bluuebunny/crossref_metadata_2025 huggingface dataset:
Biography
Authors: Seager Nicholas
Published: October 2022

This chapter surveys Samuel Johnson’s career as a biographer, exploring tensions between the ideals of life-writing he propounded in essays and conversations and his evolving practice from the 1730s to the 1780s. The chapter outlines three phases in Johnson’s development as a biographer. First, it shows how his increasingly complex moral treatment of subjects in his earliest biographies challenged extant models of writing lives either to be imitated or censured. Second, it turns to his middle years to explore the conjunctions and divergences between Johnson’s influential theories of biography and his comparatively underwhelming output. Finally, it interprets the career-topping Lives of the Poets (1779–81) as to some extent an enactment of Johnson’s precepts for life-writing and to some extent an acknowledgment that his ideals needed to be modified to reconcile compassion with rigor.
Prime
Authors: Bundock Michael
Published: October 2022

This chapter surveys the life and work of Samuel Johnson from his arrival in London in 1737 to his receipt of a pension in 1762. These were Johnson’s most productive years during which he published his major poems, the Rambler and Adventurer periodical essays, the Dictionary and Rasselas, as well as much miscellaneous journalism. Johnson’s domestic life changed fundamentally with the death of his wife Elizabeth in 1752. From that time onward, his household-family always included a number of dependants: of particular importance were Anna Williams, Francis Barber, and Robert Levet. Outside the home Johnson’s social circle grew with the formation of the Ivy Lane club and the development of a number of significant friendships: among those whom Johnson came to know were John Hawkins, Arthur Murphy, Robert Chambers, Bennet Langton, Joshua Reynolds, and Thomas Percy.
Women
Authors: Grundy Isobel
Published: October 2022

Johnson’s views of women have been much contested. In throwaway remarks recorded by Boswell, he sounds misogynist, but his actions and his writings argue the contrary. He seldom forgot that half the human race is female: he mentored younger and beginning writers and invented moral examples without regard to gender except for recognizing and trying to enter into the particular dilemma of belonging to the second sex.
Suffering
Authors: Rounce Adam
Published: October 2022

This chapter discusses the various ways in which the concept of suffering occurs in Johnson’s writing and thought. It considers the two principles uses of the verb, whereby suffering is either something that happens or is allowed to happen, and relates these to different examples, from the characters and ideas of Rasselas, Johnson’s writings on art and literature (including the annotations to Shakespeare, the “Lives” of Waller, Addison, Savage, and Pope) and his periodical essays. The argument demonstrates how the impossibility of understanding suffering in a providential world (and yet the necessity of striving to do so), results in Johnson’s trenchant and coruscating criticisms of the facile views of suffering displayed in Pope’s Essay on Man, and Jenyns’s inquiry on the nature of evil; the rejection of complacency stresses the importance of understanding suffering in Johnson’s work and life.
Happiness
Authors: Norton Brian Michael
Published: October 2022

This chapter is a comprehensive study of Samuel Johnson’s ideas of happiness. It argues that what Johnson demonstrates is not that earthly happiness is impossible, but that it is subject to conditions we would be unwise to ignore. In place of perfect happiness, Johnson offers a tempered happiness, one that will always be a work in progress and vulnerable to loss. But rather than viewing the endlessness of desire and the fragility of the good simply as obstacles to happiness, this chapter argues further, Johnson’s larger point is that there would be no happiness (as we know it) without these human realities. In scaling back our estimation of happiness, he challenges us to come to terms with happiness as it is, not as we’d like it to be, and to ask no more from life than life can allow.
Asian Americans in the Novel of Late Capitalism
Authors: Wu Cynthia
Published: October 2022

This chapter highlights the function of Asian American and Asian transnational model minority characters in two novels from the late twentieth century to the early twenty-first, Samuel R. Delany’s The Mad Man (1994) and Kevin Kwan’s Crazy Rich Asians (2013). In a late capitalist economy, Asian Americans who are intellectually and/or financially well resourced are defined by their excess and portrayed with prose that exaggerates these endowments to the level of hyperbole. The fictional worlds these characters inhabit may appear post-racial; however, these novels also show that model minority characters never completely escape their racialization or colonial subject status.
Leonhard Miksch
Authors: Ptak Ralf
Published: October 2022

As Eucken’s most important student, Miksch belonged to the closest circle of the founding generation of Ordoliberals. With his work ‘Competition as a Task’ from 1937, he decisively founded the Ordoliberal competition theory of an organised market economy. His main activity, however, was in the field of economic journalism, which he continued as a dedicated nationalist during the Nazi era. Thus, within the framework of the idea of a German large-scale economy, he always demanded that market economy and competition criteria be taken into account. After 1945, he was the only Ordoliberal to become a social democrat and, as Ludwig Erhard’s right-hand man, played a decisive role in shaping the double reform of 1948 (currency reform and the so-called Leitsätzegesetz). In the process, Miksch demonstrated a feel for the social tensions of the post-war period and came into conflict with Erhard.
Ortega y Gasset
Authors: Dinnin Alec
Published: October 2022

