bluuebunny/crossref_metadata_2025 huggingface dataset:
War and Peace
Authors: Parsell Diana P.
Published: March 2023

With the outbreak of World War I in 1914, Eliza Scidmore reports on Japan’s entry into the conflict and the Red Cross relief efforts in Europe. In Washington she becomes a female U.S. Navy yeoman and takes a job in the paymaster general’s office. In 1919 George Washington University awards her an honorary doctorate of letters for her work promoting world understanding. The period brings great personal loss and reckoning, with the deaths of her mother and brother George; the leveling of Yokohama and Tokyo in the Great Kanto Earthquake of 1923; and U.S. passage of the anti-Japanese 1924 Immigration Law. She moves abroad to Geneva, Switzerland, where she follows developments at the new League of Nations in the company of friends such as the Japanese statesman Inazo Nitobe and his American-born wife, Mary. Scidmore dies in Geneva in 1928, at age seventy-two, after an emergency appendectomy.
Crusaders for Moderation
Authors: Lok Matthijs
Published: March 2023

The fourth chapter (‘Crusaders for Moderation’) discusses the uses of European history by counter-revolutionary émigrés in the 1790s in their plans for a post-revolutionary Europe. I focus in this chapter on the case of Charles-Alexandre de Calonne, the former minister of finance under Louis XVI and self-proclaimed ‘moderate’, and his acquaintance, the British member of Parliament Edmund Burke, after first explaining the international developments and the breakdown of the European order as a result of the revolutionary wars. In the counter-revolutionary discourse of the protagonists, the ancient constitution above all guaranteed a ‘moderate’ exercise of power in line with the rule of law, as well as a unique liberty, characteristic of European monarchies since their foundation.
Post-GDPR Lawmaking in the Digital Data Society: Mimesis without Integration. Topological Understandings of Twisted Boundary Setting in EU Data Protection Law
Authors: Hert Paul De
Published: March 2023

Following up on previous research conducted on post-GDPR lawmaking, this chapter seeks to explore a second wave of post-GDPR lawmaking, particularly regarding the European Strategy for Data and its relation with the field of data protection. For this purpose, a selection of case studies is analysed to look at whether EU lawmakers seek integration, denial or mimetics of the GDPR in different data-intensive activities that have been recently regulated or are soon to be. Following this analysis, the chapter explores different paths to explain the reasons and rationale behind the adopted approach and argues for careful integration with the legal rules of a pre-existing framework of the GDPR and its principles and rules. Only then will boundaries of data protection law be able to function properly. The chapter ends with a perspective on regulatory change in EU lawmaking on the Digital Single Market and its subsequent regulatory strategies as a result of this process.
Emotional Abuse and the Law
Authors: Brake Elizabeth
Published: March 2023

Much intimate partner violence consists in emotional abuse and threats which the legal system does not address. Some reports suggest that emotional abuse can be more harmful than physical abuse. Beyond social policy, how should the law address emotional abuse? Criminalizing emotional abuse would serve the expressive function of expressing disapprobation and acknowledging the wrong to the victim. There are practical reasons not to criminalize emotional abuse—including the likely disproportionate impact on people of color. This chapter focuses on the theoretical question of whether emotional abuse wrongs the victim in the sense relevant to criminal law. A difficulty is that emotional abuse might involve only speech and apparently self-regarding behavior: how do these wrong, in the justice-relevant sense? This chapter considers two approaches. On the harm-based approach to criminal law, emotional abuse is the kind of non-consensual harm relevant to criminal law. On a Kantian approach to criminal law as intervening in certain restrictions on freedom, emotional abuse sometimes involves a justice-relevant wrong: coercion. The chapter argues that emotional abuse (even without physical abuse) coerces the victim by issuing a standing threat of severe emotional harm. Accounting for coercion requires positing a right against severe emotional harm which emotional abuse threatens to violate. This chapter shows how emotional abuse wrongs without implying that permissible self-regarding behavior which causes emotional harm (such as rejecting someone’s romantic advances) also wrongs.
If It’s Not Your Talent, How Come You’re Getting an Incentive?
Authors: Dietsch Peter
Published: March 2023

The idea that pushing for more equality comes at a cost in terms of economic efficiency is widely accepted. Underpinning this idea is the premise that some of the most productive members of society will work less if we lower their pay. If this is true, some argue, it justifies paying the most productive a premium to work, provided doing so benefits everyone. This chapter argues that the standard version of the incentives argument suffers from two important blind spots. First, it assumes that the comparative advantage of the most productive members of society is rooted in their natural talents, that is, in a factor exogenous to the production process. Second, it adopts a static framework to analyze the bargaining process in which incentive payments are negotiated, where static means taking all informational inputs from the same moment in time. The chapter uses the debate between John Rawls (1999) and G.A. Cohen (2008) to illustrate the normative repercussions of making these two assumptions. The chapter qualifies as unjust incentive payments that reward individual productivity due to specialization rather than to natural talent. In addition, it argues that individuals would not be in a position to obtain such incentive payments if bargaining took place before rather than after the acquisition of specialized skills. Finally, the chapter discusses the objection that eliminating this type of incentive payments would be inefficient.
(Owning) Our Bodies, (Owning) Our Selves?
Authors: Aas Sean
Published: March 2023

