bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized, open-label, phase 2 study of andecaliximab plus nivolumab versus nivolumab alone in advanced gastric cancer identifies biomarkers associated with survival
Authors: Shah Manish A , Cunningham David , Metges Jean-Philippe , Van Cutsem Eric , Wainberg Zev , Elboudwarej Emon , Lin Kai-Wen , Turner Scott , Zavodovskaya Marianna , Inzunza David , Liu Jinfeng , Patterson Scott D , Zhou Jingzhu , He Jing , Thai Dung , Bhargava Pankaj , Brachmann Carrie Baker , Cantenacci Daniel V T
Published: December 2021

Background

Matrix metalloproteinase-9 (MMP9) selectively cleaves extracellular matrix proteins contributing to tumor growth and an immunosuppressive microenvironment. This study evaluated andecaliximab (ADX), an inhibitor of MMP9, in combination with nivolumab (NIVO), for the treatment of advanced gastric cancer.

Methods

Phase 2, open-label, randomized multicenter study evaluating the efficacy, safety, and pharmacodynamics of ADX+NIVO versus NIVO in patients with pretreated metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma. The primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and adverse events (AEs). We explored the correlation of efficacy outcomes with biomarkers.

Results

144 patients were randomized; 141 were treated: 81% white, 69% male, median age was 61 years in the ADX+NIVO group and 62 years in the NIVO-alone group. The ORR was 10% (95% CI 4 to 19) in the ADX+NIVO group and 7% (95% CI 2 to 16) in the NIVO-alone group (OR: 1.5 (95% CI 0.4 to 6.1; p=0.8)). There was no response or survival benefit associated with adding ADX. AE rates were comparable in both treatment groups; the most common AEs were fatigue, decreased appetite, nausea, and vomiting. Programmed cell death ligand 1, interferon-γ (IFN), and intratumoral CD8+ cell density were not associated with treatment response or survival. The gene signature most correlated with shorter survival was the epithelial-to-mesenchymal gene signature; high transforming growth factor (TGF)-β fibrosis score was negatively associated with OS (p=0.036). Gene expression analysis of baseline tumors comparing long-(1+ years) and short-term (<1 year) survivors showed that GRB7 was associated with survival beyond 1 year. Human epidermal growth factor receptor 2 (HER2)-positive disease was associated with significantly longer survival (p=0.0077). Median tumor mutation burden (TMB) was 2.01; patients with TMB ≥median had longer survival (p=0.0025) and improved PFS (p=0.016). Based on a model accounting for TMB, TGF-β fibrosis, and HER2, TMB was the main driver of survival in this patient population.

Conclusion

Combination of ADX+NIVO had a favorable safety profile but did not improve efficacy compared with NIVO alone in patients with pretreated metastatic gastric or GEJ adenocarcinoma. HER2 positivity, higher TMB or GRB7, and lower TGF-β were associated with improved outcomes.

Trial registration number

NCT02864381or GS-US-296–-2013.
Call for action: incorporating wellness practices into a holistic management plan for rheumatoid arthritis—going beyond treat to target
Authors: Taylor Peter C. , Van de Laar Mart , Laster Andrew , Fakhouri Walid , Quebe Amanda , de la Torre Inmaculada , Jain Saundra
Published: December 2021

This expert opinion article explores the strategy of adopting a holistic approach to the management of rheumatoid arthritis (RA) by incorporating the wellness practices of exercise, optimised sleep, optimised nutrition, mindfulness, social connectedness and positive emotions into the management plan. The aim is to attain optimal health for each patient beyond that achievable by limiting disease management to pharmacological treatment to attain the lowest achievable composite scores of disease activity, as recommended with the current treat-to-target approach, and addressing the recent recognition of pain control as a key patient-reported outcome. Incorporating wellness practices into a busy clinical setting requires creativity and customisation based on the individual practice setting and the individual needs of each patient. Such practices can help people living with RA to achieve optimum wellness through the introduction of measures—according to individual need—designed to improve the aspects of life most impacted for that person, thereby complementing treat-to-target and pain control strategies with pharmacological agents. Clinicians must consider wellness practices in addition to treat-to-target pharmacological agents for the holistic management of people with RA.
Composite operator approach to dynamical mass generation in the (2 + 1)-dimensional Gross–Neveu model
Authors: Khunjua T. G. , Klimenko K. G. , Zhokhov R. N.
Published: December 2021

Using a nonperturbative approach based on the Cornwall–Jackiw–Tomboulis (CJT) effective action [Formula: see text] for composite operators, the phase structure of the simplest massless [Formula: see text]-dimensional Gross–Neveu model is investigated. We have calculated [Formula: see text] in the first-order of the bare coupling constant [Formula: see text] and have shown that there exist three different specific dependences of [Formula: see text] on the cutoff parameter [Formula: see text], and in each case, the effective action and its stationarity equations have been obtained. The solutions of these equations correspond to the fact that three different masses of fermions can arise dynamically and, respectively, three different nontrivial phases can be observed in the model.
Nonconforming P1 Finite Element for the Biharmonic Problem and Its Application to Stokes Problem
Authors: Staïli N. , Rhoudaf M.
Published: December 2021

The aim of this paper is to simulate the two-dimensional stationary Stokes problem. In vorticity-Stream function formulation, the Stokes problem is reduced to a biharmonic one; this approach leads to a formulation only based on the stream functions and therefore can only be applied to two-dimensional problems. The idea developed in this paper is to use the discretization of the Laplace operator by the nonconforming [Formula: see text] finite element. For the solutions which admit a regularity greater than [Formula: see text], in the general case, the convergence of the method is shown with the techniques of compactness. For solutions in [Formula: see text] an error estimate is proved, and numerical experiments are performed for the steady-driven cavity problem.
Large steps in inverse rendering of geometry
Authors: Nicolet Baptiste , Jacobson Alec , Jakob Wenzel
Published: December 2021

Inverse reconstruction from images is a central problem in many scientific and engineering disciplines. Recent progress on differentiable rendering has led to methods that can efficiently differentiate the full process of image formation with respect to millions of parameters to solve such problems via gradient-based optimization.

