bluuebunny/crossref_metadata_2025 huggingface dataset:
Parkinson’s Disease and Parkinsonian Tremor
Authors: Dirkx Michiel F. , Helmich Rick C.
Published: August 2022

Tremor is a common symptom of hypokinetic-rigid syndromes such as Parkinson disease. The classical tremor of Parkinson disease is an asymmetric pill-rolling resting tremor of the arms, but postural tremor (including re-emergent and pure postural tremor) and kinetic tremor are also very common. Tremor in atypical parkinsonism is often a symmetric postural tremor that can be jerkier in nature. The pathophysiology of rest tremor in Parkinson disease involves abnormal activity within both the basal ganglia and a cerebello-thalamo-cortical motor circuit, driven by altered dopaminergic, noradrenergic, and serotonergic projections arising from the midbrain. The dopaminergic basis of Parkinson’s tremor differs markedly between individuals and between clinical tremor phenotypes. Dopaminergic treatment (levodopa and dopamine agonists) is the first-choice treatment for rest and re-emergent tremor in Parkinson disease, and probably also rest tremor in atypical parkinsonism. Other pharmacological options include anticholinergics, beta-blockers, or even clozapine, although evidence for these treatment strategies is limited. Additionally, stereotactic surgery including focal lesioning and deep brain stimulation of both basal ganglia (GPi and STN) and thalamus (ventral intermediate nucleus, VIM) are effective treatments for most types of tremor in Parkinson disease.
Myoclonus
Authors: Merchant Shabbir , Hallett Mark
Published: August 2022

Myoclonus and tremor are two distinct categories of hyperkinetic movement disorders with distinctive neurophysiologic characteristics, which can sometimes have overlapping clinical features. In this chapter we describe two such overlap clinical syndromes, namely “cortical tremor” and “palatal tremor.” Cortical tremor is clinically characterized by tremulous movements mainly involving fingers and hands, whereas palatal tremor is characterized by repetitive jerk-like movements of the palatal muscles. On the other hand, the physiologic and pathophysiologic characteristics of cortical and palatal tremor are most consistent with those of cortical and brainstem myoclonus, respectively. Cortical tremor and palatal tremors can thus best be characterized as repetitive myoclonus of cortical and brainstem origin based on objective electrophysiology; however, by virtue of their arrhythmic or semi-rhythmic clinical phenomenology, they are characterized as tremors.
Bulimia nervosa
Authors: McNaught Elizabeth , Treasure Janet , Pollard Nick
Published: August 2022

This chapter begins by covering the epidemiology of the bulimia nervosa (BN), and details the biological, psychological, and socio-cultural risk factors. The presentation of the condition is examined, including clinical features and methods for taking a history. Differential diagnosis is outlined, and physical examination and laboratory investigations are explained. Diagnostic criteria are then given. The chapter then moves on to the neurobiological changes associated with BN, and an overview of treatments, both psychological and pharmaceutical. Complications, comorbidities are then outlined, and finally prognosis is discussed.
Other specified feeding or eating disorder (OSFED)
Authors: McNaught Elizabeth , Treasure Janet , Pollard Nick
Published: August 2022

Other specified feeding or eating disorder (OSFED) was introduced in 2013 to replace eating disorder not otherwise specified (EDNOS). All the subset disorders are eating pathologies that have a significant impact on the patient’s function and/or cause significant distress, but do not fulfil the diagnostic criteria of another eating disorder. This chapter covers atypical anorexia nervosa, bulimia nervosa of low frequency and/or limited duration, binge eating disorder of low frequency and/or limited duration, purging disorder, and night eating syndrome.
Ethical and legal aspects
Authors: McNaught Elizabeth , Treasure Janet , Pollard Nick
Published: August 2022

There are several ethical and legal aspects in the treatment of eating disorders, including confidentiality and the mental capacity act and associated potential deprivation of liberty. The chapter goes on to discuss the Mental Health Act (MHA) and conditions for sectioning and mental health tribunals, and nasogastric feeding under restraint.
Social epidemiology
Authors: Craig Tom J.
Published: August 2022

Social epidemiology is a branch of epidemiology that explores how variation in the prevalence and incidence of disease is determined by social factors such as poverty, income inequality, and social capital. This information is useful for planning the delivery of health care and for identifying potential targets for prevention. This chapter examines features of design and measurement in the and discusses key findings in relation to common mental disorders and psychosis. A final section explores how these findings are already informing preventive interventions.
Culture and mental illness
Authors: Watson Cameron , Wijesuriya Rajiv , Bhugra Dinesh
Published: August 2022

Cultures are an integral part of a person’s life and influence an individual’s social and cognitive development. They can thus contribute to the onset, perpetuation, and outcomes of many psychiatric illnesses. These have a major role in defining abnormal behaviours and deviance, but cultures can also heavily influence pathways to care by influencing explanatory models and resources. In addition, culture moulds an individual’s worldview. Cultures are incipient, with institutions of education, employment, and training having their own microcultures. Individuals learn to navigate these multiple cultural and microidentities in order to achieve their aims. The relationship between the culture and prevalence of various psychiatric disorders is quite complex. Hence, it is important to recognize that cultures have relativist characteristics rather than universalist, although some features may be common in designing, developing, and delivering services. The role of culture in mental illness is described in this chapter.
Culture and identity
Authors: Berry John W.
Published: August 2022

