bluuebunny/crossref_metadata_2025 huggingface dataset:
Stigma Associated With Sickle Cell Disease in Kumasi, Ghana
Authors: Buser Julie M. , Bakari Ashura , Seidu Abdul-Aziz , Paintsil Vivian , Osei-Akoto Alex , Amoah Rexford , Otoo Benjamin , Moyer Cheryl A.
Published: April 2021

Introduction

People with sickle cell disease (SCD) often face stigmatization in Ghana and elsewhere in Africa. Research is needed to understand whether it is necessary to design an SCD stigma reduction program in the Ghanaian setting. The aim of this study was to explore the perception of stigmatization for adults with SCD in Kumasi, Ghana.

Methodology

Using in-depth qualitative interviews, researchers conducted a phenomenological study to investigate the perception of stigmatization for people with SCD in Kumasi, Ghana. Snowball and purposive sampling was used to identify the participants.

Results

Participants ( n = 12) were mostly female, Akan, and Christian. Researchers categorized three main themes: (a) Feelings of social isolation, (b) Fear of disclosure, and (c) Bullying about physical appearance.

Discussion

The findings highlight the need to develop effective strategies to counteract stigma. Transcultural health care providers can implement stigma reduction interventions that might be applicable throughout Africa where findings are likely to resonate with patients with SCD.
Mapping Global Cyberterror Networks: An Empirical Study of Al-Qaeda and ISIS Cyberterrorism Events
Authors: Lee Claire Seungeun , Choi Kyung-Shick , Shandler Ryan , Kayser Chris
Published: April 2021

This study explores the internal dynamics and networks of terrorist groups in cyberspace—in particular, Al-Qaeda and the Islamic State of Iraq and al-Sham (ISIS). Using a “Global Cyberterrorism Dataset” that features data on cyberterror attacks between 2011 and 2016, this research analyzes these two terrorist groups through the lens of a cyber-conflict theory that integrates conflict theory with Jaishankar’s space transition theory. Through a network analysis methodology, we examine the invisible relationships and connections between the national origins and target countries of cyberterror attacks. The analysis focuses on the networks of national origins of terrorists and victims, network structures of Al-Qaeda and ISIS actors, and clustering networks of Al-Qaeda and ISIS cyberterrorists. Results indicate that terror in cyberspace is ubiquitous, more flexible than traditional terrorism, and that cyberattacks mostly occurred within the countries of origin. We conclude by discussing the complex features of cyberterror networks and identify some of the geostrategic implications of the divergent cyber strategies adopted by Al-Qaeda and ISIS.
Primary Testicular Neuroendocrine Tumor Coexisting With Seminoma Sharing Germ Cell Origin
Authors: Iida Noriyuki , Takemura Kosuke , Ito Masaya , Funata Nobuaki , Yonese Ichiro , Suzuki Hiroaki , Tsuzuki Toyonori , Koga Fumitaka
Published: April 2021

A 40-year-old, male, Japanese patient presented with the complaint of painless, right testicular swelling. Tumor markers for testicular cancer were normal. He underwent radical orchiectomy with the clinical diagnosis of stage I seminoma. Pathological examination revealed seminoma and coexisting neuroendocrine tumor (NET). Germ cell neoplasia in situ (GCNIS) was present in the vicinity of seminoma, but there was no continuity between NET and seminoma. Tumor cells of both lesions displayed amplification of 12p and isochromosome 12p on fluorescence in situ hybridization, suggesting that both tumors originated from GCNIS. The present report is the first to describe a case of primary testicular NET coexisting with seminoma in an ipsilateral testis.
Acral Dedifferentiated Chondrosarcoma: Report of a Case Arising in the Proximal Phalanx of the Fourth Finger
Authors: Gaeta Raffaele , Aringhieri Giacomo , Zampa Virna , D’Arienzo Antonio , Andreani Lorenzo , Capanna Rodolfo , Zavaglia Katia , Franchi Alessandro
Published: April 2021

Dedifferentiated chondrosarcoma is a well-recognized entity, but its occurrence in the distal extremities is exceedingly rare. We present the case of a 49-year-old woman who experienced local recurrence of an “enchondroma” of the proximal phalanx of the fourth finger of the left hand, which had been initially treated with intralesional curettage at another hospital 4 years before, and 1 year before for a local recurrence. The imaging findings indicated an aggressive behavior, and an incisional biopsy showed a highly cellular proliferation of spindle and pleomorphic elements without evidence of matrix production intermixed with few fragments of a well-differentiated cartilaginous neoplasm with bland cellular atypia, focal nuclear hyperchromatism, and binucleation. An isocitrate dehydrogenase 2 R172S mutation was detected. The final diagnosis was dedifferentiated chondrosarcoma. Despite amputation of the fourth finger, the patient developed lung metastases and further local relapse. Recurrent cartilaginous tumors of the extremities should not be underestimated and should be followed in view of the possible acquisition of aggressive clinical behavior.
CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury
Authors: Mann Ohad , Peery Dana , Bader Segev Ronnie , Klainbart Sigal , Kelmer Efrat , Sobarzo Ariel , Shub Vered , Rapoport Kira , Shamir Merav H , Chai Orit
Published: April 2021

Objectives

The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI).

