bluuebunny/crossref_metadata_2025 huggingface dataset:
Tragic Deconstruction Set Against the Impenetrable Singular and Reconstruction as Spectacle and Administration
Authors: Rosenfeld Michel
Published: November 2022

This chapter provides a critical appraisal of the jurisprudential contributions attributable respectively to Derrida and to Agamben. Derrida and Agamben can be understood as culminating various theoretical strands that have dominated the field throughout the twentieth century. Derrida, who combines Kantian universalism with Nietzschean-Heideggerian belief in the irreducibility of the singular, can be regarded as the heir of CLS. His deconstructive method highlights the indissoluble necessity to pursue justice combined with its insurmountable impossibility. Derrida thus carves out a tragic path for jurisprudence which traps those subjected to law between an unyielding universal and an impenetrable singular while leaving out the plural. In contrast, Agamben elaborates a reconstruction that replaces tragedy with a combination between spectacle and acclamation, on the one hand, and administration, on the other. In important ways, a successor of Schmitt, because of his focus on oikonomia or administration, Agamben shares much in common with Luhmann’s systems-based positivism. If justice is central for Derrida, it greatly fades for Agamben. Agamben argues that the glory and acclaim that prevails in a polity where law is necessarily kept separate from administration derives from the mystery of the Christian Holy Trinity. In contemporary secular polities, the Christian form supposedly remains intact, but the content becomes completely open ended. Agamben does not accommodate the plural any better than Derrida. The pairing of Derrida and Agamben is instructive in terms of both the challenges posed by illiberalism and the current obstacles confronting justice through the constitution.
Justice Essentials Minima and Comprehensive Pluralism’s Fixed-core Minimum Set Against its Plural Maximum
Authors: Rosenfeld Michel
Published: November 2022

Comprehensive pluralism aims to maximize accommodation of plurality and given its dialectical approach, this depends on deployment of a set of fixed normative institutional prescriptions which aggregate as the minima of the justice essentials. Regarding justice itself, this minimum depends on the key distinction between factual disagreements and those about what distributive justice ought to be. For example, is a free-market economy or one replete with state intervention better suited to the advancement of pluralist maximization with respect to all three facets of constitutional justice? In this context, the pluralist does not seek to maximize plurality but to uncover the best available means to a set goal. In contrast, a normative disagreement between a Nozickian libertarian vision of justice and a radical egalitarian one calls for pluralist accommodation. Pluralistic minima also arise concerning identity and recognition oscillating between the poles of inward retreat and outward lurch. Minima regarding autonomy and solidarity assure a baseline of care and concern among “insiders” within a just constitutional order while refraining from demeaning the dignity of “outsiders” and figure as prerequisites to justice in recognition and in representation. Next, the chapter tackles the dialectical nexus between a minimum of fixed of core constitutional prescriptions and the maximization of plurality consistent with deployment of a pluralist conception of the justice essentials. Finally, the chapter tackles the series of challenges and pathologies that currently stand in the way of a straightforward comprehensively pluralist realization of the justice essentials.
Conclusion
Authors: Rosenfeld Michel
Published: November 2022

In spite of inevitable difficulties and of uncertainties about ultimate realization of the justice essentials, the book concludes that the comprehensive pluralist approach offers the best plausible means toward constitutional justice, and this both in terms of optimizing harmonization between ethnos and demos and of striking the right equilibrium between the universal, the singular, and the plural. Moreover, when evaluated under the criteria of comprehensive pluralism, neither populist nor illiberal appropriations or invocations of the framework of liberal constitutionalism appear to stand any chance of coming close to meeting any of the relevant minima that pave the way to the justice essentials.
Priors, regularisation, sparsity
Authors: Cocco Simona , Monasson Rémi , Zamponi Francesco
Published: November 2022

Bayes’ formula includes the possibility to account for prior knowledge on the model parameters, irrespectively of the data. We may know that some parameters are positive, or small, or that most vanish, and using such information may enhance the performance of inference methods. We discuss in this chapter three classes of prior distributions, important from a practical or a conceptual point of view: (1) Lp-norm based priors, which prevent parameters to have large values or even push them to be equal to zero; (2) conjugated priors, which are mathematically elegant and whose effects can be understood in tweaking the statistics and the numbers of the data; (3) universal priors, which are invariant under a change of model definition, and whose study will force us to think about the properties of the distributions spanned by the models as their parameters vary.
Supervised learning: classification with neural networks
Authors: Cocco Simona , Monasson Rémi , Zamponi Francesco
Published: November 2022

So far we have discussed unsupervised learning, the inference of the underlying statistical structure (and adequate representations) of a set of data. Another fundamental field of application of machine learning is supervised learning, which is the task of learning an input-output relationship. Supervised learning assumes the existence of a function that associates a label, e.g. dog or cat, to each data point, e.g. an image. In practice, the machine tries to learn this function from a limited set of input-output examples. At the end of learning, one should be able to predict the right class for any input, not necessarily belonging to the data set: does this new image correspond to a dog or to a cat? In this chapter, we address two questions: How can supervised learning and classification be done in practice? How many data does one need to generalise, i.e. to avoid overfitting the examples? We will start by discussing perceptrons, also called support vector machines (SVM), which are neural networks with no hidden layer and have set the state of the art in classification for decades, and we will then turn to more complex neural networks.
Time series: from Markov models to hidden Markov models
Authors: Cocco Simona , Monasson Rémi , Zamponi Francesco
Published: November 2022

