bluuebunny/crossref_metadata_2025 huggingface dataset:
Princípios básicos e aplicações oncológicas da PET-CT/18F-FDG
Authors: Dias Edigar Henrique Vaz , Carvalho Eduardo Batista de , Pereira Diogo De Sousa
Published: April 2020

A Tomografia por Emissão de Pósitrons/Tomografia Computadorizada representa um grande salto tecnológico para a Medicina Nuclear e particularmente, para a Oncologia, visto que é capaz de distinguir alterações benignas e malignas com base em dados semiquantitativos da metabolização de radiofármacos pelos tecidos corporais. Este trabalho teve como objetivo realizar uma revisão narrativa dos principais levantamentos bibliográficos contemporâneos acerca dos princípios físicos da PET-CT/18F-FDG, suas aplicações na Oncologia e os avanços tecnológicos desta metodologia. Este trabalho foi elaborado com base em artigos obtidos de bancos de dados como PubMed, SciELO e Microsoft Academic Search, com descritores relacionados a PET-CT/18F-FDG e a Oncologia. A partir dos artigos analisados, observa-se que a PET-CT/18F-FDG é uma importante técnica para a obtenção de imagens morfofuncionais do corpo do paciente com sensibilidade e especificidade, muitas vezes, superiores aos métodos convencionais de diagnóstico por imagem. Dessa forma, a PET-CT/18F-FDG é recomendada nos casos de identificação e acompanhamento do estadiamento tumoral, monitoramento da taxa de resposta das terapias oncológicas e planejamento do alvo em tratamentos radioterápicos. Ainda, o desenvolvimento de algoritmos matemáticos e de sistemas de detecção de radiação mais eficientes na PET-CT/18F-FDG melhoram a qualidade da imagem e reduzem o tempo de exame.
Bipartição gástrica para tratamento paliativo de câncer de estômago avançado
Authors: Arruda Jose Júlio Farias , Lima Diego Laurentino , Furtado Romulo Silva , Cordeiro Raquel Nogueira , Meira Marconi Roberto Lemos
Published: April 2020

Introdução: O Câncer Gástrico (CG) é o quarto câncer mais comumente diagnosticado e a segunda principal causa de morte por câncer em todo o mundo. A sobrevida mediana raramente ultrapassa os 12 meses e, na forma metastática, a sobrevida de 5 anos é inferior a 10%. A maioria dos pacientes apresenta-se em estágios avançados da doença, frequentemente com tumores distais obstrutivos e irressecáveis, demandando tratamento paliativo, cujo objetivo é dar ao doente maior qualidade de vida. Relato do caso: Paciente, sexo masculino, 59 anos, aposentado, tabagista e etilista. Procurou Serviço de Pronto Atendimento com queixa de vômitos pós-prandiais, associados a dor abdominal epigástrica e perda de aproximadamente 8kg nos últimos 20 dias. Ao exame físico, foi identificada massa palpável em regiões de epigastro e mesogastro, dolorosa e de consistência sólida. Paciente teve como hipótese diagnóstica inicial Síndrome Pilórica secundária a neoplasia. A tomografia de abdome mostrou presença de um processo expansivo sólido, de aspecto infiltrativo, envolvendo a parede gástrica, na região do antro, inclusive promovendo sinais de estase líquida. Nódulo heterogêneo, entrando em contiguidade com a veia cava inferior, chegando a medir cerca de 1,1x0,9 cm, em seus maiores diâmetros. Diante do diagnóstico de adenocarcinoma gástrico avançado, com invasão de veia cava inferior, pâncreas e metástase hepática, sem proposta cirúrgica ou oncológica curativa, foi optado por nutrir o paciente de forma parenteral. A equipe cirúrgica optou pela cirurgia de bipartição gástrica com gastrojejuno anastomose, sob a técnica aberta, com duração aproximada de 90 minutos. Paciente recebeu alta hospitalar no quarto DPO, em boas condições clínicas, boa aceitação de dieta via oral, sem náuseas ou vômitos. Paciente veio a falecer 16 meses após a cirurgia devido a hemorragia digestiva alta secundária ao tumor avançado e sepse. Conclusão: a técnica da bipartição pode ser considerada uma técnica efetiva e segura, proporcionando um menor número de sintomas como náusea e vômitos, manutenção de dieta via oral e qualidade de vida para os pacientes sem proposta curativa.
sLRP1 (Soluble Low-Density Lipoprotein Receptor-Related Protein 1)
Authors: Chen Jiefang , Pi Shulan , Yu Cheng , Shi Hanqing , Liu Yuxiao , Guo Xiaoqing , Zhou Lian , Li Yuanyuan , He Hui , Xia Yuanpeng , Mao Ling , Hu Bo
Published: April 2020

Objective:

Recent studies suggest that the P2Y12 (P2Y purinoceptor 12) receptor of vascular smooth muscle cells in atherosclerotic plaques aggravates atherosclerosis, and P2Y12 receptor inhibitors such as CDL (clopidogrel) may effectively treat atherosclerosis. It is imperative to identify an effective biomarker for reflecting the P2Y12 receptor expression on vascular smooth muscle cells in plaques.

