bluuebunny/crossref_metadata_2025 huggingface dataset:
China and the Asian World, 1500–1900
Authors: Mosca Matthew W.
Published: November 2018

China’s relations with the Asian world between 1500 and 1900 were shaped by a variety of political, economic, and cultural factors. A common denominator in these international relationships was a loose framework of ideological principles and administrative procedures later dubbed by scholars the “tributary system.” This “system,” first posited in the early 1940s, has remained the single most influential concept for interpreting the interactions of Ming and Qing China with Asian countries. However, in recent decades it has been critiqued from various perspectives, narrowed in the scope of its application, and modified by a greater focus on the actual course of specific cases rather than ideological principles. That is, historians have increasingly come to understand China’s relations with the Asian world as influenced by pragmatic considerations and changing local dynamics, so that each relationship and the factors shaping it are best understood on their own terms. One approach to the study of Ming and Qing relations with the Asian world is to consider it within the framework of three regional groupings. China’s interactions with its neighbors in Northeast Asia were shaped by its largely stable relations with Korea and the Ryukyu Kingdom, and its radically fluctuating relations with Japan, sometimes marked by conflict and sometimes by the deliberate avoidance of political contact. Early Ming political relations with maritime Southeast Asia atrophied as the role of European and private Chinese merchant intermediaries increased. Those with continental Southeast Asia (particularly Burma, Siam, and Vietnam), more enduring, were influenced by intense regional rivalries that occasionally impinged on the borderlands of China’s southern provinces. In these two regions, the Ming–Qing transition, although particularly resented in Korea where it involved two invasions, did not radically alter existing patterns of international relations. By contrast, the vast territorial expansion of the Qing Empire did greatly change China’s foreign relations to the north and west, where it encountered states that had not had relations with the Ming. In these regions the Qing government drew principles and practices from its foreign relations in the south and east, but modified them to fit new conditions. After 1800, and more intensively after 1850, European and later Japanese imperial power began to penetrate Central, South, Southeast, and ultimately East Asia, in each region undermining existing Qing relationships with Asian neighbors. By 1900, virtually all former Qing tributaries were under the direct or indirect control of the British, Russian, French, or Japanese empires.
Ethics and Security
Authors: Papamichail Andreas , Lang Anthony F.
Published: November 2018

The concept of security is central to the study of international relations (IR), yet it remains heavily contested, both in theory and in practice. In part, this is because the concept contains intractable tensions and contradictions. Nevertheless, or perhaps as a result of this, security—if understood as a state of being that is a function of war and peace—has been the subject of ethical reflection for millennia. Greco-Roman, Judeo-Christian, and Islamic traditions, among others, all have their own conceptions of how war and violence ought to be addressed. One of the more prominent ideas drawn from these debates is the concept of the just war, which emerged from the Christian tradition. It became an influential source of critical reflection upon both legal and practical dilemmas in international security, informing a wide range of debates around the world, and it has persisted at the heart of the field of Security Studies that emerged post-World War II. However, in the last couple of decades of the 20th century, changing notions of legitimate authority and broadened conceptions of conditions that cause harm and insecurity led to challenges to state-centrism and war-centrism in Security Studies. Issues such as global health security, counterterrorism, and humanitarian intervention have demonstrated the inherent tensions within security practices and demand novel ethical engagement. Approaching the issue of security from the perspective of international political theory (IPT) allows us to probe the ethical dimensions of security and ask how justice, authority, and security are linked and with what consequences.
Information Technologies and the Global Political Economy
Authors: Hart Jeffrey A.
Published: November 2018

Information and communications technologies (ICTs) constitute a potentially transformative force in world politics. The industries associated with these technologies are growing rapidly, and some have argued that their importance in the overall economy at both the national and global levels increased in recent decades. ICT industries include both goods producers and service providers. ICT manufacturing includes all the goods-producing industries that use semiconductor components, such as consumer electronics, the computer industry, the telecommunications equipment industry, and industrial and military electronics. Within each of these groups, there are sub-industries that specialize in particular segments of the market. The services side of ICTs is also very large in terms of revenues and employment, and is growing rapidly. ICT services include, among others, the software industry, telecommunications services, data processing, and web-based information services. Many scholars argue that the importance of ICT industries goes beyond the revenues and employment generated in the industries themselves, however. ICTs may also be transformative in that they reduce transaction and communications costs in the overall economy. They make possible new forms of organization of human activity, especially as globalization and digitalization is progressing rapidly in the recent decades. Such processes have attracted the attention of international relations scholars, as they have been focusing on international regimes governing ICT-related activities in the past decade.
LGBTI Human Rights in Global Politics
Authors: Ayoub Phillip M.
Published: November 2018