So far, we have considered inference problems in which time played no role. In many applications, however, data are time series produced by a dynamical process. How can we infer the underlying rules defining this process? We will address this question in two frameworks: a simple one, in which measurements give direct access to the dynamical sequence of the states visited by the system, and a more complex one, in which data provide indirect knowledge about the states. In the latter situation, we will study a powerful approach, called hidden Markov models, and will see how to efficiently answer several questions of interest, of increasing difficulty: how to compute the likelihood of a time series of observations? How to infer the corresponding ‘hidden’ states? How to infer the model parameters?
The UN High Commissioner for Refugees’ Involvement with Internally Displaced Persons: Undermining International Refugee Law?
Authors: Ní Ghráinne Bríd
Published: November 2022

This chapter explores whether the in-state protection afforded by the UN High Commissioner for Refugees (UNHCR) to IDPs constitutes ‘protection of that country’ under the Refugee Convention and may thus be used by refugee-receiving states as a reason to deny refugee status. First, it explains the UNHCR’s role with IDPs as well as how international law and refugee law have evolved in response to the growing influence of non-state actors. It then uses both treaty interpretation and relevant domestic and international case law to determine whether protection offered by international organizations such as the UNHCR qualifies as ‘protection of that country’. The chapter argues that the UNHCR is not capable in law or in fact of providing ‘protection of that country’, and hence its activities with IDPs do not—at least in a legal sense—undermine its protection mandate towards refugees.
Article 1D of the 1951 Refugee Convention and Internally Displaced Persons
Authors: Ní Ghráinne Bríd
Published: November 2022

This chapter examines whether protection activities on behalf of IDPs from UN organs or agencies other than UNHCR could trigger the application of Article 1D of the Refugee Convention, which would render the Refugee Convention inapplicable to those persons. It argues that Article 1D cannot be triggered by activities of organs or agencies of the UN apart from the UNHCR in the context of the cluster approach to IDP protection for two reasons. First, the historic context of the treaty leads to the conclusion that Article 1D is only applicable in the context of UNRWA protection or assistance to Palestinian refugees. Second, even when the historic context is disregarded, it is illogical to apply Article 1D in the context of inter-agency IDP protection activities as an IDP will generally not be outside their country of origin and thus the question of refugee status should not arise.
Conclusion
Authors: Ní Ghráinne Bríd
Published: November 2022

The final chapter draws together the arguments made in the substantive chapters to illustrate that the development of the IDP protection framework does not, as a matter of law, undermine refugee protection. The availability of protection within a country of origin cannot be a substitute for granting refugee status unless it constitutes effective protection from persecution and there is no danger of refoulement. The book concludes by identifying current and future challenges in the relationship between IDPs and refugees, by illustrating the overall impact and importance of the findings of the research, and by setting out questions for future research.
Hume’s Intellectual Development, 1711–1752
Authors: Stewart M. A.
Published: November 2022

Provides a careful itemization of the evidence upon which an account of Hume’s intellectual biography before and immediately after the Treatise has to be based, including a summary of what we know about his education at Edinburgh. Describes what is known about Hume’s reading and thinking as he planned and wrote his first book, and about his intellectual intentions in its aftermath. Stewart stresses the unsubstantiated nature of claims frequently made in the scholarly literature. Suggests that Hume began his philosophical life as a Stoic, possibly under the influence of Shaftesbury’s Characteristicks, and that the breakdown of 1730–1 was a product of the deleterious effects of the Stoic regimen, as well as being, possibly, the result of a crisis of faith. Constructs a comprehensive list of all the authors and texts that we have reason to think Hume interested himself in early on in his intellectual development, emphasizing the importance of French works.
The Kirk and the Infidel
Authors: Stewart M. A.
Published: November 2022

Shows how Hume’s failed attempt to be elected Edinburgh’s Professor of Moral Philosophy in 1745 brings into focus the intellectual tensions between him and his principal Scottish philosophical contemporaries including Hutcheson and his Edinburgh philosophical ally William Wishart. Begins with the political context, and the opportunity offered by the prospect of a vacant Edinburgh moral philosophy chair for a trial of strength between the political factions of the day. Shows in detail how William Wishart’s ‘Specimen of Principles’, summarized in the Letter from a Gentleman to his Friend in Edinburgh, completely misrepresented Hume’s philosophy in general, and the character of his scepticism in particular. Argues Hume’s full reply was Philosophical Essays Concerning Human Understanding, published in 1748, and later re-titled An Enquiry Concerning Human Understanding.
Two Species of Philosophy
Authors: Stewart M. A.
Published: November 2022

