bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Nature and Etiologies of Risk Factors for Diaphyseal Atypical Femoral Fractures
Authors: Tsuchie Hiroyuki , Miyakoshi Naohisa , Kasukawa Yuji , Nozaka Koji , Saito Kimio , Kinoshita Hayato , Kobayashi Moto , Suzuki Norio , Aizawa Toshiaki , Abe Hidekazu , Maekawa Shigeto , Tomite Takenori , Ono Yuichi , Ouchi Kentaro , Shibata Nobusuke , Nagahata Itsuki , Takeshima Masaaki , Akagawa Manabu , Yuasa Yusuke , Sato Chie , Shimada Yoichi
Published: May 2021

Objectives: Differences in mechanisms of subtrochanteric and diaphyseal atypical femoral fractures (AFFs) are speculated in studies that analyzed differences in the patients’ background. However, the etiologies of each type of AFF have not been studied in detail. This study aimed to investigate the nature and etiologies of the risk factors for diaphyseal AFFs. Materials and Methods: Eighty consecutive Japanese patients with 91 diaphyseal AFFs (AFF group) and 110 age-matched women with osteoporosis (non-AFF control group) were included. Their clinical data were compared; factors affecting AFFs were investigated, and the etiologies of the risk factors for diaphyseal AFFs were examined. Results: Multivariate analysis revealed that femoral serrated changes, bisphosphonate or denosumab usage, and lateral and anterior femoral curvatures were risk factors for diaphyseal AFFs (p < 0.0011, p = 0.0137, and p < 0.0001, respectively). Multivariate analyses revealed that serrated changes and low serum 25(OH)D levels affected the lateral curvature (p = 0.0088 and 0.0205, respectively), while serrated changes affected the anterior curvature (p = 0.0006), each significantly affected the femoral curvature. High serum calcium (Ca) levels, lateral femoral curvature, and anterior femoral curvature were predictors of serrated changes (p = 0.0146, 0.0002, and 0.0098, respectively). Conclusion: Risk factors for diaphyseal AFFs were bone resorption inhibitor usage, a strong femoral curvature, and serrated changes. Low serum 25(OH)D levels and serrated changes are risk factors for lateral curvature, while a high serum Ca level is a risk factor for serrated changes.
Leitura e escrita de manuscritos: pena e suporte digitais na prática paleográfica
Authors: Ackel Antonio , Módolo Marcelo
Published: May 2021

A partir de uma perspectiva baseada na paleografia tradicional em diálogo com a paleografia digital, este artigo apresenta a aplicação de novos recursos de leitura e escrita de manuscritos. Para tanto, procede-se com métodos paleográficos por meio de uma ferramenta digital no processo de cópia. Utilizou-se a mesa digitalizadora modelo CTL 4100, da marca Wacom, e, como modelo de manuscrito, o fólio 94r, do Livro de horas, datado entre os séculos XIV e XV. O fragmento selecionado foi uma oração de São Lucas, em que pudemos extrair exemplos de características das escritas góticas e mostrar que, com ferramentas próprias, a paleografia digital permite e facilita o exercício da leitura paleográfica e da prática de cópia, levando o pesquisador a uma maior compreensão do processo de escrita do autor material. Pretende-se também, a partir das observações expostas, discutir o uso de meios tecnológicos como alternativa facilitadora na aplicação de práticas didáticas filológicas, direcionadas à leitura paleográfica de documentos e execução de escrita.
Fragmenta latina operis Isaaci Ninivitae
Authors: Cambraia César Nardelli
Published: May 2021

Este trabalho tem como objetivo dar a conhecer o texto de nove testemunhos fragmentários inéditos da tradução latina da obra de Isaac de Nínive: cód. XIV G 17, Biblioteca Nacional (Praga); cód. M I 159, Biblioteca Científica (Olomouc); cód. 996, Biblioteca Mazarina (Paris); cód. C 631, Biblioteca Universitária (Uppsala); cód. A XI 72, Biblioteca Universitária (Basileia); cód. A X 102, Biblioteca Universitária (Basileia); cód. A XI 71, Biblioteca Universitária (Basileia); cód. GB 8o 76, Arquivo Histórico da Cidade (Colônia); e cód. GB 8o 155, Arquivo Histórico da Cidade (Colônia). Adotaram-se critérios de edição paleográfica, a fim de permitir um estudo mais aprofundado desses registros. O conhecimento das versões presentes nesses testemunhos permitiu enquadrar parte deles na tradição latina da obra, evidenciando-se variantes e identificando-se erros conjuntivos e separativos.
Análise pragmático-discursiva de cartas trocadas entre Epifânio Dória e José Calasans
Authors: Costa Renata Ferreira , Sá José Douglas Felix de , Barbosa Luiza Daviane Santos
Published: May 2021

Este artigo tem como objetivo apresentar um estudo sobre a natureza da comunicação epistolar entre Epifânio Dória e José Calasans, dois representativos intelectuais sergipanos que mantiveram correspondência por dezesseis anos. Os corpora epistolares em análise são edições semidiplomáticas, isto é, conservadoras do estado de língua em que os textos foram escritos, de missivas manuscritas e datiloscritas de Epifânio Dória (1884-1976) e José Calasans (1915-2001), que se encontram nos espólios desses intelectuais salvaguardados no Instituto Histórico e Geográfico de Sergipe (IHGSE). A análise empreendida considera o exame das condições de produção e circulação dos textos epistolares e o seu papel na história e na sociedade. A eleição da carta como objeto de pesquisa, visando à reflexão sobre sua contextualidade, permitiu que a análise textual se conjugasse com uma perspectiva pragmática, pela própria natureza dessa situação comunicativa. Assim é que, no contexto da superfície textual, em nível pragmático-discursivo, foram sistematizadas e analisadas as rotinas verbais de abertura, pré-fecho e fecho das cartas, de acordo com o modelo de Análise Interacional da Comunicação Epistolar (AICE), proposto pela professora e pesquisadora Isabel Roboredo Seara.
O Item trouxa no português do Twitter
Authors: Duchowny Aléxia Teles , Silva Caroline de Oliveira
Published: May 2021

