bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study of Heavy Metal Concentration in Eggs Originating from Industrial Poultry Farms and Free-Range Hens in Kosovo
Authors: Aliu H. , Dizman S. , Sinani A. , Hodolli G.
Published: March 2021

The aim of the present study was to determine the most significant heavy metal concentration in hen eggs, in particular to compare the heavy metal concentration in eggs originating from industrial poultry farms versus free-range hens. The sampling process was carried out between October and December 2018, in the Republic of Kosovo. In total, 22 random egg samples were collected, with 54.5% and 45.5% of samples coming from poultry farms and free-range hens, respectively. The measurements of the heavy metals were taken by inductively coupled plasma mass spectrometry (ICP-MS), using a wide range of elements, and only the most important elements were reported, such as Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Hg, and Pb within the range of 0.48–8.45, 38.77–289, 4286.59–15383.74, 0.45–144.74, 61.68–550.59, 1078.04–11378.56, 0.29–35.42, 0.27–6.54, and 0.04–1.41 μg kg−1, respectively. This study revealed that the heavy metals in eggs from free-range hens are richer in essential elements such as Mn, Fe, and Zn, while poultry farm eggs contain a higher contribution of Cr, Cd, As, and Pb. However, the daily intake of heavy metals from egg consumption was lower than the WHO-FAO advised provisional daily intake. Therefore, egg consumption does not exceed the safety levels of toxic metals and does not pose any risk to human health.
A System Fault Diagnosis Method with a Reclustering Algorithm
Authors: Yang Zhe , Ying Shi , Wang Bingming , Li Yiyao , Dong Bo , Geng Jiangyi , Zhang Ting
Published: March 2021

The log analysis-based system fault diagnosis method can help engineers analyze the fault events generated by the system. The K-means algorithm can perform log analysis well and does not require a lot of prior knowledge, but the K-means-based system fault diagnosis method needs to be improved in both efficiency and accuracy. To solve this problem, we propose a system fault diagnosis method based on a reclustering algorithm. First, we propose a log vectorization method based on the PV-DM language model to obtain low-dimensional log vectors which can provide effective data support for the subsequent fault diagnosis; then, we improve the K-means algorithm and make the effect of K-means algorithm based log clustering; finally, we propose a reclustering method based on keywords’ extraction to improve the accuracy of fault diagnosis. We use system log data generated by two supercomputers to verify our method. The experimental results show that compared with the traditional K-means method, our method can improve the accuracy of fault diagnosis while ensuring the efficiency of fault diagnosis.
The Effects of Landscape Change on Plant Diversity and Structure in the Bale Mountains National Park, Southeastern Ethiopia
Authors: Muhammed Annissa , Elias Eyasu
Published: March 2021

Bale Mountains National Park is one of the protected areas in Ethiopia that holds the largest area of Afroalpine habitat in Africa and the second largest stand of moist tropical forest. Nevertheless, human settlements, overgrazing, and recurrent fire are the main problems in the park. This study aimed to determine the effects of human-induced landscape change in floristic composition and structure in the park. The vegetation data were collected systematically from 96 sample plots laid along 24 line transects in the edge and interior habitats of the six land cover types. Vegetation composition and landscape structural analysis were made using R software version 3.5.2 and FRAGSTATS version 4.2.1, respectively. Patch number was strong and positively affected species richness (r = −0.90,

p
<
0.05

), diversity (r = −0.96,

p
<
0.01

), and basal area (r = −0.96,

p
<
0.001

), whereas mean patch size was strong and negatively influenced species richness (r = 0.95,

p
<
0.05

), diversity (r = 0.87,

p
<
0.05

), and basal area (r = 0.82,

p
<
0.05

). The overall species richness, Shannon diversity index, and Margalef index were significantly higher in the edge habitat; however, the mean basal area of woody species was significantly higher in the interior habitat at

p
<
0.05

. This study uncovered that the park is floristically rich and diverse, and it provides a variety of ecological and economic benefits to the surrounding community and to the nation at large. However, these benefits are gradually declining due to the high level of anthropogenic activities in the park. Thus, integrated environmental management strategy that blends with sustainable use of natural resources should be implemented to minimize the threats.
Prolactin Increases the Frequency of Follicular T Helper Cells with Enhanced IL21 Secretion and OX40 Expression in Lupus-Prone MRL/lpr Mice
Authors: Alemán-García Yolanda P. , Vaquero-García Ricardo M. , Flores-Fernández Rocio , Fuentes-Pananá Ezequiel M. , Gorocica-Rosete Patricia , Pizaña-Venegas Alberto , Chávez-Sanchéz Luis , Blanco-Favela Francico , Legorreta-Haquet María V. , Chávez-Rueda Adriana K.
Published: March 2021

