bluuebunny/crossref_metadata_2025 huggingface dataset:
Discrete-Time Stochastic Processes
Authors: Berber Stevan
Published: September 2021

Chapter 3 focuses on the theory of discrete-time-stochastic processes, including their mathematical presentation in time and frequency domains. Typical discrete processes, including the Gaussian process, white noise and binary and harmonic processes, are presented. A comprehensive analysis of discrete-time stationary and ergodic processes and linear-time-invariant (LTI) systems with discrete stochastic inputs is presented. The processes are analysed in terms of their autocorrelation functions and power spectral densities that are related by the Wiener–Khintchine theorem. This chapter is placed at the beginning of the book because its content is a prerequisite for the chapters that follow, in particular, the chapter related to the theory of discrete communication systems. The unique notation used in this chapter will be used in the rest of the book. For readers of the book, it is highly advisable to read this chapter first and acquire its notation.
Transforms of Deterministic Continuous-Time Signals
Authors: Berber Stevan
Published: September 2021

Chapter 12 presents a detailed analysis of continuous-time signals and systems in the frequency domain, including the theory of Fourier series and Fourier transforms, and key examples relevant for the analysis and synthesis of signals processed in the digital transceiver blocks of a communication system. The amplitude, magnitude, phase, and power spectra are defined and calculated for typical signals. In particular, the Fourier transform of periodic signals is presented, due to its importance in communication systems theory and practice. Using a unique notation that distinguishes energy and power signals, the correlation, power, and energy spectral density functions are inter-related by proving the Wiener–Khintchine theorem. A comprehensive analysis of a linear-time-invariant system, using the concepts of impulse response, system correlation function, and power spectral density, both for power signals and energy signals, is presented. In addition, Parseval’s theorem and the Rayleigh theorem are proven.
Deriving VOS from VSO in Tongan
Authors: Polinsky Maria , Potsdam Eric
Published: September 2021

Research on word order has established several possible ways in which VOS order can be derived from VSO order. This chapter considers the derivational relationship between VSO and VOS in the Polynesian language Tongan. VSO order is basic in Tongan, and we address the derivation of VOS from this basic order in the context of multiple possibilities. We argue that Tongan VOS is better analyzed as rightward displacement of the subject as opposed to leftward displacement of the object proposed by Otsuka (2005a,c). The clause-final subject shows many of the hallmarks of rightward movement, including information-structural restrictions, locality with respect to the matrix clause, lack of clitic doubling, and connectivity with respect to case and binding. Given that rightward movement has an uneasy place in syntactic theory, we take pains to establish that the analysis is successful and worth further scrutiny.
Causative morphology as Voice-driven allomorphy
Authors: Hopperdietzel Jens
Published: September 2021

Recent syntactic approaches to event structure differ in whether causative semantics are introduced by a designated syntactic head (e.g. v
caus; Pylkkänen 2008; Harley 2017) or is interpreted configurationally (Ramchand 2008; Alexiadou et al. 2015; Wood & Marantz 2017). The examination of the morphosyntactic properties of Samoan faʻa-causatives reveals a ‘bundling paradox’ in that faʻa- appears to introduce an agent role while co-occuring with Voice morphology—a pattern which is not predicted by Caus0-approaches (Harley 2017). Instead, this chapter develops an account that analyzes causative morphology like faʻa- as the bi-directionally spell-out of the verbalizer v which is sensitive to the presence of Voice in bi-eventive configurations (cf. Embick 2010). Therefore, this chapter not only provides a first syntactic investigation of faʻa-causatives in Samoan, but also adds a new cross-linguistic perspective to the ongoing discussion of causatives at the syntax-semantics interface.
Farming in Modern Irish Literature
Authors: Grene Nicholas
Published: September 2021

This innovative study analyzes the range of representation of farming in Irish literature in the period since independence/partition in 1922, as Ireland moved from a largely agricultural to a developed urban society. In many different forms, poetry, drama, fiction, and autobiography, writers have made literary capital by looking back at their rural backgrounds, even where those may be a generation back. The first five chapters examine some of the key themes: the impact of inheritance on family, in the patriarchal system where there could only be one male heir; the struggles for survival in the poorest regions of the West of Ireland; the uses of childhood farming memories whether idyllic or traumatic; the representation of communities, challenging the homogeneous idealizing images of the Literary Revival; the impact of modernization on successive generations into the twenty-first century. The final three chapters are devoted to three major writers in whose work farming is central: Patrick Kavanagh, the small farmer who had to find an individual voice to express his own unique experience; John McGahern in whose fiction the life of the farm is always posited as alternative to an arid and rootless urban milieu; Seamus Heaney who re-imagined his farming childhood in so many different modes throughout his career.
Childhood memories
Authors: Grene Nicholas
Published: September 2021

