bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenging the Legal Self Through Performance
Authors: Leiboff Marett
Published: January 2020

This chapter reconsiders and reorients performance as a critical practice in law and the humanities, turning away from the philosophically and sociologically inflected variants of performance and performativity, toward the possibilities of performance and the theatrical as jurisprudence. In its Kantian ideal, law is expected to function in isolation and absent the self. Performance and the theatrical could not think more differently, creating conditions that enable bodily responses to engender responsiveness that affords the possibility of noticing. This ability to notice is lost in abstraction, but it is needed to enliven and point to failures or fractures in law. Lived experience provides the most potent means by which we notice; in its absence, performance offers the possibility to write experiences on our bodies, helping us to notice when law helps or hinders, harms or helps, showing us how easily law can offer or deny justice simply through the ability or inability of lawyers or justices to notice the effects and consequences of law. At least three registers of noticing can be identified through performance and into law. In no particular order, the first happens through the noticing body, triggering recognition of the consequences of a doctrine, principle, or provision because the lawyer has experienced the same or a cognate situation; the second comes from the dramaturgically grounded nodal knots binding together a present and a past and a past with a present; while in the third, bonds of recognition are created through and by association, or through training.
Affect and Empathy Studies
Authors: Keen Suzanne
Published: January 2020

This chapter discusses two domains of research into and theorizing about human emotions of interest to legal theorists and practitioners in the law. Written by a non-lawyer with expertise in English literature, narrative theory, and interdisciplinary empathy studies, it offers basic definitions of the terms “empathy” and “affect,” brief overviews of research areas, suggestions about the relevance of affect and empathy studies to law, and cautions about those applications’ limitations and liabilities. By no means prescriptive in intention, this chapter’s discussion of affect and empathy studies lays bare some of the underlying assumptions and critical attitudes of work in differing fields. All varieties of empathy, with their affordances and limitations, are resources for the rhetorical arts of persuasion. Writers and practitioners in the law should alertly consider the roles that empathy and affect play in the law, especially when legal abstractions, doctrines, and documents that evoke strong feelings are accorded the imaginative status of persons by means of Einfühlung.
Humanism and Aging
Authors: Derkx Peter , Laceulle Hanne
Published: January 2020

Humanism, as a meaning frame, is defined by four characteristics: human agency; human dignity; self-realization; and love of vulnerable, unique, and irreplaceable persons. A humanist view of aging is in favor of healthy aging and life extension, but human life is and remains inherently vulnerable (not just medically), and in a humanist view other aims are regarded as deserving a higher priority than life extension for privileged social groups with already a high (healthy) life expectancy. Humanist priorities are (1) a better social organization of a person’s life course with a better balance among learning, working, caring, and enjoying; (2) more social justice—for too long differences in socio-economic status have been determinants of shocking differences in health and longevity; (3) development and dissemination of cultural narratives that better accommodate the fulfillment of essential meaning-needs of the elderly than the stereotyping decline- and age-defying narratives); (4) less loneliness and social isolation.
The Politics of Humanism
Authors: Baker Joseph O.
Published: January 2020

While the varieties of humanist expression vary across cultural and historical contexts, all forms of humanism are necessarily related to politics by virtue of outlining ethical positions on matters of social relations. Tracing the history of humanism broadly, as well as secular humanism specifically, this chapter identifies recurring continua of conflict about the politics of humanism. There is a general, inherent tension between individualist and collectivist dimensions of humanism, which is manifest in specific disputes about orientations toward society (philosophical vs. applied humanism), religion (exclusivist vs. ecumenical humanism), ethics (scientistic vs. humanitarian humanism), and politics (libertarian vs. socialist humanism). There are also disputes within humanism that arise around the preferred strategy for managing the stigma of secularity between those who favor separatist subcultures and those who favor normalization through social reform. Ultimately a broad-based conception of humanism offers the greatest possibilities for political efficacy. In conclusion, the article outlines some of the important aspects of humanism and politics in need of further research.
Infrared renormalon in the supersymmetric $\mathbb{C}P^{N-1}$ model on $\mathbb{R}\times S^1$
Authors: Ishikawa Kosuke , Morikawa Okuto , Nakayama Akira , Shibata Kazuya , Suzuki Hiroshi , Takaura Hiromasa
Published: January 2020

In the leading order of the large-$N$ approximation, we study the renormalon ambiguity in the gluon (or, more appropriately, photon) condensate in the 2D supersymmetric $\mathbb{C}P^{N-1}$ model on $\mathbb{R}\times S^1$ with the $\mathbb{Z}_N$ twisted boundary conditions. In our large-$N$ limit, the combination $\Lambda R$, where $\Lambda$ is the dynamical scale and $R$ is the $S^1$ radius, is kept fixed (we set $\Lambda R\ll1$ so that the perturbative expansion with respect to the coupling constant at the mass scale $1/R$ is meaningful). We extract the perturbative part from the large-$N$ expression of the gluon condensate and obtain the corresponding Borel transform $B(u)$. For $\mathbb{R}\times S^1$, we find that the Borel singularity at $u=2$, which exists in the system on the uncompactified $\mathbb{R}^2$ and corresponds to twice the minimal bion action, disappears. Instead, an unfamiliar renormalon singularity emerges at $u=3/2$ for the compactified space $\mathbb{R}\times S^1$. The semi-classical interpretation of this peculiar singularity is not clear because $u=3/2$ is not dividable by the minimal bion action. It appears that our observation for the system on $\mathbb{R}\times S^1$ prompts reconsideration on the semi-classical bion picture of the infrared renormalon.
The effect of group composition and mineral supplementation during rearing on the behavior and welfare of replacement gilts
Authors: Hartnett Phoebe , Boyle Laura A , O’Driscoll Keelin
Published: January 2020

