bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI brain volume loss, lesion burden, and clinical outcome in secondary progressive multiple sclerosis
Authors: Koch Marcus W , Mostert Jop , Repovic Pavle , Bowen James D , Strijbis Eva , Uitdehaag Bernard , Cutter Gary
Published: July 2021

Background:

Magnetic resonance imaging (MRI) of brain volume measures are widely used outcomes in secondary progressive multiple sclerosis (SPMS), but it is unclear whether they are associated with physical and cognitive disability.

Objective:

To investigate the association between MRI outcomes and physical and cognitive disability worsening in people with SPMS.

Methods:

We used data from ASCEND, a large randomized controlled trial ( n = 889). We investigated the association of change in whole brain and gray matter volume, contrast enhancing lesions, and T2 lesions with significant worsening on the Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), Nine-Hole Peg Test (NHPT), and Symbol Digit Modalities Test (SDMT) with logistic regression models.

Results:

We found no association between MRI measures and EDSS or SDMT worsening. T25FW worsening at 48 and 96 weeks, and NHPT worsening at 96 weeks were associated with cumulative new or newly enlarging T2 lesions at 96 weeks. NHPT worsening at 48 and 96 weeks was associated with normalized brain volume loss at 48 weeks, but not with other MRI outcomes.

Conclusion:

The association of standard MRI outcomes and disability was noticeably weak and inconsistent over 2 years of follow-up. These MRI outcomes may not be useful surrogates of disability measures in SPMS.
Rewriting the stars: Surface tensions and gender troubles in the online media production of digital deepfakes
Authors: Holliday Christopher
Published: July 2021

This article examines a cross-section of viral Deepfake videos that utilise the recognisable physiognomies of Hollywood film stars to exhibit the representative possibilities of Deepfakes as a sophisticated technology of illusion. Created by a number of online video artists, these convincing ‘mash-ups’ playfully rewrite film history by retrofitting canonical cinema with new star performers, from Jim Carrey in The Shining (Stanley Kubrick, 1980) to Tom Cruise in American Psycho (Mary Harron, 2000). The particular remixing of stardom in these videos can – as this article contends – be situated within the technological imaginary of ‘take two’ cinephilia, and the ‘technological performativity of digitally remastered sounds and images’ in an era of ‘the download, the file swap, [and] the sampling’ (Elsaesser 2005: 36–40). However, these ‘take two’ Deepfake cyberstars further aestheticize an entertaining surface tension between coherency and discontinuity, and in their modularity function as ‘puzzling’ cryptograms written increasingly in digital code. Fully representing the star-as-rhetorical digital asset, Deepfakes therefore make strange contemporary Hollywood’s many digitally mediated performances, while the reskinning of (cisgender white male) stars sharpens the ontology of gender as it is understood through discourses of performativity (Butler 1990; 2004). By identifying Deepfakes as a ‘take two’ undoing, this article frames their implications for the cultural politics of identity; Hollywood discourses of hegemonic masculinity; overlaps with non-normative subjectivities, ‘body narratives’ and ‘second skins’ (Prosser 1998); and how star-centred Deepfakes engage gender itself as a socio-techno phenomenon of fakery that is produced – and reproduced – over time.
The COVID digital home assemblage: Transforming the home into a work space during the crisis
Authors: Watson Ash , Lupton Deborah , Michael Mike
Published: July 2021

Major changes to home life and work practices globally have been brought about by the COVID-19 crisis. Periods of strict restrictions placed on people’s movements outside their homes, aimed at curbing the spread of the novel coronavirus, have meant that the home was requisitioned as a primary site for work for many people. In this article, we draw on case studies from an ethnographic project that explored how people living in Sydney use digital technologies in the home setting. Our fieldwork commenced in early 2020, just prior to the national COVID lockdown period in Australia, and continued throughout the lockdown and the months following. As a result, we were able to document people’s experiences of transitioning to working from home during the first year of the pandemic. In this article, we adopt a sociomaterial approach together with domestication theory to analyse the complexities of the changed COVID home in the context of digitised working arrangements. We surface and theorise the tensions and leaky boundaries between workplaces and family/domestic life that are brought about by, through and beyond the digital. By addressing the sociomaterial choreographies and modalities of presence involved, we attempt to capture the processes through which the COVID digital home assemblage is continuously configured and the more or less simultaneous presence and absence of people in both domestic and work domains.
Online fandom communities as networked counterpublics: LGBTQ+ youths’ perceptions of representation and community climate
Authors: McInroy Lauren B , Zapcic Ian , Beer Oliver WJ
Published: July 2021

Online fandom communities (OFCs) provide lesbian, gay, bisexual, transgender, queer, and other sexual and/or gender minority (LGBTQ+) youth opportunities to access community-generated LGBTQ+ representations—contrasting mass media’s continued deficiencies in depiction of LGBTQ+ people and communities. This study sought to better understand LGBTQ+ adolescents’ and young adults’ (age 14–29) perceptions of OFCs regarding LGBTQ+ representation and community climate. Qualitative content analysis was employed to analyze open-ended survey questions from respondents in the United States and Canada ( n = 3665). Three primary themes emerged: (1) LGBTQ+ mass media narratives remained insufficient but were improving; (2) counternarratives produced within OFCs were even better; however, (3) the climate of OFCs created challenges and limitations, including to the quantity and quality of depictions of diverse LGBTQ+ identities. Findings indicate OFCs may take on simultaneous qualities of networked publics and counterpublics, allowing youth opportunities to contest LGBTQ+ mass media depictions and problematic representations within OFCs.
Research on flexural behavior of composite box continuous girder with corrugated steel webs and trusses
Authors: Dong Jucan , Chen Yiyan , Wu Qingxiong , Hu Aoxiang , Jiang Ruijuan , Wang Chengwei , Tong Zhaojie , Song Hua , Xu Tianhua
Published: July 2021

