bluuebunny/crossref_metadata_2025 huggingface dataset:
Criminalization and Civil Order
Authors: Duff R A
Published: August 2018

This chapter explains the ‘public wrongs’ criminalization principle. However, criminalization is one among various possible responses to public wrongs: so we must ask whether we have good reason to criminalize a public wrong rather than responding in another way. To illustrate the working of a ‘public wrongs’ principle, examples of three kinds of offence are discussed. First, ‘mala in se’, consisting in conduct supposedly wrongful prior to its legal regulation: the criminalization process here involves constructing a civic conception of the wrong. Second, different types of ‘malum prohibitum’ (consisting in conduct that might be wrongful only because legally prohibited) are discussed, to show how violations of pre-criminal regulations can constitute criminalizable wrongs. Third, ‘pre-emptive’ offences are discussed: they criminalize conduct only remotely connected to the mischief at which the law is aimed; it is important to see how far such offences can be justified—and subjected to principled constraint.
God, Suffering, and Omniscience
Authors: Rudavsky T. M.
Published: August 2018

The topic of divine predication leads more broadly to issues surrounding divine omniscience, freedom, and evil. The question of why the righteous suffer remains one of the most intractable issues in philosophical theology. More generally, the very concept of a caring deity who is both omniscient and omnipotent gives rise to a logical dilemma: if God is omniscient, then God knows past, present, and future contingents; if God is omnipotent, then God can actualize any state of affairs; if God is benevolent, then presumably God wishes the best possible state of affairs for God’s creatures; and yet we cannot help but recognize the basic fact that the righteous suffer. And so, given the ineluctable reality of human suffering, God is either not omniscient, or not omnipotent, or not benevolent. Jewish philosophers struggle to address these problems.
Concluding Comments
Authors: Rudavsky T. M.
Published: August 2018

Chapter 10 offers a conclusion to this volume. Throughout this study, medieval philosophers—Islamic, Christian, and Jewish—have been witnessed wrestling with the project of reconciling “outside” sources and influences with their understanding of Scripture. This work has provided an account of how Jewish philosophy, from the tenth century to Spinoza, forms part of an ongoing dialogue with medieval Christian and Islamic thought. A greater understanding has been achieved of the role played by science and rational thought as articulated in the conflict between faith and reason, as represented by philosophical and scientific speculation on the one hand, and acceptance of Judaic beliefs on the other. The chapter rounds up this historical survey of the major figures and schools and its discussion of the challenge of rationalist discourse within this tradition.
Productive Efficiency Analysis over Six Decades
Authors: Majumdar Sumit K.
Published: August 2018

This chapter contains an efficiency analysis for Indian industry from 1950–51 to 2013–14. Overall, there had been consistent growth in manufacturing employment over six decades, though by the 2010s only 13 million persons, or 0.1% of the population, had industrial jobs. Capital widening and deepening in India was substantial. In the 1950s, productive efficiency was high. In the 1960s, average productive efficiency declined sharply. In the 1970s, productive efficiency declined and stagnated till the 1980s when it started rising again. In the 1990s, productive efficiency rose and efficiency patterns were stable till the late 2010s when decline set in. Productive efficiency began a downward trend in the 2010s. In spite of capital widening and deepening, Indian industry was inept at managing technology. Indian industry has not possessed the competence to handle the knowledge embodied in fixed capital inputs, which is a hallmark of modern economies.
Galilean Relativity
Authors: Wittman David M.
Published: August 2018

Galilean relativity is a useful description of nature at low speed. Galileo found that the vertical component of a projectile’s velocity evolves independently of its horizontal component. In a frame that moves horizontally along with the projectile, for example, the projectile appears to go straight up and down exactly as if it had been launched vertically. The laws of motion in one dimension are independent of any motion in the other dimensions. This leads to the idea that the laws of motion (and all other laws of physics) are equally valid in any inertial frame: the principle of relativity. This principle implies that no inertial frame can be considered “really stationary” or “really moving.” There is no absolute standard of velocity (contrast this with acceleration where Newton’s first law provides an absolute standard). We discuss some apparent counterexamples in everyday experience, and show how everyday experience can be misleading.
Persian Love Stories?
Authors: Whitmarsh Tim
Published: August 2018

It is hard to tell how much authentically Persian literature made its way into Greek, but it is not impossible that some did. The Persian and Phoenician abduction stories that begin Herodotus’s Histories may be the kind of stories told by Hellenised non-Greeks. Herodotus clearly did have access to stories from multiple traditions. Another allegedly Persian story about cultural hybridisation is Zariadres and Odatis, told by Chares of Mitylene, a version of which turns up in the mediaeval Shahnameh, and which is possibly connected to a late-antique Sanskrit romance by Subandhu.
The Jewish Novel
Authors: Whitmarsh Tim
Published: August 2018

Is there such a thing as a Hellenistic ‘Jewish novel’, as certain recent critics have claimed? And if so, what is its status vis-à-vis the Greek novel? This chapter explores the relationship between Jewish and Greek culture in the long era before the Roman sack of Jerusalem, finding a mixture of Jewish resistance, anti-Semitism and assimilation. Some Jewish literature speaks of Greek and Jewish as immiscible, like the Maccabean texts, composed in the period of Hasmonean ‘nationalism’. In Judith, resistance to assimilation is troped as resistance to sexual union with a foreigner. Esther, however, presents a more complementary mode: the Jewish woman successfully marries the Persian king. Formally and linguistically too, much of this literature blends Greek and Jewish in a fluid way.
‘The Long Hellenistic’
Authors: Whitmarsh Tim
Published: August 2018

