bluuebunny/crossref_metadata_2025 huggingface dataset:
International NGOs and the (Non) Mobilization of Human Rights in the Context of Climate Change
Authors: Lock Rebecca , Vanhala Lisa
Published: May 2022

There is growing recognition that climate change constitutes an unprecedented threat to human rights. Why then do some international NGOs mobilize human rights in the context of climate change whereas others do not? This chapter explores the mobilization of a human rights framing of climate change by five key INGOs. The chapter draws on sociological institutionalist approaches to identify the factors that matter in accounting for variation in the turn to a human rights framing of climate change. We find that while some features of organizational identity—sector, type, mandate, and brand—are often evoked as reasons for the non-engagement with a human rights framing of climate change, none of these factors account for the variation in public-facing engagement that we document. Instead, we find that the way staff perceive an organization’s identity and its fit with the human rights and climate change frame is influential in shaping whether an organization mobilizes on the issue.
Who Develops Sjögren’s?
Authors: Lee Christine H. , Wallace Daniel J.
Published: May 2022

Although Sjögren’s disease is most often diagnosed in women who are of middle age or older, the disease can occur in anyone. In fact, as awareness of this disease increases, it is being increasingly recognized in younger people and in men. In the United States, one in 83 residents has features of Sjögren’s disease. Patients who are diagnosed with Sjögren’s disease are at an increased risk of being diagnosed with additional autoimmune disorders and complications, including lymphoma. Though no geographic, racial, or ethnic features have been associated with Sjögren’s disease, the incidence of autoimmune disease in family members is increased.
The Cost of Living with Sjögren’s
Authors: Bowman Simon J. , Fisher Benjamin
Published: May 2022

Determining the financial cost of Sjögren’s disease to a patient is difficult because it may include a wide range of direct and indirect costs. Direct costs related to Sjögren’s may include doctor’s visits, medications, lab tests, and much more. Indirect costs may include reduced ability to work, disability, and increased insurance premiums. However, the true financial burden can include many additional factors, and the impact on the individual will vary. This chapter explores a variety of studies that have been conducted to determine the financial cost of Sjögren’s and argues for the development of novel therapies to treat the disease.
Environmental Effects
Authors: Wilson Jeffrey W. , Olsson Peter , Mandl Thomas
Published: May 2022

Our environments contribute to our overall health and can sometimes be triggers for autoimmune disease. Common environmental factors include smoking (which is not recommended), viral and bacterial infections, air pollution, and more. Current thinking is that infection plays a role in the pathogenesis in Sjögren’s, and one such infection that has been associated with Sjögren’s disease is Epstein–Barr virus. Exposure to chromium has more recently been linked to an increased risk for Sjögren’s as well. Further research into these and other environmental contributors is needed to elucidate their role in Sjögren’s and to better help patients, practitioners, and researchers to better prevent, manage, and treat this complex disease.
The Internal Organs in Sjögren’s
Authors: Hal Scofield R. , Soliotis Fotini C. , Kassan Stuart S. , Moutsopoulos Haralampos M.
Published: May 2022

In many patients, Sjögren’s disease is largely limited to glandular disease, but some patients will have varying degrees of involvement of the internal organs, such as the heart, lung, kidney, liver, brain, and blood vessels. This involvement may be manifested in the form of pericarditis, interstitial lung disease, renal tubular acidosis, neuromyelitis optica, vasculitis, pleurisy, and complications of the lungs and the peripheral and central nervous systems—among others. To optimize management, the treating physician should be aware of the patient’s symptoms, signs, and physical findings and the relative frequency of these manifestations. Many other autoimmune syndromes coexist with Sjögren’s disease as well.
Management of Depression and Anxiety in Sjögren’s
Authors: Loehr Valerie G. , Sherwood Brown E.
Published: May 2022

Nearly all individuals experience depression and anxiety in their lifetime, but those who have a systemic process such as Sjögren’s are more susceptible to manifesting these symptoms. Inflammation, pain, medication side effects, increased risks for infection, and an altered immune system are exacerbating factors. This chapter discusses treatments for depression and anxiety, such as counseling, improving coping skills, group therapy, strengthening and stretching exercises, and medication. For Sjögren’s patients, sleep hygiene, strategies to minimize pelvic dryness, cognitive–behavioral therapy for brain fog, and working on lifestyle choices are important. Some psychotropic medications worsen dryness, so this should be taken into account. Depression and anxiety in Sjögren’s are very manageable with a team approach where the patient, support system, and treatment providers work together.
Management of Gastrointestinal Manifestations in Sjögren’s
Authors: Shetler Katerina
Published: May 2022

Sjögren’s disease may involve the entire gastrointestinal tract, liver, and pancreas. Sjögren’s patients commonly experience gastroesophageal reflux, difficulty swallowing (dysphagia), issues with gastric emptying, and abdominal pain and bloating. The symptoms may vary from mild to severe. Abnormality in esophageal function and motility is detected in up to 35% of patients with Sjögren’s. Celiac disease occurs in up to 12% of Sjögren’s patients, irritable bowel syndrome (IBS) in 39%, and indigestion (dyspepsia in 65%). Proper evaluation, diagnosis, and treatment will prevent possible complications and will significantly improve the patient’s quality of life. With certain complications, lifestyle choices can help to manage and improve the symptoms.
Management of Gynecologic and Urologic Aspects of Sjögren’s
Authors: Melkonian Rita
Published: May 2022

