bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Wherry Frederick F. , Woodward Ian
Published: June 2019

This chapter serves as the introduction to The Oxford Handbook of Consumption. The Handbook consolidates the most innovative recent work in consumption research conducted by social scientists and identifies some of the most fruitful lines of inquiry for future research. While the book emphasizes sociocultural and qualitative research, it also includes key findings from network analyses, quantitative and comparative analysis, and social experiments. The book begins by embedding marketing in its global history, enmeshed in various political, economic, and social sites. From this embedded perspective, the book branches out to examine the rise of consumer culture theory among consumer researchers and parallel innovative developments in sociology and anthropology, with scholarship analyzing the roles that identity, social networks, organizational dynamics, institutions, market devices, materiality, and cultural meanings play across a wide variety of applications, including, but not limited to, brands and branding, the sharing economy, tastes and preferences, credit and credit scoring, consumer surveillance, race and ethnicity, status, family life, well-being, environmental sustainability, social movements, and social inequality.
Misinformation, Fake News, and Dueling Fact Perceptions in Public Opinion and Elections
Authors: Barker David C. , Marietta Morgan
Published: June 2019

This chapter considers the polarized politics of truth in the United States. The chapter starts by distinguishing the most relevant concepts associated with this phenomenon. Next, it explores the proximal causes (and their psychological mechanisms), which include partisan tribalism, social identities, value projection, and media (including fake news). From there, the chapter documents the consequences of these phenomena, which include policy gridlock, social disdain, and a warped electorate. Finally, it scores the revealed usefulness of a few proposed correctives.
Debating How to Measure Media Exposure in Surveys
Authors: Goldman Seth K. , Warren Stephen M.
Published: June 2019

To answer many of the most pressing questions in the social sciences, researchers need reliable and valid measures of media exposure that can be implemented in surveys. Despite considerable effort, however, substantial disagreement remains about how best to measure this key concept. This chapter critically reviews the debate surrounding traditional frequency measures of exposure to “news” and contemporary list-based measures of political media exposure. It also evaluates the related debate over how best to capture the effects of media exposure with different observational research designs. Overall, the chapter finds that although substantial progress has been made in measurement and research design, both issues require more attention if scholars are to understand the many and varied effects of media exposure.
Digestive System
Authors: Furness John B. , Boyle Eve K. , Fakhry Josiane , Gajewski Joanna , Fothergill Linda J.
Published: June 2019

Digestive tracts vary considerably because animals have evolved different processes to convert foods to essential molecular building blocks. Differences in digestive strategies distinguish, for example, foregut and hindgut fermenters, and animals utilising different dominant food types, for example herbivores, carnivores, and folivores. Neither the modern human diet nor the size and proportions of the human gut resemble those of other primates. The human digestive system has evolved and diverged in response to introduction of new food types and food preparation techniques. For example, persistence of lactase activity into adulthood occurred in populations that maintained cattle to harvest milk. Humans have utilised non-thermal food preparation for over 2 million years and cooking for 300,000–400,000 years. For most extant humans, prepared food comprises over 70% of the diet. The modern human digestive system is suited to pre-prepared food because of its smaller volume, relative to other species, and because of differences in dentition and masticatory muscles that results in lower bite strength. Adaptations of human digestion in response to diet involved genetic selection over thousands of years. However, transmissible changes linked to diet occur in a single generation. These are best documented for epigenetic changes related to obesity, and are maladaptive in some cases. Diets for most humans have changed substantially in the last half century, too rapidly for evolutionary change in digestive physiology. The capacity to adapt to recent dramatic dietary changes has proven insufficient to avoid deleterious effects leading to obesity, diabetes, fatty liver disease, and metabolic syndrome.
Excretory System
Authors: Romagnani Paola , Anders Hans-Joachim
Published: June 2019

The kidney is the central organ of body fluid and electrolyte homoeostasis and metabolic waste excretion, the conditions of which were settled early in the evolution of multicellular organisms. Life in different environments such as sea water, fresh water, or arid land implies complex challenges for kidneys to maintain body fluid and electrolyte homoeostasis, which is achieved by distinct hormonal pathways regulating water and salt handling via transporter channels across cell membranes. For this to occur there is a tight link between the anatomy and physiology of the nephrons, the independent functional units of the kidney. Adaptation to life on land went along with a loss of de novo nephron formation, once nephrons get lost during kidney injury. The limited capacity of mammals to regenerate injured kidneys is one of the reasons for chronic kidney disease being common in humans, especially in ageing populations. This chapter provides an overview on human kidney physiology in view of its evolution across species. A better understanding of the stepwise adaptation processes provides unexpected explanations for numerous human renal diseases and associated health conditions such as hypertension and gout resulting from evolutionary trade-offs. In addition, recent changes in human lifestyle created a mismatch between kidney function and novel environmental challenges, thus representing another source of health conditions affecting the kidney. The evolutionary medicine perspective can offer a better understanding of disease pathogenesis and clues for management and prevention.
Sexuality, Reproduction, and Birth
Authors: Schiefenhövel Wulf , Trevathan Wenda
Published: June 2019