A new type of composite structure, the composite box girder with corrugated steel webs (CSWs) and trusses, is proposed recently. In order to investigate the structural behavior under positive and negative bending moments, flexural tests of the continuous girder were carried out, and the failure modes, deformation patterns, strain distribution, and development of the concrete cracks were investigated. Finite element analysis was conducted to investigate the effect of the range of concrete in the steel tube and the thickness of CSWs on the flexural behavior. The experimental and numerical results show that the test beam has a good ductility and integrity under flexural load. The contribution of CSWs to the flexural bearing capacity is very small and can be neglected. Besides, the plane section assumption is still valid when only top concrete slab and bottom steel tubes are concerned. The concrete filled in bottom steel tubes increases the stiffness and the bearing capacity of the girder. Equations to calculate the flexural bearing capacity under positive and negative bending moments were put forward and then verified with experimental results.
Association of the neutrophil–lymphocyte ratio to patient outcomes after trauma: A systematic review
Authors: Qiu Yunfei , Fitzgerald Mark , Mitra Biswadev
Published: July 2021

Introduction

Early identification of trauma injury severity is important for prognostication. The neutrophil–lymphocyte ratio (NLR) has been proposed as a marker of systemic inflammation in major trauma patients that is associated with in-hospital mortality. The aim of this systematic review is to compile all the best evidence available to determine the prognostic capabilities of the NLR in trauma and to assess the NLR as a predictor of mortality in adult major trauma patients. Additionally, comparing NLR and hospital length of stay (LOS), ICU LOS, mechanical ventilation and transfusion requirements.

Methods

We conducted a search of online information sources to identify manuscripts observing the NLR in adult major trauma patients. Outcomes of interest include mortality as defined by the author, hospital LOS, ICU LOS, mechanical ventilation and transfusion requirements. Quality was assessed using the Newcastle–Ottawa Scale. We aimed to conduct a meta-analysis if there were sufficient manuscripts included.

Results

Eight studies fulfilled our inclusion criteria. Trials were of good methodological quality. Substantial heterogeneity present between the studies prevented a meta-analysis from being conducted. Overall, five studies demonstrated the NLR as a significantly predictive marker of mortality. NLR was observed to be significantly associated with increased ICU LOS and longer duration of mechanical ventilation. Mixed results were observed between NLR and hospital LOS and transfusion requirements.

Conclusions

A potential association between NLR and mortality, ICU LOS and duration of mechanical ventilation has been reported. However, clinical utility of this measure during trauma resuscitation remains unknown.
Confronting (de)humanizing remote teaching practices
Authors: Shin Minsun
Published: July 2021

This colloquium discusses the critical need to reimagine human connections in the context of remote instruction necessitated by the COVID-19 pandemic. Educators should envisage humanizing and caring teaching practices, and address the needs of the whole person, in order to counteract education inequities and empower students in times of disruption and opportunity.
Scoring Running Records: Complexities and affordances
Authors: Rodgers Emily , D’Agostino Jerome V. , Berenbon Rebecca , Johnson Tracy , Winkler Christa
Published: July 2021

Running Records are thought to be an excellent formative assessment tool because they generate results that educators can use to make their teaching more responsive. Despite the technical nature of scoring Running Records and the kinds of important decisions that are attached to their analysis, few studies have investigated assessor accuracy. We measured precision across 114 teachers who were given a pre-coded Running Record to analyze by comparing their quantification and interpretation of the record against a scoring key. We also used Rasch measurement to examine which items teachers found easy and hard to score accurately. Analyses revealed wide variation in teachers’ accuracy, particularly in interpretation, that, according to item difficulty analysis, were caused by a few specific mistakes in scoring. Implications to improve training so that individuals administer Running Records more reliably are shared.
A novel multiple subdivision-based algorithm for quantitative assessment of retinal vascular tortuosity
Authors: Wang Gengyuan , Li Meng , Yun Zhaoqiang , Duan Zhengyu , Ma Ke , Luo Zhongzhou , Xiao Peng , Yuan Jin
Published: July 2021

Vascular tortuosity as an indicator of retinal vascular morphological changes can be quantitatively analyzed and used as a biomarker for the early diagnosis of relevant disease such as diabetes. While various methods have been proposed to evaluate retinal vascular tortuosity, the main obstacle limiting their clinical application is the poor consistency compared with the experts’ evaluation. In this research, we proposed to apply a multiple subdivision-based algorithm for the vessel segment vascular tortuosity analysis combining with a learning curve function of vessel curvature inflection point number, emphasizing the human assessment nature focusing not only global but also on local vascular features. Our algorithm achieved high correlation coefficients of 0.931 for arteries and 0.925 for veins compared with clinical grading of extracted retinal vessels. For the prognostic performance against experts’ prediction in retinal fundus images from diabetic patients, the area under the receiver operating characteristic curve reached 0.968, indicating a good consistency with experts’ predication in full retinal vascular network evaluation.
Methyl mercury triggers endothelial leukocyte adhesion and increases expression of cell adhesion molecules and chemokines
Authors: Fowler Joshua , Tsui Martin Tsz-Ki , Chavez Jessica , Khan Safeera , Ahmed Hassan , Smith Lena , Jia Zhenquan
Published: July 2021

