Academic literature on the topic 'Stine, R L Goosebumps'

As works of fction, gamebooks offer narrative-bound choices – the reader generally takes on the role of a character inserted in the narrative itself, with gamebooks consequently tending towards being a story told in the second-person perspective. In pursuance of this aim, they can, in some cases, adopt gender-neutral language as regards grammatical gender, which in turn poses a translation challenge when rendering the texts into Portuguese, a language strongly marked by grammatical gender. Stemming from an analysis of a number of gamebooks in R. L. Stine’s popular Give Yourself Goosebumps series, this article seeks to understand how gender indeterminacy (when present) is kept in translation, while examining the strategies used to this effect by Portuguese translators – and particularly how ideas of implied readership come into play in the dialogue between the North-American and Portuguese literary systems.

A small, circular patch of soybean (Glycine max) showing symptoms consistent with sudden death syndrome (SDS) (2) was noted on July 25, 1998, in a producer's field in Jersey Shore, PA. Foliar symptoms included interveinal chlorosis and necrosis, leaf cupping, and leaf abscission. The vascular cylinder of roots and stems had areas of reddish-brown discoloration. A slow-growing Fusarium sp., which produced a bluish-purple color on potato dextrose agar, was isolated from the roots of several symptomatic plants. The fungus was identified as Fusarium solani by The Fusarium Research Center, The Pennsylvania State University. Koch's postulates were tested on soybean cultivars A2506, Stine 3171, Pioneer 9305 and 9306, and Jack. Five plants per cultivar were inoculated at growth stage V1 by pouring 35 ml of a 4 × 107 spores per ml suspension on the growth mix in each pot. Five plants per cultivar were treated similarly with sterile water. Foliar symptoms of SDS began to appear 3 weeks after inoculation. Seven weeks after inoculation, symptoms of interveinal chlorosis and/or necrosis, leaf cupping, and occasional leaf abscission were apparent on the inoculated plants and on several noninoculated plants. The percentage of the plant showing symptoms was recorded and converted to the 0 to 5 scale (in which 0 = 0%, 1 = 1–10%, 2 = 11–30%, 3 = 31–40%, 4 = 41–90%, and 5= 91–100% of the leaf area affected) used by Rupe (3). Regardless of the rating method, there was a significant difference (P = 0.0001) between inoculated and noninoculated plants. There were no significant differences among cultivars. Roots of the inoculated plants were frequently discolored, in contrast to those of the noninoculated plants. F. solani was isolated from the roots of 97% of the inoculated plants and 23% of the noninoculated plants. Fungus gnats were suspected of spreading the pathogen to the noninoculated plants (1). F. solani f. sp. glycines causes SDS in soybean and its identity is confirmed by the symptoms produced on soybean (2). The symptoms produced when soybean plants were inoculated in the greenhouse were consistent with those of SDS (2) and indicate that the F. solani isolate recovered from symptomatic plants in the field was F. solani f. sp. glycines. This is the first documented occurrence of SDS on soybean in Pennsylvania. References: (1) D. W. Kalb and R. L. Millar. Plant Dis. 70:752, 1986. (2) K. W. Roy et al. Plant Dis. 81:1100, 1997. (3) J. C. Rupe. Plant Dis. 73:581, 1989.

