bluuebunny/crossref_metadata_2025 huggingface dataset:
United States Relations with Southern Rhodesia during the UDI Era
Authors: Michel Eddie
Published: July 2020

The Rhodesian Unilateral Declaration of Independence (UDI) era, a 14-year period from 1965 to 1979, posed an exceptional and challenging policy dilemma for four separate US presidential administrations. Presidents’ Lyndon B. Johnson, Richard M. Nixon, Gerald R. Ford, and Jimmy Carter were all confronted by the presence of the internationally unrecognized pariah state in southern Africa.

The shifting patterns in the US approach toward Salisbury ranging from empathy to open hostility were reflective not only of the individual viewpoints of the occupants of the Oval Office but represented the larger diverse pressures, global and domestic, shaping foreign policy during the 1960s and 1970s. The Cold War, economic interest, the need for strategic minerals, race relations, and human rights all guided White House decision making regarding Salisbury.

Across the presidential administrations, the case of Rhodesia, further exposes the tension and interaction between pragmatism and morality in US foreign relations during the 1960s and 1970s. The US approach toward the UDI state not only reveals broad patterns of conflict between realpolitik and moral justice but also depicts times when pragmatism and ethical considerations aligned together to achieve mutually compatible goals. The differing polices adopted by the occupants of the Oval Office demonstrated the competing visions within Washington itself of what constituted pragmatism or morality during the decolonization era.
Pregnancy and Non-Sexually Transmitted Infections
Authors: Borges Ana Luiza Vilela , Borges do Nascimento Chofakian Christiane , Sayuri Sato Ana Paula
Published: July 2020

The focus on non-sexually transmitted infections during pregnancy is relevant, as they are one of the main causes of fetal and neonatal morbidity and mortality in many regions of the world, especially in low- and middle-income countries, respecting no national boundaries. While their possible vertical transmission may lead to adverse pregnancy outcomes, congenital rubella syndrome, measles, mumps, varicella, influenza, Zika virus, dengue, malaria, and toxoplasmosis are all preventable by measures such as vector control or improvement in sanitation, education, and socioeconomic status. Some are likewise preventable by specific vaccines already available, which can be administered in the first years of childhood. A package for intervention also includes adequate preconception care, routine antenatal screening, diagnosis, and treatment during pregnancy. Non-sexually transmitted diseases during pregnancy have different worldwide distributions and occasionally display as emerging or re-emerging diseases. Their epidemiological and clinical aspects, as well as evidence-based prevention and control measures, are relevant to settings with ongoing transmission or those about to be in vulnerable situations. Non-sexually transmitted infections are major public and global health concerns as potential causes of epidemics or pandemics, with numerous social, economic, and societal impacts..
Dynamic Water Pricing
Authors: Grafton R. Quentin , Chu Long , Wyrwoll Paul
Published: July 2020

Water insecurity poses threats to both human welfare and ecological systems. Global water abstractions (extractions) have increased threefold over the period 1960–2010, and an increasing trend in abstractions is expected to continue. Rising water use is placing significant pressure on water resources, leading to depletion of surface and underground water systems, and exposing up to 4 billion people to high levels of seasonal or persistent water insecurity. Climate change is deepening the risks of water scarcity by increasing rainfall variability. By the 2050s, the water–climate change challenge could cause an additional 620 million people to live with chronic water shortage and increase by 75% the proportion of cropland exposed to drought. While there is no single solution to water scarcity or water justice, increasing the benefits of water use through better planning and incentives can help.

Pricing is an effective tool to regulate water consumption for irrigation, for residential uses, and especially in response to droughts. For a water allocation to be efficient, the water price paid by users should be equal to the marginal economic cost of water supply. Accounting for all costs of supply is important even though, in practice, water prices are typically set to meet a range of social and political objectives.

Dynamic water pricing provides a tool for increasing allocative efficiency in short-term water allocation and the long-term planning of water resources. A dynamic relationship exists between water consumption at a point in time and water scarcity in the future. Thus, dynamic water pricing schemes may take into account the benefit of consuming water at that time and also the water availability that could be used should a drought occur in the future. Dynamic water pricing can be applied with the risk-adjusted user cost (RAUC), which measures the risk impact of current water consumption on the welfare of future water users.
Conflict Forecasting and Prediction
Authors: D'Orazio Vito
Published: July 2020

Predictive models, which includes forecasting models, are used to study all types of conflict and political violence, including civil wars, international conflict, terrorism, genocide, and protests. These models are defined as those where the researcher explicitly values predictive performance when building and analyzing the model. This is different from inferential models, where the researcher values the accurate operationalization of a theory, and experimental or quasi-experimental designs where the focus is on the estimation of a causal effect. Researchers employ preditive models to guide policy, to assess the importance of variables, to test and compare theories, and for the development of research methods. In addition to these practical applications, there are more fundamental arguments, rooted in the philosophy of science, as to why these models should be used to advance conflict research. Their use has led to numerous substantive findings. For example, while inferential models largely support the democratic peace hypothesis, predictive models have shown mixed results and have been used to refine the scope of the argument. Among the more robust findings are the presence of nonlinear relationships and the importance of dependencies in all types of conflict data. These findings have implications for how researchers model conflict processes. As predictive models become more common and more integrated into the study of conflict, it is important that researchers understand their underlying components to use them appropriately.
Sustainable Development
Authors: Hirsch Eric
Published: July 2020

