bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract A036: Development of a stirred-tank bioreactor scale-up approach to allogeneic natural killer cell culture
Authors: Yogalingam Mathura , Jagroop Rebecca , Khalajzadeh Alireza , Irrazabal Thergiory , Perea Melissa , Pushparaj Pooja , Roshankhah Roxana , Bowles Paul , Le Michael
Published: December 2023

Natural killer (NK) cells are innate lymphocytes that play a critical role in the immune response, as they recognize and eliminate virus-infected, cancerous, and other abnormal cells in an antigen-independent manner. This unique method of recognition makes NK cells an attractive target for utilization as an immunotherapy, as studies have demonstrated they reduce both the induction of graft-versus-host disease and the risk of cytokine release syndrome compared to T-cell based therapies. Additionally, these advantages over canonical T-cell therapies make NK therapies attractive candidates for allogeneic, as opposed to autologous, products. Given their cost-effective scale-up potential, developing a stirred-tank bioreactor (STR)-based NK cell expansion platform to achieve clinical-level expansion is of significant interest, as it would reduce the cost of producing such therapies and improve patient accessibility. To test ideal culture conditions for STR expansion, NK cells were first isolated from healthy donor Leukopaks prior to cryopreservation. Frozen, isolated NK cells were then thawed, co-cultured with varying ratios of irradiated K562 cells and supplemental cytokines from Cytiva in a 6-well G-Rex or DASbox® STR. Finally, cells were harvested for downstream analytics, including identity and functional characterization by flow cytometry and potency assays. A fold expansion of greater than 100 was achieved once the ratio of irradiated K562 to NK cells was optimized. One of the primary challenges encountered was donor-to-donor variation, not only with respect to proliferative capacity, but NK functional phenotype and activity as well. Therefore, a small-scale donor screen was conducted and donors with similar proliferative and functional capabilities were selected for large-scale expansion. Future work will focus on optimizing NK cell transduction to enable genetic customization and scaling-up to a clinically-relevant STR. The successful small-scale NK expansion in an STR demonstrated here lays the groundwork for an expansion platform that enables the manufacturing of various NK-based therapeutics at clinical scale.

Citation Format: Mathura Yogalingam, Rebecca Jagroop, Alireza Khalajzadeh, Thergiory Irrazabal, Melissa Perea, Pooja Pushparaj, Roxana Roshankhah, Paul Bowles, Michael Le. Development of a stirred-tank bioreactor scale-up approach to allogeneic natural killer cell culture [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor Immunology and Immunotherapy; 2023 Oct 1-4; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Immunol Res 2023;11(12 Suppl):Abstract nr A036.
Urine Uromodulin, Kidney Tubulointerstitial Fibrosis, and Furosemide Response
Authors: Bullen Alexander L. , Vaingankar Sucheta , Madero Magdalena , Lopez Gil Salvador , Macedo Etienne , Ix Joachim H. , Rifkin Dena E. , Garimella Pranav S.
Published: December 2023

Background: Interstitial fibrosis and tubular atrophy (IFTA) are common findings on biopsy in chronic kidney disease (CKD) and are strongly predictive of kidney failure. IFTA is poorly correlated with estimated glomerular filtration rate (eGFR) and albuminuria, the most common measures of kidney function. Thus, IFTA is prognostically important, yet its presence and severity are invisible to the clinician except when kidney biopsies are obtained. Objectives: The objective of this study was to investigate (1) the cross-sectional association between urine uromodulin (uUMOD) and IFTA and (2) to determine whether uUMOD levels were associated with diuretic response after a furosemide stress test. Methods: We performed logistic regression to evaluate the association between uUMOD and fibrosis. We used linear regression models to assess the association of uUMOD with diuretic response. Results: Among 52 participants, the mean age was 42 ± 16 years, 48% were women, 23% had diabetes, and the median eGFR was 56 mL/min/1.73 m2. The mean uUMOD concentration was 5.1 (8.4) μg/mL. Each halving of uUMOD was associated with 1.74 higher odds (95% CI: 1.10, 2.75) of grade 2 or 3 fibrosis. However, this association was no longer significant after adjusting for baseline eGFR and albuminuria. Each halving of uUMOD was associated with a decreased response to furosemide. This association was also no longer significant after adjusting for baseline eGFR and albuminuria. Conclusion: In a population of individuals with a wide range of kidney function undergoing clinically indicated kidney biopsies, we did not find an association between uUMOD and interstitial fibrosis or response to loop diuretics after adjusting for eGFR and albuminuria.
Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma Treated with Radiation Therapy: A Case Report and Review of the Literature
Authors: Armstrong Paul , Hayden Patrick , Jeffers Michael , Fitzpatrick Lisa , Mcknight Aoife , Armstrong John
Published: December 2023

Introduction: Mucosa-associated lymphoid tissue lymphoma (MALT lymphoma or MALToma) is a prevalent type of primary pulmonary lymphoma. Typically, the primary therapeutic approaches involve surgery or chemotherapy, although there have been instances of radiation therapy being employed. Case Report: We present a case of pulmonary MALToma that exhibited progression despite rituximab therapy. Subsequently, the patient demonstrated a positive response to radiation therapy. Conclusion: This case highlights the potential efficacy of radiation therapy as a treatment option for pulmonary MALToma, especially in cases where other conventional treatments like rituximab have proven ineffective. Further research and studies are warranted to better understand the role of radiation therapy in managing pulmonary MALToma and to determine optimal treatment strategies for patients with this condition.
The Use of Authorized Concealment to Minimize Nocebo Side Effects: A Survey of US Public Attitudes
Authors: Geers Andrew L. , Spotts Emily K. , Vang Michael , Mayer Samantha R. , Miller Franklin G.
Published: December 2023