Systemic lupus erythematosus is characterized by high levels of IgG class autoantibodies that contribute to the pathophysiology of the disease. The formation of these autoantibodies occurs in the germinal centers, where there is cooperation between follicular T helper cells (TFH) and autoreactive B cells. Prolactin has been reported to exacerbate the clinical manifestations of lupus by increasing autoantibody concentrations. The objective of this study was to characterize the participation of prolactin in the differentiation and activation of TFH cells, by performing in vivo and in vitro tests with lupus-prone mice, using flow cytometry and real-time PCR. We found that TFH cells express the long isoform of the prolactin receptor and promoted STAT3 phosphorylation. Receptor expression was higher in MRL/lpr mice and correlative with the manifestations of the disease. Although prolactin does not intervene in the differentiation of TFH cells, it does favor their activation by increasing the percentage of TFH OX40+ and TFH IL21+ cells, as well as leading to high serum concentrations of IL21. These results support a mechanism in which prolactin participates in the emergence of lupus by inducing overactive TFH cells and perhaps promoting dysfunctional germinal centers.
Towards Revealing Parallel Adversarial Attack on Politician Socialnet of Graph Structure
Authors: Tian Yunzhe , Liu Jiqiang , Tong Endong , Niu Wenjia , Chang Liang , Chen Qi Alfred , Li Gang , Wang Wei
Published: March 2021

Socialnet becomes an important component in real life, drawing a lot of study issues of security and safety. Recently, for the features of graph structure in socialnet, adversarial attacks on node classification are exposed, and automatic attack methods such as fast gradient attack (FGA) and NETTACK are developed for per-node attacks, which can be utilized for multinode attacks in a sequential way. However, due to the overlook of perturbation influence between different per-node attacks, the above sequential method does not guarantee a global attack success rate for all target nodes, under a fixed budget of perturbation. In this paper, we propose a parallel adversarial attack framework on node classification. We redesign new loss function and objective function for nonconstraint and constraint perturbations, respectively. Through constructing intersection and supplement mechanisms of perturbations, we then integrate node filtering-based P-FGA and P-NETTACK in a unified framework, finally realizing parallel adversarial attacks. Experiments on politician socialnet dataset Polblogs with detailed analysis are conducted to show the effectiveness of our approach.
Multiobjective Optimization of Sustainable WCO for Biodiesel Supply Chain Network Design
Authors: Geng Nana , Sun Yixiang
Published: March 2021

Bioenergy is attracting more attention worldwide due to its environmental and economic benefits. The design of a feasible biodiesel supply chain network can effectively improve the production and use of biodiesel and then further promote the development of the biodiesel industry. As an easy recyclable material with high yield, kitchen waste has a good prospect and can solve public health and safety problems. This paper takes the kitchen waste producing biodiesel as the object to design and optimize the biodiesel supply chain in order to improve the sustainable development of biodiesel industry and the operational efficiency of the biodiesel supply chain. By designing a sustainable biodiesel supply chain model under defined conditions, it proposes strategic and tactical decisions related to location, production, inventory, and distribution within multiple planning cycles. In order to effectively solve the model, a Pareto optimal NSGAII heuristic algorithm is proposed and applied to a practical case study of restaurants in Jiangsu Province. The efficiency of the method and the optimal solution are verified by a case study. The overall optimization of biodiesel supply can effectively improve the efficiency of supply chain, reduce system cost, improve the profit of biodiesel operators, and promote the sustainable development of biodiesel industry, which has important guiding significance and reference value for the practice of biodiesel supply chain network planning.
A Risk Signature with Nine Stemness Index-Associated Genes for Predicting Survival of Patients with Uterine Corpus Endometrial Carcinoma
Authors: Xu Haoya , Zou Ruoyao , Liu Jiyu , Zhu Liancheng
Published: March 2021

Purpose. To identify mRNA expression-based stemness index- (mRNAsi-) related genes and build an mRNAsi-related risk signature for endometrial cancer. Methods. We collected mRNAsi data of endometrial cancer samples from The Cancer Genome Atlas (TCGA) and analyzed their relationship with the main clinicopathological characteristics and prognosis of endometrial cancer patients. We screened the top 50% of the genes in TCGA for weighted gene correlation network analysis (WGCNA) to explore mRNAsi-related gene sets. Among these mRNAsi-related genes, we further screened for those related to the prognosis of endometrial cancer patients via univariate Cox regression analysis and least absolute shrinkage and selection operator (LASSO) regression analysis. Using stepwise multivariate Cox regression analysis, a stemness index-related risk signature was constructed. Finally, we identified potential prognostic biomarkers for endometrial cancer by combining the GEO database and immunohistochemical staining. Results. The mRNAsi of endometrial cancer samples was significantly higher than that of normal samples and was related to the International Federation of Gynecology and Obstetrics (FIGO) stage, pathological grade, postoperative tumor status, and overall survival of endometrial cancer patients. We identified 21 mRNAsi-related gene modules, and 1,324 genes were obtained from the most relevant module. TCGA samples were divided into training and validation cohorts, and the training cohort was used to construct a nine-mRNAsi-related gene signature (B3GAT2, CD3EAP, DMC1, FRMPD3, LINC01224, LINC02068, LY6H, NR6A1, and TLE2). High-risk and low-risk patients had significant prognostic differences, and the risk signature could accurately predict their 1-, 3-, and 5-year survival. The nomogram composed of risk score and multiple clinicopathological features could accurately predict 1-, 3-, and 5-year survival. Finally, CD3EAP was found to be a novel prognostic biomarker for endometrial cancer. Conclusion. Endometrial cancer cell stemness is related to patient prognosis. The nine-gene risk signature is an independent prognostic factor and can accurately predict endometrial cancer patient prognosis.
A Hybrid MADM Model for Newly Graduated Nurse’s Competence Evaluation and Improvement
Authors: Cheng Fengmin , Jin Yanjun , Chien Ching-Wen , Xiong Lei , Chuang Yen-Ching
Published: March 2021