Sow longevity supported by good health and reproductive performance is necessary to optimize sow lifetime performance. In some countries, replacement gilts are reared with finisher pigs destined for slaughter, so they are exposed to sexual and aggressive behaviors performed by males. This is associated with stress and injury. Moreover, diets formulated for finishers are not designed to meet the needs of replacement gilts and may not supply the necessary minerals to promote limb health, optimal reproduction, and, thus, sow longevity. In this 2 × 2 factorial design experiment with 384 animals (32 pens [12 animals per pen]), we investigated the effect of female-only (FEM) or mixed-sex (MIX) rearing, with (SUPP) or without (CON) supplementary minerals (copper, zinc, and manganese) on locomotion, salivary cortisol levels, behavior, body lesions (BL), and hoof health of gilts. The experimental period began at transfer to the finisher stage (day 81.3 ± 0.5 of age; day 0) until breeding age (day 196 ± 0.5 of age; day 115). Locomotion was scored (0–5) biweekly from day 0 until slaughter day 67 or breeding age day 115 for the remaining gilts. Saliva samples were taken monthly from four focal gilts per pen. All counts of aggressive, harmful, sexual, and play behavior were recorded by direct observation 1 d biweekly (5- × 5-min observations/pen/d). BL scores were recorded on focal pigs biweekly from day 1 until day 99 on the back, neck, shoulder, flank, and hind quarter on each side of the body. Hind hooves were scored for eight disorders (heel erosion [HE], heel sole separation [HSS], and white line separation [WLS], dew claw length and dew claw cracks, toe length and both vertical and horizontal toe cracks) by severity, and a total hoof lesion score was calculated by summing individual scores. General linear mixed models were used to analyze cortisol, behavior, BL, and total hoof scores. Generalized linear mixed models were used for locomotion, bursitis and individual hoof disorders. There was less aggression (P < 0.05) and sexual behavior in the FEM compared to the MIX groups with more play behavior in MIX compared to FEM groups (P < 0.01). Gilts in the MIX groups had higher BL scores than gilts in the FEM groups (P < 0.001). Total hoof scores were higher in MIX (8.01 ± 0.15) than FEM (7.70 ± 0.12; P < 0.02) gilts. CON diet gilts had higher HE scores than SUPP gilts (P < 0.05). HSS (P < 0.05) and WLS (P < 0.05) scores were higher in MIX than FEM gilts. Rearing gilts in FEM groups had benefits for hoof health likely mediated through lower levels of activity due to male absence, and minerals helped reduce HE.
Comparative Effect of Mother's Hug and Massage on Neonatal Pain Behaviors Caused by Blood Sampling: A Randomized Clinical Trial
Authors: Roshanray Atefeh , Rayyani Masoud , Dehghan Mahlagha , Faghih Aref
Published: January 2020

Background

The early experience of pain can lead to complications such as tachycardia, tachypnea and increased metabolic needs of the body, thereby exacerbation of the behavioral and physiological responses to pain in neonates. The current study aimed to compare the effect of a mother's hug and massage on pain behaviors during and after blood sampling in neonates.

Method

This study was a randomized clinical trial. A total of 135 healthy full-term neonates were selected by convenience sampling method. Samples were randomly assigned to a mother's hug group, massage group or control group. In all three groups, the behavioral responses of the neonate were measured and recorded before, immediately and 5 min after blood sampling by Neonatal Infant Pain Scale. Heart rate, respiratory rate and blood oxygen saturation were recorded with pulse oximetry, and the crying period was measured from start to silence using a stopwatch.

Results

The results showed that after 5 min, the pain and heart rate in the mother's hug group decreased significantly compared to the massage and control groups (p < 0.001). There were no significant changes in the respiratory rate and blood oxygen saturation level in any of the newborns during blood sampling (p > 0.05). The duration of crying in the mother's hug group had more reduction than that of the massage and control groups (p < 0.001).

Conclusion

The placement of the baby in the mother's hug during painful procedures is recommended due to the reduction of pain, the improvement of physiological symptoms and the promotion of neonatal health.
Genome Resources forThelonectria rubi,the Causal Agent of Nectria Canker of Caneberry
Authors: Skaltsas Demetra N. , Salgado-Salazar Catalina
Published: January 2020

Thelonectria rubi is the causal agent of Nectria canker of Rubus spp. Here, we report a high-quality draft genome sequence for this pathogen, which also represents the first genome sequence for a Thelonectria species. The genome assembly was 44.6 Mb in size, assembled into 669 scaffolds and consisting of 12,973 predicted protein-coding genes. The availability of genome data for T. rubi provides a critical additional resource for an important plant pathogen and will be useful for fungal biology, comparative genomic, taxonomic and population studies of this and related species.
Examining Social Risk Factors in a Pressure Ulcer Quality Measure for Three Post-Acute Care Settings
Authors: Seibert Julie , Barch Daniel , Bernacet Amarilys , Kandilov Amy , Frank Jennifer , Free Lindsey , Roberts Quantesa , Reilly Karen , McMullen Tara , Levitt Alan , Mandl Stella , Smith Laura
Published: January 2020

OBJECTIVE

To describe and explore relationships between social demographic factors and incidence or worsening of pressure ulcer scores among post-acute care (PAC) settings.

