bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction and Definitions
Authors: Gest Justin
Published: November 2020

What does it mean to be “white”?

“Race” is a man-made concept that gives social meaning to the shade of one’s skin. There is no biological basis or scientific definition for being “white”—it is only part of a gradient of skin pigmentation. However, the associations...
Public Debates about White Working-Class People
Authors: Gest Justin
Published: November 2020

Was the white working class ever “on top”?

Given their smaller numbers, diminished resources, and lack of political clout, the fact that white working-class people still feel a sense of status demonstrates that this status is more ideological than real. This ideology follows naturally from...
What is Terrorism and who Becomes a Terrorist?
Authors: Moskalenko Sophia , McCauley Clark
Published: November 2020

What kind of violence is called terrorism?

There is no one accepted definition of terrorism. There is, however, a general agreement among government definitions that terrorism is either violence or a threat of violence whose purpose is to coerce a government or citizens. Another common...
The Role of Clean Energy
Authors: Romm Joseph
Published: November 2020

This chapter will focus on the clean energy revolution and the technologies most widely discussed for a transition to a low carbon economy. It will explore the scale of the energy transition needed to explain why some energy technologies are considered likely to be major...
Climate Change and You
Authors: Romm Joseph
Published: November 2020

This chapter will explore some of the more personal questions that climate change raises for individuals and their families.

How will climate change impact you and your family in the coming decades?

The transition to a low-carbon economy is inevitable this century, and indeed...
Beliefs About
Authors: McAuliffe Jane
Published: November 2020

Why do Muslims say that the Qur’an is God’s Own Word?

First of all, Muslims mean that the Qur’an is not Muhammad’s speech and was not written by him; it does not record divinely inspired images and ideas that he formulated and then presented in...
What does the Qur’an say about . . . ?
Authors: McAuliffe Jane
Published: November 2020

This book’s final section rapidly surveys many topics, all of which are frequently raised and discussed in the popular media. Some of these subjects, such as veiling, martyrs (often in the guise of suicide bombers), female genital mutilation, and forms of severe punishment, regularly generate...
Introduction
Authors: McCarty Nolan
Published: November 2020

The months following the election and inauguration of Donald J. Trump have been a time for reflection about the state of American politics and its deep ideological, cultural, racial, regional, and economic divisions. But one aspect that contemporary discussions often miss is that these fissures...
Is the Public Polarized?
Authors: McCarty Nolan
Published: November 2020

Given the widespread belief that the American public is deeply divided into Red and Blue camps who view each other with disdain and distrust, many readers may be surprised to learn that there is still a vigorous academic debate as to whether the public is...
What Everyone Needs to Know About Mormonism (or the Church of Jesus Christ of Latter-Day Saints)
Authors: Givens Terryl
Published: November 2020

Let’s start with the name: What to call them?

It is often the case that a word originally invoked as a term of derision comes to be tolerated—or even embraced—by the group to which it is attached. “Yankee” was not a complimentary label in...
Culture
Authors: Givens Terryl
Published: November 2020

How homogeneous are the Latter-day Saints?

Latter-day Saints do not constitute an ethnicity; however, they do diverge—in the United States at least—from national norms across a broad spectrum of cultural and social characteristics. Saints in the United States tend to be overwhelmingly white (86...
Foreign Trade in World History
Authors: Krueger Anne O.
Published: November 2020

Trade policy has long been contentious and stirred strong emotions. In the US, the most famous early controversy was the Boston Tea Party, in which the Americans objected to the tax (tariff) imposed by the British on imports of tea. The slogan for the...
What About Currency Manipulation?
Authors: Krueger Anne O.
Published: November 2020

What is the exchange rate and what does it have to do with trade?

A country’s currency, or exchange rate, is the price of a unit of foreign exchange in domestic currency (such as 1 British pound costs $1.30) or its converse, the amount...
China
Authors: Krueger Anne O.
Published: November 2020

How did China change?

In 1982, China was an extremely impoverished developing country with such sluggish growth that it is arguable whether living standards had risen at all in the previous several decades. China had been virtually irrelevant in the international economy: it had...
Explaining What Punishments the Senate May Impose
Authors: Gerhardt Michael J.
Published: November 2020

What punishments may be imposed in an impeachment proceeding?

The Constitution provides that “Judgment in cases of impeachment shall not extend further than to removal from Office, and disqualification to hold and enjoy any Office of honor, trust or profit under the United States.”1...
Treatment for Opioid Addiction
Authors: Olsen Yngvild , Sharfstein Joshua M.
Published: November 2020

What are the goals of treatment for opioid addiction?

The three major goals of treatment are to stay alive, to reduce and then stop opioid misuse, and to begin to rebuild a life.

Amid an epidemic of opioid overdoses, staying alive is a goal...
Opioids and Pregnancy
Authors: Olsen Yngvild , Sharfstein Joshua M.
Published: November 2020

What are the risks of opioid exposure during pregnancy?

Opioids cross the placenta. That means when a pregnant woman consumes opioids, some pass through to her developing fetus.

The most direct impact of opioids on the fetus is the development of tolerance. Just as...
Harm Reduction Policy for the Opioid Epidemic
Authors: Olsen Yngvild , Sharfstein Joshua M.
Published: November 2020

What is harm reduction?

