bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing daily treatment choices in multiple sclerosis: practice guidelines, biomarkers and burden of disease
Authors: Berger Thomas , Adamczyk-Sowa Monika , Csépány Tünde , Fazekas Franz , Fabjan Tanja Hojs , Horáková Dana , Ledinek Alenka Horvat , Illes Zsolt , Kobelt Gisela , Jazbec Saša Šega , Klímová Eleonóra , Leutmezer Fritz , Rejdak Konrad , Rozsa Csilla , Sellner Johann , Selmaj Krzysztof , Štouracˇ Pavel , Szilasiová Jarmila , Turcˇáni Peter , Vachová Marta , Vanecková Manuela , Vécsei László , Havrdová Eva Kubala
Published: December 2020

At two meetings of a Central European board of multiple sclerosis (MS) experts in 2018 and 2019 factors influencing daily treatment choices in MS, especially practice guidelines, biomarkers and burden of disease, were discussed. The heterogeneity of MS and the complexity of the available treatment options call for informed treatment choices. However, evidence from clinical trials is generally lacking, particularly regarding sequencing, switches and escalation of drugs. Also, there is a need to identify patients who require highly efficacious treatment from the onset of their disease to prevent deterioration. The recently published European Committee for the Treatment and Research in Multiple Sclerosis/European Academy of Neurology clinical practice guidelines on pharmacological management of MS cover aspects such as treatment efficacy, response criteria, strategies to address suboptimal response and safety concerns and are based on expert consensus statements. However, the recommendations constitute an excellent framework that should be adapted to local regulations, MS center capacities and infrastructure. Further, available and emerging biomarkers for treatment guidance were discussed. Magnetic resonance imaging parameters are deemed most reliable at present, even though complex assessment including clinical evaluation and laboratory parameters besides imaging is necessary in clinical routine. Neurofilament-light chain levels appear to represent the current most promising non-imaging biomarker. Other immunological data, including issues of immunosenescence, will play an increasingly important role for future treatment algorithms. Cognitive impairment has been recognized as a major contribution to MS disease burden. Regular evaluation of cognitive function is recommended in MS patients, although no specific disease-modifying treatment has been defined to date. Finally, systematic documentation of real-life data is recognized as a great opportunity to tackle unresolved daily routine challenges, such as use of sequential therapies, but requires joint efforts across clinics, governments and pharmaceutical companies.
Building self-advocacy in HIV care: the use of role-play to examine healthcare access for HIV-positive MSM in rural South Africa
Authors: Daniels Joseph , Struthers Helen , Soler Joshua , Ricco Emilio , Blackmon Joshaun , Teklehaimanot Senait , McIntyre James , Coates Thomas
Published: December 2020

There is high HIV prevalence and low rates of viral suppression for men who have sex with men (MSM) in South Africa, with few MSM-centered interventions to address these outcomes along the HIV treatment cascade. Participatory interventions may support community building among HIV-positive MSM through which they can share approaches of self-advocacy that are contextually grounded. We conducted a pilot study to assess the use of role-plays in influencing social isolation while also updating our understanding of MSM healthcare experiences in Mpumalanga, South Africa. The study was conducted with 21 MSM leaders who were HIV-positive. There were three groups of seven participants each who created and performed role-plays based on their healthcare experiences, with a focus group discussion (FGD) conducted afterward. Audio-recordings were transcribed, translated, and analyzed using a constant comparison approach. We found that MSM described role-play as cathartic and a future HIV care educational tool for other MSM, and that they outlined points of self-advocacy during HIV care in clinics. Our study suggests that future research should utilize role-play so to integrate contextual factors influencing HIV treatment, especially in high HIV prevalence settings.
First-line immune-checkpoint inhibitor plus chemotherapy versus chemotherapy alone for extensive-stage small-cell lung cancer: a meta-analysis
Authors: Landre Thierry , Chouahnia Kader , Des Guetz Gaëtan , Duchemann Boris , Assié Jean-Baptiste , Chouaïd Christos
Published: December 2020

Introduction:

Platin-based chemotherapy (CT) has long been the first-line standard-of-care for patients with extensive-stage small-cell lung cancer (ES–SCLC). Adding immune-checkpoint inhibitor(s) to CT (ICI+CT) in this setting is an option of interest, although its benefit is apparently modest.

Methods:

This meta-analysis was conducted on randomized trials comparing first-line ICI+CT versus CT alone for ES–SCLC. Outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), response at 12 months and adverse events (AEs). Subgroup analyses were computed according to the immunotherapy used, performance status (PS), age, platinum salt, liver metastases and brain metastases at diagnosis.

