bluuebunny/crossref_metadata_2025 huggingface dataset:
German-American Relations from 1945 to the Present
Authors: Schwabe Klaus
Published: September 2022

This chapter retraces German-American relations from the end of the Second World War up to the presidency of Joe Biden focusing on the all-important security aspect of the two former enemies’ position in the heart of Europe. The essay emphasizes in particular the period following the collapse of the German Democratic Republic (GDR) in 1989 and leading to Germany’s unification on 3 November 1990. This was the event that marked the climax of German-American cooperation based on both countries’ mutual interest in ending the Soviet Union’s rule over Eastern Europe, including East Germany. Once this was accomplished, American-German endeavours to incorporate post-Soviet Russia into a peaceful Europe largely failed. American interest in Germany dwindled when the US, NATO’s major power, became preoccupied with the fight against terrorism in the Middle East only to be reawakened to its European interests when Russia began to revise militarily the borders resulting from the collapse of the Soviet Union. The presidency of Donald Trump broke off previous efforts to revive the special American-German relationship. The survival of German-American trust and cooperation depends on America’s continued determination to base its foreign policy on value-based cooperation and multilateralism.
Listening to archaeology museums
Authors: Kannenberg John
Published: September 2022

What does an archaeology museum sound like? Museum practitioners in general have, in the past decade, participated in a ‘multisensory turn’ within the humanities, bringing a new awareness to the potentialities for sound and soundscapes in exhibition strategies. This chapter explores the intersections between archaeology, sound, and museums, offering brief overviews of sound’s relationship with archaeology and museum practice while providing key examples of sound on display within archaeology museums. Finally, a case study of an artistic research project, the Museum of Portable Sound, explores a museological object-based approach to the curation of sounds within the archaeology museum, demonstrating how empathic listening between institution and visitor can contribute positively to visitor experience.
Representing field practices in display
Authors: Tarkan Duygu , Çetin Şeyda
Published: September 2022

This chapter presents a series of digital and interactive interpretation methods in an exhibition with an exclusive focus on the archaeological processes. The exhibition, entitled ‘The Curious Case of Çatalhöyük’, opened at the ANAMED Gallery in Istanbul in 2017. The interdisciplinary approach of the excavation project was reflected in exhibition displays with 3D printed replicas of selected finds, laser-scanned digital reconstructions of the mounds, recreations of the site in Virtual Reality, and a contemporary art data sculpture developed by employing machine learning algorithms. This work poses new questions, including: What are effective ways to display archaeological practice in exhibitions? How can displays offer a more enjoyable and engaging experience for visitors while interpreting theoretical background and scientific methodologies? How are fieldnotes, databases, and photographic archives remediated in gallery displays?
Recovering the history of archaeology in museums
Authors: Delley Géraldine , Schlanger Nathan
Published: September 2022

Among the major domains studied in the history of archaeology are museums, as institutions and as sites of knowledge. In this chapter, we consider how museums have contributed to the making of archaeological knowledge—such as the National Museum of Denmark’s Three Age System, or notions of prehistoric industries at the 1867 Universal Exhibition. Another example concerns fakes—establishing the authenticity of artefacts has led to an understanding of their mode of production and use, while questions of provenance have broadened to issues of assemblage and context. The second part of this chapter considers how the history of archaeology has been mobilized as a means of outreach and education, with examples drawn from Northern Italy, Oxford, Paris, and Berlin. We conclude that museums nowadays cannot fulfil their functions without some consciousness of their history, and therefore should integrate the material and ideological conditions of archaeological knowledge into their objectives and displays.
Site museums and archaeology
Authors: Papaioannou Georgios
Published: September 2022

What is a site museum? What types and relations of sites does it involve? How do archaeological site museums serve archaeological and natural sites? How do archaeological sites relate to archaeological museums? What are the functions of an archaeological site museum? How do we approach them? What is their relation to local communities and other stakeholders towards development? This chapter highlights the concept of site museums and archaeology in the framework of museum archaeology by taking the above questions into account. It first addresses the concept, the content, and the perceptions of ‘site museum’, including its origins, types, existence, and development. It then discusses site museums and archaeology, and their relation to heritage building processes. Finally, a model for addressing archaeological site museums is presented, using the Museum at the Lowest Place on Earth (MuLPE) in Jordan as a case study.
Emotion and the return of ancestors
Authors: Fforde Cressida , Andrews Jilda , Halealoha Ayau Edward , Smith Laurajane , Turnbull Paul
Published: September 2022

More effective and informed professional practices associated with repatriation can only, this chapter argues, be achieved by acknowledging and engaging with the emotional registers and repertoires of collecting, retention, and repatriation of Indigenous Ancestral Remains. Drawing on Wetherell’s (2012) concept of affective practices the chapter identifies and considers the differing emotions and their expressions that underlie demands for repatriation and the responses of scientists. Emotion has often been neglected in repatriation scholarship, but an engagement with the affective aspects of the repatriation process offers opportunities in challenging the often polarized and polarizing characterization of this debate and extends the field of analysis in considering the consequences of repatriation to community and individual wellbeing, peace-building, and healing. We explore these ideas with examples from Hawaiian and Australian Aboriginal peoples’ perspectives particularly.
Experimental Approaches to the Study of Political Participation
Authors: de Rooij Eline A. , Burch Jessica E. M.
Published: September 2022

