bluuebunny/crossref_metadata_2025 huggingface dataset:
Michel Henry and the Prospect of a Christian Spiritual Inactivism
Authors: Nemes Steven
Published: August 2021

Christian spirituality is often “activist.” It consists in the performance of various actions through which a faithful person attempts to secure the presence of God. The argument of the present essay is that spiritual “activism” cannot actually accomplish this goal. For this reason, it is necessary to seek a foundation for all spiritual activism in spiritual “inactivism.” This means that all Christian spiritual activity must be reconceived as a response to and celebration of a prior presence of God that comes before any performance. The phenomenological philosophy of Michel Henry makes it possible to appreciate how God is so present in the very fact of being alive. This can make the whole of Christian spiritual practice a Eucharist—a perpetual thanksgiving.
Practical use and underlying physics of the BENCHMARK™ BMX™ 96 for large-bore aspiration thrombectomy: Case report of initial institutional experience
Authors: Macdonald Ian R , Cora Elena A , Grant Ian , Volders David
Published: August 2021

Endovascular thrombectomy (EVT) is part of first-line intervention for acute ischemic stroke management. Recent technological advances have demonstrated that large-bore catheters are an attractive approach for EVT. A multitude of approaches such as A Direct Aspiration first Pass Technique (ADAPT) or in conjunction with stent retrieval (Solumbra technique) have been developed with increasingly large-bore catheters, demonstrating safety and efficacy. Furthermore, these techniques have demonstrated promise for the intervention of cerebral venous thrombosis as well as posterior circulation ischemic events. Recently, advances in neurointerventional catheters have focused on improved maneuverability to navigate the neurovasculature, as well as larger inner diameters for improved procedural versatility, including aspiration. We describe a case report highlighting our early institutional experience with the recently developed large-bore catheter, the BENCHMARK™ BMX™ 96. The case report entails near complete occlusion of the internal carotid artery from acute thrombus and the utility of the BMX™ 96 catheter for treatment of such extensive clot burden. The applicability of large-bore aspiration catheters, with an emphasis on recent advances, for mechanical thrombectomy in arterial as well as venous systems is discussed. To our knowledge, this is the first reported case of use of the BENCHMARK™ BMX™ 96 access system for EVT in acute ischemic stroke. Such new-generation large-bore catheters are a promising advance in neurointervention, and our early institution experience highlights the ease of use and versatility for neurointerventional procedures such as EVT.
V3-Loop genotypes do not predict maraviroc susceptibility of CCR5-tropic virus or clinical response through week 48 in HIV-1–infected, treatment-experienced persons receiving optimized background regimens
Authors: Lewis ME , Simpson P , Mori J , Jubb B , Sullivan J , McFadyen L , van der Ryst E , Craig C , Robertson DL , Westby M
Published: August 2021

Viruses from 15 of 35 maraviroc-treated participants with virologic failure and CCR5-tropic (R5) virus in the MOTIVATE studies at Week 24 had reduced maraviroc susceptibility. On-treatment amino acid changes were observed in the viral envelope glycoprotein 120 third variable (V3)–loop stems and tips and differed between viruses. No amino acid change reliably predicted reduced susceptibility, indicating that resistance was genetic context–dependent. Through Week 24, poor adherence was associated with maraviroc-susceptible virologic failure, whereas reduced maraviroc susceptibility was associated with suboptimal background regimen activity, highlighting the importance of overall regimen activity and good adherence. Predictive values of pretreatment V3-loop sequences containing these Week 24 mutations or other variants present at >3% in pretreatment viruses of participants with virologic failure at Week 48 were retrospectively assessed. Week 48 clinical outcomes were evaluated for correlates with pretreatment V3-loop CCR5-tropic sequences from 704 participants (366 responders; 338 virologic failures [83 with R5 virus with maraviroc susceptibility assessment]). Seventy-five amino acid variants with >3% prevalence were identified among 23 V3-loop residues. Previously identified variants associated with resistance in individual isolates were represented, but none were associated reliably with virologic failure alone or in combination. Univariate analysis showed virologic-failure associations with variants 4L, 11R, and 19S ( P < 0.05). However, 11R is a marker for CXCR4 tropism, whereas neither 4L nor 19S was reliably associated with reduced maraviroc susceptibility in R5 failure. These findings from a large study of V3-loop sequences confirm lack of correlation between V3-loop genotype and clinical outcome in participants treated with maraviroc.