Results:

The literature search identified one randomized phase II (ECOG-ACRIN-5161) and four phase III trials (CASPIAN, IMPOWER-133, KEYNOTE-604 and Reck et al. 2016) that included 2775 patients (66% males, 95% smokers, median age: 64 years, PS = 0 or 1). ICI+CT was significantly associated (hazard ratio [95% confidence interval]) with prolonged OS [0.82 (0.75–0.89); p <  0.00001] and PFS [0.81 (0.75–0.87); p <  0.00001], with OS benefits for anti-PD-L1 [0.73 (0.63–0.85); p < 0.0001] or anti-PD-1 [0.76 (0.63–0.93); p < 0.006] but not for anti-CTLA-4 [0.90 (0.80–1.01), p = 0.07]. ORRs for ICI+CT or CT alone were comparable [odds ratio 1.12 (0.97–1.00); p = 0.12], but responses at 12 months favored ICI+CT [4.16 (2.81–6.17), p < 0.00001]. Serious grade-3/4 AEs were more frequent with ICI+CT [odds ratio 1.18 (1.02–1.37); p = 0.03]. Compared with CT, no ICI+CT benefit was found for ES–SCLC with brain metastases at diagnosis [HR 1.14 (0.87–1.50); p =  0.34].

Conclusions:

First-line ICI+CT appears to be superior to CT alone for ES–SCLC except for patients with brain metastases at diagnosis.
The use and diagnostic value of testing myositis-specific and myositis-associated autoantibodies by line immuno-assay: a retrospective study
Authors: Lackner Angelika , Tiefenthaler Viktoria , Mirzayeva Jalia , Posch Florian , Rossmann Christopher , Kastrati Kastriot , Radner Helga , Demel Ulrike , Gretler Judith , Stotz Michael , Graninger Winfried B , Stradner Martin H
Published: December 2020

Aims:

Line immune-assays (LIA) for the detection of myositis-specific antibodies (MSA) are used widely for characterization of idiopathic inflammatory myopathies (IIM). Their current use and significance for the diagnosis of IIM remains unclear.

Methods:

In this retrospective analysis, we retrieved clinical diagnoses of patients tested for MSA and myositis-associated antibodies (MAA) Jo-1, Mi-2α, Mi-2β, TIF1γ, SRP, MDA-5, NXP-2, SAE, PL-7, PL-12, EJ, OJ, PM-Scl100, PM-Scl75 and Ku. We calculated clinical specificity, clinical sensitivity, negative- and positive predictive values (PPV) as well as positive and negative likelihood ratios.

Results:

In total, we analyzed 3167 samples. After exclusion of repeated measurements and patients with insufficient clinical information, data of 1118 patients were available for analysis. A total of 242 patients tested positive for at least one antibody, of which 45 patients had a diagnosis of IIM; 25 IIM patients were negative for all MSA/MAA. Clinical specificity of MSA/MAA for the diagnosis of IIM ranged between 94.2% and 99.9%. Clinical sensitivity and PPV across all antibodies tested ranged from 0.0% to 12.9% and 0.0% to 72.7%, respectively.

Conclusion:

In clinical practice MSA/MAA are used widely for diagnostic work-up of IIM, resulting in a low pre-test probability. Clinicians should be aware that PPVs for most MSA/MAA are low.
Missing in action: The EU–UK foreign, security and defence policy relationship after Brexit
Authors: Whitman Richard G.
Published: December 2020

Brexit has transformed the EU–UK relationship into a foreign-policy challenge for both sides. The negotiations on the EU–UK future relationship have been a process in which both sides have been learning about the other as a third-party negotiator. The UK has taken a very different attitude to the Political Declaration, agreed alongside the Withdrawal Agreement (covering the terms of the UK’s departure from the EU), treating it as a guide rather than a roadmap for negotiations. And the UK has decided not to pursue negotiations with the EU on a future foreign, security and defence policy relationship. This is in a context in which the EU’s member states have committed to deepening security and defence cooperation. At present, and despite shared international challenges, a formal agreement on EU–UK foreign, security and defence policy looks set to be replaced by an approach of ‘muddling through’.
Lessons earned and lessons learned: What should be done next to counter the COVID-19 infodemic?
Authors: Kovalčíková Nad’a , Tabatabai Ariane
Published: December 2020

As governments and citizens around the world have struggled with the novel coronavirus, the information space has turned into a battleground. Authoritarian countries, including Russia, China and Iran, have spread disinformation on the causes of and responses to the pandemic. The over-abundance of information, also referred to as an ‘infodemic’, including manipulated information, has been both a cause and a result of the exacerbation of the public health crisis. It is further undermining trust in democratic institutions, the independent press, and facts and data, and exacerbating the rising tensions driven by economic, political and societal challenges. This article discusses the challenges democracies have faced and the measures they have adopted to counter information manipulation that impedes public health efforts. It draws seven lessons learned from the information war and offers a set of recommendations on tackling future infodemics related to public health.
Malaysia’s Hedging Strategy Towards China Under Mahathir Mohamad (2018–2020): Direct Engagement, Limited Balancing, and Limited Bandwagoning
Authors: Gerstl Alfred
Published: December 2020

To mitigate the risks and maximise the opportunities arising from China’s great power behaviour, Malaysia employed a hedging strategy during Mahathir Mohamad’s second term as prime minister. From 2018 until 2020, the middle power Malaysia applied direct engagement and elements of limited balancing and limited bandwagoning in a flexible yet consistent manner. Neither China’s Belt and Road Initiative (BRI) nor its actions in the South China Sea caused a sea change in Malaysia’s hedging strategy. Crucially, the policies towards China were embedded in omnidirectional, friendly, and well-balanced relations with the United States, Japan, and the Association of Southeast Asian Nations (ASEAN). Theoretically, this contribution applies an updated concept of hedging, initially introduced by Cheng-Chwee Kuik. As an important innovation, it adds a specific component to assess the perceptions of the political leader(s) of risks and opportunities related to the hedging target as well as the strategic value of potential balancing partners.
Pharmacoadherence: An Opportunity for Digital Health to Inform the Third Dimension of Pharmacotherapy for Diabetes
Authors: Klonoff David C. , Zhang Jennifer Y. , Shang Trisha , Mehta Chhavi , Kerr David
Published: December 2020

