bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Boundaries between Decision and Action: Effector-selective Lateralization of Beta-frequency Power Is Modulated by the Lexical Frequency of Printed Words
Authors: Scaltritti Michele , Job Remo , Alario F.-Xavier , Sulpizio Simone
Published: July 2020

Current computational and neuroscientific models of decision-making posit a discrete, serial processing distinction between upstream decisional stages and downstream processes of motor-response implementation. We investigated this framework in the context of two-alternative forced-choice tasks on linguistic stimuli, words and pseudowords. In two experiments, we assessed the impact of lexical frequency and action semantics on two effector-selective EEG indexes of motor-response activation: the lateralized readiness potential and the lateralization of beta-frequency power. This allowed us to track potentially continuous streams of processing progressively mapping the evaluation of linguistic stimuli onto corresponding response channels. Whereas action semantics showed no influence on EEG indexes of motor-response activation, lexical frequency affected the lateralization of response-locked beta-frequency power. We argue that these observations point toward a continuity between linguistic processing of word input stimuli and implementation of corresponding choice in terms of motor behavior. This interpretation challenges the commonly held assumption of a discrete processing distinction between decisional and motor-response processes in the context of decisions based on symbolic stimuli.
Lexical Information Guides Retuning of Neural Patterns in Perceptual Learning for Speech
Authors: Luthra Sahil , Correia João M. , Kleinschmidt Dave F. , Mesite Laura , Myers Emily B.
Published: July 2020

A listener's interpretation of a given speech sound can vary probabilistically from moment to moment. Previous experience (i.e., the contexts in which one has encountered an ambiguous sound) can further influence the interpretation of speech, a phenomenon known as perceptual learning for speech. This study used multivoxel pattern analysis to query how neural patterns reflect perceptual learning, leveraging archival fMRI data from a lexically guided perceptual learning study conducted by Myers and Mesite [Myers, E. B., & Mesite, L. M. Neural systems underlying perceptual adjustment to non-standard speech tokens. Journal of Memory and Language, 76, 80–93, 2014]. In that study, participants first heard ambiguous /s/–/∫/ blends in either /s/-biased lexical contexts (epi_ode) or /∫/-biased contexts (refre_ing); subsequently, they performed a phonetic categorization task on tokens from an /asi/–/a∫i/ continuum. In the current work, a classifier was trained to distinguish between phonetic categorization trials in which participants heard unambiguous productions of /s/ and those in which they heard unambiguous productions of /∫/. The classifier was able to generalize this training to ambiguous tokens from the middle of the continuum on the basis of individual participants' trial-by-trial perception. We take these findings as evidence that perceptual learning for speech involves neural recalibration, such that the pattern of activation approximates the perceived category. Exploratory analyses showed that left parietal regions (supramarginal and angular gyri) and right temporal regions (superior, middle, and transverse temporal gyri) were most informative for categorization. Overall, our results inform an understanding of how moment-to-moment variability in speech perception is encoded in the brain.
Myrcia adulterina (Myrtaceae), a new species from the Atlantic Forest of Rio de Janeiro, Brazil

Authors: FERNANDES THIAGO , FERNANDES LIMA DUANE , BRAGA JOÃO MARCELO ALVARENGA
Published: July 2020

Myrcia adulterina, a new species from the Brazilian Atlantic Forest, is here described, illustrated and compared with morphologically related species. Additionally, its distribution map and a preliminary conservation status are presented. The new species is here inferred as belonging to Myrcia sect. Reticulosae due its leaves with raised venation, staminal ring densely pilose, hypanthium prolonged in a tube with glabrous inner walls and 3-locular ovaries. Within this section, the species is morphologically related to Myrcia pubipetala, from which it can be distinguished through the laxly reticulate leaf venation and thyrsoid inflorescences with all axes strongly flattened and striated when dry. Myrcia adulterina was misidentified during at least 15 years in herbaria under the name Marlierea tomentosa (currently synonym of Myrcia strigipes, a species belonging to Myrcia sect. Aulomyrcia), which is also morphologically similar. A brief discussion clarifying the morphological differences between these species is also presented.
Revisiting the taxonomy of Ophiorrhiza codyensis and lectotypification of O. pykarensis (Rubiaceae), two endemic taxa of the Western Ghats

Authors: HAREESH VADAKKOOT SANKARAN , PREETHAMOL SIDHABHAVAN NANJAN , SABU MAMIYIL , THOPPIL JOHN ERNEST
Published: July 2020

Taxonomic identity and occurrence of Ophiorrhiza codyensis (Rubiaceae), a little known endemic species from the Western Ghats is discussed along with its rediscovery after a gap of 106 years outside from its type locality. Detailed description of the species is provided with colour photographs, ecology and conservation status. In addition, a lectotype is designated for O. pykarensis, another endemic species of the Western Ghats. A new occurrence of O. trichocarpon in the Western Ghats is also discussed.
A new species of Ceropegia (Apocynaceae) from northern Kerala, India

Authors: BIJU P. , JOSEKUTTY E.J. , KAMBALE S.S. , AUGUSTINE J. , BRUYNS P.V.
Published: July 2020