Methods

The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed.

Results

Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term ( P = 0.005) and long-term ( P = 0.023) survival. KCTS was significantly associated with short-term survival ( P = 0.002) and long-term survival ( P = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival.

Conclusions and relevance

KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.
Arterial vascular access complication in osteogenesis imperfecta
Authors: Chughtai Asim , Dey Ramita , Chattopadhyay Sudipta
Published: April 2021

We present a case of the catastrophic bleeding from the femoral access site after an uncomplicated puncture in a patient with Type 1 osteogenesis imperfecta (OI) undergoing coronary angiogram via the femoral route. This had to be treated with a covered stent at the puncture site. This is an extremely rare complication in OI. The potential pathological mechanisms of this complication are discussed. An interventionist will rarely encounter such a patient in the catheterisation laboratory but would do well to be aware of this potential complication.
Reverse tapered versus non-tapered peripherally inserted central catheters: A narrative review
Authors: Bertoglio Sergio
Published: April 2021

Introduced over 20 years ago, the reverse tapering design for PICC catheters is supposed to have some benefits in terms of both efficacy and safety. In particular, it would ensure less postoperative bleeding at the exit site and greater effectiveness in preventing kinking or twisting of the same. Since its introduction, these hypothesized advantages have never been demonstrated in clinical studies, however very scarce, which have highlighted neither advantages nor disadvantages of reverse tapered catheters when compared to non-reverse tapered ones. This narrative review analyzes some aspects of the use of reverse tapered PICCs, also paying attention to some possible undesirable effects that have arisen from the introduction into clinical practice of new subcutaneous systems of securement of PICCs to the skin. Clinicians should be aware of the fact that reverse tapering design does not represents a sure improvement in terms of safety and efficacy of PICCs and its adoption should be weighed against possible clinical disadvantages.
Walking-induced endothelial dysfunction predicts ischemic cardiovascular events in patients with intermittent claudication
Authors: Migliacci Rino , Guglielmini Giuseppe , Busti Chiara , Falcinelli Emanuela , Minuz Pietro , Gresele Paolo
Published: April 2021

Endothelial dysfunction, evaluated by flow-mediated dilatation (FMD), predicts adverse cardiovascular events in patients with intermittent claudication (IC). IC is an example of repeated ischemia/reperfusion injury that may contribute to the progression of vascular disease by worsening endothelial function, a trigger for acute cardiovascular events. The predictive value of effort-induced endothelial dysfunction for cardiovascular events in patients with IC has not been studied previously. The objective of this study was to assess whether exercise-induced endothelial dysfunction is predictive of adverse cardiovascular outcome in IC. In 44 patients with IC, we measured brachial artery FMD by B-mode ultrasonography at rest and 10 minutes after a maximal treadmill exercise. Treadmill exercise halved the FMD (from 3.5 ± 0.6% to 1.45 ± 0.46%, p < 0.05). After a follow-up period of 85 (72–98) months, a total of 20 major cardiovascular events occurred. In a multivariate analysis, a post-exercise reduction of brachial FMD > 1.3% was predictive for cardiovascular events. Maximal exercise-induced endothelial dysfunction is predictive of cardiovascular events in patients with IC.
Ten weeks in: COVID-19-related distress in adults with autism spectrum disorder
Authors: Adams Ryan E , Zheng Shuting , Taylor Julie Lounds , Bishop Somer L
Published: April 2021

This study examined COVID-19-related distress among adults with autism spectrum disorder and its associations with demographic and mental health information. A sample of 275 adults (ages 18–35) in the United States, all capable of providing self-reports, was recruited from a large national registry. Adults completed online surveys of mental health symptoms just before COVID-19 was declared a pandemic. Two months later, they completed the same surveys of mental health symptoms, and also reported about distress they had experienced as a result of the COVID-19 pandemic. Nearly two-thirds (65.9%) endorsed some form of COVID-related distress with a little over half reporting any individual form of distress. Although depressive and anxiety symptoms did not change from Time 1 to Time 2 on average, higher levels of COVID-related distress was associated with an increase in depressive and anxiety symptoms between Time 1 and Time 2. In addition, women and those who reported higher anxiety symptoms before the pandemic were more likely to report some form of COVID-related distress. The findings suggest that as this global crisis continues to unfold, it will be critical to ensure that adults with autism spectrum disorder who were experiencing mental health challenges prior to the pandemic receive appropriate monitoring.

Lay abstract

This study used data collected from 275 adults in the United States with autism spectrum disorder both before the pandemic and then 10 weeks into the pandemic to assess COVID-19-related distress and its impact. Two-thirds of those surveyed reported some type of distress related to the pandemic (i.e. difficulty coping or negative impact on emotional and mental health). While there were no changes in depressive and anxiety symptoms from prior to COVID-19 to 10 week later in the group as a whole, self-reported distress predicted increases in both anxiety and depression across the two timepoints. Furthermore, adults with higher levels of anxiety prior to the pandemic were more likely to report distress, and women were more likely to report a negative impact of the pandemic on their emotional and mental health. Findings highlight the importance of monitoring with adults with autism spectrum disorder to assess their need for mental health support, and providing ongoing support to those who already experience anxiety even before the pandemic.
Why do parents refuse childhood vaccination? Reasons reported in Finland
Authors: Nurmi Johanna , Harman Bronwyn
Published: April 2021

Aims:

This article examines the reasons for partial and complete refusal of childhood vaccination as reported by parents in Finland. It analyzes perceptions and experiences central in vaccination decisions.