The basis of pharmacotherapy requires knowledge of two properties of a drug: pharmacokinetics (PK) and pharmacodynamics (PD). In the era of precision medicine, there is growing interest in determining between-individual variations in PK and PD. While these two dimensions of pharmacotherapy are key foci of investigation, a third property is also emerging as a critical factor in understanding how a drug affects an individual. This third property of a drug is known as phamacoadherence (PA). There can be wide variation in PA among people with diabetes, whether they are using oral or injectable medications. The use of new digital health interventions and telehealth communication tools, such as smart insulin pens, is now creating opportunities for health care professionals to have a more complete understanding of the PA of drugs, which allows for more personalized prescribing practices.
There is a Chance: Songwriting for Hope as Critical Qualitative Research
Authors: Carless David
Published: December 2020

How to sustain hope amidst loss during repressive times? It may not be enough to voice the words “there is a chance”. But can the act of writing a song, of singing that song, of making a noise, constitute a commitment towards ensuring that there is a chance?
Influence of Autoimmune Antibody Testing on the Use of Immunotherapy on an Inpatient Neurology Service
Authors: Galetta Kristin , Gheihman Galina , Rosen Amy , Klein Joshua P. , Bhattacharyya Shamik
Published: December 2020

Objective:

To determine the frequency of autoimmune antibody testing in an inpatient neurology setting and its influence on immunotherapy use on an inpatient neurology service.

Methods:

A retrospective descriptive cohort study of patients admitted to the neurology inpatient service at a large tertiary academic medical center who had autoimmune and/or paraneoplastic antibody testing performed between 10/1/2017 and 10/1/2018. Characteristics of patients’ initial clinical presentation, antibody testing results, test timing in relation to initiating immunotherapy, and final diagnosis using consensus criteria were extracted and analyzed. Case reports of patients with positive antibody panels are presented.

Results:

Of 1,604 patients, 50 patients (3.1%) had an antibody panel sent. Tests resulted after an average of 17 days (range 7-27). The most common clinical presenting symptom in those with a panel sent was encephalopathy. There were 5 (10%) positive serum panels and no positive CSF panels. Only one of these 5 patients had autoimmune encephalitis and was treated with immunotherapy. Of those with negative serum and CSF panels, 15 were treated acutely with empiric immunotherapy and the remainder with supportive care. Of those treated with immunotherapy, 14/15 (93%) were treated before the panel tests resulted. Four patients who had negative panels but were empirically treated met consensus criteria for an autoimmune-mediated neurologic process.

Conclusion:

Our study suggests that the results of antibody testing did not influence inpatient neurologists’ decision to treat with immunotherapy as most treatments began prior to final results being available.
Massey, Marx, and human geography: disjunctures and provocations
Authors: Cox Kevin
Published: December 2020

Doreen Massey made contributions that command the attention of historical geographical materialists. Although she was close to the left, her work strayed very significantly from Marx. Nevertheless, through her emphases she revealed, intentionally or not, important lacunae in the work of Marxist geography. Methodologically she was close to critical realism. She accepted the idea of separate structures of social relations and patriarchy was one that she emphasized. This put her at odds with Marxist views of the social process as constituted by moments that internalize one another. Her work on space was set in opposition to classical Marxist views, most notably in its insistent particularizing tendency as opposed to one that recognizes particularity but also the way in which it gets structured by the capitalist social process as a whole. This emphasis is also apparent in her work on uneven development where production and the contradictions entailed by the capitalist mode of production get neglected. Even so, in her emphasis on particularity, she provided an important challenge, not least for the way in which we approach questions of gender, the constitution of regions and countries, and the importance of the particularity of place for understanding uneven development.
Biomechanical Analysis of a Custom-Made Mouthguard Reinforced With Different Elastic Modulus Laminates During a Simulated Maxillofacial Trauma
Authors: Tribst João Paulo Mendes , Dal Piva Amanda Maria de Oliveira , Ausiello Pietro , De Benedictis Arianna , Bottino Marco Antonio , Borges Alexandre Luiz Souto
Published: December 2020

Background/Aims:

There is a lack of data regarding the influence of different laminates for mouthguard reinforcement in the mechanical response during an impact in the orofacial region. The aim of this study was to verify the influence of the laminate framework on the stresses and strains of the anterior teeth and displacement of ethylene-vinyl acetate (EVA) custom-made mouthguards during a simulated impact. The null hypotheses was that the different laminates reinforcement would present the similar effect in maxillary structures, regardless the elastic modulus.