Cardiovascular disease is the leading cause of morbidity, mortality, and health care costs in the USA, and around the world. Among the various risk factors of cardiovascular disease, environmental and dietary exposures to methyl mercury, a highly toxic metal traditionally labeled as a neurotoxin, have been epidemiologically linked to human cardiovascular disease development. However, its role in development and promotion of atherosclerosis, an initial step in more immediately life-threatening cardiovascular diseases, remains unclear. This study was conducted to examine the role that methyl mercury plays in the adhesion of monocytes to human microvascular endothelial cells (HMEC-1), and the underlying mechanisms. Methyl mercury treatment significantly induced the adhesion of monocyte to HMEC-1 endothelial cells, a critical step in atherosclerosis, while also upregulating the expression of proinflammatory cytokines interleukin-6, interleukin-8. Further, methyl mercury treatment also upregulated the chemotactic cytokine monocyte chemoattractant protein-1 and intercellular adhesion molecule-1. These molecules are imperative for the firm adhesion of leukocytes to endothelial cells. Additionally, our results further demonstrated that methyl mercury stimulated a significant increase in NF-κB activation. These findings suggest that NF-κB signaling pathway activation by methyl mercury is an important factor in the binding of monocytes to endothelial cells. Finally, by using flow cytometric analysis, methyl mercury treatment caused a significant increase in necrotic cell death only at higher concentrations without initiating apoptosis. This study provides new insights into the molecular actions of methyl mercury that can lead to endothelial dysfunction, inflammation, and subsequent atherosclerotic development.
Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review
Authors: Stoykov Mary E. , Heidle Courtney , Kang Shamshir , Lodesky Lisa , Maccary Lindsay E. , Madhavan Sangeetha
Published: July 2021

Sensory priming is a technique to facilitate neuroplasticity and improve motor skills after injury. Common sensory priming modalities include peripheral nerve stimulation/somatosensory electrical stimulation (PNS/SES), transient functional deafferentation (TFD), and vibration. The aim of this study was to determine whether sensory priming with a motor intervention results in improved upper limb motor impairment or function after stroke. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and EMBASE were the databases used to search the literature in July 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and recommendations for the Cochrane collaboration. In total, 30 studies were included in the analysis: three studies examined TFD, 16 examined PNS/SES, 10 studied vibration, and one combined the three stimulation techniques. Most studies reported significant improvements for participants receiving sensory priming. Given the low risk, it may be advantageous to use sensory-based priming prior to or concurrent with upper limb training after stroke.
Of School Boards and Superintendents
Authors: Flood Lee D. , Angelle Pamela S.
Published: July 2021

A beloved, respected, and highly accomplished superintendent in a rural, high-risk district, Mr. Carroll, is confronted with dissident board members for the first time in his 7-year tenure. Two newly elected members have strained relationships between current board members and are calling for his resignation based upon what they perceive as low SAT scores, the excessive amount of Carroll’s salary, and the district’s focus on academic growth, rather than achievement, of students. Despite mediation from the state aimed at easing tensions on both sides, the issue reaches a boiling point at a board meeting.
Incidence of major complications from embolo-sclerotherapy of head and neck vascular malformations in a single specialist centre
Authors: Smith Helena , Lim Chung Sim , Evans Nicholas , Papadopoulou Anthie , Khalifa Mohamed , Tsui Janice , Hamilton George , Brookes Jocelyn
Published: July 2021

Objective

Current data on the nature and rate of major complications for embolo-sclerotherapy (EST) of vascular malformations are scarce. However, even fewer studies focus on vascular malformations specific to the head and neck, which confer an increased specific risk of airway compromise, neurologic and ophthalmologic injury. More understanding is required surrounding the type and incidence of complications to improve treatment planning and informed consent. Therefore, this study aimed to review major complications secondary to EST of head and neck vascular malformations over a 5-year period in a single specialized multidisciplinary centre for vascular anomalies.

Methods

All interventions were decided by the multidisciplinary team. Demographic, procedural and complication data between 1st January 2013 and 31st December 2017 were prospectively documented in a dedicated database and analysed. EST of high-flow vascular malformations (HFVMs) was performed by selective catheter angiography or direct injection, and by direct injection only for low-flow vascular malformations (LFVMs). Major complications were defined as any tissue or functional damage caused by direct injection, distal embolization or tissue reaction and were decided by the multidisciplinary team.

Results

Forty-eight patients (median age of 35 years; range of 14–70 years; 18 men and 30 women) had 100 EST procedures for head and neck vascular malformation. Of these, 14 patients had EST for HFVM and 34 patients for LFVM, total 43 and 57 procedures, respectively. Overall, five patients with HFVM developed major complications from EST when compared with two patients with LFVM ( p = 0.0167). Two patients required pre-emptive tracheostomy due to risk of post-operative airway compromise. Overall, seven (14.6%) patients experienced major complication from EST. In the HFVM group, major complications from EST occurred in five patients; four cases of tissue ulceration and necrosis (two needed debridement, one healed with resultant fibrosis that impeded speech and one resolved spontaneously) and one post-procedural airway compromise requiring tracheostomy. Meanwhile, in the LFVM group, major complications occurred in two patients; one case of severe necrosis involving the alar cartilage, lip and cheek requiring debridement and reconstruction under plastics and one simple cellulitis. No patients sustained stroke or vision impairment.

