bluuebunny/crossref_metadata_2025 huggingface dataset:
Emancipatory Politics at its Limits? An Introduction
Authors: Blühdorn Ingolfur , Butzlaff Felix , Haderer Margaret
Published: September 2021

Emancipatory politics and the very idea of emancipation have come under pressure. Feminist and post-colonial critiques, the appropriation of emancipatory ideals by right-wing populists and the crises triggered by the transgression of planetary boundaries all expose emancipatory paradoxes and raise questions about the further suitability of emancipation as a regulative ideal guiding any socio-ecological transformation of contemporary consumer societies. With this article, which introduces a Special Issue entitled The Dialectic of Emancipation - Transgressing Boundaries and the Boundaries of Transgression, we are working toward a research agenda that acknowledges the current impasse of emancipatory politics and explores its ambivalences and further potentials. Following an outline of the emancipatory paradox and a review of how emancipatory movements have continuously contested – and redrawn – restrictive boundaries, we scan sedimented understandings of the two key terms, emancipation and dialectic, feeding into the concept that we are suggesting as an analytical lens for investigating the current impasse and future prospects of emancipatory politics: the dialectic of emancipation. We preview how the contributors to this Special Issue make use of these terms as they are engaging with this research agenda and conclude by reflecting on the dangers and pitfalls associated with the concept dialectic of emancipation.
Understanding Online Safety Through Metaphors: UK Policymakers and Industry Discourses About the Internet
Authors: Dekavalla Marina
Published: September 2021

This article explores how metaphors about what the internet is inform policymaker and industry discourses, when they propose solutions on internet safety. More specifically, it analyzes documents by key players in this debate during a period when the UK government proposed direct regulation of online harms. The study finds that policy documents construct the internet primarily as a “place” that is separate from offline experience; and to a smaller extent as a “tool” that can be abused if it falls in the wrong hands. The article argues that these constructions obscure any links between online and offline risk, and that they legitimize solutions which may not take into account the social roots of online harms. It also suggests that the discourses of policymakers and SNS companies differ in the degree of agency they attribute to users, indicating a discrepancy in their approaches as direct regulation is introduced in the UK.
A glass classroom? The experiences and identities of third space women leading educational change in research-intensive universities in the UK
Authors: Denney Fiona
Published: September 2021

In today's universities, women are still underrepresented in senior leadership positions. The research-focused systems and structures that support the progression of men often work against women who are drawn to alternative career paths within the academy for a variety of reasons. UK universities have seen an increase in teaching-focused career paths as well as ‘Third Space’ roles, which navigate an increasing space between purely professional and purely academic jobs. Since 2018, four research-intensive universities in the UK have appointed women to the position of PVC Education who have come from Third Space, academic development backgrounds. This paper explores their career paths and experiences and identifies that they have had to constantly navigate between professional and academic contracts in order to negotiate their own progression, thus creating their own space in which they are able to advance. The paper considers whether women in the Third Space end up trapped in a ‘glass classroom’ or whether a more fundamental political and transformational act in gender and Third Space career progression is emerging.
The child with facial nerve palsy
Authors: Borg Tiffanie-Marie , Warwick Amy Sarah , Ahmed Mas
Published: September 2021

In this article we summarise the educational aspects regarding the clinical presentation, diagnosis and management of children presenting with facial nerve paralysis, highlighting the importance of family history. We report two cases of hereditary facial nerve paralysis managed by the authors: one a child with familial facial nerve palsy, and the other a child with Melkersson–Rosenthal syndrome. The history in both cases revealed multiple family members with the same disorder.
Case report of severe constrictive perimyocarditis and ischemic hepatitis in a Crohn’s disease patient upon infliximab-induced lupus-like syndrome
Authors: Hirschmann Simon , Fischer Sarah , Klenske Entcho , Dechant Katharina , Distler Jörg H.W. , Treutlein Christoph , Neurath Markus F. , Atreya Raja
Published: September 2021

Anti-tumor necrosis factor (TNF) antibodies have become an indispensable part in the therapeutic landscape of treating inflammatory bowel disease (IBD) patients. Nevertheless, they can be associated with the occurrence of severe systemic side effects. Here, we report the case of a 23-year-old patient with ileocolonic Crohn’s disease in endoscopic remission under ongoing anti-TNF infliximab therapy with occurrence of novel generalized arthralgia, pleuritic chest pain, and dyspnea. Clinical, laboratory, and imaging diagnostic workup in an extended clinical routine setting at the University Hospital of Erlangen, Germany, was used by a multidisciplinary team consisting of gastroenterologists, radiologists, cardiologists, and rheumatologists to investigate the underlying cause of the clinical symptoms in the patient. The results received using the aforementioned diagnostic setup led to the diagnosis of severe constrictive perimyocarditis due to infliximab-induced lupus-like syndrome with distinct ANA reactivity and elevated anti-dsDNA levels. Furthermore, pronounced ischemic hepatitis was diagnosed. Infliximab treatment was immediately stopped, and initiated corticosteroid pulse therapy only led to partial response as it had to be reduced due to pronounced psychiatric side effects. Persistent signs of pericarditis required additional ibuprofen therapy, which led to subsequent resolution of cardial symptoms. Formerly elevated liver enzymes returned to normal, and there were no clinical signs of recurrence of Crohn’s disease activity over 18 months of follow-up. The patient was subsequently switched to ustekinumab therapy for further treatment of underlying Crohn’s disease. This case report describes for the first time severe infliximab-induced lupus-like syndrome in an IBD patient, concurrently mimicking ST-elevation myocardial infarction with MRI visualization of pericarditis, occurrence of ischemic hepatitis, and pronounced signs of systemic inflammation.
Metastatic Urothelial Cancer: a rapidly changing treatment landscape
Authors: Stecca Carlos , Abdeljalil Osama , Sridhar Srikala S.
Published: September 2021

