bluuebunny/crossref_metadata_2025 huggingface dataset:
Rewriting the Origins of Quedlinburg
Authors: Greer Sarah
Published: October 2021

The foundation of Quedlinburg by Queen Mathilda in 936 seems obvious; numerous sources from the later tenth and eleventh century describe the queen as the individual responsible for setting up a convent on the site of her husband’s tomb. However, there is a striking lack of contemporary evidence for Mathilda as the founder of Quedlinburg from the early history of the monastery. This chapter reassesses our assumptions about Quedlinburg as a foundation of Queen Mathilda by considering how her reputation as Quedlinburg’s founder slowly accreted over the course of the tenth century. When the women of Quedlinburg themselves created a new history of the world––and of their monastery––in the early eleventh century, they were able to deploy this memory of Queen Mathilda to emphasize their institution’s memorial power to a new Ottonian king.
The Disputed Succession, 1678–85
Authors: Smith Hannah
Published: October 2021

Standing armies remained of intense concern to parliament during the years of the Popish Plot and Exclusion Crisis. After all, Charles II had yet to disband an army raised for a war with France that had not been waged. The disputed heir to the throne, the duke of York, was a self-proclaimed Catholic military man. Scottish Conventiclers were in rebellion and had to be suppressed by military force. Moreover, the king became estranged from the duke of Monmouth, who was not only the army’s captain-general but also posed as York’s Protestant rival for the succession to the throne.
War and Peace, 1689–1702
Authors: Smith Hannah
Published: October 2021

William III immediately took Britain into the Nine Years’ War against the French. This chapter examines how William purged the army of James VII and II’s supporters in order to fight the war. However, William was never certain of his new army’s political loyalties. Nor could he trust its British senior officers, some of whom, such as John Churchill, the future duke of Marlborough, had joined William in 1688 but had become alienated from him. William’s relations with parliament were equally troubled, and never more so than during the biggest political crisis after the end of the war, the standing army debates over the peacetime army.
The War of Succession, 1702–14
Authors: Smith Hannah
Published: October 2021

This chapter focuses on the politics of Queen Anne’s army, as successive ministries, with the Crown’s backing, attempted to ‘model’ the army to bolster their own position and aims. In an increasing tense political environment, and as the question of the succession to the throne became pressing, the army was divided by party politics, and party allegiance determined army appointments. The chapter examines Anne’s deteriorating relationship with her exceptionally successful captain-general, John Churchill, 1st duke of Marlborough. Marlborough led her army to a series of victories against the French, most famously at the battle of Blenheim, and was rewarded with ‘Blenheim House’ near Woodstock. The queen’s relations with Marlborough became ever more fraught when Marlborough demanded the post of captain-general for life, prompting suspicions that he aimed to take supreme power.
Defending and Disputing the Rival Kings, 1714–50
Authors: Smith Hannah
Published: October 2021

This chapter examines the early Georgian army’s political allegiances and analyses how the soldier-kings George I and George II and their ministers set about creating loyalism within the army. There was little support for the ’15 Rebellion among the king’s troops. Nonetheless, Jacobites still hoped that the army would intervene to restore the Stuart claimant to the throne, as it had in 1660, and this belief was a central component of Jacobite plotting in the early 1720s. But while George I and George II’s army remained loyal to them, it was beset with national resentments, particularly during the War of the Austrian Succession, when George II favoured his Hanoverian army.
Deindustrialization, Distribution, and Development
Authors: Sumner Andy
Published: October 2021

This book builds upon previous work by the author on economic development, structural change, and income inequality. The core focus of the book is the emergent processes of stalled industrialization and the spectre of premature deindustrialization in developing countries. The term ‘rust belt’ has been rarely associated with developing countries to date. In fact, it is commonly associated with deindustrialization in advanced countries and the US in particular. However, such a belt is threatening the middle-income developing world, starting from Brazil and other countries in Latin America, running down across South Africa, and then upwards to Malaysia, Indonesia, Thailand, and the Philippines in South East Asia. This book discusses the causes and consequences of these emergent processes in developing countries.
Income Inequality between Countries
Authors: Sumner Andy
Published: October 2021

This chapter is concerned with the impact of deindustrialization on inequality between countries and the catch-up (or otherwise) of developing countries to date and in the years ahead. The chapter focuses on the third great transformation outlined, specifically the fragmentation of global production. This chapter discusses the debate on the impacts of changes in global production on middle-income developing countries and assesses the empirical evidence. The myth accompanying the third transformation—that if developing countries integrate more and more into GVC world, the process will drive and sustain economic development to the level of the advanced countries—is the subject of discussion in this chapter. Theory is developed to explain the connection between the emergence of a GVC world, deindustrialization, and weaker economic growth in the developing world.
Social Epistemology, Descriptive and Normative
Authors: Goldberg Sanford C.
Published: October 2021

