bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of Measuring Points Layout around a Tunnel in the Transversely Isotropic Rock Mass
Authors: Zhang Zhizeng , Li Yongtao , Yang Weili , Wu Shunchuan , Liu Xiaoli , Zhang Bing
Published: January 2021

The arrangement of measuring points has a great impact on the uniqueness and accuracy of the back analysis of displacement. To explore the arrangement method of measuring points in the anisotropic rock mass, the principle of maximum displacement is applied to study the optimization of measuring points layout around a tunnel in the transversely isotropic rock mass. Firstly, the criterion of maximum displacement is deduced. Secondly, the variations of displacement with angle and radius are analyzed, respectively, and two key lateral pressure coefficients are obtained. Thirdly, some principles of measuring points arrangement are summarized according to the criterion of maximum displacement. Finally, an example is given to prove the correctness of these principles. These principles can be used to guide the arrangement of displacement measuring points in the transversely isotropic rock mass, especially suitable for shaft excavation in horizontal sedimentary rock.
A New Hope in Spinal Degenerative Diseases: Piezo1
Authors: Zhu Daxue , Zhang Guangzhi , Guo Xudong , Wang Yidian , Liu Mingqiang , Kang Xuewen
Published: January 2021

As a newly discovered mechanosensitive ion channel protein, the piezo1 protein participates in the transmission of mechanical signals on the cell membrane and plays a vital role in mammalian biomechanics. Piezo1 has attracted widespread attention since it was discovered in 2010. In recent years, studies on piezo1 have gradually increased and deepened. In addition to the discovery that piezo1 is expressed in the respiratory, cardiovascular, gastrointestinal, and urinary systems, it is also stably expressed in cells such as mesenchymal stem cells (MSCs), osteoblasts, osteoclasts, chondrocytes, and nucleus pulposus cells that constitute vertebral bodies and intervertebral discs. They can all receive external mechanical stimulation through the piezo1 protein channel to affect cell proliferation, differentiation, migration, and apoptosis to promote the occurrence and development of lumbar degenerative diseases. Through reviewing the relevant literature of piezo1 in the abovementioned cells, this paper discusses the effect of piezo1 protein expression under mechanical stress stimuli on spinal degenerative disease, providing the molecular basis for the pathological mechanism of spinal degenerative disease and also a new basis, ideas, and methods for the prevention and treatment of this degenerative disease.
A Lightweight SDN Fingerprint Attack Defense Mechanism Based on Probabilistic Scrambling and Controller Dynamic Scheduling Strategies
Authors: Wang Tao , Chen Hongchang
Published: January 2021

Software-defined networking (SDN) decouples the control plane from the data plane, which increases network flexibility and programmability. However, the “three-layer two-interface” architecture of SDN introduces new security issues. Attackers can collect fingerprint information (such as network types, controller types, and critical flow rules) by analyzing round-trip time (RTT) distribution of test packets. In order to defend against the fingerprint attack with limited attack time, we first design a probabilistic scrambling strategy. This strategy not only interferes with the delay distribution of probe packets in attack flow but also reduces the negative impact on the performance of legal packets in normal flow. However, if fingerprint attackers have unlimited attack time, it is not enough to defend against the attack only by this strategy. Therefore, we further propose a controller dynamic scheduling strategy to change SDN fingerprint information actively. Because scheduling different types of controllers to work in different periods will generate costs, the scheduling strategy is also responsible for determining the optimal switching time point to balance security benefits and costs. At last, we implement the defense mechanism on different types of controllers and verify its effectiveness in experimental scenarios. The experimental results show that the mechanism can effectively hide the SDN fingerprint information while reducing the negative impact on network performance.
Dynamic Model and Characteristic Analysis of Viscosity-Ultraelasticity for Bionic Vascular Network
Authors: Chen Yanli , Zhang Xueqing , Sang Zhiyue , Sha Yongbai , Bai Guiqiang
Published: January 2021

Due to the large volume of pipeline transportation, low cost, safety and the reliability, and automatic control, it is widely used in many fields of industrial development and human daily life. Most of the traditional hydraulic pipelines are steel pipes, and their structure is simple. High resistance and high consumption during transportation are not conducive to the sustainable development of society. However, the human vascular system is intricate and has excellent mechanical properties. Built on the review, research on the fluid-solid coupling characteristics of a single bionic pipeline and piping system was carried out. In order to simulate the mechanical characteristics of a fluid conveying pipeline, a fluid-structure coupling model of equation 14 of a single pipeline and the transfer matrix of the pipeline system were established. The mechanical characteristics of the pipeline are studied, and the formula is calculated. The simulation analysis shows that the axial force and flow resistance decrease first and then stabilize with the increase of frequency. Finally, the experimental verification and the results show that the method is both reasonable and effective, because the simulation curve and the experimental curve are consistent in trend.
Feedback Training Improves Compliance with Sternal Precaution Guidelines during Functional Mobility: Implications for Optimizing Recovery in Older Patients after Median Sternotomy
Authors: LaPier Ansel , Cleary Kimberly
Published: January 2021

