Now showing items 1-20 of 3299

    • Socio-Clinical Correlations with Threat Perception and Self-Efficacy in People with Type 2 Diabetes

      Hu, Jianli; Bass, Sarah; Swavely, Deborah; Zisman-Ilani, Yaara; Chen, Sophia K.; Kim, Sarah; Kelly, Patrick J.A.; Hoadley, Ariel; Rubin, Daniel; Bass|0000-0003-2742-1609; Zisman-Ilani|0000-0001-6852-2583; Hoadley|0000-0003-1360-0358; Rubin|0000-0002-6871-6246; Hu|0000-0002-3022-1950 (2024-01-26)
      Introduction: Medically underserved people perform suboptimal type 2 diabetes (T2D) self-care, which contributes to worse diabetes control and higher complication rates. A better understanding of how beliefs about self-efficacy and the threat of diabetic complications affect self-management behavior may be informative to develop more effective interventions. Research Design and Methods: The Extended Parallel Processing Model (EPPM), a theoretical framework of perceived efficacy and disease threat, was used in a cross-sectional study to categorize 168 adults with T2D from urban safety-net clinics and the local community by self-efficacy and perceived threat from T2D and cardiovascular disease. The EPPM model offers four categories: high threat (HT)/high efficacy (HE), low threat (LT)/low efficacy (LE), HT/LE, and LT/HE. Participant demographic information, complications, medications, and other characteristics were compared across the EPPM groups. Results: The sample included 168 participants, of which 76% were Black, 16% were Hispanic, and 7% were White. HT/LE people had the lowest medication adherence (p<0.01), the lowest T2D management score (p<0.0001), the highest A1C numerically (p=0.10), and the most microvascular complications relative to other EPPM groups (p<0.01). Gender, Race/Ethnicity, education, and health insurance did not vary among EPPM groups. Conclusions: The EPPM is associated with T2D clinical outcomes and self-management behaviors. Moving people from HT/LE to LT/HE may improve T2D management. This model may be useful to target people with T2D for behavioral intervention.
    • Ultra-fine Entity Typing with Indirect Supervision from Natural Language Inference

      Li, Bangzheng; Yin, Wenpeng; Chen, Muhao (2022-05-16)
      The task of ultra-fine entity typing (UFET) seeks to predict diverse and free-form words or phrases that describe the appropriate types of entities mentioned in sentences. A key challenge for this task lies in the large number of types and the scarcity of annotated data per type. Existing systems formulate the task as a multi-way classification problem and train directly or distantly supervised classifiers. This causes two issues: (i) the classifiers do not capture the type semantics because types are often converted into indices; (ii) systems developed in this way are limited to predicting within a pre-defined type set, and often fall short of generalizing to types that are rarely seen or unseen in training. This work presents LITE🍻, a new approach that formulates entity typing as a natural language inference (NLI) problem, making use of (i) the indirect supervision from NLI to infer type information meaningfully represented as textual hypotheses and alleviate the data scarcity issue, as well as (ii) a learning-to-rank objective to avoid the pre-defining of a type set. Experiments show that, with limited training data, LITE obtains state-of-the-art performance on the UFET task. In addition, LITE demonstrates its strong generalizability by not only yielding best results on other fine-grained entity typing benchmarks, more importantly, a pre-trained LITE system works well on new data containing unseen types.
    • Online interventions for reducing hate speech and cyberhate: A systematic review