For individual humans, identity is an important aspect of their being. Identity has various components, including both social attributes and personal attributes. Social attributes include gender, class, and ethnicity; personal attributes include age, personality, and other abilities. Social identity has three features: centrality, ingroup affect, and ingroup ties. The distinction between ingroups and outgroups can be particularly important for those who are migrants, refugees, and other minority groups. Identity can be cultural, religious, and place. Identity can also be bicultural or multicultural, and may be integrated. The relationship between identity, acculturation, and well-being is important, and data from studies are reported in this chapter. A knowledge and understanding of individual identities can be used to promote higher levels of well-being.
Globalization and social psychiatry
Authors: Bhavsar Vishal
Published: August 2022

Epistemological challenges in understanding the impact of globalization on mental health are reviewed, including in conceptualization and attribution. Something about globalization is inherently social and informs and influences social determinants of mental health as they are currently understood. The literature on globalization provides an important and often overlooked context to conversations within psychiatry on training, practice, and policy. In clinical encounters, phenomenological approaches that raise a conversation with local expressions of modernity and its impact can be helpful for understanding how patients present and how they experience healing. An awareness of the increasingly complex, multilayered and porous boundaries that people experience can help to contextualize global mental health movements, and to broaden the scope and horizon of social psychiatry, which remains ‘national’ in focus.
Gender
Authors: Zanca Federico , Caporusso Edoardo , Giordano Giulia Maria , Galderisi Silvana
Published: August 2022

Recently, the interest in gender differences in mental disorders has increased dramatically, both in research and clinical settings. Gender has been defined as a result of socially constructed ideas about the behaviour, actions, and roles that a subject performs. These features contribute to the heterogeneity between women and men in the areas of epidemiology, clinical presentation, functional outcome, and biological features of mental disorders. In this chapter, we summarize the literature regarding gender differences in psychiatric conditions, focusing on epidemiological and clinical aspects, as well as offering a perspective on biological features, that could contribute to determining such differences. Major depressive disorder, anxiety- and trauma-related disorders, borderline personality disorder, obsessive–compulsive disorder, and eating disorders are more frequently diagnosed in women than in men, while antisocial personality disorder, alcohol use, substance use, and conduct disorders are more frequent in men. Overall, women, as compared with men, show a more severe clinical presentation, more comorbidities with other psychiatric conditions, and a higher frequency of an ‘internalizing’ pattern. Men more often present an ‘externalizing’ pattern and comorbidity with substance use and conduct disorders. Genetic studies and magnetic resonance studies suggest gender differences in reaction to stress, which could partially explain the different gender-related features of psychiatric conditions. Despite the presence of an extensive literature, further work is needed in order to achieve an overall vision that integrates social and neurobiological aspects of gender with epidemiological and clinical features, as well as to implement the non-binary concept of gender that is absent in the available literature.
Discrimination and stigma
Authors: Pathare Soumitra , Kapoor Arjun
Published: August 2022

Discrimination and stigma operate as two distinct but concomitant phenomena and, as a result, affect attitudes, behaviours, and policies against underprivileged populations and often those with mental illnesses. Stigma has been defined as the ‘social devaluation’ of an individual or group. This is based on certain characteristics that such an individual or group is identified with and is an outcome of cognitive processes and negative attitudes that lead to rejecting behaviours at physical, social, or psychological levels. Stigma arises from the implicit belief and bias (conscious or unconscious) that individuals with certain undesired characteristics are inferior and therefore unworthy of equal treatment, respect, and dignity. Discrimination entails a range of behaviours, practices, laws, or policies that result in the marginalization of certain individuals or groups in society. It may manifest as unequal treatment, human rights violations, and social exclusion. Discrimination often can be tackled in law; therefore, it is important to understand the role of laws and policies in addressing discrimination. Persons with psychosocial disability are often discriminated against, do not have equal rights, and, in many countries, cannot marry, vote, make a will, or have employment rights. Preventing discrimination requires a range of anti-discrimination laws, policies, and decisions that address specific disadvantages and harms caused to such individuals. This needs a fundamental transformation of existing social structures and the removal of barriers to ensure that people with mental illnesses and consequent psychosocial disabilities have equal rights.
Unemployment and work
Authors: Boardman Jed , Craig Tom J.
Published: August 2022

Work and unemployment play key roles in the health and well-being of individuals and societies. The relational component of work and its susceptibility to wider social, political, and economic forces make it an important focus for social psychiatry. This chapter examines the importance of work for peoples’ mental health and the damaging effects of worklessness. Not all work is health promoting and there is clear evidence for the detrimental effects of poor-quality work environments and precarious employment. Unemployment and poor working environments are not equally distributed across socio-economic groups and contribute to health inequalities. People with mental health conditions, particularly long-term conditions, are disadvantaged in the labour market. Mental health conditions are costly, not only to individuals, but also to the workplace and the economy. Solutions to breaking these unhealthy links are examined from a public health perspective, along with the introduction of evidence-based vocational rehabilitation.
Social media
Authors: Hariman Keith
Published: August 2022

