bluuebunny/crossref_metadata_2025 huggingface dataset:
Metaverse Space Ecological Scene Design Based on Multimedia Digital Technology
Authors: Xu Xuheng , Zou Guiheng , Chen Lifeng , Zhou Ting
Published: July 2022

Yuan cosmos is a virtual world linked and created by scientific and technological means, which is mapped and interacted with the real world, and a digital living space with a new social system. With the increasing popularity of data acquisition and production equipment, people are increasingly convenient to produce multimedia data such as images, graphics, audio, video, animation, and three-dimensional models. In addition to the rapid development of digital technology itself, the biological information technology related to digital technology also greatly promotes the emergence of the metauniverse. This paper aims to study the application of multimedia digital technology to the ecological scene design of metauniverse space, introduces the related concepts of metauniverse and multimedia digital technology, expounds the related methods of multimedia digital technology and neural network related algorithms, and then takes the three-dimensional simulation of the auditory system in the interactive multisensory simulation system of the constituent elements of metauniverse as an example. The mel-frequency cepstrum coefficient (MFCC) is used to simulate the auditory characteristics of the auditory periphery (cochlea) as the perceptual end of the model. A variety of bionic mechanisms are used in the model, such as designing the connection mode of neurons, learning state and release effect, and the regeneration mechanism of neurons. For the verification of the performance of the model, the speech sample database, including English words and phrases, is recorded and the speech content information recognized by the model by means of speech recognition is experimented. The experimental results show that, in terms of phrase accuracy, the DN-1 model improves 2.59% and the DN-2 model improves 2.77% compared with MFCC feature on the basis of mixed features. When only DBN features are used, the performance improvement rate of the developmental network model is small.
Deep Learning-Based Mental Health Model on Primary and Secondary School Students’ Quality Cultivation
Authors: Li Shuang , Liu Yu
Published: July 2022

The purpose was to timely identify the mental disorders (MDs) of students receiving primary and secondary education (PSE) (PSE students) and improve their mental quality. Firstly, this work analyzes the research status of the mental health model (MHM) and the main contents of PSE student-oriented mental health quality cultivation under deep learning (DL). Secondly, an MHM is implemented based on big data technology (BDT) and the convolutional neural network (CNN). Simultaneously, the long short-term memory (LSTM) is introduced to optimize the proposed MHM. Finally, the performance of the MHM before and after optimization is evaluated, and the PSE student-oriented mental health quality training strategy based on the proposed MHM is offered. The results show that the accuracy curve is higher than the recall curve in all classification algorithms. The maximum recall rate is 0.58, and the minimum accuracy rate is 0.62. The decision tree (DT) algorithm has the best comprehensive performance among the five different classification algorithms, with accuracy of 0.68, recall rate of 0.58, and F1-measure of 0.69. Thus, the DT algorithm is selected as the classifier. The proposed MHM can identify 56% of students with MDs before optimization. After optimization, the accuracy is improved by 0.03. The recall rate is improved by 0.19, the F1-measure is improved by 0.05, and 75% of students with MDs can be identified. Diverse behavior data can improve the recognition effect of students’ MDs. Meanwhile, from the 60th iteration, the mode accuracy and loss tend to be stable. By comparison, batch_size has little influence on the experimental results. The number of convolution kernels of the first convolution layer has little influence. The proposed MHM based on DL and CNN will indirectly improve the mental health quality of PSE students. The research provides a reference for cultivating the mental health quality of PSE students.
Teaching Mode in the Management of Higher Vocational Colleges in the Era of Big Data
Authors: Zhao Huimin
Published: July 2022

In the current information society, colleges and universities have produced a wealth of data on educational learning, research, personnel training, and student management. Changes in data formats and quantity lead to changes in quality. If university administrators can summarize these massive data, conduct effective mining and analysis, and finally present the analysis results in university management decision-making, then this should be the creative research of university administrators. In the construction of digital campuses, informatization promotes multiple innovations in teaching and management in vocational colleges, resulting in teaching big data, teaching big data, and data management needs. After analyzing the reading data of students’ on-campus learning system through big data, it can be concluded that the learning data of Blue Nebula from 2017.09.20 to 2017.10.10 is 8.5 more than that of Chaoxing on average. During the period of 10.01–10.10, the learning data of the two platforms increased by 15 and 7, respectively, compared with the period of 09.20–09.30.
Biophilic Design as an Important Bridge for Sustainable Interaction between Humans and the Environment: Based on Practice in Chinese Healthcare Space
Authors: Zhao Yang , Zhan Qinchuan , Xu Tiancheng
Published: July 2022

Since the COVID-19 epidemic, there has been an increased need for well-being and sustainable development, making biophilic design in hospital environments even more significant. However, after investigation, it was found that in many countries including China, the biophilic design of some hospitals is seriously absent, while other parts have the integration of biophilic design, but the standardization and recognition are not high. By restoring the interaction between buildings and nature, biophilic design improves the quality of environments and the health of users. The basic theoretical framework of environmental psychology is followed in this research. The health promotion mechanism, applicable natural features, and relative health advantages of hospital space and environment biophilic design are first investigated. Furthermore, according to the current status of biophilic design applications in the 12 hospitals that have the closest interaction between people and the environment. Combined with the professional and functional requirements of the healthcare spaces and the users’ special demands, we propose appropriate update design methods. The goal of this study was to present ideas for healthy and efficient space environment design and to inspire sustainable environmental design for future healthcare environments.
Optimal Biologic Drugs for the Treatment of Ankylosing Spondylitis: Results from a Network Meta‐Analysis and Network Metaregression
Authors: Cao Ziqin , Guo Jia , Li Qiangxiang , Li Yajia , Wu Jianhuang
Published: July 2022