The chapter extends discussion of the human reproductive life course by providing a focus on male and female sexuality and the common result of that sexuality, the production of offspring via childbirth. It begins with an overview of sexuality in non-human primates, with emphasis on variability, considering ways in which sexual behaviours of our closest relatives are both different and similar to sexual behaviours of humans. The chapter addresses sperm competition, male and female orgasmic response, and homosexuality. The approach includes both evolutionary medicine and evolutionary psychology. The chapter considers the hours that surround the production of offspring, beginning with labour and delivery and concluding with the early postpartum treatment of the new-born infant. Topics covered include the role of the hormone oxytocin, the stages and phases of labour, posture in labour and delivery, surgical delivery, postpartum haemorrhage, neonatal hyperbilirubinaemia, treatment of the new-born, mother–infant bonding, postpartum depression, and breastfeeding. Although there are aspects of labour and delivery that benefit from clinical assistance and consideration by evolutionary medicine, most of the time the process progresses with little or no intervention as it has for thousands of generations.
Adam Smith and the Study of Ethics in a Commercial Society
Authors: Haeffele Stefanie , Storr Virgil Henry
Published: June 2019

Over time, the fields of economics and ethics have become more distinct with economics focusing on the rationality of actors, the incentives they face, and the outcomes of interacting within an amoral market setting. However, in the real world, economics and ethics are more interconnected. Humans are social and ethical beings regardless of setting. Recent studies have shown that individuals reward trustworthiness, punish dishonesty, and can develop meaningful social bonds within markets. Economists, seeking to better understand the world, should incorporate ethics into their economics. We argue that Adam Smith is an exemplar of pursuing a fuller approach to social science, and utilize his arguments on both economics and ethics to advance a study of ethical markets.
Human Ethicality
Authors: Dhami Sanjit , al-Nowaihi Ali
Published: June 2019

The neoclassical model in economics envisages humans as amoral and self-regarding (Econs). This model, also known as the homo economicus model, is not consistent with the empirical evidence. In light of the evidence, the continued use of the homo economicus model is baffling. It also stymies progress in the field by putting the burden of adjustment on auxiliary assumptions that need to compensate for an unrealistic picture of human motivation and behavior. This essay briefly outlines the evidence for a more inclusive picture of humans in which ethics and morality play a central role. It argues for replacing the homo economicus model with a homo behavioralis model that has already enabled great progress to be made in the field of behavioral economics.
Virtue and Economics, Horse and Cart
Authors: Baker Jennifer A.
Published: June 2019

Assimilating ethics to the economic way of thinking is a mistake, and I explain an alternative in this chapter. Applying virtue ethics to economics allows us to explain how economic reasoning ought to be related to our own agency. With virtue ethics, we can endorse some market norms for their contribution to general welfare and ethically critique any particular market norm on the basis of ethics. Concepts from virtue ethics can resolve established tensions between ethics and economics. Oikeiosis, or standard moral development, leaves room, in an account of virtue, for empirical discoveries (such as those economists themselves find) concerning our actual motivations. “Due action” is behavior economists can recommend, without expectations of virtue. And finally, the category of “moral indifferents” allows us to regard economics as the study of indifferents: crucial but unmoralized inputs to our collective lives.
Economics, Ethics, and Health Insurance
Authors: Hausman Daniel M.
Published: June 2019

Evaluating health care institutions and policies should depend on understanding the economic complexities of health care provision and on our values of compassion, choice, efficiency, fairness, and solidarity. These values may conflict, so applying them is difficult. We must also understand the problems with health care allocation, including employing markets. Regulations are needed first because of asymmetric information: doctors know more about treatments than patients and can exploit them. Second, health insurance is a better bargain for those who expect to be sick. Consequently, health insurance policies attract purchasers more likely to make claims. This adverse selection makes claims and premiums skyrocket, healthy people drop out, and private health insurance markets collapse, unless everyone is forced to buy insurance or insurers deny insurance to those with pre-existing conditions. Third is moral hazard: if insurance pays for a health problem, there is less incentive to avoid it or to economize on treating it. Health care policies must be economically sound and morally defensible.
The Ethics and Economics of Ecological Justice
Authors: Schmidtz David
Published: June 2019

If we are to emerge from the process of growing up with an adult conception of justice, it will be a conception of our place and of our due, alongside a conception of what other people are due, within a community that has a logic of its own. That logic will be described by economics (among other social sciences) and by ecology. Realistic possibilities are implications of those logics. Adult views about ethics and about justice will be disciplined by those logics.
Education in Medieval Europe
Authors: Young Spencer E.
Published: June 2019

This chapter highlights the institutions and content that characterized three crucial phases of education in the Middle Ages: Carolingian education, the twelfth-century Renaissance, and the rise and spread of the university. The various kinds of schools that flourished across medieval Europe reflected its classical and Christian heritages and the productive tensions between those two traditions. While the chapter reflects the predominant focus of medieval schooling on educating male Christians, it also includes discussion of the educational opportunities that were available to females and non-Christians. Although only a minority of people received a formal education in the Middle Ages, many of those attained a significant level of learning.
Plato, Socrates, and Love
Authors: Vasiliou Iakovos
Published: June 2019