Social epistemology ought to incorporate both a descriptive element (understanding our actual knowledge practices) and a normative element (assessing and evaluating those practices). While the two dominant traditions of social epistemology research in the last three decades tend to privilege one of these elements over the other, this chapter aims to articulate and defend an approach that can accommodate both and avoid the distortions.
Where Have Women Made the Most Strides?
Authors: Escobar-Lemmon Maria C. , Hoekstra Valerie J. , Kang Alice J. , Kittilson Miki Caul
Published: October 2021

Chapter 3 asks where and why have women made the most strides on high courts? What factors help courts move beyond having one “woman’s seat”? This chapter draws on the authors’ dataset on the percentage and number of women on high courts. The chapter describes regional, cross-national, and time-serial variation in the gender composition of courts and identifies the courts which have achieved gender parity. Analyses reveal that both international and regional influences play a significant role in explaining women’s representation after the appointment of the first woman, more so than accountable selectors or economic development. Specifically, the analysis suggests that courts located in regions of the world where women are commonly included on courts, as well as those with a longer commitment to international law, have more women. Additionally, larger courts are more likely to have more women justices. The chapter also underscores how progress toward parity on courts is not linear, identifying those courts which reverted to being all-men after having appointed the first woman.
International Influences on Women’s Representation on High Courts
Authors: Escobar-Lemmon Maria C. , Hoekstra Valerie J. , Kang Alice J. , Kittilson Miki Caul
Published: October 2021

Chapter 6 examines the influence of international factors on the appointment of women to high courts in the case studies, focusing on the impact of international and regional norms, the ratification of the Convention on Elimination of All Forms of Discrimination Against Women (CEDAW), and the advocacy of international and domestic nongovernmental women’s rights organizations. The emergence of regional norms of gender equity in governance, including in the judiciary, is traced for Africa, Europe, and Latin America. Drawing on United Nations and country-specific primary sources, the rise of CEDAW mandated reporting on gender diversity in the judiciary and on high courts is documented in four of the case study countries (Canada, Colombia, Ireland, South Africa). Including the United States, the five case studies highlight the role of domestic advocacy organizations that exert pressure on appointers to consider women candidates for judgeship on high courts.
Executive Control and the Writer(s)-Within-Community Model
Authors: Graham Steve
Published: October 2021

Executive control represents an interaction between social context and the mental and physical actions of writers. This chapter addresses this interactive premise as it applies to executive control in writing by illustrating how this operates theoretically through the lens of the Writer(s)-within-Community model. This model proposes that the community in which writing takes place and the cognitive capabilities and resources of those who create it simultaneously and reciprocally influence writing. The multiple ways in which context and individual capabilities interact to shape and constrain the use of executive control in writing are examined.
Assessment of Executive Functions in Children
Authors: Clair-Thompson Helen St , Wen Yunhong
Published: October 2021

Executive functions (EFs) are a range of goal-directed cognitive abilities. According to one approach, suggested by according to one approach, there are three main EFs; inhibition, shifting, and updating of working memory. EFs are important, in part because of their ability to predict clinical, educational, and functional outcomes. However, EFs have been assessed using a range of cognitive tasks and behavioural rating measures. This chapter will provide an overview of a range of executive function assessments used to assess EFs in childhood, with a focus on inhibition, shifting, and updating of working memory. It will consider the measurement properties of these tools, including data relating to reliability and validity. The measures will then be considered in terms of their suitability for different purposes and in relation to their use with children of different ages and abilities.
Executive Functions and Writing Skills in Children and Adolescents
Authors: Hooper Stephen R. , Costa Lara , Fernandez Edmund , Barker Alexandra , Valdes Courtney , Catlett Stephanie , Green Melissa
Published: October 2021

In this chapter we provide an overview of what is known and unknown about the relationships between executive functions (EF) and written expression in children and adolescents, with an emphasis on evidence-based developmental associations and dissociations between various EF and writing skills in children and adolescents. We provide an overview of several key models of EF that are applicable to written expression, highlighting critical aspects of these models with respect to their importance for writing skills. What is known and unknown about the relationships between selected EF and writing skills for children and adolescents also is described. Based on these evidence-based findings, important associations and disassociations are underscored—when either suspected or supported by the available empirical literature. Finally, the chapter concludes with targeted directions for future research into advancing our understanding of these relationships across the paediatric developmental spectrum.
Executive Functions in Skilled Writers
Authors: Olive Thierry
Published: October 2021

Executive functions are likely to intervene during composition of a text by skilled writers, as suggested by the high cognitive complexity of writing and its significant cognitive effort. However, empirical data on executive functions in skilled writers is very scarce. To sketch their role in skilled writing, this chapter presents initial assertions about how these functions may intervene. For that purpose, models of working memory in writing are reviewed to examine how they consider the role of executive functions. Next, the relationship between these functions and the main writing processes is described. The chapter ends by addressing how executive functions may be involved for orchestrating the multiple writing processes. From this review, it emerges that almost all core executive functions can be presumed to intervene during composition of a text, and consequently that further research is strongly needed to better comprehend how they intervene in skilled writing.
Preventing “Exit,” Eliciting “Voice”
Authors: Galasso Ilaria , Geiger Susi
Published: October 2021