Introduction: To minimize nocebo effects, it may be possible to employ authorized concealment, in which clinicians tell patients about the nocebo phenomenon and ask if they would prefer not to be informed about mild treatment side effects. Objective: The objective of the study was to understand public evaluations of authorized concealment for reducing nocebo effects. Methods: An online cross-sectional survey was completed by a demographically diverse US national community sample between June 2 and 6, 2023. Participants were 1,012 adults residing in 48 states, ages ranging from 18 to 94 (mean = 43.2), 65.4% regularly taking medication, and 66.6% reporting a chronic physical or mental health condition. After learning about nocebo effects, participants rated and estimated their likelihood of consenting to four potential methods for authorized concealment of mild side effects. The four methods were ranked for preference and ranked again with the options of (1) receiving all side-effect information and (2) having the opportunity to select among disclosure methods. Results: A majority of participants (86.2%) positively endorsed at least one authorized concealment method and 88.2% estimated they would consent to at least one method. Authorized concealment in which individuals learned only the most common side effects or had side-effect information available online received more positive ratings and rankings. A final ranking yielded preferences for receiving all side-effect information (30.4%) and having the opportunity to select side-effect disclosure method (31.8%). Conclusions: Our study suggests that many in the public could be open to authorized concealment for mild side effects when it is explained in reference to nocebo effects.
Expression of Nectin-4 in Chromophobe Renal Cell Carcinoma in a Multicenter Cohort: Early Prognostic and Therapeutic Considerations
Authors: Mikuteit Marie , Zschäbitz Stefanie , Autenrieth Michael , Weichert Wilko , Hartmann Arndt , Steffens Sandra , Erlmeier Franziska
Published: December 2023

Introduction: Nectin-4 is a member of the nectin family and a calcium-independent immunoglobulin-like transmembrane protein that contributes to tumor growth and angiogenesis in malignant tumors. A nectin-4-directed antibody drug conjugate, enfortumab vedotin-ejf, has recently been approved for treatment in urothelial cancer and is currently under investigation in other tumor entities such as breast, lung, and prostate cancer. In non-clear cell renal cell carcinoma (RCC), vascular endothelial growth factor (VEGF)-directed tyrosine kinase inhibitors and checkpoint inhibitors are currently treatments of choice. However, due to the rarity of disease treatment recommendations for chromophobe RCC (chRCC) are limited and new therapeutic agents urgently needed. In this study, we investigated the expression and prognostic impact of nectin-4 in a large cohort of chRCC. Methods: Patients who underwent renal surgery due to chRCC were recruited. Clinical data were retrospectively evaluated. Tumor specimen was analyzed for nectin-4 expression by immunohistochemistry. Results: Eighty-one chRCC patients were eligible for analysis. In 15 (18.5%) samples, tumors were positive for nectin-4. No significant associations were found for nectin-4 expression and clinical attributes in patients with chRCC. Kaplan-Meier analysis disclosed a 5-year overall survival for nectin-4-negative and nectin-4-positive tumors of 91.8% versus 100.0% (p = 0.316, log rank). Conclusions: In chRCC, a small subset of tumors expresses nectin-4 potentially amenable to nectin-4-directed treatment. Expression of nectin-4 is not associated with parameters of aggressiveness or survival. Due to the rare incidence of chRCC, further studies with larger cohorts are warranted.
Effect of Three Chemical Agents on Stain Removal from Dentin Caries Lesions Treated with Silver Diamine Fluoride
Authors: Rodrigues Vieira Basílio , Costa Cruz Sara Brito Silva , Maia Silvaa Cristiane Araújo , Lippert Frank , Kelly Adam , Hara Anderson Takeo , Barbosa de Sousa Frederico
Published: December 2023

Introduction: This in vitro study aimed to evaluate the effect of three different chemical agents on stain removal and mineral uptake of artificial dentin caries (ADC) lesions treated with silver diamine fluoride (SDF). Methods: Baseline L*a*b* values were determined in polished human permanent dentin blocks, and ADC lesions were induced with an acid gel for 1 week. Samples were assigned to four groups; in three groups, half of each sample received SDF (30% SDF for 3 min), while the other half received SDF followed by a bleaching treatment protocol (garlic extract, bentonite, or 35% hydrogen peroxide). The fourth group had one SDF-treated half and one half without SDF. Color changes (ΔE) were measured by spectrometry, and transversal microradiography was used to quantify integrated mineral loss (ΔZ) 24 h after treatment (SDF or SDF + bleaching). A two-way mixed ANOVA was applied to thirty percent. Results: SDF application increased mineral uptake by ADC (p = 0.001). The type of chemical agent evaluated (p < 0.0001), time (p = 0.01), and their interaction (p < 0.0001) bleached the ADC treated with SDF. However, 35% hydrogen peroxide was the only compound with a bleaching effect (p < 0.001), without returning to baseline color. None of the compounds altered the mineral uptake effect of SDF (p = 0.30). Conclusion: This in vitro study showed mineral uptake effect in ACD within 24 h after SDF application and the ability of hydrogen peroxide to partially remove (reduction of 24%) the staining caused by SDF without affecting its mineral uptake effect.
Coastal vulnerability assessment using electrical resistivity tomography in Padang Betuah, Central Bengkulu
Authors: Suhendra Suhendra , Halauddin Halauddin , Lizalidiawati Lizalidiawati , Sinaga Jesika Erni Elfrita , Fadli Darmawan Ikhlas , Idris Beni Syakban
Published: December 2023

