bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging Ethical and Legal Issues in Clinical Child and Adolescent Psychology
Authors: Fried Adam L. , Fisher Celia B.
Published: November 2018

Clinical practice and research with children and adolescents diagnosed with mental health conditions can raise complex ethical questions that touch on fundamental tensions between core ethical principles, such as autonomy, beneficence, and nonmaleficence. This chapter focuses on three dynamic ethics areas that often raise complex ethical questions in child and adolescent clinical psychology: (a) informed consent and assent policies and procedures; (b) confidentiality policies and disclosure decision-making; and (c) developing and maintaining competence. Traditional ethics sources, such as professional codes, laws and regulations, and professional guidelines, are discussed; evidence-based ethics approaches are examined that, in conjunction with traditional ethics sources, can provide contextual information to inform ethical decision-making and help psychologists tailor procedures to specific participant/client populations and/or settings.
Shifting Dynamics
Authors: Foley Catherine
Published: November 2018

This chapter examines the shifting dynamics of practice and transmission in sean nós dancing, an Irish solo, percussive, and semi-improvisatory dance form. This dance form extended its contexts of practice in the 1970s from rural, informal, and intimate gatherings in Conamara in the west of Ireland, to a national staged competitive event, the Oireachtas, considered to be the primary national competition for sean nós dancers. The chapter argues that competition culture influenced the transmission and practice of the dance form and the ethno-aesthetic embodied in its practice. With live television broadcasts of the competition from the first decade of the 2000s, an increased interest in sean nós dancing in Ireland and further afield followed, and concerns around issues of performance, identity, place, and authenticity arose.
The “First Fathers” of the Society of Jesus
Authors: Fabre Pierre Antoine
Published: November 2018

This chapter argues on the basis of textual evidence and hagiographical literature that the foundation of the Society of Jesus was a complex interweaving of narratives, and of both individual and group actions. A blurred “family portrait” of the founding fathers, an open question of spiritual (and institutional) inheritance, and the genius of Ignatius of Loyola’s refusal to sign his own auto/biography are some of the innovations built into the Society of Jesus in its forming moments, compared to medieval monastic orders. The chapter argues that a certain interior institutional instability, continuously remedied by spiritual writing and by the production of the self-defining texts (from Constitutions to global network of correspondence), and the decision to espouse geographical dispersion and linguistic diversity, accounts for the global success of the Society of Jesus in the early modern period.
Jesuit Anthropology
Authors: de Castelnau-l’Estoile Charlotte
Published: November 2018

This chapter analyzes the Jesuit missionary tradition of studying local customs and languages, which is known as “Jesuit anthropology.” By looking into some of the foundational Jesuit texts, the goal is to show how knowledge of non-Christian peoples had been constructed around the metaphor of “living books”: a “stranger” was a book, which the missionaries needed to decipher. From the information, observation, and expertise developed informally in all missionary fields, some Jesuits produced texts—some published but mostly remaining in manuscript—that were and still are considered important pieces in the European library of knowledge. The need and desire to know others was, of course, linked to religious goals: translating Christian message, administering sacraments, fulfilling divine will. From Francis Xavier to Michel de Certeau, the chapter addresses a set of Jesuit perspectives on alterity. They document the richness of interactions between the Jesuits and the local actors, but they always have to be read in light of the Jesuit project of religious conversion.
Water and Rice Production
Authors: Riddell Phil , Gujja Biksham
Published: November 2018

This chapter considers the challenges and opportunities with respect to meeting the demand for rice in the context of a trade-based concept of water, food, and nutrition security. It notes that there is more to rice than just its food value. It also has cultural values and various industrial uses while certain rice schemes have environmental or flood management benefits. The structure of the global rice sector is then presented in terms of production, demand, and trade which serve to confirm the importance of rice as an agricultural commodity. However, current production practices are—in many locations—characterized by challenges in terms of productivity, climate change, genetics, political economy, and cartels. These are analyzed before the text focusses on measures to increase the water productivity of rice before providing a ‘horizon view’ of supply and demand, prices, and the need for expanded production or new producing areas.
Israel’s National Security Policy
Authors: Freilich Chuck
Published: November 2018

Israel has responded to the uniquely harsh strategic environment it has faced ever since its establishment by developing defensive capabilities totally disproportionate to its size and has become a regional power, its existence no longer truly in doubt. Nevertheless, Israel continues to face the severe threats of weapons of mass destruction, terrorism, rockets, and cyberattacks, primarily from Iran, Hezbollah, and Hamas; the ongoing conflict with the Palestinians; and demographic challenges. This article presents both the fundamental changes that have taken place in Israel’s strategic environment, from conventional, state-based threats to primarily asymmetrical ones, and the responses it has developed to date. It also addresses Israel’s relations with the United States and other primary international actors, as well as Israel’s nuclear and regional arms control policy.
Stress and the Brain
Authors: Barch Deanna M. , Pagliaccio David
Published: November 2018

