bluuebunny/crossref_metadata_2025 huggingface dataset:
Base Towns
Authors: Kim Claudia Junghyun
Published: December 2022

When do we see social movements against the American military overseas, and what explains their varying intensity? Despite increasing interest in the global network of U.S. military bases on foreign soil, we still do not understand why some host communities mobilize against the American bases in their backyards, while others remain compliant. This book addresses this puzzle by investigating the contentious politics surrounding twenty U.S. military bases across Korea and Japan—faithful U.S. allies and two of the largest U.S. base hosts in the world. In particular, it looks at municipalities hosting these bases and differing levels of community acceptance and resistance over time. Drawing on fieldwork interviews, participant observation, and protest event data (2000–2015), the book shows that activists in base towns successfully build broad-based anti-base movements when they (1) take advantage of quotidian disruption (i.e., major changes at these bases); (2) adopt culturally resonant—but surprisingly mundane—protest frames; and (3) ally with local political elites. These activist strategies, however, sometimes end up reinforcing the widely presumed inevitability of the American presence. Ultimately, this book sheds light on marginalized actors in international politics—far removed from elite decision-making processes that shape interstate base politics, and yet living with their consequences—who sometimes manage to complicate the operations of America’s military behemoth. In doing so, the book also reminds readers that American military bases overseas, often discussed in the rather abstract terms of American power projection, have concrete local and human consequences.
Governing Bases
Authors: Kim Claudia Junghyun
Published: December 2022

This chapter shows that activists strategically court local political elites, who occasionally emerge as surprisingly influential veto players in interstate base politics. Elite involvement legitimates the anti-base movement in the eyes of latent adherents and elevates the scope of the base conflict to a question of local autonomy. Elites, however, do not exist as a mere background for activists. Some are opportunists, who co-opt the movement by capitalizing on local grievances as political leverage in their negotiations with the central government. Others become movement enthusiasts who fully embody the anti-base cause. Both opportunists and enthusiasts, however, can bring about unintended consequences by undermining the movement in the long run. Notable cases include Camp Casey in Korea and Marine Corps Air Station Iwakuni in Japan.
Studying Government Perceptions of Popular Discontent in Autocracies
Authors: Dimitrov Martin K.
Published: December 2022

Opacity is a fundamental feature of nondemocratic politics. Understanding the mechanisms of autocratic rule requires piercing the veil of authoritarian secrecy by utilizing direct sources that are generated internally for regime insiders rather than for public distribution. The chapter engages with two central questions that arise when working with internal government materials. The first is definitional: What are these direct sources? Where are they located? And how have they been constituted? The second is methodological: How do we approach documents of this kind? This chapter argues that archival ethnography is the most effective technique for engaging with direct sources. This methodological approach yields both empirical and theoretical insights about information gathering in communist autocracies that are presented in the remainder of the chapter and in Appendix A1, which illustrates how direct sources enrich our understandings of the complex issue of estimating the size of the corps of informants in autocracies.
Information-Gathering Institutions in Bulgaria, 1989–1991
Authors: Dimitrov Martin K.
Published: December 2022

This chapter analyzes how Bulgaria handled the regime crisis of 1989–1991 when sophisticated systems for the collection of information transmitted detailed intelligence to the incumbent and to elite insiders about a growing incapacity to manage overt discontent. The Bulgarian case demonstrates that the dictator’s dilemma can be solved, but this does not necessarily mean that the incumbent can avoid being deposed. A second finding is that information-gathering institutions can persist after the end of a dictatorship whose demise they have foretold—this occurred in Bulgaria and helped preclude an immediate win by the opposition in the first competitive elections in the newly democratic postcommunist regime. The final theoretical insight from the Bulgarian case is that assimilation is not an optimal solution of the problem of ethnic minority impenetrability—grievances persist and, should they be visibly expressed, can destabilize the regime. All three findings have direct relevance for China’s future.
The “Authentic” Left and Right
Authors: Lewis Hyrum , Lewis Verlan
Published: December 2022

The main objection to the social theory of ideology is that it does not deal with “authentic” ideology or ideologues, but this claim does not hold. Essentialists who believe that those ideologues who do not fit their essentialist definition are not “true” ideologues are falling victim to a private language fallacy that ultimately leads to circular reasoning (e.g., “conservatives oppose change and if conservatives support change that just shows they aren’t true conservatives”). Others assert that an alternative essence lies behind the political spectrum, but all such essences depend upon ex post storytelling rather than falsifiable claims. Those who insist that there are deep psychological roots to liberalism or conservatism are confusing correlation with causation or mistaking a psychological connection to one political issue (such as free markets) with a connection to all political issues (such as free markets and abortion and affirmative action and foreign policy).
The Future of Left and Right
Authors: Lewis Hyrum , Lewis Verlan
Published: December 2022