Methods:

The analysis is based on 38 in-depth interviews with Finnish parents who have refused all or several vaccines for their children. The interviews were analyzed using qualitative content analysis.

Results:

Three categories of reasons were identified in the analysis: 1) risks and effects of vaccination – concern about and/or experiences of possible side-effects was the most important reason for avoiding vaccines; 2) distrust – participants did not trust vaccination recommendations made by health officials and medical professionals due to perceived bias in medical research, ties between health officials and the pharmaceutical industry, and personal experiences of (suspected) adverse effects and the way these concerns were received in healthcare institutions; 3) health perceptions and practices – parents supported their vaccination choices with complementary and alternative medicine treatments and alternative health understandings. Many stated that contracting vaccine-preventable illnesses would provide longer lasting and more ‘natural’ immunity than vaccination, and possibly other health benefits.

Conclusions:

A loss of trust in medical and public health actors was central to the process in which parents came to question, contest, and eventually refuse childhood vaccination. The adverse effects of the Pandemrix vaccine in 2009–2010 have been important in leading to distrust and contestation. Distrust may relate to personal experiences of (suspected) adverse effects or to broader concerns over the neutrality of health authorities and the trustworthiness of medical research.
Storing and sharing: Everyday relationships with digital material
Authors: Horst Heather , Sinanan Jolynna , Hjorth Larissa
Published: April 2021

Solid-state drives, Bluetooth capabilities, smartphones, “the cloud,” social media platforms, and other digital technologies have fundamentally altered how we share and store digital materials. This article sets an agenda for understanding how people manage the proliferation of digital material in their everyday lives through a close examination of the strategies and rituals different people around the world employ to organize, curate, or delete digital materials. Drawing upon findings from 11 articles, it contextualizes contemporary forms with digital media and technologies with existing cultural practices of sharing and storing in relation to wider social and cultural systems and infrastructures such as household and family, logistics, health, government, and governance. We argue that the proliferation of platforms, changes in temporalities, and the emergence of different forms of digital labor have fundamentally shaped the ways in which we share and store digital material.
Veiling the image/framing the body: The labour of enduring ephemerals in the context of trans* male adult camming practices on Chaturbate
Authors: Theunissen Eva , Favero Paolo Silvio Harald
Published: April 2021

Focusing on male transgender cammers on adult web page Chaturbate, this article goes into depth with issues of labour, archiving and in/visibility. The article starts by examining the production processes that characterize adult camming and argues that much of the labour involved is hidden behind the live screen. Next, we will look into the archival procedures that accompany camming shows. We suggest that adult camming is characterized by a tension between the ephemerality of live-streamed images and their ‘endurance’ caused by automated archival procedures. The second part of the article focuses on the strategies two male transgender cammers deploy for navigating these tensions. Their experiences highlight how, in this context, pleasure and personal gain can only be achieved by exercising a degree of control on the dialectic between human agency and machine-driven automation. Controlling the scope of visibility on the live screen is crucial in this process and can be understood as a form of labour in and of itself.
Digital material value: Designing emerging technologies
Authors: Lanzeni Debora , Pink Sarah
Published: April 2021

In this article, we examine how the digital material value of emerging technologies is articulated in technology design contexts. We argue that here digital material value lies not in the monetisation of an artefact or product but in the opening up of possibilities for its use. Thus, to generate digital material value, a certain configuration of things and processes that enables its value to be relevant is required. We develop this through a processual theory of digital materiality, which attends to how the affordances of digital material things emerge in shifting circumstances, and a corresponding theory of value. To demonstrate how this happens in human experience and action, we draw on ethnographic research with drone developers in Australia. Studying digital materiality through emerging technologies goes beyond seeing technologies and data as finished commodities that are modified when consumed towards studying the incompleteness of the technology design process itself.
‘What would happen if you can’t see your money?’: Visibility and the emergent infrastructures of digital money storage in China
Authors: McDonald Tom , Guo Yanan
Published: April 2021

This article adopts an infrastructural perspective to analyse Chinese migrant factory workers’ conceptions of and approaches towards storing money on digital payment platforms. Scholars studying infrastructural systems have emphasised that such systems generally only become visible upon breakdown. However, this article finds that during the emergence of new infrastructures for monetary storage, existing infrastructures – along with the money stored within them – also become rendered conspicuous to users. In such moments, migrant factory workers are forced to assess the differences between existing and new infrastructural systems and make careful decisions over how to store their money. We claim it is necessary to acknowledge the shifting visibility of infrastructures during occasions of systemic transformation. Doing so can help to better understand how users navigate such infrastructures in attempts to solve problems of storage, while in the process re-evaluating their relationships with a variety of entities and institutions.
Micromechanical life prediction method of fiber-reinforced ceramic-matrix composites subjected to stochastic overloading at room temperature
Authors: Li Longbiao
Published: April 2021