This chapter reviews associations between early life stress and brain structure and function as assessed by structural and functional magnetic resonance imaging. Particularly, this chapter focuses on structural associations in children and adults and the regional overlap with neural alterations observed in major depressive disorder, though we also more briefly cover diffusion imaging, task-based imaging, and resting-state functional connectivity. Major depressive disorder is highlighted given that early life stress is a critical risk factor for depression and the neural alterations observed with stress and depression may serve as key mediating factors of this association. A brief methodological overview is provided for each neuroimaging domain as well as a discussion of limitations and future directions for this field.
Capitalist Social Reproduction
Authors: Gimenez Martha E.
Published: November 2018

This entry will look at Marx’s theoretical contributions to social reproduction in relationship to critical assessments of his alleged “neglect” of reproduction and to the development of the social sciences, particularly the “radical” social sciences that emerged in the late 1960s and early 1970s, and continued to develop ever since. Marx, as well as Engels, offered important insights for understanding social reproduction as an abstract feature of human societies that, however, can only be fully understood in its historically specific context (i.e., in the context of the interface between modes of production and social formations). Social reproduction in the twenty-first century is capitalist social reproduction, inherently contradictory, as successful struggles for the reproduction of the working classes, for example, do not necessarily challenge capitalism. Finally, this article argues that radical social scientists, because they identify the capitalist foundations of the social phenomena they study, have made important contributions to the study of capitalist reproduction.
The Commodification of Knowledge and Information
Authors: Rotta Tomás , Teixeira Rodrigo
Published: November 2018

This entry presents an analysis of the commodification of knowledge and information in contemporary capitalism. We provide a consistent account of how information as a commodity effects the workings of both capitalism and of Marxist theory. The first part of the chapter critically revisits Marx’s own writings on the commodification of knowledge and how the immaterial labor hypothesis initially interpreted these writings. Based on the new categories knowledge-commodity and knowledge-rent, we then present our own approach in response to the challenges raised by the immaterial labor hypothesis. Lastly, there is an analysis of the more recent contributions on the commodification of knowledge and information within the Marxist literature. The current debate on the value of knowledge has been divided between two camps: the reproduction cost approach and the average cost approach. Finally, there is a look at empirical estimates of the magnitudes of knowledge-rents.
Justification
Authors: Hefling Charles
Published: November 2018

Newman’s Lectures on the Doctrine of Justification are seldom read, but there is perhaps no better place to see his theological reasoning at work. The goals and method of the argument parallel those of Tract 90, which explicitly incorporates the conclusions arrived at in the Lectures. Newman wrote them, initially, to rebut charges of unorthodoxy, as defined by Anglican doctrinal formularies. At issue was whether justification by faith can be reconciled with Tractarian teaching on baptism and obedience as intrinsic to justification. Newman’s endeavour to expound his Church’s official doctrine in a way that minimizes its Reformation origins involves remarkable logical and rhetorical manoeuvres; by the end he appears to have abandoned most of what justification has meant, in favour of a neo-patristic understanding of divine presence, conceived as something like deification.
Doctrinal Development
Authors: Shea C. Michael
Published: November 2018

The theory of doctrinal development provided Newman with a way of resolving the Oxford Movement’s inner tensions and conflicts, even if development may not have been the inevitable terminus of Newman’s thinking during this earlier period. In the latter Newman’s of his life, development acted as a dynamic principle in his understanding of the Catholic Church’s sense of faith, both in the Church’s contemporary embodiment of doctrine and in the Church’s reception of its own teaching over time. This chapter limits itself to describing and evaluating the main features of Newman’s theory, in particular as he articulated the idea in his 1845 Essay on the Development of Christian Doctrine. The chapter also covers central features of Newman’s later expressions of development as a Roman Catholic and summarizes the place that the idea held in Newman’s life and corpus. The treatment concludes with a discussion of current trends in the scholarly conversation.
Ecclesiology
Authors: Shea C. Michael
Published: November 2018

John Henry Newman never wrote a treatise on the Church, yet ecclesiology functions like a vanishing point towards which nearly every line of his thought can be traced. It is with an orientation to the Church that Newman elaborated his conceptions of the sacraments, revelation, history, tradition, doctrinal development, and ecclesiastical offices, in addition to more abstract notions such as faith, assent, religious epistemology, and conscience. The metaphor can be taken even further. For not only does the Church enjoy an orienting presence across most developed subjects in Newman’s corpus, but like a vanishing point, the Church’s configuration can appear in remarkably diverse ways depending upon the arrangement of more proximate subjects that Newman’s various writings held in view. The vanishing point is also more than a metaphor, because at the heart of his ecclesiology is a missing document from 1847. This chapter consider’s Newman’s his developing notion of the Church as a dynamic and polycentric communion of believers.
Infallibility
Authors: Marr Ryan J.
Published: November 2018

This chapter provides a close historical analysis of the development in John Henry Newman’s understanding of infallibility from his days as a leader of the Oxford Movement up through the publication of his 1877 Preface to The Via Media. The essay begins with an overview of Newman’s perspective during the final years of his time as an Anglican, before moving into a discussion of how Newman’s viewpoint developed during the latter half of his life. The examination of Newman’s changing perspective during his Roman Catholic period focuses particularly on his theological struggles with the neo-ultramontanist faction in the Church, contending that Newman’s mature position was intended to counterbalance the maximalist interpretations of papal infallibility being advanced by such figures as Cardinal Manning and William George Ward.
The Oratory
Authors: Beaumont Keith
Published: November 2018