This chapter attends to one of the primary Ordoliberal references on mass society, the Spanish liberal philosopher, José Ortega y Gasset (1883–1955). While foundational Ordoliberal thinkers often invoke The Revolt of the Masses, their diagnoses and prescriptions regarding mass society diverge significantly from Ortega’s. Specifically, whereas Ordoliberals focus on structural processes that render individuals desperate and dependent, Ortega sees these same processes as producing a sense of self-sufficiency and omnipotence. Both, however, perceive mass society as a profound danger for liberalism and civilisation writ large. After examining how Wilhelm Röpke deploys The Revolt of the Masses in his own account of mass society, the chapter examines Ortega’s diagnosis of mass revolt before reconstructing how he believed it could be overcome. Despite borrowing elements from Ortega’s theory of mass society, it is unclear whether Ordoliberals offered a solution to the cultural problems he outlined.
Economic Constitution and the State
Authors: Tuori Klaus
Published: October 2022

The role of the state in the Ordoliberal economic constitution lies at the heart of Ordoliberalism and constitutes a key difference between the theory of Ordoliberalism and other forms of liberalism. The state imposes the constitutional framework on the economy; it does not arise as natural law, but through conscious and scientific planning. The state and the economic constitution have a more multifaceted and complex relationship than first meets the eye. This is revealed through the various definitions of state, its functions, the role of independent agencies, the relationship between the economic constitution and (mass) democracy and the discussion on authoritarian liberalism. The definition of the state within the Ordoliberal economic constitution uses the concept of a strong state, which refers to a limited state that is able resist interest groups and maintain the liberal society.

A further aspect is what kind of a state is demanded or even created by the economic constitution; the economic constitution can be created by the state but arguably also that the state can be defined and even created by the economic constitution. From this perspective, economic liberties and the functioning of competition could be presented as a key legitimation for the state.
The Strong State and ‘The Taming of Freedom’
Authors: Havertz Ralf
Published: October 2022

This chapter focuses on the Ordoliberal strong state and its theoretical conception as a precondition of free economy. It gives a brief account of the classical Ordoliberal notion of free economy with its focus on ‘complete competition’ and the establishment of an economic order. This is followed by an analysis of the Ordoliberal argument for the strong state, which reflects on the position of the state vis-à-vis the economy. It examines the Ordoliberals’ critique of mass democracy and their call for ‘a dictatorship within the boundaries of democracy’ and shows that there is a communality between this argument and Carl Schmitt’s concept of the political. This chapter, furthermore, assesses the connection between Ordoliberal governmentality and the depoliticisation of society which is focused on the generation of self-responsible entrepreneurs. It concludes with considerations about the authoritarian elements in Ordoliberal thought.
Myth, Religion and Social Market Economy
Authors: Manow Philip
Published: October 2022

This chapter addresses the religious underpinnings of Ordoliberalism. It argues that its historical origins and ideological profile must be understood against the background of Germany’s religious cleavage between a once dominant Protestant state elite and rising political Catholicism, both in the form of the Catholic centre party with its central role in the Weimar Republic, and in the form of the Catholic worker movement. This conflict became particularly visible in the political struggles over social legislation, which extended into the early Federal Republic. In contrast to many accounts, this chapter argues that Ordoliberalism ultimately failed as a political project, and was largely unsuccessful in shaping Germany’s economic post-war order. Its continued relevance is largely ideological as the founding myth of the German post-war social market economy.
Competition Laws and Their Enforcement in the Project of European Integration
Authors: Wigger Angela
Published: October 2022

Ordoliberals believed that the exposure of corporations to ‘complete’ competition would boost the competitiveness of entire economies and increase social welfare for society at large. Ordoliberals were staunch proponents of a strong state that would fight economic concentration and thereby ensure a free competitive market order composed of equally matched players. Even though a range of Ordoliberals ascended from their enclave in Freiburg and took office in the institutions of post-war West Germany and the European Community, their political influence on the formulation and subsequent enforcement of competition laws at the time has only been marginal. While discrepancies between any ideology and its actual implementation are commonplace, this chapter shows that political elites allying with organized industrial capital succeeded in watering down the envisaged utopia of ordered competition and the containment of corporate size.
Labour Market Policy
Authors: Hagemann Harald
Published: October 2022

The Ordoliberal position with regard to labour market policy is ambivalent. Whereas a policy against mass unemployment is considered as unavoidable, the experience with full employment policy, in Nazi Germany in particular, strengthened the dominant view that governmental interventions such as wage and price controls imply an inherent tendency to a planned economy. Wage and price flexibility are seen as a necessary condition for a proper functioning of the labour market. According to the Ordoliberal view, the existence of a bilateral monopoly with trade unions on one side and employers’ associations on the other prevents a stable equilibrium on the labour market. Thus, Ordoliberals favoured and inspired the liberalisation policies of Erhard in the first two decades after WWII and opposed the introduction of a minimum wage in Germany in 2015.
A ‘Fiction of the Mind’: Imagination and Idolatry in Early Modern England
Authors: Reiter Barret
Published: October 2022