At the same time, the availability of cheap derivatives does not necessarily make an inverse problem easy to solve. Mesh-based representations remain a particular source of irritation: an adverse gradient step involving vertex positions could turn parts of the mesh inside-out, introduce numerous local self-intersections, or lead to inadequate usage of the vertex budget due to distortion. These types of issues are often irrecoverable in the sense that subsequent optimization steps will further exacerbate them. In other words, the optimization lacks robustness due to an objective function with substantial non-convexity.

Such robustness issues are commonly mitigated by imposing additional regularization, typically in the form of Laplacian energies that quantify and improve the smoothness of the current iterate. However, regularization introduces its own set of problems: solutions must now compromise between solving the problem and being smooth. Furthermore, gradient steps involving a Laplacian energy resemble Jacobi's iterative method for solving linear equations that is known for its exceptionally slow convergence.

We propose a simple and practical alternative that casts differentiable rendering into the framework of preconditioned gradient descent. Our pre-conditioner biases gradient steps towards smooth solutions without requiring the final solution to be smooth. In contrast to Jacobi-style iteration, each gradient step propagates information among all variables, enabling convergence using fewer and larger steps.

Our method is not restricted to meshes and can also accelerate the reconstruction of other representations, where smooth solutions are generally expected. We demonstrate its superior performance in the context of geometric optimization and texture reconstruction.
Neural radiosity
Authors: Hadadan Saeed , Chen Shuhong , Zwicker Matthias
Published: December 2021

We introduce Neural Radiosity, an algorithm to solve the rendering equation by minimizing the norm of its residual, similar as in classical radiosity techniques. Traditional basis functions used in radiosity, such as piecewise polynomials or meshless basis functions are typically limited to representing isotropic scattering from diffuse surfaces. Instead, we propose to leverage neural networks to represent the full four-dimensional radiance distribution, directly optimizing network parameters to minimize the norm of the residual. Our approach decouples solving the rendering equation from rendering (perspective) images similar as in traditional radiosity techniques, and allows us to efficiently synthesize arbitrary views of a scene. In addition, we propose a network architecture using geometric learnable features that improves convergence of our solver compared to previous techniques. Our approach leads to an algorithm that is simple to implement, and we demonstrate its effectiveness on a variety of scenes with diffuse and non-diffuse surfaces.
Shear Properties of Earth's Inner Core
Authors: Tkalčić Hrvoje , Wang Sheng , Phạm Thanh-Son
Published: December 2021

Understanding how Earth's inner core (IC) develops and evolves, including fine details of its structure and energy exchange across the boundary with the liquid outer core, helps us constrain its age, relationship with the planetary differentiation, and other significant global events throughout Earth's history, as well as the changing magnetic field. Since its discovery in 1936 and the solidity hypothesis in 1940, Earth's IC has never ceased to inspire geoscientists. However, while there are many seismological observations of compressional waves and normal modes sensitive to the IC's compressional and shear structure, the shear waves that provide direct evidence for the IC's solidity have remained elusive and have been reported in only a few publications. Further advances in the emerging correlation-wavefield paradigm, which explores waveform similarities, may hold the keys to refined measurements of all IC shear properties, informing dynamical models and strengthening interpretations of the IC's anisotropic structure and viscosity. ▪ What are the shear properties of the IC, such as the shear-wave speed, shear modulus, shear attenuation, and shear-wave anisotropy? ▪ Can the shear properties be measured seismologically and confirmed experimentally?
CD44 Variant Exon 6 Isoform Expression as a Potential Predictor of Lymph Node Metastasis in Invasive Breast Carcinoma of No Special Type
Authors: Rustamadji Primariadewi , Wiyarta Elvan , Bethania Kristina A.
Published: December 2021

Background. Invasive breast carcinoma of no special type (IBC-NST) is the most widespread invasive carcinoma subtype causing primarily regional metastases of the lymphatic node (LNM). The capacity of CD44 variant exon 6 (CD44v6) expression as an LNM predictor biomarker in IBC-NST was explored. Methods. We conducted a cross-sectional research with 48 paraffin blocks containing IBC-NST primary tumors that were divided into two groups by LNM. The assessment has been carried out in terms of age, tumor size, tumor grade, lymphovascular invasion (LVI), and CD44v6 expression. The expression of CD44v6 was analyzed on the grounds of immunohistochemical (IHC) staining, while other data were taken from archives. Statistical analysis is carried out by univariate, multivariate, and AUROC. Results. CD44v6 exhibits a dominant expression in IBC-NST tumor cells. Univariate analysis revealed a significant association between CD44v6 and LNM status (p=0.001). Multiple logistic regression results showed that CD44v6 expression and LVI were significantly associated with LNM with OR 10.7 (95% CI: 2.43 to 47.08) and 6.22 (95% CI: 1.4 to 27.88), respectively. CD44v6 expression was able to discriminate against LNM with AUROC0.863±0.053(95% CI: 0.759 to 0.967) at the H-score cut-off 133.889 (75% sensitivity and 83.3% specificity). Conclusion. CD44v6 expression and LVI are potential predictors of LNM in IBC-NST. The H-score cut-off of the CD44v6 expression can also be used as a threshold for classification in further investigation.
Wireless Radio Frequency Automation of Intelligent Optical Fiber Transmission System Based on the Differential Evolution Method
Authors: Jin Lei , Zhao Jinghong , Huang Xing , Lu Bin
Published: December 2021

