bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed tomography angiographic parameters of pulmonary artery as prognostic factors of residual pulmonary hypertension after pulmonary endarterectomy
Authors: Niznansky Matus , Kavan Jan , Zemankova Petra , Prskavec Tomas , Ambroz David , Jansa Pavel , Lindner Jaroslav
Published: March 2021

Objectives

This study aimed to retrospectively assess using computed tomography pulmonary angiography (CTPA) for predicting residual pulmonary hypertension (RPH) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA).

Methods

We retrospectively analyzed data of 131 patients with CTEPH who underwent PEA in our center (2008–2015). We measured several diameters of the pulmonary artery and thoracic aorta preoperatively. We evaluated the relationship between these measurements (and their indices) and signs of RPH represented by pulmonary artery systolic pressure (PASP) estimated by echocardiography.

Results

Significant correlations were observed between the aortopulmonary index and prediction of any residual hypertension and moderate/severe hypertension 1 year after PEA, and any residual hypertension and severe hypertension 2 years after PEA. The aortopulmonary index was significantly related to a reduction in PASP 1 year after the operation. A lower aortopulmonary index (≤0.88 for the ascending aorta and ≤0.64 for the descending aorta) predicted lower RPH.

Conclusions

Preoperative CTPA parameters can be used to assess the risk of RPH after PEA. The aortopulmonary index has significant predictive value for RPH and a reduction in PASP after PEA. Lower values of the aortopulmonary index suggest a better outcome after PEA.
Application of material flow analysis for the assessment of current municipal solid waste management in Karachi, Pakistan
Authors: Aslam Shiza , Ali Faizan , Naseer Amna , Sheikh Zeshan
Published: March 2021

This article assesses the status of the solid waste management system (SWMS) in Karachi, the largest city of Pakistan, using the material flow analysis approach, a widely applied method in waste management (WM) studies. It involves a systematic assessment of the material flows of solid waste under the current WM system. A material flow diagram is developed to visualize the input and output waste flows. This study shows the quantification and identification of municipal solid waste (MSW) flow for the year 2019, from the point of generation to the end-use and disposal. Results show that the MSW generation increased from 10,435 to 15,600 metric tonnes per day (TPD) between 2017 to 2019. Approximately, 75% of the waste generated is collected: formally (50%); and informally (25%). The material recovery is low, accounting for only 26.28% of the total waste. There is no official material recovery and recycling facility. Therefore, material recovery solely depends on the informal sector. Results show that 70% of the daily waste ends up in landfills, which is 3120 TPD more than the formally collected waste. This estimated waste of 3120 TPD flows in either due to disposal activities of the backlogged waste or informally collected waste. Overall, Karachi’s SWMS performs poorly with a significant need for improvement. This study recommends adopting integrated WM approaches and inclusion of the informal sector to ensure the affordability and sustainability of the WM system.
Unwanted Housing: Localism and Politics of Housing Development
Authors: Manville Michael , Monkkonen Paavo
Published: March 2021

We examine pervasive opposition to building market-rate housing and relate it to localism: a perspective that grants moral authority to incumbent residents. We argue that localism has become prevalent in housing planning in the United States and that its seeming equality—allowing all communities the right to define themselves—conceals profound imbalances that favor the affluent. We use survey data from California to measure localism, using opposition to state land use preemption as a proxy. We find that localism is concentrated among white, affluent homeowners. This suggests that localist beliefs are less prevalent in the population than they are in planning practice.
Risk Factors of Acute Kidney Injury in ECMO Patients: A Systematic Review and Meta-Analysis
Authors: Mou Zhixiang , Guan Tianjun , Chen Lan
Published: March 2021

Purpose:

Acute kidney injury (AKI) is one of the most common complications in patients receiving extracorporeal membrane oxygenation (ECMO), but there is no systematic analysis regarding its risk factors. This meta-analysis aims to determine the risk factors of AKI in adult patients with ECMO treatment.

Methods:

Two authors independently carried out a systemic literature search using PubMed, Web of Science, and Embase until April 20, 2020 (inclusive) to enroll 12 studies reporting the necessary clinical characteristics. The Gender (male), age, APACHE II score, SOFA score, cancer, diabetes mellitus (DM), intra-aortic balloon pump (IABP), postcardiotomy, and ECMO supporting duration were pooled for further analysis by STATA.

Results:

Adult patients receiving ECMO who develop AKI and severe AKI incidents are usually older or have a higher APACHE II scores; in addition, severe AKI is related to higher SOFA scores, DM, and longer duration of ECMO support.