Nursing departments in hospitals must evaluate the practical competency of newly graduated nurses and assist them to increase their competence. Competency assessments often consider multiple qualitative attributes and use expert knowledge as the basis for decision-making. This study proposes a hybrid multiple attribute decision-making (MADM) model that determines practical competency of the newly graduated nurse as an evaluation framework. A causal influence-network diagram (CIND) and influential weights are obtained from nursing experts’ clinical experience using the decision-making trial and evaluation laboratory (DEMATEL)-based analytical network process analysis (DANP). The MOORA-AS method is then used to evaluate the ability expectation ratio-gap for newly graduated nurses in practice. The CIND is used to allow each newly graduated nurse to reduce the performance ratio-gaps between the current level and the aspirational level from a systematic perspective. The empirical data applies to a third-class and a first-class hospital in China. The results show that the proposed hybrid MADM model has reliable results and allows nursing department decision-makers/managers to easily evaluate and systematically improve competencies for newly graduated nurses.
Prediction Method of Gestational Diabetes Based on Electronic Medical Record Data
Authors: Liu Yang , Yu Zhaoxiang , Sun Hua
Published: March 2021

At present, the secondary application of electronic medical records is focused on auxiliary medical diagnosis to improve the accuracy of clinical diagnosis. The main research in this article is the prediction method of gestational diabetes based on electronic medical record data. In the original data, the ID number of the medical examiner did not match the medical examination record. In order to ensure the accuracy of the data, this part of the record was removed. First, the preparation stage before building the model is to determine the baseline accuracy of the original data, test the effectiveness of the machine learning algorithm, and then balance the target data set to solve the bias caused by the imbalance between data classes and the illusion of excessive model prediction results. Then, the disease prediction model is constructed by dividing the data set, selecting parameters and algorithms, and visualizing the model. Finally, the effect of predictive model construction is comprehensively judged based on multiple evaluation indicators and control experimental models. In this paper, the RF model can be used to rank the importance of the feature importance of the output feature on the importance of the classification result of the input feature. In order to test the accuracy of regression prediction, the experiment uses absolute mean error and root mean square error to evaluate the accuracy of fasting blood glucose prediction. A logistic regression model is constructed through the training set, and the test set data are brought into the prediction model for prediction. Experimental data show that when the features filtered by WBFS are used, the accuracy, F1 value, and AUC value of logistic regression are 0.809, 0.881, and 0.825, respectively, which is an increase of about 12% compared with when the feature is not used. The results show that the electronic medical record data drive can effectively improve the accuracy of predicting gestational diabetes.
Spontaneous Splenic Artery Rupture as the First Symptom of Systemic Amyloidosis
Authors: Bruserud Øyvind , Tvedt Tor Henrik Anderson , Ahmed Aymen Bushra , Vintermyr Olav Karsten , Hervig Tor , Guttormsen Anne Berit , Reikvam Håkon
Published: March 2021

Spontaneous splenic rupture is a life-threatening condition leading to a rapidly progressing hypovolemic shock due to intra-abdominal blood loss, with a mortality rate of about 10%. Spontaneous splenic rupture can be caused by widely different disorders including acute and chronic infections, neoplastic disorders, and inflammatory noninfectious disorders. In this case report, we present a 67-year-old male patient with hemorrhagic shock caused by an acute bleeding from the splenic artery. The patient was massively transfused with blood products and fluids and underwent laparotomy for hemostatic control and clinical stabilization. Multiorgan involvement by amyloid light-chain amyloidosis (AL-amyloidosis) caused by plasma cell dyscrasia, specifically with infiltration of the spleen artery, was found to be the underlying cause of his life-threatening bleeding. Based on this case, we discuss the features of serious spleen bleeding, massive transfusion therapy in the intensive care setting, and AL-amyloidosis pathophysiology and treatment.
Detection of Vascular Reactive Oxygen Species in Experimental Atherosclerosis by High‐Resolution Near‐Infrared Fluorescence Imaging Using VCAM‐1‐Targeted Liposomes Entrapping a Fluorogenic Redox‐Sensitive Probe
Authors: Manea Simona-Adriana , Vlad Mihaela-Loredana , Rebleanu Daniela , Lazar Alexandra-Gela , Fenyo Ioana Madalina , Calin Manuela , Simionescu Maya , Manea Adrian
Published: March 2021