      Windisch, Steven; Wiedlitzka, Susann; Olaghere, Ajima; Jenaway, Elizabeth (2022-05-25)
      Background: The unique feature of the Internet is that individual negative attitudes toward minoritized and racialized groups and more extreme, hateful ideologies can find their way onto specific platforms and instantly connect people sharing similar prejudices. The enormous frequency of hate speech/cyberhate within online environments creates a sense of normalcy about hatred and the potential for acts of intergroup violence or political radicalization. While there is some evidence of effective interventions to counter hate speech through television, radio, youth conferences, and text messaging campaigns, interventions for online hate speech have only recently emerged. Objectives: This review aimed to assess the effects of online interventions to reduce online hate speech/cyberhate. Search Methods: We systematically searched 2 database aggregators, 36 individual databases, 6 individual journals, and 34 websites, as well as bibliographies of published reviews of related literature, and scrutiny of annotated bibliographies of related literature. Inclusion Criteria: We included randomized and rigorous quasi-experimental studies of online hate speech/cyberhate interventions that measured the creation and/or consumption of hateful content online and included a control group. Eligible populations included youth (10–17 years) and adult (18+ years) participants of any racial/ethnic background, religious affiliation, gender identity, sexual orientation, nationality, or citizenship status. Data Collection and Analysis: The systematic search covered January 1, 1990 to December 31, 2020, with searches conducted between August 19, 2020 and December 31, 2020, and supplementary searches undertaken between March 17 and 24, 2022. We coded characteristics of the intervention, sample, outcomes, and research methods. We extracted quantitative findings in the form of a standardized mean difference effect size. We computed a meta-analysis on two independent effect sizes. Main Results: Two studies were included in the meta-analysis, one of which had three treatment arms. For the purposes of the meta-analysis we chose the treatment arm from the Álvarez-Benjumea and Winter (2018) study that most closely aligned with the treatment condition in the Bodine-Baron et al. (2020) study. However, we also present additional single effect sizes for the other treatment arms from the Álvarez-Benjumea and Winter (2018) study. Both studies evaluated the effectiveness of an online intervention for reducing online hate speech/cyberhate. The Bodine-Baron et al. (2020) study had a sample size of 1570 subjects, while the Álvarez-Benjumea and Winter (2018) study had a sample size of 1469 tweets (nested in 180 subjects). The mean effect was small (g = −0.134, 95% confidence interval [−0.321, −0.054]). Each study was assessed for risk of bias on the following domains: randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selection of the reported results. Both studies were rated as “low risk” on the randomization process, deviations from intended interventions, and measurement of the outcome domains. We assessed the Bodine-Baron et al. (2020) study as “some” risk of bias regarding missing outcome data and “high risk” for selective outcome reporting bias. The Álvarez-Benjumea and Winter (2018) study was rated as “some concern” for the selective outcome reporting bias domain. Authors' Conclusions: The evidence is insufficient to determine the effectiveness of online hate speech/cyberhate interventions for reducing the creation and/or consumption of hateful content online. Gaps in the evaluation literature include the lack of experimental (random assignment) and quasi-experimental evaluations of online hate speech/cyberhate interventions, addressing the creation and/or consumption of hate speech as opposed to the accuracy of detection/classification software, and assessing heterogeneity among subjects by including both extremist and non-extremist individuals in future intervention studies. We provide suggestions for how future research on online hate speech/cyberhate interventions can fill these gaps moving forward.
    • Social-Cultural Quantum Optics at a Predominantly White University: Refusing, Rebuffing and Undoing Racism through Collective Experiential Observation

      Sweet, Elizabeth L.; Williams-Witherspoon, Kimmika; Turner, Karen M.; Fornaro, Elisabeth (2022-05-19)
      Racism is commonly defined as prejudice plus power, but in some contexts it can be practiced as a lack of diversity, equity and inclusion. These issues have been at the forefront of popular culture and academic research for some time now, but one could argue, interest has exploded in the U.S. consciousness since May of 2020 and the video recording of the extra-judicial killing of George Floyd in Minneapolis, mirroring that of Philando Castile four years earlier in the same city. In this paper we document the ways diversity, equity and inclusion are perceived, and how those perceptions render racism (un)visible. Within this context, we introduce a framework we are calling social-cultural quantum optics (SQO). With data from two large diversity symposia at a university on the east coast that is more diverse than many coupled with our experiences at three art exhibits, we begin to construct a path unlocking small scale, quantum, determinants of racism. We argue that understanding SQO can undo its links to racism on everyday life in cities and communities where universities are located, while at the same time urging the use collective experiential observation of artistic expression to aid in data analysis.
    • Prevalence and Risk Factors for Sexually Transmitted Infections in Gay and Bisexual Prostate Cancer Survivors: Results From the Restore-2 Study

