bluuebunny/crossref_metadata_2025 huggingface dataset:
Canons and Rules of Faith
Authors: Lienhard, SJ Joseph T.
Published: June 2019

A canon is a collection of sacred books. A rule of faith is a concise statement of Christian beliefs. The Hebrew (Jewish) canon (the Christian Old Testament) comprised three parts: the Law (five books), the Prophets (eight books), and the Writings (eleven books). The Septuagint or Greek translation of the Hebrew Bible is longer, by at least seven books. The earliest New Testament canon appeared before 200, and it was finalized c.400. The New Testament comprises the Gospel (4) and the Apostle (13 letters, or 14 with Hebrews). Luke added Acts to his Gospel and John the Presbyter wrote Revelation. Seven catholic epistles complete the canon. The rule of faith, prominent in Irenaeus, Clement of Alexandria, and Tertullian, guided the perception of orthodoxy, and theological thought, in the second and third centuries. Later the creeds (baptismal and conciliar) functioned as the rule of faith had earlier.
Psalms
Authors: Cameron Michael
Published: June 2019

Historically speaking it was scarcely predictable that the predominantly Gentile Christian community of Late Antiquity should be drawn to a book of ancient Jewish prayers, much less ascribe to it divine authority. Yet Christians adopted Israel’s book of Psalms in toto as part of the treasury of the people of Christ. The Psalter not only offered prophetic teaching and training in spirituality. For many with a radical Christological perspective, the texts mediated the very voice of Christ speaking in the first person, thus opening a window on the inner life of the redeeming Lord. The Psalms received more comment from early Christian writers than any other Old Testament book. It was a constant presence in liturgy, a training book for prayer, a source of theological instruction, a blueprint for spiritual advancement, and a key that unlocked the whole Bible. The chapter examines different ways the Psalms functioned among the early Christians.
The Cross
Authors: Behr John
Published: June 2019

This chapter examines the role of the cross in early Christianity, both in constituting Scripture as Scripture and as a privileged locus of scriptural interpretation. It is through the apocalyptic unveiling of Scripture by the cross that the meaning of Scripture is revealed, so that it can be read as Scripture, and the gospel proclaimed on its basis. The cross is also a particularly fertile image, expounded both through scriptural images, from the trees of Paradise to the wood that Elijah throws into the waters to recover the head of the axe; it is also an image that early Christians saw in the world around them, from the sign of Asklepios, to the imperial banners of the army, to the outstretched wings of birds. These two dimensions come together in the early paschal material, both celebrating the victory of the Cross and making Christ present in an immediate manner.
Heaven and Hell
Authors: Trumbower Jeffrey A.
Published: June 2019

In two main parts, this chapter treats the complex relationship between Scripture interpretation and early Christian imaginings of heaven and hell. The first part surveys the resources found in scriptural traditions (including some texts eventually excluded from the canon) for the Christian development of heaven and hell. The second part looks at representative examples of early Christian exegesis with respect to the following topics: corporeality in the afterlife, the status of the dead now before the resurrection, millennialism, universal salvation, the apocatastasis, the development of purgatory and prayer for the dead, Christ’s ‘harrowing of hell’, the differentiation of rewards in heaven, and the nature of the rewards and punishments in heaven and hell respectively.
EthicsandEconomics
Authors: Davis John B.
Published: June 2019

This chapter examines the nature of ethics and economics as a single subject of investigation, and uses a complex systems approach to characterize the nature of that subject. It then distinguishes mainstream economic and social economic visions of it, where the former assumes that market processes encompass social processes, and the latter assumes that market processes are embedded in social processes. For each vision, strong and weak theses are compared. Both visions are first explained in terms of their respective views of the positive-normative distinction, then in terms of a central normative principle, and then in terms of their policy strategies. The chapter closes with comments on the future status of ethics and economics as a single subject of investigation.
With All Due Respect
Authors: White Mark D.
Published: June 2019

Mainstream economics is essentially utilitarian, both in the motivations it ascribes to individual decision-makers as well as in welfare economics and policy recommendations. But utilitarianism is widely criticized, especially regarding its failure to recognize the value of the individual or recognize meaningful rights. This chapter incorporates into economics the deontological moral philosophy of Immanuel Kant, which emphasizes principle and rights above preferences and welfare. After introducing the basic elements of Kant’s moral, it shows how Kantian ethics can be worked into the standard economic model of choice, allowing the agent to make principled decisions alongside prudential ones. It then surveys several areas of economics in which a Kantian approach can make a significant contribution, including instances of individual choice in which ethical factors are likely to be particularly important, as well as policy issues which are inherently ethical in nature, including the way the state intervenes in market activity.
Gendering the History of Education
Authors: Bailey Lucy E. , Graves Karen
Published: June 2019

Gendered analysis has enacted a radical intervention in educational history through highlighting women’s roles and experiences, exploring gendered educational forces, institutions, practices, and policies, and expanding theories and methodologies. The field encompasses women’s, feminist, and gender history and diverse sites and periods of study. Although distinct in central concerns and emphases, these approaches continue to overlap, intersect, or unfold concurrently in practice, creating productive tensions that shape the field. The perspective of how the field is gendered depends in part on how its boundaries are drawn. This is both a theoretical and a methodological matter and, for many gender scholars, also a political one. The reach and production of gendered historiography is inevitably uneven, shaped by disciplinary identities, material conditions of embodied academic labor, and the uneven availability of resources to support historical research and teaching.
Transitions from Rural to Urban Schooling
Authors: Gamson David A.
Published: June 2019

