bluuebunny/crossref_metadata_2025 huggingface dataset:
The Begams of Bhopal
Authors: Pernau Margrit
Published: April 2020

Chapter 5 looks at three generations of Begams of Bhopal, rulers of a semi-independent princely state known for its commitment to Islamic reformism and to education projects, notably for women. Each of the Begams wrote and published books advising Muslim women. Foregrounding the category of gender, the chapter shows how these texts went in line with the Indo-Muslim reformist discourse of the late nineteenth and early twentieth century. The Begams’ books showed the same transition from Aristotelian tradition, premised on the concept of balance, to the increasing importance of the expression and feeling of emotions. That these texts were written by women did not lead to a radical dissociation from the reformist program—piety and modernity, not feminism, were the Begams’ aims. But their patriarchal leanings notwithstanding, at no point did they reduce female education and emotion only to a function of the Muslim community and the upbringing of the next generation—women’s emotions mattered and contributed to the community’s welfare no less than men’s emotions. Women, too, therefore had the duty—and the right—to feel strongly.
Ashraf ʿAli Thanavi
Authors: Pernau Margrit
Published: April 2020

Chapter 7 looks at the sermons of Ashraf ‘Ali Thanavi, known for the Bihishti Zewar, his best-selling advice book for female readers. At first sight, Thanavi fitted perfectly into the pattern of reading reformist Islam as a contributing force both to modernity and to the disciplining project. The ideal and the practices he encouraged seemed to aim at a constant vigilance over the movements of the soul and at a control of emotional outbursts. However, in apparent contradiction, the anecdotes surrounding Thanavi’s life point to a valuation of religious passions. His sermons very often overwhelmed his audience, leaving them shaking and crying or bringing about spiritual ecstasy— features which added to his reputation as a preacher and which he did not want to censor or prevent, though like the other reformers, he was much more comfortable with men giving in to strong feeling than with emotional women. Righteous emotions and righteous behavior, for him, were intertwined with the creation of the righteous polity.
Nostalgia
Authors: Pernau Margrit
Published: April 2020

Chapter 9 historicizes nostalgia by looking at literary texts in Urdu, written in Delhi and looking back to the years before 1857. It traces its development from the testimonies of the immediate survivors of the revolt. The loss and grief characterizing nostalgia, for this generation were still embedded in a temporal regime in which the space of experience and the horizon of expectation had not yet parted company. This already was different for the anthropologists who were attempting to recover the memories of Delhi, and mainly of the Mughal court, before they were irretrievably forgotten. Their project was taken up by the reformers, who saw progress as inevitable and also worth striving for, but who at the same time mourned the passing of a lost world and posited it as a counter-narrative to the colonial present and to modernity. Following the changes of nostalgic feelings in detail allows us to uncover the emotional ambivalences linked to modernity.
The Western Liberal Constitution’s Internationalized Making
Authors: Sripati Vijayashri
Published: April 2020

This chapter chronologically traces the Western liberal Constitution’s internationalization from 1919-1960 to establish UNCA’s birth in 1949, rejection in 1960 and revival in 1960. This chapter comprises three sections. Section 1 traces a rise in the Constitution’s internationalization from 1919 to 1960. Section two covers the United Nations’ role from 1949-1952 in assisting Libya, a former Italian colony, adopt the Constitution and emerge independent. UNCA was rejected in 1960 because the right to self-determination morphed into an absolute right for all colonies, whereby they henceforth enjoyed a right to sculpt constitutions of their choice. At this juncture, UNCA serves a limited purpose: to implement decolonization. Section 3 outlines former UN Secretary-General, Dag Hammarskjold’s economic philosophy and his efforts at reviving united nations constitutional assistance to ensure Congo morphs into a market democracy. A discussion of the UN’s constitutional assistance from 1960-64 reveals that its use had nothing to do with perceived local incapacities for governance and how it spawned and guided UN or International territorial administration (e.g., law-making) there.
The Western Liberal Constitution’s Rise post 1989
Authors: Sripati Vijayashri
Published: April 2020

This chapter analyses United Nations Constitutional Assistance’s post-1989 rise, setting the stage for Chapter 6. It traces the Constitution’s internationalization from 1950, focussing on its conceptualization after 1989, as a rule of law strategy, and from 1999 onwards, as a ‘development’ understood as a ‘market-oriented poverty reduction’ strategy. It establishes that the Constitution, so conceptualized by the UN and the Bretton Woods Institutions was promoted in two contexts: post-conflict and development assistance. It was promoted ostensibly to achieve international law and policy ends: free markets, good governance, the rule of law and women’s rights. How the UN Development Programme melds constitutional assistance with development assistance to achieve international law and policy ends, receives focal attention. This chapter concludes that the good governance story is not about the promotion of the ‘rule of law’ or ‘development.’ Rather, it is about the internationalization of the Constitution subsumed under the ‘rule of law.’
United Nations Constitutional Assistance Continues Its Civilizing Role
Authors: Sripati Vijayashri
Published: April 2020

