bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Study of the Effect of Tinnitus Sound Matching Degree on the Efficacy of Customized Sound Therapy in Patients with Chronic Tinnitus
Authors: Wang JinYu , Ding Juan , Song Jing , Hu Li , Cong Ning , Han Zhao
Published: September 2021

Objectives: The aim of this study was to explore and compare the customized sound therapy effect between tinnitus sound matching and nonmatching patients in tinnitus customized sound therapy and therapy-related influencing factors. Methods: This prospective study investigated a total of 100 patients with unilateral chronic tinnitus who received customized sound therapy. The participants were dichotomously divided into matching (group A) and nonmatching (group B) groups after 4 stages of tinnitus matching via the tinnitus assistant app (provided by Sound Ocean Company, SuZhou, China). Each group consists of 50 participants. Before and 6 months after the treatment, Hospital Anxiety and Depression Scale (HADS), tinnitus handicap inventory (THI), and tinnitus loudness Visual Analog Scale (VAS) were used to evaluate the customized sound therapy effect and explore other related influencing factors. Results: (1) The HADS-A, HADS-D, THI, and VAS scores of 2 groups were both significantly decreased after treatment. (2) The HADS-A and THI scores improved markedly in group A than that in group B, which could be related to the hearing loss of the tinnitus side ear before treatment; the lighter the degree of hearing loss, the better the improvement. No statistically significant differences were detected in HADS-D and VAS scores between the 2 groups, and also, these were not related to the degree of hearing loss. The differences in age, gender, and tinnitus duration did not show any statistically significant effect on the improvement of the 2 groups. Conclusions: Both tinnitus sound matching and nonmatching of the customized sound therapy brought a significant effect to tinnitus participants. Our study also suggests that THI and HADS-A scores of those with tinnitus matching participants improved markedly as compared to those of nonmatching participants, and the customized sound therapy effect is negatively correlated with the severity of hearing loss.
Therapeutic Effect of Combined Dabrafenib and Trametinib Treatment of BRAF V600E-Mutated Primary Squamous Cell Carcinoma of the Thyroid: A Case Report
Authors: Brandenburg Tim , Muchalla Philipp , Theurer Sarah , Schmid Kurt Werner , Führer Dagmar
Published: September 2021

Introduction: Primary squamous cell carcinoma (PSCC) of the thyroid is an exceptionally rare malignancy accounting for <1% of all primary thyroid cancers. Therapy is multimodal including surgery, radiotherapy, and chemotherapy but with no consensus for management and therapy. Here, we describe a case of a male patient who presented with a BRAF V600E-mutated PSCC of the thyroid gland showing response to combined dabrafenib and trametinib therapy over a period of >12 months. Case Presentation: A 78-year-old male patient presented with a 3-week history of dysphonia and dyspnoea. Laryngoscopy revealed a mechanical obstruction by a right-sided, subglottical mass, which on cervical ultrasound was highly suggestive of anaplastic thyroid carcinoma. Additional workup including esophagogastroduodenoscopy showed compression of the oesophagus but no oesophageal infiltration by the tumour. Immunohistochemistry displayed CK19-positive cells indicating epithelial origin of the tumour. CK5/6 and P40 immunohistochemistry confirmed the morphological impression of squamous cell differentiation while staining with thyroid markers TTF-1 and TPO was negative and PAX8 showed a nuclear positive signal. Based on immunohistopathology, presence of TP53 and BRAF V600E mutations, and exclusion of metastatic squamous cell carcinoma of other origin, the diagnosis of a PSCC of the thyroid was established. As an individualized treatment concept, we decided to advocate combined BRAF V600E targeting by the multikinase inhibitors dabrafenib and trametinib. This led to drastic improvement in patient’s quality of life without severe side effects over a period of >12 months. Conclusion: In this case, molecular diagnosis allowed a highly individualized treatment concept with combined dabrafenib and trametinib therapy.
A Case of α-Gal-Unrelated Red Meat-Induced Urticaria Treated by Omalizumab
Authors: Kondo Makoto , Matsushima Yoshiaki , Iida Shohei , Umaoka Ai , Nakanishi Takehisa , Habe Koji , Yamanaka Keiichi
Published: September 2021

A 70-year-old healthy woman was referred to our hospital for chronic urticaria. She did not have a history of allergy, asthma, and rhinitis. She was initially diagnosed with α-gal-related urticaria based on an episode of delayed-type urticaria after eating red meat. The results of the intracutaneous allergen test for beef and pork were negative. Fluorenzyme immunoassays specific for IgE against α-gal, beef, and pork were also negative. She was diagnosed with an α-gal-unrelated red meat allergy following the reproduction of urticaria by a food challenge test. The patient was unresponsive to several drugs, including antihistamines or immunosuppressants. However, omalizumab administration suppressed her symptoms. Key Clinical Message: The diagnosis of red meat allergy may require a repeatability test by consuming red meat even though serum α-gal IgE antibody might be negative. The α-gal-unrelated red meat urticaria may be responsive to omalizumab.
Downregulation of Arntl mRNA Expression in Women with Hypertension: A Case-Control Study
Authors: Fang Zhengmei , Zhu Lijun , Jin Yuelong , Chen Yan , Chang Weiwei , Yao Yingshui
Published: September 2021

