bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactionist Theories of Emotion
Authors: McCarthy E. Doyle
Published: October 2021

Classical and contemporary developments in the study of culture are examined for ways to conceptualize emotion(s) and to frame their study. The foundation of this approach is found in early social pragmatism and interactionism, both of which view the structuring of mind, self, and emotion as sociocultural processes. The same principles are found in contemporary arguments about emotions and subjectivity made by ‟constructionist” works in psychology and social science as well as in culture theory today. These approaches have given greater emphasis to the study of everyday beliefs of social actors, arguing that the entire domain of subjectivity is not (as commonly understood) devoid of social and cultural influence. Rather, subjectivity itself is “socially constructed.” In this way and in others, pragmatist social psychology and contemporary culture theory have both enlarged and changed the idea of subjectivity from something isolated and unique and purely individual to something shared and observable. Subjectivity’s continual formation and development take place in society in interaction with others. Accordingly, emotions and the ways they are experienced exist within socially and historically variable cultures, implying that people’s ideas about what emotions are and what they mean vary across cultures as well as within cultures.
Poliheuristic Theory in Strategic Interactions
Authors: Tal-Shir Eldad , Mintz Alex
Published: October 2021

This chapter extends poliheuristic theory to the analysis of leaders’ decisions in strategic interactions and offers a framework for the conduct of both ex-ante and ex-post analyses of such decisions. Using the case study of the United States and Russia with regard to the decision to dismantle Syria’s chemical arsenal in September 2013, the authors show that the leaders’ decision followed a two-step poliheuristic process consisting of 1) eliminating alternatives dissatisfactory on non-compensatory dimensions and 2) obtaining equilibrium for the reduced choice sets through a game-theoretic strategic interaction. The chapter also discusses and uses a new method of decision analysis, applied decision analysis.
New Mexico and the Central Great Plains in the Civil War
Authors: Smith Stacey L.
Published: October 2021

This chapter investigates campaigns of the American Civil War in New Mexico Territory and the Great Plains. It contends that the U.S. federal government fought a multifront war during the 1860s that spanned the Confederate South and the American states and territories of the Far West. The war in the Far West aimed to establish U.S. territorial sovereignty and political authority over the nation’s vast North American empire. Across the 1860s, federal officials sought to defend the West against Confederate invaders, compel Native Americans to submit to U.S. rule, force Spanish Mexican citizens to give up systems of Indian slavery and peonage, and rein in rogue White Americans living in federal territories. Federal officials, however, often lacked the political clout or military force to achieve these goals. The Civil War in the Far West reveals the unevenness and weakness of the American state in the mid-nineteenth century.
Second Bull Run/Manassas
Authors: Matsui John H.
Published: October 2021

The summer of 1862 witnessed the struggle between Northern Republican and Democratic ideologies embodied in the Army of Virginia and the Army of the Potomac even as Union and Confederate armies faced off in the Second Manassas Campaign. Formed to protect Washington while Maj. Gen. George McClellan advanced on Richmond, the Army of Virginia and its leader, Maj. Gen. John Pope, implemented a Republican or “hard war” policy of military occupation by confiscating civilian property and imposing loyalty oaths. Northern and Southern Democrats (characterized by McClellan and Maj. Gen. Thomas J. “Stonewall” Jackson, respectively) recognized the threat that Pope’s ideology posed and sought to crush it, either by delaying reinforcement or decisive battlefield defeat. The defeat of Pope and his army by Confederate forces at Second Manassas delayed but did not destroy the twin Republican agendas of emancipation and destruction of the Confederacy. Pope and his political generals prefigured the total-war policies of the war’s last year.
The Chattanooga and Knoxville Campaigns
Authors: Astor Aaron
Published: October 2021

Confederate Gen. Braxton Bragg’s Army of Tennessee besieged Union forces in Chattanooga after the Battle of Chickamauga in September 1863. Union Maj. Gen. Ulysses S. Grant and Maj. Gen. George Thomas took control of the Union Army there and exploited the complex mountainous topography to create a “Cracker Line” to the west. With the siege effectively broken by late October, Bragg sent Lt. Gen. James Longstreet’s Corps to Knoxville to retake that railroad city, which had been occupied by Maj. Gen. Ambrose Burnside’s Army of the Ohio since early September. In late November the Union Army of the Cumberland and Maj. Gen. William T. Sherman’s recently arrived Army of the Tennessee broke out of Chattanooga while Burnside’s men defeated Longstreet’s attack on Knoxville’s Fort Sanders. The Union Army’s successful Chattanooga and Knoxville military campaigns opened Georgia to Union invasion, confirmed Grant’s suitability for leadership over all Union forces, and recalibrated the politics of loyalty in a bitterly divided section of the South.
Sherman’s March to the Sea
Authors: Bailey Anne J.
Published: October 2021

