bluuebunny/crossref_metadata_2025 huggingface dataset:
One yajña, Many Rituals
Authors: Ferrara Marianna
Published: June 2019

Sacrifice is a keyword in religious studies. Yajña is a governing concept of Vedic literature. On the basis of the major theories of rituals that flourished between the 18th and the 19th centuries, yajña has been referred to as a perfect example of sacrificial pattern in Vedic tradition. However, while ‘sacrifice’ as a category has been widely discussed among scholars from different fields, the equivalence between ‘sacrifice’ and yajña has been tacitly assumed in the notion of ‘Vedic sacrifice’.

Focusing on the rise of Indology as a discipline, this article explores the success of ‘sacrifice’ as a category in the history of scholarship in 18th- and 19th-century Europe. The main argument is that the equivalence between ‘sacrifice’ and yajña has developed at the crossroads between Indology and the socio-anthropological studies, while the Vedic notion of yajña is, indeed, strictly related to the semantic field that has developed around the root yaj-, of which it is proposed to maintain the etymological meaning “to honour, offer, dedicate”. As a result, it is suggested that the translation of yajña as ‘sacrifice’ may be rejected by three types of arguments: linguistic, theoretical, and historical.
L’ago variabile del Marocco: leggenda o realtà?
Authors: Barbera Manuel , Girlando Ilenia
Published: June 2019

In Moroccan Arabic the existence of a variable term depending on the different moments of the day has become an urban legend. That’s not the case. This phenomenon finds verification in this context and we attempt to explain it.
Idols and Idolatry in the Legendary Maġāzī Literature
Authors: Bellino Francesca
Published: June 2019

This article aims at analyzing idolatry inasmuch it appears as a literary motif in legendary maġāzī literature, a large and varied corpus of narratives, spread mostly in the post-Classical period (15th–19th centuries), which recount in fictional way the early Muslim military expeditions that took place during Muḥammad’s lifetime (Ar. ġazawāt, sing. ġazwa). Within this genre, it considers primarily those ġazawāt in which direct references to idolatry appear, either as references to the general concept or as references to individual idols. Regarding the latter, it provides an overview, accompanied by textual examples, of all the idols mentioned by name in the ġazawāt, divided into those that are also attested in the historical sources, and the fictitious ones invented by the narrators for narrative purposes.
Sociolinguistic Factors Affecting Vowel Devoicing in Spontaneous Japanese: A Preliminary Corpus-based Analysis
Authors: Pappalardo Giuseppe
Published: June 2019

Maekawa and Kikuchi (2005) used the Corpus of Spontaneous Japanese (CSJ) to analyse the frequency of vowel devoicing in different phonological environments. According to their analysis, the devoicing rate is highest when a fricative is followed by a stop and lowest when an affricate is followed by a fricative. Moreover, the results of their study suggest that devoicing also occurs in atypical environments, as in non-close vowels and in contexts where a vowel is followed by a voiced consonant. However, the frequency of devoicing is conditioned not only by phonological factors but, at a certain extent, also by extra-linguistic and sociological factors such as age, gender and speech style. This paper aims to analyse the sociolinguistic variation of vowel devoicing in spontaneous Japanese using the CSJ-Core consisting of about 45 hours of speech, all of which have been (sub-)phonemically segmented. Age, gender and speech style variation has been analysed for different phonological environments. Particular attention will be given to atypical environments which showed a higher rate of variability.
Note di lessicografia mandaica: l’espressione dell’afflizione
Authors: Criscuolo Alfredo
Published: June 2019

The lexical material handed down in the Mandaic literature is the result of composite and stratified processes that make its analysis difficult, especially as regards etymologies and semantics. The most valuable reference tool in Mandaic lexicography (Drower, Macuch 1963) is not more conform to the modern needs of Aramaic lexicography. The present article is a first attempt of analysis in the lexicographical field of grief and pain in Classical Mandaic.
Toward a Speech Communities Approach: A Review Article
Authors: D’Anna Luca
Published: June 2019

The present paper offers a review of Stefano Manfredi’s Arabi Juba: un pidgin-créole du Soudan du Sud (2017), discussing the potential benefits of its methodological approach for the field of Arabic linguistics and dialectology. Manfredi’s volume represents the latest and most comprehensive description of Juba Arabic, a pidgin / creole spoken in South Sudan. It includes a socio-historical introduction describing the conditions from which the speech community that gave rise to Juba Arabic first emerged, followed by nine chapters that provide a detailed description of the language at the phonological, morphological and syntactical levels. The paper also discusses how Manfredi’s approach goes in the direction of a linguistics of speech communities invoked by Magidow (2017) and how it might represent a model for future grammars of dialectal Arabic. Manfredi (2017), in fact, provides a multidimensional description of Juba Arabic, in which the diverse nature of its speakers (monolinguals native speakers vs bilinguals L2 speakers with different L1s) and the prolonged contact with its lexifier language (Sudanese Arabic) give origin to acrolectal and basilectal varieties. Manfredi analyzes internal variation from both a synchronic and diachronic perspective, resorting to the concept of “dynamic synchrony” to describe ongoing processes of language change. The linguistic situation of the Arabic-speaking world after the end of the colonial period, on the other hand, witnesses a more and more intense contact between different Arabic dialects and an increased influence from MSA, through mass media and growing rates of literacy. The situation of language contact that results from these circumstances needs more refined conceptual tools in order to be effectively described. For this reason, and in light of Magidow (2017), this review article argues that the approach adopted by Manfredi might be successfully imported in the field of Arabic dialectology.
Shaking up story time
Authors: Lenart Bartlomiej , Lewis Carla
Published: June 2019