DESIGN

The authors present the incidence of new or worsening pressure ulcers stratified by self-reported patient race and sex. Investigators used logistic regression modeling to examine relative risk of developing new or worsened pressure ulcers by sociodemographic status and multiple regression modeling to estimate the relative contribution of facility-level factors on rates of new or worsening pressure ulcers.

SETTING

Three PAC settings: long-term care hospitals, inpatient rehabilitation facilities, and skilled nursing facilities.

PARTICIPANTS

Medicare Part A residents and patients with complete stays in PAC facilities during 2015.

MAIN OUTCOME MEASURE

The incidence of new or worsened pressure ulcers as calculated using the specifications of the National Quality Forum-endorsed pressure ulcer quality measure #0678.

MAIN RESULTS

The sample included 1,566,847 resident stays in 14,822 skilled nursing facilities, 478,292 patient stays in 1,132 inpatient rehabilitation facilities, and 121,834 patient stays in 397 long-term care hospitals. Significant differences in new or worsened pressure ulcer incidence rates by sociodemographic factors were found in all three settings. Black race, male sex, and advanced age were significant predictors of new or worsened ulcers, although controlling for health conditions reduced the racial disparity. The authors noted significant differences among facilities based on ownership type, urban/rural location, and sociodemographic makeup of facilities’ residents/patients.

CONCLUSIONS

There is evidence of disparities in the incidence of new or worsened pressure ulcers across PAC settings, suggesting publicly available quality data may be used to identify and ameliorate these problems.
Sagittally Balanced Degenerative Spondylolisthesis Patients With Increased Sacral Slope and Greater Lumbar Lordosis Experience Less Back Pain After Short-Segment Lumbar Fusion Surgery
Authors: Liow Ming Han Lincoln , Goh Graham Seow-Hng , Chua Jia Long , Ling Zhixing Marcus , Soh Reuben Chee Cheong , Guo Chang-Ming , Tan Seang-Beng , Chen John Li-Tat
Published: January 2020

Study Design:

A retrospective review of prospectively collected registry data.

Objectives:

(1) Examine functional outcomes of patients with postoperative sacral slope (SS)<30 degrees versus SS≥30 degrees after single-level transforaminal lumbar interbody fusion (TLIF) for degenerative spondylolisthesis (DS); (2) determine the factors associated with SS at the last follow-up.

Summary of Background Data:

Few studies have examined the relationship between spinopelvic parameters and functional outcomes in patients with DS undergoing short-segment TLIF. Although SS of 30 degrees has been proposed as the ideal spinopelvic parameter for eliminating residual pain and disability in adult spinal deformity, the ideal value for DS remains unknown.

Methods:

Prospectively collected registry data of 63 patients who underwent single-level L4–L5 open TLIF with sagittal realignment for DS were reviewed. Pelvic incidence, lumbar lordosis (LL), pelvic tilt, SS, listhesis excursion, and Bridwell fusion grading were recorded. Patients were stratified into SS<30 degrees (n=26) or SS≥30 degrees (n=37) at the last follow-up. All patients were assessed preoperatively and postoperatively at 2 years. Receiver operating characteristics curve analysis was used to assess the relationship between expectation fulfillment and change in SS.

Results:

Patients with SS≥30 degrees had significantly lower back pain at 2 years (P<0.04). There were no differences in leg pain or outcome scores (Oswestry Disability Index, Short-Form 36 Physical, and Mental Component Summaries), although there was a trend towards better outcomes and higher satisfaction/expectation fulfillment in patients with SS≥30 degrees. The SS≥30 degrees group had a higher preoperative LL (P=0.04) and SS (P<0.01). Preoperative SS was correlated with SS (R=0.71, P<0.01) and LL (R=0.51, P<0.01) at the last follow-up. The area under the curve for change in SS was 0.680 (95% confidence interval, 0.453–0.907) for predicting expectation fulfillment at 2 years.

Conclusions:

Patients with increased SS (≥30 degrees) experienced less back pain after short-segment lumbar fusion surgery. This was associated with increased LL postoperatively, indicating better sagittal balance.
Complications Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Jenkins Nathaniel W. , Parrish James M. , Hrynewycz Nadia M. , Brundage Thomas S. , Singh Kern
Published: January 2020

Study Design:

This was a retrospective study.

Objective:

The objective of this study was to determine the incidence and risk factors for postoperative complications following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of Background Data:

The identification of independent risk factors that predispose patients to postoperative complications following MIS TLIF may allow for improved outcomes and the optimization of modifiable conditions before surgical intervention.

Materials and Methods:

Patients undergoing a single-level MIS TLIF were retrospectively reviewed. Demographic information and the presence of baseline medical conditions was recorded for all patients. Postsurgical complications that arose following the MIS TLIF procedure were recorded. The incidence of postoperative complications was tested for association with patient and surgical characteristics using bivariate Poisson regression. Independent risk factors for complications were identified through a backward stepwise regression model.