While it is true that the essentialist paradigm currently has a firm grip on society, there is the possibility that we can break free. Recognizing the myth of left and right and going granular in political discourse can minimize the scourge of ideology and make our political interactions more informed and constructive. Since political positions do not come naturally packaged together, we should stop pretending they do. Instead of thinking in terms of left and right, we should think in terms of specific policies and ideas. While ideology creates confusion by lumping opposites together, granularity dispels confusion by distinguishing between diverse policies and people. Furthermore, finding healthier tribes and engaging in adversarial collaboration would make politics more about the pursuit of the common good and less about victory for a side in the destructive tribal warfare that our politics has become.
A Legacy of Discrimination
Authors: Bollinger Lee C. , Stone Geoffrey R.
Published: December 2022

Affirmative action policies in the Unites States are under assault, especially in higher education. Students for Fair Admissions v. Harvard, a case that has reached the Supreme Court, has the potential to overturn decades’ worth of progress for minorities—especially Black students. In this robust and full-throated defense of affirmative action policies, the authors argue that in order to fully comprehend affirmative action’s intent and impact, readers must reacquaint themselves with the era in which it arose, beginning with the most important Supreme Court decision of the twentieth century, 1954’s Brown v. Board of Education of Topeka, Kansas. As the book unfolds, readers will be introduced to subsequent, and evolving, affirmative action case law that sought to dismantle racism and enable social, educational, and economic progress for Black people and other minority groups and the ongoing challenges to each of these efforts. Though progress has been made since Brown, Black Americans today continue to experience discrimination and disadvantage in nearly every facet of life. Americans, then, must view affirmative action as a very long-term commitment, especially when we consider that a relatively recent effort to secure justice for Black Americans was preceded by three and a half centuries of grave injustice. At the center of the debate over affirmative action is interpretation of the Fourteenth Amendment. Accordingly, the co-authors, two of the nation’s leading constitutional scholars, will demonstrate how and why affirmative action policies stand on firm legal ground—and can and must remain protected.
Introduction
Authors: Bollinger Lee C. , Stone Geoffrey R.
Published: December 2022

Affirmative Action, which began in the 1960s as a good faith effort to expand opportunities to Americans historically denied them—especially Black Americans—has since became defined, in the minds of some, as preferential treatment for some groups at the expense of others. How did an effort to level the playing field for all Americans come to be interpreted by some Americans as a zero-sum game with clear winners and losers? Why do many segments of the American population still encounter discrimination as a result of their race, creed, color, and national origin? Where do we go from here? This book argues that America’s obligation to remediate past discrimination based on race is far from over. And that conscience and jurisprudence not only can, but must, be intertwined to advance and protect the ideals Americans claim to cherish. Affirmative action, then, is not only constitutionally permissible, it is morally mandated.
Elucidating Law
Authors: Dickson Julie
Published: December 2022

What are the aims of legal philosophy? Which questions should it seek to address? How should legal philosophers approach and engage with their subject matter, and what constraints are incumbent on them as they do so? What are the criteria of success of theories of law, and how do we know if they have been met? Can there be progress in legal philosophy? In this new work, Julie Dickson addresses these and other questions concerning the methodology, or the philosophy, of legal philosophy and offers her own distinctive response to them. The book advocates that legal philosophers should espouse an approach that Dickson terms ‘indirectly evaluative legal philosophy’. This distinctive approach can facilitate legal philosophers’ understanding of aspects of the nature of law, whilst avoiding prematurely or inappropriately regarding law as inherently morally valuable. Law is a powerful, systemic, and institutionalized social tool. It should be understood in a manner appropriate to its character.
Elucidating Law
Authors: Dickson Julie
Published: December 2022

This opening chapter introduces some of the main themes of the book. It begins by explaining aspects of the author’s idea of what it means to elucidate law. Following a brief consideration of the idea of elucidation in certain works in philosophy, and in legal philosophy, it outlines the author’s view of four key ideas associated with the idea of elucidating law and offers a preliminary account of each of them. The chapter also discusses some of the author’s motivations for writing the book. It concludes with an outline of each chapter of the book, providing the reader with a road map for the discussion that follows.
Approaching Law
Authors: Dickson Julie
Published: December 2022

This chapter begins to develop and defend the author’s own methodology of legal philosophy: indirectly evaluative legal philosophy (IELP). It opens with an outline of six key tenets of this distinctive methodological approach. The chapter then goes on to argue that certain constraints are incumbent on legal philosophers as they approach and begin to characterize their subject matter. One of these constraints stems from the need to do adequate justice to each aspect of an important duality running through law, namely law’s social character on the one hand, and its normative character on the other. The chapter also argues that, given the character of law itself, legal philosophers should approach understanding law with an ‘attitude of due wariness’, and that this provides another constraint on the methodology of legal philosophy.
Introduction to Stochastic Processes
Authors: Bittelli Marco , Olmi Roberto , Rosa Rodolfo
Published: December 2022

In Chapter 3, the reader finds an in-depth description of the fundamental theory of stochastic processes. The Chapter introduces concepts of continuous and discrete random variables, stationarity, ergodicity, recurrent and transient states, Markov processes and Markov chains. Examples from mathematics and physics are presented to exemplify random processes such as the Buffon’s needle and the Ehrenfest Urn Model.
ARMA Processes
Authors: Bittelli Marco , Olmi Roberto , Rosa Rodolfo
Published: December 2022