Some libertarians argue that we have self-ownership, in some sense that supports controversial distributive claims, on grounds that this is the best explanation of less controversial claims regarding bodily wrongs. This chapter rebuts this explanatory argument for self-ownership; in the process, offering an alternative explanation of our rights in our bodies which refers to ownership but not to ownership of the self. The chapter argues, first, that self-ownership is not well placed to explain our rights in our bodies unless it is a reflexive relation, wherein for each competent adult X, X quite literally owns X—whatever X is. Second, it argues that no plausible account of what sorts of things beings like us literally are makes literal and reflexive ownership of ourselves an adequate explanation of our rights in our bodies. Finally, it sketches an account which explains how we can have robust ownership rights, even a kind of natural right, in our bodies, without having anything much like libertarian self-ownership. The chapter concludes that we cannot infer the sorts of things libertarians want to infer, regarding non-bodily property rights, from intuitions about rights in our bodies.
Lincoln as Political Philosopher
Authors: Edmundson William A.
Published: March 2023

This chapter outlines Abraham Lincoln’s conception of political justice. To do so, it unravels a series of puzzles that are posed by his declared views. Lincoln was dedicated to a principle of equality, but (until well into the Civil War) he opposed the abolition of slavery and opposed political equality for blacks. He embraced the principle that legitimate government is founded on popular consent, but he opposed “popular sovereignty” on the slavery question in the Territories and opposed the secession of the southern states. He presented himself as the self-made champion of the interests of workers, yet he appeared untroubled by the influence of wealth in politics, and as president enacted a massive transfer of wealth from the public domain to the corporate. The chapter concludes with an outline of a political philosophy that both reflects and expresses a “public political culture” still dominant today. Lincoln was unique only in discerning, early in his presidency, a material dimension of political equality, which John Rawls was later to prioritize: the “fair value” of the political liberties.
Whose Harm is it Anyway? Using Police Data to Represent Domestic Abuse Victims’ Experiences
Authors: Myhill Andy , Kelly Liz
Published: March 2023

There is a strong tradition of qualitative research documenting the experiences of survivors of domestic abuse. The in-depth nature of this data and the context in which it is collected contrasts with data collected by police officers largely for the purposes of recording and investigating crime. We argue that crime codes are an incomplete representation of ‘harm’ and escalation in domestic abuse. We also suggest harm indexes and severity scores that combine crime codes and sentencing data are an inadequate and potentially misleading representation of victim-survivors’ lived experiences and wider harms suffered. We caution against the use of harm index data to prioritize intervention in cases of domestic abuse and to assess police performance and the impact of interventions. We argue for a wider range of available data to be utilized in the measurement of harm and for measurement frameworks to be informed by foundational qualitative research in this field.
GBL UK TRADING LTD v H&S ALLIANCE LTD
Authors:   APPOINTED PERSON (DESIGNS)
Published: March 2023

H1 Registered designs—Invalidity proceedings—Castor wheels—Sets of articles—Wheels shown both with and without brakes—Interpretation of registration—Whether design of a product or complex product—Registry practice—Individual character—Overall impression—Basis of assessment—Prior art—Pleadings—Functional features—Appeal to Appointed Person
Peyronie’s disease questionnaire: translation into Danish and cultural adaptation
Authors: Wiborg Majken H , Laursen Birgitte S , Kallestrup Else B , Krøijer Rasmus , Lund Lars
Published: March 2023

Background

Peyronie’s disease has an impact on men’s mental and physical health.

Aim

We sought to translate the Peyronie’s Disease Questionnaire into Danish, adapt it to the Danish cultural setting, and test it in a Danish population.

Methods

Translation of the Peyronie’s Disease Questionnaire was performed according to the guidelines for adapting health status measures for use in languages other than the source language by Beaton et al. The validated American Peyronie’s Disease Questionnaire was developed to monitor patient symptoms after an intervention and to inspire a subsequent dialogue about physical and psychological symptoms with a healthcare provider, thereby allowing the patient and the healthcare professional to choose the best treatment. The expert committee agreed on a Danish version after cross-cultural adaptation. The Danish Peyronie’s Disease Questionnaire was sent by electronic mail to a preselected group of 41 men with Peyronie’s disease.

Outcomes

After completing the questionnaire, 32 men participated in a video interview regarding the questionnaire and were asked to identify any problematic fields or areas open to misunderstanding.

Results

The Peyronie’s Disease Questionnaire underwent major modifications in light of the comments of the first 10 respondents. Thereafter, only minor changes were made until data saturation was reached after 27 of the 32 respondents had been interviewed. In 87% of respondents Peyronie’s disease bothered from the last time they had intercourse, and 93% of the men experienced being bothered by having intercourse less often. Peyronie’s disease made 73% of respondents feel bodily discomfort, and 88% had intercourse less often than they used to have due to Peyronie’s disease.

Clinical Implications

The Peyronie’s Disease Questionnaire is a valuable tool in the crucial task of addressing Peyronie’s disease, providing insight into the mental and sexual health problems as well as physical challenges faced by patients.

Strengths and Limitations

The interviewer’s modest experience in conducting interviews is believed to have been duly compensated for by continuous and accumulating learning-while-doing process because the same interviewer conducted all of the interviews and did so consecutively.