Egypt is a culture that had novelistic literature earlier than others, and which was open to multiple different cultural influences over a long period. This chapter introduces the Alexander Romance, a text that embodies generic and cultural fluidity, surviving as it does in multiple different forms demonstrating multiple different linguistic and cultural registers. The Alexander Romance was antiquity’s most widely disseminated text after the Bible.
Conclusion
Authors: Whitmarsh Tim
Published: August 2018

There were many ‘contact zones’ between Greek and other peoples in antiquity, and many forms of exchange between them took place here, including trade and intermarriage. The texts discussed in this book were composed in and for many different circumstances, but they are united by their presentation of culture in this way: not as bounded and protected, but as interstitial and liminal. The novel thus expresses a different way of ‘being Greek’ to that of much mainstream Greek literature.
Explaining Cancer
Authors: Plutynski Anya
Published: August 2018

Cancer is the second leading cause of death in the world. Almost everyone’s life is in some way or other affected by cancer. Yet, when faced with a cancer diagnosis, many of us will confront questions we had never before considered: Is cancer one disease, or many? If many, how many exactly? How is cancer classified? What does it mean, exactly, to say that cancer is “genetic,” or “familial”? What exactly are the causes of cancer, and how do scientists come to know about them? When do we have good reason to believe that this or that is a risk factor for cancer? These questions are (in part) empirical ones; however, they are also (in part) philosophical. That is, they are questions about what and how we come to know. They are about how we define and classify disease, what counts as a “natural” classification, what it means to have good evidence, and how we pick out causes as more or less significant. This book takes a close look at these philosophical questions, by examining the conceptual and methodological challenges that arise in cancer research, in disciplines as diverse as cell and molecular biology, epidemiology, clinical medicine, and evolutionary biology.
Late engine activity of GRB 161017A revealed by early optical observations
Authors: Tachibana Yutaro , Arimoto Makoto , Asano Katsuaki , Harita Shohei , Fujiwara Taichi , Yoshii Taketoshi , Itoh Ryosuke , Murata Katsuhiro L , Yatsu Yoichi , Morita Kotaro , Kawai Nobuyuki
Published: August 2018

The long gamma-ray burst GRB 161017A was detected by Fermi and Swift, and its afterglow was observed by the MITSuME 50 cm optical telescope promptly, about 50 s after the burst. Early optical observations revealed that the optical light curve exhibits a plateau and rebrightening in the early afterglow phase about 500 and 5000 s after the trigger, respectively. By investigating the behavior of the spectral and temporal flux variation, it was found that the plateau and rebrightening cannot be explained in the context of the simple standard afterglow model. These observational features can be explained with two independent refreshed shocks, which indicate the long-acting central engine. We evaluated the physical parameters of the subsequent shells, and we then determined the kinetic energy ratios of the two colliding shells to the leading shell to be roughly 1 and 8, respectively. In addition, two prominent X-ray flares about 200 s after the trigger may be signatures of delayed ejections of the energetic jets responsible for the refreshed shocks. Such late activity of the central engine and X-ray flares play a crucial role in understanding the mechanisms for jet formation and photon emission.
Discovery and state transitions of the new Galactic black hole candidate MAXI J1535−571
Authors: Nakahira Satoshi , Shidatsu Megumi , Makishima Kazuo , Ueda Yoshihiro , Yamaoka Kazutaka , Mihara Tatehiro , Negoro Hitoshi , Kawase Tomofumi , Kawai Nobuyuki , Morita Kotaro
Published: August 2018

We report on the detection and subsequent X-ray monitoring of the new Galactic black hole candidate MAXI J1535−571 with the Gas Slit Camera onboard Monitor of All-sky X-ray Image (MAXI/GSC). After the discovery on 2017 September 2, made independently with MAXI and the Swift/BAT, the source brightened gradually, and in a few weeks reached the peak intensity of ∼5 Crab, or ∼1.6 × 10−7 erg cm−2 s−1 in terms of the 2–20 keV flux. On the initial outburst rise, the 2–20 keV MAXI/GSC spectrum was described by a power-law model with a photon index of ≲ 2, while after a hard-to-soft transition, which occurred on September 18, the spectrum required a disk blackbody component in addition. At around the flux peak, the 2–8 keV and 15–50 keV light curves showed quasi-periodic and anti-correlated fluctuations with amplitudes of 10%–20%, on a time scale of ∼1 d. Based on these X-ray properties obtained with the MAXI/GSC, with additional information from the Swift/BAT, we discuss the evolution of the spectral state of this source, and give constraints on its system parameters.
ALMA twenty-six arcmin2 survey of GOODS-S at one millimeter (ASAGAO): Source catalog and number counts
Authors: Hatsukade Bunyo , Kohno Kotaro , Yamaguchi Yuki , Umehata Hideki , Ao Yiping , Aretxaga Itziar , Caputi Karina I , Dunlop James S , Egami Eiichi , Espada Daniel , Fujimoto Seiji , Hayatsu Natsuki H , Hughes David H , Ikarashi Soh , Iono Daisuke , Ivison Rob J , Kawabe Ryohei , Kodama Tadayuki , Lee Minju , Matsuda Yuichi , Nakanishi Kouichiro , Ohta Kouji , Ouchi Masami , Rujopakarn Wiphu , Suzuki Tomoko , Tamura Yoichi , Ueda Yoshihiro , Wang Tao , Wang Wei-Hao , Wilson Grant W , Yoshimura Yuki , Yun Min S
Published: August 2018