Maj. Gen. William T. Sherman’s March to the Sea began at Atlanta, Georgia, on November 15, 1864, and ended thirty-seven days later in Savannah, Georgia. With roughly 60,000 infantry and 5,500 cavalry, Sherman cut a path often sixty miles wide across the state’s most fertile and populated region. He wanted to make war so harsh on civilians that they would demand that the Confederate government abandon the fight. Despite the folklore surrounding the March there was not widespread destruction, but Sherman did succeed in bringing the war to the state’s previously untouched plantation region and to the White population that had not felt any direct effects from the fighting. The March also forever changed the lives of slaves who abandoned their masters to follow Sherman’s soldiers. As a result, the March to the Sea ranks as one of the most significant Union campaigns despite the fact there were no major battles or heavy casualties.
Eastern Kentucky and Northwestern Virginia, 1861–1862
Authors: McKnight Brian D.
Published: October 2021

From May 1861 through 1862, Appalachian eastern Kentucky and northwestern Virginia stood at the forefront of many decisions by the governments of the United States and the Confederate States. These regions, with their topographical challenges, provided the perfect cover for guerrilla activity. Poor roads and isolated communities holding populaces with divided loyalties encouraged small-unit tactics. The contest for northwestern Virginia grew out of the want of control of the Baltimore and Ohio Railroad. Quick and sharp, the war in northwestern Virginia ultimately resulted in the formation of a new Union state. It provided the fields for many important figures who would grow to prominence in the coming war, including Gen. Robert E. Lee and Maj. Gen. George B. McClellan. In eastern Kentucky, the armies competed for the important road connecting the Cumberland Gap to the Bluegrass region. The Battle of Mill Springs settled the question of who would control the region.
The Future of Administrative Justice
Authors: Adler Michael
Published: October 2021

This chapter considers the future of administrative justice. Using the United Kingdom as a case study, it argues that the rise and fall of administrative justice can be likened to the swing of a pendulum. It considers first-instance decision-making, the role of outsourcing, the expanding role of administrative review and its implications for administrative justice, the decline of tribunals and the rise of ombudsmen, the effectiveness of oversight arrangements, and the impact of digitalisation. It concludes that the future of administrative justice in the United Kingdom is unlikely to involve a replay of anything that has been encountered in the past.
Coming of Age in Elite Families, c. 1200–c. 1650
Authors: Wilkinson Louise J.
Published: October 2021

Access to wealth and privileged status lent the youth culture of the aristocracies of Western Europe a distinctive flavor in the medieval and early modern periods. Issues touching wardship, property rights, and the transmission of lands between generations gave adults a vested interest in supervising the young in adolescence, and in educating them for the responsibilities of governing estates and making marriages that were, ideally, closely aligned to dynastic interests. Like adolescents from other social backgrounds, fledgling young lords and ladies were sometimes tempted into wayward behavior and rebelled in conduct, words, and deeds against their elders. Yet, common experiences and shared rites of passage among elite youth—such as undergoing military training on the part of boys and serving in great households and attending princely courts—offered young nobles a chance to socialize with one another. They experienced youthful companionship and enjoyed recreational activities together, including jousting, hawking, hunting, dancing, and making music. They also learned the intricacies surrounding courtship and love. In these ways, young men and women became acculturated into noble society.
Anglo Fears
Authors: Jacques Peter J.
Published: October 2021

The rejection of climate change science is organized by a countermovement, a collective effort to oppose a threatening social movement, in this case global environmentalism along with climate mitigation efforts. This chapter shows that, from a comparative perspective, the Anglo group of countries are quite alone in organizing the Climate Change Countermovement (CCCM), even though climate denial manifests in an unorganized way more broadly. This chapter offers the theoretical possibility that this Anglo climate denial emerges as a defense of imperial privilege threatened by the social change required to address a warming world. The theory is then supported by selections from authors of books who reject climate change and that evidence a fear of loss—of US power, of possessive individualism, and of Western progress.
The Integration of Conservation and Security
Authors: Duffy Rosaleen , Massé Francis
Published: October 2021

This chapter examines the intersections among violence, security, and the environment. It uses a political ecology lens to analyze the violences that arise from “enforcement-first” approaches in tackling the illegal wildlife trade (IWT) as one aspect of conservation. Growing concern about IWT as a threat to biodiversity and security has led to calls for an urgent response. This has encouraged and facilitated the development of responses that are anchored in law enforcement and militarization. This is in part due to the redefining of IWT as a global security threat because it is deemed as a source of funding for armed groups and involves organized crime networks. The intense focus on the need to tackle IWT has led to shifts in conservation policy, such that anti-poaching operations are often accompanied by considerable levels of violence by conservation authorities.
Cities and the Environment in Africa
Authors: Gore Christopher
Published: October 2021

The capacity of African cities to respond to environmental challenges has been confounded by a host of political, demographic, ecological, and financial issues for decades. Cities are rarely provided the revenue or given authority to spend revenue to provide sufficient environmental services. City governments are also often in conflict with national governments over their policy choices or political orientation. Multilevel collaboration is needed to address urban challenges, but African city governments and citizens do independently produce solutions. This chapter examines the evolution of responses to urban environmental challenges in two sub-Saharan African cities—Durban, South Africa, and Nairobi, Kenya—and argues that, central to advancing improvements, is understanding urban political processes and the spaces that city-based organizations create to shape and improve their future.
Legal Traditions
Authors: Duve Thomas
Published: October 2021

