bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Biomarkers Associated with Diagnosis of Osteoarthritis Patients Based on Bioinformatics and Machine Learning
Authors: Liang Yihao , Lin Fangzheng , Huang Yunfei
Published: June 2022

Osteoarthritis (OA) is thought to be the most prevalent chronic joint disease. The incidence of OA is rising because of the ageing population and the epidemic of obesity. This research was designed for the identification of novel diagnostic biomarkers for OA and analyzing the possible association between critical genes and infiltrated immune cells. 10 OA samples from patients with spinal OA and 10 normal samples were collected. GSE55235 and GSE55457 datasets including human OA and normal samples were downloaded from the GEO datasets. Differentially expressed genes (DEGs) were identified between 20 OA and 20 controls. SVM-RFE analysis and LASSO regression model were carried out to screen possible markers. The compositional patterns of the 22 types of immune cell fraction in OA were determined by the use of CIBERSORT. The expression level of the biomarkers in OA was examined by the use of RT-PCR. In this study, an overall 44 DEGs were identified: 18 genes were remarkably upregulated and 26 genes were distinctly downregulated. KEGG pathway analyses revealed that pathways were significantly enriched including IL-17 signal path, rheumatoid arthritis, TNF signal path, and lipid and atherosclerosis. Based on the results of machine learning, we identified APOLD1 and EPYC as critical diagnostic genes in OA, which were further confirmed using ROC assays. Immune cell infiltration analysis revealed that APOLD1 was correlated with mastocytes stimulated, NK cells resting, T cells CD4 memory resting, DCs stimulated, T cells gamma delta, macrophages M0, NK cells stimulated, and mastocytes resting. Moreover, we found that EPYC was correlated with mastocytes stimulated, NK cells resting, T cells CD4 memory resting, DCs stimulated, T cells gamma delta, macrophages M0, NK cells stimulated, and mastocytes resting. Overall, our findings might provide some novel clue for the exploration of novel markers for OA diagnosis. The critical genes and their associations with immune infiltration may offer new insight into understanding OA developments.
Design and Analysis of Combined Valve Spool with Linear Flow Coefficient
Authors: Xie Changxiong , Su Heng , Yang Jun , He Zhongjing
Published: June 2022

The orifice flow model is generally established based on the turbulent state, and the flow discharge is considered to be a constant value. In fact, the flow discharge has obvious nonlinearity under the condition of small opening and small pressure difference of the valve port, which makes the electro-hydraulic servo system more difficult to control. In order to improve the nonlinearity of the flow discharge, the paper designed different spool profile, such as the arc combined spool profile, the power curve combined spool profile, the index curve combined spool profile, and the mixed curve combined spool profile, and analyzed the flow discharge through CFD simulation and experiment. The results show that the flow discharge of the mixed curve combined spool is more linear and the residual sum of squares is the smallest, which is 2.56 × 10−3 under CFD numerical simulation and 3.26 × 10−4 under experiment. The combined spool has better linear characteristics, which can improve the control performance of the electro-hydraulic servo valve.
Isokinetic Assessment of Shoulder Joint Strength Ratios in Male Recreational Weightlifters: A Cross-Sectional Study
Authors: Abdelraouf Osama R. , Ebrahim Marwa Y. , Abdel-aziem Amr A. , Abdel-Rahman Soheir M. , Yamani Ahmed S. , El Askary Ahmad A.
Published: June 2022

Background. Isokinetic strength imbalance is a risk factor for movement dysfunctions and injuries related to shoulder complex. The effects of recreational weightlifting on developing the imbalances between the shoulder muscles are not yet known. Objectives. To investigate the isokinetic concentric shoulder muscle strength values (peak torque normalized to body weight) in recreational weightlifters (RWL) and to compare the shoulder muscles agonist/antagonist ratios with nonweightlifters. Methods. Thirty male RWL with mean age, weight, height, and body mass index (BMI) of 21.56 years, 84.25 kg, 175.34 cm, and 26.51 kg/m2, respectively, matched with nonweightlifters served as a control group. The normalized concentric peak torque values of shoulder flexors, extensors, abductors, adductors, and internal and external rotators were measured at angular velocity 120°/sec by using Biodex isokinetic system. Moreover, the agonist/antagonist strength ratio for all muscle groups were calculated. Results. The normalized peak torques of RWL group were significantly greater than the control group (

p
<
0.05

). The abductor/adductor and external rotator/internal rotator ratios of the RWL were significantly lower than the control group (

p
=
0.008

and 0.009, respectively). Conversely, there was no significant difference between both groups in relation to the flexor/extensor ratio (

p
=
0.259

). Conclusion. These results suggested that the recreational weightlifting exercises place trainees at risk of muscle imbalances. Therefore, the restoration of a normal concentric abductor/adductor and external rotator/internal rotator strength ratios may decrease the risk of possible shoulder injury.
Survey on Major Worldwide Regulations on Seismic Base Isolation of Buildings
Authors: Lopez-Almansa Francisco , Piscal Carlos M. , Carrillo Julian , Leiva-Maldonado Stefan L. , Moscoso Yina F. M.
Published: June 2022

Base isolation solutions are efficient alternatives for seismic protection of buildings and for enhancing resilient capacity. Currently, seismic isolation is focused principally on the critical infrastructure of public health, transportation, education, etc. Despite these considerations, the current worldwide implementation of this technology is still insufficient. A crucial step to be taken into the promotion of any earthquake‐resistant construction technique is the development of design codes that, although being inspired in the major international regulations, account for the local seismic effects, among other factors. With the aim of assisting code developers, this work analyzes and compares the code requirements for seismic base isolation in Japan, China, Russia, Italy, USA, and Chile. Two prototype seismically isolated hospital buildings located in high and medium seismicity zones (Los Angeles and New Mexico, respectively) were analyzed and designed with the examined codes. It is concluded that there are high differences among some of their requirements even though the technology used is the same.
Deep Learning-Based Music Quality Analysis Model
Authors: Jing Jing
Published: June 2022