Newman’s interest in the Oratory went hand in hand from the start with his deep attraction to the figure of St Philip Neri, founder of the first Oratory in Rome in 1575, whom he would adopt as his patron saint and model. His correspondence and several of his Catholic sermons enable us to perceive certain parallels between the two men. More importantly, his correspondence, and even more so his chapter addresses to his fellow-Oratorians given over a period of thirty years between 1848 and 1878, enable us to trace the development of his thinking concerning the Oratory, to delineate the chief characteristics of his ‘idea’ of the Oratory, and to follow the numerous vicissitudes in the life of his own community in Birmingham.
Political and Social Thought
Authors: Barr Colin , Skinner Simon
Published: November 2018

John Henry Newman was not a politician. Throughout his life he preferred the spiritual to the temporal. This tendency became even more pronounced after his conversion to Roman Catholicism, and his concomitant recognition that his ideal of a theocratic polity was now unattainable. But Newman was also consistently engaged with and in matters that might properly be considered political. As an Anglican, he was personally, politically, and practically interested in the condition of the poor, the dangers of industrialization, and the creation of a political order that was in accord with God’s plan as he and his fellow Tractarians understood it. As a Catholic he retained a citizen’s interest in political life, and was moved by patriotism to mount a sustained defence of the British constitution in the wake of the inefficiencies and incompetencies revealed by the Crimean War. He was close to a number of front-rank politicians, mostly associated with the Liberal Party. His educational initiatives were in part designed to produce an educated Catholic elite that could participate in political life. He was adamant that Roman Catholics could be good citizens, whatever the implications of the First Vatican Council. Above all, Newman was a patriot who worried about his country and gave significant thought to how it should be governed.
Philosophy of Education
Authors: Tillman M. Katherine
Published: November 2018

This chapter maintains that Newman does not fit neatly into either the philosophical or rhetorical traditions of thought about liberal education; rather, as a controversialist, he dialectically combines both approaches. In his writings about learning (the Oxford University Sermon on Wisdom, ‘The Tamworth Reading Room’, Idea of a University, Rise and Progress of Universities), Newman distinguishes the important functions of theology and the Catholic Church from the single, essential goal of liberal education, namely the development of a philosophical habit of mind. He brings out the dialectical tensions in the polarities of university and college, professor and tutor, personal influence and discipline, and in particular intellectual development and morality. The chapter takes on various interpreters and critics of Newman’s educational views, both during his lifetime—for example, the utilitarian ‘Knowledge School’ of Peel, Brougham, and Bentham—and in the scholarship of today.
The Literary Stylist
Authors: Frank Mary C.
Published: November 2018

This chapter investigates Newman’s literary style as it changed over time, paying special attention to the ways in which his Catholic writings depart from the Tractarian reserve and tendency towards abstraction that often govern his earlier prose. Much of the scholarship regarding Newman’s literary style, both in poetry and in prose, has tended to emphasize the influence of the Tractarian doctrine of reserve and the parallel exercise of authorial control through such devices as omission and reticence. This chapter argues that such characterizations are most pertinent to his earlier works, whereas a significant turn towards the anthropological, manifested in a growing openness to the physical and social dimensions of earthly life, may be discerned in Newman’s later prose.
Anglican Theological Receptions
Authors: Rowell Geoffrey
Published: November 2018

The Anglican reception of Newman was coloured for at least the fifty years following his death by the sense of loss, even betrayal, consequent upon his move to the Roman Catholic Church and his disillusionment with the Via Media ecclesiology of a ‘reformed Catholicism’ that he had advocated as an Anglican. Nevertheless there were those, such as the Anglo-Catholic Lord Halifax, who continued to find inspiration in Newman. Michael Ramsey and Pope Paul VI both responded positively to his writings, and the shift in ecumenical attitudes in Vatican II brought a renewed Anglican appreciation of him, particularly in the acceptance of the development of doctrine. Appreciation was especially shown in Anglican evaluations on the centenary of Newman’s death, though sometimes mixed with criticism.
The University
Authors: Sullivan John
Published: November 2018

What significance might John Henry Newman have for the university in the twenty-first century? This chapter focuses on four major contributions from Newman. First, he offers a picture of the task that should be at the heart of higher education, the cultivation of intellect. Second, he challenges the modern university to allow for and to facilitate the power of teachers to exercise a beneficent personal influence on their students. Third, at a time when there is a renewed salience of religion in the public domain, his advocacy of the role of religious faith in the university presents a stream of thinking that has to be constructively examined and weighed carefully, inviting neither automatic rejection nor acceptance. Finally, in the face of a range of pressures that threaten the ethos of the university, he provides a strongly counter-cultural source of ideals.
Literary Legacy
Authors: Prickett Stephen
Published: November 2018

