bluuebunny/crossref_metadata_2025 huggingface dataset:
International Organizations and Foreign Policy
Authors: Panke Diana , Henneberg Ingo
Published: February 2017

The interplay between states and international organizations has received a lot of scholarly attention, largely because the number of international organizations has increased considerably within the last century. State-of-the-art scholarship on the foreign policies of international organizations and states is presented here, as are rationalist and constructivist accounts of how the foreign policies of states impact international organizations (bottom-up perspective), as well as how, in turn, international organizations impact member-state foreign policies (top-down perspective). Thereby, the polity, politics, and policy dimensions of both states and international organizations are examined in order to explain the changes states’ foreign policies can induce, under what scope conditions, in the international organizations’ structure (polity), procedures (politics), and policy outcomes. Vice versa, also explained are the changes international organizations can induce, under what scope conditions, in the foreign policy apparatus of states (polity), foreign policy decision-making procedures (politics), and states’ foreign policies. As is illustrated, the theme “International Organizations and Foreign Policy” is not an established foreign policy subfield per se but is covered here in multiple approaches and theories. In line with the development of international relations, the bottom-up perspective has received much more scholarly attention than the top-down perspective. Furthermore, bottom-up research evidences a tendency toward the strong influence of states’ foreign policies on the policy and polity of international organizations, while the top-down influence of international organizations on states’ foreign policy apparatus, procedures, and policies is usually much more limited. Finally, an outlook into fruitful future avenues for research is outlined.
Focused Deterrence Strategies
Authors: Braga Anthony
Published: February 2017

Focused deterrence strategies are increasingly being implemented in the United States to reduce serious violent crime committed by gangs and other criminally-active groups, recurring offending by highly-active individual offenders, and crime and disorder problems generated by overt street-level drug markets. These strategies are framed by an action research model that is common to both problem-oriented policing and public health interventions to reduce violence. Briefly, focused deterrence strategies seek to change offender behavior by understanding underlying crime-producing dynamics and conditions that sustain recurring crime problems and by implementing an appropriately focused blended strategy of law enforcement, community mobilization, and social service actions. Direct communications of increased enforcement risks and the availability of social service assistance to target groups and individuals is a defining characteristic of “pulling levers” strategies.

The focused deterrence approach was first pioneered in Boston, Massachusetts and eventually tested in other jurisdictions. The available empirical evidence suggests these strategies generate noteworthy violence reduction impacts and should be part of a broader portfolio of crime reduction strategies available to policy makers and practitioners. While focused deterrence strategies attempt to prevent crime by changing offender perceptions of sanction risk, complementary crime prevention efforts seem to support the crime control efficacy of these programs. These strategies also seek to change offender behavior by mobilizing community action, enhancing procedural justice, and improving police legitimacy. Focused deterrence strategies hold great promise in reducing serious violence while improving strained relationships between minority neighborhoods and the police departments that serve them.
Transgressive Imaginations
Authors: Seal Lizzie , O'Neill Maggie
Published: February 2017

Transgressive imaginations refers to the breaking of rules and taboos including, but not limited to, acts of crime and violence as they are represented in fictive texts and ethnographic research. The focus here will be on the fictive, rather than ethnographic, element. Transgression can be understood not only as exceeding boundaries or limits but as resistance, protest, and escape. Particularly apposite is the portrayal of “heroes” and “villains” in different cultural forms, and how these contribute to popular understandings.

Cultural portrayals of those who transgress societal norms are frequently stigmatizing, and label them as mad, bad, and abject. However, the analysis of transgression also entails radical democratic possibilities, whether this is through research that challenges restrictive stereotypes and normative assumptions, or the means through which those labeled “outsiders” defy their marginalization. Cultural representations of transgression are not necessarily supportive of culturally dominant or conservative positions and can instead offer new ways of imagining social identities and social change. The ways in which transgression is imagined can both construct and challenge moral boundaries.
American Trial Films and the Popular Culture of Law
Authors: Silbey Jessica
Published: February 2017

The American trial and American cinema share certain epistemological tendencies. Both stake claims to an authoritative form of knowledge based on the indubitable quality of observable phenomena. And both are preoccupied with sustaining the authority that underlies the knowledge produced by visual perception. The American trial and cinematic form also increasingly share cultural space. Although the trial film (otherwise known as the courtroom drama) is as old as the medium of film, the continuing popularity of the legal drama centered on a courtroom verdict suggests more than a trend. The inherent affinities between law and film not only produce enduring and memorable stories about law and justice but help constitute a popular legal consciousness that sustains the authority of the rule of law in the United States. This article describes these affinities in more detail, tracing the common themes in trial films, the special case of trial film based on true stories, and the future of the genre in American popular culture. It concludes by reviewing the disciplinary approach to the study of law and visual popular culture.
Thalamocortical Interactions for Sensory Processing
Authors: Alonso Jose M. , Swadlow Harvey A.
Published: February 2017