A new species, Ceropegia ariyittaparensis P.Biju et al. is described from the low-lying lateritic plateaux of northern Kerala, SW India. This species belongs to Ceropegia sect. Tiloris H.Huber. It is most similar to Ceropegia vartakii (Kambale & S.R.Yadav) Bruyns, but differs by its elongated buds, maroon, longitudinally folded and lanceolate corolla-lobes, its taller outer coronal lobes and longer connivent inner coronal lobes, which rise in a short column above the style-head.
A revision of the planthopper genus Chionomus Fennah (Hemiptera: Fulgoroidea: Delphacidae)
Authors: WEGLARZ KATHRYN M. , BARTLETT CHARLES R
Published: July 2020

The planthopper genus Chionomus Fennah, 1971 (Hemiptera: Fulgoroidea: Delphacidae) currently includes three Neotropical species, removed from the polyphyletic genus Delphacodes Fieber, 1866. Morphological and molecular evidence further redefine Chionomus to include ten additional species (eight species removed from Delphacodes, two described as new, viz. Chionomus dolonus n. sp. and C. herkos n. sp.), with another four species synonymized. Phylogenetic analyses of morphological and molecular sequence data of the mitochondrial gene Cytochrome Oxidase I provide support for the monophyly of Chionomus. We use a mixed model Bayesian optimality criterion to define phylogenetic relationships among Chionomus and support paraphyly of the original definition of Chionomus (with respect to Delphacodes) and monophyly of the revised genus.
Multiple-Platform and Multiple-Doppler Radar Observations of a Supercell Thunderstorm in South America during RELAMPAGO
Authors: Trapp Robert J. , Kosiba Karen A. , Marquis James N. , Kumjian Matthew R. , Nesbitt Stephen W. , Wurman Joshua , Salio Paola , Grover Maxwell A. , Robinson Paul , Hence Deanna A.
Published: July 2020

On 10 November 2018, during the RELAMPAGO field campaign in Argentina, South America, a thunderstorm with supercell characteristics was observed by an array of mobile observing instruments, including three Doppler on Wheels radars. In contrast to the archetypal supercell described in the Glossary of Meteorology, the updraft rotation in this storm was rather short lived (~25 min), causing some initial doubt as to whether this indeed was a supercell. However, retrieved 3D winds from dual-Doppler radar scans were used to document a high spatial correspondence between midlevel vertical velocity and vertical vorticity in this storm, thus providing evidence to support the supercell categorization. Additional data collected within the RELAMPAGO domain revealed other storms with this behavior, which appears to be attributable in part to effects of the local terrain. Specifically, the IOP4 supercell and other short-duration supercell cases presented had storm motions that were nearly perpendicular to the long axis of the Sierras de Córdoba Mountains; a long-duration supercell case, on the other hand, had a storm motion nearly parallel to these mountains. Sounding observations as well as model simulations indicate that a mountain-perpendicular storm motion results in a relatively short storm residence time within the narrow zone of terrain-enhanced vertical wind shear. Such a motion and short residence time would limit the upward tilting, by the left-moving supercell updraft, of the storm-relative, antistreamwise horizontal vorticity associated with anabatic flow near complex terrain.
Noninvasive Cellular Oxygenation Measurement During Graded Hypoxia Using Visible–Near-Infrared Spectroscopy
Authors: Arakaki Lorilee S.L. , Ciesielski Wayne A. , McMullan D. Michael , Schenkman Kenneth A.
Published: July 2020

In critically ill patients, direct knowledge of intracellular pO2 would allow for identification of cellular hypoxia, which when prolonged leads to organ failure. We have developed a visible–near-infrared optical system that noninvasively measures myoglobin saturation, which is directly related to intracellular pO2, from the surface of the skin. We used an animal model of graded hypoxia from low levels of inspired oxygen ( n = 5) and verified that low intracellular pO2 is correlated with high steady-state serum lactate values. In addition, the pO2 gradient between arterial blood and inside muscle cells was 83 mm Hg at 21% O2, but fell to 24 mm Hg at 8% O2. Continuous myoglobin saturation measurement in skeletal muscle displayed the same trends as cerebral oxygenation with no lag in changes over time, demonstrating its relevance as a measure of systemic oxygenation.
Suppressing the Multiplex Disadvantage in Photon-Noise Limited Interferometry Using Cross-Dispersed Spatial Heterodyne Spectrometry
Authors: Egan Miles J. , Colón Arelis M. , Angel S. Michael , Sharma Shiv K.
Published: July 2020

Spatial heterodyne spectrometers are members of the static Fourier transform class of spectrometers, well-regarded for their ability to acquire high-resolution, high wavelength precision emission spectra in compact, light footprint packages. In a spatial heterodyne spectrometer experiment, a Fizeau fringe is generated for every spectral feature in a given spectrum, and spatial heterodyne spectrometer records the superposition of all Fizeau fringes in the spectrum on a detector. Hence, the sensitivity of spatial heterodyne spectrometers is constrained by uncorrelated, multiplicative photon noise that limits the detection of spectral features to those that are more luminous than the square root of the total incident flux onto the detector. In essence, powerful spectral features create a rising floor of noise that wash out less luminous features. In the present work, we introduce a novel spectrometer coupling, that being an Amici prism spectrometer in series with spatial heterodyne spectrometer, that correlates photon shot noise along one axis of a detector that in turn suppresses multiplicative photon noise within each row of the interferogram image. We demonstrate that this spectrometer pairing facilitates the measurement of weak Raman spectral features that, in a traditional spatial heterodyne spectrometer measurement, would be washed out by multiplicative photon noise.
Ageing and Elderly Care in Kerala
Authors: Rajan S. Irudaya , Shajan Aneeta , Sunitha S.
Published: July 2020