Background: Previous studies have reported that disturbance of endogenous circadian rhythms enhances the chance of hypertension and suggested that circadian clock genes could have a crucial function in the onset of the disease. This case-control study was aimed to investigate the association of the mRNA expression of aryl hydrocarbon receptor nuclear translocator like (Arntl), clock circadian regulator (Clock), and period circadian regulators 1 and 2 (Per1 and Per2) with hypertension and blood pressure levels. Methods: A total of 172 subjects were recruited in this study, including 86 hypertension and 86 nonhypertension controls. The mRNA expression levels in peripheral blood mononuclear cells were determined by real-time quantitative polymerase chain reaction. The differences in Arntl, Clock, Per1, and Per2 mRNA expression were compared between the 2 groups, and the relationship between mRNA expression and cardiometabolic risk profiles was also assessed. Results: We found that the mRNA expression of Arntl was downregulated in the hypertension cases compared with controls in women (1.10 [0.66, 1.71] vs. 1.30 [0.99, 2.06], p = 0.031). There was a significant negative correlation between the Arntl mRNA expression and SBP (r = −0.301, p = 0.004) and DBP (r = −0.222, p = 0.034) in women. In men, a negative correlation between the Per1 mRNA expression and SBP (r = −0.247, p = 0.026) was found. Conclusions: The Arntl mRNA expression may play an important role in progression of hypertension in women.
Einfluss einer achtsamkeitsbasierten Depressionsbehandlung in einer Tagesklinik auf arbeitsbezogene Bewältigungsmuster bei depressiven Patientinnen und Patienten mit berufsbezogenen Konflikten
Authors: Buxton Alice E. , Remmers Carina , Köhling Johanna , Michalak Johannes
Published: September 2021

Hintergrund: Ziel der Studie war es, den Einfluss einer achtsamkeitsbasierten Depressionsbehandlung in einer Tagesklinik auf arbeitsbezogene Bewältigungsmuster bei Patientinnen und Patienten mit einer akuten depressiven Episode und berufsbezogenen Konflikten zu untersuchen. Methode: In einer Pilotstudie wurden 81 Patientinnen und Patienten mit einer mittelgradigen oder schweren depressiven Episode und berufsbezogenen Konflikten entweder einer tagesklinischen achtsamkeitsbasierten Depressionsbehandlung (mit psychopharmakologischer Medikation bei Bedarf, N = 47) oder einer Kontrollbedingung mit psychopharmakologischer Beratung (N = 34) zugeordnet. Arbeitsbezogene Bewältigungsstile und -muster wurden mit dem Fragebogen für arbeitsbezogenes Erlebens- und Verhaltensmuster (AVEM) zu drei Messzeitpunkten (Beginn, Ende und 8-Monats-Katamnese) untersucht, um gesundheitsgefährdende Risikomuster zu untersuchen. Zudem wurde die psychopathologische Symptombelastung anhand des Beck-Depressions-Inventars (BDI-II) und des Brief-Symptom-Inventory (BSI) gemessen. Ergebnisse: Die achtsamkeitsbasierte Depressionsbehandlung reduzierte die psychopathologische Symptombelastung signifikant und bewirkte eine positive Veränderung umschriebener gesundheitsgefährdender arbeitsbezogener Bewältigungsstile und Risikomuster hin zu gesundheitsförderlichen Bewältigungsstilen. Diskussion: Wenngleich Risikomuster durch die achtsamkeitsbasierte Depressionsbehandlung nur zum Teil abgebaut werden konnten, sind die Ergebnisse vielversprechend in Bezug auf gesundheitsförderliche Veränderungen einzelner arbeitsbezogener Bewältigungsstile wie “Verausgabungsbereitschaft”, “Perfektionsstreben”, “Distanzierungsfähigkeit” und “Innere Ruhe/Ausgeglichenheit”. Schlussfolgerung: Die psychiatrische Versorgung von Patientinnen und Patienten mit einer Depression sollte arbeitsbedingte Stressfaktoren und Konflikte und deren Bewältigung berücksichtigen. Das Behandlungskonzept schließt eine Lücke in der psychiatrischen Versorgung.
The Impact of Stereotactic or Whole Brain Radiotherapy on Neurocognitive Functioning in Adult Patients with Brain Metastases: A Systematic Review and Meta-Analysis
Authors: van Grinsven Eva Elisabeth , Nagtegaal Steven H.J. , Verhoeff Joost J.C. , van Zandvoort Martine J.E.
Published: September 2021

Background & Objectives: Radiotherapy is standard treatment for patients with brain metastases (BMs), although it may lead to radiation-induced cognitive impairment. This review explores the impact of whole-brain radiotherapy (WBRT) or stereotactic radiosurgery (SRS) on cognition. Methods: The PRISMA guidelines were used to identify articles on PubMed and EmBase reporting on objective assessment of cognition before, and at least once after radiotherapy, in adult patients with nonresected BMs. Results: Of the 867 records screened, twenty articles (14 unique studies) were included. WBRT lead to decline in cognitive performance, which stabilized or returned to baseline in patients with survival of at least 9–15 months. For SRS, a decline in cognitive performance was sometimes observed shortly after treatment, but the majority of patients returned to or remained at baseline until a year after treatment. Conclusions: These findings suggest that after WBRT, patients can experience deterioration over a longer period of time. The cognitive side effects of SRS are transient. Therefore, this review advices to choose SRS as this will result in lowest risks for cognitive adverse side effects, irrespective of predicted survival. In an already cognitively vulnerable patient population with limited survival, this information can be used in communicating risks and aid in making educated decisions.
Application of DPC and DPC-GA to the dual-rotor wind turbine system with DFIG
Authors: Benbouhenni Habib
Published: September 2021

