bluuebunny/crossref_metadata_2025 huggingface dataset:
Epistemic Disobedience
Authors: Kolb-Neuhaus Roberto
Published: May 2023

Revueltas’ return from the United States after a formative period of over a decade led to dramatic changes. He decided to abandon his career as a violinist to assume himself now above all as a composer. This decision implied taking a stance regarding the various aesthetics predominant in Mexico at the time, on the one hand, a Eurocentric nationalism, an expression of internal colonialism, and on the other, his friend and boss Carlos Chávez’s varied attempts to counter this perspective. Two early compositions seem to sound a dialogue with this aesthetic environment. One of them, satirically named Tres pequeñas piezas serias, abandoned in the process of composition and therefore undated, appears to have been crafted at the time. It was published as “Two Little Serious Pieces.” Through the names of the three proposed movements, it appears to poke fun at his romantic peers at the National Conservatory, as well as, perhaps, both Chávez’s early primitivist works and his early modernist works. Futuristic modernism was far from Revueltas’ mind, considering the composition of a quasi-surrealist song, the “Duo for Duck and Canary” (Dúo para pato y canario), 1932, which transfers the intended irrationality of Carlos Barrera’s atypical poem to music. These are the first compositions that introduce a disruptive or incoherent collage as an expression of satire.
The Art of the Streets
Authors: Kolb-Neuhaus Roberto
Published: May 2023

Esquinas is one of Revueltas’ least performed works, possibly because it lacks a fundamental element required by programmers worldwide: the presumed representation of Mexicanness, the exotic component, Southern or localistic. Not a single reference to local folklore or ethnic music is contained here. “Street corners” is, however, fundamental for the understanding of Revueltas’ musical embodiment of his political passion. Best defined as poetic prose, he wrote two significant texts to accompany this music. In them, Revueltas describes who is represented there: no less, the voice of his main music-semantic subject, the downtrodden roaming the streets, expressed through vendor’s cries, funny or insulting whistlings, or the occasional pan flute of a knife sharpener. The study of Esquinas reveals the sophisticated musical abstraction of such street voices, used to sound not only the street’s actors but also their (musicalized) time and space. Revueltas will, from then on, use these music-semantic symbols to leave an imprint of a political message on further compositions. Esquinas thus becomes a fundamental premise for the understanding of his early works (1930–1936), in which this message is not embodied by resorting to words and images.
Magueyes (1931) and Música de feria (1932)
Authors: Kolb-Neuhaus Roberto
Published: May 2023

Revueltas wrote four string quartets during his short life as a professional composer, curiously all at the outset of his career (1931–1933). Two of them lack referents to local popular music genres, seemingly contesting Eurocentric precepts of organicity through a free, apparently intentional “disobedient” disaggregating accumulation of isolated musical gestures, perhaps responding to a decolonial agenda. The better-known quartets, ironically titled Magueyes and Música de feria, contain satires of a then expected folkloric nationalism, but also an affirmative proposition, defining the political as part of the sensory realm and sounding it through musical abstractions of street-vendor cries, Revueltas’ chosen symbol of his social subject. Rhetorical figures derived from verbal language help to decode satirical intent. Rancière’s philosophical avowal of the sensible invites a reading of political expression in non-figurative art such as music.
Composing for the People
Authors: Kolb-Neuhaus Roberto
Published: May 2023

Revueltas’ early works (1930–1936) embody rebellious and humorful avant-garde aesthetics targeting elitist Eurocentrism. Revueltas’ joining the League of Revolutionary Writers and Artists in 1935 and soon after his participation as a member of the delegation visiting Spain in support of the Republic in its fight against Franco’s fascist attack, however, changed the composer’s priorities. He now sought a more overt expression of his socialist beliefs, for instance, composing symphonic poems akin to socialist realism. One example of such program music was derived from a film score included in an ambitious educational film project, initially launched by Carlos Chávez in collaboration with Paul Strand. Most of the film responds to silent film aesthetics, in which content is communicated through visual action and music alone. Music here plays a signifying role of equal relevance to photography. This explains its conception, not as diegetic music supporting the action, but an autonomous discourse and—possibly—the editing of certain parts of the film following the score. From the outset, Revueltas conceived large sections of the score simultaneously as concert music, the path leading to his “symphonic suite,” identified during the present research. Revueltas treasured this score deeply, premiering it in Mexico even before the film’s first showing and conducting it also in Spain during the civil war. This chapter explores the complex history of the film’s making, but above all, the film’s intermedial aesthetics and Revueltas’ strategies for the symbolic embodiment of political intent.
Spain in the Heart
Authors: Kolb-Neuhaus Roberto
Published: May 2023

The war against fascism in Spain played a significant role in Revueltas’ life. It represented a prospect of social change that he did not find at home and, therefore, also a strong source of artistic inspiration. Strikingly, most of the works composed in 1936 and thereafter are directly or indirectly linked to this historic event. The best-known testimony of his emotional link to the Republican cause emerged in the form of an homage to Federico García Lorca, murdered that year by Franco’s followers. It coincided with the composition of three battle songs, inviting people to stand up against the impending fascism. The composer was sent to Spain in 1937 as part of a delegation of the League of Revolutionary Writers and Artists, sponsored by the Mexican government, which backed the Republicans at the time along with the Soviet Union. While there, he conducted many of his works in cultural gatherings organized by the Republic. He also composed a controversial battle song in honor of the anonymous Mexicans who volunteered to fight Franco’s forces. Upon his return to Mexico, he visited the “Niños de Morelia,” hundreds of children of Republican fighters who had been sent to safety there at the beginning of the war. This encounter led to a song cycle inspired by them and an arrangement of a popular Republican battle song, as well as a symphonic poem, Itinerario, symbolizing uprising and struggle but seemingly also the pain caused by loss of life and hope that he experienced while there.
Aberrant Reception Today (and Tomorrow?)
Authors: Kolb-Neuhaus Roberto
Published: May 2023

