bluuebunny/crossref_metadata_2025 huggingface dataset:
Political, Economic, and Social Change in Nigeria, 1945–1960
Authors: Schler Lynn
Published: April 2022

The transition from colonialism to independence in Nigeria was marked by increasing competition between different visions for the postcolonial state and society. The economic, political, and social changes that shaped the era all contributed to growing calls for independence, but they also intensified competition between regions, political leaders, political parties, classes, and political ideologies. Throughout the process of decolonization, these centrifugal forces posed an increasing threat to national unity. This chapter traces the growing calls for independence in the postwar years, as well as the various forces of disunity that plagued the era. It is vital to understand these tensions between national unity and discord in the final years of colonial rule, as they continued to pose challenges for Nigeria in the years following independence.
Culture and Numerical Cognition
Authors: Tang Rongxiang , Tang Yi-Yuan
Published: April 2022

The basic ability to encode numerical information and discriminate numerical quantity can be found in humans as well as certain nonhuman primates. However, humans are unique in that they can perform advanced numerical computation using abstract numerical symbols and number words after receiving formal mathematical instruction. Although similarities exist in numerical cognition and its associated mental processes across people, culture plays a dominant role in shaping how numbers are differentially represented and processed across various cultural groups that speak different languages. Additionally, the development of advanced numeracy skills through formal education is heavily influenced by cultural-specific factors such as parental expectation and societal norms. Understanding such cultural differences would not only profoundly advance the scientific knowledge regarding numerical cognition but also have critical implications for mathematics education and the development of intervention programs for ameliorating potential deficits related to arithmetic ability such as dyscalculia. The focus of this chapter is to provide an overview of how numerical cognition is shaped by culture, discuss pragmatic implications of cultural differences in numerical processing for education and mental health, and conclude with suggestive future directions of research pertaining to cultural differences in numerical cognition.
Culture Shapes Face Processing
Authors: Blais Caroline , Caldara Roberto
Published: April 2022

Cross-cultural studies have revealed striking differences in visual perception. Recent research has shown that even processes that have long been assumed to be universal, such as face processing, are in part shaped by the cultural environment in which one has grown up. This chapter gives an overview of the main findings with regard to the impact of culture on the visual processes involved in face identification and facial expression recognition. The chapter also discusses neurological conditions affecting face perception and how culture may interact with these conditions to modulate visual perception.
The Neuroscience of Cultural Imitative Learning and Connections to Global Mental Health
Authors: Gianola Morgan , Reynolds Losin Elizabeth A.
Published: April 2022

Cultural learning via imitation is one of the primary means through which cultural behaviors are acquired, transmitted, and built upon over time. This chapters utilizes an interdisciplinary perspective to (a) outline the core cognitive processes of cultural learning as described in the psychological anthropology and social psychology literature, (b) propose an update of the model of the neural systems underlying cultural learning relating to these core cognitive processes, (c) review the nonhuman primate and human literatures supporting each neural system in the model, and (d) discuss mental health disorders that can affect the core cognitive and neural processes involved in cultural learning and their implications for understanding the interactions between cultural learning and mental health.
Culture and Environment
Authors: Chiao Joan Y. , Mano Yoko , Sadato Norihiro
Published: April 2022

Cultural and environmental systems mutually influence the production and regulation of human behavior. Culture maintains and regulates the mental capacities important for the navigation of the social and physical environment. Geographic variation in environmental features are associated with cultural dimensions that serve as a protective factor. Identification of risk and protective factors in the environment across cultural settings is necessary for the development and implementation of prevention and intervention in global mental health. Implications of research on culture and the environment for population health disparities and global mental health are discussed.
Culture and Psychology
Authors: Matsumoto David , Hwang Hyisung C.
Published: April 2022

This chapter introduces readers to a basic model and framework with which to understand how human cultures influence, and are influenced by, psychological processes and behaviors. It provides a working definition of culture; describes the factors that influence the creation, maintenance, evolution, and function of human cultures; distinguishes them from nonhuman cultures; and introduces the subjective elements of human culture on the level of attitudes, values, beliefs, opinions, worldviews, and norms, all of which regulate behavior. The chapter discusses the relation of these elements of culture to psychological processes and social behaviors and introduces the mediating role of context. It also describes universality and culture specifics in psychological processes and behaviors leveraging the concepts of etics and emics. The chapter understands cultures as solutions to the problems of groups’ needs to adapt to their contexts and environments in order to survive. Hopefully this very basic framework of the relation between culture and psychological processes provides a basis for understanding the relation between culture and mental health, locally and globally.
Musical Activities in People with Disabilities
Authors: Schuppert Maria , Altenmüller Eckart
Published: April 2022