Excessive production of reactive oxygen species (ROS) and the ensuing oxidative stress are instrumental in all phases of atherosclerosis. Despite the major achievements in understanding the regulatory pathways and molecular sources of ROS in the vasculature, the specific detection and quantification of ROS in experimental models of disease remain a challenge. We aimed to develop a reliable and straightforward imaging procedure to interrogate the ROS overproduction in the vasculature and in various organs/tissues in atherosclerosis. To this purpose, the cell‐impermeant ROS Brite™ 700 (RB700) probe that produces bright near‐infrared fluorescence upon ROS oxidation was encapsulated into VCAM‐1‐targeted, sterically stabilized liposomes (VLp). Cultured human endothelial cells (EC) and macrophages (Mac) were used for in vitro experiments. C57BL6/J and ApoE‐/‐ mice were randomized to receive normal or high‐fat, cholesterol‐rich diet for 10 or 32 weeks. The mice received a retroorbital injection with fluorescent tagged VLp incorporating RB700 (VLp‐RB700). After two hours, the specific signals of the oxidized RB700 and 1,2‐distearoyl‐sn‐glycero‐3‐phosphoethanolamine‐N‐(7‐nitro‐2‐1,3‐benzoxadiazol‐4‐yl) (NBD‐DSPE), inserted into liposome bilayers, were measured ex vivo in the mouse aorta and various organs by high‐resolution fluorescent imaging. VLp‐RB700 was efficiently taken up by cultured human EC and Mac, as confirmed by fluorescence microscopy and spectrofluorimetry. After systemic administration in atherosclerotic ApoE‐/‐ mice, VLp‐RB700 were efficiently concentrated at the sites of aortic lesions, as indicated by the augmented NBD fluorescence. Significant increases in oxidized RB700 signal were detected in the aorta and in the liver and kidney of atherosclerotic ApoE‐/‐ mice. RB700 encapsulation into sterically stabilized VCAM‐1‐sensitive Lp could be a novel strategy for the qualitative and quantitative detection of ROS in the vasculature and various organs and tissues in animal models of disease. The accurate and precise detection of ROS in experimental models of disease could ease the translation of the results to human pathologies.
Chaos Prediction in Fractional Delayed Energy‐Based Models of Capital Accumulation
Authors: El-Borhamy Mohamed , Medhat Tamer , Ali Manal E.
Published: March 2021

This paper presents the nonlinear dynamic analysis of energy‐based models arisen from the applied systems characterized by the energy transport in the presence of fractional order derivative and time delay. The studied model is the fractional version of Bianca‐Ferrara‐Dalgaard‐Strulik (BFDS) model of economy which is viewed as a transport network for energy in which the law of motion of capital occurs. By considering the time delay as bifurcation parameter, a proof to investigate the existence of Hopf bifurcation and the phase lock solutions using the Poincare‐Linstedt and the harmonic balance methods is given. At definite values of time delay, period‐doubling bifurcations followed up by the consequences of chaotic states are detected. Simulation results assure that the BFDS model can generate new (hyper) chaotic attractors beyond half order derivatives through the effect of the time delay on that system. In accordance with the literatures related to the problem of chaos, the concluded results confirm the proposed theorem by El‐Borhamy in which the time delay possesses the ability to change the dynamic state of nonlinear systems from regular to chaotic within the fractional order derivative domain.
Dynamic System Analysis of Leadership Effectiveness in Complex Environments
Authors: Guo Shubing , Hou Yaming , Jiang Hui , Zhan Xueli , Ma Junhai
Published: March 2021

In this paper, based on chaos theory and dynamic system simulation, a dynamic model of a relational leadership system with pressure factors is established and simulated. The study found that the excessive self-leadership and the relational leadership cannot effectively improve the leadership effectiveness of leaders. In addition, with the adjustment of the self-leadership adjustment coefficient, leadership effectiveness will change from a stable state to a chaotic state. Only by adopting limited rational decision-making strategies in multicycle decision-making can leaders maintain a high level of leadership effectiveness. Previous research mainly focuses on the theoretical analysis of the complexity of the leadership system or the issuance of questionnaires, but seldom on the dynamic complex process of the leadership system. This study reveals the complexity and chaos characteristics of the dynamic evolution of the multifactor relational leadership system, puts forward the relational leadership theory and the complex leadership theory under the influence of pressure, and makes some suggestions on how to improve the leadership effectiveness under the complex environment. The research results are of great significance to theoretical innovation and practical application.
¿Debe cambiar la educación en administración?
Authors: Espejo Alvaro
Published: March 2021

En un año de importantes desafíos y profundos cambios, como ha sido el 2020, es importante tomarse el tiempo para reflexionar sobre el presente y el futuro de la educación en administración. Aunque para ello es crucial tener una visión crítica, también es fundamental valorar los aportes que se han realizado al campo de la administración a lo largo del tiempo. La investigación nos muestra que las personas, la colaboración y el propósito son los elementos centrales de la organización. Sin embargo, debido a una visión limitada sobre la administración existente en muchas escuelas de negocio, esto muchas veces ha quedado relegado frente a los objetivos económicos de las empresas.
Long-Term Follow-Up of Early Cochlear Implant Device Activation
Authors: Bruschke Stefanie , Baumann Uwe , Stöver Timo
Published: March 2021

Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.
Giant Calculus with More than 100 Small Calculi in Choledochal Cysts
Authors: Bahadur Akshay , Thakur Vijay , Bains Lovenish , Arora Prerna , Rathi Yanshul , Shukla Ashish
Published: March 2021