Background. Ankylosing spondylitis (AS) is a common immune‐related systemic chronic inflammatory osteoarthropathy. Previous studies have proven that biologic agents, including IL‐17A inhibitors (IL17Ai), TNF‐α inhibitor FC fusion protein (TNFiFCP), or fully human monoclonal antibody (TNFiNMA) and JAK inhibitor (JAKi), are effective for AS treatment. Our study is aimed at comparing the clinical efficacy, tolerability, and safety of different biological agents, including novel IL‐6 inhibitor (IL6i), IL‐23 inhibitor (IL23i), and IL‐17 A/F dual variable domain inhibitor (IL17AFi) in AS. Method. PubMed, Scopus, Embase, CNKI, and the Cochrane Library were systematically searched. A frequentist framework network meta‐analysis with a random‐effects model was performed. Ranking effects were calculated by surface under the cumulative ranking analysis (SUCRA) and cluster‐rank analysis. Results. IL17AFi reported both the highest ASAS40 (SUCRA = 91.4%) and ASAS20 (SUCRA = 92.5%) response, while IL6i and IL23i reported the lowest responses (SUCRA = 6.6% and 19.9%, respectively). With the exceptions of IL6i (RR 0.60, 95% CI (0.22 to 1.67) for ASAS40 and 1.36 (0.71 to 2.58) for ASAS20) and IL23i (0.98 (0.68 to 1.40) for ASAS40 and 0.91 (0.70 to 1.19) for ASAS20), all biological drugs demonstrated statistically superior ASAS responses than placebo. TNFiFMA performed best in the suppression of disease activity (SUCRA = 77.4%, SMD 2.35, and 95% CI (1.11 to 3.59)) and functional improvement (SUCRA = 68.8%, SMD 1.67, and 95% CI (0.59 to 2.74)). There were no significant differences in tolerability or safety between biologic drugs and placebo. Conclusions. The novel IL‐17 A/F dual variable domain inhibitor, bimekizumab, may be an ideal future treatment choice for AS, while IL‐23 and IL‐6 inhibitors demonstrate little potential in the treatment of AS. For patients with rapid disease progression and severe functional limitation, TNF‐α inhibitors, especially infliximab, are safe and effective and could be a first‐line treatment choice.
A Newly Established Cuproptosis-Associated Long Non-Coding RNA Signature for Predicting Prognosis and Indicating Immune Microenvironment Features in Soft Tissue Sarcoma
Authors: Han Jun , Hu Yunxiang , Liu Sanmao , Jiang Jian , Wang Hong
Published: July 2022

Cuproptosis, a new type of programmed cell death, is involved in the development and progression of malignancies. The study of cuproptosis-associated long non-coding RNAs (lncRNAs) in soft tissue sarcomas (STSs) is however limited. There is also uncertainty regarding the prognostic accuracy of cuproptosis-associated lncRNAs in STSs and their relationship to the tumor immune microenvironment. The aim of this study was to determine the prognostic significance of cuprotosis-associated lncRNAs in STSs and their relationship to the tumor immune microenvironment. Transcriptomic and clinical data from patients with STSs were obtained through The Cancer Genome Atlas (TCGA). Overall, 259 patients were randomly allocated to a training group or a testing group. In the training group, a cuproptosis-associated lncRNA signature was constructed, and the signature was verified in the testing group. On the basis of risk scores and clinical features, we later developed a hybrid nomogram. We also performed functional and tumor immune microenvironment analysis based on the cuproptosis-associated lncRNA signature. A signature of 5 cuproptosis-associated lncRNAs was created. Based on this signature, we categorized STS patients into high-risk and low-risk groups. The study showed that patients at high risk had a worse prognosis than those at low risk. A nomogram was then constructed combining clinical characteristics with the risk scores, and it was shown to have credible predictive power. Functional enrichment and tumor immune microenvironmental analyses showed that high-risk STSs tend to be immunologically sensitive tumors. In our study, we found a cuproptosis-associated lncRNAs signature, which serves as an independent prognostic indicator. Cuproptosis-associated lncRNAs may play a role in the tumor immune microenvironment, which might be a therapeutic target for patients with STSs.
The Application of Convolutional Neural Network Combined with Fuzzy Algorithm in Colorectal Endoscopy for Tumor Assessment
Authors: Su Te-Jen , Lee Feng-Chun , Sun Cheuk-Kwan , Ke Fu-Xiang , Wang Shih-Ming , Huang Ming-Chih
Published: July 2022

According to the Global Cancer Statistics 2020 published in the official journal of the American Cancer Society (ACS), colorectal cancer ranked 4th in incidence and 2nd in mortality, and the 2018 Cancer Registry Report of Taiwan Health Promotion Administration showed that colorectal cancer ranked 2nd in incidence and 3rd in mortality. With the rapid evolution of the times, the lifestyles of the people have shifted from what they used to be. In addition to uncontrollable factors such as family genetic disorders, diet, and bad habits, life stress may lead to an unhealthy body mass index (BMI), which, together with aging, increases the incidence of colorectal cancer. In this study, the convolutional neural network was used to assess the risk of tumor in the colon by colonoscopy. The endoscopic images of the colon, which were classified into three categories of healthy (normal), benign tumor, and malignant tumor, were adopted as training data. When this method is combined with the patient’s physical data, the risk cancer can be calculated by the fuzzy algorithm. Based on the result of this study, the accuracy of the tumor profile by colonoscopy, that is, 81.6%, is more precise than that of colorectal cancer tumor analysis studies in the recent literature. The proposed method will help physicians in the diagnosis of colorectal cancer and treatment decisions.
Probing Triple Higgs Self-Coupling and Effect of Beam Polarization in Lepton Colliders
Authors: Ahmed Ijaz , Nawaz Ujala , Khurshid Taimoor , Qazi Shamona Fawad
Published: July 2022