Results:

A total of 421 patients who underwent a primary, single-level MIS TLIF procedure were included in our analysis. The most common complication was urinary retention requiring catheterization (n=43, 10.2%), followed by pseudarthrosis (n=37, 8.8%), and then altered mental status (n=11, 2.6%). Multivariate analysis was conducted to determine the independent risk factors predictive of complications. The significant factors were obesity status (relative risk=2.2, P=0.001), the presence of diabetes (relative risk=2.6, P=0.002), and operative duration >105 minutes (relative risk=2.5, P=0.008).

Conclusions:

The present study provides the incidence of complications following MIS TLIF, as well as risk factors that are predictive of complications that may arise following the procedure. Independent variables for increased complication rates included extended operative duration, obesity, and diabetes status. The identification of these factors may be clinically useful to spine surgeons in terms of preoperative discussion and planning.
The Impact of Comorbidity Burden on Postoperative PROMIS Physical Function Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Parrish James M. , Jenkins Nathaniel W. , Hrynewycz Nadia M. , Brundage Thomas S. , Yoo Joon S. , Singh Kern
Published: January 2020

Study Design:

This was a retrospective cohort study.

Objective:

To assess the utility of Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF) in assessing postoperative recovery on the basis of the comorbidity burden after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of Background Data:

Few studies have evaluated the effect of comorbidity burden in long-term clinical recovery after MIS TLIF.

Methods:

Patients undergoing primary, 1-level to 2-level MIS TLIF were retrospectively reviewed and stratified on the basis of Charlson Comorbidity Index (CCI) score: 0 points (no comorbidities), 1–2 points (low CCI), ≥3 points (high CCI). CCI was tested for an association with demographic characteristics and perioperative variables using χ2 analysis and multivariate linear regression. Multivariate linear regression was utilized to determine the association between CCI cohorts and PROMIS PF.

Results:

A total of 187 1-level and 2-level MIS TLIF patients were included: 53 had no comorbidities, 78 had a low CCI, and 56 a high CCI. One patient in the high CCI group experienced nonunion. Patients reported similar PROMIS PF scores preoperatively and up to 1-year postoperatively. Each cohort experienced a similar improvement in PROMIS PF scores from baseline at each postoperative time point. For patients without comorbidities, the change in the postoperative PROMIS PF score from baseline was significant at every postoperative time point. However, for the patients with ≥1 comorbidities, the change in the postoperative PROMIS PF score from baseline was significant at the 3-month, 6-month, and 1-year time points, however, the change from baseline to 6 weeks was not significant.

Conclusions:

In this investigation, the authors compared the clinical recovery of patients with varying comorbidities undergoing an MIS TLIF using PROMIS PF. Regardless of comorbidity, patients reported similar preoperative PROMIS PF scores and had similar improvements throughout the 1-year follow-up. This study established that PROMIS PF is an effective tool to evaluate the recovery of patients with differing comorbidities after MIS TLIF.
Dosing Requirements of Extended-Release Tacrolimus (Astagraf XL) in African American Kidney Transplant Recipients Converted from Immediate-Release Tacrolimus (AAAKTRS)
Authors: Fleming James N. , Posadas Salas Maria A. , Taber David J.
Published: January 2020

Background:

The formal recommendation for converting twice-daily tacrolimus immediate release (IR) to once-daily tacrolimus extended release (ER) is a 1:1 dose conversion. However, more recent clinical analysis has shown that this may not be true; some patients may require a higher dose. In addition, de novo dosing tacrolimus ER has revealed that African Americans require approximately 20%–30% higher doses than Caucasians to achieve similar levels. As a result, this study sought to identify the appropriate dose conversion in the African American kidney transplant population, a population at high risk of rejection.

Methods:

This was a single-center, prospective, open-label study comparing the difference in dose-normalized trough and total daily dose necessary to reach steady-state therapeutic goal, after conversion from tacrolimus IR to tacrolimus ER, in 25 African American kidney transplant recipients.

Results:

After conversion to tacrolimus ER, there was a significant decrease in dose-normalized trough (C0) (0.44 versus 0.59, P = 0.03). Statistically significant differences were seen in both total daily and weight-based doses, when reported as actual values (15 versus 10 mg and 0.16 versus 0.11 mg/kg, respectively), as well as when standardized to achieve a target tacrolimus C0 of 8 ng/mL (18.1 versus 13.6 mg and 0.17 versus 0.15 mg/kg, respectively). The median standardized dose conversion required was 1.3 [1.0, 1.4], for the overall population. There were no instances of biopsy-proven acute rejection, allograft loss, or study drug discontinuation.

