Background check: cross-cultural differences in the spatial context of comic scenes

Cognitive research points towards cultural differences in the way people perceive and express scenes. Whereas people from Western cultures focus more on focal objects, those from East Asia have been shown to focus on the surrounding context. This paper examines whether these cultural differences are expressed in complex multimodal media such as comics. We compared annotated panels across comics from six countries to examine how backgrounds convey contextual information of scenes in explicit or implicit ways. Compared to Western comics from the United States and Spain, East Asian comics from Japan and China expressed the context of scenes more implicitly. In addition, Nigerian comics moderately emulated American comics in background use, while Russian comics emulated Japanese manga, consistent with their visual styles. The six countries grouped together based on whether they employed more explicit strategies such as detailed, depicted backgrounds, or implicit strategies such as leaving the background empty. These cultural differences in background use can be attributed to both cognitive patterns of attention and comics' graphic styles. Altogether, this study provides support for cultural differences in attention manifesting in visual narratives, and elucidates how spatial relationships are depicted in visual narratives across cultures.

League of psychiatry and mental health of a brazilian university: Promoting mental health in COVID-19 times

Introduction

Due to the current global background of the COVID-19 pandemic, mental health is an important factor to be promoted. In spite of the subjectivity of the psychological impact brought by this pandemic, the population has undergone several sudden and meaningful changes in psychic integrity. Therefore, the League of Psychiatry and Mental Health of a Brazilian public university emerges with the aim of complementing the curriculum of Psychiatric Medicine, along with promoting mental health inside and outside the university.

Objectives

Hold online events and disseminate informative material to help students, mental health professionals and general community interested in the topic.

Methods

The League did a member recruitment with academics from different health areas, who prepared and published booklets and folders with informations promoting mental health. And also, promoted speeches on online platforms from May 2020 to October 2020 with psychiatrists, psychologists and renowned professionals in Brazil.

Results

Eighteen lectures were held on topics such as “Grief in the pandemic and its implications in mental health”; “Preventing suicide in the pandemic”, among others, that had a relevant role for those who were in a vulnerable emotional state at the time. As for publications, a national reach was possible, which served as a source for the cultivation of a good psychic health to face the pandemic.

Conclusions

More than 13.600 people participated in the promoted proposals, In addition to providing positive feedbacks to the League, with the improvement of knowledge in the field of Psychiatry and Mental Health, reaching the proposed objectives.

Margins in Sinonasal Squamous Cell Carcinoma: Predictors, Outcomes, and the Endoscopic Approach

OBJECTIVES

To identify factors associated with positive margins following surgical management of sinonasal squamous cell carcinoma (SNSCC), especially with regard to endoscopic treatment.

METHODS

In a retrospective analysis of adult patients with clinically staged tumor (T)1 to T4a SNSCC within the National Cancer Database (NCDB) from 2004 to 2014, factors were associated with positive margins using multivariable binary logistic regression. Cases from 2010 to 2014 had surgical approach (open vs. endoscopic) available and were analyzed in a subgroup to assess the association of surgical approach with margin status. The association of margin status with overall survival (OS) and additional therapy administration was also assessed.

RESULTS

We identified 2,968 cases, of which 807 (27.2%) had positive margins. On multivariable analysis, factors associated with positive margins included higher T stage (T4a vs. T1: odds ratio [OR] 2.768 [95% CI 2.143-3.577]), less differentiated tumors (poorly differentiated vs. well differentiated: OR 1.403 [95% CI 1.060-1.856]), and tumors in the ethmoid sinus (vs. nasal cavity; OR 1.889 [95% CI 1.305-2.734]). Cases treated at higher volume facilities (HVFs) were associated with a lower likelihood of positive margins (OR 0.716 [95% CI 0.582-0.881]). Positive margins were associated with decreased OS (hazard ratio 1.672 [95% CI 1.464-1.908]) and an increased rate of additional therapy (OR 1.966 [95% confidence interval 1.597-2.421]). An endoscopic approach was not associated with an increased likelihood of obtaining positive margins (vs. open; OR 1.151 [0.903-1.651]).

CONCLUSION

Positive margins were less likely when performed at HVFs and more likely in the ethmoid sinus than other subsites. Importantly, there was no association between positive margins and surgical approach. Endoscopic surgery may offer a safe, less invasive alternative to open surgery for select patients.

LEVEL OF EVIDENCE

NA Laryngoscope, 130:E388-E396, 2020.

P3440Can pre-operative echocardiography predict RV failure post-LVAD implantation in children?

