bluuebunny/crossref_metadata_2025 huggingface dataset:
Delhi
Authors: Vanaik Anish
Published: October 2020

Delhi has a unique place among the three big metropolises of India. Compared to Mumbai and Kolkata, Delhi’s history is much older: stretching back to the 12th century. Its growth in size, however, is much more recent. From a population of a little over a million in 1951, Delhi and its satellites—the National Capital Region (NCR)—had a population of over eighteen million in the 2011 census. In fact, Delhi’s urban history can be divided neatly at independence. Before that time, Delhi’s urban form reflected its repeated (but not continuous) status as a setting of political power. For the period of explosive urban growth after independence, scholarship about planning initiatives and their discontents abounds. There are excellent accounts of the movement from high-modernist planning to the more recent invocations of making Delhi a world-class city. Inadequate housing and repeated displacements of the poor are keynotes in this scholarship. Social movements, particularly those of the urban poor, have been an important theme from the middle of the first decade of the 21st century. Alongside spatial conflicts over planning, there is a rich vein of empirical work, and some theorization, of the ways in which political mobilizations around religion have shaped the city. Scholars have also dwelt on the complicated structure of urban governance in Delhi—as national capital and burgeoning metropolis, as an urban region that spans four separate provinces, as a megacity engulfing rural pockets, and as an administrative and commercial center ringed by an industrial periphery. Urban interventions aimed at improving Delhi’s environment have also been a topic of scholarly study. Thus, the expulsion of so-called polluting industries in Delhi, on the one hand, has gone together with the emergence of industrial zones in the peripheries of the NCR. Broadly speaking, the scholarship on historical urbanisms in Delhi points to the ways in which shifting structures of power generated urban forms in the Delhi landscape. Unsurprisingly, one manifestation of this long history has been in the active presence of heritage discourses. There is a particularly rich literature on the ways in which the present and the past coexist in modern Delhi, and the multiple possibilities for place-making opened up thereby. The author would like to thank Deepasri Baul and the anonymous reviewer for their suggestions.
Retail Districts
Authors: Kickert Conrad
Published: October 2020

Retail districts are key elements of the urban experience, reflecting and reinforcing the economic, social, political and physical attributes of their environments. Vibrant cities and neighborhoods depend on similarly vibrant retail cores and districts, and vice versa. Furthermore, retail districts strongly influence the urban experience by facilitating the exchange of goods and culture, encouraging social capital, and enabling entrepreneurship. It is therefore surprising how peripherally urban retail districts are discussed in the academic literature, as few geographers, economists, urbanists and sociologists study them as interconnected economic, social, political and physical systems. In many Western countries, urban retail districts have struggled to keep pace with trends toward efficiency, consolidation, and decentralization of retailers, and academic research has similarly moved on. While urban retail districts represent uniquely fine-grained physical settings and conditions, the majority of contemporary retail research has shifted its focus toward macro-scale or operational processes of marketing, consumer behavior, and distribution. As a result, many relevant works on urban retail are rather dated, with any recent works written in countries where retailers have remained urbanized. In this English-language bibliography, many works are therefore British, although many foreign works exist. Over recent decades, a revival of research interest in urban vitality at the scale of the retail district has prompted advances in qualitative and quantitative insights. Analytical methods to study the external and internal structure of retail districts are similarly evolving. Contemporary scholarly debates on urban retail focus on the role of retail districts as social hubs, with authors confirming their positive effect on economic vitality and cultural transfer, while acknowledging the threat of gentrification and homogenization. An increasing number of studies focus on the withdrawal of retailers from underprivileged urban districts, resulting in a dearth of affordable access to healthy food options for their residents—coined “food deserts.” As government involvement in urban retail has diminished in many countries in the late 20th century, an increasing number of retail districts have adopted the self-taxed and governed Business Improvement District model, which has prompted significant academic inquiry and debate over the past decades. The globalization of retail corporations has prompted growing academic interest in retailing in the Global South, connecting the typically local condition of retail districts to global flows of capital and culture. This bibliography presents overview works on the current condition and evolution of urban retail, common analytical models of retail distribution and consumer behavior, and current scholarly debates.
Urban Commons
Authors: Foster Sheila R. , Iaione Christian
Published: October 2020

With global urbanization rapidly increasing and with over half of the world’s population already living in cities, the framework of the “urban commons” has emerged as a way to address contemporary urban challenges ranging from urban housing to urban inequality. The concept of urban commons is based on the idea that public spaces, urban land, and infrastructure ought to be accessible to, and able to be utilized by, urban communities to produce and support a range of goods and services important for the sustainability of those populations, particularly the most vulnerable populations. The founding principles of this movement include sharing, collaboration, civic engagement, inclusion, equity, and social justice. Urban commons are created and managed by civic collaborations including participants from local communities, government, business, academic, and local nonprofit organizations. In this way, the city is a platform utilized and optimized by citizens from all backgrounds and social statuses.
São Paulo
Authors: Rolnik Raquel , Marín-Toro Adriana , Accioly Moreira Fernanda , Kohler Harkot Marina
Published: October 2020