The work presents the dual-rotor wind energy conversion system (DRWECS) with a direct driven doubly-fed induction generator (DFIG). The system consists of a dual-rotor wind turbine (DRWT) with a DFIG, the grid side converter (GSC), and the machine side converter (MSC). To command the MSC, the direct power command (DPC) based on genetic algorithm (GA) and classical pulse width modulation (PWM) has been applied. To achieve the maximum power from the DRWT, the maximum powe point tracking (MPPT) technique has been used. The performed simulation studies confirmed the high performances of the DPC-GA contro method.
АНАЛІЗ ЕКОНОМІЧНОЇ ДОСТУПНОСТІ ОКРЕМИХ ГРУП КАРДІОЛОГІЧНИХ ПРЕПАРАТІВ В УКРАЇНІ ЗА 2016-2020 РОКИ
Authors: Symonenko N. A. , Podgaina M. V. , Nemchenko A. S. , Shpychak O. S.
Published: September 2021

Мета роботи. Аналіз економічної доступності ЛЗ фармакотерапевтичної групи ІІ рівня анатомічно-терапевтично хімічної класифікації – «Кардіологічні препарати» на вітчизняному фармацевтичному ринку у 2016-2020 роках.
Матеріали і методи. Дані щодо пропозицій дистриб’юторів були отримані на платформі «Моріон» за 2016-2020 роки, усереднено пропозиції дистриб’юторів за групою «Кардіологічні препарати», код АТХ С01. Здійснено аналіз роздрібних цін за ЛП групи С01 – кардіологічні препарати, та окремо за групою C01E Х – Різні комбіновані кардіологічні препарати. За результатами розрахунків ланцюгового індексу цін (Ір), показників адекватності платоспроможності (Cas) та економічної доступності (D) встановлено загальні тенденції до росту роздрібних цін кардіологічних препаратів в Україні впродовж останніх 5-ти років та необхідність до імпортозаміщення ЛЗ за групою, що досліджується.
Результати й обговорення. Найвищим значенням індексу роздрібних цін впродовж 2016-2020 років характеризувалася група – С01 А – Серцеві глікозиди, найменший показник росту цін відповідав групі С01 В – Антиаритмічні засоби. Встановлено, що для всіх фармакотерапевтичних підгруп групи С01 було характерне щорічне зниження показника адекватності платоспроможності. Одночасно визначено динаміку підвищення економічної доступності в середньому на 5 % – з 2,46 в 2016 р. до 2,33 в 2020 р. Встановлено, що для групи C01E Х «Різні комбіновані кардіологічні препарати» показали, що зберігаються тенденції, характерні для усієї групи С01 «Кардіологічні препарати».
Висновки. Визначено загальну тенденцію до помірного росту цін, разом з тим розраховані показники доступності дозволили визначити динаміку до поступового росту економічної доступності кардіологічних препаратів, у тому числі групи C01E Х – Різні комбіновані кардіологічні препарати.
Saturnino de Brito e o traçado sanitário da cidade de Santa Maria/RS
Authors: Piccinato Junior Dirceu
Published: September 2021

O objetivo do presente artigo é discutir sobre o traçado sanitário de Santa Maria, cidade do estado do Rio Grande do Sul, sob a perspectiva da forma urbana sanitarista articulada pelo engenheiro sanitarista Saturnino de Brito em 1918. O processo de urbanização que aconteceu a partir das primeiras décadas do século XX foi determinante para o crescimento das cidades brasileiras em condições socioambientais inadequadas. Com os avanços da microbiologia, surge a figura de um profissional que tinha domínio para atuar frente a essa realidade: o engenheiro sanitarista. A compreensão do urbanismo sanitarista de Brito tinha como desígnio dois temas: os problemas de salubridade na transformação dos espaços urbanos e a construção das cidades.
Beleza e corpo no De architectura de Vitrúvio: uma questão em aberto
Authors: D'Agostino Mário Henrique Simão
Published: September 2021

Os estilos de elocução «tenro», «médio» e «elevado», operantes na Retórica e Poética Clássicas, podem fornecer insumos para o entendimento do que historiadores têm assinalado como elementos contraditórios na tessitura do De architectura, escrito pelo arquiteto romano Vitrúvio no último quartel do século I a.C.. A conhecida analogia vitruviana da arquitetura como um corpo bem conformado vem aqui considerada por regimes de compositio possíveis de serem identificados no tratado, a invitar indagações sobre o influxo das noções de belo e sublime na ordenação da obra.
O Manifesto dos Tratados de Arquitetura em Vila Rica Setecentista: o pórtico toscano do Palácio dos Governadores de José Fernandes Pinto Alpoim
Authors: Tognon Marcos
Published: September 2021

Projetado em 1740 pelo engenheiro militar português José Fernandes PInto Alpoim, o Palácio dos Governadores, na então cidade de Vila Rica, hoje Ouro Preto, representou a definitiva instauração do poder de Dom João V na prometida terra do ouro que, após muitas insubordinações sociais desde os primeiros anos de 1700, seria intensamente urbanizada, civilizada, monumentalizada pelo seu governador, Gomes Freire de Andrade, efetivando assim a sua subordinação e deferência à monarquia e aos valores lusitanos. Palácio fortaleza que foi implantado entre as duas paróquias mais densamente habitadas da vila, e cujo pórtico de entrada trazia, em sua composição formal e proporcional, o mais límpido manifesto da linguagem arquitetônica cultuada nos tratados de Arquitetura desde o século XVI.
Avaliação da segurança viária pela percepção do cidadão francano: estudo de caso das principais avenidas, localizadas na cidade de Franca / SP
Authors: Velazquez Fernando Luis , Suave Leonardo , Simari Túlio Benetti , Coelho Tassiane de Paula Pinheiro
Published: September 2021