      Cancer Health Equity, Education and Research Lab (Temple University) (2022-05-05)
      Background: Equitable cancer survivorship care for gay and bisexual male (GBM) prostate cancer survivors should be responsive to their sexual health needs. Rates of sexually transmitted infections (STIs) are higher among GBM compared to heterosexual men across the lifespan. In addition, evidence suggests that GBM will use a variety of strategies to cope with sexual dysfunction that may increase risk for STIs. The purpose of this study was to determine the prevalence of STIs following prostate cancer treatment among GBM and identify risk factors. Methods: In 2019, 401 GBM previously treated for prostate cancer were recruited into the Restore-2 Study. They completed a baseline online questionnaire with items assessing STIs diagnosed since being treated for prostate cancer. Any STI diagnoses was regressed on demographic, clinical, and relationship related variables using binary logistic regression. Results: Forty-five participants (11.4%) were diagnosed with an STI during or following their prostate cancer treatment. The mostly commonly diagnosed STI was syphilis (4.3%), followed by gonorrhoea (2.8%), and chlamydia (2.5%). Four participants were infected with HIV following their prostate cancer treatment. Independent risk factors for STI diagnosis included time since prostate cancer diagnosis (aOR = 1.18; 95% CI: 1.10-1.26), nonmonogamous sexual relationship (aOR = 11.23; 95% CI: 2.11-59.73), better sexual function (aOR = 1.02; 95% CI: 1.01-1.04), penile injection treatment (aOR = 3.28; 95% CI: 1.48-7.29), and multiple sex partners (aOR = 5.57; 95% CI: 1.64-18.96). Conclusions: GBM prostate cancer survivors are at risk for STIs. Culturally responsive STI prevention should be incorporated into cancer survivorship plans, particularly as men are treated for and regain sexual function over time.
    • Neurosymbolic Systems of Perception and Cognition: The Role of Attention

      Latapie, Hugo; Kilic, Ozkan; Thórisson, Kristinn R.; Wang, Pei; Hammer, Patrick; Weng|0000-0002-1066-0454 (2022-05-20)
      A cognitive architecture aimed at cumulative learning must provide the necessary information and control structures to allow agents to learn incrementally and autonomously from their experience. This involves managing an agent's goals as well as continuously relating sensory information to these in its perception-cognition information processing stack. The more varied the environment of a learning agent is, the more general and flexible must be these mechanisms to handle a wider variety of relevant patterns, tasks, and goal structures. While many researchers agree that information at different levels of abstraction likely differs in its makeup and structure and processing mechanisms, agreement on the particulars of such differences is not generally shared in the research community. A dual processing architecture (often referred to as System-1 and System-2) has been proposed as a model of cognitive processing, and they are often considered as responsible for low- and high-level information, respectively. We posit that cognition is not binary in this way and that knowledge at any level of abstraction involves what we refer to as neurosymbolic information, meaning that data at both high and low levels must contain both symbolic and subsymbolic information. Further, we argue that the main differentiating factor between the processing of high and low levels of data abstraction can be largely attributed to the nature of the involved attention mechanisms. We describe the key arguments behind this view and review relevant evidence from the literature.
    • Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry

      Center for Metabolic Disease Research (Temple University) (2022-05-18)
      Background: Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease requiring a global strategy to address. The present study aimed to explore the impact of AKD on the prognosis of ischemic stroke. Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide registry of ischemic stroke or transient ischemic attack between August 2015 and March 2018. As a subgroup of CNSR-III, the patients who had serum creatinine (sCr) and serum cystatin C (sCysC) centrally tested on admission and at 3-month, and with 1-year follow-up data were enrolled. Modified AKD criteria were applied to identify patients with AKD during the first 3 months post stroke according to the guidelines developed by the Kidney Disease: Improving Global Outcomes in 2012. The primary clinical outcome was 1-year all-cause death, and secondary outcomes were stroke recurrence and post stroke disability. Results: Five thousand sixty-five patients were recruited in the study. AKD was identified in 3.9%, 6.7%, 9.9% and 6.2% of the patients by using sCr, sCr-based estimated glomerular filtration rate (eGFRsCr), sCysC-based eGFR (eGFRsCysC), and combined sCr and sCysC-based eGFR (eGFRsCr+sCysC) criteria, respectively. AKD defined as sCr or eGFRsCr criteria significantly increased the risk of all-cause mortality (adjusted HR 2.67, 95% CI: 1.27–5.61; adjusted HR 2.19, 95% CI: 1.17–4.10) and post stroke disability (adjusted OR 1.60, 95% CI: 1.04–2.44; adjusted OR 1.51, 95% CI: 1.08–2.11). AKD diagnosed by eGFRsCysC or eGFRsCr+sCysC criteria had no significant impact on the risk of all-cause death and post stroke disability. AKD, defined by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model. Conclusions: AKD, diagnosed by sCr or eGFRsCr criteria, were independently associated with 1-year all-cause death and post stroke disability in Chinese ischemic stroke patients.
    • Non-convulsive Status Epilepticus in a Patient With Schizoaffective and Seizure Disorder on Clozapine and Electroconvulsive Therapy: A Case Report

      Temple University. Hospital (2022-05-25)
      There is limited literature on electroconvulsive therapy (ECT) in patients with a severe schizophrenia spectrum illness and concomitant seizure disorder. In addition, it is unclear whether it is safe to perform ECT in a patient with these comorbidities and a history of status epilepticus. This is the case of a 48-year-old patient with a history of schizoaffective disorder, bipolar type, refractory psychosis on clozapine and ECT, and seizure disorder on carbamazepine. She presented to the emergency department with suspected post-ECT delirium four days after her last ECT treatment, was found to be in non-convulsive status epilepticus, and was admitted to the neuroscience intensive care unit. Coma induction was required for seizure control. As she stabilized, her psychosis worsened, and she required psychiatric hospitalization. Multiple factors may have contributed to the development of status epilepticus in this patient. She was on clozapine, which has a time- and dose-dependent risk of seizure that prescribers should be wary of. She had also been prescribed the antiepileptic drug carbamazepine, which induces clozapine and itself, decreasing their effectiveness. Upon the patient’s discharge, ECT was suspended indefinitely due to concern that it may have led to status epilepticus. However, case reports suggest that intractable seizures following ECT are rare. We found no reports of status epilepticus occurring more than 60 minutes after the completion of ECT. If the benefits of ECT are significant, then it should remain a treatment option for the patient.
    • Endophthalmitis Caused by Kocuria Kristinae

      Iyer, Prashanth G.; Ashkenazy, Noy; Weiss, Stephanie J.; Miller, Darlene; Flynn, Harry W. (2022-05-31)
      Kocuria is an anaerobic, Gram-positive bacterium, which has been rarely reported to cause endophthalmitis following cataract surgery, intravitreal injections, penetrating ocular trauma, and also secondary to endogenous sources. Visual prognosis is often guarded, with no previous cases reporting a final visual acuity better than 20/60. We describe a young female patient who developed culture-proven Kocuria kristinae endophthalmitis associated with a traumatic scleral rupture. Visual acuity at 2 months of follow-up improved from light perception to 20/50 after treatment with intravitreal antimicrobial therapy and pars plana vitrectomy.
    • Novel Insights on Establishing Machine Learning-Based Stroke Prediction Models Among Hypertensive Adults