This article presents an overview of the elderly in Kerala and describes various dimensions of elderly care and concerns, based on data from the Kerala Ageing Survey (KAS) 2013, conducted by the Centre for Development Studies (CDS), Thiruvananthapuram, Kerala. The article looks into the main issues, policies and programmes related to ageing and elderly care practices in Kerala and also addresses the basic care response at three levels: household, institutional and society. The ageing process in Kerala is witnessing an increase in the ratio of elderly population along with fundamental changes in families and communities. Hence, in order to accommodate the needs of the ageing population in society, various systems need to be reconstructed. The concerns and issues surrounding the ageing population requires long-term attentiveness and forward planning, where policies must be adopted with consideration for cultural and social contexts. Care for the elderly should focus on a holistic combination of health care, socio-economic protection and provision of a suitable environment for better quality of life.
The Prospect of Belt and Road Initiative in the Context of Bangladesh
Authors: Saimum Rubiat
Published: July 2020

The purpose of this article is to examine the prospect of the Belt and Road Initiative (BRI) from the perspective of Bangladesh. The article investigates fundamental aspects of China’s economic involvement in Bangladesh to understand the geo-economic basis of the initiative. In this respect, the objective and motivation behind Chinese involvement in Bangladesh’s economy are studied, and the political and economic challenges emanating from the participation of the latter country in the initiative are outlined. Methodologically, this research adopts a qualitative approach and relies on primary sources to collect data. It concludes with an observation that Chinese investments through BRI could, in the long term, be advantageous for Bangladesh’s economy as long as the regional and economic issues associated with the initiative are appropriately dealt with. Besides, it suggests that the success of the initiative in South Asia, as well as in Bangladesh, requires a collaborative effort from all the states of the region on functional issue areas such as trade and connectivity.
Health Impact Assessment (HIA): A Comparative Case Study of Sri Lanka and Wales: What Can a Developing Country Learn From the Welsh HIA System?
Authors: Walpita Yasaswi N , Green Liz
Published: July 2020

The health impact assessment (HIA) is increasingly recognized around the world as an effective governance tool to incorporate Health in All Policies to address the wider determinants of health. However, it is still poorly recognized and practiced in many developing countries, including Sri Lanka, where its applicability is most appropriate considering the complexity of social determinants of health and inequalities. This comparative case study aimed to explore the barriers for implementation of HIA in Sri Lanka in the areas of supportive policy framework, institutional infrastructure, capacity-building, and multi-sectoral collaboration and to compare them with a successful HIA system in a developed country (Wales) with a view toward identifying the “best practices” applicable in a developing country context. The case study revealed that there is an emerging government commitment in Sri Lanka to embrace the Health in All Policies approach and much potential in the health system to develop a centrally dedicated expert team with peripheral counterparts and multi-sectoral collaboration, which were the primary pillars of success in the Welsh system. However, there is a great need for capacity-building and for development of country-specific tools, which would facilitate the establishment and sustainability of HIA processes in Sri Lanka.
A door opening from Syria to Turkey; migration and the process of social acceptance and accommodation: Hatay and Karabuk provinces
Authors: Aydın Yıldırım Tuğba , Gümüş Şekerci Yasemin
Published: July 2020

This descriptive, cross-sectional study administered a questionnaire to 616 Syrian refuges, evaluating the participants’ sociodemographic characteristics and their views on the processes associated with social acceptance and cultural and social accommodation. The problems encountered among Syrian refuges after migration included expensive housing costs, language problems, difficulties making a living and education problems. Various problems were identified among subgroups, associated with working life and cultural differences. However, according to this study, Syrian refugees believed that the processes of social acceptance and the social accommodation of refugees by local populations had begun.
Stopping the bus while touring through client landscapes
Authors: Pizzini Nigel , McCormick Matt
Published: July 2020

In clinical social work, practitioners can find themselves recruited into stuck or ‘problem-saturated’ positions alongside their clients. Likening a clinical conversation to exploring the majestic scenery of New Zealand, this article opens the possibility of playful explorations that excavate otherwise overlooked or off-hand comments that turn into inspired new directions.
Effect of chemical and enzymatic treatments of alfa fibers on polylactic acid bio-composites properties
Authors: Werchefani Mouna , Lacoste Catherine , Belguith Hafedh , Gargouri Ali , Bradai Chedly
Published: July 2020

