bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion
Authors: Van Hulle Inge
Published: November 2020

The conclusion revisits the key findings of the previous chapters. The first half of the nineteenth century was a period of increased British presence in West Africa and one in which traditional normative commercial patterns with African polities were challenged through the introduction of new legal techniques and the re-interpretation of old ones. Such experimentation with legal techniques was often haphazard, improvisational, and a process of trial and error which escaped the control of the metropole and in which local protagonists took centre-stage. International legal discourse was characteristically open-ended, which allowed imperial protagonists to apply legal norms as much as possible to the benefit of varied imperial objectives. These findings paints a vastly different and more nuanced picture of British empire-building that has traditionally relied on a limited set of sources and particularly on the discourse of late nineteenth-century legal scholars.
The Science and Art of Interviewing
Authors: Gerson Kathleen , Damaske Sarah
Published: November 2020

Qualitative interviewing is one of the most widely used methods in social research, but it is arguably the least well understood. To address that gap, this book offers a theoretically rigorous, empirically rich, and user-friendly set of strategies for conceiving and conducting interview-based research. Much more than a how-to manual, the book shows why depth interviewing is an indispensable method for discovering and explaining the social world—shedding light on the hidden patterns and dynamics that take place within institutions, social contexts, relationships, and individual experiences. It offers a step-by-step guide through every stage in the research process, from initially formulating a question to developing arguments and presenting the results. To do this, the book shows how to develop a research question, decide on and find an appropriate sample, construct an interview guide, conduct probing and theoretically focused interviews, and systematically analyze the complex material that depth interviews provide—all in the service of finding and presenting important new empirical discoveries and theoretical insights. The book also lays out the ever-present but rarely discussed challenges that interviewers routinely encounter and then presents grounded, thoughtful ways to respond to them. By addressing the most heated debates about the scientific status of qualitative methods, the book demonstrates how depth interviewing makes unique and essential contributions to the research enterprise. With an emphasis on the integral relationship between carefully crafted research and theory building, the book offers a compelling vision for what the “interviewing imagination” can and should be.
Pulling It All Together
Authors: Gerson Kathleen
Published: November 2020

Chapter 7 addresses the challenges of presenting an argument with interview material. Since the volume and complexity of interview data make it challenging to present in written or oral form, the chapter offers strategies that help bring focus and order to the process. From the introduction to the presentation of findings to the closing arguments, the goal is to tell a convincing and compelling story that builds a strong case about how to solve the empirical and theoretical puzzles the interviews have addressed. Instead of highlighting examples primarily because they are “colorful,” it is important to select cases and quotes that best represent the larger patterns and core elements of your argument in order to build a powerful case supported by the findings. It is not sufficient to list quotes and assume their significance is obvious. The challenge is to present each piece of evidence in a textual context that makes its meaning clear and its significance unambiguous. The chapter then steps back to summarize the ways depth interviewing provides indispensable findings that lead to theoretical insights only it can provide. The key is to meld a systematic approach, rooted in the logical principles of scientific inquiry, with the investigation of unexplored research terrain that calls out for new analytic and empirical discoveries.
Indeterminate Identity, Personal Identity, and Fission
Authors: Fine Kit
Published: November 2020

I apply my “global” theory of vagueness to the question of vague identity. I consider, in particular, the application of the theory to the case of fission and attempt to show that the theory is able to preserve the connection between identity and what matters and between identity and psychological continuity.
Fine on Frege’s Puzzle
Authors: Ostertag Gary
Published: November 2020

The fact that (1) “Cicero = Tully” is informative whereas (2) “Cicero = Cicero” is not seems to resist explanation on traditional referentialist principles. According to Fine, the referentialist can make sense of the difference by appealing to the fact that in (2), but not (1), the singular-term occurrences are?coordinated. I argue that Fine’s account of this crucial notion is inadequate and present an alternative way of understanding it, one on which coordination facts do not enter into the content of what is said or asserted. To borrow from Wittgenstein, coordination lies not with what my words?say, but with what my words?show. To demystify the notion of showing, I indicate how it can be understood in terms of Grice’s notion of conventional implicature.
Coordination, Understanding, and Semantic Requirements
Authors: Bonardi Paolo
Published: November 2020

In his monograph Semantic Relationism, Kit Fine proposes two characterizations of coordination between proper names: an intuitive test and a technical definition. The intuitive characterization is grounded in a notion of understanding distinct from the familiar notion of linguistic competence. Three prima facie appealing proposals to characterize this notion of understanding are examined in the present chapter and then dismissed as intrinsically implausible or as incompatible with Fine’s semantics. Not even his technical characterization of coordination, involving the notion of semantic requirement, enable us to escape the impasse. Ultimately, the question of what exactly coordination between names is will remain open.
Comments on Fred Kroon and Jonathan McKeown-Green’s “Ontology: What’s the (Real) Question?”
Authors: Fine Kit
Published: November 2020

Kroon and McKeown-Green’s (K/M) chapter is a careful and thoughtful discussion of my views on a number of issues concerning the nature of ontology. These include: the connection between what I say on the topic in three different, though related, papers—“What is Metaphysics?” (WM), “The Question of Ontology” (QO), and “The Question of Realism” (QR); my objection that standard quantificational accounts are unable to do justice to ...
The Cultural Deindustrialization of New York
Authors: Clark Shannan
Published: November 2020