This chapter discusses the contribution of experiments to the study of political participation. It illustrates the increased usage of experiments in political science and sociology over the last three decades and moves the discussion of experiments beyond traditional distinctions between lab, field, and survey, highlighting studies with creative designs in terms of their setting, subject pool, intervention type, and outcome measurement. Experimental studies have enabled scholars of political participation to make stronger causal claims, testing nuanced theoretical mechanisms. One particularly exciting body of experimental work highlights the role of others in decisions to participate—to turn out to vote, donate money, sign petitions, or engage in other forms of collective action—and has started to investigate the subtle mechanisms at play in social influence, such as informational cues, social norms, and a need to belong. The chapter concludes with a discussion of the promises and pitfalls of political participation experiments.
Big Data and the Study of Political Participation
Authors: Pavan Elena
Published: September 2022

Big Data are transforming the field of political participation studies. Broadly defined as data resources characterized by higher than ever volume, velocity, and variety, they provide unique resources to map and track contemporary datafied societies and hybrid political participation patterns that mix older and newer forms of engagement. Taking a critical approach, this chapter discusses both the potentials and the challenges that Big Data raise for studying political participation. Its main claim is that Big Data, particularly those coming from social media, can take political participation studies further than ever only if their inclusion within research courses is piloted by a research orientation that bears ontological awareness, endorses epistemological proactivity and grounds in methodological creativity. After illustrating the features that contribute to mark the uniqueness of Big Data, the chapter reviews the most salient traits of this distinctive research orientation.
Ethnographic Approaches to the Study of Political Participation
Authors: Chakraborty Arnab , Lichterman Paul
Published: September 2022

Abstract: Ethnographic research gives access to distinct insights on political participation. Sensitized by classic and contemporary theoretical work, ethnographers follow political participation outside as well as inside the realm of institutionalized citizenship, focusing on activities that politicize or depoliticize in a wide range of institutional and everyday sites. This chapter argues that ethnographic research is especially good at illuminating three aspects of political participation: First and foremost, ethnographers uncover the meanings and practices that constitute different kinds of political participation. Second, ethnographic research clarifies relations between political ideas and political actors, in different settings. Third, ethnography illuminates the ambiguous and shifting boundaries between what is and is not political or politicized. In each of these areas, ethnographic work improves understandings based on assumptions that commonly drive non-ethnographic or non-empirical writings.
Economics and Political Participation
Authors: Dassonneville Ruth , Feitosa Fernando , Lewis-Beck Michael S.
Published: September 2022

VEconomic theories assume that individuals are rational actors, and that their behavior can be explained as the result of a cost–benefit calculus. A large number of studies have used economic theories to explain political participation, but expectations are sometimes not met, with inconclusive results. This chapter discusses the usefulness and limitations of economic theories for explaining political participation, with an application to the effects of economic conditions on electoral turnout and mass protest. To summarize the state of the literature on the connection between economic conditions and these conventional and unconventional political behaviors, this chapter relies on meta-analytical techniques, to the extent possible.
Online Political Participation
Authors: Earl Jennifer , Kenski Kate
Published: September 2022

Abstract: We review the literature on online political participation, including studies of undifferentiated online political participation, participation in elections and campaigns, participation in protest and social movements (i.e., activism), and other forms of participation such as political consumerism and participatory politics. Based on this review, we argue that research on contemporary political action needs to consider online aspects, even if focused on ostensibly offline action, because of the significant relationships and crossovers between offline and online action and the hybridized media context. But, we argue that researchers who have been studying online elements of political participation also need to be deeply embedded within the literatures on the form of political participation they are studying (i.e., protest, elections) instead of assuming that all digital activity is new or different.
Social and Political Cleavages and Political Participation
Authors: Dolezal Martin
Published: September 2022

This chapter reviews research on social and political cleavages and how they influence political participation. Starting with the general debate on the role of cleavages in contemporary politics, some of the most important contributions in the research literature are discussed. Scholars of political participation, it is then shown, have used the cleavage concept but have focussed primarily on specific modes such as turnout and have mostly explored social cleavages. Interpreting cleavages—or political cleavages—as a contextual factor, by contrast, has been used above all by research into protest politics. In addition to the review of extant research, an exploratory analysis shows how demographic characteristics and values associated with old and new cleavages affect various modes of participation throughout Europe.
Political Science and Political Participation
Authors: Schlozman Kay Lehman , Brady Henry E.
Published: September 2022

