bluuebunny/crossref_metadata_2025 huggingface dataset:
Does nephrotic syndrome without chronic kidney disease increase the risk of Parkinson’s disease and secondary parkinsonism? A nationwide population-based study in Taiwan
Authors: Huang Zheng-Hao , Chen Hsiang-Cheng , Chou Yu-Ching , Lin Cheng-Li , Kao Chia-Hung , Lo Hsin-Yi , Yang Tse-Yen , Liu Feng-Cheng
Published: July 2018

Objectives

Previous research has shown that patients with nephrotic syndrome (NS) have a higher risk of cognitive impairment, dementia or neurodegenerative disorder. The present study aimed to examine a relationship, if any exists between NS and Parkinson’s disease (PD), a neurodegenerative disorder and secondary parkinsonism (sPS).

Methods

A nationwide retrospective observational study conducted using data from the 2000–2010 Taiwan National Health Insurance Research Database. This study included 3663 patients with NS and 14 652 randomly selected, age-matched and sex-matched patients without NS. A Cox multivariable proportional hazards model was used to evaluate the risk of PD and sPS (PDsPS) in the NS cohort.

Results

This study identified a positive association between NS and the risk of PDsPS in both men and women and in all age groups (adjusted HR 1.51; 95% CI 1.37 to 1.66). Compared with patients without NS and comorbidities, those with NS with two or more comorbidities exhibited an 8.23-fold higher risk of PDsPS (95% CI 6.22 to 10.9) and patients with NS and one comorbidity exhibited a 2.93-fold higher risk of PDsPS (95% CI 2.37 to 3.63).

Conclusions

Patients with NS have an increased risk of PDsPS. This increased risk may be related to brain vascular damage or blood–brain barrier impairment. Further research is necessary to explore the underlying relationship between NS and PDsPS.
A systematic review of barriers and enablers to South Asian women’s attendance for asymptomatic screening of breast and cervical cancers in emigrant countries
Authors: Anderson de Cuevas Rachel Mary , Saini Pooja , Roberts Deborah , Beaver Kinta , Chandrashekar Mysore , Jain Anil , Kotas Eleanor , Tahir Naheed , Ahmed Saiqa , Brown Stephen L
Published: July 2018

Objectives

The aim of this review was to identify the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance in South Asian populations, in order to improve uptake and propose priorities for further research.

Design

A systematic review of the literature for inductive, comparative, prospective and intervention studies. We searched the following databases: MEDLINE/In-Process, Web of Science, EMBASE, SCOPUS, CENTRAL, CDSR, CINAHL, PsycINFO and PsycARTICLES from database inception to 23 January 2018. The review included studies on the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance and cervical smear testing (Papanicolaou test) in South Asian populations and those published in the English language. The framework analysis method was used and themes were drawn out following the thematic analysis method.

Settings

Asymptomatic breast or cervical screening.

Participants

South Asian women, including Bangladeshi, Indian, Pakistani, Sri Lankan, Bhutanese, Maldivian and Nepali populations.

Results

51 included studies were published between 1991 and 2018. Sample sizes ranged from 25 to 38 733 and participants had a mean age of 18 to 83 years. Our review showed that South Asian women generally had lower screening rates than host country women. South Asian women had poorer knowledge of cancer and cancer prevention and experienced more barriers to screening. Cultural practices and assumptions influenced understandings of cancer and prevention, emphasising the importance of host country cultures and healthcare systems.

Conclusions

High-quality research on screening attendance is required using prospective designs, where objectively validated attendance is predicted from cultural understandings, beliefs, norms and practices, thus informing policy on targeting relevant public health messages to the South Asian communities about screening for cancer.

PROSPERO registration number

CSD 42015025284.
Risk of pleural empyema in patients with schizophrenia: a nationwide propensity-matched cohort study in Taiwan
Authors: Shen Te-Chun , Chen Chia-Hung , Huang Yu-Jhen , Lin Cheng-Li , Chang Ting-Chang , Tu Chih-Yen , Hsia Te-Chun , Shih Chuen-Ming , Hsu Wu-Huei , Sung Fung-Chang
Published: July 2018

Objective

Thoracic infection and pneumonia are prevalent in patients with schizophrenia; however, it is unclear whether patients with schizophrenia are at an increased risk of developing pleural empyema.

Design

A retrospective cohort study with propensity-matched cohorts with and without schizophrenia.

Setting

Using the National Health Insurance Research Database of Taiwan.

Participants

We identified 55 888 patients with schizophrenia newly diagnosed in 2000–2011 and same number of individuals without schizophrenia as the comparison cohort, frequency matched by propensity scores estimated using age, sex, occupation, income, urbanisation, year of diagnosis and comorbidities.

Primary outcome measures

We assessed incident pleural empyema by the end of 2011 and used the Cox proportional hazards model to calculate the schizophrenia cohort to comparison cohort HR of pleural empyema.

Results

The overall incidence of pleural empyema was 2.44-fold greater in the schizophrenia cohort than in the comparison cohort (4.39vs1.80 per 10 000 person-years), with an adjusted HR of 2.87(95% CI 2.14 to 3.84). Stratified analyses by age, sex, occupation, income, urbanisation and comorbidity revealed significant hazards for pleural empyema associated with schizophrenia in all subgroups.

Conclusions

Patients with schizophrenia are at an increased risk of developing pleural empyema and require greater attention and appropriate support.
Different but similar: personality traits of​ surgeons and internists—results of a cross-sectional observational study
Authors: Stienen Martin N , Scholtes Felix , Samuel Robin , Weil Alexander , Weyerbrock Astrid , Surbeck Werner
Published: July 2018

Objectives

Medical practice may attract and possibly enhance distinct personality profiles. We set out to describe the personality profiles of surgical and medical specialties focusing on board-certified physicians.

