bluuebunny/crossref_metadata_2025 huggingface dataset:
Proliferating trichilemmal tumour: diagnostic challenge on core biopsy
Authors: Adegun Oluyori Kutulola , Morley Simon , Kalavrezos Nicholas , Jay Amrita
Published: February 2019

A 70-year-old woman presented with a 10-month history of an irregular mass in the left lateral nape of her neck which had recently increased in size rapidly. Ultrasound-guided core needle biopsy was obtained, and the tumour was diagnosed as a well-differentiated squamous cell carcinoma. Further imaging studies failed to demonstrate additional malignant characteristics. In view of these findings, a wide local excision of the tumour was performed. Histopathological assessment of the resected tumour revealed a proliferating trichilemmal tumour with well-differentiated features and smooth invasion front. This article serves as an important reminder of the challenges associated with pathological evaluation of core needle biopsies of adnexal tumours. It emphasises the importance of clinical-radiological-pathological correlation preferably in a multidisciplinary team setting prior to agreeing on a definitive management plan.
Where are the paediatricians? An international survey to understand the global paediatric workforce
Authors: Harper Beth D , Nganga Waceke , Armstrong Robert , Forsyth Kevin D , Ham Hazen P , Keenan William J , Russ Christiana M
Published: February 2019

Objective

Our primary objective was to examine the global paediatric workforce and to better understand geographic differences in the number of paediatricians globally. Secondary objectives were to describe paediatric workforce expectations, who provides children with preventative care and when children transition out of paediatric care.

Design

Survey of identified paediatric leaders in each country.

Setting

Paediatric association leaders worldwide.

Main outcome measures

Paediatrician numbers, provision of primary care for children, age of transition to adult care.

Results

Responses were obtained from 121 countries (73% of countries approached). The number of paediatricians per 100 000 children ranged from a median of 0.5 (IQR 0.3–1.4) in low-income countries to 72 (IQR 4–118) in high-income countries. Africa and South-East Asia reported the lowest paediatrician density (median of 0.8 paediatricians per 100 000 children, IQR 0.4–2.6 and median of 4, IQR 3–9, respectively) and fewest paediatricians entering the workforce. 82% of countries reported transition to adult care by age 18% and 39% by age 15. Most countries (91%) but only 64% of low-income countries reported provision of paediatric preventative care (p<0.001, Cochran-Armitage trend test). Systems of primary care provision varied widely. A majority of countries (63%) anticipated increases in their paediatric workforce in the next decade.

Conclusions

Paediatrician density mirrors known inequities in health provider distribution. Fewer paediatricians are entering the workforce in areas with already low paediatrician density, which may exacerbate disparities in child health outcomes. In some regions, children transition to adult care during adolescence, with implications for healthcare training and delivery. Paediatrician roles are heterogeneous worldwide, and country-specific strategies should be used to address inequity in child health provision.
Effect of bariatric surgery before pregnancy on the vascular function in the offspring: protocol of a cross-sectional follow-up study
Authors: Van De Maele Karolien , Gies Inge , Devlieger Roland
Published: February 2019

Background

The offspring of obese pregnant women are at risk for adverse metabolic, inflammatory and cardiovascular programming. Comprehensive long-term data are lacking on the contribution of changes in maternal weight after bariatric surgery before pregnancy compared with lifestyle interventions during pregnancy on the cardiovascular programming of the offspring.

Methods

EFFECTOR is designed as a cross-sectional cohort follow-up study targeting the children of different groups of women who were previously studied during their pregnancy. Four subgroups of children are identified, based on maternal weight characteristics during pregnancy: normal weight women, obese women without any intervention and obese women who underwent a lifestyle intervention during or bariatric surgery before pregnancy. Data collection is performed as a single study visit at home. Data on the sociodemographic situation, food habits and psychomotor development are obtained through questionnaires. During the home visit, extensive anthropometric and vascular assessment is performed. Information on body composition is provided by assessment of body weight and height, bioelectrical impedance analysis, skinfold measurements and ultrasound. Endothelial function is measured by non-invasive peripheral arterial tonometry (EndoPAT 2000). Biomarkers performed in blood and urinalysis conclude the data collection process.

Trial registration number

NCT02992106(Pre-results).
Assessment of boron nitride nanotube materials using X-ray photoelectron spectroscopy
Authors: Jakubinek Michael B. , Kim Keun Su , Homenick Christa , Kodra Oltion , Walker Steven , Simard Benoit
Published: February 2019

With increasing prevalence of boron nitride nanotubes (BNNTs), the need for routine and reliable assessment methods is becoming more critical both for research studies and for quality control in nanotube manufacturing. The assessment of BNNT materials using X-ray photoelectron spectroscopy (XPS) is described here through analysis of raw-BNNT materials and three case studies showing modification of BNNTs by purification or chemical functionalization. Metrics indicative of the BN content of the material, with the simplest being the B:N ratio, are described and tracked to show evolution of BNNT materials during processing. Along with changes in the elemental composition and the content of BN, high-resolution spectra of the B 1s region also show clear evolution as BNNT materials are modified, which can be used as a measure of boron nitride content and quality to assess BNNT production, purification, and functionalization.
Analytical approach to Ramanujan type and Ramanujan’s modular equations of degree 7
Authors: Mahadevaswamy
Published: February 2019

