bluuebunny/crossref_metadata_2025 huggingface dataset:
Bisexuality: Narrating Sexual Fluidity
Authors: Turai Ráhel K.
Published: February 2021

This chapter attends to bisexuality in places where it is not specifically named, such as in narratives of sexual fluidity over the lifespan. Building on a history of bisexual research addressing sexual desires, practices, and identities alongside biphobia, the chapter proposes a life narrative framework for the sociolinguistic examination of bisexuality that approaches sexual desires as both signs and effects. An analysis of a personal biography describing the process of lesbian self-realization at the end of state socialism in Hungary highlights the impact of compulsory heterosexuality on women’s lives, exposing the effects of gender hierarchy and its associated economics on the interpretation and realization of same-sex desire. However, the analysis also reveals continuities between the previous socialist culture of silence regarding homosexuality and the current capitalist culture of sexual objectification, which upholds heterosexuality by encouraging “performative bisexuality.” The chapter stresses the importance of attending to situated hierarchies of class, gender, and sexuality in the sociolinguistic study of bisexuality.
The Self in Meditation
Authors: Frazier Jessica
Published: February 2021

This chapter outlines a theory of meditation as an art of self-shaping, by emphasizing meditation’s efficacy as a tool for sculpting the “plastic” structures of the mind. First, it considers modern views of meditation as a form of healing that brings the mind “back” to its natural functioning. This stands in contrast with most traditional views of meditation as a way to change the self in permanent—and sometimes radical—ways. Second, it sketches a model of the mind’s “architecture of attention”—exploring the role of selective attention in cognitive processing and the cumulative structures of the self. Third, given this model of the mind, it considers some examples of how absorptive, deconstructive, and narrative forms of meditation shape the inner world of the practitioner. From this examination of meditative functions, there emerges an ontology of the self that recognizes its self-creative malleability. Less an atomic individual or an outward-shining power of perception, the self appears as a kind of dynamic weather system that is constantly transformed as it takes up the raw materials of sensory stimulus. On this model, meditation functions as the selective factor that allows different elements of that system to predominate and thereby shape the others. Finally, the chapter reminds that, far from the modern world’s concern with individual autonomy, classical meditation’s subtle artistry aimed to bring the self into alignment with broader realities.
Psychotherapy Integration as an Ethical Practice
Authors: grosse Holtforth Martin , Penedo Juan Martín Gómez , Locher Cosima , Blease Charlotte , Castonguay Louis G.
Published: February 2021

This chapter aims to analyze which ethical challenges clinicians face when practicing different forms of psychotherapy integration. With this purpose, the authors first define psychotherapy integration and differentiate four types of integrative approaches. Drawing on Beauchamp and Childress’s (2013) principles of biomedical ethics, the chapter highlights important common and particular ethical issues in the four types of integrationist psychotherapy practice. Finally, the authors frame questions for future research into integrative-psychotherapy ethics and consider possible clinical responses to ethics issues raised in integrative therapy.
Facial Attractiveness
Authors: Mitrovic Aleksandra , Goller Jürgen
Published: February 2021

Facial attractiveness is one of the most ubiquitous forms of beauty that people encounter and value. It is a unique category in visual aesthetics because of its deep biological foundation and essential significance for social interactions. This chapter gives an overview and discusses the rich history of facial attractiveness research from four perspectives. First, the face itself is discussed, asking what makes a face attractive, with reference to local features such as eye color and spatial configurations, and global characteristics like symmetry and averageness. Attention then turns to the face bearer, and a distinction is drawn between facial attractiveness and personal characteristics like mate quality, familiarity, and the “what is beautiful is good” stereotype. Next, the chapter examines the role of the observer, and how individual characteristics explain differences in taste and effects of facial attractiveness on perception and cognition. Finally, some inherent limitations to this research are addressed.
Physics and biophysics fundamentals of transcranial stimulation
Authors: Wang Boshuo , Aberra Aman S. , Grill Warren M. , Peterchev Angel V.
Published: February 2021

Transcranial stimulation induces or modulates neural activity in the brain through basic physical and biophysical processes. Transcranial electrical stimulation and transcranial magnetic stimulation impose an exogenous electric field in the brain that is determined by the stimulation device and the geometric and electric parameters of the head. The imposed electric field drives an electric current through the brain tissue, which macroscopically behaves as a volume conductor. The electric field polarizes neuronal membranes as described by the cable equation, resulting in direct activation of individual neurons and neural networks or indirect modulation of intrinsic activity. Computational modeling can estimate the delivered electric field as well as the resultant responses of individual neurons. This dosimetric information can be used to optimize and individualize stimulation targeting. The field distributions of transcranial stimulation are well understood and characterized, whereas analysis and modeling of the neural responses require further investigation, especially at the network level.
Computational Methods for Dosimetry
Authors: Thielscher Axel , Madsen Kristoffer H. , Strangman Gary E. , Treeby Bradley E.
Published: February 2021