Design

Prospective, observational.

Setting

Online survey containing the Ten-Item Personality Inventory (TIPI), an internationally validated measure of the Five Factor Model of personality dimensions, distributed to board-certified physicians, residents and medical students in several European countries and Canada. Differences in personality profiles were analysed using multivariate analysis of variance and Canonical Linear Discriminant Analysis on age-standardised and sex-standardised z-scores of the personality traits. Single personality traits were analysed using robust t-tests.

Participants

The TIPI was completed by 2345 board-certified physicians, 1453 residents and 1350 medical students, who also provided demographic information.

Results

Normal population and board-certified physicians’ personality profiles differed (p<0.001). The latter scored higher on conscientiousness, extraversion and agreeableness, but lower on neuroticism (all p<0.001). There was no difference in openness to experience. Board-certified surgical and medical doctors’ personality profiles were also different (p<0.001). Surgeons scored higher on extraversion (p=0.003) and openness to experience (p=0.002), but lower on neuroticism (p<0.001). There was no difference in agreeableness and conscientiousness. These differences in personality profiles were reproduced at other levels of training, that is, in students and training physicians engaging in surgical versus medical practice.

Conclusion

These results indicate the existence of a distinct and consistent average ‘physician personality’. Despite high variability within disciplines, there are moderate but solid and reproducible differences between surgical and medical specialties.
Registration and publication of emergency and elective randomised controlled trials in surgery: a cohort study from trial registries
Authors: Morley Rachael L , Edmondson Matthew J , Rowlands Ceri , Blazeby Jane M , Hinchliffe Robert J
Published: July 2018

Objectives

Emergency surgical practice constitutes 50% of the workload for surgeons, but there is a lack of high quality randomised controlled trials (RCTs) in emergency surgery. This study aims to establish the differences between the registration, completion and publication of emergency and elective surgical trials.

Design

The clinicaltrials.gov and ISRCTN.com trials registry databases were searched for RCTs between 12 July 2010 and 12 July 2012 using the keyword ‘surgery’. Publications were systematically searched for in Pubmed, MEDLINE and EMBASE.

Participants

Results with no surgical interventions were excluded. The remaining results were manually categorised into ‘emergency’ or ‘elective’ and ‘surgical’ or ‘adjunct’ by two reviewers.

Primary outcome measures

Number of RCTs registered in emergency versus elective surgery.

Secondary outcome measures

Number of RCTs published in emergency versus elective surgery; reasons why trials remain unpublished; funding, sponsorship and impact of published articles; number of adjunct trials registered in emergency and elective surgery.

Results

2700 randomised trials were registered. 1173 trials were on a surgical population and of these, 414 trials were studying surgery. Only 9.4% (39/414) of surgical trials were in emergency surgery. The proportion of trials successfully published did not significantly differ between emergency and elective surgery (0.46 vs 0.52; mean difference (MD) −0.06, 95% CI −0.24 to 0.12). Unpublished emergency surgical trials were statistically equally likely to be terminated early compared with elective trials (0.33 vs 0.16; MD −0.18, 95% CI −0.06 to 0.41). Low accrual accounted for a similar majority in both groups (0.43 vs 0.46; MD −0.04, 95% CI −0.48 to 0.41). Unpublished trials in both groups were statistically equally likely to still be planning publication (0.52 vs 0.71; MD −0.18, 95% CI −0.43 to 0.07).

Conclusion

Fewer RCTs are registered in emergency than elective surgery. Once trials are registered both groups are equally likely to be published.
Maintenance use of non-steroidal anti-inflammatory drugs and risk of gastrointestinal cancer in a nationwide population-based cohort study in Sweden
Authors: Brusselaers Nele , Lagergren Jesper
Published: July 2018

Objectives

Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are potential candidates for chemoprevention of gastrointestinal cancer. We aimed to assess the association between contemporary NSAID use (≥180 days) and gastrointestinal cancer.

Design

Nationwide Swedish population-based cohort study (2005–2012).

Setting

Sweden

Participants

All adults exposed to maintenance NSAIDs use (aspirin, n=783 870; unselective NSAIDs, n=566 209, selective cyclo-oxygenase (COX)-2 inhibitors, n=17 948) compared with the Swedish background population of the same age, sex and calendar period.

Outcome measures

The risk of different gastrointestinal cancer types expressed as standardised incidence ratios (SIR) and 95% CIs, taking into account concurrent proton pump inhibitors (PPIs) and statins usage.

Results

The SIR for gastrointestinal cancer for aspirin use was 1.02 (95% CI 1.00 to 1.04), with clearly reduced risk for long-term users (SIR=0.31, 95% CI 0.30 to 0.33 for 5.5–7.7 years), but an increased risk for short-term users (SIR=2.77, 95% CI 2.69 to 2.85), and stronger protective effect for low-dose aspirin (SIR=0.86, 95% CI 0.85 to 0.88). Users of non-selective NSAIDs showed an overall decreased risk of gastrointestinal cancer (SIR=0.79, 95% CI 0.77 to 0.82), in particular for cancer of the stomach, colorectum and oesophagus, and the SIRs were further decreased among long-term users. Users of selective COX-2 inhibitors showed a SIR=0.89 (95% CI 0.73 to 1.09) for gastrointestinal cancers. Both aspirin and unselective NSAIDs users who also were using PPIs, had higher risks for all gastrointestinal cancer types; and lower risk if using statins.