This book asks: Why has the UN empowered itself to offer constitutional assistance in sovereign Third World states? This Chapter, which draws from the UN’s official explanations completes the answer. It shows that since its birth in 1949, UNCA has: a) assisted colonies and/or sovereign states adopt what is central to colonial trusteeship: the Western liberal constitution; b) worked in response to perceived problems with their constitution-making process and the type of constitutional content they create; c) worked to achieve four ostensible ends: free markets, the rule of law, good governance (including natural resources exploitation), and civilized customs, and their modern equivalent: women’s rights; d) served ostensibly to civilize/ ‘modernize’ Third World peoples, in market-oriented ways, with a view to either manufacture their sovereignty, or ‘strengthen’ it. In these ways, since its birth, UNCA has acted as international trusteeship. Therefore, so does its child: UN/International Territorial Administration. This chapter concludes that UNCA has spawned a new civilized standard: participatory constitution-making.
Third Study
Authors: Govind Nikhil
Published: April 2020

The third chapter takes up this tradition of the developmental novel (the bildung), and seeks to understand it in its canonical form in India. In this context, it looks at two of the most influential such novels in India, both published in the 1940s—Agyeya’s Shekhar and Ismat Chughtai’s The Crooked Line. The former, though essentially a story from childhood to the twenties of the protagonist also plays with the form of the novel—there is experimentation with non-linear storytelling, with fragmentation and ellipsis. Such techniques convey the darkness of the protagonist—the novel begins with the intimation that he is to be hanged (hanging also evokes the first chapter). Chughtai’s work is also a bildung, though in a playful mode that nevertheless invokes the difficulties of establishing a working-woman protagonist from a conservative milieu.
The Stagnation Debate
Authors: McCartney Matthew
Published: April 2020

The fact Bardhan sought to explain in 1984 was economic stagnation. After 1965 there was a dramatic slowdown in the growth rates of productivity and output growth in industry, particularly heavy industry. Bardhan made one of the last canonical contributions to the debate, providing a political economy explanation for this bad policy. He argued that India was structured around three dominant proprietary classes, which undermined government efforts to mobilize resources and use them for investment. The first enduring legacy is the link between public investment and subsidies. The second enduring legacy has been the significance of episodes of growth and stagnation. The third legacy is the lasting importance of public investment in explaining economic growth.
Growth and the Subsidy Raj in India
Authors: Ghatak Maitreesh , Sen Ritwika
Published: April 2020

The Political Economy and Development of India (PEDI) proposes what is now a very well-known hypothesis about the reasons for the low-growth regime that India experienced from the 60s to the early 80s: interest-group politics in a democracy leads to populism and subsidies, choking off resources for accumulation through public investment in infrastructure. This political economy of constraints, according to Bardhan, seems to have blocked the economy’s escape from a low-level equilibrium trap of low growth. This chapter looks at a part of Bardhan’s argument, namely the relationship between subsidies and growth. The chapter studies the patterns of growth in income per capita and subsidies over the period 1980–81 to 2013–14 and finds, contrary to PEDI, that both economic growth and subsidies increased. Put together, these trends do not provide evidence in favour of the ‘Bardhan subsidy hypothesis’ that the subsidy Raj was the most important binding constraint to economic growth in the 1980s.
India’s Political Economy
Authors: Manor James
Published: April 2020

Since 1991 when economic liberalization began in earnest, governments changed several times in India, but economic policy did not change dramatically. All ruling parties sustained liberalization, but they pursued it very cautiously. That was partly explained by the fact that all ruling parties sought votes from very similar sets of interest groups. Since 2004, we have not seen significant changes on this front—so that the interest groups courted by different governments are now substantially different? Do we not see, for the first time, a marked difference between successive governments—in the interests that they mainly seek to serve, and thus in their approaches to India’s political economy? Does this not also entail, for the first time, marked changes in power relations between successive governments and what Pranab Bardhan calls ‘proprietary classes’ and other forces? He may need to produce a further edition of his book.
Business Interests and State Autonomy in India
Authors: Jenkins Rob
Published: April 2020

Given the striking increases in the wealth and stature of India’s private sector over the past quarter century, we may expect its role to have changed from that outlined The Political Economy of India (PEDI). Such a conclusion is incorrect. First, despite the considerable deregulation of the Indian economy that has taken place, state elites still enjoy significant autonomy in policymaking. Second, while industrial capital has expanded faster than the other two dominant propriety classes, the rich farmers and professionals have developed in ways that make them formidable political counterweights to industrial capital. Third, although the state elite’s vision of ‘the national interest’ has evolved toward embracing private capital and the global market, the extent of big business hegemony over public discourse and policy should not be overstated.
All Shook Up?
Authors: Chatterjee Elizabeth
Published: April 2020

The Political Economy and Development of India (PEDI) outlined highly influential theories of both the Indian state and its bureaucracy. Professionals within the public sector were one of Bardhan’s three competing dominant classes, yet he was also clear that the state was an autonomous actor distinct from the rent-seeking officials who populated its lower ranks. Three decades later, economic reforms have ostensibly challenged the public sector’s economic, ideological, and policy dominance. This chapter argues that the Indian system remains more statist—and correspondingly less ‘pro-business’—than many scholarly interpretations today allow. Nonetheless, elite public sector professionals have become fragmented that challenge their coherence as a class, while new obstacles to effective state autonomy have arisen from the nexus between politicians and the petty bureaucracy.
Glasnost’ in Practice
Authors: Lovell Stephen
Published: April 2020