We present the survey design, data reduction, construction of images, and source catalog of the Atacama Large Millimeter/submillimeter Array (ALMA) twenty-six arcmin2 survey of GOODS-S at one millimeter (ASAGAO). ASAGAO is a deep (1 σ depth ∼ 61 μJy beam−1 for a 250 kλ-tapered map with a synthesized beam size of 0${^{\prime\prime}_{.}}$51 × 0${^{\prime\prime}_{.}}$45) and wide area (26 arcmin2) survey on a contiguous field at 1.2 mm. By combining with ALMA archival data in the GOODS-South field, we obtained a deeper map in the same region (1 σ depth ∼ 30 μJy beam−1 for a deep region with a 250 kλ-taper, and a synthesized beam size of 0${^{\prime\prime}_{.}}$59 × 0${^{\prime\prime}_{.}}$53), providing the largest sample of sources (25 sources at ≥5.0 σ, 45 sources at ≥4.5 σ) among ALMA blank-field surveys to date. The number counts show that $52^{+11}_{-8}$% of the extragalactic background light at 1.2 mm is resolved into discrete sources at S1.2 mm > 135 μJy. We create infrared (IR) luminosity functions (LFs) in the redshift range of $z$ = 1–3 from the ASAGAO sources with Ks-band counterparts, and constrain the faintest luminosity of the LF at 2.0 < $z$ < 3.0. The LFs are consistent with previous results based on other ALMA and SCUBA-2 observations, which suggest a positive luminosity evolution and negative density evolution with increasing redshift. We find that obscured star-formation of sources with IR luminosities of log (LIR/L⊙) ≳ 11.8 account for ≈60%–90% of the $z$ ∼ 2 cosmic star-formation rate density.
Cumulative exposure to air pollution and subsequent mortality among older adults in China
Authors: Zhang Jiaan , McLaughlin Sara J , Li Lydia W
Published: August 2018

Background

Research on the health effects of exposure to air pollution is growing. However, relatively little attention has been paid to the effects of long-term and cumulative exposure to air pollutants. Individual-level studies on the health consequences of air pollution in China are especially scarce. The purpose of this study is to examine the effect of cumulative exposure to sulfur dioxide (SO2), an air pollutant of particular concern in China, on all-cause mortality in older Chinese adults.

Methods

Using a nationally representative sample of older adults in China (N = 11 199), we tracked mortality over an 11-year period (2000–11). Air pollution data were linked to respondents using provincial identifiers. To examine the effect of cumulative SO2 exposure on mortality, we employed multilevel multinomial logistic regression models that account for within subject clustering of observations over time and clustering at the province level.

Results

We found that every 10-μg/m3 increase in cumulative exposure to SO2 increased the odds of death by nearly 1% (OR = 1.008; 95% CI: 1.002–1.014), controlling for province- and individual-level social and economic characteristics.

Conclusions

Our analysis shows that air pollution is a risk factor for morality in older Chinese adults. Findings suggest that stronger SO2 regulations may enhance longevity.
Migrants, Ancestors, and Foreign Investments
Authors: Burchardi Konrad B , Chaney Thomas , Hassan Tarek A
Published: August 2018

We use 130 years of data on historical migrations to the U.S. to show a causal effect of the ancestry composition of U.S. counties on foreign direct investment (FDI) sent and received by local firms. To isolate the causal effect of ancestry on FDI, we build a simple reduced-form model of migrations: Migrations from a foreign country to a U.S. county at a given time depend on (1) a push factor, causing emigration from that foreign country to the entire U.S., and (2) a pull factor, causing immigration from all origins into that U.S. county. The interaction between time-series variation in origin-specific push factors and destination-specific pull factors generates quasi-random variation in the allocation of migrants across U.S. counties. We find that doubling the number of residents with ancestry from a given foreign country relative to the mean increases the probability that at least one local firm engages in FDI with that country by 4 percentage points. We present evidence that this effect is primarily driven by a reduction in information frictions, and not by better contract enforcement, taste similarities, or a convergence in factor endowments.
ESTIMATION OF EFFECTIVE DOSE OF DENTAL X-RAY DEVICES
Authors: Qiang Wang , Qiang Fu , Lin Lin
Published: August 2018