Conclusion

Long-term use of (low-dose) aspirin and non-selective NSAIDs was associated with a decreased risk of all gastrointestinal cancer types.
Anticholinergic and sedative drug burden in community-dwelling older people: a national database study
Authors: Byrne Catherine J , Walsh Caroline , Cahir Caitriona , Ryan Cristín , Williams David J , Bennett Kathleen
Published: July 2018

Objectives

The Drug Burden Index (DBI) tool quantifies individual exposure to anticholinergic and sedative medications. The DBI has been internationally validated against adverse health outcomes in older people. DBI exposure has not been reported in the Irish older population. This study aimed to: (1) develop a list of drugs with clinically significant anticholinergic and/or sedative effects (DBI medications) relevant to Ireland; (2) examine, using the DBI formula, the prevalence of exposure to DBI medications in Irish older people and (3) explore patient factors associated DBI exposure.

Design

A cross-sectional national pharmacy claims database study.

Setting

Community setting using the General Medical Services (GMS) scheme pharmacy claims database maintained by the Health Service Executive Primary Care Reimbursement Services.

Participants

Irish older individuals (aged ≥65 years) enrolled in the GMS scheme and dispensed at least one prescription item in 2016 (n=428 516).

Main outcome measures

Prevalence of exposure to DBI medications and patient factors associated with DBI exposure.

Results

282 874 (66%) of the GMS population aged ≥65 years were exposed to at least one DBI medication in 2016. Prevalence of exposure to DBI medications was significantly higher in females than males (females 71.6% vs males 58.7%, adjusted OR 1.65, 95% CI 1.63 to 1.68). Prevalence of DBI exposure increased progressively with the number of chronic drugs used, rising from 42.7% of those prescribed 0–4 chronic drugs to 95.4% of those on ≥12 chronic drugs (adjusted OR 27.8, 95% CI 26.7 to 29.0). The most frequently used DBI medications were codeine/paracetamol combination products (20.1% of patients), tramadol (11.5%), zopiclone (9.5%), zolpidem (8.5%), pregabalin (7.9%) and alprazolam (7.8%).

Conclusions

The majority of older people in Ireland are exposed to medications with anticholinergic and/or sedative effects, particularly females and those with multiple comorbidities. The high use of low-dose codeine/paracetamol combination products, Z-drugs and benzodiazepines, suggests there are opportunities for deprescribing.
The association between systolic blood pressure and in-hospital mortality in older emergency department patients who are hospitalised with a suspected infection
Authors: Warmerdam Mats , Baris Lucia , van Liebergen Margo , Ansems Annemieke , Esteve Cuevas Laura , Willeboer Merel , Rijpsma Douwe , Shetty Amith L , de Groot Bas
Published: July 2018

Objective

In existing risk stratification and resuscitation guidelines for sepsis, a hypotension threshold of systolic blood pressure (SBP) below 90–100 mmHg is typically used. However, for older patients, the clinical relevance of a SBP in a seemingly ‘normal’ range (>100 mmHg) is still poorly understood, as they may need higher SBP for adequate tissue perfusion due to arterial stiffening. We therefore investigated the association between SBP and mortality in older emergency department (ED) patients hospitalised with a suspected infection.

Methods

In this observational multicentre study in the Netherlands, we interrogated an existing prospective database of consecutive ED patients hospitalised with a suspected infection between 2011 and 2016. We investigated the association between SBP categories (≤100, 101–120, 121–139, ≥140 mmHg) and in-hospital mortality in patients of 70 years and older. We adjusted for demographics, comorbidity, disease severity and admission to ward/intensive care using multivariable logistic regression.

Results

In the 833 included older patients, unadjusted in-hospital mortality increased from 4.7% (n=359) in SBP ≥140 mmHg to 20.8% (n=96) in SBP ≤100 mmHg. SBP categories were linearly associated with case-mix-adjusted in-hospital mortality. The adjusted ORs (95% CI) for ≤100, 101–120 and 121–139 mmHgcompared with the reference of ≥140 mmHg were 3.8 (1.8 to 7.8), 2.8 (1.4 to 5.5) and 1.9 (0.9 to 3.7), respectively.

Conclusion

In older ED patients hospitalised with a suspected infection, we found an inverse linear association between SBP and case-mix-adjusted in-hospital mortality. Our data suggest that the commonly used threshold for hypotension is not clinically meaningful for risk stratification of older ED patients with a suspected infection.
Emergency preparedness: Ionising radiation incidents and medical management
Authors: Foster Crawford R M
Published: July 2018

Military personnel risk being exposed to ionising radiation through a variety of means, including industrial accidents with Ministry of Defence equipment, inadvertent exposure while on operations, terrorist activities and nuclear war. The aim of this review is to outline the possible acute health effects and immediate management of radiation casualties in the context of different exposure scenarios. It emphasises the most important principles for managing irradiated, and/or contaminated casualties, in the operational environment, as well as providing details of key references and other sources of reach-back support.
‘Plug and pipe’ strategy for treatment of ruptured intracranial aneurysms
Authors: Howard Brian M , Frerich Jason M , Madaelil Thomas P , Dion Jacques E , Tong Frank C , Cawley C Michael , Grossberg Jonathan A
Published: July 2018

Background

Aneurysmal subarachnoid hemorrhage is a potentially devastating condition, and among the first priorities of treatment is aneurysm occlusion to prevent re-hemorrhage. An emerging strategy to treat patients whose aneurysms are not ideal for surgical or endovascular treatment is subtotal coiling followed by flow diversion in the recovery phase or ‘plug and pipe’. However, data regarding the safety and efficacy of this strategy are lacking.

Methods

A retrospective cohort study was performed to evaluate the efficacy and safety of ‘plug and pipe’. All patients with a ruptured intracranial aneurysm intentionally, subtotally treated by coiling in the acute stage followed by flow diversion after recovery, were included. The primary outcome was re-hemorrhage. Secondary outcomes included aneurysm occlusion and functional status. Complications were reviewed.

