bluuebunny/crossref_metadata_2025 huggingface dataset:
A135 HEPATOLITHIASIS AND CHOLANGIOPATHY IN PEDIATRIC CYSTIC FIBROSIS: A CASE REPORT
Authors: Kortbeek S , Bhandal S , Machida H , Martin S R , Galante G J
Published: February 2020

Background

Liver disease has emerged as an important cause of cystic fibrosis (CF)-associated morbidity due to recent advancements in management and a resultant increase in life expectancy. Although focal biliary cirrhosis remains the pathognomonic finding in CF, other hepatic manifestations exist but are not as well described, particularly in the pediatric population.

Aims

Present two rare manifestations of pediatric CF-associated liver disease.

Methods

In this report, we present a pediatric CF patient with chronic abdominal pain who was found to have hepatolithiasis, cholangitis and secondary sclerosing cholangitis.

Results

A 12-year-old boy with CF was seen for abdominal pain with functional impairment. He had prior evidence of calculi in the common bile duct (CBD) and right intrahepatic (IH) duct, and had undergone endoscopic retrograde cholangiopancreatography (ERCP) twice with sphincterotomy once. Magnetic resonance cholangiopancreatography (MRCP) at presentation showed dilated CBD and bilateral IH ducts with calculi, evidence of acute cholecystitis and early cholangitis. He subsequently underwent a third ERCP with stone retrieval, stent placement and a laparoscopic cholecystectomy. Ursodiol dose was optimized and antibiotics were initiated.

Follow-up MRCP showed improvement in CBD and IH duct dilation; the stent was removed. One month later, a fifth ERCP was performed for worsening symptoms associated with a distal filling defect in the left IH duct. Sludge was removed from the CBD and another stent was placed. A sixth ERCP with stent removal showed no stones.

Interval MRCP showed resolution of IH calculi, a CBD filling defect suggestive of sludge, and thickening and enhancement of IH bile ducts with focal areas of alternating narrowing and dilation. He was maintained on antibiotics, and his symptoms persisted over the following months despite resolution of sludge, peri-portal edema and duct-wall enhancement. There was a background of increased IH ductal dilation with “beaded appearance”. Interval imaging has demonstrated persistence of these findings with recurrence of hepatolithiasis in both IH ducts, despite improved symptoms.

Conclusions

This case describes two rare manifestations of pediatric CF-associated liver disease: hepatolithiasis and secondary sclerosing cholangitis. While CFTR dysfunction alone predisposes to gallstone formation, the patient’s clinical course supports a theory for the development of hepatolithiasis resembling that of recurrent pyogenic cholangitis, whereby bacteriobilia from chronic or recurrent infection may promote lithogenesis in the presence of inflammatory bile duct damage. In this patient, secondary sclerosing cholangitis may have resulted from cycles of cholangitis and hepatolithiasis; alternatively, it may represent under-recognized cholangiopathy in the pediatric CF population.

Funding Agencies

None
A167 MANAGEMENT OF LARGE COLORECTAL POLYPS IN NOVA SCOTIA
Authors: Petropolis H , Farina D , Kohansal A R
Published: February 2020

Background

Colorectal cancer (CRC) has the third highest cancer incidence for males and females in Canada1. CRC rates are decreasing, likely due to implementation of CRC screening programs and removal of precancerous polyps. In Nova Scotia, management of large (> 2 cm) polyps is varied. Some patients are referred for endoscopic mucosal resection (EMR), while others referred for surgical resection. EMR is effective2 and associated with less morbidity and mortality compared to surgery3. Furthermore, EMR is less expensive than surgery and requires less resources when performed as a day procedure. Management of these polyps are unknown in Canada and are potentially changing with gathering evidence on the safety and effectiveness of EMR. North American and European guidelines recommend EMR for non-invasive colonic polyps as first line management.

Aims

This projects aim is to determine how large polyps are being treated in a group of FIT positive patients from Nova Scotia.

Methods

This is a retrospective observational study. The Nova Scotia Colon Cancer screening database was searched for FIT positive patients in 2017. Patients found to have > 2 cm colonic polyps were included. Malignant polyps were excluded. Electronic charts were reviewed to determine method of polyp removal. Endoscopic and histologic polyp information was obtained.

Results

196 patients had at least one polyp > 2 cm. Within the central health zone where pathology results were available 78 patients had > 2cm polyps. 13 were excluded for malignancy, one lost to follow up and one patient was miscoded. In total 63 patients were included, 8 of which underwent a surgical resection.

Of these surgically resected polyps the average size was 4 cm and 3 cm for the EMR group. The average time to removal was 3 months in the surgical group and one month in the EMR group. The average age was 68 years in the surgical group and 67 years in the EMR group. The endoscopists referring for surgery were 75% surgeon and 25% GI and the endoscopists performing EMR were 45% surgeon and 55% GI. 1 of 8 (12.5%) patients experienced complications (anastomotic leak) in the surgical group and 2 of 56 (3.6%) patients experienced post polypectomy bleeding in the EMR group.

Conclusions

In this study 12.5% of large nonmalignant polyps found in a group of FIT positive patients from Nova Scotia were removed surgically via resection. Polyps were on average larger by 1 cm in the surgical group and patients experienced a higher rate of complication. This study highlights the need for a structured system of referral and assessment for endoscopic removal of advanced polyps by expert endoscopists, to reduce the number of surgical resections.