With the continuous development and improvement of science and technology, optical fiber transmission has been transformed from traditional manual transmission to automatic transmission, and the transmission efficiency is constantly improving. In order to further analyze the performance of the intelligent optical fiber transmission process, the differential evolution analysis method is introduced in this paper, integrated architecture is built through the integrated optical and intelligent optical fiber, and the corresponding vector signal error value is solved through the comparison of transmission schemes. The error value is about 9%, through simulation experiments, which can effectively meet the requirement of automation of the wireless radio frequency of the intelligent optical fiber transmission system and realize long-distance transmission.
Valorization of Albedo Orange Peel Waste to Develop Electrode Materials in Supercapacitors for the Electric Industry
Authors: Suárez Gladis G. , Ramírez José A. , Castañón Juan F. , Galavíz Jorge A. , Meléndez Perla C.
Published: December 2021

This work proposes the use of albedo of orange peel in generation of carbon for applications in supercapacitors. For this, a comparison of compositional and electrochemical properties present in the carbons obtained of albedo, flavedo, and the complete orange peel was carried out. The morphology and composition of carbons obtained were analyzed by Field Emission Scanning Electron Microscopy (FESEM), Energy Dispersive X-ray (EDX), X-Ray Diffraction (XRD), and Fourier-transform infrared spectroscopy (FT-IR). The synthetized carbons were not subjected to the activation process by chemical compounds to relate only the properties of orange peel parts with their electrochemical behaviour. All samples were tested by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The carbon obtained of albedo presented a superior specific capacitance (210 F/g) of the rest samples. The value of albedo-based carbon capacitance is comparable with works presented in the literature that used a whole orange peel with chemical activators. In this way, it is possible to obtain large capacitances using only a part of orange peel (albedo). Thus, the importance of this study is that the albedo can be proposed as a material applied to electrodes for supercapacitors while the flavedo can be used in food industry or for oil extraction.
Numerical Calculations of the GRP Scheme for Nonconservative Ideal Fluid Mechanics Equations Relying on Parallel Calculation of Multifluid Grids
Authors: Zhan Huijing , Wu Mingze
Published: December 2021

In order to solve the numerical method of nonconservative ideal hydrodynamics equations, the viscous perturbation technique for solving nonconservative hydrodynamics equations is improved and tested by solving the Riemann problem. The calculation of nonconservative ideal fluid mechanics is based on the GRP format. This article aims at the calculation method of nonconservative ideal fluid mechanics in the GRP format. Riemann and the corresponding periodic vortex are processed. The multifluid network processing method in the article is compared with the current method. The result can prove that this format can be used to solve the nonconservative ideal fluid dynamics equation of multiple values in the GRP format group, its computing power is strong, and the result of the solution is accurate.
Study of the Physiological Dynamics of Cadmium Accumulation in Two Varieties of Rice with Different Cadmium-Accumulating Properties
Authors: Zhang Shangdu , Wu Xiang , Peng Ju , Meng Xiufei , Shi Bangzhi , Zhou Leliang , Bai Lianyang
Published: December 2021

This study focused on cadmium (Cd) uptake by two rice varieties, Yuzhenxiang (YZX) and Xiangwanxian 12 (XWX), which differ in their capacity to accumulate Cd, i.e., XWX > YZX. Treatments with three different gradients of soil Cd concentrations showed that with the increase in soil Cd concentration gradient, the Cd content in each rice plant organ also increased, i.e., Cd-3 > Cd-2 > Cd-1. The trend in the Cd content of each organ was such that the farther the organ from the root, the lower its Cd content, i.e., root > stem and sheath > leaf > grain. We observed that for all four growth stages, the booting stage is the key stage in terms of Cd absorption, where the highest levels of accumulation are observed, that is, booting stage > full heading stage > tillering stage > maturity stage. Of the two cultivars, XWX had higher SOD, POD, and CAT activities but lower MDA content. In contaminated soils, SOD, POD, and CAT activities increased gradually with the increase in Cd concentration, while MDA content decreased, which indicated that the low Cd variety XWX had an advantage over the high Cd variety YZX. Through the comparative analysis of photosynthetic physiology, it was found that the low-Cd-accumulating rice variety XWX appeared more tolerant to Cd, while the high-Cd-accumulating rice YZX was more sensitive. Therefore, the low Cd rice variety XWX was more suitable for planting safe rice in Cd-polluted paddy fields.
Assessment of Allergen-Responsive Regulatory T Cells in Experimental Asthma Induced in Different Mouse Strains
Authors: Azevedo C. T. , Cotias A. C. , Arantes A. C. S. , Ferreira T. P. T. , Martins M. A. , Olsen P. C.
Published: December 2021