A cidade escolhida para o estudo foi a cidade de Franca/SP, a qual chamou a atenção pelo elevado número de acidentes com vítimas fatais ocorridos no ano de 2018: cerca de 39 mortes registradas. Um dos principais fatores, tomado como determinante para esse estudo foi o excesso de velocidade nas vias. Diante disso, o estudo tem como objetivo avaliar 7 das 28 avenidas principais da cidade, sendo elas: Av. Brasil, Av. Chico Júlio, Av. Dr. Alonso y Alonso, Av. Dr. Hélio Palermo, Av. Major Nicácio, Av. Orlando Dompieri e Av. Presidente Getúlio Vargas. Assim, as avaliações dessas vias tiveram como base a relação junto à segurança viária por meio da percepção do cidadão francano, com o intuito de proporcionar possíveis soluções mitigadoras, para o desenvolvimento de trânsito mais otimizado, seguro e democrático. A metodologia foi baseada na avaliação da percepção dos usuários das avenidas citadas, em relação a segurança do trânsito proporcionada aos pedestres, motociclistas e motoristas, por meio de entrevistas, cuja abordagem foi de cunho pessoal e online. Os resultados obtidos informaram que 37% dos entrevistados sofreram um ou mais de um tipo de acidente. De acordo com a literatura são apontados 6 tipos de acidentes, que no geral se totalizaram em 106 ocorrências. As avenidas Alonso Y Alonso e Brasil foram as que apresentaram maior percentual e quantidade de acidentes, tanto para motoristas/motociclistas, quanto para pedestres. De forma geral, a pesquisa resultou que cerca de 52% dos entrevistados sugeriram melhorias em sinalização. Ao passo que cerca de 82% dos mesmos apontaram necessidades no aumento de conscientização do trânsito, ressaltando que nessa pesquisa os entrevistados poderiam optar por mais de uma melhoria.
Análise da ventilação natural em uma habitação de interesse social, com diferentes configurações de muro, através de simulações CFD
Authors: Xavier Ana Clara de Almeida , Lukiantchuki Marieli Azoia
Published: September 2021

A ventilação natural é uma estratégia eficiente para o condicionamento térmico passivo de edificações. No entanto, muitas vezes esse recurso é subutilizado em habitações de interesse social (HIS), caracterizadas por projetos padrões sem considerar as características climáticas da região. Além disso, essas habitações são implantadas em lotes pequenos com a presença de muros para segurança e privacidade dos moradores, impactando significativamente no aproveitamento dos ventos externos. O artigo aborda como os projetos das HIS são muito subutilizados do ponto de visto da ventilação natural, visto que o uso de estratégias simples e de baixo custo ajudam no conforto térmico além de manter a segurança e a privacidade dos moradores, tais como o uso de muros permeáveis.
Fadiga e uso de álcool por graduandos do curso de Enfermagem
Authors: Silva Nathálie Dias de Oliveira , Machado Gabriel Fernandes , Junqueira Marcelle Aparecida de Barros
Published: September 2021

Objetivo: analisar o uso de álcool no padrão binge drinking e os níveis de fadiga em graduandos do curso em Enfermagem na Universidade Federal de Uberlândia. Método: a pesquisa é de abordagem quantitativa, utilizando estatísticas descritivas e bivariadas, com o valor de p>0,05, e realizada conforme a Resolução nº 466/12 do CNS. Assim, foram aplicados questionários em uma amostra com 202 universitários da graduação em Enfermagem da Universidade Federal de Uberlândia. Resultados: o estudo mostrou a maior predominância do álcool no sexo feminino, com idade média de 22,6 anos de idade. Conclusão: a análise e a discussão dos dados possibilitaram afirmar que o uso abusivo de álcool está presente, principalmente na forma de binge drinking, e encontra-se associado à presença da fadiga e ao desempenho acadêmico nos universitários da graduação em Enfermagem, em diferentes períodos letivos.
deixis: uma proposta de anotação em XML no âmbito do texto
Authors: Magalhães Miguel , Goncalves Matilde
Published: September 2021

Neste trabalho, propomos uma metodologia para a anotação dos deíticos e da deixis em XML. A utilização da linguagem XML para a anotação de corpora tem conhecido um desenvolvimento nos últimos anos, com a publicação de diversas metodologias ou refinamento de outras já existentes. Mas a anotação da deixis tem colocado problemas uma vez que esta opera a vários níveis. De facto, a análise da deixis depende de um conjunto de elementos linguísticos, mais ou menos expressos que não podem ser analisados individualmente, mas sim na relação que estabelecem entre eles e o contexto de produção e de circulação dos textos. Esta contingência conduz a problemas de sobreposição de níveis de análise. A metodologia, aqui apresentada, não só é sensível às relações com o contexto de produção e circulação dos textos, como também permite analisar essas mesmas relações sob diversas perspectivas.
Das aktienrechtliche Freigabeverfahren nach § 246a AktG: Normzweck, Anwendungsvoraussetzungen und Reformbedarf
Authors: Alves Giulia Ferrigno Poli Die Alves
Published: September 2021