Sustainable development was famously defined in the 1987 Brundtland Report as “development that meets the needs of the present without compromising the ability of future generations to meet their needs.” In the decades that followed, anthropologists have made clear that the term requires a more specific redefinition within its context of late capitalism. For anthropologists, sustainable development evokes the effort of extending capitalist discipline while remaining conscious of economic or environmental constraints. Yet they have also found that sustainable development discourses frequently pitch certain forms of steady, careful capitalist extension as potentially limitless. Anthropologists have broadly found “sustainable” to be used by development workers and policy experts most widely in reference to economic rather than environmental constraints. Sustainable development thus presents as an environmentalist concept but is regularly used to lubricate extraction and energy-intensive growth in the name of a sustained capitalism. The intensifying impacts of climate change demonstrate the stakes of this choice.

Anthropological interruptions and interrogations of the sustainable development concept within the unfolding logic of late capitalism range from the intimate and local realm of economic lives, to the political ecology of resource extraction, to the emerging ethnography of climate change. Anthropologists investigate sustainable development at these three scales. Indeed, scale is an effective analytic for understanding its spatial and temporal effects in and on the world. Anthropologists approach sustainable development up close as it has been utilized as a short-term disciplinary instrument of transforming people identified as poor into entrepreneurs. They can zoom out to see large extractive industries as, themselves, subjects and drivers of a larger-scale, longer-term framework of sustainable development. They also zoom out even further, intervening in emergent responses to climate change, a problem of utmost urgency that affects the globe broadly and far into the future, but unevenly. The massive environmental changes wrought by energy-intensive growth have already exceeded the carrying capacity of many of the world’s ecosystems. Climate change is at once a grave problem and a potential opportunity to rethink our economic lives. It has been an impetus to redefine mainstream approaches to sustainable development within a fossil-fueled capitalism. However, a deliberate program of “neoliberal adaptation” to climate change is emerging in sites of sustainable development intervention in a way that promises a consolidation of capitalist discipline. Anthropologists should thus engage a more robust ethnographic agenda rooted in environmental justice.
Howiesons Poort
Authors: de la Peña Paloma
Published: July 2020

The Howiesons Poort is a technological tradition within the Middle Stone Age of southern Africa. This technological tradition shows different characteristics, technical and symbolic (the engraving of ostrich eggshell containers, the appearance of engraved ochre, formal bone tool technology, compound adhesives for hafting and a great variability in hunting techniques), which only developed in an extensive manner much later in other parts of the world. Therefore, the African Middle Stone Age through the material of the Howiesons Poort holds some of the oldest symbolic and complex technologies documented in prehistory. For some researchers, the Howiesons Poort still represents an unusual and ephemeral technological development within the Middle Stone Age, probably related to environmental stress, and as such there are numerous hypotheses for it as an environmental adaptation, whereas for others, on the contrary, it implies that complex cognition, deduced from the elaborated technology and symbolic expressions, was fully developed in the Middle Stone Age.
Role of Quarks in Nuclear Structure
Authors: Thomas A. W.
Published: July 2020

The strong force that binds atomic nuclei is governed by the rules of Quantum Chromodynamics. Here we consider the suggestion the internal quark structure of a nucleon will adjust self-consistently to the local mean scalar field in a nuclear medium and that this may play a profound role in nuclear structure. We show that one can derive an energy density functional based on this idea, which successfully describes the properties of atomic nuclei across the periodic table in terms of a small number of physically motivated parameters. Because this approach amounts to a new paradigm for nuclear theory, it is vital to find ways to test it experimentally and we review a number of the most promising possibilities.
Solar Wind: Interaction With Planets
Authors: Arridge Chris
Published: July 2020

The interaction between the solar wind and planetary bodies in our solar system has been investigated since well before the space age. The study of the aurora borealis and australis was a feature of the Enlightenment and many of the biggest names in science during that period had studied the aurora. Many of the early scientific discoveries that emerged from the burgeoning space program in the 1950s and 1960s were related to the solar wind and its interaction with planets, starting with the discovery of the Van Allen radiation belts in 1958. With the advent of deep space missions, such as Venera 4, Pioneer 10, and the twin Voyager spacecraft, the interaction of the solar wind other planets was investigated and has evolved into a sub-field closely allied to planetary science. The variety in solar system objects, from rocky planets with thick atmospheres, to airless bodies, to comets, to giant planets, is reflected in the richness in the physics found in planetary magnetospheres and the solar wind interaction. Studies of the solar wind-planet interaction has become a consistent feature of more recent space missions such as Cassini-Huygens (Saturn), Juno (Jupiter), New Horizons (Pluto) and Rosetta (67/P Churyumov–Gerasimenko), as well more dedicated missions in near-Earth space, such as Cluster and Magnetosphere Multiscale. The field is now known by various terms, including space (plasma) physics and solar-terrestrial physics, but it is an interdisciplinary science involving plasma physics, electromagnetism, radiation physics, and fluid mechanics and has important links with other fields of space science, including solar physics, planetary aeronomy, and planetary geophysics. Increasingly, the field is relying on high-performance computing and methods from data science to answer important questions and to develop predictive capabilities. The article explores the origins of the field, examines discoveries made during the heyday of the space program to the late 1970s and 1980s, and other hot topics in the field.
Magnetohydrodynamics: Overview
Authors: Priest E.R.
Published: July 2020