Abrasion disaster in the coastal area of Padang Betuah Beach has a high level of abrasion in Central Bengkulu. The local community utilizes abrasion in the coastal area as a tourist attraction and becomes local revenue in the research location. The location that becomes a tourist attraction is decreasing because the coastal area’s land has been abraded. After conducting research using the electrical resistivity tomography (ERT) method in 2D and 3D, it was found that claystone dominated the coastal area at the research location with a resistivity value of 16-200 Ωm at a depth of 15-20 m. The coastal area in Padang Betuah Beach is composed of clay shale rocks (207-220 Ωm), and the depth is 2-14.8 m. Clay shale rocks are not abraded in stones with resistivity values >250 Ωm. This is caused by clay shale, which has low porosity, so it has a compact rock density. Seawater is identified at a depth of 21-63 m with a resistivity value of 2.225-10.2 Ωm. The depth of seawater determined follows the average height of the cliffs in the research location. The abrasion process can be slowed down by making jetties, water breakers, and mangrove cultivation.
Drying kinetics of modification cassava-seaweed noodles using an oven
Authors: Budiarti Gita Indah , Sulistiawati Endah , Juwitaningtyas Titisari , Shitophyta Lukhi Mulia , Purba Irene Enjeli , Setiyani Seila
Published: December 2023

Consumption of noodles in the world is always increasing. Noodles made from wheat flour are unhealthy because they cause diabetes, so alternative noodles are needed, such as modified cassava flour and seaweed. Modification cassava is used because it does not contain gluten and seaweed has nutritional value to make healthy, low-calorie noodles. The purpose of this study was to determine the temperature and time of the drying parameters of seaweed noodles. The drying method uses an oven with variable temperature (60, 70, 80, and 90 ) and drying time (2, 4, 6, 8, and 10 hours). The results of the study obtained optimal water content at 60  with 6 hours of 11.75%. The drying kinetics evaluated by logarithmic equation, optimal drying constant value at 80  of 0.67 h-1 with R2 0.9391. Effective moisture diffusivity (Deff) maximum evaluated by second Fick law obtained 9.35×107 m2/sec at temperature 90  with R2=0.9227. The proximate value of ash content is 12.11%, protein is 9.46%, lipid is 0.10%, and carbohydrates is 65.08%.
Evaluation of technology of artisanal and improved production of Vitellaria paradoxa butter in Burkina Faso
Authors: Zida Issouf , Tapsoba François , Tarnagda Bakary , Zio Souleymane , Savadogo Aly
Published: December 2023

This study aims to find the current various processes for the almond producers and the extractors of shea butter in Burkina Faso. The survey was conducted in seven provinces. Three approaches to data gathering were used: group interviews in which forms were filled out during interviews; individual interviews in which the interviewer asked one person about the survey-related tasks; and semi-structured group interviews. The survey data were analyzed and the results obtained made it possible to draw up four technological diagrams of almond products and three of almond processing into butter. The surveys showed that shea kernels were produced by boiling, pit fermented, and then smoked, or only smoked. In terms of butter making, the classic churning and roasting processes were used. These results revealed that the processes of butter making and processing are not uniform in all the units of producers. However, further studies are recommended, especially to determine the physico-chemical, sensory, and microbiological parameters of the butter from the productions to better appreciate their qualities.
Performance fuzzy analytical hierarchy process to identify drought areas for disaster mitigation
Authors: Aprillya Mala Rosa , Ardyansyah Heri
Published: December 2023

Drought causes crop failure in the agricultural sector and a limited supply of clean water. Land damage due to drought in Lamongan has reached ±12,000 ha in the last decade. The lack of information regarding drought disaster mitigation resulted in quite large losses in several agricultural sectors. The purpose of this study is to develop a decision support system (DSS) that can provide information regarding the identification of drought-prone areas. The fuzzy analytical hierarchy process (FAHP) method is implemented with four criteria: rainfall intensity, slope, soil type, and distance to the river. FAHP is good for processing the weighting of several criteria and categories to produce good choices. Results, the tests carried out there were 20 sub-districts prone to drought, with an accuracy rate of the FAHP method of 85%. The average value of respondent satisfaction averaged 97.2%. DSS application can provide the status of areas prone to drought. For future studies, the temperature and evapotranspiration parameters can be added, to provide better results.
Development of a microcontroller and resistive touchscreen-based speed monitoring and control system for DC motor
Authors: Adebisi Oluwaseun Ibrahim , Ogundare Ayoade Benson , Erinosho Tolulope Christiana , Sonola Moyosoluwalorun Odunayo , Adesanu Adesewa Rofiat
Published: December 2023