In Part 1, discusses Hume’s use of the metaphors of the anatomist and painter, and explains the difference between his approach to moral philosophy and that of Hutcheson and other Scottish contemporaries. In Part 2, argues that Hume originally thought of the first Enquiry as a set of essays which presented the most important discoveries of the Treatise in an accessible way, and only later regarded it as a coherent replacement and substitute for the first book of the Treatise. In Part 3, rehearses Wishart’s attack on Hume’s philosophy and discusses how Hume met the specific charge of ‘Universal Scepticism’. Finally, argues that in Sections I and XI of the Enquiry Hume should be seen as going on the offensive against those who held him unfit to teach moral philosophy at the University of Edinburgh. In adopting the persona of an ancient Epicurean in Section XI, Hume offers a ‘moral defence’ of his own sceptical and rigorously empiricist species of philosophy.
The Dating of Hume’s Manuscripts
Authors: Stewart M. A.
Published: November 2022

A study of the collection of manuscripts deposited in the National Library of Scotland by the Royal Society of Edinburgh in 1987, especially the undated ‘An Historical Essay on Chivalry and modern Honour’, the so-called ‘early memoranda’, and the Dialogues. Argues that the ‘Essay on Chivalry’ was probably written in 1731, and that the ‘memoranda’ are conterminous with the end of Hume’s work on the Treatise. Regarding the Dialogues, identifies the stages of the text’s composition, particularly Parts 3 and 12. Argues that the manuscript shows that Hume was at work on revisions in the late 1750s as well as in the 1760s, and that the amount of revision done in 1776 has been greatly exaggerated by other commentators.
Developing Public Service Leaders
Authors: Wallace Mike , Reed Michael , O'Reilly Dermot , Tomlinson Michael , Morris Jonathan , Deem Rosemary
Published: November 2022

This book examines why and how governments and representative bodies for senior staff in public service organizations have mounted major interventions over the past two decades to develop senior staff as leaders. A critical explanation is developed of the foundational contribution made by national leadership development interventions in the 2000s to the emergence, proliferation, and normalization of leadership development provision. The authors carried out qualitative research in England, investigating the national leadership development interventions for school education, healthcare, and higher education. Political elites in government were concerned with acculturating senior staff to act as conduits for the implementation of regulated marketization reforms furthering the neoliberalization of public services, rendering them more business-like. Representative bodies for senior staff and participants in the provision were concerned to enhance individual capability and prospects for career advancement, rendering public service leadership more professional. Senior officials responsible for operating the interventions moderately subverted the interventions by focusing on generic leading activity. Senior staff were scarcely acculturated as government change agents but were acculturated towards complying with government-set performance standards and targets within its accountability regime. The authors explored the contemporary legacy of these interventions within the growing international movement to develop senior staff in public service organizations as leaders, comparing interventions in the United States of America (USA), Canada, Australia, New Zealand, and England. They conclude that leadership development has widely acculturated senior staff as leaders, though not necessarily committed to acting as government change agents. Leadership development makes a diffuse contribution towards the ongoing neoliberalization of public services.
Leadership development interventions in context
Authors: Wallace Mike , Reed Michael , O’Reilly Dermot , Tomlinson Michael , Morris Jonathan , Deem Rosemary
Published: November 2022

The chapter describes the main contextual factors that prompted the United Kingdom (UK) Labour government to invest in the suite of national leadership development interventions, concentrating on public-funded school education and healthcare, and on partly public-funded higher education (HE). Foremost is the subscription of elites in successive governments since the 1980s to the economic and political ideology of neoliberalism, supported by managerialism, generating a process of neoliberalization which extended to the regulated marketization of public services. This process challenged the ideology of professionalism and individual autonomy in service provision holding sway within most public services since the advent of the Keynesian welfare state. The associated process of neoliberalization is tracked to the point of the Labour government’s engagement with the interventions. A major motivator is shown to be government politicians’ acknowledged dependence on senior staff in public service organizations to implement the regulated marketization reform programme and operate the reformed services.
CV Benefits of Statins Outweigh Muscle Pain Risk
Authors: Rosenberg Karen
Published: November 2022

According to this study:

Statin therapy causes a small increase in reports of muscle pain, largely during the first year of treatment.

The cardiovascular benefits of statins outweigh the risk of muscle pain.
Differential Effects of Binaural Pitch Fusion Range on the Benefits of Voice Gender Differences in a “Cocktail Party” Environment for Bimodal and Bilateral Cochlear Implant Users
Authors: Oh Yonghee , Srinivasan Nirmal Kumar , Hartling Curtis L. , Gallun Frederick J. , Reiss Lina A.J.
Published: November 2022

Objectives:

Some cochlear implant (CI) users are fitted with a CI in each ear (“bilateral”), while others have a CI in one ear and a hearing aid in the other (“bimodal”). Presently, evaluation of the benefits of bilateral or bimodal CI fitting does not take into account the integration of frequency information across the ears. This study tests the hypothesis that CI listeners, especially bimodal CI users, with a more precise integration of frequency information across ears (“sharp binaural pitch fusion”) will derive greater benefit from voice gender differences in a multi-talker listening environment.

Design:

Twelve bimodal CI users and twelve bilateral CI users participated. First, binaural pitch fusion ranges were measured using the simultaneous, dichotic presentation of reference and comparison stimuli (electric pulse trains for CI ears and acoustic tones for HA ears) in opposite ears, with reference stimuli fixed and comparison stimuli varied in frequency/electrode to find the range perceived as a single sound. Direct electrical stimulation was used in implanted ears through the research interface, which allowed selective stimulation of one electrode at a time, and acoustic stimulation was used in the non-implanted ears through the headphone. Second, speech-on-speech masking performance was measured to estimate masking release by voice gender difference between target and maskers (VGRM). The VGRM was calculated as the difference in speech recognition thresholds of target sounds in the presence of same-gender or different-gender maskers.