Despite significant progress, metastatic urothelial cancer remains an incurable condition with a limited life expectancy. Platinum-based chemotherapy is still the mainstay of treatment for metastatic disease, but immunotherapy, antibody drug conjugates, and targeted agents have shown encouraging results in several recent practice changing trials. In this review, we discuss the standard of care, recent therapeutic advances, ongoing clinical trials, and future perspectives in metastatic urothelial carcinoma.
Globalizing local understanding of fragility in Eurasia
Authors: Kalra Prajakti , Saxena Siddharth Shanker
Published: September 2021

The article aims to introduce the underlying motivation and conceptual underpinning to the special issue entitled “Globalizing Local Understanding of Fragility in Eurasia.” The main purpose of this article is to problematize the popular opinion and portrayal of Central Asia (Kazakhstan, Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan) and more generally the countries of Eurasia and the Caucasus as inherently fragile states which are politically unstable and thus on the brink of collapse. This article also seeks to question narratives of modernity that are singular and constantly out of reach for large swathes of the world’s populations because of the narrowness and hegemonic nature of the architecture of global governance. By carefully considering the ways and means through which international institutions categorize countries as fragile and/or failed, the article aims to provide the theoretical foreground for the special issue which focuses on locating inherent community resilience strategies. We explain how the non-participatory norm making behavior of international organizations privilege certain actors, largely the Global North, and simultaneously ignore the majority of Eurasian states. In other words, a demand predicated in the linear evaluation of institutions and norms dictated by global institutions clash with the Eurasian model of inherent complex adaptive capability and introduce fragility. The focus thus is on understanding the ‘local’ based on the historical analysis of development in the region, nodal points of urban development and community life, forms of social capital, and community resilience strategies in the wider Eurasian region.
Accuracy of Foot Pressure Measurement on Predicting the Development of Foot Ulcer in Patients with Diabetes: A Systematic Review and Meta-Analysis
Authors: de Castro João Pedro Wardani , Ferreira Felipe Camargo , Vargas João Gustavo Franco , Bosso Lucas Bressan , Nabozny Nathan , Martins Camila Marinelli , Farhat Gabriel , Gomes Ricardo Zanetti
Published: September 2021

Objective:

Areas of the foot with diabetic ulcers have been observed to have greater plantar pressures compared to non-ulcerated. Pressures play an essential role in the mechanism of lesion, and their reduction is effective in prevention. We conducted a systematic review to evaluate pedobarography as a predictive tool for ulcer development, since there is still no consensus on this aspect.

Methods:

We searched PUBMED (MedLine), EMBASE, Scopus, Web of Science, CINAHL and Scielo for cohort studies that measured plantar pressure at baseline and verified ulcer development on follow-up. Pooled effects of accuracy, sensitivity, specificity and relative risk were calculated using the inverse variance method. Risk of bias was assessed using the QUADAS-2 tool.

Results:

Three studies ( n = 2000) had enough information on accuracy to be included into a meta-analysis, and 4 ( n = 2651) were analyzed using qualitative methods. Pooled sensitivity and specificity were found to be 0.63 (Confidence Interval (CI) 0.58-0.68) and 0.42 (CI 0.27-0.58), respectively. Pooled relative risk was 1.95 (CI 1.09-3.51). Risk of bias was low to uncertain.

Conclusions:

Pedobarography in itself appears to have low accuracy in evaluating risk of ulceration. Several methodological heterogeneities were found, and the most optimal cut-off value is yet to be determined.
The Concept of Hybridity in Journalism Studies
Authors: Hallin Daniel C. , Mellado Claudia , Mancini Paolo
Published: September 2021