People with disabilities can benefit from engagement in musical activities. Singing and musical instrument playing may not only help to improve or restore sensory-motor control, coordination, and memory, but also contribute to social integration, emotional stability, and thus overall wellbeing. Even though many people with disabilities are highly motivated to pick up musical activities, their potential still tends to be underestimated. However, there has been an impressive development concerning adaptive equipment, ergonomics, pedagogical approaches, and music repertoire for musicians with disabilities. A number of professional musicians with physical and perceptual system disorders demonstrate that high-level musical abilities can be achieved despite severe limitations. Children and adults with disabilities should be encouraged to engage in music. They should be accompanied by an alliance of parents and family, music pedagogues, therapists, physicians, as well as musical instrument manufacturers and medical technologists. By means of individual approaches, curiosity, and willingness, musical potential can be detected and fostered. This chapter reviews the impact of various types of disabilities on musical activities in amateur and professional musicians and describes initiatives, technologies, equipment, literature, and teaching approaches that support musical instrument playing and singing in people with physical, perceptual, or mental disorders.
Frameworks, Models, Theories, and Experiences for
Understanding Disability
Authors: Shakespeare Tom , Watson Nicholas
Published: April 2022

This chapter critically engages with the underlying theories and approaches to disability that have formed the basis of disability studies since its inception. It starts with a brief historical overview of the social model of disability and its relationship to medical sociology. The authors frame their arguments by drawing on empirical research from three separate studies to answer the key question that has dogged disability research and disability studies since its first inception, namely: what are the roles of impairment and disablement in the lives of disabled people and the construction of the disability experience? The chapter ends by proposing a framework for social researchers to come together, incorporating ideas from Critical Realism and the work of Roy Bhaskar, as well as the ideas of Amartya Sen, Martha Nussbaum and the Capabilities approach.
Colonialism, Consumption, ControlDrugs in Modern Asia
Authors: Mills James H.
Published: April 2022

This chapter explores the recent wave of revisionist research on the consumption and control of drugs in Asia from the nineteenth century onward. Examples from China, India, and across Southeast Asia suggest that familiar Asian drug narratives were often based on colonial-era racial or nationalist stereotypes. Monolithic actors such as the “Chinese government,” “British imperialists,” “Japanese invaders,” or “Indian princes” dissolve in the complexities of period and place. Fresh research stresses the agency of Asian customers and their tastes, habits, and practices, given sophisticated local cultures of consumption. Other histories portray a tangled competitive scramble to supply Asian markets for intoxicants and psychoactive drugs, where the lines between commerce and government control constantly shifted. Research has moved beyond opium into the twentieth century, when drugs like cannabis, morphine, heroin, and cocaine map onto Asia’s changing connections with global commodity flows. Ideas about Asian drug use informed the emerging international drugs regulatory system.
Interwar Drug Scenes and Restrictive Regulation in Britain
Authors: Hallam Christopher
Published: April 2022

This chapter traces the advent of the British structure that regulated drugs in the interwar period. Known then as the “British System,” the regime is widely misunderstood in scholarship. Seen as starting with the 1926 Rolleston Committee, it allowed doctors to prescribe heroin, morphine, and cocaine to addicts, but combined medical, juridical, and administrative elements. However, while American reformers (such as Alfred Lindesmith) believed that the British System enabled the United Kingdom to avoid the drug subcultures that emerged after the 1914 Harrison Act in the United States, in fact the regime fostered the country’s incipient drug scenes. Largely composed of upper-class bohemias, these modern scenes, alongside the broader night-time illicit economy of London’s West End, reveal a variety of drug cultures during the 1920s and 1930s using different drugs (cocaine, morphine etc.) in a variety of sites. The chapter explores early drug consumers and their relationships with the drug regulators.
The French Connection as an Illicit Trade Network
Authors: Marchant Alexandre
Published: April 2022

The French Connection, immortalized in film, was the chief post-World War II global heroin trafficking network. It ran from Marseille in the Corsican underworld mostly to US illicit markets, but was but one phase in the longer reconfiguration of global drug markets. The Marseille epicenter, along with the transatlantic and Mediterranean routes, was part of a complex multinational market composed of small, often rival teams with links to Italian and Italo-American mafias, Middle East traffickers, and French criminals exiled in Canada or South America. By the early 1970s, French and US police collaboration allegedly wiped out the organization, but while few clans remained visible or active in Marseille, many elements spread to Italy or Southeast Asia in new heroin or cocaine alliances, and inspired other traffickers. The French Connection contests pervasive myths about trafficking hubs: by its intersections with legal and political worlds, decentralized not top-down structures, and ability to spread under repression.
Meso-Level Dynamics of Atrocities
Authors: Jacobs Rachel , Straus Scott
Published: April 2022

This chapter emphasizes the meso-level dimensions of mass atrocity, which is illustrated through cases of genocide in Rwanda and Darfur, Sudan, and communist mass violence in Cambodia. This chapter asks how meso-level actors shape the patterns of violence during mass atrocity. In doing so, the authors offer three pathways through which meso-level actors can escalate, or restrain, violence. The three pathways are: first, top-down policies of violence that meso-level actors put into place; second, from-the-middle dynamics where meso-level actors escalate violence for their own independent interests; and third, information distortions by meso-level actors about the progress of national policies that lead to deaths.
Sexual Violence as a Practice of War
Authors: Thuy Seelinger Kim , Wood Elisabeth Jean
Published: April 2022