This chapter examines the conceptualization of Catholic liturgical practices within the Protestant anti-Catholic polemics of early modern England. I argue that, insofar as Protestants typically glossed such practices as ‘idolatry’, and thus, as the worship of a false god, Protestants explicitly accused Catholics of falling victim to the deceptive tendencies of their imaginations. Hence, for English Protestants, Catholics were responsible for transforming the good news of the Gospel into a mere fiction of their own making. More than a mere rhetorical posture — though of course it was also that — it is here argued that Protestant anti-Catholic polemic encodes a more generalized anxiety about the role of imagination within religious, social and political life, and thus serves as a microcosm of larger-scale transformations within the intellectual and political discourse of early modern England. Most obviously, the emphasis on the imagination, in particular within Protestant polemics, indicates a new context into which traditional scholastic psychological categories were forced in order to accommodate confessional differentiation and the new political realities of a post-Reformation world. Thus, by understanding just what Protestant polemicists meant by fictions, we can open up deeper continuities across the intellectual and political discourse of the period.
Rhetorical Strategies and the Manipulation of Discourse in Machiavelli’s Writings
Authors: De Caprio Chiara , Salvo Rossi Andrea
Published: October 2022

This chapter sheds light on the narrative strategies and techniques involving reported speech in Machiavelli’s diplomatic records and historical writings. The focus is on the diplomatic correspondence of his 1502 mission to Cesare Borgia and on his Discourses on Livy. Analysis of the rhetorical devices that Machiavelli uses to report his own words and those of others shows that his letters and the Discourses exploited the intrinsically reconstructive nature of reported speech and its paradoxical communicative function: to maximize the perception of veracity through unrestrained manipulation. Two case studies will shed light on the relationship between fact and fiction and between information and its manipulation in early modern Italy. In particular, these relationships are captured by analyzing the interplay between, on the one hand, the communicative dynamics of diplomatic writings and, on the other, research into old historical texts and the writing of contemporary history. Machiavelli’s writings demonstrate clearly that direct discourse could be used as a tool to reinforce the verisimilitude and credibility of a narrative. At the same time, his careful selection and manipulation of reported words exploited the persuasive force of the words of others to further his own line of argument.
A family of methyl esterases converts methyl salicylate to salicylic acid in ripening tomato fruit
Authors: Frick Elizabeth M , Sapkota Manoj , Pereira Lara , Wang Yanbing , Hermanns Anna , Giovannoni James J , van der Knaap Esther , Tieman Denise M , Klee Harry J
Published: October 2022

Methyl salicylate imparts a potent flavor and aroma described as medicinal and wintergreen that is undesirable in tomato (Solanum lycopersicum) fruit. Plants control the quantities of methyl salicylate through a variety of biosynthetic pathways, including the methylation of salicylic acid to form methyl salicylate and subsequent glycosylation to prevent methyl salicylate emission. Here, we identified a subclade of tomato methyl esterases, SALICYLIC ACID METHYL ESTERASE1-4, responsible for demethylation of methyl salicylate to form salicylic acid in fruits. This family was identified by proximity to a highly significant methyl salicylate genome-wide association study locus on chromosome 2. Genetic mapping studies in a biparental population confirmed a major methyl salicylate locus on chromosome 2. Fruits from SlMES1 knockout lines emitted significantly (P < 0,05, t test) higher amounts of methyl salicylate than wild-type fruits. Double and triple mutants of SlMES2, SlMES3, and SlMES4 emitted even more methyl salicylate than SlMES1 single knockouts—but not at statistically distinguishable levels—compared to the single mutant. Heterologously expressed SlMES1 and SlMES3 acted on methyl salicylate in vitro, with SlMES1 having a higher affinity for methyl salicylate than SlMES3. The SlMES locus has undergone major rearrangement, as demonstrated by genome structure analysis in the parents of the biparental population. Analysis of accessions that produce high or low levels of methyl salicylate showed that SlMES1 and SlMES3 genes expressed the highest in the low methyl salicylate lines. None of the MES genes were appreciably expressed in the high methyl salicylate-producing lines. We concluded that the SlMES gene family encodes tomato methyl esterases that convert methyl salicylate to salicylic acid in ripe tomato fruit. Their ability to decrease methyl salicylate levels by conversion to salicylic acid is an attractive breeding target to lower the level of a negative contributor to flavor.
Muon (g − 2) and the W-boson mass anomaly in a model based on Z4 symmetry with a vector-like fermion
Authors: Arora Simran , Kashav Monal , Verma Surender , Chauhan B C
Published: October 2022

The latest results of the CDF-II Collaboration show a discrepancy of 7σ with standard model expectations. There is also a 4.2σ discrepancy in the measurement of the muon magnetic moment reported by Fermilab. We study the connection between neutrino masses, dark matter, the Muon (g − 2) experiment, and the W-boson mass anomaly within a single coherent framework based on a Z4 extension of the scotogenic model with a vector-like lepton (VLL). Neutrino masses are generated at the one-loop level. The inert doublet also provides a solution to the W-boson mass anomaly through correction in oblique parameters S, T, and U. The coupling of the VLL triplet ψT to the inert doublet η provides a positive contribution to the muon anomalous magnetic moment. In the model, the VLL triplet provides a lepton portal to dark matter, $\eta _R^0$. The model predicts a lower bound mee > 0.025 eV at 3σ, which is well within the sensitivity reach of the 0νββ decay experiments. The model explains the muon anomalous magnetic moment Δaμ for 1.3 < yψ < 2.8 and a DM candidate mass in the range $152\text{ GeV}\lt M_{\eta _{R}^{0}}\lt 195\text{ GeV}$. The explanation of the W-boson mass anomaly further constrains the mass of the DM candidate, $M_{\eta _{R}^{0}}$, in the range $154\text{ GeV}\lt M_{\eta _{R}^{0}}\lt 174\text{ GeV}$.
Implementation and evaluation of a National Bereavement Support line in response to the COVID-19 pandemic in Ireland
Authors: Bates Ursula , Brennan Joanne , Keegan Orla
Published: October 2022