With over twenty million inhabitants, the São Paulo metropolitan region covers 900 square kilometers of urbanized area through thirty-nine municipalities, but its reach goes far beyond its boundaries. Its tentacles are present in distant locations in Brazil, in the continent, and in the whole world. São Paulo’s size and vastness comprise heterogeneous territories and social groups. It is a city connected to both real and virtual worlds of trade; it is an economic power, as well as a cradle for social movements and for Brazilian political leadership. But it is also a divided city crimped by both visible and invisible walls that rip its social fabric into ghettos, fortresses, and slums and besiege its public spaces. To be in the city is to be permanently exposed to its contradictory image of greatness, opulence, and poverty, with carts and armored SUVs, mansions and shacks, shopping malls and street vendors, and fancy food trucks and traditional popcorn sellers. At first glance, São Paulo looks like a fragmented city that does not seem to have originated from any kind of order. The city is in fact a child of chaos, of the wildest and ungoverned competition among individual projects aiming for social rise or simply survival, a product of the dreams of many generations of migrants and immigrants that came to the city seeking opportunities far from home. Urban plans and policy decisions have guided the city’s expansion over time, from the network of trains and trams in the 19th and early 20th centuries to the car-oriented grid of expressways from the 1940s to the present day. The bibliography on São Paulo is vast and has been produced by historians, geographers, architects, sociologists, and political scientists, among other disciplines, but is available mostly in Portuguese. In this selection, an effort was made to choose texts in English (when available), but also to cover essential readings from different disciplines, books or articles that have influenced generations of scholars, studies and authors that are considered classic works, being frequently cited, or, in a very few cases, are opening new paths and visions for the city today. The bibliography is organized by topics, starting with the city’s general and economic history, moving on to the political economy of its process of urbanization, and then covering specific themes.
Kigali
Authors: Cantrell Phillip
Published: October 2020

Kigali is the capital and largest city of the Republic of Rwanda. The founding of the city is credited to Dr. Richard Kandt (b. 1867–d. 1918), who arrived in 1898 with the first German imperial delegation. In 1907 Kandt, as the German Kaiser’s representative, constructed a house and established residency at Kigali, in present-day Muhima sector. As the Rwandan royal court was at Nyanza in the southern part of the kingdom, Mwami Yuhi Musinga (b. 1893–d. 1944) initially asked Kandt not to establish a residency at Kigali, as he feared its location in the east-central region would allow the Germans more centralized control over the kingdom. Kandt did not comply, however, and established a residence on Nyarugenge Hill near to the present-day Gakinjiro market. Thereafter Kigali served as the administrative center for both the German and Belgian colonial administrations. With a central location between Tanzania, the Belgian Congo, Uganda, and Burundi, Kigali developed into an important commercial center frequented by trade caravans. In 1962, following Rwanda’s independence, Kigali became the formal capital. Throughout the first two presidencies of Grégoire Kayibanda (1962–1973) and Juvénal Habyarimana (1973–1994), Kigali remained a relatively small, obscure city as the country was being developed. The city first came to the wider world’s attention when Habyarimana’s plane was shot down by a missile as it approached Kigali International Airport on April 6, 1994, an event that triggered the start of the Rwandan genocide. In the ensuing months, forces under Paul Kagame, who would become president in 2000, advanced southward toward the city to end the killings and take control of the country. As a result, Kigali, like most of Rwanda, experienced considerable destruction. After securing power, Kagame, and the ruling Rwandan Patriotic Front (RPF), aided by considerable development money, rebuilt and transformed Kigali. The most momentous transformation occurred as the result of hundreds of thousands of Tutsi refugees who returned to Rwanda after years in exile. Since most of the refugees no longer had any ties to their rural places of origin, they took up residence and began new lives in the urban areas, most notably Kigali. In the years since, Kigali has undergone a remarkable transformation into a highly modern and cosmopolitan commercial hub, often touted as a model for urban development in Africa. Some refer to Kigali as the “Singapore of Africa.” Yet with a metropolitan population that roughly tripled between 1991 and 2001, burgeoning presently to over one million, developmental challenges remain in terms of health, sanitation, housing, economic inclusiveness, and urban planning. Anticipating continued robust growth, Kigali launched a 2008 Conceptual Master Plan for phased-in development to 2040.
Management referral triaging process pilot study: a ‘telephone first’ approach
Authors: O’Reilly A , McDonnell C
Published: October 2020

Background

In this Occupational Health Department (OHD), a ‘telephone first’ approach was introduced to triage management referrals with potential to convert to Telephone Independent Medical Assessment (TIMA). Telephone consultation has been widely used in the UK’s NHS in the occupational health setting.

Aims

To evaluate TIMA effectiveness and efficiency of OHD resources; comparing the outcome of a triage call compared to previous default allocation of next available appointment, percentage of telephone triage calls converted to TIMA and appointment waiting times. To assess use of OHD resources arising from TIMA. To evaluate service user satisfaction following TIMA. To examine service user characteristics.

Methods

As management referrals were received, service users were given a telephone contact. Data were collected and anonymized regarding service users, who also consented to receive feedback questionnaire. Cross-sectional analysis of this management referral cohort was carried out.

Results

Two hundred and sixty-one management referrals were received in the specified period. Eighty per cent had a TIMA carried out (n = 208); 64% of management referrals with TIMA had a report issued (n = 166). Response rate to feedback questionnaire was 38% (n = 70); 94% of survey participants found TIMA acceptable going forward for management referrals (n = 66).