Conclusions:

This single-center, open-label conversion study demonstrated that there was a statistically and clinically significant decrease in dose-normalized trough after conversion from tacrolimus IR to tacrolimus ER in an African American kidney transplant population and that a 1:1 dose conversion is unlikely to meet therapeutic goals.
Estimation of External Contamination and Exposure Rates Due to Fission Product Release
Authors: Dewji S.A. , Bales K. , Asano E. , Veinot K. , Eckerman K. , Hart S. , Finklea L. , Ansari A.
Published: January 2020

In the event of a radiological incident, the release of fission products into the surrounding environment and the ensuing external contamination present a challenge for triage assessment by emergency response personnel. Reference exposure rate and skin dose rate calibration data for emergency response personnel are currently lacking for cases where receptors are externally contaminated with fission products. Simulations were conducted to compute reference exposure rate coefficients and skin dose rate coefficients from photon-emitting fission products of radiological concern. To accomplish this task, simplified mathematical skin phantoms were created using surface area and height specifications from International Commission on Radiological Protection Publication 89. Simulations were conducted using Monte Carlo radiation transport code using newborn, 1-y-old, 5-y-old, 10-y-old, 15-y-old, and adult phantoms for 22 photon-emitting radionuclides. Exposure rate coefficient data were employed in a case study simulating the radionuclide inventory for a 17 × 17 Westinghouse pressurized water reactor, following three burn-up cycles at 14,600 MWd per metric ton of uranium. The decay times following the final cycle represent the relative activity fractions over a period of 0.5-30 d. The resulting data can be used as calibration standards for triage efforts in emergency response protocols.
Using Neuroscience to Augment Behavioral Interventions for Depression
Authors: Vinograd Meghan , Craske Michelle G.
Published: January 2020

Depression is both prevalent and costly, and many individuals do not adequately respond to existing psychopharmacological and behavioral interventions. The current article describes the use of neuroscience in augmenting behavioral interventions for depression in two primary areas: anhedonia and cognitive deficits/biases. Neuroscience research has increased our understanding of the neural bases of reward processing and regulation of positive affect, and anhedonia among depressed samples can be related to deficits in each of these domains. Treatments that specifically target reward processing and regulation of positive affect in order to reduce anhedonia represent a recent advance in the field. Depression is also associated with aberrant processes relating to working memory, autobiographical memory, attentional bias, and interpretive bias. Neuroscience findings have increasingly been leveraged to augment the efficacy of cognitive-training and bias-modification interventions in these domains. The use of neuroscience to inform the development and augmentation of behavioral interventions for depression is a promising avenue of continued research.
Outcome of Surgical Management of Glaucoma Following Complex Retinal Detachment Repair With Silicone Oil Tamponade: Drainage Implant Versus Cyclophotocoagulation
Authors: Albahlal Abdullah , Alshamrani Abdulaziz , Khandekar Rajiv , Malik Rizwan
Published: January 2020

Précis:

Glaucoma drainage devices (GDDs) are effective for the management of silicone oil-induced glaucoma. Although cyclophotocoagulation (CPC) has the advantage of shorter operative time and repeatability, it carries a higher risk of failure, blindness, and phthisis.

Background/Aims:

To compare the surgical outcome of GDD implantation and diode laser CPC in the management of refractory glaucoma following vitrectomy with silicone oil (SO) injection.

Materials and Methods:

In total, 56 eyes with refractory glaucoma after SO tamponade that underwent either CPC or GDD implantation were retrospectively evaluated. All patients underwent a complete ophthalmic examination and intraocular pressure (IOP) measurement at baseline and 1 day, 1 week, 1, 3, 6, and 12 months postoperatively. The rates of complete success and qualified success (for IOP between ≥5 and ≤21 mm Hg) were analyzed.

Results:

A total of 17 eyes underwent GDD implantation and 39 eyes underwent CPC. The preoperative IOP was 35.7±7.9 mm Hg and 27.8±8.4 mm Hg for the CPC and GDD groups, respectively (P=0.001), with a worse baseline visual acuity (P=0.01) and a higher proportion of SO-filled eyes in the CPC group (P<0.01). The IOP at 1 year postoperatively was 23.5±11.5 mm Hg and 15.3±5.9 mm Hg for the CPC and GDD group, respectively (P=0.01). Both groups achieved a reduction in IOP and number of medications at 1 year (P<0.001). The success rate in the GDD group was 94.1% (16/17), and 53.8% (21/39) in the CPC group at 12 months (P<0.005). Five eyes and 1 eye lost light perception vision in the CPC and GDD groups, respectively.

Conclusions:

GDD implantation may carry a higher surgical success rate than CPC. However, CPC retains the advantage of being technically easier and repeatable.
Utility of the Modified Isolated-check Visual Evoked Potential Technique in Functional Glaucoma Assessment
Authors: Kolomeyer Natasha N. , Drinkwater Owen J. , Drivas Eleni , Zakik Amir , Zemon Vance , Sidoti Paul A. , Tsai James C. , Panarelli Joseph F.
Published: January 2020

Précis:

Cortical response to low-contrast stimuli, as measured by isolated-check visual evoked potential (icVEP) technology, has the potential to provide functional assessment that may complement standard achromatic perimetry in assessing glaucomatous change.

Purpose:

To evaluate the utility of modified icVEP testing in detecting functional glaucomatous damage.

Materials and Methods:

Subjects who met predetermined criteria of controls, glaucoma suspects, preperimetric glaucoma, or glaucoma were enrolled in this prospective cross-sectional study from a single tertiary care center. Glaucoma patients were further categorized as early, moderate, advanced, or severe on the basis of Hodapp-Anderson-Parrish criteria. icVEP testing was performed with ten 2-second runs per qualified eye using the EvokeDx testing software. Multivariate statistics were used to calculate signal-to-noise ratios (SNR) and perform outlier analysis.