The urbanization of the past two centuries that has affected virtually all sections of the globe has had dramatic and transformative influences on rural communities and their schools. The industrialization of Europe and North America in the nineteenth and early twentieth centuries has been mirrored by rapid changes over the past half-century in the countries of the Global South—Asia, Africa, and Latin America—although many of these more recent dynamics are quite distinct. Whereas standard historical narratives treated the growth of rural school enrollments on all continents as a byproduct of economic development or the result of deliberate state-building and elite imposition, more recent historiography has challenged these traditional views, pointing to evidence that peasants, locals, and indigenous groups often created their own schools or issued demands for education and academic skills well before economic expansion or compulsory attendance laws.
The History of Technology and Education
Authors: Terzian Sevan
Published: June 2019

Technology has intersected with education throughout human history. One prominent dimension has entailed various devices and tools for learning, such as illustrated texts, film, radio, television, computers, mobile technologies, and social media. A second dimension has entailed technologies of instruction pertaining to the design and utilization of messages that influence learning. Despite unlimited possibilities for inquiry, few historians have investigated this multifaceted field. Furthermore most historical studies of educational technology have ignored how technologies in different historical moments impacted particular groups of children and adults. Explicit considerations of race, gender, sexuality, and socioeconomic status have largely been lacking. Opportunities abound for historians to identify and examine the broader societal contexts that encouraged or inhibited the development and implementation of new educational technologies and to explore how these dynamics mitigated, perpetuated, or exacerbated enduring problems in education.
Catholic
Authors: Henn William
Published: June 2019

The chapter begins by affirming the ‘irrevocable’ commitment of the Catholic Church to the ecumenical movement, noting that such a commitment represents a substantial change from the Catholic Church’s initial estimation and response. It then explains the initially negative reaction, gives an account of the factors leading up to the transformation in attitude, and documents by means of official teachings the positive reassessment and enthusiastic step that took place at the time of the Second Vatican Council, especially by means of the council’s decree on ecumenism, Unitatis Redintegratio. A final section summarizes some of the more important Catholic contributions to the ecumenical movement and identifies some particular gifts that the Catholic Church may be said to have received and to have offered in the course of its participation.
The Archaeology of Roman Germany
Authors: Roymans Nico
Published: June 2019

This chapter provides an overview of the book’s main themes. The book gives Anglophone readers a representative, well-grounded survey of the current status of the archaeology of Roman Germany. It reveals a discipline that is evolving strongly in an interpretative sense, a discipline to which traditional stereotypical labels such as ‘positivist’ and ‘descriptive’ or ‘an archaeology at risk’ (Bloemers 2002) no longer apply. German archaeologists face the challenge of continuing to nurture their rigorous historicizing and empirical traditions, while at the same time seeking closer integration with social theory-building and the findings of scientific archaeology. The contributions to this volume are steps in this direction.
A History of Brain Asymmetry Studies
Authors: Christman Stephen D.
Published: June 2019

The history of the study of brain asymmetry and hemispheric specialization is reviewed, starting with Broca’s initial discovery of the left frontal basis for speech, continuing through Sperry’s work with “split-brain” patients, and ending with the componential approach that emerged in the 1980s in which the pursuit of an “ultimate dichotomy” underlying hemispheric specialization was finally abandoned and a new emphasis on hemispheric division of labor was introduced. Special emphasis is given to methodological considerations of the use of dichotic listening and tachistoscopic divided visual half-field paradigms. In addition, the topics of interhemispheric interaction and handedness are discussed, with a particular emphasis on the importance of conceptualizing handedness in terms of both direction (left versus right) and degree (strong/consistent versus mixed/inconsistent).
Erich Feuchtwanger and the Frontal Lobes
Authors: Greiffenstein Manfred F.
Published: June 2019

Erich Feuchtwanger’s 1923 monograph provided one of the first major descriptions of the neurobehavioral outcome of prefrontal damage. Feuchtwanger collected qualitative and quantitative data from 400 World War I veterans, 200 with penetrating wounds to prefrontal cortex, and 200 with nonfrontal damage. A data reanalysis with modern actuarial calculation showed that neurobehavioral signs associated with prefrontal caseness varied widely in prevalence and strength of association. “Witzeln” (social insensitivity) was uncommon but highly specific, while slowed processing was common but only modestly specific. Feuchtwanger’s data predate by 90 years the modern view that the prefrontal zones regulate social and emotional behaviors.
Early Years, 1771–1795
Authors: West Lisa
Published: June 2019

