bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioethics and Reproduction With Insights From Uruguay
Authors: Abracinskas Lillian , Puyol Santiago
Published: June 2020

As time goes by, the world experiences advances and setbacks in the field of sexual and reproductive health and rights. But new challenges appear in terms of professional performance and implementation of services created by newer laws and policies. The development of new ethical frames in dialogue with disputed value systems is one of the main obstacles to ensuring universal access and comprehensive services to guarantee the exercise of these rights.

Since 2002, Uruguay has been one of the few countries in Latin America and the Caribbean that has achieved significant advances regarding sexual and reproductive rights by recognizing them as human rights. The passage of several laws has resulted in the implementation of programs in SRHS and legal abortion as being considered mandatory for the National Health System. The follow-up and monitoring of this process by the Observatory of Mujer y Salud en Uruguay (MYSU) has demonstrated how changes in the legal framework led to a new stage for health-care providers, politicians, and decision makers and also for the social movement that has historically advocated for this agenda, all now facing new problems and challenges—some of which are completely unexpected. The high prevalence of conscientious objection exercised by physicians and OB/GYNs in refusing the provision of care in SRHS is one of the ethical dilemmas that needs to be discussed to innovate solutions to the problems and promote best practices from a gender equity and human rights paradigm.
Comprehensive Sexuality Education
Authors: Vanwesenbeeck Ine
Published: June 2020

Comprehensive sexuality education (CSE) is increasingly accepted as the most preferred way of structurally enhancing young peoples’ sexual and reproductive well-being. A historical development can be seen from “conventional,” health-based programs to empowerment-directed, rights-based approaches. Notably the latter have an enormous potential to enable young people to develop accurate and age-appropriate sexual knowledge, attitudes, skills, intentions, and behaviors that contribute to safe, healthy, positive, and gender-equitable relationships. There is ample evidence of program effectiveness, provided basic principles are adhered to in terms of content (e.g., adoption of a broad curriculum, including gender and rights as core elements) and delivery (e.g., learner centeredness). Additional and crucial levers of success are appropriate teacher training, the availability of sexual health services and supplies, and an altogether enabling (school, cultural, and political) context. CSE’s potential extends far beyond individual sexual health outcomes toward, for instance, school social climates and countries’ socioeconomic development. CSE is gaining worldwide political commitment, but a huge gap remains between political frameworks and actual implementation. For CSE to reach scale and its full potential, multicomponent approaches are called for that also address social, ideological, and infrastructural barriers on international, national, and local levels. CSE is a work never done. Current unfinished business comprises, among others, fighting persevering opposition, advancing equitable international cooperation, and realizing ongoing innovation in specific content, delivery, and research-methodological areas.
Sexual and Reproductive Health in India
Authors: Jejeebhoy Shireen , Santhya K. G. , Zavier A. J. Francis
Published: June 2020

India has demonstrated its commitment to improving the sexual and reproductive health of its population. Its policy and program environment has shifted from a narrow focus on family planning to a broader orientation that stresses sexual and reproductive health and the exercise of rights. Significant strides have been made. The total fertility rate is 2.2 (2015–2016) and has reached replacement level in 18 of its 29 states. The age structure places the country in the advantageous position of being able to reap the demographic dividend. Maternal, neonatal, and perinatal mortality have declined, child marriage has declined steeply, contraceptive use and skilled attendance at delivery have increased, and HIV prevalence estimates suggest that the situation is not as dire as assumed earlier.

Yet there is a long way to go. Notwithstanding impressive improvements, pregnancy-related outcomes, both in terms of maternal and neonatal mortality and morbidity, remain unacceptably high. Postpartum care eludes many women. Contraceptive practice patterns reflect a continued focus on female sterilization, limited use of male methods, limited use of non-terminal methods, and persisting unmet need. The overwhelming majority of abortions take place outside of legally sanctioned provider and facility structures. Over one-quarter of young women continues to marry in childhood. Comprehensive sexuality education reaches few adolescents, and in general, sexual and reproductive health promoting information needs are poorly met. Access to and quality of services, as well as the exercise of informed choice are far from optimal. Inequities are widespread, and certain geographies, as well as the poor, the rural, the young, and the socially excluded are notably disadvantaged. Moving forward and, in particular, achieving national goals and SDGs 3 and 5 require multi-pronged efforts to accelerate the pace of change in all of these dimensions of health and rights.
Franklin D. Roosevelt and US Foreign Relations
Authors: Cross Graham
Published: June 2020

Franklin D. Roosevelt was US president in extraordinarily challenging times. The impact of both the Great Depression and World War II make discussion of his approach to foreign relations by historians highly contested and controversial. He was one of the most experienced people to hold office, having served in the Wilson administration as Assistant Secretary of the Navy, completed two terms as Governor of New York, and held a raft of political offices. At heart, he was an internationalist who believed in an engaged and active role for the United States in world.