Objetiva-se analisar o item trouxa da língua portuguesa, que apresenta, atualmente, pelo menos dois significados: o etimológico de embrulho ou carga e o inovador de pessoa boba, fácil de ser ludibriada. O item sofreu um processo de “pejoratização” pelos seus usuários, fenômeno descrito pela Linguística semântica em que a palavra passa a ter uma avaliação negativa. Assim, trouxa, termo para se referir a um objeto concreto até o século XIX, passa a fazer referência também para uma pessoa tola, feita de boba pelos outros. No Twitter, em que a língua escrita apresenta muitas características da oralidade, o uso do termo para se referir a alguém bobo é muito recorrente, apresentando variadas formas nominais.
Reavaliando a etimologia de abacaxi a partir de novos dados histórico-filológicos
Authors: Maroneze Bruno
Published: May 2021

A hipótese etimológica consensual para abacaxi é que esta unidade lexical se origina do tupi, pela junção dos elementos yvá “fruta” e katĩ “que recende”, “que exala cheiro”. No presente artigo, essa hipótese é reavaliada a partir de dados de atestações anteriores desta unidade lexical. Inicialmente, apresentam-se dados lexicográficos com descrições etimológicas (seção 2); em seguida, avaliam-se as transformações fonético-fonológicas implicadas pela hipótese consensual, que levam à conclusão de que se trata de hipótese controversa (seção 3). Na seção 4, apresentam-se dados histórico-filológicos que mostram que a unidade lexical abacaxi designou um povo indígena, um rio e uma missão jesuítica, no mínimo um século antes de passar a designar uma fruta. Dessa forma, torna-se incoerente supor que uma unidade lexical que se referia a um povo pudesse ter como étimo “fruta que recende”. Por fim, conclui-se que a hipótese etimológica consensual deve ser tratada como controversa e que uma nova hipótese etimológica deve ser buscada não para o nome de uma fruta, mas sim para o nome de um povo indígena.
A Filologia e o estudo de Requerimentos do Arquivo Histórico Ultramarino
Authors: Gonçalves Eliana Correia Brandão
Published: May 2021

O artigo apresenta considerações sobre a notabilidade da Filologia na organização de edições de Requerimentos históricos do Conselho Ultramarino, que registram uma complexa rede histórico-cultural e linguística. Nesse viés, a ação transformadora da atividade filológica reverbera lampejos críticos nas descontinuidades dos diversos tempos do texto – tempo de produção, tempo de recepção e tempo de análise – e no reconhecimento das variadas lutas políticas dos nossos semelhantes, lugares de memória e territórios de identidade. No âmbito dessas conceituações e reflexões, a leitura filológica é dinâmica e plural, buscando desvelar no multiverso do texto os seus rastros e as suas significações políticas. Para tanto, será examinado o Requerimento do escravo Francisco da Cruz ao príncipe regente [D. João] que solicita proteção régia contra as injustiças praticadas por seu senhor Antônio da Cruz Veloso.
Caminhos de um manuscrito setecentista: da Vila Real de Sabará à contemporaneidade
Authors: Madeira Maria de Fátima Nunes , Módolo Marcelo
Published: May 2021

O caminho percorrido por um manuscrito, desde a sua produção, até chegar à contemporaneidade, pode revelar marcas de ações políticas que decidiram pela sua preservação. Para ilustrar esse pressuposto, apresenta-se a Carta Régia ao Juiz e officiaes da Camara para a contribuiçaõ do subsidio voluntario, de 1755, e mais especificamente sua cópia, de 1777. Logo na criação do documento, notam-se preocupações com a sua longevidade e com a segurança de sua circulação, a partir da análise codicológica do manuscrito. O catálogo “Coleção Alberto Lamego”, do IEB – Instituto de Estudos Brasileiros – configura-se como instrumento fundamental para a análise das fases de transmissão desse manuscrito, pois indica lugares de pousos em arquivos onde também se evidenciam esforços para a sua preservação e divulgação. Os estudos paleográficos e diplomáticos fornecem informações que permitem deduzir do texto e do testemunho a sua autoria, datação e observância de certas fórmulas peculiares dessa espécie documental, tornando possível a verificação de sua autenticidade e genuinidade, características imprescindíveis para que a edição semidiplomática do manuscrito possa ser utilizada como fonte documental segura para futuras pesquisas. Colecionadores, arquivistas, filólogos e demais pesquisadores são coautores nessa importante tarefa de transmitir documentos a gerações futuras.
John Muafangejo’s How God Loves His People All Over the World as Material Religion
Authors: Beyers Jaco , Kriel Lize
Published: May 2021