Additional investigation of additional years, and health zones outside the tertiary central health zone is ongoing. This will help provide more validity to our current data, and allow comparison of academic vs community management of large polyps.

Funding Agencies

None
A216 EXAMINING THE EFFECTS OF GLYPHOSATE EXPOSURE ON THE GUT BACTERIOME AND INFLAMMATION IN A MURINE MODEL OF COLITIS
Authors: Barnett J A , Haskey N , Quin C S , Bonnie R , La Berge A , Alejandra Verdugo Meza A , Hart M , Gibson D L
Published: February 2020

Background

Canada has the highest incidence of inflammatory bowel disease in the world, which is expected to rise unabated for the next 30 years. Coincidently, Canada is one of the most prolific users of the herbicide glyphosate (tradename Roundup®), with over 25 million kilograms purchased annually. Previous studies examining the effects of glyphosate on the gut bacteriome have used high levels of glyphosate (ranging from 2.5mg – 25mg/kg bw/day) and have yielded conflicting results. Our goal is to examine the effects of dietary levels of glyphosate on the gut microbiome and inflammation in an animal model of colitis. Two environmentally relevant doses were explored: (1) the acceptable daily intake currently set by the Environmental Protection Agency (EPA) (1.75mg/kg bw/day) and (2) North American dose, calculated by a registered dietician using literature values of glyphosate found within food products (0.1mg/kg bw/day.)

Aims

1) To determine if glyphosate exposure influences intestinal permeability 2) To determine if glyphosate exposure influences intestinal inflammation 3) To determine if glyphosate exposure influences colitis onset and severity. We hypothesized that exposure to glyphosate leads to bacterial dysbiosis, increased intestinal permeability and increased severity of colitis in Mucin 2 deficient mice (Muc2-/-mice).

Methods

Upon weaning, Muc2-/- mice were exposed to glyphosate through their drinking water. Animals were monitored weekly for clinical signs of colitis, including rectal prolapse. Following 12-week glyphosate exposure, intestinal permeability was measured using the FITC-dextran permeability assay. Intestinal inflammation was measured using qPCR and markers relevant to our animal model including REGIIIγ, RELM-β and CLEC-2.

Results

Exposure to glyphosate at physiologically relevant levels does not increase intestinal permeability in Muc2-/-mice, with all groups showing equal levels of FITC-dextran present within their serum. Animals exposed to the EPA dose of glyphosate exhibited earlier onset of colitis symptoms with animals receiving higher clinical scores and displaying an increased rate of rectal prolapse. Animals exposed to the EPA dose also showed a significant increase in CLEC-2 expression. CLEC-2 is a C-type lectin-like receptor expressed by immune cells and platelets and has been implicated in tumor metastasis. Additionally, overexpression of CLEC-2 has been shown to promote pathogen adherence to mammalian cells.

Conclusions

Exposure to glyphosate at levels deemed safe by the EPA increases colitis onset and severity in Muc2-/- deficient animals. Additionally, EPA level glyphosate exposure upregulates CLEC-2 expression which may have implications for tumor development and increased enteropathogenic infections.

Funding Agencies

CCCCrowdfunding, NSERC
A237 SHARED DECISION MAKING: DESIGN OF A PREGNANCY IN IBD DECISION AID (PIDA)
Authors: Williams A , Leung Y , Huang V
Published: February 2020

Background

Given a significant proportion of women with inflammatory bowel disease (IBD) are of child-bearing age, the development of a pregnancy IBD decision aid would benefit patients and clinicians. Lack of IBD-specific reproductive knowledge has been associated with increased “voluntary childlessness” and may contribute to inappropriate medication changes during or after pregnancy. Decision aids support decision making in pregnancy in general, as well as in multiple other chronic diseases. However existing literature has not identified such a resource for women with IBD.

Aims

To develop a decision aid to improve decision making regarding preconception and pregnancy in IBD among women with IBD.

Methods

We followed the International Patient Decision Aids Standards (IPDAS). A steering committee of Canadian and Australian health care professionals with an interest in IBD management in pregnancy, in addition to patient representatives, was established. Themes chosen for discussion included inheritance, fertility, nutrition, medications, mode of delivery, breastfeeding, infant health. Initial patient and clinician focus groups were conducted and responses recorded with written/audio mediums. We developed an electronic PIDA draft that incorporates individualised information (type of IBD, pre-conception or pregnant, surgical history, medications) in personalized decision making. Further patient focus groups and interviews were conducted to obtain user opinion of the PIDA draft.

Results

In July 2017, patient and clinician focus groups were conducted at a Canadian site. Three patients (pre-conception) attended the focus group. Patient concerns - impact of disease and surgery on fertility and preterm delivery; impact of drug therapies on the fetus/ infant; impact of active disease on maternal and fetal/infant health. The clinician focus group included 3 IBD specialists, 2 IBD fellows, 2 IBD nurses, an obstetrician and a neonatal intensivist. Clinician concerns - absence of pre-conception counselling and lack of patient understanding about the impact of disease activity and IBD medication use in pregnancy. Additional patient feedback obtained through interviews (n=15) at two Canadian sites since March 2019 regarding the current electronic PIDA was positive, with comments about content, personalization, readability and unbiased presentation. Suggestions were made for inclusion of additional content such as impact of IBD on sexual function, laboratory changes during pregnancy, and timing of medications post-partum.