Clinical trial registration numbers (ClinicalTrials.gov): NCT00098306 and NCT00098722
Serious illness conversations in pulmonary hypertension
Authors: Ismail Reem , Hegab Sara , Kelly Bryan , Franco‐Palacios Domingo J. , Grafton Gillian , Smith Zachary R. , Awdish Rana L.A.
Published: August 2021

Pulmonary arterial hypertension has evolved from a fatal disease with few treatment options to a chronic condition with improved survival. This improvement is possible through development of effective therapies as well as the expansion of risk stratification scores to assist clinical decision making. Despite improved disease control, quality of life, and overall prognosis, many challenges remain. The treatment itself is burdensome, with significant impact on quality of life. Many patients with pulmonary arterial hypertension still present with advanced, often end‐stage disease. Increased use of mechanical circulatory support and catheter‐based interventions have expanded use of extracorporeal life support and right ventricle assist devices. For these reasons as well as the long‐term relationships pulmonary hypertension physicians have with patients and their families, navigating the course of the illness in a considered, proactive way is essential. Understanding individual goals and revisiting them as they change over time requires comfort with the conversation itself. There are many barriers and challenges to having effective, compassionate conversations in the clinical setting with time constraints being the most often cited. Compressed visits are necessarily focused on the clinical aspects, therapy and medication adherence and tolerance. Clinicians are sometimes wary of diminishing hope in the face of ongoing treatment. Having sufficient experience and comfort with these discussions can be empowering. In this paper, we discuss the challenges involved and propose a framework to assist in incorporating these discussions into clinical care.
Mechanical Circulatory Support in Advanced Heart Failure
Authors: Arora Sonali , Atreya Auras R.
Published: August 2021

Advanced heart failure (HF) with persistent and progressive clinical decline despite maximal medical therapy portends a high mortality in the absence of advanced therapies, such as ventricular assist devices or heart transplantation. A subset of these advanced HF patients deteriorates into refractory cardiogenic shock, that is challenging to manage with vasoactive agents alone. Temporary mechanical circulatory support (MCS) device options have evolved over the years and provide a viable option to rescue and rest the myocardium of patients in cardiogenic shock. The goal of such therapy is to serve as bridge to recovery, or more often, a bridge to durable advanced therapies. For those patients with progressive advanced HF despite extensive medical therapy, durable MCS devices (ventricular assist devices) are available when heart transplantation is not feasible. In this article, we review currently available temporary and durable MCS devices, with a focus on their hemodynamic profiles, to inform optimal device selection for patients with advanced HF.
Spatial correlation in ground motion prediction errors in Central and Eastern North America
Authors: Gibson Emily M , Bensi Michelle T
Published: August 2021

Risk analysis and risk-informed design of spatially distributed infrastructure systems for earthquake hazards require an understanding of and ability to model the spatial correlation of ground motion prediction errors. We assess this spatial correlation in Central and Eastern North America (CENA) by calculating ground motion residuals and semivariograms from earthquake recordings in the Next Generation Attenuation (NGA)-East database. Although data limitations prohibit the development of a reliable model to capture this correlation, we have made notable findings relevant to future risk analyses. The spatial correlation of ground motion prediction errors in CENA is larger than those previously published for shallow crustal regions, which agrees with the lower attenuation observed in CENA. Differences in correlation behavior is also observed between tectonic and induced event recordings. This is, in part, due to the characteristics of the system of stations in which they were recorded. In addition, the choice of ground motion model (GMM) used to calculate the predicted ground motions was found to have an impact on the resulting correlation of errors and we recommend that future CENA spatial correlation models be tailored to the specific infrastructure system and location that will be analyzed.
Angiopoietin 1 release from human neutrophils is independent from neutrophil extracellular traps (NETs)
Authors: Charles Elcha , Dumont Benjamin L. , Bonneau Steven , Neagoe Paul-Eduard , Villeneuve Louis , Räkel Agnès , White Michel , Sirois Martin G.
Published: August 2021

Background

Neutrophils induce the synthesis and release of angiopoietin 1 (Ang1), a cytosolic growth factor involved in angiogenesis and capable of inducing several pro-inflammatory activities in neutrophils. Neutrophils also synthesize and release neutrophil extracellular traps (NETs), comprised from decondensed nuclear DNA filaments carrying proteins such as neutrophil elastase (NE), myeloperoxidase (MPO), proteinase 3 (PR3) and calprotectin (S100A8/S100A9), which together, contribute to the innate immune response against pathogens (e.g., bacteria). NETs are involved in various pathological conditions through pro-inflammatory, pro-thrombotic and endothelial dysfunction effects and have recently been found in heart failure (HF) and type 2 diabetes (T2DM) patients. The aim of the present study was to investigate the role of NETs on the synthesis and release of Ang1 by the neutrophils in patients with T2DM and HF with preserved ejection fraction (HFpEF) (stable or acute decompensated; ADHFpEF) with or without T2DM.

Results

Our data show that at basal level (PBS) and upon treatment with LPS, levels of NETs are slightly increased in patients suffering from T2DM, HFpEF ± T2DM and ADHF without (w/o) T2DM, whereas this increase was significant in ADHFpEF + T2DM patients compared to healthy control (HC) volunteers and ADHFpEF w/o T2DM. We also observed that treatments with PMA or A23187 increase the synthesis of Ang1 (from 150 to 250%) in HC and this effect is amplified in T2DM and in all cohorts of HF patients. Ang1 is completely released (100%) by neutrophils of all groups and does not bind to NETs as opposed to calprotectin.

