bluuebunny/crossref_metadata_2025 huggingface dataset:
Myocarditis Following Coronavirus Disease 2019 mRNA Vaccine: A Case Series and Incidence Rate Determination
Authors: Perez Yalile , Levy Emily R , Joshi Avni Y , Virk Abinash , Rodriguez-Porcel Martin , Johnson Matthew , Roellinger Daniel , Vanichkachorn Greg , Charles Huskins W , Swift Melanie D
Published: November 2021

Background

Myocarditis following coronavirus disease 2019 (COVID-19) mRNA vaccines (Pfizer-BioNTech and Moderna) has been increasingly reported. Incidence rates in the general population are lacking, with pericarditis rather than myocarditis diagnostic codes being used to estimate background rates. This comparison is critical for balancing the risk of vaccination with the risk of no vaccination.

Methods

A retrospective case series was performed using the Mayo Clinic COVID-19 Vaccine Registry. We measured the incidence rate ratio (IRR) for myocarditis temporally related to COVID-19 mRNA vaccination compared with myocarditis in a comparable population from 2016 through 2020. Clinical characteristics and outcomes of the affected patients were collected. A total of 21 individuals were identified, but ultimately 7 patients met the inclusion criteria for vaccine-associated myocarditis.

Results

The overall IRR of COVID-19–related myocarditis was 4.18 (95% confidence interval [CI], 1.63–8.98), which was entirely attributable to an increased IRR among adult males (IRR, 6.69; 95% CI, 2.35–15.52) compared with females (IRR 1.41; 95% CI, .03–8.45). All cases occurred within 2 weeks of a dose of the COVID-19 mRNA vaccine, with the majority occurring within 3 days (range, 1–13) following the second dose (6 of 7 patients, 86%). Overall, cases were mild, and all patients survived.

Conclusions

Myocarditis is a rare adverse event associated with COVID-19 mRNA vaccines. It occurs in adult males with significantly higher incidence than in the background population. Recurrence of myocarditis after a subsequent mRNA vaccine dose is not known at this time.
Persistence, Dosing, and Other Treatment Patterns Among Crohn’s Disease Patients Initiating Biologics in United States
Authors: Teeple Amanda , Sah Janvi , Mallampati Rajesh , Adams Christopher , Waters Dexter , Muser Erik
Published: November 2021

Background

This study examined biologic persistence, dosing, and other treatment patterns among Crohn’s disease (CD) patients that initiated adalimumab (ADA), certolizumab pegol (CZP), infliximab (IFX), ustekinumab (UST), and vedolizumab (VDZ).

Methods

This descriptive study pooled data from IBM MarketScan, IQVIA PharMetrics, and Optum databases and identified CD patients who initiated the above biologics. Due to low sample size, CZP was not included in the analyses. Persistence was defined as the proportion of patients that remained on the index biologic without a gap of >30 days for ADA and >120 days for UST, IFX, and VDZ between two claims. A sensitivity analysis using fixed gap (90-day) was also conducted. Dose titration (based upon mean maintenance dose) including 50% dose escalation, and 50% dose reduction was assessed among patients with ≥2 maintenance doses during follow-up among ADA, UST, and VDZ patients.

Results

After applying all selection criteria, patients were selected into bio-naive (ADA: 2047; IFX: 1127; UST: 296; VDZ: 342) and bio-experienced cohorts (ADA: 300; IFX: 341; UST: 801; VDZ: 593) based on the biologics used. Unadjusted persistence was numerically higher among bio-naive and bio-experienced UST (87.2%, 86.3%) patients followed by VDZ (78.9%, 80.8%), IFX (79.0%, 77.4%), and ADA (64.9%, 60.7%). Similar trends were observed using sensitivity analysis. Dose escalation was numerically higher for ADA patients (16.1%–16.4%) followed by UST (13.4%–16.9%), and VDZ (12.4%–14.7%). Dose reduction followed a similar trend.

