bluuebunny/crossref_metadata_2025 huggingface dataset:
Humiliation through the Prism of Islamic Thought
Authors: Euben Roxanne L.
Published: December 2019

The prevailing definition of humiliation as a violation of human dignity or respect has assumed the status of common sense, despite its elusive and derivative content. models how the dominant definition can be denaturalized and even displaced to render legible figurations of humiliation in other bodies of knowledge. It specifically traces the career of the concept and phenomenon of humiliation across three corpora foundational to Islam, the Qur’an, the Ḥadīth, and Islamic law. These texts trace different agentic sources in various combinations depending on site, subject, and stakes. The result is not a linear account of the “evolution” of humiliation in Islam, but rather a spectrum of shifts and contingencies, continuities and reversals. These arguments are adduced not in support of an Islamic theory of humiliation, but as resources for a provisional account of humiliation as a hierarchical relation instantiated in the act and experience of imposed powerlessness. So understood, this analysis of Islamic sources is just one part of an ongoing investigation into the range of resources—located in multiple traditions, practices and corpora past and present—for building up a political theoretic conception of humiliation grounded in asymmetries of power.
The Concept of Rights in Modern Japan
Authors: Takeharu Ōkubo
Published: December 2019

This chapter aims to investigate the acceptance of “rights” in nineteenth-century Japan by examining divergent interpretations of political concepts between the West, especially Europe, and East Asia. After the arrival of US warships in 1853, facing the imminent threat of Western power, Japanese scholars and statesmen raised fundamental normative issues concerning the legal and moral concepts shaping the Western world—essentially posing the question, “What is Western civilization?” They grappled both theoretically and practically with Western political thought, employing the vocabulary and concepts provided by their own East Asian legal, moral, and political traditions, such as Confucianism, in a variety of ways. Given the differences between Western and Asian legal traditions, especially, the idea of “rights” was one of the hardest to accept. This chapter examines how some key Japanese intellectuals and politicians, including Nishi Amane, Nakae Chomin, and Fukuzawa Yukichi, confronted the complex plurality of rights in jurisprudence and discourse of European thinkers such as Simon Vissering, Jean-Jacques Rousseau, and John Stuart Mill and how they used it to reconsider specifically the legal culture of East Asia. In the course of this intellectual struggle with an alien culture, these Japanese thinkers sought to liberate European political theory from a closed historical identity and imbue it with new meaning in a new context. This is a history of comparative political theory concerned with the cross-cultural phenomenon of the nineteenth-century encounter of non-Western intellectuals with the ideal and the reality of “the West.”
Organicism in Indonesian Political Thought
Authors: Bourchier David
Published: December 2019

Organicism, or the notion that political and legal institutions should reflect communalistic values embedded in “traditional culture,” has played a significant part in Indonesia’s modern history. This chapter begins with a brief overview of organicism as a concept, linking it to German theories of the Volksgeist. It then examines the study of organicism in Indonesia and its expression in the state ideology of Pancasila, arguing that to understand it primarily in culturalist terms overlooks the profound extent to which it developed in conversation with Western ideas of the East. Organicism found expression in Indonesian constitutional thinking, in conservative political party programs, in the corporatist structures of political representation between the 1960s and the 1990s, and in the ideology of Soeharto’s New Order regime. In this sense, it foreshadows the exceptionalist “Asian values” rhetoric espoused by political leaders in Singapore and Malaysia in the 1990s. The conclusion notes that while each manifestation of organicism will be different, there are common features that enable comparison across cultures and movements, including right-wing nationalist movements currently on the rise in the West.
Indigenous Struggles for Epistemic Justice
Authors: Nichols Robert
Published: December 2019

This chapter explores how questions of epistemic justice are expressed in the context of indigenous struggles against settler colonization in the anglophone world. It focuses specifically on how indigenous peoples in the Anglo-settler world (1) tend to preserve and transmit knowledge about their societies and the history of their struggles against colonization through various oral traditions, rather than the text-based or scriptural traditions of many other societies, and (2) have been subject to a particular form of eliminatory violence that has sought not only to subordinate and exploit them, but also to erase and replace them altogether with neo-European settler societies. This chapter considers how these two features articulate as problems of epistemic justice. Part I introduces a specific case study—the 1997 Supreme Court of Canada decision Delgamuukw v. British Columbia—as a means of clarifying the stakes and contours of the first problem. Part II offers a critical survey of work that has developed in the twenty years since Delgamuukw, which has increasingly linked the two highlighted issues.
Beyond Binary Sex and Gender Ideology
Authors: Costello Cary Gabriel
Published: December 2019

Perceived as natural and universal, the framing of sex and gender as binaries is in fact a cultural ideology. The empirical reality is that sex is a spectrum, manifesting in a wide array of sex variance, some of it formally categorized as intersex by scientists and doctors, and some not. This article gives an overview of how different societies have organized sex and gender into three, four, or more categories, and of the imposition of binary sex/gender as part of the European colonialist project. It then presents case histories examining four transgender and/or intersex individuals in the contemporary context, illustrating how individuals negotiate, exploit, or subvert binary sex/gender ideologies in conceptualizing physical sex variance and gender transition.
Potassium Channels and Pain
Authors: Busserolles Jérôme , Gasull Xavier , Noël Jacques
Published: December 2019