Background. Regulatory T cells (Tregs) are important in regulating responses to innocuous antigens, such as allergens, by controlling the Th2 response, a mechanism that appears to be compromised in atopic asthmatic individuals. Different isogenic mouse strains also have distinct immunological responses and susceptibility to the experimental protocols used to develop lung allergic inflammation. In this work, we investigated the differences in the frequency of Treg cell subtypes among A/J, BALB/c, and C57BL/6, under normal conditions and following induction of allergic asthma with ovalbumin (OVA). Methods. Subcutaneous sensitization followed by 4 consecutive intranasal OVA challenges induced asthma characteristic changes such as airway hyperreactivity, inflammation, and production of Th2 cytokines (IL-4, IL-13, IL-5, and IL-33) in the lungs of only A/J and BALB/c but not C57BL/6 strain and evaluated by invasive whole-body plethysmography, flow cytometry, and ELISA, respectively. Results. A/J strain naturally showed a higher frequency of CD4+IL-10+ T cells in the lungs of naïve mice compared to the other strains, accompanied by higher frequencies of CD4+IL-4+ T cells. C57BL/6 mice did not develop lung inflammation and presented higher frequency of CD4+CD25+Foxp3+ Treg cells in the bronchoalveolar lavage fluid (BALF) after the allergen challenge. In in vitro settings, allergen-specific stimulation of mediastinal LN (mLN) cells from OVA-challenged animals induced higher frequency of CD4+IL-10+ Treg cells from A/J strain and CD4+CD25+Foxp3+ from C57BL/6. Conclusions. The observed differences in the frequencies of Treg cell subtypes associated with the susceptibility of the animals to experimental asthma suggest that CD4+CD25+Foxp3+ and IL-10-producing CD4+ Treg cells may play different roles in asthma control. Similar to asthmatic individuals, the lack of an efficient regulatory response and susceptibility to the development of experimental asthma in A/J mice further suggests that this strain could be preferably chosen in experimental models of allergic asthma.
NLRC4 Gene Single Nucleotide Polymorphisms Are Associated with the Prognosis of Hemophagocytic Lymphohistiocytosis
Authors: Li Yan , Sun Chengdong , Cui Liying , Wang Qiuying
Published: December 2021

Objective. To analyze and study the correlation between NLR family CARD domain-containing 4 (NLRC4) gene single nucleotide polymorphisms and the prognosis of patients with hemophagocytic lymphohistiocytosis (HLH). Methods. In this study, we retrospectively studied the clinical data of 62 HLH patients, including 40 males and 22 females. The genomic DNA was extracted, and the genotypes at rs385076 locus and rs479333 locus of the NLRC4 gene were analyzed. The level of blood interleukin-18 (IL-18) was analyzed by enzyme-linked immunosorbent assay (ELISA). Results. Compared with the TT genotype at the NLRC4 gene rs385076 locus, the mortality of HLH patients with TC genotype and CC genotype was higher (

RR
=
3.205

, 95% CI: 1.277-4.788,

p
=
0.012

;

RR
=
3.052

, 95% CI: 1.098-4.753,

p
=
0.031

). Taking the CC genotype at rs479333 of the NLRC4 gene as a reference, HLH patients with CG genotype and GG genotype had a higher risk of death (

RR
=
3.475

, 95% CI: 1.488-5.775,

p
=
0.003

;

RR
=
2.986

, 95% CI: 1.014-5.570,

p
=
0.047

). NLRC4 gene rs385076 T>C and rs479333 C>G were significantly related to the poor prognosis of HLH patients. The area under the curve (AUC) of the receiver operating curve (ROC) for the prognostic outcome of HLH with serum IL-18 level was 0.6813 (95% CI: 0.5365-0.8260,

p
=
0.0189

). NLRC4 gene rs385076 T>C and rs479333 C>G were related to higher serum IL-18 levels. Conclusion. NLRC4 gene rs385076 T>C and rs479333 C>G are related to the poor prognosis of HLH patients.
Algorithm for the Comparison of Human Periodic Movements Using Wearable Devices
Authors: Burbano-Fernandez Marlon , Sandoval-Serna Jhoana , Riascos Yilton , Muñoz-Organero Mario , Thilagaraj M. , Venkataraman V. , Arunkumar N. , Ramirez-Gonzalez Gustavo
Published: December 2021

In the context of teaching-learning of motor skills in a virtual environment, videos are generally used. The person who wants to learn a certain movement watches a video and tries to perform the activity. In this sense, feedback is rarely thought of. This article proposes an algorithm in which two periodic movements are compared, the one carried out by an expert and the one carried out by the person who is learning, in order to determine how closely these two movements are performed and to provide feedback from them. The algorithm starts from the capture of data through a wearable device that yields data from an accelerometer; in this case, the data of the expert and the data of the person who is learning are captured in a dataset of salsa dance steps. Adjustments are made to the data in terms of Pearson iterations, synchronization, filtering, and normalization, and DTW, linear regression, and error analysis are used to make the corresponding comparison of the two datasets. With the above, it is possible to determine if the cycles of the two signals coincide and how closely the learner’s movements resemble those of the expert.
Pathology: Hub and Integrator of Modern, Multidisciplinary [Precision] Oncology
Authors:   The AACR Pathology Task Force, Compton Carolyn C. , De Marzo Angelo M. , Debnath Jayanta , Eaton Keith D. , Elenitoba-Johnson Kojo , Fiorentino Michelangelo , French Christopher A. , Fuchs Thomas J. , Giangaspero Felice , Huang Jiaoti , Iafrate A. John , Ittmann Michael M. , Jensen Roy A. , Kim Annette S. , Loda Massimo , Lorenz Robin G. , Lotan Tamara L. , Maitra Anirban , Meijer Gerrit A. , Mitchell Richard N. , Parwani Anil V. , Pezzella Francesco , Pikarsky Eli , Reis-Filho Jorge S. , Richardson Andrea L. , Rubin Mark A. , True Lawrence D.
Published: December 2021