Programming of Latin American music by symphony orchestras in Europe and the United States has tended to be selective, giving preference to works in which some expression of Southern difference is perceptible. This tendency accounts for the predominant inclusion of works such as Sinfonía India in the case of Chávez, and Sensemayá, misinterpreted as exotic jungle music. Understandably, it has led Latin American conductors to include such works in their programs when they are invited to perform in the Northern cities. One case of the use of exoticism for purposes of self-promotion responding to Northern hunger for the exotic, however, led a certain conductor to the extreme of twisting Revueltas’ life history and inventing a symphonic suite drawn from loose film music scenes that the latter had composed for a commercial nationalist film. Indeed folkloristic and primitivistic, such scenes responded to his producers’ expectations and were composed as a means of sustenance at a time when he only held a poorly paid job at the Conservatory and needed additional income. Not only is this music not representative of his aesthetics: it pointedly defines what he fought against as a composer. Due to its lure of Southern difference, though, “La noche de los Mayas,” arranged and partially composed by José Yves Limantour and falsely presented by him as Revueltas’ ultimate work, was and still is often programmed. It tells the story of a tendency still prevailing, a postcolonial perspective that defines Revueltas’ perception as a Mexicanist to this day.
Early Encounters with Urdu Literature
Authors: Molteno Marion
Published: May 2023

Extracts from Russell’s autobiography, Part II (Losses, Gains): describes studying Urdu at the School of Oriental & African Literature in London. Being already fluent he was shocked to discover how difficult he found the literature, which used a vastly bigger vocabulary and drew on Persian literary genres unfamiliar to him. He describes the differing styles of teaching of his teachers: Harley, Bilgrami, and Judd, and his debt to each; the absence of appropriate learning tools like dictionaries and course books; his response to particular writers: Nazir Ahmad, Sarshar, Azad, Hali, and the challenges of understanding the ghazal form. He then spent a year in South Asia studying in mostly Aligarh, hosted by Zakir Husain, the Vice Chancellor, and learning from mother-tongue Urdu speakers, most significantly Khurshidul Islam. He got to know writers of the Progressive Writers Movement in several cities, including Lahore with Faiz.
Rusva and Premchand: Stories of Courtesans
Authors: Molteno Marion
Published: May 2023

Russell describes the impact made on him by two writers he admires, Rusva and Premchand. Rusva described his novels as ‘a history of our times’ and in Umrao Jan Ada he gave a vivid portrait of the world of a courtesan in mid-19th C Lucknow. Umrao Jan tells Rusva her life story—how she was kidnapped as a child and sold into a brothel, where she was given the education an accomplished courtesan required, and came to accept her role. Premchand’s Bazar e Husn portrays the complex reactions of men and women in respectable society towards Saman, who was thrown out by her husband, and when threatened with destitution, was taken in by a courtesan and trained as a singer. Russell traces Premchand’s maturing as a writer through other stories, Masum Bacca, Nai Bivi, the novel Gadodan, and his last story, Kafan.
Leadership in the Progressive Writers’ Movement, 1935–1947
Authors: Molteno Marion
Published: May 2023

A study of organizational issues among Urdu writers in the Progressive Writers’ Association from 1935 to 1947, based on Russell’s contacts with writers and key written sources. The movement aimed to harness literature to social and political aims, bringing it closer to the concerns of ordinary people. Russell describes the political climate of the time, the anti-imperialist struggles, and the sympathy towards communists and others committed to an egalitarian social agenda. He points out contradictions in the attitudes of early leaders such as Sajjad Zahir; their unconscious attitudes as members of the educated elite, often from the landlord class. The organization sought to win support from established writers such as Premchand, and attracted many Urdu poets and short story writers. Though organizationally they were not equipped to achieve their original ambitious aims, they achieved considerable success in producing a new kind of literature that appealed to a much wider audience.
Jammed Keplerian gas leads to the formation and disappearance of spiral arms in a coupled map lattice for astronomical objects
Authors: Nozawa Erika
Published: May 2023

The formation and disappearance of spiral arms are studied by focusing on jammed Keplerian gas in a coupled map lattice (CML) with a minimal set of procedures for simulating diverse patterns in astronomical objects. The CML shows that a spiral arm is a type of traffic jam, and its motion is governed by both a gas inflow into and outflow from the jam. In particular, we present a new approach to simply and directly evaluating the disappearance of spiral arms, called “light-in and heavy-out”. It is based on the gas flow rate difference between the light inflow and heavy outflow leading to the disappearance of traffic jams. Furthermore, we propose an approximate formula for the remaining lifetime of spiral arms, which is immediately derived from the “light-in and heavy-out” approach without calculating their pattern speeds as in conventional differential rotation. The proposed formula is successfully applied to the CML simulations.
Mapping the Environmental Risk of Beech Leaf Disease in the Northeastern United States
Authors: Zhao Yongquan , Bonello Pierluigi , Liu Desheng
Published: May 2023

