bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between sleep disorder and quality of life in patients with type 2 diabetes: a cross-sectional study
Authors: Hashimoto Yoshitaka , Sakai Ryosuke , Ikeda Kenichiro , Fukui Michiaki
Published: June 2020

Background

We investigated the association between sleep symptoms, which cause sleep disorder, and quality of life (QoL) among people with type 2 diabetes (T2D).

Methods

In this cross-sectional study of 342 people with T2D, the Japan National Health and Wellness Survey (NHWS) database 2016 were used. We treated the respondents who reported experiencing any of the sleep symptoms as having sleep disorders. To examine health-related QoL (HRQoL), we used the physical component summary (PCS) and the mental component summary (MCS) from the 36-Item short-form and the EuroQol 5 Dimension (EQ-5D) survey instruments. Overall activity impairment was used for assessment of the effect on the individual’s ability to perform regular daily activities. We used t-test and one-way ANOVA test for comparison QoL scores between the participants with and without sleep disorders.

Results

66.4% of the participants with T2D reported having a sleep disorder. The PCS, MCS, EQ-5D, and overall activity impairment of people with sleep disorder was significantly poorer than those of the people without. Specific sleep symptoms, such as waking up to go to the bathroom, daytime sleepiness, and waking up too early (before the alarm clock), had high prevalence (35.4, 27.8 and 20.2%). The participants who experienced waking up to go to the bathroom or daytime sleepiness demonstrated significantly poorer QoL on all scores related to QoL, but those who experienced waking up too early only demonstrated significantly poorer QoL on the EQ-5D.

Conclusions

Two-thirds of people with T2D in this study suffer from sleep disorders. The people who experience waking up to go to the bathroom or daytime sleepiness had significantly poorer QoL than those without these symptoms. Thus, sleep disorders, especially the symptoms of waking up to go to the bathroom or daytime sleepiness, might be the treatment targets for QOL of people with T2DM.
Expanding the 3 Wishes Project for compassionate end-of-life care: a qualitative evaluation of local adaptations
Authors: Vanstone Meredith , Neville Thanh H. , Swinton Marilyn E. , Sadik Marina , Clarke France J. , LeBlanc Allana , Tam Benjamin , Takaoka Alyson , Hoad Neala , Hancock Jennifer , McMullen Sarah , Reeve Brenda , Dechert William , Smith Orla M. , Sandhu Gyan , Lockington Julie , Cook Deborah J.
Published: June 2020

Background

The 3 Wishes Project (3WP) is an end-of-life program that honors the dignity of dying patients by fostering meaningful connections among patients, families, and clinicians. Since 2013, it has become embedded in the culture of end-of-life care in over 20 ICUs across North America. The purpose of the current study is to describe the variation in implementation of 3WP across sites, in order to ascertain which factors facilitated multicenter implementation, which factors remain consistent across sites, and which may be adapted to suit local needs.

Methods

Using the methodology of qualitative description, we collected interview and focus group data from 85 clinicians who participated in the successful initiation and sustainment of 3WP in 9 ICUs. We describe the transition between different models of 3WP implementation, from core clinical program to the incorporation of various research activities. We describe various sources of financial and in-kind resources accessed to support the program.

Results

Beyond sharing a common goal of improving end-of-life care, sites varied considerably in organizational context, staff complement, and resources. Despite these differences, the program was successfully implemented at each site and eventually evolved from a clinical or research intervention to a general approach to end-of-life care. Key to this success was flexibility and the empowerment of frontline staff to tailor the program to address identified needs with available resources. This adaptability was fueled by cross-pollination of ideas within and outside of each site, resulting in the establishment of a network of like-minded individuals with a shared purpose.

Conclusions

The successful initiation and sustainment of 3WP relied on local adaptations to suit organizational needs and resources. The semi-structured nature of the program facilitated these adaptations, encouraged creative and important ways of relating within local clinical cultures, and reinforced the main tenet of the program: meaningful human connection at the end of life. Local adaptations also encouraged a team approach to care, supplementing the typical patient-clinician dyad by explicitly empowering the healthcare team to collectively recognize and respond to the needs of dying patients, families, and each other.

Trial registration

NCT04147169, retrospectively registered with clinicaltrials.gov on October 31, 2019.
Evaluation of in-vivo antidiarrhoeal and in-vitro antibacterial activities of the root extract of Brucea antidysenterica J. F. Mill (Simaroubaceae)
Authors: Zewdie Kaleab Alemayehu , Bhoumik Dayananda , Wondafrash Dawit Zewdu , Tuem Kald Beshir
Published: June 2020

Background

Diarrhoea has been the major cause of death especially in children of developing countries. Brucea antidysenterica is one of the several medicinal plants used traditionally for the treatment of diarrhoea in Ethiopia. Hence, the present study was undertaken to investigate the antidiarrhoeal and antibacterial activities of the root extract of B. antidysenterica.

Methods

Plant material was extracted by maceration technique using 80% methanol. The antidiarrhoeal activity was tested using castor oil-induced diarrhoea, castor oil-induced charcoal meal test, and castor oil-induced enteropooling models in mice. Whilst, the antibacterial activity of the crude extract was evaluated using agar well diffusion and broth microdilution methods.