One of the main objectives of almost all future (lepton) colliders is to measure the self-coupling of triple Higgs in the Standard Model. By elongating the Standard Model’s scalar sector, using incipient Higgs doublet along with a quadratic (Higgs) potential can reveal many incipient features of the model and the possibility of the emergence of additional Higgs self-couplings. The self-coupling of the Higgs boson helps in reconstructing the scalar potential. The main objective of this paper is to extract Higgs self-coupling by numerically analyzing several scattering processes governed by two Higgs doublet models (2HDM). These scattering processes include various possible combinations of final states in the triple Higgs sector. The determination of production cross-section of scattering processes is carried out using two different scenarios, one with and other without polarization of incoming beam, and is extended to a center of mass energy up to

s

=
3
TeV

. The computation is carried out in type-1 2HDM. Here, we consider the case of exact alignment limit (

s

β
α

=1) and masses of extra Higgs states are equal, that is,

m

H

=

m

H

0

=

m

A

0

=

m

H

±

. This choice minimizes the oblique parameters. The decays of the final state of each process are investigated to estimate the number of events at an integrated luminosity of 1

a

b

−
1

and 3

a

b

−
1

.
Estudiantes como agentes activos de su proceso formativo: una experiencia emergente en educación médica
Authors: Araya Tapia Pablo , Böhm Ghiringhelli Pauline , Bustos García Ignacio , Durán Alvarado Diego , Giacaman Salcedo Catalina , González Atenas Isidora , Laprida Acuña Camilo , Martínez Villavicencio Camila , Meléndez Campillay Javiera , Olivares Álvarez Rodrigo , Villarroel Norambuena Paula , Gana Ahumada Natalia , Zuñiga Parada Denisse , Cisternas Martínez Marcela , Püschel Illanes Klaus
Published: July 2022

Introducción: la participación de estudiantes en su proceso formativo ha emergido como un estándar de calidad en educación médica. Sin embargo, existe escasa información sobre la perspectiva concreta de los estudiantes respecto a estrategias institucionales de participación y escasas experiencias reflexivas de su propio proceso formativo. Métodos: basado en el modelo de investigación participativa, un grupo de 104 estudiantes, docentes, y funcionarios administrativos de la Escuela de Medicina de la Pontificia Universidad Católica de Chile, participaron en un proceso de reflexión sistemático de 6 meses de duración relativo a participación estudiantil, estrategias e innovaciones en educación médica. El proceso culminó con la Jornada Docente Alumno Funcionario donde se abordaron aspectos específicos de los tópicos definidos. Resultados: se identificaron estrategias mixtas de participación que incluyeron elementos de los modelos de gobernanza, co-creación y alianzas. La excelencia, el respeto y la amabilidad fueron elementos centrales de la formación médica identificados por los estudiantes. Sin embargo, se identificó también la preponderancia de una cultura de competitividad por sobre una de colaboración a nivel formativo. Existió desacuerdo sobre la relevancia del compromiso social como parte del proceso formativo en Medicina. Se enfatizó la relevancia de la formación de habilidades de comunicación, trabajo interdisciplinario y retroalimentación. Conclusiones: la participación de estudiantes en su propio proceso formativo es factible, pero requiere estrategias específicas. Un proceso de reflexión sistemático en la comunidad académica puede exponer aspectos relevantes de la identidad formativa médica. Este proceso puede exponer competencias esenciales a profundizar tales como comunicación, trabajo interdisciplinario y retroalimentación.
Profesionalizar la educación médica de residentes para un mejor cuidado de los pacientes: desarrollo e implementación de la educación por competencias CanMEDS en la UC
Authors: Hoyl Trinidad , Grez Marcela , Gomes Marcio M. , Puschel Klaus , Snell Linda
Published: July 2022

Introducción: la educación médica basada en competencias (CBME) se ha ido adoptando ampliamente; en esta, las competencias se originan de las necesidades sociales de atención de salud y están articuladas en un marco claramente definido. El Royal College de Canadá (RCPSC) ha desarrollado el marco CanMEDS, que ha sido ampliamente utilizado en formación de especialistas. Métodos: la Dirección de Postgrado de la Pontificia Universidad Católica de Chile (DPG-UC) decidió adoptar el modelo CanMEDS de CBME, y se planteó la meta de integrarlo a nivel institucional y en sus programas de especialización médica. Se utilizó el modelo de Kotter de liderazgo en gestión del cambio para describir el proceso. Resultados: comenzamos estableciendo un sentido de urgencia de realizar el cambio, y se constituyó un equipo directivo sólido para liderar el proceso. Definimos nuestra visión: consolidar un Postgrado con estándares internacionales, y aportar especialistas de excelencia a la sociedad; diseminamos la visión con jefes de programas, docentes de primera línea y residentes, usando variadas estrategias para empoderarlos. Se fijaron metas: en DPG-UC se actualizaron procesos según estándares institucionales internacionales del RCPSC;  y  a nivel de programas, post mapeo curricular, estos se reescribieron por competencias, y se consolidó la enseñanza y evaluación de roles. El 2016, la UC logró el hito histórico de ser la primera institución no canadiense, acreditada por RCPSC. Discusión y conclusiones: preparar la acreditación internacional resultó un motor para impulsar cambios. formamos una comunidad de práctica UC-RCPSC, aprendimos a incorporar la mirada internacional del RCPSC, aplicada a nuestra realidad local.  Nuestro desafío es mantener estándares internacionales, y seguir aportando especialistas de excelencia que aseguren una atención integral, experta y comprometida con la sociedad y nuestros pacientes.
De-escalated Neoadjuvant Chemotherapy in Early Triple-Negative Breast Cancer (TNBC): Impact of Molecular Markers and Final Survival Analysis of the WSG-ADAPT-TN Trial
Authors: Gluz Oleg , Nitz Ulrike , Kolberg-Liedtke Cornelia , Prat Aleix , Christgen Matthias , Kuemmel Sherko , Mohammadian Mohammad Parsa , Gebauer Daniel , Kates Ronald , Paré Laia , Grischke Eva-Maria , Forstbauer Helmut , Braun Michael , Warm Mathias , Hackmann John , Uleer Christoph , Aktas Bahriye , Schumacher Claudia , Wuerstlein Rachel , Graeser Monika , Pelz Enrico , Jóźwiak Katarzyna , zu Eulenburg Christine , Kreipe Hans Heinrich , Harbeck Nadia ,   on behalf of the ADAPT TN investigators
Published: July 2022

