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Abstract Introduction With it becoming a global pandemic, the coronavirus disease of 2019 (COVID-19) imposed public health restraints that hampered patient’s presentation to hospitals. In Lebanon, little is known about the presentation patterns of acute appendicitis (AA) patients among different population groups during the COVID-19. Therefore, this study aims to assess the effects of the COVID-19 pandemic on the rates of cases seen during the pandemic period, the adopted management strategies, and evaluate the patient outcomes compared to presentations from previous years. Methods This is a retrospective, observational cohort study with no interventional procedures. All patients presented to our tertiary health care center were diagnosed with AA between February 2019 and February 2021 comprised the study analysis. We divided our patients into the pre-pandemic period cohort March 1st, 2019, till February 29th, 2020, and the pandemic period cohort March 1st 2020 till March 1st 2021. Results We collected data retrospectively from 342 patients: 201 patients presented in the pre-pandemic period and 141 during the pandemic period. Male predominance was seen in both cohorts (51.7% and 58.9% respectively). A decrease in the number of AA cases was seen during the pandemic, however, the duration of symptoms before presentation was similar in both cohorts (p = 0.382) Additionally, the number of complicated appendicitis cases was not different between cohorts. The main imaging modality was CT in both groups with no statistically significant difference in the type of imaging between them (p = 0.398). Further, the predominant treatment modality remained surgery during the pandemic, with no difference between both periods (p = 0.200), and no statistically significant difference in the type of surgery performed as laparoscopic surgery remained the most common surgery type in the pandemic period (p = 0.43). Finally, no extra surgical and post-surgical complications were identified. Conclusion In conclusion, our study is an example of how the COVID-19 pandemic did not significantly affect patients presenting for AA. Despite the COVID-19-related restrictions, Lebanese patients with worrying symptoms were presenting to the emergency department and the American University of Beirut Medical Center was providing them with the standards of care. Our study mirrors the Lebanese experience and gives an example of a population that focused more on their current symptoms than the fear of acquiring the COVID-19 virus. Further research is needed to assess whether this was the correct approach during these times.

During COVID-19, countless dashboards served as the central media for people to learn critical information about the pandemic. Varied actors, including news organizations, government agencies, universities, and nongovernmental organizations, created and maintained these dashboards, through the onerous labor of collecting, categorizing, and circulating COVID data. This study uncovers different forms of labor and data practices—the work of “COVID data builders”—behind the construction of these dashboards based on in-depth interviews with volunteers and practitioners across the United States and India who participated in COVID dashboard projects. Specifically, we examine projects focused on marginalized and missing COVID data that aimed to show the pandemic's disproportionate and unjust impact. Through an investigation of data builders’ encounters and experiences with missing COVID data in mediating the pandemic, we ask: What data problems did COVID data builders encounter? How did they produce missing COVID data while questioning its representational capacity? And lastly, what “alternative epistemologies of data” beyond representation do their data practices suggest? Through our analysis, we surfaced three types of epistemological ambiguities COVID data builders encountered within their datasets: disappearing and ephemeral data, obscuring data, and disregarded data. By highlighting these different epistemological dimensions of missing data, we conclude that focusing on the performative and infrastructural aspects of what makes datasets “work” builds a new vocabulary for addressing missing data beyond representation. We argue that the politics of counting COVID cases is grounded in the material and affective labor of confronting, navigating, and negotiating with data's epistemological ambiguities.

Innovative cell-based therapies are important new weapons in the fight against difficult-to-treat cancers. One promising strategy involves cell therapies equipped with multiple receptors to integrate signals from more than one antigen. We developed a specific embodiment of this approach called Tmod, a two-receptor system that combines activating and inhibitory inputs to distinguish between tumor and normal cells. The selectivity of Tmod is enforced by the inhibitory receptor (blocker) that recognizes an antigen, such as an HLA allele, whose expression is absent from tumors because of loss of heterozygosity. Although unwanted cross-reactivity of the blocker likely reduces efficacy rather than safety, it is important to verify the blocker’s specificity. We have tested an A∗02-directed blocker derived from the PA2.1 mouse antibody as a safety mechanism paired with a mesothelin-specific activating CAR in our Tmod construct. We solved the crystal structure of humanized PA2.1 Fab in complex with HLA-A∗02 to determine its binding epitope, which was used to bioinformatically select specific class I HLA alleles to test the blocker’s functional specificity in vitro. We found that this A∗02-directed blocker is highly specific for its cognate antigen, with only one cross-reactive allele (A∗69) capable of triggering comparable function.