The recently emerged beech leaf disease (BLD) is causing the decline and death of American beech in North America. First observed in 2012 in northeast Ohio, U.S.A., BLD had been documented in 10 northeastern states and the Canadian province of Ontario as of July 2022. A foliar nematode has been implicated as the causal agent, along with some bacterial taxa. No effective treatments have been documented in the primary literature. Irrespective of potential treatments, prevention and prompt eradication (rapid responses) remain the most cost-effective approaches to the management of forest tree disease. For these approaches to be feasible, however, it is necessary to understand the factors that contribute to BLD spread and use them in estimation of risk. Here, we conducted an analysis of BLD risk across northern Ohio, western Pennsylvania, western New York, and northern West Virginia, U.S.A. In the absence of symptoms, an area cannot necessarily be deemed free of BLD (i.e., absence of BLD cannot be certain) due to its fast spread and the lag in symptom expression (latency) after infection. Therefore, we employed two widely used presence-only species distribution models (SDMs), one-class support vector machine (OCSVM), and maximum entropy (Maxent) to predict the spatial pattern of BLD risk based on BLD presence records and associated environmental variables. Our results show that both methods work well for BLD environmental risk modeling purposes, but Maxent outperforms OCSVM with respect to both the quantitative receiver operating characteristics (ROC) analysis and the qualitative evaluation of the spatial risk maps. Meanwhile, the Maxent model provides a quantification of variable contribution for different environmental factors, indicating that meteorological (isothermality and temperature seasonality) and land cover type (closed broadleaved deciduous forest) factors are likely key contributors to BLD distribution. Moreover, the future trajectories of BLD risk over our study area in the context of climate change were investigated by comparing the current and future risk maps obtained by Maxent. In addition to offering the ability to predict where the disease may spread next, our work contributes to the epidemiological characterization of BLD, providing new lines of investigation to improve ecological or silvicultural management. Furthermore, this study shows strong potential for extension of environmental risk mapping over the full American beech distribution range so that proactive management measures can be put in place. Similar approaches can be designed for other significant or emerging forest pest problems, contributing to overall management efficiency and efficacy.
Integration of Host Resistance, Seed Treatment, and Seeding Rate for Management of Sudden Death Syndrome, a Disease of Soybean Caused by Fusarium virguliforme
Authors: Kandel Yuba R. , Brown Mariama T. , Byrne Adam M. , Jacobs Janette L. , Chilvers Martin I. , Ernat Edward M. , Kleczewski Nathan M. , Mueller Brian , Telenko Darcy E. P. , Tenuta Albert U. , Smith Damon L. , Mueller Daren S.
Published: May 2023

Field experiments were conducted in Illinois, Indiana, Iowa, Michigan, and Wisconsin, United States, and Ontario, Canada, in 2019 and 2020 to evaluate the integrated effects of host resistance, seed treatment, and seeding rates on root rot (RR) and foliar symptoms of sudden death syndrome (foliar disease index [FDX]) and soybean yield. Seed treatments included a nontreated control and fluopyram in 2019. In 2020, commercial base treatment, base + fluopyram, and base + pydiflumetofen were tested. The base treatment included metalaxyl + pyraclostrobin + fluxapyroxad + clothianidin. The 2019 nontreated control and the 2020 base treatment were considered controls in the analysis because previous studies showed that base treatments do not provide control for sudden death syndrome. The seed treatments were tested on susceptible and moderately resistant (MR) cultivars, which were planted at three seeding rates: 272,277, 346,535, and 420,792 seeds/ha. To mitigate concern that disease pressure may impact treatment, three high disease pressure (>20% FDX) site-years out of the 15 total site-years were grouped and analyzed separately. Seed treatment with fluopyram or pydiflumetofen both reduced FDX and protected yield. Fluopyram reduced RR by about 10%, but RR was not different between pydiflumetofen and the base treatment in 2020. Both seed treatments reduced FDX, but reduction was greater for fluopyram (43.2%) than for pydiflumetofen (24.3%) based on 2020 results. Seeding rate had no effect on foliar symptoms, but the highest seeding rate showed increased RR in 2019 and greater yield both years. Performance of MR cultivars was inconsistent across both years. In 2019, MR cultivars reduced RR by 8.9%; however, in 2020, the MR cultivar had more RR than the susceptible cultivar. Additionally, FDX was only reduced in the MR cultivar in 2020. Although host resistance and seeding rate did not individually impact disease development and yield in every site-year, we showed that integrating seed treatment, host resistance, and adequate seeding rates helped maximize yield in fields with sudden death syndrome.
Association Mapping of Resistance to Tan Spot in the Global Durum Panel
Authors: Szabo-Hever Agnes , Singh Gurminder , Haugrud Amanda R. Peters , Running Katherine L. D. , Seneviratne Sudeshi , Zhang Zengcui , Shi Gongjun , Bassi Filippo M. , Maccaferri Marco , Cattivelli Luigi , Tuberosa Roberto , Friesen Timothy L. , Liu Zhaohui , Xu Steven S. , Faris Justin D.
Published: May 2023