This paper considers the use of the concept of hybridity in journalism studies, arguing that the concept of hybridity has served an important role in reorienting the field in the face of important processes of social change, but that as a “sensitizing concept” in the sense that Herbert Blumer used the term, it requires critical reflection and more careful specification of its various uses. In the first sections, we map three principal contexts in which the concept has been invoked: one focusing on new media and the blurring of professional boundaries it produces; one focusing on global flows of journalism culture, and a third which treats hybridity not as a novel but as quotidian and rooted in the structural context of the practice of journalism in general. The second part of the paper focuses on issues and challenges in the use of the concept of hybridity. We consider the tendency for hybridity to become a catch-all phrase that substitutes for more specific analysis, and the problem of treating novel phenomena as derivative forms of familiar ones. We then move to critique “presentism” in the discussion of hybridity and the distortions that result from drawing dichotomies between hybrid and “pure” forms, making the argument for taking seriously the idea that hybridity is universal. In the final section, we propose the idea of the hybridity cycle as a way of thinking about stability and change in journalism studies.
The Releasate of Avascular Cartilage Demonstrates Inherent Pro-Angiogenic Properties In Vitro and In Vivo
Authors: Nossin Yannick , Farrell Eric , Koevoet Wendy J.L.M. , Datema Frank , Somoza Rodrigo A. , Caplan Arnold I. , van Osch Gerjo J.V.M.
Published: September 2021

Objective

Cartilage is avascular and numerous studies have identified the presence of single anti- and pro-angiogenic factors in cartilage. To better understand the maintenance hyaline cartilage, we assessed the angiogenic potential of complete cartilage releasate with functional assays in vitro and in vivo.

Design

We evaluated the gene expression profile of angiogenesis-related factors in healthy adult human articular cartilage with a transcriptome-wide analysis generated by next-generation RNAseq. The effect on angiogenesis of the releasate of cartilage tissue was assessed with a chick chorioallantoic membrane (CAM) assay as well as human umbilical vein endothelial cell (HUVEC) migration and proliferation assays using conditioned media generated from tissue-engineered cartilage derived from human articular and nasal septum chondrocytes as well as explants from bovine articular cartilage and human nasal septum. Experiments were done with triplicate samples of cartilage from 3 different donors.

Results

RNAseq data of 3 healthy human articular cartilage donors revealed that the majority of known angiogenesis-related factors expressed in healthy adult articular cartilage are pro-angiogenic. The releasate from generated cartilage as well as from tissue explants, demonstrated at least a 3.1-fold increase in HUVEC proliferation and migration indicating a pro-angiogenic effect of cartilage. Finally, the CAM assay demonstrated that cartilage explants can indeed attract vessels; however, their ingrowth was not observed.

Conclusion

Using multiple approaches, we show that cartilage releasate has an inherent pro-angiogenic capacity. It remains vessel free due to anti-invasive properties associated with the tissue itself.
Do internet resources align with exercise training and physical activity guidelines for people with multiple sclerosis?
Authors: Sadeghi-Bahmani Dena , Silveira Stephanie L , Baird Jessica F , Motl Robert W
Published: September 2021

Background

Exercise training and lifestyle physical activity have been identified as evidence-based approaches for improving symptoms and quality of life among persons with multiple sclerosis (MS). Such evidence supported the development of physical activity guidelines (PAGs) for people with MS. The goal of such guidelines involved broad dissemination and uptake, as there is substantial evidence for low rates of participation in exercise training and physical activity in this population.

Objective

The current study evaluated the quality and consistency of information on webpages for physical activity against the established PAGs for people with MS.

Method

The search was conducted in September 2020 using the Google search engine for webpages containing physical activity information for people with MS. We evaluated the webpages with a list of 18 guidelines for adults with MS based on recommendations from three resources.

Results

The search yielded 157 webpages, of which 27 met the inclusion criteria. On average, webpages accurately addressed only 5 of the 18 guidelines. The most commonly addressed guidelines involved MS-specific symptom identification (n = 26), and example modalities for aerobic (n = 20) and strength (n = 16) training.

Conclusion

Many online recourses regarding physical activity and exercise training for MS were either inconsistent with the established PAGs or did not address the guidelines.
The Sociomateriality of Rating and Ranking Devices on Social Media: A Case Study of Reddit’s Voting Practices
Authors: Graham Timothy , Rodriguez Aleesha
Published: September 2021

Rating and ranking devices are everywhere on social media. While these devices may seem like objective tools to measure value and rank content, research shows how they profoundly shape social interaction and emotional expression and are central to platform moderation. Yet, very little is known about how users themselves talk about these devices, much less what this can tell us about how these devices co-constitute social reality on platforms. To explore this gap, we examine Reddit’s rating and ranking device, known as upvoting and downvoting, through a textual analysis of over half a million user comments that contain keywords such as “upvote” and “downvote” and their variants. We find that Redditors (Reddit users) rarely use or talk about voting in the way the platform intends. For the most part, Redditors not only disregard the rules about voting but also make, and enforce, their own rules, norms, and ethics around it. We uncover a rich set of voting practices that we present as the following four themes in a conceptual framework: (1) platform culture, (2) prescriptive device, (3) materialization of value, and (4) ontology of self. Drawing on a sociomaterial lens, we reposition voting as a material-discursive practice that is inseparable to Reddit culture. This provides compelling evidence that rating and ranking devices on social media intervene in and perform sociality and we invite future research to apply our conceptual framework to other rating and ranking devices on social media.
The Use of Digital Educational Resources in Times of COVID-19
Authors: Sanz-Labrador Ismael , Cuerdo-Mir Miguel , Doncel-Pedrera Luis Miguel
Published: September 2021