Results:

Voice gender differences between target and masker talkers improved speech recognition performance for the bimodal CI group, but not the bilateral CI group. The bimodal CI users who benefited the most from voice gender differences were those who had the narrowest range of acoustic frequencies that fused into a single sound with stimulation from a single electrode from the CI in the opposite ear. There was no similar voice gender difference benefit of narrow binaural fusion range for the bilateral CI users.

Conclusions:

The findings suggest that broad binaural fusion reduces the acoustical information available for differentiating individual talkers in bimodal CI users, but not for bilateral CI users. In addition, for bimodal CI users with narrow binaural fusion who benefit from voice gender differences, bilateral implantation could lead to a loss of that benefit and impair their ability to selectively attend to one talker in the presence of multiple competing talkers. The results suggest that binaural pitch fusion, along with an assessment of residual hearing and other factors, could be important for assessing bimodal and bilateral CI users.
Variation in Commercial Insurance Type Impacts Access to Cervical Spine Surgery
Authors: Durand Wesley M. , Ortiz-Babilonia Carlos , Raad Micheal , Kurian Shyam , Reyes Miguel C. , Jain Amit
Published: November 2022

Introduction.

Prior literature has demonstrated that disparities exist in health care access and outcomes by insurance status, and patients with commercial plans fare better than those with Medicaid. However, variation may exist within commercial plans, which may impact care access. The purpose of our study was to determine the association between commercial health insurance plan type and access/time to surgery among patients with degenerative cervical conditions.

Methods.

The MarketScan database (IBM Watson Health, Ann Arbor, MI) was utilized to identify the first instance of International Classification of Diseases-10-CM diagnosis codes for cervical myelopathy and radiculopathy. Patients 65 years old or below enrolled from 2015 to 2020 with a minimum of two years of continuous enrollment were included. Surgery for myelopathy included anterior cervical discectomy and fusion (ACDF), posterior cervical laminectomy and fusion, and laminoplasty, whereas surgery for radiculopathy included ACDF, cervical disk arthroplasty, and foraminotomy. The time between first diagnosis and surgery was determined. Insurance plan type was categorized as noncapitated (NC), non–high-deductible health plan, Health Management Organization–type partially or fully capitated plans, or high-deductible health plans (HDHP). Proportional hazards regression was utilized to compare time-to-incidence of surgery by plan type, adjusting for age, and sex.

Results.

In total, 55,954 patients with cervical myelopathy and 705,117 patients with cervical radiculopathy were included. Mean follow-up was 537 and 657 days for myelopathy and radiculopathy, respectively. At two years postdiagnosis, 22.6% of myelopathy and 5.6% of radiculopathy patients were managed surgically. ACDF was the most common surgery for both myelopathy (85.7% of surgically managed patients) and radiculopathy (80.6%). The mean time to surgery for myelopathy was 101 days, and 196 days for radiculopathy. The most common plan type was NC for both myelopathy (81.5%, n=44,832) and radiculopathy (80.6%, n=559,109). Time-to-occurrence of surgery was significantly higher among both myelopathy and radiculopathy patients with capitated plans and HDHP versus NC plans, but the impact was significantly greater among those with radiculopathy than myelopathy (all P<0.05).

Conclusions.

Insurance plan structure has a significant impact on incidence of and on time-to-occurrence of surgery for patients with cervical degenerative conditions. Patients with HDHP plans may experience higher costs, potentially limiting access to care.
Plexiform Melanocytic Schwannoma: Report of a Second Case and Overview of a Rare Entity
Authors: Ranson Marc , Lai Jonathan , Van Brenk Bert , McCalmont Timothy H. , Walsh Noreen M.
Published: November 2022

The seminal case report of plexiform melanocytic schwannoma, published a decade ago, indicated that this is a rare variant of schwannoma demonstrating immunohistochemical expression of melanocytic markers, electron microscopic evidence of melanosome formation, and genetic features of a benign schwannoma. We report herein, a second example of this entity. Of added interest, our case showed pseudoglandular features, as previously recorded in other variants of schwannoma. A 66-year-old man presented with a cutaneous papule on the abdomen. Histopathologically, a vertically oriented, exoendophytic, folliculocentric, dermal tumor with a plexiform architecture was observed. This was composed of nodules and diverging fascicles of bland spindle-shaped cells. Notable interstitial mucin deposition conveyed a pseudoglandular appearance to the lesion. The spindled cells co-expressed S100, SOX10, and HMB45. A minority of cells expressed Melan-A and MiTF. EMA and claudin-1 stained capsular and perifascicular perineurial cells. Melanin was absent. Plexiform melanocytic schwannoma represents one of several nerve sheath tumors that peculiarly display evidence of melanocytic differentiation. These include melanocytoneuroma, pigmented neurofibroma (or melanocytic neurofibroma), and malignant melanotic schwannian tumor. Of importance, these proliferations can be mistaken for melanocytic tumors, including melanoma. In expanding the literature on this topic, we discuss steps required to distinguish plexiform melanocytic schwannoma from melanoma and other nerve sheath tumors with melanocytic differentiation. The possible pathogenesis of these unusual neoplasms is also addressed.
EFFECTS OF HALF-DOSE PHOTODYNAMIC THERAPY ON CHRONIC CENTRAL SEROUS CHORIORETINOPATHY WITH OR WITHOUT MACULAR NEOVASCULARIZATION ASSESSED USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Nakamura Koichi , Takeuchi Jun , Kataoka Keiko , Ota Hikaru , Asai Keiko , Nakano Yuyako , Horiguchi Etsuyo , Taki Yosuke , Ito Yasuki , Terasaki Hiroko , Nishiguchi Koji M.
Published: November 2022