Approach and Results:

We found that there was a positive correlation between the level of circulating sLRP1 (soluble low-density lipoprotein receptor-related protein 1) and the number of LRP1
+
α-SMA
+
(α-smooth muscle actin), P2Y12
+
, or P2Y12
+
LRP1
+
cells in plaques from apoE
−/−
mice fed a high-fat diet. Furthermore, activation of the P2Y12 receptor increased the expression and shedding of LRP1 in vascular smooth muscle cells by inhibiting cAMP (3'-5'-cyclic adenosine monophosphate)/PKA (protein kinase A)/SREBP-2 (sterol regulatory element binding transcription factor 2). Conversely, genetic knockdown or pharmacological inhibition of the P2Y12 receptor had the opposite effects. Additionally, CDL decreased the number of lesional LRP1
+
α-SMA
+
cells and the levels of circulating sLRP1 by activating cAMP/PKA/SREBP-2 in apoE
−/−
mice fed a high-fat diet.

Conclusions:

Our study suggests that sLRP1 may be a biomarker that reflects the P2Y12 receptor level in plaques and has the potential to be an indicator for administering P2Y12 receptor inhibitors for patients with atherosclerosis.
Loss of Cardiac Ferritin H Facilitates Cardiomyopathy via Slc7a11-Mediated Ferroptosis
Authors: Fang Xuexian , Cai Zhaoxian , Wang Hao , Han Dan , Cheng Qi , Zhang Pan , Gao Feng , Yu Yingying , Song Zijun , Wu Qian , An Peng , Huang Sicong , Pan Jianwei , Chen Hou-Zao , Chen Jinghai , Linkermann Andreas , Min Junxia , Wang Fudi
Published: April 2020

Rationale:

Maintaining iron homeostasis is essential for proper cardiac function. Both iron deficiency and iron overload are associated with cardiomyopathy and heart failure via complex mechanisms. Although ferritin plays a central role in iron metabolism by storing excess cellular iron, the molecular function of ferritin in cardiomyocytes remains unknown.

Objective:

To characterize the functional role of Fth (ferritin H) in mediating cardiac iron homeostasis and heart disease.

Methods and Results:

Mice expressing a conditional Fth knockout allele were crossed with 2 distinct Cre recombinase-expressing mouse lines, resulting in offspring that lack
Fth
expression specifically in myocytes (MCK-Cre) or cardiomyocytes (Myh6-Cre). Mice lacking Fth in cardiomyocytes had decreased cardiac iron levels and increased oxidative stress, resulting in mild cardiac injury upon aging. However, feeding these mice a high-iron diet caused severe cardiac injury and hypertrophic cardiomyopathy, with molecular features typical of ferroptosis, including reduced glutathione (GSH) levels and increased lipid peroxidation. Ferrostatin-1, a specific inhibitor of ferroptosis, rescued this phenotype, supporting the notion that ferroptosis plays a pathophysiological role in the heart. Finally, we found that Fth-deficient cardiomyocytes have reduced expression of the ferroptosis regulator Slc7a11, and overexpressing Slc7a11 selectively in cardiomyocytes increased GSH levels and prevented cardiac ferroptosis.

Conclusions:

Our findings provide compelling evidence that ferritin plays a major role in protecting against cardiac ferroptosis and subsequent heart failure, thereby providing a possible new therapeutic target for patients at risk of developing cardiomyopathy.
The English Catholic Church and the Age of Mercantilism: Bishop Richard Challoner and the South Sea Company
Authors: Pizzoni Giada
Published: April 2020

This article argues that the commercial economy contributed to sustain the English Catholic Church during the eighteenth century. In particular, it analyzes the financial dealings of Bishop Richard Challoner, Vicar Apostolic of the London Mission (1758-1781). By investing in the stock market, Challoner funded charitable institutions and addressed the needs of his church. He used the profits yielded by the Sea Companies for a variety of purposes: from basic needs such as buying candles, to long-term projects such as funding female schools. Bishop Challoner contributes to a new narrative on Catholicism in England and enriches the literature on the Mercantilist Age. The new Atlantic economy offered an opening and Catholics seized it. By answering the needs of the new fiscal-state, the Catholic Church ensured its survival, secured economic integration, and eventually achieved political inclusion.
A Technology of Multiple Smelting Furnaces per Termite Mound: Iron Production in Chongwe, Lusaka, Zambia
Authors: Lyaya Edwinus C. , Chirikure Shadreck , Janney Philip E. , Rehren Thilo
Published: April 2020

With exception of Maluma (1979) and Musambachime (2016, 2017), there have been no archaeometallurgical publications on the technology and culture of iron production in Zambia. This paper presents archaeological and archaeometallurgical evidence of a technology of iron production in Chongwe in terms of spatial organization, the process of metal production (either a three-stage process involving smelting in relatively tall furnaces, refining in miniature (vintengwe) furnaces, and smithing on a hearth or a two-stage process involving smelting and smithing), furnace air supply mechanisms, liquid slag handling techniques, variation in the geochemistry of ore and clay, and the nature of the final smelting products. Archaeological field data collection techniques included ethnoarchaeological interviews, (furnace) excavation, surface collections, and surface walkover surveys, while laboratory analytical techniques included optical microscopy (OM), scanning electron microscopy (SEM), and x-ray fluorescence (XRF). New field evidence indicates that iron production in Chongwe in the previous two centuries was secluded from respective pre-modern settlements for socio-cultural and technical reasons. There are no settlement remains in and around Chongwe smelting sites. Also, most of the archaeological data in Chongwe are supportive of the two-stage process that did not involve iron refining in vintengwe furnaces. There were no iron refining sites in Chongwe. Archaeological evidence also strongly points to the use of natural air supply mechanism for the smelting furnaces because proximal ends of tuyères inter alia were not trumpeted. All smelting sites were systematically located on termite mounds. There were three to four smelting furnaces located on the western side of a termite mound. The presence of tuyère mould slags and thin and elongated slag microstructures strongly indicates that liquid slag was tapped outside the furnace apparently through tuyères and was left to cool quickly. Presence of primary wüstite and iron particles in the slags strongly suggests the production of iron as the final smelting product in Chongwe. The results are compared with the archaeology, chemistry, and mineralogy of iron production from other parts of sub-Saharan Africa, particularly in the Lake Tanganyika-Nyasa Corridor. The presence of three to four smelting furnaces per termite mound makes iron production in Chongwe a unique technology in the Corridor.
Living Outside the Wall: the Quarter of Wattle-and-daub Houses in Old Dongola of the Funj Period
Authors: Wyżgoł Maciej , Deptuła Agata
Published: April 2020