This study aims to estimate the effective doses of dental X-ray devices under common scanning protocols. After putting TLDs in the Alderson Radiation Therapy Phantom, we exposed the phantom under common scanning protocols of three dental X-ray devices, namely CBCT, dental panoramic machine and intraoral round cone device. Then effective doses were calculated using the measured absorbed doses of organs and tissues. Tissue weighting factors recommended by the ICRP were adopted in the calculation. Effective doses under common scanning protocols of three Dental X-ray devices were obtained. The effective dose of dental CT was 0.20 mSv, and that of dental panoramic machine and intraoral radiography were 0.013 and 0.0050 mSv, respectively. The tissue absorbed doses of dental CT scan were 0.63 mGy of brain, 7.7 mGy of salivary glands, 8.7 mGy of thyroid and 4.0 mGy of the lens of the eye. The tissue absorbed doses from dental panoramic machine are 0.62 mGy of salivary glands and 0.25 mGy of thyroid. And finally the tissue absorbed dose of intraoral radiography was 0.80 mGy of salivary gland. Among the three dental X-ray devices studied, dental CBCT scan can cause much higher effective dose than the other two. Brain, salivary glands, thyroid and the lens of the eye are tissues receiving relatively higher absorbed doses.
Differential Spatial Gradients of Wheat Streak Mosaic Virus into Winter Wheat from a Central Mite-Virus Source
Authors: Stilwell Abby R. , Rundquist Donald C. , Marx David B. , Hein Gary L.
Published: August 2018

The wheat curl mite (WCM), Aceria tosichella Keifer, transmits three potentially devastating viruses to winter wheat. An increased understanding of mite movement and subsequent virus spread through the landscape is necessary to estimate the risk of epidemics by the virus in winter wheat. Owing to the small size of WCMs, their dispersal via wind is hard to monitor; however, the viruses they transmit produce symptoms that can be detected with remote sensing. The objective of this study was to characterize the spatial dispersal of the virus from a central mite-virus source. Virus infection gradients were measured spatially by using aerial remote sensing, ground measurements, geostatistics, and a geographic information system between 2006 and 2009. The red edge position vegetation index as measured via aerial imagery was significantly correlated with in-field biophysical measurements. The occurrence of virus symptoms extended differentially in all directions from mite-virus source plots, and predictions from cokriging revealed an oval pattern surrounding the source but displaced to the southeast. The variable dispersal in different directions appeared to be influenced by the mite source density and wind direction and speed, but temperature also seemed likely to have affected mite spread. The spatial spread revealed in this study may be used to estimate the potential sphere of influence of mite-infested volunteer wheat in production fields. These risk parameter estimates require further validation, but they may potentially aid growers in making better virus management decisions regarding differential virus spread potential away from a central source.
Areca Palm Necrotic Ringspot Virus, Classified Within a Recently Proposed Genus Arepavirus of the Family Potyviridae, Is Associated With Necrotic Ringspot Disease in Areca Palm
Authors: Yang Ke , Shen Wentao , Li Ye , Li Zengping , Miao Weiguo , Wang Aiming , Cui Hongguang
Published: August 2018

Areca palm (Areca catechu), one of the two most important commercial crops in Hainan, China, has been severely damaged by a variety of pathogens and insects. Here, we report a new disease, tentatively referred to as areca palm necrotic ringspot disease (ANRSD), which is highly epidemic in the main growing regions in Hainan. Transmission electron microscopy observation and small RNA deep sequencing revealed the existence of a viral agent of the family Potyviridae in a diseased areca palm plant (XC1). The virus was tentatively named areca palm necrotic ringspot virus (ANRSV). Subsequently, the positive-sense single-stranded genome of ANRSV isolate XC1 was completely determined. The genome annotation revealed the existence of two cysteine proteinases in tandem (HC-Pro1 and HC-Pro2) in the genomic 5′ terminus of ANRSV. Sequence comparison and phylogenetic analysis suggested the taxonomic classification of ANRSV into the recently proposed genus Arepavirus in the family Potyviridae. Given the close relationship of ANRSV with another newly reported arepavirus (areca palm necrotic spindle-spot virus), the exact taxonomic status of ANRSV needs to be further investigated. In this study, a reverse transcription polymerase chain reaction assay for ANRSV-specific detection was developed and a close association between ANRSV and ANRSD was found.
Building a Program on Well-Being: Key Design Considerations to Meet the Unique Needs of Each Organization
Authors: Shanafelt Tait , Trockel Mickey , Ripp Jon , Murphy Mary Lou , Sandborg Christy , Bohman Bryan
Published: August 2018

The current health care practice environment has resulted in a crescendo of burnout among physicians, nurses, and advanced practice providers. Burnout among health care professionals is primarily caused by organizational factors rather than problems with personal resilience. Four major drivers motivate health care leaders to build well-being programs: the moral-ethical case (caring for their people), the business case (cost of turnover and lower quality), the tragic case (a physician suicide), and the regulatory case (accreditation requirements). Ultimately, health care provider burnout harms patients. The authors discuss the purpose; scope; structure and resources; metrics of success; and a framework for action for organizational well-being programs. The purpose of such a program is to oversee organizational efforts to reduce the occupational risk for burnout, cultivate professional well-being among health care professionals, and, in turn, optimize the function of health care systems. The program should measure, benchmark, and longitudinally assess these domains. The successful program will develop deep expertise regarding the drivers of professional fulfillment among health care professionals; an approach to evaluate system flaws and relevant dimensions of organizational culture; and knowledge and experience with specific tactics to foster improvement. Different professional disciplines have both shared challenges and unique needs. Effective programs acknowledge and address these differences rather than ignore them. Ultimately, a professional workforce with low burnout and high professional fulfillment is vital to providing the best care to patients. Vanguard institutions have embraced this understanding and are pursuing health care provider well-being as a core organizational strategy.
Association Between Hospital Volume and Mortality in Status Epilepticus: A National Cohort Study
Authors: Goulden Robert , Whitehouse Tony , Murphy Nick , Hayton Tom , Khan Zahid , Snelson Catherine , Bion Julian , Veenith Tonny
Published: August 2018

Objectives:

In various medical and surgical conditions, research has found that centers with higher patient volumes have better outcomes. This relationship has not previously been explored for status epilepticus. This study sought to examine whether centers that see higher volumes of patients with status epilepticus have lower in-hospital mortality than low-volume centers.