Magnetohydrodynamics is sometimes called magneto-fluid dynamics or hydromagnetics and is referred to as MHD for short. It is the unification of two fields that were completely independent in the 19th, and first half of the 20th, century, namely, electromagnetism and fluid mechanics. It describes the subtle and complex nonlinear interaction between magnetic fields and electrically conducting fluids, which include liquid metals as well as the ionized gases or plasmas that comprise most of the universe.

In places such as the Earth’s magnetosphere or the Sun’s outer atmosphere (the corona) where the magnetic field provides an important component of the free energy, MHD effects are responsible for much of the observed dynamic behavior, such as geomagnetic substorms, solar flares and huge eruptions from the Sun that dominate the Earth’s space weather. However, MHD is also of great importance in astrophysics, since many of the MHD processes that are observed in the laboratory or in the Sun and the magnetosphere also take place under different parameter regimes in more exotic cosmical objects such as active stars, accretion discs, and black holes.

The different aspects of MHD include determining the nature of: magnetic equilibria under a balance between magnetic forces, pressure gradients and gravity; MHD wave motions; magnetic instabilities; and the important process of magnetic reconnection for converting magnetic energy into other forms. In turn, these aspects play key roles in the fundamental astrophysical processes of magnetoconvection, magnetic flux emergence, star spots, plasma heating, stellar wind acceleration, stellar flares and eruptions, and the generation of magnetic fields by dynamo action.
The 1970s
Authors: Rolsky L. Benjamin
Published: July 2020

Few decades in the history of America resonate more with the American people than the 1960s. Freedom, justice, and equality seemed to define the immediate futures of many of America’s historically most ostracized citizens. Despite the nostalgia that tends to characterize past and present analyses of the sixties, this imaginative work is important to consider when narrating the subsequent decade: the 1970s. Such nostalgia in considering the 1960s speaks to a sense of loss, or something worked at but not quite achieved in the eyes of the nation and its inhabitants. What happened to their aspirations? Where did they retreat to? And, perhaps more importantly, to what extent did “the spirit” of the 1960s catalyze its antithesis in the 1970s?

In many ways the 1970s was a transitional period for the nation because these years were largely defined by various instances of cultural, or tribal, warfare. These events and their key actors are often under-represented in histories of late-20th-century America, yet they were formative experiences for the nation and their legacy endures in contemporary moments of polarization, division, and contestation. In this sense the 1970s were neither “liberal” nor “conservative,” but instead laid the groundwork for such terms to calcify into the non-negotiable discourse now known simply as the culture wars. The tone of the time was somber for many, and the period may be best understood as having occasioned a kind of “collective nervous breakdown.” For some, the erosion of trust in America’s governing institutions presented an unparalleled opportunity for political and electoral revolution. For others, it was the stuff of nightmares. America had fractured, and it was not clear how the pieces would be put back together.
Indigenous Peoples and the Portuguese Crown in the 17th and 18th Centuries
Authors: Alves-Melo Patricia
Published: July 2020

The native populations of Portuguese America were essential for the implementation of the Portuguese colonial project. Their labor was indispensable in constructing the colony, and political alliances with native peoples ensured the success of the conquest at several crucial moments, and only with the aid of native knowledge it was possible to occupy the land and advance the conquest of the immense territory that became known as Brazil. In this sense, peace was a necessity.

Yet, in highlighting the centrality of Indians in the settlement of the Portuguese colony in the Americas, it must also be recognized that the relations established there between Portuguese conquerors and native populations were also historically marked by tension and violence. A war of extermination, often masquerading as a “just war,” and slavery became inseparable parts of colonial strategy. Moreover, access to land and the use of indigenous labor could both constitute secure indicators of success in the conquest of Portuguese America. In the process of colonization the Portuguese Crown was confronted by various forms of native resistance and by the differing interests of diverse colonial agents. During the 17th and 18th centuries the Crown faced tensions, disputes, and contradictions in relation to the slavery and freedom of Indians and the way it solved these conflicts revealed the configuration of its indigenist policy.
beer and brewing
Authors: Rupp Travis
Published: July 2020