ABSTRACT: Introduction: Pyonephrosis is hydronephrosis accompanied by a bacterial infection in the kidney, causing suppurative destruction of the renal parenchyma; this condition is an emergency and usually associated with stones or chronic urinary tract infections. Urinalysis is typically inaccurate for establishing the diagnosis, as bacteriuria may not manifest due to ureteral obstruction. Case report: We reported a 55-year-old male patient with flanks pain and an account of stone expulsion. Based on history taking, physical examination, radiology examinations, and percutaneous nephrotomy, we concluded a diagnosis of pyonephrosis causing by Streptococcus agalactiae as known as Group B Streptococcus. Discussion: While both US and CT scan guided the early diagnosis, CT was more accurate as it is able to capture the renal function and the underlying cause of obstruction. Pyonephrosis was described as having a pus collection in the pelvicalyceal system, cortex thinning, and the appearance of stones. Conclusion: Pyonephrosis is a rare emergency, and many clinicians find it challenging to recognize since the presentations are frequently nonspecific. In order to prevent renal failure and the spread of bacteremia that entails life-threatening urosepsis, acquiring imaging knowledge (sonography and CT) and other findings are indispensable in determining this entity.

Many brain imaging studies have looked at the cortical responses to object categories and faces. A popular way to manipulate face stimuli is by using a “face space,” a high dimensional representation of individual face images, with the average face located at the origin. However, how the brain responds to faces that deviate substantially from average has not been much explored. Increasing the distance from the average (leading to increased caricaturing) could increase neural responses in face-selective regions, an idea supported by results from non-human primates. Here, we used a face space based on principal component analysis (PCA) to generate faces ranging from average to heavily caricatured. Using functional magnetic resonance imaging (fMRI), we first independently defined face-, object- and scene-selective areas with a localiser scan and then measured responses to parametrically caricatured faces. We also included conditions in which the images of faces were inverted. Interestingly in the right fusiform face area (FFA), we found that the patterns of fMRI response were more consistent as caricaturing increased. However, we found no consistent effect of either caricature level or facial inversion on the average fMRI response in the FFA or face-selective regions more broadly. In contrast, object-selective regions showed an increase in both the consistency of response pattern and the average fMRI response with increasing caricature level. This shows that caricatured faces recruit processing from regions typically defined as object-selective, possibly through enhancing low-level properties that are characteristic of objects.

BackgroundStandardized patients (SPs) are essential stakeholders in the multiple mini interviews (MMIs) that are increasingly used to assess medical school applicants’ interpersonal skills. However, there is little evidence for their inclusion in the development of instruments. ObjectiveThis study aimed to describe the process and evaluate the impact of having SPs co-design and cocreate a global measurement question that assesses medical school applicants’ readiness for medical school and acceptance status. MethodsThis study used an exploratory, sequential, and mixed methods study design. First, we evaluated the initial MMI program and determined the next quality improvement steps. Second, we held a collaborative workshop with SPs to codevelop the assessment question and response options. Third, we evaluated the created question and the additional MMI rubric items through statistical tests based on 1084 applicants’ data from 3 cohorts of applicants starting in the 2018-2019 academic year. The internal reliability of the MMI was measured using a Cronbach α test, and its prediction of admission status was tested using a forward stepwise binary logistic regression. ResultsProgram evaluation indicated the need for an additional quantitative question to assess applicant readiness for medical school. In total, 3 simulation specialists, 2 researchers, and 21 SPs participated in a workshop leading to a final global assessment question and responses. The Cronbach α’s were >0.8 overall and in each cohort year. The final stepwise logistic model for all cohorts combined was statistically significant (P

Purpose: Many cancer survivors experience cancer-related cognitive impairment (CRCI). We conducted a randomized controlled pilot trial of 2 types of yoga practice and evaluated their effects on participants' objective cognitive function., Methods: Sedentary breast or ovarian cancer survivors were randomized to practice either restorative yoga (with more meditative practice and minimal physical exertion) or vigorous yoga (with considerable physical exertion and minimal meditative practice) in 60-minute supervised sessions 3 times a week for 12 weeks, followed by 12 weeks of home practice. We used the NIH Toolbox Cognition Domain to evaluate participants at baseline, week 12, and week 24., Results: We enrolled 35 participants. For women in the restorative yoga group, overall cognitive function was statistically significantly improved at weeks 12 and 24 compared to baseline ( P  = .03 and 0.004; Cohen's D  = 0.3 and 0.5). Fluid cognitive function also significantly improved at weeks 12 and 24 ( P  = .02 and 0.0007; Cohen's D  = 0.3 and 0.6), whereas improvements in crystallized cognition were not significant. For women in the vigorous yoga group, significant improvement was only seen in tasks of crystallized cognition at week 24 ( P  = .03; Cohen's D  = 0.5). Between-group comparisons showed that at week 24, women in the restorative yoga group had significantly higher scores on fluid cognition tasks., Conclusions: Patients who participated in yoga practice demonstrated improvement in objective cognitive function over time. Restorative yoga may be more effective in improving fluid cognitive function at week 24 when compared to vigorous yoga. These promising findings should be confirmed in definitive studies., Trial Registration: Clinicaltrials.gov; NCT02305498 (Date Registered: December 2, 2014).