Conclusions:

Patients with these clinical characteristics should be paid more attention during ECMO. There remains a need for additional studies to validate these conclusions and to detect additional AKI risk factors for ECMO patients.
Improving Efficiency of Apparel Manufacturing Through the Principles of Resource Management
Authors: Fatima Anis , Tufail Muhammad
Published: March 2021

To gain the competitive advantage, it has become essential for manufacturing industry to use its resources effectively, efficiently and economically. It is required to understand that such resources are based on 5 Ms (manpower, methods, materials, money, and machinery). In this study an apparel industry was selected to create a directorial plan by using the ideologies of resource management to improve the process efficiency. For this the data related to the product layout, operation plan, and process flow was collected. Time motion study was performed for aspect analysis. Information regarding operation, number of machines and efficiency of the production line was evaluated. The proposed plan successfully increase the efficiency up to 10%. It also shows an improvement in effective utilization of manpower and money.
Improving the efficiency of sediment charcoal image analysis
Authors: Umbanhowar Charles E , Umbanhowar James A
Published: March 2021

Imaging of charcoal particles extracted from lake sediments provides an important way to understand past fire regimes. Imaging of large numbers of particles can be time consuming. In this note we explore the effects of subsampling and extrapolation of area on estimates of sum charcoal area, using resampling of real and simulated data sets and propose a protocol in which all particles are counted with only the first 100 encountered being imaged. Extrapolated estimates of sum total area of charcoal for 40 real samples were nearly identical to actual values, and error introduced due to subsampling was low (Coefficient of variation <0.2) for all but samples originally containing fewer than 50 particles. Similarly, error was low for simulated data (CV <0.02). Extrapolation provided better estimates of charcoal area than did a regression-based approach. Our results suggest that imaging a fixed number of pieces of charcoal ( n = 100) and counting any additional pieces represents a time efficient way to estimate charcoal area while at the same time retaining useful information on particle size and shape
Dating the origins of persistent oak shrubfields in northern New Mexico using soil charcoal and dendrochronology
Authors: Roos Christopher I , Guiterman Christopher H
Published: March 2021

Megafires in dry conifer forests of the Southwest US are driving transitions to alternative vegetative states, including extensive shrubfields dominated by Gambel oak ( Quercus gambelii). Recent tree-ring research on oak shrubfields that predate the 20th century suggests that these are not a seral stage of conifer succession but are enduring stable states that can persist for centuries. Here we combine soil charcoal radiocarbon dating with tree-ring evidence to refine the fire origin dates for three oak shrubfields (<300 ha) in the Jemez Mountains of northern New Mexico and test three hypotheses that shrubfields were established by tree-killing fires caused by (1) megadrought; (2) forest infilling associated with decadal-scale climate influences on fire spread; or (3) anthropogenic interruptions of fire spread. Integrated tree-ring and radiocarbon evidence indicate that one shrubfield established in 1664 CE, another in 1522 CE, and the third long predated the oldest tree-ring evidence, establishing sometime prior to 1500 CE. Although megadrought alone was insufficient to drive the transitions to shrub-dominated states, a combination of drought and anthropogenic impacts on fire spread may account for the origins of all three shrub patches. Our study shows that these shrubfields can persist >500 years, meaning modern forest-shrub conversion of patches as large as >10,000 ha will likely persist for centuries.
What Does It Mean To Be Pemphigus Patient? A Qualitative Study
Authors: Okcin Figen , Ugur Ozlem
Published: March 2021

This study aims to provide a closer examination of the problems experienced by individuals with pemphigus vulgaris with their eyes and experiences. This is a phenomenological study. The study population was completed with eight people with pemphigus vulgaris who applied to the dermatology clinic of a university hospital in a metropolis between September 2019 and March 2020. The interviews were transcribed and analyzed using phenomenological methods. Three main themes emerged and nine supporting sub-themes were identified. The main themes are (a) the physical problems they are experiencing now, (b) the psychological difficulties they are feeling now, and (c) intense future anxiety about the process and the future. This study will increase the understanding of the lived experiences of pemphigus vulgaris patients, increase the awareness of each nurse about these patients and will be able to provide better quality care to individuals with pemphigus vulgaris.
The Nexus of Homelessness and Incarceration: The Case of Homeless Men in Trenton, NJ
Authors: Adler Rachel H.
Published: March 2021

This article explores the nuanced connections between homelessness and incarceration as told through life stories of homeless men in Trenton, New Jersey. A recurrent theme in the stories was the experience of incarceration. This cycle of male homelessness and incarceration has its origins in the structural conditions of poverty, discrimination, and unemployment in Trenton. It is self-replicating because of a cultural process in which people learn and repeat how to engage with the world. Men copy other men; this is how they learn gender. If fathers or other positive male role models are absent, men are prone to learn gender from idealized, hypermasculine images that feed into the cycle of male homelessness and incarceration. When incarcerated men leave prison and return home to fatherless families and impoverished inner city neighborhoods, this has an adverse impact on them, which has an impact on the dynamics of those families and neighborhoods.
Role Model or Role Expansion? Popular Perceptions of the Military in Tunisia
Authors: Albrecht Holger , Bufano Michael , Koehler Kevin
Published: March 2021