Harm reduction is “a set of practical strategies aimed at reducing negative consequences associated with drug use.” It is also “a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”...
Surveillance, Evaluation, and Research and the Opioid Epidemic
Authors: Olsen Yngvild , Sharfstein Joshua M.
Published: November 2020

How well is the United States tracking the opioid epidemic?

Not well. For a threat that has cost tens of thousands of lives and reduced US life expectancy, the opioid crisis is not sufficiently monitored. Federal reports with data on the number of...
The Hidden Welfare State
Authors: Burman Leonard E. , Slemrod Joel
Published: November 2020

Are a trillion dollars in middle-class entitlement programs really hidden in the tax code?

Yes, give or take . . . The actual amount is in dispute for reasons we’ll get to, but many spending programs, big and small, are run through the income tax....
Snake Oil
Authors: Burman Leonard E. , Slemrod Joel
Published: November 2020

Wouldn’t a flat tax be super simple and efficient?

As discussed in chapter 4, the flat tax is basically a value-added tax with a wrinkle: businesses are allowed a deduction for wages paid, but the employees are subject to a single-rate tax on...
What Causes Eating Disorders?
Authors: Walsh B. Timothy , Attia Evelyn , Glasofer Deborah R.
Published: November 2020

Eating disorders are complex illnesses, associated with problems in emotions, behavior, and medical well-being. For many illnesses, the most effective treatments have come as a result of identifying the cause—for example, effective treatment for AIDS became possible only after a specific virus (HIV) was...
Are There Medications That Are Helpful?
Authors: Walsh B. Timothy , Attia Evelyn , Glasofer Deborah R.
Published: November 2020

Medications are one tool in the eating disorders treatment toolbox. Several different types of medications can be useful, even dramatically so. Sometimes medications are prescribed for short periods of time—days or weeks—but more typically, people need to take them for weeks or months to...
What Kinds of Psychotherapy Help Eating Disorder Symptoms The Most?
Authors: Walsh B. Timothy , Attia Evelyn , Glasofer Deborah R.
Published: November 2020

Although the landscape of helpful psychotherapies for eating disorders continues to evolve, several promising interventions are already available. They differ somewhat in theory and practice but share several features. First, these talk therapies focus on the present—on the here and now. They are more...
Nuclear Weapons and Us–North Korea Relations
Authors: McEachern Patrick
Published: November 2020

When did North Korea first pursue nuclear technology?

North Korea first demonstrated interest in nuclear technology in the 1950s. North Korean leader Kim Il Sung likely learned about the power of nuclear weapons in August 1945, along with most of the world, when...
Korean Leadership in the Twenty-First Century
Authors: McEachern Patrick
Published: November 2020

What were the ten years of progressive rule in South Korea?

After South Korea’s democratization in the late 1980s, the country continued to be led by conservative presidents until the South Korean populace elected progressive candidate Kim Dae-jung in 1997; he was inaugurated...
Inter-Korean Relations in the Twenty-First Century
Authors: McEachern Patrick
Published: November 2020

What were the inter-Korean summits?

North Korean leaders have agreed to meet with all three of South Korea’s progressive presidents but have refused to meet any of its conservative ones. South Korean conservatives toe a harder line on North Korea, including on security...
The Future
Authors: McEachern Patrick
Published: November 2020

What are the prospects for Korean unification?

The near-term prospects for Korean unification are dim, but unification remains a constitutionally derived, foundational idea of the ROK and DPRK that makes its eventual realization possible. Korean nationalism is strong on both sides of the DMZ....
Introduction
Authors: Steketee Gail , Bratiotis Christiana
Published: November 2020

In 2013, the American Psychiatric Association determined that hoarding disorder (HD) is a diagnosable mental health condition. This disorder has been studied only in the past three decades, although information about this surprisingly common problem has been accumulating at a great rate in recent years....
Population, Geography, and History
Authors: Kroeber Arthur R.
Published: November 2020

How does China’s size and population affect its economy?

It is an obvious fact, but it bears repeating: China is the world’s largest nation by population (1.4 billion) and its fourth largest by area, with a geographic size almost identical to that of the United...
From Dardania to Yugoslavia
Authors: Judah Tim
Published: November 2020

For as long as anyone can remember, the history of Kosovo has been a battlefield pitting Serbs against Albanians. Each believes different things because each has been taught different things, and as they reach further back into time it becomes easier to argue whatever...
Social Entrepreneurship
Authors: Bornstein David , Davis Susan
Published: November 2020

In development circles, there is now widespread consensus that social entrepreneurs represent a far better mechanism to respond to needs than we have ever had before--a decentralized and emergent force that remains our best hope for solutions that can keep pace with our problems and create a more peaceful world. David Bornstein’s previous book on social entrepreneurship, How to Change the World, was hailed by Nicholas Kristof in The New York Times as “a bible in the field” and published in more than twenty countries. Now, Bornstein shifts the focus from the profiles of successful social innovators in that book--and teams with Susan Davis, a founding board member of the Grameen Foundation--to offer the first general overview of social entrepreneurship. In a Q & A format allowing readers to go directly to the information they need, the authors map out social entrepreneurship in its broadest terms as well as in its particulars. Bornstein and Davis explain what social entrepreneurs are, how their organizations function, and what challenges they face. The book will give readers an understanding of what differentiates social entrepreneurship from standard business ventures and how it differs from traditional grant-based non-profit work. Unlike the typical top-down, model-based approach to solving problems employed by the World Bank and other large institutions, social entrepreneurs work through a process of iterative learning--learning by doing--working with communities to find unique, local solutions to unique, local problems. Most importantly, the book shows readers exactly how they can get involved. Anyone inspired by Barack Obama’s call to service and who wants to learn more about the essential features and enormous promise of this new method of social change, Social Entrepreneurship is the ideal first place to look.
Why Ukraine?
Authors: Yekelchyk Serhy
Published: November 2020

Why did Ukraine become a key reference point of American political struggles?