Methods:

A finite element model of human maxillary central incisors with an antagonist contact was used. A linear quasi-static analysis was used to simulate the force exerted during an impact. A total of 5 different layers were simulated inside the mouthguard at the labial portion according to the Elastic Modulus 1 MPa (Extremely flexible), 9 GPa (Low modulus reinforcement), 18 GPa (Without reinforcement), 50 GPa (Flexible alloy), 100 GPa (Titanium alloy) and 200 GPa (Hard material). The results were evaluated by means of Maximum Principal Stress (in the tooth and bone), Microstrain (periodontal ligament) and Displacement (mouthguard) criteria.

Results:

The elastic modulus of the material inside the MG influenced the stress distribution on the enamel buccal face. However, it did not affect the bone tissue stress, periodontal ligament strain or root dentin tissue stress. Conclusion: The use of reinforcement inside the custom-made mouthguard can modify the stress generated in the enamel buccal surface without improvement to the root dentin, periodontal ligament or bone tissue.
Critical Success Factors of the University of the Future in a Society 5.0: A Maturity Model
Authors: Panizzon Mateus , Barcellos Paulo Fernando Pinto
Published: December 2020

When addressing the possible futures for the university, one can ask what the new critical success factors (CSF) are that represent the core of the University of the Future, from a strategic perspective of analysis. Considering the Society 5.0 paradigm, characterized by higher levels of uncertainty, turbulence, and balance between technology and human values, adaptation to the ecosystem becomes an essential competence. Based on the literature, considering the convergence of organizational cybernetics and biomimetics, this theoretical article proposes a set of new CSF for the University of the Future, expanding the analysis of Society 5.0 and the future challenges for universities. Additionally, proposes a maturity model with eleven dimensions and three stages to support this discussion, visioning a future scenario. This foresight approach provides new insights to think over strategic critical success factors for the university to respond to possible and sustainable futures. Reconfiguration, purpose, and digitization are capacities to address the new environment set in this Smart Society. With this analysis, strategic questions are proposed for researchers and practitioners, especially to address global and regional challenges that universities will face, particularly due to the technological gap established between countries.
Fumbling Toward Foresight
Authors: Wasilko Peter J.
Published: December 2020

This personal reflection describes the evolution of the author’s relationship with The Future on his interdisciplinary research journey from the 1990’s to the present. It begins with an overview of his University work and discovery of Augmentation Research from which he derives a definition of Enabling Technologies that he tried to combine in an informal digital library venture called The Continuity Project. When further progress was blocked by technological impediments, he shifted gears to establish a formal long-term R&D focused 501(c)(3) Public Charity called The Institute for End User Computing, Inc. that ultimately failed due to regulatory compliance costs associated with premature incorporation as the Future diverged from the organization’s assumptions. Through this period, the author came to recognize a growing crisis in the academy that inspired him to launch his current initiative—an unincorporated association dedicated to exploring University Futures called Founders’ Quadrangle. In researching this new project, he discovered the Foresight literature which transformed his thinking about The Future and empowered him to formulate The Academic Sublime—a vision of his preferred future for the University with a set of core tenants against which possible futures and responses to them might be evaluated. He then engaged in Backcasting through a series of developmental stages leading to a distant future of academic city-states. Of particular note was his recognition that traditional colleges and universities are precluded from exploring many possible futures by the current regulatory schema under which they operate leading him to propose a new legal analytic framework of entities like Founders’ Quadrangle—to be called Quasi Academic Enterprises (QAE’s)—which are driven by the avoidance of regulatory impedance mismatch in their pursuit of The Academic Sublime. The paper closes with an overview of contemplated future work
Bartonella osteomyelitis versus vertebral sarcoidosis: A tale of two cases
Authors: Soni Neetu , Gupta Sarika , Pillenahalli Maheshwarappa Ravishankar , Priya Sarv , Bathla Girish
Published: December 2020

Background

Osteomyelitis is an uncommon manifestation of Bartonella henselae. Similarly, bony involvement may occur with sarcoidosis. Even though these are pathologically distinct entities, they can have overlapping imaging manifestations and therefore mimic one another. This is further complicated by the fact that both entities show non-caseating granulomatous inflammation on histopathology. We present two cases with similar imaging findings, with one case eventually diagnosed as Bartonella osteomyelitis, while the other proved to be vertebral sarcoidosis. Both patients exhibited vertebral involvement in common, and improved clinically and radiographically following antibiotics and steroids treatment, respectively. Given the overlapping pathological and imaging manifestations, and the non-specific clinical presentation, these entities may be considered in the differential consideration of each other. The presence of associated findings in such cases may be helpful.
Complete heart block in a 40-year-old man with anti-SSA/Ro autoantibodies
Authors: Raja Shariff Raja Ezman , Lim Chiao Wen , Kasim Sazzli
Published: December 2020

