bluuebunny/crossref_metadata_2025 huggingface dataset:
The Ritual Animal
Authors: Whitehouse Harvey
Published: December 2021

The ritual animal longs to belong. Rituals are a way of defining the boundaries of social groups and binding their members together. The ritual modes theory set out in this book seeks to unravel the psychology behind these processes, and to explain how ritual behaviour evolved, including how different modes of ritual performance have shaped global history over many millennia. Testing the theory has meant designing experiments run with children in psychology labs and on remote Pacific islands, gathering survey data with armed insurgents in the Middle East and Muslim fundamentalists in Indonesia, monitoring heart rate and stress among football fans in Brazil, and measuring changes in the brain as people observe traditional Chinese rituals in Singapore. The results of all this research point to new ways of addressing cooperation problems: from preventing violent extremism to motivating action on the climate crisis. Although this book is about the role of ritual in the evolution of social complexity, more broadly it models a new approach to the science of the social—an approach that is driven by real-world observation but grounded in the cognitive and evolutionary sciences. More ambitiously still, it shows how cumulative theory building can be used to deliver practical benefits for society at large, perhaps even addressing problems on a global scale by harnessing the formidable cohesive and cooperative capacities of the ritual animal.
Ritual Frequency, Emotionality, and Modes of Religiosity
Authors: Whitehouse Harvey
Published: December 2021

Collective rituals tend to come in two kinds: frequently performed but relatively lowkey; rarely enacted but emotionally intense. According to the theory of modes of religiosity, high-frequency but low-arousal rituals produce large-scale hierarchical groups (the doctrinal mode), while low-frequency but high-arousal rituals produce small-scale highly cohesive groups (the imagistic mode). This chapter describes how that theory was first developed while carrying out fieldwork in the New Guinea rainforest. But then the author realized it could help to explain how groups throughout the world take shape and spread, and it could also help to explain how complex societies evolved.
Elizabeth Stuart, Queen of Hearts
Authors: Akkerman Nadine
Published: December 2021

This book presents a biography of Elizabeth Stuart, one of the most misrepresented and underestimated figures of the seventeenth century. Elizabeth Stuart, daughter of James VI and I, was married to Frederick V, Elector Palatine in 1613. The couple were crowned King and Queen of Bohemia in 1619, only to be deposed in 1620 and exiled to the Dutch Republic in 1621. Elizabeth then found herself at the epicentre of the Thirty Years War and the Civil Wars, political and military struggles that defined seventeenth-century Europe. Following her husband’s death in 1632, Elizabeth fostered a cult of widowhood and conducted a long and fierce political campaign to regain her children’s birthright. On returning to England in 1661, Elizabeth Stuart found a country whose people still considered her their ‘Queen of Hearts’. This book reveals the impact Elizabeth Stuart had on the Stuart kingdoms and Europe, demonstrating that she was more than just the grandmother of George I.
Inseverable Ties with Austria and Spain
Authors: Akkerman Nadine
Published: December 2021

Maximilian I, Duke of Bavaria, was afraid of Habsburg expansionism and proposed a counter offer to the Palatine-Imperial match: instead of Frederick Henry, heir of the Palatinate, marrying a daughter of the Emperor, he should marry Bavaria’s niece. The monk Francesco della Rota took this proposal straight to London instead of to The Hague. It floundered. Parliament voted in favour of war with Spain, on condition that it would be a purely naval conflict. The Dutch were keen to support such a war against their enemy, with ships sailing out under Elizabeth’s flag, if the Stuart kingdoms indeed gathered their own fleet. James’s declaration of war never came, however. Meanwhile, having convinced Louis XIII of France to subsidize his military actions in the Palatinate as long as James also sponsored him, Mansfeld went to London intent on levying troops. James agreed. The Spanish ambassador at the Stuart court was irritated by the bellicose attitude against the Spanish at court and accused Elizabeth, her secretary Sir Francis Nethersole, and court favourite Buckingham of having purposely derailed the Spanish Match in order to effect a marriage between Frederick Henry, Prince Palatine, and Buckingham’s daughter Mary. This, he suggested, was so that they would see their offspring on the throne some day. (That this scheme entailed Charles never marrying was apparently seen as within Buckingham’s power to effect, too). James took the side of his daughter (and his favourite) and dismissed all Spanish diplomats from his court.
Epilogue
Authors: Akkerman Nadine
Published: December 2021

This epilogue highlights Elizabeth Stuart's legacy in material, and subsequently, in immaterial terms. It considers the contents of the will that was drawn up shortly before she left The Hague for the last time. In simple terms, Charles Louis inherited her estates; Rupert received her rings, plate, and other goods; Edward received a table diamond with a ribbon; Elisabeth a pair of emerald earrings; and Sophia the small necklace of pearls Elizabeth had always worn. The jewels Rupert inherited were, if Sophia is to be believed, given by him to his mistress Margaret Hughes, the first actress to play Desdemona. The executor of Rupert’s will, Lord Craven, presumably sold the rest to settle debts (though Elizabeth’s debts were never fully settled) and to ensure Rupert’s daughter, Ruperta, was well provided for. The Crown of the Three Kingdoms eventually came to rest on the head of one of Elizabeth’s grandchildren: Sophia's son, Georg Ludwig, Elector of Hanover, was crowned King George I of Great Britain in 1714, starting a line which reaches directly down to the longest serving monarch of the United Kingdom, Queen Elizabeth II. In the sixty-five years that she lived, Elizabeth Stuart touched every corner of Europe. Indeed, her true legacy is incalculable and it is no exaggeration to say that the original Queen of Hearts is still with us.
Understanding the Lived Experience of Caring for a Child With Severe Cerebral Palsy: A Critical Step Toward Psychologically Informed Family-Centered Care
Authors: Cook Jason E , Tovin Melissa M , Kenyon Lisa K
Published: December 2021

Objective

The purpose of this study was to explore the lived experience of parents who care for children with cerebral palsy who function at a Gross Motor Function Classification System Level V, their beliefs about pain and non–pain-related emotional distress, and what it means to provide care and comfort.