Conclusions

EST is relatively safe for head and neck vascular malformations in a high-volume experienced centre. Our major complication rate of 14.6% per patient (35.7% for HFVM; 5.9% for LFVM) or 7% per procedure (11.6% for HFVM; 3.5% LFVM) compares favourably with published data from other centres. These data will improve treatment planning and informed consent for EST for both HFVM and LFVM of the head and neck.
The association between low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio cholesterol ratio and thickened carotid intima-media thickness: A case–control study
Authors: Zhang Zhucheng , Liu Yang , Zhang Yanyan , Qin Pei , Zhao Ping , Wang Changyi , Wang Li , Peng Xiaolin , Xu Shan , Chen Hongen , Zhao Dan , Hu Dongsheng , Zhang Ming , Lou Yanmei , Hu Fulan
Published: July 2021

Background

It is indicated that Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C ratio) has greater predictive value for thickened carotid intima-media thickness (CIMT) comparing with classic lipid parameters. However, there have been few reports about their association in general Chinese population.

Method

We included a total of 1220 CIMT participants and 2440 matched controls, who had ultrasonography of carotid artery during 2009 and 2016. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for thickened CIMT risk associated with LDL-C/HDL-C ratio.

Result

In the univariate logistic regression model, there was significant association between LDL-C/HDL-C ratio and thickened CIMT (Q4 vs. Q1, OR = 1.94, 95% CI: 1.60–2.36; ptrend < 0.05). After adjusting for potential covariates, LDL-C/HDL-C ratio remained significantly associated with thickened CIMT (Q4 vs. Q1, OR = 1.81, 95% CI: 1.41–2.34, ptrend < 0.001; ≥3.05 v.s. <3.05, OR = 1.66, 95% CI: 1.37–2.02). In subgroup analyses, the association between LDL-C/HDL-C ratio and thickened CIMT remained significant in the subgroups stratified by sex, impaired fasting glucose (IFG), hypertension, and fatty liver disease but only remained significant in the subgroups of ≥45 years (OR = 2.01, 95% CI: 1.46–2.76; Ptrend <0.05), BMI ≥24 (kg/m2) (OR = 2.22; 95% CI = 1.63-3.03; Ptrend < 0.05) and BMI ≥25 (kg/m2) (OR = 2.50, 95% CI: 1.76–3.54; Ptrend < 0.05), dyslipidemia (OR = 3.28, 95% CI: 1.83–5,85; Ptrend < 0.001), and without periodontitis (OR = 2.08, 95% CI: 1.54–2.81 ; Ptrend < 0.05) comparing Q4 to Q1. Similar results were observed in the subgroup analyses for LDL-C/HDL-C ratio ≥3.05 v.s. <3.05 except for the age stratification.

Conclusion

High LDL-C/HDL-C ratio could significantly increase the risk of thickened CIMT independent of gender, IFG, hypertension, and fatty liver disease in general Chinese population.
Resilience in survivors of critical illness: A scoping review of the published literature in relation to definitions, prevalence, and relationship to clinical outcomes
Authors: Pauley Ellen , Walsh Timothy S
Published: July 2021

Survivors of critical illness face substantial challenges in their recovery, including physical and cognitive dysfunction. Resilience is the ability to adapt and maintain one’s mental health after facing such challenges. Higher resilience levels have been found to be beneficial throughout the illness trajectory in cancer patients, but resilience has not been widely researched in critical care patients. We undertook a scoping review to identify published studies on resilience following critical illness and describe: how resilience has been measured; the prevalence of low resilience in critical care patients; and what associations (if any) exist between resilience and clinical outcomes. We searched: PubMed, Medline, PsychINFO, CINAHL, Web of Science, Cochrane Library, to identify relevant studies. We found 882 unique titles: 17 were selected for full text review, 10 were considered relevant. These included ICU inpatients and survivors, and trauma and sepsis survivors. A broad critical appraisal of each study was undertaken. The overall quality of published studies was low: there was wide variation in resilience-assessment tools across the studies, including the timing of measurement; only one used a validated tool. Estimates of low resilience ranged from 28%-67%, but with varying populations, high risk of inclusion bias, and small samples. Higher resilience levels were significantly associated with lower depression, anxiety, post-traumatic stress, pain, anger, executive dysfunction, and difficulty with self-care in critical care patients and survivors. Future studies should use validated resilience assessment, determine the optimum timing, and explore prevalence, associations with outcomes, and resilience-promoting interventions in non-selected or clearly defined populations.
Dyspareunia
Authors: Morris Charlotte , Briggs Catherine , Navani Manju
Published: July 2021

Dyspareunia is persistent pain on attempted or successful vaginal penetration. It is under-reported, infrequently asked about by healthcare professionals, and affects quality of life and relationships. Dyspareunia is multifactorial and possesses biopsychosocial components. Pain may be distinct and localised, deep or persistent. Among the symptoms, women describe sensations of aching, throbbing and tearing. Disinterest in sex and relationship problems can result. This article discusses dyspareunia, its common differential diagnoses and aims to improve clinician confidence in assessing and managing dyspareunia in primary care.
Effect of polyfluoroalkyl chemicals on the occurrence of urge urinary incontinence: a population-based study
Authors: Cui Shu , Zhao Xinghua , Chu Xiaohan , Zhang Shengwei , Gu Qingyang , Xu Changbao
Published: July 2021

Background:

The artificial fluorinated group of compounds polyfluoroalkyl chemicals (PFCs) has been applied extensively in daily life for decades, and is present in food, drinking water, and indoor dust. The nephrotoxicity of PFCs has been widely studied for its characteristics of being mainly excreted through passing urine and affecting urodynamics. This work aimed to investigate the relationship between PFCs and the occurrence of urge urinary incontinence (UUI) in the United States (US) population.