Social media, which includes social networking sites such as Facebook and Twitter, and other websites, including YouTube and Pinterest, are used by more than a quarter of the global population. While some social media platforms aim to connect users or provide entertainment to viewers, there has been a plethora of research on social media and its association with mental illnesses. This chapter will outline how social media may have an effect on certain mental conditions, including affective disorders, self-harm and suicide, addiction, and attention deficit–hyperactivity disorder. Given the potential to reach a wide audience, the chapter will further describe how clinicians can make use of social media for the provision of information and research. The caveats of using social media and maintaining an online presence will also be discussed.
Urbanization as the new framework for psychiatry
Authors: Krausz Reinhard M. , Kianpoor Kiana , Jang Kerry , Vigo Daniel
Published: August 2022

Since 2008, the majority of the global population has been living in metropolitan areas, and the United Nations (UN) predicts that urban areas will account for 64% of the population by 2050. The UN also expects that all population growth up to 2030 will happen in the metropolitan areas with over 15 million inhabitants, especially in Asia and Africa. This polarization of societies is causing a paradigm shift for the rules and social framework for health care and social services to deal with the impact on social development and the way services—especially health care—will be organized. For vulnerable urban populations, the risk of serious mental illness such as psychosis will increase owing to increased stress from living in a more crowded and growing urban environment. Environmental concerns, social frameworks, and housing will be an enormous challenge for the mega-cities of tomorrow. How can psychiatry prepare itself to meet these challenges and its appropriate role of the future?
Social capital
Authors: Rotenberg Martin , McKenzie Kwame
Published: August 2022

Social capital is a theory that attempts to describe societal factors that shape the quality and quantity of our existence. It provides a way of thinking and naming societal forces which impact upon health. Social capital is relevant to social psychiatry because it provides a way to understand complex social processes that affect mental health and illnesses. This chapter discusses whether social capital can prevent or cause mental illness, and what types of social capital have impacts on the rates of mental illness. There have been a number of broad reviews of social capital and mental illness, and more specific reviews, including a focus on the impact of social capital interventions. Although it has been concluded that there is an association between some types of social capital and a lower risk of mental health problems, this conclusion is limited by the quality of the literature and strength of the associations.
Schizophrenia
Authors: Keshavan Matcheri S. , Padmanabhan Jaya
Published: August 2022

Schizophrenia is a highly disabling, common, complex, and severe psychiatric disorder characterized by impairments in cognition, thinking, perception, emotions, sense of self, social function, and behaviour. Schizophrenia affects as many as 24 million people worldwide. Several decades of research have established that schizophrenia likely results from a complex interplay of genetic and environmental risk factors, and their interaction. Schizophrenia is a neurodevelopmental disorder with possible derailments both in early development, as well as in brain maturation around adolescence involving synaptic refinements. The pathophysiology of schizophrenia involves dopaminergic and other neurotransmitter aberrations, notably in glutamatergic neurons. Widespread alterations are seen in brain circuits that underlie cognition, affect, and behaviour. Despite the progress in our understanding of this illness, treatments remain symptomatic. While dopamine-blocking drugs are still the mainstay of pharmacological treatment, individual and family psychosocial interventions are critically important.
Mental illness in prisoners
Authors: Ryland Howard
Published: August 2022

There are over 10 million people in prison worldwide at any one time. Rates of mental illness are higher in prison than in the community. There is overlap between the social determinants of incarceration and the aetiology of certain mental disorders. Prisons can be stressful places and this can contribute to the precipitation or exacerbation of mental illness. Suicide and self-harm are serious concerns, which prison authorities should act to prevent. Effective treatments are available, but services for prisoners with mental illness vary considerably. The services that are offered are often inadequate to meet the level of need. Particular groups of prisoners, such as women and older people, have specific mental health needs that should be considered. International guidelines set out basic minimum standards of care and treatment that all prisoners should benefit from.
Mental illness in the family: The view of a family member
Authors: Männikkö Miia , Helin Mari
Published: August 2022

When an individual is distressed and develops symptoms or illness, often it is the family that is involved in informal care. However, the role of the family is often misunderstood and expectations of their role on the part of professionals can be unrealistic. This chapter describes the process related to both the emotional and cognitive needs of a family member as a carer. This can be seen at three different stages: before, during, and after diagnosis. Mental illness changes the thinking, emotions, and actions the affected individual, and is equally likely to affect the interactional and emotional relationships between them and their carers and family members. Mental health and community-based training for the general public and awareness-raising campaigns can increase the chances of family members identifying mental illness at an earlier stage, thereby reducing severity and improving outcomes.
Social interventions in common mental disorders
Authors: Kelly Brendan D.
Published: August 2022