During his first two terms as president, Roosevelt had to temper his international engagement in response to public opinion and politicians wanting to focus on domestic problems and wary of the risks of involvement in conflict. As the world crisis deepened in the 1930s, his engagement revived. He adopted a gradualist approach to educating the American people in the dangers facing their country and led them to eventual participation in war and a greater role in world affairs. There were clearly mistakes in his diplomacy along the way and his leadership often appeared flawed, with an ambiguous legacy founded on political expediency, expanded executive power, vague idealism, and a chronic lack of clarity to prepare Americans for postwar challenges. Nevertheless, his policies to prepare the United States for the coming war saw his country emerge from years of depression to become an economic superpower. Likewise, his mobilization of his country’s enormous resources, support of key allies, and the holding together of a “Grand Alliance” in World War II not only brought victory but saw the United States become a dominant force in the world. Ultimately, Roosevelt’s idealistic vision, tempered with a sound appreciation of national power, would transform the global position of the United States and inaugurate what Henry Luce described as “the American Century.”
The Sanctuary Movement
Authors: González Sergio
Published: June 2020

In the spring of 1982, six faith communities in Arizona and California declared themselves places of safe harbor for the hundreds of thousands of Salvadorans and Guatemalans that had been denied legal proceedings for political asylum in the United States. Alleging that immigration officials had intentionally miscategorized Central Americans as “economic migrants” in order to accelerate their deportation, humanitarian organizations, legal advocates, and religious bodies sought alternatives for aid within their faiths’ scriptural teachings and the juridical parameters offered by international and national human rights and refugee law. Known as the sanctuary movement, this decade-long interfaith mobilization of lay and clerical activists indicted the US detention and deportation system and the country’s foreign policy initiatives in Latin America as morally bankrupt while arguing that human lives, regardless of documentation status, were sacred. In accusing the United States of being a violator of both domestic and international refugee legislation, subsequently exposing hundreds of thousands of people to persecution, torture, and death, the movement tested the idea that the country had always extended welcome to victims of persecution. Along with a broad network of anti-interventionist and humanitarian aid organizations, sanctuary galvanized more than 60,000 participants in 500 faith communities across the nation. By the 1990s, the movement had spurred congressional action in support of Central American asylees and served as the model for a renewed movement for sanctuary in support of undocumented Americans in the 21st century.
Piracy in Colonial North America
Authors: Hanna Mark G.
Published: June 2020

Historians of colonial British North America have largely relegated piracy to the marginalia of the broad historical narrative from settlement to revolution. However, piracy and unregulated privateering played a pivotal role in the development of every English community along the eastern seaboard from the Carolinas to New England. Although many pirates originated in the British North American colonies and represented a diverse social spectrum, they were not supported and protected in these port communities by some underclass or proto-proletariat but by the highest echelons of colonial society, especially by colonial governors, merchants, and even ministers.

Sea marauding in its multiple forms helped shape the economic, legal, political, religious, and cultural worlds of colonial America. The illicit market that brought longed-for bullion, slaves, and luxury goods integrated British North American communities with the Caribbean, West Africa, and the Pacific and Indian Oceans throughout the 17th century. Attempts to curb the support of sea marauding at the turn of the 18th century exposed sometimes violent divisions between local merchant interests and royal officials currying favor back in England, leading to debates over the protection of English liberties across the Atlantic. When the North American colonies finally closed their ports to English pirates during the years following the Treaty of Utrecht (1713), it sparked a brief yet dramatic turn of events where English marauders preyed upon the shipping belonging to their former “nests.” During the 18th century, colonial communities began to actively support a more regulated form of privateering against agreed upon enemies that would become a hallmark of patriot maritime warfare during the American Revolution.
Nichiren
Authors: Stone Jacqueline
Published: June 2020

The Japanese Buddhist leader Nichiren 日蓮 (1222–1282) taught exclusive devotion to the Lotus Sūtra, a scripture widely revered as the Buddha’s highest teaching. Nichiren asserted that in the present, degenerate age, other teachings, being provisional, have lost their efficacy; only the Lotus Sūtra is profound and powerful enough to lead all men and women to liberation. The form of Lotus practice that he taught—chanting the sūtra’s title or daimoku題目 in the phrase Namu Myōhō-renge-kyō南無妙法蓮華経—was available to all, whether monastics or laity, and regardless of education, ability, or social level. Often celebrated as a man of action, Nichiren was also an innovative thinker who welded some of the subtlest Mahāyāna doctrines to a universally accessible form of practice. Nichiren held that faith in the Lotus Sūtra would enable practitioners to realize buddhahood with this very body (J. sokushin jōbutsu即身成仏) and that spreading that faith would transform the current world into an ideal buddha land. Nichiren’s harsh criticisms of other Buddhist forms drew hostile responses from both government officials and leading prelates; he was twice exiled and attacked repeatedly, while some of his followers were imprisoned, had their lands confiscated, or were even killed. In his lifetime, he could claim at most a few hundred followers. But after his death, Nichiren’s following—known first as the Lotus sect (Hokkeshū 法華宗) and later as Nichirenshū 日蓮宗—would grow to become one of Japan’s major Buddhist traditions. Today, more than forty officially registered religious bodies, both traditional temple organizations and lay Buddhist movements, claim derivation from Nichiren. Some have a significant international presence. Modern critics have often labeled Nichiren intolerant on account of his Lotus exclusivism; at the same time, he set an example of principled resistance to worldly authority that continues to encourage dissenters. Nichiren’s ideal of actualizing the buddha land in this world has also inspired multiple forms of Buddhist social activism.
Colombia and the Legal-Cultural Negotiation of Racial Categories
Authors: Rappaport Joanne
Published: June 2020