Giant biliary calculus in the common bile duct (CBD) is rare. Giant calculus of choledochal cyst (CC) is even rarer, and no case of giant calculus of CC with more than 100 calculi has been reported in the indexed literature. We present the case of a 8.0 × 4.5 × 4.0 cm sized giant calculus with >100 small calculi in type IVa CCs with heterotopic pancreas in a 45-year-old male, which is a surprisingly rare occurrence. Magnetic resonance cholangiopancreatography showed multifocal irregular dilatation of intrahepatic biliary radicles with multiple filling defects with a giant calculus in CC with cholelithiasis. The case was successfully managed with open cholecystectomy and choledochotomy with retrieval of 1 giant and more than 100 small calculi with excision of CC with Roux-en-Y hepaticojejunostomy. Histopathological examination (HPE) showed inflamed CC identified with focal areas of surface ulceration with increased fibrosis areas in the wall and few pancreatic acini. A bile duct calculus is defined as “giant” when the size is 5 cm or more. Stone formation within is the most frequent complication of CC. Most intracystic calculi have been described as soft, earthy, and pigmented in appearance, supporting bile stasis as a primary etiologic factor. The only treatment for giant calculus of CBD or CC is surgical. Endoscopic treatment is mostly unsuccessful and open surgery is the treatment of choice due to giant size, increased load of calculus, and presence of calculi in the left and right hepatic ducts.
Tecendo diálogos: Han Kang, Van Gogh e Henri Meschonnic
Authors: Martins Maria Sílvia Cintra
Published: March 2021

Neste trabalho, busco esclarecimentos a respeito de diferentes obras de diferentes autores por meio da metodologia do ‘jogo de espelhos’ (Martins 2020), que possui afinidade com os estudos comparados e é tributária do paradigma indiciário (Ginzburg 1989). Aspectos teóricos da proposta da Antropologia da Linguagem, do linguista, poeta e tradutor francês Henri Meschonnic, são colocados em diálogo, primeiro com a obra Leçons de Grec (Kang 2019); em seguida com trecho da carta 179 de Van Gogh (Van Gogh Museum 2009). Obtenho, dessa forma, certos esclarecimentos a respeito da proposta literária da escritora coreana Han Kang; de eventual projeto de tradução para a carta 179 do pintor holandês Vincent Van Gogh, a qual ainda não possui tradução para a língua portuguesa; também, de aspectos ainda não muito bem compreendidos e difundidos da obra de Henri Meschonnic.
Frankenstein: das páginas do romance para às telas de cinema
Authors: Almeida Laura de , Santos Arthur Yerro Oliveira
Published: March 2021

O presente estudo aborda a intertextualidade entre o texto literário Frankenstein, ou O Prometeu Moderno (Shelley 2017), o filme adaptado de tal texto (Whale 1931) e o filme Victor Frankenstein (McGuigan 2015). Objetivamos destacar as possíveis áreas de convergência e divergência de significado entre o texto original literário e filmes adaptados a partir dele. Adotamos os conceitos de responsabilidade (Ruiz 2009) e o imaginário (Araújo 2014), nas teorias de linguagem (Costa 2002; Spica 2015) e na trajetória da Criatura (Lucas 2017). Além disso, nos baseamos nas teorias de adaptação de Hutcheon (2006), comparando-as com visões semióticas entre livros e filmes (Jeha 2004) e na transformação crítica (Wesonga 2017). Observamos que o leitor da obra literária poderá compreender melhor e interagir com significados alternativos que os filmes criam de textos literários.
Management of Arrhythmias After Heart Transplant
Authors: Joglar Jose A. , Wan Elaine Y. , Chung Mina K. , Gutierrez Alejandra , Slaughter Mark S. , Bateson Brian P. , Loguidice Michael , Drazner Mark , Kistler Peter M. , Saour Basil , Poole Jeanne E. , Murtaza Ghulam , Turagam Mohit K. , Vader Justin , Lakkireddy Dhanunjaya , Birati Edo Y. , Dhingra Ravi , Gopinathannair Rakesh
Published: March 2021

Orthotropic heart transplantation remains the most effective therapy for patients with end-stage heart failure, with a median survival of ≈13 years. Yet, a number of complications are observed after orthotropic heart transplantation, including atrial and ventricular arrhythmias. Several factors contribute to arrhythmias, such as autonomic denervation, effect of the surgical technique, acute and chronic rejection, and transplant vasculopathy among others. To minimize risk of future arrhythmias, the bicaval technique and minimizing ischemic time are current surgical standards. Sinus node dysfunction is the most common indication for early (within 30 days) pacemaker implantation, whereas atrioventricular block incidence increases as time from transplant increases. Atrial fibrillation can occur in the first few weeks following transplantation but is uncommon in the long term unless secondary to a precipitant such as acute rejection. The most common atrial arrhythmias are atrial flutters, which are mainly typical, but atypical circuits can be observed such as those that involve the remnant donor atrium in regions immediately adjacent to the atrioatrial anastomosis suture line. Choosing the appropriate pharmacological therapy requires careful consideration due to the potential interaction with immunosuppressive agents. Despite historical concerns, adenosine is effective and safe at reduced doses if administered under cardiac monitoring. Catheter ablation has emerged as an effective treatment strategy for symptomatic supraventricular tachycardias, including ablation of atypical flutter circuits. Cardiac allograft vasculopathy is an important risk factor for sudden cardiac death, yet the role of prophylactic implantable cardioverter-defibrillator implant for sudden death prevention is unclear. Current indications for implantable cardioverter-defibrillator implantation are as in the nontransplant population. A number of questions for future research are posed.
Optical Coherence Tomography Versus Intravascular Ultrasound and Angiography to Guide Percutaneous Coronary Interventions
Authors: Chamié Daniel , Costa J. Ribamar , Damiani Lucas P. , Siqueira Dimytri , Braga Sérgio , Costa Ricardo , Seligman Henry , Brito Freddy , Barreto Guilherme , Staico Rodolfo , Feres Fausto , Petraco Ricardo , Abizaid Alexandre
Published: March 2021

