bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Human Papillomavirus Infection and Risk Factors in Egyptian Women With Breast Cancer
Authors: El-Sheikh Nabila , Mousa Nahla O , Tawfeik Amany M , Saleh Alaa M , Elshikh Iman , Deyab Mohamed , Ragheb Faten , Moneer Manar M , Kawashti Ahmed , Osman Ahmed , Elrefaei Mohamed
Published: February 2021

Numerous risk factors for breast cancer (BC) have been identified. High-risk human papilloma virus (HR-HPV) is the etiological agent of cervical cancer and in some cases of head and neck cancer, specifically oropharyngeal cancer, but the role of HR-HPV in evoking neoplasia in BC is still unclear. In this study, all women above the age of 18 visiting the oncology clinic at Al-Azhar university hospital and Ain Shams specialized hospital between the period of February 2017 and March 2018 were invited to participate. We determined the prevalence of HR-HPV genotypes 16, 18, and 31 in breast tissue samples from 72 women with treatment-naïve BC and 15 women with benign breast lesions (BBL) by quantitative real-time PCR (qRT-PCR) and primer sets targeting the E6 and E7 regions. High-risk human papilloma virus DNA was detected in 16 of 72 (22.2%) BC cases (viral load range = 0.3-237.8 copies/uL) and 0 of 15 women with BBL. High-risk human papilloma virus was detected in 14 of 16 (87.5%), 2 of 16 (12.5%), and 0 of 16 (0%) for genotypes 16, 18, and 31, respectively. Forty-three age-matched healthy Egyptian women were enrolled as controls for assessment of local risk factors that can be used to initiate a strategy of BC prevention in Egypt. Assessment of the risk factors demonstrated that low education level, passive smoking, lack of physical activity, family history of cancer, and use of oral contraception were significant risk factors for BC. In conclusion, our results lead us to postulate that HR-HPV infection may be implicated in the development of some types of BC in Egyptian women. In addition, identification of local risk factors can support practical prevention strategies for BC in Egypt.
Obesity and Prevalence of Latent Tuberculosis: A Population-Based Survey
Authors: Badawi Alaa , Liu Christina J
Published: February 2021

Objective:

Diminution in body weight is a known risk factor that increases the burden of active tuberculosis (TB). However, conflicting evidence exists for the effect of body weight on the risk of latent tuberculosis infection (LTBI). The objective of the present study is to examine the prevalence of LTBI at different body weights, evaluate the extent of association between body mass index (BMI) and LTBI and identify factors mediating this relationship in an adult population.

Methods:

We conducted a cross-sectional study to estimate the relationship between BMI and LTBI in participants from the US-National Health and Nutrition Examination Survey (NHANES; 2012, n = 5156; 514 with LTBI and 4642 controls).

Results:

The association between BMI and levels of cardiometabolic risk markers in both LTBI and control groups had a similar profile. When adjusted for age and sex, BMI was significantly inversely correlated with the prevalence of LTBI ( r = −0.147, P < .001). Effect of BMI on the risk of LTBI was evaluated using multivariate logistic regression models adjusted for age, sex, diabetes, and level of education. In this model, increasing BMI was significantly associated with lower risk of LTBI (OR = 0.85; 95%CI: 0.77-0.96, P < .01).

Conclusion:

This study further establishes an inverse relationship between BMI and prevalence of LTBI. Decreased BMI can be considered as a risk factor in LTBI, the reservoir for active TB cases.
Media as the great emancipators? Exploring relations between media repertoires and cultural participation in Flanders
Authors: Vandenplas Ruben , Picone Ike
Published: February 2021

Media convergence has afforded users an increasing amount of options regarding the media they consume, available at the click of a button. This has led some to clamor about the potential for media to bridge previously existing inequalities and decrease social stratification not just in media use, but in other realms of society as well. Skeptics have argued that while the convergence of media has given users more options in their own media repertoire, social stratification persists. Moreover, if media do increase a user’s possibilities to participate in other realms of society, the persisting stratification of media use risks enacting a Matthew effect whereby the rich get richer and the poor get poorer. Using data from the Flemish participation survey, this article seeks to contribute to this discussion by exploring Flemish media use by constructing media repertoires using latent class analysis and exploring their sociodemographic profiles. Following this analysis, we compare the cultural participation patterns of the six Flemish media repertoires using negative binomial regression analysis. We find that social stratification of media use persists in Flanders, with broad and ‘highbrow’ repertoires predominantly restricted to higher status groups. Moreover, we find a structural homology between the structure of media repertoires and cultural participation, whereby broad repertoires exhibit a similar openness to cultural practices, and repertoires tailored to highbrow media exhibit a similar preference for highbrow cultural activities. As a result, we find that social stratification persists in media use and cultural participation but argues that media repertoires offer a potential entrypoint.
Treatment decisions for patients with peripheral artery disease and symptoms of claudication: Development process and alpha testing of the SHOW-ME PAD decision aid
Authors: Smolderen Kim G , Pacheco Christina , Provance Jeremy , Stone Nancy , Fuss Christine , Decker Carole , Bunte Matthew , Jelani Qurat-ul-ain , Safley David M , Secemsky Eric , Sepucha Karen R , Spatz Erica S , Mena-Hurtado Carlos , Spertus John A
Published: February 2021