Methods

A phenomenological research design was used. Eleven participants were involved in this study. Pilot interviews informed the interview guide. Data were collected via participant journals and semi-structured interviews and analyzed using van Manen’s framework for understanding experience. Trustworthiness criteria were met through a variety of strategies to ensure a rigorous research process.

Results

Four themes were revealed in this study: “life is hard, heavy with burden, worry, and love,” “remarkable,” “identity transformation and empowerment,” and “living a life that is planned, forced with structure and without spontaneity.”

Conclusion

Caring for a child with lifelong needs is complex and requires a sensitive awareness of the contextual factors that impact daily decisions and routines. Understanding the lived experiences of parents who care for children with cerebral palsy Gross Motor Function Classification System Level V is necessary to provide psychologically informed, family-centered care. Comfort theory is presented as a framework for understanding what factors influence comfort and well-being. Understanding the complex nature of comfort for an individual can lead to greater understanding and empathy-driven care. These results will provide a foundation for future studies that aim to enhance pediatric physical therapist care through provider empathy and understanding.

Impact

Caregiving parent experiences are impactful and play a large role in the life of children with developmental disabilities. Research exploring the lived experience of caregivers may enhance empathy-driven, psychologically informed, family-centered physical therapist care throughout the life course.

Lay Summary

If you are a parent who cares for a child with severe cerebral palsy, you have unique experiences that impact day-to-day activities and lifelong planning for your family and child.
Women with abuse-related posttraumatic stress disorder sleep more fitfully but just as long as healthy controls: an actigraphic study
Authors: Friedmann Franziska , Hill Holger , Santangelo Philip , Ebner-Priemer Ulrich , Neubauer Andreas B , Rausch Sophie , Steil Regina , Müller-Engelmann Meike , Lis Stefanie , Fydrich Thomas , Priebe Kathlen
Published: December 2021

Study Objectives

Subjective reports of sleep impairments are common in individuals with posttraumatic stress disorder (PTSD), but objective assessments of sleep have yielded mixed results.

Methods

We investigated sleep via actigraphy and e-diary on 6 consecutive nights in a group of 117 women with PTSD after childhood abuse (CA; PTSD group), a group of 31 mentally healthy women with a history of CA (healthy trauma controls, HTC group) and a group of 36 nontraumatized mentally healthy women (healthy controls, HC group).

Results

The PTSD group reported lower sleep quality, more nights with nightmares, and shorter sleep duration than both HTC and HC. Actigraphic measures showed more and longer sleep interruptions in the PTSD group compared to HTC and HC, but no difference in sleep duration. While the PTSD group underestimated their sleep duration, both HTC and HC overestimated their sleep duration. HTC did not differ from HC regarding sleep impairments.

Conclusions

Sleep in women with PTSD after CA seems to be more fragmented but not shorter compared to sleep patterns of mentally healthy control subjects. The results suggest a stronger effect of PTSD psychopathology on sleep compared to the effect of trauma per se.

Subset of Data from Clinical Trial

Treating Psychosocial and Neural Consequences of Childhood Interpersonal Violence in Adults (RELEASE), https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00000000, German Clinical Trials registration number: DRKS00005578
Molecular characterisation of carbapenem-resistantKlebsiella pneumoniaeclinical isolates: preliminary experience from a tertiary care teaching hospital in the Himalayas
Authors: Bhatia Mohit , Shamanna Varun , Nagaraj Geetha , Sravani Dharmavaram , Gupta Pratima , Omar Balram Ji , Chakraborty Deepika , Ravikumar K L
Published: December 2021

Background

There is a lack of whole-genome sequencing (WGS) data on multidrug-resistant (MDR) bacteria from the Uttarakhand region of India. The aim of this study was to generate WGS data of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates recovered from patients in Uttarakhand's tertiary care centre.

Methods

A cross-sectional study included 29 MDR K. pneumoniae test isolates obtained from various clinical samples submitted to the bacteriology laboratory for culture and sensitivity testing from July 2018 to August 2019. After preliminary identification and antibiotic susceptibility testing, these isolates were subjected to WGS.

Results

A total of 27 of 29 isolates were CRKP. ST14 was the most common sequence type (n=8 [29.6%]). Carbapenem resistance was mainly encoded by OXA-48-like genes (21/27 [77.8%]). All isolates had a varied arsenal of resistance genes to different antibiotic classes. KL2 (9/27 [33.3%]) and KL51 (8/27 [29.6%]) were dominant K loci types. O1 and O2 together accounted for 88.9% (n=27) of CRKP isolates. Genes encoding yersiniabactin (ybt) and aerobactin (iuc) were identified in 88.9% (24/27) and 29.6% (8/27) of isolates. The predominant plasmid replicons present were ColKP3 (55.5%), IncFII(K) (51.8%) and IncFIB(pQil) (44.4%).