Speed control is a key requirement in direct current (DC) motor applications where accuracy, reliability, flexibility, and safety are of high importance. In this study, a microcontroller and resistive touchscreen-based DC motor speed monitoring and control system were developed. The core components employed in the development of the system include Arduino ATMega328P microcontroller, thin film technology (TFT) resistive touch screen, L293D motor driver, and infrared (IR) sensor module. ATMega328P microcontroller is the brain of the system around which the overall circuit design was modeled. TFT resistive touch screen displays the motor speed and also, enables the users to set a desired speed. L293D motor driver regulates the voltage and current supplied to the motor, and a feedback loop comprising an IR sensor module ensures the maintenance of the motor speed at the desired level. A performance test was conducted on the developed system to ascertain its correct functionality. The developed speed monitoring and control system operated satisfactorily during testing; achieving a speed control in the range of 800 to 3000 rpm. The developed device is useful and can be scaled up for various domestic and industrial applications.
Generating intelligent agent behaviors in multi-agent game AI using deep reinforcement learning algorithm
Authors: Rosalina Rosalina , Sengkey Axel , Sahuri Genta , Mandala Rila
Published: December 2023

The utilization of games in training the reinforcement learning (RL) agent is to describe the complex and high-dimensional real-world data. By utilizing games, RL researchers will be able to evade high experimental costs in training an agent to do intelligence tasks. The objective of this research is to generate intelligent agent behaviors in multi-agent game artificial intelligence (AI) using deep reinforcement learning (DRL) algorithm. A basic RL algorithm called deep Q network is chosen to be implemented. The agent is trained by the environment's raw pixel images and the action list information. The experiments conducted by using this algorithm show the agent’s decision-making ability in choosing a favorable action. In the default setting for the algorithm, the training is set into 1 epoch and 0.0025 learning rate. The number of training iterations is set to one as the training function will be repeatedly called for every 4-timestep. However, the author also experimented with two different scenarios in training the agent and compared the results. The experimental findings demonstrate that our agents learn correctly and successfully while actively participating in the game in real time. Additionally, our agent can quickly adjust against a different enemy on a varied map because of the observed knowledge from prior training.
The optimization of self-assembled monolayer of thiols on screen-printed gold electrode
Authors: Rahim Nur Aina Syuhada , Harun Noor Hasmiza , Abdullah Muhammad Rosli , Jamilan Mohd Azerulazree , Kamarudin Balqis , Abdul Wahab Azimah , Ibrahim Siti Noorjannah , Jimat Dzun Noraini
Published: December 2023

The activated gold-modified electrode surface for self-assembled monolayer (SAM) is suitable for N-(3-dimethylaminopropyl)-N-ethylcarbodiimide hydrochloride (EDC), 16-mercaptohexadecanoic acid (16-MDA), and N-hydroxysuccinimide (NHS). The various substrates could potentially be used for surface functionalization that binds to one another. Using modified screen-printed gold electrodes, 16-MDA, EDC, and NHS, we developed a self-assembling monolayer. Different 16-MDA concentrations were applied to the surface of a screen-printed electrode surface to enhance the sensitivity of the working electrode. The impact of different EDC, NHS, and 16-MDA concentrations (0.4 M, 0.8 M, 1 M, 1.2 M, 1.4 M, and 1.8 M) and incubation times between 5 and 30 minutes were examined and compared. The binding surface of the screen-printed gold electrode was characterized using the differential pulse voltammetry (DPV) technique. It has been demonstrated that the substrate concentrations at 5 minutes and 30 minutes of incubation time used to have the highest surface coverage and electron transfer rates. This concentration would be utilized in the subsequent experiment to evaluate the binding of various bacterial species. These findings suggest that the SAM in a modified screen-printed gold electrode may be functionalized to detect microorganisms.
Plano de desenvolvimento urbano-ambiental para Itaipuaçu, Maricá - RJ
Authors:   Universidade de São Paulo. Faculdade de Arquitetura e Urbanismo, Tavares Jeferson
Published: December 2023

O Plano de Desenvolvimento Urbano-Ambiental para Itaipuaçu, Maricá-RJ consiste em trabalho de extensão realizado no Instituto de Arquitetura e Urbanismo (IAU-USP) que envolveu parceiros da Universidade de São Paulo (USP), agentes da sociedade civil, poder público, iniciativa privada, organizações sociais e grupos da Universidade Federal do Rio de Janeiro (UFRJ). O objetivo foi elaborar planejamento e projeto urbanístico, ambiental, jurídico e econômico de desenvolvimento do distrito de Itaipuaçu, localizado no município de Maricá-RJ. O resultado é um plano de ações para o bairro que cria a oportunidade de desenvolvimento comunitário para os próximos quarenta anos, confere segurança jurídico-fundiária aos atuais moradores e constrói condições de sustentabilidade econômica e de qualidade sócio ambiental.
Impacto do desequilíbrio da microbiota intestinal no desenvolvimento da obesidade
Authors: Goulart Anna Laura Gomes , Costa Ester Maria de Almeida , Bacelar Mariana Guedes Lopes , Nascimento Sâmya Silveira , Gomes Thaynara Faria
Published: December 2023

OBJETIVO: revisar as bases de dados atuais para identificar os impactos da disbiose intestinal na obesidade, bem como servir de pilar para realização de medidas preventivas, diagnósticas e terapêuticas. METODOLOGIA: trata-se de revisão integrativa realizada a partir de coleta de dados obtidos nas plataformas SciELO, PubMed, BVS e LILACS usando os descritores “dysbiosis”, “obesity” and “gastrointestinal microbiome”; os critérios de inclusão foram: artigos publicados nos últimos 5 anos (de 2017 a 2022), artigos originais, metanálises e estudos observacionais (ensaios clínicos e estudo de coorte) e escritos em português, inglês ou espanhol. RESULTADOS: dieta ocidental e uso de adoçante provocam alterações antropométricas, de pressão arterial, intolerância à glicose, entre outras, além de levar à prevalência de bactérias deletérias ao organismo, culminando em obesidade e diabetes mellitus; em contrapartida, dieta rica em fibras e administração de probióticos podem gerar mudanças benéficas na diversidade da flora intestinal, ademais combatem o estado inflamatório gerado pela obesidade.
Comparing follow-up of patients with vitamin K antagonists in a health center: pre- and post- COVID-19 pandemic
Authors: Aveiro Ana Sofia Dias , Vaz Vítor Daniel Pereira , Ribeiro Soraia Antunes Pereira , Pereira Tiago José Reis , Santos Ana Margarida Leitão da Silva , Graça Beatriz Nunes , Cardoso Marta Costa , Silva Carla Maria Santos
Published: December 2023