The thalamocortical pathway is the main route of sensory information to the cerebral cortex. Vision, touch, hearing, taste, and balance all depend on the integrity of this pathway that connects the thalamic structures receiving sensory input with the cortical areas specialized in each sensory modality. Only the ancient sense of smell is independent of the thalamus, gaining access to cortex through more anterior routes. While the thalamocortical pathway targets different layers of the cerebral cortex, its main stream projects to the middle layers and has axon terminals that are dense, spatially restricted, and highly specific in their connections. The remarkable specificity of these thalamocortical connections allows for a precise reconstruction of the sensory dimensions that need to be most finely sampled, such as spatial acuity in vision and sound frequency in hearing. The thalamic axon terminals also segregate topographically according to their stimulus preferences, providing a simple principle to build cortical sensory maps: neighboring values in sensory space are represented by neighboring points within the cortex.

Thalamocortical processing is not static. It is continuously modulated by the brain stem and corticothalamic feedback based on the level of attention and alertness, and during sleep or general anesthesia. When alert, visual thalamic responses become stronger, more reliable, more sustained, more effective at sampling fast changes in the scene, and more linearly related to the stimulus. The high firing rates of the alert state make thalamocortical synapses chronically depressed and excitatory synaptic potentials less dependent on temporal history, improving even further the linear relation between stimulus and response. In turn, when alertness wanes, the thalamus reduces its firing rate, and starts generating spike bursts that drive large postsynaptic responses and keep the cortex responsive to sudden stimulus changes.
Drosophila Olfaction
Authors: Gaudry Quentin , Schenk Jonathan
Published: February 2017

Olfactory systems are tasked with converting the chemical environment into electrical signals that the brain can use to optimize behaviors such as navigating towards resources, finding mates, or avoiding danger. Drosophila melanogaster has long served as a model system for several attributes of olfaction. Such features include sensory coding, development, and the attempt to link sensory perception to behavior. The strength of Drosophila as a model system for neurobiology lies in the myriad of genetic tools made available to the experimentalist, and equally importantly, the numerical reduction in cell numbers within the olfactory circuit. Modern techniques have recently made it possible to target nearly all cell types in the antennal lobe to directly monitor their physiological activity or to alter their expression of endogenous proteins or transgenes.
Asian Americans and Education
Authors: Chang Benjamin
Published: February 2017

The communities that constitute the racialized category of Asian Americans consist of approximately 20 million people in the United States, or about 5% of the total population. About 20% or 4 million are of primary or secondary school age, and over 1.1 million are in higher education. Both in popular and academic discourse, “Asian American” generally refers to people who have ethnic backgrounds in South Asia (e.g., Bangladesh, India, Pakistan, Sri Lanka), Southeast Asia (e.g., Cambodia, the Philippines, Thailand, Vietnam), and East Asia (e.g., China, Japan, Korea, Taiwan). As “Asian American” is an umbrella term used to categorize a very diverse, heterogeneous, and transnational set of populations, Asian Americans as a group present various challenges to education and research in and about the United States. These challenges can concern paradigms of achievement, citizenship, family involvement, access (e.g., higher education, bilingual education), language and culture, race and ethnicity, and school community.

In order to address these paradigmatic challenges, a great deal of scholarship has called for a disaggregation of the data on populations that fall under the pan-ethnic “Asian America” umbrella term, to gain a more nuanced and dynamic understanding of the many diverse populations and their historical, cultural, economic, and political experiences. To further address the problematic framing of Asian Americans in education and related fields, scholars have applied critical lenses to key tensions within conceptualization, policy, curriculum, and pedagogy. More recently, the notions of intersectionality and transnationalism have been generative in the study of Asian Americans, within not only educational research but also Asian American studies, which generally falls under the field of ethnic studies in the U.S. context, but has also been categorized under American studies, cultural studies, or Asian studies. While characterizations of Asian Americans as “the Model Minority” or “the Oppressed Minority” persist, the relevance of such static binaries has increasingly been challenged as the Asian American populations and migrations continue to diversify and increase.
Aging and Healthcare Costs
Authors: Karlsson Martin , Iversen Tor , Øien Henning
Published: February 2017