Beer was a staple of ancient diets, extending from the ancient Near East to Egypt and from the Greek Aegean to Rome. The brewing process developed in Anatolia, Mesopotamia, Syria, and Israel, while industrialized production of beer continued in Egypt. However, in Greek and Roman culture, discussions and acceptance of beer are not as prevalent in the composed texts of the elite populace. These authors avoid or degrade the topic. Though no one word for beer universally translates in ancient Greek and Latin languages, further examination has demonstrated that beer was a nutritional necessity and was produced in Greek and Roman history; yet, the resilience of beer is largely attributed to peoples living on or beyond the boundaries of Greek and Roman dominion. Their direct contact with Rome’s legions compelled beer’s development even without a full embrasure from aristocratic elites. Combining art, architecture, archaeology, and literature, a comprehensive story for the existence and permanence of beer is told from 9500 bce to 500 ce.
religion, Phoenician and Punic
Authors: Bonnet Corinne
Published: July 2020

The Phoenician and Punic religion was a polytheistic system, characterized by local specificities and some common features. It is attested in the whole Mediterranean basin throughout the first millennium bce, with significant evolutions since the Archaic period, due to frequent contacts with many different cultures, such as Greece, Egypt, Etruria, etc. Each kingdom or city-state (Arwad, Beirut, Byblos, Sidon, Sarepta, Tyre, to mention the most important) shapes its own pantheon, which becomes a crucial expression of micro-identities. However, many gods are shared and present both in Phoenicia and in the Mediterranean diaspora, where they undergo transformations and integrate multicultural environments. The absence of Phoenician and Punic literature is a huge obstacle to a precise understanding of the religious dynamics. Greek, Latin, Hebrew, Assyrian, and Egyptian sources fortunately provide a consistent body of evidence on gods, rituals, myths, or narratives, but they need to be accurately deciphered. The Phoenician and Punic religion appears as particularly open to foreign influences and borrowings; it often employs composite images between anthropomorphism and aniconism. As in many other religions, sacrifices represent the core of the ritual system, a “middle ground,” where gods and men interact.
Phonetics of Sign Language
Authors: Tyrone Martha
Published: July 2020

Sign phonetics is the study of how sign languages are produced and perceived, by native as well as by non-native signers. Most research on sign phonetics has focused on American Sign Language (ASL), but there are many different sign languages around the world, and several of these, including British Sign Language, Taiwan Sign Language, and Sign Language of the Netherlands, have been studied at the level of phonetics. Sign phonetics research can focus on individual lexical signs or on the movements of the nonmanual articulators that accompany those signs. The production and perception of a sign language can be influenced by phrase structure, linguistic register, the signer’s linguistic background, the visual perception mechanism, the anatomy and physiology of the hands and arms, and many other factors. What sets sign phonetics apart from the phonetics of spoken languages is that the two language modalities use different mechanisms of production and perception, which could in turn result in structural differences between modalities. Most studies of sign phonetics have been based on careful analyses of video data. Some studies have collected kinematic limb movement data during signing and carried out quantitative analyses of sign production related to, for example, signing rate, phonetic environment, or phrase position. Similarly, studies of sign perception have recorded participants’ ability to identify and discriminate signs, depending, for example, on slight variations in the signs’ forms or differences in the participants’ language background. Most sign phonetics research is quantitative and lab-based.
Students With Obsessive-Compulsive Disorder
Authors: Gaskins Clare S. , Bitalvo Melissa A. , Cohen Michele R.
Published: July 2020

There is growing evidence that obsessive-compulsive disorder (OCD) is much more common in children and adolescents than originally believed. While some youth with mild to moderate OCD may be able to navigate their school day with minimal interference, for others the disorder can cause significant impairment in the ability to concentrate on school work, complete homework, and make and maintain peer relationships. School social workers and staff can play a pivotal role in shaping learning environments that support students with OCD. This article provides an overview of clinical characteristics of OCD, its assessment and treatment, how children with the disorder may present in the school setting, and ways in which school staff can assist students with OCD.
Efficacy of Bezlotoxumab in Trial Participants Infected With Clostridioides difficile Strain BI Associated With Poor Outcomes
Authors: Johnson Stuart , Citron Diane M , Gerding Dale N , Wilcox Mark H , Goldstein Ellie J C , Sambol Susan P , Best Emma L , Eves Karen , Jensen Erin , Dorr Mary Beth
Published: July 2020

Background

Bezlotoxumab reduced rates of recurrent Clostridioides difficile infection (rCDI) vs placebo in Monoclonal Antibodies for C. difficile Therapy (MODIFY) I/II trial participants receiving antibacterial drug treatment for CDI. A secondary objective of MODIFY I/II was to assess bezlotoxumab’s efficacy against C. difficile strains associated with increased rates of morbidity and mortality.

Methods

In this post-hoc analysis of pooled MODIFY I/II data, efficacy endpoints were assessed in participants infected with restriction endonuclease analysis BI and non-BI strains of C. difficile at study entry. Treatment outcomes were compared between participants receiving bezlotoxumab (alone or with actoxumab [B, B+A]) and those receiving no bezlotoxumab (placebo or actoxumab [P, A]).

Results

From 2559 randomized participants, C. difficile was isolated from 1588 (67.2%) baseline stool samples. Participants with BI strains (n = 328) were older and had more risk factors for rCDI than non-BI strain participants (n = 1260). There were no differences in initial clinical cure rate between BI and non-BI strains in either group. The rCDI rate for BI strains treated with bezlotoxumab was lower than for the no bezlotoxumab group (B, B+A vs P, A: 23.6% vs 43.9%) and was also lower for the non-BI strains (B, B+A vs P, A: 21.4% vs 36.1%). Rates of 30-day CDI-associated rehospitalization were greater with BI vs non-BI strains in both groups.