The artworks produced at the Evangelical Lutheran Church Art and Craft Centre at Rorke’s Drift, KwaZulu-Natal, have been highly appraised and appreciated in South African art-historical circles, not in the least so as African expressions of postcolonial and anti-apartheid resistance. The work of Namibian artist John Muafangejo (1943–1987) is prominent amongst these. In this article, while borrowing generously from the methods of art historical research, our interest is primarily in works of art as objects of material religion. Erwin Panofsky introduced iconology as a way of determining the meaning of art. Iconology wants to enable the seeing of the unseen; seeing the transcendence—making it most applicable to the study of religion as a cultural practice. This article investigates in a critical way how iconology can assist in the study of material religion, especially as applied to the study of religious art. Because meaning is contextual, the conditions under which religious objects are made and interpreted are as important as the work itself. A discussion of a specific work by John Muafangejo originating from the Rorke’s Drift Centre will be conducted by testing the potential of iconology as an analytical tool in this African Christian environment.
Invocation as Self-Change
Authors: Wiley W. Brett
Published: May 2021

George Saunders, who was raised in the Catholic Church and became a Tibetan Buddhist as an adult, incorporates prayer into many of his short stories. Using Catholic and Buddhist definitions and conceptions of prayer, this essay examines prayers in three short stories—“Offloading for Mrs. Schwartz,” “My Flamboyant Grandson,” and “Tenth of December”—and argues that, though Saunders incorporates prayer that formally and content-wise appears Christian, the instances ultimately reflect a Buddhist idea of prayer as a means of self-change and as a practice that affirms the enlightenment of the person praying.
An Implicit Theology of Mad Men
Authors: Hubbard Scott
Published: May 2021

One of the most striking sites of secular-religious encounter in narrative fiction of the decade has been the baptismal imagery of the television serial drama Mad Men. Set in an era which may be said to be the high-water mark of the secularization of American culture, Mad Men’s encoding of meaning in symbolic representation in effect re-sacralizes the secular world into which those symbols are transplanted. The symbolism’s divergences from Christian doctrine and ritual that give Mad Men its distinct theological significance. This paper will explore the literary implications of Paul Ricoeur’s theory of religious symbolism. This paper conducts several close readings of key moments in the show’s use of baptismal symbolism, and offers thoughts about how Mad Men’s constellation of originally religious symbols to convey narrative significance empowers the show to perform a religious function for its audience.
Novelties in Mimosa sect. Mimosa ser. Mimosa subser. Polycephalae: a new species, new status, and new synonyms
Authors: MENDES THAINARA POLICARPO , SIMON MARCELO FRAGOMENI , PEREZ ANA PAULA FORTUNA , Silva Marcos José da
Published: May 2021

Taxonomic studies of Mimosa subser. Polycephalae revealed a new species and indicated the need for taxonomic and nomenclatural adjustments in the group. Mimosa pseudoracemosa is described and illustrated as a new species from Goiás State in central-western Brazil. We discuss its geographic distribution, environmental preferences, phenology and conservation status and compare it with the morphologically similar M. pseudoradula and M. flavocaesia. A new status for M. pseudoradula var. detonsa and a new name are proposed (= M. detonsa), including M. pseudoradula var. anapolitana and M. pseudoradula var. crystallites as its synonyms, as well an updated circumscription for M. pseudoradula without the admission of varieties. We also present descriptions, images, maps, comments on their distributions and morphological relationships, flowering and fruiting periods, and conservation statuses. In addition to the morphological and geographic discontinuities of the aforementioned taxa, their trichome micromorphology supported the establishment of the new species, as well as the taxonomic decisions involving M. pseudoradula.
A new miniature species, Bulbophyllum nghiasonii, sect. Brachyantha (Orchidaceae) from northern Vietnam
Authors: DANG MINH QUAN , AVERYANOV LEONID V. , DANG VAN SON , BUI VAN HUONG , AMSLER ROLAND , MAISAK TATIANA , TRUONG BA VUONG
Published: May 2021

The new species discovered in Thanh Hoa Province of northern Vietnam described here as a new species for science. It is similar to B. muscicola but differs in smaller habit, inflorescence shorter than leaves, shorter lateral sepals with unequally lobed blunt apex, and slender stelidia. The newly described species also can be compared with B. japonicum but it differs in the size and shape of leaves, tepals, and lip. Detailed morphological description, illustration, data on distribution, and phenology of the new species are presented.
Inga ciatiformis (Leguminosae): A new species from the Atlantic Forest, Brazil

Authors: FERNANDES JOSÉ MARTINS , GARCIA FLÁVIA CRISTINA PINTO
Published: May 2021

A new species of Inga (Leguminosae, Caesalpinioideae, Mimosoid clade), restricted to the Atlantic Forest of Minas Gerais State, Brazil, is described, illustrated, and compared in an inedited identification key to the species with stipitate extrafloral nectaries in the biome, Inga ciatiformis is similar to Inga cabelo and Inga platyptera. It differs from I. cabelo by having appressed-sericeous young branches, leaves with 1–3 pairs of leaflets, a terminal appendix 7–12 mm long, cyathiform extrafloral nectaries, bracts 9–13 mm long, linear, persistent, and a sparsely sericeous calyx (vs. hirsute-hispid young branches, leaves with 2–5 leaflets pairs, terminal appendix 2.5 mm long, capitate extrafloral nectaries, bracts 2 mm long, triangular, caducous, and a hirsute calyx). It differs from I. platyptera by having appressed-sericeous young branches, a cylindrical petiole and rachis, rachis rarely winged in the superior portion of the apical pair of leaflets, extrafloral nectaries always cyathiform, and linear bracts (vs. hispid young branches, winged petioles and rachises, extrafloral nectaries generally cupuliform, and lanceolate to ovate bracts).
Calamagrostis nandadeviensis (Poaceae, Agrostidinae), a new grass species from India
Authors: PRASAD DILESHWAR , TRIPATHI SHAILJA , JAISWAL SHUBHAM , YADAV REKHA , AGNIHOTRI PRIYANKA
Published: May 2021