This conceptual chapter evokes Albert Hirschman’s classic distinction between “exit” and “voice” to ascertain the potential for individuals to voice their concerns in the context of sharing data for genetics and personalized precision medicine initiatives. It elaborates the emerging framework of participatory medicine as a form of “invited activism” and goes on to discuss the essential role of activism by considering the strategies implemented by institutions to trigger voice when it is not initiated spontaneously. On the one hand, we diagnose a generalized failure of concerned actors to voice spontaneously around voluntary data sharing for future-oriented medical research. On the other hand, we scrutinize patient and public involvement practices made available by precision medicine initiatives as institutional attempts to increase voice and therefore as “invited activism.” We finally interrogate the limits of voice in this invited format in the context of genomics initiatives.
Datafying the Patient Voice
Authors: Hoeyer Klaus , Langstrup Henriette
Published: October 2021

This chapter discusses the temporality and moral ambiguity of healthcare activism and state-sanctioned empowerment by providing examples from the infrastructuring of Danish healthcare. Denmark is a classic Nordic welfare state. It builds on models of collaborative government, provides universal access to healthcare to Danish citizens, and it operates a particular form of data-intensive service delivery said to be citizen-centric. For years, Denmark has pioneered public digitalization and participatory methods such as user-driven innovation and citizen involvement in medical technology assessments. The rights and duties embedded within the welfare edifice serve as reminders of earlier activism and solidified forms of collaboration. The chapter explores how patients are engaged in new forms of health data production and how various forms of activism affect public digital data infrastructures, emphasizing the involved moral and epistemological ambiguity of these attempts to affect data flows. Welfare infrastructures evolve through such processes of promise, ruination, and repair.
Development, Modernity, Nation
Authors: Kumar Arun
Published: October 2021

On the basis of its relationship and scale of modernity, the history of development can be organized, schematically, into three parts. While post-war international development and Washington Consensus’s global development was built around universal modern; participatory and local development was premised in the rejection or critique of Western modernity. Thirdly, post-colonial national development projects sought to synthesize elements of the above two while articulating distinct ambitions of its own. Each of these, the introductory chapter contends, is inadequate for the purposes of understanding postcolonial development in countries such as India. Pointing to the long-standing engagement between development and the national question, it suggests using a new category of the ‘national-modern’ to understand postcolonial development.
Community
Authors: Kumar Arun
Published: October 2021

At the turn of the twentieth century, the elites began to move away from charity within their communities. Instead of investing in community welfare, they justified their move to civic, secular, modern forms of philanthropy in the name of national advancement. In the first half of the twentieth century, elites funded rural reconstruction programmes, inspired in large part by the Gandhian ‘constructive programme’. The programmes were shaped by critiques of colonial modernity and nationalist logics of Swadeshi and self-reliance. Post-colonialism, community gravitated towards modernization as elites promoted self-help over dependence on the state, while maintaining their earlier ties with the communities they came from. Elites’ shifting imaginaries of community reveals that their embrace of modernity has remained circumscribed by different social vectors.
Coda
Authors: Kumar Arun
Published: October 2021

The brief coda discusses how elites have used philanthropy, strategically, in their pursuit of power. While prior historiography on philanthropy and colonial India has discussed elites’ use of philanthropy to build collaborative regimes of power with the colonial administration, the chapter extends the argument further. It argues that in addition to collaborating with colonial administration as well as nationalist interests, elites have also used philanthropy to protect their own class interests. In this pragmatic pursuit of power, philanthropy-funded development has provided the moral justification for further accumulation of capital. Elites’ pursuit of capital and power—dressed as development—was therefore somehow acceptable because it was carried out in the name of the larger national interest.
Sergei Eisenstein’s Collage
Authors: Siraganian Lisa
Published: October 2021

Soviet director Sergei Eisenstein’s films have become nearly synonymous with cinematic montage’s birth and development. Yet scholars have almost never aligned Eisenstein’s inventiveness with painterly collage, a deeply connected trend appearing in European art. This chapter considers why thinking about Eisenstein’s theory and practice of cinematic montage, in connection with the theory and practice of painterly collage, matters to the history of modernist meaning. For artists and filmmakers alike, cutting and pasting together disparate fragments of art’s elements (its units of sense) raised one of modernism’s most misunderstood yet obsessive concerns: understanding the basic relation between art objects and beholders as a problem of how artistic meaning could be communicated. Analyzing instances of montage in his early film Strike (1925) as a chief illustration, the chapter explores the semiology of collage in comparison with Eisenstein’s semiology of montage, inserting the filmmaker as both practitioner and theorist into a conversation with “decadent” western modernism.
“Suspense Is like a Woman”
Authors: Frost Laura
Published: October 2021