Chapter 8 examines New York’s publishing and broadcasting sectors, which underwent significant deindustrialization during the postwar period. Even as intellectuals and social commentators heralded the rising tide of affluence, supposedly epitomized by white-collar workers engaged in cultural production, in fact tens of thousands employed in the city’s culture industries experienced considerable economic insecurity and inequality. The production of primetime television entertainment largely left the city for Southern California during the 1950s, and attempts during the 1960s at revitalizing New York as a production center were unsuccessful. The structural crisis of the city’s print media led to the closing of multiple daily newspapers during the mid-1960s, followed a few years later by major magazines like Life. Although a new wave of feminist activists combatted workplace discrimination as well as sexist media content, the weakened position of unions and the more general economic retrenchment of the 1970s limited their gains.
Content and the Fittingness of Emotion
Authors: Ballard Brian Scott
Published: November 2020

Many philosophers of emotion, whether perceptual or cognitive theorists, have claimed that emotions represent evaluative properties. This is often supported by an appeal to the fittingness of emotion: that emotions can be fitting shows they represent evaluative properties. In this paper, however, I argue that this inference is much too fast. In fact, no aspect of the rational assessment of emotion directly supports the claim that emotions represent evaluative properties. This inference can, however, be matured into an inference to the best explanation. But this requires coming to terms with a significant emerging rival, the attitudinal theory of emotion. In this paper, I show how this can be accomplished and the inference from fittingness to content saved.
Risk of solid cancers overall and by subtypes in patients with psoriatic arthritis treated with TNF inhibitors – a Nordic cohort study
Authors: Hellgren Karin , Ballegaard Christine , Delcoigne Bénédicte , Cordtz René , Nordström Dan , Aaltonen Kalle , Gudbjornsson Bjorn , Love Thorvardur Jon , Aarrestad Provan Sella , Sexton Joe , Zobbe Kristian , Kristensen Lars Erik , Askling Johan , Dreyer Lene
Published: November 2020

Objectives

To investigate whether TNF inhibitors (TNFi) are associated with increased risk of solid cancer in patients with psoriatic arthritis (PsA).

Methods

From the Nordic clinical rheumatology registers (CRR) here: SRQ/ARTIS (Sweden), DANBIO (Denmark), NOR-DMARD (Norway), ROB-FIN (Finland) and ICEBIO (Iceland) we identified PsA patients who started a first TNFi 2001–2017 (n = 9655). We identified patients with PsA not treated with biologics from (i) the CRR (n = 14 809) and (ii) the national patient registers (PR, n = 31 350). By linkage to the national cancer registers, we collected information on incident solid cancer overall and for eight cancer types. We used Cox regression to estimate hazard ratio (HR) with 95% CI of cancer (per country and pooled) in TNFi-exposed vs biologics-naïve, adjusting for age, sex, calendar period, comorbidities and disease activity. We also assessed standardized incidence ratios (SIR) in TNFi-exposed PsA vs the general population (GP).

Results

We identified 296 solid cancers among the TNFi-exposed PsA patients (55 850 person-years); the pooled adjusted HR for solid cancer overall was 1.0 (0.9–1.2) for TNFi-exposed vs biologics-naïve PsA from the CRR, and 0.8 (0.7–1.0) vs biologics-naïve PsA from the PRs. There were no significantly increased risks for any of the cancer types under study. The pooled SIR of solid cancer overall in TNFi treated PsA vs GP was 1.0 (0.9–1.1).

Conclusion

In this large cohort study from five Nordic countries, we found no increased risk of solid cancer in TNFi-treated PsA patients, neither for solid cancer overall nor for eight common cancer types.
Financial Media, Price Discovery, and Merger Arbitrage*
Authors: Buehlmaier Matthias M M , Zechner Josef
Published: November 2020

Using merger announcements and applying methods from computational linguistics we find strong evidence that stock prices underreact to information in financial media. A one standard deviation increase in the media-implied probability of merger completion increases the subsequent 12-day return of a long-short merger strategy by 1.2 percentage points. Filtering out the 28% of announced deals with the lowest media-implied completion probability increases the annualized alpha from merger arbitrage by 9.3 percentage points. Our results are particularly pronounced when high-yield spreads are large and on days when only few merger deals are announced.
The Legacy of Recurrent Introgression during the Radiation of Hares
Authors: Ferreira Mafalda S , Jones Matthew R , Callahan Colin M , Farelo Liliana , Tolesa Zelalem , Suchentrunk Franz , Boursot Pierre , Mills L Scott , Alves Paulo C , Good Jeffrey M , Melo-Ferreira José
Published: November 2020