Computational methods for dosimetry allow estimating and optimizing the spatial distribution and strength of the induced fields and waves in the brain, based on detailed models of the head anatomy that are derived from medical imaging data. This chapter gives an overview of the computational dosimetry methods for transcranial magnetic, electric, focused ultrasound and light stimulation. It starts with a brief introduction to the employed numerical methods and a summary of the status of the automatic generation of individual head models from magnetic resonance and computed tomography data. For each stimulation method, the basic physical equations underlying the numerical simulations are outlined, followed by a summary of the key results and validation studies. The chapter concludes with an overview of remaining limitations and open questions.
Human Rights Activism, Sexuality, and Gender
Authors: Chua Lynette J.
Published: February 2021

This chapter introduces an anthropological inquiry into human rights activism, sexuality, and gender, and proposes taking an ethnographic approach grounded in love, agency, and humanity to do so. Such an inquiry brings together queer anthropology and the anthropology of human rights to analyse the intersection of human rights and social justice activism for people with non-normative sexualities and genders. Although queer anthropology has illuminated the contingent and multiple ways of doing sexuality and gender, it usually does not examine the processes and patterns that arise out of human rights or the actions and experiences of activists. On the other hand, anthropologists of human rights have generally not focused on non-normative genders or sexualities. The proposed ethnographic approach does not merely pay attention to the interpretation, adaptation, and circulation of the substantive meanings of human rights and such affiliated identities as lesbian, gay, bisexual, and transgender (LGBT); it also analyses the emotions and interpersonal relations that give rise to and emerge from those processes and treats them as inherent to the practices of human rights and LGBT identities. Additionally, this approach is motivated by compassion for the agency and empirical realities of their research subjects. Taking this approach to develop research at the intersection of human rights activism, sexuality, and gender, the field of anthropology can further influence theories of social movements and collective action in the broader social sciences.
South African Legal Culture and its Dis/Empowerment Paradox
Authors: Mnisi Weeks Sindiso
Published: February 2021

Twenty-five years since becoming a constitutional democracy, South Africa presents the perplexing paradox of arguably having the most progressive constitution in the world, marked by full-throated socioeconomic rights protection, while also being the most unequal country in the world. This chapter makes the argument that this alarming paradox can be at least partly understood in terms of a ‘dis/empowerment paradox’ endemic to South Africa’s legal culture. It takes a historical view of the formation and impact of South African legal culture and the various levels and ways in which the dis/empowerment paradox argued for has been, and continues to be, characteristic thereof. The chapter traces the contributions of the judiciary to shaping the country’s legally pluralistic culture over the course of history and into the present. It ultimately points to judicial complicity in restraining the full realization of freedom and justice under the law—both before and after the dawn of South Africa’s modern-day Constitution—by under-utilizing law’s potential for liberation. Tracing this historical arc is aimed at helping legal, anthropological, and wider readers not familiar with South Africa’s particular circumstances to better understand the concluding argument: namely, that the purported solution to South Africa’s problems described as ‘transformative constitutionalism’ presents notable pitfalls. While the chapter does not argue that the judiciary is solely, or even mainly, responsible for the dis/empowerment paradox of law, it does argue that the judiciary is somewhat complicit in the limited socioeconomic transformation seen subsequent to adoption of the country’s progressive Constitution.
Terrorism and Theocracy
Authors: Trampedach Kai
Published: February 2021

This chapter discusses a case of ancient terrorism, the fight of the most radical branch of the Judean resistance movement against Roman rule in the first century ce by means of kidnapping and assassination. Ancient Judean terrorism was not only provoked by the foreign occupation, but also fed on the fertile ground of social antagonisms within Judean society. The zealot ideology of the Sicarii was fueled by theocratic, even apocalyptic beliefs, closely intertwined with radically egalitarian visions of society. Spectacular actions against the Roman Empire and its indigenous collaborators finally instigated the Judean War. Though modern terrorism has many different facets, the religiously motivated Islamic type shows parallels with the ancient Judean paradigm—in methods, but even more in ideology, which is based on comparable political and social conditions.
“Deeds, Not Words”
Authors: Schmidt Daniel , Sturm Michael
Published: February 2021

This chapter focuses on the manifestations and characteristics of right-wing terrorism in twentieth-century Europe, particularly on developments in Germany and Italy. When viewed from a comparative perspective, a central characteristic for right-wing terrorism is the Tatglaube, the faith in deeds. Although the worldview justifying such terrorism is grounded in racism, ethnocentrism, and nationalistic concepts of superiority, the decisive factor is violence as an end in itself, a violence that generally forgoes any justifying pattern of argument and strives to annihilate the enemy physically. The repertoire of actions taken and the formulized language of right-wing terrorism have remained largely unchanged throughout the twists and turns of twentieth-century history. Nevertheless, it is possible to differentiate various phases of right-wing terrorism, which were also influenced, in turn, by the political and societal environment. Despite the ethnocentric and nationalistic worldview from which this terrorism springs, it also becomes evident here that right-wing terrorism has always been marked by transnational influences, particularly since the end of the twentieth century.
Is the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire Adequate to Assess Individuals With Subacromial Pain Syndrome? Rasch Model and International Classification of Functioning, Disability and Health
Authors: Almeida Rafaela F , Pereira Natalia D , Ribeiro Larissa P , Barreto Rodrigo Py G , Kamonseki Danilo H , Haik Melina N , Camargo Paula R
Published: February 2021

Objective

The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is widely used to assess patients with symptoms of subacromial pain syndrome (SPS). No study has analyzed the DASH by using the Rasch model in these patients and related the level of difficulty of the items with the International Classification of Functioning Disability and Health (ICF) domains. The purpose of this study was to evaluate the measurement properties of the DASH in individuals with SPS and to describe which ICF components are influenced by SPS based on the DASH.