Conclusions

This study emphasises the need for continued genomic surveillance of MDR bacteria that could be instrumental in developing treatment guidelines based on integrating phenotypic and molecular methods.
Carvedilol as secondary prophylaxis for variceal bleeding in hepatosplenic schistosomiasis
Authors: de Abreu Eliabe Silva , Nardelli Mateus Jorge , Lima André Mourão Costa , Cardoso Jaqueline Brito , Osório Fernanda Maria Farage , Ferrari Teresa Cristina de Abreu , Faria Luciana Costa , Couto Cláudia Alves , Cançado Guilherme Grossi Lopes
Published: December 2021

Background

Upper variceal bleeding (UVB) is a possible complication of portal hypertension secondary to hepatosplenic schistosomiasis (HSS). Propranolol is a non-selective beta-blocker used as secondary prophylaxis for UVB, but no previous studies have addressed carvedilol effects in rebleeding prevention.

Methods

A retrospective exploratory study of 57 patients with chronic HSS and index UVB treated with endoscopic variceal ligation and propranolol or carvedilol was conducted. The primary outcome was UVB-free time in the first 12 mo after the initial bleeding episode.

Results

Propranolol was used for secondary UVB prophylaxis in 43 (75.4%) participants (median dose 80 [interquartile range – IQR 60–80] mg/d) and carvedilol in 14 (24.6%) participants (median dose 12.5 [IQR 7.9–25.0] mg/d). During a 12-mo follow-up, rebleeding was observed in 13 (22.8%) patients, 9 (20.9%) of those treated with propranolol and 4 (28.6%) treated with carvedilol (p=0.715). Mean time from the beginning of drug prophylaxis to rebleeding was 6±3 mo and there was no difference between that for propranolol vs carvedilol subgroups. Portal vein thrombosis did not influence the bleeding recurrence in either subgroup.

Conclusion

Carvedilol may be equally effective as propranolol in preventing secondary UVB in HSS at 12-mo follow-up.
Effector Genes in Magnaporthe oryzae Triticum as Potential Targets for Incorporating Blast Resistance in Wheat
Authors: Navia-Urrutia Monica , Mosquera Gloria , Ellsworth Rebekah , Farman Mark , Trick Harold N. , Valent Barbara
Published: December 2021

Wheat blast (WB), caused by Magnaporthe oryzae Triticum pathotype, recently emerged as a destructive disease that threatens global wheat production. Because few sources of genetic resistance have been identified in wheat, genetic transformation of wheat with rice blast resistance genes could expand resistance to WB. We evaluated the presence/absence of homologs of rice blast effector genes in Triticum isolates with the aim of identifying avirulence genes in field populations whose cognate rice resistance genes could potentially confer resistance to WB. We also assessed presence of the wheat pathogen AVR-Rmg8 gene and identified new alleles. A total of 102 isolates collected in Brazil, Bolivia, and Paraguay from 1986 to 2018 were evaluated by PCR using 21 pairs of gene-specific primers. Effector gene composition was highly variable, with homologs to AvrPiz-t, AVR-Pi9, AVR-Pi54, and ACE1 showing the highest amplification frequencies (>94%). We identified Triticum isolates with a functional AvrPiz-t homolog that triggers Piz-t–mediated resistance in the rice pathosystem and produced transgenic wheat plants expressing the rice Piz-t gene. Seedlings and heads of the transgenic lines were challenged with isolate T25 carrying functional AvrPiz-t. Although slight decreases in the percentage of diseased spikelets and leaf area infected were observed in two transgenic lines, our results indicated that Piz-t did not confer useful WB resistance. Monitoring of avirulence genes in populations is fundamental to identifying effective resistance genes for incorporation into wheat by conventional breeding or transgenesis. Based on avirulence gene distributions, rice resistance genes Pi9 and Pi54 might be candidates for future studies.
Which injected antiosteoporotic medication is worth paying for? A cost-effectiveness analysis of teriparatide, zoledronate, ibandronate, and denosumab for postmenopausal osteoporotic women in China
Authors: You Ruxu , Mori Takahiro , Ke Lei , Wan Yuansheng , Zhang Yu , Luo Fei , Feng Da , Yu Guangyi , Liu Jinyu
Published: December 2021

Objective:

The purpose of this study was to evaluate the cost-effectiveness of four injected antiosteoporotic medications including teriparatide, zoledronate, ibandronate, and denosumab for postmenopausal osteoporotic women in China.

Methods:

A Markov microsimulation model was used to compare the cost-effectiveness of the four drugs above in Chinese postmenopausal osteoporotic women with no fracture history of hip, vertebral, or wrist at various ages (65, 70, 75, and 80) of therapy initiation from the health care payer perspective.

Results:

Denosumab was dominant (ie, lower costs and greater quality-adjusted life-years [QALYs]) compared with other strategies at all ages studied. The incremental cost-effectiveness ratios (ICERs) of zoledronate or ibandronate versus no treatment were $4,482.88/ QALYs or $11,378/QALYs, respectively, at age 65 years, and the results at other ages were similar. In contrast, the incremental cost-effectiveness ratio of teriparatide strategy compared with no treatment exceeded the pre-determined threshold of a willingness-to-pay of $31,512/QALY regardless of the adoption of the patient assistance program at all ages studied, and a threshold analysis showed that teriparatide without patient assistance program became cost-effective when the annual drug cost is decreased to $1,644.87 (current cost: $8,764.65). The cost-effectiveness decision did not change in most of the one-way sensitivity analyses. A scenario analysis considering no offset effect of denosumab showed that zoledronate had the potential to become the optimal option relative to denosumab. In probabilistic sensitivity analyses, the probabilities of denosumab being cost-effective compared with other strategies were 100% at a willingness-to-pay of $31,512/QALY.