Legal anthropology has to understand and deal with complex and often plural constellations of normative bodies, legal discourses, institutions, and practices. They shape the legal regimes people live in. These legal regimes as well as the ways in which societies operate with legal diversity have developed over time. History has done more than shape the vocabulary and the grammar of each community’s law. The narratives we produce about the past are also used to construct and express individual and social identities. Thus, history and its (re)construction by later generations can impose constraints and limit available options, but also open spaces of negotiation and provide for innovation. Legal regimes of the past are often called ‘legal traditions’. In the last decades, the idea of ‘legal traditions’ has gained considerable practical importance. Especially in former colonial countries, and due to the increasing recognition of the rights of Indigenous Peoples in international and national law, many actors are drawing on history to claim rights and obligations for the present and the future. In a similar manner, some historical legal regimes seem to embody injustice, leading to pleas for the recognition of their unjust character or even for material compensation. The aim of this chapter is to offer some reflections on the concept of ‘legal traditions’ and its role in constructing our identities and shaping our present legal regimes.
Indigenous Peoples, Identity, and Free, Prior, and Informed Consultation in Latin America
Authors: Guevara Gil Armando
Published: October 2021

This chapter documents the social life of the right to free, prior, and informed consultation in Latin America. Challenging the original intent of the signatories of International Labour Organization (ILO) Convention 169 on Indigenous and Tribal Peoples (1989), Indigenous peoples, subaltern communities, and their advocates—a tacit coalition of activists, scholars, judges, legislators, and diplomats—work at the intersection of law and anthropology to redefine and substantiate the right to consultation. Two movements characterize this endeavour. First, the right is being broadened, significantly expanding the legal subjects able to claim its enforcement. Second, consultation is being upgraded from a soft to a solid right, deepening it, so to speak, as a way of overcoming the procedural trap that reduces consultations to rituals of domination. Interestingly, corporations and multilateral banks are acknowledging this decolonizing reinterpretation of the right to free, prior, and informed consultation. While its full-blown implementation as an expression of the right of Indigenous self-determination is still utopian, both broadening and deepening the right to consultation empower Indigenous and subaltern communities in their daily struggles against extractivism and developmentalism.
Combat Sports and Gladiatorial Combat in Greek and Roman Private Art
Authors: Brown Shelby
Published: October 2021

The private art of violent Greek and Roman competitions shows iconic moments commemorated by ordinary fans and a wealthy elite. The depictions assume a viewer who understands the rules and identifies with fighters, spectators, or sponsors. Greek combat sports were associated with individual achievement and persistence through pain. Equal combatants, idealized and indistinguishable in Archaic and Classical art, fought nude for personal and regional glory, overseen by a referee. Hellenistic art introduced fighters whose battered faces declared personal suffering the price of victory. Roman public combatants were degraded by competition, although ennobled by martial valour, as were gladiators who willingly faced death. In the arena, differently equipped combatants were paired as fighting ‘types’. Ordinary art emphasized action and equipment. The art of the wealthy also referenced the sponsor, who decided the terms of victory and loss. The gazes of referees and combatants turned toward him; in real life, he interacted with the audience about the outcome, and they praised his public benefaction.
Greek Festivals in the Hellenistic Era
Authors: Newby Zahra
Published: October 2021

The Hellenistic era incorporated new city foundations in Egypt and the Near East, as well as the ancient Greek cities of mainland Greece, Asia Minor, and Magna Graecia. This chapter examines Greek festivals and athletic contests amid the struggles of cities and individuals for recognition and self-identity. Relying especially on epigraphic and archaeological evidence, it will look at the Olympic Games during this period, and at the widening geographical origins of its victors. New festivals were established and played crucial roles in inter-city politics; note especially the new isolympic and isopythian games such as the Ptolemaia in Alexandria and the festival of Artemis Leucophyene at Magnesia on the Maeander. The guilds of performers played important roles in the Hellenistic period. We consider how the experience of an athletic victor now compared with that in the past.
Overview and Approaches
Authors: Scanlon Thomas F.
Published: October 2021

The aims, scope, structure and cultural background of the present volume are outlined here. It aims to present progressive current thought in the field and indicate directions for future work. It also juxtaposes Greek and Roman games and spectacle, to shed light on similarities and differences in the two cultures, and also to suggest parallels in other cultures, including our own. It aims to facilitate research and provoke thinking in particular aspects of Greek sport and Roman spectacle. The focus of the collection is to an extent in the social contexts of games, namely the evolution of sport and spectacle diachronically and geographically across cultural and political boundaries, and how games are adapted to multiple contexts and multiple purposes, reinforcing, for example, social hierarchies, performing shared values, and playing out deep cultural tensions. This chapter also interrogates the terms for sport today and in antiquity, and presents the high value placed on sport by ‘following the money’ in both eras.
Theories of Greek and Roman Sport
Authors: Christesen Paul
Published: October 2021