In order to build an efficient and effective deep much quality recognition model, a decision fusion method by leveraging the advantages of shallow learning and deep learning is formulated. In the literature, shallow learning is a traditional music-related quality recognition method, that is, artificial statistical feature extraction and recognition are designed. Meanwhile, our deep learning module leverages the so-called PCANET network to implement the feature extraction process, and subsequently takes the spectrogram describing the music-related information as the network input. First, a variety of task classifications for the music signal problem are divided. Afterward, the optimization and adoption of deep learning in the two major problems of music feature extraction and sequence modeling are introduced. Finally, a music application is presented to illustrate the practical application of deep learning in music quality evaluation. The shallow learning features and deep learning features are seamlessly combined into the SVM model for music quality modeling, based on which differential voting mechanisms are leveraged to realize the fusion of decision-making layers. Extensive experimental results have shown that the music quality recognition rate by this method can be significantly improved on our own compiled library and the Berlin database. Besides, it exhibits obvious advantages compared with the competitors.
DASH Framework Using Machine Learning Techniques and Security Controls
Authors: Shaheed Aref , Al-radwan Haisam
Published: June 2022

Interest in video streaming has increased recently, as it constitutes most of the traffic on the Internet and cellular networks. These networks use different video streaming technologies. One of the most famous technologies is DASH (which stands for Dynamic Adaptive Steaming using HTTP). DASH adapts streaming parameters according to network conditions and uses the HTTP protocol to communicate between the user and the server. DASH faces many challenges that may lead to video interruptions and poor quality of user experiences (QoE) such as bad network conditions and buffering level control. In addition to the lack of studies, we cover security issues for these types of services. In this paper, we proposed an integrated framework that consists of four components: quality prediction model, precache model, light web application firewall, and a monitoring system. These four components improve QoE and precache and increase the level of security. The results of the quality prediction model are used to predict the quality of the next segments depending on the user’s network conditions and in the precache model to improve caching to reduce the load on the streaming system and rely more on cache servers. The proposed web application firewall is a light version used to defend against video streaming attacks and verify the existence of necessary HTTP headers. The quality predictor model with the generated dataset achieved 97% classification accuracy using DecisionTree, and this experiment proved the strong relationship between congestion periods and streaming quality, which is s the main key in QoE.
Design and Optimization of Fuel Cells: A Case Study on Polymer Electrolyte Membrane Fuel Cell Power Systems for Portable Applications
Authors: Orhan Mehmet Fatih , Saka Kenan , Yousuf Mohammad
Published: June 2022

Fuel cells are energy conversion devices that directly convert chemical energy of fuels such as hydrogen to useful work with negligible environmental impact and high efficiency. This study deals with thermodynamic analysis and modeling of polymer electrolyte membrane fuel cell (PEMFC) power systems for portable applications. In this regard, a case study of powering a computer with a PEMFC is presented. Also, an inclusive evaluation of various parameters such as voltage polarization, overall system efficiency, power output, and heat generation is reported. In addition, a parametric study is conducted to study the effect of many design and operation parameters on the overall efficiency. Results show the direct influence of current density and temperature values on optimization of the design parameters in PEMFCs.
The Effect of TLR9, MyD88, and NF-κB p65 in Systemic Lupus Erythematosus
Authors: Wang Huanan , Guo Feng , Wang Min , Wang Tingting , Wang Shanzhi , Huang Yanni , Ye Feng
Published: June 2022

Purpose. This study was conducted to characterize the expression level of peripheral blood toll-like receptors 9 (TLR9), nuclear factor kappa-B protein 65 (NF-κB p65), and myeloid differentiation factor88 (MyD88) of active systemic lupus erythematosus (SLE) and analyse their clinical significance. Methods. The prospective cohort study enrolled 30 active SLE patients (SG1 group), 30 stable SLE patients (SG2 group), and 20 healthy individuals (RG group) in the First Affiliated Hospital of Hainan Medical University between January 2018 and June 2020. All SLE patients were treated with methylprednisolone tablets. Quantitative polymerase chain reaction (qPCR) was used to determine the levels of TLR9, MyD88, and NF-κB p65 in the peripheral blood mononuclear cell (PBMC). ELISA was adopted for the determination of serum interleukin (IL-6) and tumor necrosis factor-α (TNF-α). Results. Patients in SG1 showed the highest mRNA levels of TLR9, MyD88, and NF-κB p65, followed by SG2, and then RG. SG1 had the highest serum levels of IL-6 and TNF-α, followed by SG2 and RG. The level of TLR9 was positively correlated with the SLE disease activity index (SLEDAI) and negatively correlated with complement component 3 (C3) and complement component 4 (C4). MyD88 and NF-κB p65 were positively correlated with SLEDAI. Conclusion. Compared with a healthy status, SLE induces an increase in TLR9, MyD88, NF-κB p65, IL-6, and TNF-α levels, and the activation of the TLR9-MyD88-NF-κB p65 signal path was associated with the pathogenesis of SLE.
Review on the Development of Mining Method Selection to Identify New Techniques Using a Cascade‐Forward Backpropagation Neural Network
Authors: Abdelrasoul Mohamed E. I. , Wang Guangjin , Kim Jong-Gwan , Ren Gaofeng , Abd-El-Hakeem Mohamed Mohamed , Ali Mahrous A. M. , Abdellah Wael R.
Published: June 2022