Every profession has an essential, behind-the-scenes component without which it cannot function. Medicine is no exception. Pathologists are one of medicine's group of specialists whose work as diagnosticians is critical for patient care. This article describes the multifaceted role that pathologists play in oncology practice and cancer research. To do so, we will highlight the role of pathologists in a typical “day-in-the-life” of a patient's journey in cancer care. Clinicians, clinical trialists, radiologists, researchers, and pathologists, all work together to provide optimal, multidisciplinary care for patients with cancer.
Surveillance of COVID-19 Using Geospatial Data: An Emergency Department Perspective
Authors: Ashok S. , Zaka Ullah Malik , Vadivelu Nandakumar , Islam Mohammed Tariqul , Nasereddin Safa , Zafar Khan Wajahat
Published: December 2021

Background: The outbreak of coronavirus 2019 (COVID-19) which emerged in December 2019 spread rapidly and created a public health emergency. Geospatial records of case data are needed in real time to monitor and anticipate the spread of infection. Methods: This study aimed to identify the emerging hotspots of COVID-19 using a geographic information system (GIS)-based approach. Data of laboratory-confirmed COVID-19 patients from March 15 to June 12, 2020, who visited the emergency department of a tertiary specialized academic hospital in Dubai were evaluated using ArcGIS Pro 2.5. Spatiotemporal analysis, including optimized hotspot analysis, was performed at the community level. Results: The cases were spatially concentrated mostly over the inner city of Dubai. Moreover, the optimized hotspot analysis showed statistically significant hotspots (p < 0.01) in the north of Dubai. Waxing and waning hotspots were also observed in the southern and central regions of Dubai. Finally, there were nonsustaining hotspots in communities with a very low population density. Conclusion: This study identified hotspots of COVID-19 using geospatial analysis. It is simple and can be easily reproduced to identify disease outbreaks. In the future, more attention is needed in creating a wider geodatabase and identifying hotspots with more intense transmission intensity.
Assessment of the Size and Shape of the 4-Chamber View and the Right and Left Ventricles Using Fetal Speckle Tracking in Normal Fetuses at 17–24 Gestational Weeks
Authors: Anuwutnavin Sanitra , Russameecharoen Kusol , Ruangvutilert Pornpimol , Viboonchard Sommai , Sklansky Mark , DeVore Greggory R.
Published: December 2021

Introduction: The aim of the study was to establish normal reference values obtained by fetal speckle tracking analysis of the fetal heart between 17 and 24 weeks of gestation among Thai fetuses and compare the nomograms with previous studies. Methods: The 4-chamber view (4CV) of the fetal heart in 79 normal fetuses was analyzed by speckle tracking analysis to determine the best-fit regression model. The 95% reference intervals and Z-score equations of fetal cardiac parameters were computed. Results: The end-diastolic length, width, area, and circumference of the 4CV as well as the ventricular end-diastolic length, 24-segment widths, and area were all increased as a function of gestational age (GA), and 5 fetal biometric parameters. In contrast, the global sphericity index (SI), 24-segment SI, and right ventricle/left ventricle width and area ratios did not change with GA or fetal biometric measurements. There were few differences in Z-score reference ranges of fetal cardiac measurements between the current study and previous studies conducted in different patient populations. Conclusion: Our study provided z-score and corresponding centile calculators, 5th and 95th centile reference tables, and corresponding graphs for evaluating the size and shape of the 4CV and the right and left ventricles using 6 independent variables between 17 and 24 weeks of gestation. These results provide normal reference ranges for future studies of fetuses with pathologies that may alter the size and shape of the 4CV and ventricles.
A Systematic Review of Representational and Behavioral Measures of Parent-Child Attachment Available for Middle Childhood
Authors: Gastelle Marissa , Kerns Kathryn A.
Published: December 2021

A variety of parent-child attachment measures, representing a range of conceptual approaches, have been adapted for use in middle childhood. A recent surge in studies using the new methods makes a comprehensive review of these measures timely. This systematic review of 67 studies covers representational and behavioral measures of parent-child attachment used with children 9–12 years old. This paper aims to evaluate parent-child attachment measures with an emphasis on understanding their theoretical bases in addition to considering the available validity evidence. Findings identify several independently well-validated representational measures, and they highlight a continued need to investigate direct comparisons of the measures, as very little research has considered how the measures relate to each other, both conceptually and empirically. Behavioral measures of attachment in middle childhood, which are relatively new, are identified as potentially important in developing a better understanding of attachment measurement in this age group.
As Escolas de Samba Negras da periferia e a hierarquia do carnaval paulistano: difíceis acessos
Authors: Silva Gleuson Pinheiro
Published: December 2021

Este artigo propõe uma reflexão sobre a relação entre a localização das agremiações carnavalescas da cidade de São Paulo e sua posição na hierarquia do carnaval, considerando as transformações pelas quais o carnaval de Escolas de Samba passou, desde a fundação dos primeiros cordões carnavalescos até a atualidade, passando pela institucionalização e incorporação nos eventos oficiais da cidade. Observa-se que os importantes marcos do carnaval aconteceram quando a cidade conheceu intensa expansão da mancha urbana e crescimento populacional e que as Escolas de Samba tiveram importante papel na urbanidade das periferias da cidade.
Habermas e o desafio pós-moderno (ainda)
Authors: Grupillo Arthur
Published: December 2021