Results

The 80% methanolic crude extract significantly delayed the diarrhoeal onset at the two higher doses (p < 0.001) and it has also inhibited the number and weight of faecal output at all tested doses as compared with the negative control. Moreover, it showed a significant anti-motility effect (p < 0.001) at all tested doses. Whereas it displayed a significant reduction in the weight and volume of intestinal contents at the doses of 200 and 400 mg/kg (p < 0.01). The highest concentration (800 mg/mL) of test extract showed maximum zone of inhibition in all tested standard strains of bacteria (18.3 mm–22 mm). While MIC and MBC values (0.39 mg/mL and 1.56 mg/mL) showed that S. flexneri was the most susceptible pathogen for test extract.

Conclusion

The study revealed that the root extract of B. antidysenterica has antidiarrhoeal and antibacterial activities.
Hospital preparedness for mass critical care during SARS-CoV-2 pandemic
Authors: Wurmb Thomas , Scholtes Katja , Kolibay Felix , Schorscher Nora , Ertl Georg , Ernestus Ralf-Ingo , Vogel Ulrich , Franke Axel , Kowalzik Barbara
Published: June 2020

Mass critical care caused by the severe acute respiratory syndrome corona virus 2 pandemic poses an extreme challenge to hospitals. The primary goal of hospital disaster preparedness and response is to maintain conventional or contingency care for as long as possible. Crisis care must be delayed as long as possible by appropriate measures. Increasing the intensive care unit (ICU) capacities is essential. In order to adjust surge capacity, the reduction of planned, elective patient care is an adequate response. However, this involves numerous problems that must be solved with a sense of proportion. This paper summarises preparedness and response measures recommended to acute care hospitals.
Secreted breast tumor interstitial fluid microRNAs and their target genes are associated with triple-negative breast cancer, tumor grade, and immune infiltration
Authors: Terkelsen Thilde , Russo Francesco , Gromov Pavel , Haakensen Vilde Drageset , Brunak Søren , Gromova Irina , Krogh Anders , Papaleo Elena
Published: June 2020

Background

Studies on tumor-secreted microRNAs point to a functional role of these in cellular communication and reprogramming of the tumor microenvironment. Uptake of tumor-secreted microRNAs by neighboring cells may result in the silencing of mRNA targets and, in turn, modulation of the transcriptome. Studying miRNAs externalized from tumors could improve cancer patient diagnosis and disease monitoring and help to pinpoint which miRNA-gene interactions are central for tumor properties such as invasiveness and metastasis.

Methods

Using a bioinformatics approach, we analyzed the profiles of secreted tumor and normal interstitial fluid (IF) microRNAs, from women with breast cancer (BC). We carried out differential abundance analysis (DAA), to obtain miRNAs, which were enriched or depleted in IFs, from patients with different clinical traits. Subsequently, miRNA family enrichment analysis was performed to assess whether any families were over-represented in the specific sets. We identified dysregulated genes in tumor tissues from the same cohort of patients and constructed weighted gene co-expression networks, to extract sets of co-expressed genes and co-abundant miRNAs. Lastly, we integrated miRNAs and mRNAs to obtain interaction networks and supported our findings using prediction tools and cancer gene databases.

Results

Network analysis showed co-expressed genes and miRNA regulators, associated with tumor lymphocyte infiltration. All of the genes were involved in immune system processes, and many had previously been associated with cancer immunity. A subset of these, BTLA, CXCL13, IL7R, LAMP3, and LTB, was linked to the presence of tertiary lymphoid structures and high endothelial venules within tumors. Co-abundant tumor interstitial fluid miRNAs within this network, including miR-146a and miR-494, were annotated as negative regulators of immune-stimulatory responses. One co-expression network encompassed differences between BC subtypes. Genes differentially co-expressed between luminal B and triple-negative breast cancer (TNBC) were connected with sphingolipid metabolism and predicted to be co-regulated by miR-23a. Co-expressed genes and TIF miRNAs associated with tumor grade were BTRC, CHST1, miR-10a/b, miR-107, miR-301a, and miR-454.

Conclusion

Integration of IF miRNAs and mRNAs unveiled networks associated with patient clinicopathological traits, and underlined molecular mechanisms, specific to BC sub-groups. Our results highlight the benefits of an integrative approach to biomarker discovery, placing secreted miRNAs within a biological context.
Microbial succession during the transition from active to inactive stages of deep-sea hydrothermal vent sulfide chimneys
Authors: Hou Jialin , Sievert Stefan M. , Wang Yinzhao , Seewald Jeffrey S. , Natarajan Vengadesh Perumal , Wang Fengping , Xiao Xiang
Published: June 2020

Background

Deep-sea hydrothermal vents are highly productive biodiversity hotspots in the deep ocean supported by chemosynthetic microorganisms. Prominent features of these systems are sulfide chimneys emanating high-temperature hydrothermal fluids. While several studies have investigated the microbial diversity in both active and inactive sulfide chimneys that have been extinct for up to thousands of years, little is known about chimneys that have ceased activity more recently, as well as the microbial succession occurring during the transition from active to inactive chimneys.

