bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns in Mathematics Classroom Interaction
Authors: Ingram Jenni
Published: March 2021

Classroom interaction has a significant influence on teaching and learning mathematics. It is through interaction that we solve problems, build ideas, make connections, and develop our understanding. This book aims to describe, exemplify, and consider the implications of patterns and structures of mathematics classroom interaction. Drawing on a Conversation Analytic approach, the book examines how the structures of interactions between teachers and students influence, enable, and constrain the mathematics that students are experiencing and learning in school. In particular, the book considers the handling of difficulties or errors and the consequences on both the mathematics students are learning, and the learning of this mathematics. The various roles of silence and the treatment of knowledge and understanding within everyday classroom interactions also reveal the nature of mathematics as it is taught in different classrooms. The book also draws on examples of students explaining, reasoning, and justifying as they interact to examine how the structures of classroom interaction support students to develop these discursive practices. Understanding how these patterns and structures affect students’ experiences in the classroom enables us to use and develop practices that can support students’ learning. This reflexive relationship between these structures of interactions and student actions and learning is central to the issues explored in this book, alongside the implications these may have for teachers’ practice, and students’ learning.
The Poor and the Plutocrats
Authors: Teal Francis
Published: March 2021

This book begins with the incomes of the first trillion-dollar company Apple and ends with the advent of Trump and Brexit. Apple symbolizes the arrival of the mega-company and, along with that technology, has come the super-incomes of the plutocrats. In this book we examine the source of those plutocratic incomes and why they have grown so rapidly, generating the anger of those left-behind whose incomes have grown so much less, if at all. The book seeks to provide an explanation of how a world has emerged with such incomes co-existing with dire poverty. It does this by using a lot of data so the reader can see where those with the highest incomes—in the hundreds of millions of dollars—have emerged and where those with incomes of a few thousands just survive. It is a story charting the changing geography of absolute poverty and of the changing position of the unskilled in now-rich countries.
Samuel Wesley and the Crisis of Tory Piety, 1685-1720
Authors: Gibson William
Published: March 2021

This book examines the life of Samuel Wesley, the father of John and Charles Wesley, as a High Church parson in the Church of England. It examines a series of crises in Wesley’s life: his move from Dissent to the Church of England, his abandonment of James II in 1688, his failed ambitions as a parish priest, the imprisonment for debt in 1705, his problematic relations with his bishop and tumultuous marriage to Susanna Wesley, his support for the Tory Convocation measures in 1713 and the haunting of his rectory in Epworth by a poltergeist. Each of these aspects of Wesley’s life showed how awkward his continuing commitment to High Church Toryism was. The book argues that Wesley’s life demonstrates that the Revolution of 1688-9 was not a single event, but a long and protracted experience, reaching, in Wesley’s case, from 1685-1720. The Tory Crisis of Piety of this period was evidence of the Long Glorious Revolution.
Samuel Wesley and the Religious Societies, 1698–1702
Authors: Gibson William
Published: March 2021

Chapter 3 investigates Wesley’s appointment to, and early years as a parson in, Epworth, in Lincolnshire. It explores in particular his campaign to bring moral reform to the parish. It examines Wesley’s interests in the religious societies and the Society for the Promotion of Christian Knowledge (SPCK). His short-lived consideration of the society for the reformation of manners is also considered. His membership of the SPCK brought Wesley into contact with like-minded clergy and churchmen who aimed for religious renewal. The chapter also outlines how Wesley confronted his parishioners and set an acrimonious tone to his relations with them. It also considers his creation of a religious society in Epworth, which met regularly in the rectory and sought to instil greater piety and religious energy into his parishioners’ lives. It explores the rules of the society and the ways in which Wesley developed the society. Wesley’s behaviour in Epworth were not without opponents and those who derided his efforts.
Wesley and Wake
Authors: Gibson William
Published: March 2021

Chapter 5 explores Wesley’s relationship with his bishop, William Wake of Lincoln. Wesley’s strong and unbending Toryism meant that his relations with Bishop William Wake of Lincoln, who was a Whig, were difficult. Wesley posed a series of questions to Wake about such issues as excommunication, baptism and moral discipline to be imposed on Dissenters. In each case, Wesley seems to have sought Wake’s counsel with the intention of persuading him that the demands of parish life were such that toleration of Dissent was remarkably problematic. In addition, the issue of Dissenting, or ‘lay’ Baptism was an issue which divided them. Wesley’s interest in a charity school for the parish was also very clear and he clearly wanted Wake to endorse this. By a close and detailed examination of the correspondence between Wesley and Wake it is clear that while they shared an ambition for the Church they saw the ways to achieve it very differently.
Presenting the Evidence
Authors: Gamble Clive
Published: March 2021