Background:Lupus nephritis is an important concern among Systemic Lupus Erythematosus (SLE) patients in Asia and its mortality rate was reported to be 6 times higher compared to the general population [1]. Without prompt treatment it can lead to end stage renal failure and affect quality of life. 24 hour urine protein collection has long been used as the gold standard test to assess proteinuria. However due to its cumbersome process random spot urine protein-creatinine ratio is used as an alternative to replace the former in some centres before subjecting patients to renal biopsy. In a study done by Matar HE et al in 2012, he showed that there was a significant correlation between 24 hour urine protein and urine protein creatinine ratio in his 95 subjects [2].Urinalysis is a semi-quantitative screening tool for early detection of potential kidney disorders. A survey done by Siedner MJ et al on practice preferences among American Rheumatologists in 2005 reported that 64.6% of them preferred to use urinalysis as the primary tool to screen for proteinuria [3].Objectives:To assess the correlation of urinalysis test with random spot urine protein-creatinine ratio PCR) compared with 24 hour urine protein.Methods:This was a retrospective study. The electronic medical records of all SLE patients seen in the rheumatology clinic of Hospital Sultan Ismail from 1/1/2017 to 31/12/2020 were reviewed. Patients who had urinalysis, urine protein creatinine ratio and 24 hour urine protein tests done were identified. Data on demography, urinalysis, random spot urine protein creatinine ratio and 24 hour urine protein were obtained and analysed.Results:There were a total of 131 patients and 124 were females. The majority were Malays (75/131) followed by the Chinese (45/131),Indians (9/141) and others (2/131). The mean age group for the studied subjects was 34 (13-67). The urinalysis test showed that 34 of them had negative results, 37 of them had urine protein of 1 +, 18 of them had urine protein of 2+ followed by 23 patients with urine protein of 3 + and the rest had urine protein of 4+. The correlation between urinalysis and 24 hour urine protein was strong (r = 0.702), whereas the correlation between urinalysis and urine PCR ratio was stronger (r = 0.797).Conclusion:We conclude that urinalysis correlates well with both random spot urine protein creatinine ratio and 24 hour urine protein and the correlation is stronger with urine PCR.References:[1]Yap DY, Tang CS, Ma MK, Lam MF, Chan TM. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol Dial Transplant. 2012;27:3248–3254. [PubMed][2]Matar HE, Peterson P, Sangle S, D’Cruz DP. Correlation of 24-hour urinary protein quantification with spot urine protein: creatinine ratio in lupus nephritis. Lupus 2012 Jul;21(8): 836-9. doi:10.1177/0961203312437438. Epub 2012 Feb 13.[3]Siedner MJ, Christopher-Stine L, Astor BC, Gelber AC, Fine DM. Screening for proteinuria in patients with lupus: a survey of practice preferences among American rheumatologists. J Rheumatol. 2007;34:973–977. [PubMed].Disclosure of Interests:None declared

Background:Inflammatory myositis are heterogenous group of diseases affecting skeletal muscles and multiple different organs1. Manual muscle testing (MMT) is the common tool used for assessment of muscle strength. Its limitations include poor sensitivity to change, floor/ceiling effect, and under representation of certain important muscle groups2. Functional index 2(FI-2) is an objective measure of dynamic repetitive muscle function at 11 proximal and distal muscle groups which correlates well with patient-reported physical function3. Since MMT8 is inadequate and FI-2 takes longer time to administer, several timed tests to assess muscle function, endurance and fatiguability like the 2- minute walk test (2MWT) or 30s raise from a chair test and 30s arm rise test are viable alternatives to be tested. Data looking at the performance of these tests are limited to small controlled studies.Objectives:To study correlation of timed tests with MMT8 and FI-2 in assessing muscle strength, endurance at baseline and at 3 months of therapy.Methods:An observational cohort study, included 19 patients with polymyositis and dermatomyositis attending OPD and IPD service of tertiary center. Patients with nclusion body myositis, overlap myositis, chronic kidney disease, coexisting myocarditis, sepsis, malignancy, pregnancy were excluded. MMT8, FI-2 and Timed function tests were done at baseline and after 3 months.Results:The study had 19 patients of