Purpose:

Although optimal treatment in early triple-negative breast cancer (TNBC) remains unclear, de-escalated chemotherapy appears to be an option in selected patients within this aggressive subtype. Previous studies have identified several pro-immune factors as prognostic markers in TNBC, but their predictive impact regarding different chemotherapy strategies is still controversial.

Experimental Design:

ADAPT-TN is a randomized neoadjuvant multicenter phase II trial in early patients with TNBC (n = 336) who were randomized to 12 weeks of nab-paclitaxel 125 mg/m2 + gemcitabine or carboplatin d 1,8 q3w. Omission of further (neo-) adjuvant chemotherapy was allowed only in patients with pathological complete response [pCR, primary endpoint (ypT0/is, ypN0)]. Secondary invasive/distant disease-free and overall survival (i/dDFS, OS) and translational research objectives included quantification of a predictive impact of markers regarding selection for chemotherapy de-escalation, measured by gene expression of 119 genes (including PAM50 subtype) by nCounter platform and stromal tumor-infiltrating lymphocytes (sTIL).

Results:

After 60 months of median follow-up, 12-week-pCR was favorably associated (HR, 0.24; P = 0.001) with 5y-iDFS of 90.6% versus 62.8%. No survival advantage of carboplatin use was observed, despite a higher pCR rate [HR, 1.04; 95% confidence interval (CI), 0.68–1.59]. Additional anthracycline-containing chemotherapy was not associated with a significant iDFS advantage in pCR patients (HR, 1.29; 95% CI, 0.41–4.02). Beyond pCR rate, nodal status and high sTILs were independently associated with better iDFS, dDFS, and OS by multivariable analysis.

Conclusions:

Short de-escalated neoadjuvant taxane/platinum-based combination therapy appears to be a promising strategy in early TNBC for using pCR rate as an early decision point for further therapy (de-) escalation together with node-negative status and high sTILs.

See related commentary by Sharma, p. 4840
Regulation of TORC1 by MAPK Signaling Determines Sensitivity and Acquired Resistance to Trametinib in Pediatric BRAFV600E Brain Tumor Models
Authors: Li Fuyang , Bondra Kathryn M. , Ghilu Samson , Studebaker Adam , Liu Qianqian , Michalek Joel E. , Kogiso Mari , Li Xiao-Nan , Kalapurakal John A. , James C. David , Burma Sandeep , Kurmasheva Raushan T. , Houghton Peter J.
Published: July 2022

Purpose:

We investigated why three patient-derived xenograft (PDX) childhood BRAFV600E-mutant brain tumor models are highly sensitive to trametinib. Mechanisms of acquired resistance selected in situ, and approaches to prevent resistance were also examined, which may translate to both low-grade glioma (LGG) molecular subtypes.

Experimental Design:

Sensitivity to trametinib [MEK inhibitor (MEKi)] alone or in combination with rapamycin (TORC1 inhibitor), was evaluated in pediatric PDX models. The effect of combined treatment of trametinib with rapamycin on development of trametinib resistance in vivo was examined. PDX tissue and tumor cells from trametinib-resistant xenografts were characterized.

Results:

In pediatric models TORC1 is activated through ERK-mediated inactivation of the tuberous sclerosis complex (TSC): consequently inhibition of MEK also suppressed TORC1 signaling. Trametinib-induced tumor regression correlated with dual inhibition of MAPK/TORC1 signaling, and decoupling TORC1 regulation from BRAF/MAPK control conferred trametinib resistance. In mice, acquired resistance to trametinib developed within three cycles of therapy in all three PDX models. Resistance to trametinib developed in situ is tumor-cell–intrinsic and the mechanism was tumor line specific. Rapamycin retarded or blocked development of resistance.

Conclusions:

In these three pediatric BRAF-mutant brain tumors, TORC1 signaling is controlled by the MAPK cascade. Trametinib suppressed both MAPK/TORC1 pathways leading to tumor regression. While low-dose intermittent rapamycin to enhance inhibition of TORC1 only modestly enhanced the antitumor activity of trametinib, it prevented or retarded development of trametinib resistance, suggesting future therapeutic approaches using rapamycin analogs in combination with MEKis that may be therapeutically beneficial in both KIAA1549::BRAF- and BRAFV600E-driven gliomas.
Slc6a13 Deficiency Attenuates Pasteurella multocida Infection-Induced Inflammation via Glycine-Inflammasome Signaling
Authors: He Fang , Qiu Yangyang , Wu Xiaoyan , Xia Yaoyao , Yang Liu , Wu Chenlu , Li Pan , Zhang Rui , Fang Rendong , Li Nengzhang , Peng Yuanyi
Published: July 2022