      Huang, Xiao; Cao, Tianyu; Chen, Liangziqian; Li, Junpei; Tan, Ziheng; Xu, Benjamin; Xu, Richard; Song, Yun; Zhou, Ziyi; Wang, Zhuo; Wei, Yaping; Zhang, Yan; Li, Jianping; Huo, Yong; Qin, Xianhui; Wu, Yanqing; Wang, Xiaobin; Wang, Hong; Cheng, Xiaoshu; Xu, Xiping; Liu, Lishun; Wang|0000-0001-6258-4070 (2022-05-06)
      Background: Stroke is a major global health burden, and risk prediction is essential for the primary prevention of stroke. However, uncertainty remains about the optimal prediction model for analyzing stroke risk. In this study, we aim to determine the most effective stroke prediction method in a Chinese hypertensive population using machine learning and establish a general methodological pipeline for future analysis. Methods: The training set included 70% of data (n = 14,491) from the China Stroke Primary Prevention Trial (CSPPT). Internal validation was processed with the rest 30% of CSPPT data (n = 6,211), and external validation was conducted using a nested case–control (NCC) dataset (n = 2,568). The primary outcome was the first stroke. Four received analysis methods were processed and compared: logistic regression (LR), stepwise logistic regression (SLR), extreme gradient boosting (XGBoost), and random forest (RF). Population characteristic data with inclusion and exclusion of laboratory variables were separately analyzed. Accuracy, sensitivity, specificity, kappa, and area under receiver operating characteristic curves (AUCs) were used to make model assessments with AUCs the top concern. Data balancing techniques, including random under-sampling (RUS) and synthetic minority over-sampling technique (SMOTE), were applied to process this unbalanced training set. Results: The best model performance was observed in RUS-applied RF model with laboratory variables. Compared with null models (sensitivity = 0, specificity = 100, and mean AUCs = 0.643), data balancing techniques improved overall performance with RUS, demonstrating a more satisfactory effect in the current study (RUS: sensitivity = 63.9; specificity = 53.7; and mean AUCs = 0.624. Adding laboratory variables improved the performance of analysis methods. All results were reconfirmed in validation sets. The top 10 important variables were determined by the analysis method with the best performance. Conclusion: Among the tested methods, the most effective stroke prediction model in targeted population is RUS-applied RF. From the insights, the current study revealed, we provided general frameworks for building machine learning-based prediction models.
    • The Inverse Correlation Between the Duration of Lifetime Occupational Radiation Exposure and the Prevalence of Atrial Arrhythmia

      Thirumal, Rithika; Vanchiere, Catherine; Bhandari, Ruchi; Jiwani, Sania; Horswell, Ronald; Chu, San; Chamaria, Surbhi; Katikaneni, Pavan; Boerma, Marjan; Gopinathannair, Rakesh; Olshansky, Brian; Bailey, Steven; Dominic, Paari (2022-05-30)
      Objective: Advancements in fluoroscopy-assisted procedures have increased radiation exposure among cardiologists. Radiation has been linked to cardiovascular complications but its effect on cardiac rhythm, specifically, is underexplored. Methods: Demographic, social, occupational, and medical history information was collected from board-certified cardiologists via an electronic survey. Bivariate and multivariable logistic regression analyses were performed to assess the risk of atrial arrhythmias (AA). Results: We received 1,478 responses (8.8% response rate) from cardiologists, of whom 85.4% were male, and 66.1% were ≤65 years of age. Approximately 36% were interventional cardiologists and 16% were electrophysiologists. Cardiologists > 50 years of age, with > 10,000 hours (h) of radiation exposure, had a significantly lower prevalence of AA vs. those with ≤10,000 h (11.1% vs. 16.7%, p = 0.019). A multivariable logistic regression was performed and among cardiologists > 50 years of age, exposure to > 10,000 radiation hours was significantly associated with a lower likelihood of AA, after adjusting for age, sex, diabetes mellitus, hypertension, and obstructive sleep apnea (adjusted OR 0.57; 95% CI 0.38–0.85, p = 0.007). The traditional risk factors for AA (age, sex, hypertension, diabetes mellitus, and obstructive sleep apnea) correlated positively with AA in our data set. Cataracts, a well-established complication of radiation exposure, were more prevalent in those exposed to > 10,000 h of radiation vs. those exposed to ≤10,000 h of radiation, validating the dependent (AA) and independent variables (radiation exposure), respectively. Conclusion: AA prevalence may be inversely associated with radiation exposure in Cardiologists based on self-reported data on diagnosis and radiation hours. Large-scale prospective studies are needed to validate these findings.
    • Metabolic reprogramming of glial cells as a new target for central nervous system axon regeneration