Excavations at Old Dongola in 2018/2019 led to the discovery of a quarter of wattle-and-daub houses located outside the town walls. The houses, dated to the 17th − 18th century, are arranged in compounds and visibly differ from other dwellings. This paper aims to identify the functional and social organisation of domestic space, based primarily on the analysis of access and activity areas. It sheds light on the relations of private and public space as well as gender divisions. The paper also addresses the question of the identity of dwellers and the social structure of the town in the Funj period.
Kircher’s Bohemia: Jesuit Networks and Habsburg Patronage in the Seventeenth Century
Authors: Lelková Iva , Findlen Paula , Sutherland Suzanne
Published: April 2020

This study analyzes the relations between the Jesuit polymath Athanasius Kircher (1602–1680) and his correspondents in Bohemia and elsewhere in Central Europe. This research began as a digital humanities project. By analyzing data from Kircher’s correspondence with the Palladio visualization tool, we discovered a remarkable number of letters that had been sent from Bohemia, especially early on. The Jesuit network proved crucial for Kircher’s early career advancement, and he benefited, for example, from Jesuit immigration to Bohemia after the Battle of White Mountain. Our research considers how a correspondence network, that was Jesuit in origin, had expanded to include scholars, noblemen, and even the emperor and his court. All of them supported Kircher, discussed his works, and were highly invested in them. Finally, we turn to explore why Kircher ultimately fell out of favour with the imperial court, while remaining a major figure in Jesuit scholarship in Central Europe throughout the seventeenth century.
Chancellery and Diplomatic Practices in Central Asia during the Mongol Period as Shown in Old Uyghur and Middle Mongolian Documents
Authors: Vér Márton
Published: April 2020

Due to its central location the Chaghadaid ulus played a key role in the interregional diplomatic connections in the Mongol period. Unfortunately, comparing to the other three uluses of the Mongol Empire we have a very limited number of written sources concerning the Chaghadaid realm. The aim of the present paper is to show how the new results of the philological study of the Old Uyghur and Middle Mongolian documents can throw new light upon our knowledge about the diplomatic practices in the Chaghadaid ulus. The paper concentrates on the two most important institutions which facilitated diplomatic relations: the chancelleries and the postal system.
Voices from Afar: Yuan Diplomacy between Ritual and Practice
Authors: Fiaschetti Francesca
Published: April 2020

In their expansion is Southeast Asia, the medieval Mongols encountered many challenges, and among them there was the necessity to legitimize themself in the eyes of those polities which had long established relations with the Song dynasty. In building his authority the founder of the Yuan dynasty, Qubilai Qa’an, shaped his diplomacy capitalizing on the skills of his non-Mongol subjects. From Confucian scholars to state officials, envoys and generals, many individuals participated in the Yuan diplomatic machine, thus finding their own justification to belong to the Yuan imperial project. The present paper sketches the narratives and rhetoric used by some of these individuals in the case of the Mongols long and challenging interaction with the neighboring kingdom of Đại Việt, in North Vietnam.
Description of three new water mite species of Hygrobates Koch, 1837 (Lurchibates Goldschmidt & Fu, 2011) (Acari, Hydrachnidia, Hygrobatidae), parasitic in newts of the genera Paramesotriton and Pachytriton (Amphibia, Caudata, Salamandridae) from China
Authors: GOLDSCHMIDT TOM , NISHIKAWA KANTO , HIRUTA SHIMPEI F. , SHIMANO SATOSHI
Published: April 2020

Males and females of three new water mite species of the genus Hygrobates Koch, 1837, subgenus Lurchibates Goldschmidt & Fu, 2011 (Acari, Hydrachnidia, Hygrobatidae) are described. The diagnosis of the subgenus is extended based upon the new material. The new species were all just found on one newt species each: Hygrobates (Lurchibates) intermedius sp. nov. Goldschmidt, Nishikawa & Shimano was collected from newts of the species Paramesotriton qixilingensis Yuan, Zhao, Jiang, Hou, He, Murphy & Che, 2014 from Jiangxi Province, China; H. (L.) robustipalpis sp. nov. Goldschmidt, Nishikawa & Shimano on Pachytriton inexpectatus Nishikawa, Jiang, Matsui & Mo, 2011 from Guizhou Province, China and H. (L.) pilosus sp. nov. Goldschmidt, Nishikawa & Shimano on Paramesotriton yunwuensis Wu, Jiang & Hanken, 2010 found in a pet shop.
Notes on slender species of the long-jawed spider genus Tetragnatha (Araneae, Tetragnathidae) with description of three new species
Authors: DE SOUZA CASTANHEIRA PEDRO , BAPTISTA RENNER LUIZ CERQUEIRA
Published: April 2020

