bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Light-Driven Contact Hearing Aids with Acoustic Hearing Aids: Data and Clinical Tips
Authors: Shohet Jack , Bibee Jacqueline , Doherty Joni , Tanita Cheryl , Patzkowski Gina , Gende Deanna
Published: May 2020

Introduction: Contact hearing aids (CHA) offer potential advantages over conventional acoustic hearing aids (AHA) in terms of sound quality, reduced occlusion, and increased high-frequency gain. This study evaluates objective and subjective outcome data for CHA compared to AHA. Methods: Clinical outcome data were retrospectively reviewed for patients wearing CHA. Individual and group data were analyzed and then compared to unaided and AHA data. Adverse effects, device complaints, and clinical utility were documented throughout the device fitting and follow-up process. Results: CHA outcomes were better than unaided hearing and AHA for all patients completing the 3-month CHA trial period (45%). However, CHA return rate was high (55%), most often due to device repair and fit issues. Two patients returned the devices due to poor hearing benefit, though both were off-label audiometric candidates. Significantly more clinical time was required from both audiologists and otolaryngologists to successfully fit and maintain maximum device benefit. Conclusions: For proper audiometric and otologic candidates, this light-driven CHA can offer significant improvements in high-frequency sound fidelity, word recognition, and sound quality compared to AHA technology. Administering questionnaires was helpful in illuminating real-world improvements. Device fit, alignment, and quality control issues are improving, though still contributing to high device return rates at this time. Operational factors should be considered when incorporating CHA into a hearing health care practice.
Cat Rearing: A Potential Risk of Fulminant Sepsis Caused by Capnocytophaga canimorsus in a Hemodialysis Patient
Authors: Mori Jinichi , Oshima Kumi , Tanimoto Tetsuya
Published: May 2020

Capnocytophaga canimorsus is a commensal organism colonized in oral flora of dogs and cats and causes severe sepsis through bite wound in immunocompromised patients. To date, hemodialysis has not been reported as a risk of C. canimorsus infection. A 75-year-old woman with end-stage renal disease secondary to hypertension suddenly developed septic shock. She reared 6 cats in her home, but no bite or scratch wound was found on her body. She was empirically treated with piperacillin-tazobactam and temporally received continuous hemodiafiltration. On the fifth day after sampling, blood culture revealed C. canimorsus as the cause of sepsis. After 4 weeks of antibiotic therapy targeting this organism, she recovered from the sepsis and was discharged on the 109th hospitalization day. Hemodialysis patients may be vulnerable to invasion into the blood stream by C. canimorsus due to the presence of punctures in their skin and the impaired immune function associated with uremia. Physicians should consider this organism as a cause of sepsis in hemodialysis patients who rear dogs or cats even in the absence of apparent bite wounds.
Synchronous and Metachronous Metastatic Breast Cancer, with Different Histology and Opposite Immunophenotype, Treated with Combination of Chemotherapy, Anti-Her2, and Endocrine Therapy: A Case Report
Authors: Megaro Giacomina , Rossi Luigi , Ceddia Serena , Sinjari Marsela , Mannino Adele , Gozzi Elisa , Cosimati Antonella , Brandi Martina , Bitca Victoria , Toscani Ilaria , Cimino Giuseppe , Tomao Silverio
Published: May 2020

In the case of our patient, the synergic action of endocrine therapy and chemotherapy plus dual anti-HER2 combination allowed a complete disease control. Therapy should be scheduled by considering the two cancers as individual entities. The approach to breast cancer is changing from being considered a singular disease to a multiform one, according to current research focused on biological markers such as HER2, ERs, and PRs, with important implications in clinical, prognostic, and therapeutic features.
Cytomegalovirus Colitis with a Cobblestone Appearance
Authors: Kubo Kimitoshi , Kimura Noriko , Matsuda Soichiro , Tsuda Momoko , Kato Mototsugu
Published: May 2020

Cytomegalovirus (CMV) colitis with a cobblestone appearance is rare, and its endoscopic and pathological features remain poorly described. A 78-year-old woman was admitted to our hospital for disturbance of consciousness, high-grade fever, and diarrhea occurring up to 7 times a day. Sigmoidoscopy revealed a circumferential ulcer with mucosal defect, an ulcer with a cobblestone appearance extending from the upper rectum to the sigmoid colon, and an irregular ulcer on the lower rectum. She was histopathologically diagnosed with CMV colitis and intravenously treated with ganciclovir (5 mg/kg) for 7 weeks. Colonoscopy after treatment revealed an improvement of the ulcers extending from the rectum to the sigmoid colon, but no significant improvement of her general condition. She died from sepsis 4 months after hospitalization. To our knowledge, this report represents a valuable addition to the CMV literature describing a rare case of CMV colitis with a cobblestone appearance.
Kleber Mendonça e a ciranda de todos nós
Authors: Azerêdo Genilda
Published: May 2020

A questão espacial é uma preocupação nos filmes do diretor Kleber Mendonça Filho, sendo uma problemática significativa em Recife frio, O som ao redor e Aquarius, algo indiciado nos próprios títulos. Partimos da premissa de que os conflitos vivenciados pelos personagens são indissociáveis dos espaços que habitam e por onde (não) circulam. Nesses filmes, as configurações espaciais refletem relações de força e hierarquias de classe que, por sua vez, denotam resistência e violência. Dada a multiplicidade de sentidos que os diferentes espaços produzem, a discussão é embasada em Bachelard, Foucault, Soja e Ryan, Foote e Azaryahu, teóricos que investigam, respectivamente, a relação entre sensorialidade e espaço; espaço e relações de poder; narrativa; e geografia. A análise demonstra a relevância de Recife frio para uma compreensão dos outros filmes, como se constituíssem, no que diz respeito ao espaço, prismas de um mesmo objeto.
A Fotografia e seus duplos
Authors: Lissovsky Maurício
Published: May 2020