Conclusions

Introduction of a ‘telephone first’ approach resulted in improved efficiency of this OHD, allowing maximum workforce planning, and positive service user feedback.
Safety Surveillance of Bivalent Meningococcal Group B Vaccine, Vaccine Adverse Event Reporting System, 2014–2018
Authors: Duffy Jonathan , Marquez Paige , Dores Graça M , Ng Carmen , Su John , Cano Maria , Perez-Vilar Silvia
Published: October 2020

Background

In October 2014, MenB-FHbp (Trumenba, Pfizer) became the first meningococcal group B vaccine licensed in the United States. It is approved for use in individuals aged 10–25 years. Our objective was to evaluate the safety of MenB-FHbp postlicensure.

Methods

The Vaccine Adverse Event Reporting System (VAERS) is a national passive vaccine safety surveillance system. We analyzed US VAERS reports for MenB-FHbp received from the date of licensure in October 2014 through December 2018. We described the characteristics of the persons and adverse events (AEs) reported and calculated reporting rates using the number of doses distributed. We used empirical Bayesian data mining to identify AEs reported at least twice as often as expected compared with all other vaccines.

Results

VAERS received 2106 reports involving MenB-FHbp, representing 698 reports per million doses distributed. The median age of vaccinees was 17 years, and 55% were female. MenB-FHbp was given simultaneously with other vaccines in 37% of reports. Most reports (57%) described AEs that started on the day of or day after vaccination. The most common AEs reported were pyrexia (27%), headache (25%), and pain (16%). There were 44 serious reports (2% of all reports), among which 42 reported a hospitalization. Data mining identified disproportional reporting of headache, pyrexia, chills, and myalgia.

Conclusions

The AEs most commonly or disproportionately reported following MenB-FHbp were consistent with those identified in clinical trials as described in the US package insert. We did not identify any new safety issues.
Effects of Recent Use of Renin-Angiotensin System Inhibitors on Mortality of Patients With Coronavirus Disease 2019
Authors: Bae Seongman , Kim Ju Hyeon , Kim Ye-Jee , Lim Joon Seo , Yun Sung-Cheol , Kim Young-Hak , Lee Sang-Oh , Kim Sung-Han
Published: October 2020

Background

There is growing concern about the potential harmful effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19) and cardiovascular diseases (CVDs). The aim of this study was to evaluate the association between recent exposure to ACEIs/ARBs and in-hospital mortality in patients with COVID-19.

Methods

We used data from a nationwide cohort of patients with COVID-19 from the health insurance claims data of South Korea, which were released for research purposes for public health by the Ministry of Health and Welfare of South Korea. Patients with COVID-19 were identified using the relevant diagnostic code. Propensity score matching (1:1) was carried out among patients with CVD according to the type of medication (ACEIs/ARBs vs other), and the risk of death was assessed.

Results

A total of 4936 patients with COVID-19 were analyzed, of whom 1048 (21.2%) had CVD. Of the 1048 patients with CVD, 864 (82.4%) received at least 1 antihypertensive medication before the diagnosis of COVID-19, including 359 (41.6%) who received ACEIs/ARBs and 505 (58.4%) who received drugs other than ACEIs/ARBs. Using the propensity scores for ACEI/ARB use, we matched 305 pairs of patients receiving ACEIs/ARBs and patients receiving other drugs. Recent use of ACEIs/ARBs was not significantly associated with in-hospital mortality in unadjusted analysis (odds ratio [OR], 0.62; 95% CI, 0.33–1.14) or propensity score matching analysis (OR, 1.00; 95% CI, 0.46–2.16).

Conclusions

In patients with COVID-19 and underlying CVDs, the recent use of ACEIs/ARBs was not significantly associated with in-hospital mortality. These findings do not support stopping or modifying ACEIs/ARBs in patients during the current COVID-19 pandemic.
Relationship of Telomere Length to Fat Redistribution in HIV
Authors: Iyengar Sanjna , Cȏté Hélène C F , Fitch Kathleen V , Torriani Martin , Feldpausch Meghan , Srinivasa Suman
Published: October 2020

Persons with HIV demonstrate increased risk for aging-associated complications and have reduced telomere length (TL) compared with age-matched persons without HIV. Our data show that greater visceral fat is related to reduced TL in HIV, independent of age and smoking. Fat redistribution may be a relevant mediator of TL attrition in HIV.
Black Lives Matter protests and COVID-19 cases: relationship in two databases
Authors: Neyman Gregory , Dalsey William
Published: October 2020

Background

The coincidence of Black Lives Matter (BLM) protests with the COVID-19 pandemic in the USA has raised concerns about the safety of mass gatherings for political causes. This study examines two databases to probe any correlation between protests and increases of COVID-19 case rates afterward.

Methods

A BLM protest aggregator and a county-level COVID-19 database were crosswalked, matching the city that the protest occurred in with the county and its case rates at 0, 1, 2 and 3 weeks after the index protest, and was compared with a control county in the same state with the nearest match of population size and case rate at Week 0.

Results

In the 22 days after the killing of George Floyd, there were 326 counties participating in 868 protests, attended by an estimated 757 077 protestors. The median case rate at Week 3 was 0.0049 in protest counties versus 0.0041 in control counties, which was found to be statistically significant. Regression analysis found that each individual protestor contributed to the case rate by 7.65 × 10−9, which was not statistically significant.