Background

One of the most frequent complications of left ventricular assist device (LVAD) implantation is the development of right ventricular (RV) failure, which occurs in 10%-40% of patients. It is, therefore, essential to identify which LVAD candidates are at risk for RV failure and will require additional RV mechanical support with a biventricular assist device (BiVAD). However, the echocardiographic assessment of the RV is challenging due to its complex geometry and marked load dependence of its function indices. To our knowledge, there is no published evidence regarding which specific RV echocardiographic parameters should inform this decision in the paediatric population.

Aims

We sought to determine which pre-operative RV echocardiographic parameters best correlate with the need for a BiVAD, as opposed to LVAD alone, in a paediatric population undergoing VAD insertion at a tertiary care institution.

Methods

Retrospective review of the pre-operative echocardiograms of children (<18 years) with dilated cardiomyopathy undergoing elective VAD implantation at our institution, from November 2007 to December 2018. Preoperative quantitative and qualitative RV echocardiographic parameters described in the literature to be associated with RV failure after LVAD implantation in adults were collected. Moreover, qualitative RV function was independently assessed by three echocardiographers, blinded to the outcome of the patients.

Results

89 patients were included, 39 (43.8%) males, median age = 1.7 years (IQR = 6.9), median weight = 11.6 kg (IQR = 13.8). 49 (55.1%) patients had an LVAD implanted, whereas 40 (44.9%) were deemed to need biventricular support. 45 (50.6%) patients received an EXCOR Berlin Heart, 16 (18%) a HeartWare HVAD and 28 (31.4%) a Levitronix Centrimag device. Requirement of BiVAD support was significantly more common in patients with moderate to severe RV impairment, as per expert assessment (OR = 2.864; 95% CI: 1.188–6.903, p=0.018), and tricuspid regurgitation > grade III (OR = 3.154; 95% CI: 1.124–8.850, p=0.025). All the other parameters collected – tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitant jet velocity, tricuspid regurgitation duration corrected for heart rate, RV tissue Doppler indices, RV fractional area change, and RV/LV diameter ratio– were not significantly different among groups.

Conclusions

In our paediatric population, expert assessment of RV function and degree of tricuspid regurgitation were strong predictors of RV failure among patients undergoing LVAD implantation, allowing for pre-emptive RVAD implantation and improving patient outcomes.

Biliary tumorigenic effect on hypopharyngeal cells is significantly enhanced by pH reduction

Biliary reflux has been considered a potential risk factor in upper aerodigestive tract malignancies. It is not yet clearly known how pH affects the bile-induced activation of NF-κB and its related oncogenic pathway previously linked to hypopharyngeal carcinogenesis. In this study, repetitive applications of conjugated primary bile acids with unconjugated secondary bile acid, deoxycholic acid (DCA), on human hypopharyngeal primary cells reveal that strongly acidic pH (4.0) optimally enhances the tumorigenic effect of bile, by inducing activation of NF-κB, STAT3 nuclear translocation, bcl-2 overexpression and significant overexpression of the oncogenic mRNA phenotype, compared to weakly acidic pH (5.5) or neutral pH (7.0). As the pH becomes less acidic the partially activated primary bile acids and activated DCA begin to exert their influence; however, with significantly less intensity compared to bile acids at strongly acidic pH. Our findings suggest that biliary tumorigenic effect is strongly pH dependent. Controlling pH during reflux events may be therapeutically effective in reducing the potential risk of bile-induced hypopharyngeal cancer.

Multi-modality Treatment and Survival in Sinonasal Minor Salivary Gland Tumors

Objectives  The aim of this study was to analyze the effect of the multimodality treatment on survival in sinonasal minor salivary gland tumors. Methods  Adult clinical American Joint Committee on Cancer (AJCC) tumor (T) 1-4a staged cases of sinonasal minor salivary gland tumors were isolated from the National Cancer Database (2004-2014). Multivariate regressions were performed to analyze the effect of multimodality treatment. A subset analysis was also performed in patients with positive margins following surgical management. Results  We identified 556 cases, of which 293 (52.7%) patients were treated with surgery and radiotherapy (RT), 160 (28.8%) were treated with surgery alone, and 52 (9.4%) were treated with surgery and chemoradiotherapy (CRT). No patients were treated with chemotherapy alone. With surgery and CRT as a reference, the only treatment modality associated with decreased survival was RT alone (hazard ratio [HR]: 3.213 [95% confidence interval (CI): 1.578-6.543]; p  = 0.001). Within a subset analysis of patients with positive margins, surgery was associated with decreased survival (HR: 2.021 [95% CI: 1.401-3.925]; p  = 0.038), but not triple modality therapy (HR: 1.700 [95% CI: 0.798-3.662]) when compared with surgery with RT. Conclusion  The most common treatment was surgery and RT, consistent with National Comprehensive Cancer Network (NCCN) guidelines which recommends chemotherapy (CT) only in the most concerning cases. However, we found no difference in survival among most treatment modalities when compared with triple modality therapy, with the exception of RT alone. Although margins were prognostic within these cancers, we found no evidence that adjuvant CRT provides any survival benefit over surgery and RT, though surgery alone was associated with decreased survival.