Desde fins do século XIX e durante as primeiras décadas do século XX, mulheres e fotografias são figuras-chave em uma cultura em que as fronteiras entre público e privado, visível e invisível, revelado e oculto estão sendo borradas ou rapidamente modificadas. Este ensaio procura desenvolver essa premissa, discutindo trajetórias de fotógrafas e explorando imagens, provenientes dos mais diferentes campos, que colocam em cena essa correlação.
Então Ela é Escrava? Escrava Isaura, Popular History and National Identity
Authors: Halperin Paula
Published: May 2020

This paper analyzes the soap opera Escrava Isaura, aired in Brazil by the network Rede Globo from October 11, 1976 until February 5, 1977. Based on Bernardo Guimarães’ novel written in 1875, Escrava Isaura enjoyed attention from both the media and a vast national audience at a time when television had become a significant and influential medium. The narrative and aesthetics displayed showed a complex relationship between History and fiction, establishing a peculiar view of the past and slavery. Escrava Isaura launched a lively discussion in the press around slavery, patriarchy, and national identity at a time of military rule in Brazil.
Encruzilhadas, andarilhos, aprendizes
Authors: Brasil André
Published: May 2020

Tendo como ponto de partida a hipótese de Pignarre e Stengers em torno da feitiçaria capitalista, o artigo aproxima três filmes-performance – Ungüento, de Dalton Paula, Árvore do esquecimento, de Paulo Nazareth e Noirblue, de Ana Pi – para pensá-los como críticas contracoloniais, elaborações da história da diáspora negra por meio do corpo. Se o capitalismo e a colonização que lhe é indissociável configuram um “sistema feiticeiro sem feiticeiros”, cada qual à sua maneira, os três trabalhos podem ser vistos como operações de contrafeitiçaria, intervenções no tempo, com o tempo.
Riscos visíveis e invisíveis em um cinema brasileiro de levantes
Authors: Almeida Ana Caroline De
Published: May 2020

O gesto de insubordinação silenciosa, feita à espreita do olhar, foi bastante presente na produção cinematográfica brasileira realizada nos anos de 2010. A partir de uma aposta metodológica inspirada nas pranchas warburguianas no Atlas Mnemosyne, este artigo dispõe juntas sequências de oito filmes nos quais é possível sentir presente o páthos de um grito abafado manifestado quando ele não consegue mais se conter. Uma vez juntas, essas imagens são capazes de acionar, a partir de uma natureza coletiva e pública proporcionada pela própria exibição dos filmes, a energia de um levante.
Mil e uma noites na cidade industrial
Authors: Flores Luís
Published: May 2020

Arábia (2017) pode ser situado no âmbito de uma série de incursões cinematográficas aos substratos da realidade, tanto pelo prisma do documentário quanto pelos caminhos da ficção. À primeira vista, a obra parece responder às aparições históricas da figura do trabalhador no cinema brasileiro. Mas há uma região menos nítida de repercussões, com artistas que adaptaram as categorias do realismo a seus propósitos particulares. É o caso, por exemplo, de John Ford e John Huston. Neste artigo, olharemos para as imagens de Arábia no limiar dessas duas zonas de construção estética.
Apresentação
Authors: Morettin Eduardo Victorio , Cardenuto Reinaldo , Machado Patrícia Furtado Mendes , Maia Carla
Published: May 2020

Apresentação da edição 53 de Significação: revista de cultura audiovisual
Sugar‐Sweetened Beverage Intake and Cardiovascular Disease Risk in the California Teachers Study
Authors: Pacheco Lorena S. , Lacey James V. , Martinez Maria Elena , Lemus Hector , Araneta Maria Rosario G. , Sears Dorothy D. , Talavera Gregory A. , Anderson Cheryl A. M.
Published: May 2020

Background

Sugar‐sweetened beverage (
SSB
) consumption has been associated with cardiometabolic risk. However, the association between total and type of
SSB
intake and incident cardiovascular disease (
CVD
) end points such as myocardial infarction, stroke, and revascularization is limited.

Methods and Results

We examined the prospective association of baseline
SSB
consumption with incident
CVD
in 106 178 women free from
CVD
and diabetes mellitus in the CTS (California Teachers Study), a cohort of female teachers and administrators, followed since 1995.
SSB
s were defined as caloric soft drinks, sweetened bottled waters or teas, and fruit drinks, and derived from a self‐administered food frequency questionnaire.
CVD
end points were based on annual linkage with statewide inpatient hospitalization records. Cox proportional hazards models were used to assess the association between
SSB
consumption and incident
CVD
. A total of 8848
CVD
incident cases were documented over 20 years of follow‐up. After adjusting for potential confounders, we observed higher hazard ratios (
HRs
) for
CVD
(HR, 1.19; 95% CI, 1.06–1.34), revascularization (HR, 1.26; 95% CI, 1.04–1.54]), and stroke (HR, 1.21; 95% CI, 1.04–1.41) in women who consumed ≥1 serving per day of
SSB
s compared with rare/never consumers. We also observed a higher risk of
CVD
in women who consumed ≥1 serving per day of fruit drinks (HR, 1.42; 95% CI, 1.00–2.01 [
P
trend=0.021]) and caloric soft drinks (HR, 1.23; 95% CI, 1.05–1.44 [
P
trend=0.0002]), compared with rare/never consumers.