Design:

Cohort study, using 2010–2015 data from the nationwide Case Mix Programme database of the U.K.’s Intensive Care National Audit and Research Centre.

Setting:

Greater than 90% of ICUs in United Kingdom, Wales, and Northern Ireland.

Patients:

Twenty-thousand nine-hundred twenty-two adult critical care admissions with a primary or secondary diagnosis of status epilepticus or prolonged seizure.

Interventions:

Annual hospital status epilepticus admission volume.

Measurements and Main Results:

We used multiple logistic regression to evaluate the association between hospital annual status epilepticus admission volume and in-hospital mortality. Hospital volume was modeled as a nonlinear variable using restricted cubic splines, and generalized estimating equations with robust ses were used to account for clustering by institution. There were 2,462 in-hospital deaths (11.8%). There was no significant association between treatment volume and in-hospital mortality for status epilepticus (p = 0.54). This conclusion was unchanged across a number of subgroup and sensitivity analyses, although we lacked data on seizure duration and medication use. Secondary analyses suggest that many high-risk patients were already transferred from low- to high-volume centers.

Conclusions:

We find no evidence that higher volume centers are associated with lower mortality in status epilepticus overall. It is likely that national guidelines and local pathways in the United Kingdom allow efficient patient transfer from smaller centers like district general hospitals to provide satisfactory patient care in status epilepticus. Future research using more granular data should explore this association for the subgroup of patients with refractory and superrefractory status epilepticus.
E-Cigarettes in Baltimore Alcohol Outlets
Authors: Fakunle David O. , Eck Raimee , Milam Adam J. , Thorpe Roland J. , Furr-Holden Debra M.
Published: August 2018

There is limited research on e-cigarette availability despite increased use. E-cigarette availability within Baltimore alcohol outlets was analyzed for disparities among residential neighborhoods. Data were obtained via field surveys of alcohol outlets, and then spatially merged with sociodemographic data; 18.8% of alcohol outlets had any e-cigarette availability. Regression models showed greater odds ratios for e-cigarette availability when cigarettes, cigars, or hookah paraphernalia were sold, and lower odds ratios when alcohol outlets had an on-site consumption license. Outlets with e-cigarette availability were in predominantly lower-income, nonwhite neighborhoods. It is important to assess exposure of another potentially damaging substance among perpetually disadvantaged populations.
Social Determinants of Health and the Effects on Quality of Life and Well-being in 2 Rural Appalachia Communities
Authors: Hege Adam , Ball Lanae , Christiana Richard W. , Wallace Conner , Hubbard Cami , Truesdale Danielle , Hege Jennifer , Fleming Howard
Published: August 2018

Recent evidence highlights health disparities among rural communities. The purpose of this study was to learn from members of 2 Appalachia communities in North Carolina about barriers to health and well-being. Researchers conducted 3 focus groups (n = 24), which were coded and analyzed by a team of researchers to identify themes. Researchers identified 5 themes: (1) poverty/lack of economic opportunity; (2) access to health care and health resources; (3) social/mental health challenges; (4) food insecurity/hunger; and (5) youth/older adults being most vulnerable to health disparities. Ample evidence suggests that rural Appalachia is in dire need of public health attention.
Neighborhood Social and Environmental Factors and Asthma Among Children Living in Low-Income Neighborhoods
Authors: Teixeira Samantha , Zuberi Anita
Published: August 2018

Despite the knowledge that children in low-income neighborhoods are particularly vulnerable to asthma, few studies of child asthma focus on variation among low-income neighborhoods. We examined the relationship between child asthma and features associated with neighborhood poverty including safety, social cohesion, informal social control, collective efficacy, and disorder, across a sample of children from low-income neighborhoods (N = 3010; 2005-2007). Results show that the relationship between asthma and poverty is accounted for by family-level characteristics, but informal social control remains significantly and positively related to asthma after accounting for family-level characteristics. We discuss the importance of neighborhood environmental features for children's asthma.
Ophthalmic Eosinophilic Granulomatosis With Polyangiitis (Churg–Strauss Syndrome): A Systematic Review of the Literature
Authors: Akella Sruti S. , Schlachter Dianne M. , Black Evan H. , Barmettler Anne
Published: August 2018

Purpose:

To review and summarize the clinical features, presentations, diagnostic modalities, and management of ophthalmic manifestations of eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg–Strauss Syndrome).

Methods:

A systematic PubMed search of all English articles on EGPA with ophthalmic involvement was performed. Emphasis was placed on English-language articles, but any article with an abstract translated into English was also included. Only those cases that satisfied the American Rheumatology criteria (1990) for diagnosis were included. Data examined included epidemiology, pathogenesis, presentations, diagnostic modalities, and management.