The K+ channel family is one of the most complex families of ion channels. The diversity of this channel family is a real challenge for the study of pain. Potassium channels form the largest family of ion channels in mammals, with more than 80 genes encoding α subunits in humans. Their differences in structures and functions divide them into four families, all of which are expressed in somatosensory neurons and supporting glial cells. The opening of K+ channels hyperpolarizes the plasma membrane, which opposes excitation of the neuron by all other depolarizing channels. K+ channels are very efficient regulators of the electrical activity of sensory neurons and of pain perception. Their potential for the development of antinociceptive pharmacology is immense.
Bonhoeffer and the Conspiracy
Authors: Barnett Victoria J.
Published: December 2019

Dietrich Bonhoeffer’s role in the 20 July conspiracy to overthrow the Nazi regime has been a central theme in the scholarship about his life and theology. This aspect of his life has also generated controversy, since many scholars see a discrepancy between his early pacifist writings and the use of violence by the conspiracy. This chapter will examine Bonhoeffer’s role in the German resistance circles in the context of historical scholarship about the resistance. It will offer an overview of Bonhoeffer’s historical role, examine where he stood on the larger landscape of the different German resistance groups, and discuss problematic aspects of the German resistance including war crimes. It will also examine how his political engagement during this period may have influenced his theological work.
Ecclesiology
Authors: Greggs Tom
Published: December 2019

This chapter examines Bonhoeffer’s account of the church and advocates that throughout Bonhoeffer’s corpus there remains a desire to explicate the reality of the church in terms of its structural being with and for the other. This structure exists both internally in terms of its members’ relation to each other, and externally as the church relates as a corporate body to the world. The chapter considers Bonhoeffer’s ecclesiological method; the visibility of the church; vicarious representation; the church as the body of Christ; the agency of the Holy Spirit; preaching, the sacraments, and the offices of the church; and the question of the church in a religionless age.
Bonhoeffer, Community, and Witness
Authors: Harvey Barry
Published: December 2019

This chapter examines the degeneration of meaningful communal life and its effects on personal existence as experiences that render suspect credible witness to the realities of God and world. Thinking after Bonhoeffer takes up the main Christological and ecclesial trajectories of his theological project, with two of his perennial concerns providing the most promising point of departure for addressing the questions of community and witness: how Christ takes form in a congregation and how Christians might be prepared for the day when once more we are ‘called to speak the word of God in such a way that the world is changed and renewed’. This chapter concludes by showing how his concepts of the arcane discipline, the leisure space of freedom, and the polyphony of life adequately account for both concerns in light of the changes that mark a world come of age.
Sources and Texts
Authors: Kirkpatrick Matthew D.
Published: December 2019

Since his death in 1945, Bonhoeffer’s thought has been promoted and preserved by generations of scholars. Beginning with the extraordinary efforts of Eberhard Bethge, as well as the International Bonhoeffer Society, a plethora of initiatives have been undertaken to offer the researcher access to Bonhoeffer’s writings, contextualizing material, as well as to the many different secondary sources that have been written. The aim of this chapter is to provide an overview of these resources, how they have developed over the last seventy years and how they relate to one another, as well as the most up-to-date sources that are now available. This overview focuses on primary and secondary sources, the archives that hold these materials, and the tools that have been developed to aid the researcher gain comprehensive access to this extraordinary thinker.
Creation
Authors: Puffer Matthew
Published: December 2019

Dietrich Bonhoeffer’s theology of creation is rooted in the confession that Jesus Christ is the mediator. Apart from Christ’s mediation human beings cannot perceive God’s creation, because our postlapsarian world manifests only a fallen creation in which good and evil are confused and intermixed. Whereas Bonhoeffer in his student years affirmed a limited role for the orders of creation, his subsequent writings on the theology of creation can be read as a response to and reaction against the orders of creation. Although human beings have no unmediated access to knowledge of God’s creation, and know the world as fallen creation only through Christ’s redemption, in Christ they are empowered by the Spirit, incorporated into Christ’s body the church, and made a new creation. Only in light of the hoped-for eschatological fulfilment of the new creation may Christian theology speak of the beginning of God’s ways as Creator.
Scripture
Authors: Mawson Michael
Published: December 2019

This chapter outlines the contours of Dietrich Bonhoeffer’s approach to Scripture as God’s word and witness to Christ. It begins by examining the role of the Bible in Bonhoeffer’s own life and work, emphasising two of his main influences: Karl Barth and Martin Luther. The main part of the chapter turns to Bonhoeffer’s ways of attending to biblical texts in their historicity and substance. Finally, the chapter suggests that Bonhoeffer’s approach is marked by a posture of reading the Bible ‘against ourselves’—that is, to remain open to the Bible as God’s own cruciform word and witness.
Bonhoeffer and Feminist Theologies
Authors: McBride Jennifer M.
Published: December 2019