Conclusions

Danish men expressed satisfaction with the questionnaire and found it valuable as a tool when visiting the doctor for the first time.
Retained needles during intracavernosal self-injection for erectile dysfunction treatment: a case report and systematic literature review
Authors: Meilika Kirolos N , Eid Jean-Francois
Published: March 2023

Introduction

Although the breakage and entrapment of the needles inside the penis during intracavernosal self-injection for erectile dysfunction treatment is a rare complication, when it happens, it can cause significant distress and anxiety to the patients who experience it.

Aims

Our work aims to report a case of retained penile needle and to compare it with similar cases in the literature to define the risk factors and the best practice to prevent and treat this complication.

Methods

We are reporting successful surgical removal of a deeply retained penile needle with the aid of intraoperative fluoroscopy after an unsuccessful attempt of ultrasound-guided removal in the emergency room. We searched the PubMed and Embase databases for similar cases and compared the findings across all the cases.

Results

In our case, the needle was initially superficial; however, excessive manipulation in the emergency room resulted in deep displacement into the corpus cavernosum. We were able to successfully localize the needle using intraoperative fluoroscopic guidance. The needle was then surgically removed via a small skin incision with minimal dissection of cavernosal tissue. We identified 15 reported cases of retained penile needles in the literature and performed a comprehensive comparison among all the cases. It is critical to search for specialized treatment with a urologist to avoid great damage due to erroneous manipulation of the corpora cavernosa.

Conclusion

Selecting patients with good manual dexterity is essential to avoid breakage and entrapment of penile needles during intracavernosal self-injection for erectile dysfunction treatment. The management of retained penile needles should be individualized depending on the clinical picture at the time of presentation. It is critical to avoid excessive manipulation as it can push the needle deeper into the penis and make the extraction more demanding.
Decarbonizing Health Care
Authors: McSpedon Corinne
Published: March 2023

Why and how nurses must be involved in climate solutions.
New Combination Drug for Depression
Authors: Aschenbrenner Diane S.
Published: March 2023

Auvelity, an extended-release fixed combination of dextromethorphan and bupropion, is approved for the treatment of major depressive disorder in adults.

Like all antidepressants, dextromethorphan–bupropion carries a boxed warning that it may increase the risk of suicidal thoughts and behaviors in pediatric and young adult patients. Seizures can also occur and are more likely at higher doses.

The most common adverse effects of dextromethorphan–bupropion include dizziness, nausea, headache, diarrhea, somnolence, dry mouth, sexual dysfunction, hyperhidrosis, anxiety, constipation, decreased appetite, and insomnia.
Original Research: Nurses' Self-Assessed Knowledge, Attitudes, and Educational Needs Regarding Patients with Substance Use Disorder
Authors: Kratovil Amanda , Schuler Monika S. , Vottero Beth A. , Aryal Gokarna
Published: March 2023

Background:

Substance use disorder (SUD) is a chronic illness, but it's often seen as an intentional choice rather than as a disease. People with SUD are frequently stigmatized, leading to disparate care. Findings from previous studies have indicated that nurses feel inadequately prepared to care for, and tend to have negative attitudes toward, patients with SUD. But it's unknown what kind of education would better prepare nurses caring for this patient population, or whether these negative attitudes vary across practice settings.

Purpose and design:

This observational, cross-sectional, mixed-methods study sought to explore nurses' self-assessed knowledge of and attitudes toward caring for patients with SUD (whether formally diagnosed or not) in hospital settings across the United States. A secondary aim was to determine nurses' educational preferences and needs in this area.

Methods:

Data were collected over a three-month period in early 2020, using the online social networking platform Facebook. All participants were nurses working in hospital settings throughout the United States. Participants were surveyed using two tools: the Drug and Drug Problems Perceptions Questionnaire, and another questionnaire that included open-ended questions regarding nurses' SUD-related education and their experiences and perceived needs in caring for patients with SUD. Quantitative data were analyzed using analysis of variance and post hoc Tukey tests. Qualitative data were analyzed using thematic analysis.

Results:

A total of 691 nurses participated. Nurses reported having been educated in SUD but wanted additional face-to-face education from mental health specialists. The nurses working on mental health units had significantly more positive attitudes toward caring for patients with SUD than nurses on other units. Older nurses had significantly more positive attitudes toward patients with SUD than younger nurses. Qualitative analysis uncovered four themes: unmet needs, personal experiences inform care, personal beliefs inform perceptions, and judgmental attitudes.

Conclusions:

Study findings indicate that, in general, hospital nurses have negative attitudes toward patients with SUD. The results further reaffirm the need for empathy-based nursing education for nurses who care for these patients. Participants expressed a preference for face-to-face training by mental health specialists experienced in SUD. Given the increasing prevalence of SUD and the expected retirement of older nurses, it is urgent that we prioritize empathy-based nursing education, particularly for newer-to-practice nurses, in order to improve nurses' attitudes and ensure best care for patients with SUD.
CE: How to Write an Effective Résumé
Authors: Welton Robert H. , Moody Laurel
Published: March 2023

In today's health care job market, nursing students are aggressively recruited for jobs even before graduation. Employers want to see accurate, informative résumés that efficiently and honestly convey an applicant's education and skills and how they match up with the employer's needs. Although résumés remain essential tools for job seekers, in recent years requirements have changed: nursing students and new graduate nurses need to develop an employer-focused résumé geared toward a specific job. This article can assist these nurses in developing résumés that accommodate these latest trends.
Affirmative Palliative Care for Transgender and Gender Nonconforming Individuals
Authors: Lippe Megan Pfitzinger , Eyer Joshua C. , Roberts Kailey E. , Ritter Emma R. , DiMauro Pierce K. , McKinney Robert E. , Williamson Cassandra L. , Rosa William E.
Published: March 2023