Methods

The full version of the DASH was used to assess upper limb pain and function in individuals with SPS. Responses were assessed using the Rasch model. DASH items were grouped according to the level of difficulty and associated with the ICF domains to identify the most compromised aspect in these individuals.

Results

Reliability and internal consistency for the DASH were shown to be 0.93 and 0.95, respectively. Item 3 (“Turn a key”) was the easiest and 25 (“Pain during specific activity”) the most difficult. Only item 30 (“Less capable/confident/useful”) was as an erratic item. Item 15 (“Put on a sweater”) showed differential functioning by age and item 11 (“Carry a heavy object”) by sex. Seven items showed differential functioning related to the angular onset of pain during arm elevation. Sixty percent of the most difficult items belonged to the “Body function” domain of the ICF.

Conclusion

Although some psychometric properties of the DASH are adequate according to the Rasch model, adjustments to some items are necessary for individuals with SPS. Clinicians should be cautious when interpreting the DASH, especially in patients with angular onset of pain above 120 degrees of arm elevation.

Impact

The information contained in this study should be used by clinicians to interpret the results of the DASH when assessing individuals with SPS. The DASH may not be adequate to assess those with shoulder pain above 120 degrees of arm elevation. These results are not generalizable to other shoulder pathologies.
Low-dose glucocorticoids should be withdrawn or continued in systemic lupus erythematosus? A systematic review and meta-analysis on risk of flare and damage accrual
Authors: Ji Lanlan , Xie Wenhui , Zhang Zhuoli
Published: February 2021

Objective

To assess the risk of flare and damage accrual after discontinuation of low-dose glucocorticoids (GCs) in SLE.

Methods

We performed a comprehensive literature search of the PubMed, Embase, Cochrane Library and Scopus databases from inception to July 2020 for studies concerning relapses/damage accrual in SLE patients. Pooled incidence rates of flare and time to flare with their 95% CIs after GC withdrawal were calculated. The summary risk ratio (RR) and 95% CI of flare/organ damage accrual risk were computed using a random- or fixed-effects model.

Results

A total of 738 SLE patients with GC discontinuation in 17 publications were eligible for the final analysis. In the primary meta-analysis, the pooled incidence of flare was 24% (95% CI 21, 27) and 13% (95% CI 8, 18) for global and major flares, respectively. Pooled time to flare was 21.08 months (95% CI 9.32, 32.85). In the secondary meta-analysis, GC discontinuation showed an increased risk of flare compared with GC continuation [RR 1.38 (95% CI 1.01, 1.89)], but the risk of major flares was not increased [RR 1.77 (95% CI 0.40, 7.83)]. Moreover, GC withdrawal was associated with a borderline risk reduction in the SLICC/ACR damage index increase compared with GC continuation [RR 0.64 (95% CI 0.38, 1.09)].

Conclusion

GC discontinuation leads to a slightly increased risk of flare, however, no increase in major flare and a borderline reduction of risk in further damage in SLE patients. Baseline screening for candidate patients and long-term follow-up after GC withdrawal are needed to reliably evaluate the organ damage increase.
Quality, proximate composition, and sensory characteristics of Dorper, domestic commercial crossbred, and Australian sheep meat: a comparative study
Authors: Villatoro K M , Yang F , Duarte T , Phillips C R , Woerner D R , Chao M D , Yang X
Published: February 2021

The objective of this study was to compare the proximate, quality, and sensory attributes of Dorper sheep meat (Dorper), domestic commercial crossbred (DCC) and Australian commercial crossbred (ACC). A total of 60 untrimmed loins from the three sheep sources were purchased (20 sheep loins/source) and processed. The objective color, objective tenderness [Warner–Bratzler Shear Force (WBSF)], and proximate composition of the sheep meat were evaluated. A consumer panel and a trained sensory panel were also conducted to evaluate the sensory attributes. Dorper had greater (P = 0.04) carbohydrate content compared to DCC, but was not (P = 0.86) different from ACC. In addition, Dorper had the greatest WBSF value, followed by DCC, with ACC having the least WBSF out of the three (P < 0.0001). For the consumer panel, Dorper was rated to be less tender than ACC (P = 0.01), but was not different from DCC (P = 0.76). Dorper was also rated with lower flavor acceptability compared to DCC (P = 0.02), but was not different from ACC (P = 0.86). In addition, Dorper had the lowest overall acceptance rating by the consumers (P = 0.01). Trained sensory panel results followed the same trend as the consumer panel results which rated Dorper to be less tender than ACC (P = 0.002), but was not different from DCC (P = 0.10). Dorper was also rated with greater off-flavor intensity compared to DCC (P = 0.009), but was not different from ACC (P = 0.53). Finally, no differences were found for all other attributes evaluated among the sheep sources. The results indicated that consumers did not prefer Dorper over ACC and DCC. However, additional research with a more controlled environment is needed to shed light on the true palatability traits of Dorper.
Nephrotoxicity and neurotoxicity following star fruit (Averrhoa carambola) ingestion: a narrative review
Authors: Yasawardene Pamodh , Jayarajah Umesh , De Zoysa Ishan , Seneviratne Suranjith L
Published: February 2021

