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Background: Currently, the capacity to provide buprenorphine treatment (BT) is not sufficient to treat the growing number of people in the United States with opioid use disorder (OUD). We sought to examine participant retention in care rates of primary care delivered BT programs and to describe factors associated with retention/attrition for participants receiving BT in this setting. Objectives: A PRISMA-guided search of various databases was performed to identify the articles focusing on efficacy of BT treatment and OUD. Method: A systematic literature search identified 15 studies examining retention in care in the primary care setting between 2002 and 2020. Random effects meta-regression were used to identify retention rates across studies. Results: Retention rates decreased across time with a mean 0.52 rate at one year. Several factors were found to be related to retention, including: race, use of other drugs, receipt of counseling, and previous treatment with buprenorphine. Conclusions: While we only investigate BT through primary care, our findings indicate retention rates are equivalent to the rates reported in the specialty care literature. More work is needed to examine factors that may impact primary care delivered BT specifically and differentiate participants that may benefit from care delivered in specialty over primary care as well as the converse. [ABSTRACT FROM AUTHOR]

There is a requirement for an objective method to determine a safe level of low‐level military occupational blast, having recognised it can lead to neurological damage. The purpose of the current study was to evaluate the effect of artillery firing training on the neurochemistry of frontline soldiers using two‐dimensional (2D) COrrelated SpectroscopY (2D COSY) in a 3‐T clinical MR scanner. Ten men considered to be of sound health were evaluated before and after a week‐long live firing exercise in two ways. Prior to the live fire exercise, all participants were screened by a clinical psychologist using a combination of clinical interviews and psychometric tests, and were then scanned with 3‐T MRI. The protocols included T1‐ and T2‐weighted images for diagnostic reporting and anatomical localisation and 2D COSY to record any neurochemical effects from the firing. No changes to the structural MRI were recorded. Nine substantive and statistically significant changes in the neurochemistry were recorded as a consequence of firing training. Glutamine and glutamate, glutathione, and two of the seven fucose‐α (1–2)‐glycans were significantly increased. N‐acetyl aspartate, myo‐inositol + creatine, and glycerol were also increased. Significant decreases were recorded for the glutathione cysteine moiety and tentatively assigned glycan with a 1–6 linkage (F2: 4.00, F1: 1.31 ppm). These molecules are part of three neurochemical pathways at the terminus of the neurons providing evidence of early markers of disruption to neurotransmission. Using this technology, the extent of deregulation can now be monitored for each frontline defender on a personalised basis. The capacity to monitor early a disruption in neurotransmitters, using the 2D COSY protocol, can observe the effect of firing and may be used to prevent or limit these events. [ABSTRACT FROM AUTHOR]

Background: The relationship of tissue chemistry to breast density and cancer risk has not been documented despite breast density being a known risk factor. Purpose: To investigate whether distinct chemical profiles associated with breast density and cancer risk are identified in healthy breast tissue using in vivo two‐dimensional correlated spectroscopy (2D COSY). Study Type: Prospective. Population: One‐hundred‐seven participants including 55 at low risk and 52 at high risk of developing breast cancer. Field Strength/Sequence: 3 T/ axial/ T1, T2, 2D COSY. Assessment Two radiologists defined breast density on T2. Interobserver variability assessed. Peak volumes normalized to methylene at (1.30, 1.30) ppm as internal shift reference. Statistical Tests: Chi‐squared/Mann–Whitney/Kappa statistics/Kruskal Wallis/pairwise analyses. Significance level 0.05. Results: Ten percentage were fatty breasts, 39% scattered fibroglandular, 35% heterogeneously dense, and 16% extremely dense. Interobserver variability was excellent (kappa = 0.817). Sixty percentage (64/107) were premenopausal. Four distinct tissue chemistry categories were identified: low‐density (LD)/premenopausal, high‐density (HD)/premenopausal, LD/postmenopausal, and HD/postmenopausal. Compared to LD, HD breast chemistry showed significant increases of cholesterol (235%) and lipid unsaturation (33%). In the low‐risk category, postmenopausal women with dense breasts recorded the largest significant changes including cholesterol methyl 540%, lipid unsaturation 207%, glutamine/glutamate 900%, and choline/phosphocholine 800%. In the high‐risk cohort, premenopausal women with HD recorded a more active chemical profile with significant increases in choline/phosphocholine 1100%, taurine/glucose 550% and cholesterol sterol 250%. Data Conclusion: Four distinct chemical profiles were identified in healthy breast tissue based on breast density and menopausal status in participants at low and high risk. Gradual increase in neutral lipid content and metabolites was noted in both risk groups across categories in different order. In low risk, the HD postmenopausal category exhibited the highest metabolic activity, while women at high risk exhibited the highest lipid content and metabolic activity in the HD premenopausal category. Level of Evidence: 2 Technical Efficacy Stage: 3 [ABSTRACT FROM AUTHOR]