We have previously demonstrated that Slc6a13-deficient (Slc6a13−/−; KO) mice are resistant to P. multocida infection, which might be in connection with macrophage-mediated inflammation; however, the specific metabolic mechanism is still enigmatic. Here we reproduce the less sensitive to P. multocida infection in overall survival assays as well as reduced bacterial loads, tissue lesions, and inflammation of lungs in KO mice. The transcriptome sequencing analysis of wild-type (WT) and KO mice shows a large number of differentially expressed genes that are enriched in amino acid metabolism by functional analysis. Of note, glycine levels are substantially increased in the lungs of KO mice with or without P. multocida infection in comparison to the WT controls. Interestingly, exogenous glycine supplementation alleviates P. multocida infection-induced inflammation. Mechanistically, glycine reduces the production of inflammatory cytokines in macrophages by blocking the activation of inflammasome (NALP1, NLRP3, NLRC4, AIM2, and Caspase-1). Together, Slc6a13 deficiency attenuates P. multocida infection through lessening the excessive inflammatory responses of macrophages involving glycine-inflammasome signaling.
Serum Creatinine Patterns in Neonates Treated with Therapeutic Hypothermia for Neonatal Encephalopathy
Authors: Keles Elif , Wintermark Pia , Groenendaal Floris , Borloo Noor , Smits Anne , Laenen Annouschka , Mekahli Djalila , Annaert Pieter , Şahin Suzan , Öncel Mehmet Yekta , Chock Valerie , Armangil Didem , Koc Esin , Battin Malcolm R. , Frymoyer Adam , Allegaert Karel
Published: July 2022

Introduction: There is large variability in kidney function and injury in neonates with neonatal encephalopathy (NE) treated with therapeutic hypothermia (TH). Acute kidney injury (AKI) definitions that apply categorical approaches may lose valuable information about kidney function in individual patients. Centile serum creatinine (SCr) over postnatal age (PNA) may provide more valuable information in TH neonates. Methods: Data from seven TH neonates and one non-TH-treated, non-NE control cohorts were pooled in a retrospective study. SCr centiles over PNA, and AKI incidence (definition: SCr ↑≥0.3 mg/dL within 48 h, or ↑ ≥1.5 fold vs. the lowest prior SCr within 7 days) and mortality were calculated. Repeated measurement linear models were applied to SCr trends, modeling SCr on PNA, birth weight or gestational age (GA), using heterogeneous autoregressive residual covariance structure and maximum likelihood methods. Findings were compared to patterns in the control cohort. Results: Among 1,136 TH neonates, representing 4,724 SCr observations, SCr (10th–25th–50th–75th–90th–95th) PNA centiles (day 1–10) were generated. In TH neonates, the AKI incidence was 132/1,136 (11.6%), mortality 193/1,136 (17%). AKI neonates had a higher mortality (37.2–14.3%, p < 0.001). Median SCr patterns over PNA were significantly higher in nonsurvivors (p < 0.01) or AKI neonates (p < 0.001). In TH-treated neonates, PNA and GA or birth weight explained SCr variability. Patterns over PNA were significantly higher in TH neonates to controls (801 neonates, 2,779 SCr). Conclusions: SCr patterns in TH-treated NE neonates are specific. Knowing PNA-related patterns enable clinicians to better assess kidney function and tailor pharmacotherapy, fluids, or kidney supportive therapies.
Mechanismen der Immuntherapie-Resistenz bei kutanem Melanom: Erkennen eines Formwandlers
Authors: Thornton Jessica , Chhabra Gagan , Singh Chandra K. , Guzman-Perez Glorimar , Shirley Carl A. , Ahmad Nihal
Published: July 2022

Das Melanom ist eine der sieben häufigsten Krebsarten in den USA und seine Häufigkeit nimmt weiter zu. Seit 2011 haben die Entwicklungen bei zielgerichteten Therapien und Immuntherapien wesentlich dazu beigetragen, die Gesamtüberlebensraten deutlich zu verbessern. Vor dem Aufkommen zielgerichteter Therapien und Immuntherapien galt das metastasierte Melanom als Todesurteil, denn weniger als 5% der Patienten überlebten mehr als 5 Jahre. Dank der Einführung von Immuntherapien überlebt heute etwa die Hälfte der Patienten mit metastasiertem Melanom mehr als 5 Jahre. Leider bedeutet dies auch, dass die Hälfte der Melanompatienten auf die derzeitigen Therapien nicht anspricht und nach Diagnose weniger als 5 Jahre überlebt. Ein wichtiger Faktor, der zu einem geringeren Ansprechen in dieser Bevölkerungsgruppe beiträgt, ist die erworbene oder primäre Resistenz gegen Immuntherapien, die durch eine Immunevasion des Tumors entsteht. Um das Gesamtüberleben von Melanompatienten zu verbessern, müssen neue Behandlungsstrategien entwickelt werden, die das Risiko einer erworbenen Resistenz minimieren und die bestehende primäre Resistenz überwinden. In den letzten Jahren wurden bei der Identifizierung und dem Verständnis der Signalwege viele Fortschritte gemacht, die im Verlauf einer Immuntherapie zur Immunevasion des Tumors beitragen. Darüber hinaus gibt es zur Behandlung von Patienten mit immuntherapieresistentem Melanom erste Ergebnisse aus klinischen Studien. In dieser Übersicht fassen wir wichtige Mechanismen zusammen, die bei Patienten mit kutanem Melanom zur Resistenz gegen Immuntherapien führen. Wir haben uns auf tumoreigene Merkmale der Resistenz, veränderte Immunfunktionen und systemische Faktoren konzentriert, die zur Immuntherapieresistenz beim Melanom beitragen. Die Erforschung dieser Signalwege wird hoffentlich zu neuen Strategien führen, um eine erworbene Resistenz zu verhindern und eine bestehende Resistenz gegen eine Immuntherapie bei Patienten mit kutanem Melanom zu überwinden.
SLIT2 Rare Sequencing Variants Identified in Idiopathic Hypogonadotropic Hypogonadism
Authors: Wu Jiayu , Fang Zhenghuan , Wang Xinying , Zeng Wang , Zhao Yaguang , Jiang Fang , Chen Dan-Na , Zheng Ruizhi , Li Jinchen , Men Meichao , Li Jia-Da
Published: July 2022