Calamagrostis nandadeviensis, a new species of Calamagrostis (Poaceae: Agrostidinae) from India (Valley of Flowers National Park of Uttarakhand and Rohtang Pass of Himachal Pradesh) is described and illustrated. C. nandadeviensis is morphologically allied to C. lahulensis and C. scabrescens but differs from them in having deeply bifid palea and fused lodicules. Data on distribution, habitat, biotic association are presented along with an illustration and comparative photo plate.
A new species of tadpole-goby, Benthophilus persicus sp. nov. (Teleostei: Gobiidae) from the southern Caspian Sea
Authors: KOVAČIĆ MARCELO , ESMAEILI HAMID REZA , ZAREI FATAH , ABBASI KEYVAN , SCHLIEWEN ULRICH K.
Published: May 2021

A new gobiid species, Benthophilus persicus sp. nov., is described from the southern Caspian Sea, Iran. The new species is diagnosed by the following character states: dermal fold on cheek well-developed, large, rectangular; chin barbel 1/3–2/3 of eye diameter; maximum body width 15.1–22.9% of standard length; mouth width, 36.3–55.8% of head length; second dorsal fin I+7–8; origin of anal fin in front of vertical through origin of second dorsal fin; dermal tubercles present on body, clearly larger than granules, with two posterior rows of spinules forming an acute angle, always less than right angle; dorsal row of tubercles complete, 22–29; ventral row of tubercles 22–25; ventrolateral row of tubercles absent; tubercles not present on temporal and occipital head regions; granules not present on flanks; transversal suborbital row 6i below posterior end of row b; anterior interorbital transversal row pa with one or two papillae and anterior interorbital transversal papilla row pp with two or three papillae; body with 20–22 transversal ltm rows starting anteriorly behind pectoral axilla and alternating anteriorly with three longitudinal llm rows.
Two new species and new records of the genus Astenus from Madagascar (Coleoptera: Staphylinidae: Paederinae)
Authors: JANÁK JIŘÍ , BAŇAŘ PETR
Published: May 2021

Two new species of the genus Astenus Dejean, 1833, A. ambohitantelyensis Janák & Baňař, sp. nov. and A. grebennikovi Janák & Baňař, sp. nov. from Madagascar are described and illustrated. New records of eleven additional species are presented.
Parathyroid Imaging Practices for Primary Hyperparathyroidism Without Previous Operations Among Endocrine Surgery Program Directors
Authors: Obiarinze Ruth , Chen Herbert , Lindeman Brenessa , Fazendin Jessica , Ramonell Kimberly M.
Published: May 2021

Background

Attempts at preoperative localization of abnormal parathyroid gland(s) in primary hyperparathyroidism (pHPT) can be performed with a variety of modalities. Study utilization is surgeon-specific with highly variable opinions in parathyroid surgery. As more people are diagnosed with pHPT, the complexity of the disease has given rise to variation in management. This heterogeneity raises the question of the true clinical practice of imaging among individual endocrine surgeons.

Methods

To better understand the preoperative parathyroid imaging practices of endocrine surgeons, an email-based survey was disseminated to the program directors of 22 American Association of Endocrine Surgeons fellowship programs querying them on their initial diagnostic test of choice for pHPT. Clinical support team members from each respective program were subsequently contacted and answers were compared.

Results

Sixty-eight percent (15/22) of clinical team members recommended either an additional (12/15) or different imaging test (3/15) than what was recommended by their institution’s endocrine surgeon. The most common initial imaging test that was repeated by both the endocrine surgeon and clinical team member was neck ultrasound; 33% of clinical team members (7/22) responded concordantly to their surgeon with ultrasound as the initial recommendation.

Discussion

Significant variability exists in the preoperative approach to patients with hyperparathyroidism. Here, we demonstrate that inconsistency in preoperative imaging recommendations even extends to within an individual surgeon’s practice based on the impact of the clinical support team, highlighting the role for improved clinical protocols within an institution’s clinical team.
Oropharyngeal Carcinoma Treated with Surgery Alone: Outcomes and Predictors of Failure
Authors: Waltonen Joshua D. , Thomas Sydney G. , Russell Gregory B. , Sullivan Christopher A.
Published: May 2021

Objective:

To analyze the oncologic outcomes and risk factors for recurrence in patients who underwent surgery for oropharyngeal squamous cell carcinoma (OPSCC), and in whom adjuvant therapy was not recommended or was declined.

Methods:

Retrospective cohort study of patients with OPSCC who were treated with transoral surgery only at a tertiary care academic medical center from April 2010 to March 2019.

Results:

Seventy-four patients met inclusion criteria. In 16, adjuvant therapy was recommended but declined. There were 8 recurrences, of which 6 had been given recommendations for adjuvant therapy. Of the 8 recurrences, 2 died, 2 are alive with disease, and 4 were successfully salvaged. Five patients died of unrelated causes. Lymphovascular invasion (LVI, P = .016) had a significant impact on recurrence, while other pathologic features of the primary tumor such as size, location, human papillomavirus (HPV) status, and margin status did not. Margins were classified as “positive” in 4 patients, “close” in 54, and “negative” in 16. There were 3 local recurrences (4.1%), each of whom had declined adjuvant therapy. Lymph node features such as N-stage ( P = .0004), number of positive nodes ( P = .0005), and presence of extra-nodal extension (ENE, P = .0042) had a statistically significant impact on relapse. Smoking history and surgical approach showed no significant impact on recurrence.