Patients with peripheral artery disease (PAD) face a range of treatment options to improve survival and quality of life. An evidence-based shared decision-making tool (brochure, website, and recorded patient vignettes) for patients with new or worsening claudication symptoms was created using mixed methods and following the International Patient Decision Aids Standards (IPDAS) criteria. We reviewed literature and collected qualitative input from patients ( n = 28) and clinicians ( n = 34) to identify decisional needs, barriers, outcomes, knowledge, and preferences related to claudication treatment, along with input on implementation logistics from 59 patients and 27 clinicians. A prototype decision aid was developed and tested through a survey administered to 20 patients with PAD and 23 clinicians. Patients identified invasive treatment options (endovascular or surgical revascularization), non-invasive treatments (supervised exercise therapy, claudication medications), and combinations of these as key decisions. A total of 65% of clinicians thought the brochure would be useful for medical decision-making, an additional 30% with suggested improvements. For patients, those percentages were 75% and 25%, respectively. For the website, 76.5% of clinicians and 85.7% of patients thought it would be useful; an additional 17.6% of clinicians and 14.3% of patients thought it would be useful, with improvements. Suggestions were incorporated in the final version. The first prototype was well-received among patients and clinicians. The next step is to implement the tool in a PAD specialty care setting to evaluate its impact on patient knowledge, engagement, and decisional quality. ClinicalTrials.gov Identifier: NCT03190382
Kinematics and dynamics analysis of new rotary-percussive PDM drilling tool
Authors: Tian Jialin , Hu Xuehua , Dai Liming , Yang Lin , Yang Yi , Mallick Raju
Published: February 2021

This paper presents a new drilling tool with multidirectional and controllable vibrations for enhancing the drilling rate of penetration and reducing the wellbore friction in complex well structure. Based on the structure design, the working mechanism is analyzed in downhole conditions. Then, combined with the impact theory and the drilling process, the theoretical models including the various impact forces are established. Also, to study the downhole performance, the bottom hole assembly dynamics characteristics in new condition are discussed. Moreover, to study the influence of key parameters on the impact force, the parabolic effect of the tool and the rebound of the drill string were considered, and the kinematics and mechanical properties of the new tool under working conditions were calculated. For the importance of the roller as a vibration generator, the displacement trajectory of the roller under different rotating speed and weight on bit was compared and analyzed. The reliable and accuracy of the theoretical model were verified by comparing the calculation results and experimental test results. The results show that the new design can produce a continuous and stable periodic impact. By adjusting the design parameter matching to the working condition, the bottom hole assembly with the new tool can improve the rate of penetration and reduce the wellbore friction or drilling stick-slip with benign vibration. The analysis model can also be used for a similar method or design just by changing the relative parameters. The research and results can provide references for enhancing drilling efficiency and safe production.
Hot air and corporate sociotechnical imaginaries: Performing and translating digital futures in the Danish tech scene
Authors: Hockenhull Michael , Cohn Marisa Leavitt
Published: February 2021

This article analyzes the role of hype in performing and translating corporate sociotechnical imaginaries of digital technologies, into the context of Danish society. Drawing on ethnographic fieldwork of technology events in Denmark, this article proposes “hot air” as a concept to describe how hype for the future performs these imaginaries. This article describes the overlapping sociotechnical imaginaries that dominate these events and the performative effects of hype and its critique, in articulating and translating them. This article makes an empirical and conceptual contribution to the study of sociotechnical imaginaries, in particular, their socio-material performance, the role of corporations in articulating them, and how hype is central to their translation.
Visions of unification and integration: Building brains and communities in the European Human Brain Project
Authors: Mahfoud Tara
Published: February 2021

The Human Brain Project (HBP) was launched in October 2013 by the European Commission to build an information and communication technology infrastructure that would support large-scale brain modelling and simulation. Less than a year after its launch, more than 800 neuroscientists signed a letter that claimed the HBP ‘would fail to meet its goals’. Based on multi-sited ethnographic fieldwork conducted between February 2014 and January 2017 in France, Germany, the United Kingdom and the HBP headquarters in Switzerland, and over 40 interviews with scientists, engineers and project administrators, this article traces how competing visions over how brain models should be built became tied into debates over how scientific communities should be governed. Articulations of these different kinds of models and communities appealed to competing imaginaries of Europe itself – of Europe and European science as unified or pluralistic. This article argues that scientific models are sites of contestation over social and political futures. The tensions between visions of scientific unification and pluralism in the HBP mirrored the tensions between imaginaries of European political unification and pluralism.
Developing an indicative model for preserving restaurant viability during the COVID-19 crisis
Authors: Gkoumas Aristeidis
Published: February 2021