In recent years, Ukraine has emerged as the most prominent test case of American support for democracy and liberal economic reforms worldwide. A combination of several factors has made Ukraine and the...
Ukraine After Communism
Authors: Yekelchyk Serhy
Published: November 2020

Did the Ukrainians have to fight the Russians in order to secede from the Soviet Union?

In the last years of the Soviet Union, Mikhail Gorbachev’s inconsistent attempts to democratize political life resulted in the devolution of power from the centralized party apparatus to...
Livestock, Meat, and Fish
Authors: Paarlberg Robert
Published: November 2020

How are farm animals different from crops?

In some respects, they are not so different. Human beings have eaten animals—including fish—from the beginning, and we have bred domesticated animals to serve our food purposes in much the way that we have bred crops. Moreover, market...
From the Greeks to the Enlightenment
Authors: Ruse Michael
Published: November 2020

How Do We Go about Our Task?

In a perfect world, no doubt, we would consider belief and nonbelief equally for every society, for every inhabitant of Planet Earth. Christianity would count no more than, say, the cargo cult of the Melanesians. The denial...
From the Enlightenment to the Present
Authors: Ruse Michael
Published: November 2020

Were There Then No Atheists in the Enlightenment?

In 1762, David Hume left his native Edinburgh, the capital of Calvinist Scotland, and moved to the more open climes of Paris, the capital of freethinking France. Invited to dinner by the notorious Paul-Henri Thiry, Baron...
The Meaningful Life
Authors: Ruse Michael
Published: November 2020

The End of Religion?

If the arguments of Sextus Empiricus were so penetrating, if the dialogues of David Hume were so devastating, if the rhetoric of Richard Dawkins was so powerful, why on earth does anyone go on believing? Why is Christianity not on...
Ethics and the Profession of Arms
Authors: Lucas George
Published: November 2020

How can we talk about ethics in war, when people are killing each other and deliberately inflicting destruction and misery on one another?

This question expresses a common misconception that has a grain of truth. Of course killing people and destroying property are morally wrong in virtually all...
Military Ethics Apart from Combat
Authors: Lucas George
Published: November 2020

Does military ethics apply to matters other than declaring and waging war?

Military personnel are stationed in military posts and bases throughout their own countries and may be deployed on a continuing basis in other parts of the world. From there they participate in...
What’s Ahead
Authors: Blumenstyk Goldie
Published: November 2020

What does “disruption” mean when it comes to the future of higher education?

In this period of what might be considered higher education’s era of the re-set, “disruption” may well be the key buzzword. In the 1990s, Harvard Business School professor Clayton M. Christensen coined...
VAWG and Gender Discrimination, Inequality, and Power
Authors: True Jacqui
Published: November 2020

Is gender discrimination a form of VAWG?

Discriminatory gender norms may be reflected in laws, such as criminal laws that prohibit violent acts occurring in the public realm but not in the home, and civil laws that do not allow women to pass on...
Development, Poverty, and VAWG
Authors: True Jacqui
Published: November 2020

Is VAWG a “developing country”problem?

Violence against women and girls is a problem everywhere, affecting women and girls of all ages, in all locations, and regardless of income level and social status. A 2013 WHO global study revealed that over 35 percent of women...
Education, Schools, and VAWG
Authors: True Jacqui
Published: November 2020

How is VAWG perpetrated at school and through educational processes and curricula?

School-related gender-based violence (SRGBV) and VAWG occurring within the context of educational institutions are problems in all countries in the world and cut across cultural, geographic, and economic differences in societies. They...
Legal Frameworks: National and International
Authors: True Jacqui
Published: November 2020

What national laws cover VAWG? In how many countries is VAWG still not a crime?

National laws covering VAWG vary drastically throughout the world. In some countries, they are extremely comprehensive; in others, there remain large gaps that leave more women and girls vulnerable...
Pope Francis
Authors: Allen John L.
Published: November 2020

When you’re talking about an institution with more than 2,000 years of history, it’s not often that the term “unprecedented” applies. As Cardinal Francis George of Chicago famously said, “In the Church, everything’s happened at least once.” Yet the drama of the first half of...
Turkey in the world
Authors: Finkel Andrew
Published: November 2020

Where does Turkey fit into the world?

A map is the obvious place to see where Turkey fits in the world. It lies at the intersection of several overlapping regions—the Balkans, the Caucasus, the Middle and Near East, and the Eastern Mediterranean. However, the...
Conclusion
Authors: Finkel Andrew
Published: November 2020

What sort of future does Turkey face?

Since this is the last question, I allow myself the luxury of answering it obliquely, or at the very least with an anecdote or two. In 2007 I returned to Turkey after an absence of a year....
The Darfur Peace Process
Authors: Natsios Andrew S.
Published: November 2020

Given the success of the CPA, why hasn’t a similar agreement been negotiated for Darfur?