Transnational organizing by groups dedicated to promoting the rights of lesbian, gay, bisexual, transgender, and intersex (LGBTI) people is not a particularly new phenomenon, though it remained rare in the early decades of the 20th century. It was not until the advent of the sexual liberation movement in the late 1960s and early 1970s that LGBTI issues became more prominent. Moreover, despite their diversity, these transnational groups and networks have been able to speak with an increasingly unified voice, setting out a relatively coherent vision for global LGBTI human rights organizing. Over the past three decades, transnational LGBTI human rights activists have become increasingly successful in getting their voices heard and demands met within prominent international organizations such as the European Union and the United Nations. This success, however, has varied dramatically across international organizations and among the states they represent. Perhaps not surprisingly, given the Western origins and biases of transnational LGBTI movements and human rights principles, as well as the greater levels of tolerance toward homosexuality in the region, LGBTI rights organizations have had their greatest successes in Europe. Generally speaking, however, there has been a significant expansion of LGBTI rights over the past 30 years, even if it has come with a notable backlash and resistance. Yet despite these dramatic developments, the study of LGBTI politics has remained peripheral to most fields within the discipline of political science. This is slowly changing thanks to a proliferation of scholarship, including bridge-building work and an empirical turn, that is moving LGBTI research slightly closer to the center of the field.
Civil Wars, Scientific Study of
Authors: Salehyan Idean , Thyne Clayton L.
Published: November 2018

Civil war is an armed conflict between the state and another organized domestic party over a contested political incompatibility, which results in a number of casualties exceeding a certain threshold for both parties. Attempts to operationalize these criteria have produced many data sets, which conceptualize civil war as distinct from one-sided violence, organized crime, and communal fighting. Civil wars are devastating for states experiencing them, their neighbors, and the entire global community. Combatant and civilian deaths, rape, massive refugee flight, negative impacts on economy and infrastructure, spread of infectious diseases, global spread of illegal narcotics, and the promotion of terrorism are all consequences of civil wars. Theories explaining why civil wars occur focus on objectives of the rebels, ability of rebels to successfully challenge the government, influence of external actors on interactions between the government and the opposition, external financing of potential rebel groups, and impact of a state’s neighbors on the likelihood of civil conflict or how neighboring conflicts and refugee communities serve as breeding grounds for cross-border rebel movements. Conflicts persist until neither side believes that it can achieve unilateral victory and continued fighting is costly. Governments are more likely to win early when they have large armies, but time to government victory increases when they are faced with secessionist rebels and when external parties are involved. Meanwhile, external mediation diminishes informational and credible commitment problems during bargaining and reduces conflict duration. Promising directions for future research on civil war include geographic disaggregation, survey research, and computational/agent-based modeling.
Governance in Classical Islamic Thought
Authors: Anjum Ovamir
Published: November 2018

Governance in Islamic history has taken many different forms. The formative period saw most innovative deployment of the Arab tribal norms under the guidance of Islamic norms and the pressure of the rapid expansion. After the conquests, the ruling elite augmented their Arab tribal form of governance with numerous institutions and practices from the surrounding empires, particularly the Persian empire. The Umayyads ruled as Arab chiefs, whereas the Abbasids ruled as Persian emperors. Local influences further asserted themselves in governance after the Abbasids weakened and as Islamization took root. After the fragmentation of the Abbasid empire by the ah 4th century/10th century ce, a distinctively Islamic society emerged whose regional rulers upheld its law and institutions such as land-grants (iqṭāʿ), taxation (kharāj and jizya), education (legal madhhab, jāmiʿ and madrasah), and judiciary (qaḍāh). A triangle of governmental authority was established, with the caliph as the source of legitimacy, symbol of community unity, and leader of religious rites; the sultan as the territorial king who maintained the army and monopoly over violence; and the scholars (ulama’) as socioreligious leaders of their respective communities. The caliph or the sultan appointed the local qāḍīs from among the ulama’, who served not only as judges and mediators but also as moral guides and administers of endowments and jurisconsults and counselors, and thus played a key role in the self-governance of classical Islamic societies.
Place and Spirituality in the Pacific Northwest
Authors: Duntley Madeline
Published: November 2018

The challenges and benefits of the Pacific Northwest’s rugged but scenic terrain have received ample treatment in studies of religiosity in this region. The interplay of place and spirituality was first chronicled in detailed case studies of Christian missions and missionaries, rural and urban immigrants, and histories of the various Native American tribal groups of the Northwest Coast and Inland Empire. Currently, the focus is on trends unique to this region, such as interdenominational and interfaith ecumenicity in environmental and social justice campaigns, earth-based spiritual activism and conservation, emergent “nature spirituality,” the rise of religious non-affiliation (the so-called religious “nones”), and indigenous revitalization movements. Recent interest in cultural geography has produced several general works seeking to define the Pacific Northwest aesthetic and regional ethos, especially as depicted in the so-called “Northwest Schools” in art, architecture, and literature. Because the Cascade Mountain range bisects the Pacific Northwest into two radically different climate zones, literature on spirituality in the region often follows this natural topography and limits its locative lens to either the coastal zone (including the area stretching from Seattle to Southern Oregon) or the Inland Empire (the more arid zone east of the mountains from Spokane to Eastern Oregon). When the Pacific Northwest region is referred to more broadly as “Cascadia,” it includes Washington, Oregon, Idaho, northernmost California and Canada’s British Columbia.
Intellectuals and the Nation in Early 20th-Century Brazil
Authors: Miceli Sergio
Published: November 2018