Conclusion:

Patients who undergo surgery for HPV-positive OPSCC with negative margins, no PNI, no LVI, and ≤1 positive lymph node without ENE have low risk for recurrence. These patients can likely be safely treated with surgery alone. Patients with these risk factors who decline adjuvant therapy are at risk for recurrence, and should be monitored.
Cultural Considerations in the Treatment of Eating Disorders among Racial/Ethnic Minorities: A Systematic Review
Authors: Acle Ashley , Cook Brian J. , Siegfried Nicole , Beasley Tammy
Published: May 2021

Eating disorders (ED) prevalence is rising among ethnic and racial minority groups, yet disparities persist in treatment seeking, and effectiveness. The purpose of this systematic review was to summarize works that provide theoretically grounded and empirically evidenced clinical recommendations for the inclusion of culture in the treatment of eating disorders in non-white individuals. Thirty one articles revealed the following 11 core recommendation themes for how to effectively address culture in ED treatment: use culturally sensitive interventions; address barriers to treatment; understand patients within their cultural context; explore the impact of culturally contextual factors; assume a collaborative, curious therapeutic stance; understand nuances that impact clinical presentations; explore family/social supports; provide education/psychoeducation; explore ethnic identity, acculturation and acculturative stress; become educated about working with ethnic and racial minorities; and use a culturally flexible diagnostic model. Consolidating these recommendations evidenced from the literature fills a gap relevant to ED treatment and provides empirically derived, culturally-accommodating guidance on how future studies may include ethnic and racial considerations when developing treatment approaches and/or evaluating outcomes.
Identification of palliative care needs among people with dementia and its association with acute hospital care and community service use at the end-of-life: A retrospective cohort study using linked primary, community and secondary care data
Authors: Leniz Javiera , Higginson Irene J , Yi Deokhee , Ul-Haq Zia , Lucas Amanda , Sleeman Katherine E
Published: May 2021

Background:

Hospital admissions among people dying with dementia are common. It is not known whether identification of palliative care needs could help prevent unnecessary admissions.

Aim:

To examine the proportion of people with dementia identified as having palliative care needs in their last year of life, and the association between identification of needs and primary, community and hospital services in the last 90 days.

Design:

Retrospective cohort study using Discover, an administrative and clinical dataset from 365 primary care practices in London with deterministic individual-level data linkage to community and hospital records.

Setting/participants:

People diagnosed with dementia and registered with a general practitioner in North West London (UK) who died between 2016 and 2019. The primary outcome was multiple non-elective hospital admissions in the last 90 days of life. Secondary outcomes included contacts with primary and community care providers. We examined the association between identification of palliative care needs with outcomes.

Results:

Among 5804 decedents with dementia, 1953 (33.6%) were identified as having palliative care needs, including 1141 (19.7%) identified before the last 90 days of life. Identification of palliative care needs before the last 90 days was associated with a lower risk of multiple hospital admissions (Relative Risk 0.70, 95% CI 0.58–0.85) and more contacts with the primary care practice, community nurses and palliative care teams in the last 90 days.

Conclusions:

Further investigation of the mechanisms underlying the association between identification of palliative care needs and reduced hospital admissions could help reduce reliance on acute care for this population.
The International Family Study of Nonsyndromic Orofacial Clefts: Design and Methods
Authors: Auslander Allyn , McKean-Cowdin Roberta , Feigelson Devin , Brindopke Frederick , DiBona Melissa , Magee Kathy , Arakaki Lili , Kapoor Rijuta , Ly Stephanie , Conti David V. , Rakotoarison Sylvia , Mahmoudi Fouzia , McGregor Albertina , Giron Melissa , Hernandez Angela Rose , Nguyen Thi-Hai-Duc , Mwepu Anselme , Sanchez-Lara Pedro A. , Magee William
Published: May 2021

Background:

The majority of research to understand the risk factors of nonsyndromic orofacial clefts (NSOFCs) has been conducted in high-income populations. Although patients with NSOFCs in low- and middle-income countries (LMICs) are at the highest risk of not receiving care, global health infrastructure allows innovative partnerships to explore the etiologic mechanisms of cleft and targets for prevention unique to these populations.

Methods:

The International Family Study (IFS) is an ongoing case–control study with supplemental parental trio data designed to examine genetic, environmental, lifestyle, and sociodemographic risk factors for NSOFCs in 8 LMICs (through August 2020). Interview and biological samples are collected for each family. The interview includes demographics, family history of cleft, diet and water sources, maternal pregnancy history, and other lifestyle and environmental factors.

Results:

Seven of 8 countries are currently summarized (2012-2017) for a total of 2955 case and 2774 control families with 11 946 unique biological samples from Vietnam, Philippines, Honduras, Madagascar, Morocco, Democratic Republic of the Congo, and Nicaragua. The phenotype distribution was 1641 (55.5%) cases with cleft lip and palate, 782 (26.5%) with cleft lip (CL), and 432 (14.6%) with cleft palate (CP).