Chapter 5 enters into stochastic time series analysis with the description of moving average, autoregressive and autoregressive moving average processes. Seasonal time series analysis is introduced with examples applied to measures temperature and the hydrological cycle.
Markov Chain Monte Carlo
Authors: Bittelli Marco , Olmi Roberto , Rosa Rodolfo
Published: December 2022

Chapter 7 presents the Markov Chain Montecarlo method with a description of the probably the most famous algorithm in stochastic theory, the Metropolis algorithm. After a through description of the theory and code, the travelling salesman problem is presented, with the simulated annealing approach. The Travelling Salesman Problem is solved with the simulated annealing algorithm that exploits Markov Chains. The concept of Bayesian analysis is here briefly introduced and leading into the next Chapter.
The Tangle of Science
Authors: Cartwright Nancy , Hardie Jeremy , Montuschi Eleonora , Soleiman Matthew , Thresher Ann C.
Published: December 2022

Science is remarkably reliable. It puts people on the moon, performs laser eye surgery, tells us about ancient civilisations and species, and predicts the future of our climate. What underwrites this reliability? This book argues that the standard answers—the scientific method, rigour, and objectivity—are insufficient for the job. Here we propose a new model of science that places its products front and centre. This is the ‘Tangle of Science’. In this book we show how any reliable piece of science is underpinned by a vast, diverse, and thick network of other scientific products. In doing so we bring back into focus areas of science that have been long neglected, emphasising how every product, from the screws that hold the space shuttle together to ways of measuring the consumer price index to Einstein’s theory of general relativity, work together to support results we can trust.
Illustrating the Tangle
Authors: Cartwright Nancy , Hardie Jeremy , Montuschi Eleonora , Soleiman Matthew , Thresher Ann C.
Published: December 2022

This chapter illustrates the concept of a tangle using two episodes from the history of science. In the first episode, we examine how natural philosophes of the eighteenth century ‘fixed’ the boiling point of water. In the second, we shift to the twentieth century to analyse the development of the antibiotic penicillin. We argue that the virtuous features of the tangle—its richness, entanglement, and long tails—help to explain successes in both episodes.
Changing Times
Authors: Razzack Azra , Siddiqui M. Atyab
Published: December 2022

This chapter presents a narrative of the measures taken by a new team which was at the helm of affairs during 2007–14. The actions taken, the activities engaged in and the shift in focus is presented in an absorbing discussion—academic strengthening and school enrichment, fundraising, and networking, setting up of a Teachers’ Resource Centre, a Junior Science laboratory, exposure visits to museums and science centres, building infrastructure, the revival of football in the school, and so on. The perceptible difference all this made and the dynamism at play because of these new developments is visible. The nuanced understanding of a minority educational institution which emerges is illuminative.
Conclusion
Authors: Razzack Azra , Siddiqui M. Atyab
Published: December 2022

This chapter wraps up the discussion on the school in the context of the identity of Muslims in post-partition India. There is a discussion on the community and its attempt at reconfiguring after partition, on nostalgia around the school and its monumentalizing by the community. There is a discussion around the Muslim nationalist viewpoint and the leadership provided by the Congress and of leaders like Maulana Azad. The chapter ends with a reflection on what is the school all about and the differing challenges of survival and identity. The challenges for the institution are multifarious, and the Qaum which perceives itself as its most ardent supporter has to constantly stand up with positive resolute to give its survival an unmatched momentum.
Locality, Genre, and Self-Definitions of Rampuris
Authors: Khan Razak
Published: December 2022

Chapter 4 explores the agency and creativity of Rampuri subjects and their engagement with locality, history, and emotions. This is done by looking at Urdu literature and writings produced by Rampuris. This includes local histories of Rampur, biographical compendia of Rampuris as well as life narratives written by them about Rampur under the Nawabs. This exploration is done to highlight the diverse understanding of locality, identity, and public culture within Rampur. I do so by exploring another space—literary space as produced by inhabitants of Rampur. It concerns itself particularly with the issue of space and subjectivity by exploring the place identity of inhabitants of Rampur (Rampuri) and sense of belonging (Rampuriyat) that also conveys emotional attachment of self and space. This allows us to understand the role of literary articulations in place-making and imparting meaning to Rampur as a distinct locality.
Dynasties in Historical Political Economy
Authors: Van Coppenolle Brenda , Smith Daniel M.
Published: December 2022

The hereditary transfer of political power within families is a prominent feature of premodern societies and persists in some form even in modern democracies. This chapter reviews the role of dynasties in the historical development of states and how patterns in dynastic politics serve as a useful metric for understanding the evolution of power and state organization in historical political economy research. The chapter identifies and describes three broad declines in the role of dynasties in politics: (1) a decline of monarchy in favor of democracy and other forms of government, (2) a decline in the prevalence of elected members of dynasties in democracies, and (3) a decline in the gendered differences in dynastic entry into politics. Despite these general declines, dynastic ties remain advantageous to politicians’ careers in many countries, especially when it comes to reaching the top echelons of power in the executive.
Causal Inference and Knowledge Accumulation in Historical Political Economy
Authors: Callis Anna , Dunning Thad , Tuñón Guadalupe
Published: December 2022