Conclusions:

Among postmenopausal osteoporotic women in China, denosumab therapy is cost-effective at all ages examined from the health care payer perspective, compared with teriparatide, zoledronate, or ibandronate. This study will help clinicians and policymakers make better decisions about the relative economic value of osteoporosis treatments in China.
Robotic Donor Hysterectomy Results in Technical Success and Live Births After Uterus Transplantation: Subanalysis Within the Dallas Uterus Transplant Study (DUETS) Clinical Trial
Authors: JOHANNESSON LIZA , WALL ANJI E. , BAYER JOHANNA , MCKENNA GREG J. , ROSENZWEIG MATTHEW , DA GRACA BRIGET , KOON ERIC C. , TESTA GIULIANO
Published: December 2021

Minimally invasive procurement of uterine grafts for transplantation can decrease living donor recovery time. We examined recipient outcomes for grafts procured by robotic-assisted donor hysterectomies with transvaginal extraction in the Dallas UtErus Transplant Study (DUETS). All 5 grafts were successfully transplanted. Recipients had a median 4.5-hour surgical time, 0.25 L estimated blood loss, and 4-day hospital stay. Four recipients had grade III surgical complications and three had acute cellular rejection. At 18 months, graft viability was 100%, with an 80% live birth rate. This report demonstrates the feasibility and reproducible success of using uterus grafts from living donors who underwent robotic-assisted donor hysterectomy.
Impact of early glomerular filtration rate decline in response to antihypertensive treatment on risk of end-stage kidney disease and cardiovascular outcomes: a systematic review and meta-analysis
Authors: Gambaro Alessia , Lombardi Gianmarco , Ribichini Flavio L. , Mantovani Alessandro , Bignamini Angelo A. , Gambaro Giovanni
Published: December 2021

Blood pressure control, which can induce a slight decrease in the glomerular filtration rate (GFR), plays a nephron- and cardioprotective role. However, the more important early decline in GFR associated with antihypertensive therapy and strict blood pressure targets is still of concern. Since few data are available from trials and observational studies, and the phenomenon is relatively rare, we performed a meta-analysis of available studies.

We conclude that major reductions in the glomerular filtration rate occurring soon after starting angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and/or under intensive blood pressure control predict end-stage kidney disease.
Assessment of risk factors for deep vein thrombosis associated with natural anticoagulants and fibrinolytic regulatory proteins
Authors: Abdalhabib Ezeldine K. , Jackson Denise E. , Alzahrani Badr , Elfaki Elyasa , Hamza Alneil , Alanazi Fehaid , Ali Elryah I. , Algarni Abdulrahman , Ibrahim Ibrahim Khider
Published: December 2021

Deep vein thrombosis (DVT) is a critical condition and a potential cause of mortality and morbidity in Africa and worldwide with a high recurrence rate. The study was designed to assess the roles of natural anticoagulants and fibrinolytic regulatory factors in the development of DVT in Sudanese patients. A case-control study was conducted in Omdurman Teaching Hospital, Khartoum State over a period of 1 year. The study enrolled 200 patients diagnosed with DVT and 200 age-matched and gender-matched controls. Demographic data and data on acquired risk factors were collected using a semi-structured questionnaire. Protein C (PC), protein S (PS), antithrombin III (AT-III), thrombin-activable fibrinolysis inhibitor (TAFI), and plasminogen activator inhibitor-1 (PAI-1) were measured in patients and controls. Among the patients with DVT, 5.5% had PC deficiency, 8.5% had PS deficiency, and 3% had AT-III deficiency. Elevated TAFI and PAI-1 levels were demonstrated in 1.5 and 0.5% of patients, respectively. Risk factors for DVT (overweight, surgical history, and family history of DVT) were remarkably higher in patients than in controls. Among the female participants, pregnancy and usage of oral contraceptive pills were the highest associated risk factors for DVT. The findings concluded that the early assessment of risk factors, including the measurements of natural inhibitors, can predict the occurrence of DVT before it is actually detected in patients.
Refractory acquired haemophilia A in a patient with HIV treated with Emicizumab
Authors: Latef Taroob J. , Bhardwaj Prarthna , Bilal Muhammad
Published: December 2021

Acquired haemophilia is a rare coagulopathy characterized by acquired inhibitors directed against clotting factors resulting in bleeding episodes. A middle-aged woman with HIV developed refractory haemophilia with bleeding episodes resulting in recurrent hospitalizations despite several rounds of bypassing agents and several lines of immunosuppressive agents. She was eventually successfully treated with Emicizumab and has not had any major bleeding episodes for 3 years since initiation of this treatment. Emicizumab, which is a bispecific, FVIII-mimetic therapeutic antibody, has considerably reduced the annualized bleeding rates in congenital haemophiliacs with and without inhibitors and should be considered as an agent for acquired haemophilia to reduce recurrent bleeding episodes and even decrease inhibitor titer.
A challenging case of intravascular large B-cell lymphoma presenting as pyrexia of unknown origin
Authors: Wilfred Gilbert , Shukri Hamizah , Lau Ngee Siang , Fauzi Alina Md , Tan Sen Mui , Ahmad Asnawi Asral Wirda
Published: December 2021

Introduction:

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of large cell lymphoma, characterized by the growth of neoplastic cells within the lumina of small blood vessels, without an obvious extravascular tumor mass or presence of circulating lymphoma cells in the peripheral blood.

Patient concern:

A 68-year-old woman presented with fever of unknown origin and abdominal pain.