The next month is a busy time for Evans and Prestwich, who are now back in London, as they fit writing their papers into a hectic business schedule. The importance of two learned societies—the Royal Society and the Society of Antiquaries—is explained, as is the craft of putting together a scientific argument. Prestwich’s original manuscript and the referees’ reports are used to show the process. Evans’s chance discovery of comparable implements to those they had found at St Acheul proves a game changer. They came from Hoxne in Suffolk and had been found, but forgotten, sixty years before. Revolutions rely on chance. Attention is paid to the case they made that stone tools were human rather than natural. Did Evans fall back on his knowledge of numismatics and his recent struggles with a patent law case to convince sceptics that the tools from the Somme were indeed evidence of ancient humans? The language of the flints is all important. As they prepare and present their evidence, the chapter picks up the story of Falconer and his niece, Grace McCall, who were introduced in Abbeville in Chapter 2. They are now in Italy, caught up in the latest phase of the Risorgimento war.
Consolidation
Authors: Gamble Clive
Published: March 2021

The year 1863 saw the consolidation of the time revolution. Evans and Prestwich presented further weighty papers on the Somme, but the major contributions came that year in books by Lyell and Huxley. Lyell’s book outraged Falconer, and a bitter argument ensued about intellectual property. Both authors chart the developmental process by which ‘primitive’ skulls became ‘advanced’ ones. Critical to this was Huxley’s use of the Neanderthal skull that became the first ice age human. Evans, in the meantime, was excavating the ‘missing link’ fossil Archaeopteryx in the British Museum. Falconer’s ire was diverted by Boucher de Perthes’s discovery in 1863 of human remains at Moulin Quignon, outside Abbeville. If authentic, these would be the oldest fossil ancestors. What followed was a lengthy examination of the evidence, with English scientists disagreeing with their French counterparts. In 1859 the quarrymen had been treated as a source of knowledge. Now they were branded by the English as forgers. The climate of claim and counterclaim contrasts with the clarity of the 1859 protocols that proved human antiquity.
Acceptance
Authors: Gamble Clive
Published: March 2021

By the end of the decade the time revolution was a done deal. Moulin-Quignon still reverberated, but in 1865 Lubbock produced the first guided tour of the Old Stone Age, in which he accused Lyell of plagiarism. In Pre-Historic Times he filled the new space of deep history with stone tools to show an evolutionary pathway from St Acheul to the Neolithic monuments of Avebury and Stonehenge. Tracing history back was matched by the anthropologist Edward Tylor, who traced it up. Both men were interested in the evolution of racial groups and accounting for the world’s hunters and gatherers. In a typically upbeat assessment, Lubbock saw the lesson of the past as providing hope for the future. Victorian ‘savages’ at the uttermost ends of the earth had not degenerated from a civilized state. They had the potential to evolve, as his ancestors in Europe had done. Unwritten history was making universal history possible. The decade saw deaths and career changes. Prestwich largely abandoned the time revolution, married Falconer’s niece, Grace McCall, and became an Oxford professor. Falconer and Boucher de Perthes died, while Lubbock entered Parliament in 1870. Prestwich’s fixed notion of a single ice age was challenged by James Croll, who painstakingly worked out the changes in the elliptical orbit of the Earth, and from these proposed multiple ice ages. As a bookend to the decade Evans published his fact-rich volume on ancient stone implements. The path of deep history was now set in stone.
A Legacy of Zeal and Perseverance
Authors: Gamble Clive
Published: March 2021

What happened to the surviving time revolutionaries and their legacy? Knighthoods, high office, a peerage, and bespoke mansions all followed. France preserved Boucher de Perthes’s legacy better than England that of its time revolutionaries, whom it forgot. War, however, destroyed Abbeville in 1940 and with it Boucher de Perthes’s collections and public statue. Lubbock was the last to die in 1913, having seen the Piltdown forgery. Then follows an excursion into the development of the modern synthesis of human origins with scientific dates, a detailed deep-sea record of climate change and the ages of the sites they found on the Somme and at Hoxne. Changing views of our remote ancestors are shown in artists’ imaginings and through bestselling authors. The reticence of Prestwich and Evans to speculate was forgotten as deep history was fleshed out to resonate with the present. The chapter ends by placing the time revolution at the start of an interest in universal and deep history. The time revolutionaries changed our relationship with time and set in motion a dialogue with the past that continues to challenge and enthral.
The Intelligent Brain
Authors: Healy Susan D.
Published: March 2021

In this chapter I address the question as to why brain size and its variation is interesting. Because for many the answer is that a bigger brain endows greater intelligence, in this chapter I first provide a definition of intelligence, or cognition. I then describe a variety of factors that need to be considered in order to attempt to make comparisons, within or among species, of cognitive abilities. These include motivation, environmental factors, and methodologies used to train and test animals (typically) in the laboratory. For the remainder of the chapter I use the demonstration of the relationships between food storing, spatial cognition, and the hippocampus to illustrate these issues.
The Resurrection of Christ and the True Life of All Creatures
Authors: McIntosh Mark A.
Published: March 2021