Results:

There was a wide range in ophthalmic manifestations of EGPA. In order of most frequent presentation to least frequent, these include central retinal artery or vein occlusion, ischemic optic neuropathy, conjunctival nodules, orbital myositis, proptosis, dacryoadenitis, retinal vasculitis/infarcts/edema, cranial nerve palsy, and amaurosis. The 46 qualifying cases were divided into the categories of ischemic vasculitis versus idiopathic orbital inflammation due to prognostic significance. Ischemic vasculitis cases tended to be older patients (p = 0.03), unilateral (p = 0.006), require immunosuppressive therapy beyond steroids (p = 0.015), and were less likely to show improvement on therapy (p = 0.0003).

Conclusions:

Prompt diagnosis of EGPA by the ophthalmologist can decrease patient morbidity and mortality. This requires knowledge of likely ophthalmic EGPA presentations, as well as recommended workups and treatment.
Association of Risk of Obstructive Sleep Apnea With Thyroid Eye Disease: Compressive Optic Neuropathy
Authors: Habib Larissa A. , Godfrey Kyle J. , Mathews Priya , De Rojas Joaquin , Kazim Michael
Published: August 2018

Purpose:

To evaluate the association of risk of obstructive sleep apnea (OSA) and thyroid eye disease-compressive optic neuropathy (TED-CON).

Methods:

The authors performed a retrospective observational study. All TED patients evaluated by the principal investigator over the past 5 years were screened with the snoring tired observed pressure (STOP)-Bang questionnaire to assess their risk for OSA. Patients were grouped into 2 age-matched cohorts based on the presence (TED-CON) or absence of CON. The groups were then compared using chi-square analysis for binary variables and Student t test for continuous variables.

Results:

Three hundred twenty-six patients were identified to have TED. Of those, 109 were enrolled in the study. The prevalence of high risk of OSA was significantly higher in the TED-CON (59.2%) when compared with the noncompressive TED group (32.8%; p = 0.006).

Conclusions:

Obstructive sleep apnea and TED have each been independently associated with elevated serologic and tissue inflammatory mediators. The systemic inflammation associated with OSA has been implicated in the pathogenesis of disease states aggravated by untreated OSA. Effective treatment of OSA decreases the levels of circulating inflammatory mediators. Currently, smoking is the only known modifiable risk factor in TED. There is evidence to implicate the pathologic elevation of inflammatory cytokines in the mechanism of smoking on TED. This preliminary investigation reveals a significantly greater prevalence of OSA risk factors among patients with TED-CON, suggesting that this may be another modifiable risk factor associated with TED. Based on screening with the STOP-Bang questionnaire, there is a higher percentage of patients at high risk of OSA with TED with CON than with TED without CON.
Are direct-acting antivirals safe and effective in hepatitis C virus-cryoglobulinemia? virological, immunological, and clinical data from a real-life experience
Authors: Passerini Matteo , Schiavini Monica , Magni Carlo F. , Landonio Simona , Niero Fosca , Passerini Simone , Croci Alessandro L. , Bolis Matteo , Scalzi Valentina , Gubertini Guido , Ricci Elena D. , Galli Massimo , Rizzardini Giuliano
Published: August 2018

Objectives

Hepatitis C virus (HCV) is the major cause of cryoglobulinemia. Direct-acting antivirals (DAAs) have markedly changed the therapeutic outcomes in the treatment of patients with HCV. We evaluate the efficacy, safety, immunological, and clinical response of different DAA regimens in HCV-cryoglobulinemia.

Patients and methods

Ninety-three cryoglobulinemic patients, divided into symptomatic [symptomatic cryoglobulinemic patients (SCP; n=35)] and asymptomatic [nonsymptomatic cryoglobulinemic patients (NSCP; n=60)], underwent DAAs. Eighty-nine comparable noncryoglobulinemic patients were selected as a control group. We evaluated the sustained virological response (SVR), the adverse effects, and the immune and symptomatic response.

Results

Percentages of patients who achieved SVR and experienced adverse effects were not statistically different between the three groups (100, 95, 93.3% and 57.1, 53.3, 48.3%). In 68.5% of SCP and in 76.7% of NSCP, cryoglobulins disappeared at SVR. No risk factor was associated with the persistence of cryoglobulins. An increase was observed both in C4 (P=0.002; P=0.018) and in C3 (P=0.0037; P=0.031) in SCP and NSCP. About 70% of symptomatic patients showed a complete or partial symptomatic remission: persistence of symptoms is correlated to the type of clinical picture.

Conclusion

DAA regimens are safe and effective in patients with HCV-cryoglobulinemia. The achievement of SVR is necessary, but not sufficient, to achieve a complete immunological and clinical response.
Comparing fecal microbiota transplantation to standard-of-care treatment for recurrent Clostridium difficile infection: a systematic review and meta-analysis
Authors: Khan Muhammad Y. , Dirweesh Ahmed , Khurshid Talal , Siddiqui Waqas J.
Published: August 2018

Background

The use of fecal microbiota transplantation (FMT) as a treatment option for recurrent Clostridium difficile infection (rCDI) is well established. Various studies have used different forms and administration routes for FMT. We performed a systemic review and meta-analysis to update the clinical knowledge about different FMT modalities for curing rCDI compared with medical treatment (MT).

Patients and methods

We searched PubMed and Medline from inception through 10 May 2018 for randomized control trials (RCTs) comparing FMT (fresh or frozen) versus MT. We used Cochrane Collaboration’s Risk of Bias tool to assess bias in the RCTs. We estimated odds ratio (OR) with 95% confidence interval (CI) for each outcome using a random effects model. P values of less than 0.05 were considered significant.