Diagnosis:

Bone marrow aspiration showed abnormally large cells with increased hemophagocytic activity. Trephine biopsy showed moderate to large neoplastic cells with single and multiple prominent nucleoli sequestered in the blood vessel lumen. Immunohistochemistry was positive for CD20, PAX5, CD79a, MUM1, and BCL2 and showed a high proliferative fraction of 80% confirming the diagnosis of IVLBCL.

Interventions:

The patient received six cycles of R-CHOP chemotherapy.

Outcomes:

The patient has been in remission for nearly two years after completing the treatment.

Conclusion:

Clinical recognition of IVLBCL remains a challenge. Standard staging and therapeutic approaches need to be addressed to further elucidate the characterization and management of this rare disease.
Renal manifestations of paediatric systemic lupus erythematosus
Authors: Dowsett Thomas , Oni Louise
Published: December 2021

Purpose of review

Systemic lupus erythematosus is a lifelong, multisystemic disease. Around a fifth of patients present during childhood. Children are recognized to have a more active disease course with more renal involvement (lupus nephritis) when compared with adults. This review article summarizes the current literature surrounding the management of paediatric lupus nephritis.

Recent findings

International recommendations agree that active, proliferative forms of lupus nephritis are treated with a period of intense induction therapy aimed at inducing remission followed by maintenance immunosuppressive therapy for at least 3 years. Complete response rates in lupus nephritis remain inadequate, in the region of 40–60%, and disease flares are common. Revised histological classification have been proposed but they are yet to be adopted in clinical practice. Lupus nephritis progresses to chronic kidney disease (CKD) stage 5 (kidney failure) in more than 10% of patients within 10 years however the rates of CKD stages 1–4 remain largely unknown. Current trials are focused on the use of biologic agents as adjuncts to current therapy.

There is an urgent need for better outcomes in paediatric lupus nephritis. The use of biomarkers to monitor lupus nephritis and scientific studies to improve our understanding of the pathogenesis offer hope of improved outcomes.
Impact of coronavirus disease on the management of lower urinary tract symptoms and voiding dysfunction
Authors: Can Osman , Otunctemur Alper
Published: December 2021

Purpose of review

Coronavirus disease (COVID-19) has caused a crisis in the entire healthcare system since its emergence. The urgency and priority of various diseases have impacted the medical and surgical treatment in this period. We aim to review the impact of COVID-19 on lower urinary tract symptoms (LUTS) and management.

Recent findings

There may be a relationship between COVID-19 and de novo or increased LUTS. Patients with LUTS should also be evaluated for COVID-19. Management of diseases has varied during the COVID-19 due to the density of the pandemic. Virtual consultations can mitigate patients who are postponed or cancelled, such as patients with LUTS. Patients suffering voiding dysfunction may manage with oral medications such as alpha blocker and 5-alpha reductase inhibitor via telemedicine. Minimally invasive procedures with a low risk of complications and a short hospitalization time should be considered in complicated cases such as the inability to catheterize.

Telemedicine should be implemented on managements of noncomplicated LUTS and voiding dysfunction. Each centre can schedule its LUTS management approach according to the density of pandemic. Virtual consultations need to be developed to compete with face-to-face consultations.
Telehealth interventions for mobility after lower limb loss: A systematic review and meta-analysis of randomized controlled trials
Authors: Esfandiari Elham , Miller William C. , Berardi Anna , King Sheena , Ashe Maureen C.
Published: December 2021

Background:

Mobility is a crucial component for healthy aging after lower limb loss (LLL). Telehealth technologies, for example, smart devices, are novel approaches for health programs delivery regardless of geographical boundaries.

Objectives:

To assess the effect of telehealth interventions on mobility, quality of life, and antecedents of health behavior compared with a control condition (usual care or simpler telehealth interventions with fewer number of behavior change techniques [BCTs]) for community-dwelling adults (>50 years) with an LLL and the effect of mode of delivery and BCTs used in telehealth interventions on health outcomes.

Study design:

Systematic review and meta-analysis.

Methods:

We systematically searched MEDLINE, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, PsycINFO, and SPORTDiscus on January 28, 2021, to identify relevant randomized controlled trials. Two authors independently screened records and assessed risk of bias. We conducted a narrative synthesis of evidence and, when appropriate, used the standardized mean difference (SMD) and mean difference for meta-analyses and the Grading Recommendations Assessment, Development, and Evaluation approach for practice recommendations.

Results:

We identified six randomized controlled trials. Telephone was the most common delivery mode (n = 3), and “instructions for performing behaviors” was the most common BCT (n = 5). Very low certainty evidence showed no changes in mobility (six studies: SMD = 0.33 [95% confidence interval [CI] = −0.08, 0.75]), quality of life (two studies: mean difference = −0.08 [95% CI = −0.30, 0.15]), and antecedents of behavior (five studies: SMD = 0.04 [95% CI = −0.28, 0.36]).

Conclusions:

Our review highlights a knowledge gap for the effect of telehealth interventions for people with LLL. Although no promising effect was shown for telehealth interventions, very low certainty evidence precludes making a definitive clinical recommendation.
A scoping review of the application of motor learning principles to optimize myoelectric prosthetic hand control
Authors: Parr Johnny V. V. , Wright David J. , Uiga Liis , Marshall Ben , Mohamed Mohamed Omar , Wood Greg
Published: December 2021