Introduction and objectives: During the COVID-19 pandemic, the follow-up of patients treated with vitamin K antagonists (VKAs) may have been affected. This study aims to compare how these patients were monitored preand post-COVID-19 pandemic and understand the impact of non-face-to-face appointments on their follow-up. Methods: We conducted a retrospective cohort study in a Portuguese Health Center. The study included patients treated with VKAs and followed at the Health Center for international normalized ratio (INR) monitoring between March 2019 and March 2021. Data collected: sex, age, type of VKA; INR; date of INR assessment, type of appointment (face-to-face or phone/e-mail). Rosendaal’s method was used to calculate pre-COVID-19 and post-COVID-19 time in therapeutic range (TTR). Good TTR control was defined if values ≥ 70%. Results: 44 patients were included. The mean TTR in the pre-COVID-19 period was 64.55% (95% CI: 58.10 - 71.00%). The post-COVID-19 mean was slightly higher (+ 2.26%), 66.81% (95% CI: 59.66 - 73.97%), but the difference was not statistically significant (p = 0.576). The use of non-face-to-face appointments did not contribute to worsening post-pandemic TTR, showing no lower follow-up than during pre-pandemic period in which all contacts were face-to-face [CI (95%) -0.397 - 0.196 for a reference range -0.489 - 0.693]. Conclusions: The TTR value in both periods was similar and lower than the value defined for effective hypocoagulation. The use of non-face-to-face consultation in the post-COVID-19 period does not seem to have influenced the quality of hypocoagulation.
Utilização de serviços de saúde por idosos quilombolas
Authors: Barros Andressa Rayane Viana , Oliveira Bruno Luciano Carneiro Alves de , Pinto Claudia Silva , Santos Junior Getúlio Rosa dos , Silva Rosiany Pereira da , Silva Thalita Costa da , Aragão Francisco Bruno da Silva , Aragão Francisca Bruna Arruda , Costa Andréa Suzana Vieira
Published: December 2023

Objetivo: Analisar a utilização de serviços de saúde por idosos quilombolas. Métodos: Trata-se de um estudo transversal, de base domiciliar, realizado em 11 comunidades quilombolas, com 236 idosos ≥60 anos. Verificou-se diferenças estatísticas nas estimativas dos indicadores de uso de serviços de saúde segundo sexo e faixa etária. Realizaram-se testes de Qui-quadrado de Pearson ou Exa to de Fisher. As diferenças foram consideradas estatisticamente significantes quando p<0,05. Resultados: A maioria dos idosos não possuía plano de saúde, buscando, principalmente, hospital/ambulatório público. A última consulta médica de 80,3% dos participantes foi realizadanos 12 meses anteriores às entrevistas, com número menor de consulta para os homens (p= 0,027). Houve baixa internação hospitalar no último ano e procura de algum serviço de saúde nas duas últimas semanas. Conclusão: As mulheres quilombolas e os idosos mais velhos utilizam mais os serviços de saúde e, no geral, os idosos dependem do SUS para exercer o seu direito à saúde. O hospital/ambulatório público foi o serviço mais utilizado, e a UBS pouco procurada.
Sarcopenia and risk of malnutrition as risk factors for complications from COVID-19
Authors: Vasconcelos Laís Gomes Lessa , Me Mpomo Janatar Stella Vasconcelos de Melo , Macena Mateus de Lima , Souza Thamires Otaviano Marques de , Dias Celina de Azevedo , Vasconcelos Sandra Mary Lima , Ribeiro-Andrade Müller , Barros-Neto João Araújo
Published: December 2023

Purpose: This study aimed to associate nutritional and sarcopenia risk with clinical outcomes in elderly patients with COVID-19. Methods: This is a longitudinal retrospective cohort study. Hospitalized elderly individuals diagnosed with COVID-19 were included in the study. Nutritional risk was assessed using the Malnutrition Universal Screening Tool (MUST), and Sarcopenia risk was assessed using the SARC-F. Associations were assessed throughmultivariable logistic models. Results: In total, 127 patients (mean age: 71.25 ±8.06 years) were followed up until the clinical outcome. Sarcopenia risk was diagnosed in 63.8% of the sample, whereas nutritional risk was observed in 72%. Hospitalization in the intensive care unit (ICU) was required in 48.8% of the sample, 38.6% required mechanicalventilation, and 32.3% died. Elderly individuals with sarcopenia risk were more likely to be hospitalized inICUs (OR: 5.62; 95%CI: 2.2-14.3), require mechanical ventilation (OR: 4.0; 95% CI: 1.5-10.2), and die (OR: 5.06; 95% CI: 1.7-14.2). The risk of malnutrition assessed through MUST was an important risk factor for death (OR = 30.15; 95% CI: 3.6-245.8; p<0.01). Conclusion: Sarcopenia risk was a risk factor for death, hospitalization in ICU, and mechanical ventilation, while nutritional risk was a risk factor for death.
Questionários direcionados ao diabetes mellitus validados para o português do Brasil
Authors: Menezes Aline Carrilho , Amorim Maria Marta Amâncio , Apolinário Priscila Peruzzo , Lourenço Laura Bacelar de Araújo , Freitas Amanda Tainara Souza , Lago Arthur Maggi do , Trevisan Danilo Donizetti
Published: December 2023