Results

Genome-resolved metagenomics was applied to an active and a recently extinct (~ 7 years) sulfide chimney from the 9–10° N hydrothermal vent field on the East Pacific Rise. Full-length 16S rRNA gene and a total of 173 high-quality metagenome assembled genomes (MAGs) were retrieved for comparative analysis. In the active chimney (L-vent), sulfide- and/or hydrogen-oxidizingCampylobacteriaandAquificaewith the potential for denitrification were identified as the dominant community members and primary producers, fixing carbon through the reductive tricarboxylic acid (rTCA) cycle. In contrast, the microbiome of the recently extinct chimney (M-vent) was largely composed of heterotrophs from various bacterial phyla, includingDelta-/Beta-/AlphaproteobacteriaandBacteroidetes.Gammaproteobacteriawere identified as the main primary producers, using the oxidation of metal sulfides and/or iron oxidation coupled to nitrate reduction to fix carbon through the Calvin-Benson-Bassham (CBB) cycle. Further analysis revealed a phylogenetically distinctNitrospiraecluster that has the potential to oxidize sulfide minerals coupled to oxygen and/or nitrite reduction, as well as for sulfate reduction, and that might serve as an indicator for the early stages of chimneys after venting has ceased.

Conclusions

This study sheds light on the composition, metabolic functions, and succession of microbial communities inhabiting deep-sea hydrothermal vent sulfide chimneys. Collectively, microbial succession during the life span of a chimney could be described to proceed from a “fluid-shaped” microbial community in newly formed and actively venting chimneys supported by the oxidation of reductants in the hydrothermal fluid to a “mineral-shaped” community supported by the oxidation of minerals after hydrothermal activity has ceased. Remarkably, the transition appears to occur within the first few years, after which the communities stay stable for thousands of years.
Symptoms of titanium and nickel allergic sensitization in orthodontic treatment
Authors: Zigante Martina , Rincic Mlinaric Marijana , Kastelan Marija , Perkovic Vjera , Trinajstic Zrinski Magda , Spalj Stjepan
Published: June 2020

Aim

The study aimed to evaluate to which extent self-reported symptomatology, age, and sex are predictors of titanium and nickel allergic sensitization in patients in treatment with fixed orthodontic appliances.

Methods

The study analyzed 228 subjects aged 11–45 years (median 18, interquartile range 16–22); 68% of them were females, and 52% were adolescents. The allergic sensitization testing included epicutaneous patch test to titanium, titanium dioxide, titanium oxalate, titanium nitride, and nickel sulfate. The questionnaire on symptoms potentially linked to titanium and nickel sensitization was used.

Results

Prevalence of the allergic sensitization to titanium in patients undergoing orthodontic treatment was 4% (2% only to titanium without nickel) while to nickel 14% (12% nickel without titanium). Hypersensitivity to both metals at the same time was present in 2% of subjects. Sensitization to nickel was more common in females than in males (17 vs. 8%) and much more common in adults than in adolescents with small effect size (20 vs. 8%; p = 0.013). Sensitization to titanium was more common in females than in males (6 vs. 1%) with no difference in age. Multiple logistic regression analysis revealed that adult age increases the odds for being sensitized to nickel for 2.4 × (95% CI 1.1–5.6; p = 0.044) while watery eyes for 3.7 × (95% CI 1.2–11.1; p = 0.022). None of the symptoms were significant predictors of titanium sensitization.

Conclusion

Allergic sensitization to titanium and nickel are not very frequent in orthodontic patients, and self-reported symptomatology is a weak predictor of those sensitizations.
Time to definitive care among severely injured farmers compared to other work-related injuries in a Midwestern state
Authors: Swanton Amanda , Peek-Asa Corinne , Torner James
Published: June 2020

Background

Farming is a high risk occupation that predisposes workers to injury, but may also lead to barriers in reaching trauma care. Little is known about emergency and trauma care for patients with farm-related injuries. The purpose of this study was to determine whether severely injured farmers presenting to a statewide trauma system faced delays in reaching definitive care compared to other severely injured workers.

Methods

A population-based observational study was performed using the Iowa State Trauma Registry from 2005 to 2011. The registry was used to identify a multiply imputed sample of severe occupational injuries. Time to definitive care for farm- and non-farm-related injuries was compared using Kaplan-Meier curves and an extended, stratified Cox model censoring at 4 h. An interaction with time was included in the Cox model to generate hazard ratios for each hour after injury.

Results

Seven-hundred forty-eight severe occupational injuries were identified; 21% of these were farm-related. The overall median time to definitive care was nearly an hour longer for farmers compared to other workers (2h46m vs. 1h48m, p < 0.05). When adjusted for confounders, farm status remained a significant predictor of delay in reaching definitive care, but only in the first hour after injury (HR = 0.44, 95%CI = 0.24–0.83).

Conclusions

Farm-related injuries accounted for more than 1 of every 5 severe occupational injuries entered into the Iowa trauma system. We found that severely injured farmers had delays in reaching definitive trauma care, even when adjusted for confounding variables such as rurality. This effect was most pronounced in the first hour.
A sensitive method for analyzing fluconazole in extremely small volumes of neonatal serum
Authors: Saito Jumpei , Tanzawa Ayano , Kojo Yuka , Maruyama Hidehiko , Isayama Tetsuya , Shoji Kensuke , Ito Yushi , Yamatani Akimasa
Published: June 2020

Background

The need for a large volume of serum sample significantly reduces the feasibility of neonatal pharmacokinetic studies in daily practice, which must often rely on scavenged or opportunistic sampling. This problem is most apparent in preterm newborns, where ethical and practical considerations prohibit the collection of large sample volumes. Most of the fluconazole analysis assays published thus far required a minimum serum sample of 50 to 100 μL for a single assay. The purpose of the present study was to develop and validate a sensitive method requiring a smaller sample volume (10 μL) to satisfy clinically relevant research requirements.