The most crucial event in a mining project is the selection of an appropriate mining method (MMS). Consequently, determining the optimal choice is critical because it impacts most of the other key decisions. This study provides a concise overview of the development of multiple selection methods using a cascade‐forward backpropagation neural network (CFBPNN). Numerous methods of multicriteria decision‐making (MCDM) are discussed and compared herein. The comparison includes several factors, such as applicability, subjectivity, qualitative and quantitative data, sensitivity, and validity. The application of artificial intelligence is presented and discussed using CFBPNN. The Chengchao iron mine was selected for this investigation to pick the optimum mining method. The results revealed that cut and fill stoping is the most appropriate mining method, followed by sublevel and shrinkage stoping methods. The least appropriate method is open‐pit mining, followed by room and pillar and longwall mining methods.
The Management System Framework of Small- and Medium-Sized Enterprises Based on Strategic Flexible Management
Authors: Zhao Lihua , Wang Jing , Li Zhen
Published: June 2022

The framework to learn how to manage SMEs is as simple as management. The first is to identify the internal control problems and causes of SMEs, and the reasons for the internal management problems of SMEs. Then, we analyzed the management system management and development of the business model industry-standard model. Based on the construction of industrial subsystems, a simple subsystem conversion system is developed, and a simple exchange strategy matrix for equipment measurement and decision-making is constructed. Finally, taking CW as an example, the company’s case modeled and demonstrated the feasibility of the retrofit process, supporting the importance of the study. The experimental results show that asset specificity, organizational structure stability, cultural organization memory, and entrepreneur cognitive inertia are the main factors that promote the formation of strategic rigidity. Once the strategic rigidity is formed, it will have a negative effect on the enterprise, resulting in a lack of adaptability, lack of innovation power, and a decline in business performance, indicating the necessity and urgency of building an enterprise strategic flexibility system.
The Subject Construction and Role Mental Model Construction of Erotic Movies Based on Lacan’s Desire Theory
Authors: Feng Shuqin
Published: June 2022

Jacques Lacan is a famous French psychoanalyst, but his influence has long gone beyond the scope of psychoanalysis and has affected almost all fields of “human science.” Film and psychoanalysis coincided almost simultaneously and influenced each other. But with the development of film, researchers found that film studies in the period of classic film and film semiotics have come to an end. It has certain theoretical value to explore the construction of the subject and the mental model of the erotic film based on Lacan’s desire theory. Method. The body in the film and video described in this paper includes both the material body as an aesthetic object and the spiritual body with aesthetic consciousness. The so-called artistic presentation of the body element means that the beauty of the body form displayed by the actor’s body in the film video is perceived by the audience, and the desire to stare is captured by the audience, thereby completing the audience’s entire body composed of eyes, body, and mind. The body is not only an aesthetic object but also an aesthetic subject, and the human cognitive system is not just a closed brain. Because the nervous system, body, and environment are constantly changing and interacting, true cognition is a unified system of all three. The main part of this paper uses Lacan’s psychoanalytic theory to deeply analyze the relationship between the characters shown in the film. From the cognitive impairment of the self to the failure of communication between characters, the language of uncertainty entangled by desire is removed, and the behavior and facial expressions of the movie characters are used as the analysis basis to fully interpret the inner world of the characters. This includes love, hatred, pain, struggle, and many other contradictory emotions. In addition, this paper also analyzes the metaphor of the relationship between the characters from the perspective of semiotics and discusses the description of the relationship between the characters from the lens language from the perspective of cinematography. The special meaning conveyed by the recurring elements in the film is emphasized, and the correlation between the pictures is explained from the less mentioned photographic aspect of the film. Results/Discussion. Looking at Lacan’s theory, the subject, the other, and desire are linked by the subject spirit, which is the core of the connection between the three, and only through the resistance and struggle of the subject spirit can the illusion of the subject be broken. Bewilderment and the suppression of the other and desire finally become the self. And the embodiment of this true self is particularly prominent in film art. Lacan’s purpose is not merely to dissolve the subject but to seek a stand in the midst of destruction, pursuing the ultimate transcendence of man’s desire for the external other and internal desire.
Intelligent Structure Design of Learning Seats in University Smart Classroom under the Background of Intelligent Education
Authors: Gao Yang , Li Li
Published: June 2022

Under the background of intelligent education, the study chairs of intelligent classrooms in colleges and universities should reflect humanistic care and design and guide students to establish a healthy learning style. To realize the intelligent classroom learning, the intelligent seat can be applied to different sitting positions or different heights and weights. This paper designs a control system based on MC9S08DZ60 and realizes the communication between the control system and the mobile app by combining the Bluetooth module based on CSR8670. At the same time, this paper proposes an intelligent design that can adjust the seat height by voice. LD3320 speech recognition module is used for voice control, and a push rod motor with a rising speed of 7 mm/s is used to complete the lifting to meet the requirements of different sitting positions and different heights and weights. Then, the folding design of the intelligent seat for classroom learning is carried out. Infrared detectors are used at the armrests on both sides of the seat. When people have a tendency to sit down, they will speed up deployment. When a person leaves the seat, the seat will automatically retract. Finally, the objective evaluation method of pressure distribution test experiment is compared with the subjective scale evaluation of students, which verifies the effectiveness of the shape design of the chair in keeping students’ healthy sitting posture for a long time.
Fabrication and Characterization of Aluminum (Al‐6061) Matrix Composite Reinforced with Waste Glass for Engineering Applications
Authors: Wubieneh Tessera Alemneh , Tegegne Samuel Tenager
Published: June 2022

