bluuebunny/crossref_metadata_2025 huggingface dataset:
Judicial Education and International Courts
Authors: Strong SI
Published: January 2021

Although conventional wisdom suggests that the best way to ensure judicial competence is through appropriate selection processes, recent research suggests that no selection method can ensure the long-term fitness of the judiciary. Instead, judicial education programs are necessary to provide judges with the multiple skills that constitute ‘judgecraft’. Unfortunately, judicial education at the international level is both rare and relatively unsophisticated, as compared to many domestic forms of judicial education. This chapter is the first to analyse judicial education of international judges. The discussion considers the various practical and theoretical problems associated with international judicial education and offers a number of suggestions regarding further academic inquiries and reform initiatives. In particular, the text considers whether self-regulation in this particular field is appropriate and whether any alternatives exist. In so doing, this chapter seeks to increase the real and perceived legitimacy of international adjudication.
The Significance of Religious Diversity in International Human Rights Adjudication
Authors: Hessler Kristen
Published: January 2021

In this chapter, I explore the relevance of religious diversity in international human rights adjudication by focusing on the issue of abortion rights in the United States as a case study. Pointing out the complicated relationship between women’s human rights and religion, I argue that it is a mistake to emphasize religious representation as a direct contributor to the normative legitimacy of either judicial deliberation (a matter of process) or the substantive outcomes of judicial decision-making regarding human rights, whether in domestic or international courts. I first clarify the distinction between normative and sociological legitimacy, and point out two ways in which ethnic, racial, or religious diversity on courts may matter morally. I then describe the US case study regarding reproductive rights in detail, before discussing three reasons for scepticism regarding the claim that religious diversity among judges is a component of normative legitimacy for international courts.
Diversity on the Bench of the European Court of Human Rights
Authors: Nußberger Angelika , Baetens Freya
Published: January 2021

International courts differ from national courts in terms of the perception of their diversity. Factors that constitute the identity of adjudicators and are perceived as neutral at the domestic level, such as age, former profession, and cultural background, are not necessarily considered neutral in an international court. Conversely, factors that are not seen as acceptable domestically, such as membership of a political party, may be acceptable for judges at the international level. In order to understand the role of international judges in general and those on the European Court of Human Rights (ECtHR) bench in particular, this chapter scrutinizes the factors influencing the world views and personalities of judges and their effects on the judicial process (leaning towards collective or individual decision-making) as well as the extent to which the judiciary is perceived as trustworthy. The chapter also analyses the ECtHR’s continuous battle with the fundamental balancing act of dispensing individual justice while safeguarding the consistency of the system in its entirety. In the final section, the chapter examines the factors that unify the Court despite, or perhaps even because of, its diversity.
The Tribals and Outcastes Hit Back
Authors: Pati Biswamoy
Published: January 2021

This chapter focuses on the survival strategies adopted by tribal folk, as well as the shifts in their identity in course of the nineteenth century. Tribals and outcastes coped with the severe pressures unleashed upon them by the colonial agrarian interventions by retreating further into the hills. Fluidities in caste identities resulted in affluent sections amongst the tribal folk getting incorporated into the caste system as Khandayats/Kshatriyas. At the same time, this process saw the poorer sections among the tribals becoming further impoverished and increasingly classified as ‘criminal tribes’ or castes. Other forms of resistance included critiquing and questioning inequalities through movements such as the Mahima movement. This period was also marked by several tribal uprisings among various tribal groups in the hilly western interiors, including during the 1857 rebellion.
The Reformation of Common Learning
Authors: Hotson Howard
Published: January 2021

Howard Hotson’s previous contribution to this series, Commonplace Learning, explored how a fragmented political and confessional landscape turned the northwestern corner of the Holy Roman Empire into the pedagogical laboratory of post-Reformation Protestant Europe. This sequel traces the further evolution of that tradition after that region’s leading educational institutions were destroyed by the Thirty Years War (1618–1648) and their students and teachers scattered in all directions. Transplanted to the Dutch Republic, the post-Ramist tradition provided ideas, values, and methods which helped to formulate the mechanical philosophy of Descartes and institutionalize it within a network of thriving universities. Within the international diaspora of Protestant intellectuals documented in the archive of Samuel Hartlib, post-Ramist encyclopaedism provided much of the framework for the pansophic programme of Comenius, which assisted the initial spread of Baconianism and related aspirations both in England and abroad. In post-war central Europe, another branch of the tradition helped inspire Leibniz’s life-long vision of a revised combinatorial encyclopaedia as the centrepiece of a wide-ranging reform programme. But as the underlying political, confessional, educational, and intellectual context shifted after 1648, the ancient conception of the encyclopaedia as a cycle of disciplines to be mastered by every scholar exploded into a potentially infinite number of discrete topics organized alphabetically within a mere work of reference. This book weaves together many new lines of inquiry against a huge geographical and thematic canvas to contribute fresh perspectives on the fraught middle years of the seventeenth century in particular and the shape of modern knowledge more generally.
Status Quo Ante Bellum
Authors: Hotson Howard
Published: January 2021