Purpose:

To assess the effects of half-dose photodynamic therapy on subretinal fluid and macular neovascularization (MNV) using optical coherence tomography angiography in patients with chronic central serous chorioretinopathy.

Methods:

Clinical information on 168 patients (168 eyes) with chronic central serous chorioretinopathy obtained before and 6 months after treatment with half-dose photodynamic therapy was retrospectively analyzed. Patients were categorized into a success (145 eyes) or failure (23 eyes) group based on the absence or presence of subretinal fluid, respectively, and clinical data were compared between them. Macular neovascularization was studied in 147 cases with available optical coherence tomography angiography images. P < 0.05 indicated statistical significance.

Results:

The success group showed a younger patient age, better posttreatment best-corrected visual acuity, and thicker pretreatment central choroidal thickness (all, P < 0.047) than did the failure group. Regarding MNV analysis, nine, eight, and 130 eyes had definite, possible, and no MNV, respectively, at baseline; among them, 100.0%, 75.0%, and 2.3%, respectively, had MNV at 6 months posttreatment. Patients with definite MNV at baseline were less likely to show successful subretinal fluid resolution.

Conclusion:

Although half-dose photodynamic therapy is generally effective for the treatment of chronic central serous chorioretinopathy, coexisting MNV may compromise the outcome; thus, optical coherence tomography angiography–based assessment of chronic central serous chorioretinopathy is important.
MULTIMODAL IMAGING FEATURES AND TREATMENT RESPONSES OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO CENTRAL SEROUS CHORIORETINOPATHY
Authors: Jeong Areum , Kang Wonki , Sagong Min
Published: November 2022

Purpose:

To investigate features of central serous chorioretinopathy with choroidal neovascularization (CNV) on multimodal imaging and analyze their association with treatment response.

Methods:

A total of 37 patients with chronic central serous chorioretinopathy complicated by CNV were divided into bevacizumab and photodynamic therapy groups, and each group was subdivided into responders and nonresponders according to subretinal fluid status at 3 months. We assessed multimodal imaging parameters (subfoveal choroidal thickness; vortex vein engorgement; choroidal vascular hyperpermeability; and CNV morphologic pattern, area, and vessel density) and analyzed their association with treatment responses.

Results:

Responders in the bevacizumab group showed thinner subfoveal choroidal thickness (384.0 ± 103.2 vs. 398.3 ± 87.1 µm, P = 0.042), smaller CNV area (0.512 ± 0.267 vs. 1.323 ± 0.481 mm2, P = 0.007), open-circuit pattern (84.6% vs. 12.5%, P < 0.001), and capillary fringe (69.2% vs. 37.5%, P = 0.001) than nonresponders. Responders in the photodynamic therapy group had thicker subfoveal choroidal thickness (420.1 ± 93.5 vs. 395.7 ± 6.5 µm, P = 0.021), more quadrants with engorged vortex veins extending to the macula (P = 0.012), and intense choroidal vascular hyperpermeability (57.1% vs. 50.0%, P = 0.026) than nonresponders. Choroidal neovascularization showing closed-circuit pattern (85.7% vs. 0%, P = 0.001) and peripheral loop (64.3% vs. 0%, P = 0.001) demonstrated a good response to photodynamic therapy.

Conclusion:

Heterogeneous features of choroidal hyperpermeability, thickness, and CNV morphology in CNV accompanying central serous chorioretinopathy are associated with different therapeutic responses to bevacizumab and photodynamic therapy treatments.
How Are Older Adults Different Than Other Adults for Infections?
Authors: Scott Donald , Bond Mary , Manning T. Hunter , Lin-Greenberg Alan , Rosenthal Ken S.
Published: November 2022

The presentation of an infectious disease in an older adult, especially in a frail older adult or in the oldest old (≥80 years), may differ from other adults. In addition to differences in immune response, there are significant differences in anatomy, physiology, biochemistry, mental status, living conditions, and behavior that affect susceptibility, course of disease, presentation, severity, and treatment. This is the second of a series of reviews that examine differences in disease presentation for different demographics. This short review will look at some of the parameters that ask, “How are older adults different than other adults for infections?”
Double Vision and Light Sensitivity Symptoms are Associated With Return-to-School Timing After Pediatric Concussion
Authors: Schmitz Baylie , Smulligan Katherine L. , Wingerson Mathew J. , Walker Gregory A. , Wilson Julie C. , Howell David R.
Published: November 2022

Objective:

To determine the association between academic time loss postconcussion and vision symptoms/impairments among pediatric patients.