Conclusions

Infection with BI strains of C. difficile predicted poor outcomes in the MODIFY I/II trials. Bezlotoxumab (alone or with actoxumab) treatment was effective both in BI and non-BI subpopulations.
Retail price discrimination and food waste
Authors: Richards Timothy J , Hamilton Stephen F
Published: July 2020

We examine a food retailer’s incentive to use a minimum quality standard as part of a quality-based price-discrimination strategy and show how price discrimination can result in a substantial level of retail food waste. Using data from a major US food retailer, we estimate a structural model of retail price discrimination and conduct a series of counter-factual experiments to demonstrate that observed retail prices are consistent with quality-based price discrimination in the retail market. Our findings indicate that quality standards on fresh produce can explain a substantial proportion ($7.5\%$) of food waste by retailers in the US.
EHRtemporalVariability: delineating temporal data-set shifts in electronic health records
Authors: Sáez Carlos , Gutiérrez-Sacristán Alba , Kohane Isaac , García-Gómez Juan M , Avillach Paul
Published: July 2020

Background

Temporal variability in health-care processes or protocols is intrinsic to medicine. Such variability can potentially introduce dataset shifts, a data quality issue when reusing electronic health records (EHRs) for secondary purposes. Temporal data-set shifts can present as trends, as well as abrupt or seasonal changes in the statistical distributions of data over time. The latter are particularly complicated to address in multimodal and highly coded data. These changes, if not delineated, can harm population and data-driven research, such as machine learning. Given that biomedical research repositories are increasingly being populated with large sets of historical data from EHRs, there is a need for specific software methods to help delineate temporal data-set shifts to ensure reliable data reuse.

Results

EHRtemporalVariability is an open-source R package and Shiny app designed to explore and identify temporal data-set shifts. EHRtemporalVariability estimates the statistical distributions of coded and numerical data over time; projects their temporal evolution through non-parametric information geometric temporal plots; and enables the exploration of changes in variables through data temporal heat maps. We demonstrate the capability of EHRtemporalVariability to delineate data-set shifts in three impact case studies, one of which is available for reproducibility.

Conclusions

EHRtemporalVariability enables the exploration and identification of data-set shifts, contributing to the broad examination and repurposing of large, longitudinal data sets. Our goal is to help ensure reliable data reuse for a wide range of biomedical data users. EHRtemporalVariability is designed for technical users who are programmatically utilizing the R package, as well as users who are not familiar with programming via the Shiny user interface.

Availability: https://github.com/hms-dbmi/EHRtemporalVariability/

Reproducible vignette: https://cran.r-project.org/web/packages/EHRtemporalVariability/vignettes/EHRtemporalVariability.html

Online demo: http://ehrtemporalvariability.upv.es/
Characterization of Clostridioides difficile isolates recovered from two Phase 3 surotomycin treatment trials by restriction endonuclease analysis, PCR ribotyping and antimicrobial susceptibilities
Authors: Cheknis Adam , Devaris Dominique , Chesnel Laurent , Dale Suzanne E , Nary Julia , Sambol Susan P , Citron Diane M , Goering Richard V , Johnson Stuart
Published: July 2020

Objectives

To investigate the molecular epidemiology and antimicrobial susceptibility of Clostridioides difficile isolates from patients with C. difficile infection (CDI) from two Phase 3 clinical trials of surotomycin.

Methods

In both trials [Protocol MK-4261-005 (NCT01597505) conducted across Europe, North America and Israel; and Protocol MK-4261-006 (NCT01598311) conducted across North America, Asia-Pacific and South America], patients with CDI were randomized (1:1) to receive oral surotomycin (250 mg twice daily) or oral vancomycin (125 mg four times per day) for 10 days. Stool samples were collected at baseline and C. difficile isolates were characterized by restriction endonuclease analysis (REA) and PCR ribotyping. Susceptibility testing was performed by agar dilution, according to CLSI recommendations.

Results

In total, 1147 patients were included in the microbiological modified ITT population. Of 992 recovered isolates, 922 (92.9%) were typed. There was a high association between REA groups and their corresponding predominant PCR ribotype (RT) for BI, DH, G and CF strains. REA group A showed more diverse PCR RTs. Overall, the most common strain was BI/RT027 (20.3%) followed by Y/RT014/020 (15.0%) and DH/RT106 (7.2%). The BI/RT027 strain was particularly prevalent in Europe (29.9%) and Canada (23.6%), with lower prevalence in the USA (16.8%) and Australia/New Zealand (3.4%). Resistance was most prevalent in the BI/RT027 strain, particularly to metronidazole, vancomycin and moxifloxacin.