In this paper, we deduce certain modular equations of degree [Formula: see text] analogous to Ramanujan’s modular equations of degree [Formula: see text]. Also, we prove six modular equations recorded by Ramanujan in his second notebook.
Hydrothermal Synthesis of Ni-MOF Vulcanized Derivatives for High-Performance Supercapacitors
Authors: Gao Shuwen , Sui Yanwei , Wei Fuxiang , Qi Jiqiu , Meng Qingkun , Ren Yaojian , He Yezeng
Published: February 2019

A series of nickel sulfides derived from the hexagonal Ni-MOF are vulcanized through adjusting the hydrothermal time and the thiourea concentration. Among all the obtained nickel sulfides, one sample Ni-S2-3, which inherits the Ni-MOF’s morphology, shows the best electrochemical performance with a remarkable specific capacitance of 1128[Formula: see text]Fg[Formula: see text] at 1[Formula: see text]Ag[Formula: see text], a rate capacitance of 50% and a long cycle life of 74% retention after 5000 cycles. Furthermore, the asymmetrical supercapacitors (SCs) based on Ni-S2-3//AC exhibit a good supercapacitive performance with a maximum power density of 16.3[Formula: see text]Wh kg[Formula: see text] at a power density of 800[Formula: see text]Wkg[Formula: see text]. All these results indicate that vulcanizing Ni-MOF is an effective way to fabricate a superior electrode material with excellent electrochemical performance for SCs.
The renin-angiotensin system: going beyond the classical paradigms
Authors: Santos Robson Augusto Souza , Oudit Gavin Y. , Verano-Braga Thiago , Canta Giovanni , Steckelings Ulrike Muscha , Bader Michael
Published: February 2019

Thirty years ago, a novel axis of the renin-angiotensin system (RAS) was unveiled by the discovery of angiotensin-(1−7) [ANG-(1−7)] generation in vivo. Later, angiotensin-converting enzyme 2 (ACE2) was shown to be the main mediator of this reaction, and Mas was found to be the receptor for the heptapeptide. The functional analysis of this novel axis of the RAS that followed its discovery revealed numerous protective actions in particular for cardiovascular diseases. In parallel, similar protective actions were also described for one of the two receptors of ANG II, the ANG II type 2 receptor (AT2R), in contrast to the other, the ANG II type 1 receptor (AT1R), which mediates deleterious actions of this peptide, e.g., in the setting of cardiovascular disease. Very recently, another branch of the RAS was discovered, based on angiotensin peptides in which the amino-terminal aspartate was replaced by alanine, the alatensins. Ala-ANG-(1−7) or alamandine was shown to interact with Mas-related G protein-coupled receptor D, and the first functional data indicated that this peptide also exerts protective effects in the cardiovascular system. This review summarizes the presentations given at the International Union of Physiological Sciences Congress in Rio de Janeiro, Brazil, in 2017, during the symposium entitled “The Renin-Angiotensin System: Going Beyond the Classical Paradigms,” in which the signaling and physiological actions of ANG-(1−7), ACE2, AT2R, and alatensins were reported (with a focus on noncentral nervous system-related tissues) and the therapeutic opportunities based on these findings were discussed.
Solving a century-old conundrum underlying cardiac force-length relations
Authors: Han June-Chiew , Pham Toan , Taberner Andrew J. , Loiselle Denis S. , Tran Kenneth
Published: February 2019

In the late 19th century, Otto Frank presented a diagram (Frank O. Z Biol 37: 483–526, 1899) showing that cardiac end-systolic pressure-volume relations are dependent on the mode of contraction: one for isovolumic contractions that locate above that for afterloaded ejecting contractions. Conflicting results to Frank’s have been subsequently demonstrated in various species, both within and among preparations, ranging from the whole hearts to single myocytes, showing a single pressure-volume or force-length relation that is independent of the mode of contraction. Numerous explanations for these conflicting results have been proposed but are mutually contradictory and hence unsatisfying. The present study aimed to explore how these conflicting findings can be reconciled. We thus explored the cardiac force-length relation across a wide spectrum of both preloads and afterloads, encompassing the physiological working range. Experiments were performed using isolated ventricular trabeculae at physiological temperature and stimulus frequency. The force-length relation obtained from isometric contractions was indeed located above a family of those obtained from shortening contractions. Low preload conditions rendered the relation contraction mode independent. High afterload conditions also showed a comparable effect. Our exploration allowed us to reveal the loading conditions that can explain the apparent single, contraction mode-independent, force-length relation that is in contrast with that presented by Frank. Resolving this century-old cardiac conundrum highlights the caution that must be taken when using the end-systolic force-length relation to illustrate as well as to understand the concepts of the Frank-Starling law of the heart, “potential energy,” and cardiac contractility.

NEW & NOTEWORTHY Our exploration of the cardiac force-length relation under wide ranges of preload and afterload has allowed us to reconcile conflicting results in the literature regarding its length dependency. We show that the relation is dependent on the mode of contraction but can appear to be otherwise under certain conditions. This finding highlights the need for caution when using the force-length relation to understand key concepts in cardiac physiology.
CCL27/CCL28–CCR10 Chemokine Signaling Mediates Migration of Lymphatic Endothelial Cells
Authors: Karnezis Tara , Farnsworth Rae H. , Harris Nicole C. , Williams Steven P. , Caesar Carol , Byrne David J. , Herle Prad , Macheda Maria L. , Shayan Ramin , Zhang You-Fang , Yazar Sezer , Takouridis Simon J. , Gerard Craig , Fox Stephen B. , Achen Marc G. , Stacker Steven A.
Published: February 2019