Design:

Cross-sectional.

Setting:

Sports medicine clinic.

Patients:

Pediatric patients seen for care in a sports medicine clinic between the ages 6 and 18 years (n = 212; mean age = 14.3, SD = 2.4 years; 48% female) were evaluated within 21 days of concussion (mean = 9.8, SD = 5.7 days).

Independent Variable:

Patients were grouped based on academic time loss (missed >5 days vs ≤5 days of school) at their initial postconcussion evaluation.

Outcome Measures:

Patients rated concussion symptoms using the Health and Behavior Inventory (HBI) and underwent near point of convergence (NPC) testing. We compared groups on specific HBI symptom ratings of dizziness, blurry vision, seeing double, and light sensitivity, as well as NPC break and recovery point distances.

Results:

Two hundred twelve patients were included; n = 36 (17%) who reported missing >5 days of school. After adjusting for time since injury, parental education level, mechanism of injury, and preinjury anxiety, patients who reported missing >5 days of school had higher ratings of double vision (β = 0.27; 95% confidence interval [CI], 0.01-0.53; P = 0.04) and light sensitivity (β = 0.506; 95% CI, 0.061-0.951; P = 0.02), but not dizziness (β = 0.390; 95% CI, −0.047 to 0.827; P = 0.08) or blurry vision (β = 0.026; 95% CI, −0.352 to 0.404; P = 0.89).

Conclusion:

Missing >5 days of school was associated with worse double vision and light sensitivity symptoms. Given the importance of vision in learning, assessing postconcussion vision symptoms may facilitate a successful return to school. Clinicians should assess a wide spectrum of vision-specific symptoms to ensure appropriate support during the return-to-school process.
Single-port versus multi-port totally extraperitoneal (TEP) inguinal hernia repair: A meta-analysis of randomized controlled trials
Authors: Prassas Dimitrios , Rolfs Thomas Marten , Vaghiri Sascha , Kounnamas Aristodemos , Knoefel Wolfram Trudo , Krieg Andreas
Published: November 2022

Background:

The value of single-port totally extraperitoneal inguinal hernia repair (STEP) when compared to the conventional multi-port approach (TEP) is still a matter of controversy. We conducted a meta-analysis of randomized controlled trials comparing the feasibility and safety of the above-mentioned techniques.

Methods:

A systematic literature search for randomized controlled trials (RCTs) comparing the outcome STEP and TEP in patients with inguinal hernia was conducted. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The Odds Ratio and Standardized Mean Differences with 95% Confidence Intervals (CI) were calculated.

Results:

Six RCTs were identified, involving a total of 636 cases (STEP: n = 328, TEP: n = 308). There was a statistically significant difference noted between the 2 groups regarding return to everyday activities favoring the STEP group (SMD = −0.23; 95% CI [−0.41, −0.06]; P = .01; 4 studies; I
2 = 9). For the remaining primary and secondary endpoints, intra- and postoperative morbidity, conversion rate, peritoneal tears, major intraoperative bleeding, postoperative haematoseroma, operative time, postoperative pain, chronic pain, cosmetic satisfaction, hernia recurrence and in-hospital length of stay no statistically significant difference was noted between the 2 study groups.

Conclusions:

Current evidence suggests that patients who underwent STEP had similar outcomes to the traditional TEP technique with the exception of time to return to everyday activities, which was reported to be shorter in the STEP group.
The effect of AT1R-1166A/C and AT2R-1675A/G polymorphisms on susceptibility to preeclampsia: A systematic review and meta-analysis
Authors: Quan Yi , Liu Ping , Zhang Long , Guo Junliang
Published: November 2022

Background:

The aim of this meta-analysis is to investigate the association between Angiotensin II type 1 receptor (AT1R)-1166A/C, Angiotensin II type 2 receptor (AT2R)-1675A/G polymorphisms and susceptibility to preeclampsia (PE).

Methods:

Online databases, including Web of Science, PubMed, EMBASE, CINAHL, CENTRAL, Scopus, Lilacs/SciELO, and Chinese National Knowledge Infrastructure, China Wan Fang, China Science and Technology Journal Database, were used to perform the literature search up to April 2022. The odds ratio (OR) and 95% confidence interval (CI) were used as effect size. The data was analyzed by Stata 15.0 software.

Results:

According to the inclusion and exclusion criteria, a total of 22 case-control studies were identified, including 3524 cases and 6308 controls. Our meta-analysis showed that the AT1R -1166 A/C allele was significantly associated with susceptibility to PE (A vs C: OR = 0.82, 95% CI: 0.69-0.96, P = .013), and there was significant difference in recessive gene model (AA vs AC + CC: OR = 0.81, 95% CI: 0.67-0.97, P = .021). However, no association was found between AT2R-1675A/G polymorphism and susceptibility to PE.