Given the prodigious amount of scholarship on Platonic love, this article explores a different question: the nature of Plato’s love for Socrates as expressed in two dialogues, the Symposium and Phaedo, in which Plato depicts Socrates as surrounded by his lovers and disciples. By paying attention to the “outer frames” of the dialogues, that is, the relationship between the text and the reader, it is argued that Plato’s love for Socrates is displayed not only in his loving depiction of Socrates but also in Plato’s doing philosophy through the character of Socrates; Plato thereby shows what genuine love for Socrates would be like. Moreover, contrasted with the words and actions of other characters in these dialogues, Plato shows himself to be not just one among many of Socrates’ lovers, but in fact the best.
History of the Wada Test
Authors: Loring David W. , Meador Kimford J.
Published: June 2019

This chapter discusses the origins and development of the Wada test. Wada testing, named after Juhn A. Wada, M.D., is the technique of arterial administration of amobarbital (or other short acting barbiturate) to transiently inactivate brain function in the distribution of the injected artery during which cognitive testing is performed. The procedure was developed to establish cerebral language dominance in the late 1940s, and it became a routine component of the preoperative evaluation for epilepsy surgery in the mid-1950s. However, the use of Wada testing as the primary technique to identify cortical language regions and predict risk of post-operative memory decline has been increasingly displaced by electroencephalogram (EEG) video monitoring, magnetic resonance imaging (MRI) of hippocampus, positron emission tomography (PET), single photon emission computed tomography (SPECT), functional MRI (fMRI), and even multi-modality imaging.
Fluid Voices
Authors: Meizel Katherine , Scherer Ronald C.
Published: June 2019

Theatrical impersonators have long been understood to demonstrate and celebrate the transgressive powers of transvestism. But there is always more at work than dressing up; wigs and sequins are not the only technologies of transformation. Voice, too, becomes a significant technology not simply of the Self, but also of multiple intersubjectivities. Though there is a small body of literature that addresses spoken impersonation among actors, there have been no published studies of singing impersonation. In this research, the authors have sought to arrive at some preliminary methods and approaches that might be of use in such studies. In the interest of working toward a more holistic understanding of voice, they have combined ethnographic and empirical methods to illuminate how disjunctures between bodies and voices are negotiated by a Las Vegas impersonator, and how they paradoxically contribute to the construction of these performers’ own identities.
Vocal threat enhances visual perception as a function of attention and sex
Authors: Schirmer Annett , Wijaya Maria , Wu Esther , Penney Trevor B
Published: June 2019

This pre-registered event-related potential study explored how vocal emotions shape visual perception as a function of attention and listener sex. Visual task displays occurred in silence or with a neutral or an angry voice. Voices were task-irrelevant in a single-task block, but had to be categorized by speaker sex in a dual-task block. In the single task, angry voices increased the occipital N2 component relative to neutral voices in women, but not men. In the dual task, angry voices relative to neutral voices increased occipital N1 and N2 components, as well as accuracy, in women and marginally decreased accuracy in men. Thus, in women, vocal anger produced a strong, multifaceted visual enhancement comprising attention-dependent and attention-independent processes, whereas in men, it produced a small, behavior-focused visual processing impairment that was strictly attention-dependent. In sum, these data indicate that attention and listener sex critically modulate whether and how vocal emotions shape visual perception.
Actigraphic detection of periodic limb movements: development and validation of a potential device-independent algorithm. A proof of concept study
Authors: Athavale Yashodhan , Krishnan Sridhar , Raissi Afsaneh , Kirolos Nardin , Jairam Trevor , Murray Brian J , Boulos Mark I
Published: June 2019

Study Objectives

We propose a unique device-independent approach to analyze long-term actigraphy signals that can accurately quantify the severity of periodic limb movements in sleep (PLMS).

Methods

We analyzed 6–8 hr of bilateral ankle actigraphy data for 166 consecutively consenting patients who simultaneously underwent routine clinical polysomnography. Using the proposed algorithm, we extracted 14 time and frequency features to identify PLMS. These features were then used to train a Naïve–Bayes learning tool which permitted classification of mild vs. severe PLMS (i.e. periodic limb movements [PLM] index less than vs. greater than 15 per hr), as well as classification for four PLM severities (i.e. PLM index < 15, between 15 and 29.9, between 30 and 49.9, and ≥50 movements per hour).

Results

Using the proposed signal analysis technique, coupled with a leave-one-out cross-validation method, we obtained a classification accuracy of 89.6%, a sensitivity of 87.9%, and a specificity of 94.1% when classifying a PLM index less than vs. greater than 15 per hr. For the multiclass classification for the four PLM severities, we obtained a classification accuracy of 85.8%, with a sensitivity of 97.6%, and a specificity of 84.8%.

Conclusions

Our approach to analyzing long-term actigraphy data provides a method that can be used as a screening tool to detect PLMS using actigraphy devices from various manufacturers and will facilitate detection of PLMS in an ambulatory setting.
Selective Ah Receptor Ligands Mediate Enhanced SREBP1 Proteolysis to Restrict Lipogenesis in Sebocytes
Authors: Muku Gulsum E , Blazanin Nicholas , Dong Fangcong , Smith Philip B , Thiboutot Diane , Gowda Krishne , Amin Shantu , Murray Iain A , Perdew Gary H
Published: June 2019