While the Philosophy for Children (P4C) method has been adopted within classrooms by individual teachers and into some school systems by schoolboards, public and school libraries, the ideal users of this sort of programming, have been slow to recognise the benefits of this didactic methodology. This is particularly surprising given that the P4C method integrates perfectly with traditional story-time orientated programming. Not only is the integration of P4C into story-time sessions virtually seamless (as it does not aim to replace, but rather strives to enhance story-telling), but it might also help reinvigorate a well-established feature of library programming with an aim to develop 21st-century information literacy competencies. This paper examines the case for the P4C method, explains the process of integration of the P4C method with traditional story-time, and highlights the potential benefits of incorporating Philosophy for Children in public and school library programming.
Attribution and plagiarism in the creative arts
Authors: Hare Joanna , Choi Kimburley
Published: June 2019

The concepts of attribution and plagiarism can be challenging for creative art students who may engage with both text and non-text sources such as images, film, computer games, performance art and more while working on an assessment task. To introduce students to the basics of attributing non-text sources and to explain the distinctions between ethical reuse of creative works at university and in the professional setting, the authors developed an embedded Information Literacy workshop utilising a flipped classroom model. Short educational videos were produced that students watched before attending an in-class library workshop. The students also completed pre- and post-teaching tests to collect evidence of their preconceptions and knowledge before and after watching the videos and attending the library workshop. This article will report on the planning and design of the videos and the library workshop, and share the results of the formative assessment activities.
Organized violence, 1989–2018 and peace agreements
Authors: Pettersson Therése , Högbladh Stina , Öberg Magnus
Published: June 2019

This article reports on trends in organized violence and peace agreements collected by the Uppsala Conflict Data Program (UCDP). The number of fatalities in organized violence decreased for the fourth consecutive year, to reach the lowest level since 2012. In 2018, UCDP recorded almost 76,000 deaths: a decrease of 20% compared to 2017, and 43% compared to the latest peak in 2014. State-based armed conflict drives this downward trend in organized violence, with Syria accounting for much of the change. The number of civilians killed in one-sided violence also dropped in 2018, reaching its lowest level since 2012. In contrast, non-state conflict remained on a high level. The general decline in fatalities from organized violence does not correspond with the trend in the number of active conflicts. In fact, the world has seen a new peak in the number of conflicts after 2014, matched only by the number of conflicts in the early 1990s. In 1991, the peak in the number of armed conflicts corresponded with a similar peak in the number of signed peace agreements. This was followed by a decrease in the number of conflicts in the late 1990s and early 2000s. However, the most recent rise in armed conflicts has not been matched by a similar rise in the number of peace agreements. Two circumstances that characterize the recent rise in conflicts have also been found to make conflicts harder to solve: explicit religious claims and high levels of internationalization.
A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media
Authors: Lee Yi-Fang , Wei Pei-Yin , Chu Chia-Huei , Liao Wen-Huei , Shiao An-Suey , Wang Mao-Che
Published: June 2019

Whether the dimension of the osseous external auditory canal (OEAC) is related to chronic otitis media (COM) remains an important but unresolved issue. In the literature, routine canaloplasty has been suggested to help elucidate this problem. In this study, we intended to investigate the relationship between the diameter or shape of OEAC and COM. We retrospectively reviewed the high-resolution computed tomography (HRCT) images of the temporal bones of 62 patients with unilateral COM who underwent tympanoplasty from January 1, 2011, to December 31, 2013. For comparison, the HRCT images of another 62 patients with normal ears were collected to be the control group. The shape of OEAC was categorized into 5 groups according to Mahboubi’s classification, and the dimension of each patient’s OEAC was measured at 2 defined sections (annular section and isthmus/midcanal section). The most prevalent shape of OEAC for the lesion sides of the ears was cylindrical, followed by conical, and hourglass in both the COM and the control groups. As to the dimension of OEAC, there were no significant differences between lesion ears and normal ears among patients in the COM group as well as between lesion ears in the COM group and normal ears in the control group. We concluded that the bony dimension of the external ear canal was not related to COM. This suggested that chronic inflammation or infection of middle ear may not cause bony thickening of OEAC, despite the kind of OEAC shape involved.
Histological Study of The Healing of Traumatic Tympanic Membrane Perforation After Vivosorb and Epifilm Application
Authors: Yilmaz Mahmut Sinan , Sahin Elvan , Kaymaz Recep , Altunkaynak Berrin Zuhal , Akidil Ayse Oznur , Yanar Sevinc , Demir Deniz , Guven Mehmet
Published: June 2019

Background:

Untreated traumatic tympanic membrane perforations (TMPs) may lead to permanent perforations and hearing loss. There are many materials that have been previously used for repairing the TMPs.