Modelo do estudo: Revisão de escopo recomendada pelo Instituto Joanna Briggs e PRISMA-ScR. Objetivo: Analisar e sintetizar as evidências científicas sobre questionários relacionados ao diabetes mellitus validados para língua portuguesa do Brasil. Método: Foram incluídos estudos com resumo disponível e que descreveram um questionário relacionado ao diabetes mellitus publicados em inglês, espanhol ou português em periódicos indexados no PubMed,Scopus, BVS e Web of Science e nos catálogos de dissertações/teses do Portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior entre 2011 e 2022. Os descritores utilizados foram: diabetes mellitus; diabetes; surveys and questionnaires; reproducibility of results; psychometrics; validation studies; validation studies as topic; Brazil; Brazilian. O protocolo do estudo foi registrado na plataforma Open Science Framework (https://osf.io/asbjz/). Resultados: Integraram esta revisão 39 publicações cujos questionários selecionados abordaram os temas: autocuidado/ autogestão/autogerenciamento/autoeficácia; qualidade de vida; cuidado com a pele, úlceras e lesões; plano alimentar; adesão medicamentosa; estresse emocional/psicológico; conhecimento sobre diabetes; risco para desenvolvimento do diabetes; satisfação da qualidade dos cuidados em diabetes; manejo do diabetes em escolas; atitudes de profissionais da saúde frente ao diabetes. Conclusão: A utilização de questionários validados pode contribuir para a medida das barreiras e dificuldades encontradas por pessoas com diabetes mellitus e direcionar para a construção de estratégias de intervenções que sejam mais assertivas.
Maternal depression and offspring mental health at age 5: MINA-Brazil cohort study
Authors: Matijasevich Alicia , Faisal-Cury Alexandre , Giacomini Isabel , Rodrigues Julia de Souza , Castro Marcia C. , Cardoso Marly A.
Published: December 2023

OBJECTIVE: To identify longitudinal patterns of maternal depression between three months and five years after child’s birth, to examine predictor variables for these trajectories, and to evaluate whether distinct depression trajectories predict offspring mental health problems at age 5 years. METHODS: We used data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3 and 6–8 months, and 1 and 2 years after delivery. Mental health problems in 5-year-old children were evaluated with the Strengths and Difficulties Questionnaire (SDQ) reported by parents. Trajectories of maternal depression were calculated using a group-based modelling approach. RESULTS: We identified four trajectories of maternal depressive symptoms: “low” (67.1%), “increasing” (11.5%), “decreasing” (17.4%), and “high-chronic” (4.0%). Women in the “high/ chronic” trajectory were the poorest, least educated, and oldest compared with women in the other trajectory groups. Also, they were more frequently multiparous and reported smoking and having attended fewer prenatal consultations during pregnancy. In the adjusted analyses, the odds ratio of any SDQ disorder was 3.23 (95%CI: 2.00–5.22) and 2.87 (95%CI: 1.09–7.57) times higher among children of mothers belonging to the “increasing” and “high-chronic” trajectory groups, respectively, compared with those of mothers in the “low” depressive symptoms group. These differences were not explained by maternal and child characteristics included in multivariate analyses. CONCLUSIONS: We identified poorer mental health outcomes for children of mothers assigned to the “chronic/severe” and “increasing” depressive symptoms trajectories. Prevention and treatment initiatives to avoid the adverse short, medium, and long-term effects of maternal depression on offspring development should focus on women belonging to these groups.
Safe Deferral of Coronary Computed Tomography Angiography for Patients With a Low Pretest Probability of Coronary Artery Disease in 2019 European Society of Cardiology Guidelines
Authors: Varho Ville , Uusitalo Valtteri , Vaara Satu M. , Syväranta Suvi , Rajala Helena , Sinisalo Juha
Published: December 2023

Background

Coronary computed tomography angiography is increasingly used as the first‐line test for suspected coronary artery disease. Its overuse in a low pretest probability (PTP) population may lead to low diagnostic yield without change in patient management. We evaluated the clinical consequences of the updated 2019 European Society of Cardiology (ESC) chronic coronary syndromes guidelines’ PTP estimation and whether imaging could be safely deferred in patients with a low PTP.

Methods and Results

This retrospective cohort included all 1753 consecutive patients who underwent coronary computed tomography angiography for suspected coronary artery disease at Helsinki University Hospital between 2009 and 2017. PTP was calculated according to the 2013 and 2019 ESC guidelines. The overall mortality, cardiac deaths, myocardial infarctions, and hospitalizations for unstable angina were acquired from national registry data for 1 to 10 years of follow‐up (median, 4 years). Updated 2019 ESC guidelines classified 72% of the patients as having low PTP, whose imaging could have been deferred. The revascularization rate (4.7%) and annual cardiac mortality (0.4%) were low in the 857 patients reclassified from the recommendation to test, according to the 2013 ESC guideline, to deferral of coronary computed tomography angiography, according to the new 2019 guideline.