      Shriners Hospitals Pediatric Research Center (Temple University) (2022-05)
    • Spelling out the roles of individual nucleoporins in nuclear export of mRNA

      Tingey, Mark; Li, Yichen; Yu, Wenlan; Young, Albert; Yang, Weidong; Tingey|0000-0002-0365-5585; Yu|0000-0002-7366-3230; Yang|0000-0002-2615-189X (2022-05-20)
      The Nuclear Pore Complex (NPC) represents a critical passage through the nuclear envelope for nuclear import and export that impacts nearly every cellular process at some level. Recent technological advances in the form of Auxin Inducible Degron (AID) strategies and Single-Point Edge-Excitation sub-Diffraction (SPEED) microscopy have enabled us to provide new insight into the distinct functions and roles of nuclear basket nucleoporins (Nups) upon nuclear docking and export for mRNAs. In this paper, we provide a review of our recent findings as well as an assessment of new techniques, updated models, and future perspectives in the studies of mRNA’s nuclear export.
    • Recommendations for addressing the translational gap between experimental and clinical research on amyloid diseases

      Solomon, Miriam; Foderà, Vito; Langkilde, Annette Eva; Elliott, Perry; Tagliavini, Fabrizio; Forsyth, Trevor; Klementieva, Oxana; Bellotti, Vittorio (2022-05-13)
      This paper is a report of recommendations for addressing translational challenges in amyloid disease research. They were developed during and following an international online workshop organized by the LINXS Institute of Advanced Neutron and X-Ray Science in March 2021. Key suggestions include improving cross-cultural communication between basic science and clinical research, increasing the influence of scientific societies and journals (vis-à-vis funding agencies and pharmaceutical companies), improving the dissemination of negative results, and strengthening the ethos of science.
    • HIV-1 gp120 Impairs Spatial Memory Through Cyclic AMP Response Element-Binding Protein

      Fels Cancer Institute for Personalized Medicine (Temple University) (2022-05-09)
      HIV-associated neurocognitive disorders (HAND) remain an unsolved problem that persists despite using antiretroviral therapy. We have obtained data showing that HIV-gp120 protein contributes to neurodegeneration through metabolic reprogramming. This led to decreased ATP levels, lower mitochondrial DNA copy numbers, and loss of mitochondria cristae, all-important for mitochondrial biogenesis. gp120 protein also disrupted mitochondrial movement and synaptic plasticity. Searching for the mechanisms involved, we found that gp120 alters the cyclic AMP response element-binding protein (CREB) phosphorylation on serine residue 133 necessary for its function as a transcription factor. Since CREB regulates the promoters of PGC1α and BDNF genes, we found that CREB dephosphorylation causes PGC1α and BDNF loss of functions. The data was validated in vitro and in vivo. The negative effect of gp120 was alleviated in cells and animals in the presence of rolipram, an inhibitor of phosphodiesterase protein 4 (PDE4), restoring CREB phosphorylation. We concluded that HIV-gp120 protein contributes to HAND via inhibition of CREB protein function.
    • Anemoside B4 Inhibits Vascular Smooth Muscle Cell Proliferation, Migration, and Neointimal Hyperplasia