which 6 were polymyositis and 13 were dermatomyositis. Male to female ratio was 1:2.1. Anti-cell antibody was positive in 16 patients. The mean MMT8 of the study group at baseline was 60.84±16.77 and after 3 months was 67.05±11.7. Out of 19 patients, all received prednisolone as induction agent followed by Methotrexate in 13, cyclophosphamide in 9, azathioprine in 5, Rituximab by one patient. Mean scores of 30s arm lift, 30s rise from chair test and 2 min walk test were 11.7±6.39,14±7.29,101.5± 46.48 respectively at baseline and 13.05±6.5,15.6±7.1,117.84±38.4 after 3 months.Table 1.Spearman Rho Correlation between timed function tests and MMT8, FI-2, patient and physician VASΔ 30s rise from chair testΔ 30s arm lift testΔ 2 min walk testΔ MMT80.3820.3370.724**Δ FI-2Hip flexion right0.3880.4130.314Hip flexion Left0.503*0.4160.422Neck flexion0.600**0.590**0.610**Shoulder flexion right0.1830.3000.239Shoulder flexion left0.3930.2220.207Shoulder abduction right0.2360.2220.348Shoulder abduction left0.1820.2360.273Step test right0.744**0.489*0.326Step test left0.8400.500*0.378Heel rise0.4420.2940.388Toe rise0.4460.2910.419Δ Physician VAS-0.508*-0.506**-0.215Δ Patient VAS-0.600**-0.597**-0.249Δ → change from baseline to 3 months *→ Correlation is significant at the 0.05 level **→ Correlation is significant at the 0.01 levelConclusion:Timed function tests correlated well with MMT 8 and parameters with in FI-2. Thus these tests are good alternatives in assessing disease activity and response assessment in inflammatory myositis.References:[1]Selva-O’Callaghan A, Pinal-Fernandez I, Trallero-Araguás E, Milisenda JC, Grau-Junyent JM, Mammen AL. Classification and management of adult inflammatory myopathies. Lancet Neurol. 2018; 17:816–28.[2]Rider LG, Aggarwal R, Machado PM, Hogrel J-Y, Reed AM, Christopher-Stine L, et al. Update on outcome assessment in myositis. Nat. Rev. Rheumatol. 2018;14:303–18.[3]Alexanderson H, Broman L, TollbÄck A, Josefson A, Lundberg IE, StenstrÖm CH. Functional index-2: Validity and reliability of a disease-specific measure of impairment in patients with polymyositis and dermatomyositis. Arthritis Rheum. 2006;55:114–22.Disclosure of Interests: :None declared

Background:Antisynthetase syndrome (ASS) is characterized by inflammatory myopathy, interstitial lung disease, arthritis, mechanical hands and Raynaud phenomenon, among other features. Recent studies have shown that idiopathic inflammatory myopathies (IIM) may develop cardiac involvement, either ischemic (coronary artery disease) or inflammatory (myocarditis). We wonder if characteristic lung interstitial involvement (interstitial lung disease) that appears in patients with the ASS may also affect the myocardial interstitial tissue. New magnetic resonance mapping techniques could detect subclinical myocardial involvement, mainly as edema (increase extracellular volume in interstitium and extracellular matrix), even in the absence of visible late Gadolinium enhancement (LGE).Objectives:Our aim was to describe the presence of interstitial myocarditis in a group of patients with ASS.Methods:Cross-sectional, observational study performed in a tertiary care center. We included 13 patients diagnosed with ASS (7 male, 53%, mean (SD) age at diagnosis 56,8 years (±11,8)). The patients were consecutively selected from our outpatient myositis clinic. Myositis specific and associated antibodies were performed by means of line immunoblot (EUROIMMUN©). Cardiac magnetic resonance (CMR) was performed on all patients. The study protocol includes functional cine magnetic resonance and standard late gadolinium enhancement (LGE), as well as novel parametric T1 and T2 mapping sequences (modified look locker inversion recovery sequences - MOLLI) with extracellular volume (ECV) calculation 20 minutes after the injection of a gadolinium-based contrast material.Results:CMR could not be performed in one patient due to anxiety. All patients studied (12) had a normal biventricular function, without alteration of segmental contraction. A third (4 out of 12, 33%) of the studied patients showed elevated T2 myocardial values without focal LGE, half of them (2/4) with an elevated ECV, consistent with myocardial edema. Two patients with normal T2 values showed unspecific LGE focal patterns, one in the right ventricle union points and another with mild interventricular septum enhancement (Figure 1). None of the patients studied refer any cardiac symptomatology. All the four patients with T2 mapping alterations (100%) had interstitial lung involvement, but