Conclusions

The pre and post PIDA design patient and clinician focus groups and interviews affirmed the role for PIDA. Main decisions considered necessary to address included ideal timing of conception pending disease activity, management of medications, and delivery methods. Ongoing user feedback will be obtained at Australian and Canadian sites during planned alpha testing.

Funding Agencies

WCHRI, Sinai Health System, UBC
A251 VERY EARLY ONSET INFLAMMATORY BOWEL DISEASE IN CHILDREN: A SINGLE CENTER EXPERIENCE OVER 15 YEARS
Authors: Alahmari A A , Al-Bahlani A M , Frenette B , Xuan-Lan Nguyen A , Ahmed N , Sant’Anna A
Published: February 2020

Background

Very-early-onset inflammatory bowel disease (VEOIBD) refers to an IBD diagnosis established before the 6th year of life, including a subset of patients with disease onset before the age of 2 years, known as infantile-onset IBD (IO-IBD) (1). VEO-IBD accounts for 15% of pediatric IBD and infantile IBD in approximately 1% (2,3). VEOIBD is considered to be a unique entity, and compared to adults with IBD, VEO-IBD children are more likely to present with extensive and treatment-resistant disease (4).

Aims

To analyze the clinical characteristics and management of patients diagnosed with very early onset inflammatory bowel disease (VEO-IBD).

Methods

A retrospective analysis of children diagnosed with VEO-IBD (age <6 years) at the Montreal Children’s Hospital from 2003–2018 was performed. Clinical data for VEO-IBD patients was collected to identify the clinical, biochemical, endoscopic and histological features of these patients and their clinical course until 2018.

Results

A total of 28 VEO-IBD patients (71% male) were included in this study. The median age of disease onset was 52 months. A diagnosis of Crohn’s disease (CD) or CD-like intestinal manifestations accounted for 89% of the VEO-IBD cases. Most patients had Crohn’s colitis (36%) of whom 50% had evidence of granulomatous Crohn’s disease; 11 patients[NAD1] [AQAB2] (39%) had upper gastrointestinal involvement. Over their progress of the disease, 4 patients (14%) required surgical intervention, while 11 patients (39%) required biologic therapy for maintenance therapy. Genetic[NAD3] [AQAB4] results were available for 5 patients out of 28 (18%) and 3 of them were identified to have monogenic IBD.

Conclusions

In our center, the majority of patients with VEO-IBD had typical Crohn’s disease presentation. Most of the VEO-IBD patients responded well to the standard IBD treatment. Genetic studies were not done regularly for all of our patients, however, among those who had this testing performed 3/5 had an identifiable cause, suggesting that these patients should be investigated for an underlying genetic abnormality.

Funding Agencies

None
Observations on the Ultrastructure of Antennal Sensilla of Adult Glenea cantor (Cerambycidae: Lamiinae)
Authors: Dong Zishu , Yang Yubin , Dou Fugen , Zhang Yujing , Huang Huixin , Zheng Xialin , Wang Xiaoyun , Lu Wen
Published: February 2020

The external morphology and distribution of antennal sensilla of Glenea cantor Fabricius were studied with scanning electron microscopy. The antennae of G. cantor were observed to be filiform, consisting of scape, pedicel, and flagellum (nine flagellomeres). Four distinct types of sensory receptors were observed, including sensilla chaetica, sensilla trichodea, sensilla basiconica, and Böhm bristles. Three morphological subtypes of sensilla chaetica were found on the antennae, and sensilla trichodea were also categorized into three morphological subtypes. Sensilla basiconica was grouped into two morphological subtypes that were found on subsegments F2-F9 of the flagellum, and Böhm bristles were only found at the intersegmental joints between the scape and the head and between the scape and the pedicel. The antennae of male and female adults were similar in shape, length, and diameter. However, the length, diameter, distribution, and number of each of the four distinct types of sensilla on the males were significantly different from those on females. The types, lengths, diameters, numbers, and distributions of these sensilla were described, and their possible functions were also discussed. The results indicated that the base and end of an antennal segment have a similar sensillum density, but the middle section sensor density is significantly greater, especially for olfactory and gustatory sensilla, possibly because the joints are more involved in mechanical sensing. The density of sensors is closely related to its sensing function; so, future studies on the biology of olfaction and sexual communication in G. cantor will be facilitated by these observations.
Genetic Diversity of Culicoides stellifer (Diptera: Ceratopogonidae) in the Southeastern United States Compared With Sequences From Ontario, Canada
Authors: Shults Phillip , Ho Alphina , Martin Estelle M , McGregor Bethany L , Vargo Edward L
Published: February 2020