Conclusions

Consuming ≥1 serving per day of
SSB
was associated with
CVD
, revascularization, and stroke.
SSB
intake might be a modifiable dietary target to reduce risk of
CVD
among women.
Development and Validation of a Prognostic Tool for Direct Enteral Tube Insertion After Acute Stroke
Authors: Joundi Raed A. , Saposnik Gustavo , Martino Rosemary , Fang Jiming , Kapral Moira K.
Published: May 2020

Background and Purpose—

We aimed to create a novel prognostic risk score to estimate outcomes after direct enteral tube placement in acute stroke.

Methods—

We used the Ontario Stroke Registry and linked databases to obtain clinical information on all patients with direct enteral tube insertion after ischemic stroke or intracerebral hemorrhage from July 1, 2003 to June 30, 2010 (derivation cohort) and July 1, 2010 to March 31, 2013 (validation cohort). We used multivariable regression to assign scores to predictor variables for 3 outcomes after tube placement: favorable outcome (discharge modified Rankin Scale score 0–3 and alive at 90 days), poor outcome (discharge modified Rankin Scale score 5 or death at 90 days), and 30-day mortality.

Results—

Variables associated with a favorable outcome were younger age, preadmission independence, ischemic stroke rather than intracerebral hemorrhage, lower stroke severity, and a shorter time between stroke and tube placement. Variables associated with a poor outcome were older age, preadmission dependence, atrial fibrillation, greater stroke severity, and tracheostomy. Age, preadmission dependence, atrial fibrillation, cancer, chronic obstructive pulmonary disease, and shorter time to tube placement were associated with increased 30-day mortality. Using these variables, we created an online calculator to facilitate estimation of individual patient risk of favorable and poor outcomes.
C
-statistic in the validation cohort was 0.82 for favorable outcome, 0.65 for poor outcome, and 0.62 for 30-day mortality, and calibration was adequate.

Conclusions—

We developed risk scores to estimate outcomes after direct enteral tube insertion for acute dysphagic stroke. This information may be useful in discussions with patients and families when there is prognostic uncertainty surrounding outcomes with direct enteral tube placement after stroke.
Signs of Pulmonary Infection on Admission Chest Computed Tomography Are Associated With Pneumonia or Death in Patients With Acute Stroke
Authors: de Jonge Jeroen C. , Takx Richard A.P. , Kauw Frans , de Jong Pim A. , Dankbaar Jan W. , van der Worp H. Bart
Published: May 2020

Background and Purpose—

In patients with acute stroke, the occurrence of pneumonia has been associated with poor functional outcomes and an increased risk of death. We assessed the presence and consequences of signs of pulmonary infection on chest computed tomography (CT) before the development of clinically overt pneumonia.

Methods—

In 200 consecutive patients with acute ischemic stroke who had CT angiography from skull to diaphragm (including CT of the chest) within 24 hours of symptom onset, we assessed the presence of consolidation, ground-glass-opacity and the tree-in-bud sign as CT signs of pulmonary infection and assessed the association with the development of clinically overt pneumonia and death in the first 7 days and functional outcome after 90 days with logistic regression.

Results—

The median time from stroke onset to CT was 151 minutes (interquartile range, 84–372). Thirty patients (15%) had radiological signs of infection on admission, and 22 (11.0%) had a clinical diagnosis of pneumonia in the first 7 days. Patients with radiological signs of infection had a higher risk of developing clinically overt pneumonia (30% versus 7.6%; adjusted odds ratios, 4.2 [95% CI, 1.5–11.7];
P
=0.006) and had a higher risk of death at 7 days (adjusted odds ratios, 3.7 [95% CI, 1.2–11.6];
P
=0.02), but not at 90 days.

Conclusions—

About 1 in 7 patients with acute ischemic stroke had radiological signs of pulmonary infection within hours of stroke onset. These patients had a higher risk of clinically overt pneumonia or death. Early administration of antibiotics in these patients may lead to better outcomes.
LOX-1 (Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1) Deletion Has Protective Effects on Stroke in the Genetic Background of Stroke-Prone Spontaneously Hypertensive Rat
Authors: Liang Yi-Qiang , Kakino Akemi , Matsuzaka Yasunari , Mashimo Tomoji , Isono Masato , Akamatsu Tomohisa , Shimizu Hana , Tajima Michiko , Kaneko Takehito , Li Lei , Takeuchi Fumihiko , Sawamura Tatsuya , Kato Norihiro
Published: May 2020

Background and Purpose—

oxLDL (oxidized low-density lipoprotein) has been known for its potential to induce endothelial dysfunction and used as a major serological marker of oxidative stress. Recently, LOX-1 (lectin-like oxidized low-density lipoprotein receptor-1), a lectin-like receptor for oxLDL, has attracted attention in studies of neuronal apoptosis and stroke. We aim to investigate the impact of
LOX-1
-deficiency on spontaneous hypertension-related brain damage in the present study.

Methods—

We generated a
LOX-1
deficient strain on the genetic background of stroke-prone spontaneously hypertensive rat (SHRSP), an animal model of severe hypertension and spontaneous stroke. In this new disease model with stroke-proneness, we monitored the occurrence of brain abnormalities with and without salt loading by multiple procedures including
T

2

weighted magnetic resonance imaging and also explored circulatory miRNAs as diagnostic biomarkers for cerebral ischemic injury by microarray analysis.

