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Cell models of cardiac ischemia-reperfusion (IR) injury are essential to facilitate understanding, but current monolayer cell models poorly replicate the in vivo IR injury that occurs within a three-dimensional tissue. Here we show that this is for two reasons: the residual oxygen present in many cellular hypoxia models sustains mitochondrial oxidative phosphorylation; and the loss of lactate from cells into the incubation medium during ischemia enables cells to sustain glycolysis. To overcome these limitations, we incubated isolated adult mouse cardiomyocytes anoxically while inhibiting lactate efflux. These interventions recapitulated key markers of in vivo ischemia, notably the accumulation of succinate and the loss of adenine nucleotides. Upon reoxygenation after anoxia the succinate that had accumulated during anoxia was rapidly oxidized in association with extensive mitochondrial superoxide/hydrogen peroxide production and cell injury, mimicking reperfusion injury. This cell model will enable key aspects of cardiac IR injury to be assessed in vitro.

Summary: To overcome oxidative, inflammatory, and metabolic stress, cells have evolved cytoprotective protein networks controlled by nuclear factor-erythroid 2 p45-related factor 2 (Nrf2) and its negative regulator, Kelch-like ECH associated protein 1 (Keap1). Here, using high-resolution mass spectrometry we characterize the proteomes of macrophages with altered Nrf2 status revealing significant differences among the genotypes in metabolism and redox homeostasis, which were validated with respirometry and metabolomics. Nrf2 affected the proteome following lipopolysaccharide (LPS) stimulation, with alterations in redox, carbohydrate and lipid metabolism, and innate immunity. Notably, Nrf2 activation promoted mitochondrial fusion. The Keap1 inhibitor, 4-octyl itaconate remodeled the inflammatory macrophage proteome, increasing redox and suppressing type I interferon (IFN) response. Similarly, pharmacologic or genetic Nrf2 activation inhibited the transcription of IFN-β and its downstream effector IFIT2 during LPS stimulation. These data suggest that Nrf2 activation facilitates metabolic reprogramming and mitochondrial adaptation, and finetunes the innate immune response in macrophages.

Objectives: To address the knowledge gap in the practice of compassionate healthcare by elucidating patient perspectives on compassion, empathy, and sympathy.Methods: Semi-structured telephone interviews were conducted at two time points with patients undergoing head and neck cancer treatment. Questions explored participants’ understanding of compassion, sympathy, and empathy, as they relate to each other and to healthcare. Interviewers manually recorded responses. Qualitative exploratory methods were used to analyze data; inductive line-by-line coding was conducted to develop primary codes. Themes emerged through categorization of codes.Results: Ninety-five interviews conducted with 63 participants across two time points revealed four major themes – Compassion-vs-Empathy-vs-Sympathy, Coping Methods, Showing Care, and Nature of Interaction – encompassing seven categories, with a total of 24 codes. Codes were consistent across time points, except for two new codes, “positivity” and “personalized” emerging during follow-up interviews.Conclusions: Patient narrative from this study supported the concept that compassion is multidimensional and enabled several dimensions to be identified, highlighting the importance of patient perspectives in improving the provision of compassionate healthcare. Findings should be considered in future training and practice.

Objectifs : Améliorer les connaissances sur la pratique des soins compatissants en mettant en lumière le point de vue des patients sur la compassion, l’empathie et la sympathie.Méthodes : Des entretiens téléphoniques semi-structurés ont été menés à deux moments précis avec des patients suivant un traitement contre le cancer de la tête et du cou. Les questions visaient à explorer la compréhension qu’ont les participants de la compassion, de la sympathie, de l’empathie et des relations mutuelles entre ces notions dans un contexte de soins de santé. Les chercheurs ont consigné manuellement les réponses. Des méthodes exploratoires qualitatives ont été utilisées pour analyser les données et un codage inductif ligne par ligne a été effectué pour développer des codes primaires. Une catégorisation des codes a ensuite permis de faire ressortir des thèmes récurrents.Résultats : Quatre-vingt-quinze entretiens menés avec 63 participants à deux moments différents ont fait ressortir quatre thèmes principaux : 1) manifestations de bienveillance; 2) nature des interactions; 3) compassion, empathie et sympathie; 4) méthodes d’adaptation. Ces thèmes se subdivisaient en sept catégories, conduisant à un total de 24 codes. Les codes étaient cohérents d’un point de vue temporel, à l’exception de deux nouveaux codes, « positivité » et « personnalisé », apparus lors des entretiens de suivi.Conclusions : Les témoignages des patients de cette étude ont conforté le concept selon lequel la compassion est multidimensionnelle et ont permis de définir plusieurs dimensions de ce sentiment, soulignant l’importance de tenir compte du point de vue des patients pour améliorer la prestation de soins compatissants. Les conclusions devraient être intégrées dans les formations et les pratiques futures.