This chapter surveys Charles Brockden Brown’s early biography into five sections. The first provides background on eighteenth-century Quaker history and culture in Philadelphia, including the unlawful arrest and banishment of Elijah Brown, Charles’s father. The second section reviews Brown’s youth, adolescence, and education. The third discusses his law apprenticeship from 1787 to 1793, a period during which he participated in literary clubs, experimented with writing, and developed meaningful friendships. His letters during these years show interest in a variety of moral issues and sometimes critique traditional tenets of Christianity. The fourth section discusses Brown’s early publications and his manuscript epistolary narratives. The final section focuses on the years 1793–1795, when Brown strengthened connections with the New York intellectual circle and distanced himself from his Philadelphia social network, culminating in a cogent rejection of Christianity.
Political Pamphlets
Authors: Shapiro Stephen
Published: June 2019

This chapter traces the critical history of Charles Brockden Brown’s political pamphlets of 1803 and 1809 from the dominant reception of them as evidence of Brown’s so-called spontaneous conversion to political conservatism and bourgeois perspectives. The two 1803 pamphlets, on the question of American invasion of New Orleans to prevent Napoleon from acquiring it, need to be contextualized within the overall environment for politically progressive writers in the circum-Atlantic world in a period of revanchist conservatism. The 1809 Address to the Congress has a different tone and perspective. In the absence of an unexpected discovery of Brown’s lost work, a two-volume treatise on geography, the 1809 Address can stand as the closest, least rhetorically ambiguous account of Brown’s outlook on politics.
Brown and Women’s Rights
Authors: Fleischmann Fritz
Published: June 2019

Charles Brockden Brown’s lifelong commitment to the principles of the Enlightenment is well reflected in his commitment to equal rights for women in education, marriage, and social standing and in his support for women’s economic independence. The strong women he created in his fiction have attracted the admiration of readers and writers over many generations, and his exploration of gender dynamics remains unsurpassed. This essay focuses on two fictional texts, Alcuin; A Dialogue (1798) and the novel Ormond; or, The Secret Witness (1800), in which the promises of the Enlightenment and the American Revolution for the transformation of gender as a social relation are critically examined, their limits tested, and their justice affirmed. Next to the well-known Ormond, the early Alcuin emerges as a masterpiece of social satire and sociological analysis.
Brown’s Later Biographers and Reception, 1949–2000s
Authors: Hinds Elizabeth Jane Wall
Published: June 2019

Biography and reception of Charles Brockden Brown since the mid-twentieth century was marked by efforts to canonize him and to recover primary and related texts. The first generation of this era typically practiced formalist readings and focused primarily on Brown’s first four novels. Often psychobiographical, these studies created a “Gothic” and proto-Romantic Brown. Later generations have expanded the canon to include Brown’s work over his lifetime, including the many genres he worked in; have practiced more cultural and poststructuralist methodologies with an eye to gender and sexuality, geography, race, and class; have placed Brown in a more global context; and have brought Brown studies into the era of digital humanities.
Robot Imams!
Authors: McPherson Eve
Published: June 2019

Since the beginning of the twentieth century and the establishment of the modern Turkish Republic, the Islamic call to prayer in Turkey has occupied a controversial space, sonically and culturally. Early on, the new Republic attempted to “Turkicize” the call by legally mandating Turkish language recitation, a practice that was maintained for nearly twenty years despite strong popular opposition. Although this particular practice ended in 1950, the call to prayer has continued to engender controversy. One of the more recent debates has grown out of the practice of centralization. Call to prayer centralization refers to broadcasting one muezzin, or caller, from one mosque to other area mosques in an effort to diminish “cacophony” and regulate the sound quality, ostensibly to beautify the call and make it more clearly audible. Although the goals of the centralization program have been to improve the sound quality and distribution of the call, opponents of the program have voiced concerns. Such concerns include the loss of mosque “personalities” and the possible substitution of recordings for live recitation, an especially worrisome prospect in the context of a religious practice that considers live human recitation a direct conduit to the divine. This chapter examines the early twenty-first-century history of centralization and how its implementation fits into the continuing dialogue on the public declaration of faith in the context of a politically secular republic, thus contributing to studies on the use and mediation of public sonic space.
The Evolution of Voice Perception
Authors: Pisanski Katarzyna , Bryant Gregory A.
Published: June 2019

The human voice is a rich source of information and an important means of interpersonal communication. Beginning with Darwin (1872), nonverbal vocal communication has long interested evolutionary scientists, and in the last quarter century empirical research on voice production and perception from an evolutionary perspective has increased dramatically. One reason for this surge of interest is that behavioral ecologists and evolutionary psychologists have taken advantage of recent technological improvements in acoustic analysis software as well as sound recording and reproduction devices. More importantly, many voice researchers have recognized that the extraction of biologically relevant information from the vocal channel constitutes a set of adaptive problems widely shared across many species. Evolutionary scientists studying human vocal behavior therefore have a rich theoretical framework and an established comparative basis for developing specific research questions. For any vocal species, including humans, we should expect perceptual adaptations designed to process acoustic features of the vocal sounds of conspecifics (other individuals of the same species). An evolutionary approach provides a framework for specifying the nature of these adaptive perceptual problems. In this chapter, the authors describe recent work focusing on human voice perception from an evolutionary perspective and provide examples of the value of this approach for gaining a full understanding of this fundamental aspect of human behavior.
Epilogue
Authors: Kreiman Jody
Published: June 2019