In recent times, star fruit (Averrhoa carambola) nephrotoxicity and neurotoxicity have been increasingly reported, both in individuals with pre-existing renal disease and those with previously normal renal function. We summarise the clinical findings of star fruit toxicity in humans and outline the important pathogenetic insights provided by animal studies. Google Scholar, EMBASE, Scopus and PubMed were searched from 1995 through July 2020 for case reports/series on renal or neurological manifestations of star fruit toxicity in humans and mechanisms of star fruit toxicity in animal studies. Ten case series and 28 case reports in humans (total number of individuals=136) were included and 8 animal studies were analysed. Ninety-four (69.1%) patients had prior renal impairment. Renal histology showed acute oxalate nephropathy with tubulointerstitial nephritis or tubular necrosis. Neurotoxicity manifestations ranged from hiccups to status epilepticus. Oxalate and caramboxin are considered the main substances causing nephrotoxicity and neurotoxicity. Caramboxin inhibits GABA binding and activates the glutamatergic receptors. Haemodialysis improved outcomes in neurotoxicity. Nephrotoxicity and neurotoxicity need to be looked for with star fruit toxicity, both in individuals with abnormal or normal renal function. Once star fruit intoxication is identified, early renal replacement therapy should be considered. Further studies on the mechanisms of star fruit toxicity are needed.
Impact of Early Intervention in Pain Management in Cancer Patients
Authors: Gulia Abhity , Dhamija Ekta , Kumar Mukesh , Thulkar Sanjay P. , Bhatnagar Sushma
Published: February 2021

Objectives:

The present study aimed to assess the role of early intervention of nerve blocks in the management of cancer pain. We also aimed to study its effect on the quality of life and the opioid requirement.

Materials and Methods:

Sixty patients with cancer having pain, 18 to 75 years were randomised and divided into an intervention group and analgesic titration with opioids group. Patients in the intervention group received nerve block and residual pain managed with opioids. Control group patients were managed with opioids alone.

Results:

The mean visual analog scale score showed statistically significant improvement in both the groups (8.56±1.07 to 2.5±0.63 in the intervention group, 9.3±0.74 to 3.3±0.75 in the control group at 1 month (P=0.000). This was associated with a decrease in the opioid requirement in the intervention group at 1 week (P=0.014) with only 4 patients receiving morphine at the end of 1 month.

The change in the Karnofsky scale was statistically significant from baseline to 1 month in both groups.

Discussion:

Interventional pain management has a definitive role in palliative setup for pain management. Pain relief was obtained in both groups, but the quality of pain relief was better in the intervention group with an associated reduction in the opioid requirement.
Mutuality in Motor Neuron Disease: A Mixed-Method Study
Authors: Cilluffo Silvia , Bassola Barbara , Lusignani Maura
Published: February 2021

BACKGROUND: Mutuality, a positive relationship between caregiver and care receiver that affects patient's health and caregiver's burden, stress, and well-being, has never been investigated in motor neuron disease. METHOD: We conducted a mixed-method study with convergent parallel design. Quantitative data were collected with the Mutuality Scale, and qualitative data were collected using deep interviews. The sample was composed of 30 people with motor neuron diseases and 24 family caregivers. RESULTS: Deductive, qualitative content analysis of the interviews confirmed the presence of mutuality and its 4 dimensions. The average score of patients' Mutuality Scale was 3.07 (SD, 0.79; range, 1.3–4), and that of the caregivers was 3.16 (SD, 0.53; range, 2.2–3.9). The dimensions “love” and “shared values” had the highest scores, whereas the dimension “shared pleasurable activities” had the lowest score. Patients' and caregivers' answers correlated. CONCLUSION: Mutuality concept and its 4 dimensions had content validity in motor neuron disease people. Nurses should consider the level of mutuality and adopt strategies to increase and preserve it.
Treatment of Anastomotic Leaks With EndoVac After Low Anterior Resection in Colorectal Cancers
Authors: Sürek Ahmet , Bozkurt Mehmet A. , Gemici Eyüp , Kocataş Ali , Ferahman Sina , Seyhun Cemal , Binboğa Sinan , Aliş Halil
Published: February 2021

Introduction:

Endoscopic drainage should preferably be tried unless the abscess caused by the anastomotic leak is generalized and disseminated into the abdominal cavity. The aim of this study was to evaluate the results of patients treated with EndoVac.

Patient and Methods:

The medical records of patients who underwent low anterior resection and were treated using the EndoVac therapy system due to the detection of an anastomotic leak were retrospectively evaluated.

