• Behavioural and Neural Responses to Facial Disfigurement

      Center for Obesity Research and Education (Temple University) (2019-05-29)
      Faces are among the most salient and relevant visual and social stimuli that humans encounter. Attractive faces are associated with positive character traits and social skills and automatically evoke larger neural responses than faces of average attractiveness in ventral occipito-temporal cortical areas. Little is known about the behavioral and neural responses to disfigured faces. In two experiments, we tested the hypotheses that people harbor a disfigured is bad bias and that ventral visual neural responses, known to be amplified to attractive faces, represent an attentional effect to facial salience rather than to their rewarding properties. In our behavioral study (N = 79), we confirmed the existence of an implicit ‘disfigured is bad’ bias. In our functional MRI experiment (N = 31), neural responses to photographs of disfigured faces before treatment evoked greater neural responses within ventral occipito-temporal cortex and diminished responses within anterior cingulate cortex. The occipito-temporal activity supports the hypothesis that these areas are sensitive to attentional, rather than reward properties of faces. The relative deactivation in anterior cingulate cortex, informed by our behavioral study, may reflect suppressed empathy and social cognition and indicate evidence of a possible neural mechanism underlying dehumanization.
    • Brimonidine gel 0.33% rapidly improves patient-reported outcomes by controlling facial erythema of rosacea: A randomized, double-blind, vehicle-controlled study

      Layton, A. M.; Schaller, M.; Homey, B.; Hofmann, M. A.; Bewley, A. P.; Lehmann, P.; Nohlgård, C.; Sarwer, David; Kerrouche, N.; Ma, Y. M.; 0000-0003-1033-5528 (2015-09)
      Background: Facial redness contributes to impaired psychosocial functioning in rosacea patients and the only approved treatment for erythema is topical brimonidine gel 0.33%. Objectives: To evaluate patient‐reported outcomes, as well as efficacy and safety, in subjects with self‐perceived severe erythema treated with brimonidine gel 0.33% compared to vehicle. Methods: An 8‐day multicenter, randomized study comparing once‐daily brimonidine gel 0.33% with vehicle gel using a facial redness questionnaire, subject satisfaction questionnaire and a patient diary of facial redness control to assess patient‐reported outcomes. Results: Of the 92 included subjects with self‐perceived severe erythema, very few were satisfied with their appearance at baseline (4.2% brimonidine group, 0 vehicle group). On Day 8, significantly more brimonidine group subjects were satisfied with their facial appearance compared to vehicle group (36.9% vs. 21.5%; P < 0.05), with the overall treatment effect (69.6% vs. 40.4%; P < 0.01), and with the improvement in their facial redness (67.4% vs. 33.3%; P < 0.001). More brimonidine group subjects were able to control their facial redness daily (e.g. 83.0% vs. 38.9% on Day 1). On Day 8, significantly more brimonidine group subjects than vehicle group had at least a one‐grade improvement from baseline in the Clinician Erythema Assessment score (71.7% vs. 35.7%; P = 0.0011) and Patient Self‐Assessment score (76.1% vs. 47.6%; P = 0.004). More subjects in the brimonidine group (29.2%) reported treatment‐related adverse events than in the vehicle group (15.9%) but most were mild and transient. Conclusions: Once‐daily brimonidine gel 0.33% allowed patients to rapidly control their facial redness and significantly improved patient‐reported outcomes in the treatment of persistent facial erythema of rosacea.
    • Cardiovascular Manifestations of COVID-19 Infection