Empirical scholarship on historical political economy (HPE) has been greatly influenced by the so-called credibility revolution. Critics rightly worry, however, about the revolution’s capacity to aid explanation, as opposed to the estimation of treatment effects. This chapter describes three empirical strategies that can foster stronger accumulation of knowledge about generalizability and causal mechanisms and goes on to survey their use in HPE, especially in research on the consequences of European colonial expansion. Grounded in design-based approaches, these strategies offer leverage for explanation and provide avenues for the development and testing of generalizable theory. There is no necessary tension between the credibility revolution and the construction of a comprehensive, cross-case evidence base. However, it would be useful if strategies for cumulative learning—such as those described here—were leveraged more explicitly and purposively across studies.
Concurrent observations of the euphausiid Thysanoessa raschii in an Icelandic fjord by acoustics and Video Plankton Recorder: comparisons with theoretical models of target strength
Authors: Reynisson Pall , Gislason Astthor , Lawson Gareth L
Published: December 2022

In two surveys in an Icelandic fjord, September 2016 and October 2018, the target strength (TS) of the euphausiid Thysanoessa raschii was estimated at four frequencies (38, 70, 120, 200 kHz) by matching the acoustic backscatter to the number of euphausiids detected by a Video Plankton Recorder (VPR). Using forward-looking strobe lights on the VPR and doubling the towing speed lowered the estimated target strength by 4.3 dB. In 2016, the TS for euphausiids of mean length 20.7 mm averaged −98.4, −92.3, −86.6 and −82.8 dB at 38, 70, 120 and 200 kHz frequencies, respectively. In 2018, TS for euphausiids of mean length 19.9 mm averaged −98.2 dB at 38 kHz and −88.3 dB at 120 kHz. Theoretical modeling using a Distorted-Wave Born Approximation-based approach was used to compute the average target strength for the observed length distributions and for several density and sound speed contrast (g, h) and orientations. Except at 38 kHz, these results are in reasonable agreement with the TS estimated from the VPR-acoustic comparisons. The methodological approach presented provides an alternative to net-acoustic comparison or modeling for the estimation of euphausiid target strength.
Comparison of Contralateral Acceleromyography and Electromyography for Posttetanic Count Measurement
Authors: Joo Hyunyoung , Cho Sooyoung , Lee Jong Wha , Kim Won Joong , Lee Hyun Jung , Woo Jae Hee , Lee Giyear , Baik Hee Jung
Published: December 2022

Background

Electromyography has advantages over mechanomyography and acceleromyography. Previously, agreement of the train-of-four counts between acceleromyography and electromyography was found to be fair. The objective of this study was to assess the agreement of posttetanic count including agreement of neuromuscular blockade status (intense block, posttetanic count equal to 0; or deep block, posttetanic count 1 or greater and train-of-four count equal to 0) between acceleromyography and electromyography.

Methods

Thirty-six patients, aged 20 to 65 yr, participated in this study. A dose of 0.6 mg/kg rocuronium, with additional dose of 0.3 mg/kg if required, was administered to the patients. The train-of-four and posttetanic counts were monitored in the contralateral arm using electromyography at the first dorsal interosseus or adductor pollicis, and acceleromyography at the adductor pollicis. Posttetanic count measurements were performed at 6-min intervals; the responses were recorded until the train-of-four count reached 1. The authors evaluated the agreement of degree of neuromuscular blockade (intense or deep block) and that of posttetanic count between acceleromyography and electromyography.

Results

The authors analyzed 226 pairs of measurements. The percentage agreement indicating the same neuromuscular blockade status (intense or deep block) between acceleromyography and electromyography was 73%. Cohen’s kappa coefficient value was 0.26. After excluding data with acceleromyography–posttetanic counts greater than 15, a total of 184 pairs of posttetanic counts were used to evaluate the agreement between the two monitoring methods. For acceleromyography–posttetanic count, 42 (23%) pairs had the same electromyography–posttetanic count, and 93 (50%) pairs had more than the electromyography–posttetanic count. The mean posttetanic count on electromyography was 38% (95% CI, 20 to 51%) lower than that on acceleromyography (P = 0.0002).

Conclusions

Acceleromyography frequently counted more twitches than electromyography in posttetanic count monitoring. Acceleromyography– and electromyography–posttetanic counts cannot be used interchangeably to assess the degree of neuromuscular blockade.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Timing of Maternal Smoking Cessation and Newborn Weight, Height, and Head Circumference
Authors: Tatsuta Nozomi , Asato Kaname , Anai Akane , Suzuki Tomohisa , Sakurai Kasumi , Ota Chiharu , Arima Takahiro , Sugawara Junichi , Yaegashi Nobuo , Nakai Kunihiko ,   for the Japan Environment and Children's Study Group
Published: December 2022

OBJECTIVE:

To examine the relationship between timing of smoking cessation during pregnancy and anthropometric indices of newborns.