Amid the ongoing COVID-19 pandemic, the relatively small number of reported cases of the coronavirus for the last 8 months in Taiwan suggests that the country has successfully managed to mitigate the outbreak. Following a proactive strategy, an immediate response, and a well-orchestrated monitoring system, the public authorities prevented the epidemic and avoided lockdowns, curfews, or business closures enforced by other governments across the globe. This case study explores the implications for the restaurant sector of governmental control measures created to combat the spread of the virus. Based on ethnographic research, the paper investigates the impact of the health crisis management plan on the economic sustainability of small restaurants in tourism areas of Tainan City, in the south of Taiwan. Proceeding inductively, this research identifies seven key factors for restaurant viability during the COVID-19 pandemic. The results of the study indicate that cultural context, social cohesion, and the cooperation of restaurant professionals are essential to the effectiveness of any strategy for containing the coronavirus. The proposed model aims to provide a feasible tool for food and beverage providers in other countries to adjust their efforts and actions for surviving during a pandemic.
Desired Muslims: Neoliberalism, halal food production and the assemblage of Muslim expertise, service providers and labour in New Zealand and Brazil
Authors: Araújo Shadia Husseini de
Published: February 2021

Critical scholarship has shown that neoliberalism has reinforced Islamophobia, anti-Muslim racism and projections of Muslims as undesirable in many contexts, particularly in ‘the West’. Little is said about other impacts neoliberal ideology has had on the ways Muslim (immigrant) communities are viewed and (dis)integrated into Muslim-minority contexts. Against this backdrop, this paper argues that Muslims can also be desired and systematically mobilized in predominantly non-Muslim countries where neoliberalized economies capitalize on their identities. The argument is illustrated through case studies in contexts of halal food production and trade in New Zealand and Brazil. Drawing on conceptualizations of neoliberal utility/necessity perspectives on immigrants as well as on assemblage thinking, this paper shows, first, that neoliberal restructuring has played a major role in the development of trade relations with the Islamic world and thus in the emergence of demands for Muslim expertise, service providers and workers in both countries. It demonstrates, second, how Muslim identities have been systematically assembled to meet these demands, and third, that the assemblages are at the same time limited by largely (though not exclusively) neoliberal logics. Finally, the paper shows that many of the assembling practices and logics are similar in both contexts and likely to be found elsewhere. Their effects, however, diverge due to different local conditions. The findings imply that relations between neoliberal ideology and the ways Muslims are viewed and (dis)integrated in Muslim-minority contexts are complex and unfold differently across space, and that this complexity deserves greater academic scrutiny.
Accurate depiction of uncertainty in ancient DNA research: The case of Neandertal ancestry in Africa
Authors: Hawks John
Published: February 2021

All approaches to understanding the past must work with limited data. Like many other kinds of evidence of past peoples, the relation between ancient DNA and past events is intermediated by complex models that bear many assumptions, some untested or untestable. Statements about the past from this evidence are thus accompanied by uncertainty, some quantified and some unquantifiable. Accurate communication of this uncertainty is essential to effective cross-disciplinary collaboration and public understanding. Here I examine one well-studied case of ancient DNA inference: the inference of Neandertal ancestry for today’s African peoples. In this case study, scientific predictions about Neandertal introgression and the genetic variation of all living people both gave consistent predictions before the sequencing of Neandertal DNA. Still, at the time that a draft Neandertal genome was published, a myth became established among the public that today’s Africans are different from all other living humans in that they lack Neandertal ancestors. This contribution reviews public statements, press releases, and press accounts to understand the origin of this story and why it became widespread. I review the ultimate impact of this story and the path toward correcting it. In light of this example, I provide some guidelines on how to recognize accurate depiction of uncertainty and examples of how effective engagement with content experts in archaeology and biological anthropology can lead to stronger and more easily communicated scientific outcomes.
Comparing perceptions of a dimmable LED lighting system between a real space and a virtual reality display
Authors: Rockcastle S , Danell M , Calabrese E , Sollom-Brotherton G , Mahic A , Van Den Wymelenberg K , Davis R
Published: February 2021

Over the last several decades, designers have used digital screens to view images of real and simulated spaces and make critical design decisions. Screen technology has improved during this time, as technologies like OLED have replaced legacy displays (CRT, plasma, and LCD). These new screens provide a higher pixel resolution, luminous output and contrast ratio. Immersive head-mounted displays now allow designers to view immersive images, and recent developments in real-time rendering have encouraged the uptake of virtual reality (VR) head-mounted displays in mainstream practice and design education. This paper presents an experiment on lighting perception using a series of LED lighting conditions in a real space and a virtual representation of those conditions captured using a 360° high-dynamic-range camera and presented on an HTC Vive Pro HMD. Fifty-three participants were asked to rate each lighting condition by viewing it in a real space (n = 30) or via immersive HDR photographs displayed in a VR HMD (n = 23). The results show that ratings of visual comfort, pleasantness, evenness, contrast and glare are similar between the HTC Vive Pro HMD and our real space when evaluating well-lit scenes, but significant differences emerge in dim and highly contrasted scenes for a number of rating scales.
Weapons of the Strong: Elite Resistance and the Neo-Apartheid City
Authors: Bradlow Benjamin H.
Published: February 2021