Aims and Objectives:

The purpose of this study is to evaluate the clinical and histological effects of Vivosorb (Vv) and Epifilm on healing of TMPs in a rat model.

Material and Methods:

The posterior-inferior quadrant of the tympanic membranes (TMs) in right ears of 14 rats was perforated using a 20-g needle and then the animals were randomly divided into 2 equal groups (n = 7). The perforated right TMs were treated with either Vv (Vv group) or Epifilm (Ep group). The left TMs of 7 rats were perforated in same way and allowed to close spontaneously without any topical material applications (spontaneous closure group as sham control, SC). The left tympanic membranes of the other 7 rats were not perforated and used as normal controls (NC group). On postoperative 15th day, tympanic bullas were extracted from killed rats and examined morphometrically and histopathologically.

Results:

Perforation closure rate was 85.7% (6/7) in both Vv and SC groups. Perforations of Ep group closed in 7/7 (100%) ears. The thicknesses of the perforated membranes were increased in SC and especially Vv groups. Also, connective tissue fibrosis, blood clots, and epithelial degenerations were detected in SC and Vv groups. The mean fibroblastic reaction scores of Vv, Ep, and SC groups were 2.14(+), 0.57(+), and 1.71(+) respectively, on comparison with NC group. The mean neovascularization score was 1.42(+) in Vv group, 0.14(+) in Ep group, and 0.57(+) in SC group.

Conclusion and Significance:

Vivosorb and especially Epifilm can improve the healing process in traumatic TMPs and additionally, Epifilm might be more preferred for the treatment of TMPs because of causing lesser fibrosis.
Comparing the Impact of Online and Paper-and-Pencil Administration of the Self-Determination Inventory: Student Report
Authors: Raley Sheida K. , Shogren Karrie A. , Rifenbark Graham G. , Anderson Mark H. , Shaw Leslie A.
Published: June 2019

The Self-Determination Inventory: Student Report (SDI: SR) was developed to measure the self-determination of adolescents and was recently validated for students aged 13–22 with and without disabilities across diverse racial/ethnic backgrounds. The SDI: SR is aligned Causal Agency Theory and its theoretical conceptualizations of self-determined action. The validation of the SDI: SR was undertaken in two forms: online, computer-based and paper-and-pencil. The present study examined overall self-determination scores of student participants (with and without disabilities) who took the SDI: SR via the online and paper-and-pencil format to inform future research and practice using the SDI: SR. Findings suggest that the same set of items can be utilized across administration formats, but that there appear to be differences in overall SDI: SR scores when online and paper-and-pencil formats are utilized although these differences are not influenced by disability status. Implications for future research and practice are discussed to provide direction to the field related to assessment development and use of the SDI: SR in educational contexts.
Use of ultrasound combined with magnetic resonance imaging for diagnosis of breast masses and fibroids
Authors: Xiang Wei , Huang Zihui , Tang Chenhu , Shen Bo , Yu Qun , Niu Xiaohong , Meng Fanrong
Published: June 2019

Objective

To investigate the clinical value of ultrasound plus magnetic resonance imaging (MRI) for the diagnosis of breast masses and fibroids.

Methods

Clinical data for 357 patients with breast masses diagnosed at our hospital were analyzed retrospectively. The diagnostic performances were compared between 243 patients who underwent routine ultrasound examinations (control group) and 114 patients who underwent routine ultrasound plus MRI (test group).

Results

The overall accordance rates of routine ultrasound and routine ultrasound plus MRI for the diagnosis of breast masses, based on postoperative pathological diagnoses, were 70.78% (172/243) and 90.35% (103/114). The addition of MRI significantly improved the overall diagnostic performance of routine ultrasound for breast masses. The diagnostic accordance rate of routine ultrasound for the diagnosis of breast fibroids (fibroadenomas) was 74.12% (63/85 cases) compared with 93.94% (31/33 cases) for routine ultrasound plus MRI. The diagnostic performance of routine ultrasound plus MRI was therefore also significantly higher than routine ultrasound alone for diagnosing breast fibroids.

Conclusions

Routine ultrasound plus MRI can greatly improve the diagnostic accordance rates for breast masses and fibroadenomas.
Streetcars and Real Estate Rents with Implications for Transit and Land Use Planning
Authors: Nelson Arthur C. , Hibberd Robert
Published: June 2019

Modern streetcars seemed to have emerged as the darling of America’s downtown revival. Planners, however, have little experience with market responses to modern streetcars to help guide future efforts, or improve or expand current ones. This paper is the first to report the association between real estate rents and proximity to streetcar stations based on all streetcar systems launched in the U.S.A. since 1990. Using multiple functional forms, the paper shows that real estate rents for office, retail, and multifamily properties increase with proximity to streetcar stations. The analysis further tests outcomes using five functional forms: linear, semi-log, double-log, quadratic and fine-grained distance band (using one-eighth mile increments). It appears that the distance band functional form specification may be the most useful for transit and land use planning purposes. Results suggest that streetcar planning and associated land use planning should anticipate heightened demand for multifamily residential development near streetcar stations, perhaps displacing office development to about half a mile away. Retail activities may benefit from additional level of competition for location near streetcar stations by both residential and office development. Indeed, analysis finds that whereas multifamily residential rent premiums with respect to streetcar station proximity extend a mile outward, office rent premiums are lower closer to stations but rise rapidly about a half mile away, presumably outbidding multifamily residential development. Retail activities take advantage of this competition roughly to the area between the office and multifamily rent premium thresholds. Implications for fixed guideway transit and land use planning practice are offered.
Analysis of Spatial Mismatch and Equity using Commuting and Labor Sheds: Trends in Indiana
Authors: Chacon-Hurtado Davis , Kumar Indraneel , Gkritza Konstantina , Fricker Jon D.
Published: June 2019