The study of voice and voice quality has long been characterized by segregation across disciplinary lines, with little interchange of data or ideas between scholars who do not share the same research focus. Recent efforts have begun to merge traditions in the voice science community (for example, by examining the perceptual effects of changes in one or more aspects of voice production). However, studies by scientists of the manner in which humans produce and perceive voice quality remain nearly unintelligible to humanists examining issues of social, cultural, aesthetic, and political messages conveyed by the same phenomena, and vice versa. This chapter attempts to provide a preliminary foundation to support dialogues and promote mutual understanding between these two groups of scholars. The author’s intent is to show where these different scholarly traditions overlap, where they abut, and where they differ, with the goal of elucidating how these bodies of work might eventually combine as parts of a single discipline of voice studies.
Efficacy and Safety of Acupuncture for Chronic Discogenic Sciatica, a Randomized Controlled Sham Acupuncture Trial
Authors: Huang Ziling , Liu Sixing , Zhou Jing , Yao Qin , Liu Zhishun
Published: June 2019

Objective

To evaluate the efficacy and safety of acupuncture for discogenic sciatica.

Design

Single-center, parallel, randomized controlled sham acupuncture trial.

Methods

Twelve sessions of acupuncture or sham acupuncture at the same traditional acupoints over four weeks. The primary outcome was change from baseline in weekly mean leg pain, measured by the visual analog scale (VAS) over the four-week treatment period. The secondary outcomes were determined by the change from baseline in mean VAS scores for leg pain, VAS scores for low back pain, Oswestry Disability Index (ODI) scores, and 36-Item Short Form Health Survey (SF-36) scores. Patients were followed for 28 weeks.

Results

Forty-six patients were enrolled in this study between June 2017 and January 2018, of which 23 were in the acupuncture group and 23 were in the sham acupuncture group. The between-group difference in weekly mean leg pain measured by the VAS over the four-week treatment period was –7.28 mm (95% confidence interval = –13.76 to –0.80, P = 0.029), which is larger than the minimum clinically important difference of 5 mm. The between-group differences in mean VAS scores for low back pain, ODI scores, and SF-36 scores were not significant in the study period (P > 0.05 for all). The proportion of acupuncture-related adverse events was 4.3%, and all adverse events were mild and transient.

Conclusions

Twelve sessions of acupuncture showed short-term clinical benefits in relieving the symptoms of leg pain for patients with chronic discogenic sciatica compared with sham acupuncture. Acupuncture is safe in treating chronic discogenic sciatica. Further studies with larger sample sizes, a longer treatment period, and long-term follow-up should be conducted to verify these results.
Employee Inside Debt and Firm Risk-Taking: Evidence from Employee Deposit Programs in Japan
Authors: Dasgupta Sudipto , Lin Yupeng , Yamada Takeshi , Zhang Zilong
Published: June 2019

Unlike broad-based equity ownership by employees, ownership of company debt by rank-and-file employees has not received much attention. We argue that company debt held by employees in the form of in-company deposits can monitor risk-taking and facilitate risk discovery. Employee deposits have been historically widely used in Japan. For a sample of 2,104 Japanese firms, using an identification strategy that utilizes a new law in 2003 that changed the priority of employee deposits in bankruptcy and led to large-scale withdrawals of employee deposits, we find that employee deposits mitigate firms’ risk-taking behavior and reduce the agency cost of debt.

Received November 2, 2018; editorial decision May 1, 2019 by Editor Andrew Ellul. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Simultaneous tonic and phasic REM sleep without atonia best predicts early phenoconversion to neurodegenerative disease in idiopathic REM sleep behavior disorder
Authors: Nepozitek Jiri , Dostalova Simona , Dusek Petr , Kemlink David , Prihodova Iva , Ibarburu Lorenzo y Losada Veronika , Friedrich Latica , Bezdicek Ondrej , Nikolai Tomas , Perinova Pavla , Dall’Antonia Irene , Dusek Pavel , Ruml Martin , Ruzicka Evzen , Sonka Karel
Published: June 2019

Study Objectives

Rapid eye movement (REM) sleep without atonia (RWA) is the main polysomnographic feature of idiopathic REM sleep behavior disorder (iRBD) and is considered to be a promising biomarker predicting conversion to manifested synucleinopathy. Besides conventionally evaluated tonic, phasic and any RWA, we took into consideration also periods, when phasic and tonic RWA appeared simultaneously and we called this activity “mixed RWA.” The study aimed to evaluate different types of RWA, to reveal the most relevant biomarker to the conversion.

Methods

A total of 55 patients with confirmed iRBD were recruited with mean follow-up duration 2.3 ± 0.7 years. Scoring of RWA was based on Sleep Innsbruck Barcelona rules. Positive phenocoversion was ascertained according to standard diagnostic criteria during follow-up. Receiver operator characteristic analysis was applied to evaluate predictive performance of different RWA types.

Results

A total of nine patients (16%) developed neurodegenerative diseases. Yearly phenoconversion rate was 5.5%. Significantly higher amounts of mixed (p = 0.009), tonic (p = 0.020), and any RWA (p = 0.049) were found in converters. Optimal cutoffs differentiating the prediction were 16.4% (sensitivity 88.9; specificity 69.6) for tonic, 4.4% (sensitivity 88.9; specificity 60.9) for mixed, and 36.8% (sensitivity 77.8; specificity 65.2) for any RWA. With area under the curve (AUC) 0.778, mixed RWA has proven to be the best predictive test followed by tonic (AUC 0.749) and any (AUC 0.710).