Results:

In total, 140 eyes met criteria (mean±SD; age of 63±14 y; 49% male; logMAR visual acuity, 0.11±0.089). There was no significant difference in age, sex, or logMAR visual acuity among the groups. Controls had a significantly higher SNR than all other groups (P<0.003), including patients with preperimetric glaucoma. Among those with glaucoma, the early glaucoma patients had significantly higher SNR than the moderate, advanced, or severe glaucoma cohorts (P<0.04). The optimal SNR cutoff for differentiating between glaucomatous and nonglaucomatous eyes was 0.95, both with (sensitivity 82%, specificity 76%) and without (sensitivity 82%, specificity 100%) glaucoma suspects included in analysis.

Conclusions:

icVEP technology has the potential to complement standard achromatic perimetry in functional assessment of glaucomatous defects.
First Reported Case of Postneurosurgical Ventriculoperitonitis Due to Kocuria rhizophila Following a Ventriculoperitoneal Shunt Placement
Authors: Mathy Vincent , Chousterman Benjamin , Munier Anne-Lise , Cambau Emmanuelle , Jacquier Hervé , Péan de Ponfilly Gauthier
Published: January 2020

Kocuria rhizophila, a Gram-positive coccus, is usually regarded as a contaminant. It has been described in catheter device–related infections in children, but never as being involved in central nervous system infections. We report here for the first time a case of ventriculoperitonitis due to K. rhizophila in adult, identified by MALDI-TOF mass spectrometry and 16S rRNA gene sequencing.
The relationship between presystolic wave and nondipper hypertension
Authors: Kahyaoglu Muzaffer , Bayam Emrah , Gunay Nuran , Gecmen Cetin , Candan Ozkan , Yilmaz Yusuf , Guner Ahmet , Celik Mehmet , Cakmak Ender Ozgun , Uyan Cihangir
Published: January 2020

Background

A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), and the possible mechanism for PSW is considered to be left ventricular stiffness and impaired LV compliance. We aimed to compare the relationship between PSW and dipper, nondipper hypertension.

Patients and methods

A total of 83 patients were included in the study. The participating patients were divided into two groups as 42 patients with dipper hypertension and 41 patients with nondipper hypertension based on the results of ambulatory blood pressure monitoring.

Results

Left ventricular mass index (91.6 ± 12.9 vs. 106.1 ± 7.9, P < 0.001) and E/Em (7.4 [6.6–8.3] vs. 10 [8–12], P < 0.001) were significantly higher, and Em (9.9 ± 2.7 vs. 7.9 ± 3.4, P = 0.004) was significantly lower in the nondipper group compared with dipper group. And also, the PSW was found to be higher in the nondipper group. The nondipper group had markedly increased frequencies of PSW compared with the dipper group (68 vs. 38%, respectively, P = 0.008). In the multivariate logistic regression test, E/Em [odds ratio (OR) 1.464, 95% confidence interval (CI): 1.113–1.926, P = 0.006] and the presence of PSW (OR 3.115, 95% CI: 1.061–9.143, P = 0.039) were determined as independent predictive parameters for nondipper hypertension.

Conclusion

The presence of PSW on transthoracic echocardiography suggests that we may come across nondipper hypertension and a high risk of end-organ damage. PSW may be used as a useful parameter in risk stratification in hypertensive patients.
Use of feedback on medium-term blood pressure measurement skills in medical students: a randomized controlled trial
Authors: Bastos e Castro Margareth Alves , Lucchetti Alessandra Lamas Granero , Tibiriçá Sandra Helena Cerrato , da Silva Ezequiel Oscarina , Lucchetti Giancarlo
Published: January 2020

Background

The objective of this study was to assess the effect of feedback on medium-term blood pressure (BP) measurement skills in medical students versus a control group.

Methods

A randomized controlled trial in first-year medical students was conducted. After theoretical-practical training on measuring BP, the students were randomized into a control group or intervention group. The skill was assessed immediately after the training (T1) by evaluating students with a simulated standardized patient using a checklist. Students in the intervention group received feedback immediately after assessment, whereas the control group received no feedback. After 3 months (T2), each student was reassessed in the same way as for (T1).

Results

Ninety-two first-year medical students took part in the study (45 in control group and 47 in intervention group). At T1, there were no differences in the skill measured. At T2 (after three months), there was a significant difference in the intervention group (score = 23.97 ± 3.82) compared with the control group (score = 20.91 ± 4.87), P < 0.001, d = 0.69. In the intervention group, the scores were maintained at 3 months (T1 = 23.23 and T2 = 23.97, P = 0.335), whereas in the control group, scores declined significantly (T1 = 23.44 and T2 = 20.91; P = 0.002).

Conclusion

Receiving feedback promotes retention of learning of BP measurement skills over the medium term. Further studies applying feedback to other skills should be conducted.
Clinical comparison study between a newly developed optical-based fractional flow reserve device and the conventional fractional flow reserve device
Authors: Saka Yuki , Tanaka Akihito , Ishii Hideki , Takashima Hiroaki , Suzuki Akihiro , Nakano Yusuke , Sakurai Shinichiro , Ando Hirohiko , Murohara Toyoaki , Amano Tetsuya
Published: January 2020

Background

Fractional flow reserve (FFR) measurement is the gold standard for identifying the functional severity of coronary artery disease. Although we can use newly developed pressure wires with optical fibers are now available, their safety and accuracy for FFR measurement are not clear. Therefore, we planned a clinical comparison study between pressure wires with optical fibers and the conventional FFR device.