An open issue in the economics literature is whether healthcare expenditure (HCE) is so concentrated in the last years before death that the age profiles in spending will change when longevity increases. The seminal article “aging of Population and HealthCare Expenditure: A Red Herring?” by Zweifel and colleagues argued that that age is a distraction in explaining growth in HCE. The argument was based on the observation that age did not predict HCE after controlling for time to death (TTD). The authors were soon criticized for the use of a Heckman selection model in this context. Most of the recent literature makes use of variants of a two-part model and seems to give some role to age as well in the explanation. Age seems to matter more for long-term care expenditures (LTCE) than for acute hospital care. When disability is accounted for, the effects of age and TTD diminish. Not many articles validate their approach by comparing properties of different estimation models. In order to evaluate popular models used in the literature and to gain an understanding of the divergent results of previous studies, an empirical analysis based on a claims data set from Germany is conducted. This analysis generates a number of useful insights. There is a significant age gradient in HCE, most for LTCE, and costs of dying are substantial. These “costs of dying” have, however, a limited impact on the age gradient in HCE. These findings are interpreted as evidence against the red herring hypothesis as initially stated. The results indicate that the choice of estimation method makes little difference and if they differ, ordinary least squares regression tends to perform better than the alternatives. When validating the methods out of sample and out of period, there is no evidence that including TTD leads to better predictions of aggregate future HCE. It appears that the literature might benefit from focusing on the predictive power of the estimators instead of their actual fit to the data within the sample.
Professional Team Sports in the United States
Authors: Riess Steven A.
Published: February 2017

Professional sports teams are athletic organizations comprising talented, expert players hired by club owners whose revenues originally derived from admission fees charged to spectators seeing games in enclosed ballparks or indoor arenas. Teams are usually members of a league that schedules a championship season, although independent teams also can arrange their own contests. The first professional baseball teams emerged in the east and Midwest in 1860s, most notably the all-salaried undefeated Cincinnati Red Stockings of 1869. The first league was the haphazardly organized National Association of Professional Base Ball Players (1871), supplanted five years later by the more profit-oriented National League (NL) that set up strict rules for franchise locations, financing, and management–employee relations (including a reserve clause in 1879, which bound players to their original employer), and barred African Americans after 1884. Once the NL prospered, rival major leagues also sprang up, notably the American Association in 1882 and the American League in 1901.

Major League Baseball (MLB) became a model for the professionalization of football, basketball, and hockey, which all had short-lived professional leagues around the turn of the century. The National Football League and the National Hockey League of the 1920s were underfinanced regional operations, and their teams often went out of business, while the National Basketball Association was not even organized until 1949.

Professional team sports gained considerable popularity after World War II. The leagues dealt with such problems as franchise relocations and nationwide expansion, conflicts with interlopers, limiting player salaries, and racial integration. The NFL became the most successful operation by securing rich national television contracts, supplanting baseball as the national pastime in the 1970s. All these leagues became lucrative investments. With the rise of “free agency,” professional team athletes became extremely well paid, currently averaging more than $2 million a year.
Jaffa
Authors: Isaac Benjamin
Published: February 2017

The city of Joppe/Jaffa/Yafo on the eastern shore of the Mediterranean, immediately south of modern Tel Aviv, has a long history of importance as an urban centre, from the Middle Bronze Age onward until the 20th century. It was one of the few sites along the Palestinian coast that had a usable anchorage. The present article focuses on the Hellenistic, Roman, and late Roman periods, giving a brief survey of the major events, the political, social, and administrative history, and the major sources of information.
Julius Caesar, reception of
Authors: Tatum W. Jeffrey
Published: February 2017

The reception of Caesar constitutes, for obvious reasons, an immense topic. As a political idea, Caesar exhibits from the very beginning a tension between his role as dictator and destroyer of the Republic and his standing as the political and military genius who founded the Empire. This contrariety, not least by way of the analytic category of Caesarism, is especially marked in the political discourse of the 19th and 20th centuries. Caesar’s literary reception, though influenced by contemporary political conflicts, is not always tethered to them in straightforward ways. The Caesar of literature is often a reaction to the Caesar of Shakespeare. And there are other important issues: Caesar as a problem in the recovery of authenticity, or Caesar, because he is a canonical author, as a symbol of the conservative claims of the established order. In art, Caesar the god and Caesar the chivalrous king gradually give way to Caesar the slain dictator or Caesar the imperious conqueror. In popular culture, however, Caesar’s manifestations vary wildly: although he continues to register at a political level, he can also signify imperial excess or martial prowess, and he is available as a medium for lampooning the various guises of his own reception.
Theme
Authors: Hajičová Eva
Published: February 2017

In the linguistic literature, the term theme has several interpretations, one of which relates to discourse analysis and two others to sentence structure. In a more general (or global) sense, one may speak about the theme or topic (or topics) of a text (or discourse), that is, to analyze relations going beyond the sentence boundary and try to identify some characteristic subject(s) for the text (discourse) as a whole. This analysis is mostly a matter of the domain of information retrieval and only partially takes into account linguistically based considerations. The main linguistically based usage of the term theme concerns relations within the sentence. Theme is understood to be one of the (syntactico-) semantic relations and is used as the label of one of the arguments of the verb; the whole network of these relations is called thematic relations or roles (or, in the terminology of Chomskyan generative theory, theta roles and theta grids). Alternatively, from the point of view of the communicative function of the language reflected in the information structure of the sentence, the theme (or topic) of a sentence is distinguished from the rest of it (rheme, or focus, as the case may be) and attention is paid to the semantic consequences of the dichotomy (especially in relation to presuppositions and negation) and its realization (morphological, syntactic, prosodic) in the surface shape of the sentence. In some approaches to morphosyntactic analysis the term theme is also used referring to the part of the word to which inflections are added, especially composed of the root and an added vowel.
Berber-Arabic Language Contact
Authors: Kossmann Maarten
Published: February 2017