New data about slender orb-weaving species of the cosmopolitan genus Tetragnatha are presented. Tetragnatha chauliodus (Thorell, 1890) and Tetragnatha tenuissima O. Pickard-Cambridge, 1889 are redescribed, including one synonymy for each species and the first record of the first species to the Neotropical region. Also, three new species are herein described, all based on males and females. Tetragnatha megalocera new species is recorded exclusively from Brazil (Espírito Santo, Rio de Janeiro, Rio Grande do Sul and São Paulo states), while Tetragnatha renatoi new species is recorded from Venezuela, Argentina (Misiones) and Brazil (Paraná, Pernambuco, Rio Grande do Sul, Rondônia, Santa Catarina and São Paulo states). Finally, Tetragnatha chiyokoae new species is described from Yunnan province (China) and Okinawa (Japan), with an additional record for Taiwan. Furthermore, Tetragnatha exilima (Mello-Leitão, 1943), Tetragnatha filigastra Mello-Leitão, 1943 and Tetragnatha lactescens (Mello-Leitão, 1947) are nomina dubia.
Surface Turbulent Fluxes during Persistent Cold-Air Pool Events in the Salt Lake Valley, Utah. Part II: Simulations
Authors: Sun Xia , Holmes Heather A. , Xiao Hui
Published: April 2020

Realistically representing the land–atmosphere interactions during persistent cold-air pools (PCAPs) is critical in simulating the strength of PCAPs, where uncertainties in simulating the PCAP strength will impact the ability to model the poor air quality. To quantify the model performance for land–atmosphere exchange, measurements of surface turbulent and radiative energy fluxes during two PCAPs, one weak and one strong, in Utah were compared with simulations from the Weather Research and Forecasting (WRF) Model. The results show that the WRF Model simulated the surface energy fluxes well in the weak PCAP case and that the performance degraded in the strong PCAP case. The significantly overestimated surface sensible heat flux H and latent heat flux (LE) in the strong PCAP were related, in part, to the overestimated net radiation and soil moisture and unsuitable turbulence parameterizations. The simulation using the Mellor–Yamada–Nakanishi–Niino planetary boundary layer scheme produced the least bias in both net radiation and surface turbulent fluxes for the strong PCAP case, which is expected because of the local higher-order (2.5) turbulence closure scheme. The surface exchange coefficient (CH), a crucial variable used to calculate H, was overall overestimated by the WRF Model. The underestimation of the nondimensional vertical temperature gradient in the Monin–Obukhov stability function was responsible for the overestimated CH, where the stability functions deviate significantly from expected values from observations for the stable atmospheric boundary layer. Our study highlights the need to improve the flux–profile parameterizations under stable conditions over complex terrain by including impacts due to mountainous terrain, such as surface radiative flux divergence and the diurnal mountain wind system.
A Nonlinear Multiscale Theory of Atmospheric Blocking: Dynamical and Thermodynamic Effects of Meridional Potential Vorticity Gradient
Authors: Luo Dehai , Zhang Wenqi
Published: April 2020

In this paper, an extended nonlinear multiscale interaction model is proposed to examine nonlinear behavior of eddy-driven blocking as a Rossby wave packet in a three-dimensional background flow by dividing the background meridional potential vorticity gradient (PVy) into dynamical PVy related to the horizontal (mainly meridional) shear of background westerly wind (BWW) and thermodynamic PVy associated with the meridional temperature gradient (MTG). It is found that eddy-driven baroclinic blocking with large amplitude in the midtroposphere tends to have a longer lifetime (~20 days) in a baroclinic atmosphere with stratification than eddy-driven barotropic blocking without vertical variation (less than 15 days). It is shown that barotropic blocking shows a northwest–southeast orientation and has long lifetime, large retrogression, and slow decay only for weaker barotropic BWW and in higher latitudes. In a baroclinic atmosphere with stratification, baroclinic blocking shows long lifetime, strong eastward movement, slow decay, weak strength, and less local persistence for large barotropic BWW and under , but becomes less slow decay, weak retrogression, and large local persistence for small barotropic BWW and . Such a blocking with a north–south antisymmetric dipole, large amplitude, and long local persistence, characterized by a persistent large meander of westerly jet streams, is easily seen when baroclinic BWW and are small in the lower to midtroposphere. Comparatively, the magnitude of plays a larger role in the blocking change than that of , whereas the vertical variation of MTG is more important for the blocking change than the MTG itself for some cases.
The Weakening and Eastward Movement of ENSO Impacts during the Last Glacial Maximum
Authors: Liu Shanshan , Jiang Dabang , Lang Xianmei
Published: April 2020