Social environments have a decisive influence on both the global distribution of mental illness and the treatments provided. As a result, social factors need to be considered when planning any form of mental health care: all psychiatry is social. This position is consistent with the fundamental ideas of biopsychosocial psychiatry, which accord great importance to social interventions as part of a comprehensive treatment package for all mental illness. Common mental disorders such as depression and anxiety disorders are widely distributed, exert an enormous burden on populations, and urgently require treatments in all modalities: biological, psychological, and social. There are now growing evidence bases to support the use of psychosocial interventions such as social support, group interventions, psychoeducation, online therapies, family therapy, and bibliotherapy in depression and anxiety. Suicide is also a highly socially patterned phenomenon, and the greatest evidence for suicide prevention relates to interventions at group level, community level or population level that limit access to lethal means (e.g. erecting barriers at potential suicide spots, restricting paracetamol pack sizes, and restricting access to guns). Other measures include removing ligature points in psychiatric hospitals and prisons, early intervention in psychosis, and, possibly, raising more general awareness about suicide. Given the lengthy delays in biological and neuroscientific research delivering new treatments, it is likely that population-level interventions, changes in mental health policies, legislative reforms, and psychosocial treatments hold the most immediate prospects for better care for most mental disorders, including depression and anxiety, over the coming years.
Recovery and the mental health system
Authors: Hare-Duke Laurie , Ng Fiona , Slade Mike
Published: August 2022

The concept of recovery, especially related to serious mental illnesses, is of great significance and relevance in rehabilitation processes. The concept itself emerged from two somewhat distinct bodies of knowledge, which have subsequently become known as clinical recovery and personal recovery. Clinical recovery involves permanent remission (i.e. getting back to normal), whereas personal recovery is living as well as possible, irrespective of the presence of symptoms. Personal and clinical recovery are related but distinct. The human rights of people with severe mental illnesses need proper recognition. Peer support among other models can help recovery. A diverse set of approaches is needed to promote personal recovery. This chapter describes various strategies to improve mental health services in order to deliver recovery both at personal and clinical levels. Recovery-based interventions can be successful in housing and employment. Educational approaches to mental health care can help to promote human rights of individuals with mental illnesses.
Mental health in Africa
Authors: Ndetei David , Mutiso Victoria , Musyimi Christine , Alietsi Rita , Kameti Frida
Published: August 2022

On average, the mental health treatment gap in low- and middle-income countries (LMICs) is 80% versus 35% in high-income countries. This disparity can be accounted for by several factors found in LMICs, including unresponsive health systems, poor human and financial resources, inadequate supply of many medications, stigma, poor awareness, an inadequate legislative framework, and misconceptions and cultural beliefs about mental illness. Africa, and other LMICs, have to develop socioculturally and economically appropriate and sustainable innovations if they are to significantly reduce the treatment gap and move towards mental health for all. These include dialogue that involves all, to determine their own context-appropriate priorities; comprehensive documentation and maximum utilization of all existing community resources; context-appropriate use of technology for critical reach; a multidisciplinary stakeholder approach that goes beyond mental health specialists; global partnerships to discuss on experiences and best practices.
Cornea and conjunctiva
Authors: Kim Soyang Ella , Tuft Stephen
Published: August 2022

This chapter focuses on the cornea and conjunctiva. It first discusses corneal anatomy and physiology, corneal nutrition, and conjunctival anatomy and physiology. Next, it outlines history taking for anterior segment disease. It then discusses clinical knowledge areas, including blepharitis, staphylococcal hypersensitivity disorders, dry eye disease, conjunctivitis, cicatrizing conjunctival disease, conjunctival degeneration, conjunctival neoplasia, corneal degeneration, infectious keratitis (bacterial, fungal, and viral), interstitial keratitis, peripheral ulcerative keratitis, metabolic and drug-induced keratopathies, corneal dystrophies, contact lenses, corneal ectasia, keratoplasty, anterior uveal tumours, anterior segment trauma, chemical injury, and refractive surgery. Practical skills, such as the removal of a corneal foreign body, and corneal sutures, are also discussed.
Refractive surgery
Authors: Laginaf Masara , Barsam Allon
Published: August 2022

In a perfect optical system, a point source of light is focused onto a single point on the image plane; in the eye, light is focused on the retina. Optical aberrations are caused by imaging system imperfections which cause deviations in the transmission of light, preventing the convergence of light to a single point of focus. In recent years an increased understanding of higher-order wavefront aberrations has allowed improvements in both the measurement and treatment of refractive error. This chapter discusses refractive surgery. It details refractive error, aberrations, and presbyopia, along with preoperative evaluation for refractive surgery, laser refractive surgery, other corneal refractive procedures, refractive lens surgery, intraocular lenses, phakic intraocular lenses, and presbyopia correction.
Vitreoretinal surgery
Authors: Mehat Manjit , Bainbridge James
Published: August 2022