Conclusions

Among CD patients, unadjusted persistence using variable and fixed gap definition was numerically highest for UST patients whereas dose escalation was numerically highest among ADA patients. Further research is needed to examine treatment patterns after adjusting for confounders and baseline differences among biologic users.
Comparison of self-etch primers with conventional acid-etch technique for bonding brackets in orthodontics: a systematic review and meta-analysis
Authors: Kerayechian Navid , Bardideh Erfan , Bayani Shahin
Published: November 2021

Background

Bonding with self-etch primers (SEPs) is one of the most popular systems for attaching orthodontic brackets to the enamel surface. There are conflicting reports about the efficacy and success of these systems compared with acid-etch (AE) bonding.

Objective

This systematic review and meta-analysis was performed to compare SEP with conventional AE technique for bonding brackets in fixed orthodontics.

Search methods

Articles related to the subject of interest were searched in electronic databases, including PubMed, ISI Web of Science, Scopus, EMBASE, and Cochrane’s CENTRAL, from inception to 2 June 2021. Search for grey literature, and hand search for relevant studies were also performed.

Selection criteria

Based on the PICO model, randomized clinical trials using full-arch bonded fixed orthodontic appliances comparing SEP and conventional AE systems were included in the review process.

Data collection and analysis

After assessing the risk of bias, data from the included studies were extracted using custom piloted forms. Inverse-variance random-effects meta-analyses were performed to combine the results of bracket failure, adhesive remnant index (ARI), and bonding time.

Results

Nineteen randomized clinical trials were included in the systematic review and 17 randomized clinical trials [5 parallel-group (PG) and 12 split-mouth (SM) studies] were included in the meta-analysis. No significant difference in bracket failure at 6 months [risk ratio (RR) = 1.50, P = 0.26, 12 SM] and (RR = 0.68, P = 0.34, 2 PG), 12 months (RR = 1.6, 8 SM) and (RR = 1.17, P = 0.54, 2 PG), and ≥18 months (RR = 0.84, P = 0.31, 3 SM) and (RR = 1.20, P = 0.3, 3 PG) between SEP and AE groups could be found. Also, ARI score was similar between different bonding systems [mean difference (MD) = −0.44, P = 0.06, 4 SM]. The bonding time per tooth was faster in the SEP group (MD = −26.55, P < 0.001, 2 SM) and (MD = −24.00, P < 0.001, 2 PG).

Limitations

inclusion of three studies with a high risk of bias and high amount of inconsistency between the results of individual studies were the biggest limitations of our review.

Conclusions

The bracket bonding failure and ARI score were not significantly different between self-etch and conventional AE bonding systems. The bonding time was lower for the SEP, but some other requirements for SEPs like pumice prophylaxis could diminish this advantage.

Registration

The protocol for this systematic review was registered at PROSPERO with the ID CRD42021248540.
Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence
Authors: Müller Sophie Alice , Wood Rebekah Ruth , Hanefeld Johanna , El-Bcheraoui Charbel
Published: November 2021

A better understanding of serological data and risk factors for coronavirus disease 2019 (COVID-19) infection in healthcare workers (HCWs) is especially important in African countries where human resources and health services are more constrained. We reviewed and appraised the evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and its risk factors in HCWs in Africa to inform response and preparedness strategies during the SARS-CoV-2 pandemic. We followed the Preferred Reporting Items for systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines in this scoping review. Databases including PubMed, Embase and preprint servers were searched accordingly from the start of the COVID-19 pandemic to 19 April 2021. Our search yielded 12 peer-reviewed and four pre-print articles comprising data on 9223 HCWs from 11 countries in Africa. Seroprevalence varied widely and ranged from 0% to 45.1%. Seropositivity was associated with older age, lower education, working as a nurse/non-clinical HCW or in gynaecology, emergency, outpatient or surgery departments. Asymptomatic rates were high and half of the studies recommended routine testing of HCWs. This scoping review found a varying but often high SARS-CoV-2 seroprevalence in HCWs in 11 African countries and identified certain risk factors. COVID-19 public health strategies for policy and planning should consider these risk factors and the potential for high seroprevalence among HCWs when prioritizing infection prevention and control measures and vaccine deployment.
Emerging illiberal norms: Russia and China as promoters of internet content control
Authors: Flonk Daniëlle
Published: November 2021