Results—

Both
T

2

weighted magnetic resonance imaging abnormalities and physiological parameter changes could be detected at significantly delayed timing in
LOX-1
knockout rats compared with wild-type SHRSP, in either case of normal rat chow and salt loading (
P
<0.005 in all instances; n=11–20 for SHRSP and n=13–23 for
LOX-1
knockout rats). There were no significant differences in the form of magnetic resonance imaging findings between the strains. A number of miRNAs expressed in the normal rat plasma, including rno-miR-150-5p and rno-miR-320-3p, showed significant changes after spontaneous brain damage in SHRSP, whereas the corresponding changes were modest or almost unnoticeable in
LOX-1
knockout rats. There appeared to be the lessening of correlation of postischemic miRNA alterations between the injured brain tissue and plasma in
LOX-1
knockout rats.

Conclusions—

Our data show that deficiency of LOX-1 has a protective effect on spontaneous brain damage in a newly generated
LOX-1
-deficient strain of SHRSP. Further, our analysis of miRNAs as biomarkers for ischemic brain damage supports a potential involvement of LOX-1 in blood brain barrier disruption after cerebral ischemia.

Visual Overview—

An online
visual overview
is available for this article.
Legal Euthanasia in Pastoral Practice: Experiences of Pastors in the Protestant Church in the Netherlands
Authors: Boer Theo A. , Bolwijn Ronald E. , Graafland Wim , Pleizier T. Theo J.
Published: May 2020

This representative survey amongst 653 ministers in the Protestant Church in the Netherlands (PKN) maps their experiences and views with regard to euthanasia. We found that three-quarters of the ministers have experience with euthanasia requests from their parishioners. Almost two-thirds of them respect a parishioner’s euthanasia request. Differentiating the answers on the basis of modality, we see differences in attitudes, both regarding euthanasia itself and regarding the pastoral approach. Although ministers have considerable experience with euthanasia, the open questions posed reveal that ministers encounter many difficulties and dilemmas: there is urgent need for discussion and support. The article intends to contribute to the search for a best pastoral practice in dealing with euthanasia requests and explores the need for a renewed role for the PKN in the social and political debate on euthanasia.
Covert Jewish Sources of Christian Kabbalah: the Case of Guillaume Postel and ʿIyyun Traditions
Authors: Weiss Judith
Published: May 2020

The article focuses on Guillaume Postel’s Latin Zohar Commentary (1553), with the aim of uncovering a hitherto unknown influence of the medieval ʿIyyun Corpus on Postel’s Kabbalistic thought. Following a prefatory methodological exposition it is demonstrated that in addition to the more common Kabbalistic doctrines, such as those of the Zohar and other central theosophical-Kabbalistic treatises, Postel was also influenced by a different trend of Kabbalah, namely, the anonymous thirteenth-century mystical corpus originating in Languedoc, designated in scholarship as the ʿIyyun Writings. A reliable analysis of Kabbalistic Christian writings requires acquaintance with the writers’ sources, especially given the extent and divergence of medieval Kabbalistic literature. Therefore, we cannot make do with locating overt citations or references to known Kabbalistic treatises found in these writings, but also aim at uncovering covert Kabbalistic traditions which influenced them, as in the case of Postel and the ʿIyyun Corpus.
Pacifigeron indivisus (Asteraceae: Astereae), a new species endemic to Rapa, Austral Islands, and a new delimitation of the Celmisia group

Authors: SALDIVIA PATRICIO , WOOD KENNETH R. , ORLOVICH DAVID A. , LORD JANICE M.
Published: May 2020

This study reports, based on molecular phylogenetic analyses and a morphological assessment, the second species of Pacifigeron, an endemic genus of Rapa Island in French Polynesia. Detailed morphological and ecological descriptions, illustrations, IUCN Red List assessment, and a distributional map are provided. Our results support the exclusion of Pacifigeron from the Celmisia group and also allow the re-circumscription of the Celmisia group.         The new species Pacifigeron indivisus can be differentiated from P. rapensis, among other characters, by its larger leaves, larger number of capitula per capitulescence, corollas lacking long uniseriate multicellular trichomes, style of the disc florets undivided, and absence of twin trichomes on the cypsela epidermis. Molecular data indicates that Pacifigeron is related to South American Andean genera rather than to the Celmisia group as was previously proposed.                The Celmisia group is here re-circumscribed to include ca. 159 species distributed in Australasia within the following genera: Celmisia, Damnamenia, Olearia pro parte, Pachystegia, and Pleurophyllum. Given the taxonomic complexity and polyphyletic nature of Olearia, its taxonomy is briefly reviewed based on history, morphology, and phylogenetic evidence, which in turn allows delineation of its species composition within the Celmisia group. None of the Olearia species in the Celmisia group can be retained in Olearia since the type species, O. tomentosa, does not belong to the Celmisia group.
A new cryptic species of fringe-toed lizards from southwestern Arizona with a revised taxonomy of the Uma notata species complex (Squamata: Phrynosomatidae)
Authors: DERYCKE ELIZABETH G. , GOTTSCHO ANDREW D. , GOTTSCHO ANDREW D. , MULCAHY DANIEL G. , DE QUEIROZ KEVIN
Published: May 2020