Metastasis via the lymphatic vasculature is an important step in cancer progression. The formation of new lymphatic vessels (lymphangiogenesis), or remodeling of existing lymphatics, is thought to facilitate the entry and transport of tumor cells into lymphatic vessels and on to distant organs. The migration of lymphatic endothelial cells (LEC) toward guidance cues is critical for lymphangiogenesis. While chemokines are known to provide directional navigation for migrating immune cells, their role in mediating LEC migration during tumor-associated lymphangiogenesis is not well defined. Here, we undertook gene profiling studies to identify chemokine–chemokine receptor pairs that are involved in tumor lymphangiogenesis associated with lymph node metastasis. CCL27 and CCL28 were expressed in tumor cells with metastatic potential, while their cognate receptor, CCR10, was expressed by LECs and upregulated by the lymphangiogenic growth factor VEGFD and the proinflammatory cytokine TNFα. Migration assays demonstrated that LECs are attracted to both CCL27 and CCL28 in a CCR10-dependent manner, while abnormal lymphatic vessel patterning in CCR10-deficient mice confirmed the significant role of CCR10 in lymphatic patterning. In vivo analyses showed that LECs are recruited to a CCL27 or CCL28 source, while VEGFD was required in combination with these chemokines to enable formation of coherent lymphatic vessels. Moreover, tumor xenograft experiments demonstrated that even though CCL27 expression by tumors enhanced LEC recruitment, the ability to metastasize was dependent on the expression of VEGFD. These studies demonstrate that CCL27 and CCL28 signaling through CCR10 may cooperate with inflammatory mediators and VEGFD during tumor lymphangiogenesis.

Significance:

The study shows that the remodeling of lymphatic vessels in cancer is influenced by CCL27 and CCL28 chemokines, which may provide a future target to modulate metastatic spread.
Landscape of Germline and Somatic Mitochondrial DNA Mutations in Pediatric Malignancies
Authors: Triska Petr , Kaneva Kristiyana , Merkurjev Daria , Sohail Noor , Falk Marni J. , Triche Timothy J. , Biegel Jaclyn A. , Gai Xiaowu
Published: February 2019

Little is known about the spectrum of mitochondrial DNA (mtDNA) mutations across pediatric malignancies. In this study, we analyzed matched tumor and normal whole genome sequencing data from 616 pediatric patients with hematopoietic malignancies, solid tumors, and brain tumors. We identified 391 mtDNA mutations in 284 tumors including 45 loss-of-function mutations, which clustered at four statistically significant hotspots in MT-COX3, MT-ND4, and MT-ND5, and at a mutation hotspot in MT-tRNA-MET. A skewed ratio (4.83) of nonsynonymous versus synonymous (dN/dS) mtDNA mutations with high statistical significance was identified on the basis of Monte Carlo simulations in the tumors. In comparison, opposite ratios of 0.44 and 0.93 were observed in 616 matched normal tissues and in 249 blood samples from children without cancer, respectively. mtDNA mutations varied by cancer type and mtDNA haplogroup. Collectively, these results suggest that deleterious mtDNA mutations play a role in the development and progression of pediatric cancers.

Significance:

This pan-cancer mtDNA study establishes the landscape of germline and tumor mtDNA mutations and identifies hotspots of tumor mtDNA mutations to pinpoint key mitochondrial functions in pediatric malignancies.
Revolutionizing Cancer Immunology: The Power of Next-Generation Sequencing Technologies
Authors: Singer Meromit , Anderson Ana C.
Published: February 2019

It has long been appreciated that tumors are diverse, varying in mutational status, composition of cellular infiltrate, and organizational architecture. For the most part, the information embedded in this diversity has gone untapped due to the limited resolution and dimensionality of assays for analyzing nucleic acid expression in cells. The advent of high-throughput, next-generation sequencing (NGS) technologies that measure nucleic acids, particularly at the single-cell level, is fueling the characterization of the many components that comprise the tumor microenvironment (TME), with a strong focus on immune composition. Understanding the immune and nonimmune components of the TME, how they interact, and how this shapes their functional properties requires the development of novel computational methods and, eventually, the application of systems-based approaches. The continued development and application of NGS technologies holds great promise for accelerating discovery in the cancer immunology field.
ACUsmart Continuous Renal Replacement Therapy Platform: Multicenter Pilot Study for Technical and Clinical Assessment (A.M.P. Study)
Authors: Neri Mauro , Lorenzin Anna , de Cal Massimo , Brendolan Alessandra , Marchionna Nicola , Samoni Sara , Zanella Monica , De Rosa Silvia , Martino Francesca , Ricci Zaccaria , Maynar Javier , Auzinger Georg , Villa Gianluca , Payen Didier , Joannidis Michael , Ronco Claudio
Published: February 2019