Tan spot, caused by the necrotrophic fungal pathogen Pyrenophora tritici-repentis (Ptr), is an important disease of durum and common wheat worldwide. Compared with common wheat, less is known about the genetics and molecular basis of tan spot resistance in durum wheat. We evaluated 510 durum lines from the Global Durum Wheat Panel (GDP) for sensitivity to the necrotrophic effectors (NEs) Ptr ToxA and Ptr ToxB and for reaction to Ptr isolates representing races 1 to 5. Overall, susceptible durum lines were most prevalent in South Asia, the Middle East, and North Africa. Genome-wide association analysis showed that the resistance locus Tsr7 was significantly associated with tan spot caused by races 2 and 3, but not races 1, 4, or 5. The NE sensitivity genes Tsc1 and Tsc2 were associated with susceptibility to Ptr ToxC- and Ptr ToxB-producing isolates, respectively, but Tsn1 was not associated with tan spot caused by Ptr ToxA-producing isolates, which further validates that the Tsn1−Ptr ToxA interaction does not play a significant role in tan spot development in durum. A unique locus on chromosome arm 2AS was associated with tan spot caused by race 4, a race once considered avirulent. A novel trait characterized by expanding chlorosis leading to increased disease severity caused by the Ptr ToxB-producing race 5 isolate DW5 was identified, and this trait was governed by a locus on chromosome 5B. We recommend that durum breeders select resistance alleles at the Tsr7, Tsc1, Tsc2, and the chromosome 2AS loci to obtain broad resistance to tan spot.
Interaction between ferroptosis and TNF‐α: Impact in obesity‐related osteoporosis
Authors: Chen Xin , Liu Chao , Yu Rongcheng , Gan Ziqi , Zhang Zhen , Chen Zhengyuan , Liu Yuanbo , Wu Dongle , Yu Xinyi , Liu Chufeng , Cao Yang
Published: May 2023

The relationship of obesity and osteoporosis has been widely studied over the past years. However, the implications of obesity for bone health remain controversial, and the underlying molecular mechanism is not yet fully understood. This study demonstrated that high‐fat diet‐induced obesity leads to significantly decreased bone volume/tissue volume (BV/TV), trabecular number (Tb.N), and cortical thickness (Ct.Th) of male rat femur after mechanical loading effects of body weight were controlled. HFD‐induced obese rats exhibited attenuated expression of ferroptosis inhibitory protein SLC7A11 and GPX4 in bone tissues, which was correlated with elevated serum TNF‐α concentration. Ferroptosis inhibitor administration could effectively rescue decreased osteogenesis‐associated type H vessels and osteoprogenitors, and downregulate serum levels of TNF‐α to ameliorate bone loss in obese rats. Since ferroptosis and TNF‐α both affect bone and vessel formation, we further investigated the interaction between ferroptosis and TNF‐α, and its impact in osteogenesis and angiogenesis in vitro. In human osteoblast‐like MG63 and umbilical vein endothelial cells (HUVEC), TNF‐α/TNFR2 signaling promoted cystine uptake and GSH biosynthesis to provide protection against low‐dose ferroptosis inducer erastin. While, TNF‐α/TNFR1 facilitated ferroptosis in the presence of high‐dose erastin through ROS accumulation. Moreover, TNF‐α regulated ferroptosis‐induced osteogenic and angiogenic dysfunctions based on its ferroptosis regulatory role. Meanwhile, ferroptosis inhibitors could reduce intracellular ROS overproduction and enhance osteogenesis and angiogenesis in TNF‐α‐treated MG63 and HUVECs. This study revealed the interaction between ferroptosis and TNF‐α and its impact in osteogenesis and angiogenesis, which provides new insights into the pathogenesis and regenerative therapy of obesity‐related osteoporosis.
Bleeding Patterns With Relugolix Combination Therapy in Women With Endometriosis-Associated Pain [ID: 1345374]
Authors: As-Sanie Sawsan , Giudice Linda , Imm So Jung , Johnson Neil , Mehedintu Claudia , Perry Julie
Published: May 2023

INTRODUCTION:

Relugolix combination therapy (Relugolix-CT: relugolix 40 mg, estradiol 1 mg, norethindrone acetate 0.5 mg) significantly improved endometriosis-associated pain versus placebo in the SPIRIT 1&2 studies. Efficacy was maintained over 104 weeks in the long-term extension (LTE) study. Bleeding patterns in women treated up to 104 weeks with Relugolix-CT are reported.

METHODS:

SPIRIT 1&2 were IRB-approved phase 3, 24-week, randomized studies of Relugolix-CT, delayed Relugolix-CT (relugolix 40 mg monotherapy followed by Relugolix-CT; 12 weeks each), or placebo in premenopausal women (age 18–50 years) with moderate-to-severe endometriosis-associated pain. Eligible women completing SPIRIT 1&2 could enroll in the open-label LTE with once-daily Relugolix-CT. Bleeding days per cycle and bleeding patterns were recorded on eDiaries. Amenorrhea was defined as no bleeding over 28 consecutive days.

RESULTS:

Of 1,261 women originally randomized, 501 completed week 104. Baseline demographics and characteristics were balanced across treatment groups. The proportion of women achieving amenorrhea increased over time: 74.4% (95% CI 68.8–79.4) at week 24, and 82.3% (95% CI 74.6–88.4) at week 104. The average number of bleeding days per cycle (standard deviation) decreased over time from 5.8 (2.4) at baseline to 1.2 (3.3) at week 104. The number of heavy or extremely heavy bleeding days decreased from 1.9 at baseline to 0.0 at week 104.