Hybridization may often be an important source of adaptive variation, but the extent and long-term impacts of introgression have seldom been evaluated in the phylogenetic context of a radiation. Hares (Lepus) represent a widespread mammalian radiation of 32 extant species characterized by striking ecological adaptations and recurrent admixture. To understand the relevance of introgressive hybridization during the diversification of Lepus, we analyzed whole exome sequences (61.7 Mb) from 15 species of hares (1–4 individuals per species), spanning the global distribution of the genus, and two outgroups. We used a coalescent framework to infer species relationships and divergence times, despite extensive genealogical discordance. We found high levels of allele sharing among species and show that this reflects extensive incomplete lineage sorting and temporally layered hybridization. Our results revealed recurrent introgression at all stages along the Lepus radiation, including recent gene flow between extant species since the last glacial maximum but also pervasive ancient introgression occurring since near the origin of the hare lineages. We show that ancient hybridization between northern hemisphere species has resulted in shared variation of potential adaptive relevance to highly seasonal environments, including genes involved in circadian rhythm regulation, pigmentation, and thermoregulation. Our results illustrate how the genetic legacy of ancestral hybridization may persist across a radiation, leaving a long-lasting signature of shared genetic variation that may contribute to adaptation. [Adaptation; ancient introgression; hybridization; Lepus; phylogenomics.]
Evolution and Regulation of a Large Effector Family of Pyricularia oryzae
Authors: Ebbole Daniel J. , Chen Meilian , Zhong Zhenhui , Farmer Nicholas , Zheng Wenhui , Han Yijuan , Lu Guodong , Wang Zonghua
Published: November 2020

Plant pathogen effectors play important roles in parasitism, including countering plant immunity. However, investigations of the emergence and diversification of fungal effectors across host-adapted populations has been limited. We previously identified a gene encoding a suppressor of plant cell death in Pyricularia oryzae (syn. Magnaporthe oryzae). Here, we report the gene is one of a 21-member gene family and we characterize sequence diversity in different populations. Within the rice pathogen population, nucleotide diversity is low, however; the majority of gene family members display presence-absence polymorphism or other null alleles. Gene family allelic diversity is greater between host-adapted populations and, thus, we named them host-adapted genes (HAGs). Multiple copies of HAGs were found in some genome assemblies and sequence divergence between the alleles in two cases suggested they were the result of repeat-induced point mutagenesis. Transfer of family members between populations and novel HAG haplotypes resulting from apparent recombination were observed. HAG family transcripts were induced in planta and a subset of HAGs are dependent on a key regulator of pathogenesis, PMK1. We also found differential intron splicing for some HAGs that would prevent ex planta protein expression. For some genes, spliced transcript was expressed in antiphase with an overlapping antisense transcript. Characterization of HAG expression patterns and allelic diversity reveal novel mechanisms for HAG regulation and mechanisms generating sequence diversity and novel allele combinations. This evidence of strong in planta–specific expression and selection operating on the HAG family is suggestive of a role in parasitism.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Pythium spp. Associated with Root Rot and Stunting of Winter Wheat in North Carolina
Authors: Reeves Ella R. , Kerns James P. , Cowger Christina , Shew Barbara B.
Published: November 2020

In eastern North Carolina, mild to severe stunting and root rot have reduced yields of winter wheat, especially during years with abundant rainfall. Causal agents of root rot of wheat in this region were previously identified as Pythium irregulare, P. vanterpoolii, and P. spinosum. To investigate species prevalence, 114 isolates of Pythium were obtained from symptomatic wheat plants collected in eight counties. Twelve species were recovered, with P. irregulare (32%), P. vanterpoolii (17%), and P. spinosum (16%) the most common. Pathogenicity screens were performed with selected isolates of each species, and slight to severe necrosis of young roots was observed. The aggressiveness of five isolates each of P. irregulare, P. vanterpoolii, and P. spinosum was compared on a single cultivar of wheat at 14°C, and very aggressive isolates were found within all species. In vitro growth of these isolates was measured at 14 and 20°C, and all isolates grew faster at the warmer temperature. The effects of varying temperatures and rates of nitrogen on root rot caused by Pythium spp. alone or in combination were investigated. All inoculation treatments caused severe root rot under all conditions tested, and disease was more severe at 12 and 14°C compared with 18 and 20°C; however, there was no effect of nitrogen application.
Inflammation and hematopoietic stem cells aging
Authors: He Hanqing , Wang Jianwei
Published: November 2020

Hematopoietic stem cells (HSCs) replenish all lineages of blood cells throughout the lifespan. During aging, the repopulation capacity of HSCs declined, and aged HSCs display a tendency for myeloid differentiation. Several intrinsic and extrinsic factors have been identified to promote HSCs aging. In this review, we focus on the contribution of aging-associated inflammation in provoking HSCs aging and discuss the future research direction of inflammation and HSC aging.
Early ventricular contraction in children with primary hypertension relates to left ventricular mass
Authors: Gu Haotian , Singh Cheentan , Li Ye , Simpson John , Chowienczyk Phil , Sinha Manish D.
Published: November 2020

Aims:

In hypertensive adults, first-phase ejection fraction (EF1), a measure of early ventricular contraction is reduced and associated with prolonged systolic contraction and diastolic dysfunction. Whether this is true in children with primary hypertension is unknown.

Methods:

Echocardiography was performed in 47 normotensive and 81 hypertensive children. Hypertensive children were stratified according to tertiles of LVMi (g/m2.7). EF1 was calculated from the fraction of LV volume ejected up to the time of peak aortic flow. E/e’ was used as a measure of diastolic function. Myocardial wall stress (MWS) was calculated in a subsample of children from LV volumes and central aortic pressure. Time to onset of relaxation (TOR) was defined as time to peak MWS over ejection time.

