bluuebunny/crossref_metadata_2025 huggingface dataset:
Music and Language
Authors: Schön Daniele , Morillon Benjamin
Published: October 2018

This chapter begins with a historical approach that explains why music and language have long been considered as modular and as such independent brain functions. It shows some methodological limitations of the neuropsychological and neuroimaging approach in interpreting differences between music and language neural substrates. The chapter advocates for the use of a truly comparative approach to study differences and commonalities between music and language. It then highlights several common functions and operations necessary in both language and music processing and presents the sharing resource hypothesis. The study of the effects of music training and music stimulation on language processing is a privileged avenue to unravel the relation of common operations and their specific nature at the algorithmic level. The chapter concludes with a focus on the temporal dimension and the dynamic nature of oscillatory activity and their role in temporal prediction in music and language.
James and Pragmatism
Authors: Kitcher Philip
Published: October 2018

William James envisaged pragmatism as a reform of philosophy. Like his fellow pragmatist John Dewey, he held that the history of philosophy often shows how questions, once relevant and exciting, inspire a sequence of derivative and ever-narrower inquiries, in which the original point becomes lost. To read James’s pragmatism in this way distinguishes it from the reforming efforts of the logical positivists, whose concerns with “cognitive significance” and “meaningful language” neither he nor Dewey shared. Viewed in this light, James’s version of Charles Sanders Peirce’s pragmatic maxim, his theory of truth, and his interest in reconciling the claims of science and religion take on new significance. His discussions point toward a road less traveled, one that twentieth-century Anglophone philosophy did not take.
Thriving on Emotional Intelligence? Bridging Research and Practice
Authors: Lopes Paulo N.
Published: October 2018

Emotional intelligence (EI) is a useful framework with which to map emotional skills. There is evidence EI explains well-being, psychological health, the quality of social relationships, and job performance. However, measuring EI using ability tests remains a major challenge. Here, I review theory and research on EI, discuss the strengths and limitations of different models, and suggest possibilities for future research and for the development of new measures. I argue that examining areas of substantive overlap and interdependence between EI, IQ, personality, and motivation is important to achieve a full understanding of how emotionally intelligent behavior contributes to positive functioning. Moreover, I outline implications for developing EI and fostering emotionally intelligent behavior in organizations at various levels of analysis. In particular, I argue that it may be most effective to infuse EI training into team projects aimed at addressing organizational challenges related to innovation and change.
Romantic Generations
Authors: Bradshaw Michael
Published: October 2018

The concept of generation continues to influence how Romantic writing is read and interpreted. While ‘the Romantics’ and ‘Romanticism’ are retrospective organizational terms, emerging in later nineteenth-century criticism, the Romantic generations are not back-formations of this kind: Romantic writers constructed themselves and others within loose but coherent groups based on age, affiliation, aesthetic taste, and, above all, their stance in relation to the sublime historical moment, the French Revolution. It is in the poetry of the period that generational succession is most keenly articulated. There are two widely recognized generations of Romantic writers: that of Wordsworth and Coleridge; and the younger generation of Byron, Shelley, and Keats. To this traditional pairing can be added a third Romantic generation of the 1820s and ’30s, including often overlooked writers such as Beddoes, Darley, Hood, and Landon, who extended Romantic themes of imaginative creativity into the commodity culture of the mid-nineteenth century.
Poetry and Social Class
Authors: Goldberg Brian
Published: October 2018

During the Romantic period, poetry and social class were intimately connected. Many of the period’s political arguments were about the social hierarchy, and poetic writing often reflected these debates. A poet’s social origin also had much to do with what he or she wrote and how that writing might be received. Fundamentally, audiences assumed that a legitimate poet would have a classical education unavailable to writers below a certain rank. Poets regularly attempted to challenge perceived class distinctions, sometimes by experimenting with the voices and viewpoints of other ranks, sometimes by seeking social mobility in the literary marketplace. Attempts at class transit could be treated as dangerous insofar as they raised the prospect of social levelling, or as welcome if they were taken to indicate that British society rewarded merit or that that the nation’s ranks were closely linked rather than antagonistic and divided.
Literature for Children
Authors: Manly Susan
Published: October 2018

The child is often imagined in the work of Coleridge and Wordsworth as a source of creative energies and of hope for the future of humanity, as well as symbolizing a return to original naturalness. But these ideas about childhood were not peculiar to the Lake poets: they have their origin in the politicized educational theories of John Locke and Jean-Jacques Rousseau, as well as in Joseph Priestley’s revolutionary rhetoric and the children’s literature that emerged from this tradition. Variously combining these influences, a new, often realist children’s literature written by Anna Barbauld, John Aikin, Mary Wollstonecraft, William Blake, Maria Edgeworth, and William Godwin sought to revolutionize the forms and content of earlier books for children. The new children’s literature of the 1790s and early 1800s envisaged a rising generation of socially engaged thinkers capable of transforming society.
The Revolutionary Decade
Authors: Mee Jon
Published: October 2018

This chapter examines the literature of the controversy over the French Revolution. It discusses the polemical texts that contributed directly to the controversy associated with Burke, Godwin, Paine, and Wollstonecraft, but also the culture wars that perpetuated it in terms of the novel, poetry, and the theatre. In the 1790s, some of the great names associated with Romanticism came to literary maturity, Blake, Coleridge, and Wordsworth among them. The chapter reminds readers that it was a golden age of satire as a consequence of the ideological conflict, but also a decade when the definitions of literature and culture entered a period of crisis and redefinition.
Revision and Self-Citation
Authors: Stabler Jane
Published: October 2018