This chapter analyzes the implications of recent social science on sexual violence by armed actors for the investigation and prosecution of atrocity crimes. It focuses on a fundamental challenge to both: rape and other forms of sexual violence may be committed frequently by members of an armed organization without being ordered or authorized as policy. This, we term a practice. When frequent, it is driven by the gender norms held by combatants and those held by commanders. Attention to these social dynamics enhances prosecutors’ gender analysis and investigation of an armed conflict, illuminating the relationships between different acts of violence. Charging sexual violence that occurs as a practice calls for specific characterizations of the offense and type of responsibility. Because it features complicity, tolerance, and foreseeability, modes of liability such as aiding and abetting, command/superior responsibility, and joint criminal enterprise are most relevant.
Customary Responses
Authors: Quinn Joanna R.
Published: April 2022

One approach to dealing with conflict and atrocity has been the use of traditional or customary practices. Such practices are well beyond the scope of most discussions of transitional justice and other post-conflict rebuilding scenarios, which tend to include now-standard practices like truth commissions, trials, and compensation. Yet the literature shows that customary practices are often used after atrocity to help with the rebuilding process. This chapter first argues that their use mimics many of the other practices of transitional justice; and second, it considers the modalities by which such practices could be used in dealing with atrocity crimes.
Trance-Forming the Nation
Authors: Schmidt Joshua
Published: April 2022

Israel is a transnational epicenter for psychedelic trance-dance music and culture whose central activity involves attending festive dance parties. While initially avant-garde, currently idiosyncratic forms of trance-dance culture are found among diverse mainstream Israeli communities. Based on extensive ethnographic fieldwork, the chapter examines paradoxes in the way that national-Orthodox Israeli youth apply trance-dance events to assuage current-day needs and concerns.
Three Reflections on the Holocaust
Authors: Pappas Rebecca , Shilling Alexx , Hyman Yehuda , Miller Suzanne
Published: April 2022

In this chapter the choreographers Alexx Shilling, Yehuda Hyman, and Suzanne Miller describe dances that both respond to and turn away from the defining legacy of the Holocaust. Shilling narrates the creation of her performance work Absence: A History. For both Shilling and her performers, the stage became a laboratory for re-imagining and re-embodying ancestral histories—destabilizing testimony and photography as the primary means of remembering. Hyman, vacationing in Germany, discovered that a memorial fountain had been built on the unexcavated remains of a former synagogue. He writes an instruction manual on how to prepare and execute a Jewish dance action and logs the action itself as well as its repercussions over the following two years. Moshe, Moishe, Moses documents Needle and Thread, a commemorative performance that grew from a list of six hundred names of Holocaust victims collected by Yad Vashem World Holocaust Remembrance Center. Miller discusses how a rigorous choreography provides a means to bear the loss and honor the lineage of her Jewish forebears.
(Not Just) Az der rebbe tantst
Authors: Gellerman Jill
Published: April 2022

This chapter sketches a nuanced survey of Hasidic dance from the eighteenth-century East European Jewish repertoire to twenty-first-century American practice. In this study, examining the collective body of dance involves both men’s and women’s traditions, co-territorial intersections, stylistic variations, neo-Hasidic interpretations, and gender differences at dance events. Consequently, the study challenges the notion of what has come to be considered “Hasidic dance” and suggests a more inclusive portrait in the modern era beyond the quintessential dancing rebbe. The essay addresses debates on definition, anti-Hasidic polemics, and Hasidic oral tradition as early dance documents, Jewish nationalism and neo-Hasidic dance, dance details in Yiddish literature, and ethnography, the undo-ing of neat divisions between secular and sacred in simcha dancing, and the impact of the Holocaust on Hasidic dance.
Mapping a Mizrahi Presence in Israeli Concert Dance
Authors: Spiegel Nina S.
Published: April 2022

This chapter investigates the movement influence of one sector of the Mizrahi community on the development of Israeli concert dance: the Yemenite Jewish community. While Yemenite Jewish traditional movement has served as a form of inspiration for a variety of concert dance creations in Israel, its reception and representation have remained complex in Israeli society. Moreover, in depictions of Israeli concert dance, this influence is often sidelined. Although this chapter is not comprehensive, it nonetheless seeks to shift the lens by demonstrating the centrality and continued presence of choreography based on Yemenite themes throughout Israeli history, showing how its reception is interconnected with Mizrahi/Ashkenazi relations in Israeli society, and exploring interpretations of the term “ethnic” and aesthetics of Israeli concert dance. The piece addresses Baruch Agadati, Rina Nikova, and Rachel Nadav in the British Mandate era; and Sara Levi Tanai, Margalit Oved, and Barak Marshall in the statehood era.
From the Other Side
Authors: Feder Dege
Published: April 2022

Dege Feder was born and raised in a village of devout Ethiopian Jews. The dream of immigrating from Ethiopia to “Yerusalem” (Jerusalem) was a shared one among the people of her village and had been passed down for generations. At the age of eight, Feder immigrated by foot to Yerusalem in secret from the Ethiopian government. This chapter tells the story of Feder’s introduction to movement and her growth as a choreographer through a series of interview questions. In the chapter, she explains how both Ethiopian and Israeli cultures have influenced her work. Feder also touches on what challenges came alongside transitioning from her home village to Yerusalem.
Notes on the Earliest Greco-Syriac Reception of the Dionysian Corpus
Authors: Perczel István
Published: April 2022