Farming childhoods may be recalled, as in John Montague’s poems as a first formative world, or a historically foundational landscape in Polly Devlin’s memoir. Maura Laverty remembered an (imagined) childhood on a farm with her beloved grandmother, while Alice Taylor’s popular Through the Fields to School makes an idyll of her recollections. But equally there are traumatic memories of farmhood violence in the poetry of Jane Clarke or of sexual abuse in the family home, as in Claire Keegan’s short story ‘The Parting Gift’. The childhood farm milieu can also be a place of estrangement in Keegan’s novella Foster, and of alienation in Edna O’Brien’s The Country Girls.
Services vs. Hardware?
Authors: Garcia Calvo Angela
Published: September 2021

This chapter examines Spain’s and Korea’s upgrading strategies from the perspective of the telecommunications services and telecommunications equipment sector (henceforth information and communications technologies or ICT). The chapter emphasizes the link between the identities and preferences of Spain’s and Korea’s governments and characterizes two types of governments: generalists and techno-industrial. The two types of governments are connected to public preferences for upgrading in complex services and manufacturing respectively. The chapter consists of five sections. Following the chapter’s introduction, section 4.2 describes the forces shaping the transformation of the ICT industry in the 1980s and situates Spain’s and Korea’s firms. Sections 4.3 and 4.4 connect the characteristics of Spain’s and Korea’s generalist and techno-industrial governments to the two countries upgrading patterns. Section 4.5 sets the two outcomes in comparative perspective, concludes, and prepares the stage for the next chapter.
The Argument Extended
Authors: Garcia Calvo Angela
Published: September 2021

This chapter presents a more general view of the book’s argument. It uses mini-cases to explore additional aspects of Spain’s and Korea’s strategies. It also relies on a short, counterfactual comparison with Brazil to discuss three factors that enabled these countries to succeed where other late industrializing economies failed. In the case of Spain, the chapter underscores the role of path dependence. It also shows that although the characteristics of a national economy shaped upgrading strategies they did not determine them and alternative options leading to different productive structures were indeed possible. In the case of Korea, the chapter highlights the systemic aspects of upgrading strategies and the synergies derived from that country’s particular approach. The chapter consists of five sections. Following the introduction, sections 6.2 and 6.3 flesh out additional details of Spain’s and Korea’s experiences. Section 6.4 compares Spain’s and Korea’s experiences with Brazil’s. Section 6.5 concludes with a summary of the role of coordination in Spain’s and Korea’s upgrading.
Introduction
Authors: Easterling Joshua S.
Published: September 2021

The introduction brings together the various intellectual formations which structure the book and which constellate within the anchoritic and para-anchoritic writings explored throughout each chapter. It discusses alongside Paul’s images of the body of Christ and the spiritual charismata (1 Cor. 12) the emphases within late medieval orthodox culture on the authority of reformed and (sexually) purified church elites. Those priorities enlisted the apostolic conception of Christ’s body and marginalized alternative conceptions of spiritual grace, particularly those implied within the Pauline model of the charisms. The cultural and textual negotiations that this rivalry elicited anchor the book’s central contentions regarding the angelic image and the spiritual gifts, which powerfully structured late medieval religious life. These images also operated within anchoritic texts as an immensely flexible shorthand for the intersecting but also rival ideals of corporate and hierarchical authority, on the one hand, and personal inspiration and charisma, on the other.
The Arrival of Angels
Authors: Easterling Joshua S.
Published: September 2021

Chapter 1 traces the images of angels and sacred embodiment as these emerge within the culture of eleventh- and twelfth-century reforms and underwrite its suspicion (and ultimate rejection) of popular charismatics. In an unrecognized irony, reformers’ model of a sexually purified and angelic priesthood came to require both persistent defense and the unholy specter of demonic transfiguration (2 Cor. 11:14) as the countervailing threat to clerical authority and its narratives of spiritual power. The anxieties informing the several cultural transitions underway throughout the twelfth century were accordingly projected onto holy men and women, including anchorites, whose spirituality was often assumed to be in competition with that authority and potentially out of alignment with orthodox culture generally. Through forms of imitatio clerici/angeli, a subject to which later chapters will return, anchorites not only resembled their (at times unreformed) clerical counterparts but even outstripped them in charismatic power.
Charismatic Anchorites and the Making of Truth
Authors: Easterling Joshua S.
Published: September 2021

This chapter examines twelfth-century Cistercian writings as a record of contemporary unease with both popular spiritual currents and the putative corruptions of lay society in its influence on anchoritic life. In this context, John of Ford’s vita of the English anchorite Wulfric of Haselbury (d. 1154) articulates monastic emphases on virtue over charismatic graces. In relating Wulfric’s visions, the vita positions Christ’s sacramental body at the center of his spirituality, supporting as well ecclesiastical hostility toward twelfth-century apostolic movements and their potentially heterodox outgrowth. John, like other Cistercians, assumes strong affinities between vision and visitation, which in turn depended both on the various forms of angelic visitation (clerical, monastic, and celestial) and on elites’ interest in the specific content of anchoritic visions. Such writings overcome any rigid distinction between angels and clerics, angels and anchorites, and the charismatics of whom orthodox elites approved and those of whom they did not.
The Transformation of Perfection
Authors: Easterling Joshua S.
Published: September 2021