In Brazil between 1920 and 1945, the potential for professional advancement increased significantly among literate individuals in three main areas: the intellectual and academic field in São Paulo and the emergence of a university-based intelligentsia; the boom in the publishing industry and the rise of professional novelists; and the Vargas regime’s widespread and deliberate co-optation of intellectuals. The interpretation presented in this article links class dynamics to changes within the activities of intellectuals, some of whom are analyzed here in the context of political and institutional tensions produced by the collapse of the oligarchic Old Republic (1889–1930).
Cover Crops Enhance Natural Enemies While Help Suppressing Pests in a Tea Plantation
Authors: Chen Li-Lin , Yuan Pei , You Min-Sheng , Pozsgai Gabor , Ma Xu , Zhu Huaiping , Yang Guang
Published: November 2018

Tea is an economically important crop, consumed by billions of people. Despite the increasing market for pesticide-free products, the use of pesticide in tea is still high. In order to investigate whether intercropping promotes biological control organisms, Chamaecrista rotundifolia (Pers.) Greene, Indigofera hendecaphylla Jacq., Trifolium repens L., and Vigna sinensis (L.) were separately intercropped with free weeding as control in a tea plantation at Yangli, China. Arthropods were collected by taking sweep-net samples, and treatment effects on assemblages were investigated. The combined species richness of all arthropods and that of parasitoids was significantly increased in intercropped treatments while the species richness of herbivores and predators was only greater in C. rotundifolia and I. hendecaphylla intercropped treatments. Compared with control, the combined abundance of all arthropods, and that of herbivores was lower, while the abundance of parasitoids and its taxa was greater in all intercropped treatments. The abundance of predators and its taxa was greater only in tea plantations intercropped with C. rotundifolia or I. hendecaphylla. Of the herbivores, the abundance of Empoasca onukii Matsuda, Sternorrhyncha, Aleyrodidae, and Pentatomidae was greater in the areas intercropped with C. rotundifolia in comparison with the control, but the abundance of Thysanoptera and Geometridae caterpillars was lower. The recorded increase in the abundance of beneficial arthropods may explain the lower abundance of Thysanoptera or Geometridae caterpillars detected in the intercropped tea plantations. Our results indicate that intercropping has the potential to enhance arthropod biodiversity, and to provide an option for sustainable pest control in tea plantations.
Older HIV+ and HIV− Adults Provide Similar Definitions of Successful Aging: A Mixed-Methods Examination
Authors: Fazeli Pariya L , Montoya Jessica L , McDavid Chastity N , Moore David J
Published: November 2018

Background and Objective

As HIV-infected (HIV+) individuals age, there is a need to understand successful aging (SA) from the patient perspective. This study compared SA definitions between HIV+ and HIV-uninfected (HIV−) older adults and then examined correlates of SA categories.

Research Design and Methods

Ninety-three HIV+ and 46 HIV− older (aged 50+) adults provided brief definitions of SA, which was examined using content analysis. We then compared the frequency of SA categories by serostatus and examined the correlates of SA categories within both groups.

Results

Seven SA categories emerged: General Health, Cognitive Health & Ability, Physical/Biological Health & Ability, Social Relationships, Attitudes, Psychological, & Emotional Well-Being, Proactive & Engaged Lifestyle, and Independence. While no significant differences emerged, HIV− older adults were more likely to report General Health and the subcategory of Longevity/Survival, while HIV+ older adults were more likely to report subcategories of Enjoying Life & Fulfillment and Maintaining Balance. Few demographic correlates of SA categories emerged. Mood and HIV characteristics were not associated with SA categories. In both groups, those without neurocognitive impairment were significantly more likely to endorse General Health than those with neurocognitive impairment.

Discussion and Implications

HIV+ and HIV− older individuals may generally perceive SA similarly, and their definitions parallel with existing models of SA. Yet, living with a chronic illness may cause HIV+ older adults to place greater value on quality of life and life satisfaction than physical health and chronological age. Observational and intervention studies may use similar approaches in evaluating and maximizing SA.
The Predictors of and Motivations for Increased Family Involvement in Nursing Homes
Authors: Roberts Amy Restorick , Ishler Karen J , Adams Kathryn Betts
Published: November 2018

Background and Objectives

Quantitative and qualitative data from a statewide survey of family members of nursing home residents were analyzed to determine the predictors of, and motivations for, family involvement.

Research Design and Methods

We examined 3 types of involvement: visiting, providing personal care, and family–staff communication. Our mixed methods approach used (a) multilevel regression models to examine predictors of family involvement, including family member perceptions and resident, family member, and facility characteristics, and (b) a thematic analysis of qualitative data regarding the experiences of family members and their motivations for involvement.

Results

Families were more involved when a short-term stay (<3 months) was expected, and when residents were in poorer physical condition. Spouses and female family members were more involved than others, yet the effect of gender varied by relationship type. At the facility level, families of residents in rural facilities reported less family involvement. Aside from these commonalities, predictors of each type of involvement varied. Themes from the qualitative data identify unique motivations for each type of involvement—to enhance residents’ identity, care, or quality of life.