Methods

Following simple protein precipitation and centrifugation, the filtrated supernatant was injected into a liquid chromatography system and separated with a C18 reverse-phase column. Fluconazole and the internal standard (IS, fluconazole-d4) were detected and quantified using tandem mass spectrometry. The method was validated with reference to the Food and Drug Administration’s Guidance for Industry. Accuracy and precision were evaluated at six quality control concentration levels (ranging from 0.01 to 100 μg/mL).

Results

Investigated calibration curves were linear in the 0.01–100 μg/mL range. Intra- and inter-day accuracy (− 7.7 to 7.4%) and precision (0.3 to 6.0%) were below 15%. The calculated limit of detection and the lower limit of quantification (LLOQ) was 0.0019 μg/mL and 0.0031 μg/mL, respectively. Fluconazole in the prepared samples was stable for at least 4 months at − 20 °C and − 80 °C. This method was applied to analyze 234 serum samples from ten neonates who received fosfluconazole, a water-soluble phosphate prodrug of fluconazole which converts to fluconazole in the body, as part of a pharmacokinetic study using daily scavenged laboratory samples. The median (range) concentration up to 72 h after fosfluconazole administration was 2.9 (0.02 to 26.8 μg/mL) μg/mL, which was within the range of the calibration curve.

Conclusion

Fluconazole was able to be detected in an extremely small volume (10 μL) of serum from neonates receiving fosfluconazole. The method presented here can be used to quantify fluconazole concentrations for pharmacokinetic studies of the neonatal population by using scavenged samples.
Presentation, management, and outcomes of STEMI in Egypt: results from the European Society of Cardiology Registry on ST elevation myocardial infarction
Authors: Shaheen Sameh , Wafa Ahmad , Mokarab Mostafa , Zareef Basem , Bendary Ahmed , Abdelhameed Tarek , Rashwan Ahmad , Seleem Mohamad , Elmasry Magdy , Abdelhady Yaser , Abdelrazik Gomaa , Ibrahim Amr , Ghareeb Mohamad , Aly Khalid , Saraya Mahmoud , Wadie Moheb , Youssef Mahmoud
Published: June 2020

Background

Apart from few small single-center studies, there are limited data about STEMI patients in Egypt. Nineteen Egyptian centers (with and without PCI facilities) participated in this registry with 1356 patients who were compared to 7420 patients from other ESC countries. The aims of this study were to describe the characteristics of patients with STEMI, to assess STEMI management patterns particularly the current use of reperfusion therapies, to evaluate the organization of STEMI networks across Egypt, to evaluate in-hospital patient outcome, and to compare Egyptian patients with other ESC countries.

Results

Compared to other ESC countries, Egyptian patients were younger (mean age 55.4 ± 11.3 vs. 62.9 ± 12.4; p < 0.001 and 4.36% vs. 19.41%% were ≥ 75 years old; p < 0.001) with fewer females (18.44% vs. 25.63%; p < 0.001). Egypt had longer median time between symptoms onset and first medical contact: 120.0 (60.0; 240.0) vs.100.0 (50.0; 240.0) p < 0.001. Self-presentation rather than EMS presentation was the mode of admission in 86.06% in Egypt vs. 25.83% in EU countries (p < 0.001). On qualifying ECG, anterior STEMI was in 57.08% in Egypt vs. 45.98% in other countries (p < 0.001). Initial reperfusion therapy was 49.12%, 43.07%, and 7.26% for primary PCI, thrombolytic therapy and no reperfusion in Egypt vs. 85.42%, 7.26%, and 7.82% for EU countries, respectively. In-hospital mortality was 4.65% in Egypt vs. 3.50% in other countries p 0.040 and was 18.87% in no reperfusion vs. 2.10% in primary PCI vs. 4.97% in thrombolysis (p < 0.001) among Egyptians. Patients were discharged on aspirin in 98.61%, clopidogrel in 91.07%, ticagrelor in 7.31%, DAPT in 97.69%, beta blockers in 82.83%, ACE inhibitors in 84.76%, MRAs in 10.01%, and statins in 99.77%.