Much of the bluetongue (BT) and epizootic hemorrhagic disease (EHD) research in North America focuses on white-tail deer and Culicoides sonorensis (Wirth & Jones) (Diptera: Ceratopogonidae), though several other biting midge species have been suggested as vectors. Culicoides stellifer (Coquillett) has been associated with hosts susceptible to hemorrhagic disease (HD), and more recently, specimens from Florida have tested positive for EHD and BT viral RNA. If C. stellifer is acting as a vector, this could have an impact on the distribution of HD in North America. To determine if gene flow is occurring across the range of C. stellifer within the southeast United States, a mitochondrial haplotype analysis was performed using the COI gene. Our haplotype network showed no population structure in C. stellifer from Florida, Texas, and South Carolina, as the overall genetic divergence between these sites was equal to the genetic divergence within each. We also compared these haplotypes to published sequences of C. stellifer collected in Ontario, Canada. Surprisingly, the genetic diversity of the flies from Ontario was two times greater than what was observed between the southeast U.S. collection sites. This considerable divergence could be evidence of a cryptic species. A better understanding of the connectivity between C. stellifer populations across all of North America will give insight into the distribution of HD. Our results show that gene flow is occurring between sites in the southeastern United States and potentially throughout the eastern distribution of the species.
Evaluation of Confounding and Selection Bias in Epidemiological Studies of Populations Exposed to Low-Dose, High-Energy Photon Radiation
Authors: Schubauer-Berigan Mary K , Berrington de Gonzalez Amy , Cardis Elisabeth , Laurier Dominique , Lubin Jay H , Hauptmann Michael , Richardson David B
Published: February 2020

Background

Low-dose, penetrating photon radiation exposure is ubiquitous, yet our understanding of cancer risk at low doses and dose rates derives mainly from high-dose studies. Although a large number of low-dose cancer studies have been recently published, concern exists about the potential for confounding to distort findings. The aim of this study was to describe and assess the likely impact of confounding and selection bias within the context of a systematic review.

Methods

We summarized confounding control methods for 26 studies published from 2006 to 2017 by exposure setting (environmental, medical, or occupational) and identified confounders of potential concern. We used information from these and related studies to assess evidence for confounding and selection bias. For factors in which direct or indirect evidence of confounding was lacking for certain studies, we used a theoretical adjustment to determine whether uncontrolled confounding was likely to have affected the results.

Results

For medical studies of childhood cancers, confounding by indication (CBI) was the main concern. Lifestyle-related factors were of primary concern for environmental and medical studies of adult cancers and for occupational studies. For occupational studies, other workplace exposures and healthy worker survivor bias were additionally of interest. For most of these factors, however, review of the direct and indirect evidence suggested that confounding was minimal. One study showed evidence of selection bias, and three occupational studies did not adjust for lifestyle or healthy worker survivor bias correlates. Theoretical adjustment for three factors (smoking and asbestos in occupational studies and CBI in childhood cancer studies) demonstrated that these were unlikely to explain positive study findings due to the rarity of exposure (eg, CBI) or the relatively weak association with the outcome (eg, smoking or asbestos and all cancers).

Conclusion

Confounding and selection bias are unlikely to explain the findings from most low-dose radiation epidemiology studies.
An avulsion fracture of the anterior cruciate ligament attachment to the lateral femoral condyle in an elderly patient: a rare finding
Authors: Annemarie Brandsma A S E , Louren Goedhart L M , Jos Van Raay J J A M
Published: February 2020

An anterior cruciate ligament (ACL) rupture is a common injury. The ACL usually tears in its mid-substance, an avulsion fracture of the ACL mostly occurs at the tibial attachment. In few cases, an avulsion fracture occurs proximally from the ACL attachment to the lateral femoral condyle. This is a rare finding, especially in elderly patients. We report a case of an avulsion fracture of the ACL attachment to the lateral femoral condyle after a traumatic injury in a 60-year-old female. Injury was not recognized during initial assessment, but was later detected during knee arthroscopy because of persisting mechanical complaints with catching of the knee. This emphasizes the importance of a thorough physical examination and magnetic resonance imaging. As rare as this condition is, it is important for the orthopaedic surgeon in treating these patients to include femoral end avulsion injuries of the ACL in the differential diagnosis.
Resting-state fMRI detects alterations in whole brain connectivity related to tumor biology in glioma patients
Authors: Stoecklein Veit M , Stoecklein Sophia , Galiè Franziska , Ren Jianxun , Schmutzer Michael , Unterrainer Marcus , Albert Nathalie L , Kreth Friedrich-W , Thon Niklas , Liebig Thomas , Ertl-Wagner Birgit , Tonn Joerg-C , Liu Hesheng
Published: February 2020

Background

Systemic infiltration of the brain by tumor cells is a hallmark of glioma pathogenesis which may cause disturbances in functional connectivity. We hypothesized that aggressive high-grade tumors cause more damage to functional connectivity than low-grade tumors.

Methods

We designed an imaging tool based on resting-state functional (f)MRI to individually quantify abnormality of functional connectivity and tested it in a prospective cohort of patients with newly diagnosed glioma.

Results

Thirty-four patients were analyzed (World Health Organization [WHO] grade II, n = 13; grade III, n = 6; grade IV, n = 15; mean age, 48.7 y). Connectivity abnormality could be observed not only in the lesioned brain area but also in the contralateral hemisphere with a close correlation between connectivity abnormality and aggressiveness of the tumor as indicated by WHO grade. Isocitrate dehydrogenase 1 (IDH1) mutation status was also associated with abnormal connectivity, with more alterations in IDH1 wildtype tumors independent of tumor size. Finally, deficits in neuropsychological performance were correlated with connectivity abnormality.