The first public appearance of the Dionysian Corpus is linked to the intellectual circle of Severus of Antioch, who prized the corpus since they saw in its assertion of the composition with humanity of the ‘simple Jesus’ and in his ‘god-manly activity’ a vindication of their own Christology. This chapter passes under review the earliest textual citations from the corpus and compares them to the corresponding texts in the first Syriac translation by Sergius, the chief physician of Reshaina, who is also the founder of the Syriac philosophical translation movement. Through a comparative philological analysis, the chapter shows that the early citations partly coincide with the form of the text, in which Sergius’ translation contains them, and partly constitute free elaborations upon those. Especially, the strong dyophysite elements that are in the original text of the Dionysian Corpus had to be eliminated or reinterpreted. There is reason, therefore, to posit an earlier Greek redaction, which was current until a new edition, constituting a thorough revision of the first redaction, was made by John of Scythopolis, whose aim was, among others, to sanitize this dubious authority. Given the important role of the Dionysian Corpus in the theological debates, there was need for a koine text that allowed the contesting parties to conduct meaningful debates around it. John’s edition served as such a vulgate version, but there continued the editorial interventions and the translatorial solutions to enhance the text’s value as a witness to their authors’ own theological positions.
John of Scythopolis and the Dionysian Corpus
Authors: Regina Suchla Beate
Published: April 2022

The theologian, philosopher, and bishop John of Scythopolis wrote a prologue and scholia to the four treatises and ten letters of Dionysius Areopagita. With this, he was the first scholiast of the Dionysian writings, and his efforts put him at the beginning of a long succession of high-profile commentators and interpreters. His prologue is a well-thought-out composition, which defends the integrity, authenticity, and orthodoxy of the apostolic Dionysius. John’s effort to prove the orthodoxy continues throughout the scholia, which consider the Dionysian treatises and letters primarily from four theological aspects: doctrine of the Trinity, Christology, creation, and eschatology.
Origen’s Pauline Commentaries
Authors: Cocchini Francesca
Published: April 2022

Origen greatly admired Paul and used to look at Paul’s apostolate as a model for his own ministry of the Word. The Commentary on Philemon seems to have been Origen’s first commentary on Paul’s letters and it should be seen as a general introduction to the whole Pauline corpus. Most of Origen’s commentaries and homilies on Paul have been transmitted unto us only through indirect tradition: anthologies (the Apology for Origen, composed by Pamphilus and the patristic catenae of the Byzantine age) or lengthy quotations in other works (some of Jerome’s Epistles and Commentaries, the Ecclesiastical History by Eusebius). However, Origen’s most extensive surviving work on Paul’s exegesis is the Commentary on Romans, preserved in Ruphinus’ Latin translation (and adaptation) which is generally regarded as substantially reliable and provides us with an extensive essay as an example of Origen’s exegetical methodology. Although the Pauline letters normally gives only a limited access to allegorical interpretation, nevertheless Origen largely develops his typical spiritual interpretation by making even more explicit the pervasive presence of the Logos in the Apostle’s writings.
Origen’s New Homilies on the Psalms
Authors: Perrone Lorenzo
Published: April 2022

In 2012 an anonymous collection of 29 psalm homilies was discovered in the Bayerische Staatsbibliothek of Munich, and later in that year after a careful checking of the homilies against external sources such as Rufinus and Jerome and internal comparisons with Origen’s works, they were announced to be by Origen. While Origen produced a huge corpus of works on the Psalms, including commentaries, homilies, and scholia, very little of this has survived. The only surviving text of full Psalm homilies previously available was that of Rufinus’ translation of nine homilies on Psalms 36–38. Most of these new homilies were unknown before this discovery. The new homilies shed light on Origen’s literary style as well as on his thought. They appear to come from the later segment of Origen’s life and provide a more complete picture of Origen the Christian and theological scholar.
Difficulties in Writing the Life of Origen
Authors: Urbano Arthur P.
Published: April 2022

The author examines the forces at play in shaping the reception of the figure of Origen himself, either as man of the Church, heretic, or scholar. He compiles and examines the layers of evidence by genres—letters from Origen to Gregory, Africanus, Fabianus; witnesses of contemporaries, including the philosopher Porphyry; portraits from Caesarea, the Apology and Eusebius’ Ecclesiastical History, and finally Epiphanius, the heresiarch. By evaluating the ancient and modern scholarly interests in the discussion of each piece of Origen’s biography, the processes of tradition formation begin to appear in their diversity and complexity.
Origen’s Biblical Interpretation and Classical Forensic Rhetoric
Authors: Dunn Geoffrey D.
Published: April 2022

This chapter investigates the presence of classical rhetoric in Origen’s Commentarium in Epistolam ad Romanos. While others suggest that in a genre devoted to exposition rather than persuasion we should not expect to find rhetorical techniques, the position adopted here is that even exposition is an exercise in persuasion. While it is true that there is little ethos or pathos in this commentary, there are many elements of rational argumentation present. Origen’s commentary was directed against Marcionite and Valentinian Gnostic opponents in which Origen took up the conjectural issue to defend the idea of human free will and refute Gnostic determinism. We also find Origen’s reading of Romans being opposed to anthropomorphism. The work has a forensic quality to it in parts, although a great deal of it does not have an identifiable opponent. Even when Origen attempted to reconcile conflicting passages he was engaged in a typical rhetorical tactic.
Arabidopsis HOPS subunit VPS41 carries out plant-specific roles in vacuolar transport and vegetative growth
Authors: Jiang Dong , He Yilin , Zhou Xiangui , Cao Zhiran , Pang Lei , Zhong Sheng , Jiang Liwen , Li Ruixi
Published: April 2022