The aryl hydrocarbon receptor (AHR) mediates 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced toxicity that can lead to chloracne in humans. A characteristic of chloracne, in contrast to acne vulgaris, is shrinkage or loss of sebaceous glands. Acne vulgaris, on the other hand, is often accompanied by excessive sebum production. Here, we examined the role of AHR in lipid synthesis in human sebocytes using distinct classes of AHR ligands. Modulation of AHR activity attenuated the expression of lipogenic genes and key proinflammatory markers in the absence of canonical DRE-driven transcription of the AHR target gene CYP1A1. Furthermore, topical treatment with TCDD, which mediates DRE-dependent activity, and SGA360, which fails to induce DRE-mediated responses, both exhibited a decrease in the size of sebaceous glands and the number of sebocytes within each gland in the skin. To elucidate the mechanism of AHR-mediated repression of lipid synthesis, we demonstrated that selective AHR modulators, SGA360 and SGA315 increased the protein turnover of the mature sterol regulatory element-binding protein (mSREBP-1), the principal transcriptional regulator of the fatty acid synthesis pathway. Interestingly, selective AHR ligand treatment significantly activated the AMPK-dependent kinase (AMPK) in sebocytes. Moreover, we demonstrated an inverse correlation between the active AMPK and the mSREBP-1 protein, which is consistent with the previously reported role of AMPK in inhibiting cleavage of SREBP-1. Overall, our findings indicate a DRE-independent function of selective AHR ligands in modulating lipid synthesis in human sebocytes, which might raise the possibility of using AHR as a therapeutic target for treatment of acne.
Gelatin-Collagen Nonwoven Scaffold Provides an Alternative to Suprathel for Treatment of Superficial Skin Defects
Authors: Schiefer Jennifer L. , Rath Rebekka , Held Manuel , Werner Jan-Ole , Petersen Wiebke , Schaller Hans-Eberhard , Rahmanian-Schwarz Afshin
Published: June 2019

OBJECTIVE:

To evaluate the effect of a new biologic gelatin-collagen nonwoven scaffold compared with a more common synthetic wound dressing on the healing of superficial wounds.

METHODS:

Three superficial wounds with a depth of 0.5 mm and a length of 2.4 cm were created on the flanks of six minipigs using a skin dermatome. One wound on each pig was treated with the new nonwoven scaffold, one with the more common synthetic wound dressing, and one functioned as an untreated control wound. All three wounds were then covered with a semipermeable, sterile, transparent film.

RESULTS:

After 7 days, complete wound closure of all wounds could be detected; epidermal thickness and the number of epidermal cells of all treated wounds were significantly increased compared with the control wounds. The nonwoven dressing showed slightly better results compared with the more common dressing.

CONCLUSIONS:

The nonwoven scaffold is an interesting and competitive material for promoting epidermal wound healing. Because it is a biologic dressing, it degenerates completely and does not have to be removed from the wound. Further research should be conducted to compare this new dressing with other currently available wound treatments.
Health Equity and the Tripartite Mission: Moving From Academic Health Centers to Academic–Community Health Systems
Authors: Park Brian , Frank Brian , Likumahuwa-Ackman Sonja , Brodt Erik , Gibbs Brian K. , Hofkamp Holly , DeVoe Jennifer
Published: June 2019

Academic health centers (AHCs) play a significant role in educating the health care workforce, conducting innovative biomedical and clinical research, and delivering high-quality patient care. Much work remains, however, to adequately address the social determinants of health and equity that affect communities where patients live, work, and play. Doing so will help achieve the Quadruple Aim while addressing the unjust social structures that disproportionately impact communities of color and vulnerable populations. AHCs have a timely opportunity to focus their leading roles in education, research, and clinical care on social determinants, moving outside their walls to create academic–community health systems: a collection of academic–community partnerships advancing health equity through collaboration, power sharing, and cocreation.

This Perspective proposes four strategies to start developing academic–community health systems. First, embark on all efforts through cocreation with communities. Second, address how future health care professionals are recruited. Third, build the right skills and opportunities for health care professionals to address health inequities. Finally, develop research agendas to evaluate programs addressing inequities. A fully realized vision of an academic–community health system will demonstrate interdependence between AHCs and the community. While considerable AHC resources are invested in building community capacity to improve health and health equity, health systems will also benefit in a multitude of ways, including increasing the diversity of ideas and experiences integrated into health systems. These strategies will support AHCs to embed across each arm of the tripartite mission a focus on partnering with communities to advance health equity together.
Consensus on Reducing Risk in Total Joint Arthroplasty: Narcotic Use
Authors: Sodhi Nipun , Mont Michael A.
Published: June 2019

Because of the potential adverse events associated with opioid use, the purpose of this consensus was to provide guidelines to help reduce the risks when performing lower extremity joint arthroplasty. Specifically, the authors addressed: (1) the use of nonopioid pain management; (2) national and state guidelines; (3) the role of pain management specialists; and (4) multimodal pain management options for total hip and knee arthroplasty. A literature search was performed utilizing the PubMed database focused on total hip and knee arthroplasty pain managed with opioids. The authors recommend that patients be started with nonopioid-based pharmacological treatments, such as acetaminophen and nonsteroidal anti-inflammatories. If opioids are necessary, the lowest dose for the shortest duration should initially be prescribed. Appropriate preoperative optimization, intraoperative local analgesic injections, and perioperative multimodal agents, such as long-acting injections, physical therapies, and co-management with pain specialists should all be performed. By following these guidelines, the authors believe that it will help reduce the use of opioids after hip and knee arthroplasty, all while still meeting our patient’s pain control expectations.
A Novel Technique for Single-stage Correction of Severe Shepherd Crook Deformity of a Femur With the Large Cystic Lesion and Pathologic Fracture
Authors: Jayaramaraju Dheenadhayalan , Valleri Durga Prasad , Shanmuganathan Rajasekaran
Published: June 2019