Conclusion

Here, we suggested an individually applicable resting-state fMRI marker in glioma patients. Analysis of the functional connectome using this marker revealed that abnormalities of functional connectivity could be detected not only adjacent to the visible lesion but also in distant brain tissue, even in the contralesional hemisphere. These changes were associated with tumor biology and cognitive function. The ability of our novel method to capture tumor effects in nonlesional brain suggests a potential clinical value for both individualizing and monitoring glioma therapy.
Strategies for engineering advanced nanomedicines for gas therapy of cancer
Authors: Wang Yingshuai , Yang Tian , He Qianjun
Published: February 2020

As an emerging and promising treatment method, gas therapy has attracted more and more attention for treatment of inflammation-related diseases, especially cancer. However, therapeutic/therapy-assisted gases (NO, CO, H2S, H2, O2, SO2 and CO2) and most of their prodrugs lack the abilities of active intratumoral accumulation and controlled gas release, resulting in limited cancer therapy efficacy and potential side effects. Therefore, development of nanomedicines to realize tumor-targeted and controlled release of therapeutic/therapy-assisted gases is greatly desired, and also the combination of other therapeutic modes with gas therapy by multifunctional nanocarrier platforms can augment cancer therapy efficacy and also reduce their side effects. The design of nanomedicines with these functions is vitally important, but challenging. In this review, we summarize a series of engineering strategies for construction of advanced gas-releasing nanomedicines from four aspects: (1) stimuli-responsive strategies for controlled gas release; (2) catalytic strategies for controlled gas release; (3) tumor-targeted gas delivery strategies; (4) multi-model combination strategies based on gas therapy. Moreover, we highlight current issues and gaps in knowledge, and envisage current trends and future prospects of advanced nanomedicines for gas therapy of cancer. This review aims to inspire and guide the engineering of advanced gas-releasing nanomedicines.
Chicago School
Authors: Merwood-Salisbury Joanna
Published: February 2020

While contemporary scholars question the existence of a cohesive “Chicago School” of architecture, there is no doubt that by the mid-1890s Chicago came to be recognized nationally and internationally for the technological and aesthetic innovation evident in a number of commercial buildings erected in the downtown business area known as the Loop. These buildings serviced the rapid growth of a city founded earlier in the century as a major trading hub linking the East Coast and the American “West.” Principally office buildings, some were erected for particular companies while others were built as speculative ventures. These innovations were known first as the “commercial style,” then simply as “tall office buildings”; the term “skycraper” came into popular use around 1895. In order to find the correct expression for this unprecedented building type, local architects adapted historical styles including the neo-Gothic, the Romanesque, the Venetian, and the neoclassical. In their published writings, they positioned their work as the development of an indigenous American style particular to the region. By the 1920s, critics described this style as the product of an identifiable “Chicago School.” The idea of such a school played, and continues to play, a significant role in histories of modern architecture. For much of the 20th century, the term referred to a select group of commercial buildings erected between roughly 1883 and 1910. During that period, the Chicago School was positioned as precursor to the modern or International style, prefiguring the functionalism and “new objectivity” of the early-20th-century European avant-garde. Since the 1980s, scholars have dismantled the narrow and monolithic view of the subject, placing its key monuments back within the specific social and economic concerns of the late 19th century, introducing a wider range of projects and typologies for consideration, and including projects constructed up until about 1920. There is less emphasis on aesthetic commonality, and more on the diversity of built responses to the forces of industrialization, urbanization, and capitalism that shaped the American city. The texts listed here survey the Chicago School as it was defined during the 20th century as well as more recent scholarship that questions the canonical view.
Bauhaus
Authors: Vallye Anna
Published: February 2020

The Bauhaus is a paradigmatic institution of 20th-century art, in some contexts synonymous with the aesthetic and discursive institution of modernism itself. Founded in 1919 in the city of Weimar, Germany, the Bauhaus school of design (Staatliches Bauhaus) was formed through the merger of the Weimar Grand Ducal Saxon schools of fine and applied arts by its first director, the architect Walter Gropius. Having attracted controversy and persecution in the tense political environment of the Weimar Republic, the Bauhaus was forced to relocate twice (to Dessau in 1925 and to Berlin in 1932) before it was finally shut down by the Nazis in 1933. The move to Dessau, however, gave Gropius an opportunity to design and build a new headquarters for the school, which became one of the most iconic contributions to modern architecture. The Bauhaus also lived on in a constellation of attempts to revive its pedagogical and design principles in a range of geographical contexts through the century. More than that, the “Bauhaus” has entered the lexicon of modern art as a formal and conceptual entity, a “style” and an “idea,” with a profound impact on the visual culture of our time. The Bauhaus school was a wellspring of boundary-breaking experiments across the arts, including architecture, industrial and typographic design, theater, photography, textiles, painting, and sculpture. Through the full array of its initiatives, the Bauhaus emerged as an extended interrogation of the changing status and social role of art in the age of industrial production. At its core, however, the Bauhaus was a collective invention of many gifted instructors and students, who shaped the institution as a laboratory of cooperative living, working, and learning. Studies of individual artists and designers, many with distinguished careers beyond the school (Josef and Anni Albers, László and Lucia Moholy-Nagy, Johannes Itten, Marcel Breuer, Oskar Schlemmer, Marianne Brandt, Gunta Stölzl, Hannes Meyer, Ludwig Mies van der Rohe, Paul Klee, Wassily Kandinsky, Herbert Bayer, and many others) have done much to complicate Bauhaus historiography, demonstrating that its pedagogical philosophies and design approaches shifted with patterns of individual influence and undermining the notion of a cohesive and singular Bauhaus “idea.” The scope of scholarly interest in the institution is matched by the range of artistic disciplines and approaches it encompassed. This means that the extant Bauhaus literature in a plurality of languages and formats could fill a small library building. The 2019 centennial of the school’s founding has provided a fresh infusion of up-to-date scholarship.
McKim, Mead & White
Authors: Wilson Richard Guy
Published: February 2020