As we’ve seen, the situation in Sudan is complicated because the second civil war—North versus South—occurred while rebellions were taking place in other regions of the country—in the Nuba Mountains,...
Mixed Fisheries
Authors: Hilborn Ray , Hilborn Ulrike
Published: November 2020

Do fisheries catch one species or more?

Quite a few fisheries catch only one species. Many of the major fisheries fall into that category, including Peruvian anchoveta, the largest fishery in the world, as well as Alaska pollock, the biggest American fishery, and the...
Small-Scale and Artisanal Fisheries
Authors: Hilborn Ray , Hilborn Ulrike
Published: November 2020

Many of the fisheries of the world are small scale—how can they be managed?

The “loco” is a carnivorous marine snail common to the rocky shores of Chile and Peru. A large individual is about the size of a slightly flattened fist and would...
Contemporary Abortion Politics I—Opinions and Science
Authors: Solinger Rickie
Published: November 2020

What are the most common objections to abortion today, and how have objections changed over time?

Objections to abortion have changed over time. In the nineteenth century, before antibiotics, many physicians favored outlawing abortion in order to protect pregnant women from infection and...
Contemporary Abortion Politics Ii—experience and Practice
Authors: Solinger Rickie
Published: November 2020

What is the abortion rate in the United States and how has it changed in recent years?

After 1990, the number and rate of abortions declined every year for about a decade and a half, but recently, the number of abortions nationally has...
Adoption
Authors: Solinger Rickie
Published: November 2020

What does adoption look like in the United States today?

In the middle of the twentieth century, adoption became a widespread practice in the United States when thousands of parents and community authorities each year put harsh pressure on shamed, white unmarried girls and...
Birthing, Breast-Feeding, and Reproductive Politics
Authors: Solinger Rickie
Published: November 2020

In what settings are babies born in the United States today?

In 1900 more than 95 percent of American women gave birth at home. Fourteen years later, anesthesia, or “twilight sleep,” was first used to dull labor pains, accelerating over time the transition of...
Global Reproductive Health and us Programs and Politics
Authors: Solinger Rickie
Published: November 2020

What is USAID’s family-planning program?

The United States Agency for International Development (USAID) is an independent federal agency that provides economic, developmental, and humanitarian assistance around the world in support of the foreign policy goals of the United States. USAID’s family-planning programs reside within...
Health Care and Reproductive Politics
Authors: Solinger Rickie
Published: November 2020

What does the federal health care reform act of 2010 say about pregnancy, contraception, abortion, and reproductive health care generally?

The United States has the most expensive health care system of any country in the world. Medical costs per person and the percentage of...
Pandemics
Authors: Doherty Peter C.
Published: November 2020

From HIV to H1N1, pandemics pose one of the greatest threats to global health in the twenty-first century. Defined as epidemics of infectious disease across large geographic areas, pandemics can disseminate globally with incredible speed as humans and goods move faster than ever before. While vaccines, drugs, quarantine, and education can reduce the severity of many outbreaks, factors such as global warming, population density, and antibiotic resistance have complicated our ability to fight disease. Respiratory infections like influenza and SARS spread quickly as a consequence of modern, mass air travel, while unsafe health practices promote the spread of viruses like HIV/AIDS and hepatitis C. In Pandemics: What Everyone Needs to Know, Nobel Prize-winning immunologist Peter C. Doherty addresses the history of pandemics and explores the ones that persist today. He considers what promotes global spread, the types of pathogens most present today and the level of threat they pose, and how to combat outbreaks and mitigate their effects. Concise and informative, Pandemics will serve as the best compact consideration of this topic, written by a major authority in the field.
A New Russia
Authors: Colton Timothy J.
Published: November 2020

What went wrong with the attempt to reform Communism?

Mikhail Gorbachev in 1990 was the only Russian statesman ever awarded the Nobel Peace Prize (the scientist and rights advocate Sakharov won it in 1975). The committee, and justifiably, commended him for his “leading role in...
A Better Edition of Itself?
Authors: Colton Timothy J.
Published: November 2020

Why did Russia annex Crimea?

The short- and long-term challenges facing Russia are legion. In the short haul, one of the most daunting is to sort through repercussions of events to its immediate southwest. The decision to commandeer Crimea from independent Ukraine in 2014, belying...
Economic Freedom
Authors: Brennan Jason
Published: November 2020

What economic rights do libertarians believe we have?

We have a general right to conduct our financial and commercial affairs as we see fit, without having to justify ourselves or answer to society at large. Just as recognizing religious liberty requires the general protection...
Social Justice and the Poor
Authors: Brennan Jason
Published: November 2020

What is social justice?

Social justice, or distributive justice, is a moral standard by which some people judge political and economic institutions. Advocates of social justice believe the moral justification of our institutions depends on how well these institutions serve the interests of the...
Instruments of Monetary Policy
Authors: Axilrod Stephen H.
Published: November 2020

How are the Fed’s monetary instruments employed in the policy process?

In implementing its monetary policy, the Fed has several policy instruments available to it, principally the open market, discount window, and reserve requirement functions noted earlier. They all work through their influence on...
“The Next great Copyright Act”
Authors: Netanel Neil Weinstock
Published: November 2020

What is copyright reform?