Fibrous dysplasia with severe proximal femur deformity and multiple large cystic lesions associated with a pathologic fracture is an orthopedic challenge. Correction is often impossible with conventional fixation methods. We report a technique to address the deformity and fracture simultaneously in these scenarios. A 32-year-old man, a case of polyostotic fibrous dysplasia with severe shepherd crook deformity and the pathologic fracture was managed by curettage, multilevel osteotomy, tibial strut allograft, extramedullary fixed-angle implant, and augmentation with cortico-cancellous bone grafting in a single stage. The mechanical axis of the femur was corrected, with an increase in the neck-shaft angle from 70.6 to 121 degrees. Union was achieved with good outcomes in cosmetic and functional status without recurrence at 18 months follow-up. In proximal femur fibrous dysplasia, critical analysis of the bone stock for implant purchase especially in the proximal femur with large cystic lesions is essential. Augmentation of the head, neck, and calcar region with cortical strut allograft provide stable fixation and decreases the deformity recurrence. This technique is particularly useful in severe forms of the disease; wherein there would be an impaired implant purchase in the weak pathologic bone, deficient lateral wall, and a wide medullary canal.
The Nurse's Role in Counseling Patients at Risk for Cardiovascular Disease Using the 5As Model
Authors: Storer Sallyann G.
Published: June 2019

Cardiovascular disease (CVD) is often caused by modifiable risk factors related to diet and lifestyle behaviors. Counseling patients to adopt lifestyle changes for CVD risk-reduction is needed. Using the 5As strategy (ask, assess, advise, agree, assist) can help patients incorporate positive behavior changes and reduce CVD risk factors.
Combining Education With Auricular Acupressure to Facilitate Smoking Cessation in Young Adults
Authors: Wang Yi-Zen , Wang Yu-Jen , Yeh Mei-Ling
Published: June 2019

Young adults rarely use pharmacotherapy to cease smoking. This prospective experimental study was performed using a nonpharmacotherapy design. Smoking cessation education combined with auricular acupressure may be more attractive. The key factor for superior smoking cessation was the decrease of nicotine dependence in the early stage of smoking cessation.
Use of Micafungin for the Prevention and Treatment of Invasive Fungal Infections in Everyday Pediatric Care in France: Results of the MYRIADE Study
Authors: Leverger Guy , Timsit Jean-François , Milpied Noël , Gachot Bertrand
Published: June 2019

Background:

Invasive fungal infections are responsible for significant morbidity and mortality. Safety and effectiveness of antifungal agents is a particular concern in pediatric populations, where data are often limited. Micafungin is an echinocandin with demonstrated antifungal activity against a wide spectrum of Candida spp.; this subanalysis of data from the MYRIADE study describes the use of micafungin and its therapeutic outcomes in pediatric patients, in normal clinical practice.

Methods:

MYRIADE was an observational, multicenter, national, prospective, longitudinal study conducted from January 2010 to December 2012, in patients treated with micafungin using a prophylactic or curative strategy, across 17 sites [oncohematology (n = 8), neonatal intensive care units (ICUs) (n = 5) and pediatric ICUs (n = 4)]. The treatment regimen, the achievement of the therapeutic objective and the tolerance were reported.

Results:

The study population consisted of 110 pediatric patients (31 neonates, 24 children <2 years old and 55 children ≥2 to <16 years old). The therapeutic objective was achieved in 49/64 (76.6%) oncohematology patients, 28/29 (96.6%) neonatal ICU patients and 12/14 (85.7%) pediatric ICU patients. Twenty-four (21.8%) children developed an adverse event (AE); more AEs were observed in oncohematology patients compared with ICU patients [17 (26.1%) vs. 7 (15.6%)]. Only one serious AE, reported in an oncohematology patient, was considered related to micafungin.

Conclusions:

In the first large observational study of micafungin treatment or prophylaxis conducted under real-world conditions in France, micafungin was effective and well tolerated for prophylaxis of invasive fungal infections in pediatric oncohematology patients and for curative purposes in pediatric and neonatal ICU patients.
Development and Validation of Parental Vaccine Attitudes Scale for Use in Low-income Setting
Authors: Yousafzai Mohammad Tahir , Riaz Atif , Omer Saad B. , Husain Sara , Nisar Imran , Mahesar Waheed , Omar Imam Danyal , Wallace Aaron , Ali Asad
Published: June 2019

Background:

This study aimed to develop a tool and assess its validity to measure childhood vaccine related attitudes among parents in a low-income setting.

Methods:

We developed a vaccine attitudes scale (VAS) composed of 14 Likert items each with 5 responses ranging from strongly agree to strongly disagree (sum of scores range 14–70). The tool was administered to 901 parents with children 4–12 months of age during a vaccine coverage survey in Sindh, Pakistan. We performed factor analysis with eigenvalues >0.3 for sufficient factor loading and calculated Cronbach alpha for reliability.