Neither Anglicans nor Catholics ever seemed to grasp how inseparable literature and theology were for Newman. His prose fiction, like his poetry, involved complex images and symbols in a network of interconnected references, some obtrusive, some slight and allusive. Though declaring the Catholic Church essentially ‘poetic’ inverted his earlier idealized vision of Anglicanism, this remained a Catholicism with a peculiarly Anglican aesthetic. But if, for those whose interest in Newman is primarily theological, the idea of him as an essentially literary figure seems strange, for those whose knowledge of him is through choral concert performances of ‘The Dream of Gerontius’, the reality is equally strange. Writers are by nature solitary, but Newman was peculiarly solitary. Though he constantly sought community—in Oxford, and later among his fellow Catholics—whether in poetry or prose, his themes concern loneliness.
Print Culture
Authors: King Joshua
Published: November 2018

Focused on John Henry Newman’s Anglican and early Catholic years (1833–48), this chapter argues for his remarkable insight into the ways in which mass print media were formatively shaping modern religious commitment and community. It shows that Newman organized Tractarian agitation in response to the rise of a competitive and voluntary religious print market that accustomed a broad range of Britons to imagining and contesting Christian community through the circulating printed page. The media strategies Newman pursued ironically resembled those of the Evangelicals he attacked, and exposed tensions between popular and institutional religious authority, as well as between real-world religious communities and those imagined through print. The chapter concludes with Loss and Gain, written shortly after Newman’s Catholic conversion, arguing that in this novel he tries to convert into witnesses for the superiority of his new communion texts and reading practices that helped define the Oxford Movement.
Joseph Butler
Authors: Garnett Jane
Published: November 2018

This chapter emphasizes the life-long significance of Newman’s relationship with the works of Bishop Joseph Butler (1692–1752). His reading and re-reading of Butler influenced Newman’s critique of natural theology, his understanding of religious knowledge and the role of conscience, and his sensitivity to the importance of language in the cultivation of a religious imagination. Newman nuanced and contested other nineteenth-century interpretations of Butler’s concepts of analogy, probability, and certitude in the process of developing his own distinctive approach to delineating the intellectual context of faith and reflecting rigorously on moral philosophy, psychological intuition, and pastoral engagement. His ongoing conversation with Butler provided intellectual and affective underpinning for Newman’s reflection on his religious journey and his mediation of Catholicism and Englishness.
The British Naturalist Tradition
Authors: Aquino Frederick D.
Published: November 2018

This chapter argues that Newman draws upon the British Naturalist tradition in fresh ways, especially in his effort to take up the challenge of epistemological scepticism. It examines the scholarly literature that has drawn attention to how John Locke and David Hume feature as formative influences on Newman’s philosophical thought while providing a closer look at how Newman engages with and appropriates insights from the Naturalist tradition in his own context. This chapter also furnishes two examples (the trustworthiness of our cognitive faculties and conscience as a natural element of our mind) to illustrate the extent to which Newman is working within the Naturalist tradition. It concludes with two areas that deserve further reflection and development, namely, a more constructive understanding of the relationship between Newman’s naturalized epistemology and natural theology and a deeper analysis of how Newman appropriates and transforms the British Naturalist tradition.
Katharine McBride, 1935, and “Aphasia”
Authors: Risser Anthony H.
Published: November 2018

In 1929, eminent Philadelphia neurologist Theodore Weisenburg invited Bryn Mawr College psychology graduate student Katharine McBride to join him in a funded, multi-year study of the assessment and empirical classification of aphasia. The result was their co-authored 1935 book Aphasia: A Clinical and Psychological Study, a novel work that advanced an essentially equal weighting of standardized psychological testing alongside the clinical neurological examination. “Orphaned” by the death of Weisenburg and a career change by McBride, Aphasia would nonetheless become a significant and influential anchor point to the subsequent development of aphasia batteries, albeit one that would remain in stagnancy as a product of 1929–1935. A pioneer, it can be argued that McBride was one of the best neuropsychologists we never had. Her subsequent career in higher education attests to what we missed by not having her within our profession.
The relationship between type 1 IFN and vasculopathy in anti-MDA5 antibody-positive dermatomyositis patients
Authors: Ono Nobuyuki , Kai Keita , Maruyama Akihito , Sakai Mariko , Sadanaga Yuri , Koarada Shuichi , Inoue Takuya , Tada Yoshifumi
Published: November 2018

Objective

Based on the antibody profiles of inflammatory myositis patients, we investigated the type 1 IFN (T1-IFN) signature in serum and DM skin to determine the relationship between T1-IFN and vasculopathy in anti-melanoma differentiation-associated 5 gene (MDA5) antibody-positive DM patients.

Methods

We examined 47 patients with new-onset inflammatory myositis. We divided them into three groups: the anti-MDA5 antibody-positive patients (MDA5 group, n = 16), the anti-aminoacyl-tRNA synthetase antibody-positive patients (aminoacyl-tRNA synthetase group, n = 12), and the double-negative patients (n = 19). Serum T1-IFN signatures were revealed by a functional reporter assay, and we evaluated the T1-IFN signatures of skin based on Mx1 expression by immunohistochemistry.