Citizen participation matters because public officials respond to those who make their voices heard. This chapter looks broadly at what political science has learned about political participation both recently and in the past. It keys new findings to the Civic Voluntarism Model, which goes beyond the earlier SES model and locates political participation in three interrelated sets of individual factors: resources such as time, money, and civic skills; psychological engagement with politics including strong commitments to political issues; and exposure to requests for activity and political mobilization efforts. Political participation is shaped by acquisition of these factors, which, in turn, depends upon experiences in social contexts—early on at home and in school and, during adulthood, in the workplace, religious institutions, and non-political organizations. Additional factors including such aspects of political context as the characteristics of political systems and institutions—most obviously ballot access laws and campaign-finance arrangements—also influence who takes part and how much.
Political Socialization and Political Participation
Authors: Muxel Anne
Published: September 2022

This chapter focuses on socialization considered both as a background (meaning a set of roots, predictors, and determinants that fix a structural core in the political predispositions and ideological orientations that form the politicization of the individual) and as a process (integrating the idea that this background, including family transmission, evolves and that the resulting socialization is constantly being re-defined over the course of a lifetime), with the effects of time, generation, and life cycle intermingling together. This paradoxical framework—the weight of determinations on the one hand, and the constant adjustment involved in the process of socialization on the other, provides a fascinating challenge for research in political science. The chapter sheds light on recent research in the field related to a number of changes and mutations observed in our modern democracies and in citizenship, and invite a re-examination of some of the classical vectors and experiences of socialization with which individuals are confronted and that have an impact on their political participation.
Adapting the six-part story method to CAT
Authors: Dent-Brown Kim
Published: September 2022

The six-part story method (6PSM) is a projective technique where the therapist guides the client through a structured set of instructions to create and tell a new, fictional story which provides useful clinical material. The model is used to create a framework for clients to develop and tell stories to aid in assessment and therapy. The method involves giving a structured set of instructions to a client, who first draws a simple sketch in six parts, outlining a main character, their task, obstacles, helpful factors, a resolution, and an aftermath. They use this to verbalize the story, after which further detailed questioning fleshes it out. The assumption is that the situations, relationships, roles, and procedures in the story world will help the client to reveal something about those things in their own world. The 6PSM can be a useful tool to use at the start of a cognitive analytic therapy treatment, eliciting material which can helpfully be incorporated into the initial reformulation letter. The projective hypothesis seems to be supported and six-part stories can be both reliable and valid indicators of client experience. The mechanism of a fictional, projected story about a main character very different from themselves seems to allow clients freedom to reflect upon and share important images in a way that allows significant clinical material to be accessed at depth, at speed and with safety.
Safe Asset Carry Trade
Authors: Ballensiefen Benedikt , Ranaldo Angelo
Published: September 2022

We provide the first systematic asset pricing analysis of one of the main safe asset categories, the repurchase agreement (repo). Based on the temporal and cross-sectional variation in short-term rates, we form a carry that, together with a market factor, prices these near-money assets in a linear pricing model. The carry depicts heterogeneity in nonpecuniary convenience yields of collateral assets and increases in the safety premium and the liquidity premium reflecting opportunity cost. Our carry helps explain the cross-section of short-term rates, as well as of long-term bond returns after accounting for standard bond pricing factors. (JEL E40, E41, G00, G01, G10, G11).

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Abnormal Information Flow in Schizophrenia Is Linked to Psychosis
Authors: Jia Yingxin , Kudo Kiwamu , Hinkley Leighton B N , Fisher Melissa , Vinogradov Sophia , Nagarajan Srikantan , Subramaniam Karuna
Published: September 2022

Background and Hypothesis

Prior research has shown that patients with schizophrenia (SZ) show disruption in brain network connectivity that is thought to underlie their cognitive and psychotic symptoms. However, most studies examining functional network disruption in schizophrenia have focused on the temporally correlated coupling of the strength of network connections. Here, we move beyond correlative metrics to assay causal computations of connectivity changes in directed neural information flow, assayed from a neural source to a target in SZ.

Study Design

This study describes a whole-brain magnetoencephalography-imaging approach to examine causal computations of connectivity changes in directed neural information flow between brain regions during resting states, quantified by phase-transfer entropy (PTE) metrics, assayed from a neural source to an endpoint, in 21 SZ compared with 21 healthy controls (HC), and associations with cognitive and clinical psychotic symptoms in SZ.

Study Results

We found that SZ showed significant disruption in information flow in alpha (8–12 Hz) and beta (12–30 Hz) frequencies, compared to HC. Reduced information flow in alpha frequencies from the precuneus to the medio-ventral occipital cortex was associated with more severe clinical psychopathology (ie, positive psychotic symptoms), while reduced information flow between insula and middle temporal gyrus was associated with worsening cognitive symptoms.