Results

22 patients were included. No patient suffered a re-hemorrhage, either in the interval between coiling and flow diversion or in follow-up. The median interval between aneurysm rupture and flow diversion was 3.5 months. Roy–Raymond (R-R) class I or II occlusion was achieved in 91% of target aneurysms at the last imaging follow-up (15/22(68%) R-R 1 and 5/22(23%) R-R 2). Complications occurred in 2 (9%) patients, 1 of which was neurological.

Conclusions

Overall, these data suggest that subtotal coiling of ruptured intracranial aneurysms followed by planned flow diversion is both safe and effective. Patients who may most benefit from ‘plug and pipe’ are those with aneurysms that confer high operative risk and those whose severity of medical illness increases the risk of microsurgical clip ligation.
Evaluating latent tuberculosis infection diagnostics using latent class analysis
Authors: Stout Jason E , Wu Yanjue , Ho Christine S , Pettit April C , Feng Pei-Jean , Katz Dolly J , Ghosh Smita , Venkatappa Thara , Luo Ruiyan
Published: July 2018

Background

Lack of a gold standard for latent TB infection has precluded direct measurement of test characteristics of the tuberculin skin test and interferon-γ release assays (QuantiFERON Gold In-Tube and T-SPOT.TB).

Objective

We estimated test sensitivity/specificity and latent TB infection prevalence in a prospective, US-based cohort of 10 740 participants at high risk for latent infection.

Methods

Bayesian latent class analysis was used to estimate test sensitivity/specificity and latent TB infection prevalence among subgroups based on age, foreign birth outside the USA and HIV infection.

Results

Latent TB infection prevalence varied from 4.0% among foreign-born, HIV-seronegative persons aged <5 years to 34.0% among foreign-born, HIV-seronegative persons aged ≥5 years. Test sensitivity ranged from 45.8% for the T-SPOT.TB among foreign-born, HIV-seropositive persons aged ≥5 years to 80.7% for the tuberculin skin test among foreign-born, HIV-seronegative persons aged ≥5 years. The skin test was less specific than either interferon-γ release assay, particularly among foreign-born populations (eg, the skin test had 70.0% specificity among foreign-born, HIV-seronegative persons aged ≥5 years vs 98.5% and 99.3% specificity for the QuantiFERON and T-SPOT.TB, respectively). The tuberculin skin test’s positive predictive value ranged from 10.0% among foreign-born children aged <5 years to 69.2% among foreign-born, HIV-seropositive persons aged ≥5 years; the positive predictive values of the QuantiFERON (41.4%) and T-SPOT.TB (77.5%) were also low among US-born, HIV-seropositive persons aged ≥5 years.

Conclusions

These data reinforce guidelines preferring interferon-γ release assays for foreign-born populations and recommending against screening populations at low risk for latent TB infection.

Trial registration number

NCT01622140.
Ascending Aortic Strain Analysis Using 2‐Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris
Authors: Bu Zhaohui , Ma Jun , Fan Yibo , Qiao Zhiqing , Kang Yu , Zheng Ying , Wang Wei , Du Yongping , Zheng Zheng , Shen Xuedong , He Ben , Pu Jun
Published: July 2018

Background

Arterial stiffening and atherosclerosis tend to coexist. Strain imaging, using a 2‐dimensional speckle tracking (2D‐
ST
) method, has been used for arterial stiffness assessment and early identification of atherosclerosis. We investigated whether the ascending aortic strain assessed by 2D‐
ST
echocardiography at rest can predict the presence of coronary artery disease (
CAD
).

Methods and Results

Two hundred seventy‐one consecutive patients with suspected stable angina pectoris sequentially underwent exercise treadmill testing, 2‐dimensional echocardiography, M‐mode echocardiography, 2D‐
ST
echocardiography, and coronary angiography. Circumferential ascending aortic strain (
CAAS
) and radial ascending aortic strain were assessed by 2D‐
ST
echocardiography. Ninety‐two patients with coronary lumen area stenosis ≥70% were categorized as having significant
CAD
. Global
CAAS
was significantly lower in patients with significant
CAD
(7.41±2.30% versus 11.54±4.03%;
P
<0.001) and remained an independent predictor of significant
CAD
(odds ratio, 0.64 [0.54–0.75];
P
<0.001) after multivariate regression. Based on the receiver operating characteristic curve for diagnosing significant
CAD
, the optimal cut‐off value of global
CAAS
was ≤9.22% (sensitivity, 86%; specificity, 70%; area under curve=0.82;
P
<0.001). Global
CAAS
decreased with increasing severity of
CAD
and was significantly associated with 3‐vessel disease (odds ratio, 0.58 [0.42–0.79];
P
<0.001). Diagnostics for significant
CAD
were remarkably better for global
CAAS
combined with exercise treadmill testing than for exercise treadmill testing alone (area under curve=0.88 versus 0.78;
P
<0.001).

Conclusions

Global
CAAS
assessed by 2D‐
ST
echocardiography at rest was able to predict the presence of significant
CAD
and identify multivessel disease. In addition, global
CAAS
combined with exercise treadmill testing remarkably improved the diagnostics for significant
CAD
.
Endovascular Thrombectomy for Acute Basilar Artery Occlusion: A Multicenter Retrospective Observational Study
Authors: Kang Dong‐Hun , Jung Cheolkyu , Yoon Woong , Kim Seul Kee , Baek Byung Hyun , Kim Joon‐Tae , Park Man Seok , Kim Yong Won , Hwang Yang Ha , Kim Yong‐Sun , Kim Beom Joon , Han Moon‐Ku , Bae Hee‐Joon
Published: July 2018

Background

Despite the recent acceptance of thrombectomy as the standard of care in patients with acute anterior circulation stroke, the benefits of thrombectomy remain uncertain for patients with acute basilar artery occlusion (
BAO
). This study aimed to evaluate the effectiveness and safety of thrombectomy and to identify predictors of outcomes in a large cohort of patients with acute
BAO
.