Results:

The mean ± SD score on VAS was 48 ± 3 and Cronbach alpha was 0.61. Factor analysis identified that VAS measured 2 different domains related to the childhood vaccine related attitudes; (1) 10 items related to vaccine perceptions and concerns (mean 40 ± 5.5; Cronbach alpha 0.95) and (2) 4 items related to vaccine preventable disease salience and community benefit (mean 7 ± 3; Cronbach alpha 0.97). The odds of children being unimmunized was 5 times higher among parents who scored high (13–20) as compared with low (<13) on the subscale related to disease salience and community benefit (odds ratio 5.2; 95% CI: 3.6–7.6). The odds of children being unimmunized was 1.5 times higher among parents scoring high (40–50) as compared with low (<40) on subscale related to vaccine perception/concerns (odds ratio 1.5; 95% CI: 1.1–2.2).

Conclusion:

The 4-item scale assessing parental attitudes toward vaccine preventable disease salience and community benefit is sufficiently reliable and can predict vaccine acceptance among parents in low income setting.
Effect of Socioeconomic Status on Patients Supported with Contemporary Left Ventricular Assist Devices
Authors: Clemons Autumn M. , Flores Raul J. , Blum Raia , Wayda Brian , Brunjes Danielle L. , Habal Marlena , Givens Raymond C. , Truby Lauren K. , Garan A. Reshad , Yuzefpolskaya Melana , Takeda Koji , Takayama Hiroo , Farr Maryjane A. , Naka Yoshifumi , Colombo Paolo C. , Topkara Veli K.
Published: June 2019

Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly used in advanced heart failure patients. Recent studies suggest that low socioeconomic status (SES) predicts worst survival after heart transplantation. Both individual-level and neighborhood-level SES (nSES) have been linked to cardiovascular health; however, the impact of SES in CF-LVAD patients remains unknown. We hypothesized that SES is a major determinant of CF-LVAD candidacy and postimplantation outcomes. A retrospective chart review was conducted on 362 patients between February 2009 and May 2016. Neighborhood-level SES was measured using the American Community Survey data and the Agency for Healthcare Research and Quality SES index score. Individual-level SES was self reported. Kaplan–Meier survival analysis and multivariable Cox proportional hazards regression determined survival statistics. Patients in the highest SES tertile were older (58 ± 13 vs. 53 ± 14; p < 0.001), less likely to be black or Hispanic (26% vs. 70%; p < 0.001), more likely to be married (87% vs. 65%; p < 0.001), more likely to have private insurance (50% vs. 39%; p < 0.001), and more likely to have employment (29% vs. 15%; p < 0.001) compared with patients in the lowest tertile. Low nSES was associated with a decreased risk of death (hazard ratio [HR], 0.580; 95% confidence interval [CI], 0.347–0.970; p = 0.038) in comparison to the high nSES. However, after adjusting for baseline clinical morbidities, the relationship was no longer present. When selecting patients for a LVAD, SES should not be thought of as an immutable risk factor. Carefully selected low-SES patients could be safely implanted with CF-LVAD with outcomes comparable to high-SES patients.
Low-Resistance, Concentric-Gated Pediatric Artificial Lung for End-Stage Lung Failure
Authors: Thompson Alex J. , Buchan Skylar , Carr Benjamin , Poling Clinton , Hayes McKenzie , Fernando Uditha Piyumindri , Kaesler Andreas , Schlanstein Peter , Hesselmann Felix , Arens Jutta , Potkay Joseph A. , Rojas-PeÑa Alvaro , Bartlett Robert H. , Hirschl Ronald B.
Published: June 2019

Children with end-stage lung failure awaiting lung transplant would benefit from improvements in artificial lung technology allowing for wearable pulmonary support as a bridge-to-transplant therapy. In this work, we designed, fabricated, and tested the Pediatric MLung—a dual-inlet hollow fiber artificial lung based on concentric gating, which has a rated flow of 1 L/min, and a pressure drop of 25 mm Hg at rated flow. This device and future iterations of the current design are designed to relieve pulmonary arterial hypertension, provide pulmonary support, reduce ventilator-associated injury, and allow for more effective therapy of patients with end-stage lung disease, including bridge-to-transplant treatment.
Benefits of Neurohormonal Therapy in Patients With Continuous-Flow Left Ventricular Assist Devices
Authors: Yousefzai Rayan , Brambatti Michela , Tran Hao A. , Pedersen Rachel , Braun Oscar Ö. , Baykaner Tina , Ghashghaei Roxana , Sulemanjee Nasir Z. , Cheema Omar M. , Rappelt Matthew , Baeza Carmela , Alkhayyat Abdulaziz , Shi Yang , Pretorius Victor , Greenberg Barry , Adler Eric , Thohan Vinay
Published: June 2019