Commuting patterns are spatial interactions that result from the location decisions of firms, households, and the availability of transportation. Empirical evidence shows that these patterns differ across income groups, reflecting different levels of access to economic opportunities, such as jobs and modes of transportation. Accounting for this variability is an important aspect of paradigms and policies that strive for fair and equitable distribution of benefits and dis-benefits of transportation projects. However, measurable and widely accepted measures that could assist in the assessment of this distribution of transportation impacts are limited. This paper proposes a measure of accessibility mismatch for various income groups based on a ratio between commuting and labor sheds derived from open-access observed data. The paper demonstrates this measure using a case study of counties in Indiana between 2005 and 2007. The results show significant differences in the accessibility ratio between high-, middle-, and low-income groups as well as across metropolitan, micropolitan, and non-core counties, a commonly used geographical classification. This accessibility ratio can be used to explain the differences between commuting patterns across socioeconomic groups and their occupations as well as the identification of areas of limited accessibility and job opportunities.
The Nobel Prize in Economics Turns 50
Authors: Sanderson Allen R. , Siegfried John J.
Published: June 2019

The first Sveriges Riksbank Prizes in Economic Sciences in Memory of Alfred Nobel were awarded in 1969, 50 years ago. In this essay, we provide the historical origins of this sixth “Nobel” field, background information on the recipients, their nationalities, educational backgrounds, institutional affiliations, and collaborations with their esteemed colleagues. We describe the contributions of a sample of laureates to economics and the social and political world around them. We also address—and speculate—on both some of their could-have-been contemporaries who were not chosen, as well as directions the field of economics and its practitioners are possibly headed in the years ahead, and thus where future laureates may be found.

JEL Classifications: A1, B3
Chemical-Free Scouring and Bleaching of Cotton Knit Fabric for Optimum Dyeing Performance
Authors: Hannan Md. Abdul , Haque Papia , Kabir S. M. Fijul , Rahman Mohammed Mizanur
Published: June 2019

The current work endeavored to avoid chemicals during scouring and bleaching of cotton knit fabric in order to introduce a green method. Single jersey single lacoste knit fabrics were treated in water at 105 °C, 120 °C, and 130 °C for 20, 40, and 60 min at reduced process stage. Fourier transform infrared data revealed the weakening and shifting of typical bands of wax and pectin-based cotton impurities in the region of 1,740–1,200 cm−1 for the pretreated samples at 130 °C for 20 min. Color difference (Color Measurement Committee ΔE) was found within the acceptable range for 1.5% and 1% dyed samples when treated at 105 °C for 20 min, while 0.5% dyed samples required 130 °C for 20 min to achieve the desired range. The ratings for color fastness to washing, perspiration, and rubbing were 4–5 for all the chemical-free pretreated samples. The proposed process yielded better strength and dimensional stability compared to the conventionally pretreated samples.
Education for Sustainability in the Secondary Sector—A Review
Authors: Taylor Neil , Quinn Frances , Jenkins Kathy , Miller-Brown Helen , Rizk Nadya , Prodromou Theodosia , Serow Penelope , Taylor Subhashni
Published: June 2019

This article reviews Education for Sustainability (EfS) in the secondary sector across a range of countries. Drawing on journal articles, book chapters and official reports, it identifies some of the more successful approaches to implementing EfS within the secondary sector. The authors first discuss the importance of educating for sustainability at the secondary level and then explore barriers to effective EfS in secondary schools. They go on to share their insights into contextual factors that influence EfS practices which are reported in the case studies. In particular, they discuss the influence of (a) politics and curriculum renewal, (b) alignment of curriculum, resources and teaching, (c) the perceived state of EfS and (d) teachers’ professional development as determinants of EfS implementation and success.
Service Recovery on Stage: Effects of Social Media Recovery on Virtually Present Others
Authors: Hogreve Jens , Bilstein Nicola , Hoerner Kathrin
Published: June 2019