Sjögren’s patients are at increased risk for a variety of unique gynecologic and urologic complications, and this chapter will discuss a range of these complications. Vaginal dryness and dyspareunia are the most common manifestations of Sjögren’s and can often be successfully treated with topical products. Frequent urinary tract infections can occur. Pregnancy poses its own unique problems, with the potential for fetal heart block or miscarriage connected with antiphospholipid antibodies; a multidisciplinary approach with the rheumatologist, gynecologist, and pediatrician is key to the successful treatment and management of patients with Sjögren’s. The rare manifestation of lichen sclerosus needs to be addressed by the patient’s gynecologist, as this condition can cause severe vulvovaginal atrophy and regression. The pathogenesis of gynecologic manifestations such as premature ovarian failure, endometriosis, amyloidosis, and interstitial cystitis in Sjögren’s patients needs further research.
Management of Lymphoma and Other Cancers in Sjögren’s
Authors: Dunleavy Kieron , Hammitt Katherine M.
Published: May 2022

Five percent to 10% of Sjögren’s patients develop a malignancy, most commonly a non-Hodgkin’s lymphoma. This prevalence is the highest among any autoimmune disorder. The most frequent cancer in Sjögren’s is B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT), which can occur in any mucosal tissue but most often occurs in the salivary glands. About 6% of Sjogren’s-associated lymphomas involve the lung. The risk of lymphoma is associated with environmental and genetic factors as well as infections. Practitioners should evaluate patients for risk factors such as adenopathy, salivary gland swelling, vasculitis, peripheral neuropathy, and fever. Most of the hematologic malignancies are slow-growing and responsive to therapy. Development of cancer in Sjögren’s is complex and most likely involves the interplay of multiple factors. Chronic inflammation and prolonged stimulation of the immune system likely contribute to its development.
Management of Hepatic and Pancreatic Involvement in Sjögren’s
Authors: Johr Chadwick R.
Published: May 2022

Approximately 5% of Sjögren’s patients have involvement of the liver, pancreas, or biliary tree. These include autoimmune hepatitis, biliary cirrhosis, IgG4 syndrome, and scleroderma-related disorders. Diagnosed by laboratory testing (e.g., antimitochondrial or smooth muscle antibodies), imaging, or biopsy, the management includes anti-inflammatory or antifibrotic agents. Infections such as human immunodeficiency virus and hepatitis C are associated with dry eyes and dry mouth but are not a feature of autoimmune Sjögren’s and should be ruled out. Agents used to treat inflammation such as nonsteroidal anti-inflammatory drugs may elevate levels of liver enzymes. It is important to stage a patient’s hepatobiliary status in order to optimize treatment.
Sjögren’s
Authors: Rumpf Teri P. , Epstein Lynn C.
Published: May 2022

Unlike an acute illness with obvious manifestations, Sjögren’s is both invisible and unpredictable, which creates physiologic, psychological, and interpersonal stress for patients. Sjögren’s may vary in its intensity and effects, but there is no cure and it never goes away. Patients with Sjögren’s often look better than they feel, so other people may not believe they are “really” sick. A chronic illness generates stress and uncertainty. Patients do not know what will happen next and can’t predict how they will feel. Anxiety, confusion, frustration, and depression are all common emotions. Challenges brought on by the disease can lead to changes in relationships with family and friends. People may cope well at times, not well at others. Physicians can help validate the changes in patients’ lives and encourage them to maximize a sense of well-being. Despite the challenges, people with Sjögren’s can still lead meaningful, productive lives.
Vaccinations in Sjögren’s
Authors: Brasington Richard D.
Published: May 2022

One of the most important aspects of preventive care is receiving the appropriate vaccinations. This is particularly important for patients with autoimmune disease and compromised immune function, especially those who take immunosuppressive medications. Updating vaccinations is particularly important before receiving some immunosuppressive medications, because these can seriously blunt a person’s response to appropriate vaccination. For Sjögren’s patients, many common vaccinations, including the annual flu vaccine and pneumonia vaccine, are recommended. Other vaccinations, such as those utilizing a live virus, may be dangerous, and individual circumstances should be discussed with a patient’s physician. Sjögren’s patients are encouraged to get a COVID-19 vaccination.
Clinical Trials
Authors: Makara Matthew , Wallace Daniel J.
Published: May 2022

Clinical trials are an important step in advancing medical treatment options for patients and are designed to determine if an intervention is safe and effective. A successful trial requires both the appropriate patient population and trained professionals to ensure the study is carried out and findings are interpreted correctly. Although there are many agents approved for “dry eye,” only two are approved by the U.S. Food and Drug Administration (FDA) for dry mouth related to Sjögren’s. Pilocarpine (Salagen) and cevimeline (Evoxac) were approved 20 years ago. Since then no agent has been given an indication for Sjögren’s, and no agent has been approved to date to treat the systemic manifestations of the disease. This chapter will discuss some of the pros and cons of participating in a clinical trial for both patients and providers as well as the FDA approval process and where things stand regarding trials in Sjögren’s.
Populism and Civil Society
Authors: Arato Andrew , Cohen Jean L.
Published: May 2022