Discussion

Families visit more and provide more hands-on assistance when they are not confident in the care being provided or the well-being and stability of their resident loved one. Receiving adequate information, perceiving staff as friendly, and residents as looking well cared for promote greater family–staff communication.

Implications

Findings can inform strategies to increase meaningful family involvement in nursing homes.
Measurement of ambient neutrons in an underground laboratory at the Kamioka Observatory
Authors: Mizukoshi Keita , Taishaku Ryosuke , Hosokawa Keishi , Kobayashi Kazuyoshi , Miuchi Kentaro , Naka Tatsuhiro , Takeda Atsushi , Tanaka Masashi , Wada Yoshiki , Yorita Kohei , Yoshida Sei
Published: November 2018

Ambient neutrons are one of the most serious backgrounds for underground experiments searching for rare events. The ambient neutron flux in an underground laboratory at the Kamioka Observatory was measured using a $\mathrm{^3He}$ proportional counter with various moderator setups. Since the detector response largely depends on the spectral shape, the energy spectra of the neutrons transported from the rock to the laboratory were estimated by Monte Carlo simulations. The ratio of the thermal neutron flux to the total neutron flux was found to depend on the thermalizing efficiency of the rock. Therefore, the ratio of the count rate without a moderator to that with a moderator was used to determine this parameter. Consequently, the most likely neutron spectrum predicted by the simulations for the parameters determined by the experimental results was obtained. The result suggests an interesting spectral shape, which has not been indicated in previous studies. The total ambient neutron flux is $(23.5 \pm 0.7 \ \mathrm{_{stat.}} ^{+1.9}_{-2.1} \ \mathrm{_{sys.}}) \times 10^{-6}$ cm$^{-2}$ s$^{-1}$. This result, especially the energy spectrum information, could be a new and important input for estimating the background in current and future experiments in the underground laboratory at the Kamioka Observatory.
TheraBracelet Stimulation During Task-Practice Therapy to Improve Upper Extremity Function After Stroke: A Pilot Randomized Controlled Study
Authors: Seo Na J , Woodbury Michelle L , Bonilha Leonardo , Ramakrishnan Viswanathan , Kautz Steven A , Downey Ryan J , Dellenbach Blair H S , Lauer Abigail W , Roark Caroline M , Landers Lauren E , Phillips Sarah K , Vatinno Amanda A
Published: November 2018

Background

Peripheral sensory stimulation has been used in conjunction with upper extremity movement therapy to increase therapy-induced motor gains in patients with stroke. The limitation is that existing sensory stimulation methods typically interfere with natural hand tasks and thus are administered prior to therapy, requiring patients’ time commitment. To address this limitation, we developed TheraBracelet. This novel stimulation method provides subthreshold (ie, imperceptible) vibratory stimulation to the wrist and can be used during hand tasks/therapy without interfering with natural hand tasks.

Objective

The objective was to determine the feasibility of using TheraBracelet during therapy to augment motor recovery after stroke.

Design

The design was a triple-blinded pilot randomized controlled trial.

Methods

Twelve chronic stroke survivors were assigned to the treatment or control group. All participants completed 2-hour task practice therapy sessions thrice weekly for 2 weeks. Both groups wore a small vibrator on the paretic wrist, which was turned on to provide TheraBracelet stimulation for the treatment group and turned off for the control group to provide sham stimulation. Outcome measures (Box and Block Test [BBT] and Wolf Motor Function Test [WMFT]) were obtained at baseline, 6 days after therapy, and at follow-up 19 days after therapy.

Results

The intervention was feasible with no adverse events. The treatment group significantly improved their BBT scores after therapy and at follow-up compared with baseline, whereas the control group did not. For WMFT, the group × time interaction was short of achieving significance. Large effect sizes were obtained (BBT d = 1.43, WMFT d = 0.87). No indication of desensitization to TheraBracelet stimulation was observed.

Limitations

The limitation was a small sample size.

Conclusions

TheraBracelet could be a promising therapy adjuvant for upper extremity recovery after stroke.
Pre- and post-weaning injections of bovine somatotropin to optimize puberty achievement of Bos indicus beef heifers1
Authors: Moriel Philipe , Cappellozza Bruno Ieda , Piccolo Matheus B , Cooke Reinaldo F , Miranda Miguel F , Batista Luis F D , Carvalho Rafael S , Colombo Eduardo A , Santili Felipe V , Filho Ramiro V O , Ferreira Vitor S M , Vasconcelos Jose L M
Published: November 2018