Discussion:

The International Family Study is the largest case set of NSOFCs with an associated biobank in LMICs currently assembled. The biobank, family, and case–control study now include samples from 8 LMICs where local health care infrastructure cannot address the surgical burden of cleft or investigate causal mechanisms. The International Family Study can be a source of information and may collaborate with local public health institutions regarding education and interventions to potentially prevent NSOFCs.
Analogical Predication and Divine Simplicity
Authors: te Velde Dolf
Published: May 2021

The notion of analogy plays an important role in Steven Duby’s project of theologia. Traditional Reformed theology understands analogy as an “analogy of attribution” based on the creature’s participation in God’s own perfections. Duby’s discussion of analogy addresses its grounds, main forms and variations, and limitations. In response, this article suggests supplementing Duby’s broadly Thomistic explanation with key elements from the Scotist theory of univocal predication. The first benefit of this integration is a clearer balance of apophatic and kataphatic tendencies in the doctrine of God. The second result is a more sophisticated account of the doctrine of divine simplicity, combining Thomas’ emphasis on the common ratio for predicating terms of God and creatures with the Scotist notions of disjunctive properties and distinctio formalis. While speaking about God’s essence by different concepts is necessary because of our limited understanding, it is also grounded in the reality of God Himself.
“I see my ancestors”: exploring tribal college student experiences playing When Rivers Were Trails
Authors: Emmons Nichlas , LaPensee Elizabeth
Published: May 2021

The educational video game, When Rivers Were Trails, was launched in 2019. The purpose of the game is to teach players about Indigenous perspectives of history, US federal allotment policies affecting tribal nations, and some of the effects of these policies on Indigenous peoples. This article explores tribal college student experiences playing When Rivers Were Trails in hopes that it provides the basis for further research into how tribal college faculty may be able to teach the game within their own classrooms. Tribal colleges and universities were created by tribal nations to provide for the higher education needs of their citizens. Using phenomenological research methods, seven college students volunteered to participate in a brief study about their experiences playing the video game. Upon transcription and analysis of the interview data, three themes were developed that capture how these students define their experience with When Rivers Were Trails: feelings of representation, histories of land dispossession, and resilience of communities.
Breast Cancer in Togolese Women: Imaging and Clinicopathological Findings
Authors: Darré Tchin , Tchaou Mazamaesso , Djiwa Toukilnan , Douaguibe Baguilane , Bassowa Akila , Adani-Ifé Solange , Amavi Ayikoé Kossi , N’Timon Bidamin , Amadou Abdoulatif , Simgban Panakinao , N’Bortche Bingo K , Amégbor Koffi , Aboubakari Abdoul-Samadou , Napo-Koura Gado
Published: May 2021

Background:

Breast cancer is the most common cancer in women, and its incidence and mortality rates are expected to increase significantly over the next few years, particularly in developing countries. The aim of this study was to describe the epidemiological, clinical, radiological, histopathological, and prognostic aspects of breast cancer in Togo.

Materials and methods:

We retrospectively analyzed at our Department of Pathology of Lomé all cases of breast cancer in women confirmed by histology over a period of 20 years (2000-2019).

Results:

We collected 804 cases of breast cancer in women. The median age was 46.7 years (range, 12-86 years). Patients aged <40 years represented 48.38% of cases, and the left breast was more affected (51.24%). Most women were sexually active (71.52%) and resided in urban areas (66.29%). Carcinomas represented the predominant histological group (796 cases, 99.00%) with a predominance of invasive nonspecific type carcinoma (92.34%). These cancers were diagnosed at late stage III using Nottingham grading (55.10%). The TNM classification showed a predominance of grades T2NxMx (72.45%) and T4N1Mx (17.76%). The luminal B profile (40.85%) was found mostly, and the mutation of BRCA2 and BRCA1 genes was found in 2.61% of cases. Mastectomy was performed in 7.59%, radiotherapy in 3.61%, and chemotherapy in 18.66%.

Conclusion:

Breast cancer is a frequent pathology in Togolese women, predominant in young adults, often diagnosed at a late stage with limited possibilities of treatment. The establishment of early care programs is essential.
The Vulnerability of Health Infrastructure to the Impacts of Climate Change and Sea Level Rise in Small Island Countries in the South Pacific
Authors: Taylor Subhashni
Published: May 2021

Anthropogenic climate change and related sea level rise will have a range of impacts on populations, particularly in the low lying Pacific island countries (PICs). One of these impacts will be on the health and well-being of people in these nations. In such cases, access to medical facilities is important. This research looks at the medical facilities currently located on 14 PICs and how climate change related impacts such as sea level rise may affect these facilities. The medical infrastructure in each country were located using information from a range of sources such as Ministry of Health (MoH) websites, World Health Organization, Doctors Assisting in South Pacific Islands (DAISI), Commonwealth Health Online, and Google Maps. A spatial analysis was undertaken to identify medical infrastructure located within 4 zones from the coastline of each country: 0 to 50 m, 50 to 100 m, 100 to 200 m, and 200 to 500 m. The findings indicate that 62% of all assessed medical facilities in the 14 PICs are located within 500 m of the coast. The low-lying coral atoll countries of Kiribati, Marshall Islands, Nauru, Palau, Tokelau, and Tuvalu will be highly affected as all medical facilities in these countries fall within 500 m of the coast. The results provide a baseline analysis of the threats posed by sea-level rise to existing critical medical infrastructure in the 14 PICs and could be useful for adaptive planning. These countries have limited financial and technical resources which will make adaptation challenging.
¡Los policías! Latinx children’s agency in highly regulated early childhood contexts
Authors: Colegrove Kiyomi Sánchez-Suzuki , McManus Molly E , Adair Jennifer Keys , Payne Katherina A
Published: May 2021