Considering Hitchcock as a formally inventive modernist as much as a popular filmmaker, this essay argues that Hitchcock drew his principles of suspense and spectatorial pleasure—as well as the formal intricacy he promotes throughout his work—from the shifting landscape of sex and gender norms in the early to mid-twentieth century. Hitchcock’s craftsmanship was, from the beginning, intimately connected to his view of modern women, men, and sexuality. Focusing here on the first two of Hitchcock’s extant silents, The Pleasure Garden and The Lodger, this essay explores how his striking renderings of vision and cognition, stylized violence, and fraught desire are deeply rooted in interwar British culture and particularly the emergence of women exercising new forms of autonomy. These early films establish Hitchcock’s technical innovations and also constitute an archive of British cinematic and social history, imparting the intoxicating and tense texture of modernity and Hitchcock’s lifelong view of the pursuit of pleasure as an inherently risky business.
F. W. Murnau’s Sunrise
Authors: Marcus Laura
Published: October 2021

In 1926, the German film director F. W. Murnau (born F. W. Plumpe) traveled to Hollywood to make his first American film, Sunrise (1927), for Fox. The modernism of Sunrise inheres in the contrasts it sets up between the country and the city, pastoralism and the modern urban, and this chapter explores it in part as a modernist city film. This aspect is linked to the film’s status as a late silent film: Sunrise reaches out toward the articulation of language and sound, intertwining these with the image of the modern city. Silence is placed on the side of the rural and the pictorial, sound on the side of the urban and dynamic. The two women in the film (representing country and city) occupy the poles of these oppositions in what may appear a simple allegory of good and evil, but the film in fact articulates a more complex and ambivalent attitude toward the old world and the new.
“You Must Speak”
Authors: Klein Scott W.
Published: October 2021

Charlie Chaplin, silent-era film star and director, did not make his first fully talking picture until The Great Dictator in 1940—years after sound became the technological norm. The film ends with a peroration by Chaplin against the emerging horrors of European fascism. “You Must Speak” interrogates this final monologue in a number of related contexts: as a speech act that runs counter to Chaplin’s career-long distrust of language; as a meditation on the relation between sound and image in the presentation of celebrities, particularly of political figures; and, in the context of the visual iconography of other political filmmakers such as Eisenstein, Dovzhenko, and Riefenstahl—and an early sound newsreel of George Bernard Shaw—a meditation on visual and sonic scale, and how the disassociation of voice from speaker in film can question the relative efficacy of sound and image in modernist portrayals of power.
Leibniz and the Transcendental Deduction
Authors: Laywine Alison
Published: October 2021

This chapter explores the significance of Kant’s engagement with Leibniz for the Transcendental Deduction section of the Critique of Pure Reason. It is argued that the goal of the Transcendental Deduction is largely cosmological—to show that the pure concepts of the understanding relate a priori to objects if it succeeds in showing that human understanding uses these concepts to construct a world out of the appearances that are sensibly given to us in space and time. The notion of “world” that Kant employs in his cosmology has an ancestor, however, in certain views to be found in Leibniz’s philosophy—particularly in his well-known correspondence with Clarke.
Extending Infinitely Many Times Arithmetically Cohen–Macaulay and Gorenstein Subvarieties of Projective Spaces
Authors: Ballico E
Published: October 2021

We give examples of infinitely extendable (not as cones) arithmetically Cohen–Macaulay and arithmetically Gorenstein subvarieties of projective spaces and which are not complete intersections. The proof uses the computation of the dimension of the Hilbert scheme of codimension 2 subschemes of projective spaces due to G. Ellingsrud and of arithmetically Gorenstein codimension 3 subschemes due to J. O. Kleppe and R.-M. Miró-Roig.
Beyond bean counting: Is the policy effective for the innovation efficiency of wind power industry in China?
Authors: Jiang Zihao , Shi Jiarong , Liu Zhiying , Gong Lei
Published: October 2021

The technological innovation of wind power is crucial to energy security and energy structure transformation. The Chinese government has been committed to improving the innovation of the wind power industry for decades. Although academic researchers and wind power policymakers have been widely concerned about the absolute score of innovation output, concentrating on innovation output in isolation is ultimately insufficient. This article goes beyond bean counting and evaluates the innovation of the Chinese wind power industry from the perspective of relative efficiency, and then assesses the efforts of the government to improve innovation efficiency (IE). The study uses the data of 105 wind power listed enterprises in China over the period 2008–2019. According to the recommendation made by the existing papers, IE is defined as the capability to generate innovation outputs per unit of R&D investment. Regression analysis is applied to test the policy effect. During 2008–2019, the average value of IE of Chinese wind power industry is 0.196. The IE of wind power enterprises in eastern China (0.265) is higher than that in central and western China (0.169). Besides, the regression results indicate that all categories of wind power innovation policies contribute to the IE of wind power industry in China. Furthermore, the innovation policies issued by the departments of the State Council significantly improve the IE of wind power industry, but the innovation policies from the National People’s Congress and the State Council have no significant impacts on IE.
What motivates academics for external engagement? Exploring the effects of motivational drivers and organizational fairness
Authors: Atta-Owusu Kwadwo , Fitjar Rune Dahl
Published: October 2021