Despite recent claims that serious poetic revision only started during the modernist period, most Romantic-period manuscripts yield evidence of sustained and sometimes obsessive revision, which could take place over a matter of hours, days, or years. This chapter surveys different editorial approaches to authorial revision and the vexed question of whether we should base our reading texts on the ‘first finished’ version or the author’s last ever set of revisions—the question which has haunted William Wordsworth’s editors for decades. After a brief discussion of the advantages of combining genetic criticism of the manuscript page with an awareness of biographical, social, and literary contexts, the chapter turns to public-domain manuscripts to analyse three examples of manuscript revision of poetry by Wordsworth, Keats, and Shelley.
Intertextual Dialogue
Authors: Lau Beth
Published: October 2018

Intertextual dialogue in the Romantic period is shaped by conflicting imperatives. Romantic writers lived in an age when the pressure to be original and natural coincided for the first time to a significant degree with the worship and canonization of previous British authors, especially such ‘geniuses’ as Shakespeare and Milton. Major figures from every genre of the period can be seen to negotiate the competing demands to acquire legitimacy by invoking other, recognized writers, and to express their own unique vision and style—both to fit into existing literary tradition and to stand out as unique. This chapter explores the complications of intertextual dialogue in five representative authors across a variety of genres: the essayist and critic William Hazlitt, the poet and writer of marginalia Samuel Taylor Coleridge, the novelist Jane Austen, and poets John Clare and John Keats.
Book-Making
Authors: Keen Paul
Published: October 2018

Building on recent print-culture and book-history approaches, this chapter explores the ways that book production in the Romantic period was shaped by a range of factors, including technological advances such as the development of the Stanhope printing press, commercial innovations such as advertising, the evolution of a more sophisticated economic infrastructure, and political issues that frequently turned on print’s ability to reach an audience that extended beyond the traditional reading public. Assumptions in the period about book production were also influenced by highly self-reflexive debates that were inspired by all of these developments, and which raised questions that have become prominent again today in our own debates about the nature and importance of books and the changing and contested definition of ‘the literary’.
Celebrity and Anonymity
Authors: Mole Tom
Published: October 2018

This chapter argues that the discourses, understandings, and practices surrounding the attribution of literary works changed significantly during the Romantic period. It examines the wide range of attribution styles that were available in the period, including the use of initials, phrases such as ‘by a Lady’, invented names such as Malachi Malagrowther (Walter Scott), and the formula ‘by the author of’. Drawing on a quantitative analysis of the bibliographical record, it shows how the popularity of anonymous publication shifted during the period in different ways for novels and poetry volumes. These changes were bound up with the emergence of modern celebrity culture. The chapter suggests that celebrity, anonymity, and pseudonymity were not opposed to one another, but were complexly intertwined, so that anonymity could be a form of celebrity and (paradoxically) celebrity could be a form of anonymity.
Literary Uses of Dialect
Authors: Hodson Jane
Published: October 2018

This chapter argues that the Romantic period was a formative one in terms of dialect representation, marking a shift from the representation of a narrow range of dialects for primarily comic purposes in the eighteenth century to a much broader range of dialects with a greater range of literary functions in the nineteenth century. The chapter identifies three key challenges that arise when analysing historical representations of dialect: changes in understandings of the concept of ‘dialect’, the different trajectories taken by specific dialects, and the ideological implications of representing dialect in literature. The chapter identifies Scots as the most significant literary dialect of the Romantic period, and demonstrates that representations of dialect occur at the intersection of a number of highly contested categories, including class, nation, and region.
Romantic Oratory
Authors: Thompson Judith
Published: October 2018

This chapter presents Romanticism as a golden age of oratory whose variety and cross-cultural influence were obscured in the reactionary aftermath of the French Revolution. Treating public speech as a political act and an art of gender and class mobility, the chapter defines oratory in distinction to orality and rhetoric through elocutionary theorists such as Thomas Sheridan and John Thelwall, who anticipate postcolonial concepts of oracy and orature. It then highlights three chief forms of oratory recognized in the era: parliamentary (balancing the giants Burke, Sheridan, and Fox against the radical ‘counter-parliamentary’ orators Thelwall, Wedderburn, and Hunt), religious (tracing conflicts over extemporality in the established, dissenting, and millenarian traditions), and theatrical (noting Sarah Siddons’s influence upon changing views of women as speakers). It ends by considering the lecture as a Romantic genre, and recitation as a tool of active, critical, and participatory democratic education through personation.
The Romantic Lexicon
Authors: Bennett Andrew
Published: October 2018

This chapter explores the critical and theoretical reach and power of Romanticism’s poetics by examining some of the words that its practitioners deploy to describe their own work. Romanticism takes everyday, even banal words and phrases and makes them its own, inflecting and redirecting them. In so doing, Romanticism invents itself as a radically new, iconoclastic, and dissident literary movement. Paying attention to this evolving lexical cluster allows us to discern emerging patterns within and connections between ideas and practices in the major intellectual and literary developments of the late eighteenth and early nineteenth centuries. It is in the production of a newly theorized aesthetic lexicon, and in the theorizing of this lexicon, that the definition or determination of what is called ‘Romanticism’ emerges. Romantic poetics, in other words, is the Romantic lexicon.
The Greco-Roman Revival
Authors: Halmi Nicholas
Published: October 2018