Transitions to democracy promise equal political power. But political ruptures carry no guarantee that democracy can overcome the accumulated inequalities of history. In South Africa, the transition to democracy shifted power from a racial minority in ways that suggested an unusually high probability of material change. This article analyzes the limits of public power after democratic transitions. Why has the post-Apartheid local state in Johannesburg been unable to achieve a spatially inclusive distribution of public goods despite a political imperative for both spatial and fiscal redistribution? I rely on interviews and archival research, conducted in Johannesburg between 2015 and 2018. Because the color line created a sharp distinction between political and economic power, traditional white urban elites required non-majoritarian and hidden strategies that translated their structural power into effective power. The cumulative effect of these “weapons of the strong” has been to disable the capacity of the local state to countervail the power of wealthy residents’ associations and property developers. Through these strategies, elites repurposed institutional reforms for redistribution to instead reproduce the city’s inequalities.
Looking behind: Turning cards in the selection task
Authors: Nickerson Raymond S , Butler Susan F , Barch Daniel H
Published: February 2021

Wason’s selection task requires that one imagine which of four cards, each of which has a letter on one side and a number on the other, one would have to turn over to determine whether a statement about the cards is true or false. For example, one might see four cards showing T, H, 6, and 4 and be asked to say which card or cards one would have to turn over to determine whether a statement in the form of If a card has T on one side, it has 4 on the other is true. In the great majority of experiments with this task no cards are actually turned. This limits the conclusions that can be drawn from experimental results. In two experiments participants actually turned (had a computer turn) virtual cards so as to show what they contained on their originally hidden sides. Participants were given a monetary incentive to do well on the task, and they performed it, with trial-by-trial feedback, many times. Performance was much better than is typically obtained with the more common way of performing the task. Results also demonstrate the importance of the precise wording of the statement to be evaluated and how a misinterpretation could help account for a tendency for people to turn only a single card even when the turning of two is required. Results prompt several questions of a theoretical nature and are discussed as they relate to recent theoretical treatments of the selection task.
The contribution of meaning to the detection of task conflict
Authors: Hershman Ronen , Levin Yulia , Tzelgov Joseph , Henik Avishai
Published: February 2021

The colour-word Stroop task produces both information conflict (detection of the ink colour vs word meaning) and task conflict (respond to the ink colour vs read the word). In this study, we measured both reaction time and pupil dilation, and the neutral stimuli in our study were non-readable letter strings as well as meaningless non-readable stimuli (i.e., coloured patches and abstract character strings). Our results showed slowest responses in the incongruent trials and fastest responses in the congruent trials. However, no differences were found between the investigated neutrals. In contrast, pupil dilation was largest in the incongruent trials and smallest in the neutral trials. Moreover, the more the neutral stimuli were meaningless, the less the pupil dilation that was observed. Our results suggest that non-word meaningless stimuli reduced task conflict (compared with all the investigated conditions). Neutral equivalence should be taken into consideration in Stroop and Stroop-like tasks.
Thumb duplication/polydactyly
Authors: Tonkin Michael
Published: February 2021

A significant lesson for those assessing the work of others stems from the necessity to review what has been written before. It remains a common but human error to misinterpret or misrepresent the words of others and indeed, for inconsistencies in these to become apparent. This is certainly so in the field of congenital hand surgery and especially so with discussion of thumb duplication/polydactyly. Many of the presentations in this journal issue deal with the subject of thumb duplication. All involve a consideration of classification despite an emphasis on investigative measures and techniques in some. For ease of reading, I will place my comments on these articles within the categories of classification, investigations assisting management decisions and alternative techniques, though the contents of each article are not necessarily restricted to these categories.
Triple oral combination therapy with macitentan, riociguat, and selexipag for pulmonary arterial hypertension
Authors: Momoi Mizuki , Hiraide Takahiro , Shinya Yoshiki , Momota Hiromi , Fukui Shogo , Kawakami Michiyuki , Itabashi Yuji , Fukuda Keiichi , Kataoka Masaharu
Published: February 2021

Background:

The evidence regarding triple oral combination therapy for patients with pulmonary arterial hypertension (PAH) is scarce. This study was performed to investigate the effectiveness and safety of triple oral combination therapy with macitentan, riociguat, and selexipag.

Methods:

Among consecutive patients with PAH who were referred to our hospital from 2009 to 2020, those who underwent triple oral combination therapy using macitentan, riociguat, and selexipag were retrospectively analyzed. Hemodynamic and echocardiographic assessments and Kaplan–Meier analyses of all-cause death and initiation of prostacyclin infusion were conducted.