This chapter discusses the use of theory in the study of Greek and Roman sport. It begins with a brief review of the reasons for the relative paucity of theory in the relevant scholarship, then goes on to examine five different kinds of theory that have been productively applied to the study of sport: functionalism, conflict theory, the ‘discipline’ theory of Michel Foucault, Pierre Bourdieu’s work on corporeal discipline and on the relationship between sport and social inequality, and ritual theory. This is by no means a comprehensive survey of theories that have been used in the study of sport—a task that could occupy a volume of its own. The five theories discussed here were chosen because they have strong potential usefulness in the study of Greek and Roman sport.
Thematic Texts
Authors: Chew Kathryn
Published: October 2021

Early imperial literature approaches arena events as ‘spectacula’, referencing both what is seen and the viewer who sees it, both bound by a complicated reciprocity. The tensions driving this relationship are articulated by writers as consumers of these shows, at once receptive and in opposition to spectacle and its imperial sponsors. This chapter examines how spectacle informs the works of three socially distinct authors, whose writings respond to the visuality and ideology of spectacle at its height. Ovid came of age with Augustus’ rise to power and spectacle and sport are the wallpaper of his imagination. Ovid bends spectacle to his literary purposes, embracing love as an event and spectators as participants and performers. Celebrating Titus’ inaugural games for the Flavian amphitheatre, Martial avoids grand tableaux and instead praises the emperor in epigrammatic form, encapsulating momentary images. Church Father Tertullian reacts against the attraction of spectacle as a ritual force in powerful competition with Christianity for the hearts and minds of the people.
Spectatorship, Control, and Collective Groups
Authors: Sumi Geoffrey S.
Published: October 2021

It is axiomatic that the Roman emperor attempted to control the city populace through an ideology of ‘bread and circuses’ (free grain and public entertainment). Yet a riot during a food crisis in 189 ce, which began in the circus and spread to the streets, shows that spectators could be the agents of political interaction at public spectacles rather than merely passive participants, that public spectacles could be organizing events for the non-elite population. It has been argued that crowds in order to form require a ‘notion of legitimation’. Indeed, the crowd at this riot was engendered in part through the long-standing conventions of spectatorship at Roman public spectacles, including 1) public spectacles as venues for popular protest and interactions with the emperor; 2) the custom of arranged seating, including claques, factions, and trade guilds (collegia); 3) common forms of spectator response, such as acclamations.
Filgotinib decreases both vertebral body and posterolateral spine inflammation in ankylosing spondylitis: results from the TORTUGA trial
Authors: Maksymowych Walter P , Østergaard Mikkel , Landewé Robert , Barchuk William , Liu Ke , Gilles Leen , Hendrikx Thijs , Besuyen Robin , Baraliakos Xenofon
Published: October 2021

Objectives

To assess the effects of filgotinib on inflammatory and structural changes at various spinal locations, based on MRI measures in patients with active AS in the TORTUGA trial.

Methods

In the TORTUGA trial, patients with AS received filgotinib 200 mg (n = 58) or placebo (n = 58) once daily for 12 weeks. In this post hoc analysis, spine MRIs were evaluated using the Canada–Denmark (CANDEN) MRI scoring system to assess changes from baseline to week 12 in total spine and subscores for inflammation, fat, erosion and new bone formation (NBF) at various anatomical locations. Correlations were assessed between CANDEN inflammation and clinical outcomes and Spondyloarthritis Research Consortium of Canada (SPARCC) MRI scores and between baseline CANDEN NBF and baseline BASFI and BASMI scores.

Results

MRIs from 47 filgotinib- and 41 placebo-treated patients were evaluated. There were significantly larger reductions with filgotinib vs placebo in total spine inflammation score and most inflammation subscores, including posterolateral elements (costovertebral joints, transverse/spinous processes, soft tissues), facet joints and vertebral bodies. No significant differences were observed for corner or non-corner vertebral body inflammation subscores, spine fat lesion, bone erosion or NBF scores. In the filgotinib group, the change from baseline in the total inflammation score correlated positively with the SPARCC spine score. Baseline NBF scores correlated with baseline BASMI but not BASFI scores.

Conclusions

Compared with placebo, filgotinib treatment was associated with significant reductions in MRI measures of spinal inflammation, including in vertebral bodies, facet joints and posterolateral elements.

Trial registration

ClinicalTrials.gov (https://clinicaltrials.gov), NCT03117270.
Systemic autoimmune myopathies: a prospective phase 4 controlled trial of an inactivated virus vaccine against SARS-CoV-2
Authors: Shinjo Samuel K , de Souza Fernando H C , Borges Isabela B P , dos Santos Alexandre M , Miossi Renata , Misse Rafael G , Medeiros-Ribeiro Ana C , Saad Carla G S , Yuki Emily F N , Pasoto Sandra G , Kupa Léonard V K , Ceneviva Carina , Seraphim Júlia C , Pedrosa Tatiana N , Vendramini Margarete B G , Silva Clóvis A , Aikawa Nádia E , Bonfá Eloisa
Published: October 2021

Objectives

To evaluate immunogenicity and safety of an inactivated SARS-CoV-2 vaccine in systemic autoimmune myopathies (SAMs) and the possible influence of baseline disease parameters, comorbidities and therapy on immune response.