The present study evaluated the growth and puberty attainment of Bos indicus heifers administered recombinant bovine somatotropin (bST) or saline injections during preweaning and/or postweaning. On day 0, 177 suckling Nellore heifers were stratified by initial age and body weight (BW) (80 ± 10 d; 97 ± 16 kg), and randomly assigned, in a 2 × 2 factorial design (n = 44 to 45 heifers/treatment), to receive s.c. injections of saline (5 mL 0.9% NaCl) or sometribove zinc (Posilac; Elanco, Greenfield, IN; 6.14 mg/kg of BW0.75) on days 0 and 10 (PRE) and/or days 167 and 177 (POS). All heifers were managed as a single group in Brachiaria decumbens pastures from day 0 until 24 d postweaning (day 191), and then provided a corn silage–based TMR from days 191 to 380 to achieve 65% to 70% of mature BW at the end of the study (day 380). Heifer full BW was collected on days 0, 10, 167, 177, and monthly from days 191 to 380. Transrectal ultrasonography of ovaries was performed on days 1 and 10 of each month from days 229 to 380 to assess the percentage of pubertal heifers. Liver biopsies and blood samples from jugular vein were collected on days 0, 10, 167, 177, and 380. Additional blood samples were collected monthly from days 259 to 380 (n = 10 to 15 heifers/treatment). No interactions among day of the study, PRE, and POS injections of saline or bST were detected (P ≥ 0.11). Preweaning bST injections increased heifer average daily gain (ADG) from days 0 to 10 and plasma IGF-1 on day 10 (P ≤ 0.03), did not affect ADG from days 0 to 177, plasma IGF-1 from days 259 to 380, and any liver gene mRNA expression (P ≥ 0.19), but tended to decrease ADG from days 191 to 380 (P = 0.07) and percentage of pubertal heifers on days 349 (P = 0.07), 359 (P = 0.002), and 380 (P = 0.0001) compared with saline injections. Postweaning bST injections increased plasma IGF-1 on day 177 and overall liver mRNA expression of GHR-1A (P ≤ 0.05), decreased plasma IGF-1 from days 259 to 380 (P = 0.03), tended to decrease liver mRNA expression of GHR-1B on day 177 (P = 0.08), but did not affect ADG from days 167 to 177 and 191 to 380, and puberty attainment from days 229 to 380 (P ≥ 0.12) compared with saline injections. Thus, preweaning and postweaning injections of bST successfully increased heifer plasma IGF-1 concentrations 10 d after first injection. Postweaning injections of bST had no impact on puberty attainment, whereas preweaning bST injections of bST impaired puberty attainment of Nellore beef heifers.
Routine versus Selective Fortification of Human Milk with Powdered Human Milk Fortifiers in Very Low Birth Weight (VLBW) Preterm Infants: A Retrospective Pre–Post Cohort Study
Authors: Agrawal Gopal , Wazir Sanjay , Kumar Surender , Yadav Bir Singh , Balde Manish
Published: November 2018

Objectives

The objective of this study was to show the effects of routine vs. selective fortification of human milk (HM) on short-term growth and metabolic parameters.

Methods

Single-centre retrospective pre–post cohort study in India. Preterm infants ≤32 weeks’ gestation and weighing ≤1500 g were included. Routine fortification: pre-fixed feed volume (100 ml/kg/day in our unit) at which fortification was done. Selective fortification: feed volume was gradually optimized till 180–200 ml/kg/day. If weight gain was below the expected threshold (<10 g/kg/day), then fortification was considered. Primary outcome measure was rate of growth till discharge.

Results

The median rate of weight gain (g/kg/day) in the routine fortification group [10.8 (3.3, 17.1)] was comparable with that in the selective fortification group [8.4 (0, 14.2), p = 0.6]. Serum phosphorus showed a significantly higher value (5.9 vs. 4.8, p = 0.03), while rest of the metabolic parameters showed a trend towards a favourable outcome in the selective fortification group. Adverse outcomes showed a trend towards decreased feed intolerance, necrotizing enterocolitis, and sepsis in the selective fortification group.

Conclusions

Selective fortification had a comparable growth rate and showed a trend towards better metabolic parameters and lesser adverse outcomes compared with routine fortification of HM.
Impact of Bilateral Vestibulopathy on Spatial and Nonspatial Cognition: A Systematic Review
Authors: Dobbels Bieke , Peetermans Olivier , Boon Bram , Mertens Griet , Van de Heyning Paul , Van Rompaey Vincent
Published: November 2018

Objectives:

Hearing loss is considered an independent risk factor for dementia. Growing evidence in animal and human studies suggest that not only hearing loss but also vestibular loss might result in cognitive deficits. The objective of this study is to evaluate the presence of spatial and nonspatial cognitive deficits in patients with bilateral vestibulopathy. As different causes of bilateral vestibulopathy are associated with hearing loss, the objective is to evaluate if these cognitive deficits are due to the vestibular loss of the patients with bilateral vestibulopathy, or to their hearing loss, or both.

Design:

We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. (1) Data sources: MEDLINE and the Cochrane Library. (2) Study selection: Cross-sectional studies investigating cognitive performances in human patients with bilateral vestibulopathy confirmed by quantitative vestibular testing. (3) Data extraction: Independent extraction of articles by three authors using predefined data fields, including patient- and control characteristics and cognitive outcomes.

Results:

Ten studies reporting on 126 patients with bilateral vestibulopathy matched the inclusion criteria. Cognitive domains evaluated in patients with bilateral vestibulopathy included visuospatial abilities, memory, language, attention, and executive function. In only three studies, hearing performance of the included patients was briefly described. Nearly all studies demonstrated a significant impairment of spatial cognition in patients with bilateral vestibulopathy. In the few papers investigating nonspatial cognition, worse outcome was demonstrated in patients with bilateral vestibular loss performing cognitive tasks assessing attentional performance, memory, and executive function.