COVID-19 has profoundly disrupted national education systems, affecting the future well-being of school-age children. Bacher-Hicks and colleagues showed that the intensity of the search for online learning resources in the United States doubled with respect to pre-COVID-19 levels. However, areas of the country with higher incomes, better internet access, and fewer rural schools experienced significantly greater increases in search intensity. Using a similar method to study the case of Spain, we analyze the evolution of search intensity for a selection of digital educational resources over the period 2015 to 2021. Special attention is paid to the period of COVID-19 pandemic, namely, March 2020 to June 2021. The findings include a widespread rise in the use of digital resources with respect to the use in the last 5 years, which varies by digital educational resource and region. However, the use of digital resources in Spain does not seem to vary according to family income, at least in relation to open access digital educational resources. In addition, there appears to be a steady decline in search intensity for digital educational resources and a certain degree of substitutability following the surge due to the pandemic and the school closures.
The effects of methylated flavonoids on depression-like activity and pro-inflammatory cytokine thresholds in mice induced by repeated finasteride administration
Authors: She Bin , Wu Huajin , Xie Qin , Zhang Mingjuan , Zhou Nan , Pei Deyu , Tu Zheming
Published: September 2021

The aim of the study was to investigate the influence of naringenin (NGN) and its methylated derivatives (50 or 100 mg kg−1) on finasteride-caused depression-like performance in mice to identify the effects on behavior and biomarkers of inflammation in the management of depression. Depression-like behavior was induced by repeated dose of finasteride (100 mg kg−1, subcutaneously) in mice. The effects of the naringenin (50 or 100 mg kg−1) or its methylated derivatives (Ngn-M; 50 or 100 mg kg−1 or Ngn-DM; 50 or 100 mg kg−1) and duloxetine (DXT, 10 mg kg−1) were evaluated for the immobility time in tail suspension and forced swimming tests following finasteride pre-treatment. The levels of brain pro-inflammatory cytokines such as IL-1β and TNF-α were also measured by Enzyme-Linked Immunosorbent Assay to further evaluate the impact of naringenin and its methylated derivatives on inflammation. Pre-treatment with finasteride substantially increased both the immobility time spent in tail suspension and forced swimming tests and brain levels of IL-1β and TNF–α in mice. Doluxetine (DLX) was given at a dose of 10 mg kg−1, and Naringenin or its methylated derivatives were given at doses of 50 and 100 mg kg−1 orally. It reduced immobility time in both tests, restored the preference to sucrose solution, and normalized cytokine levels (p < 0.01) in mice. Similar effects were observed with DTX (10 mg kg−1) as positive control. The increased brain levels of malondialdehyde (MDA) or nitrite were considerably (p < 0.05) decreased while substantially (p < 0.05) increased glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) levels after finasteride pre-treatment relative to vehicle-control by naringenin or its methylated derivatives (50 or 100 mg kg−1). These findings demonstrated the potential for methylated flavonoids as safe and effective anti-depressive agents.
Fake news, information overload, and the third-person effect in China
Authors: Tang Shuo , Willnat Lars , Zhang Hongzhong
Published: September 2021

Based on a national survey of 1111 Chinese citizens, this study analyzes how exposure to fake news and perceptions of information overload are associated with the third-person effect. The findings indicate that fake news exposure correlates with perceived information overload and third-person perceptions of fake news. Respondents with higher levels of perceived information overload also report stronger third-person perceptions. In addition, Chinese respondents who believe that fake news affects others more than themselves are less likely to support stricter controls of fake news.
Occupational hazard of fluoroscopy: An invisible threat to orthopaedic surgeons
Authors: Wan Raymond CW , Chau Wai W , Tso Chi Y , Tang Ning , Chow Simon KH , Cheung Wing-Hoi , Wong Ronald MY
Published: September 2021

The use of fluoroscopy is widespread within different medical specialties. Improper protection may cause significant radiation hazard to medical personnel. To evaluate the concepts on radiation safety and fluoroscopy use among orthopaedic surgeons and to reflect our current training on this issue, a survey was distributed to perform an audit in our department, an academic unit. Twenty-eight orthopaedic surgeons replied. Amongst our participants, 96.4% used a lead apron at all times. Only 33% used a thyroid shield, 67% never used radiation goggles and 96% never used radiation protection gloves. 53.6% and 46.4% of participants position the fluoroscopy incorrectly in the anteroposterior and lateral positions, respectively, during use. There is clearly a need for improved safety amongst orthopaedic surgeons. A literature review was further performed, showing the hazards of fluoroscopy for doctors, including the risk of cataracts, radiation dermatitis, skin cancer and thyroid cancer. Hazards specific to females, including breast cancer risk, and in-utero irradiation of foetus were also thoroughly discussed. Recommendations towards radiation safety and practical measures to reduce fluoroscopy radiation hazard during procedure were made. Education and training to doctors on this invisible hazard is strongly advised.
Chronic Refractory Constipation in Children: Think Beyond Stools
Authors: Hasosah Mohammed
Published: September 2021