Left ventricular assist devices (LVADs) have dramatically improved short-term outcomes among patients with advanced heart failure. While neurohormonal blockade (NHB) is the cornerstone of treatment for patients with heart failure with reduced ejection fraction, its effect after LVAD placement has not been established. We reviewed medical records of 307 patients who underwent primary LVAD implantation from January 2006 to September 2015 at two institutions in the United States. Patients were followed for at least 2 years post-LVAD implantation or until explantation, heart transplantation, or death. Cox regression analysis stratifying on center was used to assess associations with mortality. Neurohormonal blockade use was treated as a time-dependent predictor. Stepwise selection indicated treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs/ARBs) (hazard ratio [HR] = 0.53 [0.30–0.95], p = 0.03), age at the time of implantation (HR = 1.28 [1.05–1.56] per decade, p = 0.02), length of stay postimplantation (HR = 1.16 [1.11–1.21] per week, p < 0.01) and INTERMACS profile of 1 or 2 (HR = 1.86 [1.17–2.97], p < 0.01) were independent predictors of mortality. In this large, retrospective study, treatment with ACEIs or ARBs was an independent factor associated with decreased mortality post-LVAD placement.
The investigation of fatty acid composition of breast milk and its relationship with dietary fatty acid intake in 5 regions of China
Authors: Liu Yan , Liu Xinru , Wang Lingning
Published: June 2019

To investigate the relationship between dietary fatty acid (FA) intake and the lactate FA levels in Chinese women.

A total of 2007 samples from 5 regions of China were collected, including 431 in Shandong, 402 in Changchun, 419 in Chongqing, 398 in Guangzhou, and 357 women in Hohhot. All participants were mothers of healthy full-term newborns, collecting the foremilk from day 1 to day 7 and the mature breast milk on day 42 after delivery. The FA composition of the breast milk was analyzed by high resolution capillary gas chromatography.

The total FA content of mature breast milk in Shandong was the highest (34.95 g/L), and that was the lowest in Guangzhou (29.72 g/L). The saturated FA content of breast milk was increased from 1 to 7 days after delivery and decreased in mature breast milk. The saturated FA content of breast milk in Hohhot was the highest (37.43%), but that was the lowest in Changchun (32.80%). Maternal dietary FA composition was positively correlated with saturated FAs (SFA), polyunsaturated FAs (PUFA), and docosahexaenoic acid (DHA) (P < .001), and negatively with monounsaturated FAs (MUFA) (P > .05) in breast milk.

The FA content of breast milk is different in different regions of China, which was affected by maternal dietary FA composition. Lactating women in China should consume more foods rich in polyunsaturated FAs to ensure the growth of infant.
Evaluation of the depiction ability of the microanatomy of the temporal bone in quarter-detector CT
Authors: Kurokawa Ryo , Maeda Eriko , Mori Harushi , Amemiya Shiori , Sato Jiro , Ino Kenji , Torigoe Rumiko , Abe Osamu
Published: June 2019

Little is known regarding differences between model-based iterative reconstruction (MBIR) and hybrid iterative reconstruction (HIR) in temporal bone computed tomography (CT). This study compared the ability to depict microstructures in temporal bone in quarter-detector CT (QDCT) between MBIR and HIR.

Sixty-two temporal bones in 31 consecutive adult patients who underwent QDCT were included. Reconstruction was performed with Forward projected model-based Iterative Reconstruction SoluTion (FIRST) BONE mild mode and Adaptive Iterative Dose Reduction 3D (AIDR3D) enhanced mild mode. Imaging quality was graded for 3 microstructures (spiral osseous lamina, tympanic membrane, and singular canal).

Spiral osseous lamina was significantly well-delineated in the AIDR3D enhanced group, compared with the FIRST group. In nearly all cases with FIRST, spiral osseous lamina was poorly defined. Although there was no significant difference, depiction of the tympanic membrane and singular canal tended to be better with AIDR3D enhanced mode.

Routine reconstruction for preoperative temporal bone CT should be performed with HIR, rather than MBIR.
Accuracy of intercellular adhesion molecule-1 for diagnosing sepsis
Authors: Li Xiang-jin , Tan En-li , Zhao Cheng-peng , Yan Juan
Published: June 2019

Background:

Sepsis is a complex and life-threatening systemic disease. A positive blood culture is the criterion standard of diagnosis for sepsis; however, it does not produce results for 24 to 72 hours. Besides, the clinical manifestations of sepsis are variable and nonspecific. Therefore, a new diagnostic biomarker for diagnosis of sepsis should be developed. The present study aims to assess the diagnostic value of intercellular adhesion molecule-1 (ICAM-1) in individuals with sepsis.

Methods:

The literature will be searched in PubMed, EMBASE, the Cochrane Library, and Web of Science databases from the inception of each database up to June 2019. The methodological quality of eligible study will be assessed by Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2). Stata 15.1 software (version 15.1, Stata Corporation) will be used to calculate the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, pre-test probability, post-test probability, and summary receiver-operating characteristic curve for diagnostic value of ICAM-1. The I
2 statistic will be used to test heterogeneity. Subgroup analysis will be used to explore the source of inconsistency. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system will be used to assess the certainty of evidence. This study will be conducted fully following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of diagnostic test accuracy.

Results and conclusions:

Our study will detect the potential of ICAM-1 for diagnosing the patients with sepsis and the results will be submitted to a peer-reviewed journal.

Discussion:

The evidence will indicate that ICAM-1 is a valuable biomarker for detecting sepsis. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.
The mortality in infectious inpatients with type 2 diabetes compared with non-diabetic population
Authors: Ma Chun-Ming , Yin Fu-Zai
Published: June 2019

The aim of the study was to determine the mortality in infectious inpatients with type 2 diabetes mellitus (T2DM) compared with non-diabetic population.

A retrospective study was conducted on 13,916 infectious inpatients in The First Hospital of Qinhuangdao. Diabetic types were classified using International classification of Diseases-10. Mortality records were collected.