Since the start of the Islamic conquest of the Maghreb in the 7th century ce, Berber and Arabic have been in continual contact. This has led to large-scale mutual influence. The sociolinguistic setting of this influence is not the same, though; Arabic influence on Berber is found in a situation of language maintenance with widespread bilingualism, while Berber influence on Arabic is no doubt to a large degree due to language shift by Berber speakers to Arabic.

Linguistic influence is found on all levels: phonology, morphology, syntax, and lexicon. In those cases where only innovative patterns are shared between the two language groups, it is often difficult to make out where the innovation started; thus the great similarities in syllable structure between Maghrebian Arabic and northern Berber are the result of innovations within both language families, and it is difficult to tell where it started. Morphological influence seems to be mediated exclusively by lexical borrowing. Especially in Berber, this has led to parallel systems in the morphology, where native words always have native morphology, while loans either have nativized morphology or retain Arabic-like patterns. In the lexicon, it is especially Berber that takes over scores of loanwords from Arabic, amounting in one case to over one-third of the basic lexicon as defined by 100-word lists.
Morphological Change
Authors: Trips Carola
Published: February 2017

Morphological change refers to change(s) in the structure of words. Since morphology is interrelated with phonology, syntax, and semantics, changes affecting the structure and properties of words should be seen as changes at the respective interfaces of grammar.

On a more abstract level, this point relates to linguistic theory. Looking at the history of morphological theory, mainly from a generative perspective, it becomes evident that despite a number of papers that have contributed to a better understanding of the role of morphology in grammar, both from a synchronic and diachronic point of view, it is still seen as a “Cinderella subject” today. So there is still a need for further research in this area.

Generally, the field of diachronic morphology has been dealing with the identification of the main types of change, their mechanisms as well as the causes of morphological change, the latter of which are traditionally categorized as internal and external change. Some authors take a more general view and state the locus of change can be seen in the transmission of grammar from one generation to the next (abductive change). Concerning the main types of change, we can say that many of them occur at the interfaces with morphology: changes on the phonology–morphology interface like i-mutation, changes on the syntax–morphology interface like the rise of inflectional morphology, and changes on the semantics–morphology like the rise of derivational suffixes. Examples from the history of English (which in this article are sometimes complemented with examples from German and the Romance languages) illustrate that sometimes changes indeed cross component boundaries, at least once (the history of the linking-s in German has even become a prosodic phenomenon). Apart from these interface phenomena, it is common lore to assume morphology-internal changes, analogy being the most prominent example.

A phenomenon regularly discussed in the context of morphological change is grammaticalization. Some authors have posed the question of whether such special types of change really exist or whether they are, after all, general processes of change that should be modeled in a general theory of linguistic change. Apart from this pressing question, further aspects that need to be addressed in the future are the modularity of grammar and the place of morphology.
Japanese Psycholinguistics
Authors: Nakayama Mineharu
Published: February 2017

The Japanese psycholinguistics research field is moving rapidly in many different directions as it includes various sub-linguistics fields (e.g., phonetics/phonology, syntax, semantics, pragmatics, discourse studies). Naturally, diverse studies have reported intriguing findings that shed light on our language mechanism. This article presents a brief overview of some of the notable early 21st century studies mainly from the language acquisition and processing perspectives. The topics are divided into various sections: the sound system, the script forms, reading and writing, morpho-syntactic studies, word and sentential meanings, and pragmatics and discourse studies sections. Studies on special populations are also mentioned.

Studies on the Japanese sound system have advanced our understanding of L1 and L2 (first and second language) acquisition and processing. For instance, more evidence is provided that infants form adult-like phonological grammar by 14 months in L1, and disassociation of prosody is reported from one’s comprehension in L2. Various cognitive factors as well as L1 influence the L2 acquisition process. As the Japanese language users employ three script forms (hiragana, katakana, and kanji) in a single sentence, orthographic processing research reveal multiple pathways to process information and the influence of memory. Adult script decoding and lexical processing has been well studied and research data from special populations further helps us to understand our vision-to-language mapping mechanism. Morpho-syntactic and semantic studies include a long debate on the nativist (generative) and statistical learning approaches in L1 acquisition. In particular, inflectional morphology and quantificational scope interaction in L1 acquisition bring pros and cons of both approaches as a single approach. Investigating processing mechanisms means studying cognitive/perceptual devices. Relative clause processing has been well-discussed in Japanese because Japanese has a different word order (SOV) from English (SVO), allows unpronounced pronouns and pre-verbal word permutations, and has no relative clause marking at the verbal ending (i.e., morphologically the same as the matrix ending). Behavioral and neurolinguistic data increasingly support incremental processing like SVO languages and an expectancy-driven processor in our L1 brain. L2 processing, however, requires more study to uncover its mechanism, as the literature is scarce in both L2 English by Japanese speakers and L2 Japanese by non-Japanese speakers. Pragmatic and discourse processing is also an area that needs to be explored further. Despite the typological difference between English and Japanese, the studies cited here indicate that our acquisition and processing devices seem to adjust locally while maintaining the universal mechanism.
Etymology in Romance
Authors: Buchi Éva , Dworkin Steven N.
Published: February 2017