Chapter 5 argues that the spiritual experiences of late medieval holy women, in particular their doubts about the Eucharist and their own salvation, were in many respects responses to orthodox figurations of sacred embodiment and the pollution fears that were repeatedly projected onto women. In this context, this chapter examines the Scale of Perfection, a work composed by the English writer Walter Hilton (d. 1394) who manages a set of ongoing contests over rival notions of perfection. Following a growing insistence among orthodox writers on Eucharistic devotion, the Scale subsumes the spiritual legitimacy of charismatic women to the sacrament and does so in a way that marginalizes the devotion of such women to their angels. It is also within the Scale and other late medieval religious writing that the prominent and intersecting ideals of perfection, the virtues, and sacred embodiment came to express a deepening suspicion of angelic charisms.
Rural and Agrarian Transformation 1984–2018 in Three Marginal Villages in Njombe Region, Tanzania
Authors: Friis-Hansen Esbern
Published: September 2021

When the author of this chapter first visited the region he encountered a place that was characterized by very high levels of poverty. These villages had not been able to benefit from state investment in maize production. However, changes in agricultural production, migration of people outside the area, and remittances, and in particular the explosion of tree farming, tomatoes, and potatoes in a relatively rich area, combined with infrastructural improvements, have been transformative. Change here has been driven by a mutually interlinked set of processes entailing agricultural transformation involving changing farming and rural transformation in a changing rural economy. This is visible in changes to asset ownership as well as relational and social well-being.
‘Authentic’ Documents
Authors: Graumann Thomas
Published: September 2021

This chapter demonstrates that the documents used on various occasions can for the most part be identified as originals, and sometimes as authenticated copies. The secretaries acting in the councils regularly point out relevant document features they can observe that allow them to determine this status. Chief among such features is the identification of signatures or of distinct annotations made in a person’s ‘own hand’. Such features, originally visible to practitioners in the councils and discernible on the original documents, are replaced in subsequent manuscript copying by the identification of ‘a different hand’ in the exemplar, which the copyist observed and noted. Annotations in the hand of the emperor are especially significant; they serve as authoritative instructions and prompt the councils into corresponding action.
Documents Incorporated–Incorporating Documents
Authors: Graumann Thomas
Published: September 2021

This chapter analyses the importance of including documents of originally distinct origin for the construction of a session’s record. It discusses the annotations affixed to documents in the process for their certain identification. It analyses the orders given by council leaders for the acceptance, reading, and filing of documents and their effects on the shape of the record. The council leadership also determines the exact order and placement of documents; our investigation can show that principles of social hierarchy govern such placing as much as the sequence of ‘recitation’ or use. Deliberate arrangement of documents serves to lay out an—often implicit—argument for the case made in the session. In later councils this practice increasingly dominates over ‘live’ speech-acts. The chapter can in this way also show the complex relationship between orality and writing, and the possibilities of editorial composition.
Collecting and Appending Signatures
Authors: Graumann Thomas
Published: September 2021

The collection of the bishops’ signatures marks the final step in the written formalization of the councils’ decisions. As performative statements, the formulae used to subscribe express and enact the bishops’ individual and collective verdicts. Collection of signatures can start at the end of the session already, and routinely continues over the course of several days or even weeks. The chapter demonstrates that sheets containing signatures were often originally physically separate from the session’s as yet unfinished protocol. Signatures, thus, must not be mistaken, the chapter demonstrates, for the verification of the record as a record. Separate collection of signatures and their later physical affixture to the roll containing the protocol can be illuminated from papyrological contexts as well as internal evidence. The practice in particular provides the background for evaluating the accusations of using ‘blank sheets’ wielded against Dioscorus at Ephesus II.
Council Acts Gathered and Organized
Authors: Graumann Thomas
Published: September 2021

The protocols of individual sessions are gathered into larger units by the council’s secretaries, bringing together the records of several sessions. A frequent (but not the only) form of textual organization is the gathering of case files. The case of Eutyches’ trial allows the reconstruction of the material shape of the relevant file and the cohesion of separate minutes in one physical document. Internal textual signals for cross-referencing and interlacing such units are uncovered that support and expand these observations. The case of Cyril of Alexandria at Ephesus I singularly shows directly the president’s own initiative to have a record combining physically the minutes of a number of sessions made.
Ancillary Documentation and the Beginnings of Dossierization
Authors: Graumann Thomas
Published: September 2021

This chapter examines the creation and collection of further documentation in and by the councils, such as letters, reports, memoranda, and petitions, directed to the imperial authorities, to bishops absent or to monastic leaders and often especially to the pope. They in turn elicited further texts, for instance of government responses. The assemblage of such texts into dossiers, in which the session-records are only one, albeit decisive, component, can be shown to begin occasionally with the council secretariats and during the conciliar period already, but regularly continues after the formal termination of the councils and in different locations. The sending, in particular, of select conciliar documentation together with pertaining cover letters results in collections of materials differently shaped in the archives of different senders and recipients.
Conclusion
Authors: Graumann Thomas
Published: September 2021