Results:

Normotensive and hypertensive children were of similar age. Hypertensive children in tertiles 2 and 3 of LVMi had higher BMI z-score than normotensives. EF1 was significantly increased in hypertensive children in tertile 1 compared with normotensive children (P < 0.001), whereas in those in tertile 3, it was significantly lower than in normotensive children (P < 0.001). EF1 was negatively associated with LVMi (β = −0.505, P < 0.001), LVM (β = −0.531, P = 0.001) and E/e’ ratio (β = −0.409, P < 0.001); in children who had MWS measured, TOR was negatively associated with EF1 (β = −0.303, P = 0.007) and positively associated with E/e’ (β = 0.459, P < 0.001).

Conclusion:

EF1 is preserved or enhanced in hypertensive children with similar LVMi to normotensive children but is increasingly reduced in those with greater LVMi. This reduction of EF1 is associated with prolonged myocardial wall stress and reduced diastolic function.
Rehabilitation Needs at 5 Years Post-Traumatic Brain Injury: A VA TBI Model Systems Study
Authors: Mahoney Elaine J. , Silva Marc A. , Reljic Tea , Dams-O'Connor Kristen , Hammond Flora M. , Monden Kimberly R. , Chung Joyce S. , Dillahunt-Aspillaga Christina , Nakase-Richardson Risa
Published: November 2020

Objective:

Describe rehabilitation needs and factors associated with unmet needs at 5 years post–traumatic brain injury (TBI).

Setting:

Five Veterans Affairs (VA) polytrauma rehabilitation centers (PRCs).

Participants:

VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI).

Design:

Prospective observational cohort.

Main Measures:

Rehabilitation Needs Survey (21-item survey that assesses cognitive, emotional, social, and functional needs); Craig Hospital Inventory of Environmental Factors (25-item survey of potential environmental barriers).

Results:

Participants endorsed a mean of 8 (SD: 6.2) ongoing and 3 (SD: 4.7) unmet rehabilitation needs at 5 years post-TBI. Approximately 65% of participants reported at least 1 rehabilitation need that remained unmet. The number and nature of needs differed across TBI severity groups. In unadjusted and adjusted linear regression models, Black race and environmental barriers (Craig Hospital Inventory of Environmental Factors total score) were predictive of unmet needs (P < .001). Those with greater unmet needs reported the physical environment (54%-63%), informational sources (54%), social attitudes (55%), healthcare access (40%), public policy (32%-37%), transportation availability (33%), and in-home assistance (32%) as the most frequent environmental barriers at 5 years post-TBI.

Conclusion:

Veterans and Service Members continue to have rehabilitation needs at 5 years post-TBI. Veterans Affairs programs to address ongoing needs and policy to support them are needed.
Procedures, Visits, and Procedure Costs in the Management of Microbial Keratitis
Authors: Ashfaq Hamza , Maganti Nenita , Ballouz Dena , Feng Yilin , Woodward Maria A.
Published: November 2020

Purpose:

To investigate the burden of procedures, visits, and procedure costs in the management of microbial keratitis (MK).

Methods:

Medical records of patients from an academic hospital outpatient facility between December 2013 and May 2018 were retrospectively reviewed. Patients were included if they were older than the age of 18 years, recruited for study of likely MK, and not concurrently undergoing treatment for other acute eye conditions. For procedural costs, Medicare data for billing were obtained using the Center for Medicare and Medicaid Services Physician Fee Lookup tool.

Results:

A total of 68 patients were included for analysis. Patients were on average 51.3 years (SD = 19.5), 55.9% women (n = 38), and 89.7% White (n = 61). Per person, the average number of procedures was 2.9 (SD = 4.2). The average number of visits was 13.9 (SD = 9.2) over an average of 26.9 weeks (SD = 24.3). Age (P < 0.0001), positive Gram stain (P = 0.03), and mixed Gram stain (P = 0.002) were positively associated with the number of procedures. Age (P = 0.0003), fungal keratitis (P = 0.02), and mixed Gram stain (P = 0.01) were positively associated with the number of visits. Race was inversely associated with the number of procedures (P = 0.045) and visits (0.03). Patients with bacterial keratitis were more likely to have amniotic membrane grafts (P = 0.01) and tarsorrhaphies (P = 0.03) than fungal patients. Across all procedures performed for the management of MK, the mean cost per patient was $1788.7 (SD = $3324.62).

Conclusions:

Patients incur many procedural costs and attend many visits during the management of MK. These findings emphasize the importance of patient–provider communication for frequent follow-up care and the potential need to perform procedures for disease management.
“Doughnut” Amniotic Membrane Transplantation With Penetrating Keratoplasty for Vernal Keratoconjunctivitis With Limbal Stem Cell Disease
Authors: Singh Aastha , Murthy Somasheila I. , Gandhi Arpan , Sangwan Virender S.
Published: November 2020

Purpose:

Severe vernal keratoconjunctivitis (VKC) can cause ocular surface disease including partial or complete limbal stem cell deficiency (LSCD), especially in early-onset and severe limbal form of VKC. We report a novel technique of doughnut amniotic membrane transplantation (AMT) along with penetrating keratoplasty (PK) for management of partial LSCD and corneal scarring in a case of severe VKC.

Methods:

Case report.