Colombia is a country that has over the past two centuries defined itself as a mestizo nation, but almost no one identifies as mestizo. During the colonial period (16th to 18th centuries), an early modern epistemology of race different from our own was founded in the notion of an ever-changing human body and on a society whose members were only in certain contexts classified by race, fostering fluid taxonomies that cannot be adequately represented by the canonical triad of “white,” “black,” and “Indigenous,” and their admixtures. If, in the 19th century, “scientific” notions of race spread across the globe, this racial discourse took particular forms in each location. In Colombia, racial categories were adjusted to mark geographic, as opposed to individual, diversity. Regions of the nascent Colombia were defined by their “whiteness” or their “blackness,” in a civilizing discourse that attempted to erase but at the same time maintain social hierarchies. This redrawing of racial taxonomies had at its center the goal, for the Andean heartlands at least, of a progressive movement toward whiteness.
Digital Resources: Latin American Travelogues Digital Collection at Brown University
Authors: Green James N.
Published: June 2020

The Latin American Travelogues Digital Collection is composed of 327 travel accounts, most written in English but some in Spanish, French, Portuguese, Dutch, and Italian. All were produced between the 16th and the early 20th centuries. The digital collection, organized beginning in 2006 under the direction of James N. Green, the Carlos Manuel de Céspedes Professor of Latin American History at Brown University, and Patricia Figueroa, the Curator of the Iberian and Latin American Collection, is a project of the Brown University Center for Digital Scholarship. The site is an open-access visual and research tool for students and scholars alike. The Latin American Travelogues Digital Collection was created to encourage students to use primary sources about Latin America and the Caribbean for research projects and essay assignments and to facilitate access to rare books through the Internet. It has proven successful in integrating Brown’s Latin American Special Collections into classroom pedagogy and promoting these works as a research tool for both undergraduate and graduate students. The project is also designed to make these travelogues freely available to researchers worldwide and to preserve these works for future generations of scholars.
Digital Resources: The Humanizing Deportation Archive
Authors: Irwin Robert
Published: June 2020

Humanizing Deportation is a community archive of digital stories (testimonial video shorts) that recounts personal experiences related to deportation and deportability. The largest qualitative archive in the world on this topic, its bilingual (English/Spanish) open access website, as of March 2020, holds close to 300 digital stories by nearly 250 different community storytellers and continues to expand. All digital stories are created and directed by the community storytellers themselves. While the vast majority of the stories were created by Mexican migrants currently living in Mexico’s largest border cities (Tijuana, Ciudad Juárez), and other major urban metropolitan regions (Mexico City, Guadalajara, Monterrey), it also includes some stories of migrants living in the United States, as well as other migrants, many in transit, passing through Mexico from such countries as Honduras, El Salvador, Guatemala, Colombia, Peru, Cuba, and as far from North America as Cameroon. Launched in 2017, Humanizing Deportation’s teams of academic facilitators remain active, and the archive continues to grow.
AIDS Crisis and Brazil
Authors: Parker Richard
Published: June 2020

The response to the AIDS crisis in Brazil has been the focus of significant attention around the world—both as a model of social mobilization that other countries might follow and as an example of the difficulty of sustaining mobilization without necessary political support. It is possible to identify at least four reasonably distinct phases in the Brazilian response to HIV and AIDS, beginning in 1983 (when the first case of AIDS in Brazil was officially reported) and running through mid-2019. An initial phase, lasting roughly a decade, from 1983 to 1992, was marked by significant conflicts between activists from affected communities and government officials, but precisely because of the broader political context of re-democratization was also the period in which many of the key ethical and political principles were elaborated that would come to provide a foundation for the Brazilian response to the epidemic thereafter. A second phase ran from 1993 to roughly the beginning of the new millennium, when these ethical and political principles were put into practice in the construction of a full-blown and highly successful national program for the prevention and control of the epidemic. During the third phase, from 2001 to 2010, the response to the epidemic increasingly became part of Brazilian foreign policy in ways that had important impacts on the global response to the epidemic. Finally, a fourth phase, from 2011 to late 2019, has been marked by the gradual dismantling of the Brazilian response to the epidemic, at first through relatively unplanned omissions on the part of the federal government, and then through a very conscious set of policy decisions aimed at deprioritizing the strategic importance of HIV- and AIDS-related public health issues in Brazil.
hermaphroditism
Authors: von Stackelberg Katharine T.
Published: June 2020