Nurses have a professional and ethical responsibility to provide inclusive, affirmative palliative care to transgender and gender nonconforming (TGNC) individuals experiencing life-limiting illness or injury. In accordance with standards for professional nursing and health organizations, nurses must continue to take tangible steps to achieve a level of care that is affirming, holistic, nonprejudicial, and collaborative. Providing quality care for TGNC individuals requires informed, competent integration of palliative nursing care, gender-affirmative care, and trans-person-centered health care within nursing practice. An interdisciplinary national team of experts collaborated to identify ways nurses could better uphold their professional responsibilities to TGNC individuals with serious illness. The purposes of this article are to: 1) describe elements of TGNC-inclusive palliative nursing care; and 2) present eight concrete recommendations to achieve affirmative clinical practice for TGNC patients living with life-limiting illness and their family of origin and/or family of choice. These recommendations address professional development, communication, medication reconciliation, mental health, dignity and meaning, social support and caregivers, spiritual beliefs and religion, and bereavement care.
Adolescents' Social Media Use May Affect Functional Brain Development
Authors: Rosenberg Karen
Published: March 2023

According to this study:

Constant checking of social media during early adolescence may be associated with changes in the brain's sensitivity to potential social rewards and punishments.
Symptoms Usually Resolve Within a Year After Mild COVID
Authors: Rosenberg Karen
Published: March 2023

According to this study:

Most health outcomes arising from a mild COVID-19 disease course remained for several months and resolved within a year of diagnosis.
Multimodal Prediction of Favorable Outcome After Cardiac Arrest: A Cohort Study*
Authors: Vanat Aurélien , Lee Jong Woo , Elkhider Hisham , Novy Jan , Ben-Hamouda Nawfel , Oddo Mauro , Rossetti Andrea O.
Published: March 2023

OBJECTIVES:

Prognostic guidelines after cardiac arrest (CA) focus on unfavorable outcome prediction; favorable outcome prognostication received less attention. Our aim was to identify favorable outcome predictors and combine them into a multimodal model.

DESIGN:

Retrospective analysis of prospectively collected data (January 2016 to June 2021).

SETTING:

Two academic hospitals (Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Brigham and Women’s Hospital, Boston, MA).

PATIENTS:

Four hundred ninety-nine consecutive comatose adults admitted after CA.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

CA variables (initial rhythm, time to return of spontaneous circulation), clinical examination (Full Outline of UnResponsiveness [FOUR] score at 72 hr, early myoclonus), electroencephalography (EEG) (reactivity, continuity, epileptiform features, and prespecified highly malignant patterns), somatosensory-evoked potentials, quantified pupillometry, and serum neuron-specific enolase (NSE) were retrieved. Neurologic outcome was assessed at 3 months using Cerebral Performance Category (CPC); 1 and 2 were considered as favorable outcome. Predictive performance of each variable toward favorable outcomes were calculated, and most discriminant items were combined to obtain a multimodal prognostic score, using multivariable ordinal logistic regression, receiving operator characteristic curves, and cross-validation. Our analysis identified a prognostic score including six modalities (1 point each): 1) early (12–36 hr) EEG not highly malignant, 2) early EEG background reactivity, 3) late (36–72 hr) EEG background reactivity and 4) continuity, 5) peak serum NSE within 48 hours less than or equal to 41 µg/L, and 6) FOUR score greater than or equal to 5 at 72 hours. At greater than or equal to 4 out of 6 points, sensitivity for CPC 1–2 was 97.5% (95% CI, 92.9–99.5%) and accuracy was 77.5% (95% CI, 72.7–81.8%); area under the curve was 0.88 (95% CI, 0.85–0.91). The score showed similar performances in the validation cohort.

CONCLUSIONS:

This study describes and externally validates a multimodal score, including clinical, EEG and biological items available within 72 hours, showing a high performance in identifying early comatose CA survivors who will reach functional independence at 3 months.
Development and External Validation of the International Early Warning Score for Improved Age- and Sex-Adjusted In-Hospital Mortality Prediction in the Emergency Department
Authors: Candel Bart Gerard Jan , Nissen Søren Kabell , Nickel Christian H. , Raven Wouter , Thijssen Wendy , Gaakeer Menno I. , Lassen Annmarie Touborg , Brabrand Mikkel , Steyerberg Ewout W. , de Jonge Evert , de Groot Bas
Published: March 2023

Objectives:

Early Warning Scores (EWSs) have a great potential to assist clinical decision-making in the emergency department (ED). However, many EWS contain methodological weaknesses in development and validation and have poor predictive performance in older patients. The aim of this study was to develop and externally validate an International Early Warning Score (IEWS) based on a recalibrated National Early warning Score (NEWS) model including age and sex and evaluate its performance independently at arrival to the ED in three age categories (18–65, 66–80, > 80 yr).

Design:

International multicenter cohort study.

Setting:

Data was used from three Dutch EDs. External validation was performed in two EDs in Denmark.