Aluminum composites with various reinforcement materials are widely applicable in advanced engineering due to their better strength to weight ratio, better stiffness, and high thermal conductivity as well as excellent wear and corrosion properties. This stimulates curiosity to study aluminum metal matrix composite reinforced with waste glass to improve its mechanical and physical properties. The composite specimens were prepared using stir‐casting rout by varying weight percentage of reinforcing waste glass powder from 0% to 30%. The fabricated composite samples were characterized using universal testing machine, FTIR, DSC, TGA, and optical microscope. The results revealed that as the waste glass particle content increased in the metal matrix, there was a significant enhancement of the mechanical properties like hardness and tensile strength as compared to the pristine sample. The microstructural properties analyzed using optical microscope show good bonding between the reinforcements and the pristine materials in the composite that indicates the glass particulates are uniformly distributed in the Al‐6061 matrix. All in all, the effect of waste glass powder in aluminum metal matrix composite was clearly observed and it enhances the mechanical, physical, and thermal properties of the newly fabricated aluminum‐based composite materials.
Quantitative Magnetic Resonance Imaging of Femoral Head Articular Cartilage Change in Patients with Hip Osteonecrosis Treated with Extracorporeal Shock Wave Therapy
Authors: Shi Lijun , Yang Xu , Wang Peixu , Ma Xiangwei , Li Dan , Wu Xinjie , Gao Fuqiang , Sun Wei
Published: June 2022

Background. Multiple reports have demonstrated the therapeutic potential of extracorporeal shock wave (ESWT) in osteonecrosis of the femoral head (ONFH). However, few studies reported the changes in hip articular cartilage after the intervention. This study aimed to investigate the effect of ESWT on femoral head cartilage using a novel technique, quantitative T2-mapping magnetic resonance imaging. Methods. A total of 143 eligible patients with unilateral early-stage ONFH were randomized into the ESWT group and control group. Seventy-three patients in the ESWT group received two sessions of ESWT with oral drug treatment, while seventy patients in the control group received oral drug treatment only. The visual analog pain scale (VAS) and Harris hip score (HHS) at 3-month, 6-month, and 12-month follow-up were used as the clinical evaluation index. The radiological evaluation index used the T2 mapping values, necrotic size, and China-Japan Friendship Hospital (CJFH) classification. Results. A total of 143 patients (62 females and 81 males) were finally included, and the characteristics before treatment were comparable between the two groups. At the last follow-up (12 months), the T2 values and ΔT2 changes in the ESWT group were all smaller than those in the control group (

p
=
0.042

;

p
=
0.039

), while the CJFH classification of ONFH and necrotic lesion size were not statistically significant. At 3 months and 6 months, the VAS in the ESWT group was lower than that in the control group (

p
=
0.021

;

p
=
0.046

) and the HHS in the ESWT group was higher (

p
=
0.028

;

p
=
0.039

). However, there were no significant differences in the VAS and HHS at 12 months between the ESWT and control groups. Conclusions. The results of the current study indicated that, based on drug treatment, ESWT is an effective treatment method for nontraumatic ONFH, which could result in significant pain relief and function restoration. Furthermore, it could delay the injury of femoral head cartilage during the progression of ONFH.
A Randomized Controlled Trial of Thai Medicinal Plant-4 Cream versus Diclofenac Gel in the Management of Symptomatic Osteoarthritis of the Knee
Authors: Koonrungsesomboon Nut , Churyen Achariya , Teekachunhatean Supanimit , Sangdee Chaichan , Hanprasertpong Nutthiya
Published: June 2022

Background. Osteoarthritis of the knee is a common degenerative musculoskeletal condition. Thai Medicinal Plant-4 (TMP-4) cream is made up of Garcinia mangostana peel, Sesamum indicum seeds, Glycine max (L.) Merr. seeds, and Centella asiatica leaves, all of which have anti-inflammatory and analgesic properties. The present study aimed at determining the efficacy and safety of TMP-4 cream versus diclofenac gel in the treatment of symptomatic osteoarthritis of the knee. Methods. A randomized-controlled trial was conducted to assess knee pain on a scale of 100 mm Visual Analog Scale (VAS) and other key metrics, including VAS knee stiffness, a modified 10-step stair climb test, a timed up and go test, the Knee Injury and Osteoarthritis Outcome Score, and safety outcomes, following administration of either TMP-4 cream or diclofenac gel for 4 weeks. Results. A total of 199 patients with moderate knee pain intensity were randomly assigned to either TMP-4 cream or diclofenac gel (allocation ratio 1 : 1). The mean changes of VAS knee pain in the TMP-4 cream and diclofenac gel groups were −31.68 ± 14.18 mm and −31.09 ± 12.41 mm, respectively, (mean difference = −0.58, 95% confidence interval = −4.37–3.20,

P
=
0.761

). The upper limit of 95% confidence interval for the comparison between TMP-4 cream and diclofenac gel was within the predefined margin of 7 mm for noninferiority. The safety was comparable between the two interventions. Conclusions. TMP-4 cream was noninferior to diclofenac gel in relieving osteoarthritic knee pain and may be considered as an alternative therapeutic option in the treatment of symptomatic osteoarthritis of the knee.
Cascaded-Recalibrated Multiple Instance Deep Model for Pathologic-Level Lung Cancer Prediction in CT Images
Authors: Wang Qingfeng , Zhou Ying , Huang Jun , Liu Zhiqin , Zhang Weidong , Liu Qiyu , Cheng Jie-Zhi
Published: June 2022