A physical condition whereby a living organism has both male and female reproductive parts, hermaphroditism is a well-established phenomenon in the ancient world. In Greek and Roman literature and art, hermaphroditism in humans had cultural significance as divine portent, erotic subject, mediating or transgressive condition, and symbol of marital union. The most significant literary accounts of human hermaphroditism are found in Plato’s Symposium and Ovid’s Metamorphoses; the greatest concentration of visual evidence is to be found in the environs of Pompeii and Herculaneum.
Upshaw, Joan King
Authors: Logan Sadye L. M.
Published: June 2020

Joan King Upshaw, MSW, LSCSW (1929–2010), was a social work entrepreneur who pioneered temporary social work staffing. She created a useful avenue for professional social workers to work in ways that supported work–life balance, to work across fields of practice, and to start their own social change ventures.
Dellums, Ronald Vernie
Authors: Logan Sadye L. M.
Published: June 2020

Ronald Vernie Dellums, MSW (1935–2018), enjoyed a long and distinguished career as a compassionate social worker, a congressman who campaigned for international peace and disarmament, and an innovative businessman with a focus on healthcare. He served in numerous leadership positions both nationally and internationally. Although essentially thought of as a leader in the defense and foreign policy fields, he also distinguished himself with domestic legislative initiatives.
Carpenter, Kenneth Stephen
Authors: Logan Sadye L. M.
Published: June 2020

Kenneth Stephen Carpenter (1924–2018) served for 55 years in the field of criminal justice. He pioneered in introducing social-work principles, programs, and practices in juvenile and adult criminal institutions and settings.
Contrasting patterns of population divergence on young and old landscapes inBanksia seminuda(Proteaceae), with evidence for recognition of subspecies
Authors: Robins Timothy P , Binks Rachel M , Byrne Margaret , Hopper Stephen D
Published: June 2020

OCBIL theory provides a basis for understanding of the evolution and ecology of biota on old, climatically buffered, infertile landscapes (OCBILs) worldwide. Here, we test a genetic hypothesis presented in OCBIL theory that predicts highly differentiated intraspecific population systems on OCBILs vs. more limited differentiation on young, often disturbed, fertile landscapes (YODFELs). We examined patterns of genomic and morphological divergence in Banksia seminuda across OCBILs and YODFELs in south-western Australia. We also used these data to determine whether these OCBIL and YODFEL populations represent distinct subspecific lineages, a point of previous contention among taxonomists. As hypothesized, genomic analyses based on 3466 SNP loci revealed strong structuring within B. seminuda, with high differentiation across narrow geographic scales among OCBIL populations vs. lower differentiation across much larger geographic scales among YODFEL populations. In addition, genomic and morphological divergence was found between OCBIL and YODFEL populations, providing comprehensive quantitative evidence for two subspecies. These findings have taxonomic implications for the species and provide support for OCBIL theory and its insights into the evolution, ecology and conservation of biota on ancient landscapes.
Understanding out of Home Care Rates in Northern Ireland: A Thematic Analysis of Mixed Methods Case Studies
Authors: Mason Will , Morris Kate , Featherstone Brid , Bunting Lisa , Davidson Gavin , McCartan Claire , Bywaters Paul , Webb Calum
Published: June 2020

Research exploring inequalities in UK child welfare interventions has produced counter-intuitive findings with respect to Northern Ireland (NI). Despite experiencing the highest levels of deprivation, NI also displays the lowest rates of children in care of all the UK nations. With reference to wider evidence in the field of child welfare inequalities, this article details the findings of two exploratory mixed methods case studies, located within NI Health and Social Care Trusts. Drawing on the narratives offered by child and family social workers, a series of possible explanations for NI’s significantly lower out of home care rates are considered. We suggest the operation of intersecting factors at multiple levels, including social work systems and practices, early help systems and structures, communities and families. These findings extend understandings of NI’s out of home care rates whilst raising broader questions for social work research and practice.
The Ethical Conflict of Dual Obligations Amongst Social Workers: The Role of Organisational Affiliation and Seniority
Authors: Zychlinski Ester , Lev Sagit , Kagan Maya
Published: June 2020