This chapter examines the effects of the Great Reforms of the 1860s on Russia’s emerging public sphere. It starts by examining the more engaging rulership style of the new Emperor, Alexander II. It then discusses the adoption of a new technology, stenography, that was designed to provide an accurate record of proceedings in the new institutions of the reform era. It goes on to consider the workings of those new institutions—the zemstvo, the municipal duma, and the courtroom—with special reference to the scope they offered for oral debate and oratory. The chapter also considers three other important venues for public speaking in the 1860s: the university, the theatre, and the church.
Trials and Tribulations
Authors: Lovell Stephen
Published: April 2020

This chapter tells the story of public speaking in Russia from the imposition of greater restrictions on the public sphere in 1867 through to the eve of Alexander II’s assassination in 1881. It shows that in this period the focus of the Russian public switched from the zemstvo to the courtroom, where a number of high-profile trials took place (and were reported, sometimes in stenographic detail, in the press). The chapter examines the careers and profiles of some of Russia’s leading courtroom orators. It also explores the activities of the Russian socialists (populists), in particular the ‘Going to the People’ movement of 1873–4 and later propaganda efforts in the city and the courtroom. It ends by considering the intensification of public discourse at the end of the 1870s: the Russo-Turkish War saw a surge of patriotic mobilization, but at the same time the populist adoption of terrorism seized public attention.
Revolutionary Talk, 1917–18
Authors: Lovell Stephen
Published: April 2020

The February Revolution brought an explosion of public talk as Russia gained the long-awaited freedoms of speech and assembly. Yet it was far from clear how this talk could be politically structured. The success of the Provisional Government seemed to depend on its outstanding rhetorician, the charismatic Aleksandr Kerensky, who kept up a frenetic public speaking schedule to audiences both civilian and military. On the Left, the Petrograd Soviet attempted to convert the popular cacophony of the revolution into effective socialist politics. Beyond the Soviet, the Bolsheviks sought to sway workers and soldiers with their radical anti-war message. In the second half of 1917, Kerensky’s charisma waned, and his desperate attempts to revive his flagging authority at a ‘State Conference’, ‘Democratic Conference’, and ‘Pre-Parliament’ all fell flat. Although the Bolsheviks’ seizure of power was more a coup than a popular uprising, it was preceded by a vigorous and increasingly effective propaganda campaign. After the October Revolution, the new regime moved quickly to suppress freedom of speech for its opponents but redoubled its own propaganda efforts. Nonetheless, it remained unclear how this still very precarious regime should best seek to address the society it aspired to rule.
The Problem of Quantum Gravity: From Feelings to Phenomena
Authors: Rickles Dean
Published: April 2020

This chapter provides a simple, schematic introduction to the problem of quantum gravity. The problem of quantum gravity spent much of its earliest history at the mercy of wider changes with respect to the ingredient theories, general relativity and quantum theory. Even once those theories settled down, quantum gravity remained firmly detached from experiments. This situation has only recently changed and promises to offer new phenomena to test proposed solutions to the problem which will enable us to make firmer statements about the more physical implications of these proposed solutions. However, we see that we may still face a problem of polysemicity stemming from the very differing interpretations and formulations that the ingredient theories allow, as well as differing motivations for pursuing quantum gravity.
Forming the Canon
Authors: Rickles Dean
Published: April 2020

This chapter charts the early development of the canonical quantum gravity (that is, the quantization of the gravitational field in Hamiltonian form). What we find in this period include: the establishment of a procedure for quantizing in curved spaces; the first expressions for the Hamiltonian of general relativity; recognition of the existence and importance of constraints (i.e. the generators of infinitesimal coordinate transformations); a focus on the problem of observables (and the realisation of conceptual implications in defining these for generally relativistic theories), and a (template of a) method for quantizing the theory. Although it commenced relatively early, the canonical approach was slow in its subsequent development. This had two sources: (1) it required the introduction of tools and concepts from outside of quantum gravity proper (namely, the constraint machinery and the parameter formalism); (2) by its very nature, it is highly rigorous in a conceptual sense, demanding lots of groundwork to be established, in terms of the structure of physical observables, before the actual issue of quantization can even be considered. Work was further complicated by the fact that these two sources of difficulty happened to be entangled. Particular emphasis is placed on the parameter formalism of Paul Weiss.
Geon Wheeler
Authors: Rickles Dean
Published: April 2020

This chapter focuses on John Wheeler’s work on geons and geometrodynamics which would lead to many concepts and results that would be of importance to quantum gravity research - these projects, initially, were rather old fashioned, harking back to the classical ‘unified field theory’ work of Einstein. Moreover, we find that this work that we now tend to think of as foundational in quantum gravity---e.g., we often think of ‘quantum geometrodynamics’ as just another phrase for ‘quantum gravity’---had its roots firmly embedded in the quest for understanding the elementary particles. It wasn’t until after 1957 that Wheeler began to look seriously at general relativity and quantum gravity independently from concerns in particle physics, and this shift in fact coincides with a more general trend to treat gravitational physics as a worthwhile field in its own right.
Institutionalizing Quantum Gravitational Research
Authors: Rickles Dean
Published: April 2020