This article contributes to the understanding of authoritarian states as norm entrepreneurs of content control norms. These emerging norms challenge the norm literature, which disregards illiberal norms and illiberal actors as norm entrepreneurs. This article focuses on two distinct but coexisting strategies that Russia and China apply for promoting and developing internet governance norms. It shows that these countries use a combination of socialization and persuasion strategies. They employ a sequencing strategy of regional coalition-building in order to create support, after which they expand a norm's range via international organizations. These norm entrepreneurs adapt their strategies to different target groups based on the degree of internalization of the norm. The article shows that a reassessment of norm theory in a broader context allows for extension to illiberal norms and illiberal actors, but also shows the limits since the applicability of strategies such as naming and shaming should be questioned.
Some Homological Properties of Category 𝒪, V
Authors: Ko Hankyung , Mazorchuk Volodymyr , Mrden Rafael
Published: November 2021

We compute projective dimension of translated simple modules in the regular block of the Bernstein–Gelfand–Gelfand category $\mathcal{O}$ in terms of Kazhdan–Lusztig combinatorics. This allows us to determine which projectives can appear at the last step of a minimal projective resolution for a translated simple module, confirming a conjecture by Johan Kåhrström. We also derive some inequalities, in terms of Lusztig’s $\textbf{a}$-function, for possible degrees in which the top (or socle) of a translated simple module can live. Finally, we prove that Kostant’s problem is equivalent to a homological problem of decomposing translated simple modules in $\mathcal O$. This gives a conjectural answer to Kostant’s problem in terms of the Kazhdan–Lusztig basis and addresses yet another conjecture by Johan Kåhrström.
Transcription factor MafB-mediated inhibition of type I interferons in plasmacytoid dendritic cells
Authors: Saiga Hiroyuki , Ueno Masaki , Tanaka Takashi , Kaisho Tsuneyasu , Hoshino Katsuaki
Published: November 2021

Type I IFNs (IFN-α and IFN-β), immunomodulatory cytokines secreted from activated plasmacytoid dendritic cells (pDCs), contribute to the innate defense against pathogenic infections and the pathogenesis of the autoimmune disease psoriasis vulgaris. A previous study has shown that an E26 transformation-specific (Ets) family transcription factor Spi-B can transactivate the type I IFN promoter in synergy with IFN regulatory factor (IRF)-7 and is required for type I IFN production in pDCs. However, the mechanism of negative regulation of type I IFNs by pDCs remains unknown. In this study, we report that a basic leucine zipper (bZip) transcription factor v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MafB) suppresses the induction of type I IFNs in pDCs. The elevated expression of MafB inhibited the transactivation of type I IFN genes in a dose-dependent manner. At the molecular level, MafB interacted with the Ets domain of Spi-B and interfered with IRF-7–Spi-B complexation. Decreased MafB mRNA expression and degradation of MafB protein in the early phase of immune responses led to the enhancement of type I IFNs in pDCs. In vivo studies indicated that MafB is involved in resistance against imiquimod-induced psoriasis-like skin inflammation. Overall, these findings demonstrate that MafB acts as a negative regulator of type I IFN induction in pDCs and plays an important role in maintaining immune homeostasis.
Interaction in vitro of pulmonary surfactant with antifungal agents used for treatment and prevention of invasive aspergillosis
Authors: Rauwolf Kerstin K , Hoertnagl Caroline , Lass-Floerl Cornelia , Groll Andreas H
Published: November 2021

Background

Optimizing antifungal therapy is important to improve outcomes in severely immunocompromised patients.

Objectives

We analysed the in vitro interaction between pulmonary surfactant and antifungal agents used for management of invasive pulmonary aspergillosis.