Lung cancer accounts for the greatest number of cancer-related mortality, while the accurate evaluation of pulmonary nodules in computed tomography (CT) images can significantly increase the 5-year relative survival rate. Despite deep learning methods that have recently been introduced to the identification of malignant nodules, a substantial challenge remains due to the limited datasets. In this study, we propose a cascaded-recalibrated multiple instance learning (MIL) model based on multiattribute features transfer for pathologic-level lung cancer prediction in CT images. This cascaded-recalibrated MIL deep model incorporates a cascaded recalibration mechanism at the nodule level and attribute level, which fuses the informative attribute features into nodule embeddings and then the key nodule features can be converged into the patient-level embedding to improve the performance of lung cancer prediction. We evaluated the proposed cascaded-recalibrated MIL model on the public Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) benchmark dataset and compared it to the latest approaches. The experimental results showed a significant performance boost by the cascaded-recalibrated MIL model over the higher-order transfer learning, instance-space MIL, and embedding-space MIL models and the radiologists. In addition, the recalibration coefficients of the nodule and attribute feature for the final decision were also analyzed to reveal the underlying relationship between the confirmed diagnosis and its highly-correlated attributes. The cascaded recalibration mechanism enables the MIL model to pay more attention to those important nodules and attributes while suppressing less-useful feature embeddings, and the cascaded-recalibrated MIL model provides substantial improvements for the pathologic-level lung cancer prediction by using the CT images. The identification of the important nodules and attributes also provides better interpretability for model decision-making, which is very important for medical applications.
AMC-070: Lenalidomide Is Safe and Effective in HIV-Associated Kaposi Sarcoma
Authors: Reid Erin G. , Shimabukuro Kelly , Moore Page , Ambinder Richard F. , Bui Jack D. , Han Semi , Martínez-Maza Otoniel , Dittmer Dirk P. , Aboulafia David , Chiao Elizabeth Yu , Maurer Toby , Baiocchi Robert , Mitsuyasu Ronald , Wachsman William ,   for the AIDS Malignancy Consortium (AMC)
Published: June 2022

Purpose:

Kaposi sarcoma (KS), an endothelial cell tumor associated with KS herpesvirus (KSHV), remains among the most common malignancies occurring with HIV infection (HIV-KS). As an oral anti-inflammatory, antiangiogenic, and immunomodulatory agent, lenalidomide is potentially an attractive alternative to standard chemotherapy for KS.

Experimental Design:

The primary objectives of this phase I/II trial were to determine the maximum tolerated dose (MTD) and response rates for lenalidomide in HIV-KS. Secondary objectives included correlating response with natural killer (NK) and T-cell subsets, plasma cytokines, viral copy number, and KSHV gene expression in biopsies. Four dose levels of oral lenalidomide taken 21 consecutive days of 28-day cycles were evaluated in adults with HIV-KS on antiretroviral therapy with controlled viremia.

Results:

Fifteen and 23 participants enrolled in phases I and II, respectively, 76% of whom had received prior KS therapy. The MTD was not reached, declaring 25 mg as the recommended phase II dose (RP2D). The most frequent adverse events were neutropenia, fatigue, leukopenia, and diarrhea. Of the 25 evaluable participants receiving RP2D, 60% responded. Correlative studies performed in a subset of participants demonstrated a significant increase in proportions of blood T cells with T-regulatory phenotype, and plasma cytokines trended toward a less inflammatory pattern. Clinical response was associated with loss of KSHV transcription.

Conclusions:

Lenalidomide is active in HIV-KS. The most common adverse events were manageable. With 60% of participants receiving RP2D obtaining a partial response and <10% discontinuing due to adverse events, the response and tolerability to lenalidomide support its use in HIV-KS.

See related commentary by Henry and Maki, p. 2485
Promotion Effects of Smoking in Polyp Development in Monozygotic Twins with Atypical Colorectal Polyposis
Authors: Yoshida Naohisa , Ishikawa Hideki , Eguchi Hidetaka , Okazaki Yasushi , Hirose Ryohei , Inoue Ken , Dohi Osamu , Itoh Yoshito , Mutoh Michihiro , Ishiguro Shingo , Ishida Hideyuki
Published: June 2022

Smoking is a known risk factor for the development of colorectal polyps. Even in familial adenomatous polyposis and serrated polyposis syndrome, smoking is a risk factor of the development of polyps. Here, we report a case of monozygotic twins with atypical colorectal polyposis showing lots of hyperplastic polyps and adenomas and describe how the polyposis developed differently in the brothers based on the presence or absence of smoking. The case was of a set of monozygotic male twins, and the twins were in their 50s. The younger brother smoked 40 cigarettes a day since he was 16 years old. The older brother had smoked about 25 cigarettes a day since he was 16 years old but stopped smoking after he was diagnosed with polyposis. As we previously reported, we managed to remove polyps as much as possible from both twins without surgery. The median number of removed polyps (IQR: 25–75%) per colonoscopy for 20 years was 9.0 (3.5–14.8) in the older brother and 20.5 (7.5–35.5) in the younger brother. There was a significant difference between the twins (p < 0.01). Additionally, genetic tests found that the twins carried a rare missense variant of BRCA2, and this variation has not been previously reported. In conclusion, these monozygotic twins with atypical colorectal polyposis showing a new variant of BRCA2 suggest that smoking is related to the development of colorectal polyps. Further analysis will be required for the identified BRCA2 variant in possible involvement in the development of atypical polyposis.
Avaliação computadorizada por fotografia digital, como recurso de avaliação na Reeducação Postural Global
Authors: Castro Pedro Claudio Gonsales de , Lopes José Augusto Fernandes
Published: June 2022