      Center for Translational Medicine (Temple University) (2020-11-19)
      SARS-CoV-2 induced the novel coronavirus disease (COVID-19) outbreak, the most significant medical challenge in the last century. COVID-19 is associated with notable increases in morbidity and death worldwide. Preexisting conditions, like cardiovascular disease (CVD), diabetes, hypertension, and obesity, are correlated with higher severity and a significant increase in the fatality rate of COVID-19. COVID-19 induces multiple cardiovascular complexities, such as cardiac arrest, myocarditis, acute myocardial injury, stress-induced cardiomyopathy, cardiogenic shock, arrhythmias and, subsequently, heart failure (HF). The precise mechanisms of how SARS-CoV-2 may cause myocardial complications are not clearly understood. The proposed mechanisms of myocardial injury based on current knowledge are the direct viral entry of the virus and damage to the myocardium, systemic inflammation, hypoxia, cytokine storm, interferon-mediated immune response, and plaque destabilization. The virus enters the cell through the angiotensin-converting enzyme-2 (ACE2) receptor and plays a central function in the virus’s pathogenesis. A systematic understanding of cardiovascular effects of SARS-CoV2 is needed to develop novel therapeutic tools to target the virus-induced cardiac damage as a potential strategy to minimize permanent damage to the cardiovascular system and reduce the morbidity. In this review, we discuss our current understanding of COVID-19 mediated damage to the cardiovascular system.
    • Cardiovascular Manifestations of COVID-19 Infection

      Center for Translational Medicine (Temple University) (2020-11-19)
      SARS-CoV-2 induced the novel coronavirus disease (COVID-19) outbreak, the most significant medical challenge in the last century. COVID-19 is associated with notable increases in morbidity and death worldwide. Preexisting conditions, like cardiovascular disease (CVD), diabetes, hypertension, and obesity, are correlated with higher severity and a significant increase in the fatality rate of COVID-19. COVID-19 induces multiple cardiovascular complexities, such as cardiac arrest, myocarditis, acute myocardial injury, stress-induced cardiomyopathy, cardiogenic shock, arrhythmias and, subsequently, heart failure (HF). The precise mechanisms of how SARS-CoV-2 may cause myocardial complications are not clearly understood. The proposed mechanisms of myocardial injury based on current knowledge are the direct viral entry of the virus and damage to the myocardium, systemic inflammation, hypoxia, cytokine storm, interferon-mediated immune response, and plaque destabilization. The virus enters the cell through the angiotensin-converting enzyme-2 (ACE2) receptor and plays a central function in the virus’s pathogenesis. A systematic understanding of cardiovascular effects of SARS-CoV2 is needed to develop novel therapeutic tools to target the virus-induced cardiac damage as a potential strategy to minimize permanent damage to the cardiovascular system and reduce the morbidity. In this review, we discuss our current understanding of COVID-19 mediated damage to the cardiovascular system.
    • Case Report: Watching and Waiting? A Case of Incomplete Glenosphere Seating With Spontaneous Reversal in Reverse Shoulder Arthroplasty

      MacAskill, Micah L.; Thomas, Rachel; Barnes, Leslie A.; 0000-0001-9274-1751 (2020-08-27)
      Introduction: Reverse shoulder arthroplasty is a useful procedure with broadening applications, but it has the best outcomes when used for rotator cuff tear arthropathy. However, this procedure is not without complications. While scapular notching and aseptic loosening are more common complications that have been extensively studied in the literature, dissociation of the glenoid component and incomplete glenosphere seating has not received much attention. Specifically, little research has explored appropriate management of incomplete seating of the glenosphere component, and no gold standard for treatment of this complication has emerged. Methods: In the case described here, an elderly patient with an incompletely seated glenosphere component post-operatively opted to pursue conservative management in order to avoid revision surgery if possible. Results: The partially engaged, superiorly directed components in this case exhibited spontaneous complete and symmetric seating of the glenosphere between six and twelve months post-operatively, indicating that conservative management of this complication in low-demand patients may be a viable option to avoid the risks associated with revision surgery. Conclusion: Further research should be pursued to explore what patient and prosthesis design factors may be suited to observation with serial radiographs when incomplete seating of the glenosphere component occurs.
    • Case series: Failure of imaging & biochemical markers to capture disease progression in COVID-19

      Dorey-Stein, Zachariah L.; Myers, Catherine; Kumaran, Maruti; Mamary, Albert; Criner, Gerard J.; 0000-0002-3761-153X; 0000-0002-0909-5048 (2020-09-19)
      We report four individuals admitted for acute respiratory failure due to COVID-19 who demonstrated significant clinical improvement prior to discharge and subsequently were readmitted with worsening respiratory failure, elevated inflammatory markers and worsening chest imaging. We propose a multi-disciplinary discharge criterion to establish a safer discharge process including trending inflammatory markers, daily imaging and pursuing follow up CT chest, particularly in individuals with significant morbidities and health disparities.
    • Characterizing degradation of palm swamp peatlands from space and on the ground: An exploratory study in the Peruvian Amazon