Results

The numbers of patients with classical DM, clinically amyopathic DM and interstitial lung disease were 1, 15 and 13 in the MDA5 group, 2, 3 and 11 in the aminoacyl-tRNA synthetase group, and 10, 1 and 4 in the double-negative group, respectively. The signs of vasculopathies (i.e. palmer papules, skin ulcers and mononeuritis multiplex) were identified only in the MDA5 patients. Most of the MDA5 group showed the highest serum T1-IFN signatures among the three groups. In the histological analysis of DM skin, perivascular inflammations were significant in the MDA5 group. The MDA5 group’s Mx1 expression was significantly strong, distributed in blood vessels and interstitial fibroblasts, and had spread to deep dermis.

Conclusion

Anti-MDA5 antibody-positive DM patients showed high T1-IFN signatures in serum and affected skin. The high T1-IFN signatures of the MDA5 antibody-positive DM patients in serum and deep vasculatures suggested that T1-IFN may have important roles in the vasculopathy of these patients.
First Report of Cucurbit Leaf Crumple Virus Infecting Three Cucurbit Crops in South Carolina
Authors: Keinath Anthony P. , Ling Kai-Shu , Adkins Scott , Hasegawa Daniel K. , Simmons Alvin M. , Hoak Steve , Mellinger H. Charles , Kousik Chandrasekar S.
Published: November 2018

Virus-like symptoms of curled and crumpled leaves, bright yellow chlorosis, and marginal leaf necrosis typical of begomovirus infection were observed on watermelon, summer squash, and muskmelon in three counties in South Carolina in August 2017. Genus-specific primers for begomovirus-A and begomovirus-B components produced amplicons of the expected sizes. Sanger sequencing of amplicons from both A and B components and BLASTn analysis revealed a high nucleotide sequence identity in seven watermelon samples from Beaufort and Charleston counties and five muskmelon samples from Charleston County with cucurbit leaf crumple virus.
Distribution and Characterization of Xanthomonas Strains Causing Bacterial Spot of Tomato in Indiana
Authors: Egel Daniel S. , Jones Jeffrey B. , Minsavage Gerald V. , Creswell Tom , Ruhl Gail , Maynard Elizabeth , Marchino Curtis
Published: November 2018

Over a 2-year period, samples of tomato suspected of being infected with bacterial spot were collected across Indiana and sent to the Purdue Plant and Pest Diagnostic Laboratory (PPDL). A total of 50 strains were collected over 2 years. An effort was made to collect from both fresh market and processing tomato fields (22 from fresh market, 25 from processing, and 3 unspecified). The PPDL screened samples for bacterial spot, and they isolated and confirmed the pathogen. The Xanthomonas isolates were then sent to Jeff Jones at the University of Florida to determine taxonomic identification, race determination, and sensitivity to copper at 50 ppm and streptomycin at 200 ppm. The majority of Xanthomonas strains collected (78%) were classified as X. perforans. The majority of the X. perforans strains were designated race T4. A total of 12% of strains were classified as X. gardneri, all of which were collected north of U.S. I-70, a route that bisects the state into approximately even halves. X. euvesicatoria was only observed on one sample. X. vesicatoria was not observed. Of all strains collected in Indiana, 84% were copper tolerant. In contrast, only 58% of the strains were insensitive to streptomycin.
Identification and Characterization of Menadione and Benzethonium Chloride as Potential Treatments of Pierce’s Disease of Grapevines
Authors: Zhang S. , Jain M. , Fleites L. A. , Rayside P. A. , Gabriel D. W.
Published: November 2018

Xylella fastidiosa infects a wide range of plant hosts and causes Pierce’s disease (PD) of grapevines. The type 1 multidrug resistance (MDR) efflux system is essential for pathogenicity and survival of bacterial pathogens in planta. X. fastidiosa, with a single MDR system, is significantly more vulnerable to inhibition by small-molecule treatments than most bacterial pathogens that typically carry redundant MDR systems. A high-throughput cell viability assay using a green fluorescent protein-marked strain of X. fastidiosa Temecula 1 was developed to screen two Prestwick combinatorial small-molecule libraries of drugs and phytochemicals (1,600 chemicals in total) approved by the Food and Drug Administration and European Medicines Agency for cell growth inhibition. The screens revealed 215 chemicals that inhibited bacterial growth by >50% at 50 µM concentrations. Seven chemicals proved to lyse X. fastidiosa cells at 25 µM, including four phytochemicals. Menadione (2-methyl-1,4-naphthoquinone, vitamin K) from the phytochemical library and benzethonium chloride (a topical disinfectant) from the chemical library both showed significant bactericidal activity against X. fastidiosa. Both menadione and benzethonium chloride foliar spray (15 and 5 mM, respectively) and soil drench (5 and 25 mM, respectively) treatments were equally effective in reducing PD symptoms by 54 to 59% and revealed that the effects of both chemical treatments became systemic. However, menadione was phytotoxic when applied as a foliar spray at effective concentrations, causing significant loss of photosynthetic capacity.
Which Study Strategies Are Nursing Faculty Recommending?
Authors: Michael Robert Kelly , Martin Kristopher
Published: November 2018