During the eighteenth century an emergent historicism, which differentiated modernity radically from past ages, questioned the traditional notion of a ‘classical tradition’ of timeless values exemplified in Greek and Roman works. Classical antiquity began to be understood as a repository of historical artefacts associated, in part nostalgically, with ‘primitive’ ways of thought. Such recognition of the distance between modernity and antiquity paradoxically encouraged identification with the latter, since antiquarian research permitted increasingly accurate imitation of classical forms in the visual arts from the 1750s, while anthropological reflection on myth stimulated a revival of mythological poetry from the 1810s. Yet British Romantic poetry, whether describing classical artworks or appropriating classical myths, engaged with classical antiquity ambivalently, often ironically. While espousing the Philhellenist cause of Greek independence from Ottoman rule, Byron and Shelley remained very conscious of the disparities between ancient and modern Greece.
Wales and the West
Authors: Constantine Mary-Ann
Published: October 2018

This chapter explores the spread and exchange of some key Romantic-era preoccupations across Wales and the West Country. Focusing on Bristol as a place where ideas and energies—religious, political, and creative—met and mixed, it shows how Welsh and English literary traditions were channelled into a variety of new forms, often in response to the turbulence of the 1789 revolution and the subsequent wars with France. While broad structures of thought, including Dissent, antiquarianism, and a complex relation with the metropolis, are shared across the entire area, Wales’s linguistic, cultural, and geographical differences made it, for English writers, a place of exotic and utopian possibilities. From the reimagined bardic world of the radical Iolo Morganwg to the Wales-inspired poems of Southey and Wordsworth, this chapter reveals direct connections and striking parallels in the lives and works of writers in both languages.
Rpp1 Encodes a ULP1-NBS-LRR Protein That Controls Immunity to Phakopsora pachyrhizi in Soybean
Authors: Pedley Kerry F. , Pandey Ajay K. , Ruck Amy , Lincoln Lori M. , Whitham Steven A. , Graham Michelle A.
Published: October 2018

Phakopsora pachyrhizi is the causal agent of Asian soybean rust. Susceptible soybean plants infected by virulent isolates of P. pachyrhizi are characterized by tan-colored lesions and erumpent uredinia on the leaf surface. Germplasm screening and genetic analyses have led to the identification of seven loci, Rpp1 to Rpp7, that provide varying degrees of resistance to P. pachyrhizi (Rpp). Two genes, Rpp1 and Rpp1b, map to the same region on soybean chromosome 18. Rpp1 is unique among the Rpp genes in that it confers an immune response (IR) to avirulent P. pachyrhizi isolates. The IR is characterized by a lack of visible symptoms, whereas resistance provided by Rpp1b to Rpp7 results in red-brown foliar lesions. Rpp1 maps to a region spanning approximately 150 kb on chromosome 18 between markers Sct_187 and Sat_064 in L85-2378 (Rpp1), an isoline developed from Williams 82 and PI 200492 (Rpp1). To identify Rpp1, we constructed a bacterial artificial chromosome library from soybean accession PI 200492. Sequencing of the Rpp1 locus identified three homologous nucleotide binding site-leucine rich repeat (NBS-LRR) candidate resistance genes between Sct_187 and Sat_064. Each candidate gene is also predicted to encode an N-terminal ubiquitin-like protease 1 (ULP1) domain. Cosilencing of the Rpp1 candidates abrogated the immune response in the Rpp1 resistant soybean accession PI 200492, indicating that Rpp1 is a ULP1-NBS-LRR protein and plays a key role in the IR.
Resistance Quantitative Trait Loci qMi-C11 and qMi-C14 in Cotton Have Different Effects on the Development of Meloidogyne incognita, the Southern Root-Knot Nematode
Authors: Da Silva Mychele B. , Davis Richard F. , Kumar Pawan , Nichols Robert L. , Chee Peng W.
Published: October 2018

Quantitative trait loci (QTLs) qMi-C11 and qMi-C14 impart a high level of resistance to Meloidogyne incognita in cotton. Breeders had previously backcrossed both QTLs into the susceptible Coker 201 to create the highly resistant M-120 RNR, and we crossed Coker 201 and M-120 RNR to create near-isogenic lines with either qMi-C11 or qMi-C14. Previous work suggests different modes of action for qMi-C11 and qMi-C14. To document individual and combined effects of the QTLs on nematode development and reproduction, Coker 201 (neither QTL), M-120 RNR (both QTLs), CH11 near isoline (qMi-C11), and CH14 near isoline (qMi-C14) were inoculated with M. incognita. At 4, 8, 12, 16, 20, 25, and 30 days after inoculation (DAI), roots were stained to observe nematode developmental stages (second-stage juvenile [J2], swollen second-stage juvenile [SJ2], third-stage juvenile [J3], fourth-stage juvenile [J4], and female), and the number of galls was counted. At 20, 25, 30, and 40 DAI, M. incognita eggs were harvested and counted. At 30 DAI, 80% of the nematodes on Coker 201 were female compared with 50, 40, and 33% females on CH14, CH11, and M-120 RNR, respectively, and greater proportions of nematodes remained in J2 in M-120 RNR (41%), CH11 (58%), and CH14 (27%) than in Coker 201 (9%). More nematodes progressed to J3 or J4 on Coker 201 and CH14 than on CH11 or M-120 RNR. Coker 201 and CH14 had more galls than M-120 RNR. Coker 201 had more eggs than the other genotypes at 30 DAI. Nematode development beyond J2 or SJ2 was significantly reduced by qMi-C11, and development beyond J3 or J4 was significantly reduced by qMi-C14. This study confirms that qMi-C11 and qMi-C14 act at different times and have different effects on the development of M. incognita, and therefore, they have different modes of action.
Characterization of Antagonistic Bacillus methylotrophicus Isolated From Rhizosphere and Its Biocontrol Effects on Maize Stalk Rot
Authors: Cheng Xingkai , Ji Xiaoxue , Ge Yanzhen , Li Jingjing , Qi Wenzhe , Qiao Kang
Published: October 2018