Methods:

There were 3157 eligible female participants retrieved from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2014. A logistic regression model was used to examine the relationship between UUI and eight kinds of PFCs. The dose–response relationship was investigated through restricted cubic spline analysis in this retrospective study.

Results:

Of the 3157 eligible female participants, 913 self-reported a history of UUI. Total PFCs, perfluorohexane sulfonic acid (PFHS), 2-(N-methyl-perfluorooctane sulfonamido) acetate (MPAH), and perfluorononanoic acid (PFNA) correlated positively with the occurrence of UUI after adjusting for age, race, education, vigorous recreational activities, hypertension, diabetes, body mass index (BMI), creatinine, and estimated glomerular filtration rate (eGFR). Based on the results of sub-group analysis, the increasing tertiles contained odds ratios [OR; 95% confidence intervals (CI)] of 1.25 (95% CI, 1.03–1.51, p = 0.026) and 1.56 (95% CI, 1.29–1.89, p < 0.001) for total PFCs compared with the lowest tertile. The OR for PFHS, MPAH, and PFNA were 1.75, 1.71, and 1.41 respectively, in the highest tertile.

Conclusion:

This study investigated the relationship between PFCs and UUI in female and found total PFCs, PFHS, MPAH, and PFNA were positively correlated with the risk of UUI. The results will contribute to developing individualized treatment for female patients suffering UUI.
Molecular profiling of soft-tissue sarcomas with FoundationOne® Heme identifies potential targets for sarcoma therapy: a single-centre experience
Authors: Scheipl Susanne , Brcic Iva , Moser Tina , Fischerauer Stefan , Riedl Jakob , Bergovec Marko , Smolle Maria , Posch Florian , Gerger Armin , Pichler Martin , Stoeger Herbert , Leithner Andreas , Heitzer Ellen , Liegl-Atzwanger Bernadette , Szkandera Joanna
Published: July 2021

Background:

Molecular diagnosis has become an established tool in the characterisation of adult soft-tissue sarcomas (STS). FoundationOne® Heme analyses somatic gene alterations in sarcomas via DNA and RNA-hotspot sequencing of tumour-associated genes.

Methods:

We evaluated FoundationOne® Heme testing in 81 localised STS including 35 translocation-associated and 46 complex-karyotyped cases from a single institution.

Results:

Although FoundationOne® Heme achieved broad patient coverage and identified at least five genetic alterations in each sample, the sensitivity for fusion detection was rather low, at 42.4%. Nevertheless, potential targets for STS treatment were detected using the FoundationOne® Heme assay: complex-karyotyped sarcomas frequently displayed copy-number alterations of common tumour-suppressor genes, particularly deletions in TP53, NF1, ATRX, and CDKN2A. A subset of myxofibrosarcomas (MFS) was amplified for HGF ( n = 3) and MET ( n = 1). PIK3CA was mutated in 7/15 cases of myxoid liposarcoma (MLS; 46.7%). Epigenetic regulators (e.g. MLL2 and MLL3) were frequently mutated.

Conclusions:

In summary, FoundationOne® Heme detected a broad range of genetic alterations and potential therapeutic targets in STS (e.g. HGF/MET in a subset of MFS, or PIK3CA in MLS). The assay’s sensitivity for fusion detection was low in our sample and needs to be re-evaluated in a larger cohort.
Cartilage Repair Capacity within a Single Full-Thickness Chondral Defect in a Porcine Autologous Matrix-Induced Chondrogenesis Model Is Affected by the Location within the Defect
Authors: Salonius E. , Meller A. , Paatela T. , Vasara A. , Puhakka J. , Hannula M. , Haaparanta A.-M. , Kiviranta I. , Muhonen V.
Published: July 2021

Objective

Large articular cartilage defects are a challenge to regenerative surgery. Biomaterial scaffolds might provide valuable support for restoration of articulating surface. The performance of a composite biomaterial scaffold was evaluated in a large porcine cartilage defect.

Design

Cartilage repair capacity of a biomaterial combining recombinant human type III collagen (rhCo) and poly-(l/d)-lactide (PLA) was tested in a porcine model. A full-thickness chondral defect covering the majority of the weightbearing area was inflicted to the medial femoral condyle of the right knee. Spontaneous cartilage repair and nonoperated healthy animals served as controls. The animals were sacrificed after a 4-month follow-up. The repair tissue was evaluated with the International Cartilage Repair Society (ICRS) macroscopic score, ICRS II histological score, and with micro-computed tomography. Additionally, histopathological evaluation of lymph nodes and synovial samples were done for toxicological analyses.