Patients often need to use their arms to assist with functional activities, but after open heart surgery, pushing with the arms is limited to <10 lb (4.5 kg) to help minimize force across the healing sternum. The main purposes of this study were to determine if older patients (>60 years old) (1) accurately estimated upper extremity (UE) weight bearing force of 10 lb or less and (2) if feedback training improved their ability to limit UE force and pectoralis major muscle contraction during functional activities. An instrumented walker was used to measure UE weight bearing force, and electromyography was used to measure pectoralis major muscle activity simultaneously during 4 functional mobility tasks. After baseline testing, healthy older subjects (

n
=
30

) completed a brief session of visual and auditory concurrent feedback training. Results showed that the self-selected UE force was >10 lb for all tasks (20.0-39.7 lb [9.1-18.0 kg]), but after feedback training, it was significantly reduced (10.6-21.3 lb [4.8-9.7 kg]). During most trials (92%), study participants used >12 lb (5.5 kg) of arm weight bearing force. Pectoralis major muscle peak electromyography activity was <23% of maximal voluntary isometric contraction and was reduced (9.8-14.9%) after feedback training. Older patients may not be able to accurately estimate UE arm force used during weight bearing activities, and visual and auditory feedback improves accuracy and also modulation of pectoralis major muscle activation. Results suggest that an instrumented walker and feedback training could be clinically useful for older patients recovering from open heart surgery.
Settlement Prediction of Foundation Pit Excavation Based on the GWO‐ELM Model considering Different States of Influence
Authors: Shi-fan Qiao , Jun-kun Tan , Yong-gang Zhang , Li-jun Wan , Ming-fei Zhang , Jun Tang , Qing He
Published: January 2021

This paper proposes a novel grey wolf optimization‐extreme learning machine model, namely, the GWO‐ELM model, to train and predict the ground subsidence by combining the extreme learning machine with the grey wolf optimization algorithm. Taking an excavation project of a foundation pit of Kunming in China as an example, after analyzing the settlement monitoring data of cross sections JC55 and JC56, the representative monitoring sites JC55‐2 and JC56‐1 were selected as the training monitoring samples of the GWO‐ELM model. And three kinds of GWO‐ELM models such as considering the influence of time series, influence of settlement factors, and after optimization were established to predict the ground settlement near the foundation pit. The predictive results are that their average relative error and average absolute error are ranked from large to small as GWO‐ELM model based on time series, GWO‐ELM model based on settlement factors, and optimized GWO‐ELM model for the three kinds of GWO‐ELM models at monitoring points JC55‐2 and JC56‐1. Accordingly, the optimized GWO‐ELM model has the strongest predictive ability.
Phase II Single-arm Study of Durvalumab and Tremelimumab with Concurrent Radiotherapy in Patients with Mismatch Repair–proficient Metastatic Colorectal Cancer
Authors: Segal Neil H. , Cercek Andrea , Ku Geoffrey , Wu Abraham J. , Rimner Andreas , Khalil Danny N. , Reidy-Lagunes Diane , Cuaron John , Yang T. Jonathan , Weiser Martin R. , Romesser Paul B. , Stadler Zsofia K. , Varghese Anna M. , Ganesh Karuna , Yaeger Rona , Connell Louise C. , Faleck David , Abou-Alfa Ghassan K. , Mcauliffe Kathleen C. , Vaiskauskas Pamela , Solter Mark L. , Ogle Martinique , Adamow Matthew J. , Holland Aliya , Vedantam Pallavi , Wong Phillip , Merghoub Taha , Vakiani Efsevia , Hollmann Travis J. , Juluru Krishna , Chou Joanne F. , Capanu Marinela , Erinjeri Joseph , Solomon Stephen , Yamada Yoshiya , Kemeny Nancy , Crane Christopher H. , Saltz Leonard B.
Published: January 2021

Purpose:

Immune checkpoint inhibition (ICI) alone is not active in mismatch repair–proficient (MMR-P) metastatic colorectal cancer (mCRC), nor does radiotherapy alone result in objective systemic benefit. However, combined radiotherapy plus ICI can induce systemic antitumor immunity in preclinical and clinical models.

Patients and Methods:

In this single-center, phase II study, patients with chemotherapy-refractory MMR-P mCRC received durvalumab 1,500 mg plus tremelimumab 75 mg every 4 weeks plus radiotherapy. The primary endpoint was objective response rate (ORR) in nonirradiated lesions. Treatment and efficacy were correlated with peripheral immune cell profiles.

Results:

We enrolled 24 patients, and report outcomes after a median follow-up of 21.8 (range: 15.9–26.3) months. The ORR was 8.3% (2 patients) [95% confidence interval (CI), 1.0–27.0]. The median progression-free survival was 1.8 (95% CI, 1.7–1.9) months, median overall survival was 11.4 (95% CI, 10.1–17.4) months. Twenty five percent of patients (n = 6) had treatment-related grade 3–4 adverse events. We observed increased circulating CD8+ T lymphocyte activation, differentiation, and proliferation in patients with objective response.

Conclusions:

This combination of radiotherapy plus ICI study did not meet the prespecified endpoint criteria to be considered worthwhile for further study. However, rare instances of systemic immune augmentation and regression in nonirradiated lesions were observed (an abscopal response). Combination durvalumab and tremelimumab plus radiotherapy is feasible in MMR-P mCRC with a manageable safety profile. Further studies of novel immunotherapy combinations, and identification of biomarkers predictive of abscopal response are warranted.
STK11/LKB1 Mutations in NSCLC Are Associated with KEAP1/NRF2-Dependent Radiotherapy Resistance Targetable by Glutaminase Inhibition
Authors: Sitthideatphaiboon Piyada , Galan-Cobo Ana , Negrao Marcelo V. , Qu Xiao , Poteete Alissa , Zhang Fahao , Liu Diane D. , Lewis Whitney E. , Kemp Haley N. , Lewis Jeff , Rinsurongkawong Waree , Giri Uma , Lee J. Jack , Zhang Jianjun , Roth Jack A. , Swisher Stephen , Heymach John V.
Published: January 2021

Purpose:

Radiotherapy with or without chemotherapy is a mainstay of treatment for locally advanced non–small cell lung cancer (NSCLC), but no predictive markers are currently available to select patients who will benefit from these therapies. In this study, we investigated the association between alterations in STK11/LKB1, the second most common tumor suppressor in NSCLC, and response to radiotherapy as well as potential therapeutic approaches to improve outcomes.