Trata-se de discutir as dificuldades de compatibilizar alguns pressupostos da filosofia de Jürgen Habermas. Ela pretende escapar a uma crítica autodestrutiva da razão, ao mesmo tempo em que concede premissas de uma ontologização da arte ou, pelo menos, de uma função poética da linguagem com forte tom antificcional. Por outro lado, ela não pode, ao seguir esta via, simplesmente inverter a parte proscrita da imagem dialética, isto é, apontar de modo “superfundamentalista” o outro esquecido da razão. Isso permite perceber como sua filosofia segue exposta ao desafio colocado pelo pensamento pós-moderno.
Viagens da literatura cabo-verdiana entre raízes e rizomas, entre árvores e ondas: literatura mundo para uma Pátria Mundo
Authors: Gomes Simone Caputo
Published: December 2021

Chaves de leitura para a Poesia Cabo-verdiana contemporânea na sua relação com os conceitos de Literatura Mundial e Literatura-Mundo, com base em propostas teóricas de Zhang Longxi, David Damrosch, Armando Gnisci, Franco Moretti, Édouard Glissant, Helena Buescu e Zilá Bernd, entre outros pesquisadores. Constructos como transárea, arquipélago e vetorização, definidos por Ottmar Ette, bem como de Postpoesia, segundo Augustín Fernández Mallo, mostrar-se-ão também produtivos para o estudo da Poesia Cabo-verdiana.
A literatura-mundial e o sistema-mundial moderno
Authors: Lugarinho Mário César , Medeiros Paulo de , Santos Emanuelle Rodrigues dos
Published: December 2021

Editorial nº 40
Periodic Repolarization Dynamics Identifies ICD Responders in Nonischemic Cardiomyopathy: A DANISH Substudy
Authors: Boas Rune , Sappler Nikolay , von Stülpnagel Lukas , Klemm Mathias , Dixen Ulrik , Thune Jens Jakob , Pehrson Steen , Køber Lars , Nielsen Jens C. , Videbæk Lars , Haarbo Jens , Korup Eva , Bruun Niels Eske , Brandes Axel , Eiskjær Hans , Thøgersen Anna M. , Philbert Berit T. , Svendsen Jesper Hastrup , Tfelt-Hansen Jacob , Bauer Axel , Rizas Konstantinos D.
Published: December 2021

Background:

Identification of patients with nonischemic cardiomyopathy who may benefit from prophylactic implantation of a cardioverter-defibrillator. We hypothesized that periodic repolarization dynamics (PRD), a marker of repolarization instability associated with sympathetic activity, could be used to identify patients who will benefit from prophylactic implantable cardioverter defibrillator (ICD) implantation.

Methods:

We performed a post hoc analysis of DANISH (Danish ICD Study in Patients With Dilated Cardiomyopathy), in which patients with nonischemic cardiomyopathy, left ventricular ejection fraction (LVEF) ≤35%, and elevated NT-proBNP (N-terminal probrain natriuretic peptides) were randomized to ICD implantation or control group. Patients were included in the PRD substudy if they had a 24-hour Holter monitor recording at baseline with technically acceptable ECG signals during the night hours (00:00–06:00). PRD was assessed using wavelet analysis according to previously validated methods. The primary end point was all-cause mortality. Cox regression models were adjusted for age, sex, NT-proBNP, estimated glomerular filtration rate, LVEF, atrial fibrillation, ventricular pacing, diabetes, cardiac resynchronization therapy, and mean heart rate. We proposed PRD ≥10 deg
2
as an exploratory cut-off value for ICD implantation.

Results:

A total of 748 of the 1116 patients in DANISH qualified for the PRD substudy. During a mean follow-up period of 5.1±2.0 years, 82 of 385 patients died in the ICD group and 85 of 363 patients died in the control group (
P
=0.40). In Cox regression analysis, PRD was independently associated with mortality (hazard ratio [HR], 1.28 [95% CI, 1.09–1.50] per SD increase;
P
=0.003). PRD was significantly associated with mortality in the control group (HR, 1.51 [95% CI, 1.25–1.81];
P
<0.001) but not in the ICD group (HR, 1.04 [95% CI, 0.83–1.54];
P
=0.71). There was a significant interaction between PRD and the effect of ICD implantation on mortality (
P
=0.008), with patients with higher PRD having greater benefit in terms of mortality reduction. ICD implantation was associated with an absolute mortality reduction of 17.5% in the 280 patients with PRD ≥10 deg
2
(HR, 0.54 [95% CI, 0.34–0.84];
P
=0.006; number needed to treat=6), but not in the 468 patients with PRD <10 deg
2
(HR, 1.17 [95% CI, 0.77–1.78];
P
=0.46;
P
for interaction=0.01).

Conclusions:

Increased PRD identified patients with nonischemic cardiomyopathy in whom prophylactic ICD implantation led to significant mortality reduction.
Heightened Cardiovascular Risk in Hypertension Associated With Renin‐Independent Aldosteronism Versus Renin‐Dependent Aldosteronism: A Collaborative Study
Authors: Hu Jinbo , Shen Hang , Huo Peiqi , Yang Jun , Fuller Peter J , Wang Kanran , Yang Yi , Ma Linqiang , Cheng Qingfeng , Gong Lilin , He Wenwen , Luo Ting , Mei Mei , Wang Yue , Du Zhipeng , Luo Rong , Cai Jun , Li Qifu , Song Ying , Yang Shumin
Published: December 2021

Background

While both renin‐dependent and renin‐independent aldosterone secretion contribute to aldosteronism, their relative associations with cardiovascular disease (CVD) risk has not been investigated.