Conclusions

Our study suggests that severely ill patients with HFpEF and diabetes synthesize and release a greater abundance of NETs while Ang1 exocytosis is independent of NETs synthesis.
Benefits and barriers: a qualitative study on online social participation among widowed older adults in Southwest China
Authors: Hong Yan , Fu Jingjing , Kong Dehui , Liu Siqi , Zhong Zhu , Tan Jing , Luo Yu
Published: August 2021

Background

With the development of digital media, online activities are increasingly becoming part of the daily life of older adults. Widowed older adults generally would face changes in social interactions and activities due to widowhood; thus, the importance of online participation may be more prominent in this population. However, a detailed evidence on the experiences of online social participation among widowed older adults is relatively sparse. This study aimed to explore widowed older adults’ perceptions regarding online social participation in southwestern China.

Methods

This study adopted a qualitative approach. Semi-structured, in-depth individual interviews were conducted with 19 widowed older adults between September–December 2020. Thematic analysis was applied to analyse the data.

Results

Two major themes, “benefits” and “barriers” were identified from the original data analysis. Subcategories concerning the theme “benefits” were “benefit perception (convenience, flexible time, supplementation)”, “health promotion”, “emotional comfort”, and “social connection”. Subcategories of “barriers” were “worries: personal economic loss”, “concerns: security of digital device”, “troubles: the diversity of online social participation”, and “difficulties: using digital media”.

Conclusions

Social participation of widowed older adults in southwestern China has begun to be integrated into the digital world; however, it remains at an early stage with the simple purpose of engagement. The older adults may face many challenges for online social participation. Although there are barriers and challenges in online social participation, widowed older adults can reap its benefits, which can be used as an important measure to facilitate a fulfilling life and successful ageing. There is no doubt that online social participation will become a trend within the foreseeable future. Family, friends and health care professionals should pay more attention to the needs of online social participation in widowed older adults and provide adequate support for them to achieve a meaningful life.
Decreased human respiratory syncytial virus activity during the COVID-19 pandemic in Japan: an ecological time-series analysis
Authors: Wagatsuma Keita , Koolhof Iain S. , Shobugawa Yugo , Saito Reiko
Published: August 2021

Background

Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV). We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan.

Methods

The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. A generalized linear gamma regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014–2020).

Results

The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% (p < 0.001) compared to those in the preceding 6 years (2014–2019). For every average ¥1 billion (approximately £680,000/$9,000,000) spent on hand hygiene products during the current month and 1 month before there was a 0.29% (p = 0.003) decrease in HRSV infections. An increase of average 1000 domestic and international airline passenger arrivals during the previous 1–2 months was associated with a 3.8 × 10− 4% (p < 0.001) and 1.2 × 10− 3% (p < 0.001) increase in the monthly number of HRSV infections, respectively.

Conclusions

This study suggests that there is an association between the decrease in the monthly number of HRSV cases and improved hygiene and sanitary measures and travel restrictions for COVID-19 in Japan, indicating that these public health interventions can contribute to the suppression of HRSV activity. These findings may help in public health policy and decision making.
Regional variation in the potentially inappropriate first-line use of fluoroquinolones in Canada as a key to antibiotic stewardship? A drug utilization review study
Authors: St-Jean Audray , Chateau Dan , Dahl Matthew , Ernst Pierre , Daneman Nick , Sketris Ingrid S. , Zhang Jianguo , Marra Fawziah , Quail Jacqueline , Bugden Shawn ,   for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators
Published: August 2021

Background

Serious adverse effects of fluoroquinolone antibiotics have been described for more than decade. Recently, several drug regulatory agencies have advised restricting their use in milder infections for which other treatments are available, given the potential for disabling and possibly persistent side effects. We aimed to describe variations in fluoroquinolone use for initial treatment of urinary tract infection (UTI), acute bacterial sinusitis (ABS), and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in the outpatient setting across Canada.

Methods

Using administrative health data from six provinces, we identified ambulatory visits with a diagnosis of uncomplicated UTI, uncomplicated AECOPD or ABS. Antibiotic exposure was determined by the first antibiotic dispensed within 5 days of the visit.

Results

We identified 4,303,144 uncomplicated UTI events among 2,170,027 women; the proportion of events treated with fluoroquinolones, mostly ciprofloxacin, varied across provinces, ranging from 18.6% (Saskatchewan) to 51.6% (Alberta). Among 3,467,678 ABS events (2,087,934 patients), between 2.2% (Nova Scotia) and 11.2% (Ontario) were dispensed a fluoroquinolone. For 1,319,128 AECOPD events among 598,347 patients, fluoroquinolones, mostly levofloxacin and moxifloxacin, ranged from 5.8% (Nova Scotia) to 35.6% (Ontario). The proportion of uncomplicated UTI and ABS events treated with fluoroquinolones declined over time, whereas it remained relatively stable for AECOPD.