Background

This study describes the design, implementation and evaluation of a national bereavement helpline developed as proactive tiered response to immediate be reavement care during the COVID pandemic, operated in partnership between a national charity and the National Health Service. The service was based on Psychological First Aid principles adapted to integrate bereavement education. Its aim was to provide asupportive compassionate listening service, education advice resources and sign posting to community services.

Methods

Two independent psychologist were commissioned to undertake a retrospective service evaluation of six months of the operation of the line, using a volunteer survey, interviews and line usage data.

Results and Conclusions

Results show that the line is meeting a need, PFA + Bereavement is providing a useful framework for service delivery, and there is good adherence to the model. Volunteers are experiencing working on the line as challenging but rewarding. Supervision and debriefing are essential for volunteer well being and confidence. Approximately 10% of callers were referred onto other services. Management report that they good oversight of governance issues and are planning for the future development, and funding of the line for the next two years.
No Association Between Processing Speed and Risk of Sport-Related Concussion in Youth Soccer
Authors: Lopez-Flores Ruby , Oldham Jessie , Howell David , Rush Justin , Taylor Alex , Berkner Paul , Mannix Rebekah , Meehan William P.
Published: October 2022

Objective:

To determine whether slow processing speed is associated with risk of sport-related concussion.

Design:

We conducted a retrospective cohort study using computerized neurocognitive assessments (Immediate Post-concussion Assessment and Cognitive Testing [ImPACT]) from the Massachusetts Concussion Management Coalition. Slow processing speed was defined as 2 SD below the sample mean (n = 131) and fast processing speed as 2 SD above the sample mean (n = 259). We used a binary logistic regression model to determine the odds of sustaining a concussion with our main predictor being processing speed (high or low) adjusted for the effects of age, sex, and prior number of concussions.

Setting:

Massachusetts Concussion Management Coalition, Institutional care.

Participants:

Three hundred ninety junior high soccer players ages 10 to 15 with a baseline score for ImPACT.

Independent Variables:

Processing Speed.

Main Outcome Measures:

Risk of sustaining a concussion.

Results:

Those with slow processing speed had a visual motor composite score of ≤19.92, those with fast-processing speed had a score of ≥46.20. Athletes with slow processing speed were younger (13 vs 14 years; P < 0.001) and more likely to be male (57% vs 49%; P = 0.014). After adjusting for the effects of age, sex, and prior concussions, there was no significant difference in the odds of sustaining a concussion between groups (aOR 1.01; 95% CI, 0.99-1.04).

Conclusions:

Despite previous research showing that slow processing speed is a risk factor for musculoskeletal injuries during sports, our study suggests that processing speed is not associated with the risk of sustaining a concussion among junior high school soccer players.
Characterizing Symptoms Before and Following Concussion in Professional Hockey
Authors: Bruce Jared M. , Meeuwisse Willem , Hutchison Michael G. , Comper Paul , Echemendia Ruben J.
Published: October 2022

Objective:

Examine SCAT5 baseline and acute symptom subscales in professional hockey players.

Design:

Longitudinal case–control.

Setting:

Preseason medical evaluations and suspected concussion evaluations.

Participants:

NHL/AHL players were given the NHL-modified SCAT5 before the 2018-2019 season (n = 1924). During the season, English-speaking players evaluated within 1 day of injury and diagnosed with concussion (n = 140) were compared with players evaluated for possible concussion, but not given a concussion diagnosis (n = 174).

Independent Variables:

Concussion diagnosis and demographic characteristics.

Main Outcome Measures:

Postconcussion Symptoms Scale (PCSS) items were subdivided into affective/emotional, cognitive, somatic/physical, sleep, and headache subscales.

Results:

Cognitive (13%), somatic/physical (10%), sleep (26%), affective (18%), and headache (6%) symptoms were reported by players at baseline. Concussed players reported more acute symptoms than active controls on each of the subscales (all P's < 0.001). Players who underwent a suspected concussion evaluation were more likely to be diagnosed with concussion if they reported affective/emotional symptoms at baseline (P < 0.001). Postinjury cognitive (P < 0.001), somatic/physical (P < 0.001), and headache (P < 0.001) symptoms best differentiated concussed players and active controls.