Experimental Design:

We conducted a retrospective analysis of 194 patients with stage I–III NSCLC, including 164 stage III patients bearing mutant or wild-type STK11/LKB1 treated with radiotherapy, and assessed locoregional recurrence (LRR), distant metastasis rates, disease-free survival (DFS), and overall survival (OS), and we investigated the causal role of LKB1 in mediating radiotherapy resistance using isogenic pairs of NSCLC cell lines with LKB1 loss or gain.

Results:

In stage III patients, with 4 years median follow-up, STK11/LKB1 mutations were associated with higher LRR (P = 0.0108), and shorter DFS (HR 2.530, P = 0.0029) and OS (HR 2.198, P = 0.0263). LKB1 loss promoted relative resistance to radiotherapy, which was dependent on the KEAP1/NRF2 pathway for redox homeostasis. Suppression of the KEAP1/NRF2 pathway via KEAP1 expression, or pharmacologic blockade of glutaminase (GLS) 1 sensitized LKB1-deficient tumors to radiotherapy.

Conclusions:

These data provide evidence that LKB1 loss is associated with LRR and poor clinical outcomes in patients with NSCLC treated with radiotherapy and that targeting the KEAP1/NRF2 pathway or GLS inhibition are potential approaches to radiosensitize LKB1-deficient tumors.
Surgical Resection for Crohn’s and Cancer: A Comparison of Disease-Specific Risk Factors and Outcomes
Authors: Larson David W. , Abd El Aziz Mohamed A. , Perry William , Behm Kevin T. , Shawki Sherief , Mandrekar Jay , Mathis Kellie L. , Grass Fabian
Published: January 2021

Background and Objectives: The goal of this study was to compare disease-specific risk factors and 30-day outcomes between patients with Crohn’s disease (CD) and colon cancer (CC) undergoing right-sided surgical resection. Methods: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP®) was interrogated to extract all patients ≥18 years undergoing elective right-sided resection for CD versus CC. Independent risk factors for surgical complications were identified through multivariable logistic regression for both groups. In a second step, surgical and medical 30-day morbidity was compared after risk adjustment. Results: The cohort consisted of 17,516 patients, of which 2,899 (16.6%) underwent surgery for CD versus 14,617 (83.4%) for CC. Independent risk factors for surgical complications in patients with CD were male gender, African American race, ASA score (III or IV), active smoking, prolonged surgery, and preoperative anemia. Independent risk factors for surgical complications in the cancer group were age ≥70 years, male gender, ASA score (III or IV), respiratory and cardiovascular comorbidities, and preoperative hypoalbuminemia (<3.5 g/dL). After risk adjustment, surgical complications (OR 1.25, p = 0.002), sepsis (OR 1.64, p = 0.012), and unplanned readmissions (OR 1.39, p = 0.004) were more common in patients with CD. Thirty-day mortality was higher in cancer patients (1.1 vs. 0.1%, p < 0.0001). Conclusions: Patients with Crohn’s disease were more prone to surgical complications and postoperative sepsis compared to the cancer group undergoing the same procedure. Careful evaluation and correction of disease-specific modifiable risk factors of patients with CD and CC, respectively, are important.
Luxury Perfusion Producing Sensory Aphasia
Authors: Sakai Daiki , Sakakibara Ryuji , Tateno Fuyuki , Aiba Yosuke
Published: January 2021

We describe the case of an 86-year-old Japanese man who, by luxury perfusion after spontaneous recanalization of the left middle cerebral artery/internal carotid artery, produced acute transient sensory aphasia. This rare phenomenon is thought to be caused by reperfusion brain injury.
Polypharmacy and Lack of Joy Are Related to Physical Frailty among Northern Japanese Community-Dwellers from the ORANGE Cohort Study
Authors: Kume Yu , Takahashi Tomoko , Itakura Yuki , Lee Sangyoon , Makizako Hyuma , Ono Tsuyosi , Shimada Hiroyuki , Ota Hidetaka
Published: January 2021

Introduction: A prevalence of frailty is gradually increasing with the progress of aging in Japan, and critical challenges regarding early diagnosis and prevention of frailty were necessary in community. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of our cross-sectional observational study was to clarify the association of frail status in northern Japanese community-dwellers aged 65 or more. Methods: 345 participants were recruited from 2018 to 2020, and after getting informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. We applied the frailty index of Gerontology-the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status by collecting data of demographics and psychosocial status using the Kihon checklist (KCL) and cognitive domains used by the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT). Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail, and 12 frail. For statistical analysis, we found that the frail group had a lower educational duration, worsened KCL items, lower cognitive functions, and a tendency toward depression compared to the other groups. Moreover, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were explanatory variables of frail status. Conclusions: We suggest that KCL is important for frail discrimination, and in order to prevent physical frailty, our community should take care of not only exercise and nutrition but also cognitive functioning and depressive tendencies. In particular, polypharmacy and the presence of fun in your life are possible to be related to frailty.
Teenagers and Precision Psychiatry: A Window of Opportunity
Authors: Sabatello Maya , Chen Ying , Herrera Carmen Fiorella , Brockhoff Erika , Austin Jehannine , Appelbaum Paul S.
Published: January 2021