Given Bonhoeffer’s sexist and patriarchal views, feminist theologians have not readily turned to Bonhoeffer as a resource for their constructive thinking. Three Bonhoeffer scholars—Rachel Muers, Lisa Dahill, and Karen Guth—offer feminist analyses that not only draw attention to the incompleteness and inadequacy of traditional readings of Bonhoeffer’s theology, but also demonstrate the productive potential for sustained engagement with his work. In doing so, they offer a twofold challenge: first, traditional Bonhoeffer scholarship is pressed to address his sexism and critically attend to issues hitherto ignored in his work; second, feminist theologies are pressed to consider Bonhoeffer as a rich theological resource for addressing a number of shared concerns. These three thinkers offer methods for mutually beneficial engagement that are overlapping yet distinct enough to provide a textured and sure foundation for this largely untapped area of Bonhoeffer studies.
The Form of Ethical Life
Authors: Ulrich Hans G.
Published: December 2019

This chapter identifies, examines, and elucidates a number of key themes and insights in Bonhoeffer’s multivalent approach to ethics. In particular, it explores Bonhoeffer’s rich conceptions of reality, formation, and conformation to Christ. It then goes on to reflect upon some of the distinctive and concrete ways in which Bonhoeffer further develops his account of the manner in which God conforms human beings to Christ, giving close scrutiny to the central ethical concepts of ‘responsibility’, ‘the mandates’, ‘natural life’, etc. Throughout, this chapter gives close attention and offers specific comment upon the ways in which the many original and distinctive features of Bonhoeffer’s decisively theological approach to ethics stand in distinction—and sometimes notable tension—in relation to other more familiar approaches to ethical thinking in his time and our own.
Religion and Secularity
Authors: Wüstenberg Ralf K.
Published: December 2019

What did Bonhoeffer mean by the term ‘religion’ when writing about a ‘nonreligious form of interpretation’ of biblical concepts? How should we understand this term and its interpretation today? Has the world of the twenty-first century really become ‘religionless’? More broadly, how does Bonhoeffer’s interpretation relate to more recent accounts of secularity and our secular age? This chapter argues that Bonhoeffer’s theological analysis in his own time, in which he deployed this concept of ‘religionlessness’, resonates with a more recent analysis of secularity offered by Charles Taylor. Specifically, this chapter claims that Bonhoeffer and Taylor identify some similar causes of secularization, and also share a critique of ‘religious individualism’. Drawing Bonhoeffer into dialogue with Taylor, then, can help to clarify his understanding of secularity.
Bonhoeffer in North America
Authors: Dorrien Gary
Published: December 2019

Dietrich Bonhoeffer studied at Union Theological Seminary in 1930/1. He had decided to go to Union because it specialized in social ministry, and by this time he had misgivings about his theory-laden Habilitation thesis. He was also interested in Union because it was in New York, a site of cultural adventure. While he thought he was open to being challenged and taught by Union faculty, he quickly concluded that Union did not teach ‘real theology’. Bonhoeffer’s mostly negative experience at Union was redeemed by his friendships with Union classmates, his participation in church and community courses, his study of American pragmatism, his introduction to black Social Gospel preaching and worship at Abyssinian Church, and his shift toward Christian pacifism, the latter notwithstanding his complaint that Union reduced Christianity to Social Gospel pacifism.
Bonhoeffer the Academic Theologian
Authors: Frick Peter
Published: December 2019

Bonhoeffer was not only a spiritual mentor and political resistor but even more so an academic theologian. Not only did he write more academic than spiritual works, but he was also actively involved in the teaching of theology, primarily at the University of Berlin and as director of the underground seminary in Finkenwalde. Bonhoeffer attempted to articulate ‘genuine theological concepts’ that would adequately capture the reality of fallen humanity in the one reality of the world in Christ. Based on rigorous exegesis and theological interpretation of biblical texts, he articulated his basic theological category, namely that of Christology, as the centre of this theology from which he developed all other theological topoi including church and ethics.
Musical Identities Mediate Musical Development
Authors: Hargreaves David J. , MacDonald Raymond , Miell Dorothy
Published: December 2019

This article has two main aims. The first is to identify those aspects of developmental psychology as a whole that are most useful in trying to explain musical development in particular. The second is to develop the central argument that the study of people's musical identities is an essential part of the explanation of their musical development. The article is organized as follows. The first section summarizes the main theoretical perspectives on musical development since the 1980s. The second section provides representative examples of empirical research from three broad areas—cognitive, social, and affective— and then looks at the cognitive aspects of musical development and learning: This was the predominant emphasis of developmental studies in the 1980s. The third section focuses on the social aspects of musical development, which have come to include the study of personality. The fourth section considers the development of the affective aspects of musical behavior, that is, those concerning emotion.
Initiating Music Programs in New Contexts: In Search of a Democratic Music Education
Authors: Mota Graça , Figueiredo Sergio
Published: December 2019