Conclusions:

Player reports of increased cognitive difficulties, somatic/physical difficulties, and headache were most associated with concussion diagnosis at the acute evaluation. An abbreviated “acute” PCSS that includes only headache, cognitive, and/or physical symptoms may be useful for diagnostic purposes when evaluation time is limited. Approximately 2% of players reported significantly elevated affective/emotional symptoms at baseline and report of affective/emotional symptoms at baseline was associated with an increased likelihood of concussion diagnosis among players referred for a suspected concussion evaluation.
Effects of care burden on the life of caregivers of the elderly: A mixed-method study model
Authors: Sezgin Handan , Cevheroglu Seda , Gök Nur Demet
Published: October 2022

Determining the care burden of elderly caregivers in the early period allows for early intervention to protect them from the negative physical, social, and psychological effects of care. This mixed-method study aimed to determine the burden levels of caregivers of elderly individuals and evaluate their opinions on the difficulties they experienced while caregiving. This study was conducted with caregivers of 89 elderly people who were determined to need care by visiting the homes of elderly people aged 65 years and over living in Famagusta. While the KATZ index of independence in activities of daily living and the Zarit Burden Interview tool were used to collect quantitative data, face-to-face interviews were conducted with 28 selected participants to collect qualitative data. The mean age of the caregivers was 52 ± 12 years; they were mostly female spouses/children/relatives, and 29.2% had moderate-to-severe care burden perceptions. The perception of caregiver burden levels increased as the level of dependency of elderly individuals and the duration of caregiving increased. Considering that caregiving burden affects every aspect of caregivers’ lives, it should be assessed regularly. To reduce care burden, it is recommended to expand home care services and short-term care facilities, use health technologies for continuous distance education and counseling in elderly care, and financially support caregivers who cannot work due to the responsibilities of providing elderly care.
Efficacy and safety assessment of orthopedic device (LSM-01) for low back pain: A randomized, single-blinded, sham-controlled, parallel-group, pilot clinical trial
Authors: Park Chae Hyun , Kang Jae Hui
Published: October 2022

Background:

Low back pain refers to pain that occurs mainly in lumbosacral spine, and is a clinically common symptom that 70% to 90% of people experience at least once during their lives.

Objectives:

We investigated the effect and safety of orthopedic device (LSM-01) for alleviate back pain caused by muscle tension in a randomized, single-blinded, sham-controlled, parallel-group, pilot trial to establish a basis for large-scale clinical trial.

Methods:

A total of 30 subjects were randomly assigned to 2 group: treatment group (LSM-01) and control group (sham device) received treatment with each device 2 to 3 times a week for a total of 6 treatment for 2 weeks. Primary outcome was visual analog scale (VAS); Secondary outcomes were pressure pain threshold (PPT), oswestry disability index (ODI), and patient global impression of change (PGIC). Statistical analysis is performed for full analysis set (FAS) population. Analysis of covariance (ANCOVA) for mean difference of VAS change and Mixed models of repeated measurements (MMRM) for the trend of VAS change were conducted to compare the differences between 2 groups before and after participants got treatment with the clinical trial device.

Results:

One participant dropped out due to personal reason and 29 participants completed the clinical pilot trial. We found that the degree of low back pain (VAS, PPT, PGIC) significantly decreased and after the trial in the treatment group compared to the control group. Also, there were no any side effects.

Conclusion:

LSM-01 can be effective in improving pain of low back pain. A future large-scale main trial will be conducted based on this pilot study results.
Comparison between simultaneous bilateral total hip arthroplasty with and without drainage: A retrospective cohort study
Authors: Kim Min-Gwang , Im Chae-Jin , Jung Woo-Chul , Yoon Taek-Rim , Park Kyung-Soon
Published: October 2022

Simultaneous bilateral total hip arthroplasty (SBTHA) is an effective procedure for patients with disease bilaterally. But there is concern about increased blood loss and complications of SBTHA than staged total hip arthroplasty (THA). This study aimed to evaluate the differences in the clinical outcomes and complication rate of SBTHA with drainage and without drainage for reducing the concerns. Between October 2015 and April 2019, a retrospective cohort study was conducted with modified minimally invasive 2-incision method and a consecutive series of 41 SBTHA performed with drainage (Group I) were compared to 37 SBTHA performed without drainage (Group II). It was assessed clinically and radiographically for a mean of 2.1 ± 0.8 years (range, 1.0-4.8 years). Postoperative hematologic values (Hgb loss, total blood loss, transfusion rate), pain susceptibility, functional outcome (Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index score) and complication were compared in the drained group and the non-drained group. Postoperative Hgb loss (I: 2163.2 ± 698.7 g, II: 1730.4 ± 572.5 g; P = .002), total blood loss (I: 1528.8 ± 421.7 mL, II: 1237.6 ± 325.9 mL; P = .001) and mean transfusion unit (I: 0.7 ± 1.0 IU, II: 0.1 ± 0.3 IU; P < .001) were significantly lower in the without drainage group than in the with drainage group. But the morphine equivalent (I: 132.7 ± 314.1 mg, II: 732.2 ± 591.5 mg; P < .001) was significantly larger in the without drainage group. No significant difference was found between the drainage group and without drainage group in Harris Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index score at final follow-up. SBTHA without drainage can reduce postoperative blood loss and the requirement for transfusion without increasing other complication. But SBTHA without drainage is more painful method than SBTHA with drainage. Therefore, SBTHA without drainage will be a good option to reduce the burden on the patient by reducing postoperative bleeding if it can control pain well after surgery. III, Retrospective case-control study.
Efficiency of nicotinamide-based supportive therapy in lymphopenia for patients with ordinary or severe COVID-19: A randomized controlled trial
Authors: Hu Qiang , Zhang Quan-Yu , Peng Cheng-Fei , Ma Zhuang , Han Ya-Ling
Published: October 2022

Background:

This study aimed to investigate the efficiency of nicotinamide-based supportive therapy for lymphopenia in patients with coronavirus disease-2019 (COVID-19).