Objective: Precision medicine raises hope for translating genetic-based knowledge about psychiatric risks into mental health benefits by motivating health-related, risk-reducing behaviors. Teenagers (ages 14–17) are an important age-group to engage in preventive efforts but, their views about psychiatric genetics are understudied. Method: An online survey with a nationally representative sample of teenagers (n = 417) was conducted. Participants were randomly assigned to receive 1 of 2 handouts, 1 emphasizing the genetic underpinnings of psychiatric conditions; the other agency-oriented and focusing on gene-environment interactions. Survey questions queried their views about behavioral changes in response to psychiatric genetic risk information and expressed willingness to undertake them. Participants’ decision-making characteristics (i.e., self-efficacy, empowerment, intolerance of uncertainty, and sensation-seeking) were assessed at baseline. Results: Teenagers strongly valued the information provided and its potential usefulness for their mental health. Information about psychiatric genetics alone impacted views about the causes of mental illness. Contrary to our hypothesis, the type of handout did not impact participants’ expressed willingness to make behavioral changes to reduce their risk of developing a psychiatric condition, but their sense of empowerment played a key role in their responses. Conclusion: Educating teenagers about gene-environment interactions may help facilitate the translational efforts of precision psychiatry. Research with teenagers across racial/ethnic groups, especially those with family histories, is needed to better understand the factors that impact teenagers’ empowerment in psychiatric genomic settings and to identify measures, including the best enablers of empowerment (e.g., educators, parents), which would allow them to reap the benefits of precision psychiatry.
Polarized Proteins in Endothelium and Their Contribution to Function
Authors: Wolpe Abigail G. , Ruddiman Claire A. , Hall Phillip J. , Isakson Brant E.
Published: January 2021

Protein localization in endothelial cells is tightly regulated to create distinct signaling domains within their tight spatial restrictions including luminal membranes, abluminal membranes, and interendothelial junctions, as well as caveolae and calcium signaling domains. Protein localization in endothelial cells is also determined in part by the vascular bed, with differences between arteries and veins and between large and small arteries. Specific protein polarity and localization is essential for endothelial cells in responding to various extracellular stimuli. In this review, we examine protein localization in the endothelium of resistance arteries, with occasional references to other vessels for contrast, and how that polarization contributes to endothelial function and ultimately whole organism physiology. We highlight the protein localization on the luminal surface, discussing important physiological receptors and the glycocalyx. The protein polarization to the abluminal membrane is especially unique in small resistance arteries with the presence of the myoendothelial junction, a signaling microdomain that regulates vasodilation, feedback to smooth muscle cells, and ultimately total peripheral resistance. We also discuss the interendothelial junction, where tight junctions, adherens junctions, and gap junctions all convene and regulate endothelial function. Finally, we address planar cell polarity, or axial polarity, and how this is regulated by mechanosensory signals like blood flow.
Syringe with Nasal Applicator versus Syringe Alone for Nasal Irrigation in Acute Rhinosinusitis: A Matched-Pair Randomized Controlled Trial
Authors: Piromchai Patorn , Phannikul Chayakorn , Thanaviratananich Sanguansak
Published: January 2021

Background/Aims: Nasal saline irrigation is a common procedure to relieve nasal symptoms in upper respiratory tract diseases. There is no consensus on the recommended nasal saline delivery devices. The objectives of this study were to evaluate efficacy, satisfaction, adherence, and adverse effects in patients with acute upper respiratory tract diseases using a syringe with a nasal applicator for nasal irrigation. Methods: Patients with acute nasopharyngitis, acute rhinitis, or acute rhinosinusitis were randomly allocated to use either (1) a syringe with a nasal applicator or (2) a syringe alone to irrigate one nostril. After the patients had completed irrigation with the allocated device in one nostril, they were instructed to perform nasal irrigation using the other device in the other nostril. All patients were instructed to use a syringe with a nasal applicator at home. The efficacy, satisfaction scores, adherence, and adverse effects were recorded. Results: Sixty-four patients were enrolled. The mean age of the patients was 33.95 years (18–59 years). The mean duration of symptoms was 4.80 days. None of the enrolled patients regularly performed nasal irrigation. Forty-two had acute nasopharyngitis, 10 had acute rhinitis, and 12 had acute rhinosinusitis. At baseline, the mean overall efficacy score for the syringe with a nasal applicator was 8.17 ± 1.43, and that for the syringe alone was 5.95 ± 2.02 (MD 2.23, p < 0.001, 95% CI 1.75–2.70). At 1 week, the syringe with the nasal applicator had significantly higher scores in 3 of 4 domains, including symptom relief, ease of use, and patients’ willingness to recommend the device to others, compared to baseline (p < 0.05). None of the enrolled patients had epistaxis, retained/dislodged the applicator during irrigation, or experienced an allergic reaction to the applicator after 1 week of nasal irrigation. Conclusion: Use of a syringe with an applicator for nasal irrigation yielded high scores in overall efficacy.
Progressive Primary Plate-Like Osteoma Cutis of the Scalp
Authors: Araghi Farnaz , Dadkhahfar Sahar , Tabary Mohammadreza , Rakhshan Azadeh , Gheisari Mehdi
Published: January 2021

Osteoma cutis (OC) or cutaneous ossification refers to uncommon bone formation in the skin. Primary OC develops without any predisposing factor or pre-existing lesion, whereas secondary OC sets out as a dystrophic ossification following traumatic, cicatricial, and neoplastic factors or other cutaneous inflammations. Herein, we report a rare case of long-standing progressive primary OC of the scalp resected in 3 sessions with no recurrence after 1 year.
Multiple Physical Symptoms of Community-Dwelling Older People in Western China: Prevalence and Its Association with Frailty
Authors: Jia Shuli , Zhao Wanyu , Zhang Yan , Hou Lisha , Xia Xin , Qiao Runjuan , Yue Jirong , Dong Birong
Published: January 2021