Although prosthetic hand rejection rates remain high, evidence suggests that effective training plays a major role in device acceptance. Receiving training early in the rehabilitation process also enhances functional prosthetic use, decreases the likelihood of developing an overreliance on the intact limb, and reduces amputation-related pain. Despite these obvious benefits, there is a current lack of evidence regarding the most effective training techniques to facilitate myoelectric prosthetic hand control, and it remains unknown whether training is effective in facilitating the acquisition and transfer of prosthetic skill. In this scoping review, we introduced and summarized key motor learning principles related to attentional focus, implicit motor learning, training eye–hand coordination, practice variability, motor imagery, and action observation, and virtual training and biofeedback. We then reviewed the existing literature that has applied these principles for training prosthetic hand control before outlining future avenues for further research. The importance of optimizing early and appropriate training cannot be overlooked. While the intuition and experience of clinicians holds enormous value, evidence-based guidelines based on well-established motor learning principles will also be crucial for training effective prosthetic hand control. While it is clear that more research is needed to form the basis of such guidelines, it is hoped that this review highlights the potential avenues for this work.
Balance control deficits in individuals with a transtibial amputation with and without visual input
Authors: Moisan Gabriel , Miramand Ludovic , Younesian Hananeh , Turcot Katia
Published: December 2021

Background:

Many individuals with a transtibial amputation (TTA) exhibit balance deficits after limb loss. However, limited evidence exists on balance deficits of individuals with a TTA using hip, knee, and ankle kinematics and center of mass outcomes.

Objectives:

To identify balance control deficits in individuals with a TTA and determine to what extent they are accentuated without visual inputs.

Study design:

Cross-sectional.

Methods:

Ten individuals with TTA and 10 healthy controls undertook a biomechanical assessment during a 30-s quiet standing task with eyes open (EO) and eyes closed (EC). The mean trunk, hip, knee, and ankle angles and center of pressure (COP) and center of mass excursions were calculated.

Results:

More ankle dorsiflexion was observed for amputated limbs compared with intact lower limbs (mean difference: 5.8-degree, P = 0.031). Less anteroposterior (mean difference: 26.5 mm, P < 0.001) and mediolateral (ML) (mean difference: 4.2 mm, P = 0.042) COP excursions were found for amputated limbs compared with intact lower limbs and for control limbs compared with intact limbs (mean difference: 18.8 mm, P = 0.019). Greater ML COP excursion was found during EC than during EO condition (mean difference: 1.1 mm, P = 0.037).

Conclusions:

Individuals with a TTA presented a greater reliance on the intact lower limb, as highlighted by the greater ankle plantarflexion and anteroposterior and ML COP excursions for intact limbs compared with amputated limbs during quiet standing tasks. During EC condition, both groups exhibited greater ML COP excursions compared with EO condition, suggesting less postural stability. These differences may place them at greater risk of falling.
Mortality disparities among patients with HIV-associated Kaposi's sarcoma in the southern United States
Authors: Knights Sheena M. , Lazarte Susana M. , Kainthla Radhika , Chiao Elizabeth Y. , Nijhawan Ank E.
Published: December 2021

Objective:

To describe risk factors for mortality in HIV-associated Kaposi's sarcoma in an urban population in Dallas, Texas.

Design:

Retrospective electronic medical record review of patients with HIV-associated Kaposi's sarcoma.

Methods:

Electronic medical records were reviewed from 1 January 2009 to 31 December 2018 for patients with a diagnosis of HIV and Kaposi's sarcoma by ICD-9 or ICD-10 codes. Demographics, HIV history, Kaposi's sarcoma history, treatment, and mortality data were collected. Mortality data was supplemented by an inquiry from the National Death Index (NDI). Survival analyses were performed using Cox proportional hazards analysis to determine independent predictors of mortality.

Results:

Black patients had higher mortality than white or Hispanic patients (hazard ratio 2.07, 95% confidence interval 1.12–3.82), even after adjusting for covariates. This mortality difference correlates with higher rates of advanced Kaposi's sarcoma disease and KS-IRIS in black patients compared with other groups and is not explained by differences in CD4+ cell count, HIV viral load, engagement in care, or ART adherence at the time of cancer diagnosis.

Conclusion:

Despite nationwide trends showing decreased incidence and decreased mortality in Kaposi's sarcoma in the ART era, a high number of Kaposi's sarcoma cases and disparities in Kaposi's sarcoma outcomes persist in certain populations in the United States.
Impact of COVID-19 on care of older adults with cancer: a narrative synthesis of reviews, guidelines and recommendations
Authors: Haase Kristen R. , Verma Ridhi , Kilgour Heather M.
Published: December 2021

Purpose of review

The aim of this study was to summarize the literature on the impact of COVID-19 on older adults with cancer, including both the impacts of COVID-19 diagnosis on older adults with cancer and the implications of the pandemic on cancer care via a synthesis of reviews, guidelines and other relevant literature.

Recent findings

Our synthesis of systematic reviews demonstrates that older adults with cancer are prone to greater morbidity and mortality when experiencing concurrent COVID-19 infection. Current evidence related to the association between anticancer treatment and COVID-19 prognosis for older adults with cancer is conflicting. Guidelines and recommendations advocate for preventive measures against COVID-19; the uptake of telemedicine and virtual care; encourage vaccination for older adults with cancer; and the use of geriatric assessment.