In this paper, a micromechanical fatigue life prediction method for fiber-reinforced ceramic-matrix composites subjected to stochastic overloading at room temperature is developed. Fatigue damage mechanisms in the matrix, interfaces, and fibers are characterized using different damage models. Relationships between the fatigue life and related degradation rate, stochastic overloading stress, and breakage of intact fibers are established. Experimental fatigue life of different C/SiC composites subjected to different stochastic overloading is predicted. For the same stochastic overloading condition, the degradation rate of fatigue life is the highest for cross-ply C/SiC composite, and the lowest for 2.5D C/SiC composite.
Experimental investigation of the fluctuating static pressure in a subsonic axisymmetric jet
Authors: Li Songqi , Ukeiley Lawrence S
Published: April 2021

Measuring the fluctuating static pressure within a jet has the potential to depict in-flow sources of the jet noise. In this work, the fluctuating static pressure of a subsonic axisymmetric jet was experimentally investigated using a 1/8” microphone with an aerodynamically shaped nose cone. The power spectra of the fluctuating pressure are found to follow the -7/3 scaling law at the jet centerline with the decay rate varying as the probe approaches the acoustic near field. Profiles of skewness and kurtosis reveal strong intermittency inside the jet shear layer. By applying a continuous wavelet transform (CWT), time-localized footprints of the acoustic sources were detected from the pressure fluctuations. To decompose the fluctuating pressure into the hydrodynamic component and its acoustic counterpart, two techniques based on the CWT are adopted. In the first method the hydrodynamic pressure is isolated by maximizing the correlation with the synchronously measured turbulent velocity, while the second method originates from the Gaussian nature of the acoustic pressure where the separation threshold is determined empirically. Similar results are obtained from both separation techniques, and each pressure component dominates a certain frequency band compared to the global spectrum. Furthermore, cross-spectra between the fluctuating pressure and the turbulent velocity were calculated, and spectral peaks appearing around Strouhal number of 0.4 are indicative of the footprint of the convecting coherent structures inside the jet mixing layer.
Effect of graphite particulate on mechanical characterization of hybrid polymer composites
Authors: Dhanunjayarao BN , Sanivada Usha Kiran , Swamy Naidu NV , Fangueiro Raul
Published: April 2021

Quest for producing lightweight and biodegradable materials has encouraged researchers to replace synthetic fibers with natural fibers. Hence a study is made to investigate the effects of introducing secondary reinforcement (natural fibers), stacking sequence, and addition of graphite particles on the mechanical characteristics and water uptakes along with diffusivity of hybrid (glass\jute) composites. Different weight fractions of graphite particulates are incorporated into the epoxy to produce different samples having 4 plies for each sample by hand layup vacuum bagging method. The obtained specimens are subjected to various mechanical tests, water absorption tests as per the ASTM standards, and optical microscopy was used to study the fracture morphology of the samples. The results displayed that the properties are deteriorated a little with the addition of secondary reinforcement, however they have improved with the addition of graphite. E-Glass as skin layer and treated jute as core layer composite exhibits ameliorate tensile strength (201.5 MPa), compression strength (515.12 MPa), flexural strength (106.9 MPa), hardness (25 BHN). However highest impact energy of 26 J is recorded for the sample with jute as skin layer and E-Glass as the core layer. Water absorption tests revealed that the addition of graphite has reduced the water absorption in the hybrid samples.
The “Social Science” of Segregation: Between the “Charitable” Surveys of the Progressive Era and the “Appraisal” Surveys of the New Deal Era
Authors: Rovner Melissa
Published: April 2021

Between the “charitable” surveys of the Progressive Era and the “appraisal” surveys of the New Deal Era, the field of “Social Science” emerged. Although the philanthropic surveys of the Progressive Era influenced housing reform for working-class Persons of Color in urban neighborhoods, while the federal surveys of the New Deal Era influenced real estate disinvestment in those same neighborhoods, each had the effect of furthering segregation. This article considers the commonalities among the discourses, methods, and results of these two seemingly disparate ends of the survey spectrum to illuminate their respective contributions to one another and to segregation.
Concurrent Ilio-Enteric and Ilio-Vesical Fistula From Large Aorto-Iliac Aneurysm
Authors: Narroway Harry G. , Parkin Cameron J. , Liang Ina , Latif Edward , Bourke Bernard M.
Published: April 2021

Iliac artery aneurysms (IAA) are associated frequently with abdominal aortic (AAA) and other degenerative large-vessel aneurysms. Concurrent fistulization of the aortoiliac tree into the gastrointestinal tract (GIT) and bladder is exceptionally rare. We herewith report a unique case of concurrent ilio-enteric and ilio-vesical fistula arising from a large aorto-iliac aneurysm.
Hypoechogenicity of the midbrain raphe detected by transcranial sonography: an imaging biomarker for depression in migraine patients
Authors: Zhang YiShui , Liu Ying , Han Ruoyun , Liu Kangding , Xing Yingqi
Published: April 2021

Background:

The high comorbidity of migraine and depression is suggestive of shared risk factors or common mechanisms between the two diseases. In individuals with a depressive disorder, there is a high prevalence of altered midbrain raphe (MBR) echogenicity, detectable via transcranial sonography (TCS), that is suggested to be linked with a dysfunction of the serotoninergic system. In patients with migraine, this alteration has seldom been explored in earlier studies, and conclusions are often lacking. Our study aimed to elucidate whether this alteration is specific to migraine and to determine whether it is related with depression.