Methods

We prospectively enrolled 51 patients (51 lesions) with intermediate coronary artery stenosis. For these lesions, FFR measurements with pressure wires with optical fibers were compared with those obtained with a conventional wire.

Results

All procedures were successfully completed without any complications. The procedure time with pressure wires with optical fibers and a conventional wire was 6.8 ± 3.0 and 6.9 ± 2.6 minutes (P = 0.89), respectively. There was no significant difference in FFR values between pressure wires with optical fibers and a conventional wire (0.83 ± 0.10 vs. 0.83 ± 0.12, P = 0.66). An excellent correlation was observed between FFR obtained with pressure wires with optical fibers and FFR obtained with a conventional wire (r = 0.81, P < 0.001). The pressure drift before and after FFR measurements was not significantly different between pressure wires with optical fibers and a convention wire (−0.01 ± 0.02 vs. −0.02 ± 0.06, P = 0.42). There was no significant difference in pressure drift defined as >0.03 or <−0.03 between pressure wires with optical fibers and a convention wire (13.7 vs. 17.6%, P = 0.79).

Conclusion

Excellent correlations were observed between FFR values measured using pressure wires with optical fibers and a conventional wire. Furthermore, measurement of FFR with pressure wires with optical fibers was as well tolerated and reliable as that with a conventional wire.
Effectiveness of vitamin D for adult patients with gingivitis
Authors: Feng Yao , Yang Dian-Song , Tang Hai-Bo , Ding Yuan-Sheng , Li Xiao-Guang
Published: January 2020

Background:

This study aims to explore the effectiveness of vitamin D for the management of adult patients with gingivitis.

Methods:

We will perform a comprehensive search from the following electronic databases: Cochrane Library, PUBMED, EMBASE, AMED, CINAHL, WANGFANG, VIP, CBM, and China National Knowledge Infrastructure. All databases will be searched from their inceptions to the present without language limitation. We will also search for unpublished data to avoid missing more potential studies. Two authors will carry out study selection, data extraction, and methodological quality evaluation, respectively. RevMan 5.3 software will be utilized for statistical analysis.

Results:

This study will summarize the up-to-date evidence about the anti-inflammatory effect of vitamin D for the management of adult patients with gingivitis through assessing modified gingival, gingival bleeding indices, inflammatory factors, plaque, quality of life, and any adverse events.

Conclusion:

This study may provide helpful evidence of vitamin D for the management of adult patients with gingivitis for clinical practice.

Systematic review registration:

PROSPERO CRD42019156561.
A case report of pulmonary thromboembolism following allergic bronchopulmonary aspergillosis
Authors: Pan Ying , Xu Feng , Ou-yang Wei
Published: January 2020

Rationale:

Allergic bronchopulmonary aspergillosis (ABPA) complicated with pulmonary thromboembolism (PTE) is rare. This report describes a patient who was diagnosed with ABPA and soon developed PTE.

Patient concerns:

A 64-year-old man was diagnosed with ABPA in hospital for recurrent fever with cough. Two months later, the patient was readmitted to the hospital because of PTE.

Diagnoses:

ABPA was diagnosed during the first hospitalization, and laboratory tests showed an increase in serum IgE and Aspergillus fumigatus-specific IgG. Sputum culture suggested A. fumigatus and high-resolution computed tomography (HRCT) showed inflammation of both lungs and central bronchiectasis. During the second hospitalization, the patient's chest angiography showed PTE.

Interventions:

The patient began treatment with antifungal drugs and corticosteroids, and was discharged from the hospital when his condition improved. Two months after discharge, the patient was treated with anticoagulant drugs due to PTE.

Outcomes:

The patient got better after taking anticoagulant drugs and was discharged from the hospital. The patient appears for regular follow-up visits in our outpatient clinic every 2 months and is currently in good condition.

Lessons:

Patients with ABPA may be concurred with PTE. The risk of PTE in ABPA should be assessed in advance and preventive strategies also need to be taken beforehand. Pulmonary artery examination is necessary once it happened.
Inappropriate antibiotic prescriptions among pediatric inpatients in different type hospitals
Authors: Miao Ruixue , Wan Chaomin , Wang Zhiling , Zhu Yu , Zhao Yun , Zhang Liling , Liu Juan , Qin Jing , Xia Jialing , Yan Huiqiong
Published: January 2020

To investigate the situation of antibiotic consumption and to assess the inappropriate use on pediatric inpatients of different types hospitals in Sichuan, China.

A cross-sectional survey of antibiotic prescriptions among hospitalized children aged 1month -14years were conducted from April 2018 to June 2018 in southwestern China. Antibiotic prescriptions were extracted from electronic records during hospitalization of each inpatient in five different types hospitals.

In this study, the antibiotic prescription rate of hospitalized children was 66.9% (1176/1758). Compared with tertiary children hospital (TC) (46.1%), general hospitals and non-tertiary children hospitals has higher rate of antibiotic prescription (almost 85%) (P 
< .001). 93.4% of inpatients received parenteral antibiotic. Overall, the most common antibiotics were Cefoperazone and enzyme inhibitor, Cefixime and Azithromycin. Lower respiratory tract infection (LRTI) was the leading reason for antibiotic consumption in pediatric wards (56.8%), followed by upper respiratory tract infection (URTI) (22.2%). For children with LRTI, Cephalosporins were heavy prescribed, especially broad-spectrum third-generation Cephalosporins (60.3%). The antibiotic prescription proportion of URTI in general hospitals and non-tertiary children hospitals (more than 18%) was higher than TC (8.1%) (P 
< .001).