The assumption of a stationary global signal linked to El Niño–Southern Oscillation (ENSO) events is often used in paleo-ENSO proxy data interpretation. This paper attempts to investigate whether the assumption is valid during the last glacial maximum (LGM) over the region 60°S–90°N, 60°E−60°W. Using four models within phase 3 of the Paleoclimate Modeling Intercomparison Project framework that well reproduce ENSO-induced variabilities, differences from the preindustrial period to LGM in the ENSO-related sea surface temperature pattern and its impacts are investigated. Compared to the preindustrial period, the ENSO impacts are revealed to weaken and shift eastward during the LGM. According to multimodel medians, ENSO impacts on precipitation and near-surface air temperature are attenuated over most regions of concern, with percentage changes in both parameters averaging −21% for the whole region; the ENSO-induced Pacific–North America (PNA) teleconnection pattern is weakened, manifested by the 41% diminished center over the North Pacific and the almost vanished activity centers over the continent. Spatially, there is a zonal contraction of 13° for the sea surface warming of ENSO, as well as eastward migration over 10° for the ENSO-induced positive precipitation anomaly center over the tropical Pacific and the PNA teleconnection pattern outside the tropics. The aforementioned changes are linked to the altered climatic background during the LGM, which features a 16° eastward shift for the Pacific Walker circulation rising branch and a weakened waveguide in the midlatitudes. The results suggest that the hypothesis of stationary ENSO impacts should be applied cautiously to the past.
Quantification of the Land Surface and Brown Ocean Influence on Tropical Cyclone Intensification over Land
Authors: Yoo Jinwoong , Santanello Joseph A. , Shepherd Marshall , Kumar Sujay , Lawston Patricia , Thomas Andrew M.
Published: April 2020

An investigation of Tropical Cyclone (TC) Kelvin in February 2018 over northeast Australia was conducted to understand the mechanisms of the brown ocean effect (BOE) and to develop a comprehensive analysis framework for landfalling TCs in the process. NASA’s Land Information System (LIS) coupled to the NASA Unified WRF (NU-WRF) system was employed as the numerical model framework for 12 land/soil moisture perturbation experiments. Impacts of soil moisture and surface enthalpy flux conditions on TC Kelvin were investigated by closely evaluating simulated track and intensity, midlevel atmospheric thermodynamic properties, vertical wind shear, total precipitable water (TPW), and surface moisture flux. The results suggest that there were recognized differentiations among the sensitivity simulations as a result of land surface (e.g., soil moisture and texture) conditions. However, the intensification of TC Kelvin over land was more strongly related to atmospheric moisture advection and the diurnal cycle of solar radiation (i.e., radiative cooling) than to overall soil moisture conditions or surface fluxes. The analysis framework employed here for TC Kelvin can serve as a foundation to specifically quantify the factors governing the BOE. It also demonstrates that the BOE is not a binary influence (i.e., all or nothing), but instead operates in a continuum from largely to minimally influential such that it could be utilized to help improve prediction of inland effects for all landfalling TCs.
Chinese Foreign Aid to Fiji: Threat or Opportunity
Authors: Salem Saber
Published: April 2020

China’s political, economic and cultural influence is steadily rising in Fiji and the Pacific region as a whole. The Sino–Fiji cooperation deepened at multiple levels after the Fijian military assumed power through a coup d’état and removed the civilian government from power in late 2006. This ‘undemocratic behaviour’ infuriated the two regional powers—Australia and New Zealand who then applied sanctions on Fiji, particularly the military brass, and encouraged their counterparts as well as multilateral aid organisations to ‘punish’ Fiji’s military ‘regime’. The military government in order to derail the impact of sanctions from its traditional donors adopted the ‘Look North Policy’, which was opening cooperation with China and attracting Chinese investment in Fiji. China welcomed the friendship gesture and furnished Fiji with financial assistance. This Chinese friendship was also due to Taiwanese involvement in the region, which was providing aid for diplomatic recognition and support at the UN. The ‘microstates’ hold about 7 per cent of UN votes. Both China and Taiwan need their votes at multilateral organisations and given that these microstates are mostly aid-dependent economies, initiated an era of Chequebook diplomacy, which is basically money for diplomatic recognition in the case of Taiwan or acceptance of One China Policy in the case of China. The microstates have time and again switched between China and Taiwan and played one against the other to get more aid money out of their diplomatic rivalry. The Sino–Taiwan aid competition in the Pacific forced US to make a strong comeback and ensure that China under the pretext of denying Taiwan space in the region actually spies on the US activities in the region. As a result, the US and its regional allies have significantly increased their foreign aid to the island nations in order to coax them to diminish their level of financial dependence on China. So far, they have not been successful enough and China’s aid package has gone far beyond the level US is giving. Today, China is the second largest donor to the region and largest financier to Fiji. Fiji has become the ace in this game as it is the regional hub of the Pacific Island states. Bearing the current high level of aid competition between traditional and emerging donors in mind, it is too early to judge whether Chinese aid will cause more harm to Fiji than benefit or vice versa. It also entirely depends on the Fijian government as to how much it relies on Chinese aid and how clean Chinese are with their soft loans. China has been blamed for not being clear and specific about the terms and conditions of its concessional loans. This vagueness and secrecy that is associated with Chinese aid been a cause for concern, especially among traditional donors.
Recognition: China’s Long March to Global Integration
Authors: Shichor Yitzhak
Published: April 2020