Introduction: Twitter journal clubs are a relatively new adaptation of an established continuing professional development (CPD) activity within healthcare. The medical radiation science (MRS) journal club 'MedRadJClub' (MRJC) was founded in March 2015 by a group of academics, researchers and clinicians as an international forum for the discussion of peer‐reviewed papers. To investigate the reach and impact of MRJC, a five‐year analysis was conducted. Methods: Tweetchat data (number of participants, tweets and impressions) for the first five years of MRJC were extracted and chat topics organised into themes. Fifth anniversary MRJC chat tweets were analysed and examples of academic and professional outputs were collated. Results: A total of 59 chats have been held over five years with a mean of 41 participants and 483,000 impressions per hour‐long synchronous chat. Ten different tweetchat themes were identified, with student engagement/preceptorship the most popular. Eight posters or oral presentations at conferences, one social media workshop and four papers have been produced. Qualitative analysis revealed five core themes relating to the perceived benefits of participation in MRJC: (1) CPD and research impact, (2) professional growth and influencing practice, (3) interdisciplinary learning and inclusion, (4) networking and social support and (5) globalisation. Conclusion: MRJC is a unique, multi‐professional, global community with consistent engagement. It is beneficial for both CPD, research engagement, dissemination and socialisation within the MRS community. [ABSTRACT FROM AUTHOR]

In order to suggest the larger terms, parameters, and limits of autoethnographic method in life narrative, this essay explores three life narratives from filmmaker, writer, and critic Manthia Diawara that engage and exemplify different models of autoethnographic method, and points up the interests and issues raised by each. In the films Rouch in Reverse and An Opera of the World and the memoir/short film In Search of Africa, it makes distinctions among counter-ethnography, 'strong' autoethnography, and the terrain 'beyond' autoethnography and suggests their applicability to the literary memoirs of such writers as Annie Ernaux and Audre Lorde. [ABSTRACT FROM AUTHOR]

The last 20 years have seen a substantial growth in research on the extent to which health sector reforms are pro-poor or pro-rich. What has been missing is knowledge synthesis work to derive operational lessons from the empirical research. This article fills the gap for the most popular form of health financing reform, health insurance. Based on publications covering 20 developing countries, we find that health insurance is no panacea for improving equity in the health sector. More importantly, we find certain design elements of health insurance can increase the likelihood of tackling inequality in the health sector in developing countries. [ABSTRACT FROM AUTHOR]

This pilot study investigates the correlation between psychological stress and antiretroviral therapy (ART) adherence and plasma HIV RNA (viral load) as mediated by psychological flexibility among Black men in the south. Data were collected from 48 HIV-positive, low income Black men. Results indicate a strong positive correlation between perceived stress and psychological inflexibility (adjusted for age and income rs = 0.67; p < 0.001), a negative correlation between psychological inflexibility and ART adherence (adjusted rs = − 0.32; p = 0.03), a negative correlation between perceived stress and ART adherence (adjusted rs = − 0.45; p = 0.006), and a negative correlation between ART adherence and viral load (adjusted rs = − 0.37; p = 0.04). Our findings suggest stress decreases adherence to ART and viral suppression among Black men living with HIV. However, psychological flexibility did not mediate the relationship between stress and treatment adherence. Hair cortisol concentrations were high (mean of 34.2 pg/mg), but uncorrelated with adherence. [ABSTRACT FROM AUTHOR]