Conclusions:

Strong evidence exists that patients with bilateral vestibulopathy suffer from impaired spatial cognition. Recent studies even suggest impairment in other cognitive domains than spatial cognition. However, in all previous studies, conclusions on the link between cognitive performance and vestibular loss were drawn without taken hearing loss into consideration as a possible cause of the cognitive impairment.
Lifestyle behaviours and health measures of women at increased risk of breast cancer taking chemoprevention
Authors: Pegington Mary , Evans D. Gareth , Howell Anthony , Donnelly Louise S. , Wiseman Julia , Cuzick Jack M. , Harvie Michelle N.
Published: November 2018

Women at increased breast cancer (BC) risk are eligible for chemoprevention. Healthy lifestyles are potentially important for these women to improve efficacy and minimise side effects of chemoprevention and reduce the risk of BC and other lifestyle-related conditions. We investigated whether women taking chemoprevention adhere to healthy lifestyle recommendations, how their lifestyle risk factors and health measures compare to women in the general population, and whether these change whilst taking chemoprevention. Lifestyle risk factors and health measures in 136 premenopausal women taking tamoxifen for prevention of BC (Tam-Prev study) were compared to both national recommendations and an age-matched female population from the Health Survey for England 2012. The Tam-Prev population had high rates of overweight and obesity (59.2%) and low adherence to physical activity recommendations (30.6%) which were comparable to the general population (55.2 and 35.1%, respectively). Fewer Tam-Prev participants were current smokers (10.5 vs. 18.2%, P = 0.032), but more exceeded alcohol recommendations (45.0 vs. 18.7%, P < 0.001). Tam-Prev participants had suboptimal diets; proportions not meeting fibre, saturated fat and non-milk extrinsic sugar recommendations were 87.8, 64.9 and 21.4% respectively. Many Tam-Prev participants had markers of cardiovascular disease risk and the metabolic syndrome. Health behaviours did not change during the first year on tamoxifen. Women taking chemoprevention had a high prevalence of unhealthy lifestyle behaviours and health measures, similar to an age-matched English cohort. Improving these measures in women at increased BC risk could significantly decrease rates of BC and other noncommunicable diseases.
Discrimination of Anti-drug Antibodies With Neutralizing Capacity in Infliximab- and Adalimumab-Treated Patients: Comparison of the Homogeneous Mobility Shift Assay and the Affinity Capture and Elution Assay
Authors: Hock Barry D. , McKenzie Judith L. , Goddard Liping , Smith Stewart M. , McEntyre Christopher J. , Keating Paula E.
Published: November 2018

Background:

The measurement of anti-drug antibody (ADA) levels in adalimumab (ADAL)-treated and infliximab (IFX)-treated patients is critical for guiding therapeutic strategies. The homogeneous mobility shift assay (HMSA) and affinity capture elution (ACE) assay provide effective, drug-tolerant formats for measuring total ADA levels. However, their ability to discriminate between ADA from samples with or without neutralizing capacity is unclear and therefore was analyzed in this study.

Methods:

Sera from ADAL and IFX patients with low drug levels (<1 mcg/mL) were analyzed by ACE, HMSA, and bridging assay. Neutralizing capacity was determined by competitive ligand-binding assay.

Results:

HMSA and ACE detected high ADA levels in all ADAL (19/42) and IFX (27/64) samples with neutralizing capacity. ADA was also detected in most of the samples without neutralizing capacity, but levels were significantly lower (P < 0.0001). Receiver operator characteristic curve analysis demonstrated that for both assays, ADA levels were a strong discriminatory marker of neutralizing ADA (area under the curve > 0.9, P < 0.0001). Using a signal >8× background as a cut-point, neutralizing ADA could be identified with high specificity (HMSA > 95%, ACE > 85%) and sensitivity (HMSA > 70%, ACE > 80%). The detection of multimeric drug–ADA complexes after HMSA was also a highly specific marker (specificity > 95%) of neutralizing ADA in both ADAL and IFX patients. Results using ACE and HMSA were highly correlated.

Conclusions:

Results obtained after HMSA and ACE analysis are strongly correlated, and in both assays, high ADA levels are a specific marker of neutralizing capacity. The detection of multimeric complexes by HMSA also selectively identifies sera with neutralizing capacity. These data support the use of these assays as quantitative rather than simple qualitative measures of ADA.
Evaluation of Big Bubble Technique for Deep Anterior Lamellar Keratoplasty in Patients With Radial Keratotomy
Authors: Einan-Lifshitz Adi , Belkin Avner , Sorkin Nir , Mednick Zale , Boutin Tanguy , Kreimei Mohammad , Chan Clara C. , Rootman David S.
Published: November 2018

Purpose:

To report the outcome of deep anterior lamellar keratoplasty (DALK) and success rates of the big-bubble (BB) technique or manual dissection after a failed use of the BB technique in eyes that underwent prior radial keratotomy (RK).

