bluuebunny/crossref_metadata_2025 huggingface dataset:
Moderate-to-Severe Tobacco Use Disorder and Discrimination Among U.S. Sexual Minority Older Adults
Authors: Kcomt Luisa , Evans-Polce Rebecca J , Engstrom Curtiss W , West Brady T , Boyd Carol J , McCabe Sean Esteban
Published: April 2021

Objectives

The dearth of research on age-related differences in risk factors for tobacco use disorder (TUD) among sexual minorities, particularly among older adults, can obscure the differential needs of sexual minority age groups for tobacco prevention and cessation. We examined the association of cumulative ethnic/racial discrimination and sexual orientation discrimination with moderate-to-severe TUD among U.S. sexual minority adults aged 50 years and older.

Method

We analyzed cross-sectional data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309 U.S. adults). Our sample consisted of 1,258 adults (lesbian/gay-, bisexual-, and heterosexual-identified adults with same-sex attraction/behavior) aged ≥50 years. Multivariable logistic regression analyses estimated the association of cumulative lifetime ethnic/racial discrimination and sexual orientation discrimination with past-year moderate-to-severe TUD and tested whether the association differed for adults aged 50–64 years versus those aged ≥65 years.

Results

An estimated 8.1% of the sample met criteria for moderate-to-severe TUD. Lifetime ethnic/racial discrimination and sexual orientation discrimination was not significantly associated with moderate-to-severe TUD for adults aged ≥50 years. However, a significant 2-way interaction was found between discrimination and age. In age-stratified analyses, greater discrimination was significantly associated with greater risk for moderate-to-severe TUD for adults aged ≥65 years, but not adults aged 50–64 years.

Discussion

Greater cumulative discrimination based on ethnicity/race and sexual orientation was associated with increased risk for moderate-to-severe TUD among sexual minority adults aged ≥65 years. Our findings underscore the importance of age considerations in understanding the role of discrimination in the assessment and treatment of TUD.
Psychosocial Stressors and Adaptive Coping Strategies in Couples After a Diagnosis of Young-Onset Dementia
Authors: Bannon Sarah M , Reichman Mira , Popok Paula , Grunberg Victoria A , Traeger Lara , Gates Melissa V , Krahn Erin A , Brandt Katherine , Quimby Megan , Wong Bonnie , Dickerson Bradford C , Vranceanu Ana-Maria
Published: April 2021

Background and Objectives

Diagnoses of young-onset dementias (YODs) are devastating for persons with dementia and spousal caregivers yet limited work has examined both partners’ perceptions of challenges and coping after diagnosis. This qualitative study investigated the psychosocial stressors and adaptive coping strategies in couples diagnosed with YOD to inform the development of psychosocial support resources.

Research Design and Methods

We conducted live video dyadic interviews with couples (persons with YOD and spousal caregivers together; N = 23 couples). We transcribed interviews and coded data based on a hybrid deductive–inductive approach, with the structure of the coding framework informed by the stress and coping framework, and all codes derived from the data. We derived themes and subthemes related to psychosocial stressors and adaptive coping.

Results

We identified 5 themes related to psychosocial stressors: the impact of diagnosis, social and family relationships, changing roles and responsibilities, planning for an uncertain future, and couple communication and relationship strain. We identified 7 themes related to adaptive coping strategies: processing emotions and cultivating acceptance, promoting normalcy, efforts to preserve persons with YOD’s independence and identity, collaborative and open communication, social support, meaning-making, humor, and positivity, and lifestyle changes and self-care.

Discussion and Implications

We replicated several themes regarding stressors and adaptive coping strategies from prior YOD research and identified novel themes and subthemes related to dyadic stressors, sources of couples’ relationship strain, and the ways in which couples effectively cope with YOD. Findings inform the development of dyadic interventions to reduce YOD-related distress for both persons with dementia and spousal caregivers.
Rare deleterious de novo missense variants in Rnf2/Ring2 are associated with a neurodevelopmental disorder with unique clinical features
Authors: Luo Xi , Schoch Kelly , Jangam Sharayu V , Bhavana Venkata Hemanjani , Graves Hillary K , Kansagra Sujay , Jasien Joan M , Stong Nicholas , Keren Boris , Mignot Cyril , Ravelli Claudia ,   Undiagnosed Diseases Network, Bellen Hugo J , Wangler Michael F , Shashi Vandana , Yamamoto Shinya
Published: April 2021