The ivory diptych of Rufius Probianus (Berlin, Staatsbibliothek, Ms. theol. lat. fol. 323) celebrates his installation as vicarius urbis Romae, the position of chief administrator of the southern Italian provinces. It can be dated to around AD 400 (with scholarly suggestions ranging from 396 to 416),...
Iceland: Political Change and Coalition Politics
Authors: Indridason Indridi H. , Kristinsson Gunnar Helgi
Published: September 2021

The chapter surveys coalition formation and coalition governance in Iceland since the 1990s. Coalition politics have been altered in a significant manner during this time period with many of the changes coinciding with the economic crash of 2008. Up to the crises, coalition governance followed a fairly predictable pattern but increased electoral volatility and decline in party cohesion complicated the formation of stable two-party coalitions. In response to these developments, governments have sought to improve coalitions management and coordination within the cabinet, which represents a shift from the ministerial model of government that has characterized Icelandic coalitions since the founding of the republic.
Norway: Towards a More Permissive Coalitional Order
Authors: Stavenes Torill , Strøm kaare W.
Published: September 2021

Consensus, collegiality, and compromise still characterize Norwegian coalition governance, but important shifts in the formation, composition, and operation of Norwegian coalitions have taken place since the 1990s. An increasingly permissive Norwegian parliamentarism has facilitated the entry of previously non-coalitionable parties, such as the Socialist Left Party and the Progress Party, into government coalitions in 2005 and 2013, respectively. Also, small parties have begun to punch well above their weight in the allocation of ministerial portfolios, as in the case of the Liberal Party in 2001, which with only two MPs negotiated three cabinet seats. The chapter further demonstrates how Norwegian coalitions increasingly have appointed so-called cross-partisan junior ministers, mainly to provide cross-partisan advice, but also to be watchdogs for their respective parties. Finally, the use of the so-called cabinet sub-committee, normally comprising the leaders of each of the coalition parties, escalated in the 2000s. This sub-committee was designed to solve the most serious inter-party conflicts and became an important vehicle of conflict resolution under prime ministers Bondevik and Stoltenberg.
Global Application of Intersectionality Theory
Authors: Bond Johanna
Published: September 2021

This chapter delves into examples of global intersectionality to illustrate the need for a thorough and consistent intersectional approach to human rights violations around the world. Although it is impossible to provide an exhaustive analysis of the many and varied types of intersectional human rights violations, this chapter offers multiple examples of intersectional human rights violations, including (1) gender-based violence, including both non-state actors who commit intimate partner violence and sexual violence in armed conflict; (2) maternal mortality and inadequate prenatal care in Brazil; (3) coerced sterilization among the Roma in Europe; (4) disproportionate discipline and punishment of Black girls in the United States; and (5) inconsistent LGBTQI rights. These case studies implicate different human rights, including the right to be free from violence, the right to education, and the right to the highest attainable standard of health. Each example demonstrates how a more nuanced, intersectional lens is necessary to capture the rights at stake and to contemplate appropriate remedies for victims of human rights violations in full.
Conclusion: An Intersectional Future for Human Rights
Authors: Bond Johanna
Published: September 2021

Intersectionality has changed the way we think about human rights. It offers a complex, comprehensive, and nuanced approach that redounds to the benefit of victims seeking redress. It allows victims to articulate the multiple and intersecting forms of subordination that have negatively affected their lives. Intersectionality rejects the anemic and siloed approach to human rights that invariably fails to capture and remedy the complex, intersectional violations that characterize the lived experience of subordination for many people. Intersectionality has positively influenced human rights discourse ranging from the UN human rights treaty bodies to local human rights organizations that have incorporated the theory into their organizational missions. The theory is gaining ground in international human rights discourse, and it will continue to transform and expand our vision of appropriate remedies for human rights violations. Only by more accurately conceiving of intersectional human rights violations can we hope to provide meaningful and comprehensive remedies to those who have experienced violations of their rights.
Patterns of Probability
Authors: Elliott Andrew C. A.
Published: September 2021

Randomness has more than one face. Different kinds of randomness (different distributions) answer different questions about uncertainty: not just ‘what are the chances?’ but also ‘how many are expected?’ and ‘how long is a waiting time between events?’ It covers the uses and ubiquity of the normal distribution and the possible pitfalls of using it. In addition to this, this chapter explores the fit between models and reality.
What Luck!
Authors: Elliott Andrew C. A.
Published: September 2021

Who is the luckiest person in the world? What do we mean by ‘luck’? Luck is usually treated as something persistent, a quality that attaches to people, places or objects. We feel that luck should be balanced, that the wheel of fortune should always rotate to balance things out, but it doesn’t. Fate is a powerful and related idea that destiny pre-ordains the course of our lives. Fortune-telling techniques purport to get a glimpse of fate and to see hidden truths. Somewhat paradoxically, most kinds of divination make use of random methods. The paradox of fairness is explained. It seems, though, that what distinguishes self-described lucky people from those who consider themselves unlucky is a question of attitude, of how one interprets the chance events that have filled our lives.
What’s There to Worry About?
Authors: Elliott Andrew C. A.
Published: September 2021