Conclusions

The present findings highlight the importance of delineating dysfunction in neural information flow in specific oscillatory frequencies between distinct regions that underlie the cognitive and psychotic symptoms in SZ, and provide potential neural biomarkers that could lead to innovations in future neuromodulation treatment development.
Older adults can use technology: why healthcare professionals must overcome ageism in digital health
Authors: Mace Ryan A , Mattos Meghan K , Vranceanu Ana-Maria
Published: September 2022

Older adults rapidly adopted technology for healthcare, known as digital health, during the COVID-19 pandemic. Older adults are increasingly using telehealth, smartphone apps, and other digital health technologies to reduce barriers to care, maintain patient-provider communication, and promote disease self-management. Yet, many healthcare professionals have maintained outdated beliefs rooted in societal ageism that digital health and older adults are incompatible. As a result, older adults have been disproportionally excluded from health services and clinical trials that use digital health relative to their younger counterparts. In this commentary, we urge all healthcare disciplines to challenge ageist beliefs and practices that have contributed to the “digital health divide” among older patients. We provide examples of evidence-based strategies and current scientific initiatives that can promote digital health inclusion in research, clinical practice, and training. By achieving digital health inclusion, we can increase access, provide preventative and comprehensive care, and decrease healthcare costs for older patients.
Morinda umbellata active fraction inhibits lipopolysaccharide induced proinflammatory cytokines by downregulating NF-κB activation
Authors: Krishnakumar Neenthamadathil Mohandas , Manikantan Kuttapetty , Suja Somasekharan Nair Rajam , Latha Panickamparambil Gopalakrishnan , Ceasar Stanislaus Antony
Published: September 2022

Morinda umbellata L. is a woody climber or liana distributed in south East Asia. It is a traditional medicinal plant with excellent curative effects against diarrhea, dysentery, and other stomach disorders. The present study was aimed to assess the effect of M. umbellata active fraction (MUAF) on various inflammatory mediators using lipopolysaccharide (LPS) induced in vivo model in Wistar rats. The effect of MUAF on secretion of TNF-α, IL-1β, and IL-6 were evaluated in LPS-induced experimental animals. The expression of TNF-α, IL-1β, IL-6, iNOS, COX-2, and nuclear factor NF-κB genes were also evaluated. The gas chromatography–mass spectrometry (GC–MS) analysis of the active fraction was carried out to identify the active compounds present in MUAF. The results of oral acute toxicity suggested the non-toxic nature of MUAF. GC–MS analysis of the MUAF leaves revealed the presence of 8 compounds. The study demonstrated that the proinflammatory cytokines such as TNF-α, IL-1β, and IL-6 were significantly inhibited by MUAF in a dose-dependent manner. Moreover, MUAF down-regulated the expression of TNF-α, IL-1β, IL-6, iNOS, COX-2, and NF-κB genes. Our research findings suggest that the presence of anti-inflammatory compounds in MUAF can effectively inhibit LPS-induced proinflammatory cytokines TNF-α, IL-β, and IL-6 in vivo. It also suppressed the over expression of TNF-α, IL-1β, IL-6, iNOS, and COX-2 possibly via downregulating NF-κB activation.
Income and Wealth Inequality in Hong Kong, 1981–2020: The Rise of Pluto-Communism?
Authors: Piketty Thomas , Yang Li
Published: September 2022

The objective of this paper is to better understand the evolution and institutional roots of Hong Kong's growing economic inequality and political cleavages. By combining multiple sources of data (household surveys, fiscal data, wealth rankings, national accounts) and methodological innovations, two main findings are obtained. First, he evidence suggests a very large rise in income and wealth inequality in Hong Kong over the last four decades. Second, based on the latest opinion poll data, business elites, who carry disproportionate weight in Hong Kong's Legislative Council, are found to be more likely to vote for the pro-establishment camp (presumably to ensure that policies are passed that protect their political and economic interests). This paper argues that the unique alliance of government and business elites in a partially democratic political system is the plausible institutional root of Hong Kong's rising inequality and political cleavages.
Fungicide-Mediated Shifts in the Foliar Fungal Community of an Invasive Grass
Authors: Lane Brett R. , Kendig Amy E. , Wojan Christopher M. , Adhikari Ashish , Jusino Michelle A. , Kortessis Nicholas , Simon Margaret W. , Holt Robert D. , Smith Matthew E. , Clay Keith , Flory S. Luke , Harmon Philip F. , Goss Erica M.
Published: September 2022

Invasive plants, which cause substantial economic and ecological impacts, acquire both pathogens and beneficial microbes in their introduced ranges. Communities of fungal endophytes are known to mediate impacts of pathogens on plant fitness but few studies have examined the temporal dynamics of fungal communities on invasive plants. The annual grass Microstegium vimineum, an invader of forests and riparian areas throughout the eastern United States, experiences annual epidemics of disease caused by Bipolaris pathogens. Our objective was to characterize the dynamics of foliar fungal communities on M. vimineum over a growing season during a foliar disease epidemic. First, we asked how the fungal community in the phyllosphere changed over 2 months that corresponded with increasing disease severity. Second, we experimentally suppressed disease with fungicide in half of the plots and asked how the treatment affected fungal community diversity and composition. We found increasingly diverse foliar fungal communities and substantial changes in community composition between timepoints using high-throughput amplicon sequencing of the internal transcribed spacer 2 region. Monthly fungicide application caused shifts in fungal community composition relative to control samples. Fungicide application increased diversity at the late-season timepoint, suggesting that it suppressed dominant fungicide sensitive taxa and allowed other fungal taxa to flourish. These results raise new questions regarding the roles of putative endophytes found in the phyllosphere given the limited number of pathogens known to cause disease on M. vimineum in its invasive range.
Optimized Sample Processing Pipeline for PCR-Based Fungicide Resistance Quantification of Stubble-Borne Fungal Pathogens
Authors: Hodgson Leon M. , Cox Belinda A. , Lopez-Ruiz Francisco J. , Gibberd Mark R. , Thomas Geoff J. , Zerihun Ayalsew
Published: September 2022