Academics have different motivations for external engagement, including to acquire external resources for research (research advancement motivation), to contribute to society (prosocial motivation), or to acquire monetary benefits (pecuniary motivation). Universities also have varying policies for rewarding external engagement. This paper examines the relationship between academics’ motivations for engaging, their perceptions of the fairness of their universities’ policies, and their actual level of external engagement. Most academics consider contributing to the betterment of society as the most important reason for engagement, followed by the advancement of their research. Conversely, few academics consider obtaining personal income to be important. The perceived importance of all three motivations is positively associated with actual engagement behavior. Notably, the strength of research advancement motivation is more closely associated with external engagement than the strength of pecuniary motivation. However, perceptions of organizational fairness are not related to external engagement.
Trends in mental health symptoms, service use, and unmet need for services among US adults through the first 8 months of the COVID-19 pandemic
Authors: Coley Rebekah Levine , Baum Christopher F
Published: October 2021

The COVID-19 pandemic has led to rising morbidity, mortality, and social and economic disruption, likely impairing mental health. The purpose of this study was to track trends in mental health symptoms, use of services, and unmet need for services among US adults, and to delineate variation across demographic strata. Data were drawn from the 2020 US Household Pulse Survey from repeated cross-sectional online surveys collected between April 23 and November 23, 2020 from 1,302,455 US adults, weighted to represent the US population. Survey respondents self-reported their symptoms of anxiety and depression, use of medication and counseling services, and unmet need for services. Reports of probable anxiety and depression rose significantly through the study period, to prevalence rates of 37% and 29%, respectively, by November, 2020, rates more than four times higher than early 2019 US norms. Use of prescription medication, counseling services, and unmet need for mental health services also rose significantly. Prevalence rates of probable mental health disorders were highest among young, less educated, single parent, female, Black and multi-racial respondents, with some vacillation in such disparities over cohorts. Young, female, and moderately educated respondents also reported higher unmet needs for services. Disparities in estimates of mental health disorders and mental health treatment indicate a striking disequilibrium between the potential need for and the use of mental health services during the COVID-19 pandemic. Rising mental health challenges are being borne largely by young, less advantaged people of color and women, with the potential for expanded interruptions to optimal functioning and societal recovery from COVID-19.
Opting into the Public List of DATA-Waivered Practitioners: Variations by Specialty, Treatment Capacity, and Practitioner Characteristics
Authors: Nguyen Thuy , Andraka-Christou Barbara , Bradford W. David , Simon Kosali
Published: October 2021

Objectives

Although increased access to buprenorphine treatment for opioid use disorder is a central policy objective in addressing the US opioid overdose crisis, insufficient capacity for buprenorphine treatment exists relative to treatment need. Little is known about the characteristics of practitioners who opt into the public listing, an online list of Drug Addiction Treatment Act (DATA)-waivered practitioners provided by the US government, as compared to those who do not. In this cross-sectional study, we examined the association of public listing with practitioner demographic data, specialty, and treatment capacity.

Methods

We combined comprehensive prescriber databases including the National Plan and Provider Enumeration System, data on DATA-waivered practitioners, and an online list waivered practitioners in January 2020 using matching algorithms. We used nonadjusted group mean comparisons and multivariate logistic regressions for the statistical analyses of 60,113 US DATA-waivered practitioners.

Results

Publicly listed waivered practitioners tended to have higher patient limits than non-listed practitioners. The proportions of psychiatrists among publicly listed practitioners were significantly lower than those of non-listed practitioners (6.6%, P < 0.001). Nonphysician prescribers, rural practitioners, male practitioners, and practitioners with fewer years of practice are overrepresented among publicly listed waivered practitioners.