Methods:

This study enrolled patients with migraine ( n = 100, 72% female) and patients with tension-type headache disorders (TTH) ( n = 62, 78.5% female) from a headache clinic. In addition, 79 healthy subjects (79.7% female) were recruited as controls. All participants underwent a standard interview to evaluate headache information and an interview with psychiatrists for depression evaluation. TCS examinations were performed on all participants.

Results:

Patients with migraine had a higher rate of MBR hypoechogenicity (28%) compared with that of healthy controls (15.2%) and that of patients with TTH (12.9%). In patients with migraine, reduced MBR echogenicity was associated with depressive symptoms assessed using the Hamilton Depression Rating Scale (HAM-D). No association between migraine self-medication and MBR echogenicity was found.

Conclusion:

Reduced-echoic MBR detected by TCS is prevalent in migraine patients and is associated with depressive symptoms. TCS-detected hypoechogenic MBR abnormality could be an imaging biomarker of depressive symptoms in patients with migraine.
Factors affecting drug survival of an alternative TNF inhibitor and secukinumab in patients with ankylosing spondylitis switching from the first TNF inhibitor
Authors: Kwon Oh Chan , Park Jung Hwan , Park Min-Chan
Published: April 2021

Background:

To investigate factors associated with drug survival of an alternative tumour necrosis factor inhibitor (TNFi) and secukinumab (SEC) after switching from the first TNFi in patients with ankylosing spondylitis (AS).

Methods:

We included a total of 78 patients with AS who switched to an alternative TNFi ( n = 56) or SEC ( n = 22) from the first TNFi. Patient characteristics at the time of switching and drug discontinuation rate were compared between the two groups. Cox regression analyses were performed to evaluate factors associated with the risk of discontinuing the alternative TNFi and SEC.

Results:

The proportion of patients with syndesmophytes was numerically lower (28.6% versus 45.5%, p = 0.155) and the C-reactive protein (CRP) level was numerically higher [3.8 (1.0–15.4) mg/L versus 1.1 (0.5–3.5) mg/L, p = 0.060] in patients who received an alternative TNFi. The drug discontinuation rate (alternative TNFi: 35.7% versus SEC: 36.4%, p = 0.957) and reasons for discontinuation were similar (primary failure, p = 0.342; secondary failure, p > 0.999; and adverse events, p = 0.670) between the two groups. A higher CRP level at switching was associated with a lower risk (adjusted HR = 0.93, 95% CI = 0.87–0.99, p = 0.022) of discontinuing the alternative TNFi, and primary failure of the first TNFi was associated with a higher risk [adjusted HR (HR) = 5.20, 95% confidence interval (CI) = 1.91–14.11, p = 0.001]. Current smokers (adjusted HR = 5.77, 95% CI = 1.20–27.74, p = 0.029) and the presence of syndesmophytes (adjusted HR = 7.49, 95% CI = 1.39–40.23, p = 0.019) were associated with a higher risk of discontinuing SEC.

Conclusion:

When switching the drug from the first TNFi in patients with AS, an alternative TNFi could be preferable in patients with higher CRP levels or syndesmophytes, or current smokers, whereas SEC could be a better choice in patients who presented primary failure of the first TNFi in terms of drug survival.
Hyper-Acute Necrotizing Encephalopathy-Like Syndrome in Early Pregnancy
Authors: Holmes Brandon B. , Nolan Amber , Wong Charmian , Sun Chung-Huan
Published: April 2021

Acute necrotizing encephalopathy (ANE) is a rare and life-threatening disease. It is caused by a cytokine-mediated injury to the brain with characteristic hemorrhagic and edematous lesions involving the bilateral thalami, brainstem, and other subcortical structures. The disease is commonly associated with antecedent viral triggers such as influenza, parainfluenza, and more recently, SARS-CoV-2, with subsequent neurologic deterioration occurring within days to weeks. Here, we present a case of a pregnant adult woman who developed a hyperacute form of ANE, progressing to brain death within 36 hours of symptom onset. Her diagnosis was confirmed via brain imaging, CSF studies, and neurohistopathological analysis. This case highlights the importance of establishing an early diagnosis for this under-recognized disease, and also suggests an association between ANE and early pregnancy.
A Search Advantage for Horizontal Targets in Dynamic Displays
Authors: Thornton Ian M. , Vuong Quoc C. , Pilz Karin S.
Published: April 2021