The Polycomb group (PcG) gene RNF2 (RING2) encodes a catalytic subunit of the Polycomb repressive complex 1 (PRC1), an evolutionarily conserved machinery that post-translationally modifies chromatin to maintain epigenetic transcriptional repressive states of target genes including Hox genes. Here, we describe two individuals, each with rare de novo missense variants in RNF2. Their phenotypes include intrauterine growth retardation, severe intellectual disabilities, behavioral problems, seizures, feeding difficulties and dysmorphic features. Population genomics data suggest that RNF2 is highly constrained for loss-of-function (LoF) and missense variants, and both p.R70H and p.S82R variants have not been reported to date. Structural analyses of the two alleles indicate that these changes likely impact the interaction between RNF2 and BMI1, another PRC1 subunit or its substrate Histone H2A, respectively. Finally, we provide functional data in Drosophila that these two missense variants behave as LoF alleles in vivo. The evidence provide support for deleterious alleles in RNF2 being associated with a new and recognizable genetic disorder. This tentative gene-disease association in addition to the 12 previously identified disorders caused by PcG genes attests to the importance of these chromatin regulators in Mendelian disorders.
Gender and Politics in Japan
Authors: Steel Gill , Martin Sherry
Published: April 2021

This article argues that Japan, a wealthy, secular country with a highly educated population, provides an important counterweight to assumptions about modernization and gender. The authors outline the ways in which gender inequality was a cornerstone of Japan’s economic development. This still has ramifications today for women’s political participation and representation, and for the quality of Japan’s democracy.
Neoclassical Realism in Japan’s Space Security
Authors: Pekkanen Saadia M.
Published: April 2021

Japan’s space security commands attention as the country shifts toward internationalism in a world returned to great power competition. Using the framing from neoclassical realism, this article discusses the ways in which Japan has adjusted both its internal portfolio and its external postures to balance against perceived threats in outer space. While neoclassical realism is foundational for understanding what motivates, empowers, and constrains states in the space domain, the article also layers in the importance of international law to the conduct of statecraft within it. Doing so gives us a more holistic understanding of the material, legal, and normative evolution of Japan’s winding space trajectories. Although Japan’s Basic Space Law of 2008 is seen as a watershed event for legal and policy purposes, the law merely caught up with the extraordinary quality and range of Japan’s long-evolving dual-use space technologies. It is these autonomous foundations that empower Japan to pursue three distinct strategies in its interest—counterspace capabilities, organizational changes, and space diplomacy—with implications for both rivals and allies in a changed world order.
Multimethod Assessment of Personality and Psychopathology
Authors: Bornstein Robert F.
Published: April 2021

Multimethod assessment of personality and psychopathology plays a central role in diagnosis, treatment planning, and risk management. This chapter presents an evidence-based framework for multimethod assessment of personality and psychopathology in clinical and research settings, with an emphasis on test score integration. To implement this framework the clinician must: (a) understand the intra- and interpersonal processes that underlie different assessment methods; (b) interpret meaningful test score divergences as well as convergences; and (c) contextualize work in this area using ideas and findings from beyond clinical psychology. Following a discussion of major personality and psychopathology assessment tools and the intra- and interpersonal dynamics that influence responses to interviews, self-attribution tests (which have traditionally been identified as objective or self-report tests), and stimulus-attribution measures (traditionally labeled projective tests), conceptual, clinical, and empirical implications of current findings in this area are discussed. A template for multimethod assessment in clinical settings is presented, using personality pathology as an exemplar. A multimethod, process-focused approach to test score validation is described, which yields separate indices of outcome-focused and process-focused validity. Finally, the principles of multimethod assessment are applied to emerging models of personality and psychopathology.
Riot Grrrl
Authors: Keenan Elizabeth K.
Published: April 2021

Since about 2010, Riot Grrrl has re-entered the public consciousness in ways that draw on nostalgia and display a desire to craft feminist histories. From reunion tours to the establishment of an archival presence in the academy, the Riot Grrrl resurgence has helped to establish the movement as an essential moment both in the founding of third-wave feminism and in the history of women in punk rock. In the process of historicization, academics and journalists have at times overemphasized Riot Grrrl’s political force, and at others struggled to address its failings, particularly around race, class, and elitism, that have shaped the movement from its beginnings. Drawing on feminist archive theory and theories of nostalgia, this chapter questions the political nature of remembering Riot Grrrl in the present day and addresses the juncture where the now-popular production of 1990s nostalgia intersects with the feminist historiography of the third wave.
Convergence in Human Resource Management
Authors: Mayrhofer Wolfgang , Brewster Chris , Pernkopf Katharina
Published: April 2021

This chapter takes the contextual view of human resource management (HRM) and its challenge to the universalistic perspective that is explored in the preceding chapters and adds the element of time. How does time change the relationship between countries in their way of managing HRM? Including time leads to a question that goes beyond snapshot views of how various aspects of context at different levels relate to HRM: How do these relationships and their effects develop as the years go by? The chapter addresses the notion of convergence in three steps. First, it examines a range of conceptual views about what convergence means in different theoretical traditions and discourses. Second, and based on that examination, it offers a balanced overview of the conceptual and empirical evidence about how HRM has been developing in different contextual settings over time, teasing out what we know for sure and what is still open for speculation. Third, the chapter outlines some promising options for future research at the conceptual, empirical, and practical levels.
Human Resource Management in the Anglo-Saxon Countries
Authors: Wood Geoffrey , Brewster Chris
Published: April 2021