The term “copyright reform” connotes a significant modification or full-scale revision of the Copyright Act. Congress typically entertains the possibility of copyright reform when new technologies for disseminating creative expression have rendered the existing Copyright Act inadequate or obsolete.

Our current...
What is Greece?
Authors: Kalyvas Stathis N.
Published: November 2020

What is this book about?

This is an attempt to make sense of the modern history of Greece. Using the term “modern Greece” is common practice in English, implying a sharp contrast between a contemporary society and its ancient antecedent, often called simply “Greece.” Greeks, however,...
Turmoil
Authors: Kalyvas Stathis N.
Published: November 2020

What was the National Schism?

Following a pattern similar to the past, Greece’s triumph in the Balkan Wars would eventually turn into a disaster. Despite (or, perhaps, because of) his intense reformist drive, Eleftherios Venizelos became a polarizing political figure, contributing to the emergence...
Geopolitics
Authors: Kamdar Mira
Published: November 2020

Who are India’s neighbors?

India is by far the largest economy in South Asia, dominating neighboring Pakistan, Sri Lanka, Bangladesh, Myanmar, and Nepal, not to mention tiny Bhutan and Sikkim. It also shares a disputed border with China, a nuclear power whose military and economic...
Important Residues from the Precolonial Period
Authors: Steinberg David I.
Published: November 2020

The Burmese look with increasing pride on their precolonial history. No group has more assiduously made contemporary use of the record of approximately 1,000 years of Burman hegemony of the region we now call Burma/Myanmar and some neighboring areas than the present State Law and...
Introduction to the Marine Environment and Pollution
Authors: Weis Judith S.
Published: November 2020

What is the marine environment?

As used in this book, the marine environment covers not only the ocean, but estuaries (e.g., bays), which are coastal areas where the seawater is diluted with freshwater coming from rivers and streams, or sometimes groundwater. Much of the...
Biological Pollution
Authors: Weis Judith S.
Published: November 2020

Where does microbial pollution come from?

Microbial pollution comes from sewage that has not been properly treated. Fecal contamination is a concern because some of the microbes it contains can cause illness. High levels of pathogens may be present in effluent from sewage plants...
Regulating and Reducing Pollution
Authors: Weis Judith S.
Published: November 2020

What is the Ocean Health Index?

Using a new comprehensive index designed to assess the benefits to people of healthy oceans, a group of scientists led by Ben Halpern have evaluated the ecological, social, economic, and political conditions for every coastal country in the...
CE: Community-Acquired Pneumonia: A Review of Current Diagnostic Criteria and Management
Authors: Cook Linda Kay , Wulf Janet Armstead
Published: November 2020

Among the most common causes of U.S. adult hospitalizations, pneumonia accounted for nearly 50,000 deaths in the United States in 2017. This article provides nurses with a thorough update on pneumonia risk factors, signs and symptoms, and diagnostic criteria, as well as inpatient treatment recommendations and recommendations for discharge and prevention, including the nurse's role in patient and family teaching. The article also details key similarities and differences between the new 2019 guideline jointly developed by the American Thoracic Society and the Infectious Diseases Society of America on diagnosis and treatment of adults with community-acquired pneumonia and their earlier 2007 guideline. One crucial difference is the growing recognition that the etiology of pneumonia is changing, necessitating the abandonment of prior categorizations of pneumonia type when determining antibiotic coverage in favor of reliance on local epidemiology and validated risk factors for antimicrobial resistance.
Examination of nursing home financial distress via Porter’s five competitive forces framework
Authors: Lord Justin , Weech-Maldonado Robert , Blackburn Justin , Carroll Nathaniel
Published: November 2020

Background

Nursing homes face increased risk of closure because of poor financial performance.

Purpose

Using resource dependency theory, Porter’s Five Forces of Competition framework, and Altman’s Z-score model, this study examines the relationship between market factors and nursing home financial distress.

Methodology/Approach

This study utilizes Medicare Cost Reports, LTCFocus, Certification and Survey Provider Enhanced Reporting, Online Survey Certification and Reporting, and the Area Health Resource File to examine an average of 10,454 nursing homes per year from 2000 to 2015. Using Porter’s framework, market factors were conceptualized as the bargaining power of buyers and suppliers, threat of substitutes and new entrants, and industry rivalry. Organizational control variables include occupancy, payer mix, size, and chain affiliation. Data were analyzed using multinomial logistic regression with robust clustering, year, and state fixed effects.

Results

Distressed nursing homes (Relative Risk Ratios [RRR] = 0.991) were less likely to be in counties with higher Medicaid concentration. Distressed (RRR = 0.717) and at-risk-of-distress nursing homes (RRR = 0.807) were less likely to be in markets with home health agencies, and nursing homes at risk of distress (RRR = 1.005) were more likely to be in markets with a higher number of hospital-based skilled nursing facility beds compared to healthy organizations. The organizational-level variables, occupancy, payer mix, size, and chain affiliation had a significant impact on nursing home financial distress.

Conclusions

The effects of external market forces on nursing home financial distress were limited; however, organizational-level variables had a significant impact on nursing home financial distress.