The homotypic fusion and protein sorting (HOPS) complex is a conserved, multi-subunit tethering complex in eukaryotic cells. In yeast and mammalian cells, the HOPS subunit vacuolar protein sorting-associated protein 41 (VPS41) is recruited to late endosomes after Ras-related protein 7 (Rab7) activation and is essential for vacuole fusion. However, whether VPS41 plays conserved roles in plants is not clear. Here, we demonstrate that in the model plant Arabidopsis (Arabidopsis thaliana), VPS41 localizes to distinct condensates in root cells in addition to its reported localization at the tonoplast. The formation of condensates does not rely on the known upstream regulators but depends on VPS41 self-interaction and is essential for vegetative growth regulation. Genetic evidence indicates that VPS41 is required for both homotypic vacuole fusion and cargo sorting from the adaptor protein complex 3, Rab5, and Golgi-independent pathways but is dispensable for the Rab7 cargo inositol transporter 1. We also show that VPS41 has HOPS-independent functions in vacuolar transport. Taken together, our findings indicate that Arabidopsis VPS41 is a unique subunit of the HOPS complex that carries out plant-specific roles in both vacuolar transport and developmental regulation.
Exploring the impact of knife imagery in anti-knife crime campaigns
Authors: Ramshaw Nicole , Dawson Paul
Published: April 2022

In response to rising knife crime levels across England and Wales, mass-media campaigns have sought to highlight the dangers of knife possession by publishing graphic pictures of blades and seized weapons. But what impact does such imagery have on a young audience? Using an experimental design embedded within a London Youth Survey, findings from the current article suggest that knife imagery can help to get the attention of young people, but may also make them feel scared and more worried about knife crime. Moreover, exploratory moderation analyses suggest the impact of knife imagery on feeling scared may be heightened amongst those already most concerned about knife crime. Policy implications are discussed—not least the extent to which it may be desirable to raise young people’s concerns about crime when the decision to carry a knife may itself be grounded in fear of victimization and self-protection.
New indicator for discordance between patient-reported and traditional disease activity outcomes in patients with early rheumatoid arthritis
Authors: Pazmino Sofia , Lovik Anikó , Boonen Annelies , De Cock Diederik , Stouten Veerle , Joly Johan , Doumen Michaël , Bertrand Delphine , Westhovens René , Verschueren Patrick
Published: April 2022

Objective

To unravel disease impact in early RA by separately quantifying patient-reported (PRF), clinical (CF) and laboratory (LF) factors. We propose a new indicator, the discordance score (DS), for early identification and prediction of patient’s unmet needs and of future achievement of sustained remission (SR) and RA-related quality of life (QoL).

Methods

Factor-scores obtained by factor analysis in the CareRA trial, allowed to compute DS, reflecting the difference between PRF and the mean of CF and LF. Improvement from baseline to week 104 (%) and area-under-the-curve (AUC) across time points per factor-score were calculated and compared between patients achieving/not achieving sustained (week 16–104) remission (DAS28CRP < 2.6) with ANOVA. Logistic and linear regressions were used to predict SR based on previous factor and discordance scores, and QoL at year 1 and 2 based on DS at week 16.

Results

PRF, CF and LF scores improved rapidly within 8 weeks. PRF improved 57%, CF 90% and LF 27%, in those achieving SR, compared with 32% (PRF: P = 0.13), 77% (CF: P < 0.001) and 9% (LF: P = 0.36) in patients not achieving SR. Patients achieving SR had an AUC of 15.7, 3.4 and 4.8 for PRF, CF and LF, respectively, compared with 33.2, 10.1 and 7.2 in participants not achieving SR (P < 0.001 for all). Early discordance was associated with later factor scores, QoL and self-efficacy.

Conclusions

All factor scores improved rapidly, especially in patients achieving sustained remission. Patient-reported burden improved less. Discordance scores could help predicting the need for additional non-pharmacological interventions to achieve sustained remission and decrease disease impact.
In rheumatoid arthritis patients, total IgA1 and IgA2 levels are elevated: implications for the mucosal origin hypothesis
Authors: Derksen Veerle F A M , Allaart Cornelia F , Van der Helm-Van Mil Annette H M , Huizinga Tom W J , Toes René E M , van der Woude Diane
Published: April 2022

Objective

Mucosal initiated immune responses may be involved in the pathophysiology of RA. The most abundant immunoglobulin at mucosal surfaces is IgA, of which two subclasses exist: IgA1 and IgA2. IgA2 is mainly present at mucosal sites and has been ascribed pro-inflammatory properties. As IgA subclasses might provide insights into mucosal involvement and pro-inflammatory mechanisms, we investigated IgA responses in sera of RA patients.