Chronic refractory constipation (CRC) is defined as children who are unable to pass stools in spite of being on maximum laxative therapy and require daily rectal stimulation in the form of enemas or suppositories to pass stools for >3 months. Children are often referred for treatment of refractory constipation that may result from uncontrolled underlying disease or ineffective treatment. Constipated children can be managed by a variety of medical therapeutic options that yield satisfying results in most cases. However, a subset of constipated children fails to benefit from conventional treatments. On treatment failure or on suspicion of organic disease the patient should be referred for further evaluation. Treatment options for treatment-resistant patients are presented. Pharmalogical and non-pharmalogical treatment modalities are reviewed and an algorithm for refractory constipation in children are presented.
Evaluating the Effectiveness of the AIDS Education and Training Center (AETC) National Human Immunodeficiency Virus/Hepatitis C Virus (HCV) Curriculum
Authors: Allison Waridibo E , Choi Aro N , Kawasaki Keito , Melhado Trisha V
Published: September 2021

Background

People with human immunodeficiency virus (PWHIV) who have hepatitis C virus (HCV) coinfection are at a higher risk of progression of liver disease than the general population. Direct acting antivirals provide a therapeutic option for HCV cure, however access to HCV specific care for PWHIV can be challenging. A paucity of specialist providers is a barrier to this care.

Objectives

This study aims to assess knowledge gained about HIV/HCV coinfection among health care providers.

Methods

AIDS Education Training Centers (AETC) have developed a modular national HIV/HCV coinfection curriculum consisting of a free selfdirected online curriculum to educate health care providers, including nonspecialist providers, involved in the care of PWHIV on HCV care and management. The effectiveness of this curriculum was evaluated with pre and post module assessment completion by learners compared with a paired t-test.

Results

716 people received links to the curriculum and 277 modules were completed by 221 unique individuals. 86% completed one module, 9% complete 2 modules, and the remaining 5% completed between 3 and all 6 modules. There were statistically significant increases in knowledge in the epidemiology module.
Intern Orthopedic Rotation Versus Emergency Medicine Procedure Month: Which one Derives More Opportunity?
Authors: Briggs Blake Chandler , Cline David Martin , Stewardson Kendall Lynn , Kugler Jordan Alexis , Lefebvre Cedric
Published: September 2021

INTRODUCTION

The American College of Graduate Medical Education (ACGME) defines 18 “key procedures” as requirements in emergency medicine (EM) residency programs. The post-graduate year-1 (PGY-1) curriculum provides an early foundation for EM trainees to gain procedural experience, but traditional PGY-1 rotations may not provide robust procedural opportunities. Our objective was to replace a traditional orthopedic rotation with a 4-week rotation that emphasized EM procedure acquisition and comprehension. Although all residents met ACGME procedural requirements before the curricular modification, the purpose of this month was to increase overall procedure numbers. The block contained dedicated procedure shifts in the emergency department as well as an asynchronous, self-directed learning course. We sought to compare the number of procedures performed by PGY-1 residents during their orthopedic rotation (the year before implementation), to the number of procedures performed during their procedure rotation (the year after implementation).

METHODS

The total number of procedures performed and logged by PGY-1 residents during the traditional orthopedic rotation (during the year prior to implementation of the new procedure rotation) were compared to the total number of procedures by the first class to undergo the new procedure rotation the following year. Thirty resident logs were reviewed (15 per class). Data were analyzed using SAS NPAR1WAY; Z < 0.05 was considered significant.

RESULTS

When compared to the orthopedic rotation, the procedure rotation had statistically significant higher numbers of procedures per resident (22, standard deviation [SD] 12, vs 11.4, SD 7.6; Z = 0.0177). A wide variety of nonorthopedic procedures accounted for the increased numbers, (13.6, SD 10.3, vs 0.9, SD 0.9; Z < 0.001). While the average number of orthopedic procedures was slightly less on the procedure rotation, there was no statistical difference (orthopedic rotation 10.13, procedure rotation 8.26; Z = 0.4605). Notably, fewer procedures were performed when 2 residents were on the procedure rotation at the same time (21 vs 10.1).

CONCLUSION

This analysis demonstrated a larger number and a wider variety of procedures performed by PGY-1 residents during a dedicated procedure rotation compared to a traditional orthopedic rotation. Furthermore, exposure to orthopedic procedures did not decline significantly. Limitations of the study include a modest number of subjects. Data may be limited by the consistency of procedure logging by individual residents. Further studies may assess procedural competency after PGY-1 year of training.
Concerns and Needs of Patients With Head and Neck Cancer in the COVID‐19 Era
Authors: Yan Flora , Rauscher Erika , Hollinger Amanda , Caputo Mary Ann , Ready John , Nguyen Shaun A. , Fakhry Carole , Nathan Cherie‐Ann O. , Leonardis Chris , Yearout Danielle , Day Terry A. , Moore Michael G.
Published: September 2021

Objective

To evaluate the concerns and needs of patients and survivors of head and neck cancer (HNC) in the COVID‐19 era.

Study Design

Prospective cross‐sectional survey.

Setting

Contact lists of 5 North American HNC advocacy groups.