Populism and Civil Society: The Challenge to Constitutional Democracy is a theoretical work that draws on extensive secondary literature as well as comparative analysis of cases. The aim is to assess the significance of what is now a global phenomenon—the populist challenge to constitutional democracy. After defining populism using the methods of immanent criticism and ideal typic construction, the book proceeds to examine the challenge in terms of its four main organizational forms: movement mobilization, political party, government, and regime. It considers the important questions: “why populism?” and “why now?” Without presupposing the authoritarian logic of the phenomenon in the definition, the book seeks to demonstrate this logic through the reconstruction of the main elements used by advocates to identify populism. It shows that authoritarian logic is not fully realized in every empirical form of populism and considers why this is so for many movement and party forms, and even populists “in” government vs. populism as “the” government. We identify the historical examples of the latter as “hybrid” regimes blending authoritarian elements and residual democratic forms. The book then proceeds to consider the uneasy relationship of populism to constitutionalism and presents populism as a form of abusive or instrumental “constitutionalism” often relying on the alleged permanence of the quasi-revolutionary constituent power. It concludes by outlining a non- and anti-populist project of democratization and social justice, distinguishing between the “popular” and the “populist,” and outlining a program based on the plurality of democracies and the rescue of some of left populism’s “host ideologies.”
Anti-Catholicism
Authors: Salazar Greg A.
Published: May 2022

Chapter 3 analyzes the publications resulting from Featley’s debates with prominent Catholic leaders. This chapter examines Featley’s use of patristic tradition in these disputes, the pastoral motivations that underpinned his polemical exchanges, and how Featley strategically issued these polemical publications to counter Catholicism and to promulgate his own alternative version of orthodoxy at several crucial political moments during the 1620s and 1630s. It looks specifically at Featley’s anti-Catholic works, the polemical debates from which these works emerge, and Featley’s strategic publishing of these works. In short, it looks at Featley’s careful, convictional, and somewhat nuanced anti-Catholicism in its historical context.
Pastoral and Practical Theology
Authors: Salazar Greg A.
Published: May 2022

Chapter 5 focuses on how, in the 1620s and 1630s, the themes of prayer and preaching in his devotional work, Ancilla Pietatis, and collection of seventy sermons, Clavis Mystica, were complementary rather than contradictory. It also builds on several of the major themes of the work by examining how pastoral and polemical motivations were at the heart of these works, how Featley continued to be an active opponent—rather than a passive bystander and victim—of Laudianism, and how he positioned himself politically to avoid being reprimanded by an increasingly hostile Laudian regime. An examination of Featley’s political and pastoral sensibilities throughout the 1630s reveals that he endeavored to provide for the perceived pastoral needs of his readers and positioned himself to avoid being reprimanded by an increasingly hostile Laudian regime. His strategic utilization of these tactical maneuvers and survival strategies throughout the 1630s allowed him to navigate the landscape.
Intuitionism and Goodness (Methods I.VIII and I.IX)
Authors: Phillips David
Published: May 2022

This chapter focuses on The Methods of Ethics, Book I, Chapters VIII and IX. Its topics are Sidgwick’s initial discussions of intuitionism and of goodness. The first section discusses the hybrid character of the concept of intuitionism, distinguishing its epistemic from its moral-theoretic component, and C. D. Broad’s coining of the term “deontology” as the name for the moral-theoretic component. The second section discusses Sidgwick’s argument for epistemic intuitionism, whose crucial premises are metaethical non-naturalism and epistemological foundationalism. The third section is a critical discussion of Sidgwick’s distinction between three “phases” of intuitionism: perceptional (sic) intuitionism, dogmatic intuitionism, and philosophical intuitionism. The fourth section discusses Sidgwick’s argument in Chapter IX that goodness is a complex non-natural property. The fifth section discusses his preliminary argument, also in Chapter IX, that nothing is good out of relation to consciousness or feeling.
Utilitarianism and Common-Sense Morality (Methods IV.III, IV.IV, and IV.V)
Authors: Phillips David
Published: May 2022

This chapter focuses on The Methods of Ethics, Book IV, Chapters III, IV, and V. Its topic is Sidgwick’s treatment of the relation between utilitarianism and common-sense morality. The first section unpacks Sidgwick’s complex, multifaceted claim that there is a “positive relation” between utilitarianism and common-sense morality, and explores his argument for the claim in the particular case of promissory obligation. The second section develops a Rossian response. The third section contrasts Sidgwick’s treatment of the relation between utilitarianism and common-sense morality with the contemporary debate between utilitarians and their critics. The fourth section discusses Sidgwick’s arguments against Herbert Spencer’s and Leslie Stephen’s proposals to replace common-sense morality. The fifth section discusses reforming common-sense morality and esoteric morality. The final section is an overview discussion of secondary literature on Sidgwick on consequentialism versus deontology.
The Protection of Human Subjects in Research
Authors: Shamoo Adil E. , Resnik David B.
Published: May 2022

This chapter discusses the history of research with human subjects, giving special attention to trends, cases, and controversies that have helped to shape ethical guidelines and policies, such as the Nazi experiments on concentration camp prisoners, the Tuskegee Syphilis Study, and the Secret Human Radiation Experiments. It discusses important ethics guidelines and codes and provides an overview of the Belmont Report, U.S. federal regulations, and the role of Institutional Review Boards in oversight of human subjects research. The chapter also addresses some key concepts and principles in human research, such as informed consent, risks vs. benefits, privacy and confidentiality, protection of vulnerable subjects, and research versus therapy.
The Misapplied Nexus of Theory and Policy
Authors: Fischerkeller Michael P. , Goldman Emily O. , Harknett Richard J.
Published: May 2022