Practical Implications

Study findings can inform policy makers on specific factors associated with nursing home financial distress and provide greater insight as it relates to designing new policies and interventions.
Benzylpenicillin Serum Concentrations in Neonates With Group B Streptococci Sepsis or Meningitis
Authors: Jansen Sophie J. , Lopriore Enrico , Bredius Robbert G. M. , van der Beek Martha T. , Moes Dirk J. A. R. , Bekker Vincent
Published: November 2020

Background:

Adequate dosage recommendations are imperative for successful treatment of invasive infections. We evaluated the occurrence of sub- and supratherapeutic serum and cerebrospinal fluid (CSF) concentrations of benzylpenicillin (BPEN) in neonates treated for a severe group B streptococci (GBS) sepsis and/or meningitis as well as discrepancies in dosing recommendations provided by pediatric reference sources.

Methods:

Retrospective analysis of (pre)term infants treated with BPEN undergoing therapeutic drug monitoring (TDM) between May 2015 and May 2019. Outcomes included numbers of sub- and supratherapeutic concentrations, and dose adjustments, clinical evolution, and dosing recommendations from six pediatric reference sources.

Results:

A total of 21 TDM samples from 8 neonates were evaluated. Among serum concentrations, 9/21 (43%) were below and 8/21 (38%) above the pre-specified therapeutic target range of 10–20 mg/L. Only 1 patient had BPEN determined in CSF whose concentration was below the lower limit of quantification. TDM identified a need for dose modification in 10/21 (48%) instances. Three of eight patients exhibited complete resolution of clinical, laboratory and radiologic signs of infection. Substantial variation in dosing recommendations (50,000–400,000 IE/kg/d) was present between reference sources.

Conclusions:

Our data reveal that under current dosage recommendations, the predefined target serum or CSF concentrations of BPEN are not achieved in all children. In case of clinical failure, serum and/or CSF BPEN concentrations should be determined. Given the wide variation in concentrations and subsequent dose requirements, further exploration of the clinical and pharmacologic characteristics of BPEN in (pre)term neonates is essential to optimize therapeutic efficacy.
Posterior chamber phakic intraocular lens with central-port design in 45- to 55-year-old patients: 1-year follow-up
Authors: Alfonso José F. , Lisa Carlos , Fernández-Vega-Cueto Luis , Besteiro Juan , Alfonso-Bartolozzi Belén
Published: November 2020

Purpose:

To assess the efficacy, safety, and predictability of the Visian implantable collamer lens with a central port in patients aged between 45 and 55 years.

Setting:

Fernández-Vega Ophthalmological Institute, Oviedo, Spain.

Design:

Retrospective case series.

Methods:

Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events over a 1-year period were evaluated retrospectively.

Results:

A total of 87 eyes (49 patients) were evaluated. The mean postoperative UDVA and CDVA were 0.82 ± 0.24 and 0.93 ± 0.12, respectively. Seventy-eight eyes (approximately 90%) achieved a CDVA of 20/25 or greater. No eye lost 1 or more lines, 53 eyes (60.92%) did not change, 15 eyes (17.24%) gained 1 line, and 19 eyes (21.84%) gained 2 lines or more of CDVA. The efficacy and safety indexes were 0.95 and 1.08, respectively. Seventy-eight eyes (89.65%) were within ±0.50 diopter (D) of the desired sphere refraction, and all eyes (100%) were within ±1.00 D. Fifty eyes (57.7%) showed a spherical equivalent within ±0.13 D. The mean postoperative IOP was 13.58 ± 1.79 mm Hg, and no significant rise (>18 mm Hg) occurred during the follow-up. The largest proportion of eyes (35.63%) reported a reduction in IOP by 1 to 2 mm Hg. Postoperative mean ECD was 2574 ± 362 cells/mm2 (0.41% loss from the preoperative baseline). The mean postoperative vault was 398 ± 187 μm, being the most prevalent range from 201 to 300 μm (22.89% of eyes). No adverse events were reported during the study.

Conclusions:

The outcomes reported in this study support the use of this lens in older patients.
Romiplostim as a Therapeutic Intervention for Tacrolimus-induced Immune Thrombocytopenia in a Pediatric Cardiac Transplant Patient
Authors: Gipson Daniel R. , Larkin Trisha , Seifert Robert , Black L. Vandy
Published: November 2020

Tacrolimus-induced immune thrombocytopenia (ITP) is a rare entity that can occur years after initiation of tacrolimus therapy following solid organ transplantation, and platelet recovery can be substantially delayed following discontinuation of tacrolimus. Romiplostim, a thrombopoietin receptor agonist approved by the FDA in 2018 for the treatment of chronic ITP in children, may be a useful therapy to hasten platelet recovery in the acute ITP setting in place of immunomodulating agents. We present a case of tacrolimus-induced ITP successfully treated with romiplostim in a child following cardiac transplantation.
Pediatric Inflammatory Multisystem Syndrome Associated With SARS-CoV-2
Authors: Bustos B Raúl , Jaramillo-Bustamante Juan Camilo , Vasquez-Hoyos Pablo , Cruces Pablo , Díaz Franco
Published: November 2020

Pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies of PIMS-TS, including 468 children reported before July 1, 2020. We found a myriad of clinical features, but we were able to describe common characteristics: previously healthy school-aged children, persistent fever and gastrointestinal symptoms, lymphopenia, and high inflammatory markers. Clinical syndromes such as myocarditis and Kawasaki disease were present in only one third of cases each one. Pediatric intensive care unit admission was frequent, although length of stay was less than 1 week, and mortality was low. Most patients received immunoglobulin or steroids, although the level of evidence for that treatment is low. The PIMS-ST was recently described, and the detailed quantitative pooled data will increase clinicians’ awareness, improve diagnosis, and promptly start treatment. This analysis also highlights the necessity of future collaborative studies, given the heterogeneous nature of the PIMS-TS.
18F-Sodium Fluoride PET/CT Findings in Osteitis Condensans Ilii
Authors: Usmani Sharjeel , Ahmed Najeeb , al Kandari Fareeda
Published: November 2020

Osteitis condensans ilii (OCI) is a benign cause of low back pain for which no clear etiology has been identified. We report cases of 2 women with breast cancer referred for 18F-NaF PET/CT for skeletal staging. Both cases show characteristic findings of OCI on CT images, with 18F-NaF PET uptake in symptomatic patient and no uptake in asymptomatic. 18F-NaF PET CT can be useful in evaluating back pain and may be used as an adjunctive biological maker for assessing OCI as a potential cause of pain.
18F-FDG PET/CT in Initial Diagnosis and Treatment Response Evaluation of Anti-NMDAr and Anti-GAD Dual Antibody Autoimmune Encephalitis
Authors: Seniaray Nikhil , Verma Ritu , Ranjan Rajeev , Belho Ethel , Mahajan Harsh
Published: November 2020

We report a case of 34-year-old woman presenting with complaints of abnormal posturing of hand and tonic-clonic seizures of few days’ duration, which soon progressed to psychotic episodes and injuries secondary to fall/abnormal movements. She underwent 18F-FDG PET for a suspicion of encephalitis, which revealed increased FDG uptake in the bilateral parietotemporal lobes (right more than left), anterior cingulate cortex, bilateral basal ganglia, thalami, and cerebellum. This atypical pattern did not conform to any known pattern of encephalitis, which was later attributed to the presence of both anti-NMDAr and anti-GAD antibodies in blood and cerebrospinal fluid.
18F-FDG PET/CT Imaging of Testicular Myeloid Sarcoma in a Pediatric Patient
Authors: Wu Junhao , Jiang Guohao , Wu Ji , Ou Lei , Zhang Chunyin
Published: November 2020

A 5-year-old boy presented with right testicular swelling for 1 week. Ultrasonography revealed a right testicular hypoechoic mass with increased blood flow. A malignant tumor was suspected, and further investigation with 18F-FDG PET/CT showed a soft tissue mass with increased FDG uptake in the right testis. Biopsy of the mass confirmed a diagnosis of myeloid sarcoma.
Dental Topics for Plastic Surgeons, Part Three: Infection and Trauma of the Dentition
Authors: Zajac Jocelyn C. , Manrique Monica , Fleury Christopher M. , Marrazzo Jason , Mantilla-Rivas Esperanza , Talbet Joseph H. , Brennan Ashleigh M. , Aivaz Marudeen , Oh Albert K. , Tate Anupama R. , Rogers Gary F.
Published: November 2020

Conditions that affect dental and periodontal structures receive sparse coverage in the plastic surgery literature, yet a working knowledge of this subject matter is important in certain areas of clinical practice and a fundamental understanding is part of plastic surgery competency tested on the in-service and written board examinations. This 4-part series written to provide plastic surgeons with a working knowledge of dental topics that may be relevant to their clinical practice. This section, Part III, covers inflammatory and infectious conditions of the dentition and related structures, as well as dentoalveolar trauma.
Molecular characterization of methicillin-resistant and -susceptible Staphylococcus aureus recovered from hospital personnel
Authors: Xu Zhen , Li Xiaodong , Tian Dan , Sun Zhuoyu , Guo Liqiong , Dong Cuixia , Tang Naijun , Mkrtchyan Hermine V.
Published: November 2020

Introduction. Methicillin-resistant

Staphylococcus aureus

(MRSA) is one of the major causes of hospital-acquired infections. Over the past two decades MRSA has become ‘epidemic’ in many hospitals worldwide. However, little is known about the genetic background of

S. aureus

recovered from hospital personnel in China.

Hypothesis/Gap Statement. The diversity of

S. aureus

genotypes warrants further surveillance and genomic studies to better understand the relatedness of these bacteria to those recovered from patients and the community.

Aim. The aim of this study was to determine the genetic diversity of MRSA and methicillin-susceptible

S. aureus

(MSSA) recovered from hospital personnel in Tianjin, North China.

Methodology. Three hundred and sixty-eight hand or nasal swabs were collected from 276 hospital personnel in 4 tertiary hospitals in Tianjin, North China between November 2017 and March 2019. In total, 535 Gram-positive bacteria were isolated, of which 59 were identified as

S. aureus

. Staphylococcal cassette chromosome mec (SCCmec) typing, multi-locus sequence typing (MLST) and spa typing were performed to determine the molecular characteristics of

S. aureus

.

Results. Thirty-one out of 276 (11 %) hospital personnel were

S. aureus

carriers, whereas 11/276 (4 %) carried MRSA. Fifty out of 59 (85 %)

S. aureus

isolates were resistant or intermediately resistant to erythromycin. The dominant genotypes of MRSA recovered from hospital personnel were ST398-t034-SCCmecIV/V and ST630-t084/t2196, whereas the major genotypes of MSSA included ST15-t078/t084/t346/t796/t8862/t8945/t11653 and ST398-t189/t034/t078/t084/t14014.