Cytobrush: A tool for sequential evaluation of gene expression in bovine endometrium

Aims were to (i) compare specific transcript abundance between endometrial samples collected by transcervical biopsy and cytobrush and (ii) measure the abundance of endometrial transcripts involved in PGF2α synthesis in samples collected by cytobrush. In Experiment 1, endometrial samples were taken transcervically by cytobrush and biopsy 10 days after ovulation. Compared to biopsy samples, abundance of transcripts for MSTN, AKR1C4 and PGR was similar, VIM, FLT1 and PTGES was lower (p < .05) and KRT18 and CD3D was greater in cytobrush samples (p < .05). Thus, there was an enrichment of epithelial and immune cells in the cytobrush samples. In Experiment 2, endometrial samples were collected by cytobrush on days 10, 13, 16 and 19 after ovulation. Abundance of PGR2 mRNA was maximum on day 10 then decreased (p < .05). Abundance of ESR1 decreased gradually from day 10 to day 16 then increased again on day 19. The greatest abundance of OXTR was noted on day 19. The sequential alterations in abundance of these transcripts are consistent with the release of PGF2α associated with luteolysis. In summary, cytobrush sampling provides representative, physiologically relevant samples of the luminal epithelium in cattle.

Mitral Valve Surgery for Rheumatic Lesions in Young Patients

BACKGROUND

The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center.

METHODS

Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014.

RESULTS

We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention.

CONCLUSIONS

Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation.

Coordenação como tecnologia de governo

Resumo O presente artigo fornece elementos para se pensar a coordenação como uma técnica de governo. Partiremos de duas pesquisas realizadas junto ao Centro Integrado de Comando e Controle (CICC) e à Secretaria Especial de Ordem Pública (SEOP) na cidade do Rio de Janeiro. Considerando que o CICC e a SEOP produziram algumas das mais importantes transformações nas áreas de segurança pública e de ordem urbana dos últimos anos nessa cidade, é significativa sua centralidade para ambas. A coordenação emerge na SEOP por meio da construção de um novo design institucional, articulando o trabalho de secretarias, coordenadorias e autarquias já existentes para produzir efeitos na produção da ordem urbana. Já no CICC, a coordenação resulta do esforço de integrar informações através da construção de um grande sistema informacional e de controle visando responder rapidamente às necessidades em eventos cotidianos assim como naqueles considerados críticos.

[Methylmercury human exposure in riverside villages of Tapajos basin, Pará State, Brazil]

Evaluation of total human exposure to mercury and methylmercury was effected in riverine villages along the Tapajos river and in the metropolitan area of Belem city, state of Para, Brazil, by using total mercury and methylmercury concentrations in hair samples in 1994 and 1995. It was observed that average concentrations of total mercury are in a range from 2 +/- 1 microg/g-1 to 20.5 +/- 12. 1 microg/g-1. While methylmercury average concentration varies from 1. 4 +/- 0.7 microg/g-1 to 18.5 +/- 11 microg/g-1. These results confirm mercury contamination in the Tapajos river and possible appearance of mercury intoxication symptoms, and recommends the monitoring of compounds in hair samples as well as the need for epidemiological and clinical studies for human health prevention and control of mercury intoxication.

[Total mercury in hair samples of inhabitants of Tapajós River, Pará State, Brazil]

This study evaluates human exposure to methylmercury in fishermen and their families in four villages on the Tapajós river: Rainha, Barreiras, São Luís do Tapajós and Paraná-Mirim. Hair analyses were performed with atomic absorption spectophotometry. Total hair mercury levels varied between 2.9mg/g and 71.5mg/g. Paraná-Mirim showed the lowest level. The highest level was found in São Luís do Tapajós and Barreiras. The hair mercury was six to seven times higher than the established safe limit of 10mg/g. No statistically significant difference was found between the mean level of total mercury taken from the inhabitants living downstream and upstream in Itaituba village (p > 0.05). These results confirm that human exposure to methylmercury is occurring on the Tapajós river and suggest that continued fish ingestion in that region is a potential risk factor for the appearance of symptoms and signs of Minamata disease. An immediate epidemiological survey program is recommended.