The purpose of the current study was to examine the frequency of ethical conflicts amongst social workers, deriving from dual obligations to clients and employers, as associated with their organisational affiliation and professional seniority. The sample included 723 social workers from three organisational sectors in Israel: the government sector, the third sector and the for-profit sector. Two-way analysis of variance (ANOVA) was conducted to examine the main and interaction effects of organisational affiliation and seniority on the frequency of ethical conflicts amongst social workers. Social workers in the for-profit and third sectors experienced a significantly higher frequency of ethical conflicts than those in the government sector. In addition, social workers with moderate seniority were found to experience ethical conflicts more frequently than those with low and high seniority. These findings have an important contribution to the ongoing public debate on the privatisation of social services, by pointing to the difficulties encountered by social workers employed in partially privatised social services in meeting their obligations to clients. Better public monitoring and adequate supervision of social workers are recommended. In addition, it is suggested that partial privatisation processes be reconsidered in the case of vulnerable populations.
The Conspicuous Hidden Curriculum and Young Women’s Daily Lives in Polish Crisis Accommodation
Authors: Mostowska Magdalena , Dębska Katarzyna
Published: June 2020

This article examines the daily routine in crisis accommodation for young women in Poland, investigating the hidden curriculum that includes highly gendered norms and expectations regarding residents. The article considers local crisis centres and state-funded Specialist Centres for Victims of Domestic Violence as well as Single Mothers’ Homes, which provide long-term accommodation for mothers with dependent children. The analysed material has been gathered during fieldwork in Warsaw and the Podkarpackie province in the Years 2017–2018 and comprises diverse data types: interviews with managers and staff at crisis centres and Single Mothers’ Homes; legal acts that regulate referrals as well as house rules adopted in these facilities. The residents were interviewed about their experiences of, and views on their daily routines, tasks and relationships within shelters. In crisis centres, expectations are focussed on self-sufficiency, while in Catholic Single Mothers’ Homes, control is exercised through religion by defining what is proper behaviour and how a mother should behave. The article concludes by investigating these practices with regard to their effectiveness in supporting women’s housing needs and examining how they relate to a broader definition of social work.
Pubertal Testosterone Tracks the Developmental Trajectory of Neural Oscillatory Activity Serving Visuospatial Processing
Authors: Fung Madison H , Taylor Brittany K , Frenzel Michaela R , Eastman Jacob A , Wang Yu-Ping , Calhoun Vince D , Stephen Julia M , Wilson Tony W
Published: June 2020

Puberty is a period of substantial hormonal fluctuations that induce dramatic physical, neurological, and behavioral changes. Previous research has demonstrated that pubertal hormones modulate cortical development, as well as sex- and age-specific patterns of cognitive development during childhood and adolescence. However, the influence of pubertal hormones on the brain’s functional development, specifically neural oscillatory dynamics, has yet to be fully examined. Thus, in the current study, we used magnetoencephalography to investigate the oscillatory dynamics serving visuospatial perception and attention, and testosterone levels and chronological age as measures of development. Within a sample of typically developing youth, age was associated with changes in alpha, theta, and gamma oscillatory activity. Novel testosterone-by-sex interactions in the gamma range were identified in critical areas of the visual and attention networks. Females had increased gamma activity with increasing testosterone in the right temporal-parietal junction and occipital cortices, while males showed increased gamma activity in the right insula with increasing testosterone. These findings reveal robust developmental alterations in the oscillatory dynamics serving visuospatial processing during childhood and adolescence and provide novel insight into the hormonal basis of sexually dimorphic patterns of functional brain development during the pubertal transition that is at least partially mediated by endogenous testosterone.
LC–MS/MS Analysis of Thiol-Containing Amino Acids in Exosomal Fraction of Serum
Authors: Onozato Mayu , Kobata Kana , Sakamoto Tatsuya , Ichiba Hideaki , Fukushima Takeshi
Published: June 2020

It has been suggested that thiol-containing amino acids could be used as biomarkers for diseases associated with oxidative stress. We investigated the thiol-containing amino acids, homocysteine (Hcy), cysteine (Cys), glutathione (GSH) and γ-glutamylcysteine (γ-GluCys), in commercial human serum by using liquid chromatography–tandem mass spectrometry (LC–MS/MS) after precolumn derivatization with 4-fluoro-7-sulfobenzofurazan. This method was applied to determine the composition of thiol-containing amino acids in exosomes prepared from the serum. Hcy, Cys, GSH and γ-GluCys could be detected in the exosomal fraction, and the ratio of each thiol-containing amino acid was similar to those in the corresponding native serum. Cys (94.76%) was most enriched in the exosomal fraction, followed by GSH (2.97%), γ-GluCys (1.59%) and Hcy (0.68%). These findings suggest that thiol-containing amino acids, Hcy, Cys, GSH and γ-GluCys, are included in exosomes in human serum.
The Importance of Advancing Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines in Children
Authors: Kao Carol M , Orenstein Walter A , Anderson Evan J
Published: June 2020