      Hergoualc'h, Kristell; Gutiérrez-Vélez, Víctor Hugo; Menton, Mary; Verchot, Louis V. (2017-03-23)
      Peru has the fourth largest area of peatlands in the Tropics. Its most representative land cover on peat is a Mauritia flexuosa dominated palm swamp (thereafter called dense PS), which has been under human pressure over decades due to the high demand for the M. flexuosa fruit often collected by cutting down the entire palm. Degradation of these carbon dense forests can substantially affect emissions of greenhouse gases and contribute to climate change. The first objective of this research was to assess the impact of dense PS degradation on forest structure and biomass carbon stocks. The second one was to explore the potential of mapping the distribution of dense PS with different degradation levels using remote sensing data and methods. Biomass stocks were measured in 0.25 ha plots established in areas of dense PS with low (n = 2 plots), medium (n = 2) and high degradation (n = 4). We combined field and remote sensing data from the satellites Landsat TM and ALOS/PALSAR to discriminate between areas typifying dense PS with low, medium and high degradation and terra firme, restinga and mixed PS (not M. flexuosa dominated) forests. For this we used a Random Forest machine learning classification algorithm. Results suggest a shift in forest composition from palm to woody tree dominated forest following degradation. We also found that human intervention in dense PS translates into significant reductions in tree carbon stocks with initial (above and below-ground) biomass stocks (135.4 ± 4.8 Mg C ha−1) decreased by 11 and 17% following medium and high degradation. The remote sensing analysis indicates a high separability between dense PS with low degradation from all other categories. Dense PS with medium and high degradation were highly separable from most categories except for restinga forests and mixed PS. Results also showed that data from both active and passive remote sensing sensors are important for the mapping of dense PS degradation. Overall land cover classification accuracy was high (91%). Results from this pilot analysis are encouraging to further explore the use of remote sensing data and methods for monitoring dense PS degradation at broader scales in the Peruvian Amazon. Providing precise estimates on the spatial extent of dense PS degradation and on biomass and peat derived emissions is required for assessing national emissions from forest degradation in Peru and is essential for supporting initiatives aiming at reducing degradation activities.
    • Child Maltreatment and the Adolescent Patient With Severe Obesity: Implications for Clinical Care

      Center for Weight and Eating Disorders (University of Pennsylvania) (2015-01-29)
      Objective: To characterize prevalence and correlates of child maltreatment (CM) in a clinical sample of adolescents with severe obesity. Method Multicenter baseline data from 139 adolescents undergoing weight loss surgery (Mage = 16.9; 79.9% female, 66.2% White; Mbody mass index [BMI] = 51.5 kg/m2) and 83 nonsurgical comparisons (Mage = 16.1; 81.9% female, 54.2% White; MBMI = 46.9 kg/m2) documented self-reported CM (Childhood Trauma Questionnaire) and associations with psychopathology, quality of life, self-esteem and body image, high-risk behaviors, and family dysfunction. Results CM prevalence (females: 29%; males: 12%) was similar to national adolescent base rates. Emotional abuse was most prevalent. One in 10 females reported sexual abuse. For females, CM rates were higher in comparisons, yet correlates were similar for both cohorts: greater psychopathology, substance use, and family dysfunction, and lower quality of life. Conclusion While a minority of adolescents with severe obesity reported a CM history, they carry greater psychosocial burden into the clinical setting.
    • Chromatin dynamics during the differentiation of long-term hematopoietic stem cells to multipotent progenitors

      Yu, Xiang Yu; Wu, Chao; Bhavanasi, Dheeraj; Wang, Hong; Gregory, Brian D.; huang, Jian; 0000-0002-1649-0038 (2017-05-30)
    • Climate Change and Human Rights