Results:

Thirty-three of the patients with detection of anastomotic leaks were treated using EndoVac therapy system. The mean number of application of the EndoVac therapy system was 5.8 (1 to 12) for each patient. Mean duration of hospitalization of the patients was 24.5 (9 to 92) days. Five patients underwent a second operation during the follow-up period after application of the EndoVac therapy system. In our study, the number of patients recovering without the need for additional treatment is 30 (30/33). Our success rate was 90.1%.

Conclusions:

The EndoVac therapy system is an alternative and helpful system in the treatment of colorectal anastomotic leaks without reoperation needed. It can also prevent permanent stoma.
Cyanoacrylate Glue Versus Absorbable Tacks in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial
Authors: Issa Michael , Tacey Mark , Geraghty Joshua , Das Atandrila , Dhir Arun , Mori Krinal , To Henry
Published: February 2021

Background:

Cyanoacrylate glue (Glubran 2) is a synthetic adhesive mesh fixation material. Its utility is being evaluated in laparoscopic total extraperitoneal (TEP) inguinal hernia repair (IHR). A multicentre randomized controlled trial was performed comparing Glubran 2 to standard of care absorbable tacks, particularly assessing chronic postoperative inguinal pain and its effects.

Materials and Methods:

Patients undergoing elective TEP IHR at 2 centers from 2017 to 2019 were randomly assigned to Glubran 2 or absorbable tack mesh fixation, and followed for 6 months. All other aspects of surgery and aftercare remained the same. Surgeons documented operative and fixation time, and the placement of fixation on standardized diagrams. Via a questionnaire, aspects of inguinal pain were evaluated before surgery, and at various time-points postoperatively over 6 months. Postoperative clinical factors were also collected.

Results:

A total of 106 operative sides were randomized to either glue (51) or tack (55) mesh fixation over a 14-month period. Similar median operative times between tack (83.0 min) and glue fixation (75.0 min) were observed. There were no significant surgical complications or observed hernia recurrences in either group. There was no significant difference in pain scores between the 2 groups at all time-points after analysis through mixed effects modeling. Temporal pain profiles over time were also similar. Totally, 55% of patients in the glue group had returned to work within 2 weeks of surgery. There was no increase in complications or pain scores despite regular lateral fixation of glue in these patients.

Conclusion:

Adding to known data, we observed no significant difference in postoperative pain, demonstrating that cyanoacrylate glue is a viable and safe alternative fixation method to absorbable tacks in laparoscopic TEP IHR. As secondary outcomes, cyanoacrylate glue permits some patients to return to work early, and we observed regular lateral mesh glue fixation without increased pain or complications.
Role of cell polarity dynamics and motility in pattern formation due to contact-dependent signalling
Authors: Bajpai Supriya , Prabhakar Ranganathan , Chelakkot Raghunath , Inamdar Mandar M.
Published: February 2021

A key challenge in biology is to understand how spatio-temporal patterns and structures arise during the development of an organism. An initial aggregate of spatially uniform cells develops and forms the differentiated structures of a fully developed organism. On the one hand, contact-dependent cell–cell signalling is responsible for generating a large number of complex, self-organized, spatial patterns in the distribution of the signalling molecules. On the other hand, the motility of cells coupled with their polarity can independently lead to collective motion patterns that depend on mechanical parameters influencing tissue deformation, such as cellular elasticity, cell–cell adhesion and active forces generated by actin and myosin dynamics. Although modelling efforts have, thus far, treated cell motility and cell–cell signalling separately, experiments in recent years suggest that these processes could be tightly coupled. Hence, in this paper, we study how the dynamics of cell polarity and migration influence the spatiotemporal patterning of signalling molecules. Such signalling interactions can occur only between cells that are in physical contact, either directly at the junctions of adjacent cells or through cellular protrusional contacts. We present a vertex model which accounts for contact-dependent signalling between adjacent cells and between non-adjacent neighbours through long protrusional contacts that occur along the orientation of cell polarization. We observe a rich variety of spatiotemporal patterns of signalling molecules that is influenced by polarity dynamics of the cells, relative strengths of adjacent and non-adjacent signalling interactions, range of polarized interaction, signalling activation threshold, relative time scales of signalling and polarity orientation, and cell motility. Though our results are developed in the context of Delta–Notch signalling, they are sufficiently general and can be extended to other contact dependent morpho-mechanical dynamics.
A novel dicistrovirus in a captive red squirrel (Sciurus vulgaris)
Authors: Dastjerdi Akbar , Everest David J. , Davies Hannah , Denk Daniela , Zell Roland
Published: February 2021