Introduction: Physical symptoms and frailty are common in older adults. A previous study has reported that multiple somatic symptoms are associated with frailty. In this study, we aimed to describe the picture of physical symptoms in older adults in western China and examine the relationship of multiple physical symptoms and frailty, as well as the sex difference of this relationship. Methods: Cross-sectional analyses were based on the West China Health and Aging Trend (WCHAT) study comprising 4,106 community-dwelling older adults (60–95 years). Frailty was assessed using the physical frailty phenotype (PFP). Participants’ experience of 28 different physical symptoms in the past 4 weeks was assessed. Physical symptoms were divided into several categories according to organ systems. Multinomial logistic regression analyses were performed to examine the association between frailty and multiple physical symptoms. Results: Nearly half of the subjects reported experiencing at least 1 physical symptom during the past 4 weeks. Musculoskeletal symptoms were the most prevalent symptoms. More than 5 physical symptoms were more likely to be frailty, even when all covariates were controlled. A significant association between multiple musculoskeletal symptoms and frailty also was found after adjusted for all covariates and multiple symptoms of other organ systems. Similar results were obtained for multiple cardiopulmonary symptoms. Furthermore, there were sex differences in these relationships. Conclusion: Multiple physical symptoms appear to have a detrimental impact on frailty in older adults. Compared with counting total symptoms, multiple symptoms of the same organ system may have a greater impact on frailty. Effective interventions and management of multiple physical symptoms are warranted to prevent frailty.
Baseline Characteristics of a National French E-Cohort of Hidradenitis Suppurativa in ComPaRe and Comparison with Other Large Hidradenitis Suppurativa Cohorts
Authors: Condamina Morgane , Penso Laetitia , Tran Viet-Thi , Hotz Claire , Guillem Philippe , Villani Axel Patrice , Perrot Pierre , Bru Marie-France , Jacquet Eric , Nassif Aude , Bachelez Hervé , Wolkenstein Pierre , Beylot-Barry Marie , Richard Marie-Aleth , Ravaud Philippe , Viguier Manuelle , Sbidian Emilie
Published: January 2021

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition substantially impacting patients’ quality of life; the pathogenesis remains unclear, and treatment is complex and not yet standardized. Observational data are increasingly being used to evaluate therapeutics in “real-life” interventions, and the development of e-cohorts is offering new tools for epidemiological studies at the population level. Objective: The aim of this study was to describe the clinical characteristics and treatment history of HS participants in the Community of Patients for Research (ComPaRe) cohort and to compare these to other cohorts. Methods: We performed a cross-sectional study of the baseline data of HS participants in ComPaRe, an e-cohort of patients with chronic diseases. Data were collected using patient-reported questionnaires about clinical-dem­ographic aspects, quality of life, and treatment history. Results: A total of 396 participants (339 females, 57 males) were included (mean age 38 years); 83 (21%) had a family history of HS, 227 (57.3%) were current smokers, and 241 (60.9%) were overweight or obese. Most of the participants declared a Hurley stage II (n = 263, 66.4%) or III (n = 76, 20.3%). The breast was more frequently affected in women than men (37.5 vs. 5.3%, p < 0.0001), whereas the dorsal region was more frequently affected in men (39.5 vs. 10.9%, p < 0.0001). Increased disease stage was associated with obesity (25.9 vs. 33.8 vs. 51.3%, p = 0.02) and some HS localizations (genital [p < 0.005], pubis [p < 0.007], gluteal fold [p = 0.02], and groin [p < 0.0001]). The most frequently prescribed treatments were oral antibiotics (n = 362, 91.4%), especially amoxicillin-clavulanic acid and cyclins. Less than 10% of participants received biologics. Most of these results were consistent with previously published cohorts. Conclusion: Recruitment of participants by such a web platform can be a faster way to get relevant scientific data for a wide variety of patients that could be used for epidemiological studies and to evaluate therapeutics in “real-life” interventions.
Intracerebral Hemorrhage Recurrence in Patients with and without Cerebral Amyloid Angiopathy
Authors: Pinho João , Araújo José Manuel , Costa Ana Sofia , Silva Fátima , Francisco Alexandra , Quintas-Neves Miguel , Soares-Fernandes João , Ferreira Carla , Oliveira Tiago Gil
Published: January 2021

Background: Intracerebral hemorrhage (ICH) recurrence risk is known to be higher in patients with cerebral amyloid angiopathy (CAA) as compared to other causes of ICH. Risk factors for ICH recurrence are not completely understood, and our goal was to study specific imaging microangiopathy markers. Methods: Retrospective case-control study of patients with non-traumatic ICH admitted to a single center between 2014 and 2017 who underwent magnetic resonance imaging (MRI). Clinical characteristics of the index event and occurrence of death and ICH recurrence were collected from clinical records. MRI images were independently reviewed by 2 neuroradiologists. Groups of patients with CAA-related and CAA-unrelated ICH defined were compared. Presence of CAA was defined according to the Boston modified criteria. Survival analysis with Kaplan-Meier curves and Cox-regression analyses was performed to analyze ICH recurrence-free survival. Results: Among 448 consecutive patients with non-traumatic ICH admitted during the study period, 104 were included in the study, mean age 64 years (±13.5), median follow-up of 27 months (interquartile range, IQR 16–43), corresponding to 272 person-years of total follow-up. CAA-related ICH patients presented higher burden of lobar microbleeds (p < 0.001), higher burden of enlarged perivascular spaces (EPVS) in centrum semiovale (p < 0.001) and more frequently presented cortical superficial siderosis (cSS; p < 0.001). ICH recurrence in patients with CAA was 12.7 per 100 person-years, and no recurrence was observed in patients without CAA. Variables associated with ICH recurrence in the whole population were age (hazard ratio [HR] per 1-year increment = 1.05, 95% CI 1.00–1.11, p = 0.046), presence of disseminated cSS (HR 3.32, 95% CI 1.09–10.15, p = 0.035) and burden of EPVS in the centrum semiovale (HR per 1-point increment = 1.80, 95% CI 1.04–3.12, p = 0.035). Conclusions: This study confirms a higher ICH recurrence risk in patients with CAA-related ICH and suggests that age, disseminated cSS, and burden of EPVS in the centrum semiovale are associated with ICH recurrence.
Outcomes of Radiofrequency Ablation versus Endoscopic Surveillance for Barrett’s Esophagus with Low-Grade Dysplasia: A Systematic Review and Meta-Analysis
Authors: Klair Jagpal Singh , Zafar Yousaf , Nagra Navroop , Murali Arvind R. , Jayaraj Mahendran , Singh Dhruv , Rustagi Tarun , Krishnamoorthi Rajesh
Published: January 2021