Conclusion

Compared to other ESC countries, Egyptian STEMI patients were younger, more frequently current smokers and diabetics, and had longer time between symptoms onset and first medical contact with more self-presentation rather than EMS presentation. Thrombolytic therapy is still a common reperfusion therapy in Egypt while primary PCI was offered to half of the patients. In-hospital mortality was significantly higher in Egypt and was highest among no reperfusion patients and lowest among PPCI patients.
The Prospectus War of the 1790s
Authors: Duff David
Published: June 2020

Prospectuses, a type of printed advertisement widely used in the eighteenth-century book trade, played a vital but previously unexamined role in the French Revolution controversy, attracting subscribers to political publications and encapsulating their message. Focusing on journal and newspaper prospectuses, which proliferated in the 1790s, this article analyzes examples from across the political spectrum, including the prospectus for the Argus by the radical journalist Sampson Perry, George Canning’s hugely influential prospectus to the Anti-Jacobin, and other examples by William Playfair, the London Corresponding Society, and other individuals and organizations. This article shows how prospectus writers exploited the distinctive resources of the genre, adapting its promissory rhetoric and hyperbolic language for political effect. It also investigates how prospectuses interacted with other forms of writing and publication, mirroring the techniques of pamphlets and contributing to the polemical intertextuality that was a feature of the Revolution debate. For all its ephemerality, the genre had a powerful impact, serving all sides of the dispute and marking a convergence of literature, politics, and advertising that typifies the innovative print culture of this period.
Lively Effigies
Authors: Ezell Margaret J. M.
Published: June 2020

This article will explore the function of printed “effigies” in the second half of the seventeenth century. The title is taken from Samuel Clarke’s frequently reprinted and enlarged compendium, The Marrow of Ecclesiastical Historie, conteined in the Lives of the Fathers, and other Learned Men, and Famous Divines, . . . Together with the Livelie Effigies of most of the Eminentest of them cut in Copper. The term “effigy” is a Janus word, meaning both a representation of a specific deceased individual as a celebratory memorial marker, and as a hated figure intended to be destroyed, such as Guy Fawkes. The article will examine what ways effigial images found in broadsides and books lay claim to the reader or viewer’s attention, and explore how are they used to communicate complex meanings about memory and erasure, even in inexpensive ephemeral publications.
Closer to Home: A Hanlin Academician Writes about Persons outside the Educated Class
Authors: Egan Ronald
Published: June 2020

Yijian zhi, the massive collection of supernatural tales compiled by Hong Mai (1123–1202) in the twelfth century, gives considerable attention to merchant figures and even members of more lowly walks of life (e.g., soldiers, butchers, waiters, and singing girls). This is unexpected since Hong Mai himself was not just an imperial official but a particularly eminent one, whose appointments included Hanlin academician and court historian. Appearing in the tales, sometimes even as protagonists, are members of society whom the superelite like Hong Mai seldom even mention in their conventional literary and scholarly writings. These Yijian zhi stories thus provide a glimpse of the ways that members of the socially and politically elite perceived persons of lowly social backgrounds. The fact that Hong Mai did not compose his stories from his own imagination but, rather, recorded tales told to him by informants, most of whom were also members of the elite, as well as his conviction that the tales narrate events that actually happened, however uncanny or “marvelous” they were, makes the collection even more valuable as a source for general upper-class perceptions. Once identified and examined, those perceptions by socially elite persons of contemporaries who did not have a classical education contain elements we might expect as well as those that may surprise us.
Translation as Method
Authors: Rojas Carlos
Published: June 2020

Taking Lu Xun's work as its starting point, this essay examines translation as a methodology for negotiating not between different languages or dialects but rather between different voices. To the extent that some fiction attempts to manifest the voices of socially marginalized figures, this translational approach offers a way of examining the possibilities and limits of this sort of negotiation. By extension, a similar translational framework may also be used to understand the attempts by critics to assess fiction's own attempts to render these marginalized voices.
Ragpicking as Method
Authors: Hillenbrand Margaret
Published: June 2020

This article explores the relationship between precarity, waste, and the ragpicker in contemporary Chinese visual culture. It asks first why precarity has come so little and so late to the theoretical scene in China, a society in which precarious experience is so rife as to be almost endemic. The essay then goes on to show how some of China's leading artists now work profusely with refuse—as a core theme of the precarious present—while noting the strange anomaly that their works offer up scant if any space for the figure of the waste picker. The artist, instead, has taken over her mantle as the sifter and sorter of garbage. This missing human figure matters, in part because waste is always about people—and their absence from aesthetic space suggests that art is responding to a felt sense that personhood is coming under assault as basic life sureties fray. But this essay also argues that the garbage takeover is part of a sustained practice of appropriation, effacement, even cruelty in the artistic representation of precarity in China. China's wasteworks are art forms born at the tense interface between different class actors, and they disclose fraught fears over where brittle life experience begins and ends in a society that has tried to eliminate class as a category of political action and analysis.
Ecology as Method
Authors: Visser Robin
Published: June 2020

In “China as Method,” Mizoguchi Yūzō argues that “a world that takes China as method would be a world in which China is a constitutive element.” Similarly, a world that takes ecology as method is a world in which humans are a constitutive element, one of “the ten thousand things” (wanwu 萬物). In this essay, the author examines distinct ways in which fictional writers imagine relational dynamics between humans, nonhuman animals, regional ecosystems, and the cosmos to theorize ecology as method. Ecology as method works to radically decenter anthropocentric understandings of the cosmos, historicizes regional ecologies in order to illuminate global dynamics, and acknowledges deterritorialization. While mourning loss, it resists sentimentalizing cultural narratives that rationalize the genocide of species as inevitable. This article focuses on three contemporary eco-writers of Inner Mongolia. Mandumai 滿都麥, one of the People's Republic of China's earliest post-Mao eco-writers, romanticizes indigeneity in his Mongolian-language stories (read in this article in Mandarin translation). Mongolian-Han Sinophone writer Guo Xuebo 郭雪波 juxtaposes “grassland logic” against “agrarian logic” in his desert fiction series, illustrating how agrilogistics dominates the ecological imagination of the ethnically diverse desert-dwellers. Finally, the article analyzes the best-selling Wolf Totem by Beijing-based sent-down youth Jiang Rong 姜戎. Despite attributing desertification to Han ignorance, the novel simultaneously maps the steppes via ecological understandings from Hanspace ontology.
Pandemic as Method
Authors: Kong Belinda
Published: June 2020