From the outset of global networked computing, policymakers and strategic thinkers were legitimately concerned about the consequences of cyber capabilities for war and viewed cyberspace through the lens of war. The reality of State behavior and interaction in cyberspace over the past two decades has been quite different from the model of war, catastrophic attack, and coercion upon which many countries base their cyber strategies and policies. Most adversary State-sponsored cyber activity occurs outside armed conflict and has not been primarily coercive in application. Instead, we have seen the persistent use of cyber operations and continuous non-coercive cyber-based exploitation of vulnerabilities organic to and inherent in cyberspace. Cyber persistence theory assumes that exploitation will continue and that a new lexicon of concepts supporting a new theoretical logic is needed to strengthen academic research and to support more effective cyber strategy and policy.
The Workings of Soil in Early English Hagiography
Authors: Fay Jacqueline
Published: May 2022

This chapter focuses on saintly soil: earth infused with the blood of saints that functioned as a primary relic, possessing miraculous powers to heal and avert disaster. The chapter argues that saints’ lives, particularly those of Oswald and Cuthbert, provide a model of ingestion in which the event of the saint’s martyrdom permeates the landscape in the form of blood and is then absorbed into the body of the worshipper who ingests a portion of this sacralized earth, infusing the body with geography and history. As the chapter shows in close readings of posthumous miracles mentioned by Bede and the compiler of the Old English Martyrology, the soil, which nourishes both physically and spiritually, literally composes part of an English body connected, in its fabric, to land and history.
The Iron Horsemen and the End of Times
Authors: Geraci Robert M.
Published: May 2022

The simultaneous rise of artificial intelligence (AI) and transhumanism was key to the science fiction and pop science emergence of Apocalyptic AI in the U.S. and Europe. In the mid-20th century, AI emerged as a science in the U.S. and became critical to American hopes for a new world. Simultaneously, transhumanist thought took root. This chapter describes the rise of Apocalyptic AI within the U.S. and Europe, exploring this through the contributions of four key individuals who provided key scientific, technological, and pop culture interventions. In different ways, each is crucial to the popular belief that human minds might be transferred to machines and the world undergo a transformation from one dominated by biological lifeforms to one inherited by the machines.
Characterization of an Anti-CD70 Half-Life Extended Bispecific T-Cell Engager (HLE-BiTE) and Associated On-Target Toxicity in Cynomolgus Monkeys
Authors: Harper Tod , Sharma Amy , Kaliyaperumal Sarav , Fajardo Flordeliza , Hsu Katie , Liu Lily , Davies Rhian , Wei Yu-Ling , Zhan Jinghui , Estrada Juan , Kvesic Majk , Nahrwold Lisa , Deisting Wibke , Panzer Marc , Cooke Keegan , Lebrec Hervé , Nolan-Stevaux Olivier
Published: May 2022

Bispecific T-cell engager (BiTE) molecules have great potential to treat cancer. Nevertheless, dependent on the targeted tumor antigen, the mechanism of action that drives efficacy may also contribute to on-target/off-tumor toxicities. In this study, we characterize an anti-CD70 half-life extended BiTE molecule (termed N6P) which targets CD70, a TNF family protein detected in several cancers. First, the therapeutic potential of N6P was demonstrated using in vitro cytotoxicity assays and an orthotopic xenograft mouse study resulting in potent killing of CD70+ cancer cells. Next, in vitro characterization demonstrated specificity for CD70 and equipotent activity against human and cynomolgus monkey CD70+ cells. To understand the potential for on-target toxicity, a tissue expression analysis was performed and indicated CD70 is primarily restricted to lymphocytes in normal healthy tissues and cells. Therefore, no on-target toxicity was expected to be associated with N6P. However, in a repeat-dose toxicology study using cynomolgus monkeys, adverse N6P-mediated inflammation was identified in multiple tissues frequently involving the mesothelium and epithelium. Follow-up immunohistochemistry analysis revealed CD70 expression in mesothelial and epithelial cells in some tissues with N6P-mediated injury, but not in control tissues or those without injury. Collectively, the data indicate that for some target antigens such as CD70, BiTE molecules may exhibit activity in tissues with very low antigen expression or the antigen may be upregulated under stress enabling molecule activity. This work illustrates how a thorough understanding of expression and upregulation is needed to fully address putative liabilities associated with on-target/off-tumor activity of CD3 bispecific molecules.
Retinal Findings of Hospitalized Neonates Recovered from COVID-19 Infection: A Prospective, Observational, Descriptive Study
Authors: Aktürk Acar Filiz , Esenülkü Mahmut Cenap , Hekimoğlu Berna
Published: May 2022

Purpose

Coronavirus disease 2019 (COVID-19) that is caused by severe acute respiratory syndrome coronavirus 2 can cause microvascular alterations that can lead to irreversible complications in multiple tissues and organs. Detrimental effects of COVID-19 on retinal structure have recently been reported in adult population. However, literature data about neonatal population is very scarce. Thus, we aimed to assess possible retinal changes of neonates recovered from COVID-19 infection in this prospective, observational, descriptive study.

Methods

The neonates recovered from COVID-19 infection were included to the study between 01 September 2020 and 30 April 2021. Their initial ophthalmological examination was made after a negative real-time reverse transcription-polymerase chain reaction obtained and all patients were re-examined 1 month later. All examinations were performed by same retina specialist using a binocular indirect ophthalmoscopy.