Background: Endoscopic therapy using radiofrequency ablation (RFA) is a recommended treatment for Barrett’s esophagus with high-grade dysplasia (BE-HGD) without a visible lesion which is managed by resection. However, currently, there is no consensus on the management of BE with low-grade dysplasia (BE-LGD) – RFA versus endoscopic surveillance. Hence, we performed a systematic review and meta-analysis of these comparative studies to compare the risk of progression to HGD or esophageal adenocarcinoma (EAC) among patients with BE-LGD treated with RFA versus endoscopic surveillance. Methods: The primary outcome was to compare the risk of progression to HGD or EAC among patients with BE-LGD treated with RFA versus endoscopic surveillance. Results: Four comparative studies reporting a total of 543 patients with BE-LGD were included in the meta-analysis (234 in RFA and 309 in endoscopic surveillance). The progression of BE-LGD to either HGD or EAC was significantly lower in patients treated with RFA compared to endoscopic surveillance (OR: 0.17, 95% confidence interval [CI]: 0.04–0.65, p = 0.01). The progression to HGD alone was significantly lower in patients treated with RFA versus endoscopic surveillance (OR: 0.23, 95% CI: 0.08–0.61, p = 0.003). The progression to EAC alone was numerically lower in RFA than endoscopic surveillance without statistical significance (OR: 0.44, 95% CI: 0.17–1.16, p = 0.09). Moderate heterogeneity was noted in the analysis. Conclusions: Based on our meta-analysis, there was a significant reduction in the risk of progression to HGD or EAC among patients with BE-LGD treated with RFA compared with those undergoing endoscopic surveillance. Endoscopic eradication therapy with RFA should be the preferred management approach for BE-LGD.
«Si una persona tiene más sueños que recuerdos, en su cabeza es joven, independientemente de la edad que tenga»: una conversación con Ernesto Rodríguez
Authors: Feixa Carles , Rodríguez Ernesto
Published: January 2021

(analítico): Ernesto Rodríguez (Montevideo, 1954) es uno de los referentes latinoamericanos en los estudios y las políticas de juventud. Su interés por la juventud surgió durante su militancia juvenil y maduró durante la dictadura militar uruguaya (1973-1984) en el seno de la oposición democrática. Tras la recuperación de la democracia, Rodríguez fundó el Centro Latinoamericano de la Juventud (Celaju), el cual se convirtió en un think tank sobre estos temas para todo el subcontinente. En los últimos años ha sido el máximo exponente de lo que puede denominarse «juvenología aplicada», asesorando a gobiernos y organismos públicos internacionales en políticas de juventud, sin dejar de investigar y preocuparse por la evolución de las juventudes. La entrevista hace un recorrido por su trayectoria, explica el origen de las instituciones nacionales e internacionales en las que trabajó y contiene un epílogo con una reflexión a distancia sobre los efectos de la pandemia entre las nuevas generaciones.
Direito Sanitário: conhecimento em evolução
Authors: Aith Fernando
Published: January 2021

"O Direito Sanitário consolida-se no Brasil como um campo de conhecimento específico a ser estudado, a exemplo do que já acontece em outros países, como a França e o Canadá. Dotado de princípios hermenêuticos que lhe são próprios, o Direito Sanitário apresenta-se hoje como o campo científico voltado especificamente a compreender de que forma se pode proteger eficazmente o direito à saúde em sociedades democráticas, abarcando estudos normativos, de jurisprudência e comparados."
Regulação de alimentos destinados a lactentes e crianças na primeira infância no Brasil: elementos para reflexão
Authors: Miranda Marissol Carvalho Costa Mattos , Castilho Selma Rodrigues de
Published: January 2021

A amamentação exclusiva até os seis meses e complementar até os dois anos de idade é recomendação da Organização Mundial da Saúde. Entretanto, diversos fatores contribuem para o desmame precoce, inclusive a propaganda excessiva dos alimentos substitutos do leite materno e a influência dos profissionais de saúde envolvidos no processo. Entendendo que se trata de uma questão de saúde pública devido aos muitos problemas acarretados por esse processo na saúde das crianças envolvidas, este artigo analisa aspectos do desenho e da implementação de marcos regulatórios no campo da promoção e exposição de alimentos destinados a lactentes e crianças na primeira infância, buscando contribuir para a reflexão sobre os desafios presentes no processo de regulação desses produtos no Brasil.
A importância da implantação dos cuidados paliativos no Sistema Único de Saúde
Authors: Schaefer Fernanda
Published: January 2021