CONCLUSION:

Treatment with Relugolix-CT in women with endometriosis-associated pain resulted in high rates of amenorrhea and complete elimination of heavy bleeding, thus demonstrating sustained benefit through 2 years. Findings may support patient counseling.
Mesh Exposure After Midurethral Sling Procedures Confers a High Risk of Persistent Stress Urinary Incontinence [ID: 1373885]
Authors: Baracy Michael , Aslam Muhammad , Hagglund Karen , Kulkarni Sanjana , Shim Catherine
Published: May 2023

INTRODUCTION:

Stress urinary incontinence (SUI) affects between 4% and 35% of adult women. Midurethral slings (MUSs) are the gold standard for the treatment of SUI. Mesh exposure has been reported in 4.7–16.4% of patients who undergo MUS. It is unclear whether mesh exposure portends an increased risk of persistent SUI. The purpose of this study was to determine whether mesh exposure is associated with MUS failure/persistent SUI.

METHODS:

This was a retrospective cohort study from December 1, 2015 to January 1, 2022, of all patients who had a MUS procedure at a large community hospital. The primary outcome was persistent SUI at the 12-week postoperative appointment after MUS in patients with and without mesh exposure.

RESULTS:

A total of 456 patients underwent MUS procedure. The incidence of persistent SUI and mesh exposure was 6.4% and 8.8%, respectively. Twenty-five percent of patients with mesh exposure experienced persistent SUI, compared with 4.6% of patients without mesh exposure (P<.0001). In univariable analysis, mesh exposure and postmenopausal status were associated with persistent SUI while asthma was associated with mesh exposure. In logistic regression, persistent SUI was 6.5 times higher in patients with MUS mesh exposure compared to those without mesh exposure (adjusted odds ratio 6.46, 95% CI 2.71–15.44).

CONCLUSION:

Mesh exposure is an independent risk factor for persistent SUI. Patients with mesh exposure are approximately seven times more likely to experience persistent SUI compared to patients without mesh exposure. Currently, there is insufficient evidence to recommend surgical revision of MUSs complicated by mesh exposure, and further studies are warranted.
Integrating Lawyers into the Perinatal Health Care Team: Initial Findings From an Innovative Medical–Legal Partnership [ID: 1377957]
Authors: Richardson Roxana , Kessler Lisa , Patchen Loral , Perry Deborah , Jensen Caitlin Schille , Thomas Angela
Published: May 2023

INTRODUCTION:

Health-harming legal needs (HHLNs), social determinants of health that have a legal remedy, are drivers of poor health outcomes for Black women and children. HHLNs include inadequate access to safe housing, employment accommodations, and income supports. A medical–legal partnership (MLP) adds an attorney to the health care team to address patients’ HHLNs in a variety of health care settings. The Perinatal LAW Project (P-LAW), an MLP between the Georgetown University Health Justice Alliance and MedStar Washington Hospital Center Women’s & Infants’ Services, addresses perinatal patients’ HHLNs in an obstetrics and gynecology practice.

METHODS:

Perinatal LAW Project attorneys record client and case data in a legal case management system. The research team analyzed data for the first 18 months of the program (March 2021 to September 2022).

RESULTS:

One hundred thirty-one patients were referred for legal assistance, primarily by social workers and health navigators. Most patients were in their second and third trimesters. The majority of patients were Black or African American, aged 20–34, and lived under 200% FPL. The most common legal issues were in the areas of employment (parental leave, discrimination), housing (conditions, eviction), public benefits (food stamps, disability benefits), and family law (child support, domestic violence). The P-LAW addressed 150 legal issues and served 117 patients.

CONCLUSION:

Medical–legal partnership is a novel approach to addressing maternal health disparities. In our experience, legal services have a high utilization rate and patients often have more than one legal need. Future efforts to measure patient outcomes, including reduced maternal stress and medical appointment attendance, will build the evidence base for MLP in the perinatal context.
Implementation of the Hear Her Campaign [ID: 1339546]
Authors: Greenberg Jessica , Apuzzio Joseph , Chaudhary Zainab , Gittens-Williams Lisa , Martino Christine , Williams Shauna
Published: May 2023

INTRODUCTION:

The Centers for Disease Control and Prevention 2020 Hear Her Campaign educates pregnant women, their support networks, and providers about urgent maternal warning signs, and empowers women to speak up; however, the effectiveness of this campaign is unknown. In 2021, our institution displayed and distributed campaign materials and formally coached patients. We performed a retrospective cohort study to assess the effects of this initiative on prenatal visits and postpartum office and emergency room visits and patient–provider communications in an urban, academic medical center.

METHODS:

A 3-month period before and after promotion of the Hear Her campaign was studied. Patients who delivered July 1, 2021, to September 30, 2021, were the study group, and patients who delivered July 1, 2019, to September 30, 2019, were the control group. Demographic data, number of prenatal visits, postpartum office and emergency room visits, and patient–provider communications were compared. Mann-Whitney, χ2, and Fisher's exact tests were used for analysis. This study was IRB approved.

RESULTS:

The study group had 346 patients, and the control, 369. Maternal demographics were similar. Median number of prenatal visits, postpartum follow-up rates, and median number of patients presenting to the emergency department postpartum were similar between the study and control groups, 7 versus 8, 68.2% versus 69.6%, and 57 (16.5%) versus 50 (13.6%), respectively. Patient–provider communications significantly increased, with 11.6% of patients communicating from 1.6% (P<.0001).