Poor interfacial adhesion between vegetable fibers and bio-based thermoplastics is recognized as a serious drawback for biocomposite materials. To be applicable for a large-scale production, one should consider appropriate methods of natural fiber handling. This study presented poly(lactic acid) (PLA) reinforced with Alfa short fibers and four types of fiber treatment were selected. The effect of these treatments on the tensile properties and the morphology of biocomposites was studied. Composite samples were produced using a twin-screw extruder and an injection molding machine with a fiber percentage of 20 wt %. Prior to composite manufacture, Alfa fibers were subjected to mechanical, chemical and enzymatic modifications. The comparison of enzyme treated fibers and NaOH treated fibers was investigated by means of biochemical and morphological analyses. It was observed that enzymes decompose lignin, pectin and hemicelluloses from the fiber bundles interface leading to the reduction of technical fiber diameter and length. The elimination of these hydrophilic components resulted also in an increase of the water resistance of treated fibers. A bigger fiber-matrix interface area was thus created, which facilitated fiber-matrix adhesion and enhanced mechanical characteristics of the composites. SEM micrographs showed homogeneous distribution of treated fibers in the polymer matrix. Tensile strength of PLA biocomposites filled with pectinase treated fibers was increased by 27% over untreated samples. The data proved that enzymatic treatment can be used as an effective and ecofriendly strategy of fiber modification for natural fiber-reinforced composite production. These materials can be used in several domains such as construction, automotive applications and packaging industries.
Purpose as a Powerful Resource in the Time of COVID-19
Authors: White Allison E.
Published: July 2020

Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has claimed thousands of lives within the past few months; disrupted people’s participation in work, family, and school settings; and challenged economic and health care systems across the globe. In light of the countless challenges posed by COVID-19, a sense of purpose (i.e., a long-term life aim that guides behavior and contributes to the world beyond oneself) may be one important psychological resource for people of all ages to develop and/or recruit during this crisis. This article provides a brief overview of the purpose development literature, the argument that a growing or solidified sense of purpose can serve as an important internal resource during periods of adversity, and recommendations for practice during the COVID-19 pandemic.
Tempering Expectations: A Qualitative Study of Prosecutorial Reform
Authors: Richardson Rebecca , Kutateladze Besiki Luka
Published: July 2020

Objectives:

We investigate path dependence and barriers to the acceptance and implementation of reform-minded prosecution, which focuses on reducing unnecessary incarceration, promoting fairness, engaging with the community, and improving accountability in the criminal justice system.

Method:

Using semistructured interviews with 47 prosecutors in two Florida jurisdictions, both with newly elected state attorneys, we explore reform-minded prosecution priorities and barriers to their effective implementation.

Results:

Findings suggest that though reform-minded priorities are present in the study prosecutor’s offices, existing prosecutorial norms, case-focused decision-making, policy ambiguities, and communication challenges serve as barriers to their effective implementation.

Conclusions:

The study highlights the role that line agents play in determining the success of reform-minded prosecution. It also identifies key barriers to reform that reform-minded prosecutors must overcome if they are to achieve meaningful changes toward greater effectiveness, transparency, and impartiality in prosecution.
YouTube and Political Ideologies: Technology, Populism and Rhetorical Form
Authors: Finlayson Alan
Published: July 2020

Digital (participatory and shareable) media are driving profound changes to contemporary politics. That includes, this article argues, important changes to the production, dissemination and reception of political ideas and ideologies. Such media have increased the number and political range of ‘ideological entrepreneurs’ promoting forms of political thought, while also giving rise to distinct genres of political rhetoric and communication. All of this is affecting how people come to be persuaded by and to identify with political ideas. In developing and justifying these claims, I draw on the Political Theory of Ideologies, Digital Media Studies and Rhetorical Political Analysis. I begin by showing how a populist ‘style’, induced by broadcast media, has been intensified by digital media, affecting ideological form and content. Next I consider, in detail, a particular example – YouTube – showing how it shapes political, ideological, communication. I then present a case-study of the UK-based political YouTuber Paul Joseph Watson. I show how the political ideology he propagates can be understood as a blend of Conservatism and Libertarianism, expressed in a Populist style, centred on the ‘revelation’ of political truths and on a promise of therapeutic benefits for followers. In a closing discussion I argue that this may be understood as a kind of ‘charismatic’ authority, and that such a political performance style is typical of these kinds of media today.
Adaptive preview consensus control for discrete-time nonlinear multi-agent systems with unknown control directions
Authors: Ren Chang-E , Chen CL Philip
Published: July 2020

In this paper, the leader-following consensus control problem of discrete-time nonlinear multi-agent systems with unknown control directions is discussed. The preview future information of the leader is utilized when the distributed controllers are designed. Fuzzy logic system is directly introduced to approximate the uncertainty and unknown control directions and the adaptive distributed controller with preview information is put forward. The designed controller can drive all the states of followers to converge to a small neighbourhood of the leader’s state. In addition, all the states of followers remain bounded. Finally, the results of simulations can display the effectiveness of the presented algorithms.
Designing variable control charts under failure censoring reliability tests with replacement
Authors: Rasay Hasan , Arshad Hossein
Published: July 2020

There exist many processes where the quality characteristic does not follow a normal distribution, and the conditions for the application of central limit theorem are not satisfied; for example, because collecting data in a subgroup is impossible or the distribution is highly skewed. Thus, researchers have developed the control charts according to the specific distribution that models the quality characteristic. In this paper, some control charts are designed to monitor an exponentially distributed lifetime. The life testing is conducted according to the failure censoring while during the test; once observing a failure item, it is replaced by a new one so that the total number of items inspected during the test remains constant. Under the condition of the test, it is discussed that the elapsed time until observing the r’th failure has Erlang distribution. According to the relation of Erlang and chi-square distributions, the chart limits are computed to satisfy a specified value of type I error. Examples are presented and the curves of average run length are derived for the one-sided and two-sided control charts. Also, a comparative study is conducted to show the performance and superiority of the proposed control charts.
Genesis of diagenetic zeolites and their impact on reservoir formation in the Middle Permian Lower-Wuerhe Formation of the Mahu Sag, Junggar Basin, Northwest China
Authors: Wang Jian , Zhou Lu , Liu Jin , Li Erting , Xian Benzhong
Published: July 2020