Etymology is the only linguistic subdiscipline that is uniquely historical in its study of the relevant linguistic data and one of the oldest fields in Romance linguistics.

The concept of etymology as practiced by Romanists has changed over the last 100 years. At the outset, Romance etymologists took as their brief the search for and identification of individual word origins. Starting in the early 20th century, various specialists began to view etymology as the preparation of the complete history of all facets of the evolution over time and space of the words or lexical families being studied. Identification of the underlying base was only the first step in the process. From this perspective, etymology constitutes an essential element of diachronic lexicology, which covers all formal, semantic, and syntactic facets of a word’s evolution, including, if appropriate, the circumstances leading to its demise and replacement.
Caucasian Languages
Authors: Chumakina Marina
Published: February 2017

Languages from at least five genetically unrelated families are spoken in the Caucasus, but there are only three endemic linguistic families belonging to the region: Kartvelian, West Caucasian, and Northeast Caucasian. These families are rather heterogeneous in terms of the number of languages and the distribution of the speakers across them. The Caucasus represents a situation where languages with millions of speakers have coexisted with one-village languages for hundreds of years, and where multilingualism has always been the norm. The richness of Caucasian languages on every linguistic stratum is dazzling: here we find some of the largest consonant inventories, inflectional systems where the mere number of word forms strains credibility (one of the Caucasian languages, Archi, is claimed to have over a million and a half word forms), and challenging syntactic structures. The typological interest of the Caucasian languages and the challenges they present to linguistic theory lie in different areas. Thus, for Kartvelian languages, the number of factors at play in the verbal system make the task of the production of a correct verbal form far from trivial. West Caucasian languages represent an instance of polysynthetic polypersonal verb inflection, which is unusual not only for Caucasus but for Eurasia in general. East Caucasian languages have large systems of non-finite forms which, unusually, retain the ability to realize agreement in gender and number while their non-finite nature is determined by the inability to head an independent clause and to express certain morpho-syntactic categories such as illocutionary force and evidentiality. Finally, all Caucasian languages are ergative to some extent.
Stepwise Distributed Open Innovation Contests for Software Development: Acceleration of Genome-Wide Association Analysis
Authors: Hill Andrew , Loh Po-Ru , Bharadwaj Ragu B. , Pons Pascal , Shang Jingbo , Guinan Eva , Lakhani Karim , Kilty Iain , Jelinsky Scott A.
Published: February 2017

Background: The association of differing genotypes with disease-related phenotypic traits offers great potential to both help identify new therapeutic targets and support stratification of patients who would gain the greatest benefit from specific drug classes. Development of low-cost genotyping and sequencing has made collecting large-scale genotyping data routine in population and therapeutic intervention studies. In addition, a range of new technologies is being used to capture numerous new and complex phenotypic descriptors. As a result, genotype and phenotype datasets have grown exponentially. Genome-wide association studies associate genotypes and phenotypes using methods such as logistic regression. As existing tools for association analysis limit the efficiency by which value can be extracted from increasing volumes of data, there is a pressing need for new software tools that can accelerate association analyses on large genotype-phenotype datasets. Results: Using open innovation (OI) and contest-based crowdsourcing, the logistic regression analysis in a leading, community-standard genetics software package (PLINK 1.07) was substantially accelerated. OI allowed us to do this in <6 months by providing rapid access to highly skilled programmers with specialized, difficult-to-find skill sets. Through a crowd-based contest a combination of computational, numeric, and algorithmic approaches was identified that accelerated the logistic regression in PLINK 1.07 by 18- to 45-fold. Combining contest-derived logistic regression code with coarse-grained parallelization, multithreading, and associated changes to data initialization code further developed through distributed innovation, we achieved an end-to-end speedup of 591-fold for a data set size of 6678 subjects by 645 863 variants, compared to PLINK 1.07's logistic regression. This represents a reduction in run time from 4.8 hours to 29 seconds. Accelerated logistic regression code developed in this project has been incorporated into the PLINK2 project. Conclusions: Using iterative competition-based OI, we have developed a new, faster implementation of logistic regression for genome-wide association studies analysis. We present lessons learned and recommendations on running a successful OI process for bioinformatics.
Popular Culture
Authors: Kidd Dustin
Published: February 2017