Conclusion

Although the increase was statistically significant, it was very small in magnitude and likely due to limitations of significantly different population sizes in comparators.
Prognostic factors for finger interphalangeal joint osteoarthritis: a systematic review
Authors: Shah Karishma , Cai He , Lane Jennifer C E , Collins Gary S , Arden Nigel K , Furniss Dominic , Filbay Stephanie R
Published: October 2020

Objective

Radiographic hand OA affects one in five adults. Symptomatic hand OA can result in functional impairment, pain and reduced quality of life. A prevalent form of hand OA is IP joint OA, however prognostic factors for IP joint OA remain poorly understood. This systematic review aimed to identify prognostic factors for IP joint OA, and to summarize the diagnostic criteria for IP joint OA in prognostic studies.

Methods

EMBASE, MEDLINE, Scopus and The Cochrane Library were searched from inception until 19 February 2020 (PROSPERO CRD42019116782). Eligible studies described diagnostic criteria defining IP joint OA, and assessed potential prognostic factors for IP joint OA. Risk of bias was assessed using a modified Quality in Prognosis Studies (QUIPS) tool and a best evidence synthesis was used.

Results

Eighteen studies were included (risk of bias: eight high, three moderate, seven low). All defined OA radiographically, and three studies incorporated clinical symptoms into their definition of OA. Forty-nine potential prognostic factors were assessed. Eight were prognostic: older age in women, female gender (both moderate evidence); family history of Heberden’s nodes, Kashin–Beck disease, older age in men, dental occupation in men, finger fracture, parity (all limited evidence). Higher BMI in women (limited evidence) was prognostic for symptomatic radiographic OA. No prognostic factors for symptomatic OA were identified.

Conclusion

IP joint OA is most commonly defined radiographically, yet criteria were heterogeneous. Eight prognostic factors for radiographic IP joint OA and one for symptomatic radiographic IP joint OA were identified, all with limited or moderate evidence. Further studies on causality and on prognostic pathways are needed.
Race, Nation, and the Color-Line in the Twenty-First Century: A Du Boisian Analysis
Authors: Thomas James M
Published: October 2020

This article argues that Du Bois’s tripartite framework consisting of the Veil, souls, and double-consciousness helps us analyze and understand the resurgence of racialized nationalism today. I juxtapose Du Bois’s early writings on German nationalism and antisemitism with his later writings on American nationalism and anti-black racism to demonstrate how antisemitism in Germany and anti-black racism in America function as constitutive elements for their respective nationalist discourses at the turn of the twentieth century. I argue that Du Bois’s analysis of the “double problem” of German nationalism served as an important precursor of his theory of the “double problem” of American nationalism. Du Bois’s concepts, when taken together, provide a still-relevant framework through which to understand contemporary expressions of racism and xenophobia that typify emergent nationalist movements in the twenty-first century.
Development and evaluation of two different lameness models in meat goats, a pilot study
Authors: Reppert Emily J , Kleinhenz Michael D , Viscardi Abbie , Montgomery Shawnee R , Crane Alison R , Coetzee Johann F
Published: October 2020

Lameness is a serious health concern for livestock species. Understanding individual animal response to pain and characterization of lameness are critical when developing appropriate treatments. The objectives of this pilot study was to evaluate two different lameness models and measures for determining response to induced lameness in meat goats. Lameness was induced by intraarticular injection into the left hind lateral claw distal interphalangeal joint with either amphotericin B (Amp-B) or kaolin-carrageenan (K-C). Response to lameness was characterized by behavior scoring, visual lameness scoring (VLS), infrared thermography (IRT) of the affected digit, pressure mat gait analysis (PMT), and plasma cortisol (CORT) analysis. Lame goats had higher VLS compared to controls (P = 0.003). Maximum temperatures measured in hooves from lame vs control goats were significantly higher (P = 0.003). Pressure mat analysis demonstrated, when compared to controls, lame goats had decreased force (P = 0.013), impulse (P = 0.007), contact pressure (P = 0.007), and contact area of the left hind limb (P = 0.009). Mean CORT levels 4 and 6 h after lameness induction were higher in lame goats (P = 0.005, P = 0.01). The two lameness methods reliably induced lameness of varying severity in healthy meat goats.
What are the Top 10 Unanswered Questions in Molecular Plant-Microbe Interactions?
Authors: Harris Jeanne M. , Balint-Kurti Peter , Bede Jacqueline C. , Day Brad , Gold Scott , Goss Erica M. , Grenville-Briggs Laura J. , Jones Kathryn M. , Wang Aiming , Wang Yuanchao , Mitra Raka M. , Sohn Kee Hoon , Alvarez Maria Elena
Published: October 2020

This article is part of the Top 10 Unanswered Questions in MPMI invited review series.