Methods

A 14‐question survey was distributed to the contact lists of 5 HNC advocacy groups evaluating patient and survivor needs and concerns related to their cancer care and COVID‐19.

Results

There were 171 respondents, with 75% in the posttreatment period. The most common concern was contraction of COVID‐19 (49%). More patients in active treatment preferred in‐person visits than those in the early (≤5 years) and late (>5) survivorship period (72% vs 61% vs 40%, P <. 001). A higher percentage of late survivors preferred virtual visits (38% vs 28%, P =. 001). In total, 91 (53.2%) respondents sought emotional support outside of immediate family and friends. This included cancer support groups (36.2%), the medical team (29.7%), and other sources outside of these (34.1%), including faith‐based organizations and online communities. A higher proportion of women than men (62% vs 41%, P =. 001) were seeking emotional support outside of immediate family and friends.

Conclusions

During the early stages of the COVID‐19 pandemic, patients with HNC who were actively undergoing treatment had increased need for support resources and preferred in‐person provider visits. Alternatively, a higher percentage of patients >5 years from treatment preferred virtual visits. Emotional support outside of family and friends was sought out by a majority of respondents. Further research is needed to determine what support and educational resources are needed to best aid these various populations.
New horizons in the roles and associations of COX-2 and novel natural inhibitors in cardiovascular diseases
Authors: Chen Wujun , Zhong Yingjie , Feng Nuan , Guo Zhu , Wang Shuai , Xing Dongming
Published: September 2021

Age-related cardiovascular disease is the leading cause of death in elderly populations. Coxibs, including celecoxib, valdecoxib, etoricoxib, parecoxib, lumiracoxib, and rofecoxib, are selective cyclooxygenase-2 (COX-2) inhibitors used to treat osteoarthritis and rheumatoid arthritis. However, many coxibs have been discontinued due to adverse cardiovascular events. COX-2 contains cyclooxygenase (COX) and peroxidase (POX) sites. COX-2 inhibitors block COX activity without affecting POX activity. Recently, quercetin-like flavonoid compounds with OH groups in their B-rings have been found to serve as activators of COX-2 by binding the POX site. Galangin-like flavonol compounds serve as inhibitors of COX-2. Interestingly, nabumetone, flurbiprofen axetil, piketoprofen-amide, and nepafenac are ester prodrugs that inhibit COX-2. The combination of galangin-like flavonol compounds with these prodrug metabolites may lead to the development of novel COX-2 inhibitors. This review focuses on the most compelling evidence regarding the role and mechanism of COX-2 in cardiovascular diseases and demonstrates that quercetin-like compounds exert potential cardioprotective effects by serving as cofactors of COX-2.
Covid-19 vaccine management (Comirnaty and mrna-1273 Moderna) in a teaching hospital in Italy: a short report on the vaccination campaign
Authors: Papini Francesca , Grassi Niccolò , Guglielmi Giovanni , Gattini Vittorio , Rago Lucia , Bisordi Costanza , Scateni Monica , Totaro Michele , Tulipani Alberto , Porretta Andrea , Tavoschi Lara , Guercini Jacopo , Luchini Grazia , Briani Silvia , Privitera Gaetano Pierpaolo , Baggiani Angelo
Published: September 2021

Objectives

In this article, we aim to share our experience in the hospital reorganization made to conduct the SARS-CoV-2 vaccination campaign, based on the principles of flexibility and adaptability.

Study design

A descriptive study.

Methods

The data concerning the organization of the vaccination campaign were taken from the operative protocol developed by the hospital dedicated task force, composed by experts in hygiene, public health, occupational medicine, pharmacists, nurses, hospital quality, and disaster managers. Data about the numbers of vaccine administered daily were collected by the Innovation and Development Operative Unit database.

Results

Vaccinations against COVID-19 started across the EU on the 27th of December 2020. The first phase of the vaccination campaign carried out in our hospital was directed to healthcare workers immunization including medical residents, social care operators, administrative staff and technicians, students of medicine, and health professions trainees. The second phase was enlarged to the coverage of extremely fragile subjects. Thanks to the massive employment of healthcare workers and the establishment of dynamic pathways, it was possible to achieve short turnaround times and a large number of doses administered daily, with peaks of 870 vaccines per day. From the 27th of December up to the 14th of March a total of 26,341 doses of Pfizer have been administered. 13,584 were first doses and 12,757 were second doses. From the 4th to the 14th of March, 296 first doses of Moderna were dispensed. It was necessary to implement adequate spaces and areas adopting anti-contagion safety measures: waiting area for subjects to be vaccinated, working rooms for the dilution of the vaccine and the storage of the material, vaccination rooms, post-vaccination observation areas, room for observation, and treatment of any adverse reactions, with an emergency cart available in each working area.