Methods and Results

This study included 212 consecutive patients with acute
BAO
who underwent either stent‐retriever or contact aspiration thrombectomy as the first‐line approach between January 2011 and August 2017 at 3 stroke centers. Clinical and radiologic data were prospectively collected and stored in a database at each center. Multivariable ordinal logistic regression was performed to assess the association between each characteristic and 90‐day modified Rankin scale scores. Reperfusion was successful in 91.5% (194/212) of patients; 44.8% (95/212) of patients achieved 90‐day modified Rankin scale 0 to 2. The symptomatic hemorrhage rate was 1.9% (4/212) and mortality was 16% (34/212). In a multivariable ordinal regression, younger age, lower National Institute of Health stroke scale on admission, and absence of diabetes mellitus and parenchymal hematoma were significantly associated with a favorable shift in the overall distribution of 90‐day modified Rankin scale scores. Treatment outcomes were similar between patients who received stent‐retriever thrombectomy and contact aspiration thrombectomy as the first‐line technique.

Conclusions

Endovascular thrombectomy was effective and safe for treating patients with acute
BAO
. Age, the baseline National Institute of Health stroke scale, diabetes mellitus, and parenchymal hematoma were associated with better outcomes. This study showed no superiority of the stent‐retriever over the aspiration thrombectomy for treating acute
BAO
.
The Juggler of Notre Dame and the Medievalizing of Modernity
Authors: Ziolkowski Jan M.
Published: July 2018

This ambitious and vivid study in six volumes explores the journey of a single, electrifying story, from its first incarnation in a medieval French poem through its prolific rebirth in the nineteenth and twentieth centuries. The Juggler of Notre Dame tells how an entertainer abandons the world to join a monastery, but is suspected of blasphemy after dancing his devotion before a statue of the Madonna in the crypt; he is saved when the statue, delighted by his skill, miraculously comes to life. Jan Ziolkowski tracks the poem from its medieval roots to its rediscovery in late nineteenth-century Paris, before its translation into English in Britain and the United States. The visual influence of the tale on Gothic revivalism and vice versa in America is carefully documented with lavish and inventive illustrations, and Ziolkowski concludes with an examination of the explosion of interest in The Juggler of Notre Dame in the twentieth century and its place in mass culture today. Volume 3: The American Middle Ages hinges upon two figures influenced by the juggler: Henry Adams, scion of Presidents and distinguished cultural historian whose works contributed to the rise of medievalism in America during the Gilded Age, and Ralph Adams Cram, the architect whose vision of Gothic accounts directly or indirectly for the campuses of West Point, Princeton, Yale, Chicago, Notre Dame, and many other universities across America. The Juggler of Notre Dame and the Medievalizing of Modernity is a rich case study for the reception of the Middle Ages in modernity. Spanning centuries and continents, the medieval period is understood through the lens of its (post)modern reception in Europe and America. Profound connections between the verbal and the visual are illustrated by a rich trove of images, including book illustrations, stained glass, postage stamps, architecture, and Christmas cards. Presented with great clarity and simplicity, Ziolkowski's work is accessible to the general reader, while its many new discoveries will be valuable to academics in such fields and disciplines as medieval studies, medievalism, philology, literary history, art history, folklore, performance studies, and reception studies.
Homer: A relational mnemohistory
Authors: Erll Astrid
Published: July 2018

This article proposes to extend the prevalent short-term and presentist frameworks of research on transcultural memory and to consider its dynamics across long-term relational mnemohistories. After more than two and a half millennia, “Homer” and the Homeric epics still resonate in memory cultures across the world. But they are often erroneously cast as “European heritage” or “foundations of the West.” This is the result of what I call a tenacious “Homeric genea-logic.” Highlighting three moments in the relational mnemohistory of Homer, this article shows, first, that already during their emergence in the archaic age, the Homeric epics were relational objects; second, how during the Middle Ages Homer could arrive in Petrarch’s Italy only as a product of relational remembering between the Roman and the Byzantine empires; and third, how twentieth-century literature (Joyce, Walcott) developed conscious modes of mnemonic relationality connecting diverse cultural memories. Relationality thus emerges as a key term for a reflexive memory culture today, a tool to overcome exclusive memory logics (“Homer as the heritage of Europe”) while enabling the articulation of meaningful long-term transcultural memories (“Homer as relational heritage in Europe”).
Connective Afrasian Sea memories: Transregional imaginaries, memory politics, and complexities of national “belonging”
Authors: Karugia John Njenga
Published: July 2018

This article focuses on memories of South Asian Kenyans and their claims to full citizenship as Kenyans through acknowledgment of their role in Kenya’s past. By focusing on memory claims and memory practices of the South Asian diaspora, it unravels complexities and tensions of scale (local, national, transregional, transnational). It adds new insights into complexities of national “belonging” in an entangled world by demonstrating how people operate as citizens within states and how memory politics are played out at nation-state level and how, simultaneously, the lived experience, affiliations, and shared memories of particular groups transcend the national scale or operate at a scale below it. This article’s seven sections focus on connected histories (a brief history of the Indian Ocean), connective memory research (explicating multi-sited methodology and using brief examples of Cape Malays and Siddis), and connective memory practice addressing memory practices in the South Asian diaspora in Kenya that consciously engage with entangled histories.
Memory studies in a moment of danger: Fascism, postfascism, and the contemporary political imaginary
Authors: Levi Neil , Rothberg Michael
Published: July 2018