In light of the deep involvement of the divine ideas in the incarnation, death, and resurrection of Christ, it becomes possible to conceive of a new cultural imaginary in which the divine ideas permit mystical theology to hear the embodied reality of all creatures as a communication event. C. S. Lewis’ investigation of the mythopoetic imagination affords us an analogy for the rediscovered use of the divine ideas tradition in the contemplative calling of humankind. Recognizing the creation as, in and of itself, also a means of communion among creatures and between creatures and God, angels and human beings have a particular role in advancing the intelligible meaning of all creatures through the development of a contemplative consciousness. In encountering the crucified yet risen Christ, Christians believe their consciousness of reality is transfigured as they are drawn into the vindicated truth of all creatures in Christ.
The World According to Kant
Authors: Jauernig Anja
Published: March 2021

The World According to Kant offers an interpretation of Immanuel Kant’s critical idealism, as developed in the Critique of Pure Reason and associated texts. Critical idealism is understood as an ontological position, which comprises transcendental idealism, empirical realism, and a number of other basic ontological theses. According to Kant, the world, understood as the sum total of everything that has reality, comprises several levels of reality, most importantly, the transcendental level and the empirical level. The transcendental level is a mind-independent level at which things in themselves exist. The empirical level is a fully mind-dependent level at which appearances exist, which are intentional objects of experience. Empirical objects and empirical minds are appearances, and empirical space and time are constituted by the spatial and temporal determinations of appearances. On the proposed interpretation, Kant is thus a genuine idealist about empirical objects, empirical minds, and space and time. But in contrast to other intentional objects, appearances genuinely exist, which is due both to the special character of experience compared to other kinds of representations such as illusions and dreams, and to the grounding of appearances in things themselves. This is why, on the proposed interpretation, Kant is also a genuine realist about empirical objects, empirical minds, and empirical space and time. This book develops the indicated interpretation, spells out Kant’s case for critical idealism thus understood, pinpoints the differences between critical idealism and ‘ordinary’ idealism, such as Berkley’s, and clarifies the relation between Kant’s conception of things in themselves and the conception of things in themselves by other philosophers, in particular, Kant’s Leibniz-Wolffian predecessors.
Kant’s Transcendental Idealism and Empirical Realism
Authors: Jauernig Anja
Published: March 2021

The core claims of transcendental idealism are examined, according to which empirical objects and empirical selves are appearances and not things in themselves, and pure space and time are nothing but forms of sensibility. Kant is shown to be a relationalist about empirical space and time in holding that empirical space and time are constituted by the spatial and temporal determinations of empirical objects. Furthermore, it is explicated how Kant can be both a transcendental idealist and an empirical realist about empirical objects, empirical selves, and empirical space and time, and how his idealism differs from transcendental realism, as well as from ordinary idealism such as Berkeley’s.
Dynamic Green’s functions in discrete flexural systems
Authors: Madine K H , Colquitt D J
Published: March 2021

The article presents an analysis of the dynamic behaviour of discrete flexural systems composed of Euler–Bernoulli beams. The canonical object of study is the discrete Green’s function, from which information regarding the dynamic response of the lattice under point loading by forces and moments can be obtained. Special attention is devoted to the interaction between flexural and torsional waves in a square lattice of Euler–Bernoulli beams, which is shown to yield a range of novel effects, including extreme dynamic anisotropy, asymmetric wave propagation, wave-guiding, filtering and the ability to create localised defect modes, all without the need for additional resonant elements or interfaces. The analytical study is complimented by numerical computations and finite element simulations, both of which are used to illustrate the effects predicted. A general algorithm is provided for constructing Green’s functions as well as defect modes. This algorithm allows the tuning of the lattice to produce pass bands, band gaps, resonant modes, wave-guides and defect modes, over any desired frequency range.
Humanist Weddings in Poland: The Various Motivations of Couples
Authors: Rejowska Agata
Published: March 2021

There has been a recent increase in the popularity of humanist (individualized and mostly secular) marriage ceremonies in Poland. The propagators of humanist weddings consider these rites of passage as an alternative to both civil ceremonies, which are seen as “bland” and “template,” and also to their religious, especially Catholic, counterparts. The conducted research reveals the various motivations of people who decide on a humanist marriage ceremony. In addition to “nonreligious” or “antireligious” motivation, the analysis also pinpoints “anti-institutional,” “individualistic,” and “practical” motives. The paper analyzes these various motivations. It additionally addresses the issue of the individualization of humanist weddings and the limits of this process. By drawing upon Neil Gross’s distinction between regulative and meaning-constitutive traditions, I argue that while humanist ceremonies are a sign of the undermining of the regulative traditions and their power, couples still deploy meaning-constitutive traditions to anchor their ceremonies.
Knowing receipt: a question of priorities
Authors: Roxburgh Alan
Published: March 2021

The recent judgment of Fancourt J in Byers v Samba Financial Group considers whether a transferee of trust assets who has taken free of the beneficiary’s proprietary interest under the applicable foreign law of property can nevertheless be exposed to personal liability under the English law of knowing receipt. The issue, as the Judge observed, may be of considerable importance to equity lawyers.
Cardiac ankyrin repeat protein contributes to dilated cardiomyopathy and heart failure
Authors: Zhang Na , Ye Feiming , Zhou Yu , Zhu Wei , Xie Cuiping , Zheng Haiqiong , Chen Han , Chen Jinghai , Xie Xiaojie
Published: March 2021