Methods for measuring the properties of individual cells within their native 3D environment will enable a deeper understanding of embryonic development, tissue regeneration, and tumorigenesis. However, current methods for segmenting nuclei in 3D tissues are not designed for situations in which nuclei are densely packed, nonspherical, or heterogeneous in shape, size, or texture, all of which are true of many embryonic and adult tissue types as well as in many cases for cells differentiating in culture. Here, we overcome this bottleneck by devising a novel method based on labelling the nuclear envelope (NE) and automatically distinguishing individual nuclei using a tree-structured ridge-tracing method followed by shape ranking according to a trained classifier. The method is fast and makes it possible to process images that are larger than the computer’s memory. We consistently obtain accurate segmentation rates of >90%, even for challenging images such as mid-gestation embryos or 3D cultures. We provide a 3D editor and inspector for the manual curation of the segmentation results as well as a program to assess the accuracy of the segmentation. We have also generated a live reporter of the NE that can be used to track live cells in 3 dimensions over time. We use this to monitor the history of cell interactions and occurrences of neighbour exchange within cultures of pluripotent cells during differentiation. We provide these tools in an open-access user-friendly format. [ABSTRACT FROM AUTHOR]

The elongating mouse anteroposterior axis is supplied by progenitors with distinct tissue fates. It is not known whether these progenitors confer anteroposterior pattern to the embryo. We have analysed the progenitor population transcriptomes in the mouse primitive streak and tail bud throughout axial elongation. Transcriptomic signatures distinguish three known progenitor types (neuromesodermal, lateral/paraxial mesoderm and notochord progenitors; NMPs, LPMPs and NotoPs). Both NMP and LPMP transcriptomes change extensively over time. In particular, NMPs upregulate Wnt, Fgf and Notch signalling components, and many Hox genes as progenitors transit from production of the trunk to the tail and expand in number. In contrast, the transcriptome of NotoPs is stable throughout axial elongation and they are required for normal axis elongation. These results suggest that NotoPs act as a progenitor niche whereas anteroposterior patterning originates within NMPs and LPMPs. [ABSTRACT FROM AUTHOR]

Smith and Watson propose eight micro-studies exploring the challenges of researching life writing. Their sources are familiar to Polish readers - Zlata's Diary by Zlata Filipović, Art Spiegelman's Maus, the writings of Mary Antin or Charlotte Salomon's autobiographical series of paintings. The authenticity of those works is examined in terms of the different perspectives of the artist, autocreation, human rights or the editing process, which gives rise to new contexts. Smith and Watson also refer to the problem of postmemory and the archive of feelings, which enrich official accounts while also questioning them. They point to issues related to digitalizing existing sources and life in the web, which creates new possibilities and challenges for both artists and researchers. [ABSTRACT FROM AUTHOR]

In the United States, where scholars typically do not hold copyright to their published work, many essays they previously published are now available only from a journal publisher for a high access fee or from an out-of-print book. As twenty-first-century researchers seek overviews and coherent histories of the many fields of literary and cultural studies that emerged over the last three decades, how can older generations of scholars, who worked primarily in print venues, put previously published work into digitally accessible formats that will keep it in current conversations? And why might new scholars want to? The author describes a new mode of republishing one's past essays in open access online, as illustrated by her and her co-author's experience. They learned the nuts and bolts, and also discovered some pitfalls, of open access republishing, including obtaining permissions from corporate publishers, correcting PDF-to-Word conversions, identifying design elements helpful for online use, and marketing their own book. [ABSTRACT FROM AUTHOR]