Zeolites are important diagenetic minerals in petroleum reservoirs and have complex impacts on reservoir quality. To highlight this critical and challenging issue, we conduct a case study in the Middle Permian Lower-Wuerhe Formation in the Mahu Sag, Junggar Basin, China. Formation mechanism of zeolites and their impacts on the reservoir quality. Our results show that there are five types of zeolite minerals (i.e. laumontite, heulandite, analcime, stilbite, and clinoptilolite) in the Lower-Wuerhe Formation reservoir, with laumontite and heulandite being the main types. Petrographic and geochemical data suggested that laumontites developed in the Lower-Wuerhe Formation were mainly precipitated from pore water, whereas heulandites were formed associated with alteration of volcanic materials. In addition, the distribution of different type of zeolite minerals is generally controlled by sedimentary facies. The heulandite–laumontite zone developed mainly in the front of fan-delta plain, and the laumontite zone developed mainly in fan-delta front. The distal part of fan-delta front is dominated by albite. The zeolite mineral assemblages are generally controlled by geochemical composition of volcanic lithic fragments. The high content of intermediate-basic volcanic lithic fragments in the eastern Mahu Slope sediments is responsible for authigenic minerals such as heulandite, chlorite, and laumontite. However, the content of intermediate-basic volcanic lithic fragments in the western Mahu Slope sediments is low which results in the cement in this region is dominated by laumontite and mixed-layer illite/smectite. In general, conglomerates deposited in fan-delta front are favorable for the formation of early laumontite and late dissolution of laumontite due to resistance to compaction by coarse fraction and accumulation of acidic fluids in structural highs, which resulted in the formation of a high-quality reservoir. Our results have general implications for hydrocarbon exploration of the zeolite-bearing conglomerate reservoirs in non-marine petroliferous basins.
Caste, Race, and Abjection: An Essay on Sub-humanity
Authors: Singh Vikash , Torkelson Jason
Published: July 2020

This article discusses continuities between the discourse of caste in ancient India, the racialization constitutive of the Enlightenment, and a similarly exclusionary, overdetermined conception of worthlessness—the lazy, immoral, deviant minorities—evident in contemporary racism as much as in the abandonment of a global underclass. We argue that the negative marking of a social condition or group as inferior and subhuman (on all kinds of grounds, moral, aesthetic, and intellectual) has been constitutive of the paradigms in which these societies subsist. The practices and project of all that is good is shadowed by this negative, its infectious, abominable presence. Analytically bringing together the politics of the homo sacer with the social psychology of abjection, we argue that such exclusion is as vested in politics and economic interests as in their psychic correspondences.
Intranasal Corticosteroid Therapy: Systematic Review and Meta‐analysis of Reported Safety and Adverse Effects in Children
Authors: Donaldson Angela M. , Choby Garret , Kim Daniel H. , Marks Lisa A. , Lal Devyani
Published: July 2020

Objectives

To address concerns related to the safety profile of both Food and Drug Administration (FDA)–approved and non‐FDA‐approved intranasal corticosteroid (INCS) use in the pediatric population.

Data Source

Systematic review of MEDLINE, PubMed, and EMBASE databases using comprehensive search strategy, including all INCS formulations and adverse events. The study design was developed using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Additional sources were identified from study references of relevant articles.

Review Methods

A structured literature search was conducted. Extracted data included age, population size, study design, drug (dosage, route, and frequency), presence of hypothalamic‐pituitary‐adrenal (HPA) axis suppression, ocular symptoms, and growth velocity adverse events.

Results

A total of 33 studies met inclusion criteria. The studies included use of INCS as nasal sprays and drops. There were no persistent abnormalities noted in cortisol level or intraocular pressure change. Growth velocity reduction was reported in 3 of 10 randomized trials. Meta‐analysis of epistaxis and headache showed no significant difference in the incidence of headache or epistaxis when FDA‐approved INCSs were compared to placebo, with a relative risk of 1.12 (95% CI, 0.77‐1.63; P =. 56) and 0.84 (95% CI, 0.60‐1.18; P =. 32), respectively. Meta‐analysis was not performed for growth velocity, HPA axis suppression, and ocular change.

Conclusions

INCSs in FDA‐approved routes of administration are generally safe to use in the pediatric population. Use of non‐FDA‐approved INCS drops may increase risk of iatrogenic Cushing’s syndrome. Growth velocity reduction, HPA axis suppression, and visual changes due to INCS are uncommon.
Contemporary Management of Jugular Paragangliomas With Neural Preservation
Authors: Manzoor Nauman F. , Yancey Kristen L. , Aulino Joseph M. , Sherry Alexander D. , Khattab Mohamed H. , Cmelak Anthony , Morrel William G. , Haynes David S. , Bennett Marc L. , O’Malley Matthew R. , Netterville James , Wanna George , Rivas Alejandro
Published: July 2020

Objectives

Management of jugular paragangliomas (PGL) has evolved toward subtotal resection (STR). The purpose of this study is to analyze neural preservation and adjuvant treatment for long‐term local control.