Atrio-ventricular dissociation (AVD), including complete heart block (CHB), are far more common in the elderly. We report a rare case of CHB in a 40-year-old man, who tested positive for anti-Ro autoantibodies without systemic features. He had been suffering for giddiness over the previous two months. On arrival, his electrocardiogram revealed high-degree AVD. Upon further history, he mentioned that his 68-year-old mother with systemic lupus erythematosus (SLE) had suffered from similar episodes, requiring a permanent pacemaker implantation. On further investigation, he tested positive for antinuclear antibodies (ANA), anti-SSA/Ro and anti-RNP antibodies. However, from history and clinical examination, he had not manifested any articular, extra-articular or extra-glandular features suspicious of rheumatological conditions. Following a failed trial of intravenous hydrocortisone, he subsequently had a permanent pacemaker implanted himself. Although difficult to ascertain whether our patient suffered from a congenital form of anti-SSA/Ro-related CHB, there is evidence to suggest delayed presentation of CHB in those with anti-SSA/Ro and neonatal lupus syndrome. Anti-SSA/Ro antibodies without systemic features can be present in 3% of the population, although this occurs more commonly in the presence of a confirm diagnosis of SLE, Sjögren’s syndrome or poly- and dermatomyositis. Despite the scarcity of evidence, a trial of steroid-based treatment was attempted prior to subjecting the young patient to a permanent pacemaker and its associated complications. To our knowledge, this is only the second case of isolated anti-SSA/Ro syndrome presenting with CHB reported in the literature.
Association of hidden fluid administration with development of fluid overload reveals opportunities for targeted fluid minimization
Authors: Branan Trisha , Smith Susan E , Newsome Andrea Sikora , Phan Rebecca , Hawkins W Anthony
Published: December 2020

Background:

Fluid overload is associated with poor outcomes, but mitigating its occurrence poses significant challenges.

Objective:

This study sought to assess the impact of hidden fluid volume on fluid overload.

Methods:

This study was a multi-center, retrospective evaluation of adults admitted to a medical or surgical intensive care unit for at least 72 h. Patients were divided into tertiles (low, moderate, and high) based on the hidden fluid volume received. Hidden fluids were defined as intravenous medications, line flushes, blood products, and enteral nutrition. The primary outcome was the incidence of fluid overload at intensive care unit (day 3). Secondary outcomes included mechanical-ventilation free days and association of hidden fluid volume with fluid overload, length of stay, and mortality.

Results:

A total of 219 (73 per tertile) were included, with hidden fluid volume comprising ⩽2500, 2501–4400, and >4400 mL in the low, moderate, and high tertiles, respectively. Incidence of fluid overload was significantly different across groups (low: 3%, moderate: 14%, high: 25%; p < 0.001). No difference existed in mechanical-ventilation free days or in-hospital mortality across tertiles. In binary logistic regression, hidden fluid volume received at 3 days was independently associated with fluid overload (odds ratio = 1.40, 95% confidence interval = 1.15–1.70).

Conclusion:

The volume of hidden fluid volume administered by intensive care unit day 3 independently predicted development of fluid overload.
Clinicopathological correlation of pre-biopsy quantitative PSMA uptake in patients with persistently raised serum PSA: initial experience in 74 patients with simultaneous 68-Ga PSMA PET/MRI
Authors: Rouf Malik A , Taneja Rajesh , Kumar Venkatesh
Published: December 2020

Objective:

To analyze 68-Ga prostate-specific membrane antigen (PSMA) uptake pattern of the prostate and its correlation with prostate-specific antigen (PSA), digital rectal examination (DRE), and Gleason’s score in the diagnosis of carcinoma of the prostate (CaP).

Methods:

This was a retrospective study conducted between June 2015 and August 2017. Patients who had undergone whole body 68-Ga PSMA HBED-CC simultaneous positron emission tomography (PET) or magnetic resonance imaging (MRI) for the diagnosis or staging of CaP were eligible. Patients who presented with persistently raised serum PSA (>4 ng/mL) and normal urine routine and negative culture were included in the study.

Results:

A total of 74 patients were included in the study. Significant positive correlation was observed between PSMA delayed uptake with the Prostate Imaging Reporting and Data System (PI-RADS) score ( p<0.001, ρ=0.750), PSA level ( p<0.001, ρ=0.414), DRE ( p<0.002, ρ=0.400), and Gleason’s score ( p<0.300, ρ=0.02). There was a significant difference between early and delayed phase of PSMA uptake in malignant prostatic lesions ( p<0.001). Delayed phase of PSMA uptake was able to characterize prostate lesions with an area under curve (AUC) of 0.91. Combined receiver operating characteristic analysis of PI-RADS score derived from multiparametric MRI and differential PSMA uptake to characterize prostatic lesions improved AUC to 0.94.

Conclusion:

Results demonstrated that the correlation with clinicopathological features (PSA, DRE, and Gleason’s score) could be used in prognostication of prostatic lesion along with PSMA PET/MRI.
Aneurysmal bone cyst in the pelvis of a cat: successful outcome of partial iliectomy with limb preservation
Authors: Winbladh Kajsa , Fransson Boel A , Svensson Gustaf , Karlstam Erika , Uhlhorn Margareta
Published: December 2020

Case summary

A 3-year-old spayed female domestic shorthair indoor cat presented with a 3-week history of pain from the pelvic region. Physical examination revealed pain elicited on palpating the pelvic area and right hip. Radiographs and CT showed an expansile, osteolytic process with intact cortex in the right wing of the ilium. CT revealed a monostotic and soft tissue-attenuating process with clear margins. Preoperative histopathological diagnosis of aneurysmal bone cyst was made from incisional biopsies. The cyst was removed en bloc with limb-sparing partial iliectomy. Histopathology confirmed the diagnosis of aneurysmal bone cyst. Recovery from surgery was uneventful. At re-examination 8 weeks and 8 months postoperatively, the cat was pain free and physical examinations were within normal limits.