METHODS:

Mothers and neonates enrolled in the JECS (Japan Environment and Children's Study), a nationwide birth cohort study, were examined. Patients with full-term neonates were included in the analysis, and 73,025 mother–neonate pairs with complete data were identified. The mothers were classified into six groups according to smoking status during pregnancy (nonsmokers [Q1, n=44,198]; ex-smokers who quit before pregnancy [Q2, n=16,461]; ex-smokers who quit in the first trimester [Q3, n=8,948]; ex-smokers who quit in the second trimester [Q4, n=498]; ex-smokers who quit in the third trimester [Q5, n=651]; and smokers who smoked throughout pregnancy [Q6, n=2,269)]). Data on smoking were based on questionnaires administered in the first, second, or third trimester and 1 month after delivery. The primary outcomes were birth weight, height, and head circumference.

RESULTS:

Compared with nonsmokers (Q1), no adverse outcomes were observed for ex-smokers who quit before pregnancy (Q2). The mean adjusted weights of male and female neonates were 135 g and 125 g lower, respectively, in Q6 participants than in Q1 participants. Comparing Q1 and Q6 participants, height was 0.6 cm and 0.7 cm smaller for male and female neonates, respectively. Head circumference in neonates of Q6 participants was 0.3 cm and 0.3 cm smaller for male and female neonates, respectively, than that in Q1 participants. Across all three measures, smoking cessation in the first and second trimester reduced the differential in outcomes between nonsmokers and individuals who smoked throughout pregnancy.

CONCLUSION:

Smoking during pregnancy is associated with reduced newborn birth weight, height, and head circumference. Earlier smoking cessation during pregnancy reduces the adverse effects of smoking on fetal growth.
Minimally Invasive Compared With Open Surgery in High-Risk Endometrial Cancer
Authors: Dinoi Giorgia , Ghoniem Khaled , Murad M. Hassan , Segarra-Vidal Blanca , Zanfagnin Valentina , Coronado Pluvio J. , Kyrgiou Maria , Perrone Anna M. , Zola Paolo , Weaver Amy , McGree Michaela , Fanfani Francesco , Scambia Giovanni , Ramirez Pedro T. , Mariani Andrea
Published: December 2022

OBJECTIVE:

To compare outcomes between minimally invasive surgery and open surgery in patients with high-risk endometrial cancer.

DATA SOURCES:

A cohort study of all patients who underwent surgery for high-risk endometrial cancer between 1999 and 2016 at Mayo Clinic (Rochester, Minnesota) and a literature search of MEDLINE, EMBASE, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, and Scopus of all published studies until December 2020.

METHODS OF STUDY SELECTION:

The systematic review identified 2,332 patients (14 studies, all retrospective except a subanalysis of a randomized comparison) and the cohort study identified 542 additional patients. Articles were included if reporting original data on overall survival and disease-free survival among patients with high-risk endometrial cancer, defined as International Federation of Gynecology and Obstetrics grade 3 endometrioid, serous, clear cell, mixed histology, or uterine carcinosarcoma. Studies that did not report at least one of the main outcomes, those in which one surgical technique (robotic or laparoscopic surgery) was missing in the comparison analysis with open surgery, and case reports were excluded. Additional data were extracted from a retrospective cohort of patients from Mayo. A random-effect model was used for meta-analysis.

TABULATION, INTEGRATION, AND RESULTS:

This systematic review and meta-analysis was registered in PROSPERO. Literature search and data extraction were performed independently by two reviewers, as well as quality assessment using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and the Newcastle-Ottawa Scale. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Meta-analysis showed that disease-free survival and overall survival in patients with high-risk endometrial cancer who underwent minimally invasive surgery were not statistically different from those of patients who underwent open abdominal surgery (relative risk [RR] 0.93, 95% CI 0.82–1.05, I2 20%, P=.23; and RR 0.92, 95% CI 0.77–1.11, I2 31%, P=.12, respectively). Subgroup analysis by stage (early vs advanced) did not identify a difference between surgical approaches.

CONCLUSION:

Minimally invasive surgery and open surgery had similar disease-free survival and overall survival in patients with high-risk endometrial cancer.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42021275535.
Measures of Racism and Discrimination in Preterm Birth Studies
Authors: Balascio Phoebe , Moore Mikaela , Gongalla Megha , Regan Annette , Ha Sandie , Taylor Brandie D. , Hill Ashley V.
Published: December 2022

OBJECTIVE:

Preterm birth (any birth at less than 37 weeks of gestation) disproportionally affects Black birthing people and is associated with adverse perinatal and fetal health outcomes. Racism increases the risk of preterm birth, but standardized measurement metrics are elusive. This narrative synthesis examines literature on measures of racial discrimination used in preterm birth research.