Methods

In two cohorts of RA patients, the EAC and IMPROVED, total IgA1 and IgA2 were measured by ELISA. Furthermore, IgA subclass levels of RF and anti-citrullinated protein antibodies (anti-CCP2) were determined. The association of these IgA subclass levels with CRP and smoking was investigated.

Results

Total IgA1 and IgA2 were increased in RA patients compared with healthy donors in both cohorts. This increase was more pronounced in seropositive RA vs seronegative RA. For RF and anti-CCP2, both IgA1 and IgA2 could be detected. No strong associations were found between IgA subclasses (total, RF and anti-CCP2) and CRP. In smoking RA patients, a trend towards a selective increase in total IgA2 and RF IgA1 and IgA2 was observed.

Conclusion

RA patients have raised IgA1 and IgA2 levels. No shift towards IgA2 was observed, indicating that the increase in total IgA is not due to translocation of mucosal IgA into the bloodstream. However, mucosal inflammation might play a role, given the association between smoking and total IgA2 levels. Despite its pro-inflammatory properties, IgA2 does not associate strongly with pro-inflammatory markers in RA patients.
COVID-19 infection and hospitalization risk according to vaccination status and DMARD treatment in patients with rheumatoid arthritis
Authors: Cordtz René , Kristensen Salome , Westermann Rasmus , Duch Kirsten , Pearce Fiona , Lindhardsen Jesper , Torp-Pedersen Christian , Andersen Mikkel P , Dreyer Lene
Published: April 2022

Objectives

The objectives of this study were to investigate the incidence of COVID-19 hospitalization in unvaccinated and vaccinated patients with RA compared with matched controls, and in patients with RA according to DMARD treatment.

Methods

This was a Danish nationwide matched-cohort study from January to October 2021. Patients with RA were identified in the DANBIO register and matched 1:20 with individuals from the general population on age, sex, and vaccination status. Primary and secondary outcomes were COVID-19 hospitalization (Danish National Patient Register) and first-time positive SARS-CoV-2 PCR test (Danish COVID-19 Surveillance Register), respectively. Stratified by vaccination status, incidence rates (IRs) per 1000 person years (PYs) and comorbidity-adjusted hazard ratios (aHRs) in cause-specific Cox models were calculated with 95% confidence intervals.

Results

In total, 28 447 unvaccinated patients and 568 940 comparators had IRs for COVID-19 hospitalization of 10.4 (8.0–13.4) and 4.7 (4.3–5.1) per 1000 PYs, respectively (aHR 1.88, 1.44–2.46). When fully vaccinated, corresponding IRs were 0.9 (0.5–1.6) and 0.5 (0.4–0.6) per 1000 PYs (aHR 1.94, 1.03–3.66). Unvaccinated RA patients had an aHR of 1.22 (1.09–1.57) for testing positive for SARS-CoV-2 and 1.09 (0.92–1.14) among vaccinated RA patients. Vaccinated rituximab-treated patients had increased crude IR of COVID-19 hospitalization compared with conventional DMARD–treated patients.

Conclusion

The incidence of COVID-19 hospitalization was increased for both unvaccinated and vaccinated patients with RA compared with controls. Importantly, the parallel decreasing risk for patients with RA suggests a comparable relative benefit of vaccination in most patients.
Performance of timed function tests as outcome measures in idiopathic inflammatory myopathy—results from a single-centre cohort
Authors: Dunga Saikumar , Kavadichanda Chengappa , Bairwa Devender , Thabah Molly Mary , Negi Vir Singh
Published: April 2022

Objective

To evaluate performance of timed function tests (TFTs) in assessing muscle strength and endurance as determined by Manual Muscle Testing 8 (MMT-8) and Functional Index 2 (FI-2), respectively, in idiopathic inflammatory myopathies (IIM).

Methods

This cohort study included 42 IIM patients satisfying 2017 EULAR/ACR criteria. Patients were classified as active (n = 18) or inactive disease (n = 24) based on clinical status at baseline. MMT-8, FI-2, 30 s rise from chair test, 30 s 1 kg arm rise test and 2-min walking distance (2MWD) were administered at baseline, 3 months and 6 months. Pearson rank correlation analysis and receiver operating curves were performed to assess the performance of timed function tests.

Results

All patients were followed up at 3 months and 39 completed 6 months’ follow-up. All the three TFTs had excellent convergent (r > 0.7, P < 0.05) and divergent validity (P < 0.05). Only 2MWD had moderate to strong correlation with ΔMMT-8 at 3 and 6 months among those with active disease (P = 0.001). All the TFTs correlated with ΔFI-2 in active disease but only Δ2MWD correlated with ΔFI-2 in inactive disease at 6 months (r = 0.506, P = 0.036). At a cut-off of 5% improvement in MMT-8, 2MWD had an area under the curve (AUC) of 0.868 with 95% sensitivity with 2% improvement at 3 months. To detect a 10% ΔMMT-8, Δ2MWD at a cut of 8% and 7% had an AUC of 0.909 and 0.893 with a sensitivity of 92% at 3 and 6 months, respectively (P < 0.05).