Conclusion:

our meta-analysis suggested that AT1R-1166A/C polymorphism had an association with susceptibility to PE, but AT2R-1675A/G polymorphism had no association with susceptibility to PE.
Is elevated triglyceride/high-density lipoprotein cholesterol ratio associated with poor prognosis of coronary heart disease? A meta-analysis of prospective studies
Authors: Guan Chun-Li , Liu Hong-Tao , Chen Dong-Hui , Quan Xiao-Qing , Gao Wei-Liang , Duan Xue-Yan
Published: November 2022

Background:

Elevated triglycerides (TG) and reduced high-density lipoprotein cholesterol (HDL-C) are recognized as essential and independent hazard factors for total death and major adverse cardiovascular events (MACE) in patients with coronary heart disease (CHD). However, whether the increased TG/HDL-C forecasted the prognosis of CHD is still unknown. Therefore, we performed a meta-analysis to investigate the relationship between the elevated TG/HDL-C ratio and poor prognosis of CHD.

Methods:

A systematic literature search was conducted in PubMed, Web of Science, EMBASE, and The Cochrane Library, until August 30, 2021. Prospective observational studies regarding the association between TG/HDL-C and long-term mortality/MACEs in CHD patients were included.

Results:

In total, 6 independent prospective studies of 10,222 participants with CHD were enrolled in the systematic and meta-analysis. Our outcomes of the meta-analysis indicated that the elevated TG/HDL-C group had a significantly increased risk of long-term all-cause mortality (hazard ratio [HR] = 2.92, 95% confidence interval [CI]: 1.75–4.86, P < .05) and long-term MACEs (HR = 1.56, 95%CI 1.11–2.18, P < .05).

Conclusion:

In patients with CHD, the present study showed that the high TG/HDL-C was associated with increased risk of long-term all-cause mortality and MACE.
Mycoplasma hominis and Ureaplasma urealyticum infections after knee arthroplasty: A case report
Authors: Luo Jingjing , Wu Xinan , Gang Xue , Zhang Nana , Wang Feifei , Rong Chengting
Published: November 2022

Rationale:

Artificial joint infection caused by Mycoplasma hominis and Ureaplasma urealyticum is rare and has not been reported.

Patients concerns:

A 59-year-old man underwent left total knee arthroplasty for 1 year of pain in the left knee joint. The indwelling urinary catheter was removed after 48 hour of the surgery. On day 8 after the surgery, the patient had fever, increased skin temperature, swelling and redness around the surgical site, and floating patella test (+). According to experience, Vancomycin, Ciprofloxacin and Linezolid were administrated. Evident decrease in C-reactive protein was observed after Linezolid administration, while there was no significant improvement in clinical symptoms. Microbiome sequencing was performed, resulting in diagnosis of positive M hominis and U urealyticum. The patient was then treated with Doxycycline in the following 3 months. During the 11-month outpatient follow-up, there was no evidence of recurrence of infection.

Diagnosis:

Microbiome sequencing was performed, resulting in diagnosis of positive M hominis and Ureaplasma urealyticum.

Interventions:

The patient recovered following with Doxycycline in the following 3 months.

Outcomes:

During the 11-month outpatient follow-up, there was no evidence of recurrence of infection.

Lessons:

M hominis and U urealyticum are common pathogens of the urinary system infections but they are rare in osteoarticular infections. In cases of fever, swelling and heat pain around the surgical site, joint fluid, negative blood culture and being irresponsive to anti-bacterial agents against the cell wall, special bacteria-related infection should be highly suspected.
The association between metabolic equivalent and visceral adiposity index among children and adolescents: Ten-cycle cross-sectional study on NHANES (1999–2018)
Authors: Zhang Yangming , Sun Qian , Dong Bowen , Liu Shuting
Published: November 2022

Metabolic disorder is globally prevalent in children and adolescents, and physical activity may have a protective role against metabolic disorder. However, the association between metabolic equivalent (MET) and visceral adiposity index (VAI) among children and adolescents remains unclear. This study aimed to address this concern. Data were retrieved from the National Health and Nutrition Examination Survey (NHANES), which used the Global Physical Activity Questionnaire to assess the physical activity levels. VAI was calculated according to body mass index (BMI), waist circumference (WC), triglyceride (TG), and high-density lipoprotein (HDL). Linear regression was adopted to assess the association between MET and VAI. Restricted cubic spline regression was used to further explore the nonlinear relationship, Interaction effect analysis was conducted to identify whether the sample characteristic could modify the effect of MET on VAI. After data cleansing, a total of 3402 participants aged <18 years were enrolled. In the fully adjusted linear regression model, the β for VAI was 0.01 (95% confidence interval [CI]: −0.08, 0.09) for the second tertile and −0.11 (95% CI: −0.20, −0.03) for the third tertile. A linear downward trend was found in the restricted cubic spline regression (overall P < .05). Interaction effect analysis revealed no significant effects of age, gender, race, income poverty ratio, and insurance (all P for interaction >0.05). High physical activity intensity is associated with decreased VAI scores in children and adolescents.
The efficacy, effectiveness, and safety of Kyung-ok-ko: A narrative review
Authors: Kim Ji-Woo , Geum Ji-Hye , Ha Won-Bae , Woo Hyeon-Jun , Han Yun-Hee , Park Shin-Hyeok , Lee Jung-Han
Published: November 2022