Popular culture is the set of practices, beliefs, and objects that embody the most broadly shared meanings of a social system. It includes media objects, entertainment and leisure, fashion and trends, and linguistic conventions, among other things. Popular culture is usually associated with either mass culture or folk culture, and differentiated from high culture and various institutional cultures (political culture, educational culture, legal culture, etc.). The association of popular culture with mass culture leads to a focus on the position of popular culture within a capitalist mode of economic production. Through this economic lens, popular culture is seen as a set of commodities produced through capitalistic processes driven by a profit motive and sold to consumers. In contrast, the association of popular culture with folk culture leads to a focus on subcultures such as youth cultures or ethnic cultures. Through this subculture lens, popular culture is seen as a set of practices by artists or other kinds of culture makers that result in performances and objects that are received and interpreted by audiences, both within and beyond the subcultural group. Holistic approaches examine the ways that popular culture begins as the collective creation of a subculture and is then appropriated by the market system. Key issues in the sociological analysis of popular culture include the representation of specific groups and themes in the content of cultural objects or practices, the role of cultural production as a form of social reproduction, and the extent to which audiences exercise agency in determining the meanings of the culture that they consume.
Ischemic Optic Neuropathy in Cardiac Surgery
Authors: Rubin Daniel S. , Matsumoto Monica M. , Moss Heather E. , Joslin Charlotte E. , Tung Avery , Roth Steven
Published: February 2017

Background

Ischemic optic neuropathy is the most common form of perioperative visual loss, with highest incidence in cardiac and spinal fusion surgery. To date, potential risk factors have been identified in cardiac surgery by only small, single-institution studies. To determine the preoperative risk factors for ischemic optic neuropathy, the authors used the National Inpatient Sample, a database of inpatient discharges for nonfederal hospitals in the United States.

Methods

Adults aged 18 yr or older admitted for coronary artery bypass grafting, heart valve repair or replacement surgery, or left ventricular assist device insertion in National Inpatient Sample from 1998 to 2013 were included. Risk of ischemic optic neuropathy was evaluated by multivariable logistic regression.

Results

A total of 5,559,395 discharges met inclusion criteria with 794 (0.014%) cases of ischemic optic neuropathy. The average yearly incidence was 1.43 of 10,000 cardiac procedures, with no change during the study period (P = 0.57). Conditions increasing risk were carotid artery stenosis (odds ratio, 2.70), stroke (odds ratio, 3.43), diabetic retinopathy (odds ratio, 3.83), hypertensive retinopathy (odds ratio, 30.09), macular degeneration (odds ratio, 4.50), glaucoma (odds ratio, 2.68), and cataract (odds ratio, 5.62). Female sex (odds ratio, 0.59) and uncomplicated diabetes mellitus type 2 (odds ratio, 0.51) decreased risk.

Conclusions

The incidence of ischemic optic neuropathy in cardiac surgery did not change during the study period. Development of ischemic optic neuropathy after cardiac surgery is associated with carotid artery stenosis, stroke, and degenerative eye conditions.
Elevated Mean Airway Pressure and Central Venous Pressure in the First Day of Mechanical Ventilation Indicated Poor Outcome
Authors: Long Yun , Su Longxiang , Zhang Qing , Zhou Xiang , Wang Hao , Cui Na , Chai Wenzhao , Wang Xiaoting , Rui Xi , Liu Dawei
Published: February 2017

Objectives:

The relationship between respiratory mechanical parameters and hemodynamic variables remains unclear. This study was performed to determine whether mean airway pressure and central venous pressure in the first day of mechanical ventilation are associated with patient outcomes.

Design:

Retrospective first 24-hour comparison during ICU stay.

Setting:

The Department of Critical Care Medicine of Peking Union Medical College Hospital.

Patients:

Patients with mechanical ventilation.

Interventions:

None.

Measurements and Main Results:

The clinical data of patients who received mechanical ventilation, especially respiratory and hemodynamic data, were collected and analyzed. In terms of the hemodynamic and perfusion data, the nonsurvivors group (177/2,208) had higher heart rate, respiratory rate, central venous pressure, and lactates and a lower perfusion index and P(v-a)co
2 (p < 0.05). In terms of respiratory condition, mean airway pressure, peak airway pressure, positive end-expiratory pressure, driving pressure, and inspiratory time/total respiration time of nonsurvivors were significantly higher, and arterial oxygen pressure and dynamic compliance worsened and were lower than the survivors (p < 0.05). Increased central venous pressure (odds ratio, 1.125; 95% CI, 1.069–1.184; p < 0.001) and elevated mean airway pressure (odds ratio, 1.125; 95% CI, 1.069–1.184; p < 0.001) were independently associated with 28-day mortality. The area under receiver operating characteristic demonstrated that central venous pressure and mean airway pressure were measured at 0.795 (95% CI, 0.654–0.757) and 0.833 (95% CI, 0.608–0.699), respectively. Based on the cutoff of central venous pressure and mean airway pressure, all of the participants were divided into the following groups: low central venous pressure and mean airway pressure, only high central venous pressure or mean airway pressure, or high central venous pressure and mean airway pressure. Post hoc tests showed significant differences among these three groups based on 28-day survival (log rank [Mantel-Cox], 131.931; p < 0.001).