This chapter explores vitreoretinal surgery. It starts off with a detailed examination of retinal anatomy, including a discussion of retinal embryology, and then discusses the physiology of the retina. Next, it outlines the clinical skills of posterior segment history taking and examination. It then discusses the use of diagnostic lenses, which enable visualization of the fundus by neutralizing the optical power of the eye (direct lenses) or increasing the refractive power of the eye to create an inverted real image of the fundus anterior to the eye (indirect lenses). It continues with a discussion of the practical skills of optical coherence tomography, ultrasonography, and retinal photocoagulation. The chapter also outlines clinical knowledge areas of vitreous disorders, retinal detachment, peripheral retinal abnormalities, macular surgery, submacular surgery, retinal tumours, choroidal tumours, vitreoretinopathies, and posterior segment trauma.
Microsurgical skills
Authors: Barnett Victoria , Sullivan Paul
Published: August 2022

Safe ophthalmic surgery requires the surgeon to have the ability to select the best instruments for a particular task, knowledge of the most effective way of using each instrument, and knowledge of the limitations and side effects of the use of each instrument. This chapter focuses on microsurgical skills. It begins with an introduction to the use of forceps and the way they are used to grasp tissues. It then goes on to discuss toothed forceps, sutures, suturing tissues, and tying a surgeon’s knot. The chapter also presents a number of surgical scenarios, such as suturing a leaking corneal wound, suturing skin during a lateral tarsal strip operation, repairing full-thickness corneal lacerations, and repairing scleral lacerations. It concludes with a discussion of the World Health Organization Surgical Safety Checklist and its impact on patient safety.
The physical origin for spatially large scatter of IGM opacity at the end of reionization: The IGM Lyα opacity-galaxy density relation
Authors: Ishimoto Rikako , Kashikawa Nobunari , Kashino Daichi , Ito Kei , Liang Yongming , Cai Zheng , Yoshioka Takehiro , Okoshi Katsuya , Misawa Toru , Onoue Masafusa , Takeda Yoshihiro , Uchiyama Hisakazu
Published: August 2022

The large opacity fluctuations in the z > 5.5 Lyα forest may indicate inhomogeneous progress of reionization. To explain the observed large scatter of the effective Lyα optical depth (τeff) of the intergalactic medium (IGM), fluctuation of UV background (Γ model), or the IGM gas temperature (T model) have been proposed, which predict opposite correlations between τeff and galaxy density. In order to address which model can explain the large scatter of τeff, we search for Lyα emitters (LAEs) around two (J1137+3549 and J1602+4228) quasar sightlines with τeff ∼ 3 and J1630+4012 sightline with τeff ∼ 5.5. Using a narrow-band imaging with Subaru/Hyper Suprime-Cam, we draw LAE density maps to explore their spatial distributions. Overdensities are found within 20 h−1 Mpc of the quasar sightlines in the low-τeff regions, while a deficit of LAEs is found in the high τeff region. Although the τeff of the three quasar sightlines are neither high nor low enough to clearly distinguish the two models, these observed τeff-galaxy density relations all consistently support the Γ model rather than the T model in the three fields, along with the previous studies. The observed overdensities near the low-τeff sightlines may suggest that the relic temperature fluctuation does not affect reionization that much. Otherwise, these overdensities could be attributed to other factors besides the reionization process, such as the nature of LAEs as poor tracers of underlying large-scale structures.
Surge in Incidence and Coronavirus Disease 2019 Hospital Risk of Death, United States, September 2020 to March 2021
Authors: Patel Bela , Murphy Robert E , Karanth Siddharth , Shiffaraw Salsawit , Peters Richard M , Hohmann Samuel F , Greenberg Raymond S
Published: August 2022

Background

Studies of the early months of the coronavirus disease 2019 (COVID-19) pandemic indicate that patient outcomes may be adversely affected by surges. However, the impact on in-hospital mortality during the largest surge to date, September 2020–March 2021, has not been studied. This study aimed to determine whether in-hospital mortality was impacted by the community surge of COVID-19.

Methods

This is a retrospective cohort study of 416 962 adult COVID-19 patients admitted immediately before or during the surge at 229 US academic and 432 community hospitals in the Vizient Clinical Database. The odds ratios (ORs) of death among hospitalized patients during each phase of the surge was compared with the corresponding odds before the surge and adjusted for demographic, comorbidity, hospital characteristic, length of stay, and complication variables.

Results

The unadjusted proportion of deaths among discharged patients was 9% in both the presurge and rising surge stages but rose to 12% during both the peak and declining surge intervals. With the presurge phase defined as the referent, the risk-adjusted ORs (aORs) for the surge periods were rising, 1.14 (1.10–1.19), peak 1.37 (1.32–1.43), and declining, 1.30 (1.25–1.35). The surge rise in-hospital mortality was present in 7 of 9 geographic divisions and greater for community hospitals than for academic centers.