Conclusions

As it is easier for patients to find buprenorphine treatment providers who are on this list, the list serves to expand buprenorphine utilization. SAMHSA should encourage providers to opt into the public list, focusing on psychiatrists and prescribers with lower patient limits, consider requiring inclusion in the list, or make inclusion an “opt out” rather than an “opt in” decision.
The Evolution of the Anesthesia Patient Safety Movement in America: Lessons Learned and Considerations to Promote Further Improvement in Patient Safety
Authors: Warner Mark A. , Warner Mary E.
Published: October 2021

Ellison C. Pierce, Jr., M.D., and a small number of specialty leaders and scientists formed a remarkable, diverse team in the mid-1980s to address a dual crisis: a safety crisis for anesthetized patients and a medical malpractice insurance crisis for anesthesiologists. This cohesive team’s efforts led to the formation of the Anesthesia Patient Safety Foundation, the American Society of Anesthesiologists’s Committees on Standards of Care and on Patient Safety and Risk Management, and the society’s Closed Claims Project. The commonality of leaders and members of the Anesthesia Patient Safety Foundation and American Society of Anesthesiologists initiatives provided the strong coordination needed for their efforts to effect change, introduce standards of care and practice parameters, obtain financial support needed to grow patient safety–oriented new knowledge, integrate industry and other relevant leaders outside of anesthesiology, and involve all anesthesia professions. By implementing successful patient safety initiatives, they promoted the recognition that anesthesiology and patient safety are inextricably linked.
Preparing Neonatal Nurses for Improved Performance, Professional Development, and National Certification Through Simulation
Authors: Zebreski Laura , Bloodgood Katherine , Wyble Kimberlee
Published: October 2021

Background:

Code and emergent situations require skilled nursing response wherever they occur. Nurse preparation for code response is an ongoing need in nursing education. The Neonatal Intensive Care Unit (NICU) at Parkland Health and Hospital System in Dallas, Texas, has a team of 3 nurse educators. These educators determined the need for increased nurse confidence, skill, and response in code and emergent situations within the NICU. The education team also recognized the need to increase nurse involvement in professional development activities and preparation for the national certification examination.

Purpose:

The purpose of this article is to describe how a NICU education team, in a level III NICU, trained nurses using simulated scenarios to improve nursing knowledge for national certification, skill, and confidence in code situations and to provide ongoing professional development opportunities within a controlled learning environment.

Methods:

The intervention designed to meet these specific goals for the NICU was the creation of a simulation team (called the “Drill Team”) to facilitate simulated activities created by the NICU education team. This simulation strategy was found to have multiple advantages for content delivery, as multiple learning styles can be incorporated into the simulated activities.

Findings:

Nurses demonstrated improved performance, knowledge acquisition, and knowledge retention after the Drill Team project. Nursing confidence in code performance also increased using this intervention.

Implications for Practice:

This educational intervention can be replicated and utilized in nursing education for all specialties.

Implications for Research:

Further research could be conducted to determine the effectiveness of simulated activities and national certification pass rates.
Lumbar Paraspinal Compartment Syndrome
Authors: Ilyas Haariss , Fagan Claire , Roser Florian , Hebela Nader M.
Published: October 2021

Background:

Lumbar compartment syndrome is a recognized clinical phenomenon, despite receiving less attention as a clinical entity. Given its rarity, the definitive presentation, diagnosis, and management strategies are not completely agreed upon.

Materials and Methods:

A literature search on PubMed of all case reports of lumbar paraspinal compartment syndromes was conducted. All case reports and reviews were analyzed for patient demographic data, presentation, diagnostic evaluation, treatment, and clinical follow-up.

Results:

A total of 37 cases of lumbar compartment syndrome were identified. Overall, 91.9% occurred in men with an average age of 30.9 years. Weightlifting (n=18, 48.6%) and physical exertion (n=7, 18.9%) accounted for the majority of presentations. In all, 37.8% of cases occurred unilaterally. Creatinine kinase, aspartate aminotransferase, and alanine aminotransferase were notably elevated. Compartment pressure was elevated with an average of 91.8 mm Hg (SD: 44.8 mm Hg). Twenty-two cases were treated operatively (59.5%) and 15 (40.5%) were treated nonoperatively. In total, 19/20 (95.0%) of cases treated operatively reported either resolution of pain or return to baseline activities without limitation, compared with 1/11 (9.1%) treated nonoperatively. This difference between the operative and nonoperative cohort was statistically significant (P<0.0001).

Conclusions:

Lumbar paraspinal compartment syndrome is a rare, but well-documented clinical entity. In all, 67.5% of cases occurred after weightlifting or physical exertion. Overall, 40.5% of cases in the literature were treated nonoperatively. Per our analysis, there is a clinically and statistically significant difference in cases treated operatively versus nonoperatively (95.0% vs. 9.1%, P<0.0001).
Novel Hemorrhagic Risk Score in Elderly Patients with Coronary Artery Disease and Gastrointestinal Malignant Tumor Comorbidity: A 10-year Clinical Inpatient Data Analysis from 2 Medical Centers
Authors: Bao Nandi , Wang Wanling , Wu Huitao , Wang Yabin , Che Hebin , Meng Wenwen , Miao Jiaxin , Han Dong , Yin Fan
Published: October 2021

Objective:

Older patients with comorbidity, such as coronary heart disease (CHD) and malignant gastrointestinal tumors, are at a high risk of bleeding events. However, risk prediction models based on risk factor assessment remain unclear. This study aimed to establish an individualized bleeding risk assessment system based on the analysis of 10-year inpatient clinical big data.