While the role of children in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains to be defined, children likely play an important role based on our knowledge of other respiratory viruses. Children are more likely to be asymptomatic or have milder symptoms and less likely to present for healthcare and be tested for SARS-CoV-2. Thus, our current estimates are likely under-representative of the true burden of SARS-CoV-2 in children. Given the potential direct benefit of a SARS-CoV-2 vaccine in children and the substantial indirect benefit through community protection, or “herd immunity,” we argue that planning and implementation of SARS-CoV-2 vaccines should include children. Furthermore, community protection occurred after widespread implementation of prior childhood vaccines against Streptococcus pneumoniae, rubella, and rotavirus. We detail considerations for vaccine clinical trials, potential barriers to the implementation of widespread vaccination and argue why children would be an ideal target population for vaccination.
Language Environments and Spoken Language Development of Children With Hearing Loss
Authors: Arora Sonia , Smolen Elaine R , Wang Ye , Hartman Maria , Howerton-Fox Amanda , Rufsvold Ronda
Published: June 2020

This study examined the relationships between adult language input and child language production in regard to the quantity and diversity of spoken language, as well as children’s knowledge of basic concepts and vocabulary. The quantity and diversity of language provided by teachers and parents were related to children’s language output and knowledge. Language ENvironment Analysis technology audio-recorded the language environments of 26 preschool children with hearing loss over 2 days. The language samples were analyzed for quantity (adult word count, child vocalization count, and conversational turn count) and diversity (lexical diversity, syntactical complexity, and clausal complexity) of language. Results indicated a relationship between adult language input and child language production, but only in regard to the quantity of language. Significant differences between the teachers and parents were reported in regard to the diversity of adult language input. These results suggest that the language input provided by adults across environments (school versus home) is considerably different and warrants further investigation.
Management of thrombus formation after electrical isolation of the left atrial appendage in patients with atrial fibrillation
Authors: Fink Thomas , Ouyang Feifan , Heeger Christian-Hendrik , Sciacca Vanessa , Reissmann Bruno , Keelani Ahmad , Schütte Christopher , Wohlmuth Peter , Maurer Tilman , Rottner Laura , Eitel Charlotte , Eitel Ingo , Rillig Andreas , Metzner Andreas , Kuck Karl-Heinz , Tilz Roland Richard , Vogler Julia
Published: June 2020

Aims

Left atrial appendage (LAA) electrical isolation (LAAEI) in addition to pulmonary vein isolation is an emerging catheter-based therapy to treat symptomatic atrial fibrillation. Previous studies found high incidences of LAA thrombus formation after LAAEI. This study sought to analyse therapeutic strategies aiming at the resolution of LAA thrombi and prevention of thromboembolism.

Methods and results

Left atrial appendage electrical isolation was conducted via creation of left atrial linear lesions or cryoballoon ablation. Follow-up including transoesophageal echocardiography was conducted. In patients with LAA thrombus, oral anticoagulation (OAC) was adjusted until thrombus resolution was documented. Percutaneous LAA closure (LAAC) under use of a cerebral protection device was conducted in case of medically refractory LAA thrombi. Left atrial appendage thrombus was documented in 54 of 239 analysed patients who had undergone LAAEI. Thrombus resolution was documented in 39/51 patients (72.2%) with available follow-up after adjustment of OAC. Twenty-nine patients underwent LAAC and 10 patients were kept on OAC after LAAEI. No thromboembolic events or further LAA thrombi were documented after 553 ± 443 days of follow-up in these patients. Persistent LAA thrombi despite adaption of OAC was documented in 12/51 patients. One patient remained on OAC until the end of follow-up, while LAAC with a cerebral protection device was performed in 11 patients in the presence of LAA thrombus without complications.

Conclusion

Left atrial appendage thrombus formation is common after LAAEI. Adjustment of OAC leads to LAA thrombus resolution in most patients. Left atrial appendage closure in the presence of LAA thrombi might be a feasible option in case of failed medical treatment.
The Trinidad and Tobago Microzonation Project: Port of Spain
Authors: Papadopoulos Ilias , Reddock Kafele , Manzano Jevan , Latchman Joan L
Published: June 2020

In this study, we present the results from the microzonation study conducted in Port of Spain (PoS), capital of the Republic of Trinidad & Tobago. A dense grid of single-site recordings was used to determine the fundamental frequency of soil above bedrock, while a grid of 26 array recordings comprised the database for finding the 1-D shear wave velocity, with depth. The resonant frequency was found to range from <1.0 Hz, for the deeper sediments to the south, near the coast, to above 4.0 Hz, on the northern outskirts of the city, closer to the rock formations. The array data processing revealed a shear wave velocity less than 360 m s–1, for the alluvial deposits, whilst for the harder formations, the velocity was at least 1000 m s–1. To validate the results, a parametric investigation, using synthetic seismograms of ambient noise for simplified 1-D models of the PoS basin sediments, was conducted. A 3-D geological model of the basin was developed, by integrating the experimental results with the simulated data. The model suggests a gradual increase, from north to south, in sediment depth down to ∼160 m. In order to understand and explain the variation of the resonance frequency, a review of the historical development of the area, for the past 250 yr, revealed large-scale, non-engineered land reclamation in the 19th and 20th centuries, resulting in areas with anomalously high amplification of seismic motion.
Application of rock physics modelling to investigate the differences between static and dynamic elastic moduli of carbonates
Authors: Ghasemi M F , Bayuk I O
Published: June 2020