O trabalho é descrito por meio de fotografia digital, utilizando-se marcadores esféricos e reflexivos fixados em pontos anatômicos pré definidos, possibilitando a análise através de um programa de computador, denominado Fisiologic, que ao processar as fotos digitais, fornece coordenadas x e y dos marcadores corporais em pixels, sendo que estas coordenadas servem para gerar valores dos segmentos corporais utilizando a forma geométrica analítica. Relato aqui o caso de uma paciente com comprometimento postural, submetida ao método da Reeducação Postural Global, onde foi realizada avaliação fisioterapêutica e posteriormente fotografada e analisada antes e após a 21ª sessão. O programa apresentou resultados satisfatórios em relação à análise postural no acompanhamento dos segmentos corporais da paciente em estudo, bem como demonstraram os exames radiológicos. Concluiu-se portanto, ser este um método eficaz de avaliação na Reeducação Postural Global.
Análise do desempenho funcional em pacientes portadores de doença de Parkinson
Authors: Goulart Fátima , Santos Clarissa Cardoso dos , Teixeira-Salmela Luci Fuscaldi , Cardoso Francisco
Published: June 2022

A Doença de Parkinson (DP) é uma doença degenerativa e progressiva do sistema nervoso central, caracterizada, principalmente, por alterações motoras. Objetivo: avaliar o desempenho funcional e a qualidade de vida de parkinsonianos nos estágios inicial e intermediário da doença. Metodologia: 20 pacientes (60,8±9,7 anos) com Hoehn e Yahr entre 1 e 3 foram avaliados e comparados com 20 indivíduos saudáveis (63,5±6,3 anos). O Perfil de Atividade Humana (PAH), a velocidade da marcha (m/s) e a velocidade para subir/descer escadas (degraus/minuto) foram usados para avaliar o desempenho funcional e o Perfil de Saúde de Nottingham para avaliar a qualidade de vida. Resultados: foram observadas diferenças significativas no PAH (p=0,000) e na velocidade da marcha (p=0,05), demonstrando pobre aptidão física e lentidão da marcha dos pacientes com DP. Conclusão: Os resultados demonstraram que alterações da performance funcional estão presentes desde fases iniciais da DP e não apenas na fase avançada.
Avaliação de um manual de exercícios domiciliares para pacientes externos de um ambulatório de bloqueio neuromuscular
Authors: Figueiredo Márcia de Menezes Paranhos , Barbosa Márcia Cristina Catarino , Moreira Maria Cecília Santos
Published: June 2022

O Acidente Vascular Encefálico (AVE) constitui um grande desafio ao processo de reabilitação por ocasionar, dentre os sintomas secundários, a hemiplegia espástica com hipertonia, redução de força e flexibilidade muscular e alterações osteoarticulares que dificultam a funcionalidade dos pacientes acometidos. Neste contexto, a intervenção fisioterapêutica deve ser freqüente e contínua para minimizar as complicações inerentes a esta enfermidade. O enfoque deste trabalho visou em analisar a aplicabilidade de um programa de exercícios domiciliares para pacientes externos do Ambulatório de Bloqueio Neuromuscular Periférico da Divisão de Medicina Física e Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (DMR) baseando-se na capacidade dos pacientes e cuidadores em assimilar e compreender a necessidade de executar os exercícios prescritos após a infiltração de toxina botulínica tipo A (TBA). Participaram deste estudo 30 pacientes que não realizavam tratamento na DMR, portadores de hemiplegia espástica após AVE isquêmico ou hemorrágico que foram submetidos à infiltração de TBA nos membros inferiores. O manual proposto continha 13 exercícios e o fisioterapeuta assinalava quais deveriam ser realizados, de acordo com a musculatura infiltrada, com intervalo de tempo especificado a serem executados diariamente. Os exercícios foram demonstrados para esclarecimento de dúvidas pré-existentes. Após 1 mês, os pacientes retornaram ao ambulatório e respondiam um questionário composto por 10 questões que coletavam dados sobre a aplicabilidade do manual de exercícios domiciliares como recurso terapêutico. A partir dos resultados obtidos, constatou-se que o programa foi efetivo pela didática do manual ser compreensível, possibilitando que a maioria dos pacientes realizasse os exercícios ativamente, favorecendo no processo educacional dos pacientes e cuidadores em relação aos cuidados à saúde. No entanto, verificou-se que alguns sujeitos apresentaram dificuldade em executar os exercícios que solicitavam a utilização do membro superior comprometido, sendo sugerido por eles, a inclusão de exercícios complementares que favoreçam a prática da cinesioterapia com a autonomia de execução. Conclui-se que para que o manual seja mais eficiente, é necessária a inserção de diferentes métodos de execução a fim de contemplar todos os pacientes com AVE respeitando o padrão motor apresentado e seus respectivos déficits funcionais.
A terapia de restrição como forma de aprimoramento da função do membro superior em pacientes com hemiplegia
Authors: Riberto Marcelo , Monroy Heloisa Moreira , Kaihami Harumi Nemoto , Otsubo Priscilla Pereira dos Santos , Battistella Linamara Rizzo
Published: June 2022