      Center for Metabolic Disease Research (Temple University) (2022-05-10)
      Vascular smooth muscle cell (VSMC) phenotypic transformation, proliferation, and migration play a pivotal role in developing neointimal hyperplasia after vascular injury, including percutaneous transluminal angioplasty and other cardiovascular interventions. Anemoside B4 (B4) is a unique saponin identified from the Pulsatilla chinensis (Bge.) Regel, which has known anti-inflammatory activities. However, its role in modulating VSMC functions and neointima formation has not been evaluated. Herein, we demonstrate that B4 administration had a potent therapeutic effect in reducing neointima formation in a preclinical mouse femoral artery endothelium denudation model. Bromodeoxyuridine incorporation study showed that B4 attenuated neointimal VSMC proliferation in vivo. Consistent with the in vivo findings, B4 attenuated PDGF-BB-induced mouse VSMC proliferation and migration in vitro. Moreover, quantitative RT-PCR and Western blot analysis demonstrated that B4 suppressed PDGF-BB-induced reduction of SM22α, SMA, and Calponin, suggesting that B4 inhibited the transformation of VSMCs from contractile to the synthetic phenotype. Mechanistically, our data showed B4 dose-dependently inhibited the activation of the phosphatidylinositol 3-kinase (PI3K)/AKT and p38 mitogen-activated protein kinase MAPK signaling pathways. Subsequently, we determined that B4 attenuated VSMC proliferation and migration in a p38 MAPK and AKT dependent manner using pharmacological inhibitors. Taken together, this study identified, for the first time, Anemoside B4 as a potential therapeutic agent in regulating VSMC plasticity and combating restenosis after the vascular intervention.
    • Indigenous oyster fisheries persisted for millennia and should inform future management

      Reeder-Myers, Leslie; Braje, Todd J.; Hofman, Courtney A.; Smith, Emma A. Elliott; Garland, Carey J.; Grone, Michael; Hadden, Carla S.; Hatch, Marco; Hunt, Turner; Kelley, Alice; LeFebvre, Michelle J.; Lockman, Michael; McKechnie, Iain; McNiven, Ian J.; Newsom, Bonnie; Pluckhahn, Thomas; Sanchez, Gabriel; Schwadron, Margo; Smith, Karen Y.; Smith, Tam; Spiess, Arthur; Tayac, Gabrielle; Thompson, Victor D.; Vollman, Taylor; Weitzel, Elic M.; Rick, Torben C. (2022-05-03)
      Historical ecology has revolutionized our understanding of fisheries and cultural landscapes, demonstrating the value of historical data for evaluating the past, present, and future of Earth’s ecosystems. Despite several important studies, Indigenous fisheries generally receive less attention from scholars and managers than the 17th–20th century capitalist commercial fisheries that decimated many keystone species, including oysters. We investigate Indigenous oyster harvest through time in North America and Australia, placing these data in the context of sea level histories and historical catch records. Indigenous oyster fisheries were pervasive across space and through time, persisting for 5000–10,000 years or more. Oysters were likely managed and sometimes “farmed,” and are woven into broader cultural, ritual, and social traditions. Effective stewardship of oyster reefs and other marine fisheries around the world must center Indigenous histories and include Indigenous community members to co-develop more inclusive, just, and successful strategies for restoration, harvest, and management.
    • Comparing Outcomes of Oligometastases Treated with Hypofractionated Image-Guided Radiotherapy (HIGRT) with a Simultaneous Integrated Boost (SIB) Technique versus Metastasis Alone: A Multi-Institutional Analysis