The elastic moduli estimated through geophysical studies carried out in wells (logging data) differ from those obtained from the triaxial tests conducted in laboratory on the available core samples. Terminologically former and latter are referred to as dynamic and static elastic moduli, respectively. Since the structural characteristics of rocks at the different scales, from micrometre to larger scales (tens of metre), are the controlling parameters of their dynamic and static moduli and their difference at the respective scale, in this study we aim to investigate the influence of the measurable (or quantifiable) parameters of the pore space on these elastic moduli. To do so, 19 dry carbonate samples of different structural characteristics were collected. Their basic petrophysical properties such as porosity and permeability were measured in laboratory. The ultra-sonic tomography was carried out to determine the heterogeneity degree, anisotropy system and average acoustic wave velocities for each core sample. SEM images were analysed to investigate the visual textural properties. The mineralogical composition of these samples was determined by the X-ray diffraction method. Based on the conducted experimental studies and using of the effective medium theory, a unique rock physics model (‘petroelastic model’) was constructed for each core sample. The average (effective) microstructural parameters characterizing the pore space of the studied carbonate samples, along with their elastic moduli were estimated through solving the inverse problem and the measured acoustic wave velocities. A multistage statistical approach, including computation of correlation coefficients, optimized regression analysis, factor analysis and bootstrap resampling, was suggested to investigate the effect of each microstructural parameters on the static and dynamic Young's moduli, ratio of dynamic to static Young's moduli (k-value), dynamic Poisson's ratio and mechanical properties (including unconfined compressive strength and internal friction angle). The obtained results show that the microstructural characteristics have different degrees of influence on the elastic moduli and can be successfully classified based on their physical nature. It was also concluded that the dynamic Poisson's ratio is independent of the studied, in this work, microstructural parameters.
Rate-optimal denoising with deep neural networks
Authors: Heckel Reinhard , Huang Wen , Hand Paul , Voroninski Vladislav
Published: June 2020

Deep neural networks provide state-of-the-art performance for image denoising, where the goal is to recover a near noise-free image from a noisy observation. The underlying principle is that neural networks trained on large data sets have empirically been shown to be able to generate natural images well from a low-dimensional latent representation of the image. Given such a generator network, a noisy image can be denoised by (i) finding the closest image in the range of the generator or by (ii) passing it through an encoder-generator architecture (known as an autoencoder). However, there is little theory to justify this success, let alone to predict the denoising performance as a function of the network parameters. In this paper, we consider the problem of denoising an image from additive Gaussian noise using the two generator-based approaches. In both cases, we assume the image is well described by a deep neural network with ReLU activations functions, mapping a $k$-dimensional code to an $n$-dimensional image. In the case of the autoencoder, we show that the feedforward network reduces noise energy by a factor of $O(k/n)$. In the case of optimizing over the range of a generative model, we state and analyze a simple gradient algorithm that minimizes a non-convex loss function and provably reduces noise energy by a factor of $O(k/n)$. We also demonstrate in numerical experiments that this denoising performance is, indeed, achieved by generative priors learned from data.
Complete Ricci Solitons via Estimates on the Soliton Potential
Authors: Wink Matthias
Published: June 2020

In this paper, a growth estimate on the soliton potential is shown for a large class of cohomogeneity one manifolds. This is used to construct continuous families of complete steady and expanding Ricci solitons in the setups of Lü–Page–Pope [24] and Dancer–Wang [17]. It also provides a different approach to the two summands system [30] that applies to all known geometric examples.
Risks versus Transformational Opportunities in Gender-Responsive Security Sector Reform
Authors: Gordon Eleanor , McHugh Ciara , Townsley Jane
Published: June 2020

This article investigates the gap between policy and practice in gender-responsive security sector reform (SSR) by exploring the ways in which risks perceived to be associated with gender-responsive SSR in conflict-affected environments legitimize inaction. A typology of risks is presented, which range from risks to individuals, security sector institutions, and peacebuilding efforts and encompass security, programmatic, fiduciary, and reputational risks. The risks are analyzed to consider the extent to which they are present and could be managed, mitigated, or avoided, rather than stall action. This article argues that the process of determining what constitutes a risk, and what constitutes a risk worth taking, is inherently political and serves to reinforce dominant power relations, including gendered power relations. The article then discusses the risks that result from inaction and the opportunities that are missed when arguments about risk trump gender responsiveness. As a result, it is argued that gender inequalities persist, women continue to be marginalized within and beyond the security sector, and transformational opportunities that could lead to sustainable peace are missed. The article concludes by arguing that the potential risks resulting from not advancing gender-responsive SSR far outweigh the perceived risks associated with it.
The Diagnostic Process
Authors: Papazoglou Emily
Published: June 2020