Methods:

Twenty four patients diagnosed with COVID-19 were randomly divided into 2 groups (n = 12) during hospitalization in a ratio of 1:1. Based on conventional treatment, the treatment group was administered 100 mg nicotinamide 5 times a day for 2 days. The control group received routine treatment only. The primary endpoint was the change in the absolute lymphocyte count. The secondary endpoints included both in-hospital death and the composite endpoint of aggravation, according to upgraded oxygen therapy, improved nursing level, and ward rounds of superior physicians for changes in conditions.

Results:

Full blood counts before and after nicotinamide administration were comparable in each group (all P > .05). Before and after receiving nicotinamide, mean absolute lymphocyte counts were similar between the two groups ([0.94 ± 0.26] × 109/L vs [0.89 ± 0.19] × 109/L, P = .565; [1.15 ± 0.48] × 109/L vs [1.02 ± 0.28] × 109/L, P = .445, respectively). Therefore, there was no statistically significant difference in the lymphocyte improvement rate between the two groups (23.08 ± 46.10 vs 16.52 ± 24.10, P = .67). There was also no statistically significant difference in the secondary endpoints between the two groups.

Conclusion:

Among patients with COVID-19, there was no statistically significant difference in the change of whole blood counts and absolute lymphocyte counts before and after intervention in both groups. Therefore, no new evidence has been found regarding the effect of niacinamide on lymphopenia in COVID-19 patients.
Mind the tributary of the canal: Are stents necessary for insulinoma enucleation in proximity to a prominent Duct of Santorini: A case report and literature review
Authors: Liu Tiantong , Xu Qiang , Zou Xi , Zhu Liang , Zhao Yupei
Published: October 2022

Rationale:

We describe a case of insulinoma located extremely close to the accessory pancreatic duct (APD), but away from the main pancreatic duct (MPD). Previous studies showed insulinoma enucleation is a safe procedure for small benign tumors >3 mm distant from the MPD. However, in this case enucleation of the tumor led to unanticipated APD injury and grade B post-operative pancreatic fistula (POPF). We provide detailed records of clinical management and argue that enucleation of tumors near APD needs to be carefully weighed.

Patient concerns:

The patient experienced a sudden increase of abdominal drain fluid and prolonged drainage time after a regular insulinoma enucleation surgery.

Diagnosis:

APD damage during the enucleation.

Interventions:

Drain fluid amylase concentration were regularly recorded and prolonged somatostatin analogs were administered.

Outcomes:

Amount of abdominal drain gradually decreased and the drain tube was removed on postoperative 37.

Lessons:

Benign pancreatic tumor close to the APD need to be evaluated carefully and clinical evidence is warranted to affirm the necessity of placing a pancreatic duct stent before the surgery.
Delayed diagnosis and management of necrotizing fasciitis of the left lower leg: A case report
Authors: Zhang Li-Xia , Liang Zhao-Jun , Zhao Bao-Yin , Shi Xue-Wen , Zhang Tao , Liu Hua , Yu Xiao-Hui
Published: October 2022

Introduction:

Necrotizing fasciitis (NF) is a rare, severe soft tissue infection, characterized by rapid and extensive necrosis of the skin, subcutaneous tissue, and superficial and deep fascia. It is frequently misdiagnosed as other infectious diseases, leading to inappropriate treatment and potentially serious consequences. It may be complicated by septic shock and multiple organ failure with a fatal outcome.

Patient concerns:

A 73-year-old woman presented with continuous itching, skin lesions, pain, and swelling of the outer side of her left leg. The patient was diagnosed with septic shock and multiorgan failure caused by left leg NF.

Diagnosis:

Septic shock and multiorgan failure caused by left leg NF.

Interventions:

Two surgeries were performed on the patient’s leg, which effectively treated her septic shock and multiple organ dysfunction.

Outcomes:

The patient was followed up three times after her discharge. She had a good recovery, was generally well with no significant sequelae, and returned to her regular life.

Conclusion:

NF is an acute severe illness with high mortality. It is easily misdiagnosed, leading to delayed or erroneous treatment and serious (or potentially fatal) outcomes. Rapid and accurate diagnosis of NF is essential for patient recovery. In difficult cases, multidisciplinary consultations may be helpful. The management of NF includes early and thorough surgical debridement, antibiotics, and symptomatic treatment.
Correlation between serum levels of PTX-3, SIL-2R, inflammatory markers, and APACHE II scores in patients with severe acute pancreatitis
Authors: Bao Yang , Ge Weiwei
Published: October 2022