Globally, yield losses associated with failed crop protection due to fungicide-resistant pathogens present an increasing problem. For stubble-borne pathogens, assessment of crop residues during the off-season could provide early fungicide resistance quantification for informed management decisions to mitigate yield losses. However, stubble assessment is hampered by assay inhibitors that are derived from decaying organic matter. To overcome assay inhibition from weathered stubble samples, we used a systems approach to quantify the frequency of resistance to demethylase inhibitor fungicides of the barley pathogen Pyrenophora teres f. teres. The system canvassed (i) 10 ball-milling conditions; (ii) four DNA extraction methodologies; and (iii) three column purification techniques for the provision of sufficient yield, quality, and purity of fungal DNA for a PCR-based fungicide resistance assay. Results show that DNA quantity and purity differed within each of the above three categories, with the optimized pipeline being (i) ball-milling samples in a 50-ml stainless steel canister for 5 min using a 20-mm ball at 30 revolutions s−1; (ii) a modified Brandfass method (extracted 64% more DNA than other methods assessed); and (iii) use of silica resin columns for the highest DNA concentration with optimal DNA purity. The chip-digital PCR assay, which quantified fungicide resistance from field samples, was unaffected by the DNA extraction method or purification technique, provided that thresholds of template quantity and purity were satisfied. In summary, this study has developed molecular pipeline options for pathogen fungicide resistance quantification from cereal stubbles, which can guide management for improved crop protection outcomes.
Role of Pessaries in the Treatment of Pelvic Organ Prolapse
Authors: Sansone Stephanie , Sze Christina , Eidelberg Andrew , Stoddard Michelina , Cho Ahra , Asdjodi Saman , Mao Jialin , Elterman Dean S. , Zorn Kevin C. , Chughtai Bilal
Published: September 2022

OBJECTIVE:

To evaluate the existing evidence on the efficacy of pessaries in improving quality of life when used for the treatment of pelvic organ prolapse (POP).

DATA SOURCES:

We searched for the terms “pelvic organ prolapse” and “pessar/y/ies/ium or vaginal support device,” and “safety or safe or outcome or complication or efficacy or effective or effectiveness” in PubMed, EMBASE, and CINAHL on March 16, 2020. A search was also performed on ClinicalTrials.gov, with no studies fitting our strict inclusion and exclusion criteria.

METHODS OF STUDY SELECTION:

Studies that reported pretreatment and posttreatment mean scores and SDs after pessary treatment for standardized questionnaires were included. Studies performed in pediatric populations, pregnancy, and use of pessaries not for prolapse were excluded. Three reviewers independently screened studies.

TABULATION, INTEGRATION, AND RESULTS:

Data abstraction was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were pooled for meta-analysis when reported by at least three studies. The primary study outcome was change in mean pretreatment and posttreatment questionnaire scores, which included those for the PFDI-20 (Pelvic Floor Distress Inventory- Short Form 20), PFIQ-7 (Pelvic Floor Impact Questionnaire - Short Form 7), and subscale POPIQ (Pelvic Organ Prolapse Impact Questionnaire Long Form). A random-effects model was used to combine estimates and capture between-study heterogeneity using the I2-statistic. Eight studies including 627 patients were included for systematic review. The mean (SD) age was 63.0±12.2 years, and the majority of patients had stage III prolapse (48.1%) followed by stage II prolapse (43.2%) when reported. Although variable, the majority of studies conducted 3-month follow-up. A negative change in pretreatment and posttreatment scores was noted, signifying improvement after pessary use: PFDI-20 mean change −46.1 (95% CI −65.4 to −26.8); PFIQ-7 mean change −36.0 (95% CI −46.0 to −26.0); POPIQ-7 (Pelvic Organ Prolapse Impact Questionnaire-7) mean change −16.3 (95% CI −26.8 to −5.7). No significant heterogeneity was found.

CONCLUSION:

Based on improvements in standardized questionnaire scores, pessaries are effective treatment options for POP.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42020172618.
Association of Availability of State Medicaid Coverage for Abortion With Abortion Access in the United States
Authors: McDonnell Jill , Jarlenski Marian , Borrero Sonya , Vinekar Kavita
Published: September 2022

OBJECTIVE:

To evaluate the association between state Medicaid coverage for abortion and abortion access measures among U.S. patients.