The mortality was higher in patients with T2DM than patients without T2DM (T2DM 4.3% vs non-diabetes 1.7%, χ
2 = 59.560, P < .001). In multiple logistic regression analysis, T2DM was an independent risk factor of death in infectious inpatients (OR = 1.539, 95% CI: 1.181∼2.006, P = .001). The mortalities between those with T2DM and those without T2DM were stratified by age. The mortalities of patients with T2DM were 0.0% in ∼39 years, 0.0% in 40 to 49 years, 2.7% in 50 to 59 years, 3.1% in 60 to 69 years, 4.1% in 70 to 79 years and 8.7% in 80∼ years groups. The mortalities of patients without T2DM were 0.2% in ∼39 years, 0.1% in 40 to 49 years, 0.6% in 50 to 59 years, 1.0% in 60 to 69 years, 3.1% in 70 to 79 years and 5.9% in 80∼ years groups. T2DM was an independent risk factor of death only in 60 to 69 years groups (OR = 2.323, 95% CI: 1.234∼4.372, P = .009).

The increase of mortality appears earlier in patients with T2DM. Infectious inpatients with T2DM are at increased risk of death and brings heavy economic burden to patients, society and government.
Epidemiology of syndesmotic fixations in a pediatric center
Authors: Lamer Stéphanie , Hébert-Davies Jonah , Leduc Stéphane , Nault Marie-Lyne
Published: June 2019

Syndesmosis injuries need to be accurately diagnosed and managed to avoid chronic pain, early arthritis, and instability. To this end, the present study aimed to analyze the epidemiology of syndesmotic injuries in a pediatric ankle fracture cohort and identify patient and surgery-related characteristics.

A retrospective review of all the ankle fractures during a 12-year period at a single pediatric referral center was conducted. Inclusion criteria were: a fractured ankle that underwent a surgical fixation, at least 1 radiograph available for review before fixation, available information regarding surgery, including operative report and fluoroscopic images, and younger than 18 years at the time of surgery. Demographic information, trauma, radiographs, surgical details, clinical examination, follow up, outcomes, and physeal status (skeletally immature, transitional, or mature) were recorded. Finally, patients were divided in 2 groups: with or without syndesmotic fixation. Statistical analysis included descriptive statistics, Mann–Whitney test for nonparametric data to compare continuous parameters, and χ
2 test for categorical parameters.

A total of 128 patients were included with a mean age of 14.1 years. There were 80 boys and 48 girls. There were 51 skeletally immature patients, 23 with transitional fractures, and 54 that were skeletally mature. The main finding of this study is that only 11 patients from the mature group underwent syndesmotic fixation. There were no cases of syndesmotic fixation in the skeletally immature and transitional groups.

This is the first retrospective study to focus specifically on syndesmotic injuries in a pediatric population who underwent ankle fracture fixation. Only 11 skeletally mature patients underwent syndesmotic fixation out of 128 patients in this cohort. This result raises the question of whether there are accurate diagnostic tools to evaluate syndesmosis in children.
Unusual recurrent renal secondary hyperparathyroidism caused by hyperplastic autograft with supernumerary parathyroid adenoma
Authors: Zhang Jun , Dong Meng-Jie , Yang Jun , Tian Dan
Published: June 2019

Rationale:

Secondary hyperparathyroidism (SHPT) is often complicated with chronic renal failure. Though the total parathyroidectomy (TPTX) with forearm autotransplantation (FAT) has been commonly used to treatment refractory renal SHPT, the recurrence of SHPT is not infrequent, resulting from hyperplastic autograft, remnant parathyroid tissues, and supernumerary parathyroid gland (SPG).

Patient concerns:

A 67-year-old man undergoing TPTX+FAT 4 years previously for renal SHPT, who received regular hemodialysis with active vitamin D supplements of Rocaltrol treatment postoperatively, was admitted to our hospital with progressively elevated serum intact parathyroid hormone (iPTH) from 176 to 1266 pg/mL for 8 months and bilateral ankle joints pain for 1 month. 99mTc-sestamibi dual-phase imaging with single positron emission tomography (SPECT)/computed tomography (CT) revealed a nodule in suprasternal fossa, besides a nodule in autografted site, accompanied with intense radioactivity.

Diagnosis:

Recurrent SHPT was easily diagnosed based on previous medical history, painful joints, increased serum iPTH level and positive findings of 99mTc-sestamibi imaging. Routine postoperative pathology showed that the nodules were consistent with an adenomatoid hyperplasic autograft and a supernumerary parathyroid adenoma in suprasternal fossa, respectively.

Interventions:

Reoperation for removing nodules in suprasternal fossa and autografted site was performed 1 month later. Then regular hemodialysis 3 times a week with Rocaltrol was continued.

Outcomes:

During 12 months of follow-up, the joints pain improved obviously and the serum iPTH level ranged from 30.1 to 442 pg/mL.

Lessons:

Although rare, recurrent renal SHPT may be caused by a coexistence of both hyperfunctional autograft and SPG after TPTX+FAT. The 99mTc-sestamibi parathyroid imaging with SPECT/CT is helpful to locate the culprits of recurrent renal SHPT before reoperation. To prevent recurrence of renal SHPT, the present initial surgical procedures should be further optimized in patient on permanent hemodialysis.