Background: ACUsmart (Medica S.P.A., Italy) is a new-generation, continuous renal replacement therapy (CRRT) machine for critically ill patients with acute kidney injury. We designed a multicenter international pilot study to provide a description of outlines of the ACUsmart system, evaluation aspects of functionality, usability, and feasibility, discriminating reasons of possible treatment’s withdrawals or discontinuations and highlighting strong and weak points of the machine. Methods: Data of 23 CRRT (and 11 plasma exchange) treatments were collected from 4 intensive care units. Parameters such as treatment duration, downtime, delivered dose, and number and type of alarms were recorded. The general perception of the machine was quantified through the administration of a survey to each component of the evaluating staff. Results: A total treatment time of 447 h was carried with ACUsmart. Eleven continuous veno-venous hemofiltration, 4 continuous veno-venous hemodialysis , and 8 continuous veno-venous hemodiafiltration were performed. The average percentage of net treatment duration with respect to total treatment duration was 92.37%. The mean prescribed dose and delivered dose were 26.33 and 24.10 mL/kg/h, respectively. In general, the machine was rated by users involved as practical and easy to use, although few components need to be slightly improved. Conclusion: ACUsmart is a new multifunctional machine that meets most of the features required in a fourth-generation CRRT equipment.
Early Unclamping Laparoscopic Partial Nephrectomy for Complex Renal Tumor: Data from a Chinese Cohort
Authors: Zhang Tao , Zhao Li , Ma Jiaxing , Min Jie , Yang Chao , Sun Xin , Qian Weiwei , Song Jin , Zhu Jinbo , Yu Dexin
Published: February 2019

Objective: To evaluate the efficacy and safety of early unclamping laparoscopic partial nephrectomy (LPN) for complex renal tumor relative to the standard artery clamping technique (SCT). Methods: Sixty-one patients with complex renal tumor (RENAL score ≥7) underwent LPN at our institution from January 2013 to April 2017. LPN was performed via SCT in 32 patients and via the early unclamping technique (EUT) in 29 patients. Operation time, warm ischemia time (WIT), blood loss, bleeding requiring transfusion, tumor volume, excisional volume loss (EVL), complications, and renal function before and after operation of the affected kidney were compared between the groups. Results: All surgeries were successful without conversion to open or nephrectomy. EUT reduced the WIT (p < 0.001) but did not increase the complication rate (p = 0.322). Although the tumor volume and EVL were larger in the EUT than in the SCT group (p = 0.011, p = 0.001), glomerular filtration rate (GFR) reduction in the affected kidney did not significantly differ between the groups (p = 0.120). Conclusion: Early unclamping LPN for complex renal tumor is safe and efficient. Additionally, the EUT could expand the application of LPN in complex renal tumors, and make this challenging surgery easier and safer.
Combination of Caffeine and Liver Albumin Plus Protects against Smoking-Induced Liver Injury in Rats
Authors: Shoukry Heba S. , Taher Maha M. , Enany AbdAllah , Ahmed Tarek , Hassan Ibrahim
Published: February 2019

Background: A number of studies have revealed the hepatoprotective effect of coffee and tea. However, the role of caffeine on smoking-induced liver injury is not well elucidated. Liver Albumin Plus (LAP) is a liver supplement given in different liver diseases; to our knowledge, its role in smoking-induced liver injury is not clear. Objectives: This study aimed to find out the protective effect of caffeine and LAP alone and in combination in attenuation of smoking-induced liver injury. Methods: Thirty male albino rats were divided into a control group and a smoking group; the smoking group was then subdivided into a smoking group, a smoking + caffeine group, a smoking + LAP group, and a smoking + caffeine + LAP group. At the end of the experimental study, blood samples were collected for assessment of liver enzymes, alpha-fetoprotein (AFP), and interleukin 6, and livers were excised. Biochemical analysis of hydrogen peroxide (H2O2), superoxide dismutase (SOD), and hypoxia-inducible factor (HIF) as well as histological examination were done. Results: The results showed that smoking elevated liver enzymes, AFP, H2O2, and HIF and decreased SOD; histologically, deterioration of the liver was observed. On administration of caffeine, significant (p < 0.05) improvement in all measured parameters and preserved liver histological structure were observed, while intake of LAP alone showed some improvement. In combination, all liver parameters were improved and histological structure was preserved in contrast to each drug alone. Conclusion: It is better to give a combination of caffeine and LAP with cigarettes smoking to attenuate smoking-induced liver injury.
Adaptação Brasileira da Escala Clima Familiar para Segurança no Trânsito
Authors: Nascimento Rezende Hugo , Sant ́Anna Bianchi Alessandra ,   Universidade Federal do Paraná, Brasil.
Published: February 2019

(analítico): esta pesquisa visa verificar evidências de validade da adaptação brasileira da Escala Clima Familiar para Segurança no Trânsito (Taubman-Ben-Ari & Katz-Ben-Ami, 2013), que avalia a percepção de jovens condutores sobre valores, prioridades, e práticas dos pais e da família em relação à condução segura. Participaram da pesquisa 420 universitários (63% homens), com idade entre 18 e 22 anos (média=19,7 anos; DP=1,3 anos). A análise fatorial indicou uma solução de cinco fatores: Comunicação/Mensagem (α=0,87), Monitoramento/Limites (α=0,87), Falta de Compromisso com a Segurança (α=0,70), Modelagem (α=0,79) e Feedback (α=0,80). Os dados mostram que a versão brasileira da escala apresentou resultados adequados e pode ser utilizada em estudos futuros sobre clima familiar em relação à condução.
Embarazo y maternidad: percepciones de las jóvenes en un contexto binacional México-Estados Unidos
Authors: Castañeda-Camey Nicté , Loude León Siantz Mary , Brazil-Cruz Lisceth
Published: February 2019