Results:

A 17-year-old boy, with onset of disease at 8 years of age, and development of partial LSCD and corneal scarring over a period of 9 years despite therapy, presented with profound visual loss due to dense bilateral corneal scarring. After the active allergy subsided, he underwent modified AMT (doughnut AMT) with simultaneous PK in his left eye. Histopathology of the excised button revealed conjunctival phenotype and dense corneal scarring up to the posterior stroma. At 1-year follow up, his best spectacle-corrected visual acuity was maintained at 20/30 in the operated eye, the graft was clear, and the ocular surface was stable.

Conclusions:

Severe VKC can cause ocular surface disease including LSCD with corneal scarring, especially in early-onset limbal form of VKC. The modified technique of AMT (doughnut AMT) along with PK can successfully visually rehabilitate and address partial LSCD in such patients.
Corneal Classics: The Most-Cited Article in the 36-Year History of Cornea
Authors: Perry Henry D.
Published: November 2020

Purpose:

To describe the most cited article in the 36 year history of Cornea.

Methods:

All articles from Cornea in the past 36 years were reviewed to find the the article with the greatest number of citations.

Results:

Descemet-Stripping Automated Endothelial Keratoplasty by Mark S. Gorovoy, MD, Cornea 2006;25:886–889 was found to have the greatest number of citations.

Conclusion:

This study led to the single greatest change of cornea transplant going from Penetrating Keratoplasty to Descemet Stripping Automated Endothelial Keratoplasty.
The Effect of Using Eye Masks and Earplugs on Intensive Care Patients Quality of Sleep and Vital Signs
Authors: Koçak Ayyüce Tuba , Arslan Selda
Published: November 2020

BACKGROUND: Intensive care unit (ICU) patients with severe health problems experience a high rate of sleep deprivation that harms their psychological and physiological health. Environmental factors are considered to be the greatest cause of sleep deprivation in the ICU, and noise and light are leading among these factors. This study aimed to investigate the effect of eye masks and earplugs on the sleep quality and vital signs of conscious ICU patients. METHODS: This study used a quasi-experimental, in similar groups, pretest-posttest design with a control group. The Richards-Campbell Sleep Questionnaire (RCSQ) was used to collect data, and vital signs were recorded every 2 hours. On day 1, standard care was provided to the experimental group (n = 32), and they were provided with eye masks and earplugs on day 2. The control group (n = 32) was provided with standard care on both days. Chi-square, t, and McNemar and McNemar-Bowker tests were used to analyze the data. Multiple regression analysis was used for predictive analysis. RESULTS: The RCSQ mean (SD) pretest and posttest scores were 50.21 (16.02) and 68.50 (17.57), respectively, for the experimental group and 55.34 (16.62) and 49.03 (15.53), respectively, for the control group. In the experimental group, the posttest RCSQ score was significantly higher than the pretest RCSQ score (P < .01). No differences in vital signs were observed in the control group. All the vital signs were found to be similar in the experimental group, except for the mean daily pulse rate. CONCLUSION: The use of earplugs and eye masks may help reduce sleep deprivation. Eye masks and earplugs can be used by nurses to improve the sleep quality of patients in ICUs.
Gabapentinoid and Opioid Utilization and Cost Trends Among Injured Workers
Authors: Liu Che , Lavin Robert A. , Yuspeh Larry , Leung Nina , Kalia Nimisha , Tsourmas Nicholas F. , Williams Leila , Bernacki Edward J. , Tao Xuguang (Grant)
Published: November 2020

Objective:

To characterize changes in opioid, gabapentin, and pregabalin utilization patterns and cost trends between 2008 and 2018 in a Louisiana workers’ compensation claims population and explore the role of gabapentinoids as alternative analgesics during the opioid epidemic.

Method:

Filled prescriptions for gabapentinoids and opioids were studied for 11 years in a cohort of 18,737 claimants.

Results:

The proportion of claimants prescribed gabapentin increased 2-fold (8.9% to 18.9%) and average drug cost per claimant decreased 22% ($612 to $480). The proportion of claimants prescribed pregabalin decreased approximately 80% (11.7% to 2.5%) and average drug cost per claim increased 224% ($911 to $2952). Proportion of claimants prescribed opioids decreased 20% (80% to 64.2%) and average drug cost per claim decreased 46% ($691 to $371).

Conclusions:

Utilization increased substantially for gabapentin and decreased for pregabalin and opioids.
Navigating Through a COVID-19 World: Avoiding Obstacles
Authors: Klatt Brooke N. , Anson Eric R.
Published: November 2020

Individuals with balance and gait problems encounter additional challenges navigating this post-coronavirus disease-2019 (COVID-19) world. All but the best fitting facemasks partially obscure the lower visual field. Facemask use by individuals with balance and gait problems has the potential to further compromise walking safety. More broadly, as the world reopens for business, balance and gait testing in clinics and research laboratories will also be impacted by facemask use. Here, we highlight some of the challenges faced by patients, clinicians, and researchers as they return to “normal” after COVID-19.