Methods

This prospective controlled study included 53 patients with SAMs and 106 non-immunocompromised control group (CTRL). All participants received two doses of the Sinovac-CoronaVac vaccine (28-day interval). Immunogenicity was assessed by anti-SARS-CoV-2 S1/S2 IgG seroconversion (SC), anti-S1/S2 IgG geometric mean titre (GMT), factor increase GMT (FI-GMT), neutralizing antibodies (NAb) positivity, and median neutralizing activity after each vaccine dose (D0 and D28) and six weeks after the second dose (D69). Participants with pre-vaccination positive IgG serology and/or NAb and those with RT-PCR confirmed COVID-19 during the protocol were excluded from immunogenicity analysis.

Results

Patients and CTRL had comparable sex (P>0.99) and age (P=0.90). Immunogenicity of 37 patients and 79 CTRL-naïve participants revealed at D69, a moderate but significantly lower SC (64.9% vs 91.1%, P<0.001), GMT [7.9 (95%CI 4.7–13.2) vs 24.7 (95%CI 30.0–30.5) UA/ml, P<0.001] and frequency of NAb (51.4% vs 77.2%, P<0.001) in SAMs compared with CTRL. Median neutralizing activity was comparable in both groups [57.2% (interquartile range (IQR) 43.4–83.4) vs 63.0% (IQR 40.3–80.7), P=0.808]. Immunosuppressives were less frequently used among NAb+ patients vs NAb- patients (73.7% vs 100%, P=0.046). Type of SAMs, disease status, other drugs or comorbidities did not influence immunogenicity. Vaccine-related adverse events were mild with similar frequencies in patients and CTRL (P>0.05).

Conclusion

Sinovac-CoronaVac is safe and has a moderate short-term immunogenicity in SAMs, but reduced compared with CTRL. We further identified that immunosuppression is associated with diminished NAb positivity.

Trial registration

COVID-19 CoronaVac in Patients With Autoimmune Rheumatic Diseases and HIV/AIDS (CoronavRheum), http://clinicaltrials.gov/ct2/show/NCT04754698
Utilization of Topiramate as an Adjunct to Lifestyle Intervention for Weight Loss in Pediatric Nonalcoholic Fatty Liver Disease
Authors: Kohut Taisa , Serai Suraj , Panganiban Jennifer
Published: October 2021

Nonalcoholic fatty liver disease is the most common chronic liver disease in children and has become the leading indication for liver transplantation in adults. The primary treatment modality is lifestyle modification to promote weight loss, which is challenging to achieve and maintain. Adjunctive weight loss medications, such as topiramate, are commonly used off-label in adults and children with obesity and found to be safe and effective. We report an adolescent male with severe obesity and nonalcoholic steatohepatitis refractory to aggressive lifestyle intervention. He was safely treated with topiramate with resultant weight loss, reduction in body mass index z-score, improvement in liver enzymes, and resolution of hepatic steatosis. This is the first report of using topiramate in a pediatric patient with obesity and nonalcoholic steatohepatitis. Topiramate should be considered in pediatric nonalcoholic fatty liver disease to help curb emotional eating and promote satiety in cases refractory to lifestyle intervention alone.
Baseline Fecal Microbiota in Pediatric Patients With Celiac Disease Is Similar to Controls But Dissimilar After 1 Year on the Gluten-Free Diet
Authors: Sample Dory , Fouhse Janelle , King Seema , Huynh Hien Q. , Dieleman Levinus A. , Willing Benjamin P. , Turner Justine
Published: October 2021

Objectives:

The objectives of this pilot study were to examine fecal microbiota composition of pediatric patients with celiac disease (CD) before and after a 1-year gluten-free diet (GFD) and to determine the association with symptoms and anti-tissue transglutaminase (aTTG) antibody.

Methods:

Stool samples were obtained from pediatric patients with CD and from healthy controls. Patients were classified by the presence (diarrhea, abdominal pain, weight loss) or absence (asymptomatic, headache, fatigue, etc.) of typical CD gastrointestinal symptoms and by aTTG normalization post-GFD intervention (< 7 U/mL). Fecal microbial composition was measured using 16S ribosomal RNA gene amplicon sequencing of the V3–V4 region.

Results:

At diagnosis, 13 of 22 patients with CD had typical gastrointestinal symptoms, the remaining patients having atypical or asymptomatic presentations. After a 1-year GFD, all symptomatic patients improved and 9 of 19 had normalized aTTG. Prior to GFD, no distinct microbial signature was observed between patients and controls (P = 0.39). Post-GFD, patients with CD had a unique microbial signature with reductions in known fiber-degrading bacteria, including Blautia, Dorea, Lactobacillus, and Prevotella compared with controls. Within the patients with CD, microbial composition was not associated with reported symptom presentation or aTTG normalization.