I offer the first critical reading in English of Parsua Bashi's graphic memoir Nylon Road, which traces a narrative of place and belonging by a diasporan Iranian woman after the cataclysmic changes of previous decades. The narrative is a dialogical autobiographical process in which Parsua, the narrating I, conducts a self-interrogation with eleven of her former selves. Together they weigh the competing belief systems of Iranian fundamentalism; Western secular humanism in Switzerland, where Bashi was a migrant (her preferred term) from 2004-09; and Soviet-style socialism, influential for many middle-class intellectuals in 1970s Iran. This visually charged clash of political and cultural positions serves as a lens for thinking about social relations and the role of women in public life. Bashi organizes Nylon Road dialogically as a site for airing visual and voiced evidence about conflicting representations of what it meant to live in, leave, and return to, Iran over a quarter century. Nylon Road's story of coming of age in revolution-era Iran presents Bashi as a daughter who, unlike Marjane Satrapi, participated in the new regime's program for decades and critiqued those escaping into exile. When she finally does so, in her thirties, she is an uncomfortable migrant in Zürich, where her multiple past selves, drawn at different ages, confront her with versions of her childhood and adolescent experience that the present-time narrating I recalls quite differently in both visual and verbal terms. The differing political positions traced in these encounters with her multiple I's, distinct in her representations, form a complex set of perspectives for both reflecting on and critiquing the Islamic Revolution within feminist, global, and postcolonial contexts. [ABSTRACT FROM AUTHOR]

In taking up the vexed example of Esmeralda Santiago'sWhen I Was Puerto Rican, I want to do two things: read it as in part a model of autoethnography organised by what Sidonie Smith and I have developed as ‘the metrics of authenticity’; and consider how such a narrative, read as strategic autoethnography, can be understood as a feminist project of—partially successful—self-representation to demystify patriarchal institutions. Although Santiago sets up a detailed autoethnographic narrative of Fifties Puerto Rico, when she turns to the immigrant teenager's encounter with Brooklyn Puerto Ricans, it is overwhelmed by the powerful model of the ‘up by the bootstraps’ story of immigrant assimilation to the American dream. Reading these two models of storytelling as competing and incompatible suggests that much women's life writing by ‘hybrid’ subjects in the Americas tells a story of incomplete ‘self-transculturation’ about the incommensurability of different languages and cultures. [ABSTRACT FROM PUBLISHER]

Fun Home includes allusions to and graphic representations of several kinds of texts—masterworks of literary modernism and Realism, classics of homoerotic fiction and autobiography, coming-out narratives, as well as Bechdel's parents' letters and photographs, official documents, maps, and anatomical and architectural drawings. Juxtaposed in its frames as visual collage, they mediate between ‘high’ and ‘low’ cultures and create a visual ‘archive of feeling’ (Cvetcovich) that attests to both the forms and the power of American discourses of sexuality in the latter half of the twentieth century. The ‘network of transversals’ established in such masterworks as Proust's Remembrance of Things Past, Joyce's Ulysses, and the Odyssey generates a structure of reversals and recognitions that both contextualises, and provides enabling frameworks for interpreting the meaning of, personal events, notably the death of teenaged Alison's father and her sense of trans-generational identifications around sexuality in the family. In addition to such intellectual puzzles, the stimulus of sexual stories, as of language itself, stirs the erotic pleasures of reading in her text. [ABSTRACT FROM AUTHOR]

Apixaban (Eliquis™), an oral direct factor Xa inhibitor, is being developed by Bristol-Myers Squibb and Pfizer as a therapy for the prevention and/or treatment of thrombotic disorders. Apixaban has been approved in the EU for the prevention of venous thromboembolism (VTE) after hip or knee replacement. A rolling submission for approval of apixaban for the prevention of stroke in patients with atrial fibrillation has also been initiated in the US. Worldwide phase III development of apixaban is underway for the prevention and treatment of VTE, and prevention of stroke in patients with atrial fibrillation. Development for acute coronary syndromes has been stopped following the discontinuation of the phase III APPRAISE-II trial. This article summarizes the milestones in the development of apixaban leading to this first approval for the prevention of VTE after hip or knee replacement. [ABSTRACT FROM AUTHOR]