A terapia de restrição consiste na imobilização do membro superior não comprometido de pacientes hemiplégicos em decorrência de acidente vascular cerebral (AVC) como forma de estímulo ao uso do membro superior que teve a sua força reduzida. Experimentos realizados em algumas amostras específicas de pacientes mostram resultados promissores com essa abordagem. Este estudo teve o objetivo verificar seu efeito numa amostra de pacientes hemiplégicos em processo de reabilitação. Foram selecionados pacientes com AVC há mais de 6 meses que se encontravam em processo de reabilitação e possuíssem força para extensão da mão e dedos de pelo menos 10º de forma voluntária. A aplicação da restrição foi associada a 6 horas de terapia multidisciplinar diariamente em dias de semana e orientada a manutenção das atividades nos finais de semana. Para avaliação dos resultados foram usados os seguintes instrumentos: medida de independência funcional (MIF), teste motor de Wolf (TMW), escala de avaliação das deficiências do AVC (EADAVC) e dinamometria de preensão. Observou-se ganho estatisticamente significante na MIF (108,5 ± 6,4 versus 113 ± 7,3, p = 0,02) e TMW (10,5 ± 6,4s versus 6,5 ± 3,7s, p = 0,006), mas não na EADAVC (56,7 ± 4,4 versus 59,4 ± 8,4, p = 0,16) ou Dinamometria de pressão (16,2 ± 4,5 kgf versus 16,3 ± 5,4 kgf, p = 0,98). A conclusão deste estudo é que a aplicação da técnica de restrição do membro superior em pacientes hemiplégicos pode resultar em ganhos agudamente, indicando um caminho alternativo na abordagem das suas incapacidades.
Discussão crítica sobre o uso da água como facilitação, resistência ou suporte na hidrocinesioterapia
Authors: Candeloro Juliana Monteiro , Caromano Fátima Aparecida
Published: June 2022

A hidrocinesioterapia é um recurso fisioterapêutico que utiliza os efeitos fisiológicos decorrentes da imersão em água aquecida, dentre eles a flutuação e a viscosidade que fazem com que as atividades motoras possam ser facilitadas, resistidas ou ofereçam suporte ao corpo ou seus segmento. Nesta revisão discute-se a prática de atividades motoras nestas três situações, enfocando o decúbito correto a ser utilizado para um determinado objetivo terapêutico e como os equipamentos aquáticos podem oferecer progressão no grau de dificuldade para diferentes atividades motoras.
Epidemiologia das lesões esportivas em atletas de basquetebol em cadeira de rodas
Authors: Rocco Fernanda Moraes , Saito Elizabete Tsubomi
Published: June 2022

A atividade esportiva para os portadores de deficiência física (PPD) foi desenvolvida com o objetivo de ser recreativa e reabilitacional, entretanto, para alguns o esporte desperta uma vocação competitiva. Nesta situação, um número excessivo de treinamentos e competições pode levar a aumento no risco de lesões esportivas, que segundo a literatura é semelhante para atletas com ou sem deficiência. Objetivo: Identificar as lesões esportivas mais freqüentes nos atletas de basquetebol em cadeira de rodas. Casuística e método: Foi realizada entrevista dirigida com 26 atletas do sexo masculino de basquetebol em cadeira de rodas, com idade entre 18 a 47anos (média de 27 anos), que participaram de um campeonato de basquetebol em cadeira de rodas em 2003. Foram obtidas informações pessoais dos atletas, etiologia da deficiência física, quanto tempo que pratica o esporte, horas de treino por semana, queixa de dor e quantificação da mesma pela escala verbal analógica, histórico de lesões durante a prática esportiva e tempo de afastamento. Resultados: Dentre as deficiências físicas apresentadas pelos atletas a lesão medular correspondeu a 42%, seqüela de poliomielite a 31% e amputação de membros inferiores a 27%. O tempo em que praticavam o esporte variou de 2 meses a 13 anos, com média de 6.5 anos. A carga horária de treinamento foi em média 21horas de treino por semana. Nestes atletas observou-se queixa de dor em 54%, sendo em sua maioria em membros superiores (79%). De todos os atletas apenas 6 (23%) nunca tinham apresentado lesão durante jogo ou treinamento. Entre os 11 atletas lesados medulares, 3 (27%) apresentaram afastamento devido à úlcera de pressão (região isquiática, sacra e paravertebral). Dentre as lesões esportivas ocorridas temos que 75% delas foram de forma aguda e 25% por esforço repetitivo. Discussão: Na literatura há muitos estudos que evidenciam uma alta prevalência de acometimento muscular em atletas que competem em cadeira de rodas, acompanhado de queixa de dor na extremidade superior do corpo, principalmente no ombro. Contusões e entorses de metacarpos são as lesões agudas e tendinites as lesões por esforço repetitivo mais encontradas na literatura. Quando expressamos o tempo de afastamento das atividades esportivas temos na literatura que em 52% este ocorre por 7 dias ou menos, em 29% por 8 a 21 dias, e em 19% por período maior que 22 dias. Vários autores citaram úlcera de pressão como fator de afastamento das atividades esportivas variando de 14% a 20% entre os atletas com lesão medular. Nosso estudo evidenciou aspectos semelhantes.
Identificação de fatores associados às úlceras por pressão em indivíduos paraplégicos relacionados às atividades de lazer
Authors: Leite Valéria Barreto Esteves , Faro Ana Cristina Mancussi
Published: June 2022