Stalk rot is one of the most serious and widespread diseases in maize, and effective control measures are currently lacking. Therefore, this study aimed to develop a new biological agent to manage this disease. An antagonistic bacterial strain, TA-1, was isolated from rhizosphere soil and identified as Bacillus methylotrophicus based on morphological and biochemical characterization and 16S ribosomal RNA and gyrB gene sequence analyses. TA-1 exhibited a strong antifungal effect on the growth of Fusarium graminearum mycelium, with 86.3% inhibition at a concentration of 108 CFU per ml. Transmission electron microscopy showed that TA-1 could disrupt the cellular structure of the fungus, induce necrosis, and degrade the cell wall. Greenhouse and field trials were performed to evaluate the biocontrol efficacy of TA-1 on maize stalk rot, and the results of greenhouse experiment revealed that the bacterium significantly reduced disease incidence and disease index. Seeds treated with a 108 CFU ml−1 cell suspension had the highest disease suppression at 86.8%. Results of field trials show that seed bacterization with TA-1 could not only reduce maize stalk rot incidence but also increase maize height, stem diameter, and grain yield. The lipopeptide antibiotics were isolated from the culture supernatants of TA-1 and identified as surfactins and iturins. Consequently, B. methylotrophicus TA-1 is a potential biocontrol agent against maize stalk rot.
The Role and Value of Public Members in Health Care Regulatory Governance
Authors: Johnson David A. , Arnhart Katie L. , Chaudhry Humayun J. , Johnson David H. , McMahon Graham T.
Published: October 2018

American medicine has progressively embraced transparency and accountability in professional self-regulation. While public members serving on health care regulatory boards involved with the accreditation, assessment, certification, education, and licensing of physicians provide formal opportunities for voicing public interests, their presence has not been deeply explored. Using 2016 survey and interview data from health care organizations and public members, the authors explore the value and challenges of public members. Public members were often defined as individuals who did not have a background in health care and provided a patient perspective, but in some instances prior health care experience did not automatically exclude these individuals from serving as public members. Public members served on the majority of national health care regulatory boards and constituted an average 9% to 15% of board composition, depending on how rigidly the organizations defined “public member.” Public members were valued for their commitment to the priorities and interests of the public, ability to help boards maintain that public focus, and various professional skills they offer to boards. A main challenge that public members faced was their lack of familiarity with and knowledge of the health care field. The authors suggest several considerations for improved public member integration into health care regulatory organizations: clearly defined roles of public members, including evaluating whether or not previous health care experience either contributes or hinders their role within the organization; greater visibility of opportunities for the public to serve on these boards; and potentially a more intensive orientation for public members.
Predictors of Referral to a Pediatric Outpatient Chronic Pain Clinic
Authors: Tumin Dmitry , Miller Rebecca , Hakim Mohammed , Shafy Shabana Z. , Drees David , Wrona Sharon , Smith Timothy P. , Tobias Joseph D. , Bhalla Tarun
Published: October 2018

Objectives:

The main objectives of this study were to retrospectively characterize the rate of referrals to an outpatient chronic pain clinic among adolescents with chronic pain, and to identify factors associated with referral.

Materials and Methods:

Adolescents, 13 to 18 years of age seen in 2010 to 2015 at outpatient clinics associated with Nationwide Children’s Hospital (NCH) and diagnosed with chronic pain were included if they lived near NCH and had not been previously referred to the NCH outpatient chronic pain clinic. Subsequent referrals to the pain clinic were tracked through December 2017 using a quality improvement database. Factors predicting referral were assessed at the initial encounter in another outpatient clinic and analyzed using multivariable logistic regression.

Results:

The analysis included 778 patients (569 female; median age, 15 y), of whom 96 (12%) were subsequently referred to the chronic pain clinic, after a median period of 3 months. Generalized chronic pain (adjusted odds ratio, 1.8; 95% confidence interval, 1.1-3.1; P=0.023) and regional pain syndromes (adjusted odds ratio, 3.1; 95% confidence interval, 1.5-6.7; P=0.003) were associated with increased likelihood of referral. The referral was also more likely among female patients and among patients with a mental health comorbidity or recent surgery or hospitalization.