Results:

Twenty-six patients underwent this combination therapy. These patients were predominantly female (73.1%) with a median age of 38 years at baseline and nine patients were taking some PAH medications at baseline. The median time from initiation of the first PAH drug to the third PAH drug in treatment naïve patients was 24 days (interquartile range, 12–47 days). Four patients (15.0%) discontinued taking any of the three vasodilators because of adverse events, and 17 patients (65.4%) reached the maximum dose of all three drugs. The mean pulmonary arterial pressure, pulmonary vascular resistance, and cardiac output improved by 29%, 65%, and 82%, respectively (median observation period: 441 days) and similar improvements were observed in treatment-naïve patients at baseline. The survival rate and prostacyclin infusion-free rate since administration of all three vasodilators was 93.3% and 74.6% at 3 years, respectively. When patients were divided by risk stratification, the prostacyclin-free rate at 3 years was 92.9% in low-/intermediate-risk patients and 55.0% in high-risk patients.

Conclusion:

Triple oral combination therapy with macitentan, riociguat, and selexipag sufficiently improved clinical parameters and was well tolerated in patients with PAH. This combination could be a particularly promising strategy in patients with low/intermediate risk and possibly even in half of patients with high risk. Further studies are needed to validate these findings. The reviews of this paper are available via the supplemental material section.
Melanoma metastasis mimicking gastric cancer: a challenge that starts from diagnosis
Authors: Monti Manlio , Guidoboni Massimo , Oboldi Devil , Bartolini Giulia , Pieri Federica , Ruscelli Silvia , Passardi Alessandro , Ridolfi Laura , De Rosa Francesco , Sullo Francesco Giulio , Frassineti Giovanni Luca
Published: February 2021

The gastrointestinal tract is an uncommon site of metastasis in melanoma. However, when the primary melanoma cannot be found, the diagnosis of gastric melanoma by endoscopic biopsy is problematic mainly because some tumors are amelanotic and do not contain melanin granules detectable by microscopy. A 56-year-old Caucasian man with melanoma was referred to us following an initial histopathological diagnosis via gastroscopy of poorly differentiated primary gastric carcinoma. A computerized tomography (CT) scan showed metastatic disease and on the basis of this information we started palliative chemotherapy. However, the atypical presentation of the disease with subcutaneous metastases prompted us to make a more in-depth evaluation. Immunohistochemical evaluation modified the diagnosis to melanoma. After only one cycle of chemotherapy, treatment was changed to dabrafenib + trametinib, which was better tolerated and initially induced a partial response. The patient is currently in good clinical condition 20 months after diagnosis. Our case report highlights the difficulty in diagnosing melanoma of the gastrointestinal tract and indicates the need for pathologists and clinicians to consider such a possibility when they are faced with a diagnosis of poorly differentiated gastric cancer and unusual sites of metastasis.
Flavonoids From the Flowers and Leaves of the Himalayan Megacodon stylophorus (Gentianaceae)
Authors: Iwashina Tsukasa , Yangzom Rinchen , Devkota Hari Prasad , Mizuno Takayuki
Published: February 2021

Five flavonol O-glycosides and 4 C-glycosylflavones were isolated from the flowers of the Himalayan Megacodon stylophorus (Gentianaceae). They were characterized as quercetin 3- O-glucoside (1), quercetin 3- O-rutinoside (2), kaempferol 3- O-glucoside (3), isorhamnetin 3- O-glucoside (4) and kaempferol 3,7-di- O-glucoside (5) (flavonols), and isovitexin (6), isoorientin (7), isovitexin X″- O-arabinoside (8) and isovitexin 4′- O-glucoside (9) ( C-glycosylflavones) by ultraviolet, liquid chromatography-mass spectrometry, acid hydrolysis, nuclear magnetic resonance, and/or high-performance liquid chromatography and thin-layer chromatography comparisons with authentic samples. On the other hand, 5 C-glycosylflavones were isolated from the leaves and identified as 6, 7, 9, vitexin (10), and orientin (11). Although many C-glycosylflavones and xanthones have been reported from Gentianaceae species, flavonols are minor occurrence in the family. Flavonoids were reported from the Megacodon species for the first time.
High Mobility Group Box Chromosomal Protein-1 Induces Myofibroblast Differentiation and Extracellular Matrix Production via RAGE, p38, JNK and AP-1 Signaling Pathways in Nasal Fibroblasts
Authors: Lee Soo-Hyung , Cho Jae Hoon , Park Joo-Hoo , Cho Jung-Sun , Lee Heung-Man
Published: February 2021

Background

Chronic rhinosinusitis is involved in myofibroblast differentiation and extracellular matrix (ECM) accumulation. High mobility group box chromosomal protein 1 (HMGB-1) is known to stimulate lung fibroblast to produce ECM in lung fibrosis. The aim of this study was to investigate whether HMGB-1 induces myofibroblast differentiation and ECM production in nasal fibroblasts and to identify the signal pathway.