Methods and Results

A total of 2909 participants from the FOS (Framingham Offspring Study) with baseline, serum aldosterone concentration, and plasma renin concentration who attended the sixth examination cycle and were followed up until 2014 and who were free of CVD were included. We further recruited 2612 hypertensive participants from the CONPASS (Chongqing Primary Aldosteronism Study). Captopril challenge test was performed to confirm renin‐dependent or ‐independent aldosteronism in CONPASS. Among 1433 hypertensive subjects of FOS, when compared with those with serum aldosterone concentration <10 ng dL
−1
(normal aldosterone), participants who had serum aldosterone concentration ≥10 ng dL
−1
and plasma renin concentration ≤15 mIU L
−1
(identified as renin‐independent aldosteronism) showed a higher risk of CVD (hazard ratio, 1.40 [95% CI, 1.08–1.82]), while those who had serum aldosterone concentration ≥10 ng dL
−1
and plasma renin concentration >15 mIU L
−1
(identified as renin‐dependent aldosteronism) showed an unchanged CVD risk. In CONPASS, renin‐independent aldosteronism carried a significantly higher risk of CVD than normal aldosterone (odds ratio, 2.57 [95% CI, 1.13–5.86]), while the CVD risk remained unchanged in renin‐dependent aldosteronism. Elevation of the urinary potassium‐to‐sodium excretion ratio, reflective of mineralocorticoid receptor activity, was only observed in participants with renin‐independent aldosteronism.

Conclusions

Among patients with hypertension, renin‐independent aldosteronism is more closely associated with CVD risk than renin‐dependent aldosteronism.
Angiotensin‐Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Outcomes in Patients Hospitalized for COVID‐19
Authors: Pan Michael , Vasbinder Alexi , Anderson Elizabeth , Catalan Toniemarie , Shadid Husam R. , Berlin Hanna , Padalia Kishan , O’Hayer Patrick , Meloche Chelsea , Azam Tariq U. , Khaleel Ibrahim , Michaud Erinleigh , Blakely Pennelope , Bitar Abbas , Huang Yiyuan , Zhao Lili , Pop‐Busui Rodica , Loosen Sven H. , Chalkias Athanasios , Tacke Frank , Giamarellos‐Bourboulis Evangelos J. , Reiser Jochen , Eugen‐Olsen Jesper , Hayek Salim S. ,   the ISIC Group
Published: December 2021

Background

Use of angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers (ACEi/ARB) is thought to affect COVID‐19 through modulating levels of angiotensin‐converting enzyme 2, the cell entry receptor for SARS‐CoV2. We sought to assess the association between ACEi/ARB, biomarkers of inflammation, and outcomes in patients hospitalized for COVID‐19.

Methods and Results

We leveraged the ISIC (International Study of Inflammation in COVID‐19), identified patients admitted for symptomatic COVID‐19 between February 1, 2020 and June 1, 2021 for COVID‐19, and examined the association between in‐hospital ACEi/ARB use and all‐cause death, need for ventilation, and need for dialysis. We estimated the causal effect of ACEi/ARB on the composite outcomes using marginal structural models accounting for serial blood pressure and serum creatinine measures. Of 2044 patients in ISIC, 1686 patients met inclusion criteria, of whom 398 (23.6%) patients who were previously on ACEi/ARB received at least 1 dose during their hospitalization for COVID‐19. There were 215 deaths, 407 patients requiring mechanical ventilation, and 124 patients who required dialysis during their hospitalization. Prior ACEi/ARB use was associated with lower levels of soluble urokinase plasminogen activator receptor and C‐reactive protein. In multivariable analysis, in‐hospital ACEi/ARB use was associated with a lower risk of the composite outcome of in‐hospital death, mechanical ventilation, or dialysis (adjusted hazard ratio 0.49, 95% CI [0.36–0.65]).

Conclusions

In patients hospitalized for COVID‐19, ACEi/ARB use was associated with lower levels of inflammation and lower risk of in‐hospital outcomes. Clinical trials will define the role of ACEi/ARB in the treatment of COVID‐19.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04818866.
Oxygen Metabolic Stress and White Matter Injury in Patients With Cerebral Small Vessel Disease
Authors: Kang Peter , Ying Chunwei , Chen Yasheng , Ford Andria L. , An Hongyu , Lee Jin-Moo
Published: December 2021

Background:

Chronic hypoxia-ischemia is a putative mechanism underlying the development of white matter hyperintensities (WMH) and microstructural disruption in cerebral small vessel disease. WMH fall primarily within deep white matter (WM) watershed regions. We hypothesized that elevated oxygen extraction fraction (OEF), a signature of hypoxia-ischemia, would be detected in the watershed where WMH density is highest. We further hypothesized that OEF would be elevated in regions immediately surrounding WMH, at the leading edge of growth.

Methods:

In this cross-sectional study conducted from 2016 to 2019 at an academic medical center in St Louis, MO, participants (age >50) with a range of cerebrovascular risk factors underwent brain magnetic resonance imaging using pseudocontinuous arterial spin labeling, asymmetric spin echo, fluid-attenuated inversion recovery and diffusion tensor imaging to measure cerebral blood flow (CBF), OEF, WMH, and WM integrity, respectively. We defined the physiologic watershed as a region where CBF was below the 10th percentile of mean WM CBF in a young healthy cohort. We conducted linear regression to evaluate the relationship between CBF and OEF with structural and microstructural WM injury defined by fluid-attenuated inversion recovery WMH and diffusion tensor imaging, respectively. We conducted ANOVA to determine if OEF was increased in proximity to WMH lesions.