Conclusions:

Pediatric patients with CD only had a unique microbial signature compared with healthy controls when placed on the GFD. These results suggest that pediatric patients with CD may not have a unique fecal microbial signature indicative of inherent dysbiosis, in contrast to that suggested for older patients. In children with CD, diet may play a role in shaping microbial composition more so than disease status.
Association of Fecal Calprotectin With Endoscopic and Histologic Activity in Pediatric Inflammatory Bowel Disease
Authors: Crawford Erin , Gestrich Catherine , Malay Sindhoosha , Young Denise , Perry Sharon , Splawski Judy , Sferra Thomas J. , Saab Shahrazad , Moses Jonathan
Published: October 2021

Objectives:

Fecal calprotectin (FC) is a noninvasive marker of intestinal inflammation used for screening and ongoing monitoring of inflammatory bowel disease (IBD); it is unclear the association of specific FC values with disease activity. The aim of our study was to examine the association of FC values with endoscopic and histologic severity.

Methods:

We performed a retrospective chart review of patients who had FC done between 30 days and 1 day before colonoscopy at our institution. IBD patients were graded using the simple endoscopic score for Crohn’s disease or Mayo endoscopic score for ulcerative colitis. Histologic slides were graded using the Geboes method.

Results:

Three-hundred thirty-one patients were included in the study and 107 had IBD. For endoscopy, median FC was lowest for all IBD patients with no disease (181 μg/g) and highest in severe disease (921 μg/g), with significant difference between no disease and moderate and severe disease (P = 0.019, 0.003), and between mild and severe disease (P = 0.012). For histology, median FC was lowest with no disease (328 μg/g) and highest in severe disease (895 μg/g), with significant difference between no disease and moderate and severe disease (P = 0.021, 0.018). The control population had a significantly lower median FC than the IBD population in endoscopic remission (35.5 versus 181 μg/g; P = 0.018).

Conclusions:

There was a linear increase in FC values associated with increasing disease severity in the undifferentiated IBD cohort. Values for IBD patients in endoscopic remission were significantly different from our control population. FC may be a useful noninvasive marker to assess disease severity.
The Role of Endonasal Endoscopic Skull Base Repair in Posttraumatic Tension Pneumocephalus
Authors: Dalolio Martina , Cordier Dominik , Al-Zahid Saif , Bennett Warren O. , Prepageran Narayanan , Waran Vicknes , Mariani Luigi , Koeppl Ruth , Brand Yves , Roethlisberger Michel
Published: October 2021

Objectives:

Information about the endonasal endoscopic approach (EEA) for the management of posttraumatic tension pneumocephalus (PTTP) remains scarce. Concomitant rhinoliquorrhea and posttraumatic hydrocephalus (PTH) can complicate the clinical course.

Methods:

The authors systematically reviewed pertinent articles published between 1961 and December 2020 and identified 6 patients with PTTP treated by EEA in 5 reports. Additionally, the authors share their institutional experience including a seventh patient, where an EEA resolved a recurrent PTTP without rhinoliquorrhea.

Results:

Seven PTTP cases in which EEA was used as part of the treatment regime were included in this review. All cases presented with a defect in the anterior skull base, and 3 of them had concomitant rhinoliquorrhea. A transcranial approach was performed in 6/7 cases before EEA was considered to treat PTTP. In 4/7 cases, the PTTP resolved after the first intent; in 2/ 7 cases a second repair was necessary because of recurrent PTTP, 1 with and 1 without rhinoliquorrhea, and 1/7 case because of recurrent rhinoliquorrhea only. Overall, PTTP treated by EEA resolved with a mean radiological resolution time of 69 days (range 23–150 days), with no late recurrences. Only 1 patient developed a cerebrospinal fluid diversion infection probably related to a first incomplete EEA skull base defects repair. A permanent cerebrospinal fluid diversion was necessary in 3/7 cases.

Conclusions:

Endonasal endoscopic approach repair of air conduits is a safe and efficacious second-line approach after failed transcranial approaches for symptomatic PTTP. However, the strength of recommendation for EEA remains low until further evidence is presented.
The Biomedical Research Hub: A Federated Platform for Patient Research Data
Authors: Barnes Craig , Bajracharya Binam , Cannalte Matthew , Gowani Zakir , Haley Will , Kass-Hout Taha , Hernandez Kyle , Ingram Michael , Juvvala Hara Prasad , Kuffel Gina , Martinov Plamen , Maxwell J. Montgomery , McCann John , Malhotra Ankit , Metoki-Shlubsky Noah , Meyer Chris , Paredes Andre , Qureshi Jawad , Ritter Xenia , Schumm L. Philip , Shao Mingfei , Sheth Urvi , Simmons Trevar , VanTol Alexander , Zhang Zhenyu , Grossman Robert L.
Published: October 2021

Objective

The objective was to develop and operate a cloud-based federated system for managing, analyzing and sharing patient data for research purposes, while allowing each resource sharing patient data to operate their component based upon their own governance rules. The federated system is called the Biomedical Research Hub (BRH).

Methods

The BRH is a cloud-based federated system built over a core set of software services called framework services. BRH framework services include authentication and authorization, services for generating and assessing FAIR data, and services for importing and exporting bulk clinical data. The BRH includes data resources providing data operated by different entities and workspaces that can access and analyze data from one or more of the data resources in the BRH.