Methods

Human nasal fibroblasts were cultured. After stimulation with HMGB-1, expressions of α-smooth muscle actin (α-SMA) and fibronectin were determined by real-time PCR and western blot. Total collagen was measured by Sircol assay. To investigate signal pathway, various signal inhibitors and RAGE siRNA were used.

Results

HMGB-1 increased α-SMA and fibronectin in mRNA and protein levels. It also increased collagen production. RAGE siRNA inhibited HMGB-1-induced α-SMA and fibronectin, and production of collagen. Furthermore, the inhibitors of RAGE downstream molecules such as p38, JNK and AP-1 also blocked the HMGB-1-induced effects.

Conclusions

HMGB-1 induces myofibroblast differentiation and ECM production in nasal fibroblast, which is mediated by RAGE, p38, JNK and AP-1 signal pathway. These results suggest that HMGB-1 may play an important role in tissue remodeling during chronic rhinosinusitis progression.
Decreased numbers and sex-based differences of circulating regulatory T cells in patients with seropositive undifferentiated arthritis
Authors: Niu Hong-Qing , Yuan Chenrui , Yan Chenglan , Li Na , Lei Yuan-Sheng , Li Xuxu , Ru Jinli , Li Xiao-Feng
Published: February 2021

Aims:

CD4+ T cells play crucial roles as both mediators and regulators of the pathogenesis of rheumatoid arthritis (RA). However, the characteristics of CD4+ T cell subpopulations in the earliest stage of RA development remain unclear. Hence, we determined the proportions and absolute counts of circulating CD4+ T cell subsets in patients with seropositive undifferentiated arthritis (SUA), the early and preclinical stage of RA.

Methods:

Peripheral blood samples and clinical information were collected from 177 patients with SUA, 104 patients with RA, and 120 healthy controls. All patients were newly diagnosed and untreated. Proportions and absolute counts of CD4+ T cell subpopulations were determined by flow cytometric analysis.

Results:

In patients with SUA, percentages and absolute counts of circulating regulatory T (Treg) cells were decreased significantly and Th17/Treg cell ratios were abnormally increased, whereas Th17 cell numbers were similar to those in healthy controls. In addition, sex-based differences in circulating Treg cells were observed, with female SUA patients having lower proportions and absolute counts of Treg cells than those in males. Moreover, female patients with SUA had higher erythrocyte sedimentation rates and 28-joint Disease Activity Scores than those in males.

Conclusion:

Immune tolerance deficiency resulting from an abnormal reduction in circulating Treg cells might be the most crucial immunological event in the earliest stage of RA. The sex-specific disparity in Treg cells should also be considered for immunoregulatory and preventive strategies targeting early RA.
Implantable system for treprostinil and lung transplantation: case series from delivery for pulmonary arterial hypertension study
Authors: Feldman Jeremy P. , Gomberg‐Maitland Mardi , Shapiro Shelley M. , Lautenbach Amy A. , Morris Marty , Murphy Jeff A. , Waxman Aaron B. , Bourge Robert C.
Published: February 2021

The implanted system for treprostinil has been described in previous publications. There is no information published about how to handle this system around lung or heart–lung transplantation. We present the experience from the DelIVery for Pulmonary Arterial Hypertension study. Seven subjects from five pulmonary arterial hypertension centers were included in this retrospective chart review. All subjects were participating in the previously described DelIVery for pulmonary arterial hypertension study. Seven subjects with implanted pumps have been listed for lung or heart–lung transplant. Six subjects underwent lung or heart–lung transplantation and one remains on the transplant list. Three different methods of patient management for transplant were used. In three subjects, the implanted system was filled with saline prior to transplantation and treprostinil was infused via an external system. Three subjects had their drug‐filled implanted pump and catheter system explanted at the time of transplant. One patient had the drug‐filled implanted system removed prior to being listed for transplantation. Four subjects were hospitalized while waiting for transplantation. In conclusion, the implanted system for treprostinil is an important advance in the care of pulmonary arterial hypertension subjects. The experience described here provides three effective strategies for managing the implanted system around lung or heart–lung transplantation. The optimal strategy will depend on patient characteristics and lung transplant program preferences and wait list times.
Incorporating telehealth into health service psychology training: A mixed-method study of student perspectives
Authors: Dopp Alex R , Mapes Ayla R , Wolkowicz Noah R , McCord Carly E , Feldner Matthew T
Published: February 2021

Objective

Telehealth is increasingly recognized as an avenue for enhancing psychologists’ capacities to meet the mental health needs of a diverse and underserved (due to barriers e.g., distance, transportation) public. The present study sought to inform training in telepsychology (i.e., telehealth delivery of psychological services) by using both quantitative and qualitative methods to explore the perspectives of doctoral students who have already been involved in such training.

Method

A total of 19 predoctoral students from two universities, with at least some experience in telepsychology training, provided their perspectives on two complementary research questions: (1) How do students perceive their level of competence in various domains of telepsychology?; and (2) What are students’ perspectives on the process of telepsychology competency development during their doctoral training?