Results

We included seven RCTs comprising a total of 543 patients with recurrent CDI. There was a nonsignificant trend toward resolution of diarrhea following a single fresh FMT infusion compared with frozen FMT and MT (OR=2.45, 95% CI=0.78–7.71, P=0.12, I
2=69%). Subgroup analysis of fresh FMT vs. frozen FMT showed no difference between the two groups (OR=2.13, 95% CI=0.22–20.41, P=0.51, I
2=61%). Frozen FMT infusion through upper route versus lower route showed no difference (OR=0.62, 95% CI=0.15–2.54, P=0.51, I
2=0%). There was a nonsignificant trend favoring multiple treatments with FMT versus multiple courses of MT (OR=3.68, 95% CI=0.74–18.22, P=0.11, I
2=0%).

Conclusion

FMT is a promising treatment modality for rCDI compared with MT alone. Different forms and routes of FMT administration seem to be equally efficacious. In future, more well-designed RCTs directed at homogenous FMT preparation and delivery methods are required to validate these findings.
Facial nerve decompression
Authors: Andresen Nicholas S. , Sun Daniel Q. , Hansen Marlan R.
Published: August 2018

Purpose of review

Facial nerve paralysis is a debilitating condition. Bell's palsy and temporal bone trauma are common causes of acute facial palsy, with recurrent idiopathic paralysis and Melkersson–Rosenthal syndrome accounting for a smaller subset of cases. Properly selected patients may benefit from facial nerve decompression. This article will review the relevant literature on facial nerve decompression.

Recent findings

The middle cranial fossa approach provides access to the primary site of lesion in Bell's palsy while preserving hearing. Patients with complete facial paralysis secondary to Bell's palsy or temporal bone trauma, more than 90% degeneration on electroneurography testing, and absent voluntary electromyography within 14 days of onset may benefit from facial nerve decompression. Facial nerve decompression may prevent future occurrences of recurrent forms of facial nerve paralysis. The return of facial nerve function following decompression will occur over weeks to months.

Appropriately selected patients with facial paralysis secondary to Bell's palsy or temporal bone trauma may benefit from facial nerve decompression. Patients should be counseled regarding the risks of decompression and that the return of maximal facial nerve function may be delayed up to 12 months.
Practice Patterns and Utilization of Tube Feedings in Acute Pancreatitis Patients at a Large US Referral Center
Authors: Machicado Jorge D. , Gougol Amir , Paragomi Pedram , O'Keefe Stephen J. , Lee Kenneth , Slivka Adam , Whitcomb David C. , Yadav Dhiraj , Papachristou Georgios I.
Published: August 2018

Objectives

Clinical trials on tube feedings (TFs) have not been sufficiently powered to change practice patterns in acute pancreatitis (AP). We aimed to describe the use, duration, and resource utilization of TF in AP patients at an expert US center.

Methods

Of 423 AP patients prospectively enrolled at the University of Pittsburgh Medical Center from 2004 to 2014, 139 (33%) received TF. Data on TF were assessed in 100 (72%) of 139 patients with complete data available.

Results

Patients on TF were more likely to be male, be obese, have alcohol etiology, and have moderately severe (34% vs 19%) or severe AP (62% vs. 3%) (P < 0.05). Tube feedings were started after a median of 5 days (interquartile range, 3–8 days) from admission and were administered for a median of 39 days (interquartile range, 19–58 days). A nasojejunal route (95%) with an oligomeric formula (92%) was the preferred TF strategy. Feeding tube complications led to at least 1 endoscopic tube replacement in 42% of patients and to an unexpected health care visit in 29% of those discharged on TF (16/55 patients).

Conclusions

Tube feedings form an important component in the management of patients with moderately severe and severe AP. Further studies should define the optimal utilization of TF and ways to reduce TF-related complications.
Cannabis Use Is Associated With Increased Risk of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Authors: Njei Basile , Sharma Prabin , McCarty Thomas R. , Singh Manpreet , Haque Lamia , Aslanian Harry R. , Jamidar Priya , Muniraj Thiruvengadam
Published: August 2018

Objective

The aim of this study was to investigate the impact of cannabis on post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP).

Methods

The US Nationwide Inpatient Sample was queried to identify patients who underwent endoscopic retrograde cholangiopancreatography pancreatitis from 2004 to 2014. Cannabis use was identified by International Classification of Diseases, Ninth Edition codes, and patients in remission were excluded. Poisson regression models were used to derive adjusted incidence risk ratios (IRRs) for outcomes.

Results

Among 37,712 patients with PEP, 0.4% had documented cannabis use disorder. From 2004 to 2014, the rate of PEP and cannabis use increased (8.9%–11.0% [P < 0.01] and 0.20%–0.70% [P < 0.01], respectively). Univariate analysis demonstrated cannabis was associated with increased risk of PEP (IRR, 1.70; 95% confidence interval [CI], 1.50–1.90; P < 0.01). On multivariate analysis, cannabis use was an independent predictor of PEP (IRR, 1.2; 95% CI, 1.1–1.4; P = 0.004). Cannabis was not associated with in-hospital death (IRR, 0.15; 95% CI, 0.02–1.04; P = 0.06) but was associated with shorter hospital stay (IRR, 0.96; 95% CI, 0.94–0.98; P < 0.001) and lower costs (IRR, 0.91; 95% CI, 0.91–0.92; P < 0.001).