METHODS:

We analyzed data from the Guttmacher Institute’s 2014 Abortion Patient Survey. Respondents were included if they reported being enrolled in Medicaid, regardless of whether Medicaid covered the abortion. The exposure was self-report of residence in a state where Medicaid can be used to pay for abortion. Access outcomes included more than 14 days’ wait time between decision for abortion and abortion appointment, presentation at more than 10 weeks of gestation when in the first trimester, and travel time more than 60 minutes to the clinic. Multivariable regression was performed to test the association between state Medicaid abortion coverage and dichotomous access outcomes, controlling for patient demographics.

RESULTS:

Of 2,579 respondents enrolled in Medicaid who reported state of residence, 1,694 resided in states with Medicaid coverage for abortion and 884 resided in states without Medicaid coverage for abortion. Patients residing in states with Medicaid coverage for abortion had lower odds and rates of waiting more than 14 days between deciding to have an abortion and the appointment (adjusted odds ratio [aOR] 0.70; 95% CI 0.57–0.85, 66.8% vs 74.1%, P<.001), having abortions at more than 10 weeks of gestation when in the first trimester (aOR 0.62; 95% CI 0.49–0.80, 13.6% vs 20.1%, P<.001), and traveling more than 60 minutes to the abortion clinic (aOR 0.63; 95% CI 0.51–0.78, 18.7% vs 27.6%, P<.001) when compared with patients residing in states without Medicaid coverage for abortion.

CONCLUSION:

Availability of state Medicaid coverage for abortion is associated with increased abortion access. Our findings support repealing the Hyde Amendment to promote equitable access to reproductive health care, particularly in the post-Roe era.
Pilot Implementation of a Health Equity Checklist to Improve the Identification of Equity-Related Adverse Events
Authors: Fan Linda L. , Sheth Sangini S. , Pettker Christian M.
Published: September 2022

OBJECTIVE:

To establish a sustainable and trackable process to delineate the role of social determinants of health, bias, and racism in adverse gynecologic events.

METHODS:

The existing process entails monthly reviews of adverse events. Each case is assessed for preventability, harm, and standards of care. The equity-focused process consists of: 1) creation of a standardized health equity checklist; 2) application of the checklist to each gynecologic adverse event beginning on September 1, 2020; 3) collection of event review data in a secure central digital repository; 4) review of the cases to understand apparent causes of the event; 5) exploration of areas for improvement by using standard fields; and 6) identification of specific ideas for change.

RESULTS:

Within 15 months, 46 safety events were identified by standard criteria. Twenty-four of the cases were deemed preventable. Of the 24, there were 12 cases in which social determinants of health or bias or both social determinants of health and bias were identified playing a role. Diagnostic delays and care delays were attributed to social determinants of health and implicit bias. Our process has mapped areas of infrastructure as well as the need for culture improvement and has also highlighted the need for restorative work on addressing implicit bias and improving approaches to shared decision making.

CONCLUSION:

Through the use of a health equity checklist, we have illustrated the feasibility of creating a systematic and trackable process to begin delineating the role of social determinants of health, bias, and racism in adverse gynecologic events.
Weight-Based Compared With Fixed-Dose Enoxaparin Prophylaxis After Cesarean Delivery
Authors: Bruno Ann M. , Allshouse Amanda A. , Campbell Heather M. , Branch D. Ware , Lim Ming Y. , Silver Robert M. , Metz Torri D.
Published: September 2022

OBJECTIVE:

To evaluate fixed compared with weight-based enoxaparin dosing to achieve prophylactic anti-Xa levels after cesarean delivery.

METHODS:

Individuals meeting institutional criteria for enoxaparin thromboprophylaxis after cesarean delivery were randomly allocated to fixed (40 mg daily for body mass index [BMI, calculated as weight in kilograms divided by height in meters squared] lower than 40; 40 mg every 12 hours for BMI 40 or higher) or weight-based (0.5 mg/kg every 12 hours) enoxaparin dosing. Enoxaparin was initiated during inpatient hospitalization and continued at discharge for 14 days. Those with contraindication to anticoagulation, plan for therapeutic anticoagulation, or known renal impairment were excluded. The trial was unmasked. The primary outcome was prophylactic (0.2–0.6 international units/mL) peak anti-Xa level 4–6 hours after at least the third enoxaparin dose (at steady state). Secondary outcomes included subprophylactic and supraprophylactic peaks, outpatient peak, and venous thromboembolism (VTE) and wound complications in the first 6 weeks postpartum. Sample size of 121 per group was planned. At interim analysis with 50% enrollment, the trial was stopped early for efficacy. Primary analyses followed intention-to-treat principle with worst-case imputation for missing outcomes. Secondary analyses were complete case.