This paper provides a framework for China’s gradual global integration. From historical exclusion, China became initially and partly incorporated to the world in the 1950s and 1960s while ignored by most of the countries. A quantitative breakthrough in the 1970s has led to a universal recognition, still formal and restricted throughout the 1980s and 1990s, making China a great power by the early twenty-first century. China’s rise and gradual integration in the international community is interpreted here based on Marx’s theory of ownership and Professor Charles Taylor’s theory of recognition. Both regard status as a property which is an outcome not just of a unilateral individual claim but of multilateral social relations. Adapted to the international society, these theories underscore China’s global integration. Therefore, China is now entitled to, and capable of, playing a more active and, moreover, leading global role, not just because of its unilateral claims and remarkable achievements, but also, and perhaps much more, because of its multilateral recognition—not in the formal diplomatic sense—of China’s entitlement and capabilities of doing it. Also, in addition to joining, and occasionally heading, international organisations, China introduced its One Belt One Road initiative as a unique contribution of a model for the West, and especially for less-developed countries. While it is post-Mao China’s domestic reform which attract most international attention and are regarded a revolutionary breakthrough with the past, the real and most innovative breakthrough is China’s integration in the world. Domestic reforms were undertaken throughout Chinese history; international integration is new and unprecedented.
Progressive hemifacial atrophy with characteristic ocular manifestations in a Chinese patient with a CRB1 mutation
Authors: Liu Jinghua , Liu Ying , Wang Liming , Zhang Xiaohan , Hao Peng , Li Xuan
Published: April 2020

Progressive hemifacial atrophy (PHA) is mainly characterized by asymmetrical atrophy of craniofacial tissue; however, 10% to 30% of patients with PHA exhibit ocular manifestations. Here, we describe abnormal ocular findings in a Chinese patient with PHA. The patient was a 29-year-old Chinese man. Characteristic ocular findings in his affected eye included keratic precipitate, corneal endothelial degeneration, fundus tessellation, pupillary dilation, direct light reflex loss, and visual evoked potential alteration. Whole exosome sequencing revealed that the patient harbored a mutation in the CRB1 gene; this gene has been associated with various retinal dystrophies. During 10 years of follow-up, the patient’s ocular status remained stable. To the best of our knowledge, this is the first report of ocular manifestations of PHA in a Chinese patient, and the first report of a CRB1 mutation in a patient with PHA; these findings may inform future research regarding PHA.
MiR-195-5p inhibits the development of chronic obstructive pulmonary disease via targeting siglec1
Authors: Li S , Jiang L , Yang Y , Cao J , Zhang Q , Zhang J , Wang R , Deng X , Li Y
Published: April 2020

Chronic obstructive pulmonary disease (COPD), characterized by chronic inflammation, is a recognized global health crisis. Sialic acid-binding immunoglobulin-like lectin 1 (siglec1 or CD169), mainly expressed in macrophages and dendritic cells, is markedly upregulated after encountering pathogens or under acute/chronic inflammation conditions. However, it is rarely reported that whether siglec1 plays a role in the development of COPD. In this study, we found that siglec1 had higher expression in the lungs from COPD rats and in peripheral blood mononuclear cells (PBMCs) from COPD patients. Knockdown of siglec1 in vivo and in vitro dramatically decreased pro-inflammatory cytokines production in pulmonary macrophages and alleviated pulmonary inflammatory responses in COPD rats as well as inactivated nuclear factor kappa B (NF-κB) signaling. In addition, we identified a new microRNA, miR-195-5p, which has never explored in COPD, was lower expressed in COPD rats and PBMC of COPD patients, and could negatively modulate siglec1 expression in macrophages. Moreover, overexpression of miR-195-5p via miR-195-5p mimics in vitro and in vivo could significantly alleviate pro-inflammatory cytokines production in pulmonary macrophages and pulmonary inflammatory responses in COPD rats. Together, our findings suggested that miR-195-5p inhibited the development of COPD via targeting siglec1, which might become a therapeutic target to improve COPD.
Book review: Ritanjan Das. 2018. Neoliberalism and the Transforming Left in India: A Contradictory Manifesto
Authors: Pedersen Jørgen Dige
Published: April 2020

Ritanjan Das. 2018. Neoliberalism and the Transforming Left in India: A Contradictory Manifesto. London, UK and New York, NY: Routledge/Edinburgh South Asian Studies. 227 pp., Price £120.00, ISBN: 978-1-138-73229-2 (Hardback), ISBN: 978-1-315-18851-5 (e-book).
“I smile, but Without Showing My Teeth”: The Lived Experience of Cleft, Lip, and Palate in Adults
Authors: Moi Asgjerd Litleré , Gjengedal Harald , Lybak Kari , Vindenes Hallvard
Published: April 2020

Objective:

To explore and describe the experience of growing up with unilateral cleft lip and palate (CLP) in adults.

Design:

Face-to-face interviews. Giorgi’s phenomenological method was used for analysis.

Participants:

Twenty-one (mean age: 40.8 years) adults treated for unilateral CLP during childhood and adolescence participated in the study.

Results:

Growing up with CLP meant to become aware of bodily otherness. The possible reactions from peers early in life complicated the striving for inclusion outside the close family. Being self-confident, clever in school, physically fit, and having trusted friends represented barriers against teasing and bullying. Nevertheless, the reflected image, in mirrors, windows, and photos, reminded the participants of the objectifying looks from others and often led to bodily adjustments that persisted into adulthood. The trajectory of treatment was not questioned during childhood, and the participants accepted the decisions on care made by experts and parents. Although problems related to the cleft could persist or return after the termination of ordinary treatment, a more hesitant view on the possible benefits of additional surgery was typical in adulthood.