The past few decades have seen major discoveries in the field of molecular plant-microbe interactions. As the result of technological and intellectual advances, we are now able to answer questions at a level of mechanistic detail that we could not have imagined possible 20 years ago. The MPMI Editorial Board felt it was time to take stock and reassess. What big questions remain unanswered? We knew that to identify the fundamental, overarching questions that drive our research, we needed to do this as a community. To reach a diverse audience of people with different backgrounds and perspectives, working in different areas of plant-microbe interactions, we queried the more than 1,400 participants at the 2019 International Congress on Molecular Plant-Microbe Interactions meeting in Glasgow. This group effort resulted in a list of ten, broad-reaching, fundamental questions that influence and inform our research. Here, we introduce these Top 10 unanswered questions, giving context and a brief description of the issues. Each of these questions will be the subject of a detailed review in the coming months. We hope that this process of reflecting on what is known and unknown and identifying the themes that underlie our research will provide a framework to use going forward, giving newcomers a sense of the mystery of the big questions and inspiring new avenues and novel insights.

[Formula: see text] Copyright © 2020 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Hormetic Effects of Dimethachlone on Mycelial Growth and Virulence of Sclerotinia sclerotiorum
Authors: Hu Simin , Li Jinli , Wang Pengju , Zhu Fuxing
Published: October 2020

Fungicide hormesis has implications for the application of fungicides to control plant diseases. We investigated the hormetic effects of the dicarboximide fungicide dimethachlone on mycelial growth and virulence of the necrotrophic plant pathogen Sclerotinia sclerotiorum. Dimethachlone at sublethal doses in potato dextrose agar (PDA) increased the mycelial growth of S. sclerotiorum. After the growth-stimulated mycelia were subcultured on fresh PDA and inoculated on rapeseed leaves, increased mycelial growth and virulence were observed, indicating that hormetic traits were passed down to the next generation. Dimethachlone applied to leaves at 0.002 to 500 μg/ml stimulated virulence, with a maximum stimulation amplitude (MSA) of 31.4% for the isolate HLJ4, which occurred at 2 μg/ml. Dimethachlone-resistant isolates and transformants had a mean virulence MSA of 30.4%, which was significantly higher (P = 0.008) than the MSA for sensitive isolates (16.2%). Negative correlations were detected between MSA and virulence in the absence of any fungicide (r = –0.872, P < 0.001) and between MSA and mycelial growth on PDA (r = –0.794, P = 0.002). Studies on hormetic mechanisms indicated that dimethachlone had no significant effects on expression levels of three virulence-associated genes, that is, a cutinase-encoding gene SsCut, a polygalacturonase gene SsPG1, or an oxaloacetate acetylhydrolase gene SsOah1. The results will contribute to understanding hormesis and have implications for the judicious application of fungicides to control plant diseases.
How Effective Is Aerobic Exercise Training in Improving Aerobic Capacity After Heart Transplant? A Systematic Review and Meta-analysis
Authors: Groen Keriann , Robison Patrycia , Xiong Annie , Irwin Kent E. , Stein Amy Buros , Evans Christian C.
Published: October 2020

Purpose:

Studies suggest that additional exercise (Ex) training beyond “usual care” increases peak VO2 in people post-heart transplant (HTx); however, no recent studies have quantified improvements or compared moderate-intensity aerobic Ex (MOD) to high-intensity interval training (HIIT). The purpose of this study was to quantify improvements in VO2 for patients post-HTx undergoing additional Ex training and compare effectiveness of MOD to HIIT.

Methods:

Inclusion criteria were: randomized clinical trials, systematic reviews, or meta-analyses published between 2008 to 2018, subjects post-HTx, participated in an aerobic Ex program beyond usual care, and reported peak VO2.

Results:

A total of 242 records were obtained and 7 randomized clinical trials were reviewed. The average PEDro score was 4.86 (range 2–7). The within-group weighted mean difference (WMD) in peak VO2 comparing baseline to post-training for the Ex group = 3.3 (0.5) ml/kg/min and for the control group = −0.2 (0.2) ml/kg/min. The between-group WMD in peak VO2 = 3.5 (7.9) ml/kg/min, Hedge's g = 0.606 (95% confidence intervals = 0.337–0.874), P < .001, favoring Ex. Comparison between Ex protocols indicated that there was no difference between HIIT and MOD (Q = 1.83, P = .176).

Conclusions:

Physical therapists should challenge patients post-HTx with aerobic Ex that goes beyond usual post-HTx care and should consider incorporating HIIT into the treatment plan or home program to maximize the benefits of rehabilitation when possible.
Efficacy of prehospital administration of fibrinogen concentrate in trauma patients bleeding or presumed to bleed (FIinTIC)
Authors: Ziegler Bernhard , Bachler Mirjam , Haberfellner Hubert , Niederwanger Christian , Innerhofer Petra , Hell Tobias , Kaufmann Marc , Maegele Marc , Martinowitz Uriel , Nebl Carolin , Oswald Elgar , Schöchl Herbert , Schenk Bettina , Thaler Markus , Treichl Benjamin , Voelckel Wolfgang , Zykova Ivana , Wimmer Christine , Fries Dietmar
Published: October 2020

BACKGROUND

Trauma-induced coagulopathy (TIC) substantially contributes to mortality in bleeding trauma patients.

OBJECTIVE

The aim of the study was to administer fibrinogen concentrate in the prehospital setting to improve blood clot stability in trauma patients bleeding or presumed to bleed.

DESIGN

A prospective, randomised, placebo-controlled, double-blinded, international clinical trial.