Discussion:

Referrals to our chronic pain clinic were more likely for adolescents with generalized chronic pain, regional pain syndromes, and patients with mental health comorbidities. Recent hospitalization or surgery, but not recent emergency department visits, were associated with pain clinic referral. The multivariable analysis did not find disparities in referral by race or socioeconomic status.
A Comprehensive Evaluation of Obstetrics and Gynecology Residencies' Global Health Training Programs
Authors: Trivedi Shivika , Haddad Lisa B. , Narvaez Jennifer , Walker Elizabeth , Kapadia Sameer , Jamieson Denise J. , Lathrop Eva
Published: October 2018

OBJECTIVE:

To compile a comprehensive summary of obstetrics and gynecology global health training programs and to describe program type, global distribution of work, effect, and reciprocity within programs.

METHODS:

This cross-sectional observational study identified all U.S. obstetrics and gynecology residencies with global health training programs, described residency and program characteristics, and evaluated the publications resulting from them. Eligible articles included those published in 2011–2016 about work done in a global health training location by global health training faculty. All eligible articles were evaluated for academic effect. The inclusion of host country authors on articles served as a proxy for reciprocity. Article content was assessed to evaluate whether programs addressed Millennium Development Goals.

RESULTS:

Among 245 obstetrics and gynecology residencies, 196 (80%) had global health training programs. Location and faculty members were identified for 67 (34%) programs, of which 26 (39%) had global health training faculty who had published articles meeting inclusion criteria. Of 698 articles reviewed, 78% addressed at least one Millennium Development Goal, including 39% that addressed improving maternal health (Millennium Development Goal 5). Approximately half (48%) of authors were from host countries.

CONCLUSION:

Most obstetrics and gynecology residencies are offering global health training. The majority of programmatic work addresses Millennium Development Goals and thus is aligned with global health priorities. The effect and reciprocity of global health training programs varies across institutions. Residencies could benefit from internal analysis of their global health training programs to evaluate whether knowledge gained is being disseminated and to ensure equitable partnerships and the creation of sustainable, influential initiatives.
Complication Rates and Outcomes After Hysterectomy in Transgender Men
Authors: Bretschneider C. Emi , Sheyn David , Pollard Robert , Ferrando Cecile A.
Published: October 2018

OBJECTIVE:

To describe the rate and 30-day outcomes after gender affirmation surgery in transgender men.

METHODS:

We conducted a cross-sectional population-based study. Patients with male gender who underwent hysterectomy for benign indications between 2013 and 2016 in the American College of Surgeons’ National Surgical Quality Improvement database were identified. Propensity score matching was performed to ameliorate selection bias. Student t test and Mann-Whitney tests were used to compare continuous variables between two groups where appropriate. The χ2 and Fisher exact tests were used where appropriate to compare categorical variables across groups. Logistic regression models were used to evaluate factors associated with any postoperative adverse event.

RESULTS:

Of 159,736 hysterectomies performed during the study period, 521 (0.3%) were performed in transgender men. The mean age was 23.9±13.8 years, and the median body mass index was 29.0 (range 24.8–34.2). The majority of patients were white (64.5%). The most common specified diagnosis associated with hysterectomy was gender identity disorder (20.9%). Laparoscopy was the most common route (57.2%) followed by laparoscopic-assisted vaginal hysterectomy (20.0%) and abdominal hysterectomy (15.2%). After propensity matching was performed, the composite rate of postoperative complications was similar between the transgender male and control groups (3.4% vs 3.3%, P=.92). On multivariate logistic regression controlling for age, presence of a major medical comorbidity, and primary mode of surgery, transgender male status and presence of a major medical comorbidity were not significantly associated with complications (adjusted odds ratio [OR] 1.11, 95% CI 0.56–2.10 and adjusted OR 1.16, 95% CI 0.58–2.27, respectively). Age remained weakly associated with postoperative complications (adjusted OR 1.04, 95% CI 1.01–1.06), whereas minimally invasive approaches to hysterectomy were significantly associated with lower incidences of complications (vaginal, adjusted OR 0.04, 95% CI 0.002–0.17; laparoscopic adjusted OR 0.09, 95% CI 0.04–0.18; and laparoscopic-assisted vaginal hysterectomy, adjusted OR 0.07, 95% CI 0.02–0.20).

CONCLUSION:

Less than 1% of hysterectomies performed annually are for transgender male patients. Postoperative complications after hysterectomy in this patient population are similar to the complication rates found in cisgender women.
Risk of Sepsis and Mortality Among Patients With Chronic Obstructive Pulmonary Disease Treated With Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Blockers
Authors: Lai Chih-Cheng , Wang Ya-Hui , Wang Cheng-Yi , Wang Hao-Chien , Yu Chong-Jen , Chen Likwang
Published: October 2018

Objectives:

This study aimed to compare the effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the risk and outcomes of sepsis in patients with chronic obstructive pulmonary disease.

Design:

A retrospective study.

Setting:

Taiwan’s National Health Insurance Research Database.

Patients:

All patients with chronic obstructive pulmonary disease who received angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for more than 90 days between 2000 and 2005 were recruited for this study. Pairwise matching (1:1) of the angiotensin-converting enzyme inhibitor and angiotensin receptor blocker groups resulted in two similar subgroups with 5,959 patients in each.

Interventions:

None.