This article introduces a theory on military role expansion in emerging democracies and poses a broad question: who wants the military to adopt which role in society and politics? Drawing on an original, nationally representative survey conducted in Tunisia, the article explores people’s preferences for the military to remain a security provider or serve in government and contribute to policing protests. Findings reveal that public support for military role expansion is substantial and varies across political cleavages. We test hypotheses to account for cleavages driven by the country’s authoritarian past versus partisan divides during Tunisia’s transition to democracy. Findings indicate that popular support for military role expansion is driven by anti-system sentiments prevalent in contemporary Tunisian politics: while voters prefer the military as a role model for security provision, non-voters support its enhanced role in politics. These observations have ample implications for the research programs on civil–military relations and the dynamics of democratic consolidation. Tunisia’s experience warrants greater attention to anti-system attitudes caused by people’s disillusionment with democratic procedures. In turn, authoritarian legacies do not appear to play a prominent role during such challenging transitions toward democratic consolidation.
Addressing Transactional Distance Through Teaching Presence Strategies in Online Journalism and Mass Communication Courses
Authors: Delaney Brian , Betts Kristen
Published: March 2021

This multiple case study of four journalism and mass communication programs examines teaching presence as a mechanism for mitigating transactional distance in online learning environments. This study explores instructor-to-student communication strategies and techniques utilized by experienced online journalism and mass communication educators, and the contributions of instructional designers in collaborative course design and delivery settings. Six emergent themes are identified and discussed. Recommendations for journalism and mass communication educators, including administrators, are provided.
Modeling and Molecular Dynamic Simulation of F(ab′)2 Fragment of Nimotuzumab for Lung Cancer Diagnostics
Authors: Sastyarina Yurika , Firdaus Ade Rizqi Ridwan , Nafisah Zuhrotun , Hardianto Ari , Yusuf Muhammad , Ramli Martalena , Mutalib Abdul , Soedjanaatmadja Ukun MS
Published: March 2021

Lung cancer is one of the leading causes of cancer-related deaths in the world among both men and women. Several studies in the literature report that overexpression and mutation of the epidermal growth factor receptor (EGFR) are implicated in the pathogenesis of some lung cancers. Nimotuzumab is a humanized monoclonal antibody (mAb) that inhibits EGF binding because it binds to the extracellular domain of the EGFR. Nimotuzumab requires bivalent binding for stable attachment to cellular surface, which leads to nimotuzumab selectively binding to cells that express mAbs of moderate to high EGFR levels, and this could explain its low toxicity. This property has an advantage for development of nimotuzumab as a therapeutic and diagnostic agent. Monoclonal antibodies are large in size (150 kDa), thus penetrating slowly and residing in the blood for extended periods of time (from days to weeks); their use in imaging studies can result in low signal-to-background ratios and poor image quality. A reduction in the size of the immunoglobulin molecule has also been proposed as a means for increasing tumor penetration by mAbs. Nevertheless, it is known that the penetration of mAb into tumor cell is slow, due to its high molecular weight. Therefore, mAb is not very attractive to be used for imaging diagnostic purpose because of its kinetics and potential to elicit antibody response. The objective of this research was to study the homology modeling of a simpler functional molecule based on nimotuzumab, which consists of 2 antigen-binding fragments (Fab), namely, F(ab′)2, using MODELER. The crystal structure of Fab of nimotuzumab from protein data bank was used as a template to construct the model of F(ab′)2. Molecular dynamic simulation was performed to evaluate the stability of F(ab′)2 and conformational changes of F(ab′)2 in simulation. The result showed the dynamic behavior of antigen-binding site region of F(ab′)2 throughout simulation. This result is expected to be useful in the further development of F(ab′)2 fragment nimotuzumab as a lung cancer diagnostic.
Food and White Multiculturalism: Racial Aesthetics of Commercial Gentrification in Amsterdam’s Javastraat
Authors: Fiore Elisa , Plate Liedeke
Published: March 2021

In this article, we use Hage’s (2000) critique of White multiculturalism’s orientalizing logic of ethnic enrichment as a lens to analyze the multicultural valorization through ethnic food of the Javastraat, the commercial artery of Amsterdam’s Indische Buurt district. Stemming from a larger ethnographic study of gentrification in the area, the article provides evidence of how racial aesthetics have served as the central guiding principle in the transformation of the neighborhood from a dark space of grime, crime, and decay to the current space of hipness, coolness, and global culture. While being celebrated as a living example of multicultural society in the inner city, we argue that the area embodies a multicultural reality in which White, middle-class residents, and visitors are the prime occupiers of space and aesthetic organizing principle of the neighborhood’s landscape.
Impact of COVID-19 on multiple sclerosis care and management: Results from the European Committee for Treatment and Research in Multiple Sclerosis survey
Authors: Portaccio Emilio , Fonderico Mattia , Hemmer Bernhard , Derfuss Tobias , Stankoff Bruno , Selmaj Krzysztof , Tintorè Mar , Amato Maria Pia
Published: March 2021

Background:

The spread of Coronavirus disease-19 (COVID-19) poses unique challenges in the management of people with multiple sclerosis (PwMS).

Objectives:

To collect data about the impact of COVID-19 emergency on access to care for PwMS and on MS treatment practices.

Methods:

Between March and July 2020, the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) promoted an online survey covering patient access to care, management of relapses and visits, disease-modifying therapy (DMT) and experience with COVID-19.