only 4 out of 8 (50%) of the rest ASS patients without T2 mapping positivity. The autoimmune profile was as follows: 10 anti-Jo1/Ro52, 1 anti-EJ/Ro52, 2 anti-PL12.Conclusion:Myocarditis, although subclinical, appears to be a feature in ASS patients. T1 and T2 mapping sequences might be valuable to detect and monitor subclinical cardiac involvement in these patients. The possibility that the same etiopathogenic mechanism may be involved in the interstitial tissue in lung and myocardium is raised. More studies must be done in order to assert the prevalence of myocarditis in ASS.References:[1]Dieval C et al. Myocarditis in Patients With Antisynthetase Syndrome: Prevalence, Presentation, and Outcomes. Medicine (Baltimore). 2015 Jul;94(26):e798.[2]Myhr KA, Pecini R. Management of Myocarditis in Myositis: Diagnosis and Treatment. Curr Rheumatol Rep. 2020 Jul 22; 22:49.[3]Sharma K, Orbai AM, Desai D, Cingolani OH, Halushka MK, Christopher-Stine L, Mammen AL, Wu KC, Zakaria S. Brief report: antisynthetase syndrome-associated myocarditis. J Card Fail. 2014 Dec;20(12):939-45.Figure 1.Cardiac magnetic resonance images from ASS patients.Disclosure of Interests:None declared

Background:Manual muscle testing (MMT) and Functional index 2(FI-2) are the usual methods in assessing disease activity in IIM1. Limitations of MMT8 include low sensitivity to change, floor/ceiling effect, and under-representation of certain important muscle groups1 while FI-2 takes a longer time to administer. Several Timed function tests (TFTs) like the 2-minute walk test (2MWT) or 30s raise from a chair test and 30s 1kg arm rise test may be better alternatives and less time taking2. Data looking at the performance of these tests are limited to small controlled studies.Objectives:To assess the performance of timed function tests against MMT8 and FI-2 in assessing muscle strength and endurance at baseline, 3 and 6 months of therapy.Methods:An observational cohort study, included 41 patients with polymyositis and dermato-myositis attending OPD and IPD service of tertiary centre. MMT8, FI-2 and Timed function tests were done at baseline, at 3 months and at 6 months. (Figure 1)Figure 1.Consort diagram showing the workflow in study populationResults:Forty one patients included in the study had completed three month follow-up assessment, while 17 patients achieved a six-month evaluation. Out of 41 patients, 11 (27%) were polymyositis, and 30 (73%) were dermatomyositis. The mean MMT8 of the total study population at baseline was 57±15, at three months (n=41) was 66 ±10 and at six months (n=17) was 71 ± 10, while in active subgroup was 50 ± 18, 64 ± 9 (n=41), 67 ± 9.6 (n=17)at baseline, three months and six months respectively. The change in TFTs showed a moderate to strong correlation with the change in Fi-2 among the study population at three months and six months (Table 2). Among the TFTs 2MWT showed moderate correlation with both MMT8 and FI-2 in active disease.Table 1.Spearman Rho Correlation between change in timed function tests with change in MMT8, change in FI-2 at 3 months and 6 monthsAt 3 months (n=41)At 6 months (n=17)Active disease(n=18)Inactive disease(n=23)Active disease(n=7)Inactivedisease(n=10)Correlation of Δ MMT8 withΔ30s rise form chair0.1430.3460.2000.347Δ30s1kg arm lift0.0180.2840.3620.168Δ2MWD0.755*0.3130.482*0.334Correlation of ΔFI-2 withΔ30s rise form chair0.784*0.495*0.486*0.424*Δ30s1kg arm lift0.671*0.1070.704*0.301Δ2MWD0.834*0.623*0.808*0.506**p<0.05Conclusion:Using timed function tests can be an excellent alternative to FI-2 in assessing muscle endurance. 2-minute walk distance is a better alternative to conventional muscle testing as it measures both power and endurance, and this can overcome the ceiling effect of MMT-8.References:[1]Rider LG, Aggarwal R, Machado PM, Hogrel J-Y, Reed AM, Christopher-Stine L, et al. Update on outcome assessment in myositis. Nat. Rev. Rheumatol. 2018;14:303–18.[2]Agarwal S, Kiely PD. Two simple, reliable and valid tests of proximal muscle function, and their application to the management of idiopathic inflammatory myositis. Rheumatology. 2006 Jul 1;45(7):874-9.Acknowledgements:I would like to acknowledge my patients, my teachers, colleagues, and paraclinical staff of the department of Clinical Immunology JIPMERDisclosure of Interests:None declared