SETTING

This emergency care trial was conducted in 12 Helicopter Emergency Medical Services (HEMS) and Emergency Doctors’ vehicles (NEF or NAW) and four trauma centres in Austria, Germany and Czech Republic between 2011 and 2015.

PATIENTS

A total of 53 evaluable trauma patients aged at least 18 years with major bleeding and in need of volume therapy were included, of whom 28 received fibrinogen concentrate and 25 received placebo.

INTERVENTIONS

Patients were allocated to receive either fibrinogen concentrate or placebo prehospital at the scene or during transportation to the study centre.

MAIN OUTCOME MEASURES

Primary outcome was the assessment of clot stability as reflected by maximum clot firmness in the FIBTEM assay (FIBTEM MCF) before and after administration of the study drug.

RESULTS

Median FIBTEM MCF decreased in the placebo group between baseline (before administration of study treatment) and admission to the Emergency Department, from a median of 12.5 [IQR 10.5 to 14] mm to 11 [9.5 to 13] mm (P = 0.0226), but increased in the FC Group from 13 [11 to 15] mm to 15 [13.5 to 17] mm (P = 0.0062). The median between-group difference in the change in FIBTEM MCF was 5 [3 to 7] mm (P < 0.0001). Median fibrinogen plasma concentrations in the fibrinogen concentrate Group were kept above the recommended critical threshold of 2.0 g l−1 throughout the observation period.

CONCLUSION

Early fibrinogen concentrate administration is feasible in the complex and time-sensitive environment of prehospital trauma care. It protects against early fibrinogen depletion, and promotes rapid blood clot initiation and clot stability.

TRIAL REGISTRY NUMBERS

EudraCT: 2010-022923-31 and ClinicalTrials.gov: NCT01475344.
Preoperative conversion from a laparoscopic to an exploratory laparotomy cholecystectomy
Authors: Shah Rajiv N. , Tiesenga Frederick , Jorge Juaquito
Published: October 2020

Introduction:

Acute cholecystitis (AC) with cholelithiasis is commonly presented as right upper quadrant pain with radiation to the scapula. A lethal complication before any surgical intervention in a patient with AC is sepsis.

Presentation of Case:

We present a rare case of a patient who had AC complicated with sepsis. Patient was surgically prepared for a laparoscopic cholecystectomy but later changed to an exploratory laparotomy cholecystectomy due to complaints of preoperative diffuse abdominal pain and concerns of intra-abdominal sepsis. A central line for antibiotics, metronidazole, and vancomycin, was placed during surgery to treat his sepsis. Patient had an uneventful postop recovery.

Discussion:

Surgical solutions should be discussed during preoperative work-up with any changes in potential signs of sepsis and abdominal pain. Laparoscopic cholecystectomy is a less invasive procedure but carries a risk with potential intraoperative complications in treating gangrenous cholecystitis with biliary sludge; therefore exploratory laparotomy should be discussed as a potential intervention.

Conclusion:

Conversion to an exploratory laparotomy seems inevitable when concerns of complications arise before surgery to reduce morbidity and mortality. Severe peritonitis with a gangrenous gallbladder posed an increased risk for a laparoscopic procedure and therefore a conversion to an exploratory laparotomy was initiated.
Are you in pain if you say you are not? Accounts of pain in Somali–Canadian women with female genital cutting
Authors: Perović Mateja , Jacobson Danielle , Glazer Emily , Pukall Caroline , Einstein Gillian
Published: October 2020

As a rite of passage to womanhood, 2 million girls undergo female genital circumcision (FGC)—the tradition of cutting, and often removing parts of the vulva—every year. The current study is the first to focus on the connection between peripheral nerve damage and chronic neuropathic pain in women with FGC. We used mixed methods—quantitative, qualitative, and physiological—to study chronic pain in Somali–Canadian women (N = 14). These women have the most extensive form of FGC, which includes removal of the glans clitoris, labia minora, medial portion of the labia majora, and stitching together the remaining parts of the labia majora. Our results indicate a multifaceted pain experience in women with FGC. Although they report good overall health and very low pain levels on the short form of the McGill Pain Questionnaire, pressure-pain quantitative sensory testing of the vulvar region applied through vulvalgesiometers shows pain thresholds consistent with those reported by women with chronic vulvar pain. Furthermore, qualitative interviews reveal a considerable amount of often debilitating pain in daily life. These results challenge the use of assessment tools offering elicited verbal pain language and highlight the importance of culturally sensitive ways of conceptualizing, measuring, and managing pain.
The effect of early procedural pain in preterm infants on the maturation of electroencephalogram and heart rate variability
Authors: Lavanga Mario , Bollen Bieke , Caicedo Alexander , Dereymaeker Anneleen , Jansen Katrien , Ortibus Els , Van Huffel Sabine , Naulaers Gunnar
Published: October 2020