Methods:

Total clinical data of 56,819 patients with CHD and 25,988 patients with malignant digestive tract tumors (admitted from January 2008 to December 2017) were retrospectively collected at the First and Second Medical Centers of Chinese People's Liberation Army General Hospital. Among them, 1307 patients with CHD and malignant digestive tract tumors were screened as the derivation cohort. The dependent variable was the occurrence of major clinical bleeding events. Baseline statistics and hypothesis tests of differences were performed for independent variables according to the occurrence of bleeding. Decision Tree, eXtreme Gradient Boosting (XGBoost), logistic regression, and random forest models were used for comparison. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC) were applied as the criteria for evaluating and verifying model performance. To evaluate this developed model, another cohort comprising 454 patients (admitted from January 2018 to December 2019) was prospectively enrolled as the validation cohort based on the same inclusion and exclusion criteria.

Results:

Among the 64 variables with <50% missing values, the recursive feature elimination method with a random forest model was used to screen the selected variables. The highest accuracy was obtained following the selection of 10 scalars, and the final model was constructed accordingly. XGBoost demonstrated the best performance comprehensively. The AUC-ROC of this model was 0.981, with an accuracy, sensitivity, and specificity of 0.939, 0.950, and 0.927, respectively. In the validation cohort, the AUC-ROC, accuracy, sensitivity, and specificity of the XGBoost model were 0.702, 0.718, 0.636, and 0.725, respectively. The rate of major bleeding events has a positive correlation with the bleeding risk score quintiles. To allow for convenient clinical application, a smartphone application was developed for easy access and calculation (http://fir.master-wx.com/sghr).

Conclusion:

We successfully established a risk model and score for predicting bleeding events in older patients with comorbidity, such as CHD and gastrointestinal cancer.
Cutaneous paraneoplastic presentation of colon cancer in a patient with history of ureterosigmoidostomy
Authors: Swindle Mike , Fernstrum Austin , Sharma Timmie , Mishra Kirtishri , Bukavina Laura , Prunty Megan , Bodner Donald
Published: October 2021

Ureterosigmoidostomy was commonly utilized as a procedure for continent urinary diversion. However, ureterosigmoidostomy is associated with complications such as infection, electrolyte disturbances, and neoplasia development. A 40-year-old Caucasian male presented with acute left flank pain. Past medical history was significant for bladder exstrophy for which ureterosigmoidostomy urinary diversion was performed during childhood. On physical exam, multiple circular erythematous patches were scattered across the forearms that had been presented for 2 years. Cross-sectional imaging demonnttated an ill-defined mass at the site of ureteral implantation with associated severe left hydroureteronephrosis. Endoscopy revealed a mass at the site of ureteral implantation and biopsy demonstrated invasive, poorly differentiated adenocarcinoma. The dermatosis was diagnosed as interstitial granulomatous dermatitis, a rare inflammatory skin condition associated with underlying autoimmune disease or malignancy. Patient elected operative management with left nephrectomy, sigmoidectomy, and ileal conduit diversion. Ihis case demonnttates a rare presentation of cutaneous paraneoplastic syndrome after development of colon cancer after ureterosigmoidostomy. Ureterooolonic urinary diversion has a demonnttaaie risk of neoplasia development at the anastomotic site, requiring routine endoscopic surveillance.
Cardiometabolic Consequences of Targeted Anticancer Therapies
Authors: Guha Avirup , Gong Yan , DeRemer David , Owusu-Guha Jocelyn , Dent Susan F. , Cheng Richard K. , Weintraub Neal L. , Agarwal Neeraj , Fradley Michael G.
Published: October 2021

Cardiometabolic disease (CMD) is the most common preventable cause of death in the world. A number of components are included in the spectrum of CMD, such as metabolic syndrome/obesity, hyperglycemia/diabetes, dyslipidemia, and hypertension, which are independently associated with cardiovascular disease risk. These conditions often occur together, and patients with cancer frequently undergo treatments that can generate or worsen CMD. This review highlights and presents mechanistic and epidemiological evidence regarding CMD in 4 categories of anticancer medications, namely, mTOR/PI3K-Akt inhibitors, multitargeted tyrosine kinase inhibitor, immune checkpoint inhibitor therapy, and endocrine therapy. Patients taking these medications need careful monitoring during therapy. There is a role for cardio-oncology and onco-primary care specialists in optimally managing patients at risk to mitigate CMD during treatment with these and other investigational anticancer medications.
A Role for Peroxisome Proliferator-Activated Receptor Gamma Agonists in Counteracting the Degeneration of Cardiovascular Grafts
Authors: Assmann Anna Kathrin , Goschmer Daniel , Sugimura Yukiharu , Chekhoeva Agunda , Barth Mareike , Assmann Alexander , Lichtenberg Artur , Akhyari Payam
Published: October 2021