RESULTS:

From June 2020 to November 2021, 74 individuals were randomized to weight-based enoxaparin and 72 to fixed-dose enoxaparin. Those who received weight-based dosing were more likely to achieve prophylactic anti-Xa levels than those who received fixed dosing in primary analysis (49/74 [66%] vs 32/72 [44%], relative risk [RR] 1.49, 95% CI 1.10–2.02) and secondary analysis (49/60 [82%] vs 32/57 [56%], RR 1.45, 95% CI 1.12–1.88). Subprophylactic levels occurred more frequently with fixed dosing; supraprophylactic levels did not differ significantly by dosing. At the outpatient postoperative visit, 52% of participants (15/29) with weight-based dosing compared with 15% (5/33) with fixed dosing achieved prophylactic peak anti-Xa level (RR 3.41, 95% CI 1.42–8.24). There were no VTEs in either group. Wound complications occurred in five individuals (7%) with weight-based enoxaparin dosing compared with one individual (1%) with fixed enoxaparin dosing (RR 4.86, 95% 0.58–40.63).

CONCLUSION:

Weight-based dosing was more effective than fixed enoxaparin dosing in achieving prophylactic peak anti-Xa levels after cesarean delivery.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT04305756.
Reproductive Justice for the Deaf Community
Authors: Panko Tiffany L.
Published: September 2022

Almost half of all pregnancies each year in the United States are mistimed or unwanted and associated with adverse health outcomes. Deaf women are as likely to be pregnant as their hearing counterparts but are 67% more likely to experience unintended pregnancy. Although there are limited data on the sexual health behaviors of deaf individuals, research has shown that deaf people are more likely than the general population to rely on withdrawal and condoms to prevent pregnancy. Further, health resources and communication with physicians are often not fully accessible, with the former often in spoken or written English and the latter when sign language interpreters are not present. The combination of use of less--effective methods of contraception and inaccessible health resources puts deaf women at heightened risk for unintended pregnancy. Deaf women are denied reproductive justice when they are inadequately equipped to practice bodily autonomy and prevent unintended pregnancies. In this commentary, I present literature to illustrate the disparity deaf women face compared with hearing women and to make the case for the association among unintended pregnancy, its adverse effects, and reproductive injustice for deaf women. As a medically trained deaf woman conducting reproductive health research, I leverage my lived experience and accrued knowledge to elucidate the shortcomings and strategies to use. As public health researchers and health care professionals, we can alleviate this injustice with inclusive research methodology, representation on research and health care teams, and ensuring access to health information with time given and accommodations provided.
The effect of extracorporeal shock wave therapy in coccydynia: a systematic review and meta-analysis
Authors: Nikouei Farshad , Shakeri Mohammadreza , Ghandhari Hasan , Motalebi Mohsen , Ameri Ebrahim
Published: September 2022

Background:

Extracorporeal shock wave therapy (ESWT) has been used in the treatment of coccydynia. However, it has not yet been validated due to the dispersion of studies, the low number of patients, and the use of different measuring instruments. This meta-analysis was performed with the aim of collecting homogeneous studies to achieve a reliable result.

Methods:

The authors searched electronic databases including Google Scholar, Scopus, ScienceDirect, ISI Web of Science, Embase, and PubMed to find studies in which the effect of ESWT on coccydynia using visual analog scale (VAS) scores was evaluated starting in January 1990 through August 2021. All search procedures were performed by two authors.

Results:

The mean pain changes of 81 patients from four studies in 1 mo, 2 to 4 mo, and 6 to 12 mo after using ESWT were analyzed. Overall mean change of VAS score in 1 mo, 2 to 4 mo, and 6 to 12 mo after applying ESWT was -42.41 (I2=86.96%, 95% confidence interval [CI] of −56.88, −27.94, P=0.001), −41.01 (I2=0.0%, 95% CI of −46.98, −35.04, P=0.001) and −50.13 (I2=82.41%, 95% CI of −67.33; −32.94, P=0.001), respectively.

Conclusions:

The authors showed that ESWT lessened pain in patients with coccydynia. This effect did not diminish during a year; instead, it further reduced pain in patients. However, more research is needed to verify the results.

Level of Evidence:

Level I.
Pitfalls and suggestions for the treatment of open, comminuted fractures of the middle phalanx using custom-made dynamic external fixators: a retrospective case series
Authors: Ntourantonis Dimitrios , Iliopoulos Ilias , Pantazis Konstantinos , Baikousis Andreas , Korovessis Panagiotis
Published: September 2022

Background:

The proximal interphalangeal joint (PIPJ) is a synovial joint prone to injury encompassing a wide spectrum of severity. In the setting of complicated injuries, dynamic external traction systems are considered to be the optimal treatment modality with numerous different Kirschner-wire configurations combined with rubber bands, springs, pulleys, or hinges being described. However, many of these pose significant technical challenges for the surgeon or are unwieldy to the patient emphasizing the need for simple, easy to construct, and well-tolerated modifications, which are equally effective in reducing the fracture and allowing early motion.