Results:

Three-hundred and sixty neurologists from 52 countries (68% from Europe) completed the survey. 98% reported COVID-19-related restrictions. Telemedicine was adopted to overcome the limited access to care and was newly activated (73%) or widely implemented (17%). 70% reported changes in DMT management. Interferons and glatiramer were considered safe. Dimethyl fumarate, teriflunomide and fingolimod were considered safe except for patients developing lymphopenia. No modifications were considered for natalizumab in 64%, cladribine in 24%, anti-CD20 in 22% and alemtuzumab in 17%; 18% (for alemtuzumab and cladribine) and 43% (for anti-CD20) considered postponing treatment.

Conclusion:

The ECTRIMS survey highlighted the challenges in keeping standards of care in clinical practice. Telemedicine clearly needs to be implemented. Gathering data on DMT safety will remain crucial to inform treatment decisions.
Perfect timing: Leveraging the timing of defection to assess the effect of electoral rules on party switching
Authors: Radean Marius
Published: March 2021

When legislators switch parties between elections this may be viewed as undemocratic since, bypassing voters, they are changing the outcomes of elections. Do electoral institutions affect the likelihood of party switching? I argue that legislators are less likely to switch in candidate-centered electoral systems where, because of personal voting, parties cannot insulate defectors from voter retribution. When they switch though, legislators do so early in the term to exploit voters’ short retrospective time horizon. These expectations are tested using a quasi experimental research design that estimates the effect of the 2008 Romanian electoral reform on party switching. In 2008 Romania changed its electoral system from a closed-list PR to a candidate-centered electoral system, where all candidates compete in single-member districts. Both hypotheses are supported by empirics. This helps weed out competing explanations which now have to account for both the decrease in and the different timing of party switching.
Mortality trends for young adults in Sweden in the years 2000–2017
Authors: Ågren Gunnar , Bremberg Sven
Published: March 2021

Aim:

Mental health problems in young people seem to be on the rise and more so in Sweden than in other locations. The aim was to compare the development of mortality rates for young adults in Sweden with Western Europe in total.

Methods:

Young adults were defined as individuals aged 20–34 years and the study period was 2000–2017. Mortality data were derived from the Institute of Health Metrics and Evaluation.

Results:

During the period 2000–2017, the mortality rate in young adults in Sweden stayed about the same, while in Western Europe as a whole the mortality rate decreased by 42%. The leading explanation for the unfavourable Swedish development was deaths due to drug use, mainly opioids, which increased by 60% during this period. The other major causes of death decreased both in Sweden and Western Europe, but decreased more slowly in Sweden. The differences in the rate of decrease between Sweden and Western Europe were for self-harm (27%), transport injuries (12%), unintentional injuries (31%) and for neoplasms (23%). The unfavourable development in Sweden resembled the development in the USA.

Conclusions:

The risks of four of the five leading causes of death in this age group were affected by the individuals’ social conditions. The unfavourable mortality development in young adults in Sweden was mainly due to substance use. A contributing cause might be the change in the Swedish healthcare system that introduced competition between providers, which might have encouraged providers to prescribe opioids.
The heroes’ children: Rescuing the Great War’s orphans
Authors: Kind-Kovács Friederike
Published: March 2021

World War I and its aftermath produced a particularly vulnerable group of child victims: war orphans. This group included children whose fathers had fallen in battle, who had disappeared, or who had not (yet) returned home. Most of Europe’s war and postwar societies witnessed the massive presence of these child victims, and responded in various ways to rescue them and secure their future survival. This article offers an exploration of the ways in which the Hungarian part of the Austro-Hungarian monarchy, and then later the post-imperial Hungarian state, became invested in providing care and relief to Hungarian war orphans. In contrast to other groups of child victims, whose parents were blamed for neglecting their parental duties, war orphans as the offspring of ‘war heroes’ profited from the public appreciation of their fathers’ sacrifice for the war effort and the Hungarian nation. The public discourse in the contemporary Hungarian media offers a glimpse into the emergence of a new public visibility of these child victims and of a new recognition of the societal obligation to care for them. Exploring World War I and its aftermath as a telling example of political transformation in the 20th century, the article showcases how war orphans were taken to personify essential notions of war- and postwar destruction, while also capturing visions of postwar recovery. It furthermore examines how welfare discourses and relief practices for Hungary’s war orphans were embedded in contemporary gender norms, notions of proper Christian morality and ethnic nationalism. On this basis, the article assesses the ways in which the case of Hungary’s war orphans not only mirrors the professionalization but also the fundamental transformation of child welfare in the aftermath of World War I.
A reconfigurable soft wall-climbing robot actuated by electromagnet
Authors: Zhang Wendong , Zhang Wen , Sun Zhenguo
Published: March 2021