Cardiac ankyrin repeat protein (CARP) is a cardiac‐specific stress‐response protein which exerts diverse effects to modulate cardiac remodeling in response to pathological stimuli. We examined the role of CARP in postnatal cardiac development and function under basal conditions in mice. Transgenic mice that selectively overexpressed CARP in heart (CARP Tg) exhibited dilated cardiac chambers, impaired heart function, and cardiac fibrosis as assessed by echocardiography and histological staining. Furthermore, the mice had a shorter lifespan and reduced survival rate in response to ischemic acute myocardial infarction. Immunofluorescence demonstrated the overexpressed CARP protein was predominantly accumulated in the nuclei of cardiomyocytes. Microarray analysis revealed that the nuclear localization of CARP was associated with the suppression of calcium‐handling proteins. In vitro experiments revealed that CARP overexpression resulted in decreased cell contraction and calcium transient. In post‐mortem cardiac specimens from patients with dilated cardiomyopathy and end‐stage heart failure, CARP was significantly increased. Taken together, our data identified CARP as a crucial contributor in dilated cardiomyopathy and heart failure which was associated with its regulation of calcium‐handling proteins.
SMURF2‐mediated ubiquitin signaling plays an essential role in the regulation of PARP1 PARylating activity, molecular interactions, and functions in mammalian cells
Authors: Ilić Nataša , Tao Yulei , Boutros‐Suleiman Sandy , Kadali Venkata Narasimha , Emanuelli Andrea , Levy‐Cohen Gal , Blank Michael
Published: March 2021

Poly(ADP‐ribose) polymerase 1 (PARP1) is a key molecular stress sensor and response mediator implicated in multiple cellular functions in health and diseases. Despite its importance and intrinsic involvement in pivotal molecular and cellular processes, including DNA repair, transcription regulation, chromatin organization, and cell death, the regulatory mechanisms of PARP1 are poorly understood. In this study, we show that SMURF2, a HECT‐type E3 ubiquitin ligase and suggested tumor suppressor, physically interacts with PARP1 in different cellular settings, directly ubiquitinates it in vitro and stimulates its PARylation activity in cells, the phenomenon that required SMURF2 E3 ubiquitin ligase function. Intriguingly, in the cellular environment SMURF2 was found to regulate the dynamic exchange of ubiquitin moieties on PARP1, mostly decreasing its monoubiquitination. Through the set of systematic mass spectrometry analyses conducted on SMURF2‐modified cells, we identified on PARP1 18 lysine residues (out of 126 present in PARP1) as sites which ubiquitination was considerably affected by SMURF2. Subsequent site‐directed mutagenesis coupled with in cellula ubiquitination and PARylation assays unveiled K222 as a critical site enabling a cross talk between SMURF2‐modulated monoubiquitination of PARP1 and its activity, and pointed to K498, S507, and a KTR triad (K498/K521/K524) as the main auto‐PARylation sites affected by SMURF2. The results also uncovered that SMURF2 controls PARP1 interactome, influencing its functions and expression in a context‐dependent manner. Taken together, these findings suggest that SMURF2‐mediated ubiquitin signaling plays an essential role in PARP1 regulation, beyond the regulation of its protein expression.
Some dystrophy phenotypes of dystrophin‐deficient mdx mice are exacerbated by mild, repetitive daily stress
Authors: Lindsay Angus , Holm John , Razzoli Maria , Bartolomucci Alessandro , Ervasti James M. , Lowe Dawn A.
Published: March 2021

Psychosocial stressors can cause physical inactivity, cardiac damage, and hypotension‐induced death in the mdx mouse model of Duchenne muscular dystrophy (DMD). Because repeated exposure to mild stress can lead to habituation in wild‐type mice, we investigated the response of mdx mice to a mild, daily stress to determine whether habituation occurred. Male mdx mice were exposed to a 30‐sec scruff restraint daily for 12 weeks. Scruff restraint induced immediate physical inactivity that persisted for at least 60 minutes, and this inactivity response was just as robust after 12 weeks as it was after one day. Physical inactivity in the mdx mice was not associated with acute skeletal muscle contractile dysfunction. However, skeletal muscle of mdx mice that were repeatedly stressed had slow‐twitch and tetanic relaxation times and trended toward high passive stiffness, possibly due to a small but significant increase in muscle fibrosis. Elevated urinary corticosterone secretion, adrenal hypertrophy, and a larger adrenal cortex indicating chronic activation of the hypothalamic‐pituitary‐adrenal (HPA) axis were measured in 12‐week stressed mdx mice relative to those unstressed. However, pharmacological inhibition of the HPA axis did not affect scruff‐induced physical inactivity and acute corticosterone injection did not recapitulate the scruff‐induced phenotype, suggesting the HPA axis is not the driver of physical inactivity. Our results indicate that the response of mdx mice to an acute mild stress is non‐habituating and that when that stressor is repeated daily for weeks, it is sufficient to exacerbate some phenotypes associated with dystrophinopathy in mdx mice.
Mistaken Identity: Frequency and Effects of Gender-Based Professional Misidentification of Resident Physicians
Authors: Berwick Shana , Calev Hila , Matthews Andrew , Mukhopadhyay Amrita , Poole Brian , Talan Jordan , Hayes Margaret M. , Smith C. Christopher
Published: March 2021

Purpose

Evaluation of the medical profession at all levels has exposed episodes of gender-based role misidentification whereby women physicians are disproportionately misidentified as nonphysicians. The authors of this study investigate this phenomenon and its repercussions, quantifying the frequency with which resident physicians experience role misidentification and the effect this has on their experience and behavior.