DATA SOURCES:

Six databases (CINAHL, Cochrane, EMBASE, PubMed [MEDLINE], Scopus, Web of Science) and ClinicalTrials.gov were searched. Search terms were categorized into three groups (racism terms, measurement terms, preterm birth terms) to identify original research articles that explored associations between racism and preterm birth. English-language, original research articles with U.S. populations were included.

METHODS OF STUDY SELECTION:

Studies were excluded if conducted in only White populations, if only paternal factors were included, or if only racial differences in preterm birth were described. Articles were independently reviewed by two blinded researchers for inclusion at every stage of screening and data extraction; a third reviewer resolved discrepancies.

TABULATION, INTEGRATION, AND RESULTS:

Sixty studies were included in the final analysis. Articles primarily included measures examining interpersonal forms of racism (n=17) through the Experiences of Discrimination and Everyday Discrimination scales, neighborhood composition (n=22) with the Neighborhood Deprivation Index and the Index of Concentration at the Extremes, policy-level racism (n=12) through institutions such as residential racial segregation or policy inequities, or multiple forms (n=9).

CONCLUSION:

Among studies, assessment methods and application of constructs varied. This heterogeneity poses significant challenges to understanding associations between racial discrimination and preterm birth and to describing potential etiologic pathways of preterm birth, which ultimately hinders development of effective intervention. Strategies to capture multilevel exposures to racism require the development and expansion of metrics that are culturally inclusive, empirically valid, and reliable among Black pregnant populations.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42022327484.
Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy
Authors: Bizzarri Nicolò , Dostálek Lukáš , van Lonkhuijzen Luc R. C. W. , Giannarelli Diana , Lopez Aldo , Falconer Henrik , Querleu Denis , Ayhan Ali , Kim Sarah H. , Ortiz David Isla , Klat Jaroslav , Landoni Fabio , Rodriguez Juliana , Manchanda Ranjit , Kosťun Jan , Ramirez Pedro T. , Meydanli Mehmet M. , Odetto Diego , Laky Rene , Zapardiel Ignacio , Weinberger Vit , Dos Reis Ricardo , Pedone Anchora Luigi , Amaro Karina , Salehi Sahar , Akilli Huseyin , Abu-Rustum Nadeem R. , Salcedo-Hernández Rosa A. , Javůrková Veronika , Mom Constantijne H. , Scambia Giovanni , Cibula David
Published: December 2022

OBJECTIVE:

To evaluate the association of number of radical hysterectomies performed per year in each center with disease-free survival and overall survival.

METHODS:

We conducted an international, multicenter, retrospective study of patients previously included in the Surveillance in Cervical Cancer collaborative studies. Individuals with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1–IIA1 cervical cancer who underwent radical hysterectomy and had negative lymph nodes at final histology were included. Patients were treated at referral centers for gynecologic oncology according to updated national and international guidelines. Optimal cutoffs for surgical volume were identified using an unadjusted Cox proportional hazard model, with disease-free survival as the outcome and defined as the value that minimizes theP-value of the split in groups in terms of disease-free survival. Propensity score matching was used to create statistically similar cohorts at baseline.

RESULTS:

A total of 2,157 patients were initially included. The two most significant cutoffs for surgical volume were identified at seven and 17 surgical procedures, dividing the entire cohort into low-volume, middle-volume, and high-volume centers. After propensity score matching, 1,238 patients were analyzed—619 (50.0%) in the high-volume group, 523 (42.2%) in the middle-volume group, and 96 (7.8%) in the low-volume group. Patients who underwent surgery in higher-volume institutions had progressively better 5-year disease-free survival than those who underwent surgery in lower-volume centers (92.3% vs 88.9% vs 83.8%,P=.029). No difference was noted in 5-year overall survival (95.9% vs 97.2% vs 95.2%,P=.70). Cox multivariable regression analysis showed that FIGO stage greater than IB1, presence of lymphovascular space invasion, grade greater than 1, tumor diameter greater than 20 mm, minimally invasive surgical approach, nonsquamous cell carcinoma histology, and lower-volume centers represented independent risk factors for recurrence.

CONCLUSION:

Surgical volume of centers represented an independent prognostic factor affecting disease-free survival. Increasing number of radical hysterectomies performed in each center every year was associated with improved disease-free survival.
Digital Therapeutic Device for Urinary Incontinence
Authors: Weinstein Milena M. , Dunivan Gena C. , Guaderrama Noelani M. , Richter Holly E.
Published: December 2022

OBJECTIVE:

To evaluate the long-term efficacy of an 8-week regimen of pelvic floor muscle training guided by a motion-based digital therapeutic device compared with a standard home program in the treatment of stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (MUI).

METHODS:

The primary virtual trial was conducted from October 2020 to March 2021; 363 women with SUI or stress-predominant MUI were randomized to complete pelvic floor muscle training using the device (intervention group) or a standard home pelvic floor muscle training program (control group) for 8 weeks. Primary outcomes included change in UDI-6 (Urogenital Distress Inventory, Short Form) score and SUI episodes on a 3-day bladder diary. The PGI-I (Patient Global Impression of Improvement) was also assessed, with “much better” and “very much better” responses considered as improvement. In this planned secondary analysis, symptom and adherence data were collected in follow-up at 6 and 12 months. A modified intention-to-treat analysis was performed using Student's t tests and χ2 tests as appropriate.