Increasingly, customers use social media to voice complaints, making those comments visible to a wide range of uninvolved, virtually present others (VPOs). Many companies seek to shift their complaint-handling efforts away from public online platforms and toward private interactions. However, this approach might not be optimal due to the importance of transparency in social media recovery and its impact on VPOs. Using multiple experiments and building on signaling theory, vicarious learning, and trust repair mechanisms, this study reveals that service recovery transparency acts as an important signal of quality, eliciting trust, and improving VPOs’ word-of-mouth (WOM) and purchase intentions. However, service recovery transparency forms a signal of poor quality when the service recovery is unsuccessful, resulting in negative implications for VPOs’ WOM and purchase intentions. Conditional transparency provides transparency about selected aspects of the service recovery (i.e., the process or result), enabling companies to exploit the positive aspects of transparency and evoke more favorable VPO intentions than would arise with complete opaqueness. Such efforts are necessary because even high brand equity firms suffer when failing to provide recovery transparency.
Trans-Iliac Aortic Valve Replacement: Feasibility, Safety, and Medium-Term Follow-up
Authors: Gennari Marco , Trabattoni Piero , Pepi Mauro , Polvani Gianluca , Salvi Luca , Agrifoglio Marco
Published: June 2019

Background:

Transcatheter aortic valve replacement (TAVR) is nowadays generally accepted as the treatment of choice for high- to intermediate-risk patients with severe aortic stenosis not suitable for the standard surgical replacement. Many vascular accesses have been described for the valve delivery, comprising the common iliac artery as the arterial site of access.

Methods:

From September 2008 to June 2014, 440 patients underwent TAVR at our institution. We report a series of 12 patients that have undergone TAVR via a trans-iliac (TI) retroperitoneal surgical approach and also discuss its feasibility, security, and medium-term follow-up.

Results:

The 30-day survival rate was 92%. Only 1 local vascular access major complication occurred requiring an iliac-femoral bypass grafting with a vascular graft. Two patients experienced transient neurological ischemic attack. At 3-year follow-up, all the 11 patients were alive and well and the echocardiographic evaluation revealed good function of the prosthesis.

Conclusions:

The TI route seems to be feasible with a low profile of local complications. It may be a reasonable access alternative to the femoral artery and to the trans-apical approach. A broader, prospective study is advisable to gain general consensus on this approach.
Evaluability assessment: An application in a complex community improvement setting
Authors: Brunner Richard , Craig Peter , Watson Nick
Published: June 2019

Evaluation is essential to understand whether and how policies and other interventions work, why they sometimes fail, and whether they represent a good use of resources. Evaluability assessment (EA) is a means of collaboratively planning and designing evaluations, seeking to ensure they generate relevant and robust evidence that supports decision-making and contributes to the wider evidence base. This article reports on the context, the process undertaken and evidence from participants in an EA facilitated with public service workers involved in implementing a complex, area-based community improvement initiative. This is a novel context in which to conduct an EA. We show how the process allows practitioners at all levels to identify activities for evaluation and co-produce the theory of change developed through the EA. This enables evaluation recommendations to be developed that are relevant to the implementation of the programme, and which take account of available data and resources for evaluation.
Let us play together! Can play tutoring stimulate children’s social pretend play level?
Authors: Perren Sonja , Sticca Fabio , Weiss-Hanselmann Barbara , Burkhardt Bossi Carine
Published: June 2019

Social pretend play may have a positive impact on children’s social development because it involves positive peer interactions and challenges their social-cognitive abilities. The current study aimed to investigate whether variations in play tutors’ active support and play management are associated with variations in children’s social pretend play level in the context of a pretend play tutoring intervention. Moreover, the moderating role of children’s social skills (cooperative behaviour and sociability) was examined. In total, 50 children from eight playgroups participated in the study (50% females, mean age at T1 = 46.6 months, SD = 4.3). Six play tutoring sessions took place during normal playgroup sessions (30–40 minutes each). Both the play tutors’ active support and play management and the children’s social pretend play were videotaped and rated for each 10-minute interval. Furthermore, teachers rated children’s social skills before the intervention. The study showed that active support – but not play management – was positively associated with children’s social pretend play level. Furthermore, children’s sociability positively predicted children’s social pretend play level during the intervention and also intensified the positive effect of active support on children’s social pretend play level. In contrast, children’s cooperative behaviour was not significantly associated with their social pretend play level. These results suggest that play tutoring in a group setting needs to be tailored to children’s needs and should actively aim to include withdrawn children, so that they can also profit more strongly from the intervention.
Dorsal Wrist Extrinsic Carpal Ligament Injury Exacerbates Volar Radiocarpal Instability After Intra-Articular Distal Radius Fracture
Authors: Bui Christopher N. H. , Rafijah Gregory H. , Lin Charles C. , Kahn Timothy , Peterson Alexander , Lee Thay Q.
Published: June 2019

Background: Volar radiocarpal instability is often seen after loss of fixation of volar lunate facet fragments. The pathogenesis of post-traumatic volar radiocarpal instability is poorly understood. The purpose of this study was to determine if injury to the dorsal wrist extrinsic carpal ligaments contributes to volar radiocarpal instability. Methods: Six matched pairs of cadaveric upper extremities were tested using a dynamic hand testing system. In group 1, the intact wrist, the wrist with a volar lunate facet fracture, and the fractured wrist after 500 cycles of grip were tested. In group 2, in addition to the intact and fractured wrist, the fractured wrist with the dorsal extrinsic carpal ligaments cut and the fractured wrist with the dorsal extrinsic carpal ligaments cut after 500 cycles of grip were also tested. Volar-dorsal displacement of the lunate was measured from 45° wrist flexion to 45° wrist extension in 22.5° increments with the wrist flexors/extensors loaded for each condition. Results: Volar lunate translation did not significantly increase after the volar lunate facet fracture alone, and was not evident to a significant extent until the dorsal wrist extrinsic carpal ligaments were cut. Further instability of the lunate occurred after grip cycling only with the dorsal extrinsic capsular ligaments cut. Conclusions: Injury to the dorsal wrist extrinsic carpal ligaments exacerbates volar radiocarpal instability. Unrecognized dorsal sided injury may be a contributing factor to why stable fixation of volar lunate facet fragments remains problematic after volar plating of intra-articular distal radius fractures with displaced volar lunate facet fragments.
Porphyria Cutanea Tarda Associated With Acute Hemorrhagic Pancreatitis
Authors: Singh Manasi , Duckett Ashley , Heincelman Marc
Published: June 2019