Conclusions

The updated 2019 ESC guideline PTP score aids clinicians in safely preventing the overuse of cardiac imaging in patients deemed at low PTP of coronary artery disease. Diagnostic yield, revascularization rate, and cardiac mortality are low in patients with low pretest risk.
Excess Bed Days and Hospitalization Costs Associated With 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation
Authors: Ngo Linh , Denman Russell , Hay Karen , Kaambwa Billingsley , Ganesan Anand , Ranasinghe Isuru
Published: December 2023

Background

The incidence and type of complications following catheter ablation of atrial fibrillation have been extensively examined, but the impact associated with these complications on the length of stay and hospitalization costs is unknown.

Methods and Results

This cohort study included 20 117 adult patients (mean age 62.6±11.4 years, 30.3% women, median length of stay 1 day [interquartile range 1–2 days]) undergoing atrial fibrillation ablation in financial years 2011 to 2017 in Australia with available cost data from the National Hospital Cost Data Collection, which determines government reimbursement of health services provided. The primary outcome was the costs associated with complications occurring up to 30 days postdischarge adjusted for inflation to 2021 Australian dollars. We used generalized linear models to estimate the increase in length of stay and cost associated with complications, adjusting for patient characteristics. Within 30 days of hospital discharge, 1151 (5.72%) patients experienced a complication with bleeding (3.35%) and pericardial effusion (0.75%) being the most common. On average, the occurrence of a complication was associated with an adjusted 3.3 (95% CI, 3.1–3.6) excess bed days of hospital care (totaling 3851 days), and a $7812 (95% CI, $6754–$8870) increase in hospitalization cost (totaling $9.0 million). Most of the total excess cost was attributable to bleeding ($3.8 million, 41.9% of total excess cost) and pericardial effusion ($1.6 million, 18.2%).

Conclusions

Complications following atrial fibrillation ablation were associated with significant increase in length of stay and hospitalization costs, most of which were attributable to bleeding and pericardial effusion. Strategies to improve procedural safety and reduce health care costs should focus on these complications.
Resting Heart Rate Independent of Cardiovascular Disease Risk Factors Is Associated With End‐Stage Renal Disease: A Cohort Study Based on 476 347 Adults
Authors: Tsai Min‐Kuang , Gao Wayne , Chien Kuo‐Liong , Kyaw Thu Win , Baw Chin‐Kun , Hsu Chih‐Cheng , Wen Chi‐Pang
Published: December 2023

Background

The relationship between resting heart rate (RHR) and the risk of end‐stage renal disease (ESRD) among those without cardiovascular disease remains unclear. We aim to establish temporal consistency and elucidate the independent relationship between RHR and the risk of ESRD.

Methods and Results

This cohort enrolled participants from 476 347 individuals who had taken part in a screening program from 1996 to 2017. We identified 2504 participants who had ESRD, and the median follow‐up was 13 years. RHR was extracted from electrocardiography results, and the study assessed the relationship between RHR and the risk of ESRD using the Cox proportional hazards model. Of the participants, 32.6% had an RHR of 60 to 69 beats per minute (bpm), and 22.2% had an RHR of ≥80 bpm. Participants with an RHR of ≥80 bpm had a higher stage of chronic kidney disease, lower estimated glomerular filtration rate, and more proteinuria than those with an RHR of 60 to 69 bpm. Participants with an RHR of 80 to 89 and ≥90 bpm had a 24% (hazard ratio [HR], 1.24 [95% CI, 1.09–1.42]) and 64% (HR, 1.64 [95% CI, 1.42–1.90]) higher risk of ESRD, respectively. The risk of ESRD remained significantly elevated (HR, 1.32 [95% CI, 1.10–1.58] per 10‐beat increase from 60 bpm) after excluding participants who smoked; had hypertension, diabetes, or hyperlipidemia; or were overweight.

Conclusions

An RHR of ≥80 bpm is significantly associated with an increased risk of ESRD. These results suggest that RHR may serve as a risk factor for kidney disease in individuals without established cardiovascular disease risk factors.
Role of Sex in the Association of Socioeconomic Status With Cardiovascular Health in Black Americans: The Jackson Heart Study
Authors: Joseph Joshua J. , Williams Amaris , Azap Rosevine A. , Zhao Songzhu , Brock Guy , Kline David , Odei James B. , Foraker Randi , Sims Mario , Brewer LaPrincess C. , Gray Darrell M. , Nolan Timiya S.
Published: December 2023

Background

Socioeconomic status (SES) is associated with cardiovascular health (CVH). Potential differences by sex in this association remain incompletely understood in Black Americans, where SES disparities are posited to be partially responsible for cardiovascular inequities. The association of SES measures (income, education, occupation, and insurance) with CVH scores was examined in the Jackson Heart Study.

Methods and Results

American Heart Association CVH components (non–high‐density‐lipoprotein cholesterol, blood pressure, diet, tobacco use, physical activity, sleep, glycemia, and body mass index) were scored cross‐sectionally at baseline (scale: 0–100). Differences in CVH and 95% CIs (Estimate, 95% CI) were calculated using linear regression, adjusting for age, sex, and discrimination. Heterogeneity by sex was assessed. Participants had a mean age of 54.8 years (SD 12.6 years), and 65% were women. Lower income, education, occupation (non‐management/professional versus management/professional occupations), and insurance status (uninsured, Medicaid, Veterans Affairs, or Medicare versus private insurance) were associated with lower CVH scores (all
P
<0.01). There was heterogeneity by sex, with greater magnitude of associations of SES measures with CVH in women versus men. The lowest education level (high school) was associated with 8.8‐point lower (95% CI: −10.2 to −7.3) and 5.4‐point lower (95% CI: −7.2 to −3.6) CVH scores in women and men, respectively (interaction
P
=0.003). The lowest (<25 000) versus highest level of income (≥$75 000) was associated with a greater reduction in CVH scores in women than men (interaction
P
=0.1142).