The New York partnership of Charles Follen McKim (b. 1847–d. 1909), William R. Mead (b. 1846–d. 1928), and Stanford White (b. 1853–d. 1906) became one of the most important architectural firms in the United States from the late 1870s to the 1920s, producing more than one thousand buildings. McKim and White were the principal designers and Mead ran the office crew, which at times numbered more than 200 employees. They helped to introduce into the United States an interest in early American architecture and were instrumental in creating what came to be known as the Colonial Revival style with houses in resorts such as Newport, Rhode Island and the New Jersey seashore as well as in New York and Boston. Their early work was picturesque, frequently covered with wooden shingles, but in the mid-1880s they moved toward a more formal approach as seen in the Georgian for houses. Classicism based upon European precedents became dominant by the mid-1880s with works such as the Villard houses in New York and the Boston Public Library, which became one of the most celebrated buildings in the United States. Very involved in the World’s Columbian Exposition in Chicago in 1893 they helped in establishing classicism derived from the teachings of the École des Beaux-Arts in Paris, which McKim attended in the later 1860s. Their work grew in scale with the design of the new campus of Columbia University and New York University in the Bronx, along with other major projects such as Pennsylvania Station. McKim directed the renovations of the White House and also served as a member of the McMillan Commission for the renewal of Washington, DC, which served a major influence on the Civic Art, or City Beautiful, Movement. All three of the partners were close friends with leading artists and sculptors and they designed the bases for major monuments. Following the deaths of White and McKim and Mead’s retirement in 1916, the firm continued for many years under the leadership of several men who had worked closely the partners, such as William Mitchell Kendall, Burt Leslie Fenner, and William S. Richardson. The last building designed under the firm’s name was the American History Museum (1955–1964) of the Smithsonian Institution in Washington, DC.
Theoretical Terms in Science
Authors: Andreas Holger
Published: February 2020

What is a theoretical term? This question can be answered in at least two different ways. First, a theoretical term is simply a non-observational term. Second, a theoretical term is one whose meaning depends on the axioms of a scientific theory. According to the first explanation, a theoretical term cannot be applied using just unaided perception, without drawing inferences. This explanation defines the notion of theoreticity merely as the absence of observability. The second explanation, by contrast, has the virtue of giving a positive characterization of the notion of theoreticity. Both explanations stand in the need of further elaboration. If we characterize theoretical terms by non-observability, we need to explain what an observational term is. There is no consensus in the literature as to whether and, if so, to what extent it is feasible to draw the theory-observation distinction. On the one hand, critics of the theory-observation distinction have often attacked only weak proposals of how to draw the distinction in question. On the other hand, the extreme skepticism by Thomas S. Kuhn, Paul K. Feyerabend, and Norwood R. Hanson concerning the distinction is increasingly losing consensus among contemporary philosophers of science. This is evidenced, for example, by attempts at exploiting the formal semantics of theoretical terms in one version of structural realism. If we explain the notion of a theoretical term by way of semantic dependency upon a scientific theory, we need to give an account of this semantic relation. How does a theory determine the meaning of a theoretical term? What, if any, are the differences between theoretical terms and defined terms? How can we distinguish, in a sensible way, between the synthetic assertions of a scientific theory about the world and meaning postulates determining the meaning of theoretical terms? Various formal semantics of theoretical terms have been devised in order to answer these questions. Notably, the idea that the meaning of a theoretical term is determined by a scientific theory, or a set of such theories, has already been expressed by Pierre Duhem and Henrie Poincaré. The theory-observation distinction can be applied to syntactic and semantic entities. Thus, we can speak of theoretical terms and theoretical concepts. Moreover, we can speak of theoretical entities, in the sense of specific objects that are the referents of theoretical concepts. Philosophical research on theoreticity concerns syntactic aspects inasmuch as semantic aspects of theoreticity.
Aemilia Lanyer
Authors: Greenstadt A. Eliza
Published: February 2020