Results:

In a cohort of 42 participants (age 50–80), the physiologic watershed region spatially overlapped with regions of highest WMH lesion density. As CBF decreased and OEF increased, WMH density increased. Elevated watershed OEF was associated with greater WMH burden and microstructural disruption, after adjusting for vascular risk factors. In contrast, WM and watershed CBF were not associated with WMH burden or microstructural disruption. Moreover, OEF progressively increased while CBF decreased, in concentric contours approaching WMH lesions.

Conclusions:

Chronic hypoxia-ischemia in the watershed region may contribute to cerebral small vessel disease pathogenesis and development of WMH. Watershed OEF may hold promise as an imaging biomarker to identify individuals at risk for cerebral small vessel disease progression.
Indigenous Peoples and Multiscalar Environmental Governance: The Opening and Closure of Participatory Spaces
Authors: Gustafsson Maria-Therese , Schilling-Vacaflor Almut
Published: December 2021

There has been an unprecedented inclusion of Indigenous peoples in environmental governance instruments like free, prior, and informed consent; reducing emissions from deforestation and forest degradation (REDD+) projects; climate adaptation initiatives; and environmental impact assessment. We draw on theories of participatory governance to show how locally implemented processes have been shaped by their interactions with invited, closed, and indigenous-led spaces at multiple scales. Empirically, our article is based on field research in Latin America, semistructured interviews, and a systematic literature review. We find four main barriers that have (re-)produced environmental injustices in environmental governance: first, a lack of influence over the institutional design of governance instruments; second, the exclusion of Indigenous peoples in the domestication of global instruments; third, policy incoherencies constraining the scope for decision-making; and fourth, weak cross-scale linkages between Indigenous-led spaces. This article helps to elucidate constraints of participatory spaces and identify leeway for transformation toward environmental justice.
Reduced Interference and Serial Dependency Effects for Naming in Older but Not Younger Adults after 1 Hz rTMS of Right Pars Triangularis
Authors: Drucker Jonathan H. , Epstein Charles M. , McGregor Keith M. , Hortman Kyle , Gopinath Kaundinya S. , Crosson Bruce
Published: December 2021

1 Hz repetitive transcranial magnetic stimulation (rTMS) was used to decrease excitability of right pars triangularis (R PTr) to determine whether increased R PTr activity during picture naming in older adults hampers word finding. We hypothesized that decreasing R PTr excitability would reduce interference with word finding, facilitating faster picture naming. 15 older and 16 younger adults received two rTMS sessions. In one, speech onset latencies for picture naming were measured after both sham and active R PTr stimulation. In the other session, sham and active stimulation of a control region, right pars opercularis (R POp), were administered before picture naming. Order of active vs. sham stimulation within session was counterbalanced. Younger adults showed no significant effects of stimulation. In older adults, a trend indicated that participants named pictures more quickly after active than sham R PTr stimulation. However, older adults also showed longer responses during R PTr than R POp sham stimulation. When order of active vs. sham stimulation was modeled, older adults receiving active stimulation first had significantly faster responding after active than sham R PTr stimulation and significantly faster responding after R PTr than R POp stimulation, consistent with experimental hypotheses. However, older adults receiving sham stimulation first showed no significant differences between conditions. Findings are best understood, based on previous studies, when the interaction between the excitatory effects of picture naming and the inhibitory effects of 1 Hz rTMS on R PTr is considered. Implications regarding right frontal activity in older adults and for design of future experiments are discussed.
11. The Manner of Our Deaths
Authors: Graham Philip
Published: December 2021

After Geoffrey’s distressing death in 1995, which is described in some detail, Mary advocated for the legalisation of euthanasia for elderly people who feel they are a burden to others. This was a highly unpopular cause even among campaigners for professional healthcare assistance to the terminally ill. She wrote (jointly) Easeful Death (2008). Her daughter, Fanny, always a troubled soul, died in 2000 to her great distress. In a book, Dishonest to God (2010), she expressed her hostility to the bishops in the House of Lords intervening in policy debates. In the book, she was dismissive of claims that morality depended on religious belief, describing herself as an ‘atheist Anglican’. Until her retirement in 2015, interviews with fellow peers suggest she was a rather unsociable but hard-working and greatly respected member of the House of Lords. She moved home from Wiltshire to London in 2010, eventually settling in a flat owned by her youngest daughter, Maria. Extremely active and independent to the end, she refused to go into a care home. She had a rapid demise in March 2019. In January 2019, only two months before she died, she was interviewed for a series appropriately called Confessions, by an ex-Anglican priest, Giles Fraser. Accepting the label of atheist Anglican, she dismissed the need for a God, instead seeing Christianity as placing paramount importance, as she did herself, on love for other people.
Implementation of the Early-Onset Sepsis Risk Calculator at a Community Level I Nursery
Authors: Oak Sharmila , Stempowski Melanie , Frank Erin
Published: December 2021

The objective of this retrospective cohort study was to decrease the frequency of laboratory draws and the number of neonates receiving empiric antibiotics who are born to mothers with chorioamnionitis from 100% to 50% 6 months following implementation of the sepsis risk calculator (SRC) at a level 1 community nursery. Data were compared pre- and post-implementation of the SRC using the Fischer’s exact test. The rate of intravenous (IV) antibiotic use decreased from 93% to 7% ( P < .0001). The rate of blood culture collection decreased from 100% to 46% ( P < .0001). With implementation of the SRC, administration of IV antibiotics, laboratory draws, and IV placement significantly decreased without increasing rates of early-onset sepsis in our patient population. Our study demonstrated that the SRC can be effectively and safely implemented at a level 1 community–based newborn nursery, resulting in a decrease in unnecessary medical treatment without negative patient outcomes.