As lesões da medula espinhal trazem como conseqüência o déficit motor e sensitivo, abaixo do nível lesionado além de disfunções vasomotoras e alterações autonômicas, entre outras. A úlcera por pressão (UP) é uma das mais freqüentes e graves conseqüências da lesão medular, ainda observada na maioria dos indivíduos paraplégicos. O objetivo deste estudo foi identificar os fatores associados à úlcera por pressão em indivíduos paraplégicos com lesão nível T6 ou abaixo, relacionados à prevenção de UP e atividades de lazer. A pesquisa foi realizada na triagem de um centro de reabilitação no município de São Paulo, junto a 35 indivíduos paraplégicos. Deste total (35) 90,32% eram do sexo masculino, 22,58% deles com idade maior do que 53 anos, com tempo de paraplegia entre 1 e 3 anos para 45,16 e etiologia traumática da paraplegia para 83,87% dos casos. O uso da televisão e vídeo foi a atividade de lazer mais citada (67,74%). Verificou-se que em 70,0% dos casos as atividades de lazer eram mais passivas e as mais ativas em 18,18%, sendo o aparecimento de UP para mais ativos. Auto-exame de pele e mudança de decúbito as medidas mais citadas. Uma abordagem holística por parte dos profissionais reabilitadores é de fundamental importância para a eficácia da prevenção de UP, sendo a triagem uma oportunidade terapêutica positiva para a prevenção de UP.
Estudo da associação entre dor patelofemoral e retropé varo
Authors: Venturini Claudia , Morato Flávio , Michetti Henrique , Russo Mayra , Carvalho Vanice de Paula
Published: June 2022

A dor patelofemoral, também denominada dor anterior do joelho está presente em 25% da população, onde 36% são adolescentes e com maior prevalência no sexo feminino e atletas. Objetivo: Verificar a associação entre a presença de retropé varo a partir da posição neutra da subtalar e a dor patelofemoral. Métodos: Foram recrutados 10 voluntários com dor patelofemoral unilateral ou bilateral. Os voluntários foram submetidos à avaliação do alinhamento do retropé a partir da posição neutra da subtalar. Para isso, os voluntários foram posicionados em decúbito ventral, com o pé pendente para fora da mesa. Os ângulos formado pelas retas que dividem as pernas e os calcâneos ao meio foram medidas através de um goniômetro universal. O teste de Fisher foi utilizado para verificar a associação entre dor patelofemoral e varismo de retropé maior ou igual ou menor que 8 graus. Resultados: Os resultados do presente estudo demonstraram que todos os membros com grau de retropé maior que 8 (75%) apresentavam dor, totalizando 15 joelhos. Já os joelhos avaliados com retropé menor ou igual a 8; 2 (10%) apresentavam dor e 3 (15%) não apresentaram dor. Associação estatisticamente significativa entre o grau de retropé e a presença de dor foram encontrados (p= 0,009). Discussão: O varismo de retropé leva a pronação excessiva da subtalar associada à rotação interna da tíbia com conseqüente alteração do alinhamento do membro inferior e dor patelofemoral, Conclusão: Os resultados desse estudo sugerem que existe a associação entre o retropé varo e a dor patelofemoral.
Alterações de comunicação e linguagem de pacientes portadores de lesão encefálica adquirida: estudo descritivo retrospectivo
Authors: Cecatto Rebeca Boltes , Jucá Sueli Hamada , Nacarato Maria Inês , Maeda Fabiana Regina Giacomini , Prieto Fernanda Franco
Published: June 2022

Há poucos estudos brasileiros abordando a comunicação e linguagem dos pacientes adultos com lesões encefálicas adquiridas, bem como sua relação com as melhoras motoras e cognitivas durante a reabilitação. Esse fator, somado à complexidade da avaliação dessas alterações justifica este estudo. O objetivo deste estudo foi descrever as alterações de comunicação nos pacientes adultos com lesões encefálicas adquiridas atendidos pela equipe de reabilitação de pacientes com lesões encefálicas adquiridas e correlacionar esses dados com variáveis biodemográficas, clínicas e achados aos exames de imagem. Cento e dezenove prontuários médicos de pacientes hemiplégicos sob reabilitação, atendidos entre Outubro de 2002 e 2004 foram avaliados. Foram tabulados dados clínicos, biodemográficos, resultados de exame de imagem e o padrão de transtorno de comunicação de acordo com a avaliação realizada no serviço de fonoaudiologia. O grau de incapacidade foi avaliado pela medida de independência funcional (MIF). O AVE correspondeu a 74% dos casos, seguido pelo TCE em 20% e 6% de outras etiologias. Cinqüenta e um pacientes apresentaram alterações de linguagem, enquanto 43 tinham outras alterações fonoaudiológicas e não de linguagem e 25 sem alterações; 30,9% de afasias (sendo 56% dessas, mistas, a mais prevalente), 27,7% de disartrias, 24,5% de apraxias, 22,3% de alterações lingüístico-cognitivas, 21,3% de alterações de voz, 20,2% de disfagias, 14,9% de alterações sensoriomotoras orais, 3,2% de hipoacusias e 1,1% de anomias. Não foram encontradas associações entre o gênero na comparação dos subgrupos com afasia, portadores de distúrbio lingüístico-cognitivo, TCE ou AVE, bem como nenhum paciente sugerindo dominância cerebral para linguagem à direita. A prevalência das afasias apresentou relação com a lateralidade esquerda da lesão e a dos distúrbios lingüístico-cognitivos com a lateralidade direita e com a presença de TCE, sendo menor o número de afásicos entre os pacientes com TCE do que no resto da amostra. A MIF apresentou associação com as alterações de linguagem, sugerindo que estas influenciaram o grau de independência dos pacientes. Conclusões: A comunicação e suas alterações estão ligadas às outras alterações cognitivas, motoras, sócio-culturais e pessoais do paciente, o que reforça a importância das equipes interdisciplinares no diagnóstico funcional e reabilitação dos pacientes com lesões encefálicas adquiridas.