Conclusions:

In retrospect, growing up with a unilateral CLP was found to have been an unquestioned part of the adult participants’ childhood, a burden that they feared would, to some extent, also be passed to their own children. However, the CLP had not prevented them from achieving goals and satisfaction in life. The occurrence of persisting psychological, functional, and esthetic challenges in adults suggests the need for an individualized, lifelong, and multidisciplinary perspective on CLP follow-up.
Meta-analysis of Noninsertional Achilles Tendinopathy
Authors: Jarin Ian , Bäcker Henrik C. , Vosseller J. Turner
Published: April 2020

Background:

Achilles tendinopathy is a common clinical problem that can be either insertional or noninsertional. A variety of treatment methods have been described, although little consensus exists on an optimal method or methods. We sought to investigate the current evidence on different treatment methods for noninsertional Achilles tendinopathy, with a focus on functional outcomes.

Methods:

We performed a review of the available literature in PubMed and the Cochrane Central Register of Controlled Trials. Data from included studies were categorized according to treatment method and analyzed with respect to functional outcome and complication rate.

Results:

In total, 1420 abstracts were reviewed, of which 72 articles containing 3523 patients met inclusion criteria. Within the 72 studies included, 6 operative techniques and 19 nonoperative treatments were evaluated.

Conclusion:

A wide variety of treatments are available for noninsertional Achilles tendinopathy, although newer treatments and most operative methods lack high-level evidence. Eccentric exercise is the most thoroughly studied and supported nonoperative treatment, while tenotomy and debridement is the operative procedure with the most evidence of efficacy. Platelet-rich plasma injections and extracorporeal shockwave therapy have proven to be viable second-line nonoperative treatments. Gastrocnemius recession and flexor hallucis longus transfer have shown benefit in case series.

Level of Evidence:

Level II, systematic review.
A phase 2 multicenter study of ublituximab, a novel glycoengineered anti-CD20 monoclonal antibody, in patients with relapsing forms of multiple sclerosis
Authors: Fox Edward , Lovett-Racke Amy E , Gormley Matthew , Liu Yue , Petracca Maria , Cocozza Sirio , Shubin Richard , Wray Sibyl , Weiss Michael S , Bosco Jenna A , Power Sean A , Mok Koby , Inglese Matilde
Published: April 2020

Background:

Ublituximab, a novel monoclonal antibody (mAb) targeting a unique epitope on the CD20 antigen, is glycoengineered for enhanced B-cell targeting through antibody-dependent cellular cytotoxicity (ADCC). Greater ADCC may allow lower doses and shorter infusion times versus other anti-CD20 mAbs.

Objective:

The objective was to determine optimal dose, infusion time, and activity of ublituximab in relapsing multiple sclerosis.

Methods:

This is a phase 2, placebo-controlled study. Patients received three ublituximab infusions (150 mg over 1–4 hours on day 1 and 450–600 mg over 1–3 hours on day 15 and week 24) in six dosing cohorts. The primary endpoint was B-cell depletion.

Results:

In all cohorts ( N = 48), median B-cell depletion was >99% by week 4, maintained at weeks 24 and 48. Most common adverse events (AEs) were infusion-related reactions (all grade 1–2), with no apparent increased incidence at shorter infusion times. There were no AE-related discontinuations. At weeks 24 and 48, no T1 gadolinium-enhancing lesions ( p = 0.003) and a 10.6% decrease in T2 lesion volume ( p = 0.002) were detected. The annualized relapse rate was 0.07; 93% remained relapse free on study. Overall, 74% of patients had no evidence of disease activity (NEDA).

Conclusion:

Ublituximab was safely infused as rapid as 1 hour, producing robust B-cell depletion and profound reductions in magnetic resonance imaging (MRI) activity and relapses.
Book review: Shakya, M. 2018: Death of an Industry: The Cultural Politics of Garment Manufacturing During the Maoist Revolution in Nepal
Authors: Ranaware Krushna
Published: April 2020

Shakya, M. 2018: Death of an Industry: The Cultural Politics of Garment Manufacturing During the Maoist Revolution in Nepal. New Delhi, India: Cambridge University Press. xv + 157 pp. £67.50 cloth, ISBN: 9781107191266 (hardback).
Immunoglobulin G subtypes‐1 and 2 differentiate immunoglobulin G4‐associated sclerosing cholangitis from primary sclerosing cholangitis
Authors: Vujasinovic Miroslav , Maier Pia , Maetzel Hartwig , Valente Roberto , Pozzi‐Mucelli Raffaella , Moro Carlos F , Haas Stephan L , Said Karouk , Verbeke Caroline S , Maisonneuve Patrick , Löhr J‐Matthias
Published: April 2020

Background

Autoimmune pancreatitis is a special form of chronic pancreatitis with strong lymphocytic infiltration and two histopathological distinct subtypes, a lymphoplasmacytic sclerosing pancreatitis and idiopathic duct centric pancreatitis. Immunoglobulin G4‐associated cholangitis may be present at the time of autoimmune pancreatitis type 1 diagnosis or occur later over the course of the disease. Immunoglobulin G4 is considered reliable but not an ideal marker for diagnosis of autoimmune pancreatitis type 1 with reported sensitivity between 71–81%. It is essential to differentiate sclerosing cholangitis with autoimmune pancreatitis from primary sclerosing cholangitis as the treatment and prognosis of the two diseases are totally different. It was the aim of the study to find a marker for immunoglobulin G4‐associated cholangitis that would distinguish it from primary sclerosing cholangitis.