Conclusion. Although the predominant genotypes of MRSA recovered from hospital personnel in this study were different from the main genotypes that have previously been reported to cause infections in Tianjin and in other geographical areas of China, the MRSA ST398-t034 genotype has previously been reported to be associated with livestock globally. The dominant MSSA genotypes recovered from hospital personnel were consistent with the those previously reported to have been recovered from the clinic.
MicroRNA-24-3p promotes skeletal muscle differentiation and regeneration by regulating HMGA1
Authors: Dey Paromita , Soyer Miles A. , Dey Bijan K.
Published: November 2020

Numerous studies have established the critical roles of microRNAs in regulating post-transcriptional gene expression in diverse biological processes. Here, we report on the role and mechanism of miR-24-3p in skeletal muscle differentiation and regeneration. miR-24-3p promotes myoblast differentiation and skeletal muscle regeneration by directly targeting high mobility group AT-hook 1 (HMGA1) and regulating it and its direct downstream target, the inhibitor of differentiation 3 (ID3). miR-24-3p knockdown in neonatal mice increases PAX7-positive proliferating muscle stem cells (MuSCs) by derepressingHmga1andId3. Similarly, inhibition of miR-24-3p in the tibialis anterior muscle preventsHmga1andId3downregulation and impairs regeneration. These findings provide evidence that the miR-24-3p/HMGA1/ID3 axis is required for MuSC differentiation and skeletal muscle regenerationin vivo.
Long-read isoform sequencing reveals survival-associated splicing in breast cancer
Authors: Veiga Diogo F.T. , Nesta Alex , Zhao Yuqi , Mays Anne Deslattes , Huynh Richie , Rossi Robert , Wu Te-Chia , Palucka Karolina , Anczukow Olga , Beck Christine R. , Banchereau Jacques
Published: November 2020

Tumors display widespread transcriptome alterations, but the full repertoire of isoform-level alternative splicing in cancer is not known. We developed a long-read RNA sequencing and analytical platform that identifies and annotates full-length isoforms, and infers tumor-specific splicing events. Application of this platform to breast cancer samples vastly expands the known isoform landscape of breast cancer, identifying thousands of previously unannotated isoforms of which ~30% impact protein coding exons and are predicted to alter protein localization and function, including of the breast cancer-associated genesESR1andERBB2. We performed extensive cross-validation with -omics data sets to support transcription and translation of novel isoforms. We identified 3,059 breast tumor-specific splicing events, including 35 that are significantly associated with patient survival. Together, our results demonstrate the complexity, cancer subtype-specificity, and clinical relevance of novel isoforms in breast cancer that are only annotatable by LR-seq, and provide a rich resource of immuno-oncology therapeutic targets.
A scale-free, fully connected global transition network underlies known microbiome diversity
Authors: Jing Gongchao , Zhang Yufeng , Liu Lu , Wang Zengbin , Sun Zheng , Knight Rob , Su Xiaoquan , Xu Jian
Published: November 2020

Microbiomes are inherently linked by their structural similarity, yet the global features of such similarity are not clear. Here we propose as solution a search-based microbiome transition network. By traversing a composition-similarity based network of 177,022 microbiomes, we show that although the compositions are distinct by habitat, each microbiome is on-average only seven neighbors from any other microbiome on Earth, indicating the inherent homology of microbiome at the global scale. This network is scale-free, suggesting a high degree of stability and robustness in microbiome transition. By tracking the minimum spanning tree in this network, a global roadmap of microbiome dispersal was derived that tracks the potential paths of formulating and propagating microbiome diversity. Such search-based global microbiome networks, reconstructed within hours on just one computing node, provide a readily expanded reference for tracing the origin and evolution of existing or new microbiomes.
Identification of enriched hyperthermophilic microbial communities from a deep-sea hydrothermal vent chimney under electrolithoautotrophic culture conditions
Authors: Pillot G. , Ali O. Amin , Davidson S. , Shintu L. , Godfroy A. , Combet-Blanc Y. , Bonin P. , Liebgott P.-P.
Published: November 2020

Deep-sea hydrothermal vents are extreme and complex ecosystems based on a trophic chain. We are still unsure of the identities of the first colonizers of these environments and their metabolism, but they are thought to be (hyper)thermophilic autotrophs. Here we investigate whether the electric potential observed across hydrothermal chimneys could serve as an energy source for these first colonizers. Experiments were performed in a two-chamber microbial electrochemical system inoculated with deep-sea hydrothermal chimney samples, with a cathode as sole electron donor, CO2as sole carbon source, and nitrate, sulfate, or oxygen as electron acceptors. After a few days of culture, all three experiments showed growth of electrotrophic biofilms consuming the electrons (directly or indirectly) and producing organic compounds including acetate, glycerol, and pyruvate. Within the biofilms, the only known autotroph species retrieved were members ofArchaeoglobales. Various heterotrophic phyla also grew through trophic interactions, withThermococcalesgrowing in all three experiments as well as other bacterial groups specific to each electron acceptor. This electrotrophic metabolism as energy source driving initial microbial colonization of conductive hydrothermal chimneys is discussed.