Introduction: Idiopathic hypogonadotropic hypogonadism (IHH) is a rare reproductive disorder resulting from gonadotropin-releasing hormone (GnRH) deficiency. However, in only approximately half of patients with IHH is it possible to identify a likely molecular diagnosis. Mice lacking Slit2 have a reduced number or altered patterning of GnRH neurons in the brain. In order to assess the contribution of SLIT2 to IHH, we carried out a candidate gene burden test analysis. Methods: A total of 196 IHH probands and 2,362 ethic-matched controls were recruited for this study. The IHH probands and controls were subjected to whole-exome sequencing. In the IHH patients with SLIT2 variants and their available family members, detailed phenotyping and segregation analysis were performed. Results: Nine heterozygous SLIT2 rare sequencing variants (RSVs) were identified in 13 probands, with a prevalence of 6.6%. Furthermore, we identified an increased mutational burden for SLIT2 in this cohort (odds ratio = 2.2, p = 0.021). The segregation analysis of available IHH families revealed that the majority of SLIT2 RSVs were inherited from unaffected or partially affected parents. Conclusion: Our study suggests SLIT2 as a new IHH-associated gene and expands the clinical and genetic spectrum of IHH. Furthermore, SLIT2 alone does not appear to be sufficient to cause the disorder, and it may interact with other IHH-associated genes to induce a clinical phenotype.
Incidence and Risk Factors of Left Ventricular Thrombus in Acute ST-Segment Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention: A Meta-Analysis
Authors: Wang Pei , Ye Xudong , Yan Dongdong , Peng Yu , Zhang Zheng
Published: July 2022

Objective: Left ventricular thrombosis (LVT) is a common complication of acute ST-segment elevation myocardial infarction (STEMI). This study attempted to synthesize the available evidence to understand the incidence and risk factors of LVT in acute STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science for studies published from January 2001 to January 2022. The random-effects and fixed-effects model meta-analysis estimated pooled incidence, mean difference (MD), odds ratio (OR), and 95% confidence interval (CI). The Review Manager 5.4 software was used for meta-analysis performance. Results: The results of meta-analysis showed that the incidence of LVT in acute STEMI treated by primary PCI was 4% (95% CI [0.03, 0.05]), and the overall pooled incidence in patients with anterior STEMI was 10.0% (95% CI [0.07, 0.12]). Anterior STEMI (OR = 11.93, 95% CI [6.25, 22.78], p = 0.0003), left anterior descending-related infarct (OR = 6.85, 95% CI [3.70, 12.66], p < 0.00001), left ventricular wall motion abnormalities (OR = 7.53, 95% CI [3.18, 17.82], p < 0.00001), and lower post-PCI LVEF (MD = 13.78, 95% CI [12.15, 15.41], p < 0.00001) were risk factors for post-PCI LVT. Conclusion: The incidence of LVT after acute STEMI in the PCI era remains high. This study provides a preliminary overview of STEMI patients at risk for post-PCI LVT and will help the design of prospective randomized controlled trials for the management and prevention of LVT.
Karakteristik Faal Paru Berdasarkan Pemeriksaan Spirometri pada Pasien Suspek Tumor Paru dan Mediastinum
Authors: Pratiwi Suryanti , Agus Setyawan Ungky , Listyoko Aditya , Kirana Intan
Published: July 2022

Pendahuluan: Keganasan paru merupakan penyakit paru yang memiliki tingkat kematian tertinggi di dunia. Pemeriksaan untuk mengetahui fungsi paru dengan menggunakan spirometri.

Tujuan: Penelitian ini bertujuan untuk mengetahui distribusi faal paru pasien dengan diagnosis suspek tumor paru dan mediastinum di Rumah Sakit Saiful Anwar (RSSA) Malang berdasarkan usia, jenis kelamin, indeks massa tubuh (IMT), dan diagnosis.

Metode: Penelitian deskriptif analitik, pendekatan cross-sectional dengan menggunakan data rekam medis Januari 2018 – Desember 2019 kemudian dilakukan uji spearman.

Hasil: Hasil penelitian menunjukkan diagnosis suspek tumor paru dan mediastinum paling banyak pada rentang usia 51-60 tahun, jenis kelamin terbanyak laki-laki, diagnosis terbanyak tumor paru. Hasil interpretasi pemeriksaan spirometri terbanyak menunjukkan restriksi, dan IMT normal. Hasil analisis hubungan gambaran faal paru memiliki p-value pada suspek tumor paru dan mediastinum (0,814), jenis kelamin (0,003), dan IMT (0,360).

Kesimpulan: Terdapat hubungan yang signifikan antara gambaran faal paru dengan jenis kelamin dan tidak didapatkan hubungan yang signifikan antara gambaran faal paru dengan diagnosis dan IMT.
Terapi Asam Tranexamat dalam Bidang Dermatologi
Authors: Murlistyarini Sinta , Pratama Lucky
Published: July 2022

