID-19 pandemic, significant public funds have been invested worldwide into the research, development, and manufacturing of pharmaceutical products to combat the novel coronavirus. Traditionally, intellectual property (IP) rights have been justified in the pharmaceutical sector because of the time and cost associated with drug discovery and development. However, if (a) the cost of research for COVID-19 related innovations have largely been subsidized by the public through public research grants; (b) the time for development has been significantly reduced through publicly funded initiatives; and (c) manufacturing has been de-risked through taxpayer funded advance purchase agreements, should IP rights be asserted on innovations that have largely already been paid for by the public?. There needs to be clear legal and regulatory frameworks, informed by policy objectives such as principles of “responsible research and innovation” and “global public good,” to ensure that outcomes of publicly funded efforts can ultimately reach the intended public. Without any access and production conditions associated with the use of public efforts, worldwide supplies to medical solutions that benefited from these public initiatives can be frustrated. This article proposes a legal framework to address future access and availability problems to medical innovations that benefit from publicly funded initiatives.
Deep medullary veins are associated with widespread brain structural abnormalities
Authors: Liu Zi-Yue , Zhai Fei-Fei , Ao Dong-Hui , Han Fei , Li Ming-Li , Zhou Lixin , Ni Jun , Yao Ming , Zhang Shu-Yang , Cui Li-Ying , Jin Zheng-Yu , Zhu Yi-Cheng
Published: December 2021

Our aim is to investigate the association of cerebral deep medullary veins (DMVs) with white matter microstructural integrity and regional brain atrophy in MRI. In a community-based cohort of 979 participants (mean age 55.4 years), DMVs were identified on susceptibility-weighted imaging. Brain structural measurements including gray matter and hippocampus volumes, as well as diffusion tensor metrics, were evaluated. The mean (SD)number of DMVs was 19.0 (1.7). A fewer number of DMVs was related to lower fractional anisotropy and higher mean diffusivity in multiple voxels on the white matter skeleton (threshold-free cluster enhancement corrected p < 0.05, adjusted for age and sex). Also, fewer DMVs were significantly related to a lower gray matter fraction and a hippocampal fraction (0.10 and 0.11 per DMV, respectively; SE, 0.03 for both; p < 0.001 for both). A significant correlation between DMVs’ reduction and cortical atrophy was observed in the bilateral occipital lobes, temporal lobes, hippocampus, and frontal lobes (p < 0.001, adjusted for age, sex, and total intracranial volume). Our results provided evidence that cerebral small venules disease play a role in brain parenchymal lesions and neurodegenerative processes.
Association between lesion enhancement and breast cancer in contrast-enhanced spectral mammography
Authors: Boy Fatma Nur Soylu , Goksu Kamber , Tasdelen Iksan
Published: December 2021

Background

Contrast-enhanced spectral mammography (CESM) may help to determine the malignancy potential of lesions according to the degree of enhancement.

Purpose

To investigate the correlation between the degree of contrast enhancement of the lesions in contrast-enhanced spectral mammography (CESM) and the final histopathological diagnosis in patients with BI-RADS 4 and 5 lesions.

Material and Methods

CESM was performed in 128 patients who had BI-RADS 4 and 5 lesions on mammography and underwent histopathological examination. A total of 128 index lesions were scored using a 4-point scale regarding the degree of contrast enhancement (0 = no contrast enhancement, 1 = minimal, 2 = moderate, 3 = marked), a score of 2 and 3 was accepted as suggestive of malignancy. The study was approved in our institutional scientific committee.

Results

In total, 76 (59.4%) of the lesions had benign histopathological results, whereas 52 of them had malignant results. Contrast enhancement was not observed in 22.7% of the lesions while 24.2% had minimal enhancement, 18.8% had moderate enhancement, and 34.4% had marked enhancement in CESM. The sensitivity of the degree of contrast enhancement in CESM was 98.1%, when the specificity was 77.6%, positive predictive value was 75%, negative predictive value was 98.3%, and accuracy was 85.9%.

Conclusion

This study demonstrated that the degree of contrast enhancement of the lesions in CESM may be used in daily practice with easily performing a visual scale in predicting the malignancy potential of the lesions.