The chapter opens with a personal reflection on the Covid-19 virus as a snapshot written in February 2020, and an interpretation of these reflections in light of the themes of this book. While the risks of a novel virus may be hard to quantify, many of the issues that make us worry are well understood, and can be measured, but how can they be presented in ways that are easy to understand? Unnatural deaths cause concern that is disproportionate to the true risks. The risks of death while travelling have diminished considerably over recent decades, while death due to deliberate violence represents a very small proportion of all deaths.
Mixing it Up
Authors: Elliott Andrew C. A.
Published: September 2021

Mozart’s musical dice game is one example of how musicians and other artists have incorporated aleatoric elements into their work. Jazz improvisation means every performance is different. Cage left space for the environment to make its own music, but Xenakis took a mathematician’s understanding of randomness and created avant-garde compositions that use the orchestra in new ways. Generative techniques use random numbers to provide new music and other kinds of art on demand. Blocked creativity can be freed by deliberate injections of spontaneity.
A Chance to Live
Authors: Elliott Andrew C. A.
Published: September 2021

This chapter explores the role of randomness in genetics and evolution. We are each a blend of genetic determinism and chance. Through the process of meiosis, genetic material from father and mother are shuffled through recombination to provide the DNA for new individuals, each of whom is unique, but who nonetheless retain links to their genetic heritage. Some probabilistic aspects of evolution are explored: how does a process fuelled by chance nonetheless result in viable organisms? What are the chances of us being here, now?
Sharing the Risk
Authors: Elliott Andrew C. A.
Published: September 2021

Insurance makes use of the law of large numbers to mitigate the effects of risks on individuals by allowing them to be shared collectively. Early insurance arrangements arose as friendly societies and mutual insurance companies. Marine insurance has a long history and remains a major insurance market. Fire insurance provides compensation in the face of a capricious and frightening risk, but also invites fraudulent claims. Increasing amounts of information provide challenges for insurance underwriting: can there be too much information? The principle of insurance is that of averaging out of independent risks, but when risks are not independent, as may be the case when it comes to climate change, is there still any role for insurance?
Expressive meaning across linguistic levels and frameworks
Authors: Trotzke Andreas , Villalba Xavier
Published: September 2021

This chapter summarizes recent work on expressive meaning within a variety of linguistic frameworks and concludes that linguistic research on the formal means of expressing emotions is still understudied across different linguistic complexity levels. Based on this thematic introduction, the chapter provides an overview of the present volume, highlighting common concepts and ideas of the individual chapters, but also stressing important differences in how expressive meaning is investigated.
On classifiers and affect in the nominal domain
Authors: Corver Norbert
Published: September 2021

This chapter presents six case studies on the encoding of affective-expressive information in the Dutch nominal domain. Each affective phenomenon that is discussed, displays a formal property that, from a surface perspective, could be qualified as ‘disorganizing.’ It is proposed that disorganization is only apparent and that the affective-expressive nominal expression has an organized structure that falls within the variation space as defined by UG. It is the different formal organization, compared to the organization of nominal expressions with descriptive contents, which yields ‘the feel of disorganization.’ The availability of different grammatical routes provided by UG allows the language user to use her language for distinct communicative functions, including the expression of one’s affective feelings. It is proposed that the Classifier Projection plays an important role in the manifestation of those routes.
Mirative implicatures at the syntax-semantics interface
Authors: Cruschina Silvio , Bianchi Valentina
Published: September 2021

This chapter investigates the mirative implicature that is associated with two distinct Romance constructions: Mirative Focus Fronting (MFF) and Doubly Inflection Construction (DIC). Despite the distinct level at which the mirative meaning is syntactically encoded in the two constructions, the mirative import displays consistent properties. Both in MFF and in DIC, this meaning can be captured as a conventional implicature about the falsity of the at-issue proposition in the most normal worlds. The modal parameters that are required to interpret the implicature are anchored to the world and time of utterance and to the conversational community; hence, this mirative implicature is not exclusively anchored to the speaker’s perspective, but it also involves the interlocutor(s) in the attempt to arrive at a joint evaluative commitment.
Human Rights Conflicts and the Creation of Corporate Responsibility Collaborations
Authors: George Erika
Published: September 2021

This chapter provides comparative accounts of the creation of industry sector–specific regulatory instruments and governance institutions arising from allegations of corporate complicity in human rights abuses after conflicts with concerned constituencies and affected communities. The selected case studies demonstrate that there are consequences for conduct inconsistent with social expectations for business. The chapter considers cases originating in emerging market economies and complex operating environments, comparing the advocacy strategies of human rights activists and corporate responses. Cases studied include: the controversial role of transnational corporations in the internet communications technology sector in censorship and surveillance practices and the risks presented to the right to freedom of expression and the right to privacy; the relationship of transnational corporations in the pharmaceutical sector to human rights and the risks presented to the right to health and the right to life when access to essential medicines is compromised; and the relationship of transnational corporations in the extractives sector to human rights and the risks presented to human security when extractive sector companies contract with security forces that abuse violent force and use deadly force to silence dissent. The chapter explains how conflicts over corporate complicity in alleged abuses served to catalyze the creation of the different industry-specific multistakeholder initiatives, including: the Global Network Initiative, a private multistakeholder project to promote more responsible business practices; the Accelerating Access Initiative, a global public-private partnership to increase access to affordable medicines and create change; and the Voluntary Principles on Security, a tripartite multistakeholder initiative to address security and human rights. This chapter will show that crisis appears to serve as a catalyst for change.
The Effect of Preoperative Nutritional Intervention for Adult Spinal Deformity Patients
Authors: Oe Shin , Watanabe Jun , Akai Tatsuya , Makino Tomomi , Ito Midori , Yamato Yu , Hasegawa Tomohiko , Yoshida Go , Banno Tomohiro , Arima Hideyuki , Mihara Yuki , Ushirozako Hiroki , Yamada Tomohiro , Ide Koichiro , Watanabe Yuh , Kurosu Kenta , Nakai Keiichi , Matsuyama Yukihiro
Published: September 2021