Results

The results of our study provide early evidence that doctoral trainees are able to develop telepsychology competencies and suggest that a supportive, training-oriented environment and fit between telepsychology and existing programmatic areas of emphasis are likely key to success.

Conclusions

Continued efforts to enhance training in providing telepsychology services should focus on how to best define, measure, and promote competency development in this emerging specialty area.
Prefrontal and hippocampal atrophy using 7-tesla magnetic resonance imaging in patients with Parkinson’s disease
Authors: Oh Byeong H , Moon Hyeong C , Kim Aryun , Kim Hyeon J , Cheong Chae J , Park Young Seok
Published: February 2021

Background

The pathology of Parkinson’s disease leads to morphological changes in brain structure. Currently, the progressive changes in gray matter volume that occur with time and are specific to patients with Parkinson’s disease, compared to healthy controls, remain unclear. High-tesla magnetic resonance imaging might be useful in differentiating neurological disorders by brain cortical changes.

Purpose

We aimed to investigate patterns in gray matter changes in patients with Parkinson’s disease by using an automated segmentation method with 7-tesla magnetic resonance imaging.

Material and Methods

High-resolution T1-weighted 7 tesla magnetic resonance imaging volumes of 24 hemispheres were acquired from 12 Parkinson’s disease patients and 12 age- and sex-matched healthy controls with median ages of 64.5 (range, 41–82) years and 60.5 (range, 25–74) years, respectively. Subgroup analysis was performed according to whether axial motor symptoms were present in the Parkinson’s disease patients. Cortical volume, cortical thickness, and subcortical volume were measured using a high-resolution image processing technique based on the Desikan-Killiany-Tourville atlas and an automated segmentation method (FreeSurfer version 6.0).

Results

After cortical reconstruction, in 7 tesla magnetic resonance imaging volume segmental analysis, compared with the healthy controls, the Parkinson’s disease patients showed global cortical atrophy, mostly in the prefrontal area (rostral middle frontal, superior frontal, inferior parietal lobule, medial orbitofrontal, rostral anterior cingulate area), and subcortical volume atrophy in limbic/paralimbic areas (fusiform, hippocampus, amygdala).

Conclusion

We first demonstrated that 7 tesla magnetic resonance imaging detects structural abnormalities in Parkinson’s disease patients compared to healthy controls using an automated segmentation method. Compared with the healthy controls, the Parkinson’s disease patients showed global prefrontal cortical atrophy and hippocampal area atrophy.
The Use of High Strength Sutures and Anchors in Olecranon Fractures: A Systematic Review
Authors: Nazifi Omid , Gunaratne Rajitha , D’Souza Harry , Tay Aaron
Published: February 2021

Purpose/Background:

Olecranon fractures are common, particularly in the elderly osteoporotic population. Although various techniques of fixation are available, the gold standard—tension band wiring (TBW)—has high complication and reoperation rates. We sought to identify current evidence for the use of high-strength suture tension banding methods to determine whether they reduce complications and reoperation rates while maintaining fixation.

Methods:

A systematic review of several databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases included Cochrane, PubMed, MEDLINE and Embase. We searched for evidence of at least Level I to IV (according to NHMRC) of the use of tension band suturing or anchors in the surgical treatment of displaced olecranon fractures. We also analyzed the cost of fixation in our institute.

Results:

Four hundred and forty articles were identified. Of these, 9 met the inclusion criteria. One hundred thirty-one subjects had an average age of 66 years. All the studies showed that high-strength suture tension banding/anchoring maintained fixation with displaced olecranon fractures, reducing the complication rates and showed minimal reoperation rates. There was also a significant cost advantage of the suture tape construct mainly due to avoiding subsequent removal of metal.

Conclusion:

Tension band suturing or anchoring displaced olecranon fractures may be an alternative cost effective method to TBW in maintaining fixation, reducing metalware complications and reducing re-operation rates.

Level of Evidence:

IV.
Women in Higher Education: Are They Ready to Take Up Administrative Positions?—A Mixed-Methods Approach to Identify the Barriers, Perceptions, and Expectations
Authors: Mayya Shreemathi S. , Martis Maxie , Ashok Lena , Monteiro Ashma Dorothy
Published: February 2021

Higher education is anticipating vacancies in senior leadership positions over the coming years. Women are likely to be candidates for these openings, as the number of women pursuing doctoral degrees is rising. However, in the present scenario, there is a dearth of women in senior leadership positions in India. With a purpose to identify the factors influencing the decision of women to take up senior leadership positions, a cross-sectional survey was planned in India. Female faculty ( n = 136) employed on a tenure basis in state public universities were the respondents. Data were collected using a self-administered questionnaire and focus group discussions. About 48% of the participants expressed that they decline opportunities for administrative positions. The distance to the workplace was found to be a barrier to take up senior leadership positions. Recommendations to promote the readiness of women to take up senior leadership are discussed.
Heyde Syndrome: An Unusual Cause of Gastrointestinal Bleeding
Authors: Dahiya Dushyant Singh , Kichloo Asim , Zain El-Amir , Singh Jagmeet , Wani Farah , Mehboob Asad
Published: February 2021