This chapter describes the establishment of such a quantum gravity-friendly environment that enabled it to go out into the world on its own, somewhat less dependent on other areas of physics. It is more concerned with the development of basic infrastructure. The focus is on private philanthropy and the reasons behind a mid-century surge in funding for gravitational and quantum gravitational physics, which themselves are centered around the establishment of the Institute of Field Physics.
An empirical question?
Authors: Currie Gregory
Published: April 2020

This book asks whether, in what circumstances, and to what degree we learn from fiction. But it may be objected that that is the wrong question. The philosophically interesting question about fiction, it may be said, is not whether people do learn from it but ‘What is there to be learned?’ Answering this question requires analytical and interpretive effort, not the provision of evidence, either of an experimental kind or derived from common experience. This chapter is devoted to the task of undermining the objection. It is argued that an inquiry into the epistemic status of fiction must be in part an empirical one, though it is emphasized that the right kinds of empirical evidence may be very hard to obtain. One objection to this approach is that it suggests a need to radically revise our ways of approaching and appreciating works of fiction. There is some justice in the concern, and it is suggested that revision is best avoided by thinking of ourselves as engaged, not in learning, but in a pretence of learning.
Body Space/City Space
Authors: Gökarıksel Banu
Published: April 2020

This Reflection explores the production of the body as a space and the remaking of city spaces through an analysis of Muslim women’s veiling as an embodied spatial practice in contemporary Turkey. This exploration builds on geographic approaches to space as relational, always in the making, and produced by everyday practices and to bodies that emphasize their porosity, fluidity, and multiscalar dimensions. In a period of Turkish history when the headscarf continues to be restricted and stigmatized, the Reflection examines the effects of veiling on women’s bodies by focusing on how this practice redefines a woman’s relation to her body when she starts wearing a headscarf as an adult. Veiling initiates a struggle to discipline and shape her body according to her Islamically oriented ideals, thus remaking her body emotionally and materially. This practice also shifts her experiences of different city spaces across Istanbul. The Reflection traces the place of veiling and veiled bodies from the streets of a conservative neighborhood to a shopping mall and a city square that is central to political activism. Approaching veiling as an embodied spatial practice opens up new questions to explore about how veiling is productive of spaces and participates in the continuous process of space-making.
Geometry and Visual Space from Antiquity to the Early Moderns
Authors: Hatfield Gary
Published: April 2020

This chapter examines the development of a geometrical framework for understanding and explaining spatial aspects of visual perception, including perception of the sizes, shapes, and positions of things in the field of view. The structure of this framework is built on the fact that vision typically occurs in straight lines (rectilinearly). Within this framework, the chapter selectively focuses on size perception. This focus allows for a comparative examination of how a single problem was treated geometrically by various theorists, ancient, medieval, and modern. The theorists examined are Euclid and Ptolemy, who were extramissionists, and Ibn al-Haytham, Kepler, Descartes, and Berkeley, each of whom adopted, in one way or another, an intromissionist scheme. In comparing Descartes and Berkeley, notice is taken of Berkeley’s interpretive bent in treating Descartes’s account of distance perception in a way that requires mental calculation, where Descartes sometimes offered psychophysiological mechanisms (avoiding mental calculation).
The Metamorphosis of Criminal Justice
Authors: Hodgson Jacqueline S.
Published: April 2020

The focus of this book is the potentially radical and fundamental changes that are taking place within criminal justice in Britain and in France and the ways that these are driven by wider domestic, European, or international concerns. This metamorphosis away from established values and practices is eroding what were once regarded as core rights and freedoms in the name of efficiency, security, and justice to victims. Beginning with a comparative analysis of adversarial and inquisitorial procedural values and traditions, and an examination of broad trends in domestic and European criminal justice, the book then discusses how the roles of prosecution and defense have been reshaped in different ways in both jurisdictions—both in the text of the law and in their practices. The final part considers how systems within different procedural traditions adapt to address, or provide a remedy for, systemic flaws that produce wrongful convictions and, in particular, the role of the defense in these procedures. By adopting a comparative approach with France, the study explores the nature and reach of these trends, the ways that they challenge and disrupt criminal processes and values, and the contrasting responses that they provoke. It reveals how criminal justice traditions continue to be shaped in different ways by broader policy and political concerns; how different systems adapt, change, and distort when faced with (sometimes conflicting) pressures domestically and externally; and how different procedural values may serve to structure or limit reform, and so work to facilitate or resist change.
Perspectives on Adversarial and Inquisitorial Criminal Procedure
Authors: Hodgson Jacqueline S.
Published: April 2020