Methods:

A retrospective chart review of patients who underwent DALK after RK at Toronto Western Hospital, Canada, between 1999 and 2017 was performed. Demographic characteristics, success rates of the BB technique and manual dissection, intraoperative and postoperative complications, and best spectacle-corrected visual acuity before and after corneal transplant were analyzed.

Results:

Ten eyes of 9 patients were included in the analysis. The average age was 64 ± 10 years (range 49–82). The average time between the RK surgery and the corneal transplant was 20 ± 5 years (range 8–24). Indications for corneal transplant were significant irregular astigmatism in 5 eyes (50%), central scarring or haze in 4 eyes (40%), and progressive hyperopia with visual fluctuation in one eye (10%). BB was successfully achieved in one eye (10%). In 6 eyes (60%), manual dissection was performed, and in 3 eyes (30%), DALK surgery was converted to penetrating keratoplasty. The average best spectacle-corrected visual acuity on the last follow-up visit was 0.26 ± 0.08 logMAR (Snellen equivalent 20/36). One eye that underwent manual DALK and one eye that underwent penetrating keratoplasty developed a rejection episode 4 and 2 months after keratoplasty, respectively. In both cases, rejection resolved with topical steroids.

Conclusions:

In eyes that underwent prior RK, DALK by manual dissection should be considered as a preferable surgical technique.
Current Characteristics of Native Valve Infective Endocarditis in Japan
Authors: Kobayashi Daiki , Kuriyama Nagato , Takahashi Osamu , Hirano Keita , Nanki Nobuki , Arioka Hiroko , Osugi Yasuhiro , Yokota Kyoko
Published: November 2018

Objectives

The aim of this study was to evaluate the characteristics of infective endocarditis (IE) over 10 years in Japan, where many elderly people are expected to develop aortic valvular diseases.

Methods

We conducted a retrospective cohort study with all IE adult patients who were admitted to St Luke's International Hospital in Tokyo, Japan, from 2003 to 2015. All patients who were clinically diagnosed with IE by infectious disease doctors were enrolled. Our primary outcomes were in-hospital all-cause mortality and an indication for valvular surgery. Secondary outcomes were the types of infected valves and causative pathogens.

Results

A total of 101 patients had IE. The mean age was 67.4 (SD, 18.3) years, and 60.4% were men. In terms of outcomes, dose-dependent trends were observed in the various age groups. The trend test for operation by age group was significant (P = 0.03), but it was not for mortality (P = 0.18), Staphylococcus aureus infection (P = 0.25), or for atrial valve infection (P = 0.17). Patients who were younger than 40 years tended to have operations more frequently than did those who were 65 years or older (odds ratio [OR], 4.89; 95% confidence interval [CI], 1.01–23.75). Those whose body mass index was 25 kg/m2 or higher (OR, 7.18; 95% CI, 1.03–50.26) and those who had diabetes (OR, 6.29; 95% CI, 1.82–21.72) were more likely to be infected by S. aureus. Those who had hypertension tended to suffer from aortic valve IE (OR, 3.36; 95% CI, 1.05–10.75).

Conclusion

Elderly patients had lower rates of surgical intervention but similar mortality to younger patients. Obesity and diabetes were risk factors for S. aureus IE, and hypertension was a risk factor for aortic valve IE.
Impact of direct-acting antivirals on leukocytic DNA telomere length in hepatitis C virus-related hepatic cirrhosis
Authors: Demerdash Hala M. , Elyamany Amany S. , Arida Emad
Published: November 2018

Background

Direct-acting antiviral (DAAs) represent advancement in the management of hepatitis C virus (HCV)-related hepatic cirrhosis. A high proportion of patients achieve a sustained virologic response; eradication of HCV is coupled with a decreased risk of hepatocellular carcinoma. Recent evidence suggests that shortening of the DNA telomere may be linked to cellular senescence as well as predisposition to malignant transformation.

Objective

This study aimed to assess pretreatment leukocytic DNA telomere length in HCV-related cirrhosis and post viral eradication using DAAs.

Patients and methods

This study included 24 patients with HCV-related cirrhosis, Child–Pugh A. Whole-blood samples were obtained from patients before treatment and 12 weeks after the end of treatment, as well as from 24 healthy controls. Terminal restriction fragment, corresponding to telomere length, was measured using a nonradioactive Southern blot technique, detected by chemiluminescence.

Results

DNA telomere length was significantly shorter before treatment compared with 12 weeks after end of treatment in HCV-related cirrhotic patients. Also, it was significantly shorter in patients before treatment compared with healthy individuals.

Conclusion

Telomere elongation in blood leukocytes can be considered a marker of recovery of inflammation after DAAs-induced HCV eradication. Still, the possibility of activation by cancer initiation cannot be excluded.
Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities
Authors: Drott Jenny , Fomichov Victoria , Starkhammar Hans , Börjeson Sussanne , Kjellgren Karin , Berterö Carina
Published: November 2018

Background:

Oxaliplatin (OXA) is frequently used in the treatment of patients with colorectal cancer, and OXA-induced neurotoxic side effects are common. Reports on real-time patient-reported neurotoxic side effects and impact on the patient's daily activities are sparse in existing studies.