Study Design

Retrospective chart review.

Settings

Tertiary neurotology practice.

Subjects and Methods

Adults undergoing surgical treatment of jugular PGL between 2006 and 2019. Patients, disease, and treatment variables were collected retrospectively. Single predictor logistic regression was used to ascertain predictors of regrowth or need for salvage radiation.

Results

A total of 41 patients (median age, 47 years; 76% female) were identified. Most patients presented with advanced‐stage disease (Glasscock‐Jackson stage III‐IV = 76%). Subtotal resection (STR) was performed in 32 (78%) patients. Extended STR (type 1) was the most commonly performed conservative procedure (n = 19, 59%). Postoperative new low cranial neuropathy (LCN) involving CN X and XII was rare (n = 3 and n = 1, respectively). Seventeen patients (41%) underwent postsurgical therapy for tumor regrowth or recurrence, including 15 patients who underwent adjuvant (n = 4) or salvage (n = 11) radiation. Overall tumor control of 94.7% was achieved at a mean follow‐up of 35 months. All patients treated with combined modality treatment had local control at last follow‐up. Logistic regression identified no single predictor for postsurgical radiation treatment or salvage‐free survival.

Conclusion

Management of jugular PGL with a conservative approach is safe and effective with a low rate of new LCN deficit. Active surveillance of residual tumor with salvage radiation for growth results in excellent long‐term tumor control.
Aerosol Dispersion During Mastoidectomy and Custom Mitigation Strategies for Otologic Surgery in the COVID‐19 Era
Authors: Chari Divya A. , Workman Alan D. , Chen Jenny X. , Jung David H. , Abdul‐Aziz Dunia , Kozin Elliott D. , Remenschneider Aaron K. , Lee Daniel J. , Welling D. Bradley , Bleier Benjamin S. , Quesnel Alicia M.
Published: July 2020

Objective

To investigate small‐particle aerosolization from mastoidectomy relevant to potential viral transmission and to test source‐control mitigation strategies.

Study Design

Cadaveric simulation.

Setting

Surgical simulation laboratory.

Methods

An optical particle size spectrometer was used to quantify 1‐ to 10‐µm aerosols 30 cm from mastoid cortex drilling. Two barrier drapes were evaluated: OtoTent1, a drape sheet affixed to the microscope; OtoTent2, a custom‐structured drape that enclosed the surgical field with specialized ports.

Results

Mastoid drilling without a barrier drape, with or without an aerosol‐scavenging second suction, generated large amounts of 1‐ to 10‐µm particulate. Drilling under OtoTent1 generated a high density of particles when compared with baseline environmental levels (P <. 001, U = 107). By contrast, when drilling was conducted under OtoTent2, mean particle density remained at baseline. Adding a second suction inside OtoTent1 or OtoTent2 kept particle density at baseline levels. Significant aerosols were released upon removal of OtoTent1 or OtoTent2 despite a 60‐second pause before drape removal after drilling (P <. 001, U = 0, n = 10, 12; P <. 001, U = 2, n = 12, 12, respectively). However, particle density did not increase above baseline when a second suction and a pause before removal were both employed.

Conclusions

Mastoidectomy without a barrier, even when a second suction was added, generated substantial 1‐ to 10‐µm aerosols. During drilling, large amounts of aerosols above baseline levels were detected with OtoTent1 but not OtoTent2. For both drapes, a second suction was an effective mitigation strategy during drilling. Last, the combination of a second suction and a pause before removal prevented aerosol escape during the removal of either drape.
COVID‐19 Airway Management Isolation Chamber
Authors: Blood Timothy C. , Perkins Jonathan N. , Wistermayer Paul R. , Krivda Joseph S. , Fisher Nathan T. , Riley Charles A. , Ruhl Douglas S. , Hong Steven S.
Published: July 2020

Objective

During the coronavirus pandemic (COVID‐19), health care workers are innovating patient care and safety measures. Unfortunately, many of these are not properly tested for efficacy. The objective of this study was to determine the efficacy of the novel COVID‐19 Airway Management Isolation Chamber (CAMIC) to contain and evacuate particulate.

Study Design

Multi‐institutional proof‐of‐concept study.

Setting

Two academic institutions: Walter Reed National Military Medical Center (WRNMMC) and Madigan Army Medical Center (MAMC).

Subjects and Methods

Smoke, saline nebulizer, and simulated working port models were developed to assess the efficacy of the CAMIC to contain and remove ultrafine particles. Particulate counts were collected at set time intervals inside and outside the system.

Results

With the CAMIC on, smoke particulate counts inside the chamber significantly decreased over time: r(18) = −0.88, P <. 001, WRNMMC; r(18) = −0.91, P <. 001, MAMC. Similarly, saline nebulizer particulate counts inside the chamber significantly decreased over time: r(23) = −0.82, P <. 001, WRNMMC; r(23) = −0.70, P <. 001, MAMC. In the working port model, particulate counts inside the chamber significantly decreased over time: r(23) = −0.95, P <. 001, WRNMMC; r(23) = −0.85, P <. 001, MAMC. No significant leak was detected in the smoke, saline nebulizer, or working port model when the CAMIC was turned on.