Fringe-toed lizards (Uma) are among the most specialized lizards in North America, adapted to insular windblown sand habitats in the hyper-arid southwestern deserts, with allopatric distributions, subtle morphological variation, and an unstable taxonomic history. We analyzed a morphological dataset of 40 characters for 65 specimens and a molecular dataset of 2,286 bases from three mitochondrial loci for 92 individuals and interpreted these data alongside published analyses of multi-locus genetic data with the goal of revising the taxonomy of the Uma notata (Baird 1858) species complex. We confirmed that fringe-toed lizards from the Mohawk Dunes in southwestern Arizona (U. sp.) constitute a cryptic species sister to the rest of the complex that can be diagnosed with DNA barcoding and geography, so we describe and name this species Uma thurmanae sp. nov. We also confirmed the evolutionary distinctiveness of U. inornata (Cope 1895), an endangered species endemic to Coachella Valley in southern California. We designate a lectotype for the taxon U. “rufopunctata”, but we put its name in quotation marks to reflect its uncertain taxonomic status with respect to its neighboring species U. cowlesi and U. notata.
The genus Gynacantha Rambur, 1842 in the South Pacific (Odonata: Anisoptera: Aeshnidae)
Authors: THEISCHINGER GUNTHER , MARINOV MILEN , BYBEE SETH , JENSEN COLIN , THEUERKAUF JÖRN , RASHNI BINDIYA
Published: May 2020

Available information on Gynacantha Rambur, 1842 species from the South Pacific is reviewed. Specimens were found to be sufficiently similar to G. rosenbergi Kaup in Brauer, 1867 to be placed in the same species group (G. rosenbergi group—established here) but also distinct enough to form a subgroup of its own (G. rosenbergi Pacific group). All species of the G. rosenbergi group are diagnosed, with three species, Gynacantha vitiana sp. n. (male and female) from Viti Levu, Fiji, G. koroana sp. n. (male) from Koro, Fiji and G. vanuatua sp. n. (male) from Malekula, Vanuatu being described as new to science. A key is presented for identification of the males.
A New Theoretical Framework for Understanding Multiscale Atmospheric Predictability
Authors: Sun Y. Qiang , Zhang Fuqing
Published: May 2020

Here we present a new theoretical framework that connects the error growth behavior in numerical weather prediction (NWP) with the atmospheric kinetic energy spectrum. Building on previous studies, our newly proposed framework applies to the canonical observed atmospheric spectrum that has a −3 slope at synoptic scales and a −5/3 slope at smaller scales. Based on this realistic hybrid energy spectrum, our new experiment using hybrid numerical models provides reasonable estimations for the finite predictable ranges at different scales. We further derive an analytical equation that helps understand the error growth behavior. Despite its simplicity, this new analytical error growth equation is capable of capturing the results of previous comprehensive theoretical and observational studies of atmospheric predictability. The success of this new theoretical framework highlights the combined effects of quasi-two-dimensional dynamics at synoptic scales (−3 slope) and three-dimensional turbulence-like small-scale chaotic flows (−5/3 slope) in dictating the error growth. It is proposed that this new framework could serve as a guide for understanding and estimating the predictability limit in the real world.
Are My Pediatric Patients at Increased Risk of Developing Chronic Kidney Disease?
Authors: Primack William , Kleeman Stuart , Boineau Frank , Jernigan Stephanie
Published: May 2020

Chronic kidney disease (CKD) is an underrecognized and often undiagnosed cause of morbidity and mortality. Many children and adolescents are at increased risk of developing CKD as they mature and age, secondary to conditions commonly cared for by pediatric health professionals. Prematurity, diabetes mellitus, hypertension, congenital heart disease, sickle cell disease and trait, severe obesity, cancer chemotherapy, other drug toxicities, and systemic situations that may cause acute kidney injury such as sepsis or extracorporeal membrane oxygenation therapy predispose to potential CKD. Clinicians should be aware of these conditions in order to screen for CKD, choose non-nephrotoxic treatments for these children whenever possible, and treat or refer those who have early signs of CKD.
Patterns of Bone Damage in Patients With Chronic Middle Ear Inflammation
Authors: Wiatr Agnieszka , Strek Pawel , Wiatr Maciej
Published: May 2020

Background:

Despite different etiologies, chronic otitis media involves the damaging and restructuring of bone tissue. The inflammatory process destroys elements of the ossicular chain, and bone lesions may appear that allow the development of otogenous complications.

Aims/Objectives:

A correlation between the degree of damage to the ossicular chain as well as the bony walls of the middle ear and the type of chronic inflammatory lesions was sought. Destructive changes to bones were observed using scanning microscopy.

Material and Methods:

The removed damaged fragments of the ossicles were prepared for evaluation with a scanning microscope. Preparations were sputter-coated with a thin layer of gold and subsequently evaluated.

Results:

Of 220 surgeries carried out in the discussed period, destruction of the middle ear bone walls, opening the way for the development of intracranial complications, was found in 27 patients. Most of them had ongoing chronic otitis media with granulation.