The Anglo-Saxon countries or the liberal market economies are just about the only example of a country grouping that both the cultural theories and the comparative institutional theories agree on. Culturally, these countries are characterized by low power distance, high individualism, and low uncertainty avoidance. Institutionally, these countries have shared legal origins (common law) and specific political systems (first-past-the-post in most instances). They are the stock market capitalist, liberal market, or compartmentalized capitalist countries. They are characterized by powerful private property rights, lesser rights for other stakeholders, and government being less interested in supporting stakeholder rights, with commensurate suspicion of government involvement (other than in respect of bailouts of politically connected insider corporations) and taxation. Competition is depicted as unalloyed good, even if in practice such markets are often characterized by powerful oligopolies. This is important because the original theories of management and of human resource management, most of the research, and much of the current thinking in these areas come from the United States of America; most of the largest management consultancies have their headquarters or draw their inspiration from the United States; and academic teaching and publication follow the United States. There have, however, been debates about how cohesive and consistent the Anglo-Saxon category is and precisely how the implications for human resource management are manifested in each country.
Narratives of Progress and Les Ballets Jazz De Montréal
Authors: Templeton Melissa
Published: April 2021

This chapter offers Les Ballets Jazz de Montréal as a challenge to historical narratives that identify the contemporary moment through a lens of liberal progress. While there may be some validity to scholarship that sees the ballet performed today as increasingly inclusive, ethnically diverse, and culturally sensitive, Les Ballets Jazz de Montréal’s historical trajectory is not a move toward multicultural inclusivity, but rather a renewing of racist imagery and a continual struggle to legitimize itself by strengthening its connection to Europeanist aesthetics. Using the company’s past as a lens for thinking about historiography, this chapter studies Les Ballets Jazz de Montréal to disrupt linear narratives that connect the evolution of contemporary ballet to notions of multicultural advancement.
Mark Morris
Authors: Kourlas Gia
Published: April 2021

Mark Morris has consistently created sophisticated ballets full of nuance, restraint, and musicality. Though he is known best as a modern dance choreographer, his ballets constitute an important part of his creative power. This chapter examines his works created for companies including American Ballet Theatre (ABT) and San Francisco Ballet; pays homage to his collaborative relationship with the designer Isaac Mizrahi; and includes the insight of several of the dancers who graced his ballets, including Mikhail Baryshnikov, who commissioned Morris’s first work for ABT: Drink to Me Only with Thine Eyes. Such interviews reveal Morris’s influence beyond the stage. When considered as a whole, the ballets, exceptional for their individual look and temperament, remain timeless: they celebrate the beauty of unaffected dancing.
Models of Administrative Justice
Authors: Mashaw Jerry L.
Published: April 2021

Considerable scholarship over the past several decades has been devoted to exploring ‘models’ of administrative justice. By ‘model’ most authors seem to mean a particular administrative justice regime’s central characteristics such as its epistemological presuppositions, institutional structure, procedure commitments, and legitimating norms. This chapter explores that literature by describing alternative model-building efforts, critical commentary on existing models, and some applications of various models to illuminate and critique administrative justice practices in ongoing administrative systems. The chapter concludes with a simple suggestion concerning the stance that one should take in analysing or critiquing any particular approach to model building as an analytic tool. In my view the purpose of model building is straightforward: models of administrative justice allow us to specify the dimensions of administrative justice that are of interest and to structure investigation either of particular administrative practices or of the characteristic approaches of a society or a legal culture. Whether a particular model or set of models, or a particular approach to building them, is useful depends upon what an analyst is trying to do and the degree to which the models constructed or deployed contribute to the success of that project.
Prosecuting Race and Adolescence
Authors: Henning Kristin
Published: April 2021

The U.S. Supreme Court has explicitly recognized adolescents’ developmental immaturity and potential for rehabilitation as a significant mitigating factor in criminal cases. Yet, persistent racial disparities at all stages of the juvenile and criminal legal systems suggest that key principles of adolescent development are not applied equitably across race and class. Racial stereotypes that portray youth of color as inherently dangerous negatively affect judgments about adolescent maturity, culpability, risk of recidivism, and deserved punishment. As gatekeepers of juvenile court jurisdiction, prosecutors have a unique opportunity to identify and resist explicit and implicit racial bias in the system and insist upon developmental equity for all youth. This chapter draws upon recent findings in developmental psychology and the cognitive science of bias to offer a framework that will improve prosecutorial decision-making, enhance public safety, and help all youth achieve a healthy and productive transition to adulthood.
Electronic Waste and Environmental Justice
Authors: Pellow David N.
Published: April 2021

This chapter offers a review of the interdisciplinary literatures on electronic waste (e-waste) from an environmental justice perspective. Specifically, the author explores how e-waste reflects dynamic changes in the ways that the materiality of digital media intersects with ecological concerns and social inequalities. The author draws on several examples of e-waste production, reuse, recycling, and export around the globe as illustrations of these tensions. The author also discusses the ways that grassroots social movements and policy makers have responded to this crisis. Finally, the chapter considers a number of debates about the changing character of environmental justice struggles in the e-waste industry and workplaces.
Journalism in the Age of Twitter
Authors: Barnard Stephen R.
Published: April 2021