This exploratory research project examines nurse faculty preferences regarding study strategies often suggested to nursing students. Respondents were nursing faculty (n = 152) currently teaching in nursing programs in a southern state. Findings reveal that, although faculty suggest an array of “high” and “moderate” utility study methods, they also advise students to employ methods with “low” or unknown levels of utility. These findings suggest a need for faculty development with a focus on highlighting efficacious study strategies.
Is antidyslipidemic statin use for cancer prevention a promising drug repositioning approach?
Authors: Kobayashi Yusuke , Banno Kouji , Kunitomi Haruko , Nagai Shimpei , Takahashi Takayuki , Anko Mayuka , Iijima Moito , Takeda Takashi , Matoba Yusuke , Nakamura Kanako , Tsuji Kosuke , Tominaga Eiichiro , Aoki Daisuke
Published: November 2018

Novel pharmacological therapies are in development for cancer, ranging from conventional chemotherapeutic drugs to molecular targeted drugs, antibody-based drugs, and immune checkpoint inhibitors, which are developed using new technologies. However, the increasing cost of new drug development is increasing the costs of national healthcare and putting pressure on government finances worldwide. Under these circumstances, drug repositioning (i.e. discovering novel effects of existing drugs, thereby allowing their use to treat other diseases) has become a major focus because of reliability and cost reduction. It is becoming increasingly clear that statins (currently used for treating dyslipidemia) can be effective in the prevention of coronary disease, heart failure, and arrhythmia. Epidemiological as well as basic research studies and epidemiological surveys have showed that statins have a suppressive effect on cancers and that they have an antitumor effect on colorectal, prostate, breast, cervical, endometrial, and ovarian cancers. Given the pharmacological mechanism of action of statins, they may have an antitumor effect on cancer types in which the mevalonate pathway is activated as well as on tumors with p53 mutations. To investigate this further, it would be necessary to conduct a large-scale survey after confirming the clinical background of patients as well as their mutational status, and therefore, great hope has been placed on the role of academia and public institutions. Thus, there is an urgent need for researchers to be actively involved in investigator-initiated clinical trials.
Variability in skilled nursing facility screening and admission processes: Implications for value-based purchasing
Authors: Lawrence Emily , Casler Jessica-Jean , Jones Jacqueline , Leonard Chelsea , Ladebue Amy , Ayele Roman , Cumbler Ethan , Allyn Rebecca , Burke Robert E.
Published: November 2018

Background:

Hospitalized older adults are increasingly admitted to skilled nursing facilities (SNFs) for posthospital care. However, little is known about how SNFs screen and evaluate potential new admissions. In an era of increasing emphasis on postacute care outcomes, these processes may represent an important target for interventions to improve the value of SNF care.

Purpose:

The aim of this study was to understand (a) how SNF clinicians evaluate hospitalized older adults and make decisions to admit patients to an SNF and (b) the limitations and benefits of current practices in the context of value-based payment reforms.

Methods:

We used semistructured interviews to understand the perspective of 18 clinicians at three unique SNFs—including physicians, nurses, therapists, and liaisons. All transcripts were analyzed using a general inductive theme-based approach.

Results:

We found that the screening and admission processes varied by SNF and that variability was influenced by three key external pressures: (a) inconsistent and inadequate transfer of medical documentation, (b) lack of understanding among hospital staff of SNF processes and capabilities, and (c) hospital payment models that encouraged hospitals to discharge patients rapidly. Responses to these pressures varied across SNFs. For example, screening and evaluation processes to respond to these pressures included gaining access to electronic medical records, providing inpatient physician consultations prior to SNF acceptance, and turning away more complex patients for those perceived to be more straightforward rehabilitation patients.

Conclusions:

We found facility behavior was driven by internal and external factors with implications for equitable access to care in the era of value-based purchasing.

Practice Implications:

SNFs can most effectively respond to these pressures by increasing their agency within hospital–SNF relationships and prioritizing more careful patient screening to match patient needs and facility capabilities.
The Incidence of Lacrimal Drainage Disorders Across a Tertiary Eye Care Network: Customization of an Indigenously Developed Electronic Medical Record System—eyeSmart
Authors: Das Anthony Vipin , Rath Suryasnata , Naik Milind N. , Ali Mohammad Javed
Published: November 2018

Purpose:

To assess the incidence of lacrimal drainage disorders across a tertiary eye care network in India.

Methods:

A 5-year retrospective review of all the patients who were diagnosed with lacrimal drainage disorders across the tertiary care network of L.V. Prasad Eye Institute was performed from January 2013 to December 2017. All the patient data were retrieved using all the diagnostic terms assigned to the lacrimal drainage disorders in the in-house electronic medical record system eyeSmart. The incidence of each disorder, demographic details, and clinical presentations were captured.