Patients:

All consecutive ED patients greater than or equal to 18 years in the Netherlands Emergency department Evaluation Database (NEED) with at least two registered vital signs were included, resulting in 95,553 patients. For external validation, 14,809 patients were included from a Danish Multicenter Cohort (DMC).

Measurements and Main Results:

Model performance to predict in-hospital mortality was evaluated by discrimination, calibration curves and summary statistics, reclassification, and clinical usefulness by decision curve analysis. In-hospital mortality rate was 2.4% (n = 2,314) in the NEED and 2.5% (n = 365) in the DMC. Overall, the IEWS performed significantly better than NEWS with an area under the receiving operating characteristic of 0.89 (95% CIs, 0.89–0.90) versus 0.82 (0.82–0.83) in the NEED and 0.87 (0.85–0.88) versus 0.82 (0.80–0.84) at external validation. Calibration for NEWS predictions underestimated risk in older patients and overestimated risk in the youngest, while calibration improved for IEWS with a substantial reclassification of patients from low to high risk and a standardized net benefit of 5–15% in the relevant risk range for all age categories.

Conclusions:

The IEWS substantially improves in-hospital mortality prediction for all ED patients greater than or equal to18 years.
Iterative Development of the Caregiver Wellness After Traumatic Brain Injury Program (CG-Well)
Authors: Kreitzer Natalie , Adeoye Opeolu , Wade Shari L. , Kurowki Brad G. , Thomas Stephanie , Gillespie Lauren , Bakas Tamilyn
Published: March 2023

Objectives:

(1) To iteratively design a web/phone-based intervention to support caregivers of adults acutely following traumatic brain injury (TBI), Caregiver Wellness (CG-Well), and (2) to obtain qualitative and quantitative feedback on CG-Well from experts and caregivers to refine the intervention.

Setting:

A level I trauma and tertiary medical center.

Participants:

Convenience sample of a total of 19 caregivers and 25 experts.

Design:

Multistep prospective study with iterative changes to CG-Well: (1) developed intervention content based on qualitative feedback from a prior study and literature review; (2) obtained qualitative feedback from 10 experts; (3) refined content using a modified Delphi approach involving 4 caregivers and 6 experts followed by qualitative interviews with 9 caregivers; (4) designed CG-Well website and videos; and (5) obtained feedback on program acceptability, appropriateness, and feasibility from 6 caregivers and 9 experts.

Interventions:

CG-Well included content on TBI, self-care and support, and skill-building strategies delivered through a website and telephone calls.

Main Outcome Measure(s):

Qualitative data were analyzed using content analysis. Caregivers and experts completed Likert-type scales to rate module relevance, clarity, accuracy, utility and website acceptability, appropriateness, and feasibility (1 = strongly disagree to 5 = strongly agree). Means and standard deviations (SD) characterized ratings.

Results:

Qualitative findings were instrumental in designing and refining CG-Well. Ratings were positive for modules (means and SD for relevant [4.9, 0.33], clear [4.6, 0.53], accurate [4.9, 0.33], and useful [5, 0]) and the website (means and SD for acceptable [4.8, 0.36], appropriate [4.8, 0.35], and feasible [4.8, 0.36]).

Conclusions:

The iterative design process for CG-Well resulted in a highly acceptable program. An early-stage randomized controlled trial is underway to estimate treatment effects for a future well-powered clinical trial.
An Absence of Persistent Postural Stability Deficits Following a Sport Concussion in Collegiate Athletes
Authors: Troiano Mia , Thompson Xavier , Boukhechba Mehdi , Hertel Jay , Resch Jacob E.
Published: March 2023

Objective:

The purpose of our study was to determine whether persistent postural stability deficits exist in athletes following sport concussion (SC) in comparison with preinjury (baseline) values using Sample Entropy (SampEn).

Setting:

Sports medicine clinic.

Patients or Other Participants:

Participants consisted of 71 collegiate athletes (44 male, 27 female) with an average age of 19.9 ± 0.96 years who had a history of 1 concussion that occurred during their time as a collegiate athlete.

Design:

In our prospective, cohort design participants completed the Sensory Organization Test (SOT) at baseline, upon reporting symptom-free following a diagnosed SC, and upon establishing a new baseline prior to the start of the subsequent sport season.

Main Outcome Measures:

The SOT's condition scores were calculated and analyzed in alignment with the manufacturer's instructions. SampEn was calculated in the anterior-posterior (AP) and medial-lateral (ML) directions from the center-of-pressure oscillations over the 20-second time series for each SOT condition. The SOT and SampEn outcome scores for each condition were analyzed with repeated-measures analyses of variance.

Results:

Significant main effects were observed for the SOT's conditions 3 (F
1.6, 114.8 = 7.83, P = .001, η
2 = 0.10 [0.02-0.20]), 5 (F
1.8, 126.8 = 11.53, P < .001, η
2 = 0.14 [0.04-0.25]), and 6 (F
1.9, 134.5 = 25.11, P < .001, η
2 = 0.26 [0.14-0.37]), with significant improvements across time. Significant main effects were also observed for SampEn in the AP direction for conditions 3 (F
2, 140 = 7.59, P = .001, η
2 = 0.10 [0.02-0.19]) and 6 (F
2, 140 = 6.22, P = .003, η
2 = 0.08 [0.011-0.170]), with significant improvements across time.