This chapter critically examines Twitter’s journalistic significance, taking stock of the myriad ways the platform has shaped media work and grappling with what implications this has had for the journalistic field. After reviewing some of the most salient sociological contributions to the study of journalism before social media, the chapter offers an evaluation of Twitter’s popularity among journalists and an assessment of its implications for the profession as well as scholarship on it. Then, it looks beyond Twitter and journalism to examine how the emerging hybrid media system has loosened the profession’s control over information, which has led to fundamental shifts in the relationship between the journalistic and political fields. Thus, in addition to providing a detailed assessment of what sociological accounts reveal about the practice of journalism, the chapter shows how recent scholarship has complicated those understandings by revealing how shifting norms and field boundaries lead to new questions and discoveries about the profession as well as its role in the public sphere. The chapter concludes by offering some reflections on the state of the field as well as some suggestions to help guide future research.
The Evolution of Music
Authors: Till Rupert
Published: April 2021

This chapter explores how the representation of music has developed within human cultures. It begins by discussing the soundscapes of prehistoric landscapes, in order to better understand the acoustic ecologies of the past. This is followed by investigating the role of music within societies, addressing how music interacts with work, ritual, and trance. Discussion of lithophones, drums, and dancing is followed by addressing bone pipes, the earliest musical instrument archaeologists found, exploring music as technology for socialization and community. Bronze horns in Europe such as the Carnyx and Greek and Roman music provide evidence of complex technological processes applied to music making, showing an increasing sophistication in the use of technology to create sonic meanings. The paper concludes that the representation of meaning in sound through an aural symbolic language, combines semiotics and embodied knowledge in complex networks of understanding that play a significant role in human cultures.
Symbolism and Archaeoastronomy in Prehistory
Authors: Silva Fabio , Pimenta Fernando , Tirapicos Luís
Published: April 2021

This chapter explores the symbolic and conceptual relations between prehistoric groups and the sky. The study of how people engage with the sky is known as cultural astronomy, a term that comprises any field concerned with sky and culture, including archaeoastronomy. The latter focuses on analyzing the archaeological record for evidence of past skyscapes, i.e., past forms of engagement with the celestial objects, and how they would feature in the world views of the societies under study. The chapter discusses six case studies from the Western part of the Iberian Peninsula that are representative of prehistoric contexts found in other parts of the world. They illustrate how prehistoric skyscapes provided not only spatial axes for the construction of structures that align to celestial objects and events but, more importantly, how such alignments served as temporal anchors moored to key environmental, social, and symbolic moments of transition.
Visual Culture
Authors: Rosser Gervase
Published: April 2021

The chapter first reviews an old assumption that the ‘realism’ of Dante must have responded to the ‘naturalism’ of Giotto and other contemporary artists. Taken simply, this assumption is naïve and valueless. The chapter proceeds to consider the contrary view, now more prevalent, that in the Commedia Dante’s visionary mind detached itself from material images, rendering these irrelevant. This attitude is also problematized, in the light of Dante’s persistent use of visual imagery in ways which complicate the assumed distinction between words and images. Selected fourteenth-century paintings are cited to demonstrate how certain painters, like Dante in his poetry, were capable of working simultaneously in more than one register, with deliberate intent to bring the audience first into lively engagement with a naturalistically realized scene, and then to disturb that recognition, prompting awareness of a truth which lies beyond the surface. Both Dante and these artists engaged the same challenge, and deployed equivalent means.
Philosophy and Theology
Authors: Porro Pasquale
Published: April 2021

This chapter focuses on Dante’s philosophical and theological interests, starting from the poet’s account of the genesis of his love for philosophy in the second treatise of the Convivio. The circumstances of Dante’s philosophical formation are recalled, together with the Convivio’s main themes. This latter work is presented and discussed as a bold project of philosophical dissemination in the vernacular aimed, in almost messianic tones, at bringing to completion the natural desire for knowledge in which the ultimate human happiness consists. Particular attention is also paid to the limits of this project, in terms of both its recipients and its content. Dante’s relationship with the Averroistic tradition, the medical and physiognomic approach to the question of nobility, and the persistence of some genuinely philosophical themes in the context of the poetic theology of the Commedia are also examined.
The Manuscript Tradition, or on Editing Dante
Authors: Zinelli Fabio
Published: April 2021

The editions of Dante’s works represent as many responses as there are questions raised by their peculiar manuscript tradition. This chapter discusses the methodological procedures of the main editorial enterprises related to Dante’s vernacular works and the results achieved by these enterprises. It also addresses the tradition of the Latin works. It discusses the geographical dissemination of manuscripts and the value of local traditions insofar as they help us find a way out of the complicated tradition of the Commedia and of the Rime. The chapter also investigates the ways in which the tradition bears marks of authorship, focusing on such problems as the debated existence in manuscripts of a ‘song book’ planned by Dante himself or on the possible authorial chapter division of the Vita Nova. Dante’s philology is always an ‘author-oriented’ philology showing at its best to what extent philology and hermeneutics can reinforce one another.
Modernist Dante
Authors: Caselli Daniela
Published: April 2021