Since this book is a sequel to Commonplace Learning, it begins with a synopsis of the previous volume. Ramism before 1620 was most deeply rooted in the fragmented political and confessional geography of the northwestern corner of the Holy Roman Empire. Its function was to provide small polities with the means to transmit the maximum amount of useful learning with a minimum of time, effort, and expense. The appeal of this pedagogy to magistrates, rulers, parents, and students generated a motive force capable of spreading Ramism horizontally from one gymnasium to another and then vertically through gymnasia illustria to full universities, even in the face of opposition by humanists and theologians. Student demand then forced the universities to adapt begin expounding traditional Aristotelian philosophical substance in quasi-Ramist pedagogical form. Once Bartholomäus Keckermann (c. 1572–1608) had emancipated philosophical instruction from the text of Aristotle in this way, bolder men like the young Johann Heinrich Alsted (1588–1638) began using Keckermann’s systematic method to assemble increasingly eclectic doctrinal mixtures. The stage was set to deploy similar pedagogical methods to ease the assimilation of the bold new philosophies of the era of Descartes into university instruction as well. But before that happened, however, the outbreak of the Thirty Years War destroyed the network of German Reformed educational institutions which had sustained this tradition and scattered its students and teachers in all directions. The Reformation of Common Learning narrates some of the consequences of that diaspora for the intellectual history of the mid-seventeenth century.
Transplantation
Authors: Hotson Howard
Published: January 2021

The outbreak of the Thirty Years War flooded the young Dutch universities with students, teachers, and pedagogical impulses displaced from the ruined universities and academies of Reformed central Europe (section 4.i). With the collapse of Heidelberg, Marburg, and Herborn, Leiden suddenly seized leadership of the post-Ramist tradition when Franco Burgersdijk (1590–1635) overhauled Keckermann’s work to create the most successful logic textbook for the next generation, as well as matching textbooks for the ‘three philosophies’: metaphysics, natural philosophy, and ethics (section 4.ii). Burgersdijk’s successors then used the post-Ramist framework to gather eclectic materials which rapidly emancipated Dutch university philosophy from the substance as well as the form of Aristotle. His student and successor, Adriaan Heereboord (1613–61), assembled material from Descartes and other ancient and modern philosophies within a basically Aristotelian systematic framework, but chose to leave the competing systems unreconciled in order to introduce students to the philosophical options and disputes of their day (section 4.iii). Meanwhile, other Dutch philosophers had been assembling still more eclectic mixtures of old and new within similar post-Ramist frameworks, which, with the addition of Cartesianism, produced the philosophica novantiqua associated with Heereboord’s student, Johannes de Raey (1622–1702), and De Raey’s student, Johannes Clauberg (1622–65) (section 4.iv).
Expansion and Adaptation
Authors: Hotson Howard
Published: January 2021

The following two chapters show how crucial elements of the educational reforms developed above all by Comenius and propagated by Hartlib and his associates emerged out of common roots in the post-Ramist pedagogical traditions of central Europe. The goal of pansophia—expressed by Comenius as ‘Omnes, Omnia, Omnino’, that is, to teach all things to all human beings thoroughly and completely, by all available means—is the ultimate logical extension of the basic aim of Ramus and the tradition deriving from him: to provide a broader education to a wider segment of the population as quickly, easily, and inexpensively as possible (section 7.i). The means proposed to achieve these goals were also very similar: namely, to produce readily digestible compendia governed by Ramus’ three laws of method (section 7.ii). No less important for Comenius’ pedagogical programme were the praecognita, systemata, and gymnasia which structured Keckermann’s textbooks, together with the lexica added by Alsted. Even the most ‘Baconian’ of Comenius’ textbooks, the famous Orbis sensualium pictus (1658), emerged from a lengthy discussion amongst Hartlib’s friends undertaken in terms far more reminiscent of Keckermann and Alsted than of Bacon himself (section 7.iii).
Reception
Authors: Hotson Howard
Published: January 2021

A comprehensive study of the reception of the post-Ramist tradition within central, east-central and northern Europe is a topic too large and amorphous for treatment in the space available here. Instead, the third section of this book deals with the more limited topic. Between the relatively modest and successful project of developing textbooks for teaching a revised philosophia novantiqua (Part I) and the hugely ambitious pursuit of universal reformation via pansophia and pampaedia (Part II) lay the intermediate aim of overhauling Alsted’s Encyclopaedia on the basis of the intellectual developments of mid-century. This chapter introduces that topic in three stages. The first provides a brief reminder of the scope and structure of Alsted’s culminating work (section 9.i). The second surveys its avid reception at every Latinate level of society throughout the Reformed world and beyond it (section 9.ii). The third discusses some of the objections to the work which helped provoke efforts to revise it (section 9.iii).
Cerebrospinal fluid monoamine levels in central disorders of hypersomnolence
Authors: Barateau Lucie , Jaussent Isabelle , Roeser Julien , Ciardiello Claudio , Kilduff Thomas S , Dauvilliers Yves
Published: January 2021

Study Objectives

Whether the cause of daytime sleepiness in narcolepsy type 1 (NT1) is a direct consequence of the loss of orexin (ORX) neurons or whether low orexin reduces the efficacy of the monoaminergic systems to promote wakefulness is unclear. The neurobiology underlying sleepiness in other central hypersomnolence disorders, narcolepsy type 2 (NT2), and idiopathic hypersomnia (IH), is currently unknown.