Inspired by Walter Benjamin’s concept of the “moment of danger,” this essay considers the contemporary return of the memory of fascism and Nazism among both far-right political movements and liberal and left critics of the right. We briefly sketch how memories and symbols derived from the fascist and National Socialist era, among other sources, help constitute new political subjects in our moment of danger, and we look extensively at responses to the election of Donald Trump and evaluate the way the invocation of the fascist era as memory and warning shapes versions of resistant remembrance. We argue that transnational memory studies needs to think more about the historical consciousness that buttresses contemporary far-right politics and about the potential memory politics that might oppose it.
Remembering Hope: Transnational activism beyond the traumatic
Authors: Rigney Ann
Published: July 2018

This article argues for the need for memory studies to go beyond its present focus on traumatic memories and to develop analytical tools for capturing the cultural transmission of positivity and the commitment to particular values. Building on an emerging interest in the relationship between memory and activism, it puts its case for a re-orientation of memory studies through a close analysis of the commemoration of the Paris Commune which shows how the festive mode of commemoration itself turned the memory of defeat into a carrier of hope.
Ability of a New Smartphone Pulse Pressure Variation and Cardiac Output Application to Predict Fluid Responsiveness in Patients Undergoing Cardiac Surgery
Authors: Joosten Alexandre , Boudart Céline , Vincent Jean-Louis , Vanden Eynden Frederic , Barvais Luc , Van Obbergh Luc , Rinehart Joseph , Desebbe Olivier
Published: July 2018

BACKGROUND:

Pulse pressure variation (PPV) can be used to predict fluid responsiveness in anesthetized patients receiving controlled mechanical ventilation but usually requires dedicated advanced monitoring. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a novel smartphone application that calculates PPV and cardiac output (CO) from a picture of the invasive arterial pressure waveform obtained from any monitor screen. The primary objective was to compare the ability of PPV obtained using the Capstesia (PPVCAP) and PPV obtained using a pulse contour analysis monitor (PPVPC) to predict fluid responsiveness. A secondary objective was to assess the agreement and the trending of CO values obtained with the Capstesia (COCAP) against those obtained with the transpulmonary bolus thermodilution method (COTD).

METHODS:

We studied 57 mechanically ventilated patients (tidal volume 8 mL/kg, positive end-expiratory pressure 5 mm Hg, respiratory rate adjusted to keep end tidal carbon dioxide [32–36] mm Hg) undergoing elective coronary artery bypass grafting. COTD, COCAP, PPVCAP, and PPVPC were measured before and after infusion of 5 mL/kg of a colloid solution. Fluid responsiveness was defined as an increase in COTD of >10% from baseline. The ability of PPVCAP and PPVPC to predict fluid responsiveness was analyzed using the area under the receiver-operating characteristic curve (AUROC), the agreement between COCAP and COTD using a Bland-Altman analysis and the trending ability of COCAP compared to COTD after volume expansion using a 4-quadrant plot analysis.

RESULTS:

Twenty-eight patients were studied before surgical incision and 29 after sternal closure. There was no significant difference in the ability of PPVCAP and PPVPC to predict fluid responsiveness (AUROC 0.74 [95% CI, 0.60–0.84] vs 0.68 [0.54–0.80]; P = .30). A PPVCAP >8.6% predicted fluid responsiveness with a sensitivity of 73% (95% CI, 0.54–0.92) and a specificity of 74% (95% CI, 0.55–0.90), whereas a PPVPC >9.5% predicted fluid responsiveness with a sensitivity of 62% (95% CI, 0.42–0.88) and a specificity of 74% (95% CI, 0.48–0.90). When measured before surgery, PPV predicted fluid responsiveness (AUROC PPVCAP = 0.818 [P = .0001]; PPVPC = 0.794 [P = .0007]) but not when measured after surgery (AUROC PPVCAP = 0.645 [P = .19]; PPVPC = 0.552 [P = .63]). A Bland-Altman analysis of COCAP and COTD showed a mean bias of 0.3 L/min (limits of agreement: −2.8 to 3.3 L/min) and a percentage error of 60%. The concordance rate, corresponding to the proportion of CO values that changed in the same direction with the 2 methods, was poor (71%, 95% CI, 66–77).

CONCLUSIONS:

In patients undergoing cardiac surgery, PPVCAP and PPVPC both weakly predict fluid responsiveness. However, COCAP is not a good substitute for COTD and cannot be used to assess fluid responsiveness.
Harry Potter und die Widersprüche der Kulturindustrie
Authors: Babenhauserheide Melanie
Published: July 2018

J.K. Rowlings erfolgreiche Romanreihe um den Charakter Harry Potter hat weltweit die Fans begeistert und ist in die Bildungserfahrungen einer ganzen Generation eingegangen. Inwiefern bestätigen und überschreiten die Romane dabei gesellschaftliche Herrschaftsverhältnisse? Während die Reihe bislang oft als entweder affirmativ oder emanzipatorisch verstanden wurde, betrachtet diese erste umfassende Reflexion aus der Perspektive der Kritischen Theorie Adornos die ideologischen Widersprüche anhand der Themen Ökonomie, Tod, Diskriminierung, Recht, schulische Autorität und Kulturindustrie, die sich um das Querschnittsthema ›Erwachsenwerden‹ gruppieren. Die Konflikte, die die enthaltenen Widersprüche auf Seiten der Fans provozieren, enthüllen eine Dialektik der Kulturindustrie in Bezug auf (Halb-)Bildung heute.
Creating Communities
Authors: Melcer-Padon Nourit
Published: July 2018