Conclusions

Among Black Americans, measures of SES were associated with CVH, with a greater magnitude in women compared with men for education and income. Interventions aimed to address CVH through SES should consider the role of sex.
An Agenda for the Study of the Jesus Letter
Authors: Trompf Garry W.
Published: December 2023

The ancient correspondence allegedly between the Toparch Abgar V of Edessa and Jesus of Nazareth is usually treated in modern scholarship as legendary, though possession of it was important for the legitimation of Armenia as the first Christian kingdom in ca. 314 A.D. (prior to Constantine’s ‘Christian’ rule of a united Roman Empire from 324, and well before Theodosius I’s Edict of Thessalonica in 380). This paper attempts to create a demythologized space in which to reconsider the historical probability that Jesus, widely reputed as a healer in the chief (Near Eastern) Jewish centre of influence, was asked for help by an ailing eminent and replied to his request. Along the way, questions will be raised for further research (italicized) and so in this sense the article takes the form of an Agenda.
Horace and the Parthians
Authors: Smykov Evgeniy
Published: December 2023

This paper aims to explore the Parthian theme in Horace’s poems throughout its development. First, it delves into the works featuring the ethnonym Parthus, which, unlike the synonymous Medus, notably aligns with the events contemporaneous to the poet. It becomes evident that Horace’s early works reflect the Parthian invasion of 41/40 B.C. and the anxiety surrounding the possibility of a recurrence. However, this apprehension is gradually replaced by verses celebrating victory over the Parthians and their apprehension of Roman power. Ultimately, these poems demonstrate their acknowledgment of Roman authority and the compromise established during the age of Augustus. Horace himself never forgets the threat posed by the Parthians, yet there is no compelling reason to consider him an advocate for a conquest war against their eastern neighbors. He appeared content with the diplomatic compromise that had been achieved.
On the Participation of Armenians in the Mongol Ilkhanate’s Invasion of Syria (1259–1260)
Authors: Hovhannisyan Aram
Published: December 2023

This study examines the participation of Cilician Armenians in the Mongol Ilkhanate’s Syrian invasions in 1259–1260. Drawing upon data from mediaeval sources and various perspectives in scholarly literature, this paper addresses the following key questions: 1. Where were the troops of the Armenian Kingdom of Cilicia and their allied countries consolidated? 2. To what extent did the troops of the Armenian King Het‘um I join forces with the Mongols? The inquiry also presents the specific details of the capture of Syrian cities and explores the likelihood of Armenian troops’ involvement in these operations. In the final section, the paper delves into the events surrounding the famous Battle of Ain-Jalut and examines the potential participation of Armenians in this pivotal conflict, in which the allies suffered defeat and were subsequently compelled to retreat.
Iranian Lexical Material in the Caucasus
Authors: Gippert Jost
Published: December 2023

The present article examines the peculiar shape that the Middle Iranian word for ‘praise’, āfrīn, has achieved as a loanword in the language of the Caucasian “Albanians” where it appears as afre- in the complex verb afre-pesown ‘praise, bless’. Based on a thorough investigation of the morphology of formations with the light verb -pesown in Caucasian Albanian, it is proven that a recent proposal, which assumes the influence of an agreement marker, is untenable; instead, it is shown how afre- can have emerged from a metanalysis of afrin as a case form.
The Armenians Themselves Burnt Their Own Houses and Desecrated Their Own Churches
Authors: Ferrari Aldo
Published: December 2023

Luigi Villari’s book Fire and Sword in the Caucasus, published in London in 1906, is widely quoted by the scholars who study the history of South Caucasus at the time of the first Russian Revolution in 1905. After a short introduction about the interesting figure of this author, the first part of the article will take into consideration Villari’s peculiar attitude toward the Armenians. The larger part of the article will consider his first-hand description of the massacres perpetrated by the Azeris (Tartars) in the region of Nakhichevan. As a matter of fact, Luigi Villari’s testimony of the tragic events of 1905 is more interesting than ever to understand the origins of a contrast that continues—even if in a deeply different situation—to stain with blood the relationship between Armenians and the South Caucasian Turks.
Headscarves at the Crossroads between Plural Narratives: Where is Turkey Moving Toward?
Authors: Madera Adelaide
Published: December 2023

In a recent judgement, the ECJ held that a ban on employees wearing visible political, philosophical or religious signs in the workplace does not amount to direct discrimination under EU law. The Turkish government condemned such a ruling, as an expression of European Islamophobia. However, the issue of religious headscarves has been at the center of a harsh decades-long political and legal debate in Turkey, where it has symbolized the clash between tradition and modernity, religious and secular values. In the present article, the tensions underlying the multiple narratives of the Islamic headscarf will be analyzed starting from the polarization between two opposite views: Turkey as a secular State versus Turkey as a theocracy. The article will underline the need for a depolarization of the legal-political conflict between religion and public space, allowing women to build their autonomous understanding of the religious message and to self-define their identities in the public space.