Dicistroviruses are single-stranded RNA viruses in the family Dicistroviridae. The viruses have mainly been detected in arthropods and are the cause of several devastating diseases in many of these species such as honeybees. Increasingly, dicistroviruses have also been detected in both mammalian and avian species in faeces, blood and liver, but with unconfirmed pathology. Here, we report a novel dicistrovirus detected in the intestinal content of a captive red squirrel with enteritis along with the disease history, pathology and genomic characterisation of the virus. Virus particle morphology resembled those of picornaviruses with a diameter of 28–32 nm but failed to be detected using a mammalian/avian pan viral microarray. Next-generation sequencing confirmed a dicistrovirus having a typical dicistrovirus genome organization, but with the polyprotein 1 being shorter by about 100 amino acids, compared to that of other dicistroviruses. Phylogenetic analysis of ORF1 and ORF2 sequences clustered the virus with two yet unassigned dicistroviruses detected in Gorilla gorilla and a freshwater arthropod and likely to be designated to a new genus. Our data further highlights the ever-growing diversity of dicistroviruses, but the clinical significance of the virus in mammalian species and particularly red squirrels has yet to be established.
The humoral response to BK polyomavirus in kidney transplant recipients is dominated by IgM antibodies that use a distinct repertoire compared to IgG against the same antigen
Authors: Ngoc-Khanh Nguyen , Laetitia Gautreau-Rolland , Marie-Claire Devilder , Cynthia Fourgeux , Debajyoti Sinha , Jeremie Poschmann , Maryvonne Hourmant , Céline Bressollette-Bodin , Xavier Saulquin , Dorian McIlroy
Published: February 2021

1.

The BK polyomavirus (BKPyV) persists asymptomatically in the kidney and active replication is only seen in immunosuppressed individuals, such as kidney transplant (KTx) recipients, in whom BKPyV reactivation can cause significant morbidity. KTx recipients with BKPyV reactivation mount a robust humoral response, but this often fails to clear the virus. In order to characterize the BKPyV-specific B-cell receptor (BCR) repertoire in KTx recipients, we used fluorescence-labeled BKPyV virus-like particles (VLPs) to sort with BKPyV-specific B-cells, then single-cell RNAseq to obtain paired heavy and light chain antibody sequences, and gene transcriptome data. The BCR repertoire was highly diverse in terms of both V-gene usage and clonotype diversity, with approximately 3% repertoire overlap between patients. The BKPyV-specific response was characterized by the presence of both memory IgG and memory IgM B-cells with extensive somatic hypermutation, which expressed distinct BCR repertoires within the same patient. The gene expression profile of IgG and IgM memory B-cells was highly similar, with only 19 genes, includingCD83, CD79AandPARP1showing significant differential expression. These results confirm that the IgM memory B-cells are a significant component of the BKPyV-specific humoral response, and show for the first time that IgG and IgM repertoires directed against the same antigen can have significant differences.
Electronic data management for vaccine trials in low resource settings: Upgrades, scalability and impact of ODK
Authors: Marks Michael , Lal Sham , Brindle Hannah , Gsell Pierre-Stéphane , MacGregor Matthew , Stott Callum , van de Rijdt Martijn , Gutiérrez Almazor Guillermo , Golia Suman , Watson Conall , Diallo Abdourahamane , Toure Alhassane , Houlihan Catherine , Keating Patrick , Martin Hélène , Restrepo Ana-Maria Henao , Anokwa Yaw , Roberts Chrissy h
Published: February 2021

Background

ODK provides software and standards that are popular solutions for off-grid electronic data collection and has substantial code overlap and interoperability with a number of related software products including CommCare, Enketo, Ona, SurveyCTO and KoBoToolbox. In combination with the use of statistical analysis software such as R, these tools provide fully open-source options for off-grid use in public health data collection, management, analysis and reporting. During the 2018-2020 Ebola epidemic in the North Kivu & Ituri regions of Democratic Republic of Congo, we leveraged ODK and other tools to support the DRC Ministère de la Santé RDC and World Health Organization in their efforts to administer an experimental vaccine (VSV-Zebov-GP) as part of their strategy to control the transmission of infection.

Method

New functions were developed to facilitate the use of ODK, Enketo and R in large scale data collection, aggregation, monitoring and near-real-time analysis during clinical research in health emergencies. We present open-source enhancements to ODK that include a built-in audit-trail, a framework and companion app for biometric registration of ISO/IEC 19794-2 fingerprint templates, enhanced performance features, better scalability for studies featuring millions of data form submissions, increased options for parallelization of research projects, and pipelines for automated management and analysis of data. We also developed novel encryption protocols for enhanced web-form security in Enketo.

Results

Against the backdrop of a complex and challenging epidemic response, our enhanced platform of open tools was used to collect and manage data from more than 280,000 eligible study participants who received VSV-Zebov-GP under informed consent. These data were used to determine whether the VSV-Zebov-GP was safe and effective and to guide daily field operations.

Conclusions

We present open-source developments that make electronic data management during clinical research and health emergencies more viable and robust. These developments will also enhance and expand the functionality of a diverse range of data collection platforms (Ona, KoBoToolbox etc.) that are based on the ODK software and standards.