Video Abstract is available for insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A328).
Craniofacial Anthropometry of Healthy Turkish Young Adults: Outer Canthal, Inner Canthal, Palpebral Fissure, and Interpupillary Distances
Authors: Bahşi Ilhan , Orhan Mustafa , Kervancioğlu Piraye , Karatepe Şeyma , Sayn Semih
Published: November 2020

This study aims to examine the values of the orbital region in Turkish young adults by the two-dimensional photogrammetry. Anthropometric measurements of the eye and eyelid-related parameters were taken from 100 female and 100 male volunteer Turkish young adults, ranging in age from 18 to 25 years. Endocanthion (en), exocanthion (ex), and pupil (p) were identified on the photograph and the distances between these points were measured with the ImageJ program. The average values of the en-en, ex-en (R), ex-en (L), p-p, and ex-ex were found as 32.92 ± 2.84, 32.48 ± 2.06, 32.22 ± 2.01, 65.32 ± 3.77, and 97.75 ± 5.09 mm, respectively. There were statistically significant differences between the genders in all parameters. Although there are many studies examining these parameters, comprehensive studies are needed in different populations and in many cases. In this study, we believe that the results obtained for Turkish young adults can be used as reference values.
Extensive Polyostotic Craniofacial Fibrous Dysplasia With Optic Nerve Impingement
Authors: Hu Allison C. , Lee Christine J. , Hsu Frank P.K. , Vyas Raj M.
Published: November 2020

Fibrous dysplasia is a benign overgrowth of metaplastic fibrous material resulting in disorganized deposition of bony matrix. Surgical intervention is the primary treatment modality. Here the authors present the case of a 36-year-old male with extensive and severe fibrous dysplasia of the calvarium, orbit, sphenoid, and facial bones causing significant facial distortion and impingement of his optic nerve. Combined operative treatment with craniofacial plastic surgery and neurosurgery was performed. Repair consisted of extensive intra- and extracranial resection and contouring of involved bones followed by reconstruction of the superior orbital rims, forehead, orbital roof, and calvarium with custom polyetheretherketone (PEEK) implant. The authors discuss the advantages of using computer assisted design/modeling, intraoperative neuronavigation, and custom prosthetic cranioplasty for surgical treatment of extensive fibrous dysplasia; a review of the current surgical literature is provided.
Subjective Smell Assessment as An Office-based Rapid Procedure In COVID-19 Era
Authors: Abdel-Aziz Mosaad , Abdel-Aziz Nada M. , Abdel-Aziz Dina M. , Azab Noha
Published: November 2020

A recent history of smell disorder may be a potential predictor for COVID-19. The authors used a subjective olfaction score that was demonstrated on a hard paper-bar. The authors examined 480 patients who were attending the outpatient clinic. Ninety-seven patients (20.2%) demonstrated variable degrees of recent smell disorder. For those patients, lab testing including nasopharyngeal swab for real-time polymerase chain reaction (RT-PCR) was performed. Eighty-eight of them (90.7%) have been confirmed to be COVID-19 positive. Although psychophysical testing is more reliable, subjective assessment of smell is a rapid procedure and can be used as an office-based method for patients’ screening in COVID-19 era. Smell disorder could be an alarming sign for COVID-19 even with absent characteristic symptoms.
The Effect of Different Dose Regimens of Tranexamic Acid in Reducing Blood Loss in Rhinoplasty: A Prospective Randomized Controlled Study
Authors: Avci Hakan
Published: November 2020

Rhinoplasty is a common surgical procedure. Bleeding prevention is a crucial part of the surgery. We aimed to evaluate the different dose regimens of tranexamic acid (TXA) in reducing intraoperative blood loss among patients undergoing rhinoplasty.

This prospective randomized study was performed in patients scheduled for rhinoplasty surgery between March 2019 and March 2020. The patients were divided into 3 groups containing 30 patients in each group. The patients in Group 1 received the first dose of 1 g intravenous (IV) TXA 10 minutes before the surgery, and the second dose was administered at the end of the operation. The patients in Group 2 received only a single dose of 1 g of IV TXA 10 minutes before the surgery. The patients in Group 3 did not receive medication. Demographic data were obtained through a review of patient's medical records. Preoperative and postoperative hemoglobin levels, postoperative transfusion, and complications rate were compared between the study groups.

No significant differences were observed between the study groups in terms of age, gender, body mass index, American Society of Anesthesiologists scores, and the level of preoperative Hb values (P > 0.05). The mean total blood loss was lower in Group 1 than the other groups, but the difference was not statistically significant (P = 0.464).

The administration of single-dose IV TXA or intermittent IV doses of TXA could decrease total blood loss in rhinoplasty, but the statistical and clinical relevance was not significant.
Diagnostic Performance of Noninvasive Imaging for Assessment of Axillary Response After Neoadjuvant Systemic Therapy in Clinically Node-positive Breast Cancer
Authors: Samiei Sanaz , de Mooij Cornelis M. , Lobbes Marc B. I. , Keymeulen Kristien B. M. I. , van Nijnatten Thiemo J. A. , Smidt Marjolein L.
Published: November 2020

Objective:

The purpose of this study was to perform a systematic review and meta-analysis to determine the diagnostic performance of current noninvasive imaging modalities for assessment of axillary response after neoadjuvant systemic therapy (NST) in clinically node-positive breast cancer patients.

Summary of Background Data:

NST can lead to downstaging of axillary lymph node disease. Imaging can potentially provide information about the axillary response to NST and, consequently, tailor the surgical management.