How does historical reality interrelate with fiction? And how much are readers themselves involved in the workings of fictional literature? With innovative interpretations of various well-known texts, Nourit Melcer-Padon introduces the use of literary masks and illustrates literature's engagement of its readers' ethical judgement. She promotes a new perception of literary theory and of connections between thinkers such as Iser, Castoriadis, Sartre, Jung and Neumann. The book offers a unique view on the role of the community in post-existentialist modern cultural reality by emphasizing the importance of ritual practices in literature as a cultural manifestation.
Konsum zeigen
Authors: Bieling Simon
Published: July 2018

Unternehmen und Werbeagenturen bestimmen seit gut zehn Jahren nicht mehr allein, wie Konsumprodukte öffentlich in Bildern dargestellt werden. Wozu man sie verwenden und was man sich von ihnen erwarten kann, darüber tauschen sich Konsumentinnen und Konsumenten heute auch eigenständig auf Bildplattformen wie Instagram, Tumblr und Flickr miteinander aus. Mithilfe einer eigens entwickelten Methode zeigt Simon Bieling erstmals umfassend, wie sich unser Verhältnis zu Marken und Produkten der Konsumwelt verändert hat - und wie die Bilderwelten der Social Media uns differenzierte Einsichten in die Alltagskultur der Gegenwart verschaffen können.
Zwischen »Ghetto« und »Normalität«
Authors: Tijé-Dra Andreas
Published: July 2018

Die »Krise der Vorstädte« - seit mehr als 30 Jahren verursacht die Stigmatisierung von bestimmten Stadtteilen in französischen Großstädten, den »banlieues«, städtebauliche und soziale Probleme. Neuere geographische Arbeiten fokussieren oft die Konstitution der stigmatisierten Stadtteile durch stadtpolitische oder mediale Akteure. Weniger Aufmerksamkeit erhielten bislang gegenhegemoniale Perspektiven, die diese wirkmächtigen Diskurse infrage stellen. Am Beispiel der französischen Rap-Musik untersucht Andreas Tijé-Dra solche Positionierungspraktiken, die alternative Raum- und Identitätskonzepte hervorbringen.
Die Bilder des Comics
Authors: Press Alexander
Published: July 2018

Welche Stellung haben die Bilder in Comics? Und was sind die Grundlagen ihrer Wahrnehmung durch die Betrachter_innen? Obwohl diese Fragen in allen einschlägigen Arbeiten zur Comicforschung mit scheinbarer Selbstverständlichkeit angesprochen und diskutiert werden, wird ihnen nur selten systematisch nachgegangen. Alexander Press präsentiert nun neue theoretische und methodische Konzepte zur Erforschung der piktoralen Komponente des Comics. In detaillierten Werkanalysen entwickelt er u.a. das Konzept des Integrationseffektes und erläutert narrative Funktionen des graphischen Stils.
Freiheit als Kritik
Authors: Schubert Karsten
Published: July 2018

Wie können Freiheit und Widerstand innerhalb von Foucaults Theorie der Macht und Subjektivierung konzipiert werden? Karsten Schubert liefert die erste systematische Rekonstruktion der sozialphilosophischen Debatte um Freiheit bei Foucault und eine neue Lösung für das Freiheitsproblem: Freiheit als die Fähigkeit zur reflexiven Kritik der eigenen Subjektivierung - kurz: Freiheit als Kritik - ist das Resultat von freiheitlicher Subjektivierung in politischen Institutionen. Der Band zeigt so die Konsequenzen von Foucaults Freiheitsdenken für die Demokratietheorie und die allgemeine sozialphilosophische Freiheitsdiskussion auf.
Idyllische Ländlichkeit
Authors: Baumann Christoph
Published: July 2018

In Zeiten sinkender Auflagen erfreuen sich Zeitschriften, die sich mit dem ländlichen Leben beschäftigen, großer Beliebtheit - allen voran die Zeitschrift »Landlust«. Ausgehend von neueren Überlegungen der Sozial- und Kulturgeographie geht Christoph Baumann dieser Lust am Ländlichen nach. Unter Zusammenführung einer historischen Auseinandersetzung, einer medienanalytischen Detailstudie sowie einer gesellschaftsdiagnostischen Interpretation der idyllischen Ländlichkeit zeigt seine Studie, inwiefern sich eine positive Bezugnahme auf das Ländliche historisch herausgebildet hat und welche Rolle sie in unserer urbanen Gegenwartsgesellschaft einnimmt.
Interkulturelles Lernen im Geographieunterricht
Authors: Reinhardt Felix
Published: July 2018

Wie kann Begegnung durch interkulturelles Lernen gefördert werden? Felix Reinhardt nutzt einen phänomenologischen Zugriff über den Bezug zu Bernhard Waldenfels, um ein Verständnis von Begegnung abzuleiten, das mit seinem Verunsicherungspotential zusammen gedacht wird. Für die Geographie wird eine Parallele zum Spüren von Atmosphären nach Jürgen Hasse gezogen. Danach lassen sich Atmosphären in kulturellen Heim- und Fremdwelten über Begegnungen auf verschiedene Arten entdecken. Am Beispiel konkreter Unterrichtsmaterialien zeigt Felix Reinhardt, wie das Einlassen - als zentrales didaktisches Ziel des begegnungsorientierten Konzepts - im Geographieunterricht eingeübt werden kann.
Methods of Monitoring Training Load and Their Association With Changes Across Fitness Measures in Hurling Players
Authors: Malone Shane , Hughes Brian , Collins Kieran , Akubat Ibrahim
Published: July 2018