Conclusion

2MWD is a reliable indicator of muscle strength, endurance and treatment response. The 2MWD can be self-administered by patients, making it a potential patient-reported outcome measure.
Pedigree-based analyses of changes in genetic variability in three major swine breeds in Taiwan after a disease outbreak
Authors: Wu Ruei-Syuan , Wang Hsu-Chang , Su Chan Liang , Wang Pei-Hwa , Lin En-Chung
Published: April 2022

Pedigree analysis was performed in three major Taiwanese swine breeds to evaluate the genetic variability in the current population and determine the main reason for genetic diversity (GD) loss after the occurrence of foot-and-mouth disease (FMD) in Taiwan. The pedigree files of the Duroc, Landrace, and Yorkshire breeds, containing 60,237, 87,177, and 34,373 records, respectively, were analyzed. We divided the population into two subpopulations (pre-1998 and post-1998) to determine the role of FMD in GD loss. Pedigree completeness and related indicators were analyzed to evaluate the pedigree quality, and several parameters were used to measure the levels of GD and further used to determine the major cause of GD loss. The pedigree completeness indexes for the different breeds were higher than 0.60, and the trend was enhanced after the FMD outbreak. The estimated proportion of random genetic drift in GD loss increased in all breeds over time (from 62.64% to 78.44% in Duroc; from 26.26% to 57.99% in Landrace; and from 47.97% to 55.00% in Yorkshire, respectively). The effective population size of Duroc and Landrace were increased by the time (Duroc: from 61.73 to 84.75; Landrace: from 108.70 to 113.64); however, it shows opposite trend in Yorkshire population (decline from 86.21 to 50.00). In summary, the occurrence of FMD led to the major loss of GD loss by random genetic drift. Therefore, for the recovery of GD, breeders in Taiwan should increase the effective population size with newly imported genetic materials and adjust the breeding strategy to reduce the inbreeding rate.
Regional Water Availability and WASH Indicators as Predictors of Malnutrition in Under-5 Children: Analysis of the National Family Health Survey, India (2015–16)
Authors: Das Milan , Verma Madhur , Sahoo Soumya Swaroop , Gupta Madhu
Published: April 2022

Background

Water, sanitation and hygiene (WASH) practices determine child nutrition in resource-constrained countries and are influenced by regional water availability. We assessed any relationship between malnutrition and WASH practices among under-5 children in India’s areas as per water availability.

Methods

We did a secondary data analysis of the National Family Health Survey-IV. Stunting, wasting and being underweight were the significant outcomes. Regional water availability, households’ source of water, sanitation and disposal of the child stool were the major independent variables. We report the prevalence estimates, bivariate associations and adjusted odds ratio to predict the child’s malnutrition per regional water availability after using appropriate sampling weight.

Results

Of the 186 875 children, 41%, 20% and 36% were stunted, wasted and underweight. Only 26% of children had access to improved drinking water sources, whereas 50.0% were defecating in open. Around 65% of children’s stools were disposed of in unhygienic ways. Undernutrition depicted a significant association with independent variables. There were higher chances of stunting with a decrease in regional water availability, unimproved sanitation and unhygienic ways of stool disposal. Wasting was intensified by all these factors, except the safe disposal of stools.

Conclusions

WASH indicators exert a protective effect on undernutrition.
Highly pathogenic avian influenza virus incursions of subtype H5N8, H5N5, H5N1, H5N4, and H5N3 in Germany during 2020-21
Authors: King Jacqueline , Harder Timm , Globig Anja , Stacker Lina , Günther Anne , Grund Christian , Beer Martin , Pohlmann Anne
Published: April 2022

From October 2020 to July 2021, five different subtypes (H5N8, H5N5, H5N1, H5N4, and H5N3) and seven genotypes of highly pathogenic avian influenza viruses (HPAIV) belonging to clade 2.3.4.4b were detected in a broad array of avian hosts in Germany. Initial incursion by wild birds with an unprecedented involvement of charadriiforme species at the Wadden Sea coast only carrying subtype H5N3, lateral spread between poultry with detection of novel reassortants and mixed infections in poultry holdings, suspected spillback of HPAIV from poultry to wild birds, and detection of HPAIV-infected wild birds during the following summer in 2021 were hallmarks of this epizootic. Local reassortment events with low pathogenic AIV strains were detected by phylogenetic analyses, with a dominating HP H5N8 and later HP H5N1 strain responsible for most cases. In addition, the first-ever described HPAIV strain of subtype H5N4 could be genetically characterized.
An Arts-Based Workshop Using Scalp Tattoos to Connect Students with Cancer Patients’ Experiences of Chemotherapy and Hair Loss
Authors: Clements Meredith L. , Wimbish Preston W. , Wall Rachel E.
Published: April 2022

Problem

Students eager to enter the medical field must develop perspective-taking skills that enhance their ability to connect with patients. Toward this goal, the authors developed a pilot workshop for undergraduate students that included an art activity during which they collaborated to design scalp tattoos to symbolize cancer patients’ experiences with chemotherapy and hair loss.