Methods

Eleven biogenic amines including the monoaminergic neurotransmitters and their metabolites and five trace amines were measured in the cerebrospinal fluid (CSF) of 94 drug-free subjects evaluated at the French National Reference Center for Narcolepsy: 39 NT1(orexin-deficient) patients, 31 patients with objective sleepiness non orexin-deficient (NT2 and IH), and 24 patients without objective sleepiness.

Results

Three trace amines were undetectable in the sample: tryptamine, octopamine, and 3-iodothyronamine. No significant differences were found among the three groups for quantified monoamines and their metabolites in crude and adjusted models; however, CSF 5-hydroxyindoleacetic acid (5-HIAA) levels tended to increase in NT1 compared to other patients after adjustment. Most of the biomarkers were not associated with ORX-A levels, clinical or neurophysiological parameters, but a few biomarkers (e.g. 3-methoxy-4-hydroxyphenylglycol and norepinephrine) correlated with daytime sleepiness and high rapid eye movement (REM) sleep propensity.

Conclusions

We found no striking differences among CSF monoamines, their metabolites and trace amine levels, and few associations between them and key clinical or neurophysiological parameters in NT1, NT2/IH, and patients without objective sleepiness. Although mostly negative, these findings are a significant contribution to our understanding of the neurobiology of hypersomnolence in these disorders that remain mysterious and deserve further exploration.
Genotypic variation in C and N isotope discrimination suggests local adaptation of heart-leaved willow
Authors: Hu Yi , Guy Robert D , Soolanayakanahally Raju Y
Published: January 2021

Plants acquire multiple resources from the environment and may need to adjust and/or balance their respective resource-use efficiencies to maximize grow and survival, in a locally adaptive manner. In this study, tissue and whole-plant carbon (C) isotopic composition (δ13C) and carbon/nitrogen (C/N) ratios provided long-term measures of use efficiencies for water (WUE) and nitrogen (NUE), and a nitrogen (N) isotopic composition (δ15N)-based mass balance model was used to estimate traits related to N uptake and assimilation in heart-leaved willow (Salix eriocephala Michx.). In an initial common garden experiment consisting of 34 populations, we found population-level variation in δ13C, C/N ratio and δ15N, indicating different patterns in WUE, NUE and N uptake and assimilation. Although there was no relationship between foliar δ13C and C/N ratios among populations, there was a significant negative correlation between these measures across all individuals, implying a genetic and/or plastic trade-off between WUE and NUE not associated with local adaptation. To eliminate any environmental effect, we grew a subset of 21 genotypes hydroponically with nitrate as the sole N source and detected significant variation in δ13C, δ15N and C/N ratios. Variation in δ15N was mainly due to genotypic differences in the nitrate efflux/influx ratio (E/I) at the root. Both experiments suggested clinal variation in δ15N (and thus N uptake efficiency) with latitude of origin, which may relate to water availability and could contribute to global patterns in ecosystem δ15N. There was a tendency for genotypes with higher WUE to come from more water-replete sites with shorter and cooler growing seasons. We found that δ13C, C/N ratio and E/I were not inter-correlated, suggesting that the selection of growth, WUE, NUE and N uptake efficiency can occur without trade-off.
Interdisciplinary, Innovative, and International: Nursing and Engineering Technology Students Creating New Patient Technology
Authors: Karagory Pamela M. , Hountz Diane
Published: January 2021

This article describes an innovative interdisciplinary project that partnered nursing and engineering technology students. The students constructed patient transfer and mobility technology that addressed crucial operational, safety, and usability metrics. The final constructed prototype was presented to an international audience during a two-week study abroad. The project was designed to explore the development of effective interdisciplinary teamwork, recognition of discipline-specific expertise, and a greater understanding of the global health care environment. Qualitative content analysis design was used to determine the impact on leadership development, effective team synergy, and the global health care experience.
Maximizing Career Advancement During the COVID-19 Pandemic: Recommendations for Postgraduate Training Programs
Authors: Vande Vusse Lisa K. , Ryder Hilary F. , Best Jennifer A.
Published: January 2021

The ongoing novel Coronavirus disease 2019 (COVID-19) pandemic has created many threats as well as opportunities for the career development of physicians-in-training. Institutional responses to the demand for patient care reduced the time many residents have to pursue clinical electives, scholarship projects, and other experiences meant to clarify and advance their personal and professional goals. Moreover, many academic medical centers experienced profound fiscal losses that require thoughtful revisions to budgets and curricula. In this article, the authors recommend strategies for residency programs to mitigate these losses and capitalize on growth in virtual education, scholarship opportunities, and relationships arising from the pandemic. Drawing from career development guidelines from the National Career Development Association and existing literature about factors associated with positive career outcomes, the authors suggest leadership roles, curricula, and events that training programs can quickly and inexpensively implement to help residents grow as professionals, achieve personal training goals, produce scholarship, and attain future employment. To help trainees manage their careers, the authors recommend structured mentorship and education in career pathways and the preparation of job application materials. To foster attainment of specific knowledge and cultivate lifelong learning, the authors recommend leveraging existing resources to provide time, funding, academic coaching, and skills training for scholarship projects. To promote development of effective work relationships and community, the authors recommend appointment of a faculty champion for career advancement, scholarship showcases, attendance at virtual journal clubs, and networking through social media outlets. These recommendations for supporting career advancement may apply to early career faculty development as well as undergraduate and postgraduate medical education beyond the pandemic era. Outcomes studies will be needed to evaluate the impact of these recommendations.
Scleroderma epidemiology update
Authors: Calderon Leonardo Martin , Pope Janet E.
Published: January 2021

Purpose of review

Systemic sclerosis (scleroderma, SSc) is a rare multisystem autoimmune disease characterized by autoantibodies, vasculopathy, and fibrosis of the skin and internal organs. This review aims to provide an overview and summary of the recent epidemiological studies in systemic sclerosis.