      Sinden, Amy (2007)
      Global warming may well be the most profound moral issue ever to face the human species. Profound moral issues demand a profound response from law, and as we enter the twenty-first century, human rights is (at least at a rhetorical level) the law's best response to profound, unthinkable, far-reaching moral transgression. More fundamentally, it is the law's strongest condemnation of the exploitation of the weak by the powerful. As such, it was the law's response to the moral crises of the twentieth century, and I want to suggest that it may be an appropriate legal response to the moral crisis of the twenty-first century as well. Human rights function to counteract power imbalances in society. By acting as trumps human rights effectively put a thumb on the scale in favor of the weaker party in order to correct for the distorting effects of power. Because the economic model has become the dominant lens through which we view the world, climate change is often analyzed as a market failure brought on by the tragedy of the commons. But market failure is only part of the problem. There is a far more fundamental and intractable problem standing in the way of meaningful action to stem global warming. That is the political failure brought on by the enormous disparity in power and resources between those interests that stand to gain from climate change regulation and those that - at least in the short run - stand to lose. Thinking of climate change as a human rights issue can help us see that it is not just a matter of aggregate costs and benefits, but of winners and losers - of the powerful few preventing the political system from acting to protect the powerless many.
    • Clinical Study: Sustained Weight Loss with Vagal Nerve Blockade but Not with Sham: 18-Month Results of the ReCharge Trial

      Papadia, Francesco Saverio (2015-06-28)
      Background/Objectives. Vagal block therapy (vBloc) is effective for moderate to severe obesity at one year. Subjects/Methods. The ReCharge trial is a double-blind, randomized controlled clinical trial of 239 participants with body mass index (BMI) of 40 to 45 kg/m or 35 to 40 kg/m with one or more obesity-related conditions. Interventions were implantation of either vBloc or Sham devices and weight management counseling. Mixed models assessed percent excess weight loss (%EWL) and total weight loss (%TWL) in intent-to-treat analyses. At 18 months, 142 (88%) vBloc and 64 (83%) Sham patients remained enrolled in the study. Results. 18-month weight loss was 23% EWL (8.8% TWL) for vBloc and 10% EWL (3.8% TWL) for Sham (P < 0.0001). vBloc patients largely maintained 12-month weight loss of 26% EWL (9.7% TWL). Sham regained over 40% of the 17% EWL (6.4% TWL) by 18 months. Most weight regain preceded unblinding. Common adverse events of vBloc through 18 months were heartburn/dyspepsia and abdominal pain; 98% of events were reported as mild or moderate and 79% had resolved. Conclusions. Weight loss with vBloc was sustained through 18 months, while Sham regained weight between 12 and 18 months. vBloc is effective with a low rate of serious complications.
    • Clustering, hierarchical organization, and the topography of abstract and concrete nouns

      Dove, Guy; Eleanor Saffran Center for Cognitive Neuroscience (Temple University) (2014-04-28)
      The empirical study of language has historically relied heavily upon concrete word stimuli. By definition, concrete words evoke salient perceptual associations that fit well within feature-based, sensorimotor models of word meaning. In contrast, many theorists argue that abstract words are “disembodied” in that their meaning is mediated through language. We investigated word meaning as distributed in multidimensional space using hierarchical cluster analysis. Participants (N = 365) rated target words (n = 400 English nouns) across 12 cognitive dimensions (e.g., polarity, ease of teaching, emotional valence). Factor reduction revealed three latent factors, corresponding roughly to perceptual salience, affective association, and magnitude. We plotted the original 400 words for the three latent factors. Abstract and concrete words showed overlap in their topography but also differentiated themselves in semantic space. This topographic approach to word meaning offers a unique perspective to word concreteness.
    • Comparative Pragmatism