Background:

Specific algorithms for use of optical coherence tomography (OCT) to guide percutaneous coronary intervention (PCI) are scarce. Also, the relative benefits of intravascular imaging guidance have not been tested against an optimized angiography-guided PCI strategy. In iSIGHT (Optical Coherence Tomography Versus Intravascular Ultrasound and Angiography to Guide Percutaneous Coronary Interventions), we aimed to investigate whether OCT-guided PCI achieves noninferior stent expansion compared with intravascular ultrasound (IVUS) guidance and if both imaging modalities lead to superior stent expansion compared with an optimized angiography-based strategy.

Methods:

Patients ≥18 years old undergoing PCI for ≥1 lesion in native coronaries of 2.25 to 4.00 mm in diameter were randomized 1:1:1 to OCT-, IVUS-, or angiography-guided PCI. Predetermined guidance protocols were applied in all groups. An external elastic membrane–based protocol was used for stent sizing by OCT and IVUS. The primary end point was noninferiority of stent expansion (minimum stent area ≥90% of the average reference lumen area), measured by post-PCI OCT, in OCT-guided versus IVUS-guided PCI (noninferiority margin, 6.5%).

Results:

One hundred fifty-one patients (156 lesions) were randomly allocated to OCT (51 lesions [32.7%]), IVUS (52 lesions [33.3%]), or angiography (53 lesions [34.0%]). Stent expansion with OCT guidance (98.01±16.14%) was noninferior to IVUS (91.69±15.75%; 1-sided lower 95% CI, 0.55 mm
2
;
P
non-inferiority
<0.001) and superior to angiography (90.53±14.84%,
P
=0.041). IVUS and angiography obtained similar stent expansions (
P
=0.921). Stent edge dissection and periprocedural complication rates were not significantly different among the groups.

Conclusions:

Stent expansion with OCT guidance using a dedicated external elastic membrane–based sizing strategy was noninferior to that achieved with IVUS and superior to an optimized angiographic strategy.

Registration:

URL:
plataformabrasil.saude.gov.br
; Unique identifier: 69968417.8.0000.5462.
Patent Ductus Arteriosus Stenting for All Ductal-Dependent Cyanotic Infants
Authors: Ratnayaka Kanishka , Nageotte Stephen J. , Moore John W. , Guyon Peter W. , Bhandari Krishna , Weber Rachel L. , Lee Jesse W. , You Hyeri , Griffin Danica A. , Rao Rohit P. , Nigro John J. , El-Said Howaida G.
Published: March 2021

Background:

Ductal-dependent cyanotic newborns require a secure source of pulmonary blood flow. There has been a recent migration to selective ductal (patent ductus arteriosus [PDA]) stenting for some of these children. Universal (nonselective) ductal stenting for all infants with ductal-dependent pulmonary blood flow is controversial. We examine outcomes from a single center with this practice change.

Methods:

We compare outcomes of all ductal-dependent pulmonary blood flow infants (2013–2020 [January–June]) in the following treatment eras: Era 1 (selective PDA stenting; 2013–2017) or Era 2 (universal PDA stenting; 2018–2020 [January–June]).

Results:

Eighty-eight patients (Blalock-Taussig shunt, n=41; PDA stent, n=47) met inclusion criteria. In Era 1, most received Blalock-Taussig shunt (62% [41/66]). In Era 2, all received PDA stents (100% [22/22]). There were more females in Era 2, but otherwise no demographic differences between eras. There were no differences in mortality, treatment failures, complications, or reinterventions between eras. Postprocedure length of stay was shorter in Era 2 (8 versus 22 days,
P
=0.02). There were less surgical revisions for PDA stent patients (2% versus 20%,
P
=0.02). Postprocedure recovery surrogate end points favored Era 2 and PDA stenting. Additional analysis revealed PDA stent (compared with Blalock-Taussig shunt) patients had shorter post-procedure (10 versus 29 days,
P
≤0.001) length of stay and more symmetrical branch pulmonary arteries (0.9 versus 0.7,
P
=0.001) at subsequent surgery.

Conclusions:

PDA stenting for almost all ductal dependent cyanotic newborns can be safe and effective and may have lower morbidity than selective PDA stenting.
US Antiarrhythmic Drug Treatment for Patients With Atrial Fibrillation: An Insurance Claims–Based Report
Authors: Tardos Jonathan G. , Ronk Christopher J. , Patel Miraj Y. , Koren Andrew , Kim Michael H.
Published: March 2021

Background

Current American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines and European Society of Cardiology guidelines recommend antiarrhythmic drugs (AADs) for maintenance of sinus rhythm in patients with atrial fibrillation. We assessed the concordance between healthcare provider real‐world practice and current guidelines with respect to first‐line AAD rhythm management.