Conclusions

Mixed, tonic and any RWA may serve as biomarkers predicting the conversion into neurodegenerative disease in iRBD. The best predictive value lies within mixed RWA, thus it should be considered as standard biomarker.
Efficacy of sheep as a digestibility model for cattle when fed concentrate-based or forage-based diets
Authors: Chishti Ghazanfar A , Carvalho Pedro H V , Pinto Ana Carolina , Silva Flavia A S , Felix Tara L
Published: June 2019

The objectives were to determine the efficacy of sheep as a digestibility model for cattle feeding two diets, forage or concentrate based, under current genetics. Twelve Suffolk wethers were blocked into two periods with six wethers in each period. Within each period, wethers were fed a forage-based diet (n = 3) or a concentrate-based diet (n = 3). Six angus steers were also fed a forage-based diet (n = 3) or a concentrate-based diets (n = 3) in switchback design with two periods. All animals were adapted to diets for a minimum of 3 wk, then feed intake, refusals, and feces were collected. Feed and fecal dry matter (DM), organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), and starch were analyzed. Refusals were analyzed for DM. Data were analyzed using Proc Mixed in SAS with diet and species as fixed and period as a random effect. Dry matter intake as percentage of body weight for each animal within each period was used as a covariable. There was an interaction (P < 0.01) between species and diet for DM and OM digestibility. When fed the concentrate-based diet, DM and OM digestibility were similar between wethers and steers (P > 0.18); however, when fed the forage-based diet, DM and OM digestibility was less (P < 0.01) for wethers than steers. Like DM and OM, an interaction (P < 0.05) between species and diet was present for starch digestibility. When fed the forage-based diet, starch digestibility did not differ (P = 0.66) between wethers and steers; however, when fed concentrate-based diet, wethers had a greater starch digestibility (P < 0.05) than steers. There was no interaction (P > 0.45) between species and diet for NDF and ADF digestibility. Regardless of the diet fed, NDF and ADF digestibilities were greater (P < 0.05) in steers than wethers. Present day sheep were not a good model for cattle when fed forage-based diets, but sheep were an acceptable model for cattle when fed concentrate-based diets.
Assessment of Epicardial Adipose Tissue Thickness in Children with Familial Mediterranean Fever
Authors: Ghobrial Emad E , Farag Yomna M , Abdul-Aziz Doaa M , Omar Mai A
Published: June 2019

Background

Familial Mediterranean fever (FMF) is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness is used in prediction of atherosclerotic risk. The aim of our study was to evaluate EAT thickness in FMF patients for early detection of risk of atherosclerosis and to be compared with its level in healthy controls.

Methods

Thirty 6- to 18-year-old children with FMF and 30 age- and sex-matched children (control group) were included in the study. Disease characteristics, disease severity and Mediterranean fever gene mutations were recorded. EAT thicknesses was measured by echocardiography.

Results

EAT in patients’ group was significantly greater than that of controls (5.21 ± 2.3 vs. 2.81 ± 2.96 mm, p = 0.001) and was correlated with cholesterol level and platelets count (p = 0.047 and 0.018, respectively).

Conclusion

This study concluded that EAT thickness was statistically increased in FMF patients than controls with a positive correlation with cholesterol level and platelet count. This finding suggests a higher risk for atherosclerosis in these patients. Follow-up study is needed to verify the effect of treatment of FMF on the EAT thickness. Further studies with larger number of patients following-up EAT are needed to verify this finding.
Improved Primers for the Specific Detection of Leifsonia xyli subsp. xyli in Sugarcane Using a Conventional PCR Assay
Authors: Sun Sheng-Ren , Chen Jun-Lü , Duan Yao-Yao , Chu Na , Huang Mei-Ting , Fu Hua-Ying , Gao San-Ji
Published: June 2019

Ratoon stunting disease (RSD), one of the most important diseases of sugarcane, is caused by the bacterium Leifsonia xyli subsp. xyli (Lxx). Lxx infects sugarcane worldwide and RSD results in high yield losses and varietal degeneration. It is highly challenging to diagnose RSD based on visual symptomatology because this disease does not exhibit distinct external and internal symptoms. In this study, a novel Lxx-specific primer pair Lxx-F1/Lxx-R1 was designed to detect this pathogen using a conventional PCR assay. These primers were then compared with four published Lxx-specific primers and one universal Leifsonia generic primer pair LayF/LayR. Sugarcane leaf samples were collected from Saccharum spp. hybrids in commercial fields (315 samples) and from germplasm clones of five Saccharum species and Erianthus arundinaceus (216 samples). These samples were used for comparative field diagnosis with six conventional PCR assays. Sensitivity tests suggested that the PCR assay with primers Lxx-F1/Lxx-R1 had the same detection limit (1 pg of Lxx genomic DNA) as the primer pairs Cxx1/Cxx2 and CxxITSf#5/CxxITSr#5 and had 10-fold higher sensitivity than the primer pairs Pat1-F2/Pat1-R2, LayF/LayR, and C2F/C2R. Comparison of PCR assays revealed that natural Lxx-infection incidence (6.1%) in field sample evaluation identified by Lxx-F1/Lxx-R1 primers was higher than incidences (0.7 to 3.0%) determined by other primer pairs. Moreover, no nonspecific DNA amplification occurred within these field samples with Lxx-F1/Lxx-R1 primers, unlike with the primer pairs Cxx1/Cxx2 and LayF/LayR. Diverse Leifsonia strains were identified by PCR detection with LayF/LayR primers in the field samples, whereas whether these Leifsonia strains were pathogenic to sugarcane requires further research. Our investigations revealed that the PCR assay with the newly designed primers Lxx-F1/Lxx-R1 could be widely used for RSD diagnosis and Lxx-pathogen detection with satisfactory sensitivity and specificity.
Use of Thermal Imaging to Identify Deep-Tissue Pressure Injury on Admission Reduces Clinical and Financial Burdens of Hospital-Acquired Pressure Injuries
Authors: Koerner Suzanne , Adams Diane , Harper Scot L. , Black Joyce M. , Langemo Diane K.
Published: June 2019