Study Design.

A prospective nutritional intervention study for adult spinal deformity (ASD) patients.

Objective.

To investigate how a nutritional intervention affects the incidence of postoperative medical complications and the nutritional status.

Summary of Background Data.

The medical complication rate in ASD surgery is very high, and one risk factor is malnutrition. Nutritional intervention may improve the patient's nutritional status and reduce risk, but this is unexplored regarding ASD surgery.

Methods.

Malnourished patients (i.e., a prognostic nutritional index [PNI] score of <50) scheduled for surgery after November 2018 (Group I) received nutritional intervention consisting of nutritional guidance and supplements on the surgery day. The medical complication rates between Group I and Group NI (malnourished patients who underwent surgery between January 2014 and October 2018; historical controls) were evaluated. The nutritional status courses of Group I and Group NI2 (patients who did not participate in nutritional intervention after November 2018) were assessed.

Results.

Group I had 24 patients in (mean age, 70 yr), and Group NI had 69 patients (mean age, 68 yr). The mean intervention duration was 41 days. The preoperative PNI score did not differ between the groups, but there was a significant difference in medical complications incidences (Group I: 25%; Group NI: 53.6%; P = 0.015). The nutritional status significantly deteriorated in Group I (PNI: 47–45; P = 0.011) and Group NI2 (61 patients; mean age, 68 yr; PNI: 52–48; P = 0.000), but the PNI changes were significantly smaller in Group I (ΔPNI: Group I: −1.9, Group NI 2: −3.5; P = 0.027).

Conclusion.

Nutritional intervention with guidance and supplements reduced postoperative medical complications in malnourished patients. The nutritional status of ASD patients requiring surgery also naturally worsened, suggesting that ASD may contribute to malnutrition. Nutritional intervention may reduce the nutritional status deterioration.

Level of Evidence: 3
Immunization With RANKL Inhibits Osteolytic Bone Metastasis in Breast Cancer
Authors: Kim Bora , Cho Yong Jin , Park Mineon , Lim Wonbong
Published: September 2021

Breast cancer cells often metastasize to bone. Accumulating evidence suggests that inhibiting the receptor activator of nuclear factor-κB ligand (RANKL) not only leads to reduced bone metastasis of breast cancer but also has antitumoral effects. Here, we used mutant receptor activator of nuclear factor-κB ligand (RANKLM) as a vaccine for active immunization to induce antibodies for immunotherapy of bone metastatic cancer. We investigated whether anti-RANKL antibodies inhibit osteolytic bone metastasis in vitro and in a murine model. MC3T3 cells stimulated by MDA-MB-231 culture medium secreted growth differentiation factor-15 (GDF-15), which induced the nuclear factor-κB signaling cascade. In addition, RANKLM treatment-induced reduction of intraosseous growth of MDA-MB-231 cells correlated with decreased GDF-15 expression, a reduced number of osteolytic lesions, and slower tumor progression. In addition, vaccination with RANKLM led to significant improvement in overall survival and skeletal metastasis in tumor-bearing mice. Induction of anti-RANKL antibodies by RANKLM decreased GDF-15 production by deactivating nuclear factor-κB signaling, which in turn inhibited metastasis of MDA-MB-231 cells to bone. Taken together, the results demonstrate a role for RANKLM immunization in preventing bone metastasis of breast cancer.
Update on ophthalmic manifestations of systemic lupus erythematosus: pathogenesis and precision medicine
Authors: Lee Iris , Zickuhr Lisa , Hassman Lynn
Published: September 2021

Purpose of review

Systemic lupus erythematosus (SLE) is an autoimmune disease with manifestations in multiple organs including the eyes. Several ocular manifestations like dry eye, retinopathy, and choroidopathy have been linked with specific systemic manifestations like lupus nephritis or CNS disease. Furthermore, the presence of ocular manifesattions can correlated with the severity of SLE. Finally, some medications used in the treatment of uveitis can present with lupus-like disease. Therefore, communication between the ophthalmologist and rheumatologist is vital.