This chapter traces a history of Dante’s reception in anglophone literature between the 1870s and the 1950s. It acknowledges his importance in Ezra Pound, T.S. Eliot, and James Joyce, but engages more closely with Samuel Beckett, Djuna Barnes, and Virginia Woolf. It shows that the modernist Dante that emerges from these authors’ work is both a formal and political one: recruited as an anti-authoritarian voice from the past and seen anew from feminist and queer perspectives, this is not a twenty-first century Dante forced against his will to virtue-signal, however; on the contrary, this is a Dante anachronistically familiar with key ‘vices’ of twentieth-century authors, readers and commentators. Focusing on sullenness, resistance, and fatigue, the chapter argues for a new understanding of modernist experiments with Dante’s political and formal complexity that refuse to use him as a ‘code or a weapon […] to crush someone’, as Dorothy Richardson put it.
Dante and the Performing Arts
Authors: Arqués Corominas Rossend
Published: April 2021

This chapter explores the reception of Dante in the performing arts, especially the Commedia. The first part outlines public readings of Dante, from Boccaccio to the present day (Benigni, Bene, etc.) via fifteenth- and sixteenth-century Florence. It also revisits Gustavo Modena and other nineteenth-century patriotic actors. The second part offers a chronology of the presence of Dante’s work in the theatrical field in three periods: the nineteenth century with Francesca da Rimini and some other characters from the Commedia who occupy a prominent place in the theatre scene and European opera—especially in works by Pellico and D’Annunzio; the turn of the century, when the pre-Raphaelite and symbolist Beatrice from Vita nuova gains more prominence; and the second half of the twentieth century and the beginning of the twenty-first, with a focus on dance, music, and theatre.
Digital Dante
Authors: Kumar Akash
Published: April 2021

This chapter considers the intersection of Dante and digital humanities by means of historical perspective, a broad survey of the field as it has developed over the past few decades, and an extended look at recent trends in developing projects. Attention is given to how and why Dante has emerged as a particular point of contact between the digital and humanistic, as well as to issues of the canon that can be both reinforced by digital projects and subverted by drawing attention to other voices and works within the tradition. This chapter also provides an extended look from within at the recent development and elaboration of Columbia University’s Digital Dante, seeking to point the way to future work and new paradigms of digital exploration in the world of Dante.
Defeated by the nines: nine extracellular strategies to avoid microbe-associated molecular patterns recognition in plants
Authors: Buscaill Pierre , van der Hoorn Renier A. L.
Published: April 2021

Recognition of microbe-associated molecular patterns (MAMPs) by cell-surface receptors is pivotal in host-microbe interactions. Both pathogens and symbionts establish plant-microbe interactions using fascinating intricate extracellular strategies to avoid recognition. Here we distinguish nine different extracellular strategies to avoid recognition by the host, acting at three different levels. To avoid the accumulation of MAMP precursors (Level 1), microbes take advantage of polymorphisms in both MAMP proteins and glycans, or downregulate MAMP production. To reduce hydrolytic MAMP release (Level 2), microbes shield MAMP precursors with proteins or glycans and inhibit or degrade host-derived hydrolases. And to prevent MAMP perception directly (Level 3), microbes degrade or sequester MAMPs before they are perceived. We discuss examples of these nine strategies and envisage three additional extracellular strategies to avoid MAMP perception in plants.
Effects of autoclaving on compressive strength of bovine bones and their use as chewing agents for dogs
Authors: Pezzali J G , Machado G S , Marx F R , Eugênio D A , Schroeder B , Pignone V N , Trevizan L
Published: April 2021