Relevance and novel information

Feline aneurysmal bone cysts are rare and reported cases are few. To our knowledge, this is the first report describing the CT appearance of a pelvic aneurysmal bone cyst and partial iliectomy with limb preservation in a cat with successful short-term outcome.
Physical activity monitoring to assess disability progression in multiple sclerosis
Authors: Stuart Charlotte M , Varatharaj Aravinthan , Domjan Janine , Philip Sheaba , Galea Ian ,   SIMS study group
Published: December 2020

Background

Clinical outcome measurement in multiple sclerosis (MS) usually requires a physical visit. Remote activity monitoring (RAM) using wearable technology provides a rational alternative, especially desirable when distance is involved or in a pandemic setting.

Objective

To validate RAM in progressive MS using (1) traditional psychometric methods (2) brain atrophy.

Methods

56 people with progressive MS participated in a longitudinal study over 2.5 years. An arm-worn RAM device measured activity over six days, every six months, and incorporated triaxial accelerometry and transcutaneous physiological variable measurement. Five RAM variables were assessed: physical activity duration, step count, active energy expenditure, metabolic equivalents and a composite RAM score incorporating all four variables. Other assessments every six months included EDSS, MSFC, MSIS-29, Chalder Fatigue Scale and Beck’s Depression Inventory. Annualized brain atrophy was measured using SIENA.

Results

RAM was tolerated well by people with MS; the device was worn 99.4% of the time. RAM had good convergent and divergent validity and was responsive, especially with respect to step count. Measurement of physical activity over one day was as responsive as six days. The composite RAM score positively correlated with brain volume loss.

Conclusion

Remote activity monitoring is a valid and acceptable outcome measure in MS.
CD8+ T cell gene expression analysis identifies differentially expressed genes between multiple sclerosis patients and healthy controls
Authors: Brorson IS , Eriksson AM , Leikfoss IS , Vitelli V , Celius EG , Lüders T , Berge T , Harbo HF , Nilsen H , Bos SD
Published: December 2020

Background

Genetic and clinical observations have indicated T cells are involved in MS pathology. There is little insight in how T cells are involved and whether or not these can be used as markers for MS.

Objectives

Analysis of the gene expression profiles of circulating CD8+ T cells of MS patients compared to healthy controls.

Methods

RNA from purified CD8+ T cells was sequenced and analyzed for differential gene expression. Pathway analyses of genes at several p-value cutoffs were performed to identify putative pathways involved.

Results

We identified 36 genes with significant differential gene expression in MS patients. Four genes reached at least 2-fold differences in expression. The majority of differentially expressed genes was higher expressed in MS patients. Genes associated to MS in GWAS showed enrichment amongst the differentially expressed genes. We did not identify enrichment of specific pathways amongst the differentially expressed genes in MS patients.

Conclusions

CD8+ T cells of MS patients show differential gene expression, with predominantly higher activity of genes in MS patients. We do not identify specific biological pathways in our study. More detailed analysis of CD8+ T cells and subtypes of these may increase understanding of how T cells are involved in MS.
Exploring interface design to support caregivers’ needs and feelings of trust in online content
Authors: Hussein Thana , Chauhan Preet K , Dalmer Nicole K , Rudzicz Frank , Boger Jennifer
Published: December 2020

Introduction

Family caregivers of people living with dementia require a range of accurate, current, and reliable information throughout the care trajectory. Much of this information is available online, however it can be difficult for caregivers to identify and decide what content is relevant to them. Little is known about how online design cues impact family caregivers’ decision to assess how trustworthy information is and whether to engage with it.

Methods

Our exploratory research focused on the interface design of CARE-RATE, an online search tool intended to support more effective information searches for family caregivers seeking dementia care-related resources. Data from focus groups were coupled with design literature to inform the development of three mockups that were evaluated by seven dementia caregiver experts.

Results

Participants preferred a search bar design because of its simplicity, familiarity, and functionality. Design elements that impact trust included logos from reputable organizations, transparency of content author, and ratings from other caregivers.

Conclusion

Feelings of trust regarding information, including the ability to ascertain trustworthiness, is a major aspect of caregivers’ willingness to engage with online content. Transparency and familiarity appear to be key elements that impact caregivers’ trust in online information, which agrees with current web design research.
“Give me Liberty or Give me Covid-19”: Anti-lockdown protesters were never Trump puppets
Authors: Schradie Jen
Published: December 2020

Dismissing conservative participants in protests as duped fools or ranting ideologues who have fallen prey to fake news is a dangerous reaction that fails to recognize the essential and grassroots role they play in profoundly effective conservative messaging that continues to outfox progressive information campaigns. This article uses the collective action against Covid-19 stay-at-home orders and mask requirements as an example of the broader arguments in the book, The Revolution That Wasn’t: How Digital Activism Favors Conservatives (Harvard University Press, 2019).
Instrumented balance assessment in mild traumatic brain injury: Normative values and descriptive data for acute, sub-acute and chronic populations
Authors: Parrington Lucy , Popa Bryana , Martini Douglas N , Chesnutt James C , King Laurie A
Published: December 2020