CONCLUSION:

Promotion of the Hear Her Campaign in this inner-city cohort correlated with an increase in maternal interaction with the health care system via patient–provider communication without increasing the use of emergency department services. More studies are needed to evaluate the effect on maternal health outcomes.
Barriers to HPV Vaccination in Women at a Federally Qualified Health Center [ID: 1377846]
Authors: Blakey-Cheung Sophie , Demertzis Kristen , Zeeshan Quratulain
Published: May 2023

INTRODUCTION:

Human papillomavirus (HPV) vaccination significantly decreases the rate of HPV-related diseases; however, vaccine uptake is limited in the United States. New York State set a goal of 80% HPV vaccination by 2023. First-dose rates at our Federally Qualified Health Center (FQHC) in 2021 were 68% in girls aged 13–19 years and 31% in women aged 20–29 years. Little research surrounding barriers to HPV vaccination in adults exists.

METHODS:

An anonymized survey was distributed to providers at a network of FQHCs using REDCap. Question domains included provider demographics, provider attitudes, and practices. Questions were subdivided by patient age group. Descriptive statistics were analyzed.

RESULTS:

Our response rate was 15%. Respondent specialties included family practice (49%), women's health (27%), pediatrics (13%), and internal medicine (11%). Frequency of vaccine recommendation decreased as patient age increased. Most common barriers for vaccination included previous vaccination, parental or patient objection, and lack of time for counseling. Additional barriers in the 19–45 age group included concerns about efficacy and cost. Common reasons for patient refusal included objection to vaccination, feeling low risk for infection, lack of knowledge, and side effect concerns.

CONCLUSION:

The expansion of HPV vaccination eligibility to include women aged 27–45 in 2018 provided an opportunity to protect more patients against HPV-related diseases. Patient and provider knowledge about HPV risk and vaccine efficacy can limit the implementation. Significant barriers for vaccine administration included the lack of provider engagement, knowledge about the vaccine, and time for counseling. This study underscores the need for provider and patient education about the benefits of HPV vaccination, especially in the 19–45 age group.
What Is the Accuracy of YouTube Abortion Procedure Videos for Reliable Informational Content Based on Their Societal Bias? [ID: 1379766]
Authors: Acero Nicole , Foncham Juanita , Francis Antonia , Herrero Emma , Kayaalp Emre , Mcilvaine Jamie
Published: May 2023

INTRODUCTION:

YouTube is commonly used as an easily accessible online resource for patients seeking to learn about medical procedures, their safety, and their risks. Abortion is a common yet polarizing medical procedure. There is no current research that evaluates the accuracy of instructional videos available to patients. Given the reliance of information gathered on the internet to inform medical decision making, this study was designed to assess whether any given video can deliver accurate information about this topic in an unbiased manner.

METHODS:

Surgical methods of abortion were used as a search query into YouTube. The videos were screened with strict exclusion criteria. The percent accuracy of each video was calculated as compared to the Surgical Curriculum in Obstetrics and Gynecology (SCOG) checklist for the corresponding procedure.

RESULTS:

Thirty-two videos were analyzed and categorized into three “video slant” groups: neutral (n=23), anti-choice (n=4), and pro-choice (n=5). Using the SCOG checklist, neutral videos had the highest average accuracy percentage of 45.9%, anti-choice videos 24.6%, and pro-choice 18.5%.

CONCLUSION:

Using the SCOG checklist, the accuracy of instructional videos were inconsistent across the three identified “video slants.” Patients should consider this when accessing YouTube videos for information regarding abortion procedures.
Levels of Gynecologic Care
Authors: Breitkopf Daniel , Banks Erika , Chelmow David , Lara-Torre Eduardo , McCue Kelly , Ogburn Tony , Pfeifer Samantha , Anderson Ted , Valea Fidel A.
Published: May 2023

Systems of care have been established for obstetrics, trauma, and neonatology. An American College of Obstetricians and Gynecologists Presidential Task Force was established to develop a care system for gynecologic surgery. A group of experts who represent diverse perspectives in gynecologic practice proposed definitions of levels of gynecologic care using the Delphi method. The goal is to improve the quality of gynecologic surgical care performed in the United States by providing a framework of minimal institutional requirements for each level. Subgroups developed draft criteria for each level of care. The entire Task Force then met to reach consensus regarding the levels of care final definitions and parameters. The levels of gynecologic care framework focuses on systems of care by considering institutional resources and expertise, providing guidance on the provision of care in appropriate level facilities. These levels were defined by the ability to care for patients of increasing risk, complexity, and comorbidities, organizing gynecologic care around hospital capability. This framework can also be used to inform the escalation of care to appropriate facilities by identifying patients at risk and guiding them to facilities with the skills, expertise, and capabilities to safely and effectively meet their needs. The levels of gynecologic care framework is intended for use by patients, hospitals, and clinicians in the United States to guide where elective surgery can be done most safely and effectively by specialists and subspecialists in obstetrics and gynecology. The key features of the levels of gynecologic care include ensuring provision of risk-appropriate care and regionalization of care by facility capabilities.
Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer
Authors: Pan Weiyu , Guo Jiaojiao , Li Jiali , Su Jieakesu , Zhang Xiaolei , Liu Jia , Xu Chen , Hou Yingyong
Published: May 2023

Objective:

The purpose of this study was to investigate the prognostic significance of schistosome eggs’ location in schistosomal colorectal cancer (SCRC).