The PD-L1/PD-1 immune checkpoint axis is the strongest T cell exhaustion inducer. As immune dysfunction occurs during obesity, we analyzed the impact of obesity on PD-L1/PD-1 expression in white adipose tissue (WAT) in mice and in human white adipocytes. We found that PD-L1 was overexpressed in WAT of diet-induced obese mice and was associated with increased expression of PD-1 in visceral but not subcutaneous WAT. Human in vitro cocultures with adipose-tissue-derived mesenchymal stem cells (ASC) and mononuclear cells demonstrated that the presence of ASC harvested from obese WAT (i) enhanced PD-L1 expression as compared with ASC from lean WAT, (ii) decreased Th1 cell cytokine secretion, and (iii) resulted in decreased cytolytic activity towards adipocytes. Moreover, (iv) the implication of PD-L1 in obese ASC-mediated T cell dysfunction was demonstrated through PD-L1 blockade. Finally, (v) conditioned media gathered from these cocultures enhanced PD-L1 expression in freshly differentiated adipocytes, depending on IFNγ. Altogether, our results suggest that PD-L1 is overexpressed in the WAT of obese individuals during IFNγ secretion, leading to T cell dysfunction and notably reduced cytolytic activity. Such a mechanism could shed light on why adipose-tissue-infiltrating viruses, such as SARS-CoV-2, can worsen disease in obese individuals. [ABSTRACT FROM AUTHOR]

Presents the author's postscript to her artwork titled 'Life? or Theatre?' History of the Grunwalds, the author's maternal family; Experience as a German Jew living in exile on the Cote d'Azur of France; Experience during and after the making of the artwork; Author's life with her abusive grandfather.

Reviews the essay `De Tilene au Plateau,' which looks at the boundaries between autobiography and ethnography. Analysis of the ambiguities of the female autobiographer/novelist/essayist's subject position.

Focuses on multicultural autobiographies in order to consider the activity of naming, its contexts, costs and pleasures. Emphasis on ethnicity and gender; Names in American autobiography as an index to the conundrums of identity formation; Social layering and linguistic troping of identity; Investigation of name origins; Discrepancies between names and social roles.

The article presents an obituary for Ousmane Sembene, an African author and motion picture director.

Background: Many young men who have sex with men (YMSM) are reluctant to seek health services and trust local physicians. Online information seeking may encourage YMSM to identify and see trustworthy physicians, obtain sexual health services, and obtain testing for sexually transmitted infections (STIs). This study examined online STI information seeking behaviors among Chinese YMSM and its association with offline physician visits.Methods: We conducted a nationwide online survey among YMSM through WeChat, the largest social media platform in China. We collected information on individual demographics, sexual behaviors, online STI information seeking, offline STI testing, and STI physician visits. We examined the most commonly used platforms (search engines, governmental websites, counseling websites, generic social media, gay mobile apps, and mobile medical apps) and their trustworthiness. We assessed interest and willingness to use an MSM-friendly physician finder function embedded within a gay mobile app. Logistic regression models were used to examine the correlation between online STI information searching and offline physician visits.Results: A total of 503 men completed the survey. Most men (425/503, 84.5%) searched for STI information online. The most commonly used platform to obtain STI information were search engines (402/425, 94.5%), followed by gay mobile apps (201/425, 47.3%). Men reported high trustworthiness of information received from gay mobile apps. Men also reported high interest (465/503, 92.4%) and willingness (463/503, 92.0%) to use a MSM-friendly physician finder function within such apps. Both using general social media (aOR =1.14, 95%CI: 1.04-1.26) and mobile medical apps (aOR =1.16, 95%CI: 1.01-1.34) for online information seeking were associated with visiting a physician.Conclusion: Online STI information seeking is common and correlated with visiting a physician among YMSM. Cultivating partnerships with the emerging mobile medical apps may be useful for disseminating STI information and providing better physician services to YMSM. [ABSTRACT FROM AUTHOR]