Heyde syndrome is a multisystem disorder characterized by the classical triad of aortic stenosis, gastrointestinal (GI) angiodysplasias, and acquired von Willebrand syndrome. GI angiodysplasias, common in older patients, are tortuous, thin-walled blood vessels seen in the mucosa or submucosa of the GI tract and are highly prone to rupture resulting in GI bleeds. In this case report, we describe an elderly female with a past medical history of end-stage renal disease and chronic anemia who presented to the emergency department (ED) with complaints of dark-tarry stools and associated abdominal cramping. Patient reported a history of dark-tarry stools and multiple blood transfusions in the past, secondary to severe anemia. An inpatient echocardiogram was performed, revealing severe aortic stenosis. Additionally, gastroenterology was consulted for esophagogastroduodenoscopy and colonoscopy, which were negative for active bleeding. About a year ago, the patient underwent capsule endoscopy at an outlying facility, which was positive for angiodysplasia. Therefore, due to high clinical suspicion, presence of aortic stenosis, and GI angiodysplasia, a platelet function assay was ordered. It was found to be abnormal, pointing to the presence of acquired von Willebrand syndrome. Hence, a diagnosis of Heyde syndrome was established. The patient gradually improved and was discharged with a follow-up appointment with the cardiologist for a possible transcatheter aortic valve replacement procedure. The patient underwent the procedure without complications, after which she did not report episodes of GI bleeding. In this case report, we discuss the presentation, pathophysiology, diagnostic approach, and management of patients with Heyde syndrome.
Teaching STEM Entrepreneurship With Societal Significance: Building on the Small Business Innovation Research Program
Authors: Bandera Cesar
Published: February 2021

Undergraduate students are aware of problems with societal significance, but few have tacit knowledge on how to address them through entrepreneurship or how to research the multidisciplinary technical, financial, and regulatory requirements. This paper describes a one-semester entrepreneurship course that teaches undergraduate students how to identify societally significant opportunities for STEM-based innovations, and how to de-risk associated business models. This course differs from traditional entrepreneurship education in three ways. First, it builds upon the federal Small Business Innovation Research (SBIR) program (“America’s Seed Fund”). Second, students learn to navigate the multidisciplinary strategic decisions that often accompany business models developed for societally impactful opportunities. Third, by becoming intimately familiar with proposal writing and submission protocols, those students willing to commit to entrepreneurship, or intrapreneurship if in the job market, have better chances of raising significant funds (>$1 M) through the SBIR program than from equity investors or commercial banks. The experiential nature of the course promotes students’ ability to discover tacit opportunities, whereas learning SBIR protocols promotes students’ ability to discover codified opportunities. The paper presents the pedagogical concepts, learning objectives, and evaluation criteria of this novel course.
What is contemporary political violence? An interview with Mohammad-Mahmoud Ould Mohamedou
Authors: Ould Mohamedou Mohammad-Mahmoud , Adraoui Mohamed-Ali
Published: February 2021

Should “jihadist” violence be analyzed as a specificity of contemporary global conflict, or should we instead look at it in terms of broader and more encompassing historical dynamics, dynamics that characterize other religious traditions, as much as the other modes of political, cultural, and social thought of our times? In this interview, Professor Mohammad-Mahmoud Ould Mohamedou warns of the intellectual trap of taking violent actors at their word—a tendency all too present in contemporary analyses of jihadism, Islamic-inspired radicalization, and, more generally, religious justifications of violence.
An interesting case of vesical fistula complicating urogenital tuberculosis
Authors: Shekar P. Ashwin , Patel Hardik , Gopalakrishnan Ganesh
Published: February 2021

Background

The genitourinary tract is one of the commonest regions that can be affected by extrapulmonary tuberculosis where the diagnosis can be quite difficult. A high index of suspicion and an awareness of the atypical clinical manifestations of urogenital tuberculosis (UGTB) are important, especially in patients from regions where tuberculosis continues to be a major public health problem.

Case presentation

Herein, we report a 33-year-old male who presented with a non-healing fistula at the site of suprapubic catheter following an emergency repair of traumatic bladder rupture. Further evaluation revealed a scarred, small capacity bladder with urinary fistulae along with a poorly functioning kidney which was suspicious of a tuberculous etiology. Urinary isolation of Mycobacterium tuberculosis and a positive bladder biopsy confirmed our suspicions that the findings were indeed part of the spectrum of UGTB. The patient was started on anti-tubercular chemotherapy and underwent a nephrectomy along with an ileal conduit and is doing well at 1-year follow-up.

Conclusion

To conclude, urogenital tuberculosis always has to be kept in mind especially when dealing with patients with non-healing urinary fistula, especially in endemic countries. A high index of suspicion along with careful and methodical workup of patients with atypical complications following common surgeries can lead to identification of this morbid condition and thereby avoid mismanagement and progression to chronic kidney disease.