This article, which discusses the concept of “democratic music education,” begins by situating the principles for advocacy, providing a rationale where these are discussed from the perspective of different authors. The next section establishes a framework for what could be a sustainable music education program from the perspective of a democratic approach. Then, it addresses the issue of initial and continuing music teacher education, pointing to a professional profile that will be capable of working in diverse formal and nonformal music educational contexts, while maintaining an ongoing reflexive critical attitude. The final section presents a number of research findings about the implementation of social projects involving music education in Brazil, and one project of social inclusion through engagement with music that is being implemented in Portugal. The article concludes by summarizing the main points covered and their broad implications for a redefinition of music education.
Children's Ways of Learning Inside and Outside the Classroom
Authors: Harwood Eve , Marsh Kathryn
Published: December 2019

This article focuses on children's musical play, including that involving interactions with popular music and popular culture. It outlines features of musical play, especially as found in communities of practice in the playground, and the disjunction that may often occur between children's challenging, social, and participatory enactment of play and the pedagogical characteristics of classroom music. The article suggests a child-centered approach to music learning and teaching that endeavors to bridge the gap between children's external, informal music-making and musical experiences in the school.
Creativity in the Secondary Music Classroom
Authors: Odena Oscar
Published: December 2019

This article, which reviews key research in, and practices of, creativity in music education in order to assist the reader to better understand what is known about musical creativity in teaching, learning, and development between ages 12 and 18, aims to support teachers in promoting musical creativity in their classrooms. The choice of studies reviewed focuses on key research-based publications, mostly centered on formal education settings, and embracing all types of methodological approach. The first part of the article examines some of the meanings attached to the word “creativity,” drawing on aesthetics, musicology, psychology, and education; and the second focuses on a conceptualization of musical creativity for the secondary classroom, incorporating a cross-cultural perspective. The article concludes with a discussion of promising practices and some final considerations.
Processes of Instrumental Learning: The Development of Musical Expertise
Authors: Hallam Susan , Bautista Alfredo
Published: December 2019

This article explores the processes underlying learning to play an instrument. The processes underpinning the learning of a musical instrument require time, effort, and commitment, although the extent to which these are needed depends on the nature of the music itself and the particular cultural traditions that pertain in relation to its creation and performance. Widening participation in instrumental learning means that most learners will engage with music-making in the longer term as a recreational activity either through amateur music-making or as listeners. What they need to develop as a result of their learning is a love of music and the meta-cognitive skills that will support them throughout their lifetimes in whatever musical activities they choose to pursue. To reflect these changes, music educators need to consider what their curricular priorities should be. Learning is most enjoyable when what is to be learned is challenging (not too easy or too difficult) and there is a sense of achievement when it has been mastered.
Queering Brighton
Authors: Whiteley Sheila
Published: December 2019

Every place has its local history of queerness, as shown in this chronicle of queerness in Brighton, England. The author sketches an account of Brighton’s non-normative sexual practices and sexually dissident residents and visitors, especially from the late nineteenth century on. The discussion identifies many gay clubs and other sites of queer community. Two examples illustrate aspects of mid-twentieth-century queer culture: the 1960s radio comedy “Round the Horne,” rich in camp humor and using the queer underground language Polari; and a recent poem by Brighton poet John McCullough that shows nostalgic affection for Polari. The author includes information about her own initiation into the gay world of Brighton. The queer culture of Brighton has produced extensive historical and present-day local self-documentation on websites, which provides much of the information for this discussion.
Fear and Anxiety in Young Children and Their Assessment
Authors: Broeren Suzanne , Hudson Jennifer L. , Rapee Ronald M.
Published: December 2019

Fear and anxiety are normal aspects of childhood development. For some young children, the experience of fear and anxiety can become severe and chronic and can start to interfere with daily life. If intervention is not provided, these problems tend to remain fairly stable over childhood and adolescence and are associated with an increased risk for other mental health problems across the life span. Before interventions can be delivered to young children, early detection of fear and anxiety using psychometrically sound and standardized measures is needed. In addition to providing a review of fear and anxiety in young children, this chapter provides a summary of the methods used to assess anxiety in this age group, discussing relevant measures along with the pragmatics of assessment. A multimethod, multisource approach to the assessment of fear and anxiety in young children is recommended.
Addressing Barriers and Limitations of Developmental Screening in Community Contexts
Authors: Silver Rebecca B. , Beers Megan , Godoy Leandra , Dickstein Susan
Published: December 2019

This chapter describes the triage assessment, a structured way for mental health consultants to conceptualize concerns identified via developmental screening processes and frame feedback to support family engagement with next steps. This chapter (a) describes the rationale, goals, and critical elements of triage assessments; (b) suggests pragmatic guidelines for implementation; and (c) discusses lessons learned from experience conducting triage assessments in community settings, including the importance of promoting family engagement and considerations for increasing sustainability. This chapter describes work conducted in pediatric primary care clinics serving young children at high risk for adverse developmental, behavioral, and social-emotional outcomes. However, the purpose, essential components, and structure of triage assessments are relevant as second-stage screening practices for all settings. As screening becomes broadly implemented, the triage assessment helps providers respond to red flag concerns highlighted by first-stage screening practices and support families to get help to address these concerns.
Assessment of Early Parent–Child Relationships
Authors: Clark Roseanne , Tluczek Audrey , Moore Elizabeth C. , Evenson Amber L.
Published: December 2019