Conclusions:

Following a diagnosed SC, our results suggest that collegiate athletes returned if not exceeded baseline values at the symptom-free and new baseline assessments. The application of linear and nonlinear measures of postural stability following a SC yielded similar outcomes in conjunction with a baseline assessment. Our findings support the clinical utility of the baseline SC assessment when evaluating persisting balance deficits when using linear or nonlinear measures.
Stress and Sleep in Relation to Severity of Building Related Symptoms
Authors: Claeson Anna-Sara , Edvardsson Berit , Liljelind Ingrid
Published: March 2023

Objective

This study investigates different aspects of stress and sleep in medically examined individuals with varying severity of building-related symptoms (BRS).

Methods

Three questionnaires were used to assess acute and long-term stress and sleep (Perceived Stress Scale; Shirom Melamed Burnout Questionnaire, and Karolinska Sleep Questionnaire).

Results

Individuals with BRS, regardless of severity, did not differ in level of perceived stress (indicator of short-term stress). The indicators of long-term stress differed between the groups where an increased severity was associated with higher levels of burnout and sleep problems.

Conclusions

The study suggests an association between symptom severity and measures of long-term stress and sleep quality. This has implications for the treatment of persons affected by BRS, because not only the environment needs to be treated, but also the concurrent signs of distress, such as burnout or sleep problems.
The utility of delta troponin in diagnosing significant coronary artery disease in patients with symptomatic atrial fibrillation.
Authors: Oxenford Cassie , Fryar James , Pelecanos Anita , O’Rourke Peter , Tan Christopher , Alghamry Alaa
Published: March 2023

Background

Troponin I (cTnI) elevation is common in patients with atrial fibrillation (AF) but does not reliably indicate underlying coronary ischemia. We investigated whether dynamic changes in cTnI value (delta troponin) are useful in revealing significant coronary artery disease (sCAD) in patients presenting with symptomatic AF.

Methods

We conducted a retrospective case-control study analyzing serial cTnI values in 231 patients presenting with symptomatic AF who had an objective assessment for underlying CAD within 6 months of the index admission. Diagnostic performance of an elevated cTnI (>0.04 μg/L) only, and elevated cTnI coupled with Youden Index derived cutoffs for absolute and relative changes in troponin, for distinguishing patients with sCAD, was evaluated.

Results

A total of 107 patients had an elevated cTnI on serial measurements. In this group, the area under the receiver operating characteristic curve was 0.69 [95% confidence interval (CI), 0.56–0.81] for relative delta troponin and 0.71 (95% CI, 0.59–0.83) for absolute delta troponin. The optimal diagnostic cutoff for relative delta troponin was > −0.42, and > −0.055 μg/L for absolute delta troponin. The specificity of elevated troponin to diagnose sCAD increased from 56 to 77% when relative delta troponin was added, and to 88% with absolute delta troponin. Although the sensitivity of cTnI elevation (57.1%) decreased to 50% for relative and 35.7% for absolute delta troponin, the negative predictive values were high and similar at 86%.

Conclusion

When added to the troponin peak, delta troponin is a promising test for the diagnosis of significant coronary artery disease in patients presenting with symptomatic AF with elevated cTnI. This result requires prospective validation in a larger cohort of patients.
All-Cause 30-Day Readmission and Mortality
Authors: Hamadi Hanadi Y. , Boamah Sheila , Apatu Emma , Tafili Aurora , Spaulding Aaron
Published: March 2023

OBJECTIVE

The aim of this study was to determine whether Magnet® and non-Magnet hospitals differ in the occurrence of 30-day readmission and mortality rates among the Medicare population when considering community health factors.

BACKGROUND

Magnet hospitals have shown favorable outcomes regarding 30-day readmission and mortality; however, previous research has not evaluated whether the hospital community influences the likelihood of the patient being readmitted to a hospital or how Magnet facilities may mitigate potential mortality risks.

METHOD

This study used a cross-sectional study design of 1791 hospitals using a propensity score matching technique to compare Magnet and non-Magnet hospitals with similar hospital and community characteristics.

RESULTS

Results reveal no differences in readmission scores between Magnet and non-Magnet hospitals. When considering mortality scores, Magnet hospitals had better performance for pneumonia, congestive heart failure, and chronic obstructive pulmonary disease compared with non-Magnet hospitals.

CONCLUSIONS

Our results suggest that there may be universal efforts to improve overall readmission rates taken by hospitals to minimize potential penalties and maximize patient outcomes.
Value of Handheld Optical Illuminated Magnifiers for Sustained Silent Reading by Visually Impaired Adults
Authors: Kaminski John E. , Yoshinaga Patrick D. , Chun Melissa W. , Yu Megan , Shepherd John D. , Chan Tiffany L. , Deemer Ashley , Bittner Ava K. ,   the BeST-AID Study Team
Published: March 2023

SIGNIFICANCE

Vision rehabilitation providers tend to recommend handheld, illuminated optical magnifiers for short-duration spot reading tasks, but this study indicates that they are also a viable option to improve sustained, continuous text reading (e.g., books or magazines), especially for visually impaired adults who read slowly with only spectacle-based near correction.

PURPOSE

The utility of handheld optical magnifiers for sustained silent reading tasks involving normal-sized continuous text could be a valuable indication that is not recognized by vision rehabilitation providers and patients.