Objective:

The aim of this study was to identify and assess patient-reported OXA-induced neurotoxic side effects and their impact on the patient's daily activities, during and after chemotherapy.

Methods:

In a multicenter prospective longitudinal study, 46 chemo-naïve patients with colorectal cancer treated with postoperative adjuvant OXA-based chemotherapy were monitored during treatment and at 3-, 6-, 9-, and 12-month follow-ups. Patients were recruited from September 2013 to June 2016. In total, 370 Oxaliplatin-Associated Neurotoxicity Questionnaire responses were available for analysis. A mobile phone-based system was used to receive real-time assessments.

Results:

All patients reported neurotoxic side effects and impact on daily activities during treatment. The side effects changed in character and body location over time and had an impact on the daily activities.

Conclusions:

The high prevalence of OXA-induced neurotoxic side effects significantly interfered with the patients' daily activities. We found significant differences between baseline data and follow-up time points for neurotoxicity, and the patients had not returned to baseline after 1 year.

Implications for Practice:

The real-time assessment using mobile phone technology seems to be a valuable tool for monitoring patient-reported neurotoxicity and interventions for tailored care. Effectively identifying neurotoxicity and its impact on the patient's daily activities is important in supportive cancer care.
Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-Year Follow-Up
Authors: Nelson Jonas A. , Tecci Michael G. , Lanni Michael A. , Fischer John P. , Fosnot Joshua , Selber Jesse C. , Wu Liza C. , Serletti Joseph M.
Published: November 2018

Background:

The long-term impact of abdominally based free flap breast reconstruction is incompletely understood. The aim of this study is to provide long-term, subjective and objective health data on abdominally based free flap breast reconstruction patients, with specific attention to the effects of laterality, flap type, and obesity.

Methods:

Patients were enrolled in this prospective study between 2005 and 2010 and completed preoperative, early (<1 year), and long-term (5 to 10 years) evaluations. Objective examination included an assessment of upper and lower abdominal function and a functional independence measure. Patient-reported outcomes included the 36-Item Short-Form Health Survey and the BREAST-Q abdominal well-being module. Scores were compared by laterality (unilateral versus bilateral), flap type (muscle-sparing free transverse rectus abdominis musculocutaneous versus deep inferior epigastric artery perforator), and presence of obesity.

Results:

Fifty-one patients were included, with an average 8.1-year follow-up. Overall, 78.8 percent of patients had stable or improved scores across the upper and lower abdominal function and functional independence measures, and minimal objective differences across flap laterality or types were observed. Postoperative scores improved for 36-Item Short-Form Health Survey physical health (p < 0.001) and mental health (p < 0.001), and did not differ based on laterality or flap type. Obesity negatively impacted physical health (p = 0.002) and mental health (p = 0.006).

Conclusions:

Abdominally based autologous breast reconstruction is associated with significant improvements in long-term quality of life across key domains of physical and mental health with little functional impairment and no long-term differences across flap type or laterality. Obese patients, however, may be at risk for subjective physical and mental health impairment, perhaps unrelated to the surgery itself.
Modular organization of the murine locomotor pattern in presence and absence of sensory feedback from muscle spindles
Authors: Santuz Alessandro , Akay Turgay , Mayer William P. , Wells Tyler L. , Schroll Arno , Arampatzis Adamantios
Published: November 2018

For exploiting terrestrial and aquatic locomotion, vertebrates must build their locomotor patterns based on an enormous amount of variables. The great number of muscles and joints, together with the constant need for sensory feedback information (e.g. proprioception), make the task of creating and controlling movement a problem with overabundant degrees of freedom. It is widely accepted that the central nervous system might simplify the creation and control of movement. This could happen through the generation of activation patterns, which are common to many different muscles, rather than specific to individual muscles. These activation patterns, called muscle synergies, can be extracted from electromyographic data and describe the modular organization of movement. We extracted muscle synergies from the hindlimb muscle activities of wild type and genetically modified mice, in which sensory feedback from muscle spindles is eliminated. Muscle spindle-deficient mice underwent a modification of the temporal structure (motor primitives) of muscle synergies that resulted in diminished functionality during walking. In addition, both the temporal and spatial components (motor modules) of muscle synergies were severely affected when external perturbations were introduced of when animals were immersed in water. These findings show that group Ia/II sensory feedback from muscle spindles regulates motor function in normal and perturbed walking. Moreover, when group Ib Golgi tendon organ feedback is lacking due to the reduction of gravitational load in conditions of enhanced buoyancy, the modular organization of swimming is almost completely compromised.

Significance statement

Locomotion on land and in water requires the coordination of a great number of muscle activations and joint movements. Moreover, constant feedback about the position of own body parts in relation to the surrounding environment and the body itself (proprioception) is required to maintain stability and avoid failure. The theory of muscle synergies states that the central nervous system might control muscles in orchestrated groups (synergies) rather than individually. We used this concept on genetically modified mice, lacking one of the two classes of proprioceptors. Our results provide evidence that proprioceptive feedback is required by the central nervous system to accurately tune the modular organization of locomotion.