Malone, S, Hughes, B, Collins, K, and Akubat, I. Methods of monitoring training load and their association with changes across fitness measures in hurling players. J Strength Cond Res 34(1): 225–234, 2020—The aim of the current investigation was to assess the dose-response relationship for various methods of monitoring training load (TL) and changes in aerobic and anaerobic fitness in hurling players. Training and match load measures were collected from 30 hurling players (speed at different blood lactate [vLT, vOBLA], maximal oxygen uptake [Vo
2max], speed at Vo
2max [vVo
2max], peak treadmill velocity [PTV] running economy [RE] Yo-Yo intermittent recovery test (Yo-YoIR1, Yo-YoIR2), speed at 5, 10 , 20 m, and repeated sprint ability [6 × 35 m]) before and after during a 12-week in-season period. Mean weekly training and match loads as determined by s-RPE, bTRIMP, luTRIMP, eTRIMP, iTRIMP, and gTRIMP were correlated with each other, percentage change in Vo
2max, vVo
2max, RE, PTV, the speed at blood lactate concentrations of 2 mmol·L−1 (vLT) and 4 mmol·L−1 (vOBLA), and YoYoIR1, Yo-YoIR2 performance. iTRIMP showed a trivial association with s-RPE and a small to moderate association with other heart rate–based methods. Small to large changes (effect size: 0.38–1.12) were observed in aerobic and anaerobic fitness measures were observed across the 12-week period. Trivial to very large associations (r = 0.11–0.78) were observed between TL variables and changes in fitness depending on the variable analyzed. iTRIMP was shown to have large to very large associations with changes in vOBLA {r = 0.78 (95% confidence interval [CI]: 0.71–0.88)}, Vo
2max (r = 0.77 [95% CI: 0.68–0.82]), RE (r = 0.77 [95% CI: 0.67–0.82]), Yo-YoIR1 (r = 0.69 [95% CI: 0.51–0.72]), and RSAb (r = 0.66 [95% CI: 0.60–0.72]) with moderate associations reported between iTRIMP and other variables. All other measures of TL showed trivial to moderate associations (r = 0.11–0.66). The current investigation shows that fully individualized training load (iTRIMP) measures may potentially offer a better understanding of dose-response relationships when compared with subjective and nonindividualized measures of TL to changes in aerobic and anaerobic fitness in team sports athletes; as such, it may be suggested that practitioners should use individualized measures of TL assessment within their day-to-day practices.
Baseline Assessments of Strength and Balance Performance and Bilateral Asymmetries in Collegiate Athletes
Authors: Dai Boyi , Layer Jacob , Vertz Cole , Hinshaw Taylour , Cook Ross , Li Yongming , Sha Zhanxin
Published: July 2018

Dai, B, Layer, J, Vertz, C, Hinshaw, T, Cook, R, Li, Y, and Sha, Z. Baseline assessments of strength and balance performance and bilateral asymmetries in collegiate athletes. J Strength Cond Res 33(11): 3015–3029, 2019—Injuries to upper and lower extremities comprise more than 70% of the total injuries in collegiate athletes. Establishing normative data of upper and lower extremity strength and balance may help guide postinjury rehabilitation and return-to-play decisions. The purposes of the current study were to develop the normative data of performance and bilateral asymmetries during 4 upper and lower extremity strength and balance tests in collegiate athletes and to quantify the correlations between strength and balance performance and bilateral asymmetries. A total of 304 male and 195 female Division I athletes from 14 sports performed a maximum push-up test to assess upper extremity strength, a countermovement jump test to assess lower extremity strength, an upper extremity reaching test to assess upper extremity balance, and a lower extremity reaching test to assess lower extremity balance. Bilateral ground reaction forces were collected for the push-up and jump tests. Reaching distances were measured for the 2 balance tests. Bilateral asymmetries were generally less than 10%. Significant sports effects were observed for all 5 performance variables (p < 0.001) but not for asymmetry variables (p ≥ 0.36). Weak correlations were found between strength and balance performance and asymmetries (r < 0.3). Normative data are sex and sports specific in collegiate athletes. Increased asymmetries could be more individualized rather than sex and sports specific. When return-to-play decisions are made, athletes following injuries need to demonstrate less than 10% of asymmetries to be consistent with the normative data. Strength and balance should be evaluated and improved with specific focuses.
Strength Training in Long-Distance Triathletes: Barriers and Characteristics
Authors: Luckin Kate M. , Badenhorst Claire E. , Cripps Ashley J. , Landers Grant J. , Merrells Robert J. , Bulsara Max K. , Hoyne Gerard F.
Published: July 2018

Luckin, KM, Badenhorst, CE, Cripps, AJ, Landers, GJ, Merrells, RJ, Bulsara, MK, and Hoyne, GF. Strength training in long-distance triathletes: Barriers and characteristics. J Strength Cond Res 35(2): 495–502, 2021—The purpose of this investigation was to identify perceived and physical barriers toward the completion of concurrent strength training and endurance training in long-distance triathletes. Three hundred ninety long-distance triathletes (224 women, 166 men; age [y]: 39 ± 10) completed a 68-question self-administered, semiquantitative survey that assessed endurance and strength training characteristics, experience in triathlon, and perceived barriers regarding the completion of strength training. Mean training hours per week was 14.92 ± 5.25, with 54.6% reporting participation in strength training. Heavy strength training was the most commonly reported (39.4%), with significantly more men completing this form of strength training (p < 0.001). Results from subjects who did not complete strength training indicated that perceived time constraints (53.1%) in addition to lack of knowledge on exercise progression and form (52.5%) are prominent perceived barriers to strength training completion. Identification of the barriers perceived by long-distance triathletes that prevent them from completing concurrent strength training and endurance training may be useful for coaches, athletes, and sports scientists who seek to incorporate strength training for injury prevention and performance improvement.