Analyzing the evolving nature of core features of adversarial and inquisitorial processes in an applied and dynamic way, this chapter examines the two traditions through a variety of lenses and contexts. Beginning with the organizing principles of both traditions, it examines how jurisdictions have adapted their procedures with the common ambition of avoiding a contested trial. Adopting an external standpoint, it then analyzes the adversarial tradition’s association with individual rights, fairness, and transparency, and its resulting appeal to systems seeking to move away from a more state-dominated process. It then examines the ways that different procedural values play out within the context of international criminal justice, concluding with an analysis of contemporary pan-European influences on criminal procedure and the challenges in developing common criminal justice values and standards of fair trial through the ECtHR and the EU that often run counter to domestic trends.
Custodial Legal Advice
Authors: Hodgson Jacqueline S.
Published: April 2020

This chapter considers the ways in which transnational procedural standards for the provision of custodial legal advice have been received in different jurisdictions by the courts, by review bodies, and on the ground, exploring the extent to which we are seeing movement toward a pan-European model of custodial defense, or whether countervailing factors militate against harmonization beyond a set of common basic thresholds, thereby undermining rights that are effective in practice. Evidence obtained through custodial interrogation is central to case disposition, with or without trial, and so procedural protections traditionally reserved for court are increasingly required during this pretrial phase if the accused is to be dealt with according to the standards of a fair trial. This necessitates a cultural as well as legal shift in how states understand the adjudicatory phase of criminal proceedings and its backward reach to include significant aspects of the investigation.
The characteristics of lymphocytes in patients positive for anti-MDA5 antibodies in interstitial lung disease
Authors: Huang Wenhan , Ren FeiFeng , Luo Lei , Zhou Jun , Huang Dongmei , Pan Zhuma , Tang Lin
Published: April 2020

Objective

The aim was to investigate the characteristics of blood lymphocytes in patients positive for anti-melanoma differentiation-associated gene 5 antibodies (anti-MDA5+) in interstitial lung disease.

Methods

Thirty-eight anti-MDA5+ patients with interstitial lung disease were admitted to our hospital, and the lymphocyte count, lymphocyte subtypes and lung high-resolution CT were recorded. Some of the cases were examined by bone marrow aspiration.

Results

Compared with the control group, the blood lymphocyte counts of anti-MDA5+ patients before treatment were significantly lower (P < 0.05). After treatment, lung interstitial lesions in some cases were reduced and the lymphocyte counts increased, whereas their CD4:CD8 ratio decreased (P < 0.05). In contrast, lung interstitial lesions of other cases were exacerbated after treatment and the lymphocyte counts decreased, whereas the CD4:CD8 ratio increased (P < 0.05). In cases with exacerbated lung interstitial lesions after treatment, there were fewer CD4 and CD8 T cells than before treatment, and the change in CD8 T cells was significant (P < 0.05). Bone marrow aspiration biopsy indicated that there was no abnormality in the distribution of bone marrow lymphocytes.

Conclusion

Anti-MDA5+ patients showed a decrease in blood lymphocyte counts. The presence of anti-MDA5+ in patients with pulmonary interstitial lesions was positively correlated with blood lymphocyte counts but negatively correlated with the CD4:CD8 ratio. The CD8 T cells decreased more significantly than CD4 T cells in patients with aggravation of interstitial lung disease. The change in blood lymphocytes in anti-MDA5+ patients might be attributable to transfer of lymphocytes to the lungs to participate in the local immune response.
Evolutionary analysis of exogenous and integrated HHV-6A/HHV-6B populations
Authors: Forni Diego , Cagliani Rachele , Clerici Mario , Pozzoli Uberto , Sironi Manuela
Published: April 2020

Human betaherpesviruses 6A and 6B (HHV-6A and HHV-6B) are highly prevalent in human populations. The genomes of these viruses can be stably integrated at the telomeres of human chromosomes and be vertically transmitted (inherited chromosomally integrated HHV-6A/HHV-6B, iciHHV-6A/iciHHV-6B). We reconstructed the population structures of HHV-6A and HHV-6B, showing that HHV-6A diverged less than HHV-6B genomes from the projected common ancestral population. Thus, HHV-6B genomes experienced stronger drift, as also supported by calculation of nucleotide diversity and Tajima’s D. Analysis of ancestry proportions indicated that HHV-6A exogenous viruses and iciHHV-6A derived most of their genomes from distinct ancestral sources. Conversely, ancestry proportions were similar in exogenous HHV-6B viruses and iciHHV-6B. In line with previous indications, this suggests the distinct exogenous viral populations that originated iciHHV-6B in subjects with European and Asian ancestry are still causing infections in the corresponding geographic areas. Notably, for both iciHHV-6A and iciHHV-6B, we found that European and American sequences tend to have high proportions of ancestry from viral populations that experienced considerable drift, suggesting that they underwent one or more bottlenecks followed by population expansion. Finally, analysis of HHV-6B exogenous viruses sampled in Japan indicated that proportions of ancestry components of most of these viruses are different from the majority of those sampled in the USA. More generally, we show that, in both viral species, both integrated and exogenous viral genomes have different ancestry components, partially depending on geographic location. It would be extremely important to determine whether such differences account for the diversity of HHV-6A/HHV-6B-associated clinical symptoms and epidemiology. Also, the sequencing of additional exogenous and integrated viral genomes will be instrumental to confirm and expand our conclusions, which are based on a relatively small number of genomes, sequenced with variable quality, and with unequal sampling in terms of geographic origin.
Utilization of Video for Competency Evaluation
Authors: Fieler Gina
Published: April 2020