Results

A total of 15 neonates [9 (60%) male, 6 (40%) female, mean gestational age of 38.9 ± 0.9 weeks (ranging from 37 to 40 week)] were evaluated in the study. The mean age at the time of hospitalization was 17.5 ± 8.7 days (ranging from 2 to 29 days), and the mean duration of hospitalization was 12.5 ± 6.2 days (ranging from 4 to 27 days). Except for one patient with bilateral avascular area in Zone-III, no further retinal manifestation related to COVID-19 was found in the study.

Conclusion

COVID-19 infection can cause retinal damage in neonates. Therefore, these patients should be closely monitored for signs of ocular involvement.
Disease Incidence and Severity of Cercospora Leaf Spot in Sugar Beet Assessed by Multispectral Unmanned Aerial Images and Machine Learning
Authors: Barreto Abel , Ispizua Yamati Facundo Ramón , Varrelmann Mark , Paulus Stefan , Mahlein Anne-Katrin
Published: May 2022

Disease incidence (DI) and metrics of disease severity are relevant parameters for decision making in plant protection and plant breeding. To develop automated and sensor-based routines, a sugar beet variety trial was inoculated with Cercospora beticola and monitored with a multispectral camera system mounted to an unmanned aerial vehicle (UAV) over the vegetation period. A pipeline based on machine learning methods was established for image data analysis and extraction of disease-relevant parameters. Features based on the digital surface model, vegetation indices, shadow condition, and image resolution improved classification performance in comparison with using single multispectral channels in 12 and 6% of diseased and soil regions, respectively. With a postprocessing step, area-related parameters were computed after classification. Results of this pipeline also included extraction of DI and disease severity (DS) from UAV data. The calculated area under disease progress curve of DS was 2,810.4 to 7,058.8%.days for human visual scoring and 1,400.5 to 4,343.2%.days for UAV-based scoring. Moreover, a sharper differentiation of varieties compared with visual scoring was observed in area-related parameters such as area of complete foliage (AF), area of healthy foliage (AH), and mean area of lesion by unit of foliage ([Formula: see text]). These advantages provide the option to replace the laborious work of visual disease assessments in the field with a more precise, nondestructive assessment via multispectral data acquired by UAV flights.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Evidence-based Potential Therapeutic Applications of Cannabinoids in Wound Management
Authors: Kibret Berhanu Geresu , Patel Sheel , Niezgoda Jonathan , Guns William , Niezgoda Jeffrey , Gopalakrishnan Sandeep , Baban Babak , Cubillos Paola , Villeneuve David , Kumar Pritesh
Published: May 2022

BACKGROUND

Although wound management is a major component of all domains of healthcare, conventional therapeutics have numerous limitations. The endocannabinoid system of the skin, one of the major endogenous systems, has recently been connected to wound healing. Cannabinoids and their interactions with the endogenous chemical signaling system may be a promising therapeutic option because they address some of the fundamental pathways for physiologic derangement that underpin chronic integumentary wounds.

RECENT ADVANCES

The therapeutic applications of cannabinoids are increasing because of their legalization and resulting market expansion. Recently, their immunosuppressive and anti-inflammatory properties have been explored for the treatment of wounds that are not effectively managed by conventional medicines.

CRITICAL ISSUES

Failure to manage wounds effectively is associated with reduced quality of life, disability, mortality, and increased healthcare expenditures. Therapeutic options that can manage wounds effectively and efficiently are needed. In this review, the authors summarize recent advances on the use of cannabinoids to treat skin disorders with an emphasis on wound management.

FUTURE DIRECTIONS

Effective wound management requires medicines with good therapeutic outcomes and minimal adverse effects. Despite the promising results of cannabinoids in wound management, further controlled clinical studies are required to establish the definitive role of these compounds in the pathophysiology of wounds and their usefulness in the clinical setting.
Posterior Exposure in Kocher–Langenbeck With Gluteus Minimus Debridement vs. the Gibson Approach: A Cadaveric Study
Authors: Vemulapalli Krishna Chandra , Zuelzer David A. , Ahmad Heba A. , Warner Stephen J. , “Chip” Routt Milton L. , Gary Joshua L.
Published: May 2022

Objective:

To quantify the posterior acetabular exposure achieved with the Kocher–Langenbeck (K–L) with gluteus minimus debridement and Gibson approaches.

Methods:

A Kocher–Langenbeck approach and a subsequent Gibson approach on the contralateral hip were performed in the prone position on 9 fresh frozen cadavers. Calibrated digital images were obtained of the Kocher–Langenbeck exposure, Kocher–Langenbeck exposure after gluteus minimus debridement, and Gibson exposure. The surface area of the posterior hip and pelvis visualized with each approach was calculated and compared with the contralateral side to assess for the difference between exposures.

Results:

In 5 of the 9 cadavers, the Kocher–Langenbeck exposure before gluteus minimus debridement yielded an increased exposure in comparison with the Gibson approach, and the exposure was equivocal in 3 specimens. An increase of greater than 10% was considered significant. The exposure increased anteriorly and cranially by an average of 13.1 cm2 after debridement of the gluteus minimus caudal to the superior gluteal neurovascular bundle in the Kocher–Langenbeck approach.