Methods:

172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed.

Results:

There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 (P < 0.001) and LNs’ eggs (P < 0.001). Survival analyses showed that in stage III SCRC, eggs’ presence in LN associated with worse DFS (P = 0.004) or marginally worse OS (P = 0.056), patients with PS2 had shorter OS (P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC (P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs’ presence in LN was an independent prognostic factor for DFS in stage III SCRC (P = 0.006).

Conclusions:

In stage III SCRC, eggs’ presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.
In silico Evaluation of a Vancomycin Dosing Guideline Among Adults with Serious Infections
Authors: Williams Paul , Cotta Menino Osbert , Abdul-Aziz Mohd H. , Wilks Kathryn , Farkas Andras , Roberts Jason A.
Published: May 2023

Background:

This study aimed to compare the achievement of pharmacokinetic–pharmacodynamic (PK-PD) exposure targets for vancomycin using a newly developed dosing guideline with product-information-based dosing in the treatment of adult patients with serious infections.

Methods:

In silico product-information- and guideline-based dosing simulations for vancomycin were performed across a range of doses and patient characteristics, including body weight, age, and renal function at 36–48 and 96 hours, using a pharmacokinetic model derived from a seriously ill patient population. The median simulated concentration and area under the 24-hour concentration–time curve (AUC0-24) were used to measure predefined therapeutic, subtherapeutic, and toxicity PK-PD targets.

Results:

Ninety-six dosing simulations were performed. The pooled median trough concentration target with guideline-based dosing at 36 and 96 hours was achieved in 27.1% (13/48) and 8.3% (7/48) of simulations, respectively. The pooled median AUC0-24/minimum inhibitory concentration ratio with guideline-based dosing at 48 and 96 hours was attained in 39.6% (19/48) and 27.1% (13/48) of simulations, respectively. Guideline-based dosing simulations yielded improved trough target attainment compared with product-information-based dosing at 36 hours and significantly less subtherapeutic drug exposure. The toxicity threshold was exceeded in 52.1% (25/48) and 0% (0/48) for guideline-and product-information-based dosing, respectively (P < 0.001).

Conclusions:

Critical care vancomycin dosing guidelines appeared slightly more effective than standard dosing, as per product information, in achieving PK-PD exposure associated with an increased likelihood of effectiveness. In addition, these guidelines significantly reduce the risk of subtherapeutic exposure. The risk of exceeding toxicity thresholds, however, was greater with the guidelines, and further investigation is suggested to improve dosing accuracy and sensitivity.
Solitary punctate chorioretinitis —a unique subtype of punctate inner choroidopathy
Authors: Gan Yuhong , He Guiqin , Zeng Yunkao , Zhang Xiongze , Su Yongyue , Lan Mi  , Ji Yuying , Zhuang Xuenan , Wen Feng
Published: May 2023

Purpose:

To describe a case series of a special subtype of punctate inner choroidopathy (PIC) with solitary lesions in the macular area— and named as solitary punctate chorioretinitis (SPC).

Methods:

This retrospective observational study clinically evaluated 12 eyes from 12 PIC patients with solitary lesions. Demographic data and multimodal imaging features were analyzed for the included patients.

Results:

All the included patients were Chinese and of Han ethnicity. The median age of the included patients was 29.5 years (range: 25-40 years). Most patients (11/12, 91.67%) were myopic, with median refraction errors of -4.4 diopters (D) (range: -8.5-0 D). Solitary chorioretinitis lesions were yellow‒white and appeared hyperfluorescent during the entire phase of fundus fluorescein angiography (FFA) without leakage (75%, 9/12) and hypofluorescent on indocyanine green angiography (ICGA) (100%, 11/11). On spectral domain optical coherence tomography (SD-OCT), active inflammatory lesions appeared as isolated, heterogeneous, moderately reflective material at the outer retina (10/12, 83.33%) in the fovea or parafoveal region with disruption of the outer retinal layers. When the inflammatory lesions regressed, the moderately reflective materials in the outer retina were absorbed or regressed with outer retinal tissue loss. Additional sequelae of lesion regression included focal choroidal excavation (FCE) and intraretinal cystoid space. Secondary choroidal neovascularization (CNV) was noticed in 2 eyes (2/12, 16.67%).

Conclusions:

SPC is a rare and unique subtype of PIC.SPC may also be an unrecognized etiology of some forms of FCE and idiopathic CNV.
Abnormalities in the retinal capillary plexuses in Coats' disease in adulthood on OCT angiography
Authors: Krivosic Valérie , Mecê Pedro , Dulière Cedric , Lavia Carlo , Zegrari Samira , Tadayoni Ramin , Gaudric Alain
Published: May 2023

Purpose:

To describe and quantify the abnormalities of the retinal capillary plexuses using OCT angiography in Coats' disease.

Methods:

Retrospective study. Eleven eyes of 11 patients with Coats’ disease (9 men and 2 women aged 32 to 80 years) compared to 9 fellow eyes and 11 healthy control eyes.

Horizontal bands of contiguous 3 x 3 mm OCT angiograms of the superficial vascular plexus (SVP) and deep capillary complex (DCC) were acquired from the optic disc to 6 mm temporal to the fovea, through areas with telangiectasia visible on fluorescein angiography in 9 cases.