This article shows how two Latina bilingual teachers provided opportunities for their Latinx students from immigrant families to enact their agency in a highly regulated Head Start bilingual preschool classroom in ways that aligned with culturally sustaining pedagogy. Using video-cued ethnography and data from the Blinded Study, the authors center three- and four-year-old children who engaged in a collaborative, dynamic make-believe game involving a struggle between family members and los policías (“the police”). Using traditional qualitative methods, the authors first identify and name all the different ways in which the children enacted their agency and demonstrated capabilities in their play, particularly the cultural capabilities that challenge deficit discourses about Latinx immigrant communities. They contextualize the children’s play using teacher interview data in which the teachers explained their thinking behind the pedagogical decisions that made this type of learning and play possible. Finally, the authors explore how the teachers’ identities and histories positioned them to engage with their students in culturally sustaining ways. It is argued that with the growing global awakening to white supremacy structures and violence, there is urgency in creating time and space to support young children’s agency and their right to practice the skills they need to contribute to their communities’ well-being and survival now and in the future.
Modeling Cell Survival Fraction and Other Dose-Response Relationships for Immunodeficient C.B-17 SCID Mice Exposed to 320-kV X Rays
Authors: Scott Bobby R. , Lin Yong , Saxton Bryanna , Chen Wenshu , Potter Charles A. , Belinsky Steven A.
Published: May 2021

US homeland security concerns related to potential misuse of γ-ray-emitting radiation sources employed in radiobiological research (eg, shielded cesium-137 irradiators) led to recommendations by the National Research Council to conduct studies into possibly replacing γ-ray irradiators used in research involving small rodent and other models with X-ray instruments. A limiting factor is suitability of the X-ray photon energy spectra. The objective of our research was to demonstrate the suitability of the radiation energy spectrum of 320-kV X rays after filtration (HVL = 4 mm Cu) for in-vivo cytotoxicity studies in immunodeficient C.B-17 SCID mice. By using a previously-published Hazard Function (HF) model to characterize dose-response relationships for in vivo bone marrow and spleen cell survival fractions and also to characterize the acute lethality risk (hematopoietic syndrome mode) we demonstrate that the filtered 320-kV X-ray beam appears suitable for such studies. A key finding for C.B-17 SCID mice when compared to results previously obtained for immunocompetent C.B-17 mice is that the immunodeficient mice appear to be more radioresistant, implicating a possible role of the immune system capacity in radiosensitivity of mammals.
Enhanced heat transfer in H2O inspired by Al2O3 and γAl2O3 nanomaterials and effective nanofluid models
Authors: Adnan  , Khan Umar , Ahmed Naveed , Mohyud-Din Syed Tauseef
Published: May 2021

Currently, thermal improvement in the nanofluids over a curved Riga sheet is a topic of interest and attained popularity among the researchers. Therefore, the colloidal suspension of water suspended by [Formula: see text] and [Formula: see text] over a curved Riga surface is modeled for the heat transfer analysis. The nondimensionalization of the model is accomplished via invertible variables. On the basis of dynamic viscosities and thermal conductivities of [Formula: see text] and [Formula: see text] nanoparticles, two nanofluid models developed over a semi-infinite region. Then, the models solved numerically and found graphical results for the flow characteristics, thermophysical properties and local thermal performance rate by altering the pertinent flow parameters. It is examined that the fluid motion rapidly decreases for [Formula: see text] and momentum boundary layer region decreases. The squeezed and curvature parameters lead to reduce in the nanofluid velocity. The temperature of more magnetized enhances significantly. Thermophysical characteristics of the nanofluids enhance for higher volumetric fraction factor. More heat transfer at the Riga surface for higher M and R.
A novel decision tree model based on chromosome imbalances in cell-free DNA and CA-125 in the differential diagnosis of ovarian cancer
Authors: Zhang Weina , Zhang Yu-min , Gao Yuan , Zhang Shengmiao , Chu Weixin , Wei Guopeng , Li Ke , He Xuesong , Chen Long , Guo Li , Luan Shufang , Zhang Ping
Published: May 2021

Objective:

CA-125 is widely used as biomarker of ovarian cancer. However, CA-125 suffers low accuracy. We developed a hybrid analytical model, the Ovarian Cancer Decision Tree (OCDT), employing a two-layer decision tree, which considers genetic alteration information from cell-free DNA along with CA-125 value to distinguish malignant tumors from benign tumors.

Methods:

We consider major copy number alterations at whole chromosome and chromosome-arm level as the main feature of our detection model. Fifty-eight patients diagnosed with malignant tumors, 66 with borderline tumors, and 10 with benign tumors were enrolled.

Results:

Genetic analysis revealed significant arm-level imbalances in most malignant tumors, especially in high-grade serous cancers in which 12 chromosome arms with significant aneuploidy ( P<0.01) were identified, including 7 arms with significant gains and 5 with significant losses. The area under receiver operating characteristic curve (AUC) was 0.8985 for copy number variations analysis, compared to 0.8751 of CA125. The OCDT was generated with a cancerous score (CScore) threshold of 5.18 for the first level, and a CA-125 value of 103.1 for the second level. Our most optimized OCDT model achieved an AUC of 0.975.