Conclusions:

Debridement of the gluteus minimus caudal to the level of the superior gluteal neurovascular bundle can significantly increase anterior and cranial exposure in the Kocher–Langenbeck approach and provide similar areas of access when compared with that in the Gibson approach.
Histological Transformation and Clonal Relationship of Subcutaneous Marginal Zone B-Cell Lymphoma and Diffuse Large B-Cell Lymphoma
Authors: Abbott James , Corean Jessica , Laggis Caroline , Halwani Ahmad , Toydemir Reha , Miles Rodney , Florell Scott , Wada David
Published: May 2022

Histological transformation (HT) is an exceptionally uncommon and poorly understood event where a low-grade or indolent B-cell lymphoma transforms into a more aggressive entity, typically diffuse large B-cell lymphoma (DLBCL). The pathogenesis is unclear; however, HT is associated with a worse prognosis. This article reports a unique case of marginal zone lymphoma (MZL) limited to skin/subcutis (confirmed with PET-CT) that subsequently developed DLBCL, followed by nodal MZL. We explored phenotypic, molecular genetic, and cytogenetic findings in subcutaneous MZL with HT to DLBCL and subsequent progression to systemic MZL. Shared clonal peaks between the tumors were demonstrated through immunoglobulin heavy chain PCR, and genomic microarray analysis revealed both unique genomic abnormalities and shared regions of copy-neutral loss of heterozygosity in all specimens. BCL-2 expression was present in the original subcutaneous MZL, lost on conversion to Primary cutaneous diffuse large B cell lymphoma (PCDLBCL)-NOS, and regained during subsequent transformation to systemic MZL. The PCDLBCL-NOS did not demonstrate FISH rearrangements for MYC, BCL2, and BCL6. Here, we describe the histologic, immunophenotypic, and cytogenetic abnormalities of the clonally related transformation of subcutaneous MZL, PCDLBCL-NOS, and eventual systemic MZL. The predominantly subcutaneous presentation of MZL may be associated with a more aggressive outcome and raises consideration for careful evaluation of patients who present with this pattern.
Outcomes of embryo vitrification at different developmental stages
Authors: Xu Lizhen , Gao Shanshan , Jiang Jingjing , Sun Mei , Sheng Yan , Tang Rong
Published: May 2022

Introduction:

Advances in cell culture media have led to a shift from cleavage stage embryo transfer to blastocyst stage transfer. Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages. There has been controversy. This study is sought to evaluate the clinical outcomes of vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing Artificial Reproductive Technique treatments.

Material and method:

The study was performed on 2740 women undergoing frozen embryo thawing transfer. Patients’ basic situation, status of frozen embryo transfer cycle, clinical pregnancy rate, early abortion rate, sex ratio of birth, and birth weight were retrospectively analyzed. We compared the main clinical results of recovery of frozen embryo on the cleavage stage and blastocyst stage. Furthermore, we evaluated the clinical outcomes of blastocyst cryopreservation on Day 5, 6, or 7 after oocyte retrieval according to the day of blastocyst expansion were evaluated.

Results:

The implantation ratio of cleavage stage embryos was 21.62% compared with 43.52% on D5 (P < .05). The D5, D6, and D7 implanting rates were statistically different. The pregnancy rates were 57.56%, 51.76%, and 35.95% versus 37.79%, respectively for embryos cryopreserved on D5, D6, D7, and D3. The ectopic pregnancy rate and early abortion rate were statistically different between D5 and D3. The sex ratio, the birth weight, and birth defect were not statistically different among the four groups.

Conclusions:

Blastocyst transfer achieved a higher implantation rate than vitrified cleavage stage embryo and decreased ectopic pregnancy rate. With increased incubation days before expansion blastocyst formed, the implantation rate is reduced and the early abortion rate increases.
Clinical role of miR-421 as a novel biomarker in diagnosis of gastric cancer patients
Authors: Xu Yingying , Wang Guiping , Hu Wenqing , He Songbing , Li Dandan , Chen Ping , Zhang Jinjie , Gao Yongshun , Yu Duonan , Zong Liang
Published: May 2022

Background:

Gastric cancer (GC) has been identified as one of the most common malignancies. It was found that microRNAs can be used as potential biomarkers for GC diagnosis. The aim of this study was to estimate the diagnostic value of 4 potential microRNAs in GC.

Methods:

PubMed, Embase, Cochrane Library, and Web of Science were used to search published studies. The quality of the studies was scored with the Quality Assessment of Diagnostic Accuracy Studies. The pooled sensitivity and specificity, diagnostic odds ratio (DOR) and area under the curve (AUC) were calculated. The heterogeneity was evaluated using Cochrane Q statistics and the inconsistency index.

Results:

A total of 22 studies reporting the diagnostic value of miR-21 (n = 9), miR-106 (n = 10), miR-421 (n = 5) and miR-223 (n = 3) were included. Quality Assessment of Diagnostic Accuracy Studies scores showed the high quality of the selected 22 articles. The random effects model was adopted by evaluating the heterogeneity between articles. The DOR, AUC, and Q value of miRNA-21 were 12.37 (95% confidence interval [CI]: 5.36–28.54), 0.86 and 0.79, respectively. The DOR, AUC and Q value of miRNA-106 were 12.98 [95% CI: 7.14–23.61], 0.85 and 0.78, respectively. The DOR, AUC and Q value of miRNA-421 were 27.86 [95% CI: 6.04–128.48], 0.92 and 0.86, respectively. The DOR, AUC and Q value of miRNA-223 were 18.50 [95% CI: 7.80–43.86], 0.87 and 0.80, respectively. These results indicate that miRNA-421 has the highest diagnostic accuracy, followed by miR-223, miRNA-21, and miRNA-106 among the 4 microRNAs in GC.