Die Probleme des Freigabeverfahrens, klassisches Thema im deutschen Gesellschaftsrecht, lassen sich durch die Gegenüberstellung zweier Faktoren zusammenfassen: einerseits, die Verpflichtung, einige Hauptversammlungsbeschlüsse zu registrieren, damit sie Rechtswirkungen entfalten können – die sogenannten „eintragungsbedürftigen Hauptversammlungsbeschlüsse“; andererseits, das Recht jedes einzelnen Aktionärs, die Rechtmäßigkeit der Hauptversammlungsbeschlüsse mittels der Anfechtungs- und Nichtigkeitsklagen (die zusammen als „Beschlussmängelklagen“ bezeichnet werden) zu kontrollieren. In der deutschen gesellschaftsrechtlichen Praxis werden jedoch lediglich Beschlüsse im Handelsregister eingetragen, gegen die keine Beschlussmängelklage anhängig ist. Mit anderen Worten, die Überschneidung dieser beiden Faktoren führt zusammen mit der praktischen Dynamik des Eintragungssystems zu einer Blockade-Situation. Mit der Einführung des Freigabeverfahren hat das Gesetzgeber darauf abgezielt, die Blockade zu überwinden und die Beschlüsse trotz anhängiger Klage registrieren zu lassen. Ungeachtet seiner unwiderlegbaren praktischen Bedeutung stellt das Verfahren eine Vielzahl von ungelösten Rechtsfragen zur Diskussion.
Mixoma odontogênico e seus diagnósticos diferenciais com base no coeficiente de difusão aparente: relato de caso e breve revisão da literatura
Authors: Alves Andreza Oliveira , Macedo Lady Jane da Silva , Silva Nickolas Souza , Oliveira Giuliano da Paz , Pinto Antonione Santos Bezerra
Published: September 2021

Objetivo: Este relato discute as principais descobertas advindas da análise de imagens radiográficas relacionadas ao mixoma odontogênico, enfatizando a importância dos valores do coeficiente de difusão aparente (ADC) no diagnóstico. Relato de caso: Uma paciente do sexo feminino buscou tratamento por conta de um edema na região da maxila, associado a dispneia noturna. O uso de tomografia computadorizada de eixo cônico revelou uma imagem hipodensa invadindo o seio maxilar direito. O valor médio do ADC foi 2,07 ± 0,30 × 10-³ mm²/s e contribuiu para a definição da hipótese de diagnóstico, diferenciando a lesão de seu principal diagnóstico diferencial. Exame histopatológico confirmou a suspeita de mixoma odontogênico. Conclusão: Mixoma odontogênico é uma rara e benigna neoplasia mesenquimal, de caráter localmente agressivo. Parâmetros de sequência de difusão e valores ADC podem ser úteis para diferenciar o mixoma odontogênico de outras lesões odontogênicas.
Sex-Related Differences in the Prevalence and Prognostic Value of the Academic Research Consortium for High Bleeding Risk Criteria
Authors: Nardin Matteo , Cao Davide , Mehran Roxana , Chandiramani Rishi , Chiarito Mauro , Sartori Samantha , Qiu Hanbo , Zhang Zhongjie , Golani Ekta , Nicolas Johny , Baber Usman , Dangas George , De Luca Giuseppe , Stefanini Giulio G. , Sweeny Joseph , Sharma Samin K. , Kini Annapoorna
Published: September 2021

Background:

Bleeding events after percutaneous coronary intervention are associated with substantial morbidity and mortality. Female patients undergoing percutaneous coronary intervention are often older and present with a higher burden of comorbidities, which in turn increases their risk of adverse events, including bleeding complications. The Academic Research Consortium (ARC) have proposed a list of clinical criteria to define high bleeding risk (HBR). Our aim was to evaluate the prevalence and predictive value of the ARC-HBR criteria according to sex in a contemporary cohort of patients undergoing percutaneous coronary intervention.

Methods:

All consecutive patients receiving coronary stenting between 2014 and 2017 at a tertiary-care center were defined as HBR if they fulfilled at least 1 major or 2 minor ARC-HBR criteria. The primary bleeding end point was the composite of periprocedural in-hospital or postdischarge bleeding up to 1 year. Individual components of the primary bleeding end point, all-cause mortality, and myocardial infarction were also evaluated.

Results:

Of the total 9623 patients, 6979 (72.5%) were male and 2644 (27.5%) female. The prevalence of HBR was significantly higher in females compared with males (56.5% versus 39.9%,
P
<0.001). With regard to the individual criteria, moderate/severe anemia and moderate chronic kidney disease were more common in females, while oral anticoagulation and mild anemia were more frequent among males. The presence of HBR was associated with an increased risk of bleeding in both females (10.0% versus 4.4%; hazard ratio, 2.57 [95% CI, 1.80–3.67];
P
<0.001) and males (8.7% versus 2.9%; hazard ratio, 3.19 [95% CI, 2.50–4.08];
P
<0.001)(p
interaction
=0.344). The ARC-HBR criteria associated with the highest bleeding risk at 1 year were severe/end-stage chronic kidney disease and thrombocytopenia in females, and moderate/severe anemia in males.

Conclusions:

In a real-world cohort of percutaneous coronary intervention patients, females were more often at HBR than males. The prognostic value of the ARC-HBR definition was consistent between female and male patients, despite sex-related differences in the prevalence and bleeding risk associated with individual ARC-HBR criteria.
Bleeding and Subsequent Cardiovascular Events and Death in Atrial Fibrillation With Stable Coronary Artery Disease: Insights From the AFIRE Trial
Authors: Kaikita Koichi , Yasuda Satoshi , Akao Masaharu , Ako Junya , Matoba Tetsuya , Nakamura Masato , Miyauchi Katsumi , Hagiwara Nobuhisa , Kimura Kazuo , Hirayama Atsushi , Matsui Kunihiko , Ogawa Hisao ,   on behalf of the AFIRE Investigators
Published: September 2021

Background:

Early bleeding after percutaneous coronary intervention is associated with increased risk of death and myocardial infarction; however, the association between bleeding and subsequent major adverse cardiac and cerebrovascular events (MACCE) remains unclear in patients with atrial fibrillation and stable coronary artery disease. We thus aimed to investigate this association.