Conclusions:

The results suggested that genetic variations extracted from cfDNA can be combined with CA-125, and together improved the differential diagnosis of malignant from benign ovarian tumors. The model would aid in the pre-operative assessment of women with adnexal masses. Future clinical trials need to be conducted to further evaluate the value of CScore in clinical settings and search for the optimal threshold for malignancy detection.
Dramatic response of refractory metastatic squamous cell carcinoma of the skin with cetuximab/pembrolizumab
Authors: Hober Candice , Jamme Philippe , Desmedt Eve , Greliak Anna , Mortier Laurent
Published: May 2021

Cutaneous squamous cell carcinoma (cSCC) accounts for 20% of skin cancers. At an advanced stage the prognosis is poor, making cSCC the second leading cause of death from skin cancer. In cases of metastatic or unresectable disease, anti-programmed cell death 1 (anti-PD1) treatment has shown promising results in a recent phase II study. Although anti-PD1 treatment now offers higher response rates, the responses remain inconsistent and may lead to therapeutic impasses. Preclinical data have suggested synergy between anti-epidermal growth factor receptor (anti-EGFR) and immunotherapy. We report the case of a patient with metastatic cSCC that proved refractory first to anti-EGFR/carboplatin and then to immunotherapy, but who showed a complete and durable response with cetuximab/pembrolizumab combination. This response could reflect synergy of the two treatments.
Exploring internet of healthcare things for establishing an integrated care link system in the healthcare industry
Authors: Wan HC , Chin KS
Published: May 2021

With the ageing population all over the world, long-term care services, such as nursing care, are essential to provide care and treatments to elderly patients in the community. During the nursing care services, elderly patients who live in the nursing homes require to be treated and consulted in a number of healthcare organisations, for example hospitals, mental health centres and rehabilitation centres. Currently, the data management for the elderly is relatively centralised to establish their own electronic medical records and protected health information without decision support functionalities. The community and healthcare industry are eager to develop a safe and comprehensive system to provide adequate healthcare services and monitoring to the elderly. In this study, an internet of healthcare things (IoHT)-based care link system (IoHT-CLS) is proposed, which provides a structured framework on integrating IoHT and artificial intelligence (AI) to generate a one-stop solution for managing elderly’s healthcare facilities. The elderly can be effectively linked into the integrated IoHT system by using various sensing and data collection technologies. The collected data are further processed by means of the adaptive neuro-fuzzy inference system and case-based reasoning to provide the functionalities of risk management and customised elderly service programmes for the elderly care institutions. Consequently, this study contributes to the healthcare management through the enhancement of service quality in the community.
Differences in the Demographics and Preferred Management of Knee Cartilage Injuries in Soccer Players Across FIFA Centers of Excellence
Authors: Marom Niv , Warner Tyler , Williams Riley J.
Published: May 2021

Objective

We sought to report on the demographics and epidemiology of knee cartilage injuries and preferred management in soccer players, across FIFA Medical Centers of Excellence (FMCE).

Design

A descriptive questionnaire focusing on characteristics of knee cartilage injuries and their management in soccer players during the 10-year period prior to the distribution of the questionnaire was sent to all FMCE around the world in September 2019 via an online platform. Voluntary responses from centers were processed and analyzed. Descriptive characteristics were reported using median and interquartile ranges (IQR) for continuous variables and frequencies and percentages (%) for discrete variables.

Results

A total of 15 centers from 5 continents responded to the questionnaire and reported on a total of 4526 soccer players. Among centers, the median age was 27 years (IQR: 23-38), the median rate of male players was 75% (IQR: 68-90), and the median rate of professional players was 10% (IQR: 5-23). The most common reported etiology for cartilage injury was traumatic (median 40%, IQR: 13-73). The most common nonoperative treatment utilized was physical therapy (median 90%, IQR: 51%-100%) and the most common operative treatment utilized was bone marrow stimulation/micro-fracture (median 40%, IQR: 19-54%). The utilization of other cartilage restoration procedures varied across centers.

Conclusions

Our findings highlight different tendencies in the management of these injuries across FMCE and emphasize the need for collaborative efforts focusing on establishing consensus guidelines for the optimal management of these challenging injuries in soccer players.
COVID-19 vaccination willingness among people with multiple sclerosis
Authors: Xiang Xinran M , Hollen Chris , Yang Qian , Brumbach Barbara H , Spain Rebecca I , Wooliscroft Lindsey
Published: May 2021

Background

Hesitancy to receive COVID-19 vaccination is a major public health concern. COVID-19 vaccine willingness and the factors contributing to willingness in adults with multiple sclerosis (MS) is unknown. We administered an online survey from 1 December 2020 to 7 January 2021 to adults with MS to estimate COVID-19 vaccine willingness among adults with MS. Bivariate analysis with chi-square testing compared categorical variables associated with vaccine willingness.

Results

Of 401 respondents, 70.1% were willing to receive an authorized COVID-19 vaccination if it was available to them, 22.7% were unsure, and 7.2% were unwilling. The most frequent concern for those unsure was vaccine safety. Vaccine willingness was associated with increased perceived personal risk of COVID-19 (χ2 = 45.4; p < 0.0001), prior influenza vaccine acceptance (χ2 = 97.6; p < 0.0001), higher educational level (χ2 = 50.2; p < 0.0001), and if respondents discussed or planned to discuss the COVID-19 vaccine with their neurologists (χ2 = 64.3; p < 0.0001).

Conclusion

While COVID-19 vaccination willingness is high among people with MS, nearly 30% were either unwilling or unsure about being vaccinated. Neurologists should be aware of patient-centered factors associated with COVID-19 vaccine willingness and address COVID-19 vaccine safety concerns in discussions with their vaccine-unsure MS patients.