Conclusions

Fluoroquinolones were commonly used as first-line therapies for uncomplicated UTI and AECOPD. However, their use varied widely across provinces. Drug insurance formulary criteria and enforcement may be a key to facilitating better antibiotic stewardship and limiting potentially inappropriate first-line use of fluoroquinolones.
Dynamic nomograms combining N classification with ratio-based nodal classifications to predict long-term survival for patients with lung adenocarcinoma after surgery: a SEER population-based study
Authors: Wang Suyu , Yu Yue , Xu Wenting , Lv Xin , Zhang Yufeng , Liu Meiyun
Published: August 2021

Background

The prognostic roles of three lymph node classifications, number of positive lymph nodes (NPLN), log odds of positive lymph nodes (LODDS), and lymph node ratio (LNR) in lung adenocarcinoma are unclear. We aim to find the classification with the strongest predictive power and combine it with the American Joint Committee on Cancer (AJCC) 8th TNM stage to establish an optimal prognostic nomogram.

Methods

25,005 patients with T1-4N0–2M0 lung adenocarcinoma after surgery between 2004 to 2016 from the Surveillance, Epidemiology, and End Results database were included. The study cohort was divided into training cohort (13,551 patients) and external validation cohort (11,454 patients) according to different geographic region. Univariate and multivariate Cox regression analyses were performed on the training cohort to evaluate the predictive performance of NPLN (Model 1), LODDS (Model 2), LNR (Model 3) or LODDS+LNR (Model 4) respectively for cancer-specific survival and overall survival. Likelihood-ratio χ2 test, Akaike Information Criterion, Harrell concordance index, integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to evaluate the predictive performance of the models. Nomograms were established according to the optimal models. They’re put into internal validation using bootstrapping technique and external validation using calibration curves. Nomograms were compared with AJCC 8th TNM stage using decision curve analysis.

Results

NPLN, LODDS and LNR were independent prognostic factors for cancer-specific survival and overall survival. LODDS+LNR (Model 4) demonstrated the highest Likelihood-ratio χ2 test, highest Harrell concordance index, and lowest Akaike Information Criterion, and IDI and NRI values suggested Model 4 had better prediction accuracy than other models. Internal and external validations showed that the nomograms combining TNM stage with LODDS+LNR were convincingly precise. Decision curve analysis suggested the nomograms performed better than AJCC 8th TNM stage in clinical practicability.

Conclusions

We constructed online nomograms for cancer-specific survival and overall survival of lung adenocarcinoma patients after surgery, which may facilitate doctors to provide highly individualized therapy.
Resilience and its associated factors in head and neck cancer patients in Pakistan: an analytical cross-sectional study
Authors: Zahid Nida , Zahid Wajeeha , Khalid Wardah , Azam Iqbal , Ikram Mubasher , Hassan Aneesa , Iftikar Haissan , Bhamani Shireen Shehzad , Jabbar Adnan Abdul , Akhtar Shabbir , Siddiqui Moghira Iqbaluddin , Awan Mohammad Sohail , Asad Nargis , Ahmad Khabir
Published: August 2021

Introduction

The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC) such as Pakistan.

Methods

An analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding their resilience scores was collected through Wagnild and Young’s Resilience scale that comprises of 14 items (RS-14). Moreover, depression and anxiety were also assessed via Hospital Anxiety and Depression Scale (HADS) and social support was assessed by Enriched Social Support Instrument (ESSI).

Results

The data was analyzed by linear regression modeling. Unadjusted and adjusted beta coefficients with 95% CI were reported. A total of 250 head and neck cancer patients were recruited, 79% of them were males. Mean age of the patients was 51.59 years with 93% having high social support and only 8% having severe depression and 3% having severe anxiety. After adjusting for the covariates in multivariable analysis resilience was associated with severe depression (− 17[− 20.98,-12.93]) or borderline depression (− 4[− 8.41,-0.39]), severe anxiety (− 11 [− 17.88,-4.18]), low social support (− 6[− 9.62,-1.71]), having family members of > 6 in the household (− 2[− 4.31,-0.29), smokeless tobacco users post- treatment (10[5.79, 14.45]), and those who underwent tracheotomy (− 4[− 7.67,-0.21]). There was a significant interaction between education and role in the family (decision maker).

Conclusion

In Pakistan, a South Asian LMIC, collectivist culture prevails, family ties are greatly promoted thus resilience and social support is highly prevalent in head and neck cancer patients resulting in lower prevalence of depression and anxiety. Our study highlights that higher resilience is prevalent among small families less than six members, as the welfare of the individual is prioritized over multiple needs of the family. Formal Education and role in household/decision making power are effect modifiers in our study, demonstrating its protective effect on the mental health of head and neck cancer patients. High resilience scores were reported among current smokeless tobacco users as compared to quitters post treatment. Resilience-building interventions should be formulated to aid head and neck cancer patients to cope with the disease and its sequel.
Translating and validating a Japanese version of the Patient Care Ownership Scale: a multicenter cross-sectional study
Authors: Fujikawa Hirohisa , Son Daisuke , Kondo Kayo , Djulbegovic Mia , Takemura Yousuke , Eto Masato
Published: August 2021

Background

Patient care ownership (PCO) is an essential component in medical professionalism and is crucial for delivering high-quality care. The 15-item PCO Scale (PCOS) is a validated questionnaire for quantifying PCO in residents; however, no corresponding tool for assessing PCO in Japan exists. This study aimed to develop a Japanese version of the PCOS (J-PCOS) and validate it among Japanese medical trainees.