Conclusions

A wide variation in C. difficile strains, both within and across different geographical regions, was documented by both REA and ribotyping, which showed overall good correlation.
Perioperative Risk of the Sitting Position for Elective Posterior Cervical Spine Surgery: A Retrospective Case Series
Authors: Rahmani Redi , Susa Stephen T , Sandwell Stephen E , Kimmell Kristopher T , Maurer Paul K , Silberstein Howard J , Nadler Jacob W , Walter Kevin A
Published: July 2020

BACKGROUND

The sitting cervical position for elective posterior cervical decompression and fusion affords advantages over prone positioning, but remains unpopular due to concerns about venous air embolism (VAE).

OBJECTIVE

To demonstrate the safety and efficacy of sitting cervical surgery in our series and in the literature.

METHODS

To evaluate the incidence of complications, we retrospectively identified all adult patients who underwent elective sitting posterior cervical surgeries at our institution from 2009 to 2014. Using International Classification of Diseases-9 coding, we searched for incidences of air embolism, myocardial infarction, pulmonary embolism, and deep vein thrombosis. Operative time, estimated blood loss, and case type distribution were also recorded. We then calculated the incidence of clinically significant VAE in sitting cervical surgeries.

RESULTS

Between 2009 and 2014, 558 surgeries were performed in the sitting cervical position. No VAE was identified. The average operative time was 1 h 25 min. A total of 30-d perioperative complications among sitting position patients included 3 myocardial infarctions, 1 pulmonary embolism attributed to venous thrombosis, and 2 patients with deep venous thrombosis for a total cardiovascular complication rate of 1.1%. The incidence of clinically significant VAE in the literature is 1.5%.

CONCLUSION

We present the second largest case series to date on the sitting position for cervical surgeries, highlighting its safety and efficacy. This position provides a surgical field with superior visualization, allowing decreased operative time and blood loss. The risk of clinically significant VAE is low. Intraoperative monitoring for these events with less invasive means is safe and effective.
Brief Pain Inventory–Short Form: A New Method for Assessing Pain in the Emergency Department
Authors: Im Dana D , Jambaulikar Guruprasad D , Kikut Anna , Gale Jasmine , Weiner Scott G
Published: July 2020

Objective

The numeric rating scale (NRS), which does not capture the multidimensional experience of pain, is commonly used to measure pain in the emergency department (ED). In this study, we assess the utility and feasibility of the Brief Pain Inventory–Short Form (BPI-SF) in the ED.

Methods

This was a cross-sectional, prospective, convenience sample study of adult patients presenting to the ED with chest, abdominal, or musculoskeletal pain. Using confirmatory factor analysis, we investigated the construct validity of the BPI-SF. We determined the association between NRS and BPI-SF scores. We assessed the feasibility and utility of administering the BPI-SF in the ED setting by evaluating 1) the time required to complete the BPI-SF and 2) how patients perceive the BPI-SF compared with the NRS.

Results

One hundred participants were included for analysis. The median NRS pain level on ED arrival (interquartile range [IQR]) was 7 (5–8). The median BPI-SF score (IQR) was 57 (43–73) on a 0–110 scale. Fit indices for the two-factor structure were statistically superior when compared with the one-factor model of the BPI-SF (comparative fit index 0.90 vs 0.64). Higher pain severity score, pain interference score, and total BPI-SF score were associated with higher NRS scores (P < 0.01). The mean time needed to complete the BPI-SF (SD) was 3 minutes 47 seconds (1 minute 35 seconds). Seventy-three percent of the patients preferred the BPI-SF to the NRS for pain assessment in the ED.

Conclusions

Our study demonstrates the validity, feasibility, and utility of the BPI-SF in the ED setting.
Dry Bean and Anthracnose Development From Seeds With Varying Symptom Severity
Authors: Halvorson Jessica M. , Lamppa Robin S. , Simons Kristin , Conner Robert L. , Pasche Julie S.
Published: July 2020

Anthracnose, caused by the fungal pathogen Colletotrichum lindemuthianum, is a damaging seed-transmitted disease of dry beans that causes reduced seed quality and yield. Seed-to-seedling transmission of C. lindemuthianum has been documented as high as 15% in asymptomatic seeds under greenhouse conditions. Increasing pathogen colonization in seeds has been correlated with increasing anthracnose seed symptoms via quantitative PCR (qPCR), but stem colonization has not been quantified. Previous studies also have characterized seed yield and quality losses caused by planting C. lindemuthianum–infected seeds, but none evaluated the effect of growing asymptomatic seeds on disease and plant development under field conditions. A real-time qPCR assay was developed in this study and used to detect C. lindemuthianum in the stems of seedlings as early as 15 days after planting. Field trials measured the seed-to-seedling transmission of C. lindemuthianum across levels of anthracnose symptoms in seeds ranging from healthy to severely discolored. Results from these two field trials indicated that emergence and yield decreased and foliar symptoms, pathogen detection, and incidence of symptoms on progeny seeds increased as the severity of infection in planted seeds increased. In both years, planting asymptomatic seeds resulted in higher anthracnose severity than planting healthy seeds. Yield, seed weight, and incidence of symptoms on progeny seeds were not higher in asymptomatic seeds than in healthy seeds in 2014, when moderate disease pressure was observed. However, these factors were significantly different in 2015, when anthracnose severity was driven up to 75% by conducive weather conditions. This serves as a strong warning to growers that planting seed grown in a field where anthracnose was present, even if those seeds are asymptomatic, can result in yield and quality losses. Planting certified dry bean seed is always recommended.
Fungicidal Actions and Resistance Mechanisms of Prochloraz to Penicillium digitatum
Authors: Zhang Yuchao , Zhang Bao , Luo Chaoxi , Fu Yanping , Zhu Fuxing
Published: July 2020