Using a relational approach to assessment integrates the theoretical application of developmental, psychological and psychiatric disciplines (Clark, Tluczek, & Gallagher, 2004; Sameroff & Emde, 1989; Sameroff, McDonough, & Rosenblum, 2004). Clark, Tluczek, Moore, and Evenson (2019, Chapter 2) presents a review of these perspectives. This chapter introduces best practices in the assessment of parent–child relationships and provides an in-depth description and illustration of the Parent–Child Early Relational Assessment, composed of both objective ratings and a subjective video replay interview used to engage the parent in assessing his or her relationship with his or her child. In addition, reliability, validity, research findings, and the clinical utility of a wide range of parent–child relationship assessment tools and procedures are provided. The importance of considering the individual contributions of the parent, the infant or young child, the family, and the cultural context in the assessment process is highlighted. Guidelines are also included on the use of relational assessments in research and to inform clinical practice.
Distinguishing Temperament From Psychopathology
Authors: Rettew David C.
Published: December 2019

Identifying the boundaries between more extreme levels of temperament traits and psychiatric symptoms or disorders can be challenging, but clinicians are often called on to make such determinations. Despite modern views of psychiatric illness as binary yes-or-no conditions, a vast literature has accumulated demonstrating strong links between various temperament dimensions and nearly all types of psychopathology. Less well understood is how these domains are related and to what degree traits and psychopathology share a common etiology. In the end, a more dimensionally minded clinical approach that includes quantitative assessment with incremental treatment, health promotion in addition to disease reduction, and a focus on the family rather than individuals may be productive regardless of how particular behaviors are labeled.
Mapping Musical Development in Learners with the Most Complex Needs: The Sounds of Intent Project
Authors: Ockelford Adam , Welch Graham F.
Published: December 2019

This article focuses on the Sounds of Intent project, aimed mapping the musical development of young people with the most complex needs. From 2002, the research team worked with practitioners who were active in the field—music therapists, teachers, and others—to develop accurate descriptions and shared interpretations of the different forms and levels of musical engagement they observed among children and young people with complex needs. The theoretical framework developed by the team is discussed.
The Misunderstanding of Music-Technology-Education: A Meta Perspective
Authors: Himonides Evangelos
Published: December 2019

This article explores the concept of “technology” within the wider contexts of music and education. It draws upon a recent position paper by Himonides and Purves (2010), which argues that technology should not be viewed as a solution for the music educator to apply in the classroom. “Music technology” should be treated like any other tool that supports learning and teaching; helps us engage with valued forms of knowledge; celebrates and recognizes the importance of prior learning and experience; requires the teacher to scaffold learning; needs assessment to be congruent with learning; promotes the active engagement of the learner; fosters both individual and social processes and outcomes; recognizes the significance of informal learning; depends on teacher learning; and, finally, demands consistent policy frameworks with support for teaching and learning as the primary focus.
Music Education from a Slightly Outside Perspective
Authors: Lundström Håkan
Published: December 2019

This article focuses on the ways people gain sufficient musical knowledge to be able to learn songs and transmit these to others. It discusses music learning in an oral culture; an anthropological view of learning; and challenges for music education.
Valid trust declarations over property not owned by the settlor or over unascertainable property
Authors: Wilde David
Published: December 2019

It seems to be widely believed that settlors can never make valid declarations of trust over property that, at the time of the declaration, they do not own; or which is unascertainable then. It is argued that this is a misconception: arising from a failure to distinguish between (1) rules applicable to self-declarations of trust and (2) rules applicable to declarations of trust to be constituted by vesting title to property in others as trustees.
Validation of Paediatric Nutrition Screening Tool (PNST) among Hospitalized Malaysian Children
Authors: Ong Shu Hwa , Chen Seong Ting
Published: December 2019

Background

It is recommended to screen hospitalized children to identify those at risk of malnutrition. Constricted schedule in tertiary care settings calls for the needs of a less burdensome yet effective nutrition screening tool. This study aimed to validate the use of Paediatric Nutrition Screening Tool (PNST) among hospitalized children in a Malaysian tertiary hospital.

Methods

This cross-sectional study recruited children below 18 years old admitting into general paediatric ward in a public hospital. The PNST and Subjective Global Nutritional Assessment (SGNA) were performed on 100 children (64 boys and 36 girls). The objective measurements include anthropometry (z-scores for weight, height and body mass index), dietary history and biochemical markers were measured. These were used to classify malnutrition as per Academy of Nutrition and Dietetics/American Society of Parental and Enteral Nutrition (AND/ASPEN) Consensus Statement for identification of paediatric malnutrition and WHO growth standards for children. Cohen’s kappa was computed to report the level of agreement.