Methods

We performed a multicenter cross-sectional survey to test the validity and reliability of the J-PCOS. The study sample was trainees of postgraduate years 1–5 in Japan. The participants completed the J-PCOS questionnaire. Construct validity was assessed through exploratory and confirmatory factor analyses. Internal consistency reliability was examined by calculating Cronbach’s alpha coefficients and inter-item correlations.

Results

During the survey period, 437 trainees at 48 hospitals completed the questionnaire. Exploratory factor analysis of the J-PCOS extracted four factors: assertiveness, sense of ownership, diligence, and being the “go-to” person. The second factor had not been identified in the original PCOS, which may be related to a unique cultural feature of Japan, namely, a historical code of personal conduct. Confirmatory factor analysis supported this four-factor model, revealing good model fit indices. The analysis results of Cronbach’s alpha coefficients and inter-item correlations indicated adequate internal consistency reliability.

Conclusions

We developed the J-PCOS and examined its validity and reliability. This tool can be used in studies on postgraduate medical education. Further studies should confirm its robustness and usefulness for improving PCO.
Healthcare workers preparedness for COVID-19 pandemic in the occupied Palestinian territory: a cross-sectional survey
Authors: Alser Osaid , Alghoul Heba , Alkhateeb Zahra , Hamdan Ayah , Albarqouni Loai , Saini Kiran
Published: August 2021

Background

The COVID-19 pandemic threatens to overwhelm the capacity of a vulnerable healthcare system in the occupied Palestinian territory (oPt). We aimed to evaluate the availability of personal protective equipment (PPE) and the level of preparedness among HCWs in the oPt.

Methods

A cross-sectional study was conducted using a validated online questionnaire distributed through convenient sampling between March 30, 2020 and April 12, 2020. Outcomes were availability of PPE, healthcare workers (HCWs) preparedness in oPt for COVID-19 pandemic, and regional and hospital differences in oPt in terms of availability of PPE and HCWs preparedness. Descriptive statistics and univariate analysis were used in this study.

Results

Of 138 respondents, only 38 HCWs (27.5%) always had access to facemasks and 15 (10.9%) always had access to isolation gowns. Most HCWs did not find eye protection (n = 128, 92.8%), N95 respirators (n = 132, 95.7%), and face shields (n = 127, 92%) always available. Compared to HCWs in West Bank, those in the Gaza Strip were significantly less likely to have access to alcohol sanitizers (p = 0.03) and gloves (p < 0.001). On average, governmental hospitals were significantly less likely to have all appropriate PPE than non-governmental institutions (p = 0.001). Only 16 (11.6%) surveyed felt confident in dealing with a potential COVID-19 case, 57 (41.3%) having received any COVID-19-related training, and 57 (41.3%) not having a local hospital protocol.

Conclusion

HCWs in oPt appear to be underprepared and severely lacking adequate PPE provision. The lack of PPE provision will exacerbate spread of COVID-19 and deepen the crisis, whilst putting HCWs at risk.
Feminism, gender medicine and beyond: a feminist analysis of "gender medicine"
Authors: Shai Ayelet , Koffler Shahar , Hashiloni-Dolev Yael
Published: August 2021

The feminist women’s health movement empowered women’s knowledge regarding their health and battled against paternalistic and oppressive practices within healthcare systems. Gender Medicine (GM) is a new discipline that studies the effect of sex/gender on general health. The international society for gender medicine (IGM) was embraced by the FDA and granted funds by the European Union to formulate policies for medical practice and research.

We conducted a review of IGM publications and policy statements in scientific journals and popular media. We found that while biological differences between men and women are emphasized, the impact of society on women is under- represented. The effect of gender-related violence, race, ethnic conflicts, poverty, immigration and discrimination on women’s health is seldom recognized. Contrary to feminist practice, GM is practiced by physicians and scientists, neglecting voices of other disciplines and of women themselves.