Method

In 2018, the authors conducted a cross-sectional survey study of internal medicine, surgical, and emergency medicine residents at a single, large, urban, tertiary academic medical center. The survey tool captured both the self-reported frequency and effect of professional misidentification. The authors used a t test and linear multivariate regression to analyze the results.

Results

Of the 260 residents who received the survey, 186 (72%) responded, and the authors analyzed the responses of 182. All 85 of the women respondents (100%) reported being misidentified as nonphysicians at least once in their professional experience by patients or staff members, compared with 49% of the 97 men respondents. Of those 182 residents, 35% of women were misidentified more than 8 times per month by patients compared with 1% of men. Of the 85 women physicians responding to the survey, 38% felt angry and 36% felt less satisfied with their jobs as a result of misidentification compared with, respectively, 7% and 9% of men. In response to role misidentification, 51% of women changed their manner of attire and 81% changed their manner of introduction, compared with, respectively, 7% and 37% of men.

Conclusions

These survey results demonstrate that women physicians are more likely than men physicians to be misidentified as nonphysicians and that role misidentification provokes gender-polarized psychological and behavioral responses that have potentially important professional ramifications.
Is There a Replication Crisis in Medical Education Research?
Authors: Hope David , Dewar Avril , Hay Christopher
Published: March 2021

Scholars are increasingly aware that studies—across many disciplines—cannot be replicated by independent researchers. Here, the authors describe how medical education research may be vulnerable to this “replication crisis,” explain how researchers can act together to reduce risks, and discuss the positive steps that can increase confidence in research findings. Medical education research contributes to policy and influences practitioner behavior. Findings that cannot be replicated suggest that the original research was not credible. This risk raises the possibility that unhelpful or even harmful changes to medical education have been implemented as a result of research that appeared defensible but was not. By considering these risk factors, researchers can increase the likelihood that studies are generating credible results. The authors discuss and provide examples of 6 factors that may endanger the replicability of medical education research: (1) small sample sizes, (2) small effect sizes, (3) exploratory designs, (4) flexibility in design choices, analysis strategy, and outcome measures, (5) conflicts of interest, and (6) very active fields with many competing research teams. Importantly, medical education researchers can adopt techniques used successfully elsewhere to improve the rigor of their investigations. Researchers can improve their work through better planning in the development stage, carefully considering design choices, and using sensible data analysis. The wider medical education community can help by encouraging higher levels of collaboration among medical educators, by routinely evaluating existing educational innovations, and by raising the prestige of replication and collaborative medical education research. Medical education journals should adopt new approaches to publishing. As medical education research improves, so too will the quality of medical education and patient care.
Diclofenac Is Superior to Paracetamol in Postoperative Pain Scores and Analgesic Consumption in Supratentorial Craniotomy With No Difference in Platelet and Clot Function: A Prospective Randomized Controlled Trial
Authors: Rajkiran Ragula , Soni Shiv Lal , Jangra Kiran , Bhagat Hemant , Singh Ajay , Singh Apinderpreet , Panda Nidhi B. , Kaloria Narender
Published: March 2021

Background:

The use of nonsteroidal anti-inflammatory drugs in neurosurgery remains controversial because of potential risk of hematoma formation secondary to platelet dysfunction. This study aimed to investigate the efficacy and safety of diclofenac compared with paracetamol for the management of postcraniotomy pain.

Methods:

In all, 110 adult patients undergoing craniotomy for supratentorial tumors were randomized to receive either intravenous paracetamol (15 mg/kg) or intravenous diclofenac sodium (1.5 mg/kg) 30 minutes before the end of surgery and postoperatively at 12-hour intervals up to 48 hours. The analgesic efficacy of diclofenac and paracetamol was assessed using the Numerical Rating Scale (NRS) score at 12, 24, and 48 hours after surgery. We also examined the need for rescue analgesia, coagulation profiles using a Sonoclot analyzer, and incidence of intracranial hematoma formation.

Results:

At 24 hours postsurgery, NRS scores were lower in group D than in group P; median (interquartile range) and mean rank NRS score in group D was 3.00 (1.0), 43.71, respectively, compared with 3.00 (1.0), 59.29 in group P (P=0.004). Patients in group P received more rescue analgesia than those in group D. Coagulation profiles were similar between groups at 24 hours. Activated clotting time was longer in group D (128.76±12.61 s) than in group P (123.84±09.77 s; P=0.03) at 48 hours, although remained within normal limits in both groups; clot rate and platelet function were similar at 48 hours. There was no difference in the incidence of postoperative tumor bed hematoma.