The COVID-19 virus itself may be particularly deleterious for older adults with cancer. However, the health system and social impact of the pandemic, including global disruptions to the healthcare system and related impacts to the delivery of cancer care services, have equally important consequences.
Randomized Controlled Trial of Early Outpatient COVID-19 Treatment with High-Titer Convalescent Plasma
Authors: Sullivan David J. , Gebo Kelly A. , Shoham Shmuel , Bloch Evan M. , Lau Bryan , Shenoy Aarthi G. , Mosnaim Giselle S. , Gniadek Thomas J. , Fukuta Yuriko , Patel Bela , Heath Sonya L. , Levine Adam C. , Meisenberg Barry R. , Spivak Emily S. , Anjan Shweta , Huaman Moises A. , Blair Janis E. , Currier Judith S. , Paxton James H. , Gerber Jonathan M. , Petrini Joann R. , Broderick Patrick B. , Rausch William , Cordisco Marie Elena , Hammel Jean , Greenblatt Benjamin , Cluzet Valerie C. , Cruser Daniel , Oei Kevin , Abinante Matthew , Hammitt Laura L. , Sutcliffe Catherine G. , Forthal Donald N. , Zand Martin S. , Cachay Edward R. , Raval Jay S. , Kassaye Seble G. , Foster E. Colin , Roth Michael , Marshall Christi E. , Yarava Anusha , Lane Karen , McBee Nichol A. , Gawad Amy L. , Karlen Nicky , Singh Atika , Ford Daniel E. , Jabs Douglas A. , Appel Lawrence J. , Shade David M. , Ehrhardt Stephan , Baksh Sheriza N. , Laeyendecker Oliver , Pekosz Andrew , Klein Sabra L. , Casadevall Arturo , Tobian Aaron A.R. , Hanley Daniel F.
Published: December 2021

BACKGROUND

The efficacy of polyclonal high titer convalescent plasma to prevent serious complications of COVID-19 in outpatients with recent onset of illness is uncertain.

METHODS

This multicenter, double-blind randomized controlled trial compared the efficacy and safety of SARS-CoV-2 high titer convalescent plasma to placebo control plasma in symptomatic adults ≥18 years positive for SARS-CoV-2 regardless of risk factors for disease progression or vaccine status. Participants with symptom onset within 8 days were enrolled, then transfused within the subsequent day. The measured primary outcome was COVID-19-related hospitalization within 28 days of plasma transfusion. The enrollment period was June 3, 2020 to October 1, 2021.

RESULTS

A total of 1225 participants were randomized and 1181 transfused. In the pre-specified modified intention-to-treat analysis that excluded those not transfused, the primary endpoint occurred in 37 of 589 (6.3%) who received placebo control plasma and in 17 of 592 (2.9%) participants who received convalescent plasma (relative risk, 0.46; one-sided 95% upper bound confidence interval 0.733; P=0.004) corresponding to a 54% risk reduction. Examination with a model adjusting for covariates related to the outcome did not change the conclusions.

CONCLUSION

Early administration of high titer SARS-CoV-2 convalescent plasma reduced outpatient hospitalizations by more than 50%. High titer convalescent plasma is an effective early outpatient COVID-19 treatment with the advantages of low cost, wide availability, and rapid resilience to variant emergence from viral genetic drift in the face of a changing pandemic.

Trial Registration

ClinicalTrials.gov number, NCT04373460.
Modeling and predicting the overlap of B- and T-cell receptor repertoires in healthy and SARS-CoV-2 infected individuals
Authors: Ortega Maria Ruiz , Spisak Natanael , Mora Thierry , Walczak Aleksandra M.
Published: December 2021

Adaptive immunity’s success relies on the extraordinary diversity of protein receptors on B and T cell membranes. Despite this diversity, the existence of public receptors shared by many individuals gives hope for developing population wide vaccines and therapeutics. Yet many of these public receptors are shared by chance. We present a statistical approach, defined in terms of a probabilistic V(D)J recombination model enhanced by a selection factor, that describes repertoire diversity and predicts with high accuracy the spectrum of repertoire overlap in healthy individuals. The model underestimates sharing between repertoires of individuals infected with SARS-CoV-2, suggesting strong antigen-driven convergent selection. We exploit this discrepancy to identify COVID-associated receptors, which we validate against datasets of receptors with known viral specificity. We study their properties in terms of sequence features and network organization, and use them to design an accurate diagnosis tool for predicting SARS-CoV-2 status from repertoire data.
Possible Cross Reactivity of Feline and White-tailed Deer Antibodies Against the SARS-CoV-2 Receptor Binding Domain
Authors: Hancock Trevor J. , Hickman Peyton , Kazerooni Niloo , Kennedy Melissa , Kania Stephen A. , Dennis Michelle , Szafranski Nicole , Gerhold Richard , Su Chunlei , Masi Tom , Smith Stephen , Sparer Tim E.
Published: December 2021

In late 2019, a novel coronavirus began circulating within humans in central China. It was designated SARS-CoV-2 because of its genetic similarities to the 2003 SARS coronavirus (SARS-CoV). Now that SARS-CoV-2 has spread worldwide, there is a risk of it establishing new animal reservoirs and recombination with native circulating coronaviruses. To screen local animal populations in the United States for exposure to SARS-like coronaviruses, we developed a serological assay using the receptor binding domain (RBD) from SARS-CoV-2. SARS-CoV-2’s RBD is antigenically distinct from common human and animal coronaviruses allowing us to identify animals previously infected with SARS-CoV or SARS-CoV-2. Using an indirect ELISA for SARS-CoV-2’s RBD, we screened serum from wild and domestic animals for the presence of antibodies against SARS-CoV-2’s RBD. Surprisingly pre-pandemic feline serum samples submitted to the University of Tennessee Veterinary Hospital were ∼50% positive for anti-SARS RBD antibodies. Some of these samples were serologically negative for feline coronavirus (FCoV), raising the question of the etiological agent generating anti-SARS-CoV-2 RBD cross-reactivity. We also identified several white-tailed deer from South Carolina with anti-SARS-CoV-2 antibodies. These results are intriguing as cross-reactive antibodies towards SARS-CoV-2 RBD have not been reported to date. The etiological agent responsible for seropositivity was not readily apparent, but finding seropositive cats prior to the current SARS-CoV-2 pandemic highlights our lack of information about circulating coronaviruses in other species.