To investigate the correlation of serum pentraxin 3 (PTX-3), soluble interleukin-2 receptor (SIL-2R), C-reactive protein (CRP), procalcitonin (PCT) levels, and acute physiology and chronic health evaluation II (APACHE II) scores in patients with severe acute pancreatitis (SAP). A total of 30 patients with SAP from October 2020 to October 2021 were selected as the SAP group, and 42 patients with mild acute pancreatitis (MAP) or moderate-severe acute pancreatitis (MSAP) was selected as the control group. The serum levels of PTX-3, SIL-2R, CRP, PCT, and APACHE II scores were evaluated. The serum levels of PTX-3, SIL-2R, CRP, PCT, and APACHE II scores at admission in the SAP group were significantly higher than those in the control group (all P < .05). Spearman analysis showed that serum PTX-3, SIL-2R, CRP, and PCT levels were positively correlated with APACHE II scores (all P < .05). The mortality rate within 28 days was 26.7% in the SAP group; moreover, the serum PTX-3, SIL-2R, CRP, and PCT levels and APACHE II scores at admission in the death group were significantly higher than those in the survival group (all P < .05). The receiver operating curve showed that the combined prediction value of all indicators (PTX-3 + SIL-2R + CRP + PCT + APACHE II) was superior to the single indicators, and the diagnostic sensitivity and specificity were 90.9% and 84.2%, respectively. Serum PTX-3, SIL-2R, CRP, and PCT levels and APACHE II scores have high guiding significance in early diagnosis and prognostic evaluation of SAP patients.
Epidemiological features and risk factors for measles and rubella in Taiwan during 2011 to 2020
Authors: Yu Chia-Peng , Chen Bao-Chung , Chou Yu-Ching , Hsieh Chi-Jeng , Lin Fu-Huang
Published: October 2022

The risk of geographic transmission of infectious diseases due to air travel varies greatly. Our aim is to survey empirical data that provide a retrospective historical perspective on measles and rubella. This study used the open data website provided by the Taiwan Centers for Disease Control (TCDC) to extract the reported numbers of measles and rubella case between 2011 and 2020. There were 306 cases of measles and 135 cases of rubella. The incidence of measles and rubella per million population were 0 to 6.0 and 0 to 2.6, respectively. There was a gradual increase in the numbers of cases in those aged 20–39 years, and distinct duration patterns. It indicated that the risk of contracting rubella has significantly decreased in the last 5 years. Measles cases aged 20 to 39 years accounted for 72.5% of all cases. Rubella cases aged 20 to 39 years accounted for 59.3% of all cases. The male and residency in the Taipei metropolitan area or northern area were identified as potential risk factors for measles and rubella. Coverage with the first dose of the measles, mumps and rubella (MMR) vaccine in Taiwan increased from 97.31% to 98.86%, and the uptake rate of the second dose of the MMR vaccine increased from 95.73% to 98.39% between 2010 and 2020. Furthermore, the numbers of imported cases of measles (n = 0) and rubella (n = 0) reported during the coronavirus disease 2019 (COVID-19) pandemic were lower than those from 2011 to 2019. Measles and rubella cases were imported most frequently from Cambodia and Vietnam. This study represents the first report of confirmed cases of acquired measles and rubella from surveillance data of the TCDC between 2011 and 2020, also demonstrates that the numbers of cases of measles and rubella significantly decreased in Taiwan during the COVID-19 pandemic.
Skin endothelial cell and microcirculation function study in recurred keloids patients after keloid surgery and radiotherapy
Authors: Li Wenbo , Shan Mengjie , Hao Yan , Liu Hao , Wang Youbin , Qiu Jie
Published: October 2022

Background:

Keloid is a type of benign tumor of the skin with abnormal proliferation of fibrous tissue. We sought to observe the changes in skin microcirculation and endothelial cell function around the recurred keloid and explore the skin microcirculation characters in recurred keloid patients.

Methods:

Six patients with recurred keloid were treated with keloid surgery and radiotherapy for the second time. Microcirculation of recurred keloids and their surrounding normal skin tissue was observed with laser Doppler flowmeter before operation. Expression of vascular endothelial growth factor (VEGF), CD31, and HIF-1α were identified by several assay.

Results:

The local blood flow of group RN was enhanced. The average strength of group N is 0.87. The average strength of group RN is 2.08. The expression of VEGF, CD31, and hypoxia inducible factor-1α (HIF-1α) protein in the keloid-recurred skin (RN) group was higher than the normal skin group via immunohistochemistry (IHC) and Western blotting analysis. The relative expression of VEGF and CD31 mRNA was significantly increased in RN group samples (P < .05).

Conclusions:

There are significant differences in the expression of VEGF, CD31, and HIF-1α in the recurred keloid skin after radiotherapy and normal skin. They may be used as potential biomarkers and targets for future research on keloid recurrence.
Immediate postoperative lumbar spine magnetic resonance imaging: Correlation with postoperative pain in lumbar microdiscectomy
Authors: Noh Sung Hyun , Ndraha Eveline , Shin Dong Ah , Cho Pyung Goo , Kim Keung Nyun , Kim Sang Hyun
Published: October 2022