Recent findings

Global trends of scleroderma demonstrate greater prevalence of SSc in European, North, and South American patients compared with East Asian patients. However, the greatest prevalence (47 in 100 000), was found among the indigenous peoples in Canada. Phenotypical differences exist depending on the age of presentation with greater internal organ involvement and disease acceleration present in older patients. Sex differences include greater severity of disease expression, relative prevalence of diffuse cutaneous SSc, and organ involvement in males versus females. New studies conflict with previous data reporting greater proportion of pulmonary arterial hypertension in females. Furthermore, the effect of low median household income is demonstrated as a factor increasing risk of death in SSc patients.

Understanding the epidemiological factors in SSc enables patient care through patient classification, prognostication, and monitoring. Future research may emphasize enrichment of SSc patients in randomized trials who are more likely to progress or be treatment responsive, focused screening, and personalized patient care through the creation and validation of new SSc criteria and subsets.
Current Surgical Management of Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis
Authors: Riddle Ashley , Westerkam Linnea , Feltner Cynthia , Sayed Christopher
Published: January 2021

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic dermatologic condition that often necessitates surgical treatment. Surgical approaches vary substantially with little data on efficacy and safety.

OBJECTIVE

Summarize the literature on HS surgery with regards to patient characteristics, surgical approaches, and study quality. Compare postsurgical recurrence rates with a meta-analysis.

Methods

PubMed, Embase, and Scopus were searched for studies on surgical HS management published after 2004. A random effects meta-analysis of recurrence rates was performed on eligible studies.

Results

Of 715 identified studies, 59 were included in the review and 33 in the meta-analysis. Twenty-two studies of wide excision had the lowest pooled recurrence rate at 8% (95% confidence interval [CI] 2%–16%); local excision had the highest at 34% (95% CI 24%–44%). For studies of wide/radical excision, flap repair had the lowest pooled recurrence rate at 0% (95% CI 0%–4%); delayed primary closure had the highest at 38% (95% CI 20%–59%).

Conclusions

Wide excision and flap-based reconstruction are associated with a lower postsurgical HS recurrence, although this must be balanced against potentially higher morbidity of extensive procedures. Heterogeneity and methodological limitations of the evidence limit the ability to make a strong conclusion about the relative recurrence rates associated with surgical techniques.

Registration

PROSPERO ID: CRD42020159948.
An Objective, Quantitative Assessment of Flexible Hyaluronic Acid Fillers in Lip and Perioral Enhancement
Authors: Nikolis Andreas , Bertucci Vince , Solish Nowell , Lane Vanessa , Nogueira Alessandra
Published: January 2021

BACKGROUND

HARK is an FDA-approved flexible filler designed for lips.

OBJECTIVE

To quantitatively evaluate subject outcomes by measuring the change in lip texture, color (redness), lip fullness, and lip and perioral surface stretch (dynamic strain) after treatment.

METHODS AND MATERIALS

In this 8-week open-label, Phase IV multicenter study, subjects were treated with HARK in the lips and HARR and/or HARD in perioral wrinkles and folds as add-on treatment. Assessments included 2D photographic analyses of lip texture and color, and 3D photographic assessments of lip enhancement and dynamic strain.

RESULTS

HARK significantly improved lip texture (p ≤ .002), lip redness (p < .001), and added fullness to the lips (lip enhancement measurements; p < .001), at Week 8 after treatment. In addition, lower lip wrinkles were significantly reduced (p = .007) and there was a reduction in upper lip wrinkles (not statistically significant). Surface stretch (dynamic strain) in the lip and perioral region was significantly increased after treatment (p < .001).

CONCLUSION

This analysis provides an objective measure of the beneficial effects of flexible hyaluronic acid fillers in lip augmentation and perioral enhancement and demonstrates a significantly improved lip texture, red color, and fullness. A significant increase in surface stretch (dynamic strain) is indicative of tissue expansion and improvement in lip smoothness.
In Vitro Fertilization for Polycystic Ovarian Syndrome
Authors: ZOLTON JESSICA R. , TORREALDAY SAIOA
Published: January 2021

In vitro fertilization is indicated for infertile women with polycystic ovarian syndrome (PCOS) after unsuccessful treatment with ovulation induction agents or in women deemed high-risk of multiple gestations who are ideal candidates for single embryo transfers. PCOS patients are at increased risk of ovarian hyperstimulation syndrome; therefore, attention should be made in the choice of in vitro fertilization treatment protocol, dose of gonadotropin utilized, and regimen to achieve final oocyte maturation. Adopting these strategies in addition to close monitoring may significantly reduce the ovarian hyperstimulation syndrome risk. Future developments may improve pregnancy outcomes and decrease complications in PCOS women undergoing fertility treatment.
FULL-THICKNESS MACULAR HOLE SECONDARY TO LIVE INTRAOCULAR FILARIAL WORM: A NOVEL CLINICAL ASSOCIATION
Authors: Chawla Shobhit , Gupta Mohit , Misra Diva K.
Published: January 2021

Purpose:

To report a unique case of live intraocular filarial worm leading to development of a full-thickness macular hole (FTMH).