Asam Traneksamat merupakan antifibrinolitik sintetik analog lisin yang pertama kali dipatenkan pada tahun 1957. Pada awalnya asam traneksamat diindikasikan untuk digunakan dalam kondisi perdarahan abnormal atau kecenderungan perdarahan akibat hiperfibrinolisis lokal maupun sistemik. Namun saat ini penggunaannya meluas ke bidang dermatologi khususnya untuk digunakan pada urtikaria kronik dan angioedema, serta melasma. asam traneksamat bekerja dengan secara reversible memblok binding site plasmin yang menghambat aktivasi plasminogen menjadi plasmin sehingga dapat menstabilkan pembekuan darah. Asam traneksamat juga dapat mengurangi pelepasan vasoactive peptides yang dimediasi oleh plasmin seperti bradikinin dan histamin sehingga dapat membantu mengendalikan gejala urtikaria dan angioedema. Asam traneksamat memiliki peran penting pada melasma dengan cara mengurangi aktivasi plasmin pada kulit yang terpapar UV sehingga menghambat pelepasan asam arakidonat dan prostaglandin E2 yang pada akhirnya akan menghambat proses melanogenesis. Asam traneksamat telah digunakan secara oral dan topical sebagai terapi pada penyakit kulit dengan efek samping yang minimal. Namun masih dibutuhkan penelitian lebih lanjut untuk mengetahui cara kerja, dosis, serta cara pemberian yang optimal untuk mengatasi keainan pada kulit.
Multiple Biliary Stones: a Rare Long-term Complication after Whipple Procedure
Authors: Kirschbaum-Rubin Steven , Flores-Ortega Diego
Published: July 2022

A hypertensive, diabetic woman underwent a successful Whipple procedure at the age of 84 due to carcinoma of the ampulla of Vater. She presented an extremely rare complication 24 months after the surgery, consisting of acute cholangitis due to multiple biliary lithiases associated with a bilioenteric anastomotic stricture. The diagnosis was confirmed with computed tomography, magnetic resonance cholangiopancreatography, and cholangiography.The patient was successfully treated with multiple percutaneous transhepatic cholangioplasties.
Coordenação do cuidado na perspectiva das pessoas com hipertensão na atenção primária à saúde
Authors: Rêgo Anderson da Silva , Santos Fernanda Gatez Trevisan dos , Radovanovic Cremilde Aparecida Trindade , Arnaldo Juliana  Gabrielle Santos , Martins Mayara Almeida , Silva Marcelo da , Salci Maria Aparecida
Published: July 2022

Objetivo: analisar a satisfação de pessoas com hipertensão acerca da coordenação do cuidado na Atenção Primária à Saúde. Método: trata-se de um estudo transversal, realizado com 417 pessoas em um município de médio porte, localizado na região sul do Brasil. Os dados foram coletados no primeiro semestre de 2016, utilizando instrumento de avaliação adaptado e validado sobre domínios estruturais da Atenção Primária à Saúde e utilizado questões referentes à coordenação do cuidado. Realizou-se análise descritiva e inferencial para tratamento das variáveis. Resultados: evidenciou-se que os entrevistados avaliaram satisfatoriamente a utilização dos prontuários durante a consulta por parte dos profissionais de saúde e discussão dos resultados oriundos da consulta no serviço especializado. Pessoas com controle pressórico inadequado avaliaram insatisfatoriamente a anotação das queixas e necessidades em saúde, verbalizadas durante as consultas, agendamento para retorno e encaminhamento por escrito de competência das Unidades Básicas de Saúde, como também, atendimento garantido e informações esclarecedoras sobre os resultados da consulta no serviço referenciado. Conclusão: As pessoas com hipertensão apresentaram satisfação com a coordenação do cuidado na Atenção Primária à Saúde.
Deleção terminal do braço curto do cromossomo 6 (6p25.3p24.3): uma revisão de literatura e relato de caso de uma criança brasileira
Authors: Santos Brendha Zancanela , Zancanela Luana Beltrame , Argemi Carla Touren , Chiquetti Eloá Maria dos Santos
Published: July 2022

Introdução: As síndromes de deleção são eventos raros na prática clínica. A deleção cromossômica ocorre quando segmentos de informação genética são perdidos em um ou mais cromossomos. A ausência de alguns genes implica em fenótipos variados, cuja explicação detalhada ainda não está totalmente elucidada. Objetivo: Relatar o caso de uma criança com deleção de segmento terminal de 8,9 Mb do braço curto do cromossomo 6 (em 6p25.3p24.3) Métodos: Esse relato de caso foi aprovado pelo Comitê de Ética e Pesquisa da Instituição. Para sua elaboração, foram adicionados os dados de exames fornecidos pela família do paciente desde o pré-natal até a primeira infânciae a discussão com profissionais relacionados ao caso. Descrição do Caso: B.A.G., criança de dois anos, sexo feminino, filha única de pais não consanguíneos, sem antecedentes na família de doenças similares. Nasceu por cesárea prematura (IG 35 semanas), apresentando Síndrome de Dandy-Walker, tetralogia de Fallot, perímetro cefálico no percentil 97 e fácie sindrômica, com hipertelorismo, baixa implantação das orelhas e opacidades do cristalino bilateralmente. Conclusão: As deleções no cromossomo 6 são alterações genéticas de grande raridade. Até 2004, existiam apenas 43 casos na literatura médica, excluindo a anomalia do cromossomo 6 em anal 31. No que se refere às deleções terminais do braço curto, a do caso em questão - 6p24-pter - foram associadas o atraso no desenvolvimento, malformações cerebrais, anormalidades na câmara anterior do olho, perda auditiva, anormalidades no ouvido, micrognatia e cardiopatias 25.
Novas tendências, mais concentração? Os padrões de distribuição de matrículas no ensino superior brasileiro entre 2010 e 2019
Authors: Coelho Ruan de Oliveira , Penha Pedro Henrique Elgaly da , Milanski Bruna Aparecida
Published: July 2022