Porphyria cutanea tarda (PCT) is a condition of dysregulated heme synthesis that leads to accumulation of photosensitizing precursors with resultant fragility and blistering of the skin. It can be hereditary or acquired and has been known to be associated with hepatic C virus, alcohol, HIV, and estrogen. In this article, we report an unusual presentation of PCT associated with acute hemorrhagic pancreatitis in a 57-year-old man. He presented initially to a community hospital with acute onset of epigastric abdominal pain and new-onset ascites. Lipase was elevated. Diagnostic paracentesis was grossly bloody. He was then transferred to our institution for concern for acute hemorrhagic pancreatitis. On arrival, physical examination demonstrated vesicles and bullae with erythematous bases, in different stages of healing seen over the dorsal aspects of both hands with scaling, scarring, and hypopigmentation and hyperpigmentation of the skin. Laboratory evaluation and skin biopsy confirmed the diagnosis of PCT. Search for an underlying etiology failed to reveal typical predisposing factors. This report illustrates that acute hemorrhagic pancreatitis may be an underlying etiology for PCT.
Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review
Authors: Van Dyck Pieter , Zazulia Katja , Smekens Céline , Heusdens Christiaan H.W. , Janssens Thomas , Sijbers Jan
Published: June 2019

Background:

Magnetic resonance imaging (MRI) signal intensity (SI) measurements are being used increasingly in both clinical and research studies to assess the maturity of anterior cruciate ligament (ACL) grafts in humans. However, SI in conventional MRI with weighted images is a nonquantitative measure dependent on hardware and software.

Purpose:

To conduct a systematic review of studies that have used MRI SI as a proxy for ACL graft maturity and to identify potential confounding factors in assessing the ACL graft in conventional MRI studies.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review was conducted by searching the MEDLINE/PubMed, Scopus, and Cochrane Library electronic databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify studies that examined the healing of the intra-articular portion of the ACL graft by assessing SI on MRIs.

Results:

A total of 34 studies were selected for inclusion in this systematic review. The MRI acquisition techniques and methods to evaluate the ACL graft SI differed greatly across the studies. No agreement was found regarding the time frames of SI changes in MRI reflecting normal healing of the ACL tendon graft, and the graft SI and clinical outcomes after ACL reconstruction were found to be poorly correlated.

Conclusion:

The MRI acquisition and evaluation methods used to assess ACL grafts are very heterogeneous, impeding comparisons of SI between successive scans and between independent studies. Therefore, quantitative MRI-based biomarkers of ACL graft healing are greatly needed to guide the appropriate time of returning to sports after ACL reconstruction.
Barriers to an Information Effect on Diagnostic Disparities of Autism Spectrum Disorder in Young Children
Authors: Schelly David , González Patricia Jiménez , Solís Pedro J.
Published: June 2019

Objectives:

Autism spectrum disorder (ASD) is underdiagnosed in children from minority and low socioeconomic status families, and reports indicate that parental “lack of awareness” of symptoms is a factor, which implicates the adoption of the category globally. However, parental knowledge of ASD has failed to explain emerging clusters of cases. The objective of the present research was to identify and describe barriers to an “information effect” in diagnosis.

Methods:

Interviews were conducted with the parents of 54 children with ASD in Costa Rica, many living within clusters that appeared after a genetic study conducted an information campaign for recruitment. The interviews explored factors influencing symptom recognition and help-seeking behaviors. Several barriers were identified that prevent information about ASD or exposure to diagnosed cases from influencing parents’ help-seeking behaviors.

Results:

Early symptoms in most children gave parents no reason to suspect ASD. Later, parents’ understanding of ASD depended on caricatures of the disorder. Parents often received unsolicited advice from strangers, although rarely from family, and it was always seen as critical of their parenting; furthermore, the advice was too late to influence the referral process, which was well underway by the time classical symptoms of ASD appeared, if they did at all. Postdiagnosis, the interviewees occasionally gave advice to other parents, mostly strangers, but none had apparently been diagnosed.