Results

The PNST identified 57% of hospitalized children as being at risk of malnutrition. In this study, there was a stronger agreement between PNST with AND/ASPEN malnutrition classification (k = 0.602) as when PNST was compared with WHO (k = 0.225) and SGNA (k = 0.431). The PNST shows higher specificity (85.29%) and sensitivity (78.79%) when compared with AND/ASPEN than with WHO malnutrition criteria (55.81% specificity and 66.67% sensitivity).

Conclusion

This study showed the usefulness of routine use of PNST for screening the malnutrition risk of hospitalized children in Malaysian tertiary hospital settings.
Follicular helper T cells in type 1 diabetes
Authors: Shao Feng , Zheng Peilin , Yu Di , Zhou Zhiguang , Jia Lijing
Published: December 2019

Type 1 diabetes (T1D) is an autoimmune disease caused by the dysfunction of immune system and consequently the destruction of insulin‐producing β cells. In past decades, numerous studies have uncovered that CD4+ T cell subsets are critical in the pathogenesis of T1D, manifesting that type 1 T helper (Th1) and Th17 cells are pathogenic, while regulatory T (Treg) cells and Th2 cells are protective. More recently, the pathogenic role of another subset, follicular helper T (Tfh) cells that essentially regulate germinal center (GC) formation and humoral responses, has also been demonstrated in T1D and many other autoimmune diseases. In this review, we summarize the evidence for the aberrant differentiation and function of Tfh cells in T1D, and also discuss the underlying mechanisms. A better understanding on the pathogenic role of Tfh cells in T1D will inspire the design of potential therapeutic strategies to target this subset in the future.
Chemokine CCL2 contributes to BBB disruption via the p38 MAPK signaling pathway following acute intracerebral hemorrhage
Authors: Guo Fuyou , Xu Dingkang , Lin Yazhou , Wang Guoqing , Wang Fang , Gao Qiang , Wei Qingjie , Lei Shixiong
Published: December 2019

Intracerebral hemorrhage (ICH) remains a devastating type of stroke that lacks an effective treatment. Recent evidence has demonstrated that CCL2 is involved in the blood‐brain barrier (BBB) disruption and propagermanium (PG) as a CCL2 receptor inhibitor is neuroprotective in ischemic stroke. However, whether PG therapy exert effective role in acute ICH still unclear. In this study, our goal was to investigate the potential role of CCL2 and the effects of PG in ICH. Differentially expressed RNAs including CCL2 were detected in human ICH. CCL2 and the activation of p‐p38 MAPK and AQP4 expression were analyzed in rats after ICH. Brain water content and BBB integrity as well as neurological function were also examined after PG administration. In addition, the mechanism by which CCL2‐mediated BBB injury was further investigated by cell coculture. Our findings showed that PG could effectively reduce brain edema and improve neurobehavioral functions. p‐p38 MAPK and AQP4 expression were significantly inhibited by PG in vivo and in vitro. To the best of our knowledge, this is the first demonstration of PG in neuroprotecting the BBB integrity by inhibition of CCL2‐CCR2‐p38 MAPK pathway following ICH, targeting CCL2 could be developed as a novel treatment for hemorrhagic stroke.
Early Postoperative Outcomes of Normal Pressure Hydrocephalus: Results of a Service Evaluation
Authors: D’Antona Linda , Blamey Sandra C. , Craven Claudia L. , Sewell Darreul , Manohara Shivani , Leemans Michelle , Worby Susannah , Thompson Simon D. , Golahmadi Aida K. , Funnell Jonathan P. , Thorne Lewis , Watkins Laurence D. , Luoma Astri M.V. , Toma Ahmed K.
Published: December 2019

Background:

Patients with normal pressure hydrocephalus (NPH) are often elderly, frail and affected by multimorbidity. Treatment is surgical with cerebrospinal diversion shunts. The selection of patients that are of an acceptable level of risk to be treated surgically has been a matter of debate for years and has deprived some patients of life-changing surgery. The aim of this service evaluation was to investigate the preoperative risk factors and early postoperative morbidity of patients with NPH using a standardized postoperative survey.

Materials and Methods:

Consecutive NPH patients admitted for neurosurgical management of NPH between May 2017 and May 2018 were included in this prospective service evaluation. In addition to the collection of traditional outcome measures, the cardiac version of the Postoperative Morbidity Survey (C-POMS) was conducted on postoperative days 4, 7, and 10 to identify postoperative morbidity.

Results:

Eighty-eight patients (63 males, age mean±SD, 75±7 y) underwent 106 surgical procedures (61 lumbar drains, 45 ventriculoperitoneal shunts). There was no 30-day mortality and no unexpected return to the operating room or admission to intensive care unit. There was 1 conservatively managed surgical complication. On postoperative day 4, the C-POMS identified no postoperative morbidity in 72% of the patients, and mild morbidity (postoperative nausea and mobility issues) in 28%. There was a delay in discharge in 50% of the patients with no postoperative morbidity on day 4, highlighting areas of our service requiring improvement.