Funding

This research is funded by the Department of Health and Social Care using UK Aid funding and is managed by the NIHR (PR-OD-1017-20001). The views expressed in this publication are those of the authors and not necessarily those of the Department of Health and Social Care.
Negative-Binomial and Quasi-Poisson regressions between COVID-19, mobility and environment in São Paulo, Brazil
Authors: Ibarra-Espinosa Sergio , de Freitas Edmilson Dias , Ropkins Karl , Dominici Francesca , Rehbein Amanda
Published: February 2021

Brazil, the country most impacted by the coronavirus disease 2019 (COVID-19) on the southern hemisphere, use intensive care admissions per day, mobility and other indices to monitor quarantines and prevent the transmissions of SARS-CoV-2. In this study we quantified the associations between residential mobility index (RMI), air pollution, meteorology, and daily cases and deaths of COVID-19 in São Paulo, Brazil. We applied a semiparametric generalized additive model (GAM) to estimate: 1) the association between RMI and COVID-19, accounting for ambient particulate matter (PM2.5), ozone (O3), relative humidity, temperature and delayed exposure between 3-21 days, and 2) the association between COVID-19 and exposure to for ambient particulate matter (PM2.5), ozone (O3), accounting for relative humidity, temperature and mobility. We found that an RMI of 45.28% results in 1,212 cases (95% CI: 1,189 to 1,235) and 44 deaths (95% CI: 40 to 47). Increasing the isolation from 45.28% to 50% would avoid 438 cases and 21 deaths. Also, we found that an increment of 10 μg·m-3of PM2.5results in a risk of 1.140 (95% CI: 1.021 to 1.274) for cases and 1.086 (95% CI: 1.008 to 1.170) for deaths, while O3produces a relative risk of 1.075 (95% CI: 1.006 to 1.150) for cases and 1.063 (95% CI: 1.006 to 1.124) for deaths, respectively. We compared our results with observations and literature review, finding well agreement. Policymakers can use such mobility indices as tools to control social distance activities. Spatial distancing is an important factor to control COVID-19. Small increments of air pollution result in an increased number of COVID-19 cases and deaths.
Lower regional gray matter volume in the absence of higher cortical amyloid burden in late-life depression
Authors: Takamiya Akihiro , Casteele Thomas Vande , Koole Michel , De Winter François-Laurent , Bouckaert Filip , Van den Stock Jan , Sunaert Stefan , Dupont Patrick , Vandenberghe Rik , Van Laere Koen , Vandenbulcke Mathieu , Emsell Louise
Published: February 2021

Late-life depression (LLD) is associated with a risk of developing Alzheimer’s disease (AD). However, the role of AD-pathophysiology in LLD, and its association with clinical symptoms and cognitive function are elusive. In this study, one hundred subjects underwent amyloid positron emission tomography (PET) imaging with [18F]-flutemetamol and structural MRI: 48 severely depressed elderly subjects (age 74.1±7.5 years, 33 female) and 52 age-/gender-matched healthy controls (72.4±6.4 years, 37 female). The Geriatric Depression Scale (GDS) and Rey Auditory Verbal Learning Test (RAVLT) were used to assess the severity of depressive symptoms and episodic memory function respectively. Amyloid deposition was quantified using the standardized uptake value ratio. Whole-brain voxel-wise comparisons of amyloid deposition and gray matter volume (GMV) between LLD and controls were performed. Multivariate analysis of covariance was conducted to investigate the association of regional differences in amyloid deposition and GMV with clinical factors, including GDS and RAVLT. As a result, there were no significant group differences in amyloid deposition. In contrast, LLD showed significant lower GMV in the left temporal and parietal region. GMV reduction in the left temporal region was associated with episodic memory dysfunction, but not with depression severity. Regional GMV reduction was not associated with amyloid deposition. LLD is associated with lower GMV in regions that overlap with AD-pathophysiology, and which are associated with episodic memory function. The lack of corresponding associations with amyloid suggests that lower GM driven by non-amyloid pathology may play a central role in the neurobiology of LLD presenting as a psychiatric disorder.
Effect of Adapted Ergometer Setup and Rowing Speed on Lower Extremity Loading in People with and without Spinal Cord Injury
Authors: Fang Ying , Troy Karen L.
Published: February 2021

Introduction

Functional electrical stimulation assisted rowing (FES-rowing) on an adapted ergometer is used in spinal cord injury (SCI) rehabilitation. A primary goal is to mechanically load the lower extremity to prevent disuse osteoporosis. Recent studies reported the small foot reaction force in FES-rowing was not sufficient to prevent bone loss.

Objective

This study aims to investigate the effect of ergometer setup and rowing speed on lower extremity loading in able-bodied and SCI individuals.

Design

Twenty able-bodied novice rowers and one experienced SCI rower rowed on an adapted ergometer with different speeds and setups. Motion capture system and force sensors were used to calculate forces and moments at the knee.

Main Outcome Measures

Foot reaction force and knee moment for all participants, and tibiofemoral force of the SCI rower.

Results

Peak foot reaction forces of able-bodied rowers ranged from 0.28 – 0.45 body weights (BW), which was less than half the force in normal rowing. A fast rowing speed, forward seat position, and large knee RoM were associated with higher foot force and knee moment during able-bodied rowing. The SCI subject had the greatest foot reaction force (0.40 BW) when rowing with small knee RoM at a rear seat position and the highest tibiofemoral force (2.23 BW) with large knee RoM at a rear seat position.