Conclusion:

Compared with paracetamol, diclofenac sodium provided more effective postoperative analgesia at 24 hours with no evidence of adverse effects on coagulation profiles in patients undergoing craniotomy for supratentorial tumors.
What Can a Child Do With One Normal-Hearing Ear? Speech Perception and Word Learning in Children With Unilateral and Bilateral Hearing Losses Relative to Peers With Normal Hearing
Authors: Pittman Andrea L. , de Diego-Lázaro Beatriz
Published: March 2021

Objectives:

To examine the effects of unilateral hearing loss on children’s ability to perceive familiar words and to learn and retain new words. Because children with unilateral hearing loss receive full auditory input in one ear, their performance was expected to be consistent with that of children with normal hearing rather than that of children with moderate bilateral hearing loss.

Design:

Participants were 36 school-age children with normal hearing bilaterally, 11 children with moderate bilateral hearing loss, and 11 children with mild-to-profound unilateral hearing loss (six right and five left). Half of the normally hearing children and two-thirds of the children with unilateral hearing loss were from bilingual Spanish/English-speaking homes. One of the 11 children with bilateral hearing loss was from a bilingual Spanish/English-speaking home. All children completed a word recognition test in English and in Spanish, a word-learning task comprised of nonsense words constructed using the phonotactic rules of English, Spanish, and Arabic, and a next-day word-retention test.

Results:

Word recognition did not differ across groups in English or Spanish. Learning and retention of nonsense words was highest for the children with normal hearing in all three languages. The children with unilateral and bilateral losses learned and recalled the English nonsense words as well as their normally hearing peers, but performance for the Spanish and Arabic nonsense words was significantly and similarly reduced by hearing loss in either ear.

Conclusions:

Failure to learn and retain new words given a full auditory representation in one ear suggests that children with unilateral and bilateral hearing losses may share a unifying feature of impairment at the level of the central auditory system.
A novel universal medial approach for difficult posteromedial tibial plateau fractures: a prospective case series
Authors: Fathy Ayman , Michael Fady
Published: March 2021

Background:

Tibial plateau fractures are considered to be one of the most common fractures with an increasing incidence of motor vehicle accidents. Posteromedial fracture, in particular, is considered a more challenging case. Combination of posteromedial fragment fracture with central articular depression or medial condyle fracture make it much more difficult to reduce and adequately fix the fractured fragments. The aims of this study were to describe a new extensile medial approach for the management of different types of tibial plateau fractures with posteromedial fragments and to evaluate results using this approach.

Methods:

Between January 2015 and January 2017, 15 patients with Schatzker IV, V, or VI fractures, in combination with a posteromedial fragment, were operated for open reduction of the fracture with restoration of the articular surface alignment. Fixation was done by double plate osteosynthesis. Complete healing time and knee-function scores were recorded in the follow-up period.

Results:

The average age of patients was 41.8 yr; the mean follow-up period was 30 mo. One patient had superficial wound dehiscence and was treated conservatively. No patients with knee instability or loss of reduction were reported.

Conclusions:

The posteromedial approach offers a very good access to view, reduce, and fix difficult posteromedial fractures together with comminuted tibial plateau fractures without the need for dissection of the neurovascular bundle in the fossa or soft-tissue injury.

Level of Evidence:

Level IV.
Management trends of clavicular fractures at a level 1 trauma center: a retrospective chart review
Authors: Taylor Aaron , Simske Natasha M. , Wilson Eleanor S. , Jasty Naveen , Vallier Heather A.
Published: March 2021

Background:

Controversy remains regarding optimal treatment of clavicular fractures, despite evidence touting lower nonunion rates for operative interventions. Given increasing evidence supporting operative treatment, the goal of this study was to observe trends in operative versus nonoperative treatment over a 15-year period.

Methods:

One thousand and eighty nine patients with any clavicular fracture (AO Foundation/Orthopaedic Trauma Association 15A to 15AC) between 2004 and 2018 were identified. Patient records were queried for demographic information, injuries to the head or chest, and treatment modality (operative vs. nonoperative). Independent sample t-tests, Fisher exact, or chi-square tests were used for analysis, with P less than 0.05 representing significance.

Results:

Of the 1089 qualified patients, the average age was 47.5 yr and 70.7% were men. Two hundred forty-two patients (20.2%) were managed operatively. Two hundred seventy-one patients (24.8%) had isolated injuries. Operative clavicle management increased from 6.4% of patients in 2004 and 2005 to 31.5% in 2018 (P<0.001). During this time, both patient age and chest-injury rates increased (both P<0.01). Patients with head injuries had a fixation rate of 4.8%, compared with 45.5% in patients with chest injuries. Those fixation rates differed from the rate for isolated clavicular fractures (30.9%) and those polytraumatized patients who had both chest and head injuries (18.8%) (P=0.026).