Results

The lateral half of the cartilage defect in the operated groups showed better filling than the medial half. The mean overall macroscopic score for the rhCo-PLA, spontaneous, and nonoperated groups were 5.96 ± 0.33, 4.63 ± 0.42, and 10.98 ± 0.35, respectively. The overall histological appearance of the specimens was predominantly hyaline cartilage in 3 of 9 samples of the rhCo-PLA group, 2 of 8 of the spontaneous group, and 9 of 9 of the nonoperated group.

Conclusions

The use of rhCo-PLA scaffold did not differ from spontaneous healing. The repair was affected by the spatial properties within the defect, as the lateral part of the defect showed better repair than the medial part, probably due to different weightbearing conditions.
Tuberculosis presenting as arthritis of the ankle: A case report
Authors: Basnayake Oshan , Mathangasinghe Yasith , Nihaj Ahamed , Pitagampalage Ranji , Jayarajah Umesh , Gunawardena Kawmadi , Mendis Harsha
Published: July 2021

Tuberculosis presenting as monoarticular involvement in immunocompetent patients is rare. Here, we report a Sri Lankan patient presenting with ankle swelling due to tuberculosis with no other extrapulmonary or pulmonary involvement. Magnetic resonance imaging showed destruction of articular cartilage of the ankle joint with chronic inflammation of the subtalar joint. The diagnosis was confirmed by synovial tissue culture which was positive for Mycobacterium tuberculosis. The patient recovered uneventfully with anti-tuberculosis treatment. Therefore, a high degree of suspicion is necessary to diagnose extrapulmonary tuberculosis when patients are presenting with atypical monoarthritis.
Usefulness of a Radiofrequency Transseptal Needle in the Second Puncture of Fontan Extracardiac Conduit
Authors: Nagatomo Yusaku , Nagata Hazumu , Fukuoka Shoji , Hirata Yuichiro , Yamamura Kenichiro , Ohga Shouichi
Published: July 2021

We performed a second puncture of the extracardiac conduit in an 11-year-old Fontan patient to assess the patency of the stent previously deployed in the left pulmonary vein. For the first puncture, a mechanical Brockenbrough needle was selected to puncture the Gore-Tex conduit, an electrical insulator. For the second puncture, the location of that previous hole was detected as an indentation covered with atrial tissue, which is an electrical conductor. The second puncture was performed safely using a radiofrequency transseptal needle.
Correlation Between the Spinal Instability Neoplastic Score (SINS) and Patient Reported Outcomes
Authors: Versteeg Anne L. , Sahgal Arjun , Laufer Ilya , Rhines Laurence D. , Sciubba Daniel M. , Schuster James M. , Weber Michael H. , Lazary Aron , Boriani Stefano , Bettegowda Chetan , Fehlings Michael G. , Clarke Michelle J. , Arnold Paul M. , Gokaslan Ziya L. , Fisher Charles G. ,   AO Spine Knowledge Forum Tumor
Published: July 2021

Study Design:

International multicenter prospective observational cohort study on patients undergoing radiation +/− surgical intervention for the treatment of symptomatic spinal metastases.

Objectives:

To investigate the association between the total Spinal Instability Neoplastic Score (SINS), individual SINS components and PROs.

Methods:

Data regarding patient demographics, diagnostics, treatment, and PROs (SF-36, SOSGOQ, EQ-5D) was collected at baseline, 6 weeks, and 12 weeks post-treatment. The SINS was assessed using routine diagnostic imaging. The association between SINS, PRO at baseline and change in PROs was examined with the Spearmans rank test.

Results:

A total of 307 patients, including 174 patients who underwent surgery+/− radiotherapy and 133 patients who underwent radiotherapy were eligible for analyses. In the surgery+/− radiotherapy group, 18 (10.3%) patients with SINS score between 0-6, 118 (67.8%) with a SINS between 7-12 and 38 (21.8%) with a SINS between 13-18, as compared to 55 (41.4%) SINS 0-6, 71(53.4%) SINS 7-12 and 7 (5.2%) SINS 13-18 in the radiotherapy alone group. At baseline, the total SINS and the presence of mechanical pain was significantly associated with the SOSGOQ pain domain (r = −0.519, P < 0.001) and the NRS pain score (r = 0.445, P < 0.001) for all patients. The presence of mechanical pain demonstrated to be moderately associated with a positive change in PROs at 12 weeks post-treatment.

Conclusion:

Spinal instability, as defined by the SINS, was significantly correlated with PROs at baseline and change in PROs post-treatment. Mechanical pain, as a single SINS component, showed the highest correlations with PROs.
Patient Satisfaction With Telehealth and Experiences During the COVID-19 Pandemic Among Uninsured Free Clinic Patients
Authors: Kamimura Akiko , Panahi Samin , Meng Hsien-Wen , Sundrud Justine , Lucero Mary
Published: July 2021