Results

The BRH contains multiple data commons that in aggregate provide access to over 6 PB of research data from over 400,000 research participants.

Discussion and conclusion

With the growing acceptance of using public cloud computing platforms for biomedical research, and the growing use of opaque persistent digital identifiers for datasets, data objects, and other entities, there is now a foundation for systems that federate data from multiple independently operated data resources that expose FAIR APIs, each using a separate data model. Applications can be built that access data from one or more of the data resources.
A Standardized Protocol for Quantifying the Behavioral Dynamics of Food-seeking in Mice
Authors: Ha Dong-Soo , Lee Young Hee , Kim Kyu Sik , Kim You Bin , Choi Hyung Jin
Published: October 2021

Food is generally hidden in a natural environment and require free-living animals to search for it. Although such food-seeking behaviors involve motivation and exploration, previous studies examined food-seeking simply by measuring the time spent in the food zone or the frequency of pursuing food-cued context. Moreover, after discovering food, animals need to taste and smell it in order to evaluate their nutritional value or possible toxicity. However, researchers could not easily distinguish food-seeking from food-evaluating behaviors because food was visible or accessible throughout each test. Herein, we describe a behavioral protocol that triggers animals to show the behavioral dynamics of food-seeking (e.g., navigation, nose-digging, and paw-digging) and that exclusively elicits food-seeking without provoking any other food-evaluating behaviors. First, we prepared an open-field box with the floor covered with bedding. After we hid foods under the bedding of each corner, the test mice were habituated in this arena for four days (pre-test phase). On the next day (test phase), they were placed under the same conditions, but the foods previously hidden were removed. This process enabled the mice to perceive their surroundings as a food-hidden environment, which induced the animal to exhibit sustained food-seeking. In conclusion, the protocol presented here is a powerful method for provoking multiple forms of food-seeking and quantifies food-seeking independently from other food-related behavioral stages.
Modelling the effect of COVID-19 mass vaccination on acute admissions in a major English healthcare system
Authors: Booton RD , Powell AL , Turner KME , Wood RM
Published: October 2021

Background

Managing high levels of severe COVID-19 in the acute setting can impact upon the quality of care provided to both affected patients and those requiring other hospital services. Mass vaccination has offered a route to reduce societal restrictions while protecting hospitals from being overwhelmed. Yet, early in the mass vaccination effort, the possible effect on future bed pressures remained subject to considerable uncertainty. This paper provides an account of how, in one healthcare system, operational decision-making and bed planning was supported through modelling the effect of a range of vaccination scenarios on future COVID-19 admissions.

Methods

An epidemiological model of the Susceptible-Exposed-Infectious-Recovered (SEIR) type was fitted to local data for the one-million resident healthcare system located in South West England. Model parameters and vaccination scenarios were calibrated through a system-wide multi-disciplinary working group, comprising public health intelligence specialists, healthcare planners, epidemiologists, and academics. From 4 March 2021 (the time of the study), scenarios assumed incremental relaxations to societal restrictions according to the envisaged UK Government timeline, with all restrictions to be removed by 21 June 2021.

Results

Achieving 95% vaccine uptake in adults by 31 July 2021 would not avert a third wave in autumn 2021 but would produce a median peak bed requirement approximately 6% (IQR: 1% to 24%) of that experienced during the second wave (January 2021). A two-month delay in vaccine rollout would lead to significantly higher peak bed occupancy, at 66% (11% to 146%) of that of the second wave. If only 75% uptake was achieved (the amount typically associated with vaccination campaigns) then the second wave peak for acute and intensive care beds would be exceeded by 4% and 19% respectively, an amount which would seriously pressure hospital capacity.

Conclusion

Modelling provided support to senior managers in setting the number of acute and intensive care beds to make available for COVID-19 patients, as well as highlighting the importance of public health in promoting high vaccine uptake among the population. Forecast accuracy has since been supported by actual data collected following the analysis, with observed peak bed occupancy falling comfortably within the inter-quartile range of modelled projections.
Effects of Age, Sex, Serostatus and Underlying Comorbidities on Humoral Response Post-SARS-CoV-2 Pfizer-BioNTech Vaccination – A Systematic Review
Authors: Notarte Kin Israel , Ver Abbygail Therese , Velasco Jacqueline Veronica , Pastrana Adriel , Catahay Jesus Alfonso , Salvagno Gian Luca , Yap Eric Peng Huat , Martinez-Sobrido Luis , Torrelles Jordi , Lippi Giuseppe , Henry Brandon Michael
Published: October 2021