METHODS

Handheld, illuminated optical magnifiers were dispensed to 29 visually impaired adults who completed the sustained silent reading test by phone at baseline without the new magnifier and 1 month after using the magnifier. Reading speed in words per minute (wpm) was calculated from the time to read each page and then averaged across up to 10 pages or determined for the fastest read page (maximum).

RESULTS

From baseline without the magnifier to 1 month with the magnifier, there was a significant improvement in mean reading speed by 14 wpm (95% confidence interval [CI], 2.6 to 24; P = .02) and for maximum reading speed by 18 wpm (95% CI, 5.4 to 30; P = .005) on average across participants. Participants who had slower baseline reading speeds without the magnifier demonstrated significantly greater improvements in mean and maximum reading speeds on average with the magnifier (95% CI, 8 to 32 [P = .003]; 95% CI, 4 to 36 [P = .02]). A significantly greater number of pages were read with the new magnifier than without it (Wilcoxon z = −2.5; P = .01). A significantly greater number of pages were read with the magnifier by participants who read fewer pages at baseline (95% CI, 0.57 to 5.6; P = .02) or had greater improvements in mean reading speed (95% CI, 0.57 to 5.6; P = .007).

CONCLUSIONS

Many visually impaired adults read more quickly and/or read a greater number of pages after using a new magnifier for a month than compared to without it. The largest gains occurred among those with more difficulty at baseline, indicating the potential to improve reading rates with magnifiers for those with greater deficits.
Case Report: When Two Is Worse Than One—Stereo Imbalance in a Case of Wavefront-guided Scleral Lenses
Authors: Nguyen Lan Chi , Lew Wei Hau , Kauffman Matthew J. , Marsack Jason D. , Applegate Raymond A. , Coates Daniel R.
Published: March 2023

SIGNIFICANCE

Wavefront-guided scleral lenses (WGSLs) reduce visually debilitating residual higher-order aberrations. Although reduced higher-order aberrations lead to improvement in monocular high-contrast visual acuity (VA), the success of the lenses in everyday life depends on additional factors such as retinal contrast, binocular balance, and stereoacuity.

PURPOSE

This report describes a case where WGSLs provided improved monocular vision compared with scleral lenses (SLs) but reduced binocularity and stereoacuity.

CASE REPORT

A 48-year-old woman with moderate keratoconus right eye (OD) and severe left eye (OS) was fitted with SLs and WGSLs. Visual acuity with best SLs was 20/20−2 OD and 20/25−2 OS. Residual higher-order root-mean-square (HORMS) wavefront error (6 mm pupil) was 0.56 μm OD and 1.38 μm OS. Visual acuity with WGSLs was 20/16−2 OD and 20/25+2 OS, and residual HORMS was 0.41 μm OD and 0.98 μm OS. Monocularly, WGSLs were reported to provide better VA. However, binocularly, the patient reported an “imbalanced feeling” and preferred the SLs over WGSLs. Binocular VA at distance was 20/25 with SLs and 20/25−2 with WGSL. To investigate, the Worth Four-Dot test was performed, and the outcomes reported fusion with SLs but suppression OS at distance with WGSLs. Stereoacuity was 160 arc seconds at near and 120 arc seconds at distance with SLs and 400 arc seconds at near and >1200 arc seconds at distance with WGSLs. Dichoptic contrast balancing showed a balance point of 0.48 with SLs and 0.17 with WGSLs, indicating a strong preference toward OD. Simulation of the patient's retinal image revealed a greater difference in image contrast between the two eyes with WGSLs.

CONCLUSIONS

Wavefront-guided scleral lenses reduced HORMS and improved VA compared with SLs. However, in this case, it inadvertently caused binocular imbalance. As WGSLs become more widely available, future work should include methods to optimize binocular balance to maximize overall patient satisfaction.
Fecal Microbiota Transplantation as a Cancer Therapeutic
Authors: Stoff Ronen , Wolf Yochai , Boursi Ben
Published: March 2023

For decades, cancer research and treatment focused on the cellular level, viewing cancer as a genetic disease of cell transformation. In the era of chemotherapy and radiotherapy, studies from the second half of the 19th century suggesting an association between the microbiota and cancer were almost neglected. The main focus of the field was limited to identification of specific viruses and bacteria that may serve as direct carcinogens leading to the recognition of 7 viruses (i.e., human papillomavirus, hepatitis B virus, and Kaposi sarcoma–associated herpesvirus) and 1 bacterium (Helicobacter pylori) as human carcinogens by the International Agency for Research on Cancer (https://monographs.iarc.who.int/agents-classified-by-the-iarc/). Shortly after the publication of the first draft of the human genome project in February 2001, the Nobel laureate microbiologist Joshua Lederberg raised the question: “Is human identity all in the genes?” It took more than a decade later and the development of multiomic techniques to confirm that his answer “each one of us is a small ecological community” was correct (Lederberg J. Keynote Address: Beyond the Genome. Brooklyn Law Rev 67). This ecological notion became relevant to cancer prevention, prediction, and treatment following the immunotherapy revolution and the understanding of the metabolic and immunologic roles of the microbiota in health and disease. Recently, the microbiota was recognized as an emerging hallmark of cancer following a large body of research showing its role in tumorigenesis, treatment efficacy and toxicity, and initial data regarding the role of microbial modulation in cancer therapy (Cancer Discov 2022;12(1):31–46). In the current review, we will focus on the role of fecal microbiota transplantation, the first microbial modulation technique that is used mainly in low-complexity conditions such as recurrent Clostridium difficile infections (Aliment Pharmacol Ther 2017;46(5):479–493), as a possible cancer therapeutic. However, to better understand the suggested roles of fecal microbiota transplantation in medical oncology, we first need to understand cancer as an ecological niche and the role of the microbiota in tumorigenesis and cancer treatment, specifically immunotherapy.
Higher self-perceived stress reactivity is associated with increased chronic pain risk
Authors: Boring Brandon L. , Richter Alison , Mathur Vani A.
Published: March 2023