RESULTS:

Of 299 participants analyzed at 8 weeks, 286 (95.7%) returned 6- and 12-month data (151 in the control group, 135 in the intervention group). Mean age was 51.9±12.8 years, and mean body mass index (BMI) was 31.8±7.4; 84.6% of participants were parous, and 54.9% were postmenopausal. Mean change in UDI-6 score from baseline to 6 and 12 months was significantly greater in the intervention group than in the control group (20.2±20.9 vs 14.8±19.5, P=.03 and 22.7±23.3 vs 15.9±20.3, P=.01, respectively). Participants in the intervention group had more than twice the odds of reporting improvement on the PGI-I compared with participants in the control group (OR 2.45, 95% CI 1.49–4.00).

CONCLUSION:

Pelvic floor muscle training guided by a motion-based digital therapeutic device yielded significantly greater urinary incontinence symptom improvement compared with a standard home pelvic floor muscle training program at 6 and 12 months, although continued improvement waned over time. This technology may facilitate pelvic floor muscle training access and adherence for women with SUI and stress-predominant MUI and represents an effective modality for scaling first-line care.

FUNDING SOURCE:

Renovia Inc.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT04508153.
Outcomes of Tibiotalocalcaneal Hindfoot Fusion Nails Used for Acute Lower Extremity Trauma in a High-Risk Patient Population
Authors: Fisher Kalin J. , Shannon Steven F. , Dean Christina M. , Coale Max A. , Healey Kathleen M. , O'Toole Robert V. , Manson Theodore T. , O'Hara Nathan N. , Sciadini Marcus F.
Published: December 2022

Objective:

To determine the outcomes of high-risk patients treated with tibiotalocalcaneal hindfoot fusion nails.

Design:

Retrospective case series.

Setting:

Level I trauma center.

Patients/Participants:

Between January 2007 and December 2016, 50 patients with significant medical comorbidities treated with a tibiotalocalcaneal hindfoot fusion nail in the setting of acute distal tibia and ankle trauma considered to be limb-threatening.

Intervention:

Tibiotalocalcaneal hindfoot fusion nail.

Main Outcome Measurements:

Two-year cumulative incidence of unplanned reoperation and estimated survival with limb salvage at 2 years.

Results:

Of the 50 patients, 20 (38%) had an unplanned reoperation (mean: 2.5 reoperations), including 19 for implant removal, 11 for irrigation and debridement and/or placement of an antibiotic delivery device, and 4 for revision fusion. Three patients required amputation and 3 patients died within 2 years of injury, resulting in an estimated survival with limb salvage at 2 years of 79% (95% confidence interval: 67%–91%). After accounting for the competing risk of death and incomplete follow-up, the 2-year cumulative incidence of unplanned reoperation was 64% (95% confidence interval: 62%–67%).

Conclusions:

Patients in this series experienced a high rate of return to the operating room but a relatively low rate of amputation. Because patients were indicated for this course of treatment on the basis of comorbidities felt to put them at high risk of loss of limb with traditional treatment, acute hindfoot fusion nailing might represent a viable option in select high-risk patients and injuries. Clinicians should be aware that complications are still common.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Impact of Prone Position in COVID-19 Patients on Extracorporeal Membrane Oxygenation*
Authors: Massart Nicolas , Guervilly Christophe , Mansour Alexandre , Porto Alizée , Flécher Erwan , Esvan Maxime , Fougerou Claire , Fillâtre Pierre , Duburcq Thibault , Lebreton Guillaume , Para Marylou , Stephan François , Hraiech Sami , Ross James T. , Schmidt Matthieu , Vincentelli André , Nesseler Nicolas ,   for the Extracorporeal Membrane Oxygenation for Respiratory Failure and/or Heart failure related to Severe Acute Respiratory Syndrome Coronavirus 2 (ECMOSARS) Investigators
Published: December 2022

OBJECTIVES:

Prone positioning and venovenous extracorporeal membrane oxygenation (ECMO) are both useful interventions in acute respiratory distress syndrome (ARDS). Combining the two therapies is feasible and safe, but the effectiveness is not known. Our objective was to evaluate the potential survival benefit of prone positioning in venovenous ECMO patients cannulated for COVID-19–related ARDS.

DESIGN:

Retrospective analysis of a multicenter cohort.