Magnetic resonance imaging (MRI) has been extensively used in the management of patients with a herniated lumbar disc. Nevertheless, immediate postoperative MRI has not become a standard procedure, with limited research suggesting that the findings are often similar to preoperative MRI in both symptomatic and asymptomatic patients. This study aimed to determine the benefits of immediate postoperative MRI in patients with or without postoperative symptoms and its correlation with these symptoms. A total of 172 patients who underwent lumbar spine microdiscectomy at our institution between 2014 and 2021 were included. Patients who had previous spinal surgery and lumbar fusion were excluded. Patient data were collected from medical records. MRI was performed 3 days after surgery and assessed by 2 neurosurgeons to minimize bias. Immediate postoperative MRI results showed dural sac compression or foraminal stenosis in 29 patients (16.86%), of which 10 had postoperative pain and 19 were pain free. Among the 143 patients (83.14%) without these findings on MR imaging, 38 had postoperative pain. Immediate postoperative MRI did not correlate with postoperative pain (P = .421/.357). Intraoperative bleeding and the Charlson comorbidity index (CCI) showed significant correlations with postoperative pain (P = .018 and .002, respectively). In a multivariate analysis, intraoperative blood loss and CCI independently correlated with postoperative pain (P = .001 and .001, respectively). Based on our findings, intraoperative blood loss and CCI appear to be the factors that may predict the persistence of postoperative pain, despite normal findings on MRI.
Postoperative analgesia of intraoperative nefopam in patients undergoing anterior cervical spine surgery: A prospective randomized controlled trial
Authors: Raksakietisak Manee , Rushatamukayanunt Pranee , Wilaiwan Kulanong , Homprasert Chakkarin , Nitising Akkapong , Sawasdiwipachai Prasert , Pantubtim Chanitda
Published: October 2022

Background:

Nefopam is a non-opioid, non-nonsteroidal anti-imflammatory drug, analgesic drug that inhibits the reuptake of serotonin, norepinephrine, and dopamine. It is widely used as an adjuvant for pain. This study investigated whether the intraoperative, intravenous infusion of nefopam (20 mg) reduces postoperative morphine consumption, pain scores, and alleviates neuropathic pain in patients undergoing cervical spine surgery.

Methods:

A prospective, paralleled design, randomized study was conducted on 50 patients (aged 18–75 years) in a university-based hospital. The patients were assigned to an intervention or a control group (25 patients in each). The intervention group received a 1-hour infusion of nefopam (20 mg) before the end of surgery. The control group received normal saline (NSS). The outcome measures were morphine consumption during the first 24 postoperative hours, numerical rating scale (NRS) pain scores, and scores for the Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T) in patients with neuropathic pain and adverse drug reactions. The NPSI-T scores were assessed on the preoperative day, postoperative day 1, 3, 15, and 30. The outcome assessors were blinded to group allocation.

Results:

Fifty patients were analyzed. During the first 24 postoperative hours, morphine consumption was 8 mg (nefopam) and 12 mg (NSS; P = .130). The intervention and control groups demonstrated no significant differences in the median NRS scores or total NPSI-T scores or adverse drug reactions.

Conclusions:

A single, intraoperative infusion of 20 mg of nefopam did not significantly reduce postoperative (24 hours) morphine consumption in patients undergoing anterior cervical spine surgery.
A case of hemophagocytic lymphohistiocytosis after BNT162b2 COVID-19 (Comirnaty®) vaccination
Authors: Shimada Yoshitaka , Nagaba Yasushi , Okawa Hiroyuki , Ehara Kaori , Okada Shinya , Yokomori Hiroaki
Published: October 2022

Rationale:

Coronavirus disease (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus, was reported in Wuhan of China in December 2019. The world is still in a state of pandemic owing to COVID-19. COVID-19 vaccines help our bodies develop immunity against the virus that causes COVID-19 without having to get the illness. Herein, we describe a rare case of a critical disorder, hemophagocytic lymphohistiocytosis (HLH), in a patient with nephritic sclerosis associated with hypertension, following mRNA COVID-19 vaccination. HLH is a life-threatening hyperinflammatory syndrome caused by aberrantly activated macrophages and cytotoxic T cells that may rapidly progress to terminal multiple organ failure.

Patient concerns:

An 85-year-old Japanese woman with chronic renal failure and hypertension was included in this study. Routine laboratory investigations provided the following results: white blood cell (WBC) count, 4.6 × 109/L; hemoglobin (Hb), 8.1 g/dL; platelet count, 27 × 109/L; blood urea nitrogen 48.9 mg/dL, and serum creatinine 3.95 mg/dL. The patient developed malaise, vomiting, and persistent high fever (up to 39.7°C) on the 12th day after receiving the second dose of the vaccine. Initial evaluation revealed neutropenia. The total WBC count was 0.40 × 109/L (Neutrophils 0, Lymphocytes 240/μ, blast 0%); Hb 9.0 g/dL, platelet count 27 × 109/L; and, C Reactive Protein 9.64 mg/dL.

Diagnosis:

Further tests showed hyperferritinemia (serum ferritin 2284.4 μg/L). Bone marrow examination revealed haemophagocytosis. A provisional diagnosis of HLH associated with the Comirnaty® vaccination was made based on the HLH-2004 diagnostic criteria.

Interventions:

The patient was treated with granulocyte colony-stimulating factor and 500 mg methylprednisolone.

Outcomes:

A significant improvement was observed in the patient’s condition; the abnormal laboratory results resolved gradually, and the patient was discharged.

Lessons:

This case serves to create awareness among clinicians that HLH is a rare complication of COVID-19 vaccination and should be considered, especially in patients with a history of chronic renal failure and hypertension.