This essay deploys the concept of pandemic as a set of discursive relations rather than a neutral description of a natural phenomenon, arguing that pandemic discourse is a product of layered histories of power that in turn reproduces myriad forms of imperial and racial power in the new millennium. The essay aims to denaturalize the idea of infectious disease by reframing it as an assemblage of multiple histories of American geopower and biopower from the Cold War to the War on Terror. In particular, Asia and Asian bodies have been targeted by US discourses of infection and biosecurity as frontiers of bioterrorism and the diseased other. A contemporary example of this bio-orientalism can be seen around the 2003 SARS epidemic, in which global discourses projected the source of contagion onto Asia and Asians. Pandemic as method can thus serve as a theoretical pathway for examining cultural concatenations of orientalism and biopower.
Script as Method
Authors: Pang Laikwan , Ko Chun-Kit
Published: June 2020

This essay argues that the two main types of contemporary Chinese scripts, complicated characters (fantizi 繁體字) and simplified characters (jiantizi 簡體字), are sites of heavy cultural and political contestation. The two script systems witness the internal bifurcation of the Chinese written language, which should not be considered as unified vis-à-vis the diversification of the verbal languages. Supported with many concrete examples, the essay demonstrates the different kinds of political struggles involved in the publication of the same materials in the two different scripts. These cases also illustrate the heavy censorship involved in contemporary PRC literature, and the authors are particularly interested in demonstrating the meanings of the option of fantizi publication toward many PRC writers. The two scripts could not be understood as simple variations of the same set of language, but the shifts between them involve actual translations, which in turn would help us gain new insights on the idea of world literature.
Modelling the reciprocal dynamics of dialogical communication: On the communication-philosophical undercurrent of radical constructivism and second-order cybernetics
Authors: Kastberg Peter
Published: June 2020

Even though both Ernst von Glasersfeld, the founding father of radical constructivism, and his epistemological alter ego, Heinz von Foerster, one of the principal architects of second-order cybernetics, would both repeatedly stress the formative importance of communication, neither would ever model communication as a phenomenon per se. I will propose a first modelling of communication as seen through the stereoscopic lens of these two schools of thought. I will first present, discuss and evaluate how communication is traditionally modelled. This will serve as an informed backdrop when I proceed to integrate the common denominators pertaining to communication from relevant works of both scholars. In addition to the fact that both would willingly profess to the ‘Linguolaxis’ of Maturana and Varela, i.e., that humans exist suspended in communication, two basic assumptions have proven formative. Firstly, that communication is perceived as a flux, as an almost William-James-like ‘stream of communication’. Secondly, and this is more in the vein of Heraclitus, that both communicators and communication alike undergo transformations in the process of immersion. This implies favouring a view of communication in which communication is a perpetual oscillation between ongoing reciprocal perturbations (Glasersfeld), that occur over time, and the endeavours to re-establish (cognitive) homeostasis (Foerster). The latter must not be reduced to either mere compliance, as it were, i.e., that the ‘other’ does as s/he is told, or to the mutual understanding of a dominance-free communication of a Habermasian persuasion, but rather in the pragmatic notion of ‘compatibility’ (Glasersfeld). For illustrative purposes I will end this paper by translating these notions into a model depicting what I have labelled co-actional communication, in effect forging an exemplar.
Hegel and the Peircean ‘object’
Authors: Barnham Chris
Published: June 2020

Peirce’s semiotics is well known for advocating a triadic, rather than a dyadic, sign structure, but interpretations of how such a structure works in practice have varied considerably. This paper argues that the Peircean ‘object’ is central to understanding Peirce’s philosophical intent and that this element should be construed as a mediating element within the sign rather than as an originating source of it. This interpretation resonates with the fundamentally anti-dualist character of Peirce’s philosophy and it creates potential convergences with the medieval philosophy of Duns Scotus – which was so influential in Peirce’s thinking. Moreover, construal of the ‘object’ as a mediating entity within the sign highlights important parallels with Hegelian thought and the role of the ‘essence’ in the latter’s dialectics. It is argued, indeed, that Peirce’s triadic template for the sign has strong Hegelian roots. This substantially repositions Peirce’s semiotics; it becomes, as in Hegel’s dialectics, an account of concept formation. The over-arching framework in which this takes place, however, retains an adherence to Peirce’s empiricist background and so avoids the reliance on logic which is the defining characteristic of Hegel’s dialectical method.
Política exterior y paz: ¿un juego en dos niveles?
Authors: Badillo Sarmiento Reynell
Published: June 2020