The demethylation inhibitor (DMI) fungicide prochloraz has been widely used in China to control citrus green mold, which is caused by Penicillium digitatum. The 50% effective concentration (EC50) values of prochloraz for 129 isolates of P. digitatum collected in 2017 from citrus groves of four provinces of China ranged from 0.0032 to 0.4582 mg/liter. Analysis of the distribution of natural logarithms of EC50 values indicated that 111 isolates with EC50 values lower than 0.05 mg/liter could be considered sensitive to prochloraz. Relative baseline sensitivity was established based on the 111 sensitive isolates, and the mean EC50 value was 0.0090 ± 0.0054 mg/liter (SD). Prochloraz at 60, 100, and 140 mg/liter provided preventive efficacies of 67.8, 93.0, and 96.4%, respectively. Prochloraz at 0.005 and 0.01 mg/liter disrupted cell membrane integrity of conidia but reduced cell membrane permeability of mycelia. Prochloraz at 0.01 mg/liter reduced ergosterol content in mycelia by 41.8%. Two prochloraz-resistant isolates with EC50 values of 3.97 and 5.68 mg/liter were attained by consecutive subculturing on prochloraz-amended PDA. Studies on the expression levels of three potential target genes, CYP51A, CYP51B, and CYP51C, demonstrated that whether in the absence or presence of prochloraz, only CYP51B in the resistant isolates was overexpressed at least 10-fold higher than that of the sensitive ones. Sequencing of the three genes showed that only CYP51B in the resistant isolates had a 199-bp insertion in the promoter region. In addition, only CYP51B displayed point mutations of G405S, G389C, and Y390S in the coding regions in the resistant isolates. These results were important for understanding the resistance mechanisms of P. digitatum to prochloraz.
Gender Differences in the Prevalence of Metabolic Syndrome Among Taiwanese Air Force Personnel
Authors: Wang Wei-Yun , Li Chih-Hao , Wu Yi-Syuan , Chien Wu-Chien , Wang Kwua-Yun , Tzeng Wen-Chii
Published: July 2020

Background

Authors of several studies have reported differences in the prevalence of metabolic syndrome (MetS) between men and women. However, information is lacking on gender difference among military personnel.

Objective

The aim of this study was to examine the prevalence of MetS and its component abnormalities among Taiwanese Air Force personnel by gender and age groups.

Methods

A population-based study was conducted including 14 872 Taiwanese Air Force personnel. Data were retrieved from the military's Health Management Information System. Analyses were performed using Student t test, χ2 test, and linear-by-linear χ2 test. Statistical significance was defined as P < .05.

Results

The MetS prevalence was 14.0% (15.1% in men and 5.3% in women). Metabolic syndrome was associated with age for both men and women (both P
trend < .001), with a greater prevalence of MetS in men aged 18 to 44 years than in women, but not in the age group of 45 years or older. In men, MetS was most prevalent in those with increased waist circumference (78.2%), followed by those with elevated blood pressure (75.6%). By contrast, in women, it was most prevalent in those with increased waist circumference (86.5%), followed by those with reduced high-density lipoprotein cholesterol (84.3%).

Conclusions

Our findings suggest that military nurses and other health providers should consider the gender- and age-based MetS prevalence trend among Taiwanese Air Force personnel when designing interventions to identify vulnerable subgroups at a high risk of MetS. Health management programs should be adapted to minimize metabolic risks.
An Integrated Review of Hypertrophic Cardiomyopathy in Black Populations
Authors: Arabadjian Milla , McCarthy Margaret , Dickson Victoria Vaughan
Published: July 2020

Background

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder globally, affecting 0.2% to 0.5% of individuals. Existing clinical HCM guidelines do not address diverse populations, specifically minority groups who often experience health disparities.

Objective

The aim of this study was to describe the state of the science of HCM in black populations.

Methods

This integrated review guided by Whittemore and Knafl's methodology included literature search of multiple databases, data evaluation, and analysis. Publications between 2000 and 2020 were included if they addressed HCM cardiac anatomic manifestations, disease course, symptoms, quality of life, or outcomes in black populations.

Results

Six articles met the inclusion criteria. Overall, blacks are underrepresented in HCM research. Certain HCM structural phenotypes are more commonly exhibited in blacks, and physiology drives HCM treatment. Sudden death events and all-cause mortality do not differ between blacks and whites with HCM. Fewer blacks with HCM undergo genetic testing than whites with HCM. The lack of diversity in general genomic databases has resulted in reclassification of several genetic variants identified as more common in blacks.