Measurements and Main Results:

The primary outcome was sepsis, and the secondary outcome was death. The occurrence rate of sepsis was 3.67 per 100 person-years for the patients receiving angiotensin-converting enzyme inhibitors and 2.87 per 100 person-years for those receiving angiotensin receptor blockers. In addition, the patients receiving angiotensin-converting enzyme inhibitors had a higher risk of septic shock (adjusted hazard ratio, 1.45; 95% CI, 1.26–1.67) and mortality (adjusted hazard ratio, 1.31; 95% CI, 1.22–1.40) than those receiving angiotensin receptor blockers. No matter whether the patients had prior severe exacerbation before the index date, those receiving angiotensin-converting enzyme inhibitors had a higher risk of sepsis, septic shock, and mortality than those receiving angiotensin receptor blockers (all p < 0.001).

Conclusions:

Angiotensin receptor blockers were associated with lower rates of sepsis and mortality than angiotensin-converting enzyme inhibitors in the patients with chronic obstructive pulmonary disease. The similar findings were also noted in subgroup analysis.
Decreased T-Cell Programmed Death Receptor-1 Expression in Pregnancy-Associated Melanoma
Authors: Ko Jennifer S. , Gastman Brian R. , Conic Ruzica , Tellez Diaz Trujillo Alejandra , Diaz-Montero Claudia Marcela , Billings Steven D. , Tarhini Ahmad , Funchain Pauline , Atanaskova Mesinkovska Natasha
Published: October 2018

Introduction:

Pregnancy depends on tolerance of an immunologically foreign fetus through type 1 T-cell suppression. Worse melanoma outcomes have been described within 1 year of childbirth. We assessed immunopathologic factors that may account for the observed negative impact of pregnancy on outcome.

Materials and Methods:

Women of child-bearing age with ≥24 months follow-up were identified from our Institutional Melanoma Registry. Women with available primary tumor blocks were compared [history of childbirth within 1 year of diagnosis (CB1Y) (n = 18) vs. nonpregnant age-matched controls (n = 13)]. Immunohistochemical staining with quantification of immune infiltrates: CD68+ tumor-associated macrophages, CD3+ tumor-infiltrating T cells, and PD-1+ activated/exhausted T cells; and hematolymphangiogenesis: CD31+/D2-40− blood vessels and D2-40+ lymphatics was performed by 2 blinded dermatopathologists.

Results:

CB1Y tumors showed decreased CD3+ tumor-infiltrating T cells (P < 0.05) with significantly reduced PD1 expression (P ≤ 0.05). The CD3:PD1 ratio was higher in CB1Y (P < 0.05). Other tested parameters did not significantly differ between the 2 groups.

Discussion:

As PD1 expression is induced during type 1 T-cell activation, these data suggest that immune ignorance or suppression may predominate in CB1Y. Further studies are required to identify interventions that may promote tumor-associated T-cell inflammation in such patients.
Hooked on Hooks? A Study in the Utilization of Skin Hooks
Authors: Clark Summer , Truong Valerie , Stasko Thomas
Published: October 2018

BACKGROUND

The skin hook is a valuable instrument used in the practice of dermatologic surgery. However, because of numerous factors, the degree of its use varies extensively.

OBJECTIVE

The purpose of this study was to examine practice trends among dermatologic surgeons regarding the use of skin hooks, as well as analyze factors influencing their use.

METHODS

A survey comprising 14 questions was distributed to members of the American College of Mohs Surgery and the American Society for Dermatologic Surgery. Results were recorded, and statistical analysis was conducted using the 2-sample z-test to compare 2 population proportions.

RESULTS

Five hundred seventy-one responses were received, with comments. 85.1% of respondents reported using skin hooks. Their use was further characterized as minimal (20.7%), moderate (29.0%), and extensive (35.4%). The utilization of skin hooks was additionally categorized based on age, gender, fellowship training, number of years in practice, practice setting, and history of experience/observance of a sharps exposure. Only the presence or absence of fellowship training demonstrated a statistically significant difference in the use of skin hooks.

CONCLUSION

Skin hooks are highly used tools among dermatologic surgeons. Their use requires appropriate training and experience, and care must be taken to minimize risk of exposure.
EVOLUTION AND PATTERNS OF CHOROIDAL THICKNESS CHANGES IN RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Giacuzzo Clarice , Bergin Ciara , Potic Jelena , Forestier Edwige , Daruich Alejandra , Pournaras Jean-Antoine , Konstantinidis Lazaros , Wolfensberger Thomas J.
Published: October 2018

Purpose:

To evaluate the changes in choroidal thickness (CT) before and after a successful pars plana vitrectomy for rhegmatogenous retinal detachment (RD), and to compare the evolution of CT with respect to the extent of RD.

Methods:

Fifty-four patients were divided into three groups: peripheral macula-on RD (>3 mm from the fovea; 14 eyes); paracentral macula-on RD (fovea-sparing; ≤3 mm from the fovea; 14 eyes); and macula-off RD (involving the fovea; 26 eyes). Choroidal thickness was measured at 1 month (M1) and 3 months (M3) postoperatively, preoperatively in macula-on RDs, with enhanced depth imaging optical coherence tomography, from the nasal side (+2.5 mm) to the temporal side (−2.5 mm) of the fovea.