Conclusions:

During the first 24 hours of mechanical ventilation, patients with elevated mean airway pressure and elevated central venous pressure had worse outcomes.
Repeatability of Central Corneal Thickness Measurement Using Rotating Scheimpflug Camera in Dry and Normal Eyes
Authors: Lee Jong-Hyuck , Kim Jae Hyuk , Kim Sun Woong
Published: February 2017

Purpose:

To compare the repeatability of central corneal thickness (CCT) measurement using the Pentacam between dry eyes and healthy eyes, as well as to investigate the effect of artificial tears on CCT measurement.

Methods:

The corneal thicknesses of 34 patients with dry eye and 28 healthy subjects were measured using the Pentacam. One eye from each subject was assigned randomly to a repeatability test, wherein a single operator performed three successive CCT measurements time points—before and 5 min after instillation of one artificial teardrop. The repeatability of measurements was assessed using the coefficient of repeatability and the intraclass correlation coefficient.

Results:

The coefficient of repeatability values of the CCT measurements in dry and healthy eyes were 24.36 and 10.69 μm before instillation, and 16.85 and 9.72 μm after instillation, respectively. The intraclass correlation coefficient was higher in healthy eyes than that of in dry eyes (0.987 vs. 0.891), and it had improved significantly in dry eyes (0.948) after instillation of one artificial teardrop. The CCT measurement fluctuated in dry eyes (repeated-measures analysis of variance, P<0.001), whereas no significant changes were detected in healthy eyes, either before or after artificial tear instillation.

Conclusions:

Central corneal thickness measurement is less repeatable in dry eyes than in healthy eyes. Artificial tears improve the repeatability of CCT measurements obtained using the Pentacam in dry eyes.
Pitfalls and Rewards for Implementing Ocular Motor Testing in Acute Vestibular Syndrome
Authors: Dumitrascu Oana M. , Torbati Sam , Tighiouart Mourad , Newman-Toker David E. , Song Shlee S.
Published: February 2017

Objectives:

Isolated acute vestibular syndrome (iAVS) presentations to the emergency department (ED) pose management challenges, given the concerns for posterior circulation strokes. False-negative brain imaging may erroneously reassure clinicians, whereas HINTS-plus examination outperforms imaging to screen for strokes in iAVS. We studied the feasibility of implementing HINTS-plus testing in the ED, aiming to reduce neuroimaging in patients with iAVS.

Methods:

We launched an institutional Quality Improvement initiative, using DMAIC methodology. The outcome measures [proportion of iAVS subjects who had HINTS-plus examinations and underwent neuroimaging by computed tomography/magnetic resonance imaging (CT/MRI)] were compared before and after the established intervention. The intervention consisted of formal training for neurologists and emergency physicians on how to perform, document, and interpret HINTS-plus and implementation of novel iAVS management algorithm. Neuroimaging was not recommended if HINTS-plus suggested peripheral vestibular etiology. If a central process was suspected, brain MRI/MR angiogram was performed. Head CT was reserved only for thrombolytic time-window cases.

Results:

In the first 2 months postimplementation, HINTS-plus testing performance by neurologists increased from 0% to 80% (P=0.007), and by ED providers from 0% to 9.09% (P=0.367). Head CT scans were reduced from 18.5% to 6.25%. Brain MRI use was reduced from 51.8% to 31.2%. About 60% of the iAVS subjects were discharged from the ED; none were readmitted or had another ED presentation in the ensuing 30 days.

Conclusions:

Implementation of HINTS-plus evaluation in the ED is valuable and feasible for neurologists, but challenging for emergency physicians. Future studies should determine the “dose-response” curve of educational interventions.
“Phacing” a New Cause of Carotid Artery Dissection
Authors: Kulyk Caterina , Farina Filippo , Palmieri Anna , Viaro Federica , Causin Francesco , Laverda Anna M. , Baracchini Claudio
Published: February 2017

Introduction:

Cervical arterial dissection (CAD) is a frequent and preventable cause of ischemic stroke in young patients. Several arguments suggest that genetic and developmental disorders could play an important role as part of a multifactorial predisposition of sporadic CAD.

We present 2 cases of young patients with CAD in association with cutaneous lesions and nonatherosclerotic multivessel arteriopathy.

Case Reports:

Our first patient was a 17-year-old white girl with sudden onset of weakness in her right upper limb. A magnetic resonance angiogram showed a severe stenosis along the extracranial and intracranial segments of the left internal carotid artery and the left middle cerebral artery. A complete ultrasound study confirmed the stenoses with characteristics suggestive of dissection.