The COVID-19 pandemic is a significant public health issue especially for underserved populations. Little is known about patient satisfaction with telehealth among free clinic patients or other underserved populations. The purpose of this study is to examine factors associated with patient satisfaction with in-person services and telehealth during the pandemic and describe the experiences during the pandemic among free clinic patients. Data were collected from 628 uninsured English- and Spanish-speaking patients of a free clinic using an online survey from June to August in 2020. Free clinic patients are satisfied both with in-person services and telehealth. Factors associated with satisfaction were slightly different for in-person services and telehealth. The major experiences during the pandemic were related to food/diet and physical inactivity. This study examined a new trend in patient satisfaction and is important because telehealth may be a stepping-stone on how to handle future doctor visits for underserved populations. Furthermore, as the pandemic rapidly develops and changes daily life experiences, the uninsured population faces imminent impacts in various aspects of their life experiences.
The Impact of COVID-19 on the Care of Patients With Noncommunicable Diseases in Low- and Middle-Income Countries: An Online Survey of Patient Perspectives
Authors: Devi Ratna , Goodyear-Smith Felicity , Subramaniam Kannan , McCormack Jessica , Calder Amanda , Parag Varsha , Bizri Luna El , Majumdar Anurita , Huang Pai-Hui , Bullen Chris
Published: July 2021

We sought to gain insights into the impacts of COVID-19 and associated control measures on health and health care of patients from low- and middle-income countries with cardiovascular disease, diabetes, and mental health conditions, using an online survey during the COVID-19 pandemic. The most common concern for the 1487 patients who took part was contracting COVID-19 when they accessed health care. Of those infected with COVID-19, half said that their health had been worse since being infected. Collectively, most people reported an increase in feelings of stress and loneliness. The COVID-19 pandemic has led to a range of health care impacts on patients with noncommunicable diseases, including constraints on access to care and health effects, particularly mental well-being.
Medication Adherence in Type 2 Diabetes Mellitus: A Qualitative Exploration of Barriers and Facilitators From Socioecological Perspectives
Authors: Onwuchuluba EE , Oyetunde OO , Soremekun RO
Published: July 2021

Adherence to antidiabetic medications (ADMs) remains a serious challenge among type 2 diabetes mellitus (T2DM) patients. Factors affecting medication adherence are not fully understood in Nigeria. This qualitative study explored patients’ views on barriers and facilitators of medication adherence. Data collection was through face-to-face, semistructured, in-depth interviews conducted on 25 purposively sampled patients attending a public tertiary hospital. The interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis based on socioecological framework. NVIVO version 10 identified more codes. Most commonly identified barriers were organizational (clinic structure), personal (perception of T2DM as a dangerous illness), interpersonal (lack of spousal support), and community (concerns about taking ADMs in social gatherings). It was observed that female patients received more spousal support than the males. The facilitators of adherence include perceiving medication-taking a routine, the need to live longer, having savings for ADMs, purchasing medications to last until the next clinic visit. This study identified barriers and facilitators unique to Nigerian T2DM patients. Interventions anchored on these factors would improve medication adherence.
Critical Issues in the Science of Reading: Striving for a Wide-Angle View in Research
Authors: Hoffman James V. , Cabell Sonia Q. , Barrueco Sandra , Hollins Etta R. , Pearson P. David
Published: July 2021

This report reflects a panel presentation and discussion at the 2020 Literacy Research Conference focused on the science of reading (SoR). Each panelist presents a summary of the presentation and incorporates the comments of the Literacy Research Association (LRA) members attending the session virtually and posting in the chat room. Each presentation takes a critical stance on the possibilities for expanding the lens for the SoR. Concerns are raised regarding the narrow interpretation of the SoR and impact of this narrow conception on research, theory, and practice.
Women Inclusivity in Entrepreneurial and STEM Related Education—A Case Study
Authors: Paravastu Seshadri , Paravastu Narasimha S
Published: July 2021

This paper presents an interdisciplinary case study on women's inclusivity in an entrepreneurship class consisting of adults enrolled in interdisciplinary majors, including science, technology, engineering, and mathematics (STEM) disciplines. With women empowerment through entrepreneurship education as a theme, this case study in learning innovations aims to encourage diversity and inclusivity in the classroom in discussing successful women entrepreneurs alongside men. Acceptance of ideas proposed by women in a class setting formed a basis for this study. Furthermore, this case study used the idea to reinforce women's empowerment during in-class lectures subtly. This paper reports findings based on our case study across multiple undergraduate and graduate classes comprising majors and adults from STEM disciplines.
Spectral damping scaling factors for horizontal components of ground motions from subduction earthquakes using NGA-Subduction data
Authors: Rezaeian Sanaz , Al Atik Linda , Kuehn Nicolas M , Abrahamson Norman , Bozorgnia Yousef , Mazzoni Silvia , Withers Kyle , Campbell Kenneth
Published: July 2021

This article develops global models of damping scaling factors (DSFs) for subduction zone earthquakes that are functions of the damping ratio, spectral period, earthquake magnitude, and distance. The Next Generation Attenuation for subduction earthquakes (NGA-Sub) project has developed the largest uniformly processed database of recorded ground motions to date from seven subduction regions: Alaska, Cascadia, Central America and Mexico, South America, Japan, Taiwan, and New Zealand. NGA-Sub used this database to develop new ground motion models (GMMs) at a reference 5% damping ratio. We worked with the NGA-Sub project team to develop an extended database that includes pseudo-spectral accelerations (PSA) for 11 damping ratios between 0.5% and 30%. We use this database to develop parametric models of DSF for both interface and intraslab subduction earthquakes that can be used to adjust any subduction GMM from a reference 5% damping ratio to other damping ratios. The DSF is strongly influenced by the response spectral shape and the duration of motion; therefore, in addition to the damping ratio, the median DSF model uses spectral period, magnitude, and distance as surrogate predictor variables to capture the effects of the spectral shape and the duration of motion. We also develop parametric models for the standard deviation of DSF. The models presented in this article are for the RotD50 horizontal component of PSA and are compared with the models for shallow crustal earthquakes in active tectonic regions. Some noticeable differences arise from the considerably longer duration of interface records for very large magnitude events and the enriched high-frequency content of intraslab records, compared with shallow crustal earthquakes. Regional differences are discussed by comparing the proposed global models with the data from each subduction region along with recommendations on the applicability of the models.
Burn-induced heterotopic ossification from incidence to therapy: key signaling pathways underlying ectopic bone formation
Authors: Hu Xianglin , Sun Zhengwang , Li Fengfeng , Jiang Chaoyin , Yan Wangjun , Sun Yangbai
Published: July 2021