Nas últimas décadas, observou-se uma expansão global das vagas nos sistemas de ensino superior de vários países, o que foi acompanhado de um processo de crescente mercantilização nesse segmento da educação. Isto é, cada vez mais, a iniciativa privada passou a ter mais participação na sua oferta, e isso acarretou, dentre outras coisas, numa intensificação do fenômeno de diversificação institucional. As pesquisas estrangeiras sobre o tema possuem como foco justamente essa diversificação. Este artigo, entretanto, visa analisar o caso brasileiro também sob a ótica da concentração de matrículas na última década, que foi a de maior crescimento de modelos emergentes de oferta educacional, como a modalidade a distância. Os resultados apontam para a ocorrência de uma variação heterogênea da concentração de matrículas, em vários tipos de curso, mas para uma distribuição homogênea nos dois anos analisados, com uma concentração mais acentuada no ano final.
As origens intelectuais do fascismo e suas reinvenções: entre a “revolução conservadora” e o Tradicionalismo
Authors: Vasconcelos Francisco Thiago Rocha
Published: July 2022

Neste artigo, abordamos o fascismo a partir de suas fundamentações teóricas, tematizando as continuidades entre suas origens intelectuais e os desenvolvimentos mais recentes no pensamento e na prática política. Nosso ponto de partida foi a interpretação de Karl Polanyi sobre as origens intelectuais da “revolução conservadora”, movimento intelectual e político europeu do início do século XX. Em seguida, traçamos paralelos com o pensamento de Julius Evola, expoente do Tradicionalismo, corrente intelectual que desperta especial interesse no pensamento político da extrema direita ou da nova direita atuais. Demonstramos como os princípios intelectuais do fascismo permanecem sendo tendências latentes ou explícitas de desenvolvimento ao longo da história, servindo de fundamento para a restrição da democracia e para o manejo da política de massas em tempos de crise do capitalismo através do apoio a populismos de direita.
Transformações recentes na educação superior brasileira
Authors: Garcia Sylvia Gemignani , Brito Murillo Marschner Alves de , Hey Ana Paula
Published: July 2022

Nos últimos 25 anos, os sistemas nacionais de educação superior vêm experimentando um processo significativo de expansão e diversificação institucional sobre o qual as ciências sociais vêm se debruçando largamente. Avanços recentes no acesso à educação secundária têm promovido o crescimento da população elegível à educação superior, processo que vem acompanhado de um conjunto relevante de mudanças na organização institucional  e na estrutura de oportunidades que tem se apresentado às coortes mais jovens de estudantes que alcançam os níveis educacionais mais avançados. Pesquisas atuais têm documentado as transformações ocorridas no campo da educação superior em inúmeras dimensões. Trata-se de uma literatura diversa, interessada em evidenciar as características das mudanças institucionais nesse sistema em expansão, objeto de intensas lutas sociais.
Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Scientific Statement From the American Heart Association
Authors: Geller Bram J. , Sinha Shashank S. , Kapur Navin K. , Bakitas Marie , Balsam Leora B. , Chikwe Joanna , Klein Deborah G. , Kochar Ajar , Masri Sofia C. , Sims Daniel B. , Wong Graham C. , Katz Jason N. , van Diepen Sean ,   on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Cardiovascular Surgery and Anesthesia
Published: July 2022

The use of temporary mechanical circulatory support in cardiogenic shock has increased dramatically despite a lack of randomized controlled trials or evidence guiding clinical decision-making. Recommendations from professional societies on temporary mechanical circulatory support escalation and de-escalation are limited. This scientific statement provides pragmatic suggestions on temporary mechanical circulatory support device selection, escalation, and weaning strategies in patients with common cardiogenic shock causes such as acute decompensated heart failure and acute myocardial infarction. The goal of this scientific statement is to serve as a resource for clinicians making temporary mechanical circulatory support management decisions and to propose standardized approaches for their use until more robust randomized clinical data are available.
Learning and Inference in Sparse Coding Models With Langevin Dynamics
Authors: Fang Michael Y.-S. , Mudigonda Mayur , Zarcone Ryan , Khosrowshahi Amir , Olshausen Bruno A.
Published: July 2022

We describe a stochastic, dynamical system capable of inference and learning in a probabilistic latent variable model. The most challenging problem in such models—sampling the posterior distribution over latent variables—is proposed to be solved by harnessing natural sources of stochasticity inherent in electronic and neural systems. We demonstrate this idea for a sparse coding model by deriving a continuous-time equation for inferring its latent variables via Langevin dynamics. The model parameters are learned by simultaneously evolving according to another continuous-time equation, thus bypassing the need for digital accumulators or a global clock. Moreover, we show that Langevin dynamics lead to an efficient procedure for sampling from the posterior distribution in the L0 sparse regime, where latent variables are encouraged to be set to zero as opposed to having a small L1 norm. This allows the model to properly incorporate the notion of sparsity rather than having to resort to a relaxed version of sparsity to make optimization tractable. Simulations of the proposed dynamical system on both synthetic and natural image data sets demonstrate that the model is capable of probabilistically correct inference, enabling learning of the dictionary as well as parameters of the prior.
Unpacking South African Institutions of Higher Learning Efforts and Hurdles to Respond to COVID-19: Social Service Professionals’ Lenses
Authors: Kang’ethe Simon Murote
Published: July 2022

Incontrovertibly, COVID-19 has overwhelmed institutions of learning in a big way with various institutions in South Africa endeavoring to surmount the challenges in different ways. This article has reviewed various sources of secondary literature from mainly journals. Findings established that institutions of higher learning need to strengthen their institutional modus operandi of communicating coronavirus messages; to change the staff and students’ mindset to strengthen response; advocacy to relay message to staff and students; infrastructural support to mitigate the effects of staff and students; and to avail requisite psychosocial support. The article also established the following hurdles: teaching adjustments and gadget deficits; disruption of school curriculum and academic calendar; and pitfalls of working from home. The article has recognized the need for institutions to enlist the support of social service professionals such as social workers in availing the requisite psychosocial support to both students and the staff.