A hospitalização da morte e o desenvolvimento tecnológico da medicina ao longo do século XX tornaram-na um evento asséptico e solitário que retirou do enfermo a autonomia sobre o próprio processo de morrer. No entanto, o envelhecimento populacional e o aumento das doenças crônicas não transmissíveis estão exigindo que a medicina volte sua atenção ao doente, e não apenas à doença, estimulando o repensar sobre o processo de morrer e incentivando o enfermo a se reapropriar da própria morte. A partir de pesquisa bibliográfica e normativa e de metodologia exploratória, o presente artigo pretende discutir os cuidados paliativos como um direito a ser garantido ao enfermo terminal, que, ao reconhecer a finitude da vida, busca em seus momentos finais conforto físico, mental e espiritual. A ressignificação da morte e do processo de morrer é hoje elemento necessário para garantir a autonomia do paciente sobre o próprio corpo e a qualidade de sua vida até os momentos finais, daí a importância da Resolução n. 41/2018 para o Sistema Único de Saúde brasileiro.
Mecanismos jurídicos de segurança do paciente: repensando o tratamento legal do tema no Brasil
Authors: Albuquerque Aline , Regis Arthur
Published: January 2021

A judicialização da medicina é um fenômeno crescente no Brasil, ou seja, há um incremento paulatino de demandas judiciais em face de profissionais de medicina em decorrência de eventos adversos. Este artigo objetivou identificar e sintetizar os mecanismos jurídicos adotados por distintos países para lidar com temas relacionados à segurança do paciente e aos danos aos pacientes decorrentes dos cuidados em saúde. Considerando as premissas previamente estabelecidas neste artigo e seu escopo, foram categorizados os seguintes mecanismos: (i) solução extrajudicial de conflitos em cuidados em saúde; (ii) sistema de queixas de pacientes; (iii) compensação de danos sem culpa ou administrativos; e (iv) disclosure e pedido de desculpas. Tratou-se de estudo teórico e documental, que se alicerçou na literatura especializada sobre cada um dos temas que são objeto dos mecanismos assinalados e no Relatório da União Europeia acerca dos Direitos dos Pacientes, de 2016. Conclui-se que o modelo brasileiro centrado na judicialização da medicina conduz ao enfraquecimento dos laços de confiança estabelecidos entre profissional de saúde e paciente e ao dispêndio de recursos materiais e humanos excessivos pelo Estado e pelas partes envolvidas nas ações judiciais, sem que o resultado da ação judicial garanta satisfação das demandas; e, ainda, não se tem como resultante das ações judiciais a melhoria sistêmica da qualidade dos serviços de saúde.
Efetivação das políticas públicas em saúde protetivas às crianças com síndrome congênita do zika e o impacto na judicialização da saúde
Authors: Vasconcelos Alessandra Alves de , Dadalto Luciana , Sarsur Marcelo
Published: January 2021

A síndrome congênita do zika fez surgir no Brasil um universo de crianças que necessitam de medicamentos, exames médicos e consultas especializadas, além de uma vigilância rigorosa de seu crescimento e desenvolvimento neuropsicomotor (DNPM). No entanto, nem todas conseguem receber o tratamento adequado e acabam buscando o Poder Judiciário para ter seus direitos efetivados. Nesse contexto, o presente artigo objetivou apresentar as principais demandas que chegam ao Poder Judiciário por parte das famílias que têm filhos com essa síndrome, bem como avaliar o alcance das políticas de saúde instituídas para garantir a integralidade da atenção e a proteção social dessas crianças e suas famílias. Verificou-se que, apesar de o direito à saúde ser assegurado constitucionalmente e imputar ao poder público, em todas as suas esferas, o dever de fornecer assistência médica e farmacêutica com equidade e universalidade, a alocação de recursos e a atenção à saúde dispensadas a essas crianças demonstraram-se insuficientes e precárias, gerando assim, uma transferência de atribuições do Poder Executivo para o Poder Judiciário, que se torna a última esperança das famílias.
On the occurrence and distribution of the narrowly endemic Andaman Lantern Flower Ceropegia andamanica (Apocynaceae: Ceropegieae)
Authors: Maheshwari M. Uma , Karthigeyan K.
Published: January 2021

Ceropegia andamanica is a herbaceous plant which is narrowly endemic to South Andaman Island in India.  It is assessed as critically endangered per IUCN Red List criteria using primary and secondary information on EOO, AOO and number of collection.
On the epidemiology of helminth parasites in Hangul Deer Cervus hanglu hanglu (Mammalia: Artiodactyla: Cervidae) of Dachigam National Park, India
Authors: Khurshid Naziya , Tak Hidayatullah , Nazir Ruqeya , Bhat Kulsum Ahmad , Manzoor Muniza
Published: January 2021

A one-year study conducted to ascertain the prevalence and risk factors associated with helminth infection in Hangul Deer Cervus hanglu hanglu at Dachigam National Park revealed that 40.45% (89 of 220 samples) were infected with four helminth species including Heamonchus contortus, Trichuris ovis, Dictyocaulus viviparus, and Moneizia expansa.  The study signified that the infection was more prevalent during the dry season (summer and autumn) as compared to the wet season (winter and spring).  The overall prevalence of Heamonchus contortus was the highest (23.18%) followed by Trichuris ovis (8.18%), followed by Dictyocaulus viviparus (5.45%), and Moneizia expansa (3.63%).  The present study should be of importance in conserving the erstwhile state animal, listed as Critically Engendered in 2017 by IUCN.
Ibadi Manuscripts in a European Collection
Authors: Brugnatelli Vermondo
Published: January 2021