      Rebouché, Rachel (2012)
      Over the past decade, high courts in many countries have either struck down statutes criminalizing abortion or upheld recently passed statutes expanding legal grounds for abortion. These courts have employed comparative analysis to position their decisions on a spectrum of transnational approaches to abortion law. The spectrum, as these courts describe it, ranges from unrestricted abortion, purportedly the approach of the United States under Roe v. Wade, to a broad prohibition on abortion, purportedly the approach of Germany under decisions of its Federal Constitutional Court. This comparative method, first identified by constitutional law scholars in the late 1970s and 1980s, relies on oversimplified and sometimes inaccurate portrayals of the law and of practice. Yet three decades later, this method continues to circulate among courts all over the world. This article displaces the myth that comparative experience fits along a bi-directional spectrum by introducing a model better tailored to the realities of law and practice — comparative pragmatism. The article begins by critiquing recent decisions by courts in Colombia, South Africa, Portugal, and Mexico that have used comparative law to justify their decisions as part of a modern and universal conversation. By employing the prevailing comparative method, however, these courts not only misrepresent U.S. and German law, they look to comparators that are over thirty-years old and are exclusively from the global North. The article traces the courts’ methodology to a one-size-fits-all strategy embraced by women’s rights activists participating in each case. This method, however well-intentioned, blinds courts and lawmakers to local circumstances that will dictate realization of newly recognized rights. The article concludes by describing comparative pragmatism, a novel mode of comparative analysis, that draws upon public health literature and encourages contextualized reform strategies consistent with the state’s ability to implement formal rights.
    • Concept Mapping as a Mechanism for Assessing Science Teachers’ Cross-Disciplinary Field-Based Learning

      Garner, Joanna K.; Kaplan, Avi; Hathcock, Stephanie; Bergey, Bradley W.; 0000-0002-2898-0085 (2019-07-11)
      Two common goals of science teacher professional development (PD) are increased content knowledge (CK) and improved readiness to teach through inquiry. However, PD assessment challenges arise when the context is structured around inquiry-based, participant-driven learning, and when the content crosses scientific disciplines. This study extended the use of concept mapping as an assessment tool for examining changes in the content knowledge of 21 high school science teachers who participated in a field-based environmental science summer institute. The scoring rubric focused on documenting concepts, links, and map organization and scope in an attempt to capture development of cross-disciplinary knowledge in ways that correspond with theories of expertise development. The analysis revealed significant gains from pre-PD to post PD maps in the sophistication of links between concepts and in the number of additional, participant-generated scientifically valid concepts. Relative to the initial maps, post PD maps also manifested more complete clustering of concepts. Findings are discussed in reference to previous studies on teachers’ learning and implications for future research using concept mapping as a means of assessing teacher PD.
    • Contracting Pregnancy

      Rebouché, Rachel (2020)
      Several states recently have passed laws that permit and regulate gestational surrogacy, changing course from the prohibitions that characterized an earlier era. These statutes require mental health counseling before pregnancy and legal representation for all parties to the contract. Scholars and practitioners alike herald this legislation as the way forward in protecting the interests of both intended parents and surrogates. State law, however, may not resolve a recurrent tension over who controls prenatal decision making in gestational surrogacy agreements. Intended parents want authority to make decisions regarding the pregnancy. Contract provisions cater to that desire and support the broader assumption that parents should seek as much prenatal information as possible. Yet surrogates have the right, by statute and as patients, to manage their prenatal care. Analyzing the most controversial terms of surrogacy contracts—those governing prenatal testing, prenatal behavior, and abortion—this Article demonstrates that neither statutory rights nor contractual remedies adequately address disputes over prenatal care. Rather, mental health professionals who provide pre-pregnancy counseling and lawyers who draft surrogacy contracts have greater effect on parties’ expectations and conduct. Lawyers, in implementing surrogacy contracts, help build trust between parties that induces compliance with otherwise unenforceable terms. When there is a conflict between the parties, lawyers diffuse it. This Article identifies the consequences of relational contracting for surrogacy, including shielding parties’ behavior from view and entrenching the power of fertility agencies and brokers. It concludes by suggesting how law might challenge the dominance of professionals and agencies by opening the fertility market to a broader population of participants.
    • Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2021-01-07)
      Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads mainly by means of aerosols (microdroplets) in enclosed environments, especially those in which temperature and humidity are regulated by means of air-conditioning. About 30% of individuals infected with SARS-CoV-2 develop coronavirus disease 2019 (COVID-19) disease. Among them, approximately 25% require hospitalization. In medicine, cases are identified as those who become ill. During this pandemic, cases have been identified as those with a positive SARS-CoV-2 polymerase chain reaction test, including approximately 70% who were asymptomatic—this has caused unnecessary anxiety. Individuals more than 65 years old, those affected by obesity, diabetes, asthma, or are immune-depressed owing to cancer and other conditions, are at a higher risk of hospitalization and of dying of COVID-19. Healthy individuals younger than 40 years very rarely die of COVID-19. Estimates of the COVID-19 mortality rate vary because the definition of COVID-19–related deaths varies. Belgium has the highest death rate at 154.9 per 100,000 persons, because it includes anyone who died with symptoms compatible with COVID-19, even those never tested for SARS-CoV-2. The United States includes all patients who died with a positive test, whether they died because of, or with, SARS-CoV-2. Countries that include only patients in which COVID-19 was the main cause of death, rather than a cofactor, have lower death rates. Numerous therapies are being developed, and rapid improvements are anticipated. Because of disinformation, only approximately 50% of the U.S. population plans to receive a COVID-19 vaccine. By sharing accurate information, physicians, health professionals, and scientists play a key role in addressing myths and anxiety, help public health officials enact measures to decrease infections, and provide the best care for those who become sick. In this article, we discuss these issues.
    • Coronavirus Outbreak in Italy: Physiological Benefits of Home-Based Exercise During Pandemic

      Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine (Temple University) (2020-05-07)
      The Coronavirus Disease 2019 (COVID-19) pandemic has forced the hardest-hit populations, like Italians, to radically change their daily habits, starting with social distancing, strict preventive measures, and self-isolation. These precautions also apply to sport-related facilities and activities. The difficulty to practice physical activity during this dramatic moment in time adds to the risks associated with sedentary habits, due to staying all the time at home. Here, the importance and the benefits of maintaining exercise routine, even at home, are emphasized in order to avoid the consequences of inactivity.
    • Cost-Benefit Analysis, Ben Franklin, and the Supreme Court

      Sinden, Amy (2014)
      This article looks at the ongoing debate over the use of cost-benefit analysis in agency rulemaking through a case study of a set of EPA power plant regulations that brought that debate before the U.S. Supreme Court in 2009. In the briefing before the Court, a peculiar pattern emerged: the briefs for the environmentalists opposing CBA portrayed it as highly formal, rigid, quantitative, and technical, while the industry and think-tank briefs advocating CBA painted it as informal, based in common sense, and associated with Ben Franklin. These diverging descriptions reflect the fact that cost-benefit analysis is not a monolith but comes in many varieties on a spectrum from informal to formal. Examining the rulemakings leading up to and following the Supreme Court’s opinion, this case study illustrates the importance of clearly defining the term “CBA” and the intellectual sloppiness and irrationality that can result when policymakers fail to distinguish between these very different forms of analysis.
    • Cost-Effective Cosmetic-Grade Hyaluronan Hydrogels for ReNcell VM Human Neural Stem Cell Culture

      Ma, Weili; Suh, Won H.; 0000-0002-4036-8307 (2019-09-20)
      Hyaluronic acid (HA) is a polysaccharide polymer frequently used as a starting material to fabricate hydrogels, especially for recapitulating the brain’s extracellular matrix (ECM) for in vitro neural stem cell (NSC) cultures. Here, we report the successful synthesis of a methacrylated HA (MeHA) polymer from an inexpensive cosmetic-grade hyaluronan starting material. The MeHA polymers synthesized from cosmetic-grade HA yielded similar chemical purity to those from pharmaceutical/research-grade HA reported in the literature. Crosslinked MeHA (x-MeHA) hydrogels were formed using radical polymerization which resulted in mechanical properties matching previously reported mechanical property ranges for enhanced neuronal differentiation of NSCs. We assessed cellular adhesion, spreading, proliferation, and stiffness-dependent neuronal differentiation properties of ReNcell VM human neural stem cells (hNSCs) and compared our results to studies reported in the literature (that utilized non-human and human pluripotent cell-derived NSCs).