Conclusions

These data support public policies aimed at containing pandemic surges and supporting healthcare delivery during surges.
SARS-CoV-2 Vaccine Efficacy in Patients with Hematologic Malignancies: Practical Points for Further Research
Authors: Guven Deniz C , Sahin Taha K , Akın Serkan , Uckun Fatih M
Published: August 2022

This letter to the editor responds to comments on a recently published article on seroconversion rates after COVID-19 vaccination.
Long after “People before Highways”: Social Movements and Expert Activism in Greater Boston, 1960–2016
Authors: Porcelli Apollonya Maria , Frickel Scott , Niznik Aaron
Published: August 2022

The study investigates the way local social movements respond to structural transformations in city politics. Drawing from archival research, published scholarship, and 51 in-depth interviews, we characterize the mobilization of experts into social movements in Greater Boston since the 1960s as a long-term shift from “protecting places” to “providing services.” Consonant with a shift from centralized to decentralized municipal government, we show how an initially unified resistance to urban renewal morphed into two diverging and opposing movements. One focused on housing affordability and relied on market-driven tactics; the other sought to enhance the “production of nature” through grassroots community organizing. These findings support two contributions to the scholarship on expert activism by showing that: (1) social movement organizations (SMOs) respond to structural shifts epistemologically, as well as organizationally; and (2) expert activism can alter the conditions and context of knowledge production in neighborhoods and the movements that rise in their defense.
Retained energy in lactating beef cows; effects on maintenance energy requirement and voluntary feed intake
Authors: Briggs Emma A , Holder Amanda L , Gross Megan A , Moehlenpah Alexandra N , Taylor Jared D , Reuter R R , Foote Andrew P , Goad Carla L , Lalman David L
Published: August 2022

The objectives of these experiments were to determine the relationship between maintenance requirements and energy partitioned to maternal tissue or milk production in limit-fed Angus cows and to determine the relationship between retained energy during the lactation period to dry-period voluntary forage intake (VDMI). Twenty-four mature fall-calving Angus cows were used in a 79-d study during late lactation to establish daily metabolizable energy required for maintenance (MEm). Cows were individually fed daily a mixed diet (2.62 Mcal MEl/kg, 18.2% crude protein) to meet energy and protein requirements of 505 kg beef cows producing 8.2 kg milk daily. If cow BW changed by ±9 kg from initial BW, daily feed intake was adjusted to slow BW loss or reduce BW gain. Milk yield and composition were determined on 3 occasions throughout the study. Maintenance was computed as metabolizable energy intake minus retained energy assigned to average daily maternal tissue energy change, average daily milk energy yield, and average daily energy required for pregnancy. After calves were weaned, cows were fed a low-quality grass hay diet (8.2% crude protein, 65% NDF) and VDMI was measured for 21 days. Lactation maintenance energy was 83% the default value recommended by NASEM (2016. Nutrient Requirements of Beef Cattle: Eighth Revised Edition.) for lactating Angus cows. Increasing lactation-period retained energy (decreasing BW loss and increasing milk energy yield) was associated with lower maintenance energy requirements (P < 0.01; R2 = 0.92). Increased residual daily gain during lactation was associated with lower lactation maintenance energy requirements (P = 0.05; R2 = 0.17). Post-weaning VDMI was not related to late-lactation milk energy production, although sensitive to lactation period BCS and BW loss. These results contradict previous reports, suggesting that maintenance requirements increase with increasing milk yield.
Behavioral economic methods predict future COVID-19 vaccination
Authors: Strickland Justin C , Reed Derek D , Dayton Lauren , Johnson Matthew W , Latkin Carl , Schwartz Lindsay P , Hursh Steven R
Published: August 2022

Increasing vaccine utilization is critical for numerous diseases, including COVID-19, necessitating novel methods to forecast uptake. Behavioral economic methods have been developed as rapid, scalable means of identifying mechanisms of health behavior engagement. However, most research using these procedures is cross-sectional and evaluates prediction of behaviors with already well-established repertories. Evaluation of the validity of hypothetical tasks that measure behaviors not yet experienced is important for the use of these procedures in behavioral health. We use vaccination during the COVID-19 pandemic to test whether responses regarding a novel, hypothetical behavior (COVID-19 vaccination) are predictive of later real-world response. Participants (N = 333) completed a behavioral economic hypothetical purchase task to evaluate willingness to receive a hypothetical COVID-19 vaccine based on efficacy. This was completed in August 2020, before clinical trial data on COVID-19 vaccines. Participants completed follow-up assessments approximately 1 year later when the COVID-19 vaccines were widely available in June 2021 and November 2021 with vaccination status measured. Prediction of vaccination was made based on data collected in August 2020. Vaccine demand was a significant predictor of vaccination after controlling for other significant predictors including political orientation, delay discounting, history of flu vaccination, and a single-item intent to vaccinate. These findings show predictive validity of a behavioral economic procedure explicitly designed to measure a behavior for which a participant has limited-to-no direct prior experience or exposure. Positive correspondence supports the validity of these hypothetical arrangements for predicting vaccination utilization and advances behavioral economic methods.
Involvement of the intrinsic functional network of the red nucleus in complex behavioral processing
Authors: Sung Yul-Wan , Kiyama Sachiko , Choi Uk-Su , Ogawa Seiji
Published: August 2022