Approach

A 90-minute, arts-based workshop was held in April 2019. One author selected anonymous excerpts from previously conducted interviews with patients experiencing ovarian and uterine cancer. These excerpts were shared with students to humanize patients’ perspectives and give context to the difficulty of coping with chemotherapy-induced alopecia. Students discussed these excerpts and images of scalp tattoos from the internet. Together, they then designed scalp tattoos representing their perspective on the experience of coping with chemotherapy and hair loss and drew them onto mannequin heads.

Outcomes

Twenty members of the university community participated in this workshop, including 3 faculty members and 17 undergraduate students. Participants worked together to create 2 sets of scalp tattoos. Of the 20 participants, 75% (n = 15) responded to the postworkshop survey. All respondents were undergraduate students, and 73% (n = 11) reported an increase in empathy toward patients and 87% (n = 13) an increased connection with the patient experience. All respondents agreed that the art activity demonstrated the importance of taking the patient’s perspective.

Next Steps

This arts-based workshop is effective and can be replicated for other audiences, including undergraduate students, medical students, and practicing clinicians, to encourage perspective-taking and compassion for patients. Further analysis of students’ skill development using pre- and postworkshop data is needed.
The Utility of the Modified Fels Knee Skeletal Maturity System in Limb Length Prediction
Authors: Furdock Ryan J. , Cho Elizabeth , Benedick Alexander J. , Yu Jiao , Sattar Abdus , Liu Raymond W.
Published: April 2022

Background:

Predicting ultimate lower extremity length is important in the treatment of lower limb length discrepancy (LLD), congenital limb deficiency, and other etiologies. Utilizing skeletal age over chronological age improves the prediction of ultimate lower extremity length. The recently described modified Fels knee skeletal maturity system allows for skeletal age estimation via imaging always available in LLD patients. We sought to compare the accuracy of the modified Fels knee skeletal maturity system versus chronological age in ultimate limb length prediction of a modern adolescent clinical population.

Methods:

The medical records of all patients treated at our institution over a 20-year period with unilateral lower extremity pathology and available lower extremity imaging before and after reaching skeletal maturity were reviewed. Skeletal maturity was defined radiographically by closed distal femoral, proximal tibial, and proximal fibular physes. The femoral, tibial, and lower extremity length was measured in all radiographs. The modified Fels knee skeletal maturity system was applied to all radiographs obtained before maturity to estimate skeletal age. The accuracy of 3 widely utilized lower extremity length prediction systems was compared when utilizing estimated Fels skeletal age versus chronological age inputs.

Results:

A total of 245 radiographs (109 before maturity) from 43 patients were eligible for inclusion. On cross-sectional analysis, linear modeling using Fels skeletal ages was uniformly associated with higher (improved) R
2 values than chronological age-based models. On longitudinal analysis, skeletal age mixed-effects models had significantly lower (improved) Akaike information criterion and Bayesian information criterion values than chronological age models in all cases. Cohen d values were also significantly different (P<0.05) for the skeletal age models compared with chronological age models in all cases.

Conclusions:

In the treatment of LLD, the modified Fels knee skeletal maturity system can be readily applied to available imaging to improve the prediction of ultimate femoral, tibial, and lower extremity length. This skeletal maturity system may have significant utility in the estimation of ultimate LLD and determination of appropriate timing of epiphysiodesis.

Level of Evidence:

Level III.
Outcomes Evaluating Quality of Life and Their Measurement Properties in Early-onset Scoliosis: A Systematic Review
Authors: Baird Charles , Archer James , Gardner Adrian , Rushton Alison , Heneghan Nicola R.
Published: April 2022

Introduction:

Early-onset scoliosis (EOS) is a spinal deformity affecting children under the age of 10. Understanding the impact of EOS on quality of life can be achieved through appropriate patient/carer-reported outcome measures (PROMs). The aim of this systematic review was to identify, evaluate and summarize the evidence for the measurement properties of health-related quality of life (HR-QoL) outcome measures in the EOS population.

Methods:

A 2-stage search methodology was conducted across the PubMed, MEDLINE, EMBASE, EMCARE, PsychINFO, and CINAHL databases. Search 1 identified PROMs used to evaluate the quality of life in EOS, and search 2 identified studies of the measurement properties of these PROMs. Two reviewers performed searching, study screening and selection and assessed studies for risk of bias using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. One reviewer performed data extraction. Evidence for each measurement property per PROM was summarized and evaluated using a modified GRADE approach.

Results:

Search 1 identified 19 (10 disease-specific, 9 generic) PROMs that have been used to assess HR-QoL or a relevant domain in the EOS population. Search 2 identified only one PROM (the 24-item Early-Onset Scoliosis Questionnaire, EOSQ) with eligible studies (n=4) evaluating measurement properties. There is low-quality evidence for sufficient content validity, very low-quality evidence for sufficient reliability and low-quality evidence for sufficient criterion validity, specifically regarding the pulmonary function domain) of the EOSQ. Construct validity and responsiveness were rated as indeterminate. There were no studies on measurement error.

Conclusions:

Our search strategy found that measurement properties have only been evaluated for one PROM, the EOSQ. There is low-quality evidence for sufficient measurement properties for the EOSQ in patients under the age of 10 with EOS. Further research is needed to improve the quality of evidence for EOSQ measurement properties and investigate other PROMs in this population.

Level of Evidence:

Level II.