Conclusions:

The results implicate efforts to educate parents about symptoms of ASD, where a focus on generic developmental delays and neurodevelopmental disorders in general may be more effective than ASD-specific information.
Comparison of Vancomycin Treatment Failures for Methicillin-Resistant Staphylococcus aureus Bacteremia Stratified by Minimum Inhibitory Concentration
Authors: Wingler Mary Joyce B. , T. Childress Darrell , Maldonado Ricardo A.
Published: June 2019

Background: Optimal treatment of methicillin-resistant Staphylococcus aureus bacteremias (MRSABs) with vancomycin minimum inhibitory concentrations (MICs) high within the susceptible range is of concern due to the high rate of mortality and increased prevalence. Objective: The purpose of this study is to evaluate vancomycin treatment failures in patients with MRSAB stratified by vancomycin MIC. Methods: In this retrospective chart review, patients ≥19 years of age with MRSAB between July 2010 and December 2016 were included if they received intravenous vancomycin for ≥72 hours. Vancomycin treatment failures were compared between patients with vancomycin MICs of ≤1 mg/L and 2 mg/L. Vancomycin treatment failure was defined as microbiological failure at 7 days. Inpatient mortality, 30-day readmission, vancomycin-associated nephrotoxicity, and early bacteremia clearance at 48 to 96 hours were assessed as secondary endpoints. Results: Fifty-eight patients were included in the vancomycin MIC ≤1 mg/L group and 22 patients in the vancomycin MIC 2 mg/L group. No significant difference was found in vancomycin treatment failures at 7 days between groups (88% vs 91%, respectively; P = .850). At 96 hours, there was no significant difference in vancomycin treatment failures between groups (72% vs 90%, respectively; P = .127). No significant difference was found in mortality ( P > .99) or 30-day readmission ( P > .99). Conclusions: In this study, vancomycin treatment failures were not more prevalent in patients with vancomycin MIC of 2 mg/L at 7 days. Regardless of MIC, antibiotics should be switched to an alternative agent at 7 days for persistent bacteremia.
Excellent long-term survival of children with Down syndrome and standard-risk ALL: a report from the Children’s Oncology Group
Authors: Matloub Yousif , Rabin Karen R. , Ji Lingyun , Devidas Meenakshi , Hitzler Johann , Xu Xinxin , Bostrom Bruce C. , Stork Linda C. , Winick Naomi , Gastier-Foster Julie M. , Heerema Nyla A. , Stonerock Eileen , Carroll William L. , Hunger Stephen P. , Gaynon Paul S.
Published: June 2019

The Children’s Cancer Group 1991 study was a clinical trial for children with National Cancer Institute standard-risk acute lymphoblastic leukemia (ALL). This trial demonstrated that 5 doses of vincristine and escalating IV methotrexate (MTX) without leucovorin rescue in the interim maintenance (IM) phases resulted in superior event-free survival (EFS) when compared with 2 doses of vincristine, oral (PO) MTX, PO mercaptopurine, and dexamethasone. This report describes a favorable outcome of this regimen in patients with Down syndrome (DS). Forty-four patients with DS were randomized to the arms containing PO MTX during IM, and 31 to those containing IV MTX. Ten-year EFS rates for patients with DS randomized to IV MTX vs PO MTX were 94.4% ± 5.4% vs 81.5% ± 6.6%, respectively. IV methotrexate with strict escalation parameters, as given in this study, was well tolerated, although the mean total tolerated dose received was lower in patients with DS than in those without DS. There was no increase in hepatic toxicity, systemic infections, or treatment-related deaths in patients with DS during IM on either the IV or PO MTX arms, as compared with those without DS. The incidence of mucositis was increased in patients with DS as compared with patients without DS, particularly among patients who received IV MTX. This trial was registered at www.clinicaltrials.gov as #NCT00005945.
Orthostatic intolerance in chronic fatigue syndrome
Authors: Garner Richard , Baraniuk James N.
Published: June 2019

Background

Orthostatic intolerance (OI) is a significant problem for those with chronic fatigue syndrome (CFS). We aimed to characterize orthostatic intolerance in CFS and to study the effects of exercise on OI.

Methods

CFS (n = 39) and control (n = 25) subjects had recumbent and standing symptoms assessed using the 20-point, anchored, ordinal Gracely Box Scale before and after submaximal exercise. The change in heart rate (ΔHR ≥ 30 bpm) identified Postural Orthostatic Tachycardia Syndrome (POTS) before and after exercise, and the transient, exercise-induced postural tachycardia Stress Test Activated Reversible Tachycardia (START) phenotype only after exercise.

Results

Dizziness and lightheadedness were found in 41% of recumbent CFS subjects and in 72% of standing CFS subjects. Orthostatic tachycardia did not account for OI symptoms in CFS. ROC analysis with a threshold ≥ 2/20 on the Gracely Box Scale stratified CFS subjects into three groups: No OI (symptoms < 2), Postural OI (only standing symptoms ≥ 2), and Persistent OI (recumbent and standing symptoms ≥ 2).

Conclusions

Dizziness and Lightheadedness symptoms while recumbent are an underreported finding in CFS and should be measured when doing a clinical evaluation to diagnose orthostatic intolerance. POTS was found in 6 and START was found in 10 CFS subjects. Persistent OI had symptoms while recumbent and standing, highest symptom severity, and lability in symptoms after exercise.