Conclusions:

Early postoperative outcomes of NPH patients are good after both ventriculoperitoneal shunt insertion and lumbar drainage. This evaluation provides initial evidence on the utility of the C-POMS as a service evaluation tool in the standardized assessment postoperative outcomes in neurosurgery patients.
Increased Risk of Stroke Among Young Adults With Serious Traumatic Brain Injury
Authors: McFarlane Timothy D. , Love Josh , Hanley Shane , Dixon Brian E. , Hammond Flora M.
Published: December 2019

Objective:

To quantify the risk of acute ischemic stroke (AIS) following traumatic brain injury (TBI) according to severity.

Setting:

Indiana Network for Patient Care, including medical records from more than 100 Indiana hospitals and affiliated practices.

Participants:

Individuals 18 years and older with TBI from 2005 to 2014.

Design:

Retrospective cohort.

Main Measures:

AIS incidence in the first 30, 31 to 180, and 181 days after TBI. Time to AIS using a stratified Cox proportional hazards model.

Results:

Among 58 294 patients with TBI, AIS risk was greatest in the first 30 days (incidence rate = 23.3 per 1000 person-months), declining to 3.1 and 1.3 per 1000 person-months after 31 to 180 and 181 days or more, respectively. Cervical artery dissection increased the risk of AIS in the first 30 days (incidence rate = 170.9 per 1000 person-months). In the first 30 days, serious TBI increased risk for all age groups, with the largest effect observed among those aged 18 to 24 years. Over time, serious TBI modified the effect of age on AIS only for those aged 18 to 24 years.

Conclusions:

These findings add to a growing body of work demonstrating that the acute and postacute stages of TBI play an accelerative role in AIS risk, particularly among younger patients, cervical artery dissection, and serious TBI.
High rates of serology testing for coeliac disease, and low rates of endoscopy in serologically positive children and adults in Israel: lessons from a large real-world database
Authors: Guz-Mark Anat , Feldman Becca S. , Ghilai Adi , Hoshen Moshe , Cohen Herman Avner , Shkalim Zemer Vered , Assa Amit , Zevit Noam , Shamir Raanan
Published: December 2019

Background:

Although coeliac disease is common worldwide, little is known regarding screening patterns in unselected populations, and on real-life adherence to professional guidelines for coeliac disease diagnosis and management.

Objective:

To explore current practices in the diagnosis and management of coeliac disease, using data from a large Health Maintenance Organization in Israel that covers 54% of the population.

Methods:

A population-based electronic database of about 4.5 million individuals was reviewed during the period of 1 January 2008 to 31 December 2015. Rates and results of coeliac disease serology testing and endoscopy procedures were examined. Subgroup analysis was performed by age, sex, ethnicity and socioeconomic status.

Results:

Coeliac disease serology cumulative testing rate was 17.1% and 8.9% in the paediatric and adult population, respectively. The cumulative incidence of positive coeliac disease serology was 0.45% in children and 0.17% in adults, and was associated with age, sex, ethnicity and socioeconomic status sub-groups (P-value < 0.01). Gastrointestinal endoscopies were not subsequently performed in 44.1% of children and 47.1% of adults with positive coeliac disease serology. Within the study period, 36% of children and 56% of adults never achieved coeliac disease serology normalization.

Conclusion:

In a large real-life database, screening for coeliac disease was common. However, confirmatory intestinal biopsies were under-utilized, and coeliac disease serology often remained positive over a long period time in both children and adults.
Prognostic role of preoperative albumin-bilirubin grade on patients with hepatocellular carcinoma after surgical resection: a systematic review and meta-analysis
Authors: Geng Li , Zong Ruilong , Shi Yibing , Xu Kai
Published: December 2019

Recent studies have reported albumin-bilirubin (ALBI) grade affected the prognosis of patients with hepatocellular carcinoma (HCC). To more precisely evaluate the relationship among the ALBI grade and the prognosis of patients with HCC after liver resection. We systematically retrieved articles from PubMed, Web of Science, Cochrane Library, and CNKI. The prognostic value of ALBI grade on overall survival (OS) and recurrence-free survival (RFS) of patients with HCC after liver resection was evaluated by pooled hazard ratio (HR) with 95% confidence interval (CI).Through multiple databases search, we enrolled 20 high-quality studies with 11365 patients, regarding the association between the ALBI grade and the prognosis of patients with HCC after liver resection. Our results showed that higher ALBI grade is associated with poored OS (HR, 1.64; 95% CI: 1.51–1.78; P < 0.001; I2 = 24.9%) and RFS (HR, 1.42; 95% CI: 1.26–1.59; P < 0.001; I2 = 0). Moreover, subgroup analysis showed the significant correlation between ALBI grade and poor long-term survival was not altered in different geographical areas, sample sizes, follow-up duration, and quality scores. The ALBI grade may be as effective predictive biomarkers for prognosis in patients with HCC after liver resection.
Clinical score predicting a successful endoscopic approach of esophageal anastomotic leaks: external validation
Authors: Azevedo Richard , Coelho Mariana , Gouveia Catarina , Loureiro Rui , Freire Ricardo , Silva Rui , Cravo Marília , Pereira António Dias , Ribeiro Mário Dinis , de Ferro Susana Mão
Published: December 2019

Background

Recently, a clinical prediction rule has been proposed to predict the chance of successful endoscopic stenting in benign esophageal anastomotic leakage, perforation and fistula. We aimed to validate this score in a cohort of patients with anastomotic leaks managed with self-expanding metal esophageal stents, by assessing technical and clinical success rates and comparing the agreement between the predicted and the actual clinical success.