Conclusions:

(1) Bone loss of the skull base was observed more frequently in patients with chronic otitis media with granulation than with cholesteatoma. (2) In chronic otitis media with cholesteatoma, damage to the ossicular chain was observed significantly more frequently than in the case of otitis media with granulation.
Who are “We”? Couple Identity Clarity and Romantic Relationship Commitment
Authors: Emery Lydia F. , Gardner Wendi L. , Carswell Kathleen L. , Finkel Eli J.
Published: May 2020

This research introduces the construct of couple identity clarity—the extent to which an individual, as one of two partners in a romantic relationship, believes that the two of them know who they are as a couple. Cross-sectional (Studies 1–2), experimental (Study 3), and longitudinal (Study 4) studies supported the hypothesis that couple identity clarity is associated with higher commitment. Moreover, higher couple identity clarity, although related to actual agreement between partners on their identity as a couple, predicted commitment above and beyond agreement (Study 2)—as well as predicted reduced likelihood of relationship dissolution over a 9-month period (Study 4). Exploratory analyses revealed that successful conflict resolution may enhance couple identity clarity, in turn predicting commitment (Study 4). These studies highlight the importance of people’s understanding of who they are as a couple and how this understanding shapes relationship persistence.
WP:NOT, WP:NPOV, and Other Stories Wikipedia Tells Us: A Feminist Critique of Wikipedia’s Epistemology
Authors: Menking Amanda , Rosenberg Jon
Published: May 2020

Wikipedia has become increasingly prominent in online search results, serving as an initial path for the public to access “facts,” and lending plausibility to its autobiographical claim to be “the sum of all human knowledge.” However, this self-conception elides Wikipedia’s role as the world’s largest online site of encyclopedic knowledge production. A repository for established facts, Wikipedia is also a social space in which the facts themselves are decided. As a community, Wikipedia is guided by the five pillars—principles that inform and undergird the prevailing epistemic and social norms and practices for Wikipedia participation and contributions. We contend these pillars lend structural support to and help entrench Wikipedia’s gender gap as well as its lack of diversity in both participation and content. In upholding these pillars, Wikipedians may unknowingly undermine otherwise reasonable calls for inclusivity, subsequently reproducing systemic biases. We propose an alternative set of pillars developed through the lens of feminist epistemology, drawing on Lorraine Code’s notion of epistemic responsibility and Helen Longino’s notion of procedural objectivity. Our aim is not only to reduce bias, but also to make Wikipedia a more robust, reliable, and transparent site for knowledge production.
MMPI-2 Profiles of Mothers Engaged in Parental Alienation
Authors: Roma Paolo , Marchetti Daniela , Mazza Cristina , Burla Franco , Verrocchio Maria Cristina
Published: May 2020

Parental alienation (PA) describes a family dynamic in which a parent engages in behaviors that are likely to foster a child’s unjustified rejection of the other parent. PA is considered a particular form of child psychological maltreatment with both short- and long-term negative consequences. Parents who attempt to turn a child against the other parent in cases of separation/divorce can be difficult to identify. Increasing our understanding of the personality features of these parents via psychological assessment may enable us to identify PA more quickly following the onset of abuse. In the present study, the personality characteristics of mothers engaging in PA were examined through a comparative analysis of MMPI-2 profiles. The results indicated that alienating mothers presented higher moral virtue and extroversion. They were more vulnerable to interpersonal stress and they demonstrated unsuccessful self-representation. The findings provide a preliminary model for understanding the profile of mothers who engage in PA.
Cody Complex foragers and their use of grooved abraders in Great Plains and Rocky Mountains of North America
Authors: LaBelle Jason M , Newton Cody
Published: May 2020

Comparison of Late Paleoindian sites of the Great Plains and Rocky Mountains reveals 36 site components from 28 sites containing ground stone tools, including nine Cody Complex examples. Much of the ground stone use appears related to generalized activity, as few items have functionally specific forms. However, the Cody components have an unexpectedly higher number of grooved abraders as compared to other complexes. We note that Paleoindian examples contain wider u-shaped grooves compared to Late Prehistoric/Protohistoric abraders related to arrow production. We argue that Paleoindian abraders represent shaft abraders, used in the production of dart shafts within weaponry systems. We propose several hypotheses for the emergence of this technology during Cody times. The most parsimonious explanation is that the specific sites containing these abraders represent large camps, occupied for long periods and containing diverse chipped and ground stone assemblages.
Advisor Interaction Goals and Verbal Messages: Merging a Multiple Goals Approach and the Integrated Model of Advice Giving
Authors: Guntzviller Lisa M. , Pulido Manuel D. , Liao Danni , Butkowski Chelsea P.
Published: May 2020

Based on the integrated model of advice giving and theorizing about interaction goals, we examined how advisors’ goal intensity and complexity predicted perceptions of advisor harmfulness and helpfulness. We also examined predictors of goal intensity and complexity, such as advisors’ relational satisfaction with recipients, which generally increased goal intensity and complexity. Recipients and advisors rated advisors’ behaviors as more helpful when advisors reported greater intensity of the problem-solving goal but not the other three goals (emotional support, eliciting disclosure, and facilitating reappraisal). However, recipients and advisors rated advisors’ behaviors as more harmful when advisors had low versus moderate or high goal complexity. Qualitative analyses of conversation transcripts revealed patterns of interaction behavior associated with goal intensity and complexity. We discuss how goal intensity and complexity may relate to advisors’ messages and interaction patterns during the conversation, and therefore recipient and advisor perceptions of advisors’ helpfulness and harmfulness.
When antithrombin substitution strikes back
Authors: Broman Lars Mikael
Published: May 2020

Commercially available products used for antithrombin supplementation, for example, in extracorporeal life support, may contain latent antithrombin, a hyper-stable strongly procoagulative and anti-angiogenic residue. Latent antithrombin is associated with severe thrombosis in the critically ill. In the manufacturing process of fractionated antithrombin from plasma, heat treatment, citrate, and freeze drying speed up the transformation of native antithrombin to latent antithrombin. Manufacturers are not required to assess and report the latent antithrombin content of their products. When reported, the latent antithrombin fractions in their product range from <1% to 40% of total antithrombin compared with <3% in the healthy adult and less in children. The aims of this work were (1) to convey increased awareness to clinicians who may experience defaulted, expected effect after antithrombin supplementation in, for example, heparin anticoagulation during extracorporeal life support and (2) to urge manufacturers to assess and disclose latent antithrombin content in their products.
Incidence of early intra-cranial bleeding and ischaemia in adult veno-arterial extracorporeal membrane oxygenation and extracorporeal cardiopulmonary resuscitation patients: a retrospective analysis of risk factors
Authors: Malfertheiner Maximilian Valentin , Koch Andrea , Fisser Christoph , Millar Jonathan Edward , Maier Lars Sigfried , Zeman Florian , Poschenrieder Florian , Lubnow Matthias , Philipp Alois , Müller Thomas
Published: May 2020