This study aimed to evaluate the effect of autoclave processing on compressive stress of spongy and cortical bones, and the effect of autoclaved bones as chewing agents to reduce dental calculus in adult dogs. Spongy and cortical bones were autoclaved (1 ATM, 30 min, and 120°C) and compressive strength was evaluated in autoclaved and raw bone specimens. Autoclaved bones were offered to ten Beagle dogs divided into two groups of 5 dogs each: Group 1 – received a portion of the autoclaved bovine cortical bone (ACB) and Group 2 – received a portion of the autoclaved bovine spongy bone (ASB). Prior to the experimental period (1-d) and every two days thereafter, oral photographs were taken on both sides of the dental arch to evaluate dental calculus reduction over time. The vestibular surface of the canines, premolars, and molars teeth was evaluated using integration software to measure the proportion between the area covered by calculus and the total teeth area. The effect of bone type, treatment (raw vs. autoclaved), and their interaction were evaluated using the PROC GLIMMIX procedure of SAS (version 9.4). Linear equations were generated to estimate calculus reduction over time for ACB and ASB. Compressive strength was higher (P < 0.05) in cortical bones compared to spongy bones. However, the autoclaving procedure did not affect (P > 0.05) compressive strength, regardless of the bone type. The teeth area covered by calculus of dogs that were offered ACB reduced from 41% to 32% in 5 days, and at the end of 15 days a reduction of 62.2% was observed, resulting in a remaining of 15.5% of teeth area covered by calculus. In this group, the dental calculus area reduced by 57.7% after 5 days, and at the end of the trial, only 5.4% of teeth were still covered by calculus, which represents a reduction of 81%. The linear regression analysis revealed no significant difference between the slopes for the ACB and ASB equations (P > 0.05). No health complications such as tooth fracture, intestinal obstructions, and oral lesions were observed throughout the study. Our results demonstrated that the autoclave processing did not impair compressive strength of spongy and cortical bones. This corroborates with the results observed in vivo, which suggests that autoclaved bones are chewing agents for adult dogs with additional benefits of lower risk of bacterial contamination.
Acute Leukoencephalopathy with Restricted Diffusion in an Infant with Severe COVID-19 and Dengue Coinfection Progressing to West Syndrome
Authors: Kariyappa Mallesh , Govindarajan Varun , Kommalur Anitha
Published: April 2021

COVID-19 pandemic is increasingly being recognized in infants and some develop cytokine storm mediated tissue damage. We report 5-month-old infant presenting with fever, refusal of feeds, developing altered sensorium and convulsions during the hospital course, tested positive for SARS-CoV2 RT-PCR in second week of illness. Her serology was also Dengue positive. She had features of cytokine storm and her MRI Brain suggested acute demyelinating encephalomyelitis (ADEM). She was treated with high-dose methylprednisolone followed oral prednisolone, under antibiotics cover. Infant improved gradually over 3 weeks duration following a stormy hospital course. On follow-up, infant showed delayed motor milestones with epileptic spasms and hysparrhthymia on EEG, progressing to develop secondary West syndrome. Features of acute encephalopathy, hypercytokinemia and restricted diffusion on DWI–MRI, with post-encephalopathic epilepsy, pointed to a differential of ADEM—acute leukoencephalopathy with restricted diffusion (ALERD) as the primary diagnosis; establishing ALERD as a possible neurological complication of COVID-19 infection in infants.
Single Nucleotide Polymorphisms (SNPs) in PRKG1 & SPATA13-AS1 are associated with bronchodilator response: a pilot study during acute asthma exacerbations in African American children
Authors: Fishe Jennifer N. , Labilloy Guillaume , Higley Rebecca , Casey Deirdre , Ginn Amber , Baskovich Brett , Blake Kathryn V.
Published: April 2021

Objective

Inhaled bronchodilators are the first-line treatment for asthma exacerbations, but individual bronchodilator response (BDR) varies by race and ethnicity. Studies have examined BDR’s genetic underpinnings, but many did not include children or were not conducted during an asthma exacerbation. This pilot study tested single-nucleotide polymorphisms’ (SNPs’) association with pediatric African American BDR during an acute asthma exacerbation.

Methods

This was a study of pediatric asthma patients in the age group 2–18 years treated in the emergency department for an asthma exacerbation. We measured BDR before and after inhaled bronchodilator treatments using both the Pediatric Asthma Severity Score (PASS) and asthma severity score. We collected genomic DNA and examined whether 21 candidate SNPs from a review of the literature were associated with BDR using crude odds ratios (OR) and adjusted analysis.

Results

The final sample population was 53 children, with an average age of 7.2 years. The average initial PASS score (scale of ascending severity from 0 to 6) was 2.5. After adjusting for BMI, age category, gender and smoke exposure, rs912142 was associated with decreased odds of having low BDR (OR, 0.20; 95% confidence interval (CI), 0.02–0.92), and rs7081864 and rs7903366 were associated with decreased odds of having high BDR (OR, 0.097; 95% CI, 0.009–0.62)

Conclusions

We found three SNPs significantly associated with pediatric African American BDR that provide information regarding a child’s potential response to emergency asthma exacerbation treatment. Once validated in larger studies, such information could guide pharmacogenomic evidence-based emergency asthma treatment to improve patient outcomes.
Recurrent implantation failure: how common is it?
Authors: Pirtea Paul , Scott Richard Thomas , de Ziegler Dominique , Ayoubi Jean Marc
Published: April 2021

Purpose of review

To clarify a lingering issue, the true incidence of repeated implantation failures (RIF) in women undergoing successive frozen euploid single embryo transfers (FE-SET).

Recent findings

As not all Assisted reproductive techinique (ART) attempts are crowned by success, it has been questioned since incept of ART whether failures resulted from an embryonic or endometrial cause. RIF has received no precise definition but a trend has existed toward setting a more stringent definition, as reproductive biology has become more effective and ART success rates improved. No scientific society has yet convened on a universally accepted definition. The advent of effective and well tolerated pregestational testing of embryos for aneuploidy (PGT-A) has allowed to not transfer aneuploid embryos, which are bound not to succeed. This, therefore, justify revisiting the concept of RIF when only euploid embryos are transferred.