A deep-tissue pressure injury (DTPI) is a serious type of pressure injury that begins in tissue over bony prominences and can lead to the development of hospital-acquired pressure injuries (HAPIs). Using a commercially available thermal imaging system, study authors documented a total of 12 thermal anomalies in 9 of 114 patients at the time of admission to one of the study institution’s ICUs over a 2-month period. An intensive, proven wound prevention protocol was immediately implemented for each of these patients. Of these 12 anomalies, 2 ultimately manifested as visually identifiable DTPIs. This represented a 60% reduction in the authors' institution’s historical DTPIs/HAPI rate. Because these DTPIs were documented as present on admission using the thermal imaging tool, researchers avoided a revenue loss associated with nonreimbursed costs of care and also estimated financial benefits associated with litigation expenses known to be generated with HAPIs.

Using thermal imaging to document DTPIs when patients present has the potential to significantly reduce expenses associated with pressure injury litigation. The clinical and financial benefits of early documentation of skin surface thermal anomalies in anatomical areas of interest are significant.
Is It Safe to Ask the Questions That Matter Most to Me? Observations From a Female Residency Applicant
Authors: Weaver Alice N. , Willett Lisa L.
Published: June 2019

Tens of thousands of senior medical students interview for medical residency positions each year. As the applicant pool shifts to include more women, married individuals, and young parents, the criteria by which interviewees evaluate programs are also changing. Concerns including parental leave policies, lactation facilities, access to childcare, partner recruitment resources, and inclusivity in the work environment are important in selecting an ideal program. However, the National Resident Matching Program Match Communication Code of Conduct prohibits interviewers from addressing gender, marital status, and intent to bear children, so the burden of introducing such topics falls on the interviewees. These topics can be difficult to discuss with potential employers, especially when weighed against the pressure to obtain a competitive position through the Match.

In this Invited Commentary, the authors draw on personal experience to examine the questions that residency programs need to answer, encouraging both applicants and programs to improve communication during the residency interview process.
Microbiome and autoimmune diseases: cause and effect relationship
Authors: Nogueira Ana Rita , Shoenfeld Yehuda
Published: June 2019

Purpose of review

The human body is the host of trillions of different prokaryotic microorganisms that colonize the skin and the mucosae. The interaction between human cells and these organisms is mediated by the immune system, sustaining a very complex and fragile balance. The immune cells need to prevent uncontrolled growth of pathogenic microbes and promote tolerance toward the existence of the beneficial ones. Growing evidence associates the disruption of this symbiotic relationship with the development of autoimmune diseases.

Recent findings

Human studies led to the identification of gut dysbiosis patterns in patients with rheumatoid arthritis, lupus and multiple sclerosis. Interestingly, the inoculation of pathogenic bacteria in animal models was associated with the development of these autoimmune diseases.

A better understanding of the microbiota–human interaction will enable the development of novel treatment choices. Currently, new molecules using helminth compounds are under investigation and have already revealed promising results.
Intraoperative Use of O-arm in Pediatric Cervical Spine Surgery
Authors: Verhofste Bram P. , Glotzbecker Michael P. , Hresko Michael T. , MacDougall Robert D. , Birch Craig M. , O’Neill Nora P. , Karlin Lawrence I. , Emans John B. , Proctor Mark R. , Hedequist Daniel J.
Published: June 2019

Introduction:

Traditionally, fluoroscopy and postoperative computed tomographic (CT) scans are used to evaluate screw position after pediatric cervical spine fusion. However, noncontained screws detected postoperatively can require revision surgery. Intraoperative O-arm is a 3-dimensional CT imaging technique, which allows intraoperative evaluation of screw position and potentially avoids reoperations because of implant malposition. This study’s objective was to evaluate the use of intraoperative O-arm in determining the accuracy of cervical implants placed by a free-hand technique using anatomic landmarks or fluoroscopic guidance in pediatric cervical spine instrumentation.

Methods:

A single-center retrospective study of consecutive examinations of children treated with cervical spine instrumentation and intraoperative O-arm from 2014 to 2018 was performed. In total, 44 cases (41 children, 44% men) with a mean age of 11.9 years (range, 2.1 to 23.5 y) were identified. Instability (n=16, 36%) and deformity (n=10, 23%) were the most frequent indications. Primary outcomes were screw revision rate, neurovascular complications caused by noncontained screws, and radiation exposure.