Learner self-assessment and accountability are important features in nursing education. Innovative competency sessions enhance the delivery of quality care. This project investigated the addition of video into established competency evaluations for the purpose of learner review and self-evaluation. An experimental design was used to determine the effects of video on learner self-evaluation. With 95 percent confidence, the mean total self-evaluation score for those without the video was higher than for those with the video, supporting the hypothesis that those without video recall would inflate their self-evaluation scores.
Student-Centered Reading Using PDF Software as an Innovative Teaching Strategy in Graduate Nursing Education
Authors: Brackney Dana E. , Lane Susan H.
Published: April 2020

Student engagement in scholarly reading and critical thinking contributes to nursing science. However, graduate students often lack the skills and experience needed to read and analyze scholarly writings in depth. This case example describes use of portable document format technology with reading prompts to improve student scholarship in a master of science in nursing program. Theory and research guided development of the visible reading innovation. Student work with this pilot assignment sequence indicates an increase in student engagement with the text, as evidenced by student comment content, comment spacing throughout the text, and text integration into a summative writing assignment.
Effect of Physical Condition on Outcomes in Transplant Patients: A Retrospective Data Analysis
Authors: Andres Kayla , Wayman Brooke , Rodriguez Tina , Kline Margaret , Haveman Joshua , Brower Chelsea , Williams Stephanie F.
Published: April 2020

Background:

Stem cell transplantation is a potential curative procedure for many patients with hematologic malignancies. These patients because of age, comorbid medical conditions, and prior therapies can present in various physical conditions from good performance status to frail, which may affect transplant outcomes.

Objective:

To assess the relationship of measurable physical conditioning metrics to survival, progression-free survival, relapse rate, and transplant-related morbidity and mortality in the context of our current rehabilitation program.

Methods:

We conducted a retrospective review of 207 patients who had undergone hematopoietic stem cell transplantation with 6 months of follow-up. Data were collected from their pretransplant rehabilitation evaluation and their 60-day posttransplant evaluation including their Karnofsky Performance Status (KPS) score, Timed Up and Go, pain, fatigue, and distress measurements. Using their KPS score patients were categorized as high performers (KPS ≥80) and low performers (KPS ≤70).

Results:

Patients experienced significant decreases in pain, fatigue, and distress after transplant. There were no significant differences in overall survival, progression-free survival, relapse rate, or transplant-related mortality between high and low performers. When controlling for transplant type, high performers had half the risk of dying compared with low performers.

Conclusions:

Our study demonstrated better posttransplant standard measures regardless of initial performance status. Our data suggest that patients with a better pretransplant performance status have better overall survival. One limitation of our study is the exercise program was not supervised and adherence is unknown.
Interprofessional Improv: Using Theater Techniques to Teach Health Professions Students Empathy in Teams
Authors: Zelenski Amy B. , Saldivar Norma , Park Linda S. , Schoenleber Vonnie , Osman Fauzia , Kraemer Sara
Published: April 2020

Problem

Health professionals need to learn how to relate to one another to ensure high-quality patient care and to create collaborative and supportive teams in the clinical environment. One method for addressing both of these goals is teaching empathy during professional training to foster connection and commonality across differences. The authors describe a pilot improvisational theater (improv) course and present the preliminary outcomes showing its impact on interprofessional empathy.

Approach

In 2016–2017, the authors piloted a 15-hour course to teach interprofessional empathy to health professions students at the University of Wisconsin–Madison using improv techniques. The authors used a convergent mixed-methods design to evaluate the course’s impact on interprofessional empathy. Students enrolled in the course (intervention group, n = 45) and a comparison group (n = 41) completed 2 validated empathy questionnaires (Interpersonal Reactivity Index [IRI], Consultative and Relational Empathy [CARE] measure) and a facial expression recognition task to measure empathy in the pre- and postintervention periods. Differences were examined using paired t tests. Semistructured interviews were conducted with 8 course participants to gain a deeper understanding of the course’s effects.

Outcomes

The intervention group’s mean scores on 5 CARE items improved significantly: ease, care, explain, help, and plan. On the IRI, personal distress levels decreased significantly in both the intervention and comparison groups. In the interviews, students who took the class reported a positive impact on their interprofessional relationships and on their ability to think on their feet. They also reported improv influenced other areas of their lives, including patient care and interactions with people outside their work life.

Next Steps

The authors have continued to offer the course. They aim to conduct a randomized controlled study with medical students and test durability by measuring empathy again 3–6 months following the intervention.
Anterior Cervical Arthrodesis With Polyetheretherketone Spacers
Authors: Ross Donald A. , Pollock Jeffrey M. , Li Ningcheng Peter , Yoo Jung U. , Obayashi James T.
Published: April 2020

Study Design:

This was a retrospective study of 2 surgeons’ use of a single polyetheretherketone (PEEK) device.