Objective: Identify the most salient elements of the head and neck cancer (HNC) care experience described by patients and caregivers in focus group interviews. Methods: Three focus groups of patients and caregivers were facilitated by research assistants and clinicians. Open-ended guiding questions captured/elicited aspects of care that were appreciated, warranted improvement, or enhanced communication and information. A four-step Delphi process derived consensus among focus group facilitators (n = 5) regarding salient discussion points from focus group conversations. Results: Seven salient themes were identified: (1) information provision, (2) burden related to symptoms and treatment side effects, (3) importance of social support, (4) quality of care at both hospital and provider levels, (5) caring for the person, not just treating cancer, (6) social and emotional impact of HNC, and (7) stigma and insufficient information regarding human papillomavirus-related HNC. Conclusion: Participants reported varying needs and support preferences, a desire for individualized communication, and to feel cared for as both a person and a patient. Findings illuminate the intricate details underlying high-quality, compassionate, person-centered HNC cancer care.

O artigo pretende radiografar dois fenómenos de sinal contrário que marcam a compreensão das ‘margens’ da literatura brasileira contemporânea. Em primeiro lugar, refletiremos sobre a incomum importância que, gradativamente, adquiriu no Brasil a conquista de um ‘lugar de fala’ para representações e discursos não hegemónicos do ponto de vista social e cultural, tais como a literatura periférica ou a literatura migrante. Em segundo lugar e por oposição a essa admirável abertura, que deu uma notável especificidade à literatura brasileira, ponderaremos a permanência de uma certa inflexibilidade relativamente à entrada no cânone brasileiro de certos discursos híbridos e heterodoxos do ponto de vista literário e artístico – tais como as excelentes propostas de Flávio de Carvalho, Hélio Oiticica ou Nuno Ramos –, um fenómeno incompreensível, se tivermos presente a mencionada integração e canonização de outras heterodoxias e ‘margens’ literárias nas últimas décadas e, sobretudo, a centralidade da ‘tradição da antitradição’ na História da Literatura brasileira.

En este artículo, “Iberê Camargo y el autorretrato: identidad expandida y alteridad”, partiendo de la idea de que todo autorretrato es un ‘otro-retrato’, se trata de analizar críticamente el obstinado rigor de la doble obediencia creativa plástico-escritural con la que Iberê Camargo construye, como affaire verbale et visuelle, no pocos de los numerosos autorretratos de su continuado, pero variado y versátil, ‘yo’. En este sentido, por un lado, procedemos a un análisis evaluativo de las especificidades y aportes del artista, reflejando su completa absorción de valores literarios. Por otro lado, además de disertar sobre la cuestión de la representación ‘auto-bio-gráfica’ y de la pensée subjetiva con transitivas palabras e imágenes, procuramos leer —esto es, distantes de cualquier inmaculada concepción, interpretar—, entre otros, dos de los más emblemáticos y paradigmáticos libros de su singular producción literaria: los autorretratosigurados y/o ‘otro-retratos’ letrados No andar do tempo (1988) y Gaveta dos guardados (2009).

Researchers have studied that human-computer interactions (HCIs) can be more effective only when machines understand the emotions conveyed in speech. Speech emotion recognition has seen growing interest in research due to its usefulness in different applications. Building a neutral speech model becomes an important and challenging task as it can help in identifying different emotions from stuttered speech. This paper suggests two different approaches for identifying neutral pitch from stuttered speech. The implementation has proved through its accuracy the best model that can be adopted for neutral speech pitch identification. [ABSTRACT FROM AUTHOR]

RESUMO Objetivo: Avaliar a hipótese de que o Modified Early Warning Score (MEWS) por ocasião da alta da unidade de terapia intensiva associa-se com readmissão, e identificar o nível desse escore que prediz com maior confiabilidade a readmissão à unidade de terapia intensiva dentro de 48 horas após a alta. Métodos: Este foi um estudo observacional retrospectivo a respeito do MEWS de pacientes que receberam alta da unidade de terapia intensiva. Comparamos dados demográficos, escores de severidade, características da doença crítica e MEWS de pacientes readmitidos e não readmitidos. Identificamos os fatores associados com a readmissão em um modelo de regressão logística. Construímos uma curva Característica de Operação do Receptor para o MEWS na predição da probabilidade de readmissão. Por fim, apresentamos o critério ideal com maior sensibilidade e especificidade. Resultados: A taxa de readmissões foi de 2,6%, e o MEWS foi preditor significante de readmissão, juntamente do tempo de permanência na unidade de terapia intensiva acima de 10 dias e traqueostomia. A curva Característica de Operação do Receptor relativa ao MEWS para predizer a probabilidade de readmissão teve área sob a curva de 0,82, e MEWS acima de 6 teve sensibilidade de 0,78 (IC95% 0,66 - 0,9) e especificidade de 0,9 (IC95% 0,87 - 0,93). Conclusão: O MEWS associa-se com readmissão à unidade de terapia intensiva, e o escore acima de 6 teve excelente precisão como preditor prognóstico.