Introduction:

Experiencing stress can contribute to unfavorable pain experiences, but outcomes vary across individuals. Evidence suggests that a person's specific reactivity to stressful events may influence pain responses. Previous studies measuring physiological stress reactivity have found associations with pain both clinically and in the laboratory. However, the time and cost required for testing physiological stress reactivity may limit clinical application.

Objective:

Self-reported perception of one's own stress reactivity has been shown to correlate with physiological stress reactivity in relation to health outcomes and may represent a valuable tool in clinical pain assessment.

Methods:

Using data from the Midlife in the US survey, we selected participants who did not have chronic pain at baseline (n = 1512) and who had data at follow-up 9 years later. Stress reactivity was assessed using a subscale of the Multidimensional Personality Questionnaire. We conducted a binary logistic regression to determine the odds of developing chronic pain, controlling for demographics and other health-related variables.

Results:

Results indicate that higher reported stress reactivity at baseline increased the odds of developing chronic pain at follow-up (odds ratio (OR) = 1.085, 95% confidence interval (CI) (1.021, 1.153), P = 0.008), with the only other significant predictor being the number of chronic conditions (OR = 1.118, 95% CI (1.045, 1.197), P = 0.001).

Conclusion:

Findings provide evidence for the predictive criterion validity of self-reported stress reactivity in the context of chronic pain risk. More generally, with increased need for virtual assessment and care, self-reported stress reactivity may be a useful, time-efficient, and cost-efficient tool for predicting pain outcomes in research and clinical contexts.
DIAGNOSIS AND OUTCOMES OF 225 CONSECUTIVE CASES OF CRPS OF THE HAND.
Authors: del PIÑAL Francisco
Published: March 2023

Background:

The lack of specific tests and potential diagnostic inaccuracy may be behind the stunning figures of complex regional pain syndrome (CRPS) cases. The author tested the hypothesis that patients “diagnosed with” CRPS at referral could be assigned to recognized conditions and treated accordingly.

Methods:

From January 2018 to April 2021, 225 consecutive patients attended the author’s office having been diagnosed with and treated for CRPS for an average of 16±26 months. There were 180 females and 45 males - no patient was excluded.

Results:

All patients could be allocated in named conditions: 79 had a wrong diagnosis; 7 had a true causalgia; 16 were dystonic-psychogenic hands; 20 presented a flare reaction; and 90 had an “irritative” carpal tunnel syndrome. The remaining 13 patients had a miscellany of symptoms within a substandard management setting. Surgery was offered to 175 with a correctable cause; 50 (20 of whom had a tangible cause responsible for their pain) declined and their outcome is unknown. The remaining 125 were operated and tracked for an average of 20±9 months. In the operated group, pain dropped 7.5±2.2 points (p<0.0001) on a numerical rating scale of 0 to 10. Disabilities of the Arm, Shoulder and Hand (DASH) scoring fell from 80 to 16 (p<0.0001). Operated patients rated their satisfaction on a scale of 0 to 10 as 8.9±1.9.

Conclusions

. Unlike CRPS, all patients in this series had a true, diagnosable condition explaining their clinical picture. Most patients who accepted to be operated had a favorable outcome.
Fabrication and assessment of partial finger prostheses made using 3D-printed molds: A case study
Authors: Putra Ketut B. , Montgomery Nathan , Kalamdani Samira , Chen Lei , Kelly Brian , Wensman Jeffrey , Shih Albert
Published: March 2023

3D printing for custom prosthetic finger fabrication can have better fit and comfort than non-custom off-the-shelf ones while reducing fabrication labor time. The purpose of this case study was (1) to design and fabricate custom prosthetic fingers using 3D-printed molds for the treatment of partial finger amputation; (2) to evaluate patient satisfaction of the custom prosthetic fingers fabricated using 3D-printed molds and compare them to the custom prosthetic fingers fabricated through a conventional method of molding using plaster casts. The method to develop the custom prosthetic finger are as follows: (1) The shapes of the residual digits and contralateral fingers were acquired using a high-resolution 3D optical scanner. (2) Prosthetic fingers were designed by modifying the model of the residual digits and the contralateral fingers. (3) Molds of the prosthetic fingers were designed using computer-aided design software and fabricated by 3D printing. The study compared hand function tests and rehabilitation outcome surveys to evaluate the performance of the prosthetic fingers fabricated using 3D-printed molds and plaster casts. This case suggests that the prosthetic fingers fabricated using 3D-printed molds had comparable performance to the prosthetic fingers fabricated using plaster casts. The aesthetics and transparency of the prosthetic fingers contributed highly to the low satisfaction of the prosthetic fingers fabricated using 3D-printed molds.