Objective:

Our objective was to investigate the fusion adjunct placed within PEEK devices to examine the likelihood of an arthrodesis, regardless of the PEEK interbody device itself.

Summary of Background Data:

The effectiveness of PEEK interbody devices in anterior cervical arthrodesis has been questioned.

Methods:

The authors retrospectively reviewed the results of 121 patients with demineralized bone matrix (DBM) and 96 with local autograft bone placed within identical PEEK devices for anterior cervical arthrodesis (from 2011 to 2018); 1 surgeon used DBM and another local autograft bone. Arthrodesis was determined independently by a surgeon and 2 blinded neuroradiologists.

Results:

For DBM versus autograft; mean age was 60 versus 61 years, smoking status 42.1% versus 31%, diabetes mellitus 18.2% versus 28%, mean body mass index 31 versus 30, and follow up averaged 17 months in both groups. For DBM versus autograft; a radiographic arthrodesis was observed in 22.3% versus 76% of patients. Refusion at the index level was required in 5.8% of the DBM and 0% of the autograft patients.

Conclusions:

A PEEK interbody device filled with local autograft resulted in a higher radiographic fusion rate and a lower need for reoperation at the index level than an identical device filled with DBM. Caution is warranted in assigning fusion failure to the PEEK device alone in anterior cervical discectomy and fusion surgery.
Scapholunate Ligament Reconstruction With a Novel Technique for Passing Split Extensor Carpi Radialis Brevis Tendon Graft Through Bone Tunnels
Authors: Tie Joyce , Koh Keith , Tang Camelia Qian Ying , Teoh Lam Chuan
Published: April 2020

We report 2 patients with acute scapholunate dissociation with static instability and wide scapholunate gapping. They underwent scapholunate reconstruction using a split extensor carpi radialis brevis (ECRB) tendon graft via a dorsal approach. This technique is adapted from the modified Brunelli tenodesis, utilizing a portion of the ECRB instead of a flexor carpi radialis tendon graft to reconstruct the scapholunate interosseous ligaments and dorsoradiotriquetral ligaments. The novel aspects of this technique include the use of a trifold plastic sheet of biaxially oriented polypropylene to facilitate the smooth passage of the 2 mm size ECRB tendon graft through the 2 mm bone tunnel. This enables us to avoid drilling larger holes in carpal bones with a relatively poor vascular supply and allows this technique to be utilized in patients with more delicately sized scaphoid and lunate bones. A 2 mm drill bit was used to create the scaphoid and lunate tunnels, which is smaller than that in the published literature. This trifold biaxially oriented polypropylene plastic sheath can be adapted to the use of many other techniques that require passing a tendon graft through a bone tunnel.
Increased Inpatient Length of Stay After Early Unplanned Transfer to Higher Levels of Care
Authors: Sykora Daniel , Traub Stephen J. , Buras Matthew R. , Hodgson Nicole R. , Geyer Holly L.
Published: April 2020

Objectives:

Patients admitted to a medical-surgical unit infrequently require early transfer to higher level care, although how their inpatient length of stay compares to untransferred patients, or those directly admitted to intermediate care, is unknown. We sought to compare the inpatient length of stay of these groups.

Design:

Single-site retrospective analysis.

Setting:

An academic hospital specializing in complex care.

Patients:

We evaluated 23,694 patients admitted to the Hospital Internal Medicine service over a 4-year period (January 1, 2013, to December 31, 2016).

Interventions:

None.

Measurements and Main Results:

Using 6- and 24-hour definitions of early transfer, we categorized patients as admitted to medical-surgical unit without early transfer (medical-surgical unit), transferred (TX) early to higher level care, or initially admitted to an intermediate care unit. We report patient characteristics and inpatient length of stay adjusted for patient demographics (age and sex) and initial acuity (measured by Emergency Severity Index). There were significant increases in both unadjusted inpatient length of stay (6 hr: medical-surgical unit = 73.4 hr, TX = 137.9 hr, intermediate care unit = 101.1 hr; 24 hr: medical-surgical unit = 72.4 hr, TX = 141.9 hr, intermediate care unit = 98.2 hr; p < 0.01 for all groups) and adjusted inpatient length of stay (6-hr definition: medical-surgical unit = 50.9 hr [95% CI, 50.3–51.6 hr], TX = 100.4 hr [90.4–112.0 hr], intermediate care unit = 72.3 hr [70.6–74.0 hr]; 24-hr definition: medical-surgical unit = 50.3 hr [49.7–50.9 hr], TX = 108.3 hr [101.5–116.0 hr], intermediate care unit = 70.7 hr [69.0–72.3 hr]; p < 0.0001 for comparison of TX to medical-surgical unit and intermediate care unit in both groups). The increases in inpatient length of stay for the TX groups were not explained by differences in demographics or acuity.