Trial registration The trial was registered at the following: https://clinicaltrials.gov/ct2/show/NCT03567811
Getting back to fire suméŝ: exploring a multi-disciplinary approach to incorporating traditional knowledge into fuels treatments
Authors: Wynecoop Monique D. , Morgan Penelope , Strand Eva K. , Sanchez Trigueros Fernando
Published: June 2019

Background

Evaluating fuel treatment effectiveness is challenging when managing a landscape for diverse ecological, social, and economic values. We used a Participatory Geographic Information System (PGIS) to understand Confederated Colville Tribal (CCT) member views regarding the location and effectiveness of fuel treatments within their ancestral territory within the Colville National Forest (CNF) boundary. The 2015 North Star Fire burned 88 221 ha (218 000 acres) of the CCT ancestral territory.

Results

We sampled thirty plot pairs that were treated or untreated prior to being burned by the North Star Fire and again one growing season post fire. Species diversity was significantly increased by wildfire in both treated and untreated plots. Species richness was significantly increased in the plots that were treated, and there was no significant change in species richness from wildfire within the untreated plots. The percent canopy cover of two of the six culturally important plants (Fragariaspp.L. andArnica cordifoliaHook.) significantly increased one growing season post wildfire within treated plots and one (Arctostaphylos uva-ursi[L.] Spreng.) significantly decreased in the treated plots post wildfire. These post-fire monitoring results were consistent with CCT member management recommendations and desired outcomes of understory thinning, prescribed fire, and natural ignition found using PGIS.

Conclusions

Together, the results suggest that prior thinning and prescribed burning can foster vegetation response to subsequent wildfires, including culturally important plants. Further, integrating Traditional Knowledge (TK) into fuels treatments can improve ongoing adaptive management of national forests that include tribal ancestral lands.
Metabolic Dysregulation Controls Endocrine Therapy–Resistant Cancer Recurrence and Metastasis
Authors: Blundon Malachi A , Dasgupta Subhamoy
Published: June 2019

Cancer recurrence and metastasis involves many biological interactions, such as genetic, transcription, environmental, endocrine signaling, and metabolism. These interactions add a complex understanding of cancer recurrence and metastatic progression, delaying the advancement in therapeutic opportunities. We highlight the recent advances on the molecular complexities of endocrine-related cancers, focusing on breast and prostate cancer, and briefly review how endocrine signaling and metabolic programs can influence transcriptional complexes for metastasis competence. Nuclear receptors and transcriptional coregulators function as molecular nodes for the crosstalk between endocrine signaling and metabolism that alter downstream gene expression important for tumor progression and metastasis. This exciting regulatory axis may provide insights to the development of cancer therapeutics important for these desensitized endocrine-dependent cancers.
Multiple Sclerosis Risk Factors and Pathogenesis
Authors: Nourbakhsh Bardia , Mowry Ellen M.
Published: June 2019

PURPOSE OF REVIEW

This article summarizes recent advances in the identification of genetic and environmental factors that affect the risk of developing multiple sclerosis (MS) and the pathogenic processes involved in acute relapses and relapse-independent disability progression.

RECENT FINDINGS

The number of single-nucleotide polymorphisms associated with increased risk of MS has increased to more than 200 variants. The evidence for the association of Epstein-Barr virus infection, vitamin D deficiency, obesity, and smoking with increased risk of MS has further accumulated, and, in cases of obesity and vitamin D deficiency, the evidence for causal association has strengthened. Interactions between genetic and environmental factors have been studied more extensively. Dietary factors and changes in the gut microbiota are emerging as possible modulators of the disease risk. Several processes important to MS pathogenesis have been newly investigated or investigated more comprehensively, including the role of B cells, innate immune cells, meningeal inflammation, cortical and gray matter demyelination, and early axonal and neuronal loss.

MS is a complex disease in which the interaction between genetic and environmental factors causes a cascade of events, including activation of the adaptive and innate immune system, blood-brain barrier breakdown, central nervous system demyelination, and axonal and neuronal damage with variable degrees of repair. These events manifest as potentially reversible focal neurologic symptoms or progressive nonremitting physical and cognitive disability, or both. Advances in the understanding of the risk factors and pathogenic mechanisms of MS have resulted in improved therapeutic strategies. The results of ongoing or future studies are needed to successfully and fully translate these advances into clinical practice.
Progressive Multiple Sclerosis
Authors: Ontaneda Daniel
Published: June 2019

PURPOSE OF REVIEW

This article provides an update on progressive forms of multiple sclerosis (MS), with a focus on pathogenic mechanisms, clinical features, imaging features, and recent therapeutic advances.

RECENT FINDINGS

Progressive forms of MS are identified by a history of progressive accrual of disability independent of relapse, but they share many biological, clinical, and MRI features with relapsing MS. Both relapses and new lesions can occur in the context of progressive MS, and establishing when the transition from relapsing to progressive MS occurs is often difficult. Several pathogenic mechanisms coexist in progressive MS. Targeting inflammation in both primary and secondary progressive MS appears to reduce the accumulation of disability.

Progressive MS remains a diagnostic challenge, and the pathogenesis underlying progression is complex. Significant overlap in the biology and clinical and imaging features of progressive MS exists with relapsing forms of the disease. The use of disease-modifying and symptomatic treatments may improve the quality of life for patients with progressive MS.