Patients and methods

We performed a retrospective analysis of patients with autoimmune pancreatitis at our outpatient clinic. Patients from the primary sclerosing cholangitis registry were taken as a control group. Blood samples for the measurement of immunoglobulin subclasses were analysed at the time of diagnosis.

Results

Patients with autoimmune pancreatitis and immunoglobulin G4‐associated cholangitis had higher values of immunoglobulin G2 when compared to autoimmune pancreatitis alone or primary sclerosing cholangitis with a high specificity (97%) and high positive predictive value (91%). In patients with normal or low immunoglobulin G2 or immunoglobulin G4, a high level of immunoglobulin G1 indicated primary sclerosing cholangitis.

Conclusion

Immunoglobulin G1 and immunoglobulin G2 can distinguish patients with immunoglobulin G4‐associated cholangitis from those with primary sclerosing cholangitis.
DIFFERENCES IN RADIOGRAPHIC MEASUREMENTS ON STANDING VERSUS SUPINE PELVIC RADIOGRAPHS
Authors: Spiker Andrea M. , Graf Ryan M. , Duminie Sean P. , Kliethermes Stephanie A. , Goodspeed David C.
Published: April 2020

Background:

Accurate pelvic radiographic measurements is of clear clinical importance, as these measurements can drive the indications for surgery, the surgical approach utilized, and/or the degree of correction during hip preservation surgery. Currently, there are a large number of measurements available and reported on the literature when referencing anterior-posterior (AP) pelvic radiographs. However, there is no standardization of whether these pelvic radiographs are obtained in the standing or supine position.

Hypothesis/Purpose:

Standing vs. Supine radiographs, obtained in the same patient, will result in different value for standard radiographic measurements used in making hip pathology diagnoses.

Methods:

All new patients who presented for evaluation of hip pain between September 2016 and July 2018 were retrospectively reviewed. Inclusion criteria included age 18-50, no prior hip surgery/injury, and both standing and supine AP pelvis radiographs dated within 2 years of each other. Measurements were obtained on 26 radiographs (52 hips), blinded to patient demographics and standing versus supine radiograph. Measurements included minimum joint space, lateral center edge angle (LCEA), acetabular depth, acetabular inclination, Tönnis Grade, crossover sign, posterior wall sign, ischial spine sign.

Results:

Standing films resulted in significantly lower LCEA and acetabular depth measurements, and higher acetabular inclination. Supine measurements for crossover sign were 5.69 times more likely to be positive than standing measurements. Similarly, supine measurements for ischial spine were 7.93 times more likely to be positive (see Table 1).

Conclusion:

Based on our study, supine films are almost 6 times more likely to give a positive crossover sign and almost 8 times more likely to give a positive ischial spine sign than a standing film in the same patient. Additionally, LCEA, acetabular depth will be lower and acetabular inclination will be higher on standing films. As such, our recommendation is to obtain standing AP pelvis radiographs to obtain the most accurate pelvic radiographic measurements in hip preservation patients.

Tables: [Table: see text]
COST-EFFECTIVENESS FOR RETURN-TO-PLAY (RTP) PROGRAMS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Authors: DeFrancesco Christopher , Lebrun Drake , Molony Joseph , Fabricant Peter D.
Published: April 2020

Background:

Rupture of the anterior cruciate ligament (ACL) is a common injury in young athletes. Safe return-to-play (RTP, i.e. sports competition) is important to patient satisfaction, and appropriate criteria for RTP may reduce the risk of graft injury.

Purpose:

The purpose of this study is to assess the cost-effectiveness of a comprehensive RTP rehabilitation protocol relative to standard post-ACL reconstruction rehabilitation.

Methods:

A decision-analysis model was utilized to compare standard rehabilitation with an RTP program which included supplemental neuromuscular retraining, functional testing, and clinical follow-up. Cost-effectiveness was evaluated from a payer perspective. Costs of surgical procedures and rehabilitation protocols, risks of ipsilateral graft rupture and contralateral ACL injury, risk reductions due to the RTP program, and relevant utilities based on International Knee Documentation Committee (IKDC) outcomes were derived from the available literature. An incremental cost-effectiveness ratio (ICER) of <$100,000/QALY was used to determine cost-effectiveness. Sensitivity analyses were performed on pertinent model parameters to measure their effect on base-case conclusions. In the base-case analysis, the cost of an RTP program was conservatively assumed to be $1,721 more than the standard rehabilitation protocol. The relative risk of ACL graft rupture following completion of the RTP program was assumed to be 0.75 (25% reduction).

Results:

In the base-case analysis, the RTP program was cost-effective compared with the standard rehabilitation protocol (ICER $54,939/QALY). Based on one-way threshold analyses, the RTP program was cost-effective as long as the additional cost was <$2,092 or the RTP program decreased the incidence of graft rupture by >7.7%.

Conclusion:

Our data suggests that, assuming modest associated decreases in graft failure, the addition of neuromuscular retraining, functional testing, and clinical follow-up to a formal rehabilitation program is cost-effective. The cost-effectiveness of such additions is related to the costs as well as any associated decreases in subsequent event risk, as shown in Figure 1.

Figures: [Figure: see text]