Conclusions

The CAMIC system appears to provide a barrier that actively removes particles from within the chamber and limits egress. Further studies are necessary to determine clinical applicability. The CAMIC may serve as an adjunct to improve health care worker safety and patient outcomes.
Patient Perceptions of Head and Neck Ambulatory Telemedicine Visits: A Qualitative Study
Authors: Triantafillou Vasiliki , Layfield Eleanor , Prasad Aman , Deng Jie , Shanti Rabie M. , Newman Jason G. , Rajasekaran Karthik
Published: July 2020

Objective

During the COVID‐19 pandemic, there has been unprecedented use of telemedicine for otolaryngology ambulatory visits. Patient satisfaction with telemedicine is an important metric, but survey‐based questionnaires do not capture the nuances of the patient experience. This study aims to understand head and neck patients’ perceptions about telemedicine clinic visits during COVID‐19.

Methods

Fifty‐six established patients who had video‐based telemedicine visits with an otolaryngology–head and neck surgery faculty member between March 25, 2020, and April 24, 2020, completed unstructured telephone interviews. Conventional content analysis was used to analyze the interview data. Retrospective chart reviews were conducted to determine the patients’ demographic, disease, and treatment information.

Results

The primary benefits of telemedicine were accessibility and cost and time savings. Primary limitations included the ability to perform a physical examination. Most patients expressed a willingness to participate in future remote visits if appropriate or necessitated by social circumstances.

Discussion

Telemedicine is a disruptive process, and long‐term adoption requires understanding patient perception of and satisfaction with telemedicine. Head and neck cancer patients were generally satisfied with telemedicine. The study elucidated patient perceived benefits and limitations of telemedicine.

Implications for Practice

Continued implementation of telemedicine in otolaryngology–head and neck ambulatory clinics will require consideration of contextual features surrounding the virtual delivery of care, with particular attention to visit appropriateness for telemedicine and social circumstances.
Introduction to the Special Series on Results-Blind Peer Review: An Experimental Analysis on Editorial Recommendations and Manuscript Evaluations
Authors: Maggin Daniel M. , Robertson Rachel E. , Cook Bryan G.
Published: July 2020

Publication bias occurs when studies with statistically significant results and large effects are more likely to be published than similarly rigorous studies with null and mixed findings. Results-blind peer review requires peer reviewers to consider only the “Introduction” and “Method” sections of submitted manuscripts prior to making editorial recommendations. This process ensures recommendations for publication focus on methodological rigor and not the direction, significance, or magnitude of the reported effects. The current investigation experimentally tested whether reviewers’ editorial recommendations and perceptions of manuscript importance, quality, and rigor varied as a function of type of review (i.e., results-blind or results-included) among 44 reviewers. Results indicated reviewer recommendations did not vary as a function of review type. However, reviewers found results-blind manuscripts less rigorous than results-included and reported less confidence in their recommendations on result-blinded manuscripts. Descriptive findings of results-blind reviewing were mixed with some support for the method, but a lack of confidence in its overall effectiveness. We discuss findings in relation to the conceptual benefits of results-blind reviewing and the increased focus on open and transparent science within special education and preview the papers included in the special section.
Behavior Therapy for the Treatment of Tourette’s Disorder in India: A Patient Series from an Indian General Hospital Psychiatric Unit
Authors: Varadharajan Natarajan , Chakrabarti Subho , Sahoo Swapnajeet , Balachander Srinivas
Published: July 2020

Reports on behavioral interventions for the treatment of Tourette’s disorder (TD) from India are limited. This patient series describes the usefulness and feasibility of conducting behavioral interventions for patients with TD from an Indian general hospital psychiatric unit. Behavioral treatments in these seven consecutively treated adult/adolescent patients with TD included all components of habit reversal treatment, comprehensive behavioral intervention for tics, and exposure with response prevention in some patients. Patients were predominantly male, with adolescent-onset severe TD, typical features and psychiatric comorbidities, and poor response to multiple medications prior to the institution of behavior therapy. In addition to long delays in diagnosis, none of the patients or their caregivers had been informed by the doctors they had consulted earlier about TD or the need for behavioral treatments before attending our center. Institution of behavioral treatments along with medications led to a 75% reduction in the severity of tics and reduction in comorbid symptoms. Patients and caregivers also reported similar rates of improvement as well as reductions in subjective distress and caregiver burden. Five patients have been followed up for seven months to seven years; apart from one patient, all others have had only minor exacerbations of tics during this period. This limited experience suggests that behavior therapies for TD can be successfully implemented in low-resource, non-specialized Indian settings. They are effective, and gains from such treatment are usually enduring.
Healthcare Providers on the Frontline: A Quantitative Investigation of the Stress and Recent Onset Psychological Impact of Delivering Health Care Services During COVID-19 in Kashmir
Authors: Khanam Aaliya , Dar Shabir Ahmad , Wani Zaid Ahmad , Shah Naveed Nazir , Haq Inaamul , Kousar Shazia
Published: July 2020

Background:

Frontline healthcare workers (FHCWs) are at an increased risk of contracting COVID-19. We aimed to assess the stress and psychological impact of the COVID-19 pandemic among FHCWs.