Results:

In peripheral macula-on RD, the intereye difference in CTs showed thickening throughout follow-up (subfoveally: preoperatively = 19.6% ± 43.9%, M1 = 22.9% ± 27.5%, M3 = 18.2% ± 35.6%). In paracentral macula-on RD, the intereye difference in CTs showed a thinning throughout follow-up (subfoveally: preoperatively = −7.8% ± 21.9%, M1 =−5.5% ± 26.1%, M3 = −9.3% ± 19.4%), as well as in the macula-off RD (subfoveally: M1 = −14.1% ± 18.7%, M3 = −9.9% ± 15%).

Conclusion:

The extent of RD was related to the evolution of the CT before and after surgery. Further studies are necessary to clarify the relationship between the changes in CT and the effects of circulatory alterations, vitrectomy, and RD.
CHANGES OF CONE PHOTORECEPTOR MOSAIC IN AUTOSOMAL RECESSIVE BESTROPHINOPATHY
Authors: Nakanishi Ayami , Ueno Shinji , Hayashi Takaaki , Katagiri Satoshi , Ito Yasuki , Kominami Taro , Fujinami Kaoru , Tsunoda Kazushige , Iwata Takeshi , Terasaki Hiroko
Published: October 2018

Purpose:

To assess the morphological changes of cone photoreceptors in eyes with autosomal recessive bestrophinopathy.

Methods:

Both eyes of five patients with autosomal recessive bestrophinopathyunderwent spectral domain optical coherence tomography and adaptive optics fundus imaging. The cone photoreceptor densities were measured at intervals of 100 μm between 500 μm nasal and temporal eccentricities from the foveal center.

Results:

The median age of the patients was 30 years (range, 23–45 years), and the best-corrected visual acuity ranged from 20/20 to 20/80. Adaptive optics fundus images showed reduced cone photoreceptor densities corresponding to the damages of the photoreceptor layer in the spectral domain optical coherence tomography images in four patients with relatively good best-corrected visual acuity. The cone photoreceptor densities at the center of the fovea were less than one-third of the normal cone densities (range 11,600–30,400 cells/mm2). Cone photoreceptor mosaics were visible over the lesions with serous retinal detachment and retinal edema, although they were partially hyporeflective.

Conclusion:

There is a significant cone photoreceptor loss in the macular region of patients with autosomal recessive bestrophinopathy, although they had relatively good visual acuity. Monitoring cone photoreceptors by adaptive optics fundus imaging should provide accurate assessments of the disease status and indications for future therapeutic interventions.
The perceptions and experiences of national regulatory nurse leaders in advancing the advanced practice registered nurse compact policy agenda
Authors: Hahn Joyce A.
Published: October 2018

Background and purpose:

The Advanced Practice Registered Nurse (APRN) Compact was approved at the National Council of State Boards of Nursing Delegate Assembly in May 2015. Since that date, only three states have been successful in the legislative adoption of the compact. Thus, the purpose of this study was to explore the experiences and perceptions of nursing regulatory leaders involved with the individual state adoption of the APRN Compact.

Methods:

This qualitative study followed a phenomenological–hermeneutic methodology approach.

Conclusions:

Four themes emerged from within the data: legislative political environment; professional organizational barriers; strategies to push past barriers; and moving forward. An overarching theme of consistent communication was evident.

Implications for practice:

This study identifies barriers experienced in the legislative state adoption process and successful strategies to overcome these barriers to move the APRN compact forward.
Focal Degeneration of Vestibular Neuroepithelium in the Cristae Ampullares of Three Human Subjects
Authors: Okayasu Tadao , O’Malley Jennifer T. , Nadol Joseph B.
Published: October 2018

Background:

We report a unique pattern of focal degeneration of the neuroepithelium of cristae ampullares, thick subepithelial extracellular deposits, and neural degeneration in three humans.

Objective:

To characterize the pattern of vestibular degeneration and measure the thickness of subepithelial deposits in these three cases and controls.

Methods:

The subepithelial deposits of vestibular end organs in three subject cases and controls were studied using hematoxylin and eosin, periotic acid-Schiff, Gomori trichrome staining, and immunostaining for antineurofilament, antimyosin VIIa, and anticollagen 4a1. The thickness of deposit as measured by light microscopy was compared with that of control groups (age-matched controls, patients with unilateral Menière's disease, vestibular neuritis, cupulolithiasis, severe nonfocal degeneration of the vestibular neuroepithelium, and Alport syndrome). The correlation of thickness of deposits with age from 0 to 100 years was also investigated.

Results:

Focal loss of hair cells in the neuroepithelium, thick subepithelial deposits, and degeneration of subepithelial dendrites and Scarpa's ganglion were found in all three cristae of three subject cases. Immunostaining demonstrated a decrease of afferent neural fibers in the cristae and focal fragmentation of the basement membrane adjacent to the deposits. The thickness of the subepithelial deposits in three cristae of three subject cases was significantly greater than that of all controls. In the three cristae of normal controls, the thickness of deposits demonstrated a positive correlation with age.