Results:

A total of 272 screws were inserted (60 occipital and 212 cervical screws). All screws were evaluated on fluoroscopy as appropriately placed. Four screws (1.5%) in 4 cases (9%) were noncontained on O-arm imaging and required intraoperative revision. A mean of 7.7 levels (range, 5 to 13) were scanned. The mean CT dose index and dose-length product were 15.2±6.87 mGy and 212.3±120.48 mGy×cm. Mean effective dose was 1.57±0.818 mSv. There was no association between screw location and noncontainment (P=0.129). No vertebral artery injuries, dural injuries, or neurologic deficits were related to the 4 revised screws.

Conclusions:

Intraoperative non-navigated O-arm is a safe and efficient method to evaluate screw position in pediatric patients undergoing cervical spine instrumentation. Noncontained screws were detected in 9% of cases (n=4). O-arm delivers low radiation doses, allows for intraoperative screw revision, and negates the need for postoperative CT scans after confirmation of optimal implant position.

Level of Evidence:

Level IV.
Reducing Risk in Total Joint Arthroplasty: Immunocompromised Patients
Authors: Mehrotra Kapil , Mayman David J.
Published: June 2019

Immunodeficiency limits the body’s natural ability to fight infection, thus increasing the patient’s risk of postoperative complications. Moreover, rates of immunosuppression in the United States are on a steady climb secondary to the duality of greater life expectancy of the immunosuppressed and expanding indications for immunosuppressant use. Taken together, these 2 factors foreshadow the growing challenge orthopedic surgeons will face, as higher rates of immunocompromised patients will inevitably present for procedures in the decade ahead. These patients present with the 3-fold effect of a weakened ability to heal, fight infections, and maintain homeostasis. In the surgeon’s armamentarium must be a thorough understanding of the mechanisms behind the immunocompromised state, the complications to remain vigilant of, and the consequences of failure. The surgeon should seek assistance from other specialists early and make sure the patient is informed of elevated risks before proceeding. Further research is needed to optimize the care of this patient population.
Perioperative Management of Diabetes for Total Joint Arthoplasty: A Consensus Article
Authors: Livshetz Isaac , Nett Michael
Published: June 2019

Diabetes mellitus (DM) is an increasingly prevalent comorbidity among patients undergoing total joint arthroplasty. Uncontrolled DM is a known risk factor for a multitude of postoperative complications, the most dreaded of which is periprosthetic joint infection, but also includes wound complications, deep venous thrombosis, and worse functional outcomes. Given that uncontrolled DM is a modifiable risk factor, it would be prudent for the surgeon to do all that is possible to minimize perioperative risks related to DM while also avoiding unnecessary surgical delays. In this article, we review risk mitigating measures including surgical screening, cutoff thresholds for hemoglobin A1C and maintaining good perioperative glycemic control. We recommend that all presurgical patients be screened for DM by measuring A1C. A value of 8.0% is a reasonable cutoff in surgical candidates and those falling above this value should be referred for glucose optimization before proceeding with surgery. Hemoglobin A1C has not been found to be a good predictor of postoperative complications and thus a strict A1C cutoff should be evaluated on a case by case basis. Maintaining tight glucose control, specifically avoiding hyperglycemia and large glucose fluctuations, is beneficial in the perioperative period and striving for a glucose goal between 80 and180 mg/dL is recommended.
Definition of a Yoga Breathing (Pranayama) Protocol That Improves Lung Function
Authors: Kupershmidt Sabina , Barnable Traci
Published: June 2019

This study tests the hypothesis that yoga breathing (pranayama) improves lung function in healthy volunteers during a 6-week protocol. A randomized controlled pilot study demonstrated an improvement in peak expiratory flow rate and forced expiratory volume. The easy-to-learn approach can be translated to the inpatient and outpatient settings.
The Effect of Aromatherapy on Fatigue and Anxiety in Patients Undergoing Hemodialysis Treatment
Authors: Karadag Ezgi , Samancioglu Baglama Sevgin
Published: June 2019

The aim of this study was to examine the effect of the application of lavender oil on fatigue and anxiety levels in patients undergoing hemodialysis treatment. This randomized controlled study was conducted with 60 patients (30 patients in intervention group, 30 patients in control group) in a province located in southeastern Turkey. After the patients in both groups were informed about the study, a questionnaire, the Fatigue Severity Scale, and the Beck Anxiety Inventory were applied to the patients. In the intervention group, a statistically significant difference was found between pretest and posttest scores of the Fatigue Severity Scale (t = 7.177, P = .001) and the Beck Anxiety Inventory (t = 10.371, P = .001). Mean scores of fatigue and anxiety decreased significantly following aromatherapy and also fatigue and anxiety levels declined. Lavender aromatherapy can be applied as an effective nursing intervention to reduce fatigue and anxiety of patients with chronic renal failure and undergoing hemodialysis treatment.
Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia
Authors: Al Luhidan Lama , Madani Areej , Albanyan Esam A. , Al Saif Saif , Nasef Minosh , AlJohani Sameera , Madkhali Azzah , Al Shaalan Mohammed , Alalola Sulaiman
Published: June 2019

Background:

Group B streptococcus (GBS) is a leading cause of neonatal bacterial sepsis and meningitis globally. Studies concerning the incidence and burden of neonatal GBS disease in Saudi Arabia are lacking. This study determined the incidence and burden of GBS infection among neonates in association with maternal GBS screening.