In this article we show that while GM may promote some aspects of women’s health, at the same time it reaffirms conservative positions on sex and gender that can serve to justify discrimination and disregard the impact of society on women’s lives and health. An alternative approach, that integrates feminist thinking and practices into medical science, practice and policies is likely to result in a deep and beneficiary change in women’s health worldwide.
Engineered hypoxia-responding Escherichia coli carrying cardiac peptide genes, suppresses tumor growth, angiogenesis and metastasis in vivo
Authors: Samadi Mitra , Majidzadeh-A Keivan , Salehi Malihe , Jalili Neda , Noorinejad Zeinab , Mosayebzadeh Marjan , Muhammadnejad Ahad , Sharif khatibi Azadeh , Moradi-Kalbolandi Shima , Farahmand Leila
Published: August 2021

Development of engineered non-pathogenic bacteria, capable of expressing anti-cancer proteins under tumor-specific conditions, is an ideal approach for selectively eradicating proliferating cancer cells. Herein, using an engineered hypoxia responding nirB promoter, we developed an engineered Escherichia coli BW25133 strain capable of expressing cardiac peptides and GFP signaling protein under hypoxic condition for spatiotemporal targeting of mice mammary tumors. Following determination of the in vitro cytotoxicity profile of the engineered bacteria, selective accumulation of bacteria in tumor microenvironment was studied 48 h after tail vein injection of 108 cfu bacteria in animals. For in vivo evaluation of antitumoral activities, mice with establishment mammary tumors received 3 consecutive intravenous injections of transformed bacteria with 4-day intervals and alterations in expression of tumor growth, invasion and angiogenesis specific biomarkers (Ki-67, VEGFR, CD31and MMP9 respectively), as well as fold changes in concentration of proinflammatory cytokines were examined at the end of the 24-day study period. Intravenously injected bacteria could selectively accumulate in tumor site and temporally express GFP and cardiac peptides in response to hypoxia, enhancing survival rate of tumor bearing mice, suppressing tumor growth rate and expression of MMP-9, VEGFR2, CD31 and Ki67 biomarkers. Applied engineered bacteria could also significantly reduce concentrations of IL-1β, IL-6, GC-SF, IL-12 and TNF-α proinflammatory cytokines while increasing those of IL-10, IL-17A and INF-γ. Overall, administration of hypoxia-responding E. coli bacteria, carrying cardiac peptide expression construct could effectively suppress tumor growth, angiogenesis, invasion and metastasis and enhance overall survival of mice bearing mammary tumors.
Mean-square exponential input-to-state stability of stochastic quaternion-valued neural networks with time-varying delays
Authors: Dai Lihua , Hou Yuanyuan
Published: August 2021

In this paper, we first consider the stability problem for a class of stochastic quaternion-valued neural networks with time-varying delays. Next, we cannot explicitly decompose the quaternion-valued systems into equivalent real-valued systems; by using Lyapunov functional and stochastic analysis techniques, we can obtain sufficient conditions for mean-square exponential input-to-state stability of the quaternion-valued stochastic neural networks. Our results are completely new. Finally, a numerical example is given to illustrate the feasibility of our results.
Molecules linked to Ras signaling as therapeutic targets in cardiac pathologies
Authors: Ramos-Kuri Manuel , Meka Sri Harika , Salamanca-Buentello Fabio , Hajjar Roger J. , Lipskaia Larissa , Chemaly Elie R.
Published: August 2021

The Ras family of small Guanosine Triphosphate (GTP)-binding proteins (G proteins) represents one of the main components of intracellular signal transduction required for normal cardiac growth, but is also critically involved in the development of cardiac hypertrophy and heart failure. The present review provides an update on the role of the H-, K- and N-Ras genes and their related pathways in cardiac diseases. We focus on cardiac hypertrophy and heart failure, where Ras has been studied the most. We also review other cardiac diseases, like genetic disorders related to Ras. The scope of the review extends from fundamental concepts to therapeutic applications. Although the three Ras genes have a nearly identical primary structure, there are important functional differences between them: H-Ras mainly regulates cardiomyocyte size, whereas K-Ras regulates cardiomyocyte proliferation. N-Ras is the least studied in cardiac cells and is less associated to cardiac defects. Clinically, oncogenic H-Ras causes Costello syndrome and facio-cutaneous-skeletal syndromes with hypertrophic cardiomyopathy and arrhythmias. On the other hand, oncogenic K-Ras and alterations of other genes of the Ras-Mitogen-Activated Protein Kinase (MAPK) pathway, like Raf, cause Noonan syndrome and cardio-facio-cutaneous syndromes characterized by cardiac hypertrophy and septal defects. We further review the modulation by Ras of key signaling pathways in the cardiomyocyte, including: (i) the classical Ras-Raf-MAPK pathway, which leads to a more physiological form of cardiac hypertrophy; as well as other pathways associated with pathological cardiac hypertrophy, like (ii) The SAPK (stress activated protein kinase) pathways p38 and JNK; and (iii) The alternative pathway Raf-Calcineurin-Nuclear Factor of Activated T cells (NFAT). Genetic alterations of Ras isoforms or of genes in the Ras-MAPK pathway result in Ras-opathies, conditions frequently associated with cardiac hypertrophy or septal defects among other cardiac diseases. Several studies underline the potential role of H- and K-Ras as a hinge between physiological and pathological cardiac hypertrophy, and as potential therapeutic targets in cardiac hypertrophy and failure.