Our second patient was a 7-year old white girl with a past history of left middle cerebral artery ischemic stroke. During the follow-up, an ultrasonographical examination discovered an asymptomatic dissection of the right internal carotid artery.

Both patients reported a history of large unilateral hemangiomas; in the first case a coloboma of the left optic disc and an aortic aneurysm were also present. These findings were suggestive of PHACE—a neurocutaneous developmental syndrome associated with constitutional arteriopathy of the major cerebral vessels.

Conclusions:

Noteworthy, among vascular abnormalities of PHACE, CADs have never been reported before. Our 2 cases suggest that CAD is an underecognized cerebrovascular manifestation of PHACE and it should be searched for in these patients. Ultrasound, being noninvasive and portable, is a useful tool for the assessment and follow-up of these patients.
Mechanisms of saccade suppression revealed in the anti-saccade task
Authors: Coe Brian C. , Munoz Douglas P.
Published: February 2017

The anti-saccade task has emerged as an important tool for investigating the complex nature of voluntary behaviour. In this task, participants are instructed to suppress the natural response to look at a peripheral visual stimulus and look in the opposite direction instead. Analysis of saccadic reaction times (SRT: the time from stimulus appearance to the first saccade) and the frequency of direction errors (i.e. looking toward the stimulus) provide insight into saccade suppression mechanisms in the brain. Some direction errors are reflexive responses with very short SRTs (express latency saccades), while other direction errors are driven by automated responses and have longer SRTs. These different types of errors reveal that the anti-saccade task requires different forms of suppression, and neurophysiological experiments in macaques have revealed several potential mechanisms. At the start of an anti-saccade trial, pre-emptive top-down inhibition of saccade generating neurons in the frontal eye fields and superior colliculus must be present before the stimulus appears to prevent express latency direction errors. After the stimulus appears, voluntary anti-saccade commands must compete with, and override, automated visually initiated saccade commands to prevent longer latency direction errors. The frequencies of these types of direction errors, as well as SRTs, change throughout the lifespan and reveal time courses for development, maturation, and ageing. Additionally, patients diagnosed with a variety of neurological and/or psychiatric disorders affecting the frontal lobes and/or basal ganglia produce markedly different SRT distributions and types of direction errors, which highlight specific deficits in saccade suppression and inhibitory control. The anti-saccade task therefore provides valuable insight into the neural mechanisms of saccade suppression and is a valuable tool in a clinical setting.

This article is part of the themed issue ‘Movement suppression: brain mechanisms for stopping and stillness’.
Models of inhibitory control
Authors: Schall Jeffrey D. , Palmeri Thomas J. , Logan Gordon D.
Published: February 2017

We survey models of response inhibition having different degrees of mathematical, computational and neurobiological specificity and generality. The independent race model accounts for performance of the stop-signal or countermanding task in terms of a race between GO and STOP processes with stochastic finishing times. This model affords insights into neurophysiological mechanisms that are reviewed by other authors in this volume. The formal link between the abstract GO and STOP processes and instantiating neural processes is articulated through interactive race models consisting of stochastic accumulator GO and STOP units. This class of model provides quantitative accounts of countermanding performance and replicates the dynamics of neural activity producing that performance. The interactive race can be instantiated in a network of biophysically plausible spiking excitatory and inhibitory units. Other models seek to account for interactions between units in frontal cortex, basal ganglia and superior colliculus. The strengths, weaknesses and relationships of the different models will be considered. We will conclude with a brief survey of alternative modelling approaches and a summary of problems to be addressed including accounting for differences across effectors, species, individuals, task conditions and clinical deficits.

This article is part of the themed issue ‘Movement suppression: brain mechanisms for stopping and stillness’.
Inhibitory dysfunction contributes to some of the motor and non-motor symptoms of movement disorders and psychiatric disorders
Authors: Jahanshahi Marjan , Rothwell John C.
Published: February 2017

Recently, it has been proposed that similar to goal-directed and habitual action mediated by the fronto-striatal circuits, the fronto-striato-subthalamic-pallidal-thalamo-cortical network may also mediate goal-directed and habitual (automatic) inhibition in both the motor and non-motor domains. Within this framework, some of the clinical manifestations of Parkinson's disease, dystonia, Tourette syndrome and obsessive–compulsive disorder can be considered to represent an imbalance between goal-directed and habitual action and inhibition. It is possible that surgical interventions targeting the basal ganglia nuclei, such as deep brain stimulation of the subthalamic nucleus or the internal segment of the globus pallidus, improve these disorders by restoring a functional balance between facilitation and inhibition in the fronto-striatal networks. These proposals require investigation in future studies.

This article is part of the themed issue ‘Movement suppression: brain mechanisms for stopping and stillness’.