Results:

A total of 20,102 patients were diagnosed with lacrimal drainage disorders in the 5-year period. The 2 most prevalent disorders were primary acquired nasolacrimal duct obstruction (n = 10,364, 51.56%) followed by congenital nasolacrimal duct obstruction (CNLDO; n = 5394, 26.83%). The most frequently encountered proximal lacrimal disorder was punctal stenosis (n = 603, 3%). More than 2/3rd of the patients presented with epiphora as their presenting complaint (n = 13,907, 69.18%) followed by a discharge (n = 4023, 20.01%). Although two-thirds of the patient with primary acquired nasolacrimal duct obstruction were females (n = 7081, 68.32%), the same was not true for the CNLDO group, where there was a near equal gender distribution (M:F = 1.06:1). Predisposition to laterality was neither noted in primary acquired nasolacrimal duct obstruction nor in CNLDO. The prevalence of complex CNLDO was 16.80% (n = 907), the rest being simple CNLDO. It was easy to capture the incidence of lacrimal disorders with the electronic medical record system; however, the same was not true for the surgical details. The reasons for this were lack of clarity with surgical codes, no separate drop downs for success/failure or complications, and variations in the documentation.

Conclusions:

This study depicts the incidence of various lacrimal drainage disorders in a very large cohort of patients. There is a need to modify the International Classification of Diseases (ICD) classification to incorporate all the diagnostic terminologies commonly used so as to capture the real global scenario. The present study helped to further customize the electronic medical record system that caters to the intricacies of lacrimal disorders.
Eculizumab Is Safe and Effective as a Long‐term Treatment for Protein‐losing Enteropathy Due to CD55 Deficiency
Authors: Kurolap Alina , Eshach Adiv Orly , Hershkovitz Tova , Tabib Adi , Karbian Netanel , Paperna Tamar , Mory Adi , Vachyan Arcadi , Slijper Nadav , Steinberg Ran , Zohar Yaniv , Mevorach Dror , Baris Feldman Hagit
Published: November 2018

Objectives:

Loss of the complement inhibitor CD55 leads to a syndrome of early‐onset protein‐losing enteropathy (PLE), associated with intestinal lymphangiectasia and susceptibility to large‐vein thrombosis. The in vitro and short‐term treatment benefits of eculizumab (C5‐inhibitor) therapy for CD55‐deficiency have been previously demonstrated. Here we present the 18‐months treatment outcomes for 3 CD55‐deficiency patients with sustained therapeutic response.

Methods:

Three CD55‐deficiency patients received off‐label eculizumab treatment. Clinical and laboratory treatment outcomes included frequency and consistency of bowl movements, weight, patient/parent reports of overall well‐being, and serum albumin and total protein levels. Membrane attack complex deposition on leukocytes was tested by flow cytometry, before and during eculizumab treatment.

Results:

Marked clinical improvement was noted in all 3 patients with resolution of PLE manifestations, that is, diarrhea, edema, malabsorption, overall well‐being, growth, and quality of life. In correlation with the clinical observations, we observed progress in all laboratory outcome parameters, including increase in albumin and total protein levels, and up to 80% reduction in membrane attack complex deposition on leukocytes (P < 0.001). The progress persisted over 18 months of treatment without any severe adverse events.

Conclusions:

CD55‐deficiency patients present with early‐onset diarrhea, edema, severe hypoalbuminemia, abdominal pain, and malnutrition. Targeted therapy with the terminal complement inhibitor eculizumab has positive clinical and laboratory outcomes in PLE related to CD55 loss‐of‐function mutations, previously a life‐threatening condition. Our results demonstrate the potential of genetic diagnosis to guide tailored treatment, and underscore the significant role of the complement system in the intestine.
Inflammatory Bowel Diseases and School Absenteeism
Authors: Eloi Clémentine , Foulon Gauthier , Bridoux‐Henno Laure , Breton Estelle , Pelatan Cecile , Chaillou Emilie , Grimal Isabelle , Darviot Estelle , Carré Emilie , Gastineau Swellen , Tourtelier Yann , Nicaise Dorothee , Rousseau Chloe , Dabadie Alain
Published: November 2018

Objectives:

Inflammatory bowel diseases (IBDs) are chronic diseases which negatively affect the schooling of children. The aim is to analyze school absenteeism and its causes in children followed for IBD.

Methods:

A prospective multicenter study of IBD patients aged from 5 to 18 years old, from September 2016 to June 2017. Data on absenteeism and its causes were collected via a monthly questionnaire completed by patients or their family by mail. The results were compared with existing data supplied by the school authorities (497 students without IBD divided by class).

Results:

A total of 106 patients (62 boys), median age of 14 (5–18), were included. The global response rate was 83.1%. The patients with IBD were absent an average of 4.8% ± 5.5% of school days during the school year, against 3.2% ± 1.6% for non IBD group (P = 0.034). Digestive disorders accounted for 34% of the causes of absenteeism. Approximately 27% of the absences were due to scheduled events (hospitalizations, endoscopy, or consultations). By excluding the absences for scheduled care, the rate of school absenteeism of patients with IBD is significantly lower than that of non‐IBD group.