Graphic abstract
Learning analytics of humanities course: reader profiles in critical reading activity
Authors: Majumdar Rwitajit , Bakilapadavu Geetha , Majumder Reek , Chen Mei-Rong Alice , Flanagan Brendan , Ogata Hiroaki
Published: August 2021

This study investigates learner’s reading behaviors in a critical reading task in humanities course using learning analytics techniques. A Critical Analysis of Literature and Cinema course was selected as a context. The course activities evolved over 10 years, and for this instance, some face-to-face classroom critical reading activities were migrated to online mode by using BookRoll, a learning analytics enhanced eBook platform. Students (n=22 out of the 50 registered) accessed Hayavadana, an Indian play uploaded on BookRoll, and attempted to identify performative elements and cultural references in the text and highlight them. In this study, we analyze learner’s reading logs gathered in the learning record store linked to BookRoll during that activity. We extend our previous work where we identify four online reading profiles: effortful, strategic, wanderers, and check-out, based on learner’s clickstream interactions and time spent with the content. We validate the profiles with qualitative interview data collected from the learners and illustrate the quantified learning behaviors of each of those profiles based on an engagement metric. Our work aims to initiate further discussion related to the application of learning analytics in humanities courses both to probe into the learning behaviors of the students and thereby enhance the experiences with the use of interactive learning environments and data-driven services.
Italian PhD students at the borders: the relationship between family background and international mobility
Authors: Tocchioni Valentina , Petrucci Alessandra
Published: August 2021

Previous literature has suggested that PhD students’ mobility has become a fundamental step during doctoral studies, both for training purposes and for creating transnational research networks. In recent years, there has been a significant increase in migration of highly educated and highly skilled Italians. Most studies concentrate on employment-related characteristics of researchers’ and scientists’ mobility, largely neglecting other topics, such as family background characteristics of those who decide to study and go abroad. Using the Istat Survey on occupational conditions of PhD holders conducted in 2014 and 2018 in Italy, along with modelling using multinomial logistic regression analyses, we aim to investigate the relationship between family background characteristics and mobility during PhD studies according to different types of international stay. Our results show that both parental education and mother’s economic activity are related to the propensity for studying abroad among PhD candidates, whereas father’s social class seems to have a lower impact on this decision. The gap in doctoral mobility among PhD students with respect to socio-economic status seems also to vary according to the different types of stay abroad. Overall, our findings intend to shed light on potential disparities related to studying abroad among PhD students and their links to family background, which may have future repercussions on students’ occupational prospects.
Dissociation between 2-[18F]fluoro-2-deoxy-D-glucose positron emission computed tomography, ultrasound and clinical assessments in patients with non-severe rheumatoid arthritis, including remission
Authors: Rinkin Charline , Fosse Pacôme , Malaise Olivier , Chapelier Nathalie , Horrion Jil , Seidel Laurence , Albert Adelin , Hustinx Roland , Malaise Michel G.
Published: August 2021

Background

Inflammation of patients joints with severe disease activity of rheumatoid arthritis (RA) has already been visualized and quantified by 2-[18F]fluoro-2-deoxy-D-glucose positron emission computed tomography ([18F] FDG PET/CT), but little is known about the metabolic status and its relationship with clinical and ultrasonography (US) metrology in patients with low/moderate activity or in remission.

Methods

Clinical assessments [based on 28-joint disease activity score (DAS28-CRP) and Clinical Disease Activity Index (CDAI)], [18F] FDG PET/CT, US and X-ray were performed on 63 RA patients classified into remission or low/moderate or severe disease activity groups. PET/CT was visually and then semi-quantitatively analysed by determining the standardized uptake value (SUV) of positive joints.

Results

Of the 1764 joints, 21.1% were tender only, 13.7% swollen only, 27.6% tender or swollen, 7.3% tender and swollen, 20.5% PET/CT-positive and 8.6% US-positive. PET and US measurements were correlated, albeit with poor concordance. The positive predictive value of PET/CT for clinical evaluation (tender and/or swollen) was low, whereas its negative predictive value was high. Highly significant differences were found with the number of PET/CT-positive joints and with cumulative SUV between “severe” and “non-severe” patients (including those in remission and those with low/moderate activity) and not between those classified as “remission” and “non-remission” or “remission” and “low/moderate activity”. Moreover, the correlation between PET/CT measurements and clinical activity was positive only in the CDAI severe disease group. In patients in remission or with low/moderate activity, only 20–30% of joints were PET/CT-negative. In remission, PET/CT and US were positive in different joints, and PET/CT-positive but US-negative joints mainly exhibited RA (38.1%) or normal (49.2%) and not osteoarthritic (12.7%) X-ray patterns.

Conclusions

[18F] FDG PET/CT was effective at distinguishing patients with severely active disease from other patients. In non-severe RA patients, including those in remission, PET/CT results are discordant from US and clinical observations. A longitudinal analysis is needed to explore the clinical relevance of such infra-clinical disease.
Perceived stress among university students in Oman during COVID-19-induced e-learning
Authors: Malik Mustafa , Javed Sarfaraz
Published: August 2021

Background

Higher education institutions across the world moved to e-learning in response to the disruptions caused by the pandemic. While e-learning has an advantage for students that they can attend to their courses from anywhere at their convenience, yet the sudden disruptive shift to e-learning during the pandemic saw students facing many challenges, which had strong ability to induce mental health issues among the students. This study aimed at examining the impact of COVID-19-induced e-learning on the university students’ stress perceptions in Oman.