This article demonstrates a reconfigurable soft wall-climbing robot actuated by electromagnet. The robot follows the earthworm movement gait and is capable of translation, deflection, and rotation movement while working on a sloping ferromagnetic wall. Also the electromagnetic actuator provides a significant improvement in expeditiousness compared with existing actuation modes. The speed of the robot can be adjusted by modulating the power frequency. When the period of motion cycle is 30 ms, the speed is about 26.5 mm s−1, and the robot can rotate with a velocity of 14.1° s−1 on the horizontal plane. It can also climb a vertical wall at the speed of 12.6 mm s−1. The robot is composed of two kinds of modules which can be connected by the magnets embedded. It can also be reconfigured in different working conditions, such as crossing an inaccessible gap, and thus has the potential to be used in flaw detection, surface cleaning, and exploration of ferromagnetic structures.
Helping the waiter to hold his tray: Rigid haptic linkage promotes inter-personal motor coordination
Authors: Ferreiro Dardo N , Frith Chris D , Bahrami Bahador
Published: March 2021

When a glass is lifted from a tray, there is a challenge for the waiter. He must quickly compensate for the reduction in the weight of the tray to keep it balanced. This compensation is easily achieved if the waiter lifts the glass himself. Because he has, himself, initiated the action, he can predict the timing and the magnitude of the perturbation of the tray and respond (via the holding hand) accordingly. In this study, we examined coordination when either one or two people hold the tray while either one of them or a third person removes the glass. Our results show that there is exquisite coordination between the two people holding the tray. We suggest that this coordination depends upon the haptic link provided by the rigid platform that both people are holding. We conclude that the guest at a reception should not lift his drink from the waiter’s tray until they have the waiter’s attention but, if too thirsty to wait, should lend a hand holding the tray.
Embodied mental imagery improves memory
Authors: Marre Quentin , Huet Nathalie , Labeye Elodie
Published: March 2021

According to embodied cognition theory, cognitive processes are grounded in sensory, motor, and emotional systems. This theory supports the idea that language comprehension and access to memory are based on sensorimotor mental simulations, which does indeed explain experimental results for visual imagery. These results show that word memorisation is improved when the individual actively simulates the visual characteristics of the object to be learned. Very few studies, however, have investigated the effectiveness of more embodied mental simulations, that is, simulating both the sensory and motor aspects of the object (i.e., motor imagery) from a first-person perspective. The recall performances of 83 adults were analysed in 4 different conditions: mental rehearsal, visual imagery, third-person motor imagery, and first-person motor imagery. Results revealed a memory efficiency gradient running from low-embodiment strategies (i.e., involving poor perceptual and/or motor simulation) to high-embodiment strategies (i.e., rich simulation in the sensory and motor systems involved in interactions with the object). However, the benefit of engaging in motor imagery, as opposed to purely visual imagery, was only observed when participants adopted the first-person perspective. Surprisingly, visual and motor imagery vividness seemed to play a negligible role in this effect of the sensorimotor grounding of mental imagery on memory efficiency.
Lenvatinib, toripalimab, plus hepatic arterial infusion chemotherapy versus lenvatinib alone for advanced hepatocellular carcinoma
Authors: He Min-Ke , Liang Run-Bin , Zhao Yang , Xu Yu-Jie , Chen Huan-Wei , Zhou Yuan-Min , Lai Zhi-Cheng , Xu Li , Wei Wei , Zhang Yao-Jun , Chen Min-Shan , Guo Rong-Ping , Li Qi-Jiong , Shi Ming
Published: March 2021

Background:

Lenvatinib is the first-line treatment for advanced hepatocellular carcinoma, but prognosis is still unsatisfactory. Recently, hepatic arterial infusion chemotherapy (HAIC), and immune checkpoint inhibitors showed promising results for advanced hepatocellular carcinoma. Considering different anti-malignancy mechanisms, combining these three treatments may improve outcomes. This study aimed to compare the efficacy and safety of lenvatinib, toripalimab, plus HAIC versus lenvatinib for advanced hepatocellular carcinoma.

Methods:

This was a retrospective study including patients treated with lenvatinib [8 mg (⩽60 kg) or 12 mg (>60 kg) once daily] or lenvatinib, toripalimab plus HAIC [LeToHAIC group, lenvatinib 0–1 week prior to initial HAIC, 240 mg toripalimab 0–1 day prior to every HAIC cycle, and HAIC with FOLFOX regimen (oxaliplatin 85 mg/m2, leucovorin 400 mg/m2, 5-fluorouracil bolus 400 mg/m2 on day 1, and 5-fluorouracil infusion 2400 mg/m2 for 46 h, every 3 weeks)]. Progression-free survival, overall survival, objective response rate, and treatment-related adverse events were compared.

Results:

From February 2019 to August 2019, 157 patients were included in this study: 71 in the LeToHAIC group and 86 in the lenvatinib group. The LeToHAIC group showed longer progression-free survival (11.1 versus 5.1 months, p < 0.001), longer overall survival (not reached versus 11 months, p < 0.001), and a higher objective response rate (RECIST: 59.2% versus 9.3%, p < 0.001; modified RECIST: 67.6% versus 16.3%, p < 0.001) than the lenvatinib group. In addition, 14.1% and 21.1% of patients in the LeToHAIC group achieved complete response of all lesions and complete response of the intrahepatic target lesions per modified RECIST criteria, respectively. Grade 3/4 treatment-related adverse events that were more frequent in the LeToHAIC group than in the lenvatinib group included neutropenia (8.5% versus 1.2%), thrombocytopenia (5.6% versus 0), and nausea (5.6% versus 0).