Conclusion:

Children with IBD are more frequently absent from school than non‐IBD group. The main cause of school absenteeism appears to be associated with the disease itself. The share of scheduled absenteeism is quite large. The organization and scheduling of the patients’ care path must be a priority to maximally limit the negative impact of their disease on the patients’ schooling.
What’s New in Dermatopathology: Inflammatory Dermatoses
Authors: Penn Lauren , Rothman Lisa , Sutton Angela M. , Brinster Nooshin K. , Vidal Claudia I.
Published: November 2018

Inflammatory skin diseases encompass a vast array of conditions. The field continues to expand and evolve with resurgence of conditions, through newly recognized medication adverse effects, and via more detailed descriptions of known dermatoses. The importance of clinicopathologic correlation and an up to date knowledge of dermatologic conditions cannot be overstated. This review focuses on an array of recent important developments in the histologic diagnosis of inflammatory conditions that affect the skin.
Assessing the Quality of Global Clinical Practice Guidelines on Gout Using AGREE II Instrument
Authors: Wang Dongke , Yu Yang , Chen Yaolong , Yang Nan , Zhang Heng , Wang Chunyu , Wang Qi , Wang Xiaoqin , Zeng Xiaofeng , Estill Janne
Published: November 2018

Objective

The aim of this study was to assess the quality of global clinical practice guidelines (CPGs) on gout.

Methods

We systematically searched MEDLINE, CBM (Chinese Biomedical Literature database), GIN (Guidelines International Network), NICE (National Institute for Health and Clinical Excellence), NGC (National Guideline Clearinghouse), WHO (World Health Organization), SIGN (Scottish Intercollegiate Guidelines Network), DynaMed, UpToDate, and Best Practice databases from their inception until January 2017 to identify and select CPGs related to gout. Two reviewers independently assessed the eligible gout CPGs using the AGREE II instrument.

Results

We evaluated 15 CPGs published between 2007 and 2017, produced by 13 different developers. Quality of evidence and strength of recommendations were presented in 14 (93%) and 13 (87%) CPGs, respectively. The mean scores (±SD) for each AGREE II domain were as follows: (i) scope and purpose: 75% (±17%), (ii) stakeholder involvement: 39% (±19%), (iii) rigor of development: 43% (±17%), (iv) clarity and presentation: 82% (±14%), (v) applicability: 31% (±12%), and (vi) editorial independence: 23% (±29%).

Conclusions

The quality of gout CPGs was suboptimal, and various incompatible grading systems of quality of evidence and strength of recommendations were used. The use of a standardized international grading system is essential to ensure high methodological quality of gout CPGs. Tools such as AGREE II could substantially improve the development and update of future gout CPGs.
The Safety of Electroconvulsive Therapy in Patients With Implanted Deep Brain Stimulators
Authors: Peroski Michael S. , Chu Michael M. , Doddi Seshagiri Rao , Regenold William T.
Published: November 2018

Currently there is no consensus statement about the safety of electroconvulsive therapy in patients who have implanted electrodes for deep brain stimulation. We present a summary of the existing literature on this topic, consisting of 21 cases, and then report a case performed at the University of Maryland Medical Center. Notably, with appropriate safety precautions and careful patient selection, there were no adverse events reported in the literature that were related to the presence of the deep brain stimulation device in any of the cases. Based on our review of the literature and the case we present, we have found no evidence so far to indicate that electroconvulsive therapy in patients with an implanted deep brain stimulator is unsafe.
Guiding the Refinement of Biochemical Knowledgebases with Ensembles of Metabolic Networks and Machine Learning
Authors: Medlock Gregory L. , Papin Jason A.
Published: November 2018

Mechanistic models are becoming common in biology and medicine. These models are often more generalizable than data-driven models because they explicitly represent biological knowledge, enabling simulation of scenarios that were not used to construct the model. While this generalizability has advantages, it also creates a dilemma: how should model curation efforts be focused to improve model performance? Here, we develop a machine learning-guided solution to this problem for genome-scale metabolic models. We generate an ensemble of candidate models consistent with experimental data, then performin silicoensemble simulations for which improved predictiveness is desired. We apply unsupervised and supervised learning to the simulation output to identify structural variation in ensemble members that maximally influences variance in simulation outcomes across the ensemble. The resulting structural variants are high priority candidates for curation through targeted experimentation. We demonstrate this approach, calledAutomatedMetabolicModelEnsemble-DrivenElimination ofUncertainty withStatistical learning (AMMEDEUS), by applying it to 29 bacterial species to identify curation targets that improve gene essentiality predictions. We then compile these curation targets from all 29 species to prioritize refinement of the entire biochemical database used to generate them. AMMEDEUS is a fully automated, scalable, and performance-driven recommendation system that complements human intuition during the curation of hypothesis-driven models and biochemical databases.

Significance

Mechanistic computational models, such as metabolic and signaling networks, are becoming common in biology. These models contain a comprehensive representation of components and interactions for a given system, making them generalizable and often more predictive than simpler models. However, their size and connectivity make it difficult to identify which parts of a model need to be changed to improve performance further. Here, we develop a strategy to guide this process and apply it to metabolic models for a set of bacterial species. We use this strategy to identify model components that should be investigated, and demonstrate that it can improve predictive performance. This approach systematically aides the curation of metabolic models, and the databases used to construct them, without relying on the intuition of the curator.