Methods:

An 18-year-old woman presented with decreased vision in the right eye of 1 week duration. Her best-corrected visual acuity in the right eye was 6/24, whereas it was 6/6 in the left eye. Clinically, there was presence of a live intravitreal worm with FTMH and inferior retinal track marks in the right eye, whereas the left eye was normal. Spectral-domain optical coherence tomography of the right eye established the FTMH with hyperreflective debris at its base. The patient underwent right eye vitrectomy with worm retrieval in-toto followed by an internal limiting membrane peel and 15% sulfur hexafluoride gas injection. The worm sample was sent for histopathological analysis.

Results:

At 1 month, the patient had successive closure of FTMH with improvement in the visual acuity upto 6/6 in the right eye. Histopathology confirmed the worm as Wuchereria bancrofti.

Conclusion:

Presence of a live worm in posterior segment can precipitate formation of a FTMH. Possible reasons for development of MH could be secondary to subclinical trauma induced by excessive whipping movements of the worm in the subretinal space or by triggering an acute posterior vitreous detachment.
ENDOGENOUS ENDOPHTHALMITIS CAUSED BY GROUP B STREPTOCOCCUS IN A HEALTHY, TERM NEONATE
Authors: O'Bryhim Bliss E. , Harocopos George J. , Rajagopal Rithwick , Schwartz Drew J. , Lee Andrew R.
Published: January 2021

Purpose:

The purpose of this study was to describe an unusual case of unilateral, endogenous endophthalmitis in an otherwise healthy, term neonate.

Methods:

A 3-week-old otherwise healthy, term male infant was referred to St. Louis Children's Hospital for a second opinion of presumed panuveitis of the right eye.

Results:

Diffusion-weighted magnetic resonance imaging demonstrating purulent intraocular contents facilitated the diagnosis of endophthalmitis. Examination of surgical vitreous samples by staining and cytology demonstrated gram-positive bacterial cocci in short chains, thereby confirming endophthalmitis. Polymerase chain reaction testing of vitreous fluid identified Streptococcus agalactiae, despite an unremarkable systemic workup and a negative prepartum maternal Group B streptococcal screen.

Conclusion:

Endogenous endophthalmitis is a rare but devastating cause of vision loss in otherwise healthy, term neonates. Prompt diagnosis may be facilitated by magnetic resonance imaging and diagnostic vitreous biopsy.
SPONTANEOUS CLOSURE OF MACULAR HOLE AFTER VITRECTOMY FOR MYOPIC RETINOSCHISIS WITH FOVEAL DETACHMENT
Authors: Funahashi Shoko , Ito Yasuki , Kataoka Keiko , Takeuchi Jun , Nakano Yuyako , Fujita Ai , Horiguchi Etsuyo , Taki Yosuke , Terasaki Hiroko
Published: January 2021

Purpose:

To discuss a case of a macular hole formation after vitrectomy for myopic retinoschisis with foveal detachment and spontaneous closure, during long-term follow-up.

Methods:

Case report.

Results:

A 71-year-old man with myopic retinoschisis with foveal detachment had a vitrectomy with internal limiting membrane peeling combined with cataract surgery in the left eye. The preoperative best-corrected visual acuity was 8/20, and the axial length was 27.11 mm. A macular hole with foveal detachment was observed 1 month after surgery. However, the macular hole closed spontaneously with foveal detachment at 4 months of follow-up. Foveal detachment resolved, and the best-corrected visual acuity improved to 20/20 at nine months of follow-up.

Conclusion:

This case suggests that the macular hole formed after vitrectomy for myopic retinoschisis with foveal detachment with internal limiting membrane peeling can close spontaneously.
Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease risk: current status and treatments
Authors: Reyes-Soffer Gissette
Published: January 2021

Purpose of review

The role of triglyceride-rich lipoproteins (TRLs) in the development of atherosclerotic cardiovascular disease (ASCVD) is at the forefront of current research and treatment development programs. Despite extreme lowering of LDL-cholesterol there remains a high risk of cardiovascular disease and mortality. Recent large epidemiological, genomic wide association studies and Mendelian randomization studies have identified novel mechanisms and targets regulating TRL. This review will focus on recent and ongoing clinical trials that aim to reduce cardiovascular risk by decreasing plasma levels of TRL.

Recent findings

Ongoing efforts of basic and clinical scientist have described novel TRL regulating mechanism. The concentration on lifestyle changes is key to prevention and treatment guidelines. There is continue evidence that supports previous guidelines using fibrates alone and in combination with niacin to reduce TRLs, in special cases. The recent results from the REDUCE-IT study support the use of eicosapentaenoic acid (EPA) for risk reduction and ASCVD, but recently presented data from the Long-Term Outcome Study to Assess Statin Residual Risk Reduction With Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia and Omega-3 Fatty Acids in Elderly Patients With Acute Myocardial Infarction studies do not support the use of combination EPA/docosahexaenoic acid. The latter highlights the need for further studies into the pathways regulating ASCVD risk reduction after EPA administration. The identification of novel targets, such as apolipoprotein C3 and angiopoietin-like protein-3, are driving the development of novel treatments, and is the focus of this review.

