What Has Been the Impact of COVID-19 on Driving Digitalization, Innovation and Crisis Management of Higher Education and Quality Assurance?-A Taiwan Case Study in Alignment with the INQAAHE Virtual Review.

The impact of COVID-19 on higher education and quality assurance (QA) has already elicited global attention and discussion. QA agencies and networks quickly learned to adapt in order to carry out assessments, accreditations, recognitions, and reviews in a full virtual mode. These practices include using shared folders for virtual desk review, video conferencing platforms for interviews, and virtual site visits. In order to respond to the 2020 pandemic, The International Network for Quality Assurance Agencies in Higher Education (INQAAHE) swiftly adopted a virtual mode of the GGP review exercise for the GGP alignment applicants. The Higher Education Evaluation and Accreditation Council of Taiwan (HEEACT) was the first case that underwent a thorough virtual review process of GGP alignment during the 2020 pandemic. Therefore, this study aims to outline the impact of the pandemic in Taiwan higher education as well as provide the meta-analysis of the virtual review process of the INQAAHE GGP alignment by using HEEACT as a case study.

Inpatient Management of Migraine.

Migraine is a frequently disabling neurologic condition which can be complicated by medication overuse headache and comorbid medical disorders, including obesity, anxiety and depression. Although most migraine management takes place in outpatient clinics, inpatient treatment is indicated for migraine refractory to multiple outpatient treatments, with intractable nausea or vomiting, need for detoxification from medication overuse (such as opioids and barbiturates), and significant medical and psychiatric disease. The goals of inpatient treatment include breaking the current cycle of headache pain, reducing the frequency and/or severity of future attacks, monitored detoxification of overused medications, and reducing disability and improving quality of life.

Proceeding report of the Symposium on Hidradenitis Suppurativa Advances (SHSA).

Hidradenitis Suppurativa (HS) is a chronic debilitating skin condition that impairs the productivity and the quality of patients` lives. HS has recently drawn lots of attention among scholars to further expand their knowledge but it still loads with uncertainties and gaps to be explored. This publication addresses these uncertainties, and provides a road-map for researchers, scholars and clinicians from different disciplines for their future studies about HS. This is a proceeding report of the first Symposium on Hidradenitis Suppurativa Advances (SHSA), and it reviews the scientific sessions about the epidemiology, pathophysiology, presentations, and management of HS. This symposium was a great opportunity for experts in the HS field to exchange their knowledge, and improve their mutual understanding of this disease.

Microneedling: A Comprehensive Review.

BACKGROUND: Microneedling is a minimally invasive procedure that uses fine needles to puncture the epidermis. The microwounds created stimulate the release of growth factors and induce collagen production. The epidermis remains relatively intact, therefore helping to limit adverse events. The indications for microneedling therapy have grown significantly, and it is becoming a more widely used treatment in dermatology. OBJECTIVE: A comprehensive review of microneedling in human subjects and its applications in dermatology. METHODS AND MATERIALS: A search was performed using PubMed/MEDLINE and Science Direct databases. Search terms included "microneedling," "needling," and "percutaneous collagen induction." All available studies involving human subjects were included in the discussion, with priority given to prospective, randomized trials. RESULTS: Studies demonstrate microneedling efficacy and safety for the treatment of scars, acne, melasma, photodamage, skin rejuvenation, hyperhidrosis and alopecia and for facilitation of transdermal drug delivery. While permanent adverse events are uncommon, transient erythema and postinflammatory hyperpigmentation are more commonly reported. CONCLUSION: Microneedling appears to be an overall effective and safe therapeutic option for numerous dermatologic conditions. Larger and more randomized controlled trials are needed to provide greater data on the use of microneedling for different dermatologic conditions in different skin types.

Mineralocorticoid Receptor (MR) trans-Activation of Inflammatory AP-1 Signaling: DEPENDENCE ON DNA SEQUENCE, MR CONFORMATION, AND AP-1 FAMILY MEMBER EXPRESSION.

Glucocorticoids are commonly used to treat inflammatory disorders. The glucocorticoid receptor (GR) can tether to inflammatory transcription factor complexes, such as NFκB and AP-1, and trans-repress the transcription of cytokines, chemokines, and adhesion molecules. In contrast, aldosterone and the mineralocorticoid receptor (MR) primarily promote cardiovascular inflammation by incompletely understood mechanisms. Although MR has been shown to weakly repress NFκB, its role in modulating AP-1 has not been established. Here, the effects of GR and MR on NFκB and AP-1 signaling were directly compared using a variety of ligands, two different AP-1 consensus sequences, GR and MR DNA-binding domain mutants, and siRNA knockdown or overexpression of core AP-1 family members. Both GR and MR repressed an NFκB reporter without influencing p65 or p50 binding to DNA. Likewise, neither GR nor MR affected AP-1 binding, but repression or activation of AP-1 reporters occurred in a ligand-, AP-1 consensus sequence-, and AP-1 family member-specific manner. Notably, aldosterone interactions with both GR and MR demonstrated a potential to activate AP-1. DNA-binding domain mutations that eliminated the ability of GR and MR to cis-activate a hormone response element-driven reporter variably affected the strength and polarity of these responses. Importantly, MR modulation of NFκB and AP-1 signaling was consistent with a trans-mechanism, and AP-1 effects were confirmed for specific gene targets in primary human cells. Steroid nuclear receptor trans-effects on inflammatory signaling are context-dependent and influenced by nuclear receptor conformation, DNA sequence, and the expression of heterologous binding partners. Aldosterone activation of AP-1 may contribute to its proinflammatory effects in the vasculature.

Incidental left atrial and ventricular thrombi on routine CT: outcome and influence on subsequent management at an urban tertiary care referral center.

Incidental left-sided cardiac thrombi are occasionally encountered on CT. This study examined clinical findings and outcome in patients with incidental cardiac thrombi on CT. Our image database was reviewed for incidental left-sided cardiac thrombi on CT. These patients' charts were retrospectively reviewed. Thirty-five patients had incidental left-sided cardiac thrombi on CT, 26 of which were ventricular and 9 atrial. Thirty-two thrombi were unknown prior to the CT, and the radiologist interpretation triggered echocardiography or anticoagulation in most cases. Embolic complications occurred in 14 patients, 4 of which were fatal. Twelve patients had concomitant cancer, 6 of which were newly discovered. Incidental left-sided cardiac thrombi on CT appeared to confer substantial morbidity and mortality in our study. In many cases, the cardiac thrombi were new and led to changes in management. A high rate of malignancy was also noted, which may be related to the hypercoagulable state of malignancy.