Methods and Results

Administrative claims data from the deidentified Optum Clinformatics Data Mart database were used. Patients were included if they were initiated on an AAD in 2015 to 2016, had 1 year of continuous data availability before their first AAD pharmacy claim, and had a diagnosis for atrial fibrillation within that period. Concordance was assessed by comparing the AAD initiated by the healthcare provider against guideline recommendations for first‐line treatment, given the presence of heart failure, coronary artery disease, both, or neither (as determined by
International Classification of Diseases, Ninth Revision
and
Tenth Revision
[
ICD‐9
and
ICD‐10
] codes). Concordance was also assessed by provider type using Medicare taxonomy codes. For the 15 445 patients included, 51% of healthcare providers initiated AAD treatments with amiodarone, 18% flecainide, 15% sotalol, 8% dronedarone, 5% propafenone, and 2% dofetilide. The overall rate of guideline concordance was 61%, with differences by provider type: 67% for electrophysiologists, 61% for cardiologists, and 60% for others (internal medicine, etc).

Conclusions

There continues to be a sizable gap in concordance between practice and guidelines in first‐line rhythm management of patients with atrial fibrillation. Further research is needed to identify possible explanations for non–guideline‐recommended use of AADs, in addition to enhanced AAD educational strategies for practitioners.
Novel RyR2 Mutation (G3118R) Is Associated With Autosomal Recessive Ventricular Fibrillation and Sudden Death: Clinical, Functional, and Computational Analysis
Authors: Shauer Ayelet , Shor Oded , Wei Jinhong , Elitzur Yair , Kucherenko Nataly , Wang Ruiwu , Chen S. R. Wayne , Einav Yulia , Luria David
Published: March 2021

Background

The cardiac ryanodine receptor type 2 (RyR2) is a large homotetramer, located in the sarcoplasmic reticulum (SR), which releases Ca
2+
from the SR during systole. The molecular mechanism underlying Ca
2+
sensing and gating of the RyR2 channel in health and disease is only partially elucidated. Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT1) is the most prevalent syndrome caused by RyR2 mutations.

Methods and Results

This study involves investigation of a family with 4 cases of ventricular fibrillation and sudden death and physiological tests in HEK 293 cells and normal mode analysis (NMA) computation. We found 4 clinically affected members who were homozygous for a novel RyR2 mutation, G3118R, whereas their heterozygous relatives are asymptomatic. G3118R is located in the periphery of the protein, far from the mutation hotspot regions. HEK293 cells harboring G3118R mutation inhibited Ca
2+
release in response to increasing doses of caffeine, but decreased the termination threshold for store‐overload‐induced Ca
2+
release, thus increasing the fractional Ca
2+
release in response to increasing extracellular Ca
2+
. NMA showed that G3118 affects RyR2 tetramer in a dose‐dependent manner, whereas in the model of homozygous mutant RyR2, the highest entropic values are assigned to the pore and the central regions of the protein.

Conclusions

RyR2 G3118R is related to ventricular fibrillation and sudden death in recessive mode of inheritance and has an effect of gain of function on the protein. Despite a peripheral location, it has an allosteric effect on the stability of central and pore regions in a dose‐effect manner.
Levinas and the Daodejing on the Feminine: Intercultural Reflections
Authors: Ma Lin
Published: March 2021

This article revisits the theme of the feminine in Levinas’s writings and the Daodejing. First it addresses the question why the feminine as thematized through eros (and habitation) in Levinas’s early work loses her centrality in his later texts. Second it explores the feminine water metaphor and the Dao of ci
in the Daodejing. On the basis of these interpretations, it attempts at an analysis of relevant ambiguities and problematics concealed in Levinas’s philosophical enterprise, and urges for the exigency of an intercultural perspective, instead of remaining within a singular intellectual tradition.
Free and Easy Wandering Among Upbuilding Discourses: A Reading of Fables in Zhuangzi and Kierkegaard
Authors: Williams George Willis
Published: March 2021

Both Zhuangzi and Søren Kierkegaard use fables to portray humorous and clever insights about life. Here two fables are drawn from the first chapter of the Zhuangzi and compared from a variety of perspectives with two fables found in Kierkegaard’s Upbuilding Discourses in Various Spirits. Questions about the value of comparing oneself with others, the character of dependence and independence, and matters related to self-identity and utility are explored. Contrasts related to theological concerns in Kierkegaard and their absence in Zhuangzi, as well as the former’s promotion of wuwei spontaneity rather than Kierkegaard’s emphasis on making determined choices are highlighted.
Mao Qiling’s Critical Reflections on the Four Books
Authors: Pfister Lauren F.
Published: March 2021

After introducing some scholarship on the value of Mao Qiling’s (1623–1713) works, we present an account of canonization processes in order to understand the hermeneutic context of Mao’s battle with the Cheng-Zhu orthodoxy. His work is an attempt to decanonizing Zhu Xi’s Four Books, preferring instead an alternative relying on the Old Texts of the Taixue/Daxueand Zhongyong . Mao argues against Zhu Xi’s textual changes and interpretations on a number of bases, producing a hermeneutics of suspicion against the Cheng-Zhu orthodoxy. Instead, Mao offers an alternative account of the sagely way, following precedents of Wang Yangming.
Philosophy of Learning in Wang Yangming and Francis Bacon
Authors: Yao Xinzhong
Published: March 2021