(analítico): El objetivo del estudio fue analizar algunas percepciones que las jóvenes tienen del embarazo y la maternidad temprana en dos comunidades binacionales atravesadas por la migración: Tepatitlán de Morelos, Jalisco, México y San Joaquín, California, Estados Unidos. El enfoque metodológico fue cualitativo interpretativo, con una estrategia basada en la construcción categorías analíticas a partir de los relatos. Se realizaron 12 grupos focales en escuelas públicas con estudiantes de secundaria y bachillerato en edades comprendidas entre 14-18 años. Los hallazgos evidencian que los factores asociados al embarazo y la maternidad temprana, se relacionan con un conjunto de condiciones socioestructurales y sociosimbólicas que imperan en la familia la escuela y la comunidad, en donde la mayoría de las veces, se genera un contexto de vulnerabilidad, exclusión y desigualdad de género.
fronteras de la publicidad televisada en la era de conexión
Authors: Coca Adriana Pierre , Santos Alexandre Tadeu dos
Published: February 2019

la reflexión piensa las fronteras entre la internet y la publicidad televisada y tiene como enfoque teórico y metodológico la Semiótica de la Cultura, con la discusión basada en el concepto de frontera propuesto por Lotman (1999) y las incursiones de los autores Jenkins et al. (2014) y Manovich (2005) sobre la era de la conexión de la cultura, así como los apuntes de Machado A. (2011) sobre el audiovisual. Nos importa el diálogo y las intersecciones entre los diferentes sistemas de signos, pues creemos que así como la internet transforma la manera de producir la publicidad, al mismo tiempo se sobrepone a ella.
Configurações da assincronia audiovisual no cinema letrista de 1951/1952
Authors: Uchôa Fábio Raddi
Published: February 2019

Na vanguarda letrista, o cinema é tomado como objeto de realização e reflexão por meio dos filmes de Isou, Lemaître, Wolman e Debord, realizados entre 1951-52. Neste artigo, são examinados os debates letristas, em particular as formulações sobre uma arte cinematográfica discrepante, presentes na revista ION n. 1 e em escritos de Lemaître. Quatro filmes do período são debatidos, atentando à sua relação com a assincronia audiovisual. Sugere-se que tais experiências incluem duas tendências: de uma parte, a centralidade das emissões vocais rodeadas por imagens alheias e, de outra, a agressão à tela e às imagens, retomando os diálogos cinema/teatro e a concepção do cinema como forma de ação.
A casa de Ulisses no labirinto de espelhos
Authors: Peixoto Gustavo Rocha
Published: February 2019

O sonho de Telêmaco, entre morcegos melancólicos, dá início a uma  odisseia noturna pelos labirintos espelhados da historiografia da arquitetura. O livro A coluna e o vulto, publicado em 2017, trata das“permutas de significados entre corpo e arquitetura.” O que deveria ser uma resenha daquele inovador ensaio de Mario Henrique d’Agostino, terminou por se converter em “mal disfarçado pretexto” para umaprofunda reflexão sobre os graus e direções da historiografia da arquitetura permeada por imaginação arquitetural e mitos literários de longa reverberação; por certezas e verdades; filologia e filosofia. Estãoconvocados para depor em juízo Homero e James Joyce; Manfredo Tafuri, Rudolf Wittkower, Joseph Rykwert, Giambattista Vico e Marco Lucchesi; Le Corbusier, Stanley Kubrick e Lewis Carroll.
Revisitando Toulouse Le Mirail:
Authors: Vianna Fabiano Borba
Published: February 2019

O artigo aborda a concepção e a recente demolição parcial do projeto Toulouse Le Mirail, de autoria do escritório francês Candilis-Josic-Woods, relacionando-o com o período do após-Guerra e com temas que emergiram durante discussões e encontros do Team 10. Investiga-se o encontro de Royaumont em 1962, oportunidade em que o projeto foi apresentado por Georges Candilis e recebeu críticas devido à sua grande escala, revelando o posicionamento de autores como Jaap Bakema, José Antonio Coderch, Fernando Távora e André Schimmerling, todos presentes ao encontro. O método conjuga pesquisa bibliográfica, investigação em arquivos do Team 10 pertencentes ao acervo do Het Nieuwe Instituut em Rotterdam, além de um componente empírico, com visita de campo à obra. Como resultado, questiona-se em que medida os valores arquitetônicos e urbanísticos relacionados ao projeto, podem ser reinterpretados para embasar novas reflexões condizentes com a realidade das intervenções em assentamentos habitacionais de grande escala.
Low Fluoroscopy Permanent His Bundle Pacing Using Electroanatomic Mapping
Authors: Sharma Parikshit S. , Huang Henry D. , Trohman Richard G. , Naperkowski Angela , Ellenbogen Kenneth A. , Vijayaraman Pugazhendhi
Published: February 2019

Background:

Conventional permanent His Bundle pacing (PHBP) can be challenging and associated with high fluoroscopy exposure. The aim of this study was to assess the feasibility and safety of performing low fluoroscopy PHBP using 3-dimensional electroanatomic mapping and comparing outcomes with conventional fluoroscopy guided PHBP implants.

Methods:

PHBP was performed at 2 centers using electroanatomic mapping-guided low fluoroscopy implantation in 10 patients using a novel protocol (group 1) and conventional fluoroscopy guided implantation in 20 patients (group 2). The primary end point was feasibility of achieving PHBP with low/zero fluoroscopy and safety end points included total radiation exposure (fluoroscopy time and dose area product), procedure-related complications associated with lead implantation or need for lead revisions.