Conclusions

The teaching hospital of Pisa faced the beginning of the immunization campaign readjusting its spaces, planning an adequate hospital vaccination area and providing an organization plan to ensure the achievement of the targets of the campaign. This represented a challenge due to limited vaccine doses supplied and the multisectoral teams of professionals to coordinate in the shortest time and the safest way possible. The organizational model adopted proved to be adequate and therefore exploited also for the second phase aimed to extremely fragile subjects.
Antenatal and postnatal management of posterior urethral valves: where do we stand?
Authors: Abdelhalim Ahmed , Hafez Ashraf T.
Published: September 2021

Introduction

Posterior urethral valve (PUV) is the leading etiology of lower urinary tract obstruction (LUTO) in boys and is an important cause of end-stage renal disease (ESRD) in children. The aim of this article is to review the current status on antenatal intervention for PUV as well as postnatal medical and surgical management.

Main body

MEDLINE, EMBASE, Pubmed and Google Scholar search was conducted throughout December 2020 using the keywords: posterior urethral valves, congenital urinary obstruction, antenatal, valve bladder syndrome, medical, anticholinergics, alpha blocker, antibiotics, biofeedback, diversion, augmentation cystoplasty and renal transplantation. Only papers written in English were included. The relevant literature was summarized. Despite advances in antenatal intervention for fetal LUTO, it remains associated with considerable fetal and maternal morbidity. Patient selection criteria for antenatal intervention are greatly debated. Fetal intervention has resulted in improved perinatal survival in properly selected cases, with a questionable benefit to postnatal renal function. There is decent evidence supporting the use of anticholinergics in infants and young children following valve ablation, with less robust evidence advocating alpha blockers, overnight catheter drainage and biofeedback. The role of urinary diversion remains contentious. Optimizing bladder dynamics is crucial for successful renal transplantation outcomes.

Conclusion

While antenatal intervention has failed to improve renal function outcomes of PUV, patient-centered medical and sometimes surgical interventions can help delay the progression of chronic kidney disease. Lifelong monitoring and management of the associated bladder dysfunction is indispensable even after successful renal transplantation.
Modelling the bioinformatics tertiary analysis research process
Authors: Pidò Sara , Crovari Pietro , Garzotto Franca
Published: September 2021

Background

With the advancements of Next Generation Techniques, a tremendous amount of genomic information has been made available to be analyzed by means of computational methods. Bioinformatics Tertiary Analysis is a complex multidisciplinary process that represents the final step of the whole bioinformatics analysis pipeline. Despite the popularity of the subject, the Bioinformatics Tertiary Analysis process has not yet been specified in a systematic way. The lack of a reference model results into a plethora of technological tools that are designed mostly on the data and not on the human process involved in Tertiary Analysis, making such systems difficult to use and to integrate.

Methods

To address this problem, we propose a conceptual model that captures the salient characteristics of the research methods and human tasks involved in Bioinformatics Tertiary Analysis. The model is grounded on a user study that involved bioinformatics specialists for the elicitation of a hierarchical task tree representing the Tertiary Analysis process. The outcome was refined and validated using the results of a vast survey of the literature reporting examples of Bioinformatics Tertiary Analysis activities.

Results

The final hierarchical task tree was then converted into an ontological representation using an ontology standard formalism. The results of our research provides a reference process model for Tertiary Analysis that can be used both to analyze and to compare existing tools, or to design new tools.

Conclusions

To highlight the potential of our approach and to exemplify its concrete applications, we describe a new bioinformatics tool and how the proposed process model informed its design.
To tune or not to tune, a case study of ridge logistic regression in small or sparse datasets
Authors: Šinkovec Hana , Heinze Georg , Blagus Rok , Geroldinger Angelika
Published: September 2021

Background

For finite samples with binary outcomes penalized logistic regression such as ridge logistic regression has the potential of achieving smaller mean squared errors (MSE) of coefficients and predictions than maximum likelihood estimation. There is evidence, however, that ridge logistic regression can result in highly variable calibration slopes in small or sparse data situations.

Methods

In this paper, we elaborate this issue further by performing a comprehensive simulation study, investigating the performance of ridge logistic regression in terms of coefficients and predictions and comparing it to Firth’s correction that has been shown to perform well in low-dimensional settings. In addition to tuned ridge regression where the penalty strength is estimated from the data by minimizing some measure of the out-of-sample prediction error or information criterion, we also considered ridge regression with pre-specified degree of shrinkage. We included ‘oracle’ models in the simulation study in which the complexity parameter was chosen based on the true event probabilities (prediction oracle) or regression coefficients (explanation oracle) to demonstrate the capability of ridge regression if truth was known.

Results

Performance of ridge regression strongly depends on the choice of complexity parameter. As shown in our simulation and illustrated by a data example, values optimized in small or sparse datasets are negatively correlated with optimal values and suffer from substantial variability which translates into large MSE of coefficients and large variability of calibration slopes. In contrast, in our simulations pre-specifying the degree of shrinkage prior to fitting led to accurate coefficients and predictions even in non-ideal settings such as encountered in the context of rare outcomes or sparse predictors.