Several lines of evidence point to the existence of a visual processing advantage for horizontal over vertical orientations. We investigated whether such a horizontal advantage exists in the context of top-down visual search. Inspired by change detection studies, we created displays where a dynamic target -- a horizontal or a vertical group of five dots that changed contrast synchronously -- was embedded within a randomly flickering grid of dots. The display size (total dots) varied across trials, and the orientation of the target was constant within interleaved blocks. As expected, search was slow and inefficient. Importantly, participants were almost a second faster finding horizontal compared to vertical targets. They were also more efficient and more accurate during horizontal search. Such findings establish that the attentional templates thought to guide search for known targets can exhibit strong orientation anisotropies. We discuss possible underlying mechanisms and how these might be explored in future studies.
Excess deaths in treatment-resistant depression
Authors: Brenner Philip , Reutfors Johan , Nijs Michel , Andersson Therese M-L
Published: April 2021

Background:

Patients with treatment-resistant depression (TRD) have an increased mortality risk compared with other patients with depression, but it is not known how this translates into absolute numbers of excess deaths.

Methods:

Swedish national registers were used to identify a cohort of 118,774 antidepressant initiators 18–69 years old with a depression diagnosis. Patients who initiated a third consecutive treatment trial were classified as having TRD. Flexible parametric survival models were used to estimate the mortality risk due to all causes and external causes (suicides and accidents), comparing TRD patients with patients with other depression while adjusting for clinical and sociodemographic covariates and including interactions with TRD, age, and Charlson comorbidity index (CCI) for a number of somatic comorbidities. Standardized survival was estimated, as were numbers of excess deaths among TRD patients within each age and comorbidity category.

Results:

Compared with the mortality risk of other depressed patients, patients with TRD experienced excess deaths in most age and comorbidity categories in the range of 7–16 deaths per 1000 patients during 5 years. Highest numbers for all-cause excess deaths were found among patients 18–29 years old with CCI 1, where 16 [95% confidence interval 5–28] of the expected 37 [25–48] deaths per 1000 patients were excess deaths. The majority of the excess deaths were due to external causes.

Conclusion:

Patients with TRD experience significant numbers of excess deaths compared with other patients with depression.
Right middle lobe obstruction associated with synchronous endobronchial carcinoid and aspergillosis
Authors: Kim Yoonjoo , Park Dongil , Chung Chaeuk
Published: April 2021

Pulmonary carcinoids originate from neuroendocrine cells of the lung and comprise 0.5%–5% of all lung malignancies. Endobronchial carcinoids are rare, low-grade malignant tumors that occasionally coexist with other infectious diseases, including tuberculosis and nontuberculous mycobacterial infection. We treated a 63-year-old woman who presented with a right middle lobe obstruction. A chest computed tomography scan demonstrated a mass-like lesion in the right middle lobe with mediastinal lymphadenopathy. She underwent an exploratory operation after 2 weeks of antibiotic treatment. The pathology revealed a right middle lobe bronchial carcinoid tumor and aspergillosis. Chest computed tomography scans have revealed no recurrence of the carcinoid or aspergillosis during the 5-year follow-up.
Development of the Canadian Women-Centred HIV Care Model Using the Knowledge-to-Action Framework
Authors: Loutfy Mona , Tharao Wangari , Kazemi Mina , Logie Carmen H. , Underhill Angela , O’Brien Nadia , Pick Neora , Kestler Mary , H.Yudin Mark , Rana Jesleen , MacGillivray Jay , Kennedy V. Logan , Jaworsky Denise , Carvalhal Adriana , Conway Tracey , Webster Kath , Lee Melanie , Islam Shaz , Nicholson Valerie , Ndung’u Mary , Proulx-Boucher Karène , Carter Allison , Gormley Rebecca , Narasimhan Manjulaa , Welbourn Alice , de Pokomandy Alexandra , Kaida Angela ,   on behalf of the CHIWOS Research Team
Published: April 2021

In Canada, women make up 25% of the prevalent HIV cases and represent an important population of those living with HIV, as a high proportion are racialized and systemically marginalized; furthermore, many have unmet healthcare needs. Using the knowledge-to-action framework as an implementation science methodology, we developed the “Women-Centred HIV Care” (WCHC) Model to address the needs of women living with HIV. The WCHC Model is depicted in the shape of a house with trauma- and violence-aware care as the “foundation”. Person-centred care with attention with attention to social determinants of health and family make up the “first” floor. Women’s health (including sexual and reproductive health and rights) and mental and addiction health care are integrated with HIV care, forming the “second” floor. Peer support, leadership, and capacity building make up the “roof”. To address the priorities of women living with HIV in all their diversity and across their life course, the WCHC Model should be flexible in its delivery (e.g., single provider, interdisciplinary clinic or multiple providers) and implementation settings (e.g., urban, rural).
Election boycott in a hybrid regime: The case of 2020 parliamentary elections in Serbia
Authors: Bursać Dejan , Vučićević Dušan
Published: April 2021