Methods:

PubMed and Embase were searched for studies that compared noninvasive imaging after NST with axillary surgery outcome to identify axillary response in patients with initial pathologically proven axillary lymph node metastasis. Two reviewers independently screened the studies and extracted the data. A meta-analysis was performed by computing the pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results:

Thirteen studies describing 2380 patients were included for final analysis. Of these patients, 1322 had undergone axillary ultrasound, 849 breast MRI, and 209 whole-body 18F-FDG PET-CT. The overall axillary pathologic complete response rate was 39.5% (941/2380). For axillary ultrasound, the pooled sensitivity, specificity, PPV, and NPV were 65%, 69%, 77%, 50%, respectively. For breast MRI, the pooled sensitivity, specificity, PPV, and NPV were 60%, 76%, 78%, 58%, respectively. For whole-body 18F-FDG PET-CT, the pooled sensitivity, specificity, PPV, and NPV were 38%, 86%, 78%, 49%, respectively.

Conclusions:

The diagnostic performance of current noninvasive imaging modalities is limited to accurately assess axillary response after NST in clinically node-positive breast cancer patients.
End Colostomy With or Without Mesh to Prevent a Parastomal Hernia (GRECCAR 7)
Authors: Prudhomme Michel , Rullier Eric , Lakkis Zaher , Cotte Eddy , Panis Yves , Meunier Bernard , Rouanet Philippe , Tuech Jean-Jacques , Jafari Mehrdad , Portier Guillaume , Dubois Anne , Sielezneff Igor , Parc Yann , Faucheron Jean-Luc , Meurette Guillaume , Lelong Bernard , Piessen Guillaume , Karoui Mehdi , Fabbro-Peray Pascale , Demattei Christophe , Bertrand Martin M.
Published: November 2020

Objective:

To evaluate whether systematic mesh implantation upon primary colostomy creation was effective to prevent PSH.

Summary of Background Data:

Previous randomized trials on prevention of PSH by mesh placement have shown contradictory results.

Methods:

This was a prospective, randomized controlled trial in 18 hospitals in France on patients aged ≥18 receiving a first colostomy for an indication other than infection. Participants were randomized by blocks of random size, stratified by center in a 1:1 ratio to colostomy with or without a synthetic, lightweight monofilament mesh. Patients and outcome assessors were blinded to patient group. The primary endpoint was clinically diagnosed PSH rate at 24 months of the intention-to-treat population. This trial was registered at ClinicalTrials.gov, number NCT01380860.

Results:

From November 2012 to October 2016, 200 patients were enrolled. Finally, 65 patients remained in the no mesh group (Group A) and 70 in the mesh group (Group B) at 24 months with the most common reason for drop-out being death (n = 41). At 24 months, PSH was clinically detected in 28 patients (28%) in Group A and 30 (31%) in Group B [P = 0.77, odds ratio = 1.15 95% confidence interval = (0.62;2.13)]. Stoma-related complications were reported in 32 Group A patients and 37 Group B patients, but no mesh infections. There were no deaths related to mesh insertion.

Conclusion:

We failed to show efficiency of a prophylactic mesh on PSH rate. Placement of a mesh in a retro-muscular position with a central incision to allow colon passage cannot be recommended to prevent PSH. Optimization of mesh location and reinforcement material should be performed.
A Propensity Score-matched Analysis of Long-term Oncologic Outcomes After Nipple-sparing Versus Conventional Mastectomy for Locally Advanced Breast Cancer
Authors: Wu Zhen-Yu , Han Hyun Ho , Kim Hee Jeong , Chung Il-Yong , Kim Jisun , Lee Sae Byul , Son Byung-Ho , Eom Jin Sup , Kim Sung-Bae , Ahn Jin-Hee , Gong Gyung Yub , Kim Hak-Hee , Ahn Sei-Hyun , Ko BeomSeok
Published: November 2020

Objectives:

To compare the long-term oncologic outcomes of nipple-sparing mastectomy (NSM) with those of conventional mastectomy (CM) in patients with locally advanced breast cancer (LABC) receiving neoadjuvant chemotherapy (NACT).

Summary of Background Data:

NSM has been increasingly implemented in patients with breast cancer. However, oncologic efficacy of NSM in patients with LABC has not been sufficiently demonstrated.

Methods:

The study group comprised 850 patients with clinical stage IIB to IIIC breast cancer who underwent NACT followed by either NSM and immediate breast reconstruction or CM alone. After propensity score-matching, 418 patients were included in the analysis. Local recurrence-free survival, disease-free survival (DFS), distant metastasis-free survival, and overall survival (OS) rates were calculated using the Kaplan-Meier method and compared using log-rank tests between the NSM and CM groups.

Results:

After matching, the mean follow-up period was 70 ± 25 months for the NSM group and 74 ± 27 months for the CM group (P = 0.181). There were no significant differences between the groups in terms of 6-year local recurrence-free survival (91.6% vs. 95.8%; P = 0.239), DFS (70.5% vs. 73.4%; P = 0.583), distant metastasis-free survival (79.8% vs. 77.4%; P = 0.320), or OS (87.6% vs. 84.8%; P = 0.465) rates. Additionally, we identified 30 patients in the NSM group who initially presented with tumor extension in the subareolar area; the nipple-areola complex was successfully preserved after NACT, and no recurrence at the nipple was observed in these patients.