Conclusions:

Lenvatinib, toripalimab, plus HAIC had acceptable toxic effects and might improve survival compared with lenvatinib alone in advanced hepatocellular carcinoma.
A new visual feedback-based system for the assessment of pinch force, endurance, accuracy and precision. A test-retest reliability study
Authors: Dottor Alberto , Camerone Eleonora , Job Mirko , Barbiani Diletta , Frisaldi Elisa , Testa Marco
Published: March 2021

Introduction

Given that pinch is a precision grip involved in sustained submaximal activities, a Sustained Contraction (SC) task could be associated to Maximal Voluntary Contraction (MVC). To better evaluate the thumb-index system, the test-retest reliability of pinch MVC and SC, measured by a visual feedback-based pinch gauge was assessed.

Methods

26 healthy participants performed MVC and SC in two separate sessions. SC required to maintain 40%MVC as long as possible and it was evaluated in terms of time, accuracy (Mean Distance between force trace and target force, MD), precision (Coefficient of Variability of force trace, CV). MD and CV analyses were conducted dividing the SC task into three equivalent time stages (beginning, middle, exhaustion). Relative Reliability (RR) was measured by Intraclass Correlation Coefficient, and Absolute Reliability (AR) was measured by Standard Error of Measurement and by Bland-Altman plot.

Results

MVC and Time showed high RR and AR in both hands. RR of MD and CV in right hand was excellent in the beginning and middle stages, and fair in the exhaustion one, showing decreasing reliability as fatigue increases. In the left hand RR of MD and CV was generally lower. MD showed excellent reliability in the beginning stage and good reliability in the other stages. CV showed fair relative reliability at both beginning and middle stages, excellent in the last one. Conversely, it was observed high AR of MD and CV in all stages in both hands.

Conclusions

All indices are reliable to assess motor control of thumb-index pinch in both hands.
Factors That Predict Sagittal Plane Knee Biomechanical Symmetry After Anterior Cruciate Ligament Reconstruction: A Decision Tree Analysis
Authors: Palmieri-Smith Riann M. , Curran Michael T. , Garcia Steven A. , Krishnan Chandramouli
Published: March 2021

Background:

Biomechanical knee asymmetry is commonly present after anterior cruciate ligament (ACL) reconstruction. Factors that could assist in identification of asymmetrical biomechanics after ACL reconstruction could help clinicians in making return-to-play decisions. The purpose of this study is to determine factors that may contribute to knee biomechanical asymmetry present after ACL reconstruction.

Hypothesis:

We hypothesized that quadriceps strength and activation and patient-reported function would allow for identification of patients with symmetrical knee biomechanics.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

Thirty-one subjects (18 women; time since ACL reconstruction = 284.4 ± 53.6 days) who underwent ACL reconstruction and were to return to activity were recruited. Participants completed bilateral assessments of isokinetic quadriceps strength, quadriceps activation using the superimposed burst technique, and biomechanical function testing during a single-leg forward hop. The International Knee Documentation Committee (IKDC) subjective knee form was also completed. Symmetry values were calculated for each variable. Decision trees were utilized to determine which input factors (quadriceps strength symmetry, quadriceps activation symmetry, IKDC score, age, sex, height, mass, graft type) were able to identify participants who had symmetrical knee flexion angles (KFAs) and extension moments. Angles and moments were considered symmetrical if symmetry values were ≥90%.

Results:

Quadriceps strength and activation symmetry were able to predict whether a patient landed with symmetrical or asymmetrical KFAs, with thresholds of 77.2% strength symmetry and 91.3% activation symmetry being established. Patient-reported function and quadriceps strength were factors that allowed for classification of participants with symmetrical/asymmetrical knee extension moments, with thresholds of 89.1 for the IKDC and 80.0% for quadriceps strength symmetry.

Conclusions:

Quadriceps strength contributed to both models and appears to be a critical factor for achieving symmetrical knee biomechanics. High patient-reported function and quadriceps activation are also important for restoring knee biomechanical symmetry after ACL reconstruction.

Clinical Relevance:

Quadriceps strength and activation and patient-reported function may be able to assist clinicians in identifying ACL patients with symmetrical/asymmetrical knee biomechanics.
Simplifying Access to the Lateral Sphenoid Recess: A Modification of the Transpterygoid Approach
Authors: Sreenath Satyan B. , Tang Dennis M. , Almeida João Paulo De , Soni Pranay , Woodard Troy D. , Recinos Pablo F. , Kshettry Varun R. , Sindwani Raj
Published: March 2021

Background

Meningoencephaloceles originating in the lateral recess of the sphenoid sinus can be difficult to access. Historically, the endoscopic transpterygoid approach was advocated, which carries additional morbidity given the dissection of the pterygopalatine fossa (PPF) contents to provide a direct line approach to the defect. Given our increased facility with angled endoscopes and instrumentation, we now approach this region in a less invasive manner.