Main outcome measures:

Vascular density (VD) and fractal dimension (FD).

Results:

The VD was significantly decreased in both plexuses in eyes with Coats’ disease compared to normal and fellow eyes within the 6 mm temporal to the fovea (SVP: 21.5 versus 29.4 %, p=0.00004 and versus 30.3%, p= 0.00008. DCC, 16.5 versus 23.9%, p=0.00004 and versus 24.7%, p=0.00008, respectively). The FD was also significantly decreased in eyes with Coats’ disease (SVP: 1.796 versus 1.848 p=0.001 and versus 1.833, p=0.003. DCC: 1.762 versus 1.853, p=0.003 and versus 1.838, p=0.004, respectively).

Conclusion:

Retinal plexuses’ VD was decreased in Coats' disease, including in areas with no visible telangiectasia.
Pulmonary Cystic Echinococcosis in a Child Presenting in the United Kingdom with Fever and Chest Pain: A Brief Report and Discussion on Management
Authors: Lees Emily A. , Ives Andrew , Fowler Darren , Lakhoo Kokila , Grant David , Kelly Dominic , Paulus Stéphane , Segal Shelley , Gilchrist James J. , Kew Alex , Chiodini Peter , Kadambari Seilesh
Published: May 2023

Cystic echinococcosis is a zoonosis caused by the larvae of Echinococcus granulosus. Pulmonary disease may be asymptomatic until the cyst ruptures or becomes secondarily infected. We report a case of pulmonary cystic echinococcosis presenting in the United Kingdom, with discussion on management: optimum antihelminthic agent, length of treatment and type of operative intervention. Treatment should be individualized to the clinical scenario.
Demonstrating a Statistically Significant Association Between Anal High-Grade Squamous Intraepithelial Lesion and Positive OncoE6 Anal Test in Men Who Have Sex With Men and are Living With HIV
Authors: Jordan Jeanne A. , Rivas Karina I. , Aldous Annette , Connors Kaleigh A. , Jair Kamwing , Klein David A. , Hoke Elizabeth S. , Abbott Stephen E.
Published: May 2023

Objectives

The aim of the study is to determine whether a positive OncoE6 Anal Test result has statistically significant higher odds of being associated with high-grade squamous intraepithelial lesion (HSIL) and to calculate sensitivity and specificity of this test for predicting HSIL in adult men who have sex with men and are living with HIV (MSMLWH).

Materials and Methods

Men living with HIV 18 years or older having ≥atypical squamous cells of undetermined significance–grade anal cytology results were eligible to enroll in this cross-sectional study. Anal samples were collected just before the high-resolution anoscopy procedure. OncoE6 Anal Test results were compared with histology, the reference standard. Sensitivity, specificity, and odds ratio were calculated using HSIL as the threshold.

Results

Two hundred seventy-seven consented MSMLWH were enrolled between June 2017 and January 2022. Of these, 219 (79.1%) had biopsies obtained and histology performed; 81 of 219 participants (37%) had 1 or more biopsies with HSIL results while the remaining 138 of 219 (63%) had only low-grade squamous intraepithelial lesion or were negative for dysplasia. Anal samples from 7 participants (8.6%, 7/81) with HSIL and 3 (2.2%, 3/138) with low-grade squamous intraepithelial lesion had positive OncoE6 Anal Test results. Odds of having HSIL were 4.26 times higher among participants testing positive for HPV16/HPV18 E6 oncoprotein(s) (OR = 4.26, 95% CI = 1.07–16.95, p = .04). The OncoE6 Anal Test demonstrated excellent specificity, 97.83% (93.78–99.55), but poor sensitivity, 8.64% (3.55–17.0).

Conclusions

In this highest-risk population for anal cancer, one could combine the OncoE6 Anal Test, having excellent specificity, with the anal Pap test, having higher sensitivity. Patients found having both an abnormal anal Pap and positive OncoE6 Anal Test result could be triaged for rapid scheduling of their high-resolution anoscopy.
Bacteria in Extracorporeal Membrane Oxygenation Circuit Clots of a Patient With Persistent Bacteremia: A Case Report
Authors: Drop Joppe G. , Verhage Latisha , van Westreenen Mireille , Wildschut Enno D. , de Hoog Matthijs , van Beusekom Heleen , van Ommen C. Heleen
Published: May 2023

A neonate with pulmonary hypertension was supported with extracorporeal membrane oxygenation (ECMO). During ECMO support, the patient developed Enterococcus faecalis bacteremia, treated with targeted antibiotics. Despite the maximum dose of antibiotics, routine blood cultures remained positive throughout the ECMO treatment. A circuit change was performed due to buildup of thrombotic material and disseminated intravascular coagulation (DIC) inside the circuit. Thrombus formation was more extensive in the first than the second circuit. Gram-positive diplococci were present in all initial circuit clots and gram-positive masses surrounded by fibrin were found inside thrombi of the second circuit. Scanning electron microscopy (SEM) revealed a dense fibrin network with embedded red blood cells and bacteria in the first circuit. In the second circuit, SEM analysis revealed scattered micro thrombi. Polymerase chain reaction for identification of bacteria in the thrombus of the first circuit showed the same bacteria as found in blood cultures and did not achieve a sufficient signal in the second circuit. This case report shows that bacteria can nestle in thrombi of an ECMO circuit and that there is a rationale for a circuit change in a patient with persistent positive blood cultures and DIC.