The current management of elevated triglyceride levels and the effect on cardiovascular outcomes is an emerging area of research. New data from fish oil studies suggest differences in EPA vs. EPA/docosahexaenoic acid cardio protection outcomes. The preliminary data from ongoing clinical trials of novel triglyceride-lowering therapeutics are promising. These programs will ultimately provide foundations for future triglyceride-lowering guidelines.
Telehealth Competencies for Nursing Education and Practice
Authors: Rutledge Carolyn M. , O'Rourke Jennifer , Mason Anne M. , Chike-Harris Katherine , Behnke Lyn , Melhado Lolita , Downes Loureen , Gustin Tina
Published: January 2021

Background

Telehealth is a rapidly growing health care delivery modality with advanced practice nurses as key providers. This growth has occurred without critical consideration of provider training. Training requires the development of competencies situated within a framework.

Problem

Standardized telehealth competencies for advanced practice nursing are missing. The purpose of this article is to describe the development of telehealth competencies for education and practice.

Approach

Using the Four P's of Telehealth framework (planning, preparing, providing, and performance evaluation), a modified Delphi technique was used to identify, develop, and evaluate telehealth competencies.

Outcomes

Competencies were arranged around telehealth domains, expected activities, and outcomes. Effective use of the competencies to guide curriculum development, practice, and future research related to telehealth was identified.

Conclusions

Providing education with competencies aligned to the Four P's Telehealth framework will provide learners with tools to assume leadership roles in all phases of telehealth implementation, delivery, and refinement.
Characteristics of Burn-Injured Children in 117 U.S. PICUs (2009–2017): A Retrospective Virtual Pediatric Systems Database Study*
Authors: McCrory Michael C. , Woodruff Alan G. , Saha Amit K. , Halvorson Elizabeth E. , Critcher Brittany M. , Holmes James H.
Published: January 2021

OBJECTIVES:

To describe characteristics and outcomes of children with burn injury treated in U.S. PICUs.

DESIGN:

Retrospective study of admissions in the Virtual Pediatric Systems, LLC, database from 2009 to 2017.

SETTING:

One hundred and seventeen PICUs in the United States.

PATIENTS:

Patients less than 18 years old admitted with an active diagnosis of burn at admission.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A total of 2,056 patients were included. They were predominantly male (62.6%) and less than 6 years old (66.7%). Cutaneous burns were recorded in 92.1% of patients, mouth/pharynx burns in 5.8%, inhalation injury in 5.1%, and larynx/trachea/lung burns in 4.5%. Among those with an etiology recorded (n = 861), scald was most common (38.6%), particularly in children less than 2 years old (67.8%). Fire/flame burns were most common (46.6%) in children greater than or equal to 2 years. Multiple organ failure was present in 26.2% of patients. Most patients (89%) were at facilities without American Burn Association pediatric verification. PICU mortality occurred in 4.5% of patients. On multivariable analysis using Pediatric Index of Mortality 2, greater than or equal to 30% total body surface area burned was significantly associated with mortality (odds ratio, 5.40; 95% CI, 2.16–13.51; p = 0.0003). When Pediatric Risk of Mortality III was used, greater than or equal to 30% total body surface area burned (odds ratio, 5.45; 95% CI, 1.95–15.26; p = 0.001) and inhalation injury (odds ratio, 5.39; 95% CI, 1.58–18.42; p = 0.007) were significantly associated with mortality. Among 366 survivors (18.6%) with Pediatric Cerebral Performance Category or Pediatric Overall Performance Category data, 190 (51.9%) had a greater than or equal to 1 point increase in Pediatric Cerebral Performance Category or Pediatric Overall Performance Category disability category and 80 (21.9%) had a new designation of moderate or severe disability, or persistent vegetative state.

CONCLUSIONS:

Burn-injured patients in U.S. PICUs have a substantial burden of organ failure, morbidity, and mortality. Coordination among specialized facilities may be particularly important in this population, especially for those with higher % total body surface area burned or inhalation injury.
Perioperative Adverse Events in Women Undergoing Vaginal Prolapse Repair With Uterine Preservation Versus Concurrent Hysterectomy: A Matched Cohort Study
Authors: Yuan Angela S. , Chang Olivia H. , Ferrando Cecile A.
Published: January 2021

Objective

The objective of this study is to compare the incidence of perioperative adverse events (AEs) in women undergoing vaginal prolapse repair with uterine preservation (hysteropexy) versus concurrent hysterectomy.

Methods

This was a retrospective matched cohort study between 2012 and 2019. Patients who received a sacrospinous or uterosacral hysteropexy or colpopexy with hysterectomy were matched by surgeon, surgical year, and age. The electronic medical record was queried for demographic and perioperative data. Strict definitions were used for all clinically relevant AEs.