Durante los dos periodos presidenciales de Juan Manuel Santos, la política exterior colombiana dirigió una buena parte de sus esfuerzos a solidificar, a través del involucramiento de actores internacionales, las negociaciones que se llevaban a cabo con la otrora guerrilla de las Fuerzas Armadas Revolucionarias de Colombia (FARC-EP). En el presente texto se analiza ese proceso a través de la teoría de los dos niveles de juego (two-level game theory). Además, se considera que la organización de la política exterior colombiana alrededor de la solidificación de los Diálogos de La Habana respondió a la necesidad de consolidar este proceso, de dotarlo de legitimidad entre la población y de garantizar la implementación de lo acordado. Así, a través de acciones concretas y del proceso de internacionalización en sí mismo se construyó una suerte de “blindaje internacional” que establece restricciones a la posibilidad de dar marcha atrás a lo establecido en el Acuerdo.
Factores asociados con la presencia de patógenos productores de betalactamasas de espectro extendido en infecciones urinarias en una clínica privada, Lima (Perú)
Authors: Remenik-Zarauz Vania , Diaz-Velez Cristian , Apolaya-Segura Moisés
Published: June 2020

Introducción: las infecciones del tracto urinario (ITU) son el segundo motivo más frecuente de atención médica, y la resistencia a los antibióticos entre las enterobacterias gramnegativas ha aumentado de manera importante en todo el mundo, dada la aparición de organismos productores de betalactamasa de espectro extendido (BLEE). Se busca identificar factores asociados a la presencia de ITU por patógeno productor de BLEE. Materiales y métodos: se realizó un estudio trasversal analítico, un análisis de la base de datos de urocultivos de una clínica privada y una evaluación de los factores posiblemente asociados a la presentación de ITU por el microorganismo BLEE, como el sexo, la edad, el número de hospitalizaciones e ITU previas. Resultados: se estudiaron 1405 urocultivos positivos y se encontró que el 85.48 % fueron de sexo femenino. La edad media de la población fue de 39.98 ± 24.51 años, el 24.13 % de edad mayor a 60 años, y el 55.56 % habían sido atendidos ambulatoriamente. El 49.18 % de los cultivos fue positivo para ITU BLEE, de los cuales el 96,58 % no habían presentado una ITU previa. Se encontró que existe una asociación estadísticamente significativa (0,007; p ≤ 0,05) entre el sexo y el desarrollo de ITU por microorganismo productor de BLEE. El masculino es el de mayor asociación (OR 1,224; IC95 %: 1,035-1,448). También se encontró una asociación con la edad, el número de hospitalizaciones previas y haber estado en UCI. No se encontró ninguna asociación entre la presencia de ITU previas. Conclusiones: existe una elevada frecuencia de ITU BLEE, y los factores asociados a dicha infección fueron tener sexo masculino, una edad mayor a 60 años y hospitalizaciones previas.
Optimizing indications of impacting bone allograft transplantation in osteonecrosis of the femoral head
Authors: Chen Leilei , Hong Guoju , Hong Zhinan , Lin Tianye , Chen Zhenqiu , Zhang Qingwen , He Wei
Published: June 2020

Aims

The aim of this study was to report the medium-term outcomes of impaction bone allograft and fibular grafting for osteonecrosis of the femoral head (ONFH) and to define the optimal indications.

Methods

A total of 67 patients (77 hips) with ONFH were enrolled in a single centre retrospective review. Success of the procedure was assessed using the Harris Hip Score (HHS) and rate of revision to total hip arthroplasty (THA). Risk factors were studied, including age, aetiology, duration of hip pain, as well as two classification systems (Association Research Circulation Osseous (ARCO) and Japanese Investigation Committee (JIC) systems).

Results

After a mean follow-up period of 8.61 years (SD 1.45), 81.3% (52/64) of enrolled cases had a good or excellent HHS at latest follow-up (declining to 76.0% (38/50) for those with more than eight years of follow-up). Overall survival was 92.1% at eight years’ follow-up (95% CI 83.2% to 96.4%). A total of 12 hips (19.0%) failed (reoperation or HHS < 70 points) at final follow-up. Rate of success was adversely affected by increasing age, duration of pain, and more severe disease as measured using the ARCO and JIC classifications, but not by aetiology of the ONFH.

Conclusion

We report favourable medium-term results of this procedure. Best outcomes can be expected in patients matching the following indications: younger than 40 years; less 12-month hip pain before surgery; femoral head collapse being less than 2 mm; and integrated lateral wall of femoral head. Cite this article: Bone Joint J 2020;102-B(7):838–844.
A survey of Hip Society surgeons concerning the direct anterior approach total hip arthroplasty
Authors: Woolson Steven T.
Published: June 2020

Aims

To establish whether there was a consensus among the members of the Hip Society (HS) on the role of direct anterior approach (DAA) contemporary primary total hip arthroplasty (THA).

Methods

An online survey was sent to all 112 active and senior members of the HS, to which 71 members responded. The survey was constructed to determine whether they believed that evidence-based medicine proves, in modern clinical practice, that the DAA has significant benefits compared to risks when contrasted with other approaches. In addition, they were asked if they currently used the DAA.

Results

While only 16.9% (12/71) of respondents had been trained in a generic anterior approach during residency, 49.3% (35/71) had used the DAA in their clinical practice in the past or were using it at the present time. Unexpectedly, 42.9% (15/35) of respondents who had used the DAA in the past had abandoned it by the time of this survey. Only 22.5% (16/71) of all respondents believed that evidence-based medicine proves that the DAA has significant benefits compared to risks in contrast to other approaches.