PATIENTS:

Patients on venovenous ECMO who tested positive for severe acute respiratory syndrome coronavirus 2 by reverse transcriptase polymerase chain reaction or with a diagnosis on chest CT were eligible.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

All patients on venovenous ECMO for respiratory failure in whom prone position status while on ECMO and in-hospital mortality were known were included. Of 647 patients in 41 centers, 517 were included. Median age was 55 (47–61), 78% were male and 95% were proned before cannulation. After cannulation, 364 patients (70%) were proned and 153 (30%) remained in the supine position for the whole ECMO run. There were 194 (53%) and 92 (60%) deaths in the prone and the supine groups, respectively. Prone position on ECMO was independently associated with lower in-hospital mortality (odds ratio = 0.49 [0.29–0.84]; p = 0.010). In 153 propensity score-matched pairs, mortality rate was 49.7% in the prone position group versus 60.1% in the supine position group (p = 0.085). Considering only patients alive at decannulation, propensity-matched proned patients had a significantly lower mortality rate (22.4% vs 37.8%; p = 0.029) than nonproned patients.

CONCLUSIONS:

Prone position may be beneficial in patients supported by venovenous ECMO for COVID-19–related ARDS but more data are needed to draw definitive conclusions.
Transfusion practices in patients with advanced cancer: a retrospective study in a palliative care service
Authors: Marote Sara , Marinho Joana , Silva Maria Cândida , Ferraz Gonçalves José
Published: December 2022

Background:

Anemia is highly prevalent in patients with advanced cancer and adversely affects the quality of life. There are limited data on the frequency, clinical utility, and effectiveness of red blood cell (RBC) transfusions, and no randomized controlled clinical trials or clinical practice guidelines are available. The aim of this study was to evaluate clinician practices on RBC transfusion in an oncologic palliative care service and its impact on patients' symptoms, adverse events, and overall survival.

Methods:

This is a retrospective analysis of all patients with advanced cancer who received RBC transfusions admitted for 3 years. Preblood counts, the reason for transfusion, subjective benefit, and objective outcomes were listed.

Results:

We identified 179 patients who underwent RBC transfusions. The mean age was 67 years, and 60% were male. We found a total of 435 RBC units in 301 transfusion episodes. Asthenia/fatigue was the most frequent symptom (68%). The mean pretransfusion hemoglobin (Hb) was 6.85 g/dL, and 48% of patients had a Hb above 7 g/dL. The symptomatic benefit was achieved in 36% of patients. Adverse events were reported in 4%, with a 30-day survival rate of 57%. A statistically significant association was found between Eastern Cooperative Oncology Group performance status (ECOG-PS) and the symptomatic benefit (P = .005). Hb level pretransfusion, ECOG-PS, and symptomatic benefits with transfusions were significantly associated with survival.

Conclusion:

This study suggests that patients with advanced cancer with a higher functioning level may benefit more from RBC transfusion. Post-transfusion symptomatic benefits and pretransfusion ECOG-PS and Hb levels are independent predictors of survival. Further studies are needed to develop validated measures of objective functional changes to evaluate transfusions' clinical impact and identify patients most likely to benefit from it.
The prognostic impact of magnesium in acute heart failure is different according to the presence of diabetes mellitus
Authors: Cidade-Rodrigues Catarina , Cunha Filipe M. , Elias Catarina , Carreira Marta , Barroso Isaac , Bettencourt Paulo , Lourenço Patrícia
Published: December 2022

Background:

Hypermagnesemia predicts mortality in chronic heart failure (HF); however, in acute HF, magnesium does not seem to be outcome-associated. Diabetes mellitus (DM) frequently associates with altered magnesium status. We hypothesized that DM might influence the prognostic impact of magnesium in acute HF.

Methods:

This is a retrospective cohort study of hospitalized patients with acute HF. Patients without data on admission serum magnesium were excluded. Follow-up: 1 year from hospital admission. Primary end point: all-cause mortality. Patients were divided according to median serum magnesium (1.64 mEq/L). The Kaplan-Meier survival method was used to determine survival curves according to magnesium levels. The analysis was stratified according to the presence of DM. A multivariable Cox regression analysis was used to study the prognostic impact of magnesium.

Results:

We studied 606 patients. The mean age was 76 ± 12 years, 44.1% were male, 50.7% had DM, and 232 (38.3%) died during follow-up. Median magnesium was 1.64 (1.48–1.79) mEq/L. Patients with magnesium ≥1.64 mEq/L had higher 1-year mortality [141 (46.4%) vs 91 (30.1%), P < .001]. After adjustments for age, sex, history of atrial fibrillation, systolic blood pressure, heart rate, ischemic etiology, B-type natriuretic peptide, estimated glomerular filtration rate, alcohol consumption, antihyperglycaemic agents or glycated hemoglobin, admission glycemia, New York Heart Association class IV, and severe left ventricle systolic dysfunction, serum magnesium ≥1.64 mEq/L was associated with higher mortality only in patients with DM: HR 1.89 (95% confidence interval: 1.19–3.00), P = .007, and 1.27 (95% confidence interval: 0.83–1.94) and P = .26 for non-DM patients. The results were similar if magnesium was analyzed as a continuous variable. Per 0.1 mEq/L increase in magnesium levels, patients with DM had 13% increased risk of 1-year mortality.

Conclusions:

Higher magnesium levels were associated with worse prognosis only in HF patients with DM.