Conclusions:

miR-21, miR-106, miR-421, and miR-223 have good diagnostic efficacy, especially miR-421, could be used as auxiliary diagnostic indicator for GC.
Imaging characteristics of slow-growing soft tissue chondroma of the tongue
Authors: Park Yoonsoo , Kim Ha Youn , Yu In-kyu , Jang Dong-Sik , Kim Joo Heon
Published: May 2022

Introduction:

Extraskeletal soft tissue chondroma (STC) is a rare benign tumor. Soft-tissue chondromas rarely occur in the oral cavity. In this study, we aimed to confirm a slow-growing tongue mass using magnetic resonance imaging.

Patient concerns:

A 60-year-old woman presented with a painful, slow-growing tongue mass that had persisted for 17 years. Intraoral examination revealed a pedunculated mass covered with mucosa on the right side of her tongue.

Diagnosis:

CT and MRI revealed a lobulated heterogeneously enhancing mass without calcification. Compared with previous images obtained 17 years prior, the mass presented slow growth, more prominent enhancement, and lobulated contour. Histopathological examination confirmed the presence of STC.

Interventions:

Excision of the mass surrounding normal tissue was performed under general anesthesia.

Outcomes:

During 1-year follow-up period, no recurrence was observed.

Conclusions:

In this study, STC lesions were slow-growing, and changed from weakly homogeneous enhancement and clean margins to markedly heterogeneous enhancement and lobulated margins over time.
Inferior Alveolar Nerve Lateralization Surgery for Implant Installation in Atrophic Posterior Mandible With Accessory Mental Foramen: A Challenge for the Usual Technique
Authors: Yoshimoto Marcelo , Marques Gabriel Bueno , Andrade Maristela , Shinohara Elio Hitoshi
Published: May 2022

Implantology allows edentulous patients to smile and chew with confidence. However, the atrophy at posterior region of the mandible is still a challenge due the presence of the inferior alveolar nerve (iAN). The options of restoration with oral implants in this area with great atrophies are few and hazardous. The possibilities are: bone grafting, short implants, which are not always possible. So, the solution falls on the techniques of inferior alveolar nerve lateralization (IANL) or transposition. The knowledge of the anatomy and path of the IAN is decisive in this type of surgery. But anatomical variations may occur. Like the presence of an accessory mental foramen. This clinical study will present a relatively rare case of the occurrence of an accessory mental foramen that obliged to change the technique of iAN lateralization to contour this anatomical variance and install oral implants, maintaining the integrity of the iAN bundle.
The U-Turn Tournedos (UTT) Flap: A Technical Surgical Evolution for Deep Complex Calvarial Defects
Authors: Lessard Lucie , Zammit Dino
Published: May 2022

Patients treated for complex oncological calvarial defects are at a higher risk of severe complications (38%): infection, meningitis, dehiscence, and hardware/brain exposure. The patient cohorts at our center have led to the development of the “U-Turn” technical (UTT) addition of our previously reported turnover “tournedos” myocutaneous latissimus dorsi free flap. This allows for an improved ability to fill these large, round, complex defects, maintaining the safety of our original surgical technique, while improving aesthetic outcomes.

A single-institution case series of complex microsurgical reconstructions for full-thickness oncologic calvarial defects using the UTT addition was reviewed. A free 30 cm latissimus dorsi myocutaneous flap was harvested, deepithelialized in-situ, and turned over with the dermal component laying on the avascular reconstructed dura. Both ends were positioned next to each other into a U shape and sutured together, creating a 15 cm round paddle.

Fifty two complex microsurgical procedures for oncological calvarial defect reconstruction were performed. The 7 most recent were ideal for the UTT addition. There were no instances of microvascular thrombosis, infection, cerebral spinal fluid leak, or major wound healing problems. All procedures provided stable volume and full coverage, with all patients requiring debulking and contouring to achieve optimal aesthetic results. All flaps remained stable after debulking.

The UTT addition takes the previously established “tournedos” latissimus dorsi free flap to another level of reconstruction, providing a larger volumetric filler, round shape, better defect filling, better durability, and better aesthetics, even in irradiated and/or infected calvarial chronic wound bed.
Does BMI Matter? A 10-Year Single Institutional Experience on 571 Bariatric Surgery Patients With BMI >50 kg/m2
Authors: Badaoui Joseph N. , Maroun Justin W. , Oyefule Omobolanle O. , Mandrekar Jay , McKenzie Travis J. , Kendrick Michael L. , Kellogg Todd A. , Ghanem Omar M.
Published: May 2022

Introduction:

Patients undergoing bariatric surgery with body mass index (BMI) >50 kg/m2 are at a higher risk of surgical morbidity when compared with less obese patients, however, there is limited data correlating surgical risk and efficacy with increasing BMI in patients with severe obesity. We hypothesize that regardless of the degree above 50 kg/m2 their BMI, patients with severe obesity respond similarly to bariatric surgery.

Materials and Methods:

We performed a retrospective analysis of patients with BMI >50 kg/m2 who underwent biliopancreatic diversion with duodenal switch, Roux-en-Y gastric bypass, or sleeve gastrectomy at a single institution. Outcomes were compared in patients with a BMI between 50 and 60 kg/m2 to patients with a BMI >60 kg/m2 and included percent total weight loss as well as early and late complications. Statistical analyses were performed using logistic regression, univariate, and multivariate models.