Methods

A multicenter retrospective cohort study including patients submitted to endoscopic stenting due to anastomotic leak was conducted. Variables of the score (leak size, location and C-reactive protein) were collected and the chance of success (≤50, 50–70 and ≥70%) and its accuracy was assessed.

Results

Fifty-three patients, submitted to esophageal stenting after cancer (n = 47) and bariatric surgery were included. Clinical success was achieved in 62% of patients. The area under the ROC curve to differentiate between successful and failed therapies showed a good discriminative power of the score (AUC 0.705; P < 0.01). For a predicted chance of success >50%, the positive predictive value was 72.5%; for a chance of success ≤50%, the negative predictive value was 69.2%.

Conclusions

The application of this predictive model in patients with anastomotic leaks proved to be valid in a different cohort from that in which it was derived. Its usefulness in clinical practice may be anticipated, favoring stenting in patients with a chance of success >50%. However, we must be cautious in patients with a lower probability of success and a case-by-case decision should be made.
Orphenadrine in treatment of muscle cramps in cirrhotic patients: a randomized study
Authors: Abd-Elsalam Sherief , Ebrahim Shaimaa , Soliman Shaimaa , Alkhalawany Walaa , Elfert Asem , Hawash Nehad , Elkadeem Mahmoud , Badawi Rehab
Published: December 2019

Objective

Many patients of liver cirrhosis are complaining of muscle cramps, which are annoying to them. There is no effective treatment for muscle cramps in cirrhotic patients till now. This study purposed to evaluate efficacy and safety of orphenadrine in the treatment of muscle cramps in cirrhotic patients.

Methods

One hundred and twenty four patients who had muscle cramps three or more times weekly were included. They were divided into two arms: 62 patients administrated orphenadrine and 62 administrated placebo. They were followed up till 2 weeks after the end of therapy. Muscle cramps were evaluated using questionnaire as regards severity, duration, and frequency. Also, side effects of orphenadrine were recorded.

Results

Frequency, duration of muscle cramps, and pain score improved significantly after 1 month of orphenadrine therapy in comparison to placebo. Few side effects were recorded in the form of dry mouth, drowsiness, and nausea.

Conclusion

Orphenadrine is considered as promising safe drug for treatment of muscle cramps associated with liver cirrhosis.
Should we use papilla morphology to estimate the size of the terminal common bile duct during endoscopic retrograde cholangiopancreatography?
Authors: Lopes Luís , Canena Jorge , Fernandes João , Moreira Marta , Costa Inês , Gomes-Fonseca João , Araújo Tarcísio , Alexandrino Gonçalo , Lourenço Luís , Horta David , Giestas Sílvia , Ribeiro Helena , Ramada José , Familiari Pietro , Dinis-Ribeiro Mário
Published: December 2019

Objective

A small common bile duct (CBD) diameter has been associated with complications and with a difficult biliary cannulation. Previous studies suggested that this diameter can be predicted during the endoscopic retrograde cholangiopancreatography (ERCP) simply by observing the papillary morphology. Despite this published suggestion there is no study addressing this topic. This study evaluated a possible association between the morphology of the major papilla and the diameter of the terminal CBD (t-CBD).

Methods

Observational cross-sectional study including consecutive patients with naïve papillae was referred for ERCP in two affiliated university hospitals. The transverse (p-transv) and longitudinal measures (p-long) of the papilla were obtained using a visual method. Papillae were classified into nonprominent, prominent, bulging or other. The t-CBD was measured 1 cm from the papilla using fluoroscopic images in prone/supine. Measurements were performed by two senior endoscopists and outcomes were evaluated using correlation and linear regression model.

Results

We included 245 patients with a median age of 76 years. The median p-transv for each type of papillae was as follows: nonprominent = 6 mm, prominent = 9 mm, bulging = 15 mm and other = 6 mm; P < 0.001. The median t-CBD for nonprominent = 7.62 mm, prominent = 8.34 mm, bulging = 8.60 mm and other = 8.52 mm; P = 0.40. The correlation between the transverse and longitudinal measures of papilla and the t-CBD were 0.0092 and 0.0614, respectively. In the regression model, the t-CBD diameter was not explained by papilla’s size or morphology (R
2 = 1.70%; P = 0.80).

Conclusion

The morphology of the papilla must not be used as a predictor of the diameter of the CBD as there is no correlation between these two items.