Results:

PHBP was successful in 9 of 10 patients (90%) in group 1 and 100% successful in the group 2 patients. The mean His lead fluoroscopy time was significantly lower in group 1 (0.2±0.2 minutes) compared with 8±7 minutes in group 2 (
P
=0.002) as was the total fluoroscopy time (0.8±0.3 versus 13±8 minutes,
P
=0.003) and the dose area product (96±83 versus 1531±923 microGy/m
2
,
P
=0.003). The HB capture threshold was lower in group 1 (0.7±0.4 at 1 ms) compared with patients in group 2 (1.15±0.7 at 1 ms)
P
=0.04. There were no procedure-related complications or lead dislodgements in either group. There was an increase in HB capture threshold in 1 patient (5%) in group 2 at 1-month follow-up.

Conclusions:

Electroanatomic mapping-guided PHBP is feasible can be performed safely and results in a significant reduction in fluoroscopy duration and exposure.
Talin-Dependent Integrin Activation Regulates VE-Cadherin Localization and Endothelial Cell Barrier Function
Authors: Pulous Fadi E. , Grimsley-Myers Cynthia M. , Kansal Shevali , Kowalczyk Andrew P. , Petrich Brian G.
Published: February 2019

Rationale:

Endothelial barrier function depends on the proper localization and function of the adherens junction protein VE (vascular endothelial)-cadherin. Previous studies have suggested a functional relationship between integrin-mediated adhesion complexes and VE-cadherin yet the underlying molecular links are unclear. Binding of the cytoskeletal adaptor protein talin to the β-integrin cytoplasmic domain is a key final step in regulating the affinity of integrins for extracellular ligands (activation) but the role of integrin activation in VE-cadherin mediated endothelial barrier function is unknown.

Objective:

To test the requirement of talin-dependent activation of β1 integrin in VE-cadherin organization and endothelial cell (EC) barrier function.

Methods and Results:

EC-specific deletion of talin in adult mice resulted in impaired stability of intestinal microvascular blood vessels, hemorrhage, and death. Talin-deficient endothelium showed altered VE-cadherin organization at EC junctions in vivo. shRNA (short hairpin RNA)-mediated knockdown of talin1 expression in cultured ECs led to increased radial actin stress fibers, increased adherens junction width and increased endothelial monolayer permeability measured by electrical cell-substrate impedance sensing. Restoring β1-integrin activation in talin-deficient cells with a β1-integrin activating antibody normalized both VE-cadherin organization and EC barrier function. In addition, VE-cadherin organization was normalized by reexpression of talin or integrin activating talin head domain but not a talin head domain mutant that is selectively deficient in activating integrins.

Conclusions:

Talin-dependent activation of EC β1-integrin stabilizes VE-cadherin at endothelial junctions and promotes endothelial barrier function.
Five-Year Clinical and Echocardiographic Outcomes From the NOTION Randomized Clinical Trial in Patients at Lower Surgical Risk
Authors: Thyregod Hans Gustav Hørsted , Ihlemann Nikolaj , Jørgensen Troels Højsgaard , Nissen Henrik , Kjeldsen Bo Juel , Petursson Petur , Chang Yanping , Franzen Olaf Walter , Engstrøm Thomas , Clemmensen Peter , Hansen Peter Bo , Andersen Lars Willy , Steinbruüchel Daniel Andreas , Olsen Peter Skov , Søndergaard Lars
Published: February 2019

Background:

The NOTION trial (Nordic Aortic Valve Intervention) was designed to compare transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) in patients ≥70 years old with isolated severe aortic valve stenosis. Clinical and echocardiographic outcomes are presented after 5 years.

Methods:

Patients were enrolled at 3 Nordic centers and randomized 1:1 to TAVR using the self-expanding CoreValve prosthesis (n=145) or SAVR using any stented bioprostheses (n=135). The primary composite outcome was the rate of all-cause mortality, stroke, or myocardial infarction at 1 year defined according to Valve Academic Research Consortium-2 criteria.

Results:

Baseline characteristics were similar. The mean age was 79.1±4.8 years and mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 3.0%±1.7%. After 5 years, there were no differences between TAVR and SAVR in the composite outcome (Kaplan-Meier estimates 38.0% versus 36.3%, log-rank test
P
=0.86) or any of its components. TAVR patients had larger prosthetic valve area (1.7 cm
2
versus 1.2 cm
2
,
P
<0.001) with a lower mean transprosthetic gradient (8.2 mm Hg versus 13.7 mm Hg,
P
<0.001), both unchanged over time. More TAVR patients had moderate/severe total aortic regurgitation (8.2% versus 0.0%,
P
<0.001) and a new pacemaker (43.7% versus 8.7%,
P
<0.001). Four patients had prosthetic reintervention and no difference was found for functional outcomes.

Conclusions:

These are currently the longest follow-up data comparing TAVR and SAVR in lower risk patients, demonstrating no statistical difference for major clinical outcomes 5 years after TAVR with a self-expanding prosthesis compared to SAVR. Higher rates of prosthetic regurgitation and pacemaker implantation were seen after TAVR.