Aemilia Lanyer (b. 1569–d. 1645) was one of the first women in England to publish her original literary compositions. Her book, Salve Deus Rex Judaeorum, printed in 1611, was the first volume of English poetry that appeared with the female author’s full name on its title page. The book set other precedents as well: its final poem, “The Description of Cooke-ham,” is the earliest known English “country house poem.” The volume contains nine dedications in verse and prose, all addressed to prominent women, making it the first English publication both written by and exclusively dedicated to members of the female sex. One of these, “The Authors Dreame to the Ladie Marie, the Countesse Dowager of Pembrooke,” addressed to the poet Mary Sidney, is the earliest extant poem in English written by a female author in praise of another woman’s literary achievements. The topic of the volume’s title poem, a retelling of Christ’s Passion, is less unusual; however, Lanyer takes a distinctively gendered approach to the story. In her version, the men surrounding Jesus repeatedly prove themselves obtuse, weak, unreliable, or treacherous, while the women, in contrast, are perceptive, caring, and loyal. At the climactic moment when Pontius Pilate condemns Jesus to death, Lanyer inserts a defense of Eve, claiming that the male sex’s culpability for Christ’s crucifixion cancels out any guilt women once bore for original sin. On this basis the narrator calls for the end of female subordination and a new era of gender equality. In addition to its significance for the histories of authorship and feminism, Lanyer’s work has received critical attention for its engagement with religious authority, including conventions of devotional poetry and scriptural interpretation. Scholars have further examined how Salve’s author navigates differences of gender, religion, race, nationality, class, and desire to achieve a public voice. This scholarly interest has been recent, however: only one edition of Lanyer’s book was printed in her lifetime, and there is no evidence that it had a wide influence. Since then, her work was forgotten until the 20th century, when she became one of many neglected female writers to be reclaimed for literary history. Thus, with the exception of one dissertation from the 1930s, the research on Lanyer begins in the 1970s.
Textiles: 1400 to 1700
Authors: Wilson Katherine Anne
Published: February 2020

The global production, use, and circulation of textiles were of great economic and cultural importance throughout the period 1400–1700, a span of time generally characterized as the Renaissance. In the period 1400–1700 the types and varieties of textiles proliferated and were frequently traded and gifted over large distances. For their users, textiles, in their multiple forms, were markers of distinction as well as functional everyday items. Traditionally, writing on textiles in the Renaissance has been influenced by two trends. First, the distinction of 19th-century scholars between “fine” and “decorative arts” tended to prioritize painting, sculpture, and architecture rather than textiles. Second, a divide between the art historical approach and the economic history approach has characterized the study of textile history. Since the turn of the 21st century, the range of approaches to the study of Renaissance textiles has widened considerably to attempt to bring together and, indeed, challenge and extend these approaches. In particular, a focus has emerged on examining the global role of textiles as objects in trade and diplomacy, recognizing their roles as objects that moved across boundaries and their role in shaping market economies and merchant strategies. In addition, important work has been undertaken on the ways textiles functioned as consumer items and on the ways they shaped spaces in homes and residences. Textiles have also been considered as performative actors that shaped emotions and actions.
Antibiotic Treatment Failure and Associated Outcomes Among Adult Patients With Community-Acquired Pneumonia in the Outpatient Setting: A Real-world US Insurance Claims Database Study
Authors: Tillotson Glenn , Lodise Thomas , Classi Peter , Mildvan Donna , McKinnell James A
Published: February 2020

Background

Antibiotic treatment failure is common among patients with community-acquired pneumonia (CAP) who are managed in the outpatient setting and is associated with higher mortality and increased health care costs. This study’s objectives were to quantify the occurrence of antibiotic treatment failure (ATF) and to evaluate clinical and economic outcomes between CAP patients who experienced ATF relative to those who did not.

Methods

Retrospective analysis of the MarketScan Commercial & Medicare Supplemental Databases was performed, identifying patients ≥18 years old, with a pneumonia diagnosis in the outpatient setting, and who received a fluoroquinolone, macrolides, beta-lactam, or tetracycline. ATF was defined as any of the following events within 30 days of initial antibiotic: antibiotic refill, antibiotic switch, emergency room visit, or hospitalization. Outcomes included 30-day all-cause mortality and CAP-related health care costs.

Results

During the study period, 251 947 unique patients met inclusion criteria. The mean age was 52.2 years, and 47.7% were male. The majority of patients received a fluoroquinolone (44.4%) or macrolide (43.6%). Overall, 22.1% were classified as ATFs. Among 18–64-year-old patients, 21.2% experienced treatment failure, compared with 25.7% in those >65 years old. All-cause mortality was greater in the antibiotic failure group relative to the non–antibiotic failure group (18.1% vs 4.6%, respectively), and the differences in 30-day mortality between antibiotic failure groups increased as a function of age. Mean 30-day CAP-related health care costs were also higher in the patients who experienced treatment failure relative to those who did not ($2140 vs $54, respectively).

Conclusions

Treatment failure and poor outcomes from outpatient CAP are common with current guideline-concordant CAP therapies. Improvements in clinical management programs and therapeutic options are needed.
Reimplantation Bypass Using One Limb of a Double-Origin Posterior Inferior Cerebellar Artery for Treatment of a Ruptured Fusiform Aneurysm: Case Report
Authors: Lang Michael J , Catapano Joshua S , Paisan Gabriella M , Koester Stefan W , Cole Tyler S , Labib Mohamed A , Zhou James J , Fredrickson Vance L , Frisoli Fabio A , Lawton Michael T
Published: February 2020

BACKGROUND AND IMPORTANCE

Posterior inferior cerebellar artery (PICA) aneurysms are uncommon, and aneurysms associated with anatomical PICA variants are even rarer. Although often treated endovascularly, aneurysms associated with anatomical PICA variants may not be suitable for endovascular intervention because of the risk of compromise of brainstem perforators and may be more amenable to open techniques. This case report describes the successful treatment of an aneurysm associated with a double-origin PICA (DOPICA) by distally reimplanting one of the PICA limbs.