Previous studies suggested the possibility that the red nucleus (RN) is involved in other cognitive functions than motion per se, even though such functions have yet to be clarified. We investigated the activation of RN during several tasks and its intrinsic functional network associated with social cognition and musical practice. The tasks included finger tapping, n-back, and memory recall tasks. Region of interest for RN was identified through those tasks, anatomical information of RN, and a brain atlas. The intrinsic functional network was identified for RN by an analysis of connectivity between RN and other regions typically involved in seven known resting state functional networks with RN used as the seed region. Association of the RN network with a psychological trait of the interpersonal reactivity index and musical training years revealed subnetworks that included empathy related regions or music practice related regions. These social or highly coordinated motor activity represent the most complex functions ever known to involve the RN, adding further evidence for the multifunctional roles of RN. These discoveries may lead to a new direction of investigations to clarify probable novel roles for RN in high-level human behavior.
Injury severity analysis of electric bike crashes in Changsha, Hunan Province: taking different lighting conditions into consideration
Authors: Hu Lin , Wu Xiaotong , Hu Xinting , Wang Fang , Wu Ning
Published: August 2022

With the increasing use of electric bikes, electric bike crashes occur frequently. Analysing the influencing factors of electric bike crashes is an effective way to reduce mortality and improve road safety. In this paper, spatial analysis is performed by geographic information system (GIS) to present the hot spots of electric bike crashes during daylight and darkness in Changsha, Hunan Province, China. Based on the Ordered Probit (OP) model, we studied the risk factors that led to different severities of electric bike crashes. The results show that the main influencing variables include age, illegal behaviour, collision type and road factors. During daylight and darkness, elderly electric bike riders over the age of 65 years have a higher probability of fatal crashes. Not following traffic signals and reverse driving are significantly related to the severity of riders' injuries. In darkness, frontal collisions are significant factors causing rider injury. In daylight, more serious crashes will be caused in bend and slope road segments. In darkness, roads with no physically separated bicycle lanes increases the risk of riders being injured. Electric bike crashes are mainly concentrated in the commercial, public service and residential areas in the main urban area. In suburbs at darkness, electric bike riders are more likely to be seriously injured. Adding protection measures, such as improved lighting, non-motorized lane facilities and interventions targeting illegal behaviour in the hot spot areas can effectively reduce the number of electric bike crashes in complex traffic.
A threat from both sides: Multiple introductions of genetically distinct H5 HPAI viruses into Canada via both East Asia-Australasia/Pacific and Atlantic flyways
Authors: Alkie Tamiru N , Lopes Sara , Hisanaga Tamiko , Xu Wanhong , Suderman Matthew , Koziuk Janice , Fisher Mathew , Redford Tony , Lung Oliver , Joseph Tomy , Himsworth Chelsea G , Brown Ian H , Bowes Victoria , Lewis Nicola S , Berhane Yohannes
Published: August 2022

From 2016 to 2020, high pathogenicity avian influenza (HPAI) H5 viruses circulated in Asia, Europe, and Africa, causing waves of infections and the deaths of millions of wild and domestic birds and presenting a zoonotic risk. In late 2021, H5N1 HPAI viruses were isolated from poultry in Canada and also retrospectively from a great black-backed gull (Larus marinus), raising concerns that the spread of these viruses to North America was mediated by migratory wild bird populations. In February and April 2022, H5N1 HPAI viruses were isolated from a bald eagle (Haliaeetus leucocephalus) and broiler chickens in British Columbia, Canada. Phylogenetic analysis showed that the virus from bald eagle was genetically related to H5N1 HPAI virus isolated in Hokkaido, Japan, in January 2022. The virus identified from broiler chickens was a reassortant H5N1 HPAI virus with unique constellation genome segments containing PB2 and NP from North American lineage LPAI viruses, and the remaining gene segments were genetically related to the original Newfoundland-like H5N1 HPAI viruses detected in November and December 2021 in Canada. This is the first report of H5 HPAI viruses’ introduction to North America from the Pacific and the North Atlantic-linked flyways and highlights the expanding risk of genetically distinct virus introductions from different geographical locations and the potential for local reassortment with both the American lineage LPAI viruses in wild birds and with both Asian-like and European-like H5 HPAI viruses. We also report the presence of some amino acid substitutions across each segment that might contribute to the replicative efficiency of these viruses in mammalian host, evade adaptive immunity, and pose a potential zoonotic risk.
Acute disseminated encephalomyelitis
Authors: Clare Eleni
Published: August 2022

Acute disseminated encephalomyelitis (ADEM) is a relatively rare autoimmune process that causes demyelination of the central nervous system. This condition primarily affects children under age 10 years and can produce symptoms including fever, vomiting, headaches, and altered mental status. Diagnostic criteria include encephalopathy (behavioral changes or altered mental status not explained by fever) and MRI findings of demyelination during the first 3 months of developing symptoms without subsequent new MRI findings. Patients can have full recovery within days to weeks if recognized and treated promptly. This article describes an ED visit and hospital course for a 3-year-old girl with headaches and fatigue who was diagnosed with and treated for ADEM.
And Then I Remember
Authors: Wiggins Morgan
Published: August 2022

A psych nurse worries about the limits of virtual rapport with patients.
The Use of Virtual Mentoring With Underrepresented Minority Groups in Baccalaureate Programs of Nursing: A Systematic Review of the Literature
Authors: Dahlman Jennifer J.
Published: August 2022

AIM

The purpose of this systematic review is to explore the state of science on virtual mentoring in baccalaureate programs of nursing (BSN) and its impact on recruitment and retention of underrepresented minority (URM) groups.