Conclusions:

In a single facility study, patients admitted to a medical/surgical unit who require early transfer to intermediate care unit have a significant and unexplained increase in inpatient length of stay. This unexplained increased inpatient length of stay suggests that triage to the appropriate inpatient unit significantly affects inpatient length of stay.
Short-term Revision Risk of Patellofemoral Arthroplasty Is High: An Analysis from Eight Large Arthroplasty Registries
Authors: Lewis Peter L. , Tudor Francois , Lorimer Michelle , McKie John , Bohm Eric , Robertsson Otto , Makela Keijo T. , Haapakoski Jaason , Furnes Ove , Bartz-Johannessen Christoffer , Nelissen Rob G. H. H. , Van Steenbergen Liza N. , Fithian Donald C. , Prentice Heather A.
Published: April 2020

Background

Patellofemoral arthroplasty (PFA) is one option for the treatment of isolated patellofemoral osteoarthritis, but there are limited data regarding the procedure and results. Because isolated patellofemoral arthritis is relatively uncommon, available case series generally are small, and even within national registries, sample sizes are limited. Combining data from multiple registries may aid in assessing worldwide PFA usage and survivorship.

Questions/purposes

We combined and compared data from multiple large arthroplasty registries worldwide to ask: (1) What proportion of patients undergoing primary knee arthroplasty have PFA? (2) What are the patient and prosthesis characteristics associated with PFA in common practice, as reflected in registries? (3) What is the survivorship free from revision of PFA and what are the reasons for and types of revisions?

Methods

Data were provided by eight registries that are members of the International Society of Arthroplasty Registries (ISAR) who agreed to share aggregate data: Australia, New Zealand, Canada, Sweden, Finland, Norway, the Netherlands, and the United States. De-identified data were obtained for PFA performed from either the beginning of year 2000, or the earliest recorded implantation date after that in each individual registry when PFA data collection commenced, up to December 31, 2016. This included patient demographics, implant use, all-cause revision rate (determined by cumulative percent revision [CPR]), and reasons for and type of revision.

Results

During the data collection period, 6784 PFAs were performed in the eight countries. PFAs comprised less than 1% of primary knee replacements in all registries. Patient demographics were comparable in all countries. Patients were generally more likely to be women than men, and the mean age ranged from 50 years to 60 years. All registries showed a high rate of revision for PFA. The 5-year CPR for any reason ranged from 8.0% (95% CI 4.5 to 11.5) in Norway to 18.1% (95% CI 15.5 to 20.7) in the Netherlands. The most common reason for revision across all countries was disease progression (42%, 434 of 1034). Most PFAs (83%, 810 of 980) were revised to a TKA.

Conclusions

The revision risk of PFA in all registries surveyed was more than three times higher than the reported revision risk of TKA at the same times. The survivorship of PFA is similar to that of the no-longer-used procedure of metal-on-metal conventional hip replacement. Although there may be potential functional benefits from PFA, these findings of consistent and alarmingly high rates of revision should create concern, particularly as this procedure is often used in younger patients.

Level of Evidence

Level III, therapeutic study.
Resveratrol Attenuates Aortic Dissection by Increasing Endothelial Barrier Function Through the SIRT1 Pathway
Authors: Wang Kaijie , Zhao Jinping , Zhang Wenwen , Zhu Minglin , Xu Ming , Li Dan , Shi Hongjie , Zhang Ming , Shi Jiajun , Dong Zhe
Published: April 2020

Aortic dissection (AD) is a serious condition and a health issue on a global scale. β-Aminopropionitrile–induced AD in mice is similar to the pathogenesis of AD in humans. Resveratrol (RSV) is a natural polyphenolic substance that provides anti-inflammatory and cardiovascular effects, but the role of RSV in AD is unclear. In this study, we investigated the effects and mechanisms of RSV on β-aminopropionitrile–induced AD in mice. Our results indicate that RSV can prevent the occurrence of AD. More meaningfully, we found that the protective effect comprises an increase in sirtuin 1 (SIRT1) expression in endothelial cells for the reconstruction of their structure, reducing the recruitment of inflammatory cells by endothelial cells and inhibiting the inflammation response, thereby suppressing the occurrence of AD.
Preconception diet, fertility, and later health in pregnancy
Authors: Grieger Jessica A.
Published: April 2020

Purpose of review

Women should enter pregnancy in the best possible health. There is increasing recognition of the importance of nutrition for reproductive health; however, key dietary factors in relation to optimizing fertility are nonexistent. The purpose of this review is to investigate dietary factors, preconception, and the association with fertility and later health in pregnancy.

Recent findings

This article summarizes recent literature assessing preconception dietary intake and the association with fertility, time to pregnancy, and also the relationship with polycystic ovary syndrome and gestational diabetes; these conditions associate with each other, and also with infertility. The impact of paternal diet is also reported.

There is recent interest investigating diet and time to pregnancy, suggesting higher intakes of fruit, minimal intake of fast food and sugar sweetened beverages, and a diet lower in glycemic load, may improve time to pregnancy. There is minimal recent literature on paternal diet and impact on fertility. Present advice to women with polycystic ovary syndrome is in line with international recommendations for lifestyle management to improve reproductive outcomes; and for gestational diabetes, prepregnancy may be an optimal time to improve dietary intakes, particularly through consumption of an overall healthy dietary pattern or a Mediterranean-style dietary pattern.