Within the framework of studies concerning the importance of European manuscript collections for Ibadi history, this article aims at retracing the history of an archive put together by the French scholar Auguste Bossoutrot (1856–1937). This archive gathered a quantity of materials on the Arabic and Berber languages collected during his life. In particular, some of the manuscripts contain parts of a long religious work in Berber (Kitāb al-Barbariyya), discovered in the island of Djerba (Tunisia) among the Ibadi community of the island towards the end of the nineteenth century. This text was firstly discovered and reported to the scientific community by another French scholar, A. De Calassanti-Motylinski (1854–1907), but his untimely death prevented him from publishing it and the whereabouts of the manuscripts that contained it remained unknown until the discovery of Bossoutrot’s papers, which contained the longest extant copy of the work (about 900 pages).
From Djerba to Warjalān
Authors: Neji Mohamed , Love Paul M.
Published: January 2021

This article focuses on letters in private Ibadi libraries and their importance for understanding the primary means of communication among Ibadi communities in the premodern Maghrib. Using the example of a letter from the 7th/13th-century Ibadi Shaykh Abū ʿAbdallāh al-Ṣidghiyānī from the island of Djerba (Tunisia) to the Ibadis of Warjalān (Algeria), it seeks to highlight the importance of the archive of unedited Ibadi manuscript letters. This corpus of correspondences has not received the care and maintenance it merits because these letters do not belong to a recognized volume or book and are today located in private libraries unavailable to the public. The article also uses the example of al-Ṣidghiyānī’s letter to emphasize the importance of the manuscript letters and their role in maintaining intellectual ties among the Ibadi cities of the Maghrib. This brief article consists of two parts. The first part offers a general presentation of the archive where the letter is today held: the El Barounia Library in Djerba, Tunisia. The second part presents the manuscript and its author in their historical context.
‮مجموعة المخطوطات الإباضيّة بمكتبة الباسيّين بجربة‬‎
Authors: ‮البوجديديّ‬‎ ‮د. علي‬‎
Published: January 2021

‮الملخص‬‎

‮يمكن أن تُسهم دراسة مخطوطات الباسي الإباضيّة منها، رغم ما شابها من ضياع، في إعادة تأريخ المكتبة، كما يمكنها أن تلقي ضوءا على تاريخ العائلة في علاقتها بالإباضيّة مدّا وجزرا. فضلا عن أهميّة دراسة المجموعات الإباضيّة في الكشف عن حركة صور تلقّي العلوم والمعارف وتبادلها داخل الفضاء الجزيريّ وتأثرها بالفضاءات المتاخمة لها وعن علاقات الجوار والتّثاقف بين إباضيي جربة مع غيرهم مغربا ومشرقا، وتشي بعمق تواصلهم المغاربيّ والمتوسطيّ. ويصير المخطوط تبعا لذلك خزّانا للأفكار والرّؤى والتصوّرات، لا يقلّ أهميّة عن التّحف المتحفيّة والمباني المعماريّة، ومختلف مكوّنات التّراث الماديّ وغير الماديّ الأخرى. تلك هي ملامح الحركة الدّؤوب التي تتكشّف من خلال دراسة مجموعات المخطوطات الإباضيّة بجربة، والتي تنمّ عن ثقافة المخطوط عند الإباضيّة، وتبرز مكانة العلم والتعلّم في الجزيرة، وفي حوض البحر الأبيض المتوسّط عموما. وقد أسهم مشروع رقمنة مكتبة الباسيّين بجربة في التفطّن إلى مجموعة من المخطوطات الإباضيّة على جانب كبير من الطّرافة والقيمة العلميّة تبرز هذا التّفاعل الحيّ بين إباضيّة جربة وغيرها من مناطق العلم والمعرفة، كما تؤكّد على علوّ شأن آل الباسي ومؤسّسيها الحاج سالم وعثمان تحديدا، وتكشف عن تنوّع مصادر مخطوطات الباسي وحرص القائمين عليها على جلبها ونسخها وعنايتهم بتجليدها وحفظها‬‎
Introduction of Neolophiotrema xiaokongense gen. et sp. nov. to the poorly represented Anteagloniaceae (Pleosporales, Dothideomycetes)

Authors: REN GUANG-CONG , WANASINGHE DHANUSHKA N. , MONKAI JUTAMART , HYDE KEVIN D. , MORTIMER PETER E. , XU JIANCHU , PANG AIMIN , GUI HENG
Published: January 2021

The monotypic Neolophiotrema (typified by N. xiaokongense) is introduced for a wood-inhabiting taxon classified in Dothideomycetes. The genus is characterized by, coriaceous, immersed to semi-immersed ascomata, hamathecium with cellular pseudoparaphyses and overlapping 1–2-seriate, hyaline ascospores. Phylogenetic analysis of combined SSU, LSU, ITS, tef1-α and rpb2 sequence data supports the placement of Neolophiotrema in Anteagloniaceae (Pleosporales). A morphology-based synopsis key is provided to facilitate the identification of species of Anteagloniaceae. The classification and nature of species boundaries in Anteagloniaceae are discussed.
Cymbella xiaojinensis sp. nov., a new cymbelloid diatom species (Bacillariophyceae) from high altitude lakes, China
Authors: ZHANG YUN , LIAO MENGNA , LI YAN-LING , CHANG FENG-QIN , KOCIOLEK JOHN PATRICK
Published: January 2021

This paper describes a new species of Cymbella from an alpine lake in the Hengduan Mountains, southwestern China. The detailed morphological description of the new species, named Cymbella xiaojinensis sp. nov. is presented, based on light and scanning electron microscopy. The main features of C. xiaojinensis are characterized by strongly dorsiventral, triangular valves with a strongly reverse-lateral raphe system positioned near the proximal ends and an asymmetrical, larger central area, occupying approximately 1/2 of the width with the valve. Most morphological characteristics of the new species are similar to C. shudunensis, C. terrafuegiana, C. pamirensis, and C. gravida, but differ in details of size, valve shape, striae density, central area, and number of stigmata.