BackgroundIdiopathic inflammatory myopathy (IIM) is associated with a high prevalence of malignancy, in which anti-transcriptional intermediary factor 1-γ(TIF1-γ) antibody is at a high risk of malignancy compared to the other myositis-specific antibodies, including anti-aminoacyl-tRNA synthetase (ARS), melanoma differentiation-associated gene 5 (MDA5), and Mi-2 antibody [1]. Although some subgroups of IIM have a high risk of malignancy up to 10 years after diagnosis [2], long-term relationships between malignancy and each antibody are not elucidated so far.ObjectivesTo clarify the risk of malignancy in IIM in each antibody type with standard incidence ratios (SIR) of malignancy and the long-term occurrence of malignancy.MethodsFrom our IIM cohort at the University of Tokyo hospital, we enrolled patients who fulfilled with Bohan and Peter criteria for dermatomyositis/polymyositis or 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for IIMs and with positivity for anti-ARS, MDA5, Mi-2, or TIF1-γ antibody. We retrospectively collected the data and calculated SIRs by using the database of Cancer Statistics, Cancer Information Service, National Cancer Center, Japan. Fisher exact test and Wilcoxon test were used to compare the clinical features in each group. Cumulative incidence of cancer occurrence was estimated by Kaplan-Meier methods, and Log-rank test was used to compare the cancer-free survival.ResultsThe study included 111 patients, including 16 patients being diagnosed with a malignancy within a three-year before and after the occurrence of IIM. Patients with malignancy were significantly older age at the onset of IIM (median age (interquartile range) 67.5 (62.3-70.8) vs. 52.0 (41.5-61.5). p<0.001) and more frequently with anti-TIF1-γ antibody (25.0% vs. 4.2%, p=0.015). After adjustment for age, the proportion of anti-TIF1-γ antibody remains significantly higher in the malignancy group (p=0.01). SIRs (95% confidence interval) in each type of antibody were anti-ARS of 2.21 (1.03-4.55), anti-MDA5 of 1.89 (0.49-6.02), anti-Mi-2 of 2.75 (0.14-17.84), and anti-TIF1-γ of 14.73 (4.72-40.50) (Table 1). Types of malignancy included four gastric cancers, two bladder cancers, breast cancers, cervical cancers, ovarian cancers, and lung cancer, one pancreatic cancer, rectal cancer, and renal cancer. Kaplan-Meier estimated cancer-free survival was significantly lower in patients with anti-TIF1-γ antibody than patients with anti-ARS antibody (p<0.01) (Figure 1). The frequencies of malignancy of IIM patients with anti-ARS, MDA5, Mi-2, or TIF1-γ antibody through the follow-up period were 15.6%, 20.0%, 11.1%, 50.0%, respectively.Figure 1.Comparison of malignancy rate of idiopathic inflammatory myopathy with anti-ARS, and TIF1-γ antibodies in 10 years.Table 1.Standard incident ratio (SIR) of malignancy in idiopathic inflammatory myopathy according to myositis-specific antibodies.Total (Person-years)ObservedExpectedSIR (95% CI)Anti-ARS antibody51083.622.21 (1.03-4.55)Anti-MDA5 antibody21031.591.89 (0.49-6.02)Anti-Mi-2 antibody5610.362.75 (0.14-17.84)Anti-TIF1-γ antibody3940.2714.73 (4.72-40.50)Total815165.842.74 (1.62-4.56)ConclusionIIM patients with anti-TIF1-γ antibody and with anti-ARS antibody had a higher prevalence of malignancy than the general population. In addition, anti-TIF1-γ antibody are more associated with malignancy rather than anti-ARS antibody in 10 years as well. Malignancy associated with anti-TIF1-γ positive IIM occurred exclusively within the one year before and after the IIM diagnosis, and cancer should be particularly investigated at the IIM diagnosis.References[1]DeWane ME, Waldman R, Lu J. Dermatomyositis: Clinical features and pathogenesis. J Am Acad Dermatol. 2020;82:267-281.[2]Lundberg IE, Fujimoto M, Vencovsky J, Aggarwal R, Holmqvist M, Christopher-Stine L, Mammen AL, Miller FW. Idiopathic inflammatory myopathies. Nat Rev Dis Primers. 2021;7:86.Characters from table content including title and footnotes: 3299Disclosure of InterestsShinji Izuka: None declared, Toshihiko Komai Speakers bureau: Tanabe Mitsubishi, Kissei, Pfizer, Amgen GlaxoSmithKline and Chugai., Grant/research support from: GlaxoSmithKline., Hirofumi Shoda Speakers bureau: Pfizer, Bristol-Myers Squibb, Eli Lilly, Sanofi, AbbVie, GlaxoSmithKline, Gilead, Boehringer Ingelheim, Jansen, Novartis, Chugai, Takeda, Astellas, Eisai, Asahi Kasei and Daiichi-Sankyo., Grant/research support from: Novartis, Keishi Fujio Speakers bureau: Tanabe Mitsubishi, Bristol-Myers Squibb, Eli Lilly, Chugai, Jansen, Pfizer, Ono, AbbVie, Ayumi, Astellas, Sanofi, Novartis, Daiichi Sankyo, Eisai, Asahi Kasei and AstraZeneca., Grant/research support from: Tanabe Mitsubishi, Bristol-Myers Squibb, Eli Lilly, Chugai, Eisai, Tsumura and Asahi Kasei.