Methods:

This was an exploratory hospital-based study. A semistructured e-questionnaire was developed and shared through emails, WhatsApp groups, Facebook, and Twitter. The study instruments used were stress questionnaire and the impact of event scale—revised.

Results:

We received 133 valid responses. A total of 81 (61.4%) of the respondents were single, 74 (55.6) were male, 70 (52.6%) were between 20 and 29 years of age, and 91 (68.4%) were from urban background. A total of 83 (62.4%) of respondents were doctors and 28 (21.1%) were registered nurses. A total of 36 (27.1%) were posted in emergency and 34 (25.6%) were in the in-patient department. Feeling sad and pessimistic, feeling of being avoided by others, the burden of change in the quality of work, and worrying whether the family will be cared for in their absence were significantly more in nurses as compared to the doctors. Stress due to burden in an increase in the quantity of work was seen more in FHCWs working in the swab collection center as compared to those working in the in-patient department, emergency, or theaters. Severe psychological impact was seen in 81 (60.9%) of FHCWs. The psychological impact was significantly more in males and in those who were married. It was also significantly related to the place of posting.

Conclusion:

More than half of the FHCWs had a severe psychological impact owing to COVID-19. The psychological impact was more in males and those who were married, and it was related to the place of posting of the FHCWs. Nurses had significantly higher stress as compared to doctors.
“How do you like them now?” Expected reactions upon discovering that a friend is a political out-group member
Authors: Buliga Elena , MacInnis Cara
Published: July 2020

Republican or Democrat participants imagined how they would respond upon learning about the political group membership of a potential or established friend. Four vignettes (friend political in-group; friend political out-group; potential friend political in-group; potential friend political out-group) were presented in a random order. After each, participants provided expected reactions. Overall, reactions (e.g., hope of the relationship lasting, intentions to engage in friendship maintenance behaviors, trust) were most positive toward the established in-group friend, followed by potential in-group friend, then the established out-group friend, and lastly the potential out-group friend. That is, participants expected to be more positive toward a person they just met than an established close friend, simply due to knowing these individuals’ political group memberships. Some of these differences were moderated by intergroup attitudes or political identification. Discoveries of political group membership may influence the development or maintenance of friendships.
Long-term results of endovenous laser ablation of saphenous vein reflux: Up to nine years of follow-up
Authors: Karam Boutros , Moussally Moustafa , Nassar Hussein , Ataya Karim , Jaafar Rola , Haddad Fady
Published: July 2020

Introduction

Endovenous laser ablation (EVLA) has become the gold standard for the treatment of saphenous vein reflux. We report the long-term clinical and ultrasound results of EVLA.

Methods

This study is a retrospective review of patients who underwent EVLA of saphenous vein over four years. Clinical results were assessed using venous clinical severity score (VCSS), and ultrasound results were classified according to Bush classification.

Results

Over a median follow-up time of 4.4 years, 168 EVLA-treated patients showed a drop in VCSS from 4.38 to 1.39. Ultrasound results of 140 treated great saphenous veins showed that 64% had one or more cause of recurrence. The presence of neovascularization correlated well with the lack of improvement of VCSS.

Conclusion

EVLA resulted in drop in VCSS from 4.38 to 1.39. Among 140 treated great saphenous veins, reflux in the anterior accessory saphenous vein was the primary cause (23.5%) of recurrence.
Resistance Training Impact on Mobility, Muscle Strength and Lean Mass in Pancreatic Cancer Cachexia: A Randomized Controlled Trial
Authors: Kamel FatmaAlzahraa H , Basha Maged A , Alsharidah Ashwag S , Salama Amr B
Published: July 2020

Objective:

To determine the efficacy of a three-month resistance training programme on the mobility, muscle strength and lean body mass of patients with pancreatic cancer-induced cachexia.

Design:

Randomized controlled trial.

Setting:

Elsahel Teaching Hospital, outpatient clinic of the Faculty of Physical Therapy, Cairo, Egypt.

Participants:

Patients with pancreatic cancer-induced cachexia.

Interventions:

Participants were randomized to the resistance training group ( n = 20) and control group ( n = 20).

Main measures:

Outcomes including mobility, muscle strength and lean body mass were measured at baseline, three months after surgical resection and 12 weeks after intervention.

Results:

The mean (SD) age was 51.9 (5.03) years and body mass index was 21.1 (1.13) kg/m²; 65% of patients were male. Compared to the control group, the resistance training group showed significant improvement in mobility: 400-m walk performance (270.3–256.9 seconds vs 266.4–264.2 seconds, respectively) and chair rise (13.82–12.53 seconds vs 13.77–13.46 seconds, respectively). Similarly, muscle strength was also significantly improved in the resistance training group than in the control group; we observed increase in peak torque of knee extensors ( P = 0.004), elbow flexors ( P = 0.001) and elbow extensors, improvement in lean mass of the upper limb (6.28–6.46 kg vs 6.31–6.23 kg, respectively) and lower limb (16.31–16.58 kg vs 16.4–16.31 kg, respectively).

Conclusion:

A three-month resistance training improved the mobility of patients with pancreatic cancer-induced cachexia. Muscle strength and lean body mass also improved.