Background:

Cerebral complications in veno-arterial extracorporeal membrane oxygenation are known to have a strong impact on mortality and morbidity. Aim of this study is to investigate the early incidence, risk factors and in-hospital mortality of intra-cranial ischaemia and haemorrhage in adults undergoing veno-arterial extracorporeal membrane oxygenation treatment.

Methods:

This study is a single-centre retrospective analysis on adult patients undergoing veno-arterial extracorporeal membrane oxygenation for different indications. The inclusion criterion included patients with early routine cerebral computed tomography imaging during extracorporeal membrane oxygenation, with no clinical evidence of cerebral pathology prior to cannulation. Cerebral complications were grouped by aetiology and the territories of the brain’s supplying arteries.

Results:

One hundred eighty-seven adult patients with a total of 190 veno-arterial extracorporeal membrane oxygenation treatments were included. A total of 16.3% (n = 31) had evidence of either cerebral ischaemia (11.1%) or haemorrhage (5.8%); one patient suffered from both. Cerebral computed tomography scans were performed early in median on the first day after extracorporeal membrane oxygenation cannulation; in-hospital mortality of intra-cranial ischaemia and haemorrhage was 71.4% and 45.5%, respectively. Associated with an increased risk for ischaemic lesions were cannulation of the ascending aorta, higher age, presence of an autoimmune disease and cardiac surgery prior to veno-arterial extracorporeal membrane oxygenation. An association with haemorrhagic lesions was found for a lower blood PaCO2 at 2 hours, lower blood flow through the extracorporeal membrane oxygenation device at 2 hours, higher international normalized ratio and constantly higher activated partial thromboplastin time values as well as higher mean arterial pressures until haemorrhagic lesions were evident.

Conclusion:

Cerebral complications are frequent in patients on veno-arterial extracorporeal membrane oxygenation and may be clinically silent events. Careful monitoring with routine neuroimaging seems to be the most appropriate diagnostic approach at present. Intra-cranial ischaemia occurs more frequent than haemorrhage and is associated with cannulation of the aorta ascendens.
Ex vivo models for research in extracorporeal membrane oxygenation: a systematic review of the literature
Authors: Malfertheiner Maximilian Valentin , Broman Lars Mikael , Vercaemst Leen , Belliato Mirko , Aliberti Anna , Di Nardo Matteo , Swol Justyna , Barrett Nicholas , Pappalardo Federico , Bělohlávek Jan , Taccone Fabio Silvio , Millar Jonathan Edward , Crawford Lachlan , Lorusso Roberto , Suen Jacky Y , Fraser John F
Published: May 2020

With ongoing progress of components of extracorporeal membrane oxygenation including improvements of oxygenators, pumps, and coating materials, extracorporeal membrane oxygenation became increasingly accepted in the clinical practice. A suitable testing in an adequate setup is essential for the development of new technical aspects. Relevant tests can be conducted in ex vivo models specifically designed to test certain aspects. Different setups have been used in the past for specific research questions. We conducted a systematic literature review of ex vivo models of extracorporeal membrane oxygenation components. MEDLINE and Embase were searched between January 1996 and October 2017. The inclusion criteria were ex vivo models including features of extracorporeal membrane oxygenation technology. The exclusion criteria were clinical studies, abstracts, studies in which the model of extracorporeal membrane oxygenation has been reported previously, and studies not reporting on extracorporeal membrane oxygenation components. A total of 50 studies reporting on different ex vivo extracorporeal membrane oxygenation models have been identified from the literature search. Models have been grouped according to the specific research question they were designed to test for. The groups are focused on oxygenator performance, pump performance, hemostasis, and pharmacokinetics. Pre-clinical testing including use of ex vivo models is an important step in the development and improvement of extracorporeal membrane oxygenation components and materials. Furthermore, ex vivo models offer valuable insights for clinicians to better understand the consequences of choice of components, setup, and management of an extracorporeal membrane oxygenation circuit in any given condition. There is a need to standardize the reporting of pre-clinical studies in this area and to develop best practice in their design.
Prediction of readiness to decannulation from venovenous extracorporeal membrane oxygenation
Authors: Hartley Emma L , Sanderson Barnaby , Vasques Francesco , Daly Kathleen JR , Lozinski Maria , Barrett Nicholas A , Camporota Luigi
Published: May 2020

Objective:

The criteria and process for liberation from extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome are not standardized. The predictive accuracy of the oxygen challenge test as a diagnostic test in determining weaning and decannulation from venovenous extracorporeal membrane oxygenation was tested.

Design:

A single-centre, retrospective, observational cohort study.

Setting:

Tertiary referral severe respiratory failure centre in a university hospital in the United Kingdom.

Patients:

253 adults with severe acute respiratory distress syndrome requiring extracorporeal membrane oxygenation.