Often the Balance Error Scoring System (BESS) is used to assess balance during a clinical evaluation of a patient presenting with mild Traumatic Brain Injury (mTBI). Although recent research has shown the benefits of using inertial sensor measures such as the Root Mean Square (RMS) of the acceleration in place of clinical scoring, few normative data are available for clinicians to reference. The purpose of this paper was to provide normative data collected using wearable sensors for healthy controls across three age groups, as well as providing cohort data for mTBI participants across three stages following injury (acute, sub-acute and chronic). The RMS in the Medio-Lateral direction (ML RMS sway) of each condition (double stance – DS; single stance – SS; and tandem stance – TS) was extracted per participant for analysis. The average ML RMS sway across all conditions was also calculated (ML RMS-Av). Percentiles were calculated to provide normative data, and two multivariate general linear models were used to evaluate differences between 1) non-athlete controls, athlete controls, and athletes with acute mTBI, and 2) non-athletic cohorts of control, sub-acute and chronic mTBI groups across young, middle-aged, and older adults. Model 1 revealed athletes with acute mTBI had more ML RMS sway than athlete controls the for the DS condition ( p < 0.001), but no differences with non-athlete controls. Athlete controls also had less ML RMS sway for the SS condition and ML RMS-Av ( p ≤ 0.022) compared with non-athlete controls. Model 2 revealed less ML RMS sway in the control group than the sub-acute and chronic mTBI groups for DS ( p ≤ 0.004), but no differences between the sub-acute and chronic group, while more ML RMS sway occurred in the chronic group compared with the control and sub-acute groups for the TS condition and ML RMS-Av ( p ≤ 0.013). Older adults had more ML RMS sway than young and middle-aged adults for SS, TS and ML RMS-Av ( p ≤ 0.019), while there were no differences between the young and middle-aged adults. Normative values presented here can help increase the practical application of instrumented balance assessment of mTBI patients through wearable sensors. ML RMS sway in the DS condition provided the clearest distinction between control and mTBI groups, but we caution that young adult athletes need to be assessed against athletic peers in the absence of baseline normative values. In non-athlete cohorts, age and gender norms may not be necessary to consider when assessing DS performance; however, age may be an important factor to consider when accessing norms for other stance conditions or the average performance across all conditions.
Experiential Learning in a Canadian Physical Education Class: A Comparative Perspective from Pre-service PE Teachers in Canada and China
Authors: Hector Sydney , Salinitri Geri
Published: December 2020

This article focuses on a comparative analysis of traditional Physical Education games and experiential learning on the part of teacher candidates enrolled in an Ontario Faculty of Education and one in Southwest China. Funded by the Social Sciences and Humanities Research Council of Canada (SSHRC) partnership grant for research on Reciprocal Learning between Canada and China, the researchers conducted a qualitative study interviewing ten teacher candidates from the reciprocal Faculties of Education. Emergent themes included risk-taking and resilience, willingness to implement foreign practices, division of sport-related skills, and daily physical activity (DPA). Findings suggest that DPA is overlooked in Canadian classrooms; Chinese teachers are more likely to implement foreign practices, and skills development in traditional PE games is disparate between Canada and China.
Implementation and Usefulness of Telemedicine During the COVID-19 Pandemic: A Scoping Review
Authors: Hincapié María Alejandra , Gallego Juan Carlos , Gempeler Andrés , Piñeros Jorge Arturo , Nasner Daniela , Escobar María Fernanda
Published: December 2020

Objectives:

Identify and summarize the available literature on the acceleration in the use of telemedicine in the midst of the COVID-19 pandemic, with an aim to provide justification and guidance for its implementation to overcome the limitations associated with the pandemic worldwide.

Methods:

We conducted a scoping review through different search strategies in MEDLINE and Google Scholar to identify the available literature reporting data on implementation and usefulness of various modalities of telemedicine during the current pandemic. We summarized the included studies according to field and mode of implementation in a narrative way.

Results:

We included 45 studies that fulfilled selection criteria. About 38% of the studies were conducted in the United States of America (USA), followed by 15.5% in India and 15.5% in China. Most studies (73%) were cross-sectional studies based on historical records. All publications were written in English with the exception of 1 studied published in Spanish. The majority of reports focused on use of telemedicine for outpatient care, followed by in-hospital care.