A developmental evaluation can be a powerful tool for obtaining a thorough overview of your child’s development and determining whether any diagnoses are appropriate. Evaluations can be done with very young children (and even in infancy), so waiting for an evaluation until your child is school-aged often means missing out on valuable intervention time. The more information you have about your child’s difficulties, the more effectively you can address them. The process of identifying the type of provider needed will be discussed with an emphasis on how to vet providers to help ensure a quality evaluation. The components of an evaluation along with information on how to interpret the results of standardized testing will be discussed.
Handling Practical Issues
Authors: Papazoglou Emily
Published: June 2020

This chapter reviews practical issues that arise when raising a child with a developmental disorder. Answers are provided to common questions. This includes advice on how to capitalize on the power of praise, how to support your child getting a sufficient amount of sleep, and how to manage screen time. Safety issues are discussed including how to handle wandering behavior and the importance of proactively alerting emergency responders to your child’s needs. Options for participating in extracurricular activities are reviewed. Strategies for boosting independence in completing daily living skills, such as chores and self-care activities, are discussed.
The Backed-Up Bed Blocker
Authors: Croskerry Pat
Published: June 2020

In this case, a middle-aged male presents to a busy community emergency department with a chief complaint of constipation. The emergency physician cannot see him immediately and gives an order to a nurse for a saline enema. It proves ineffective (fortuitously). When the physician later assesses the patient, the patient is complaining of back pain and found to have weakness on straight leg raising, reduced sphincter tone, and urinary retention. His problems turn out to be more complicated than constipation.
The Perfect Storm
Authors: Croskerry Pat
Published: June 2020

In this case, a 51-year-old patient suffers a generalized seizure in the dialysis clinic of a tertiary care hospital. She is found to be in atrial fibrillation and is transferred to the emergency department (ED) for further assessment, with consultations to cardiology and neurology. She is initially assessed by a clinical clerk, who records that the patient is unable to move her legs due to pain. The patient has a stormy course in the ED and finally ends up being admitted to neurology and on to neurosurgery for eventual management of a serious diagnosis. The case brings out a number of issues regarding patient management embedded in a variety of cognitive biases in a busy ED.
A Case of Premature Closure
Authors: Croskerry Pat
Published: June 2020

This case describes a young male who is brought to the emergency department of a major teaching hospital at night by friends. He has multiple stab wounds to the upper back, arms, and scalp. He is seen by the chief emergency resident. He has one laceration on his left scalp, two on the left arm, and one inferior to the left scapula. The resident’s main concern is the laceration to the patient’s posterior chest. Eventually, in consultation with the attending emergency physician, he is satisfied that the patient’s pleural cavity has not been entered and did not require a chest computed tomography scan. His lacerations are repaired, and he is discharged home with his mother. Several days later, the patient starts experiencing symptoms from a major missed diagnosis.
Failed Frequent Flyers
Authors: Croskerry Pat
Published: June 2020

Two cases are reviewed in Case 16; both demonstrate problems with “frequent flyers” in the emergency department (ED). The principal characteristic of these patients is that despite their symptoms and complaints being minor, they frequently present to the ED. Inevitably, ED staff tend to view their visits disparagingly. However, like the boy who cried wolf, they will occasionally have serious underlying conditions that need to be addressed. A prominent cognitive pattern is described: the cognitive miser function. It is the tendency to uncritically accept things at face value. Although this may be adequate for many routine decisions, the failure to unpack sufficient information will sometimes result in suboptimal decision making.
The Michelin Lady
Authors: Croskerry Pat
Published: June 2020

This case describes the presentation to an emergency department of a patient with severe facial swelling and difficulty breathing. It is a classic demonstration of the metaheuristic anchoring and adjustment. The attending physician anchors to the visual presentation of the patient and to a working diagnosis that had been made by paramedics transporting the patient. Despite inconsistencies with this diagnosis, the physician persists with his anchor and fails to adjust to other possibilities. Level of arousal and associated anxiety may influence this bias.
A Hard Tale to Swallow
Authors: Croskerry Pat
Published: June 2020

This case describes the experience of a young woman who spends 28 hours in an emergency department before her diagnosis is made. She endures numerous transitions of care between successive physicians that involve a variety of biases in an emergency department that is extremely busy at times. Personal characteristics of the patient appear to make her vulnerable to multiple implicit biases: race, obesity, psychiatric stigmatization, and others. A particular feature of the case is inattentional blindness, which surfaces in several other cases in this book.
Deceptive Detachment
Authors: Croskerry Pat
Published: June 2020

In this case, a young female nurse develops symptoms of conjunctivitis in both eyes. She engages physician colleagues in informal corridor consultations that assume a minor diagnosis. With no improvement, she initiates a third assessment that sets up a formal evaluation in which important findings are made that lead to a correct diagnosis.