Methods

We describe the endoscopic modified transpterygoid approach (MTPA), a quicker approach to the lateral sphenoid recess which preserves the PPF contents through a single nostril corridor.

Results

In the MTPA, the face of the sphenoid and anterior junction of the pterygoid plates are removed, allowing for mobilization of the PPF contents with the periosteum intact. Angled instrumentation is then used to resect the meningoencephalocele and repair the skull base defect in the lateral recess. If increased exposure is needed, this can be gained by sacrificing the sphenopalatine artery and even the vidian nerve, although this is rarely required.

Conclusions

The MTPA obviates the need for PPF dissection and simplifies access to the lateral sphenoid recess while minimizing postoperative morbidity. This approach should be considered for accessing meningoencephaloceles and other benign lesions in this challenging location.
Immunosuppressive Regulation of Dendritic Cells and T Cells in Allergic Rhinitis by Semaphorin 3A
Authors: Liu Honghui , Xia Jinye , Chen Yu , Ai Jingang , Wang Tiansheng , Tan Guolin
Published: March 2021

Background

Semaphrin3A (Sema3A) was found to play a major role in immune regulation in autoimmune diseases and to be of importance in allergic disease. However, the effect of Sema3A on allergic rhinitis (AR) is not fully clear.

Objective

We sought to elucidate the effects of Sema3A on the regulation of dendritic cells (DCs) and naive CD4+ T cells in AR.

Methods

The expression of Sema3A in nasal mucosa was measured by immunohistochemical staining and western blotting. Human peripheral blood mononuclear cells were separated by the Ficoll-Hypaque method. DCs and naive CD4+ T cells were purified by magnetic selection. A human Sema3A Fc chimera was added to DCs and naive CD4+ T cells in vitro to evaluate the effect of Sema3A on the function of DCs and T cells. Labeling T cells with CFSE was used to determine cell proliferation. Flow cytometry was used to detect the DC maturation markers (CD40 and CD83) and T helper 17 (Th17) and regulatory T cell (Treg) percentages. ELISA was used to detect the IL10, IL17, IL4, and IFNγ cytokine levels.

Results

The expression of Sema3A in AR inferior turbinate tissue was lower than that in healthy control tissue. Compared with healthy control DCs, AR DCs showed decreased levels of the DC maturation markers CD40 and CD83 after Sema3A treatment. Furthermore, Sema3A decreased naive CD4+ T cell proliferation in AR. In addition, Sema3A increased the percentage of Tregs but had no obvious effect on Th17 cells. Moreover, Sema3A significantly increased levels of IL10 and IFNγ, and decreased level of IL4, but had no obvious effect on level of IL17.

Conclusion

AR presented with low expression of Sema3A in nasal mucosa, and Sema3A could decrease DC maturation, T cell proliferation, and Treg polarization.
Myelolipoma of renal sinus in a patient with end-stage renal disease: A rare differential diagnosis in renal neoplasms
Authors: Farzaneh Ted , Ibe Ifegwu , Zada Sherehan
Published: March 2021

Myelolipoma is an uncommon benign neoplasm composed of mature adipose tissue and hematopoietic elements. Myelolipoma occurs most frequently in the adrenal gland but occasionally can be seen in extra-adrenal locations such as lung, liver, retroperitoneum, mediastinum, and kidney. We report a case of extra-adrenal myelolipoma presented as a localized asymptomatic mass in the renal sinus of left native kidney of a 60-year-old woman. The patient was being investigated for end-stage renal disease status post renal transplant. Histologic examination of the lesion showed classic features for myelolipoma. Our case illustrates the awareness of this entity in unusual location and the appropriate use of diagnostic modalities to prevent unnecessary surgical interventions particularly in patients with major co-morbidity in the future.
A Case of Anaplasmosis during a Warm Minnesota Fall
Authors: Khera Kushal D. , Southerland Danielle M. , Miller Nathaniel E. , Garrison Gregory M.
Published: March 2021

A healthy 33 year old male presented in December with a 3 week history of fever and fatigue. He had been deer-hunting in northern Minnesota 1 month prior and had sustained a tick bite. Extensive laboratory investigations and a lumbar puncture were conducted. He was empirically with doxycycline and had rapid improvement in his symptoms. Subsequently, PCR and serologic testing returned positive for Anaplasma phagocytophlium. Anaplasmosis is a tick-borne illness caused by the bacterium Anaplasma phagocytophilum and is typically seen in the warmer months. This patient’s presentation in December was uncommon for a tick-borne illness in Minnesota. Regional weather records demonstrated unseasonably warm temperatures during the patient’s trip. Ixodes ticks are known to be sensitive to temperature and humidity, which likely contributed to increased tick activity, leading to disease transmission. This case highlights the importance for clinicians to be aware of local weather patterns and how this might influence seasonal disease presentations.
A Comprehensive Resiliency Framework: Theoretical Model, Treatment, and Evaluation
Authors: Park Elyse R , Luberto Christina M , Chad-Friedman Emma , Traeger Lara , Hall Daniel L , Perez Giselle K , Goshe Brett , Vranceanu Ana-Maria , Baim Margaret , Denninger John W , Fricchione Gregory , Benson Herbert , Lechner Suzanne C
Published: March 2021

Background

There is heterogeneity in conceptualizations of resiliency, and there is, to date, no established theoretically driven resiliency assessment measure that aligns with a targeted resiliency intervention. We operationalize resiliency as one’s ability to maintain adaptive functioning in response to the ongoing, chronic stress of daily living, and we use a novel resiliency measure that assesses the target components of an evidence based resiliency intervention. We present our resiliency theory, treatment model, and corresponding assessment measure (Current Experience Scale; CES).