Results

One hundred and thirty hysteropexy (89 sacrospinous, 41 uterosacral) patients were matched to 260 concurrent hysterectomy (6 sacrospinous, 253 uterosacral, 1 both) patients. Mean age and body mass index were 58 years (±13 years) and 27.9 kg/m2 (±6 kg/m2). Compared with hysteropexy, cases with hysterectomy were longer, had higher blood loss, and a longer hospital stay. The overall incidence of AEs was 29.0% for concurrent hysterectomy versus 10.5% in hysteropexy cases (P = 0.02); on logistic regression, concurrent hysterectomy remained a statistically significant predictor of AEs, with an adjusted odds ratio of 4.03 (95% confidence interval, 1.48–11.01). There was no difference in Dindo grade 3 complications between concurrent hysterectomy and hysteropexy procedures (0.8% vs 1.3%, P = 0.12). In a subanalysis examining the 2 hysteropexy types, there were no significant differences in AEs.

Conclusions

The overall incidence of serious AEs is low in women with uterovaginal prolapse undergoing vaginal native tissue repair with or without hysterectomy. Vaginal hysteropexy is associated with lower odds of experiencing AEs, shorter operating times, a shorter length of stay, and less blood loss.
Phylogenomic analysis of Anabaenopsis elenkinii (Nostocales, Cyanobacteria)
Authors: Delbaje Endrews , Andreote Ana Paula D. , Pellegrinetti Thierry A. , Cruz Renata B. , Branco Luis H. Z. , Fiore Marli F.
Published: January 2021

The saline-alkaline lakes (soda lakes) are the habitat of the haloalkaliphilic cyanobacterium Anabaenopsis elenkinii, the type species of this genus. To obtain robust phylogeny of this type species, we have generated whole-genome sequencing of the bloom-forming Anabaenopsis elenkinii strain CCIBt3563 isolated from a Brazilian soda lake. This strain presents the typical morphology of A. elenkinii with short and curved trichomes with apical heterocytes established after separation of paired intercalary heterocytes and also regarding to cell dimensions. Its genome size is 4 495 068 bp, with a G+C content of 41.98 %, a total of 3932 potential protein coding genes and four 16S rRNA genes. Phylogenomic tree inferred by RAxML based on the alignment of 120 conserved proteins using GTDB-Tk grouped A. elenkinii CCIBt3563 together with other genera of the family Aphanizomenonaceae. However, the only previous available genome of Anabaenopsis circularis NIES-21 was distantly positioned within a clade of

Desikacharya

strains, a genus from the family Nostocaceae. Furthermore, average nucleotide identity values from 86–98 % were obtained among NIES-21 and

Desikacharya

genomes, while this value was 76.04 % between NIES-21 and the CCIBt3563 genome. These findings were also corroborated by the phylogenetic tree of 16S rRNA gene sequences, which also showed a strongly supported subcluster of A. elenkinii strains from Brazilian, Mexican and Kenyan soda lakes. This study presents the phylogenomics and genome-scale analyses of an Anabaenopsis elenkinii strain, improving molecular basis for demarcation of this species and framework for the classification of cyanobacteria based on the polyphasic approach.
Emergence of mgrB locus deletion mediating polymyxin resistance in pandemic KPC-producing Klebsiella pneumoniae ST15 lineage
Authors: de Araújo Longo Luís Guilherme , Fontana Herrison , Santos de Sousa Viviane , Chilinque Zambão da Silva Natalia , Souto Martins Ianick , Meurer Moreira Beatriz
Published: January 2021

Klebsiella pneumoniae

causes a diversity of infections in both healthcare and community settings. This pathogen is showing an increased ability to accumulate antimicrobial resistance and virulence genes, making it a public health concern. Here we describe the whole-genome sequence characteristics of an ST15 colistin-resistant

K. pneumoniae

isolate obtained from a blood culture of a 79-year-old female patient admitted to a university hospital in Brazil. Kp14U04 was resistant to most clinically useful antimicrobial agents, remaining susceptible only to aminoglycosides and fosfomycin. The colistin resistance in this isolate was due to a ~1.3 kb deletion containing four genes, namely mgrB, yebO, yobH and the transcriptional regulator kdgR. The study isolate presented a variety of antimicrobial resistance genes, including the carbapenemase-encoding gene bla
KPC-2, the extended-spectrum beta-lactamase (ESBL)-encoding gene bla
SHV-28 and the beta-lactamase-encoding gene bla
OXA-1. Additionally, Kp14U04 harboured a multiple stress resistance protein, efflux systems and regulators, heavy metal resistance and virulence genes, plasmids, prophage-related sequences and genomic islands. These features revealed the high potential of this isolate to resist antimicrobial therapy, survive in adverse environments, cause infections and overcome host defence mechanisms.
Helicobacter suis and Helicobacter pylori infection in a colony of research macaques: characterization and clinical correlates
Authors: Marini Robert P. , Patterson Mary M. , Muthupalani Sureshkumar , Feng Yan , Holcombe Hilda , Swennes Alton G. , Ducore Rebecca , Whary Mark M. , Shen Zeli , Fox James G.
Published: January 2021

Introduction.

Helicobacter suis

(

Helicobacter heilmannii

type 1) commonly infects nonhuman primates but its clinical importance is in question.

Aim. To characterize

H. suis

infection in a colony of rhesus macaques (Macaca mulatta) used in cognitive neuroscience research.

Hypothesis/Gap Statement. Inquiries into the nature of

Helicobacter suis

in nonhuman primates are required to further define the organism’s virulence and the experimental animal’s gastric microbiome.