Conclusions

Blacks are underrepresented in HCM research, even those focused on elucidating HCM manifestations, disease course, and outcomes in black populations. This may be due in part to HCM research that is largely generated from specialty centers that can require patients to navigate complex healthcare systems to reach expert HCM care. Longitudinal studies with large samples of blacks with HCM are necessary to elucidate how HCM affects this population.
Moderator Role of Mutuality on the Association Between Depression and Quality of Life in Stroke Survivor–Caregiver Dyads
Authors: Pucciarelli Gianluca , Lyons Karen S. , Simeone Silvio , Lee Christopher S. , Vellone Ercole , Alvaro Rosaria
Published: July 2020

Background

Authors of previous research have not yet analyzed the role of potential moderators in the relationship between depressive symptoms and quality of life (QOL).

Aims

The aim of this study was to examine the moderating effect of mutuality between depressive symptoms and QOL in stroke survivor and caregiver dyads.

Methods

This study used a longitudinal design with 222 stroke survivor–caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed for 12 months. We examined survivor and caregiver QOL dimensions (physical, psychological, social, and environmental), depression, and mutuality at baseline and every 3 months. Hierarchical linear modeling was used to test 4 longitudinal dyadic moderation models (1 for each QOL domain).

Results

Survivors (50% male) and caregivers (65% female) were 70.8 (SD, 11.9) and 52.5 (SD, 13.1) years old, respectively. We observed no significant moderating effects of mutuality for survivors across the 4 dimensions of QOL over time. However, higher survivor mutuality was significantly associated with higher survivor psychological and social QOL at baseline. Regarding caregivers, caregiver mutuality significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.63, P < .05), psychological (B = 0.63, P < .01), and social (B = 0.95, P < .001) QOL at baseline, but not in environmental QOL. Higher caregiver mutuality was significantly associated with less improvement in caregiver physical QOL over time.

Conclusions

Mutuality is a positive variable on the association between depression and QOL for both members of the dyad at discharge but may lead to declines in physical health for caregivers over time. Further work is needed to understand the role of mutuality on long-term outcomes and associations with increased care strain.
Variation in Knowledge of Stroke Warning Signs by Age and Presence of Conventional Risk Factors
Authors: Oh Juyeon , Kim Hyun Young , Kim Young Seo , Kim Sun Hwa
Published: July 2020

Background

It is important to recognize stroke in the general public.

Objectives

The purpose of this study was to investigate factors affecting knowledge of stroke warning signs (SWSs) according to age group in the Korean population.

Methods

This study is a cross-sectional study. Using data from the Korean Community Health Survey conducted in Korea in 2017, 198 403 subjects were analyzed. Knowledge about SWSs was assessed by face-to-face interviews using structured close-ended questionnaires with 5 items about stroke symptoms (sudden unilateral weakness of face, arm or leg; sudden difficulty in speaking, or trouble understanding speech; sudden visual impairment in 1 eye, or double vision; sudden dizziness or loss of balance; and sudden severe headache).

Results

The overall percentage of subjects with good knowledge of SWSs (>4 correct answers to the SWS questionnaire) was 66.5%. It was highest in the middle-aged subjects (72.6%), followed by the young subjects (63.5%) and the older subjects (61.5%). The youngest of the young subjects and the oldest of the older subjects had the least knowledge. Subjects with conventional risk factors generally had more knowledge about SWSs, except for those with diabetes mellitus. However, in the young subjects, knowledge about SWSs was not increased by the presence of conventional risk factors such as hypertension and dyslipidemia.

Conclusion

Stoke risk factors are increasing among young people; they still have poor knowledge about SWSs. More education is needed to increase appropriate treatment, especially in young people with stroke-related risk factors.
Factors Associated With Knowledge Retention 3 Months After a Sexual Assault Forensic Examiner Blended Learning Course
Authors: Patterson Debra , Resko Stella
Published: July 2020

Introduction

A blended learning continuing education course may appeal to busy healthcare professionals because the primary content can be learned online while an in-person component can hone clinical skills. The current study assessed knowledge retention in a sample of healthcare professionals who participated in a nationwide sexual assault forensic examiner blended learning course (12-week online course and 2-day in-person patient simulation).

Methods

Participants' characteristics, motivation, and external barriers were collected through a precourse web-based survey. Participants' knowledge was assessed through pretests and posttests for 12 modules and a 3-month postcourse examination. Utilizing repeated measures analysis of variance, the study examined whether participants retained their knowledge at the 3-month follow-up point. Multiple linear regression was utilized to explore the factors associated with knowledge retention.

Results

The results found a knowledge score from 77.92% to 68.83% correct. The findings indicate that participants who were interested in the blended learning course because of the 2-day patient simulation were more likely to retain knowledge. Learners with more years of experience also had slightly higher knowledge retention. Conversely, participants who were interested in becoming a sexual assault forensic examiner because of a sexual assault experience had lower knowledge retention. Participation in a past online course also was associated with a reduction in knowledge retention.

Discussion

The findings indicate a modest knowledge loss 3 months after the blended learning course. Still, some participants experienced less knowledge retention than others. Postcourse activities such as a brief refresher course may be useful to help these participants maintain their knowledge gains.