Preterm infants show a higher incidence of cognitive, social, and behavioral problems, even in the absence of major medical complications during their stay in the neonatal intensive care unit (NICU). Several authors suggest that early-life experience of stress and procedural pain could impact cerebral development and maturation resulting in an altered development of cognition, behavior, or motor patterns in later life. However, it remains very difficult to assess this impact of procedural pain on physiological development. This study describes the maturation of electroencephalogram (EEG) signals and heart rate variability in a prospective cohort of 92 preterm infants (<34 weeks gestational age) during their NICU stay. We took into account the number of noxious, ie, skin-breaking, procedures they were subjected in the first 5 days of life, which corresponded to a median age of 31 weeks and 4 days. Using physiological signal modelling, this study shows that a high exposure to early procedural pain, measured as skin-breaking procedures, increased the level of discontinuity in both EEG and heart rate variability in preterm infants. These findings have also been confirmed in a subset of the most vulnerable preterm infants with a gestational age lower than 29 weeks. We conclude that a high level of early pain exposure in the NICU increases the level of functional dysmaturity, which can ultimately impact preterm infants' future developmental outcome.
A Multibiomarker Latent Class Analysis in Moderate to Advanced Heart Failure
Authors: Thompson Jessica Harman , Faulkner Kenneth M. , Lee Christopher S.
Published: October 2020

Background

Biomarker science in heart failure (HF) is advancing quickly in our ability to diagnosis and treat patients with this complex syndrome. Researchers are urged to not use single-marker strategies, but instead evaluate biomarkers in patterns to better understand their relationship to one another, as well as disease progression. Latent class mixture modeling allows researchers to determine novel associations between biomarkers.

Objective

The objectives of this study were to identify and compare latent classes of cardiovascular biomarkers among patients with moderate to advanced HF.

Methods

This was a cross-sectional study of 96 participants with moderate to advanced HF. Latent class mixture modeling was used to identify unique classes of biomarkers and their associations to sociodemographic and clinical variables.

Results

The average age of the sample was 54 years, with most of the sample being men (77%) and having an average ejection fraction of 23%. Two unique classes of biomarkers were identified. Latent class 1 had higher levels of all biomarkers, whereas latent class 2 had lower levels. The higher biomarker class had, on average, more neurohormonal activation and fluid retention; however, the higher levels of biomarker class were not more likely to be diagnosed with advanced HF or have more comorbidities.

Conclusion

By identifying classes of biomarkers, providers may be better able to identify patients who are at risk of progressing into advanced HF quicker or those who are more likely to have more severe complications, such as fluid overload or renal disease.
Pilot Study: Thinking Outside the Square in Cultivating “Soft Skills”—Going beyond the Standard Optometric Curriculum
Authors: Cham Kwang Meng , Gaunt Heather , Delany Clare
Published: October 2020

SIGNIFICANCE

No research in optometric education that uses Moore's concept of creativity and object-based learning to cultivate “soft skills” exists. The design and outcomes of this study will contribute to the body of optometric education, and future research will assess the applicability of these findings to other allied health disciplines.

PURPOSE

Optometrists, like all health care professionals, need to be proficient in soft skills such as effective communication and interpersonal skills. Rather than assuming these soft skills can be developed “on the job,” we implemented a teaching intervention for students to develop their communication, interpersonal, and teamwork skills.

METHODS

Students from optometry, arts management, and animation attended an autobiographical museum in interdisciplinary groups and examined an artifact relating to aspects of professionalism mentioned previously. We evaluated whether and how students experienced this activity as enhancing their creativity and other soft skills via survey results and thematic analysis of their reflective essays.

RESULTS

Our findings showed that this group work has augmented their professional development, with approximately 90% of the students reporting that it had helped in critical self-reflection and future improvement of communication and interpersonal skills. Eighty percent of the students stated that this group work was beneficial and enjoyable and recommended object-based and interdisciplinary learning to be embedded in future group work. Themes generated from the essays were the following: (a) perceptions of object-based learning in a museum and (b) insights into group work experiences.

CONCLUSIONS

This is the first pilot study that investigates group work across optometry and nonclinical disciplines in a post-graduate curriculum using museum objects. Our findings, based on students' perceptions, imply that students emerged from the program with the intent to transfer their learning to their future practice. We propose that this purposefully designed-based and creative group work may support the development of professional attributes essential for optometric students.
Optometry Compensation Study: Narrowing Down the Unexplained Gender Wage Gap in Optometry
Authors: Simpson Rachel S. , Scott Breanna J. , Hamm Kate J. , Tyra Jacquelyn M. , Jackson Heather M. , Fermil Marie L. P. , Kinder Leslie K. , Bassi Carl J.
Published: October 2020

SIGNIFICANCE

Men earn at least 6.5% more than women in their first full-time jobs as optometrists. For current salaries, the gender wage gap is more than 13%. This study details the gender wage gap that remains after controlling for practice ownership, residency training, and employer-defined full-time work.

PURPOSE

The purpose of this study was to measure the gender wage gap by region and practice type for full-time optometrists who did not complete a residency and do not own their practice.

METHODS

Participants completed an online survey, providing data for their first and current optometry positions and demographic information. Respondents who reported full-time employment in the United States, not completing a residency, and not owning their practice were selected for further analysis by census region and practice type. In each category, the gender wage gap was calculated.

RESULTS

In all regions and practice types, men were paid higher starting salaries than women. For current salaries, men were paid higher in almost all regions and practice types. The wage gap increased from starting salary to current salary, although not in all regions and practice types.