Conclusions

Applying tuned ridge regression in small or sparse datasets is problematic as it results in unstable coefficients and predictions. In contrast, determining the degree of shrinkage according to some meaningful prior assumptions about true effects has the potential to reduce bias and stabilize the estimates.
A case report of breast cancer and membranous nephropathy with positive anti phospholipase A2 receptor antibodies
Authors: Mathew David , Gupta Sanjana , Ashman Neil
Published: September 2021

Background

Testing for antibodies against podocyte phospholipase A2 receptor-1 (PLA2R) allows clinicians to accurately identify primary membranous nephropathy (MN). Secondary MN is associated with a spectrum of pathology including solid organ malignancy. PLA2R positivity in these patients occurs, although no case of PLA2R-positive MN has been definitively linked to cancer.

Case presentation

We describe a case of biopsy-proven PLA2R-positive MN, in whom invasive ductal carcinoma of the breast was discovered. The patient underwent surgery and adjuvant chemotherapy (including cyclophosphamide) and went into a sustained complete remission of her nephrotic syndrome.

Discussion and conclusions

Case series have reported PLA2R positivity in patients with solid organ malignancy associated MN. Our case is unusual as it is a breast malignancy, and the patients nephrotic syndrome and anti-PLA2Rab titres improved with treatment of the cancer. Here we report, to the best of our knowledge, the first case of oestrogen receptor-2 positive breast cancer associated with PLA2R positive MN in a young lady that was treated successfully by treating the malignancy.
Tanzanian men’s engagement in household chores is associated with improved antenatal care seeking and maternal health
Authors: Chahalis Emily , McGhie Josie , Mulokozi Generose , Barham Shannon , Chappell Carter , Schenk Charisse , Linehan Mary , Torres Scott , Dearden Kirk A. , West Josh H. , Hall P. Cougar , Crookston Benjamin T.
Published: September 2021

Background

Male support for partners’ antenatal care (ANC) has the potential to improve women’s care-seeking and maternal health outcomes. This study describes factors that are associated with men’s involvement in household tasks and explores the relationship between men’s help with tasks and women’s ANC-seeking, diet and workload during pregnancy as well as other health behaviors.

Methods

This study was conducted in five Lake Zone regions of Tanzania. Cross-sectional surveys were carried out among approximately 10,000 households that had children under the age of 2 years. Surveys were administered to mothers of children less than 2 years and where available, their male partners. Data were collected between December 2015 and May 2020, in conjunction with a large-scale campaign aimed at reducing childhood stunting by changing the behavior of mothers, caregivers, and decision makers. Data analysis included bivariate analysis and logistic regression modeling.

Results

Men’s engagement in household activities was significantly associated with living in an urban setting, being younger, having at least some formal schooling, early verbal interactions with their children, and male involvement in healthcare decisions. Additionally, mothers of male partners that were engaged in household activities were significantly older and more likely to have at least some secondary school education. Relative to households where men only infrequently helped out with chores or not at all, women from households where men frequently helped were significantly more likely to have taken iron tablets during pregnancy, report having eaten more than usual, lessening their household workload during their most recent pregnancy, and more likely to have played with their child in the week prior to the survey.

Conclusion

Male’s participation in household tasks is associated with a general improvement in mother’s ANC behaviors. Implicit in these findings is that general primary education for both men and women has health benefits that transcend socioeconomic class and that future interventions aimed to engage males in household tasks may target older males with less education living in rural areas.
Head and neck cancer risk factors in the French West Indies
Authors: Auguste Aviane , Joachim Clarisse , Deloumeaux Jacqueline , Gaete Stanie , Michineau Léah , Herrmann-Storck Cécile , Duflo Suzy , Luce Danièle
Published: September 2021

Objectives

The incidence of head and neck squamous cell carcinoma (HNSCC) in the French West Indies (FWI) is relatively high, despite a low prevalence of tobacco smoking and alcohol drinking. Little is known about other risk factors in the FWI. We assessed associations between several factors and HNSCC risk, their population attributable fractions (PAF) in the FWI, and compared these PAFs by subsite, sex and age.

Materials and methods

We conducted a population-based case-control study (145 cases and 405 controls). We used logistic regression models to estimate adjusted odds-ratios (OR), PAFs and their 95% confidence intervals (CI).

Results

Tobacco smoking, alcohol drinking, high-risk HPV, family history of HNC, low BMI and several occupations and industries were significantly associated to the occurrence of HNSCC. The majority of HNSCC cases were attributable to tobacco smoking (65.7%) and alcohol (44.3%). The PAF for the combined consumption of tobacco and/or alcohol was 78.2% and was considerably larger in men (85%) than in women (33%). The PAFs for the remaining risk factors were 9% for family history of HNSCC, 9% for low BMI, 15% for high-risk HPV, and 25% for occupations. The overall PAF for all risk factors combined was 89.0% (95% CI = 82.0–93.2). The combined PAFs by sex were significantly greater in men (93.4%, 95% CI = 87.5–96.5) than in women (56.4%, 95% CI = 18.7–76.6).

Conclusion

Tobacco and alcohol appeared to have the greatest impact on HNSCC incidence among the studied risk factors, especially among men. Prevention programs for HNSCC in the FWI should target tobacco and alcohol cessation, particularly in men. Future research should emphasise on the role of occupational factors to better understand this disease.