With the advent of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, several vaccines have been developed to mitigate its spread and prevent adverse consequences of the Coronavirus Disease 2019 (COVID-19). The mRNA technology is an unprecedented vaccine, usually given in two doses to prevent SARS-CoV-2 infections. Despite effectiveness and safety, inter-individual immune response heterogeneity has been observed in recipients of mRNA-based vaccines. As a novel disease, the specific immune response mechanism responsible for warding off COVID-19 remains unclear at this point. However, significant evidence suggests that humoral response plays a crucial role in affording immunoprotection and preventing debilitating sequelae from COVID-19. As such this paper focused on the possible effects of age, sex, serostatus, and comorbidities on humoral response (i.e., total antibodies, IgG and/or IgA) of different populations post-mRNA-based Pfizer-BioNTech vaccination. A systematic search of literature was performed through PubMed, Cochrane CENTRAL, and Google Scholar. Studies were included if they reported humoral response to COVID-19 mRNA vaccines. A total of 32 studies was identified and reviewed, and the percent difference of means of reported antibody levels were calculated for comparison. Findings revealed that older individuals, the male sex, seronegativity, and those with more comorbidities mounted less humoral immune response. Given these findings, several recommendations were proposed regarding the current vaccination practices. These include giving additional doses of vaccination for immunocompromised and elderly populations. Another recommendation is conducting clinical trials in giving a combined scheme of mRNA vaccines, protein vaccines, and vector-based vaccines.
Quantitative chest CT combined with plasma cytokines predict outcomes in COVID-19 patients
Authors: Carbonell Guillermo , Del Valle Diane Marie , Gonzalez-Kozlova Edgar , Marinelli Brett , Klein Emma , Homsi Maria El , Stocker Daniel , Chung Michael , Bernheim Adam , Simons Nicole W. , Xiang Jiani , Nirenberg Sharon , Kovatch Patricia , Lewis Sara , Merad Miriam , Gnjatic Sacha , Taouli Bachir
Published: October 2021

Despite extraordinary international efforts to dampen the spread and understand the mechanisms behind SARS-CoV-2 infections, accessible predictive biomarkers directly applicable in the clinic are yet to be discovered. Recent studies have revealed that diverse types of assays bear limited predictive power for COVID-19 outcomes. Here, we harness the predictive power of chest CT in combination with plasma cytokines using a machine learning approach for predicting death during hospitalization and maximum severity degree in COVID-19 patients. Patients (n=152) from the Mount Sinai Health System in New York with plasma cytokine assessment and a chest CT within 5 days from admission were included. Demographics, clinical, and laboratory variables, including plasma cytokines (IL-6, IL-8, and TNF-α) were collected from the electronic medical record. We found that chest CT combined with plasma cytokines were good predictors of death (AUC 0.78) and maximum severity (AUC 0.82), whereas CT quantitative was better at predicting severity (AUC 0.81 vs 0.70) while cytokine measurements better predicted death (AUC 0.70 vs 0.66). Finally, we provide a simple scoring system using plasma IL-6, IL-8, TNF-α, GGO to aerated lung ratio and age as novel metrics that may be used to monitor patients upon hospitalization and help physicians make critical decisions and considerations for patients at high risk of death for COVID-19.
Investigating trends in those who experience menstrual bleeding changes after SARS-CoV-2 vaccination
Authors: Lee Katharine MN , Junkins Eleanor J , Luo Chongliang , Fatima Urooba A , Cox Maria L , Clancy Kathryn BH
Published: October 2021

Early in 2021, many people began sharing that they experienced unexpected menstrual bleeding after SARS-CoV-2 inoculation. We investigated this emerging phenomenon of changed menstrual bleeding patterns among a convenience sample of currently and formerly menstruating people using a web-based survey. In this sample, 42% of people with regular menstrual cycles bled more heavily than usual while 44% reported no change after being vaccinated. Among respondents who typically do not menstruate, 71% of people on long-acting reversible contraceptives, 39% of people on gender-affirming hormones, and 66% of post-menopausal people reported breakthrough bleeding. We found increased/breakthrough bleeding was significantly associated with age, systemic vaccine side effects (fever, fatigue), history of pregnancy or birth, and ethnicity. Generally, changes to menstrual bleeding are not uncommon nor dangerous, yet attention to these experiences is necessary to build trust in medicine.

Teaser

Increased bleeding can occur post SARS-CoV-2 vaccines; this study investigates patterns in who experiences these changes.
Regenerative and non-regenerative transcriptional states of the human epicardium: from foetus to adult and back again
Authors: Knight-Schrijver Vincent R. , Davaapil Hongorzul , Ross Alexander , He Xiaoling , Vallier Ludovic , Gambardella Laure , Sinha Sanjay
Published: October 2021

Epicardial activation appears to be required for cardiac regeneration. Although reverting quiescent adult epicardium to an active neonatal or foetal state will likely represent a key therapeutic approach for human cardiac regeneration, the exact molecular differences between human adult and foetal epicardium are not understood. We used single-cell RNA sequencing to compare epicardial cells from both foetal and adult hearts. We found two foetal epicardial cell types, mesothelial and fibroblast-like, with only the mesothelial population present in adults. We also identified foetal-specific epicardial genes associated with regeneration and angiogenesis, and found that adult epicardium may be primed for immune and inflammatory responses. We predict that restoring the foetal epicardial state in human hearts would increase adult angiogenic potential. Finally, we demonstrated that human embryonic stem-cell derived epicardium is a valid model for the foetal epicardium and for investigating epicardial-mediated cardiac regeneration in humans. Our study defines regenerative programs in human foetal epicardium that are absent in the adult, brings human context to animal studies, and provides a roadmap for directing the epicardium in human heart regeneration.