CONCLUSIONS

When practice ownership, residency completion, and full-time work are controlled for, there remains a difference in the pay received by men and women in optometry. The salary data presented in this study may help optometrists narrow the wage gap.
Case Report: Adult Retinoblastoma Progression in 19 Months
Authors: Zhou Liang , Zhu Xiao-Hua , Zhang Ke , Hu Rong , Myers Frank
Published: October 2020

SIGNIFICANCE

Retinoblastoma is the most common intraocular malignancy in childhood, comprising 4% of all pediatric cancers. Adult onset is extremely rare. Enucleation is usually performed in adult cases because of the atypical presentations and malignant features of the tumor, which lead to misdiagnosis.

PURPOSE

We report a case of a 34-year-old woman who presented with an intraocular mass that was present for 19 months without any treatment before enucleation.

CASE REPORT

A 34-year-old woman with a history of a dark shadow in her right eye for 2 weeks presented with a whitish-pink mass in the nasal superior retina. Angiography revealed leakage of vessels on the surface of the tumor. Ultrasound showed a midrange echogenic mass in the right eye. The patient denied treatment and was not seen again until 19 months after her first visit. B-scan ultrasound showed enlargement of intraocular growth without calcification. The patient subsequently underwent enucleation, and retinoblastoma was confirmed with histopathology of the enucleated eye.

CONCLUSIONS

Retinoblastoma in adulthood is very rare. It has different clinical characteristics that need to be differentiated from other retinal tumors, such as primitive neuroectodermal tumor. They can develop very fast, but needle biopsy is not recommended. Eye care practitioners should be aware of the possibility of this malignancy in adults.
Quality Indicators for Children With Traumatic Brain Injury After Transition to an American College of Surgeons Level I Pediatric Trauma Center
Authors: Campbell Maryellen , Zagel Alicia L. , Ortega Henry , Kreykes Nathan , Tu Albert , Linabery Amy M. , Plasencia Laura , Krause Ernest , Bergmann Kelly R.
Published: October 2020

Objective

The aim of the study was to compare quality indicators, including frequency of acute surgical and emergent interventions, and resource utilization before and after American College of Surgeons (ACS) level I trauma verification among children with moderate or severe traumatic brain injury (TBI).

Methods

This is a retrospective review of patients younger than 18 years treated for moderate or severe TBI, as determined by International Classification of Disease codes. Our institution obtained ACS level I trauma verification in 2013. Outcomes during the pre-ACS (June 2003–May 2008), interim (June 2008–May 2013), and post-ACS (June 2013–May 2018) periods were compared via nonparametric tests. Tests for linear trend were conducted using Cochran-Armitage tests for categorical data and by linear regression for continuous variables.

Results

There were 677 children with moderate or severe TBIs (pre-ACS, 125; interim, 198; post-ACS, 354). Frequency of any surgical intervention increased significantly in the post-ACS period (12.2%) compared with interim (5.1%) and pre-ACS periods (5.6%, P = 0.007). More children in the post-ACS period required intracranial pressure monitoring (P = 0.017), external ventricular drain placement (P = 0.003), or endotracheal intubation (P = 0.001) compared with interim and pre-ACS periods. There was no significant change in time to operating room (P = 0.514), frequency of decompression (P = 0.096), or time to decompression (P = 0.788) between study periods. The median time to head CT decreased significantly in the post-ACS period (26 minutes; interquartile range [IQR], 9–60) compared with interim (36 minutes; IQR, 21–69) and pre-ACS periods (53 minutes; IQR, 36–89; P < 0.001). Frequency of repeat head computed tomography decreased significantly in the post-ACS period (30.2%) compared with interim (56.1%) and pre-ACS periods (64.0%, P
trend = 0.044).

Conclusions

Transition to an ACS level I trauma verification was associated with improvements in quality indicators for children with moderate or severe TBI.
Optical Coherence Tomography Angiography Characteristics and Predictors of Visual Outcomes in Patients With Acute and Chronic Nonarteritic Anterior Ischemic Optic Neuropathy
Authors: Moon Yeji , Song Min Kyung , Shin Joong Won , Lim Hyun Taek
Published: October 2020

Background:

To investigate the correlation between optical coherence tomography angiography (OCTA) characteristics and visual outcomes in patients with acute and chronic nonarteritic anterior ischemic optic neuropathy (NAION).

Methods:

We retrospectively reviewed clinical data and OCTA images of 26 eyes of 26 patients who had been diagnosed with unilateral NAION. OCTA images were acquired from 17 eyes at the acute stage and from 21 eyes at the chronic stage of NAION. We analyzed the peripapillary vessel density (VD) and macular VD in various layers of the retina and choroid for all images. Possible correlations between the OCTA parameters and visual outcomes were investigated.

Results:

Among the OCTA parameters for the acute stage of NAION, the temporal peripapillary VD was found to be positively correlated with final visual acuity and visual field with statistical significance (P = 0.039 and 0.009, respectively). In the chronic stage of NAION, both peripapillary and superficial macular VDs were positively correlated with visual outcomes. The nasal perifoveal VD in the superficial capillary plexus (SCP) also had a significant correlation with final visual acuity for both acute and chronic stages (the Spearman correlation coefficient = 0.565 and 0.685, respectively).

Conclusions:

In patients with NAION, significant correlations were found between OCTA parameters and visual outcomes. The temporal peripapillary VD measured during the acute stage was a significant predictor of final visual outcomes. The decreased nasal perifoveal VD in the SCP was strongly associated with poor visual prognosis.