Conclusion:

The COVID-19 pandemic has promoted the use of telemedicine, a tool that has transformed the provision of medical services. Several modes of implementation are useful to overcome difficulties for patient care during the pandemic. Its benefits are specific to different fields of medical practice. Such benefits, along with the guidance and reported experiences should invite health systems to work for an effective and comprehensive implementation of telemedicine in various fields.
In-situ analysis of the hydration ability of bone graft material using a synchrotron radiation X-ray micro-CT
Authors: Seo Seung-Jun , Kim Yong-Gun
Published: December 2020

The conventional micro-computed tomography (μCT) is a non-destructive imaging technique used for obtaining 2D and 3D information for scaffolds. The main composition and internal structure are important in mimicking and designing the characteristics of natural bone. This study was three-dimensional evaluating the external or internal structures and the hydration effects of bone graft materials by using the in-situ image technique. Synchrotron radiation micro-computed tomography (SR-μCT) was used to extract information on the geometry of two biphasic calcium phosphates (BCP) with identical chemicals and different micro-macro porosity, pore size distribution, and pore interconnection pathways. Volume analysis by hydration was used to measure the two bone graft materials at 0, 5, and 10-min intervals. The SR-μCT image was achieved with information regarding the internal pore structure and hydration effects evaluated under 3D visualization. Both types of bone graft materials showed structures suitable for tissue engineering applications. The SR-μCT in-situ techniques with 3D information provided a detailed view of the structures. Thus, SR-μCT could be an available, unbiased 3D alternative to in-situ analysis.
Book review: Sudha Pai (Ed.), Constitutional and Democratic Institutions in India: A Critical Analysis
Authors: Katju Manjari
Published: December 2020

Sudha Pai (Ed.), Constitutional and Democratic Institutions in India: A Critical Analysis. Hyderabad: Orient BlackSwan. 2020. 504 pp. ₹1350. ISBN: 9789352878468
Book review: Pradip Ninan Thomas, The Politics of Digital India: Between Local Compulsions and Transnational Pressures
Authors: Arun P.
Published: December 2020

Pradip Ninan Thomas, The Politics of Digital India: Between Local Compulsions and Transnational Pressures. Delhi: Oxford University Press. 2019. 231 pp. ₹995. ISBN-13: 9780199494620 (In “Media Dynamics in South Asia” series edited by Adrian Athique, Vibodh Parthasarathi, and S. V. Srinivas)
Differences in the Development of Fibrocartilage Layers in the Quadriceps Tendon and Patellar Tendon Insertions in Rabbits: A Quantitative Study
Authors: Mutsuzaki Hirotaka , Nakajima Hiromi
Published: December 2020

Background:

Differences in the development of fibrocartilage layers in quadriceps tendon (QT) and patellar tendon (PT) insertion sites are unclear. Because the mechanical environments for the QT and PT are different, the development of the QT and PT insertions may differ.

Purpose:

To investigate differences in the development of fibrocartilage layers in the QT and PT insertion sites in rabbits through use of quantitative morphometric evaluations.

Study Design:

Descriptive laboratory study.

Methods:

This study included 54 male Japanese White rabbits. Animals were euthanized at ages 1 day and 1, 2, 3, 4, 6, 8, 12, and 24 weeks (n = 6 for each age). Chondrocyte number, proliferation, apoptosis, sex-determining region Y box 9 (Sox9)–positive rates, safranin O–stained glycosaminoglycan (GAG) areas, tidemark length, insertion width, and patellar length were evaluated and compared with the same parameters at age 24 weeks and between QT and PT insertion sites.

Results:

Chondrocyte proliferation was low up to age 2 weeks for QT insertion and low up to 1 week for PT insertion. Chondrocyte apoptosis was high at 1 day and Sox9 expression was low up to 1 week for PT insertion. Sox9 expression was higher in QT than in PT insertion at age 12 weeks. The high chondrocyte count continued to age 1 day in PT insertion and up to 6 weeks in QT insertion. The chondrocyte number was higher in QT than in PT insertion at age 2 weeks. The period of thicker GAG lasted from 2 to 8 weeks in PT insertion and from 1 to 12 weeks in QT insertion. GAG thickness in QT insertion was higher than in PT insertion at age 4 and 12 weeks.

Conclusion:

Development of fibrocartilage layers in QT and PT insertion sites was completed at age 24 weeks in rabbits. However, the period of high chondrocyte count and period of thicker GAG were longer in QT than in PT insertion up to 12 weeks.

Clinical Relevance:

Development of fibrocartilage layers in QT and PT insertions differed in rabbits. Our results may contribute to the development of appropriate treatments based on age and the development of methods for regeneration of the insertion.
Strength of HRM systems and perceived organizational support as determinants of employment relationships: The perspective of HR managers and workers’ representatives
Authors: Díaz-Fernández Mirta , López-Cabrales Alvaro , Valle-Cabrera Ramón
Published: December 2020

This article seeks to explain and understand how the strength of a human resource management (HRM) system and perceived organizational support (POS) determine employment relationships (ERs) in organizations and the behaviors they generate in terms of organizational citizenship behavior (OCB) and intentions to remain (IR). A typology of ERs is proposed, considering perceptions about the HRM system (Ability, Motivation, and Opportunity [AMO] model), its strength, and POS. An analysis was adopted, looking into organizations in two separate studies in service sectors (hospitality and financial services), taking as informants to 130 and 87 HRM managers and 30 workers’ representatives as proxies of organizations and employees, respectively. Cluster analysis and analysis of variance (ANOVA) were conducted, and results are congruent with theoretical frameworks such as Attribution Theory and Social Exchange Theory. Depending on how stakeholders understand the way in which the HRM system is implemented and the level of POS, certain ERs are developed and explain employees’ responses in terms of OCB and IR behaviors.

JEL CLASSIFICATION: M1.