The 2020 elections in Serbia were held on 21st of June, as the first elections in Europe since the outbreak of coronavirus pandemic. The pre-electoral period was marked by the announcement of boycott from opposition, followed by a number of attempts of ruling party to mitigate the potential negative effects. The decision of opposition to restrain from participation came as a response to the long-term accusations of heavily biased electoral and media conditions, which culminated in EU-mediated (but largely unsuccessful) roundtable talks in 2019. On a larger scale, the administration headed by the President Aleksandar Vučić is becoming increasingly authoritarian, with several indices now classifying Serbia as a hybrid regime. As expected, the elections brought a convincing victory to Vučić’s Serbian Progressive Party, which won 188 out of 250 seats. Despite the overwhelming triumph, government was formed more than four months later. This paper is contributing to the literature on actors’ strategies in hybrid regimes. Although only short-term effects of the boycott could be assessed, the 2020 elections in Serbia demonstrate that legitimacy of the regime cannot be endangered if the opposition is not supported by international actors, and moreover, that the election results have only strengthened the regime.
Acceptability of nurse-led reviews for inflammatory rheumatological conditions: A qualitative study
Authors: Herron Daniel , Chew-Graham Carolyn A , Hider Samantha , Machin Annabelle , Paskins Zoe , Cooke Kendra , Desilva Erandie Ediriweera , Jinks Clare
Published: April 2021

Background:

People with inflammatory rheumatological conditions (IRCs), are at increased risk of comorbidities such as cardiovascular disease, osteoporosis, anxiety and depression. The INCLUDE pilot trial evaluated a nurse-delivered review of people with IRCs which sought to identify and initiate management of comorbid conditions.

Aim:

A nested qualitative study was undertaken to examine the acceptability of the INCLUDE review.

Methods:

A qualitative interview-based design in UK primary care settings. A purposive sample of 20 patients who attended an INCLUDE review, were interviewed. Inductive thematic analysis was undertaken. Themes were agreed through multidisciplinary team discussion and mapped onto constructs of the Theoretical Framework of Acceptability (TFA).

Results:

Six themes mapped onto six of the seven TFA constructs. Patients reported the review to be effective by identifying and initiating management of previously unrecognised comorbid conditions. Some participants reported barriers to following recommendations, such as lifestyle modifications or taking more medication.

Conclusion:

A nurse-delivered review to identify comorbidities is acceptable to patients with IRCs. The TFA provided a novel analytical lens.
Sustainability in additive manufacturing: Exploring the mechanical potential of recycled PET filaments
Authors: Schneevogt Helge , Stelzner Kevin , Yilmaz Buket , Abali Bilen Emek , Klunker André , Völlmecke Christina
Published: April 2021

Herein, the effects of recycled polymers on the mechanical properties of additively manufactured specimens, specifically those derived by fused deposition modelling, are determined. The intention is to investigate how 3D-printing can be more sustainable and how recycled polymers compare against conventional ones. Initially, sustainability is discussed in general and more sustainable materials such as recycled filaments and biodegradable filaments are introduced. Subsequently, a comparison of the recycled filament recycled Polyethylene terephthalate (rePET) and a conventional Polyethylene terephthalate with glycol (PETG) filament is drawn upon their mechanical performance under tension, and the geometry and slicing strategy for the 3D-printed specimens is discussed. Finally, the outcomes from the experiments are compared against numerically determined results and conclusions are drawn.
Interventions and outcomes of adult patients with B-ALL progressing after CD19 chimeric antigen receptor T-cell therapy
Authors: Wudhikarn Kitsada , Flynn Jessica R. , Rivière Isabelle , Gönen Mithat , Wang Xiuyan , Senechal Brigitte , Curran Kevin J. , Roshal Mikhail , Maslak Peter G. , Geyer Mark B. , Halton Elizabeth F. , Diamonte Claudia , Davila Marco L. , Sadelain Michel , Brentjens Renier J. , Park Jae H.
Published: April 2021

CD19-targeted chimeric antigen receptor (CAR) T-cell therapy has become a breakthrough treatment of patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). However, despite the high initial response rate, the majority of adult patients with B-ALL progress after CD19 CAR T-cell therapy. Data on the natural history, management, and outcome of adult B-ALL progressing after CD19 CAR T cells have not been described in detail. Herein, we report comprehensive data of 38 adult patients with B-ALL who progressed after CD19 CAR T therapy at our institution. The median time to progression after CAR T-cell therapy was 5.5 months. Median survival after post–CAR T progression was 7.5 months. A high disease burden at the time of CAR T-cell infusion was significantly associated with risk of post–CAR T progression. Thirty patients (79%) received salvage treatment of post–CAR T disease progression, and 13 patients (43%) achieved complete remission (CR), but remission duration was short. Notably, 7 (58.3%) of 12 patients achieved CR after blinatumomab and/or inotuzumab administered following post–CAR T failure. Multivariate analysis revealed that a longer remission duration from CAR T cells was associated with superior survival after progression following CAR T-cell therapy. In summary, overall prognosis of adult B-ALL patients progressing after CD19 CAR T cells was poor, although a subset of patients achieved sustained remissions to salvage treatments, including blinatumomab, inotuzumab, and reinfusion of CAR T cells. Novel therapeutic strategies are needed to reduce risk of progression after CAR T-cell therapy and improve outcomes of these patients.
HLA-haploidentical vs matched unrelated donor transplants with posttransplant cyclophosphamide-based prophylaxis
Authors: Gooptu Mahasweta , Romee Rizwan , St. Martin Andrew , Arora Mukta , Al Malki Monzr , Antin Joseph H. , Bredeson Christopher N. , Brunstein Claudio G. , Chhabra Saurabh , Fuchs Ephraim J. , Ghosh Nilanjan , Grunwald Michael R. , Kanakry Christopher G. , Kekre Natasha , McGuirk Jospeh P. , McNiece Ian K. , Mehta Rohtesh S. , Mielcarek Marco , Milano Fillipo , Modi Dipenkumar , Reshef Ran , Solomon Scott R. , Schroeder Mark A. , Waller Edmund K. , Inamoto Yoshiro , Soiffer Robert J. , Eapen Mary
Published: April 2021