Contrary to lingering beliefs, the results of our study indicate that RIF following three successive euploid embryo transfers in a morphologically normal endometrium is a rare occurrence (<5%). This supports the concept that ART failures mainly result from embryonic causes. Our data also propose a new – functional – definition of RIF being an ART failure following 3 successive FE-SET attempts. Our findings, therefore seriously question the soundness of prescribing the often complex and expensive endometrial testing procedures that largely publicized for treating RIF.
A Prescription for Resilience
Authors: Mann Sharon N. , McLinton Sarven S. , McEwen Kathryn , Heath Georgina
Published: April 2021

Objective:

Globally, leaders require strategies to sustain the performance and well-being of themselves and their teams while managing and adapting to uncertainty, workplace turbulence, and high job demands. This study evaluates the Resilience at Work Leader 180 Scale assessing leader behaviors that either promote or detract from resilience in others.

Method:

Study participants comprised Australian pharmacy employees (N = 80) in two groups made up of the senior leadership team (n = 10) and their direct report employees (n = 70). A mixed-methods design was employed using a directed content analysis.

Results:

Results indicate that the Resilience at Work Leader 180 Scale provides insight into leader behaviors that foster or detract from employee resilience.

Conclusion:

This scale is of value to researchers and organizations interested in a measure of leader resilience.
Management of chronic pulmonary disease in the time of coronavirus disease 2019
Authors: Palla John , Laguna Theresa A.
Published: April 2021

Purpose of review

The purpose of this review is to discuss the most recent data describing the impact of coronavirus disease 2019 (COVID-19) on the pediatric population with chronic pulmonary disease. We specifically focus on children with asthma, cystic fibrosis (CF), and lung transplant recipients.

Recent findings

Children with asthma, CF, and lung transplant recipients do not appear to have an increased risk of morbidity or mortality with COVID-19 infection compared to the general pediatric population. Data does not support the change or withdrawal of any asthma or CF maintenance medications; however, does advocate for the cessation of aerosolized medications whenever possible to minimize transmission risk. It may not be necessary to adjust immunosuppressive therapy when managing COVID-19 in pediatric lung transplant patients. Mechanisms of infection in airway epithelial cells in children may differ from adults, resulting in a milder phenotype.

Current data about pediatric patients with chronic lung disease infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is promising but remains scarce. Additional study is needed to definitively understand the complex interplay of the SARS-CoV-2 virus in the airway of children with chronic lung disease, how it differs from adults, and how best to manage the symptoms of acute infection.
The Second Victim Experience and Support Tool: A Cross-Cultural Adaptation and Psychometric Evaluation in Italy (IT-SVEST)
Authors: Scarpis Enrico , Castriotta Luigi , Ruscio Edoardo , Bianchet Beatrice , Doimo Anna , Moretti Valentina , Cocconi Roberto , Farneti Federico , Quattrin Rosanna
Published: April 2021

Objective

Second victims are defined as healthcare workers involved in an unanticipated adverse patient event, who experienced professional and psychological distress. The Second Victim Experience and Support Tool (SVEST) is a survey developed and validated in the United States, which describes the experience of second victims. This study aims to perform the cross-cultural adaptation of the SVEST and to evaluate its psychometric characteristics in the Italian context.

Methods

Translation and cross-cultural adaptation process was performed according to the World Health Organization guidelines. Then, 349 healthcare workers, including nurses, doctors, residents, and technicians, involved in direct patient care—a potential second victim—completed the Italian version of SVEST in a validation survey at the Academic Hospital of Udine. The SVEST consists of 29 items, divided into 7 dimensions, 2 outcome variables, and 7 support options. The Italian version was assessed for internal consistency through Cronbach α, for content validity with content validity index for scales and for item and for construct validity with Confirmatory Factor Analysis.

Results

The internal consistency of the instrument was adequate in its overall evaluation with Cronbach α value of 0.88 (95% confidence interval = 0.86). The content validity index for scales was 0.94 and that for item was 0.70. The confirmatory factor analysis results showed a good model fit for the 9-factor structure (χ2 = 676.18, df = 327, P < 0.001). Root mean squared error of approximation, Akaike information criterion, and comparative fix index Tucker-Lewis index values also suggested a good fit to the data.

Conclusions

The Italian version of the SVEST can be used to evaluate second victim experiences, demonstrating adequate validity, reliability, and good psychometric properties.
Support for Healthcare Professionals After Surgical Patient Safety Incidents: A Qualitative Descriptive Study in 5 Teaching Hospitals
Authors: Serou Naresh , Husband Andy K. , Forrest Simon P. , Slight Robert D. , Slight Sarah P.
Published: April 2021

Objective

Patient safety incidents can have a profound effect on healthcare professionals, with some experiencing emotional and psychological distress. This study explored the support medical and nonmedical operating room staff received after being involved in a surgical patient safety incident(s) in 5 UK teaching hospitals.