Conclusions:

In this matched control study, we demonstrated comparable long-term oncologic outcomes between NSM with immediate reconstruction and CM alone after NACT for LABC. In patients who had tumors extending to the subareolar area before NACT, NSM can be tried if tumor involvement of the nipple-areola complex appears resolved on imaging studies after chemotherapy.
The first decade of research advances in influenza D virus
Authors: Yu Jieshi , Li Feng , Wang Dan
Published: November 2020

From its initial isolation in the USA in 2011 to the present, influenza D virus (IDV) has been detected in cattle and swine populations worldwide. IDV has exceptional thermal and acid stability and a broad host range. The virus utilizes cattle as its natural reservoir and amplification host with periodic spillover to other mammalian species, including swine. IDV infection can cause mild to moderate respiratory illnesses in cattle and has been implicated as a contributor to bovine respiratory disease (BRD) complex, which is the most common and costly disease affecting the cattle industry. Bovine and swine IDV outbreaks continue to increase globally, and there is increasing evidence indicating that IDV may have the potential to infect humans. This review discusses recent advances in IDV biology and epidemiology, and summarizes our current understanding of IDV pathogenesis and zoonotic potential.
Assessing the impact of non-pharmaceutical interventions (NPI) on the dynamics of COVID-19: A mathematical modelling study in the case of Ethiopia
Authors: Ejigu Bedilu Alamirie , Asfaw Manalebish Debalike , Cavalerie Lisa , Abebaw Tilahun , Nanyingi Mark , Baylis Matthew
Published: November 2020

The World Health Organisation (WHO) declared COVID-19 a pandemic on March 11, 2020 and by November 14, 2020 there were 53.3M confirmed cases and 1.3M reported deaths in the world. In the same period, Ethiopia reported 102K cases and 1.5K deaths. Effective public health preparedness and response to COVID-19 requires timely projections of the time and size of the peak of the outbreak. Currently, in the absence of vaccine or effective treatment, the implementation of NPIs (non-pharmaceutical interventions), like hand washing, wearing face coverings or social distancing, is recommended by WHO to bring the pandemic under control. This study proposes a modified Susceptible Exposed Infected and Recovered (SEIR) model to predict the number of COVID-19 cases at different stages of the disease under the implementation of NPIs with different adherence levels in both urban and rural settings of Ethiopia. To estimate the number of cases and their peak time, 30 different scenarios were simulated. The results reveal that the peak time of the pandemic is different in urban and rural populations of Ethiopia. In the urban population, under moderate implementation of three NPIs the pandemic will be expected to reach its peak in December, 2020 with 147,972 cases, of which 18,100 are symptomatic and 957 will require admission to an Intensive Care Unit (ICU). Among the implemented NPIs, increasing the coverage of wearing masks by 10% could reduce the number of new cases on average by one-fifth in urban-populations. Varying the coverage of wearing masks in rural populations minimally reduces the number of cases. In conclusion, the projection result reveals that the projected number of hospital cases is higher than the Ethiopian health system capacity during the peak time. To contain symptomatic and ICU cases within health system capacity, the government should give attention to the strict implementation of the existing NPIs or impose additional public health measures.
Physiotherapy service provision in a specialist adult cystic fibrosis service: a pre-post design study with the inclusion of an allied health assistant
Authors: Hall Kathleen , Maxwell Lyndal , Cobb Robyn , Steele Michael , Chambers Rebecca , Roll Mark , Bell Scott C , Kuys Suzanne
Published: November 2020

Question(s)

What is the impact of including an allied health assistant (AHA) role on physiotherapy service delivery in terms of service provision, scope of practice and skill mix changes in an acute respiratory service?

Design

A pragmatic pre-post design study examined physiotherapy services across two three-month periods: current service delivery [P1] and current service delivery plus AHA [P2].

Outcome measures

Clinical and non-clinical activity contributing to physiotherapy services delivery quantified as number, type and duration (per day) of all staff activity, and categorised for skill level (AHA, junior, senior).

Results

Overall physiotherapy service delivery increased in P2 compared to P1 (n=4730 vs n=3048). Physiotherapists undertook fewer respiratory (p < 0.001) and exercise treatments (p < 0.001) but increased patient reviews for inpatients (p < 0.001) and at multidisciplinary clinics in P2 (56% vs 76%, p < 0.01). The AHA accounted for 20% of all service provision. AHA activity comprised mainly non-direct clinical care including oversight of respiratory equipment use (e.g. supply, set-up, cleaning, loan audits) and other patient related administrative tasks associated with delegation handovers, supervision and clinical documentation (72%) and delegated supervision of established respiratory (5%) and exercise treatments (10%) and delegated exercise tests (3%). The AHA completed most of the exercise tests (n = 25). AHA non-direct clinical tasks included departmental management activities such as statistics and ongoing training (11%). No adverse events were reported.

Conclusion

Inclusion of an AHA in an acute respiratory care service changed physiotherapy service provision. The AHA completed delegated routine clinical and non-clinical tasks. Physiotherapists increased clinic activity and annual reviews. Including an AHA role offers safe and sustainable options for enhancing physiotherapy service provision in acute respiratory care services.