Recent findings

Ocular and systemic manifestations of SLE can be linked by common pathological processes including immune complex deposition, complement fixation, and vascular injury. Recent research correlating ophthalmic imaging with SLE disease has yielded heterogeneous results likely due to the clinical heterogeneity of SLE, but molecular technologies have and will continue to yield contributions to the emergence of new therapeutics for the treatment of SLE.

Ocular manifestations are prevalent in patients with SLE. The association with certain manifestations and other disease manifestations highlights the importance of collaboration between the ophthalmologist and rheumatologist. Additional research utilizing clinico-molecular techniques will likely continue to improve our knowledge in the treatment of SLE in the future.
IMT504 blocks allodynia in rats with spared nerve injury by promoting the migration of mesenchymal stem cells and by favoring an anti-inflammatory milieu at the injured nerve
Authors: Casadei Mailín , Fiore Esteban , Rubione Julia , Domínguez Luciana María , Coronel María Florencia , Leiguarda Candelaria , García Mariana , Mazzolini Guillermo , Villar Marcelo J. , Montaner Alejandro , Constandil Luis , Romero-Sandoval E. Alfonso , Brumovsky Pablo R.
Published: September 2021

IMT504, a noncoding, non-CpG oligodeoxynucleotide, modulates pain-like behavior in rats undergoing peripheral nerve injury, through mechanisms that remain poorly characterized. Here, we chose the spared nerve injury model in rats to analyze the contribution of mesenchymal stem cells (MSCs) in the mechanisms of action of IMT504. We show that a single subcutaneous administration of IMT504 reverses mechanical and cold allodynia for at least 5 weeks posttreatment. This event correlated with long-lasting increases in the percentage of MSCs in peripheral blood and injured sciatic nerves, in a process seemingly influenced by modifications in the CXCL12-CXCR4 axis. Also, injured nerves presented with reduced tumor necrosis factor-α and interleukin-1β and increased transforming growth factor-β1 and interleukin-10 protein levels. In vitro analysis of IMT504-pretreated rat or human MSCs revealed internalized oligodeoxynucleotide and confirmed its promigratory effects. Moreover, IMT504-pretreatment induced transcript expression of Tgf-β1 and Il-10 in MSCs; the increase in Il-10 becoming more robust after exposure to injured nerves. Ex vivo exposure of injured nerves to IMT504-pretreated MSCs confirmed the proinflammatory to anti-inflammatory switch observed in vivo. Interestingly, the sole exposure of injured nerves to IMT504 also resulted in downregulated Tnf-α and Il-1β transcripts. Altogether, we reveal for the first time a direct association between the antiallodynic actions of IMT504, its promigratory and cytokine secretion modulating effects on MSCs, and further anti-inflammatory actions at injured nerves. The recapitulation of key outcomes in human MSCs supports the translational potential of IMT504 as a novel treatment for neuropathic pain with a unique mechanism of action involving the regulation of neuroimmune interactions.
Who are the placebo responders? A cross-sectional cohort study for psychological determinants
Authors: Wang Yang , Chan Esther , Dorsey Susan G. , Campbell Claudia M. , Colloca Luana
Published: September 2021

A number of studies have demonstrated substantial individual differences in placebo effects. We aimed to identify individual psychological factors that potentially predicted the magnitude of placebo hypoalgesia and individual responsiveness. The Research Domain Criteria framework and a classical conditioning with suggestions paradigm were adopted as experimental models to study placebo phenotypes in a cohort of 397 chronic pain participants with a primary diagnosis of temporomandibular disorder (TMD) and 397 healthy control (HC) participants. The magnitude of placebo hypoalgesia was operationalized as the average difference in pain ratings between the placebo and control conditions. The individual placebo responsiveness was identified as the status of placebo responders and nonresponders based on a permutation test. We observed significant placebo effects in both TMD and HC participants. A greater level of emotional distress was a significant predictor of smaller magnitude (slope b = −0.07) and slower extinction rate (slope b = 0.51) of placebo effects in both TMD and HC participants. Greater reward seeking was linked to greater postconditioning expectations (ie, reinforced expectations) in TMD (slope b = 0.16), but there was no such a prediction in HC participants. These findings highlight that negative valence systems might play a role in impairing placebo effects, with a larger impact in chronic pain participants than in healthy participants, suggesting that individuals reporting emotional distress and maladaptive cognitive appraisals of pain may benefit less from placebo effects.
Canadian surveillance study of complex regional pain syndrome in children
Authors: Baerg Krista , Tupper Susan M. , Chu Luan Manh , Cooke Nicole , Dick Bruce D. , Doré-Bergeron Marie-Joëlle , Findlay Sheri , Ingelmo Pablo M. , Lamontagne Christine , Mesaroli Giulia , Oberlander Tim F. , Poolacherla Raju , Spencer Adam Oscar , Stinson Jennifer , Finley G. Allen
Published: September 2021