Clinical Trial Registration:

URL:
https://clinicaltrials.gov
. Unique identifier: NCT01057173.
Descriptions of eight new species of the genus Parancistrocerus Bequaert (Hymenoptera: Vespidae: Eumeninae), with a key to the Oriental species
Authors: LI TINGJING , CARPENTER JAMES M.
Published: February 2019

Eight new species, namely Parancistrocerus latitergus sp. nov. (China), P. lamnulus sp. nov. (China), P. laticlypeus sp. nov. (Thailand), P. prominens sp. nov. (Thailand), P. guangxiensis sp. nov. (China), P. discarinatus sp. nov. (Thailand), P. abyssicavus sp. nov. (Thailand), and P. similiandrocles sp. nov. (China) are described and illustrated. Parancistrocerus samarensis (von Schulthess, 1934) and P. incorruptus incorruptus Giordani Soika, 1972, are newly recorded from China and Thailand, respectively. An updated key to the Oriental species of the genus Parancistrocerus is also given.
On the second specimen of Atractus alytogrammus (Serpentes: Dipsadidae), with description of its unusual hemipenial morphology
Authors: ANGARITA-SIERRA TEDDY
Published: February 2019

The semi-fossorial snakes of the genus Atractus Wagler 1828 are widely distributed throughout South America, ranging from Panama to northeastern Argentina at elevations from sea level to 4500 m (Passos et al. 2013a). Atractus currently comprises 150 species that inhabiting several types of tropical habitats, being the most diverse genus of snakes in the world (Passos et al. 2018). Colombia harbours the most species richness of the genus with about 42 currently recognized species, representing about 1/3 of generic diversity (Uetz et al. 2018). Köhler & Kieckbusch (2014) recently has named Atractus alytogrammus based on an individual collected by Federico Meden more than fifty years ago near the municipality of San José de Guaviare (2°33’55’’N, 72°38’19’’W). The second known specimen of A. alytogrammus was found by A.F. Aponte (male, ICN-R-13018) hidden under a pile of palm leaves (3°00’05"N, 72°13’9.9"W; 209 m above sea level) at 7:58 am on February 02 2016 in the oil palm plantations of POLIGROW Colombia Ltda, municipality of Mapiripán, department of Meta, Colombia. This region is located in the Orinoquia-Amazonia ecotone 82 Km (airline) northeast from the type-locality (Fig. 1). I report herein the unknown color in life (Fig. 2), change of shades after preservation (Fig. 3B–D) and hemipenial morphology (Fig. 4), besides amplifying the meristic and morphometric variability of this poorly known species (Table 1).
Explicit Ensemble Prediction of Hail in 19 May 2013 Oklahoma City Thunderstorms and Analysis of Hail Growth Processes with Several Multimoment Microphysics Schemes
Authors: Labriola Jonathan , Snook Nathan , Jung Youngsun , Xue Ming
Published: February 2019

Hail forecast evaluations provide important insight into microphysical treatment of rimed ice. In this study we evaluate explicit 0–90-min EnKF-based storm-scale (500-m horizontal grid spacing) hail forecasts for a severe weather event that occurred in Oklahoma on 19 May 2013. Forecast ensembles are run using three different bulk microphysics (MP) schemes: the Milbrandt–Yau double-moment scheme (MY2), the Milbrandt–Yau triple-moment scheme (MY3), and the NSSL variable density-rimed ice double-moment scheme (NSSL). Output from a hydrometeor classification algorithm is used to verify surface hail size forecasts. All three schemes produce forecasts that predict the coverage of severe surface hail with moderate to high skill, but exhibit less skill at predicting significant severe hail coverage. A microphysical budget analysis is conducted to better understand hail growth processes in all three schemes. The NSSL scheme uses two-variable density-rimed ice categories to create large hailstones from dense, wet growth graupel particles; however, it is noted the scheme underestimates the coverage of significant severe hail. Both the MY2 and MY3 schemes produce many small hailstones aloft from unrimed, frozen raindrops; in the melting layer, hailstones become much larger than observations because of the excessive accretion of water. The results of this work highlight the importance of using a MP scheme that realistically models microphysical processes.
Improving self-regulation and executive functioning skills in primary school children in a remote Australian Aboriginal community: A pilot study of the Alert Program®
Authors: Wagner Bree , Olson Heather Carmichael , Symons Martyn , Mazzucchelli Trevor G , Jirikowic Tracy , Latimer Jane , Watkins Rochelle , Cross Donna , Boulton John , Wright Edie , Carter Maureen , Bruce Kaashifah , Cherel Sue , Fitzpatrick James
Published: February 2019

Self-regulation and executive functioning impairments are common in children with fetal alcohol spectrum disorder. Given the high rates of fetal alcohol spectrum disorder identified amongst children living in the remote Fitzroy Valley region of Western Australia, the Alert Program® was identified as a culturally safe intervention for use in local primary schools. Researchers collaborated with Aboriginal Elders, community members, and staff from a Fitzroy Valley primary school to trial the Alert Program®. Teachers were trained to deliver eight Alert Program® lessons to children in class. Self-regulation and executive functioning were measured using teacher and parent/caregiver questionnaires three times. Data were analyzed using repeated-measures ANOVA. Teacher-led delivery of the Alert Program® was feasible in a region with high fetal alcohol spectrum disorder rates. As measured by teacher and parent/caregiver ratings, this curriculum may improve the self-regulation and executive functioning of children for some outcomes and provide sustained effects for some children. This community partnered pilot research, evaluated a school-based program to reduce the behavioral impact of fetal alcohol spectrum disorder, and informed design of a larger trial across eight Aboriginal community schools.
The effect of carbon nanofibers on fresh and mechanical properties of lightweight engineered cementitious composite using hollow glass microspheres
Authors: Aslani Farhad , Wang Lining , Zheng Meizhiwen
Published: February 2019