Conclusion:

Although both age and degeneration of the vestibular neuroepithelium may be associated with the thickness of the subepithelial deposits, in this unique pattern of degeneration, the thickness of the subepithelial deposits was significantly greater than that in all controls.
Effect of LED therapy for the treatment nipple fissures
Authors: Campos Thalita Molinos , dos Santos Traverzim Maria Aparecida , Sobral Ana Paula Taboada , Bussadori Sandra Kalil , Fernandes Kristianne Santos Porta , Motta Lara Jansiski , Makabe Sergio
Published: October 2018

Introduction:

Poor positioning of the child in relation to the breast and improper suckling are the main causes of nipple fissure. Treatment options for nipple fissures include drug therapy with antifungal and antibiotics, topical applications of lanolin, glycerin gel, creams and lotions, the milk itself, hot compresses, and silicone nipple shields. Studies involving light-emitting diode (LED) therapy have demonstrated anti-inflammatory properties, the enhancement of the wound repair process, and the control of pain. As it does not cause discomfort, is relatively inexpensive and may impede the discontinuation of breastfeeding, phototherapy could be a viable option for the treatment of nipple fissures.

Aim:

The principal objective of the proposed study is to evaluate the effectiveness of LED therapy for the treatment of nipple fissures in postpartum mothers.

Materials and methods:

One hundred patients treated with a medical diagnosis of bilateral nipple trauma classified as nipple fissures or cracks will participate in the study, randomized into 2 groups: The control group will receive orientation regarding breast care and adequate breastfeeding techniques. The experimental group will receive the same orientation and phototherapy sessions using a device developed especially for the treatment of nipple trauma. Both groups will be followed up for 6 consecutive weeks.
Chronic thromboembolic pulmonary hypertension as the first manifestation of nephrotic syndrome in a 12-year-old child
Authors: Ma Fan , Zhou Kaiyu , Hua Yimin , Liu Xiaoliang , Duan Hongyu , Li Yifei , Wang Chuan
Published: October 2018

Rationale:

Chronic thromboembolic pulmonary hypertension (CTEPH) is rare in children and determining the underlying etiologies is essential for treatment. Venous thromboembolism, a well-known complication in nephrotic syndrome (NS), always occurrs during the treatment in course of the disease. However, CTEPH as the first manifestation of NS has not been reported till now.

Patient concerns:

A 12-year-old boy initially complained of hemoptysis, cough and shortness of breath with exertion, any symptoms regarding NS such as edema were not presented. Due to the identification of P2 enhancement, liver enlargement (2 cm below the rib) and jugular vein distension, pulmonary hypertension (PH) was firstly suspected and ultimately confirmed by detection of enlargement of right atrium (RA) and right ventricle (RV) enlargement (RA = 45mm, RV = 30mm), mild tricuspid valve regurgitation (TR) and elevation of pulmonary arterial pressure (63 mmHg) on echocardiogram. In order to search the underlying causes of PH, series of targeted laboratory evaluation and imaging were conducted, and pulmonary arterial embolism (PE) in inferior lobes of double lungs was found on chest contrast-enhanced computed tomography.

Diagnosis:

NS was unexpectedly discovered by detection of lower serum albumin level (24.4 g/L), severe proteinuria (+++, 4.62 g/24 h) when we were searching for the predisposing factors causing thromboembolism.

Interventions and outcomes:

After treatment of NS, the symptom regarding shortness of breath with exertion gradually became less apparent and was relieved one month later. Proteinuria and microscopic hematuria also disappeared. Encouragingly, RA and RV dilation, and the pulmonary arterial pressure almost returned to a normal range half a year later, with alleviation of MR.

Lessons:

CTEPH can occur rarely in children and NS is an important predisposing factor. PE could be the first manifestation of NS. When pediatricians encounter children with PE or CTEPH, NS as the underlying etiology should be considered. Except for renal venous thrombosis, the possibility of PE needs to be paid more attention in children with NS.
Expression of resistance gene and prognosis of chemotherapy in primary epithelial ovarian cancer
Authors: Yang Fengmei , Gao Bo , Chen Wei , Du Enfu , Liang Yong , Hu Xiuxue , Yang Xiaofeng
Published: October 2018

The sensitivity of tumor cells to chemotherapy drugs may become attenuated accounts for various reasons. Reduced drug sensitivity may cause the failure of chemotherapy and affect the prognosis of patients with cancer. This study investigates the relationship between the expression levels of lung resistance protein (LRP) and placental glutathione S-transferase-P1 (GSTP1), the resistance of primary epithelial ovarian cancer (PEOC) to chemotherapy, and the prognosis of patients with platinum drug-resistant PEOC.

Quantitative PCR (QT-PCR) was used to detect the mRNA level of the resistance genes LRP, GSTP1 in all tissue and cell lines.

The expression levels of resistance gene (LRP, GSTP1) in PEOC were the highest, followed by borderline adenoma tissues, and the lowest levels found in benign tumor tissues, the difference of genes expression between different tissues was statistically significant; the difference between the expression rates and relative expression level of drug resistance genes was statistically significant in platinum sensitive group compare with the platinum resistant group. The difference between resistant gene negative-expression and positive-expression of chemotherapy efficiency, disease free survival time, and recurrence time were statistically significant. The resistant genes expression in the PEOC patients of the negative-group survival curves was higher than that in the positive group. With ascites non-cellular component (ANCC) stimulated SKOV3 cells, the cell proliferation inhibition rate (CPIR) increased, and with ANCC stimulated SKOV3/DDP, the expression of LRP and GSTP1 also increased.

ANCC may promote the expression of drug resistance genes, and the expression of genes may predict the poorly prognosis of epithelial ovarian cancer.