Methods:

The AFIRE trial (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) was a multicenter, open-label trial conducted in Japan. This post hoc analysis included 2215 patients with atrial fibrillation and stable coronary artery disease treated with rivaroxaban or rivaroxaban plus an antiplatelet agent. MACCE was defined as a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death from any cause. The association of bleeding with subsequent MACCE risk was investigated using time-adjusted Cox multivariate analysis after adjusting for baseline characteristics and time from bleeding. Bleeding events were classified according to the International Society on Thrombosis and Haemostasis criteria.

Results:

Among the 2215 patients, 386 (17.4%) had bleeding during follow-up, of whom 63 (16.3%) also experienced MACCE; MACCE incidence was higher in patients with bleeding than in those without (8.38% versus 4.20% per patient-year; hazard ratio, 2.01 [95% CI, 1.49–2.70];
P
<0.001). The proportion of patients with both bleeding and MACCE (developed after bleeding) was 73.0% (46 of 63); 27.0% (17 of 63) experienced MACCE before bleeding. Time-adjusted Cox multivariate analysis revealed a temporal association between major bleeding and subsequent MACCE, with particularly high MACCE risks within 30 days after major bleeding (hazard ratio, 7.81 [95% CI, 4.20–14.54]).

Conclusions:

In patients with atrial fibrillation and stable coronary artery disease, major bleeding was strongly associated with subsequent MACCE. Thus, it is important to prevent major bleeding to avoid cardiovascular events and death.

Registration:

URL:
https://www.umin.ac.jp/ctr
; Unique identifier: UMIN000016612. URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02642419.

Graphic Abstract:

A
graphic abstract
is available for this article.
Role of Venous Endothelial Cells in Developmental and Pathologic Angiogenesis
Authors: Lee Heon-Woo , Xu Yanying , He Liqun , Choi Woosoung , Gonzalez David , Jin Suk-Won , Simons Michael
Published: September 2021

Background:

Angiogenesis is a dynamic process that involves expansion of a preexisting vascular network that can occur in a number of physiological and pathological settings. Despite its importance, the origin of the new angiogenic vasculature is poorly defined. In particular, the primary subtype of endothelial cells (capillary, venous, arterial) driving this process remains undefined.

Methods:

Endothelial cells were fate-mapped with the use of genetic markers specific to arterial and capillary cells. In addition, we identified a novel venous endothelial marker gene (
Gm5127
) and used it to generate inducible venous endothelium-specific Cre and Dre driver mouse lines. Contributions of these various types of endothelial cells to angiogenesis were examined during normal postnatal development and in disease-specific setting.

Results:

Using a comprehensive set of endothelial subtype-specific inducible reporter mice, including tip, arterial, and venous endothelial reporter lines, we showed that venous endothelial cells are the primary endothelial subtype responsible for the expansion of an angiogenic vascular network. During physiological angiogenesis, venous endothelial cells proliferate, migrating against the blood flow and differentiating into tip, capillary, and arterial endothelial cells of the new vasculature. Using intravital 2-photon imaging, we observed venous endothelial cells migrating against the blood flow to form new blood vessels. Venous endothelial cell migration also plays a key role in pathological angiogenesis. This was observed both in formation of arteriovenous malformations in mice with inducible endothelium-specific Smad4 deletion mice and in pathological vessel growth seen in oxygen-induced retinopathy.

Conclusions:

Our studies establish that venous endothelial cells are the primary endothelial subtype responsible for normal expansion of vascular networks, formation of arteriovenous malformations, and pathological angiogenesis. These observations highlight the central role of the venous endothelium in normal development and disease pathogenesis.
Two Myths of Representational Measurement
Authors: Tal Eran
Published: September 2021

Axiomatic measurement theories are commonly interpreted as claiming that, in order to quantify an empirical domain, the qualitative structure of data about that domain must be mapped to a numerical structure. Such mapping is supposed to be established independently, i.e., without presupposing that the domain can be quantified. This interpretation is based on two myths: that it is possible to independently infer the qualitative structure of objects from empirical data, and that the adequacy of numerical representations can only be justified by mapping such qualitative structures to numerical ones. I dispel the myths and show that axiomatic measurement theories provide an inadequate characterization of the kind of evidence required to detect quantities.
“Like Son, Like Father”
Authors: MacLachlan David
Published: September 2021

Markus Barth’s book Die Taufe: Ein Sakrament? had an evident and important influence on the development of his father Karl Barth’s theological understanding of the nature and practice of Christian baptism. This essay explores that influence, considers its scope and significance, and suggests in the course of so doing that the relationship between the elder and the younger Barth is a notable factor in what led to the provocative theology of baptism at which Karl Barth arrived in the late, fragmentary volume of the Church Dogmatics.
Henckelia inaequalifolia (Gesneriaceae), a new species from Sichuan, China
Authors: SHI XI-ZUO , WANG JIA-CAI , YANG LI-HUA
Published: September 2021