Conclusion

A comprehensive literature review found only three prospective randomized clinical trials (RCT) comparing the DAA with another approach with greater than one-year follow-up. Two showed minor benefits within the early postoperative period only, and one of those showed poorer mid-term results. Most of the published comparison studies with short follow-up show longer surgical times and greater blood loss for the DAA, and many three-month comparison studies show higher complication rates for the DAA using a proprietary traction table. The complications included problems with wound healing, lateral femoral cutaneous nerve injury, femoral component loosening, and femoral fractures. Because of the lack of evidence from RCTs showing superiority of the DAA over other approaches and reports of higher complications, the opinion of a large majority (77.5%; 55/71) of HS surgeons was that the DAA lacks sufficient evidence to warrant its use. Cite this article: Bone Joint J 2020;102-B(7 Supple B):57–61.
Development and early findings of a semiautomated arthroplasty registry in a multi-institutional healthcare network
Authors: Florissi Isabella , Galea Vincent Philip , Sauder Nicholas , Colon Iban Yhan , Heng Marilyn , Ahmed Fraz K. , Malchau Henrik , Bragdon Charles R.
Published: June 2020

Aims

The primary aim of this paper was to outline the processes involved in building the Partners Arthroplasty Registry (PAR), established in April 2016 to capture baseline and outcome data for patients undergoing arthroplasty in a regional healthcare system. A secondary aim was to determine the quality of PAR’s data. A tertiary aim was to report preliminary findings from the registry and contributions to quality improvement initiatives and research up to March 2019.

Methods

Structured Query Language was used to obtain data relating to patients who underwent total hip or knee arthroplasty (THA and TKA) from the hospital network’s electronic medical record (EMR) system to be included in the PAR. Data were stored in a secure database and visualized in dashboards. Quality assurance of PAR data was performed by review of the medical records. Capture rate was determined by comparing two months of PAR data with operating room schedules. Linear and binary logistic regression models were constructed to determine if length of stay (LOS), discharge to a care home, and readmission rates improved between 2016 and 2019.

Results

The PAR captured 16,163 THAs and TKAs between April 2016 and March 2019, performed in seven hospitals by 110 surgeons. Manual comparison to operating schedules showed a 100% capture rate. Review of the records was performed for 2,603 random operations; 2,298 (88.3%) had complete and accurate data. The PAR provided the data for three abstracts presented at international conferences and has led to preoperative mental health treatment as a quality improvement initiative in the participating institutions. For primary THA and TKA surgeries, the LOS decreased significantly (p < 0.001) and the rate of home discharge increased significantly (p < 0.001) between 2016 and 2019. Readmission rates did not correlated with the date of surgery (p = 0.953).

Conclusion

The PAR has high rates of coverage (the number of patients treated within the Partners healthcare network) and data completion and can be used for both research purposes and quality improvement. The same method of creating a registry that was used in the PAR can be applied to hospitals using similar EMR systems. Cite this article: Bone Joint J 2020;102-B(7 Supple B):90–98.
Tibial shape and size predicts the risk of tibial plateau fracture after cementless unicompartmental knee arthroplasty in Japanese patients
Authors: Hiranaka Takafumi , Yoshikawa Ryo , Yoshida Kenjiro , Michishita Kazuhiko , Nishimura Takehiro , Nitta Shingo , Takashiba Kenichiro , Murray David
Published: June 2020

Aims

Cementless unicompartmental knee arthroplasty (UKA) has advantages over cemented UKA, including improved fixation, but has a higher risk of tibial plateau fracture, particularly in Japanese patients. The aim of this multicentre study was to determine when cementless tibial components could safely be used in Japanese patients based on the size and shape of the tibia.

Methods

The study involved 212 cementless Oxford UKAs which were undertaken in 174 patients in six hospitals. The medial eminence line (MEL), which is a line parallel to the tibial axis passing through the tip of medial intercondylar eminence, was drawn on preoperative radiographs. Knees were classified as having a very overhanging medial tibial condyle if this line passed medial to the medial tibial cortex. They were also classified as very small if a size A/AA tibial component was used.

Results

The overall rate of fracture was 8% (17 out of 212 knees). The rate was higher in knees with very overhanging condyles (Odds ratio (OR) 13; p < 0.001) and with very small components (OR 7; p < 0.001). The OR was 21 (p < 0.001) in those with both very overhanging condyles and very small components. In all, 69% of knees (147) had neither very overhanging nor very small components, and the fracture rate in these patients was 1.4% (2 out of 147 knees). Males had a significantly reduced risk of fracture (OR 0.13; p = 0.002), probably because no males required very small components and females were more likely to have very overhanging condyles (OR 3; p = 0.013). 31% of knees (66) were in males and in these the rate of fracture was 1.5% (1 out of 66 knees).

Conclusion

The rate of tibial plateau fracture in Japanese patients undergoing cementless UKA is high. We recommend that cemented tibial fixation should be used in Japanese patients who require very small components or have very overhanging condyles, as identified from preoperative radiographs. In the remaining 69% of knees cementless fixation can be used. This approach should result in a low rate of fracture. Cite this article: Bone Joint J 2020;102-B(7):861–867.