CLINICAL PRESENTATION

A 78-yr-old man with a Hunt-Hess grade III, Fisher grade IV subarachnoid hemorrhage secondary to a ruptured distal right PICA aneurysm associated with a DOPICA was treated with PICA-PICA bypass and trapping of the aneurysm. This is the first reported case in the literature of successful bypass of a DOPICA-associated aneurysm. Radiographically, the bypass remained patent with successful obliteration of the aneurysm, and at discharge from the hospital, the patient had a Glasgow Coma Scale score of 15 and modified Rankin Scale score of 3.

CONCLUSION

This case demonstrates a novel reimplantation bypass for a ruptured aneurysm that exploits this rare variant anatomy of a DOPICA.
Hybrid TaON/LaTiO2N photoelectrode for water oxidation
Authors: An Pengda , Yang Baopeng , Zhang Ning , Li Hongmei , Liu Min
Published: February 2020

Efficient and stable photoelectrodes for water oxidation are highly desirable in the field of photoelectrochemical (PEC) water splitting. However, photoelectrodes with low externally applied bias usually exhibit weak photocurrent and vice versa. Herein, novel and efficient CoOx-TaON/LTON composite photoanodes have been successfully prepared by a microwave assisted method followed with a particle transfer procedure. The obtained photoanode generated an anodic photocurrent of ~7.2 mA cm−2 at 1.2 VRHE and initiated the anodic photourrent at ~0.5 VRHE. The HC-STH of the composite photoelectrode reached 1.0% at 1.2 VRHE. Further, stoichiometric oxygen and hydrogen are stably produced on the photoanode and the counter electrode with a Faraday efficiency of unity for 2 h.
Genome-Wide Association Mapping of Adult-Plant Resistance to Stripe Rust in Common Wheat (Triticum aestivum)
Authors: Yang Fangping , Liu Jindong , Guo Ying , He Zhonghu , Rasheed Awais , Wu Ling , Cao Shiqin , Nan Hai , Xia Xianchun
Published: February 2020

Stripe rust, caused by Puccinia striiformis f. sp. tritici, is a globally devastating disease of common wheat (Triticum aestivum L.), resulting in substantial economic losses. To identify effective resistance genes, a genome-wide association study was conducted on 120 common wheat lines from different wheat-growing regions of China using the wheat 90K iSelect SNP array. Seventeen loci were identified, explaining 9.5 to 21.8% of the phenotypic variation. Most of these genes were detected in the A (seven) and B (seven) genomes, with only three in the D genome. Among them, 11 loci were colocated with known resistance genes or quantitative trait loci reported previously, whereas the other six are likely new resistance loci. Annotation of flanking sequences of significantly associated SNPs indicated the presence of three important candidate genes, including E3 ubiquitin-protein ligase, F-box repeat protein, and disease resistance RPP13-like protein. This study increased our knowledge in understanding the genetic architecture for stripe rust resistance and identified wheat varieties with multiple resistance alleles, which are useful for improvement of stripe rust resistance in breeding.
How much time do nurses spend using electronic devices at work?
Authors: Sun Carolyn , Cato Kenrick
Published: February 2020

Results of the Patient Care and Tracking Increasing Electronics in Nurses' Use of Time (PATIENT) study
Designing Well-Being: Using Design Thinking to Engage Residents in Developing Well-Being Interventions
Authors: Thomas Larissa R. , Nguyen Rita , Teherani Arianne , Lucey Catherine R. , Harleman Elizabeth
Published: February 2020

Problem

Improving well-being in residency requires solutions that focus on organizational factors and the individual needs of residents, yet there are few examples of successful strategies to address this challenge. Design thinking (DT), or human-centered design, is an approach to problem-solving that focuses on understanding emotions and human dynamics and may be ideally suited to tackling well-being as a complex problem. The authors taught residents to use DT techniques to identify, analyze, and address organizational well-being challenges.

Approach

Internal medicine residents at the University of California, San Francisco completed an 8-month DT program in 2016–2017. The program consisted of four 2-hour workshops with small group project work between sessions. In each session, resident teams shared their progress and analyzed emerging themes to solve well-being problems. At the conclusion of the program, they summarized the final design principles and recommendations that emerged from their work and were interviewed about DT as a strategy for developing well-being interventions for residents.

Outcomes

Eighteen residents worked in teams to design solutions to improve: community and connection, space for reflection, peer support, and availability of individualized wellness. The resulting recommendations led to new interventions to improve well-being through near-peer communities. Residents emphasized how DT enhanced their creative thinking and trust in the residency program. They reported that not having enough time to work on projects between sessions and losing momentum during their clinical rotations were their biggest challenges.

Next Steps

Residents found DT useful for completing needs assessments, piloting interventions, and outlining essential design principles to improve well-being in residency. DT’s focus on human values may be particularly suited to developing well-being interventions to enhance institutional community and culture. One outcome—that DT promoted creativity and trust for participants—may have applications in other spheres of medical education.