Conclusion

Ergometer setup and speed can double the force generation at the foot during both able-bodied rowing and FES-rowing. Rowing forms (range of motion and speed) that resulted in the greatest foot reaction force were different for able-bodied rowers and SCI rowers, indicating a trade-off between motion and force generation in FES-rowing that warrants further investigation with more SCI rowers. Clinicians and physical therapist should be aware that ergometer setups can be easily adjusted to modify rowing forms and loading patterns of users with SCI.
Assessment of Post SARS CoV 2 Fatigue among Physicians Working in COVID Designated Hospitals in Dhaka, Bangladesh
Authors: Hasan A T M Hasibul , Islam Muhammad Sougatul , Khan Nushrat , Munna Nazmul Hoque , Choton Wahidur Rahman , Arefin Mostofa Kamal , Zubayer Khan Mohammad Abdullah Az , Mansur Mohaimen , Hassan Rashedul , Siddiqui Numera , Arefin Muhammad Shamsul , Afroze Nayema , Islam Md. Salequl
Published: February 2021

Background

Fatigue has been observed after a number of infectious disease outbreaks around the world. After the outbreak of SARS CoV-2 in Wuhan, China in 2019, the disease turned into a pandemic very rapidly. Mental health is a key issue associated with such outbreaks. To explore the fatigue level among physicians working in designated public and private hospitals in Bangladesh, we conducted a matched case-control study of post-SARS-CoV-2 fatigue.

Method

In this study 105 physicians who were diagnosed as COVID-19 infected, got treatment, and declared cured at least 6 weeks before the interview date, were recruited as cases and the same number of age and designation matched healthy physicians as control who are working in the same hospital. Case and control were selected in 1:1 ratio from each of the hospitals. The study population was selected by inclusion and exclusion criteria after taking informed written consent. Data collection was done by a semi-structured questionnaire. Diagnosis of COVID--19 infection was done by detection of SARS CoV-2 antigen by RT-PCR from reference laboratories in Bangladesh or by HRCT Chest.

Result

Around two-thirds of the physicians were male (67.6% versus 32.4%). Most of them aged less than forty years (80.5%). The cases had a greater number of comorbid conditions than those who were negative. The FSS score (mean) was much higher for cases (36.7 ± 5.3 versus 19.3 ± 3.8) than the control group with a statistically significant difference with no significant gender differentiation. Similarly, around 67.7% of the previously COVID positive physicians represented in the highest FSS score tertile compared to the respondents in the control group had a mean score of less than 3. The difference was also highly significant.

Conclusion

Physicians, who had a previous history of COVID-19 infection had a higher total and mean FSS score, signifying a more severe level of fatigue than the physicians who had never been COVID-19 positive while working in the same hospital irrespective of their age and sex.
A potent bispecific nanobody protects hACE2 mice against SARS-CoV-2 infection via intranasal administration
Authors: Wu Xilin , Cheng Lin , Fu Ming , Huang Bilian , Zhu Linjing , Xu Shijie , Shi Haixia , Zhang Doudou , Yuan Huanyun , Nawaz Waqas , Yang Ping , Hu Qinxue , Liu Yalan , Wu Zhiwei
Published: February 2021

The dramatically expanding COVID-19 needs multiple effective countermeasures. Neutralizing antibodies are a potential therapeutic strategy for treating COVID-19. A number of neutralizing nanobodies (Nbs) were reported for their in vitro activities. However, in vivo protection of these nanobodies was not reported in animal models. In the current report, we characterized several RBD-specific Nbs isolated from a screen of an Nb library derived from an alpaca immunized with SARS-CoV-2 spike glycoprotein (S); among them, three Nbs exhibited picomolar potency against SARS-CoV-2 live virus, pseudotyped viruses, and 15 circulating SARS-CoV-2 variants. To improve the efficacy, various configurations of Nbs were engineered. Nb15-NbH-Nb15, a novel trimer constituted of three Nbs, was constructed to be bispecific for human serum albumin (HSA) and RBD of SARS-CoV-2. Nb15-NbH-Nb15 exhibited sub-ng/ml neutralization potency against the wild-type and currently circulating variants of SARS-CoV-2 with a long half-life in vivo. In addition, we showed that intranasal administration of Nb15-NbH-Nb15 provided 100% protection for both prophylactic and therapeutic purposes against SARS-CoV-2 infection in transgenic hACE2 mice. Nb15-NbH-Nb15 is a potential candidate for both prevention and treatment of SARS-CoV-2 through respiratory administration.

One sentence summary

Nb15-NbH-Nb15, with a novel heterotrimeric bispecific configuration, exhibited potent and broad neutralization potency against SARS-CoV-2 in vitro and provided in vivo protection against SARS-CoV-2 infection in hACE2 transgenic mice via intranasal delivery.

Graphical abstract:

Highlights

We described a novel heterotrimeric configuration of Nb-NbH-Nb (Nb15-NbH-Nb15) that exhibited improved viral inhibition and stability.

Nb15-NbH-Nb15 provides ultrahigh neutralization potency against SARS-CoV-2 wild type and 18 mutant variants, including the current circulating variants of D614G and N501Y predominantly in the UK and South Africa.

It is the first to demonstrate the Nbs efficacy in preventing and treating SARS-CoV-2 infection in hACE2 transgenic mice via intranasal delivery.