Conclusions

Cannabis use was associated with an increase in PEP without significant increase in mortality.
Symptom Map of Endocrine Therapy for Breast Cancer: A Scoping Review
Authors: Zhu Yehui , Cohen Susan M. , Rosenzweig Margaret Q. , Bender Catherine M.
Published: August 2018

Background

Multiple symptoms associated with endocrine therapy have a detrimental impact on medication adherence and quality of life.

Objective

The purpose of this scoping review is to map the symptoms during endocrine therapy for breast cancer to provide implications for current practice and suggestions for future research.

Methods

The PubMed, CINAHL, and China Science Periodical Databases were searched to identify related studies published in English and Chinese languages. References of included articles were reviewed for additional eligible studies. Of the 2551 articles identified, 57 articles met inclusion criteria and were included in this scoping review.

Results

Evidence for the 16 most studied symptoms and 15 most prevalent symptoms were synthesized. Five key symptoms associated with endocrine therapy were identified, including joint/muscle pain, hot flashes, low sexual interest/desire, joint/muscle stiffness, and fatigue/lack of energy. Rarely studied but highly prevalent symptoms and other gaps in the symptom science during endocrine therapy for breast cancer were identified.

Conclusion

Nurses caring for women receiving endocrine therapy for breast cancer should assess the 5 key symptoms identified. There remain substantial gaps in the science related to the symptom experience during endocrine therapy for breast cancer. Future studies should focus on the domains of symptom intensity and distress, specific understudied symptoms, symptom clusters, and development of symptom assessment instruments specific to symptoms associated with endocrine therapy.

Implications for Practice

This scoping review identified 5 well-studied and highly prevalent symptoms that should be assessed in women with breast cancer receiving endocrine therapy.
Nutrition support for treating cancer-associated weight loss: an update
Authors: Molfino Alessio , Amabile Maria Ida , Muscaritoli Maurizio
Published: August 2018

Purpose of review

Patients with cancer present high risk for involuntary body weight loss and reduced food intake, which, contributing to progressive tissue wasting and affecting the nutritional status, are often under-estimated in the clinical practice. In this article, we aimed at focusing on cancer-associated weight loss and investigating recent evidences on the indications of nutritional interventions to treat this condition.

Recent findings

During the last few years, increased emphasis has been addressed on the mechanisms underlying body weight loss in cancer that can be induced by either cancer metabolism and inflammation, either several side-effects of the anticancer treatments. This led to consider clinical parameters, such as BMI, body weight change and food intake, and their modification overtime, in predicting patient's overall survival. In this light, nutritional support has to be considered to maintain or restore nutritional status, improve tolerance to oncological therapies, and ameliorate physical performance and quality of life.

Increased awareness on weight loss in cancer patients and on cancer cachexia is needed to carry out a nutritional assessment at an early stage of cancer journey and to establish its management and nutritional support to obtain advantages in terms of treatment tolerance and clinical outcomes.
Targeting the divergent TGFβ superfamily cytokine MIC-1/GDF15 for therapy of anorexia/cachexia syndromes
Authors: Tsai Vicky Wang-Wei , Brown David A. , Breit Samuel N.
Published: August 2018

Purpose of review

To review recent finding on MIC-1/GDF15 and re-evaluate it as a potential target for the therapy of anorexia/cachexia syndromes.

Recent findings

MIC-1/GDF15 consistently induces anorexia/cachexia in animal models. Its actions on brainstem feeding centers leads to anorexia, inducing prolonged undernutrition and consequent loss of both lean and fat mass. Epidemiological studies by multiple groups have linked substantially elevated serum levels of this cytokine to anorexia/cachexia syndromes in diverse diseases such as cancer, chronic renal and cardiac failure, and chronic obstructive lung disease. These elevated serum levels are similar to those required to induce this syndrome in animals. Recent identifications of its previously elusive receptor as GFRAL, has enhanced understanding of its biology and suggests that modulating the MIC-1/GDF15–GFRAL pathway may be a therapeutic target for anorexia/cachexia syndrome.

Inhibiting MIC-1/GDF15 or its receptor GFRAL are high-value potential targets for treatment of anorexia/cachexia syndrome in patients whose elevated serum levels may justify its use.
Effects of male telomeres on probability of paternity in sand lizards
Authors: Pauliny Angela , Miller Emily , Rollings Nicky , Wapstra Erik , Blomqvist Donald , Friesen Chris R. , Olsson Mats
Published: August 2018

Standardized swim-up trials are used in
in vitro
fertilization clinics to select particularly motile spermatozoa in order to increase the probability of a successful fertilization. Such trials demonstrate that sperm with longer telomeres have higher motility and lower levels of DNA damage. Regardless of whether sperm motility, and successful swim-up to fertilization sites, is a direct or correlational effect of telomere length or DNA damage, covariation between telomere length and sperm performance predicts a relationship between telomere length and probability of paternity in sperm competition, a prediction that for ethical reasons cannot be tested on humans. Here, we test this prediction in sand lizards (
Lacerta agilis
) using experimental data from twice-mated females in a laboratory population, and telomere length in blood from the participating lizards. Female identity influenced paternity (while the mechanism was not identified), while relatively longer male telomeres predicted higher probability of paternity. We discuss potential mechanisms underpinning this result.