Kyung-ok-ko (KOK), a traditional medicinal formula in East Asia, has been recently studied across various fields. However, comprehensive reviews of clinical applications of KOK targeting clinical and experimental studies are lacking. Therefore, the application of KOK is being limited to the range of tonic medicines. To overcome this limitation, we aim to investigate the effectiveness, mechanism, and safety of KOK to obtain evidence regarding its effects in clinical applications. We searched for clinical and experimental articles in 11 databases (PubMed, Cochrane Library, Excerpta Medica dataBASE, China National Knowledge Infrastructure, Google Scholar, Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, Koreanstudies Information Service System, Korean Medical Database, DBpia, and ScienceON). We selected 54 studies based on the inclusion criteria. Three clinical studies used KOK for a consumptive disease and health promotion. Fifty-one experimental studies reported the antioxidant activity, neuroprotective activity, anticancer effect, anti-inflammatory activity, immunological activity, growth promotion, impacts on cardiovascular system diseases, gastrointestinal system diseases, respiratory system diseases, and metabolic bone disease, hepatoprotective function, and antifatigue function of KOK, which were considered effective and safe in consumptive, chronic, metabolic, inflammatory, and immune diseases. We identified the effectiveness of KOK in the treatment of a wide range of diseases. However, further clinical studies are warranted in the future.
Paxlovid administration in elderly patient with COVID-19 caused by Omicron BA.2.0: A case report
Authors: Zhang Liulu , Zhang Shasha , Han Jing , Yi Yile , Zhou Hourong , Li Jianquan
Published: November 2022

Rationale:

Paxlovid has shown the potential decreasing the hospitalization rate of mild or moderate coronavirus disease 2019 (COVID-19) and death in few of clinical trials, and is expected to the most promising medicine targeting Severe Acute Respiratory Syndrome Coronavirus 2 (SRAS-COV-2). However, there are no enough evidences to show it effectiveness for all patients with SARS-COV-2, especially among elderly patients and newest Omicron variant.

Patient concerns and diagnosis:

A 79 year’s old female patient was admitted to hospital because of the moderate COVID-19 caused by the Omicron variant BA2.0. He presented the initial syndromes including Xerostomia, cough and fever. Chest computed tomography (CT) scanning at admission showed the exudation lesions on lung. The laboratory examination revealed that there are increased C-reactive protein (CRP), Ferritin and erythrocytesedimentationrate (ESR) and decreased white blood cells.

Interventions:

The oral Paxlovid (Nirmatrelvir/Ritonavir) was administrated on second day after admission.

Outcomes:

The syndromes of Xerostomia, cough and fever was improved on third day after use of Paxlovid. The levels of CRP, ESR and counts of white blood cells returned the normal after three days of admission. The chest CT scanned on the third and sixth day after Paxlovid used showed the absorption of lesions. The examination of SARS-COVS viral nucleic acid turned negative at fifth day of admission.

Lessons:

As a result, we would consider that Paxlovid is a suitable oral drug for elderly patients with SARS-COV2 even Omicron variant, it’s benefit to improve patient’s symptom and signs and can prevents COVID-19 with the high-risk factors from severe disease, although it didn’t shorten the time for viral nucleic acid to turn negative.
Prevalence of undiagnosed hepatitis B virus infection in patients with COVID-19A single center retrospective study
Authors: Săndulescu Oana , Streinu-Cercel Anca , Miron Victor Daniel , Apostolescu Cătălin Gabriel , Nițescu Maria , Drăgănescu Anca Cristina , Streinu-Cercel Adrian ,   on behalf of ESCMID Study Group for Viral Hepatitis (ESGVH)
Published: November 2022

At its onset, the coronavirus disease 2019 (COVID-19) pandemic brought significant challenges to healthcare systems, changing the focus of medical care on acute illness. Disruptions in medical service provision have impacted the field of viral hepatitis, with screening programs paused throughout much of 2020 and 2021. We performed a retrospective study on consecutive outpatients with COVID-19 during the second and third wave of COVID-19 in Romania, from November 2020 to April 2021, aiming to characterize the prevalence of undiagnosed hepatitis B virus (HBV) infection among patients presenting with acute illness. Overall, 522 patients had available records during the study timespan. Their mean ± standard deviation age was 51 ± 13 years; 274 (52.5%) were male. We identified 16 (3.1%) cases of active HBV infection; only six of these patients were aware of their HBV status, and 3 of the newly diagnosed cases were identified as candidates for HBV treatment. A total of 96 patients (18.4%) had serological markers suggestive for prior HBV vaccination. A large proportion of patients (n = 120, 23.0%) had positive HBV core antibodies; among these, 90 (17.2%) had cleared a previous HBV infection (being positive for HBV surface antibodies and HBV core antibodies). We identified the following parameters that were significantly more frequent in patients with a history of HBV infection: older age (P < .001), hypoalbuminemia (P = .015), thrombocytopenia (P < .001), thrombocytopenia followed by thrombocytosis (P = .041), increased blood urea nitrogen (P < .001) and increased creatinine (P = .011). In conclusion, the COVID-19 pandemic has taught us essential lessons about the importance of maintaining access to screening programs and of ensuring active monitoring of patients with chronic infections such as hepatitis B, even during a medical crisis.