Hollow glass microsphere (HGM) according to the preferred embodiments may be used as fillers in composite materials, where they impart properties of cost reduction, weight reduction, improved processing performance enhancement, improved machinability and/ or improved workability. More specifically, the HGMs may be used as inorganic cementitious materials, concrete systems, and ceramics. On the other hand, carbon nanofibers (CNFs) are becoming domination in the market of nanomaterials because of its unique properties and its potential to reinforce cementitious materials. To take advantage of both the low density of HGMs and the high mechanical performance of CNFs, this study aims to develop lightweight engineered cementitious composite (LWECC) by adopting a novel material combination of HGMs and CNF. By replacing 40% of fly ash with HGMs, this study successfully developed LWECC mixes with desirable workability and density due to the smooth surface, spherical shape and low density of HGM. Due to the extra reinforcement effect of CNF, the developed LWECC composite is able to achieve lightweight without disturbance of mechanical strength compared to normal weight ECC. The newly developed LWECC is able to achieve a density less than 1820 kg/m3 with compressive and flexural strength up to 48 MPa and 8 MPa, respectively.
Ten years on from an appraisal of litigation against English Health Trusts in otolaryngology: What have we learnt?
Authors: Zorlu N , Nash R , Srinivasan R
Published: February 2019

NHS Resolution provides indemnity cover for legal claims against the NHS, assists the NHS with risk management and aims to share lessons from claims in order to improve safety. The study aimed to investigate the financial costs of litigation against English Health Trusts in otolaryngology over a 10-year period, to see if any lessons have been learned and identify trends that may lead to a potential reduction in costs and improve patient safety. A Freedom of Information request was made to NHS Resolution for information regarding claims made to otolaryngology departments over the last 10 years. There was a total of 612 successful claims in the 10-year period between 2008/2009 and 2017/2018 with costs of nearly £87 million. Overall, the costs of litigation have increased dramatically, and the main areas for these successful claims can be identified, but restrictions in the detail of information released allows too little insight for improvements to be made to avoid them in future. This continues to be a major problem for healthcare funding and practice.
Family Firms as Institutions: Cultural reproduction and status maintenance among multi-centenary shinise in Kyoto
Authors: Sasaki Innan , Ravasi Davide , Micelotta Evelyn
Published: February 2019

Our study investigated how multi-centenary family firms in the area of Kyoto – collectively known as shinise – maintain a high social status in the community. Our analysis unpacks the socio-cultural practices through which the ongoing interaction among these actors re-enacts and reproduces the social order that ascribes shinise a distinct social standing in exchange for their continued commitment to practices and structures that help the community preserve its cultural integrity and collective identity. By doing so, our findings trace a connection between status maintenance and the expressive function that a category of firms performs within a community. At the same time, our study reveals a dark side of high status, by showing how their commitments lock shinise in a position of ‘benign entrapment’ that may impose sacrifices on family members and severe limitations to their personal freedom.
“It’s Not Discrimination”: Chinese Migrant Workers’ Perceptions of and Reactions to Racial Microaggressions in Australia
Authors: Li Yao-Tai
Published: February 2019

Racial microaggressions appear in different forms and affect racial and ethnic groups through everyday practices. We know little, however, about how racial microaggressions are perceived and operate in the context of institutionalized racism. In an immigration context, the structural mechanisms that influence migrant workers’ interpretations of racial microaggressions remain understudied. This article examines job-search processes, self-perceptions of foreign-ness, group interactions, and work experiences of Chinese migrant workers in Australia. I argue that the intersection of foreign-ness, human capital, and migrant status reflects structural inequality in the field of overseas employment, which involves an ideological system that reminds migrant workers of their differences/otherness when racial microaggressions happen. The intersection also influences how migrant workers interpret and react to such microaggressions. Meanwhile, workplace relations and interaction patterns ease tensions between advantaged and disadvantaged groups, yet persistent racial stereotypes and unequal race relations are maintained in everyday life.
Timing of Anticoagulation in Atrial Fibrillation Status Post Cardioembolic Stroke
Authors: Core Ashley , Pinner Nathan , Bethea Brittany , Starr Jessica A.
Published: February 2019

Background:

Anticoagulation is the mainstay of secondary stroke prevention in patients with atrial fibrillation; however, few studies have assessed the optimal timing for initiation of anticoagulation post cardioembolic stroke. In the 2 weeks following an acute cardioembolic stroke, the risk of recurrent stroke is as high as 8%, but this risk must be balanced against the risk of hemorrhagic transformation with early initiation of anticoagulation.

Purpose:

This study described the time to initiation of anticoagulation and evaluated the in-hospital incidence of hemorrhagic and ischemic complications in 106 patients with atrial fibrillation post an acute cardioembolic stroke.

Methods:

A single-center retrospective cohort study was conducted to describe the time to initiation of therapeutic anticoagulation in patients with atrial fibrillation admitted to the hospital for an acute cardioembolic stroke. The primary outcome was the time to initiation of anticoagulation from the time of stroke onset. Secondary outcomes included the incidence of in-hospital hemorrhagic and ischemic complications.

Results:

The median time to initiation of anticoagulation was 59.5 hours after stroke onset for those who did not receive thrombolytic therapy and 82.6 hours for those who did received thrombolytic therapy. Out of 100 patients initiated on anticoagulation, no ischemic complications were observed. Four patients experienced a hemorrhagic conversion following initiation of anticoagulation. In 3 of these patients, anticoagulation was initiated within 48 hours of stroke onset.

Conclusion:

A small percentage of patients experienced an in-house hemorrhagic conversion when anticoagulation was initiated between 48 hours and 7 days.