Methods

An invitation letter and information sheet were e-mailed to all medical and nonmedical operating room staff (N = 927) across the 5 sites. Semistructured interviews were arranged with a range of different healthcare professionals working in operating rooms across a wide variety of surgical specialities. Interviews were audio recorded, transcribed verbatim, and analyzed using an inductive thematic approach.

Results

We conducted 45 interviews with medical and nonmedical operating room staff, who emphasized the importance of receiving personalized support soon after the incident. Operating room staff described how the first “go to” people were their peers and reported feeling comforted when their peers empathized with their own experience(s). Other participants found it very difficult to seek support, perceiving it as a sign of weakness. Although family members played an important role in supporting second victims, some participants felt unable to discuss the incident with them, fearing that they might not understand.

Conclusions

There should be clear support structures in place for operating room staff who have been involved in surgical incidents. Health organizations need to offer timely support to frontline staff after these incidents. Senior clinicians should be proactive in offering support to junior colleagues and empathize with their own experiences, thus shifting the competitive culture to one of openness and support.
Auxiliary Tests of Autonomic Functions
Authors: Quispe Rodrigo C. , Novak Peter
Published: April 2021

The autonomic nervous system is a complex neural network that controls several organ systems. Its assessment includes a detailed history of autonomic functions, clinical examination, and autonomic tests. Most widely used is a battery of tests that assess cardiovascular reflex autonomic and sudomotor tests, which include deep breathing (assesses parasympathetic function), Valsalva maneuver, tilt test (both assess parasympathetic and adrenergic functions), and sudomotor testing for the evaluation of postganglionic sudomotor fibers. These basic tests represent a foundation of autonomic testing. Nevertheless, the autonomic nervous system also controls organ systems not directly assessed by basic tests. This review describes a number of auxiliary autonomic tests that can be used in addition to basic autonomic tests or can be used independently to explore particular autonomic functions or to answer a specific clinical question. The auxiliary tests described in this review evaluate cardiovascular, thermoregulatory, gastrointestinal, genitourinary, eye, and exocrine functions. These tests are cold pressor test, sustained handgrip maneuver, reverse tilt test, venoarteriolar reflex, laser Doppler flare imaging, microneurography, neck suction, lower body negative pressure, venous occlusion plethysmography, pharmacologic assessment of postganglionic sympathetic outflow, plasma norepinephrine, sympathetic skin response, video cinefluoroscopic swallowing test, esophageal manometry test, small bowel manometry test, wireless motility capsule test, urodynamic studies, penile plethysmography, intracavernosal papaverine injection, infrared video pupillography, corneal confocal microscopy, pupillary response to dilute pilocarpine and hydroxyamphetamine, Schirmer test, tear osmolarity test, and salivary secretion test. The protocol of each test is described in detail. This review can be used as a quick reference for the auxiliary autonomic tests.
Purposeful microbiology comment added to urine cultures with Staphylococcus aureus increases orders for follow-up blood cultures
Authors: Duncan Donald Brody , Vincent Yasmeen Marbaniang , Main Cheryl
Published: April 2021

Introduction. Patients with

Staphylococcus aureus

bacteriuria (SABU) often have underlying invasive disease, including

S. aureus

bacteremia (SAB). It has been proposed that most patients with SABU should have a blood culture done to rule out SAB. A preliminary audit suggested that our local hospitals had a low rate of follow-up blood culture orders for patients with SABU. In response to this, our microbiology laboratory changed the comment appended to urine cultures with growth of

S. aureus

to make a more assertive link between SABU and SAB and to recommend follow-up blood cultures.

Aim. We designed a retrospective quasi-experimental study to see if the change in microbiology comment wording had an effect on clinician behaviour. We hypothesized that this simple comment change to make a more assertive link between SABU and SAB would lead to an increase in follow-up blood culture orders.

Methodology. We used microbiology records to identify adult patients with urine cultures positive for

Staphylococcus aureus

at three acute-care hospitals in Hamilton, Ontario, Canada, for 1 year pre- and post-intervention. We recorded urine and blood culture results, timing, patient demographics, and in-hospital mortality.

Results. A total of 243 adult patients with urine cultures with

S. aureus

were identified for inclusion. The primary outcome was met, as there was a significant increase in blood culture orders between the pre-intervention and post-intervention groups (66.9 % vs 80.4 %). This difference was mainly driven by an increase for emergency department and urgent care patients (30.6 % vs 63.6 %). The inpatient group had a high baseline rate of blood culture orders that did not change significantly (80.0 % vs 84.7 %). There was no significant change in detection of SAB (23.5 % vs 32.7 %) or inpatient mortality (18.0 % vs 24.7 %).

Conclusion. Our study shows that a simple, purposeful comment appended to urine cultures with

S. aureus

leads to a significant increase in follow-up blood culture orders.