Burn injury is one of the potential causes of heterotopic ossification (HO), which is a rare but debilitating condition. The incidence ranges from 3.5 to 5.6 depending on body area. Burns that cover a larger percentage of the total body surface area (TBSA), require skin graft surgeries, or necessitate pulmonary intensive care are well-researched risk factors for HO. Since burns initiate such complex pathophysiological processes with a variety of molecular signal changes, it is essential to focus on HO in the specific context of burn injury to define best practices for its treatment. There are numerous key players in the pathways of burn-induced HO, including neutrophils, monocytes, transforming growth factor-β1-expressing macrophages and the adaptive immune system. The increased inflammation associated with burn injuries is also associated with pathway activation. Neurological and calcium-related contributions are also known. Endothelial-to-mesenchymal transition (EMT) and vascularization are known to play key roles in burn-induced HO, with hypoxia-inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) as potential initiators. Currently, non-steroidal anti-inflammatory drugs (NSAIDs) and radiotherapy are effective prophylaxes for HO. Limited joint motion, ankylosis and intolerable pain caused by burn-induced HO can be effectively tackled via surgery. Effective biomarkers for monitoring burn-induced HO occurrence and bio-prophylactic and bio-therapeutic strategies should be actively developed in the future.
Nitrogen and Carbon Nitride-Doped TiO2 for Multiple Catalysis and Its Antimicrobial Activity
Authors: Ashfaq Atif , Ikram Muhammad , Haider Ali , Ul-Hamid Anwar , Shahzadi Iram , Haider Junaid
Published: July 2021

Nitrogen (N) and carbon nitride (C3N4)-doped TiO2 nanostructures were prepared using co-precipitation route. Fixed amount of N and various concentrations (0.1, 0.2, 0.3 wt%) of C3N4 were doped in TiO2 lattice. Through multiple techniques, structural, chemical, optical and morphological properties of samples were thoroughly investigated. XRD results verified anatase TiO2 presence along the substitutional doping of N, while higher degree of crystallinity as well as increased crystallite size were noticed after doping. HR-TEM study revealed formation of nanostructures incorporated on two dimensional (2D) C3N4 nanosheet surface. Elemental composition was checked out using EDS technique which confirmed the presence of dopant in product. Optical characteristics were evaluated with UV–vis spectroscopy which depicted representative redshift in absorption spectra resulted in a reduction in bandgap energy in N/C3N4-doped TiO2 samples. The formation of Ti–O–Ti bonds and different molecular vibrations were disclosed by FTIR. Trap sites and charge carrier’s migration in the materials were evaluated with PL spectroscopy. Multiple catalytic activities (photo, sono and photo-sono) were undertaken to evaluate the dye degradation performance of prepared specimen against methylene blue and ciprofloxacin. Further, antimicrobial activity was analyzed against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria.
Strategy to track double-J stents placed during COVID-19 using smartphone-based stent tracker application to prevent forgotten double-J stent in a high-volume centre: a smart solution
Authors: Mulay Abhirudra , Kapoor Rohit , Sharma Sonu , Asabe Shashikant , Belagali Hareesh , Singh Siddharth , Satav Vikram , Sabale Vilas
Published: July 2021

Background

Forgotten or retained (double-J) DJ stents may lead to several complications. Management of retained DJ stents poses a challenge for urologists not just surgically but also medicolegally and adds to the economic burden of the patient. Difficulty in follow-up for patients due to the contagious nature of COVID-19 and several restrictions posed in the form of lockdown. Smartphones today have become an integral part of our daily lives providing a convenient and reliable platform for data storage and access.

Methods

All patients requiring placement of DJ stents and agreeing to enrol in the study were registered on the application over the physicians smartphone. SMSs regarding dates for removal of stent and follow-up with the literature regarding stent care were sent to the patients in their regional language.

Results

A total of 100 patients were stented during this period of 3 months. Mean age was 42.61 years with three patients of paediatric age group. Mean duration of stent was 6 weeks. All patients received periodic messages (average 3) regarding follow-up and date for stent removal. 3%(n = 3) patients were delayed for follow-up; 2% (n = 2) patients lost to follow-up, compared to a 9% to 10% loss to follow-up in patients followed up only on paper discharges in our department previously.

Conclusion

It significantly reduced the number of physical visits of the patient to the hospital and provided a more streamlined tracking of the indwelling stents for the user; patient compliance was found to be almost 98%; being cloud based (android/iOS), it was easily accessible to the user; and with the option of sharing the account details, the patient record could be accessed by several residents from their individual devices, which significantly reduced loss to follow-up rates from 9 to 2%.