      Shenker, Rachel F.; Price, Jeremy G.; Jacobs, Corbin D.; Palta, Manisha; Czito, Brian G.; Mowery, Yvonne M.; Kirkpatrick, John P.; Boyer, Matthew J.; Oyekunle, Taofik; Niedzwiecki, Donna; Song, Haijun; Salama, Joseph K. (2022-05-13)
      Purpose: We previously reported on the clinical outcomes of treating oligometastases with radiation using an elective simultaneous integrated boost technique (SIB), delivering higher doses to known metastases and reduced doses to adjacent bone or nodal basins. Here we compare outcomes of oligometastases receiving radiation targeting metastases alone (MA) versus those treated via an SIB. Methods: Oligometastatic patients with ≤5 active metastases treated with either SIB or MA radiation at two institutions from 2013 to 2019 were analyzed retrospectively for treatment-related toxicity, pain control, and recurrence patterns. Tumor metastasis control (TMC) was defined as an absence of progression in the high dose planning target volume (PTV). Marginal recurrence (MR) was defined as recurrence outside the elective PTV but within the adjacent bone or nodal basin. Distant recurrence (DR) was defined as any recurrence that is not within the PTV or surrounding bone or nodal basin. The outcome rates were estimated using the Kaplan–Meier method and compared between the two techniques using the log-rank test. Results: 101 patients were treated via an SIB to 90 sites (58% nodal and 42% osseous) and via MA radiation to 46 sites (22% nodal and 78% osseous). The median follow-up among surviving patients was 24.6 months (range 1.4–71.0). Of the patients treated to MA, the doses ranged from 18 Gy in one fraction (22%) to 50 Gy in 10 fractions (50%). Most patients treated with an SIB received 50 Gy to the treated metastases and 30 Gy to the elective PTV in 10 fractions (88%). No acute grade ≥3 toxicities occurred in either cohort. Late grade ≥3 toxicity occurred in 3 SIB patients (vocal cord paralysis and two vertebral body compression), all related to the high dose PTV and not the elective volume. There was similar crude pain relief between cohorts. The MR-free survival rate at 2 years was 87% (95% CI: 70%, 95%) in the MA group and 98% (95% CI: 87%, 99%) in the SIB group (p = 0.07). The crude TMC was 89% (41/46) in the MA group and 94% (85/90) in the SIB group. There were no significant differences in DR-free survival (65% (95% CI: 55–74%; p = 0.24)), disease-free survival (60% (95% CI: 40–75%; p = 0.40)), or overall survival (88% (95% CI: 73–95%; p = 0.26)), between the MA and SIB cohorts. Conclusion: Both SIB and MA irradiation of oligometastases achieved high rates of TMC and similar pain control, with a trend towards improved MR-free survival for oligometastases treated with an SIB. Further investigation of this technique with prospective trials is warranted.
    • Cardiac Sarcoidosis Diagnostic Challenges and Management: A Case Report and Literature Review

      Temple University. Hospital (2022-05-09)
      Sarcoidosis can be presented as cardiac sarcoidosis (CS), which is challenging to diagnose due to its clinical silence. Ventricular arrhythmias and atrioventricular blocks can be fatal and cause sudden death in patients with cardiac sarcoidosis. Five percent of sarcoidosis patients have clinically evident cardiac sarcoidosis. However, autopsy reports and imaging studies have shown a higher prevalence of cardiac involvement. Early recognition is important to prevent such detrimental consequences. Cardiac sarcoidosis is increasingly being diagnosed owing to increased awareness among physicians and new diagnostic tools like MRI and positron emission tomography (PET) scan replacing traditional endomyocardial biopsy. A definitive diagnosis of CS remains challenging due to the non-specific clinical findings that can present similar symptoms of common cardiac disease; therefore, the imaging and biopsies are substantial for diagnosis confirmation. Pharmacological and Implantable devices are two main therapeutic approaches in cardiac sarcoidosis, in which steroids and pacemaker therapy have shown better outcomes. This review summarizes the available data related to the prevalence, prognosis, diagnosis, and management of cardiac sarcoidosis.
    • Ukrainians in Flight: Politics, Race, and Regional Solutions

      Ramji-Nogales, Jaya; Ramji-Nogales|0009-0004-6107-6030 (2022-05-23)
      The situation of Ukrainians fleeing the Russian invasion exemplifies, as the organizers of this symposium note, both a shock to the international order and a powerful international response. Europeans, and Global North states more broadly, have welcomed Ukrainians with a generosity that sits in stark contrast to their treatment of the vast majority of contemporary refugees. This exceptional response demonstrates a key gap in the legal architecture, namely the absence of an international agreement on shared responsibility for hosting refugees. It also highlights a substantive shortcoming in international refugee law: its failure to protect most people fleeing armed conflict. In contrast, regional law from Africa and Latin America has for some time extended refugee protection to individuals escaping generalized violence. Beyond the substantive law, in many cases, regional protection is a preferable option for individuals fleeing violent conflict. In addition to these structural and substantive concerns, the exceptionally rapid and generous response to the Ukrainians demonstrates the deep politicization of international refugee policy and highlights the invidious role of race in the international legal order.