BACKGROUND

Research shows that URMs have significantly higher attrition rates than other BSN students. Innovative approaches to recruitment and retention through virtual means may increase the diversity of BSN programs and the nursing workforce.

METHOD

Studies in peer-reviewed articles between 2010 and 2021 were selected based on their relevance to the research questions posed. Evidence was summarized.

RESULTS

Although literature validated that virtual mentoring is used with graduate students, few BSN programs use mentoring as a strategy to recruit and retain URMs. None of the studies reviewed used this intervention virtually.

CONCLUSION

Additional research is required to determine if virtual mentoring can be used to recruit and retain URMs.
Diagnostic Outcome of Genetic Testing for Neuromuscular Disorders in a Tertiary Center
Authors: Al Sultani Husam , Hafeez Komal , Shaibani Aziz
Published: August 2022

Genetic testing is an effective and reliable modality in clinical neuromuscular diagnosis. The recent developments in testing methods and increasing reliance on genetic testing in clinical practice require more studies to examine the benefits and advantages of such tests. We examined the results of single-gene sequencing/repeat analysis, panels, and whole-genome sequencing (WES) of 514 tests of 393 patients. All patients were suspected of a neuromuscular disorder and the samples were either WBC or muscle tissue. 28.60% (n.147) of the tests were positive while 23.74% (n.122) were VUS. In single-gene sequencing/repeat analysis, 43.08% were positive, in panels, 23.17% were positive, while 30.00% were positive in WES. Our results showed consistency with current studies and improvement of the utility of genetic testing. Although some obstacles are identified, providing statistical data can support more usage and popularity of genetic testing among physicians and patients.
Long-Term Remission With Low-Dose Rituximab in Myasthenia Gravis: A Retrospective Study
Authors: Castiglione Juan I. , Rivero Alberto D. , Barroso Fabio , Brand Patricio , Lautre Andrea , Kohler Alejandro A.
Published: August 2022

Objetive:

Rituximab (RTX) is a therapeutic option, for patients with myasthenia gravis (MG) not responding to conventional immunosuppressive treatment. In this cohort, we evaluated long-term efficacy of RTX in the treatment of refractory generalized MG.

Methods:

A retrospective study was performed in adult patients with refractory generalized MG and at least 24 months of follow-up, between January/2015 and October/2021. The Myasthenia Gravis Status and Treatment Intensity Score was used to assess outcomes, and CD19/CD20+ B-cell counts were monitored.

Results:

Sixteen patients with MG (8 antiacetylcholine receptor+ and 8 muscle-specific antikinase+; mean age 45.5 ± 16.2 years) treated with low-dose RTX protocols were included. CD19/CD20 levels remained undetectable 12 months after induction, and no new relapses were observed during follow-up.

Conclusions:

Low-dose RTX infusions were sufficient to achieve undetectable CD19/20 cell counts and sustained clinical remission. In low and middle-income countries, the impact of low-dose RTX therapy represents a paradigm shift in decision-making for long-term treatment.
What Is in the Myopathy Literature?
Authors: Al-Lahham Tawfiq , Lacomis David
Published: August 2022

We cover intensive care unit–acquired neuromuscular disorders associated with coronavirus disease 2019. Outcomes may be worse than expected in these patients, and there is some evidence that coronavirus disease 2019 causes myopathy directly. Corticosteroid regimens in Duchenne muscular dystrophy are addressed including outcomes in pulmonary and cardiac function. A recent article notes a continued diagnostic delay in Duchenne muscular dystrophy. An interesting report of a Canary Islands cohort of patients with oculopharyngeal muscular dystrophy is discussed. Features and clinical pearls related to a series of patients with limb-girdle muscle dystrophy R12 (anoctaminopathy) and a misdiagnosis of idiopathic inflammatory myopathy are provided. The last section on autoimmune myopathy includes articles on clinical and pathologic features associated with myositis-specific antibodies and dermatomyositis, the epidemiology of immune-mediated necrotizing myopathies (IMNMs) in Olmsted County, Minnesota, and features of a German cohort of hydroxy-3-methylglutaryl coenzyme A reductase–associated IMNM. A recent article proposes the benefit of early intravenous immunoglobulin use for adults with IMNM. We also highlight a report of 2 unusual cases of antisignal recognition particle myopathy presenting with asymmetric distal weakness.