Conclusions:

Our data indicated that from 2004 to 2018, there was a five-fold increase in the rate of operative management of clavicular fractures. This rise in fixation rates may substantially influence the rate of complications, secondary surgeries, and cost of additional healthcare utilization. It is important to counsel patients individually to limit unnecessary surgery.

Level of Evidence:

Level IV.
Role of machine learning in management of degenerative spondylolisthesis: a systematic review
Authors: El-Daw Sherif , El-Tantawy Ahmad , Aly Tarek , Ramadan Mohamed
Published: March 2021

Background:

Machine learning is a field of artificial intelligence that allows a computer system to learn through repetitive processes and improve with experience. Precise study of medical data benefits early disease recognition, patient care, and community services.

Methods:

The purpose of this systematic review was to assess the evidence for effectiveness of machine learning and artificial intelligence in the management of spondylolisthesis. A literature search of published and unpublished articles resulted in the retrieval of more than 1000 potential studies on the subject area. Eight were reviewed according to inclusion criteria.

Results:

Expert medical doctors examined the pelvis and lumbar spine shape and orientation to diagnose spondylolisthesis. However, some shape and orientation parameters were misleading and unclear. Therefore, automatic diagnosis methods (classification methods) have been proposed to help medical doctors. The most important parameter of classification was found to be the grade of spondylolisthesis.

Conclusions:

Although the proposed results may be misleading, the studies provided evidence to suggest that two-thirds of the patients with grade I spondylolisthesis were stable enough to tolerate decompression without fusion, but that one-third of the patients appeared to develop instability over time. This instability often led to reoperation for spinal fusion at the level of listhesis. It is possible to create a predictive machine learning algorithm that is calibrated and accurate to predict discharge placement.

Level of Evidence:

Level I.
Anterior Controllable Antedisplacement and Fusion (ACAF) Technique for the Treatment of Multilevel Cervical Spondylotic Myelopathy With Spinal Stenosis (MCSMSS)
Authors: Luo Xi , Wang Shunmin , Sun Kaiqiang , Sun Jingchuan , Wang Yuan , Jiang Jialin , Zhao Feng , Guo Yongfei , Shi Jiangang
Published: March 2021

Study Design:

Retrospective study.

Objective:

To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), compared with hybrid decompression fixation (HDF).

Summary of Background Data:

A retrospective analysis of 94 cases with MCSMSS was carried out. Fifty-four patients were treated with ACAF, whereas 40 patients were treated with HDF.

Methods:

The operation time, intraoperative blood loss, postoperative complications, Japanese Orthopedic Association score, Neck Disability Index score, parameters at axial computed tomography, cervical curvature and the Kang grade were compared between 2 groups.

Results:

The patients were followed up for 12–17 (15.6±1.6) months. Compared with HDF, ACAF group achieved better decompression according to computed tomography measurement and Kang grade (P<0.05), and recovered to a greater cervical Cobb angle (P<0.05). However, Japanese Orthopedic Association score and Neck Disability Index showed no significant difference 1 year after surgery (P>0.05). In addition, ACAF presented longer operation time (P<0.05) and similar intraoperative blood loss (P>0.05), compared with HDF. In terms of complications, ACAF produced less incidences of cerebrospinal fluid leakage, implant complication, epidural hematoma, and C5 palsy compared with HDF.

Conclusions:

ACAF is an effective method for the treatment of MCSMSS. In comparison to HDF, ACAF has the advantages of more sufficient decompression, more satisfactory cervical curvature, and lower incidence rates of complications.
A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation
Authors: Cao Le-Qing , Zhou Yang , Liu Yan-Rong , Xu Lan-Ping , Zhang Xiao-Hui , Wang Yu , Chen Huan , Chen Yu-Hong , Wang Feng-Rong , Han Wei , Sun Yu-Qian , Yan Chen-Hua , Tang Fei-Fei , Mo Xiao-Dong , Liu Kai-Yan , Fan Qiao-Zhen , Chang Ying-Jun , Huang Xiao-Jun
Published: March 2021

Background

For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT.

Methods

A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables.

Results

All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P 
< 0.001, P = 0.004, and P 
< 0.001, respectively) and worse LFS (P 
< 0.001, P = 0.017, and P 
< 0.001, respectively), and OS (P 
< 0.001, P = 0.009, and P 
< 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P 
< 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score.

Conclusion

This new risk score system might stratify patients with different risks of relapse, which could guide treatment.
Exercise Protocol With Limited Shoulder Range of Motion for 15 or 30 Days After Conservative Surgery for Breast Cancer With Oncoplastic Technique
Authors: Rizzi Samantha K.L.A. , Haddad Cinira A.S. , Giron Patrícia S. , Figueira Patrícia V.G. , Estevão Amanda , Elias Simone , Nazário Afonso C.P. , Facina Gil
Published: March 2021

Objective:

The objective is to evaluate the effect of limiting shoulder range of motion (ROM) for 15 or 30 days on surgical complications and on shoulder ROM, pain, and upper limb function of breast cancer patients following conservative oncoplastic surgery.