This article is a comparative study of the philosophical views on learning and learning methods elaborated by Wang Yangming and Francis Bacon. It argues that as different criteria for the advancement of learning Bacon’s empirical learning and Wang’s “learning of the heart-mind” represent two different philosophical orientations, and are responsible, at least partially, for laying down the basis for the parting ways of China and Europe at the dawn of the modern era. It concludes that an appreciation of the mutual complementarity rather than opposition between these two philosophical approaches will be a sign for the new and real advancement of learning.
Human Dignity in Classical Chinese Philosophy: The Daoist Perspective
Authors: Zhang Qianfan
Published: March 2021

This article discusses the Daoist contribution to the idea of human dignity in the classical Chinese philosophy, particularly in aspects that had been ignored by the Confucians and the Moists. By criticizing the traditional morality and reviving the faith in a primitive, self-sufficient life, Laozi and Zhuangzi add an important dimension to the classical understanding of human dignity: individual freedom, particularly the freedom of living under minimum burden, direction, and oppression of the state. By comparing the Daoist conception of human dignity with those of the Confucians and Moists, the article concludes that all three classical schools, if rationally construed, should support the view that the establishment of a liberal constitutional scheme is necessary to preserve and protect minimum/basic dignity in both physical and spiritual well-being of every human person who lives in a modern society.
Healing the Planet
Authors: Grange Joseph
Published: March 2021

Our planet is sick and perhaps on a tipping point of extinction. The causes are well known—global warming, the collapse of the world economy, human greed, and thermonuclear war—to name but a few agents at work in the contemporary world. America and China hold the world’s destiny in their grip. How they will interact is unknown. What is known is that both civilizations have in their traditions the ways and means to reverse this approaching apocalypse. Each country is now passing through cultural explosions. This article searches classical Chinese and American philosophy for concepts and social forms that can give shape to this era of upheaval. I have confidence in the genius of Confucius as well as that of certain great classical American philosophers. Read together they can help us come to deal with both the decay of established orders and the overwhelming novelty now sweeping through our consciousness.
Space, Time, and Eternity
Authors: Neville Robert Cummings
Published: March 2021

On the one hand, Chinese traditions of philosophy are famous for emphasizing that things are changes, that reality is filled with processes rather than substances. This philosophy was present at least from the Yijing onward and was developed in diverse ways by Confucians, Daoists, and then Chinese Buddhists. But there has not been a similar rich development of the idea of eternity, that nontemporal context within which change can be recognized and measured. This article argues, first, that change presupposes an ontological context of eternity and, second, that eternity so conceived can be experienced and even interpreted in terms of the Chinese traditions.
Word Made Flesh—Organic Process: Inner Word in Gadamer
Authors: Fuyarchuk Andrew
Published: March 2021

Interpretations of the inner word overlook the fact that for Gadamer language is both written and spoken and that these two mediums are in a dialectical relation. After disputing Zimmermann’s interpretation of the inner word, the paper uses McLuhan to explain Gadamer’s dialectical method for understanding how thought that comes to language participates in the self-unfolding structure of a living organism. Central to this argument is a turn of the inner ear which in contrast to sensory memory based on sight recollects the musical origins of language in acoustic space and renders the movements of a dialogue comparable to song.
An Iambic Quotation in Plato’s Timaeus
Authors: Tissol Garth
Published: March 2021

At Timaeus 86d2 Plato quotes a line and a third of iambic trimeter probably from an unknown tragedy, possibly from a comedy. Its context is Timaeus’ argument that one suffering from diseases of the soul is often considered willingly bad, but wrongly so: οὐχ ὡς νοσῶν ἀλλ’ ὡς ἑκὼν κακὸς κακῶς | δοξάζεται, ‘he is wrongly considered not as sick but as willingly bad’. This quotation has not to my knowledge been noted in scholarship. The prosaic vocabulary of the quotation is reminiscent of Euripides, whereas its theme links it to Deianeira’s remarks on the disease of eros in Sophocles’ Trachiniae. As transmitted in Parisinus A and printed in modern editions, the quotation is metrically defective, lacking the word κακῶς. I argue that it was lost by haplography and ought to be restored, as was proposed in the commentary of a sixteenth-century translator, Cornarius (1561).
Ecocriticism, Theology, and the Environment in Haviva Pedaya’s The Eye of the Cat
Authors: Hacohen-Bick Tafat
Published: March 2021

Haviva Pedaya’s book The Eye of the Cat presents an innovative theology of ecology, yet in correspondence with traditional Jewish-Kabbalistic sources. I discuss Pedaya’s ecopoetic reading of these sources, as well as her own midrashim in this regard. Pedaya raises questions regarding the place of man in the world; political questions regarding center and periphery; urbanization and nature; construction and destruction. These questions arise via the book’s unique poetic expression. Pedaya offers a theology of waste, addressing the place of garbage in the human sphere through the Kabbalistic idiom regarding the collection of qlipoth (“husks” ‮קליפות,‬‎). The Kabbalistic project of collecting the qlipoth, which previously functioned in the context of an esoteric and mostly secretive symbolic system, now takes on a different meaning in light of the real “husks” that demand to be collected and reused.