This study describes the minimum incidence of pediatric complex regional pain syndrome (CRPS), clinical features, and treatments recommended by pediatricians and pain clinics in Canada. Participants in the Canadian Paediatric Surveillance Program reported new cases of CRPS aged 2 to 18 years monthly and completed a detailed case reporting questionnaire from September 2017 to August 2019. Descriptive analysis was completed, and the annual incidence of CRPS by sex and age groupings was estimated. A total of 198 cases were reported to the Canadian Paediatric Surveillance Program, and 168 (84.8%) met the case definition. The minimum Canadian incidence of CRPS is estimated at 1.14/100,000 (95% confidence interval 0.93-1.35/100,000) children per year. Incidence was highest among girls 12 years and older (3.10, 95% confidence interval 2.76-3.44/100,000). The mean age of CRPS diagnosis was 12.2 years (SD = 2.4), with the mean time from symptom onset to diagnosis of 5.6 months (SD = 9.9) and no known inciting event for 19.6% of cases. Most cases had lower limb involvement (79.8%). Nonsteroidal anti-inflammatory drugs (82.7%) and acetaminophen (66.0%) were prescribed more commonly than antiepileptic drugs (52.3%) and antidepressants (32.0%). Referrals most commonly included physical therapy (83.3%) and multidisciplinary pain clinics (72.6%); a small number of patients withdrew from treatment because of pain exacerbation (5.3%). Pain education was recommended for only 65.6% of cases. Treatment variability highlights the need for empiric data to support treatment of pediatric CRPS and development of treatment consensus guidelines.
Reporting Medical Device Events
Authors: Zhuang Chen , Kuo Jonathan Y.
Published: September 2021

The Food and Drug Administration (FDA) is responsible for protecting public health by regulating medical devices, radiation-emitting electronic devices, drugs, biologics, food, tobacco, and cosmetics. After a product reaches the market, the Agency continues to evaluate a product's safety by monitoring adverse events. FDA's Center for Devices and Radiological Health facilitates reporting of medical device events and complaints by manufacturers, importers, healthcare facilities, and the general public to help FDA identify potential safety signals and/or improve medical device performance. FDA has established 2 reporting mechanisms (1) reporting through the public MedWatch system and (2) direct user facility collaboration via the MedSun program.
Alternatives for Measuring Sitting Accumulation in Workplace Surveys
Authors: Clark Bronwyn K. , Stephens Samantha K. , Goode Ana D. , Healy Genevieve N. , Winkler Elisabeth A.H.
Published: September 2021

Objectives:

To develop and assess the measurement properties of self-report measures of accumulation of sitting time.

Methods:

Seven candidate measures were collected in 51 workers from three office environments (79% women) via online questionnaire administered immediately before and after 7-day monitoring periods (activPAL3 24-hour protocol with diary recorded work hours).

Results:

Three measures had some validity (P < 0.05 vs activPAL): % of sitting in long bouts more than or equal to 30 minutes, sitting strategy frequency (0 to 100), and interruption rate (n/h sitting). Agreement was limited. Some reliability (intraclass correlation or kappa P < 0.05) was seen for these measures, strategy variety (0 to 100), typical day (five categories), and making a conscious effort to sit less (yes/no).

Conclusions:

Two brief and one longer option may suit workplace studies requiring self-report measures of sitting accumulation. Validity was weaker for sitting accumulation than sitting time.
Head Roll-Tilt Subjective Visual Vertical Test in the Diagnosis of Persistent Postural-Perceptual Dizziness
Authors: Yagi Chihiro , Morita Yuka , Kitazawa Meiko , Nonomura Yoriko , Yamagishi Tatsuya , Ohshima Shinsuke , Izumi Shuji , Takahashi Kuniyuki , Wada Yoshiro , Kitahara Tadashi , Horii Arata
Published: September 2021

Objective:

To examine the validity of head roll-tilt subjective visual vertical (HT-SVV) in diagnosing persistent postural-perceptual dizziness (PPPD).

Study Design:

Retrospective review.

Setting:

Tertiary referral center.

Patients:

Sixty-one patients with PPPD, 10 with unilateral vestibular hypofunction (UVH), and 11 with psychogenic dizziness (PD), showing chronic vestibular symptoms for >3 months.

Interventions:

Head-tilt perception gain (HTPG, i.e., mean perceptual gain [perceived/actual tilt angle]) during right or left head tilt of approximately 30° (HT-SVV) and conventional head-upright SVV (UP-SVV) were measured. Bithermal caloric testing, cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP), and posturography were conducted.

Main Outcome Measures:

Multiple comparisons were performed for the HT-SVV and other vestibular tests among the disease groups. A receiver operating characteristic curve was created to predict PPPD using HTPG.

Results:

HTPG was significantly greater in the PPPD group than in the UVH and PD groups. There were no significant differences in UP-SVV, cVEMP, oVEMP, and posturography (foam ratio and Romberg ratio on foam) among the disease groups, while the UVH group had the highest canal paresis compared to the other two groups. The area under the curve of the receiver operating characteristic curve for predicting PPPD was 0.764, and the HTPG value of 1.202 had a specificity of 95.2% for diagnosing PPPD.

Conclusions:

While conventional vestibular tests including UP-SVV, VEMPs, and posturography did not show abnormalities in PPPD, high HTPG in the HT-SVV test, an excessive perception of head tilt, can be a specific marker for discriminating PPPD from other chronic vestibular diseases.