Importance

We report cross-reactive antibodies from pre-pandemic cats and post-pandemic South Carolina white-tailed deer that are specific for that SARS-CoV RBD. There are several potential explanations for this cross-reactivity, each with important implications to coronavirus disease surveillance. Perhaps the most intriguing possibility is the existence and transmission of an etiological agent (such as another coronavirus) with similarity to SARS-CoV-2’s RBD region. However, we lack conclusive evidence of pre-pandemic transmission of a SARS-like virus. Our findings provide impetus for the adoption of a One Health Initiative focusing on infectious disease surveillance of multiple animal species to predict the next zoonotic transmission to humans and future pandemics.
A Meta-Analysis of the 16S-rRNA Gut Microbiome Data in Honeybees (Apis Mellifera)
Authors: Gkantiragas Alexis G. , Gabrielli Jacopo
Published: December 2021

1.

Honeybees (Apis Mellifera) perform an essential role in the ecosystem and economy through pollination of insect-pollinated plants, but their population is declining. Many causes of honeybees’ decline are likely to be influenced by the microbiome which is thought to play an important role in bees and is particularly susceptible to infection and pesticides. However, there has been no systematic review or meta-analysis on honeybee microbiome data. Therefore, we conducted the first systematic meta-analysis of 16S-rRNA data to address this gap in the literature. Four studies were in a usable format – accounting for 336 honeybee’s worth of data – the largest such dataset to the best of our knowledge. We analysed these datasets in QIIME2 and visualised the results in R-studio. For the first time, we conducted a multi-study evaluation of the core and rare bee microbiome and confirmed previous compositional microbiome data. We established that Snodgrassella, Lactobacillus, Bifidobacterium, Fructobacillus and Saccaribacter form part of the core microbiome and identify 251 rare bacterial genera. Additional components of the core microbiome were likely obscured by incomplete classification. Future studies should refine and add to our existing dataset to produce a more conclusive and high-resolution portrait of the honeybee microbiome. Furthermore, we emphasise the need for an actively curated dataset and enforcement of data sharing standards.

Abstract Figure

Figure 1

Graphical abstract.

Made by the author in Biorender.com.
Superior immunogenicity and effectiveness of the 3rd BNT162b2 vaccine dose
Authors: Lustig Yaniv , Gonen Tal , Melzer Lilac , Gilboa Mayan , Indenbaum Victoria , Cohen Carmit , Amit Sharon , Jaber Hanaa , Doolman Ram , Asraf Keren , Rubin Carmit , Fluss Ronen , Mendelson Ella , Freedman Laurence , Regev-Yochay Gili , Kreiss Yitshak
Published: December 2021

In a prospective cohort study involving 12,413 Health Care Workers (HCW), we assessed immunogenicity, vaccine-effectiveness (VE) and safety of the third BNT162b2 vaccine dose. One month after third dose, anti-RBD-IgG were induced 1.7-folds compared to one month after the second. A significant increase in avidity from 61.1% (95%CI:56.1-66.7) to 96.3% (95%CI:94.2-98.5) resulted in a 6.1-folds neutralizing antibodies induction. Linear mixed model demonstrated that the third dose elicited a greater response among HCW≥60 or those with ≥two comorbidities who had a lower response following the second dose. VE of the third dose relative to two doses was 85.6% (95% CI, 79.2-90.1%). No serious adverse effects were reported. These results suggest that the third dose is superior to the second dose in both quantity and quality of IgG-antibodies and safely boosts protection from SARS-CoV-2 infection by generating high avidity antibodies to levels that are not significantly different between healthy and vulnerable populations.
Eukaryotic translation initiation factor eIF4E-5 is required for spermiogenesis in Drosophila melanogaster
Authors: Shao Lisa , Fingerhut Jaclyn M. , Falk Brook L. , Han Hong , Maldonado Giovanna , Qiao Yuemeng , Lee Vincent , Hall Elizabeth , Chen Liang , Polevoy Gordon , Hernández Greco , Lasko Paul , Brill Julie A.
Published: December 2021

Drosophila sperm development is characterized by extensive post-transcriptional regulation whereby thousands of transcripts are preserved for translation during later stages. A key step in translation initiation is the binding of eukaryotic initiation factor 4E (eIF4E) to the 5’ mRNA cap. Drosophila has multiple paralogs of eIF4E, including four (eIF4E-3, -4, -5, and -7) that are highly expressed in the testis. Other than eIF4E-3, none of these has been characterized genetically. Here, using CRISPR/Cas9 mutagenesis, we determined that eIF4E-5 is essential for male fertility. eIF4E-5 mutants exhibit defects during post-meiotic stages, including a fully penetrant defect in individualization, resulting in failure to produce mature sperm. eIF4E-5 protein localizes to the distal ends of elongated spermatid cysts, where it regulates non-apoptotic caspase activity during individualization by promoting local accumulation of the E3 ubiquitin ligase inhibitor Soti. eIF4E-5 mutants also have mild defects in spermatid cyst polarization, similar to mutants affecting the cytoplasmic polyadenylation-element binding protein Orb2 and atypical protein kinase C (aPKC). Our results further extend the diversity of non-canonical eIF4Es that carry out distinct spatiotemporal roles during spermatogenesis.

Summary Statement

The testis-enriched translation initiation factor eIF4E-5 is needed for spermatid cyst polarization, individualization of mature sperm and male fertility in Drosophila.