Materials and Methods:

A randomized clinical trial was conducted with 60 women with breast cancer who underwent conservative oncoplastic surgery. The day after surgery, all patients started an exercise protocol with shoulder exercises limited to 90 degrees. Two weeks after surgery they were randomized into Free ROM Group (n=30) or Limited ROM Group (n=30). The Free ROM Group was allowed to perform shoulder exercises with unlimited ROM; the Limited ROM Group continued with shoulder movement restricted at 90 degrees until 30 days after surgery, at which time they were also allowed free ROM. The primary outcome was the incidence of postoperative complications (dehiscence, seroma, infection, and necrosis) and secondary outcomes were shoulder ROM, pain, and upper limb function.

Results:

No difference in the incidence of postoperative scar complications between groups was noted. There was no difference between the groups in shoulder joint amplitude, pain, or upper limb function.

Conclusions:

The free ROM exercise protocol 15 days post surgery was safe concerning cicatricial complications.
Treatment of Typically Developing Toddlers with Hair-Pulling Behavior and Concurrent Poor Sleep Hygiene: A Case Series
Authors: Fodstad Jill C. , Greve Katherynne T. , Curtin Michelle J. , Lagges Ann M.
Published: March 2021

Objective:

Hair-pulling disorder is a rare condition with onset most commonly in adolescence and a well-documented association with comorbid psychiatric disorders. Minimal literature currently exists detailing the occurrence and treatment of this condition in young children, particularly less than 5 years old.

Method:

This case report describes 2 cases of children (<24 months old) with hair-pulling disorder and concurrent highly disrupted sleep. Treatment aimed at addressing sleep hygiene through parental psychoeducation and training, competing items, and faded naptime/bedtime.

Results:

In both children, sleep hygiene intervention yielded significant improvement in sleep disruption patterns and hair-pulling behavior across approximately a 3-month period that maintained at 1- and 3-month follow-ups.

Conclusion:

Identifying factors that may be related or concurrent to hair pulling in young children is vital in ensuring that treatment is individualized and effective.
Ocular Complications After Laser or Light-Based Therapy—Dangers Dermatologists Should Know
Authors: Juhasz Margit , Zachary Christopher , Cohen Joel L.
Published: March 2021

BACKGROUND

Laser and light-based technologies have been used in the medical field for over 50 years. In dermatologic and cosmetic practice, cutaneous side effects are commonly discussed; however, ocular injury may also occur.

OBJECTIVE

To complete a systematic review of the current literature regarding ocular complications in the dermatologic field after laser and/or light-based therapies.

MATERIALS AND METHODS

A systematic review of the Medline database was performed in August 2020 using the search terms “laser or light and ocular and complication.” The inclusion criteria were articles written in English discussing ocular complications after laser or light-based therapy for dermatologic or cosmetic indications.

RESULTS

A total of 36 articles were included for review. Carbon dioxide was the most frequently used laser causing ocular damage, and the most common ophthalmologic complication was temporary ectropion. Patients described visual disturbances and pain as the most common symptoms. A large proportion of articles did not report the use of appropriate eye protection at the time of injury.

CONCLUSION

Although ocular injury post-laser or light-based procedures are rare, clinicians must be acutely aware of the signs and symptoms associated with eye damage. The informed consent process should thoroughly describe the possibility of ocular complications post-treatment, and medical practices should have appropriate emergency plans and protective equipment in place to decrease both patient and staff risk of injury.
European Multicenter Prospective Study Evaluating Long-Term Safety and Efficacy of the Polycaprolactone-Based Dermal Filler in Nasolabial Fold Correction
Authors: Moers-Carpi Marion , Christen Marie-Odile , Delmar Henry , Brun Patrick , Bodokh Isaac , Kestemont Philippe
Published: March 2021

BACKGROUND

Age-related changes affecting facial areas can be corrected using minimally invasive dermal fillers. The use of polycaprolactone-dermal filler (PCL-filler) in aesthetics is increasing.

OBJECTIVE

To evaluate the long-term safety and efficacy of the PCL-filler, in a European, multicenter, prospective study.

MATERIALS AND METHODS

Subjects (n = 90) with moderate/severe nasolabial folds (Wrinkle Severity Rating Scale [WSRS]: 3 to 4) were treated on Day 0 with a single injection of similar volume on each side; safety and efficacy assessments were performed over an 18-month period. In 1 of the 3 study centers, safety was evaluated at 30 months.

RESULTS

At Month 12 (M12; primary endpoint), 84% of subjects showed a ≥1-point improvement on the WSRS (M6: 92%; M18: 64%). From the investigator/subject's evaluation, from Day 7 to M12, Global Aesthetic Improvement was reported for >90% of subjects, with the effect maintained for up to 18 months in >80% of patients. Subjects/investigators reported high satisfaction and skin quality improvement. Most of the immediate injection-site reactions disappeared after 2 to 4 days. No severe or unexpected adverse events were reported.

CONCLUSION

This study demonstrated the long-term safety and efficacy of the PCL-filler, with safety confirmed for up to 30 months.