There was inappropriate use of antibiotic in hospitalized children including overuse of parenteral administration, overprescribing of antibiotic on URTI and misuse of third-generation Cephalosporins in pediatric inpatients with LRTI. Compared with tertiary freestanding children hospital, the irrational antibiotic prescription of general hospitals and non-tertiary children hospitals were more serious. Management strategy should be implementer on quality improvement of antibiotic use.
The relationship between low serum magnesium level and intracerebral hemorrhage hematoma expansion
Authors: Zhu Rending , He Xiaolu , Du Yanqun , Chen Nan , Wang Wei , Sun Yue , Sun Jian , Liu Wanjun , Wang Xun , Fang Chuanqin
Published: January 2020

Background:

Hematoma expansion (HE) is related to clinical deterioration and unfavorable prognosis in intracerebral hemorrhage (ICH). Some studies have revealed that low serum magnesium level is associated with larger hematoma volume at admission, HE, and unfavorable outcomes. However, the conclusions remain unsettled. The purpose of this study is to evaluate the association between low serum magnesium level and HE by meta-analysis.

Methods:

We will search the following electronic bibliographic databases: PubMed, Medline, Embase, Web of Science, and The Cochrane Library. Studies will be included if they reported a relationship of low serum magnesium level and HE, mortality or poor outcome.

Results:

The results of this study will be submitted to a peer-reviewed journal for publication.

Conclusion:

This will be the first systematic review and meta-analysis to evaluate the association of HE following ICH with Hypomagnesemia. We look forward to the results will offer scientific proof to predict HE for ICH patients with low serum magnesium level.

PROSPERO registration number:

This protocol has been registered in the PROSPERO network with number: CRD42019135995.
Warfarin prevented de novo portal vein thrombosis after transjugular intrahepatic portosystemic shunt
Authors: Zhang Linhao , Huan Hui , Tong Huan , Wei Bo , Wang Zhidong , Liu Chao , Wu Hao
Published: January 2020

Portal vein thrombosis (PVT) might impair the prognosis of cirrhotic patients. However, formation of de novo PVT after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients without preexisting PVT was rarely reported. Moreover, it is not known whether warfarin is efficient in preventing de novo PVT after TIPS. The current study aimed to investigate retrospectively the incidence and location of de novo PVT, and preventive effects of warfarin on de novo PVT after TIPS for cirrhotic patients. Patients who received TIPS placement between March 1, 2015 and March 1, 2016 in our hospital were screened retrospectively. Patients without preexisting PVT before TIPS and those who were followed up for at least 12 months were included. There were 2 groups: 1 group received warfarin (warfarin group) post-TIPS, while another group (control group) did not receive prophylactic drug to prevent PVT. Their baseline characteristics and follow-up data were retrieved. The occurrence of PVT, adverse events due to warfarin, difference in stent patency and clinical complications such as stent dysfunction, hepatic encephalopathy, mortality, liver cancer, variceal bleeding, infection, and liver failure, and results of follow-up biochemical examination were compared. Eighty-three patients without preexisting PVT were included. There were 56 patients in the control group and 27 in the warfarin group. The incidence of PVT in the warfarin group was 14.8% (4/27), whereas the incidence in the control group was 42.9% (24/56, P = .013). The location of de novo PVT was mainly at left portal vein. Adverse events due to warfarin was mostly mild, such as hemorrhinia and gingival hemorrhage. No significant difference regarding to stent patency and clinical complications between the 2 groups was found. At 24-month after-TIPS, for the remaining patients in both groups, the total bilirubin was significantly increased while the red blood cell count was significantly decreased in control group compared with those in warfarin group (P < .05). PVT could commonly occur after TIPS in patients without preexisting PVT. Warfarin could prevent PVT in these patients, and might improve patient's liver function.
Dementia screening for elderly in-patients and its association with nursing care satisfaction-an observational study
Authors: Huang Li-Kai , Tsai Jui-Chen , Lee Hsun-Hua , Kuan Yi-Chun , Lee Yao-Tung , Lin Chia-Pei , Chao Shu-Ping , Hu Chaur-Jong
Published: January 2020

Inappropriate care for patients with cognitive dysfunction in the hospital could worsen quality of care and medical service satisfaction.

All elderly participants were recruited from acute wards of 5 departments in an university hospital. They were administered the Chinese version of Ascertain Dementia 8 (AD8) at admission and the Nursing Service Satisfaction Questionnaire before discharge.

A total of 345 participants completed the study. There were 91 (26.4%) participants with AD8 ≥ 2, the cut-off value of high risk of dementia. The prevalence was much higher than prior community-based reports. The Nursing Service Satisfaction Score was significantly lower in AD8 ≥ 2 than in AD8 < 2 (56.99 ± 0.94 vs 60.55 ± 0.48, P < .01).

Using AD8 in hospital-based screening might be more efficient than in the community in terms of cost-effectiveness due to higher positive rate and easier approach to diagnostic facilities. AD8 ≥ 2 is also an indicator to identify care dissatisfaction among inpatients. By identifying patients with cognitive dysfunction, such as its related communication barriers, care systems could be tailored for more friendly services.