Methodology. Animals with and without clinical signs of vomiting and abdominal pain (n=5 and n=16, respectively) were evaluated by histology, culture, PCR amplification and sequencing, fluorescent in situ hybridization (FISH) and serology. Three of the five animals with clinical signs, an index case and two others, were evaluated before and after antimicrobial therapy.

Results. The index animal had endoscopically visible ulcers and multifocal, moderate, chronic lymphoplasmacytic gastritis with intraglandular and luminal spiral bacteria. Antimicrobial therapy in the index animal achieved histologic improvement, elimination of endoscopically visible ulcers, and evident eradication but clinical signs persisted. In the other treated animals, gastritis scores were not consistently altered, gastric bacteria persisted, but vomiting and abdominal discomfort abated.

Nineteen of 21 animals were PCR positive for

H. suis

and five animals were also PCR positive for

H. pylori

. Organisms were detected by FISH in 17 of 21 animals: 16S rRNA sequences of two of these were shown to be

H. suis

. Mild to moderate lymphoplasmacytic gastritis was seen in antrum, body and cardia, with antral gastritis more likely to be moderate than that of the body.

Conclusion. No clear association between the bacterial numbers of

Helicobacter

spp. and the degree of inflammation was observed.

H. suis

is prevalent in this colony of Macaca mulatta but its clinical importance remains unclear. This study corroborates many of the findings in earlier studies of

H. suis

infection in macaques but also identifies at least one animal in which gastritis and endoscopically visible gastric ulcers were strongly associated with

H. suis

infection. In this study, serology was an inadequate biomarker for endoscopic evaluation in diagnosis of

H. suis

infection.
Land Use Change and Coronavirus Emergence Risk
Authors: Rulli Maria Cristina , D’Odorico Paolo , Galli Nikolas , Hayman David T.S.
Published: January 2021

Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) causing coronaviruses are mostly discovered in Asian horseshoe bats. It is still unclear how ongoing land use changes may facilitate SARS-related coronavirus transmission to humans. Here we use a multivariate hotspot analysis of high-resolution land-use data to show that regions of China populated by horseshoe bats are hotspots of forest fragmentation, livestock and human density. We also identify areas susceptible to new hotspot emergence in response to moderate expansion of urbanization, livestock production, or forest disturbance, thereby highlighting regions vulnerable to SARS-CoV spillover under future land-use change. In China population growth and increasing meat consumption associated with urbanization and economic development have expanded the footprint of agriculture, leading to human encroachment in wildlife habitat and increased livestock density in areas adjacent to fragmented forests. The reduced distance between horseshoe-bats and humans elevates the risk for SARS-related coronavirus transmission to humans.

Sentence summarizing manuscript

Wildlife reservoirs for SARS-coronavirus-2 live in global hotspots of forest fragmentation, livestock, and human density in China
Pupillometry signatures of sustained attention and working memory
Authors: Keene Paul A. , deBettencourt Megan T. , Awh Edward , Vogel Edward K.
Published: January 2021

There exists an intricate relationship between attention and working memory. Recent work has further established that attention and working memory fluctuate synchronously, by tightly interleaving sustained attention and working memory tasks. This work has raised many open questions about physiological signatures underlying these behavioral fluctuations. Across two experiments, we explore pupil dynamics using real-time triggering in conjunction with an interleaved sustained attention and working memory task. In Experiment 1, we use behavioral real-time triggering and replicate recent findings from our lab (deBettencourt et al., 2019) that sustained attention fluctuates concurrently with the number of items maintained in working memory. Furthermore, highly attentive moments, detected via behavior, also exhibited larger pupil sizes. In Experiment 2, we develop a novel real-time pupil triggering technique to track pupil size fluctuations in real time and trigger working memory probes. We reveal that this pupil triggering procedure elicits differences in sustained attention, as indexed by response time. These experiments reflect methodological advances in real-time triggering and further characterize an important biomarker of sustained attention.
Endothelial junctional membrane protrusions serve as hotspots for neutrophil transmigration
Authors: Arts Janine J.G. , Mahlandt Eike K. , Grönloh Max L.B. , Schimmel Lilian , Noordstra Ivar , van Steen Abraham C.I. , Tol Simon , van Rijssel Jos , Nolte Martijn A. , Postma Marten , Khuon Satya , Heddleston John M. , Wait Eric , Chew Teng-Leong , Winter Mark , Montanez Eloi , Goedhart Joachim , van Buul Jaap D.
Published: January 2021

Upon inflammation, leukocytes rapidly transmigrate across the endothelium to enter the inflamed tissue. Evidence accumulates that leukocytes use preferred exit sites, though it is not yet clear how these hotspots in the endothelium are defined and how they are recognized by the leukocyte. Using lattice light sheet microscopy, we discovered that leukocytes prefer endothelial membrane protrusions at cell junctions for transmigration. Phenotypically, these junctional membrane protrusions are present in an asymmetric manner, meaning that one endothelial cell shows the protrusion and the adjacent one does not. Consequently, leukocytes cross the junction by migrating underneath the protruding endothelial cell. These protrusions depend on Rac1 activity and by using a photo-activatable Rac1 probe, we could artificially generate local exit-sites for leukocytes. Overall, we have discovered a new mechanism that uses local induced junctional membrane protrusions to facilitate/steer the leukocyte escape/exit from inflamed vessel walls.