Henckelia inaequalifolia, a new species in the genus Henckelia of the family Gesneriaceae is described here. The detailed morphological description, photographic illustration and geographical distribution of the new species are provided. Its morphological affinities between related species are also discussed in this paper.
Calanthe × yarlungzangboensis, a new natural hybrid in genus Calanthe (Orchidaceae) from China
Authors: WU PO-PO , WANG ZI , JIA NING-XIA , GUO SHI-WEI , LIU CHANG-CHENG , JIN XIAO-HUA , GUO KE
Published: September 2021

Calanthe × yarlungzangboensis P. P. Wu & Z. Wang, a new natural hybrid was described and illustrated from Xizang, China. Calanthe griffithii and C. tricarinata were considered as putative parentage by morphological traits and molecular data from nrITS and two plastid DNA (rbcL and matK). Calanthe × yarlungzangboensis is easily distinguished from its parentage by mid-lobe with three tuberculatus lamellae. The new hybrid grows in subalpine evergreen coniferous forest dominated by Tsuga dumosa in the eastern Himalayas with elevation about 2500m.
The Canary Intermediate Poleward Undercurrent: Not Another Poleward Undercurrent in an Eastern Boundary Upwelling System
Authors: Vélez-Belchí P. , Caínzos V. , Romero E. , Casanova-Masjoan M. , Arumí-Planas C. , Santana-Toscano D. , González-Santana A. , Pérez-Hernández M. D. , Hernández-Guerra A.
Published: September 2021

Poleward undercurrents are well-known features in eastern boundary upwelling systems. In the California Current upwelling system, the California poleward undercurrent has been widely studied, and it has been demonstrated that it transports nutrients from the equatorial waters to the northern limit of the subtropical gyre. However, in the Canary Current upwelling system, the Canary intermediate poleward undercurrent (CiPU) has not been properly characterized, despite recent studies arguing that the dynamics of the eastern Atlantic Ocean play an important role in the Atlantic meridional overturning circulation, specifically on its seasonal cycle. Here, we use trajectories of Argo floats and model simulations to characterize the CiPU, including its seasonal variability and its driving mechanism. The Argo observations show that the CiPU flows from 26°N, near Cape Bojador, to approximately 45°N, near Cape Finisterre and flows deeper than any poleward undercurrent in other eastern boundaries, with a core at a mean depth of around 1000 dbar. Model simulations manifest that the CiPU is driven by the meridional alongshore pressure gradient due to general ocean circulation and, contrary to what is observed in the other eastern boundaries, is still present at 1000 dbar as a result of the pressure gradient between the Antarctic Intermediate Waters in the south and Mediterranean Outflow waters in the north. The high seasonal variability of the CiPU, with its maximum strength in autumn and minimum in spring, is due to the poleward extension of AAIW, forced by Ekman pumping in the tropics.
Emotional Response to Testing in Gifted and Highly Gifted Children
Authors: Cornoldi Cesare , Giofrè David , Mammarella Irene Cristina , Toffalini Enrico
Published: September 2021

Whether intellectually gifted children have a greater emotional response when tested is still unclear. This may be due to the marked heterogeneity of this particular population, and the fact that most studies lack the power to reduce the noise associated with this heterogeneity. The present study examined the relationship between performance and emotional response in 468,423 Italian fifth-graders taking a national test on mathematics and language. Analyses were performed using statistical models with polynomial terms. Special attention was paid to estimating the mean emotional response of the children who were gifted (1.5-2.5 standard deviations above the mean) or highly gifted (more than 2.5 standard deviations above the mean). The results showed that, although a lower emotional response correlated with a higher achievement, this relationship is nonlinear, and the estimates for gifted and highly gifted children were virtually the same. Girls showed a greater emotional response than boys on all levels of performance. The theoretical and practical implications of these findings are discussed.
Evaluation of damage within sandwich honeycomb panels subjected to impact fatigue loading
Authors: Oubouzid Ahcene , Keskes Boualem , Vieille Benoit
Published: September 2021

This work was aimed at investigating damage evolution within sandwich panels consisting of aluminum skins and Nomex™ honeycomb core, with three different values of the core densities, subjected to multiple impacts. Repeated impacts at low energy were conducted using an impact fatigue machine. Bending tests were conducted to determine the residual stiffness after impacts in order to analyze the evolution of a damage parameter D. A model was therefore proposed for describing the changes in this parameter as a function of impact cycles N. After repeated impacts, the D(N) curves are characterized by an S-shaped curve. A good agreement is observed between model and experimental results, the maximum standard deviation being less than 7% for different densities. Microscopic observations of the impacted specimens were conducted in order to evaluate the crater growth (associated with permanent indentation). The inﬂuence of the number of impacts on the dimensions of the impact zone has also been evaluated. For all the core densities, the permanent indentation gradually increases as a function of impact cycles.
Lethal giant basal cell carcinoma
Authors: Byard Roger W , Wills Stephen , Gilbert John D
Published: September 2021

Basal cell carcinomas are the most common malignancy in Caucasian populations with a very low predisposition to metastatic disease and an excellent prognosis if appropriately treated. Given the rarity of a lethal outcome two cases are reported. Case 1: A 61-year-old reclusive man who had an untreated facial basal cell carcinoma for 10 years died of hypothermia and sepsis complicating the extensively ulcerated and infected tumour. He also had underlying cardiomegaly, ischaemic heart disease and chronic obstructive pulmonary disease. Case 2: A 60-year-old man who had an untreated lower lumbar basal cell carcinoma for 14 years died of sepsis, inanition and pulmonary thromboembolism (due to a right-sided deep venous thrombosis) complicating the deeply ulcerated tumour. Untreated giant basal cell carcinoma may uncommonly present for medicolegal assessment with complex pathophysiological lethal mechanisms. The possibility of Diogenes syndrome should be considered.
The Influence of the Psychophysical Assessment Paradigm on Pitch Discrimination for Adults (and a Pilot Sample of Children)
Authors: Flagge Ashley G. , Puranen Lucile , Mulekar Madhuri S.
Published: September 2021