Aortic valve replacement for severe stenosis is a standard procedure in cardiovascular medicine. However, the use of biological prostheses has limitations especially in young patients because of calcifying degeneration, resulting in implant failure. Pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist, was shown to decrease the degeneration of native aortic valves. In this study, we aim to examine the impact of pioglitazone on inflammation and calcification of aortic valve conduits (AoC) in a rat model. Cryopreserved AoC (n = 40) were infrarenally implanted into Wistar rats treated with pioglitazone (75 mg/kg chow; n = 20, PIO) or untreated (n = 20, controls). After 4 or 12 weeks, AoC were explanted and analyzed by histology, immunohistology, and polymerase chain reaction. Pioglitazone significantly decreased the expression of inflammatory markers and reduced the macrophage-mediated inflammation in PIO compared with controls after 4 (P = 0.03) and 12 weeks (P = 0.012). Chondrogenic transformation was significantly decreased in PIO after 12 weeks (P = 0.001). Calcification of the intima and media was significantly reduced after 12 weeks in PIO versus controls (intima: P = 0.008; media: P = 0.025). Moreover, echocardiography revealed significantly better functional outcome of the AoC in PIO after 12 weeks compared with control. Interestingly, significantly increased intima hyperplasia could be observed in PIO compared with controls after 12 weeks (P = 0.017). Systemic PPAR-gamma activation prevents inflammation as well as intima and media calcification in AoC and seems to inhibit functional impairment of the implanted aortic valve. To further elucidate the therapeutic role of PPAR-gamma regulation for graft durability, translational studies and long-term follow-up data should be striven for.
Stratification Analysis of Statin Effect on Major Adverse Cardiac Events After Percutaneous Coronary Intervention in Patients on Hemodialysis
Authors: Horikoshi Takeo , Nakamura Takamitsu , Yoshizaki Toru , Nakamura Jun , Makino Aritaka , Saito Yukio , Obata Jun-ei , Sawanobori Takao , Takano Hajime , Umetani Ken , Watanabe Akinori , Asakawa Tetsuya , Kugiyama Kiyotaka
Published: October 2021

The statin use in patients on hemodialysis remains controversial, and no beneficial effects of statin on the reduction of adverse cardiovascular events have been reported in these patients. This study used stratification analysis to examine the clinical factors in patients on hemodialysis who could benefit from statin for secondary prevention. This prospective multicenter study included 234 consecutive patients on hemodialysis with coronary artery disease who underwent successful reperfusion therapy with percutaneous coronary intervention. The patients were followed up for up to 3 years or until the occurrence of major adverse cardiac events (MACEs; defined as a composite of all-cause death and nonfatal myocardial infarction). Inverse probability of treatment weighting adjustment was used to remove the selection bias. During the median follow-up period of 30 months, MACEs occurred in 55 patients. Patients with MACEs had significantly lower statin therapy (P < 0.001). Multivariable Cox proportional hazards analysis showed that the patients on statins had a significantly reduced rate of MACE occurrence [adjusted hazard ratio 0.30 (0.11–0.81), P = 0.02]. The stratification analysis of outcomes according to the presence of clinical factors showed that beneficial effects of statin were associated with man, elderly, lower body mass index, lower abdominal circumference, hypertension, diabetes, higher C-reactive protein, symptomatic heart failure, lower left ventricular function, nonacute coronary syndrome, and shorter stent length. Statin was effective for the prevention of MACEs in patients on hemodialysis who underwent percutaneous coronary intervention. We identified specific clinical factors affecting statin effectiveness for secondary prevention.
Considerations for Inotrope and Vasopressor Use in Critically Ill Patients With Pulmonary Arterial Hypertension
Authors: Adie Sarah K. , Abdul-Aziz Ahmad A. , Ketcham Scott W. , Moles Victor M.
Published: October 2021

Pulmonary arterial hypertension (PAH) is a rare and progressive cardiopulmonary disease, characterized by pulmonary vasculopathy. The disease can lead to increase pulmonary arterial pressures and eventual right ventricle failure due to elevated afterload. The prevalence of PAH in patients admitted to the intensive care unit (ICU) is unknown, and pulmonary hypertension (PH) in the ICU is more commonly the result of left heart disease or hypoxic lung injury (PH due to left heart disease and PH due to lung diseases and/or hypoxia, respectively), as opposed to PAH. Management of patients with PAH in the ICU is complex as it requires a careful balance to maintain perfusion while optimizing right-sided heart function. A comprehensive understanding of the underlying physiology and underlying hemodynamics is crucial for the management of this population. In this review, we summarized the evidence for use of vasopressors and inotropes in the management of PH and extrapolated the data to patients with PAH. We strongly believe that the understanding of the hemodynamic consequences of inotropes and vasopressors, especially from data in the PH population, can lead to better management of this complex patient population.