Posttransplant cyclophosphamide (PTCy) graft-versus-host disease (GVHD) prophylaxis has enabled haploidentical (Haplo) transplantation to be performed with results similar to those after matched unrelated donor (MUD) transplantation with traditional prophylaxis. The relative value of transplantation with MUD vs Haplo donors when both groups receive PTCy/calcineurin inhibitor/mycophenolate GVHD prophylaxis is not known. We compared outcomes after 2036 Haplo and 284 MUD transplantations with PTCy GVHD prophylaxis for acute leukemia or myelodysplastic syndrome in adults from 2011 through 2018. Cox regression models were built to compare outcomes between donor types. Recipients of myeloablative and reduced-intensity regimens were analyzed separately. Among recipients of reduced-intensity regimens, 2-year graft failure (3% vs 11%), acute grades 2 to 4 GVHD (hazards ratio [HR], 0.70; P = .022), acute grades 3 and 4 GVHD (HR, 0.41; P = .016), and nonrelapse mortality (HR, 0.43; P = .0008) were lower after MUD than with Haplo donor transplantation. Consequently, disease-free (HR, 0.74; P = .008; 55% vs 41%) and overall (HR, 0.65; P = .001; 67% vs 54%) survival were higher with MUD than with Haplo transplants. Among recipients of myeloablative regimens, day-100 platelet recovery (95% vs 88%) was higher and grades 3 and 4 acute (HR, 0.39; P = .07) and chronic GVHD (HR, 0.66; P = .05) were lower after MUD than with Haplo donor transplantation. There were no differences in graft failure, relapse, nonrelapse mortality, and disease-free and overall survival between donor types with myeloablative conditioning regimens. These data extend and confirm the importance of donor-recipient HLA matching for allogeneic transplantation. A MUD is the preferred donor, especially for transplantations with reduced-intensity conditioning regimens.
LncRNA-Fendrr protects against the ubiquitination and degradation of NLRC4 protein through HERC2 to regulate the pyroptosis of microglia
Authors: Wang Li-Qing , Zheng Yue-Ying , Zhou Heng-Jun , Zhang Xiong-Xin , Wu Pin , Zhu Sheng-Mei
Published: April 2021

Objectives

Targeted inhibition of inflammatory response can reduce diabetic cerebral ischemia–reperfusion (I/R) injure. Pyroptosis is characterized by caspase-1 dependence and the release of a large number of pro-inflammatory factors. LncRNA-Fendrr is associated with a variety of diseases, but Fendrr has not been studied in diabetic cerebral I/R. NLR-family CARD-containing protein 4 (NLRC4) regulate the pyroptosis of microglia cells. This study was designed to investigate whether Fendrr is involved in the effects of diabetic cerebral I/R injury.

Methods

The diabetic brain I/R model in mice was constructed. Mouse microglia cell line BV-2 cells were exposed to high glucose followed by hypoxia/reoxygenation (H/R). Fendrr and some pyroptosis-associated proteins were detected by qRT-PCR, western blot or ELISA. HE staining was used to detect pathological changes. Microglia pyroptosis was detected by TUNEL staining. RNA pull-down and RNA Immunoprecipitation were used to detect binding of Fendrr to HERC2 (E3 ubiquitin ligase), and CO-IP detected binding of HERC2 to NLRC4. The ubiquitination of NLRC4 was detected by ubiquitination experiments.

Results

Fendrr was significantly increased in the diabetic cerebral I/R model, and NLRC4 inflammatory complex and pyroptosis mediated inflammatory factors were increased. NLRC4 and inflammatory cytokines associated with pyroptosis were decreased in the high glucose-treated hypoxia/reoxygenation (H/R)-induced microglia after Fendrr knockdown. Fendrr bound to HERC2 protein, and HERC2 bound to NLRC4. Meanwhile, Fendrr could inhibit the ubiquitination of NLRC4, HERC2 promoted the ubiquitination of NLRC4 protein. Moreover, the effect of Fendrr overexpression in the diabetic cerebral I/R model of microglia can be reversed by HERC2 overexpression.

Conclusion

Fendrr can protect against the ubiquitination and degradation of NLRC4 protein through E3 ubiquitin ligase HERC2, thereby accelerating the pyroptosis of microglia.