Pitch discrimination ability has been of research interest due to its potential relationship to language and literacy. However, assessment protocols for pitch discrimination have varied widely. Prior studies with both children and adults have produced conflicting performance findings across different pitch discrimination research paradigms, though they have consistently shown that discrimination accuracy is based on the psychophysical assessment method applied. In the present study, we examined pitch discrimination performance among convenience samples of 19 adult women and ten female children across six different adaptive psychophysical measurement conditions. We found pitch discrimination performance in both groups to be impacted by the measurement paradigm such that, while adults exhibited significantly better discrimination thresholds than did children, the pattern of performance across the six conditions was similar for both the adults and the children.
Suicide Rates and Differences in Rates Between Non-Hispanic Black and Non-Hispanic White Populations in the 30 Largest US Cities, 2008-2017
Authors: Schober Daniel J. , Benjamins Maureen R. , Saiyed Nazia S. , Silva Abigail , Shrestha Susana
Published: September 2021

Objectives

Suicide is a leading cause of death in the United States, and rates vary by race and ethnicity. An analysis of suicide across large US cities is absent from the literature. The objective of this study was to examine suicide rates among the total population, non-Hispanic Black population, and non-Hispanic White population in the United States and in the 30 largest US cities.

Methods

We used data from the National Vital Statistics System to calculate non-Hispanic White, non-Hispanic Black, and total age-adjusted suicide rates for the 30 largest US cities and for the entire nation during 2 periods: 2008-2012 and 2013-2017. We also examined absolute and relative differences in suicide rates among non-Hispanic White populations and non-Hispanic Black populations in each city.

Results

The overall age-adjusted suicide rate per 100 000 population in the United States increased significantly from 12.3 in 2008-2012 to 13.5 in 2013-2017. Total suicide rates were stable in most cities; rates increased significantly in only 1 city (Louisville), and rates decreased significantly in 2 cities (Boston and Memphis). The non-Hispanic White suicide rate was significantly higher—1.3 to 4.3 times higher—than the non-Hispanic Black suicide rate in 24 of 26 study cities during 2013-2017. From 2008-2012 to 2013-2017, non-Hispanic White suicide rates decreased significantly in 3 cities and increased significantly in 3 cities; non-Hispanic Black suicide rates increased significantly in 5 cities and decreased in none. Absolute differences in suicide rates among non-Hispanic White populations and non-Hispanic Black populations increased significantly in 1 city (Louisville) and decreased significantly in 2 cities (Memphis and Boston).

Conclusions

Our study may inform the use of evidence-based programs and practices to address population-level risk factors for suicide.
Mindfulness- and Acceptance-Based Interventions for Stroke Survivors: A Systematic Review and Meta-Analysis
Authors: Han Areum
Published: September 2021

Mindfulness- and acceptance-based intervention (MABI) is an emerging evidence-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes for people with stroke. Three electronic databases, PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.
A method to predict electric vehicles’ market penetration as well as its impact on energy saving and CO2 mitigation
Authors: Fu Shijun , Fu Hongji
Published: September 2021

Introduction:

Although forecasting electric vehicles’ growth in China was frequently reported in the literature, predicting electric vehicles market penetration as well as corresponding energy saving and carbon dioxide mitigation potential in a more suitable method is not well understood.

Methods:

This study chose the double species model to predict electric vehicles’ growth trajectory under mutually competitive conditions between electric vehicles and internal combustion engine vehicles. For comparison, it set two scenarios: with 200 and 300 vehicles per thousand persons at 2050. To give details on energy saving and carbon dioxide mitigation potential induced by electric vehicles’ market penetration, it further divided electric vehicles into five subgroups and internal combustion engine vehicles into seven subgroups, therein forming respective measurement formulas.

Results:

This paper solved the double species model and thus got its analytical formula. Then it employed the analytical formula to conduct an empirical study on electric vehicles market penetration in China from year 2010 to 2050. Under scenario 300, electric vehicles growth trajectory will emerge a quick growth stage during 2021–2035, thereafter keeping near invariant till 2050. Meanwhile, current internal combustion engine vehicles’ quick growth will continue up to 2027, then holding constant during 2028–2040, afterwards following a 10-year slowdown period. Scenario 200 has similar features, but a 2-year delay for electric vehicles and a 5-year lead time for internal combustion engine vehicles were found. On average, scenario 300 will save 114.4 Mt oil and 111.5 Mt carbon dioxide emissions, and scenario 200 will save 77.1 Mt oil and 73.4 Mt carbon dioxide emissions each year. Beyond 2032, annual 50.0% of road transport consumed oil and 18.6% of carbon dioxide emissions from this sector will be saved under scenario 300.

Discussion:

Compared with scenario 200, scenario 300 was more suitable to predict electric vehicle market penetration in China. In the short-term electric vehicle penetration only brings about trivial effects, while in the long-term it will contribute a lot to both energy security and carbon dioxide mitigation. The contribution of this article provided a more suitable methodology for predicting electric vehicle market penetration, simulated two coupled trajectories of electric vehicles and internal combustion engine vehicles, and discussed relative energy-saving and climate effects from 2010 to 2050.