Methods:

The authors retrospectively analyzed prospectively collected data of 12 patients with open complex PIPJ fracture dislocations treated with a custom-made external fixator based on the one that was originally suggested by Suzuki et al. All patients were men with an average age of 55.1 yr (23 to 81). Injured digits involved four index, five middle, and three ring fingers.

Results:

The mean follow-up was 54.36 mo, and all patients healed without a second operation and returned to their jobs and preinjury level of activity. The average active range of motion of the PIPJ was 75.16±3.18 degrees, DIPJ was 69.33±14.7 degrees, and MCPJ was 88.75±1.97 degrees. Mean Quick Disabilities of Arm, Shoulder, and Hand (DASH)-Japan Society for Surgery of the Hand (JSSH) score at the final examination was 4.33±1.38 (range 2.3 to 6.8). The authors recorded five complications involving two rubber bands breaking, one pin-track infection, one rubber band-axial traction pin malposition, and one swan neck deformity, which were treated accordingly.

Conclusions:

One of the most crucial factors affecting outcome in this kind of injury is the appearance of the digit and functional results. None of the participants in this series had any complaint about the appearance of their fingers in the final examination, and 10 out of 12 judged the cosmetic result as very good. To the authors' knowledge, this report is one of the few that describes the functional outcome of pins and rubbers traction system (PRTS) application in complex fracture and fractures-dislocations with severe comminution of the middle phalanx and not only fractures related to the PIP joint.

Level of Evidence:

Level V.
A retrospective study on internal fixation of femoral neck fractures with Hansson Pins® in Switzerland
Authors: Conti Tiziano , Majewski Martin
Published: September 2022

Background:

Hansson Pins® (The Swemac Group, Linköping, Sweden) are devices for the internal fixation of femoral neck fractures that are widely used in Scandinavia. The authors hypothesized that the pins could be used with satisfactory results outside of Scandinavia, that they were a valid alternative to cancellous screws and the dynamic hip screw, and that they also could be used in elderly patients.

Methods:

Sixty-five consecutive patients with femoral neck fractures who received internal fixation with Hansson Pins between January 2007 and December 2016 at the Oberengadin Hospital in Switzerland were included in this retrospective study. The hospital’s electronic database was searched for information, and questionnaires were sent to the patients.

Results:

After internal fixation with Hansson Pins, 22% of the patients needed a hip prosthesis. For patients 70 yr and older, this rate was 33%. For 60% of the patients who needed a hip prosthesis, the reason for arthroplasty was nonunion. For 20%, the reason was avascular necrosis of the femoral head, and for another 20% of the patients symptomatic coxarthrosis was the cause.

Conclusions:

The rate of salvage arthroplasties in this study was similar to the rates in the literature of Hansson Pins (mostly from studies performed in Scandinavia), cancellous screws and dynamic hip screws. The findings suggested that Hansson pins could be used with good results outside of Scandinavia and that they were a reasonable alternative to cancellous screws and the dynamic hip screw. The pins also could be used with satisfactory outcomes in elderly patients, but the rate of salvage arthroplasties would be higher.

Level of Evidence:

Level IV.
Comparison of manipulation rates for robot-assisted, customized, and conventional total knee arthroplasty: a retrospective cohort study
Authors: Markel Michael J. , Grieme Caleb , Szakiel Paulina , Abraham Nijo , Rigor Paolo Diaz , Geng Xue , Lee Ji Won , Boucher Henry R.
Published: September 2022

Background:

With projected increases in total knee arthroplasties (TKA), patient outcomes without complications are essential. Arthrofibrosis, a potential complication after TKA that may impact long-term patient outcome, may be remedied by manipulation under anesthesia (MUA); however, it is not risk-free. This study investigated the association between manipulation and newer implants and sophisticated techniques, which hold promise for preventing arthrofibrosis and improving patient outcomes.

Methods:

The authors retrospectively reviewed 1260 primary knee arthroplasty cases (717 conventional, 217 customized, and 326 robot-assisted) performed by an orthopaedic surgeon from January 1, 2016 to May 31, 2020. Patient records were reviewed for manipulation and demographics (type of implant, sex, body mass index [BMI], smoking status, and prior surgery).

Results:

Overall manipulation rate was 1.3% (n=17). Manipulation rates for conventional customized and robot-assisted TKAs did not vary significantly (1.84%, n=6; 0.46%, n=1; 1.39%, n=10, respectively; P=0.466). Multivariable logistic regression showed no statistically significant difference in the odds of manipulation depending on the type of implant. However, those who smoked were 4 times more likely to have a manipulation (OR: 4.187, 95% CI: 1.119 to 15.673) when controlling for covariates (type of implant, sex, BMI, and prior surgery). Additionally, those with prior surgery were 2.8 times as likely to have a manipulation (OR: 2.808, 95% CI: 1.039 to 7.589) when controlling for covariates.

Conclusions:

There were no statistically significant differences in manipulation rates among conventional, customized, and robot-assisted TKAs. However, current smoking status and prior surgery were associated with higher risk of manipulation.

Level of Evidence:

Level III.