Intervention:

None

Measurements and Main Results:

Patients had median age: 43 years (interquartile range: 32-52) years, extracorporeal membrane oxygenation days: 9 (interquartile range: 6-14) and acute physiology and chronic health evaluation II score 17.5 (interquartile range: 15-20). Oxygen challenge test value (PaO2-OCT) with best prediction was 31 kPa (232 mmHg; sensitivity 0.74; specificity 0.70; area under curve 0.77 (confidence interval: 0.73-0.81)). PaO2-OCT did not perform well as a prospective test to identify readiness to decannulation. Only 24 patients (10%) were decannulated 48 hours after their first positive oxygen challenge test (true positive) and 73.4% patients were false positives (positive oxygen challenge test but not decannulated). True positives had higher tidal volume (541 ± 218 vs 368 mL ± 210; p < 0.05) and minute ventilation (9.34 ± 5.36 vs 6.33 L/min ± 4.43; p < 0.05). Blood flow (3.17 ± 0.23 vs 3.53 L/min ± 0.56; p < 0.05), sweep gas flow (1.42 ±1.83 vs 3.74 L/min ± 2.43; p < 0.05) and extracorporeal membrane oxygenation minute volume at time of first positive oxygen challenge test was lower in true positives (1.66 ± 2.26 vs 4.82 ± 3.43 L/min). This was a strong predictor for decannulation within 48 hours (area under curve: 0.88, confidence interval: 0.88-0.89).

Conclusions:

In severe acute respiratory distress syndrome requiring venovenous extracorporeal membrane oxygenation, the PaO2-OCT is a poor predictor of readiness to decannulate from extracorporeal membrane oxygenation. Additional factors involved in the control of respiratory drive and carbon dioxide clearance, particularly native lung dead space and total minute ventilation, should be assessed.
A novel veno-arteriovenous extracorporeal membrane oxygenation with double pump for the treatment of Harlequin syndrome
Authors: Contento Carlo , Battisti Andrea , Agrò Bruno , De Marco Marina , Iaiza Alessandra , Pietraforte Laura , Pisani Patrizia , Proietti Antonio , Vitalini Emiliano , Montalto Andrea , Musumeci Francesco
Published: May 2020

Objectives:

The Harlequin syndrome is a complication observed in patients receiving peripheral venoarterial extracorporeal membrane oxygenation. This condition is defined as a critical variation in the oxygen saturation between the upper and the lower part of the body deriving from a poor lung function.

Methods:

Between July 2018 and November 2019, a total of 60 patients (42 men and 18 women; mean age 57.4 ± 10.0 years; range = 28-71 years) underwent peripheral venoarterial extracorporeal membrane oxygenation in our center. Harlequin syndrome was identified in eight cases (six men and two women; 13.3%) of the 60 venoarterial extracorporeal membrane oxygenation–supported patients. As a result of the Harlequin syndrome, all these patients required conversion to veno-arteriovenous extracorporeal membrane oxygenation. Control and monitoring of the blood flows of the return cannulae were performed using two centrifugal pumps, one for each inlet line, according to the patient requirements to achieve optimum hemodynamic and oxygenation.

Results:

Mean duration of veno-arteriovenous extracorporeal membrane oxygenation support was 5.3 ± 1.4 days. Seven patients (87.5%) were switched to venovenous extracorporeal membrane oxygenation, and after 13.5 ± 2.7 days, those patients were totally weaned from extracorporeal membrane oxygenation support. One patient (12.5%) had an improvement in the pulmonary function, but the cardiac function was poor. This patient was switched to venoarterial extracorporeal membrane oxygenation, and after 10 days, the patient was completely weaned from extracorporeal membrane oxygenation support.

Conclusion:

The use of a secondary centrifugal pump to manage the blood flow directed to the internal jugular vein, in the veno-arteriovenous extracorporeal membrane oxygenation setup, allows the reduction in the risk of blood clot formation, clotting factor consumption, and pulmonary embolism when compared to the use of an external clamp.
Managing shoulder pain in manual wheelchair users: a scoping review of conservative treatment interventions
Authors: Mason Barry , Warner Martin , Briley Simon , Goosey-Tolfrey Victoria , Vegter Riemer
Published: May 2020

Objective:

To review the literature that has explored conservative treatments for the management of shoulder pain in manual wheelchair users.

Methods:

Five databases were systematically searched in february 2020 for terms related to shoulder pain and manual wheelchair use. Articles were screened and included if they investigated the conservative treatment of shoulder pain in wheelchair users. Participants’ physical characteristics, experimental design and primary and secondary outcome measures were extracted from studies. Studies were grouped according to treatment type to identify gaps in the literature and guide future research.

Results:

The initial search identified 407 articles, of which 21 studies met the inclusion criteria. Exercise-based treatment interventions were most prevalent ( n = 12). A variety of exercise modalities were employed such as strengthening and stretching ( n = 7), ergometer training ( n = 3), Pilates classes ( n = 1) and functional electrical stimulation ( n = 1). Only three studies supplemented exercise with an additional treatment type. The Wheelchair Users Shoulder Pain Index was used by 18 studies as the primary measure of shoulder pain. Only seven of these included an objective measure of shoulder function. Participant characteristics varied among studies, and physical activity levels were frequently not reported.

Conclusions:

Despite the high prevalence of shoulder pain in manual wheelchair users, the number of studies to have explored conservative treatment types is low. Exercise is the most commonly used treatment, which is encouraging as physical inactivity can exacerbate other health conditions. Few studies have adopted interdisciplinary treatment strategies or included objective secondary measures to better understand the mechanisms of pain.