Methods

To establish the psychometric properties of the CES, we report the factor structure and internal consistency reliability (N = 273). Among participants in our resiliency intervention (N = 151), we explored construct validity in terms of associations with theoretical model constructs, a validated resiliency measure, and sensitivity to change from before to after the intervention.

Results

Results indicated that a 23-item, 6-factor solution was a good fit to the data (RMSEA = .08, CFI = .97; TLI =.96) and internal consistency was good (α = .81 to .95). The CES showed correlations in the expected direction with resiliency model constructs (all p’s < .001) and significant post intervention improvements.

Conclusion

Our resiliency theory, treatment model, and outcome appear aligned; the CES demonstrated promise as a psychometrically sound outcome measure for our resiliency intervention and may be used in future longitudinal studies and resiliency building interventions to assess individuals’ resiliency to adapt to ongoing stress.
Religious Subjectivities and Digital Collectivities on Social Networking Sites in India
Authors: Bhatia Kiran Vinod
Published: March 2021

This article analyses how the infrastructural architecture of social networking sites (SNS) is conducive to the emergence of religious subjects and digital collectivities. I argue that SNS enable social connections, and subjectivities are created to reify discriminatory religious and political practices and discourses online. This study identifies and responds to three critical arguments about SNS and religious subjectivities. First, it challenges the liberal assumptions that advancement in SNS will lead to the creation of depoliticized and more rational societies. I argue that SNS deepens the already existing social segregations in the society through the creation of digital collectivities. Digital collectivities inform functional possibilities (ontology) and discursive modes (epistemology) of enacting religious subjectivities. These collectivities not only shape the ways in which users articulate their religious and political allegiance but also the content of their online presence. Finally, in unpacking the formation and existence of digital collectivities and how they are linked with the emergence of religious subjects, I examine the question of digital ontology—the debate regarding what a religious subject on SNS is and of epistemology—how is a religious subject defined.
Towards conceptions of green gentrification as more-than-human
Authors: Kocisky Katherine
Published: March 2021

This article seeks to expand scholarly conceptions of green gentrification by emphasizing the complex and contradictory connections between nonhumans and humans as critical for understanding neighborhood change. Drawing from posthumanist scholarship, as well as literature on urban political ecology, urban greening, gentrification and “just green enough,” this article argues that to understand green amenities not only as sites of injustice, but rather as dynamic sites of injustice and resistance, requires disaggregating amenities from traditional conceptions of green gentrification. In doing so, it is possible to analyze the complex agencies of greenspace itself as connected to pluralized forms of (in)justice associated with race, ethnicity, gender, sexuality, and class. To illustrate this, I use a more-than-human framework to reconceptualize three existing “just green enough” case studies of (1) riverfront development, (2) urban linear parks, and (3) community gardens to show how injustice and resistance are not only broad-based, but unique to amenity and place. The aim of this review is to offer new ways of understanding and analyzing the dialectic of injustice and resistance associated with green gentrification.
Inherited glycosylphosphatidylinositol defects cause the rare Emm-negative blood phenotype and developmental disorders
Authors: Duval Romain , Nicolas Gaël , Willemetz Alexandra , Murakami Yoshiko , Mikdar Mahmoud , Vrignaud Cedric , Megahed Hisham , Cartron Jean-Pierre , Masson Cecile , Wehbi Samer , Koehl Bérengere , Hully Marie , Siquier Karine , Chemlay Nicole , Rotig Agnes , Lyonnet Stanislas , Colin Yves , Barcia Giulia , Cantagrel Vincent , Le Van Kim Caroline , Hermine Olivier , Kinoshita Taroh , Peyrard Thierry , Azouzi Slim
Published: March 2021

Glycosylphosphatidylinositol (GPI) is a glycolipid that anchors >150 proteins to the cell surface. Pathogenic variants in several genes that participate in GPI biosynthesis cause inherited GPI deficiency disorders. Here, we reported that homozygous null alleles of PIGG, a gene involved in GPI modification, are responsible for the rare Emm-negative blood phenotype. Using a panel of K562 cells defective in both the GPI-transamidase and GPI remodeling pathways, we show that the Emm antigen, whose molecular basis has remained unknown for decades, is carried only by free GPI and that its epitope is composed of the second and third ethanolamine of the GPI backbone. Importantly, we show that the decrease in Emm expression in several inherited GPI deficiency patients is indicative of GPI defects. Overall, our findings establish Emm as a novel blood group system, and they have important implications for understanding the biological function of human free GPI.