Methods:

A retrospective cohort chart review study included all neonatal GBS disease cases identified through microbiology lab records within the first 90 days of life in the hospital from January 2004 to December 2016. Charts were reviewed to collect maternal and neonatal characteristics using a standardized form.

Results:

Over 13 years, of 108,609 live births, 55 GBS disease cases were identified (overall incidence, 0.51/1000 live births), 69.1% (n = 38) of those had early onset disease (EOD). The annual incidence in 2015 and 2016 was significantly higher than in any previous year (P < 0.0001), coinciding with the discontinuation of routine universal maternal GBS screening. Median age at presentation was 1 day (range, 0–54 days). We found that 67.3% (n = 37) of mothers were not screened antenatally, 72.9% (n = 27) of whom had neonates present with EOD. Neonates of unscreened mothers were more likely to have GBS disease (P = 0.01) and to present with EOD (P = 0.005). Urinary tract infection was the most common manifestation (47.3%, n = 26), followed by sepsis (43.6%, n = 24). Mortality rate was 3.6% (n = 2).

Conclusions:

The incidence of neonatal GBS infection in Saudi Arabia is similar to the worldwide incidence. Universal antenatal screening discontinuation was significantly associated with an increase in EOD incidence.
Safety and Efficacy of Tigecycline to Treat Multidrug-resistant Infections in Pediatrics: An Evidence Synthesis
Authors: Sharland Mike , Rodvold Keith A. , Tucker Hal R. , Baillon-Plot Nathalie , Tawadrous Margaret , Hickman M. Anne , Raber Susan , Korth-Bradley Joan M. , Díaz-Ponce Humberto , Wible Michele
Published: June 2019

Background:

The need for antimicrobial therapies effective against multidrug resistant organisms for children remains unmet. Tigecycline shows antibacterial activity across a broad spectrum of bacteria and is approved for treating complicated skin and skin-structure infections, complicated intra-abdominal infections and, in the United States, community-acquired bacterial pneumonia for adult patients. No blinded, randomized phase 3 tigecycline clinical trials on neonates or children have been completed or planned. This review aimed to provide a comprehensive synthesis of all the existing data sources, both on-label and off-label, for tigecycline use in children.

Methods:

Data on tigecycline use in children were identified from published and unpublished sources including clinical trials, expanded access and compassionate use programs, databases of healthcare records and patient safety monitoring.

Results:

Pharmacokinetic simulations predicted that tigecycline 1.2 mg/kg (maximum dose 50 mg) every 12 hours (q12h) in children 8–11 years and 50 mg q12h in children 12 to <18 years would achieve exposure similar to adults receiving 50 mg q12h. Available phase 2 pediatric clinical trial data and data from other sources demonstrated similar clinical efficacy between adult and pediatric patients treated with tigecycline. These data showed no new or unexpected safety concerns with tigecycline in children.

Conclusions:

Information presented here may help guide the appropriate use of tigecycline in children with multidrug resistant infections. Continued pharmacovigilance from real-world observational studies may also further refine appropriate use of tigecycline.
Impact of Shifts to Birth Testing on Early Infant Diagnosis Program Outcomes in KwaZulu-Natal, South Africa
Authors: Smith Shayla , Govender Kerusha , Moodley Pravi , La Russa Philip , Kuhn Louise , Archary Moherndran
Published: June 2019

Background:

South African early infant diagnosis guidelines shifted to recommending an initial HIV nucleic acid-based test (NAT) test at birth in 2015. Prior to this, initial NAT was recommended at 6 weeks of age. Here we examine parameters of early infant diagnosis performance in KwaZulu-Natal before and after this change.

Methods:

Data on all HIV diagnostic NAT conducted for the province between January 2013 and April 2016 were assembled and analyzed. Laboratory barcodes allowed identification of repeat tests on the same child. We evaluated coverage, positivity rates, age at testing and frequency of repeat tests across birth cohorts.

Results:

In birth cohorts 2013 and 2014, 62.1% and 61.8%, respectively, of tests <16 weeks were done in children who were 6–8 weeks of age. In birth cohort 2015, 41.3% of tests <16 weeks were done earlier at <2 weeks of age. The percentage of children with a positive result who had at least 1 follow-up test increased from 11.5% and 13.1% in birth cohorts 2013 and 2014, respectively, to 24.8% in 2015. The percentage of infants with an initial nonpositive result who received at least 1 follow-up test did not appreciably change from 15.0% and 14.4% in 2013 and 2014, respectively, to 14.7% in 2015.

Conclusions:

Birth testing allows for earlier identification of HIV-infected infants who need urgent antiretroviral treatment initiation. Although follow-up testing rates may be underestimated in this data source, repeat testing rates remained low. More effort is needed to ensure infants tested at birth continue to be engaged in care and undergo follow-up testing.