Results

A total of 966 usable responses were received. The results showed that 96.9% (moderate stress = 82.5% and high stress = 14.4%) reported having experienced stress through e-learning during COVID-19. The results further indicated that there was a significant negative correlation between perceived stress and the students’ academic performance. The family support and institutional support were observed to have a significant effect on students’ stress perception.

Conclusions

Students are away from the physical campuses over a year now, continuing their courses and programs online. The numerous challenges they are facing through e-learning, together with the prevailing uncertainty, have intensified stress among them. The continued stress over time will not only affect their academic performance, but their mental and physical health as well, as the stress has proven to be one of the major causes of various physical and mental disorders. While e-learning seems to emerge as a new normal, the students require proper attention, help, and support from their families and institutions. The institutions should revisit their online courses and program delivery mechanisms, methods, and practices to ensure that students are not over stressed.
Juvenile psammomatoid ossifying fibroma with fluid–fluid levels: an unusual presentation
Authors: Kalliath Linda , Karthikeyan D. , Pillai Nataraj , Padmanabhan Deepthi , Balasundaram Partheeban , Kripesh Gokul
Published: August 2021

Background

Juvenile ossifying fibroma is an uncommon benign fibro-osseous tumor commonly involving the craniofacial skeleton of young patients with locally aggressive behavior and a high recurrence rate. Depending on the site of involvement it can present clinically as nasal obstruction, facial swelling, or proptosis.

Case presentation

Here we present a case of juvenile ossifying fibroma with an aneurysmal bone cyst component in the left nasal cavity in a 15-year-old boy who presented with gradually progressing left-sided nasal obstruction. Imaging findings were consistent with juvenile ossifying fibroma. Endoscopic resection of the tumor was done, and histopathological examination revealed it to be a psammomatoid variant of juvenile ossifying fibroma. Here we discuss its imaging findings, differential diagnosis, treatment options, and histopathological features.

Conclusion

Despite being a slow-growing benign tumor, early diagnosis and treatment are necessary due to its locally aggressive nature and invasion of adjacent structures. Complete surgical resection is the mainstay of treatment because of the high recurrence rate.
High-resolution seismic velocity analysis by sign-based weighted semblance
Authors: Khoshnavaz M. Javad
Published: August 2021

Building an accurate velocity model plays a vital role in routine seismic imaging workflows. Normal-moveout (NMO)-based seismic velocity analysis is a popular method for making the velocity models. However, traditional velocity analysis methodologies are not generally capable of handling amplitude variations across moveout curves, specifically polarity reversals caused by amplitude-variation-with-offset (AVO) anomalies. I have developed an NMO-based velocity analysis approach that circumvents this shortcoming by modifying the conventional semblance (CS) function to include polarity and amplitude correction terms computed using correlation coefficients of seismic traces in the velocity analysis scanning window with a reference trace. Thus, the proposed method workflow is suitable for any class of AVO effects. The approach is evaluated with four synthetic data examples of different conditions and field data consisting of a common-midpoint gather. Lateral resolution enhancement using the proposed method workflow is evaluated by comparison between the results from the workflow and the results obtained by the application of CS and three semblance-based velocity analysis algorithms developed to circumvent the challenges associated with amplitude variations across moveout curves, caused by seismic attenuation and class II AVO anomalies. According to the obtained results, the proposed method is superior to all of the presented workflows in handling such anomalies.
HIV-1 Establishes a Sanctuary Site in the Testis by Permeating the BTB Through Changes in Cytoskeletal Organization
Authors: Wu Siwen , Frank Ines , Derby Nina , Martinelli Elena , Cheng C Yan
Published: August 2021

Studies suggest that HIV-1 invades the testis through initial permeation of the blood–testis barrier (BTB). The selectivity of the BTB to antiretroviral drugs makes this site a sanctuary for the virus. Little is known about how HIV-1 crosses the BTB and invades the testis. Herein, we used 2 approaches to examine the underlying mechanism(s) by which HIV-1 permeates the BTB and gains entry into the seminiferous epithelium. First, we examined if recombinant Tat protein was capable of perturbing the BTB and making the barrier leaky, using the primary rat Sertoli cell in vitro model that mimics the BTB in vivo. Second, we used HIV-1–infected Sup-T1 cells to investigate the activity of HIV-1 infection on cocultured Sertoli cells. Using both approaches, we found that the Sertoli cell tight junction permeability barrier was considerably perturbed and that HIV-1 effectively permeates the BTB by inducing actin-, microtubule-, vimentin-, and septin-based cytoskeletal changes in Sertoli cells. These studies suggest that HIV-1 directly perturbs BTB function, potentially through the activity of the Tat protein.