Results:

There were 571 patients with BMI >50 kg/m2 who underwent bariatric surgery at our center, 170 (29.8%) had a BMI >60 kg/m2. Percent total weight loss was statistically significant between the BMI 50 and 60 kg/m2 and BMI >60 kg/m2 groups at 24 months (P=0.047) but not at 60 months (P=0.54). No significant difference was found in the incidence of early complications in a univariate (P=0.46) or a multivariate (P=0.06) analysis. The BMI >60 subgroup was associated with a higher rate of late complications in univariate analysis (heart rate=2.37; 1.03-5.47, P=0.04), but not in multivariate analysis (P=0.78).

Conclusions:

Efficacy and complication rates of bariatric surgeries are similar in patients with BMI 50 to 60 kg/m2 and >60 kg/m2, providing evidence supporting similar management of patients despite specific subgroups.
Beneficial Effect of Repetitive Transcranial Magnetic Stimulation Combined With Physiotherapy After Cervical Spondylotic Myelopathy Surgery
Authors: Farrokhi Majid R. , Salehi Sina , Nejabat Negar , Safdari Mohammad , Ramezani Abadeh Hosein
Published: May 2022

Purpose:

Cervical spondylotic myelopathy (CSM) is one of the most notable causes of spinal cord impairment among elderly people worldwide. Little is written about the influence of postoperative rehabilitation on recovery of function in patients with CSM. In this study, we assessed the combined effects of repetitive transcranial magnetic stimulation (rTMS) combined with physiotherapy and physiotherapy alone on motor and sensory improvement assessed after spinal cord decompression in patients with CSM.

Methods:

This prospective study comprised 52 patients with CSM; they were divided into two randomized groups after spinal cord decompression. The first group (group Ι) includes 26 patients, received a combination of rTMS and physiotherapy. The second group (group ΙΙ) of 26 patients underwent only physiotherapy. The neurologic assessment measures, including American Spinal Cord Injury Association score, modified Japanese Orthopaedic Association score, Ashworth scale, and Nurick grade, were recorded before and after rehabilitation interventions for each patient.

Results:

According to the neurologic assessment measures, physiotherapy with/without rTMS after surgical decompression corresponded to significant improvement of motor function (P < 0. 01) without significant restoration of sensory function (P > 0. 01). Recovery rates of motor function were significantly better in group Ι than in group ΙΙ (P < 0. 01). There was no significant difference between two groups with respect to age (P = 0.162) and sex (P = 1.00).

Conclusions:

Although physiotherapy with/without rTMS improves motor function recovery after CSM surgery, rTMS in combination with physiotherapy leads to a more rapid motor function recovery than physiotherapy alone.
Waves in the Earth's core. II. Magneto–Coriolis modes
Authors: Luo Jiawen , Marti Philippe , Jackson Andrew
Published: May 2022

We investigate the normal modes of a rapidly rotating, electrically conducting, inviscid fluid sphere in the presence of a background magnetic field. Neglecting the fast modes that are essentially slightly modified inertial waves, we focus on the slower branch of modes traditionally called magneto–Coriolis (MC) modes. We focus on the magnetostrophic limit, an approximation that neglects the fluid inertia for these modes by setting the magnetic Rossby numberEηequal to zero, converting the momentum equation from a prognostic to a diagnostic equation. In contrast to a local analysis and contrary to previous assertions, this inertialess-inviscid double limit is perfectly well behaved and shows thatEη→0andEη=0are essentially identical. With applied axisymmetric background fields, we find the modes are critically damped, with decay rates greater than or equal to the eigenfrequency, in contrast to the local theory. We find evidence for both eastward and westward propagating columnar modes, in contradiction of commonly perceived wisdom. The results bode well for numerical time integrations based on the magnetostrophic approximation, which is highly suited to the core of the Earth and holds the potential for more realistic solutions of the dynamo equations.
Stress axis programming generates long-term effects on cognitive abilities in a cooperative breeder
Authors: Reyes-Contreras Maria , Taborsky Barbara
Published: May 2022

The ability to flexibly adjust behaviour to social and non-social challenges is important for successfully navigating variable environments. Social competence, i.e. adaptive behavioural flexibility in the social domain, allows individuals to optimize their expression of social behaviour. Behavioural flexibility outside the social domain aids in coping with ecological challenges. However, it is unknown if social and non-social behavioural flexibility share common underlying cognitive mechanisms. Support for such shared mechanism would be provided if the same neural mechanisms in the brain affected social and non-social behavioural flexibility similarly. We used individuals of the cooperatively breeding fish
Neolamprologus pulcher
that had undergone early-life programming of the hypothalamic–pituitary–interrenal axis by exposure to (i) cortisol, (ii) the glucocorticoid receptor antagonist mifepristone, or (iii) control treatments, and where effects of stress-axis programming on social flexibility occurred. One year after the treatments, adults learned a colour discrimination task and subsequently, a reversal-learning task testing for behavioural flexibility. Early-life mifepristone treatment marginally enhanced learning performance, whereas cortisol treatment significantly reduced behavioural flexibility. Thus, early-life cortisol treatment reduced both social and non-social behavioural flexibility, suggesting a shared cognitive basis of behavioural flexibility. Further our findings imply that early-life stress programming affects the ability of organisms to flexibly cope with environmental stressors.