Methods

Amphotericin B formulations, mould-active triazoles and echinocandins were tested in vitro against 24 clinical isolates of different Aspergillus spp. with and without the addition of a commercial porcine surfactant (Curosurf®; Poractant alfa, Nycomed, Austria). The data are presented as MIC or minimum effective concentration (MEC) ranges, as MIC or MEC values that inhibited 90% of the isolates (MIC90 or MEC90) and as geometric mean (GM) MIC or MEC values.

Results

For amphotericin B products, addition of surfactant to a final concentration of 10% led to a statistically significant reduction of the GM MIC for all Aspergillus isolates tested after 24 h (0.765 versus 0.552 mg/L; P < 0.05). For the mould-active triazoles, addition of 10% surfactant resulted in a significantly higher GM MIC at 48 h (0.625 versus 0.898 mg/L; P < 0.05). For the echinocandins, the addition of 10% surfactant led to a significantly higher GM MEC after both 24 h (0.409 versus 0.6532 mg/L; P < 0.01) and 48 h (0.527 versus 0.9378 mg/L; P < 0.01). There were no meaningful differences between individual members of the three existing classes of antifungal agents or between the different Aspergillus spp. tested.

Conclusions

Using EUCAST methodology, addition of porcine surfactant up to a concentration of 10% had a minor, and presumably non-relevant, impact on the in vitro activity of antifungal agents used in prophylaxis and treatment of invasive pulmonary aspergillosis.
Diagnosis of Thrombotic Thrombocytopenic Purpura by ADAMTS13 Activity Quantification
Authors: Dimopoulos Konstantinos , Philips Malou , Goetze Jens P
Published: November 2021

Background

Rapid quantification of ADAMTS13 activity in plasma is essential for establishing a diagnosis of thrombotic thrombocytopenic purpura (TTP); a rare, but potentially lethal disorder. The current methods for quantitating ADAMTS13 activity are manual and only available at specialized laboratories, which often results in initiation of specific treatments long before a diagnosis of TTP is established.

Methods

We compared the performance of the HemosIL, a novel and rapid automated method, and the current standard FRET (fluorescence resonance energy transfer) method in quantitating ADAMTS13 activity using 706 consecutive plasma samples collected over a period of 14 years. The clinical accuracy of both methods was further examined using 212 diagnostic samples.

Results

The correlation between the FRET and HemosIL methods in all 706 samples and in the 212 diagnostic samples was excellent (Pearson’s r of 0.919 and 0.912, respectively). Both methods displayed a high degree of clinical accuracy using the current cutoff of ADAMTS13 activity <0.10 kIU/L (<10%) as diagnostic for TTP: the area under the curve (AUC) was 97.7% for the FRET method and 99.5% for the HemosIL method. When applying a lower cutoff (ADAMTS13 activity <0.05 kIU/L or <5%), the diagnostic accuracy of the HemosIL method increased further (AUC = 99.7%).

Conclusions

A novel, rapid method for ADAMTS13 quantification is comparable to the more laborious FRET method in patients with possible TTP. A rapid analysis available in the acute setting assessing patients with possible TTP allows for improved care and optimized treatment of a life-threatening condition.
Estimating the impact of engagement with digital health interventions on patient outcomes in randomized trials
Authors: Nelson Lyndsay A , Spieker Andrew J , Mayberry Lindsay S , McNaughton Candace , Greevy Robert A
Published: November 2021

Objective

Guidance is needed on studying engagement and treatment effects in digital health interventions, including levels required for benefit. We evaluated multiple analytic approaches for understanding the association between engagement and clinical outcomes.

Materials and Methods

We defined engagement as intervention participants’ response rate to interactive text messages, and considered moderation, standard regression, mediation, and a modified instrumental variable (IV) analysis to investigate the relationship between engagement and clinical outcomes. We applied each approach to two randomized controlled trials featuring text message content in the intervention: REACH (Rapid Encouragement/Education and Communications for Health), which targeted diabetes, and VERB (Vanderbilt Emergency Room Bundle), which targeted hypertension.

Results

In REACH, the treatment effect on hemoglobin A1c was estimated to be −0.73% (95% CI: [−1.29, −0.21]; P = 0.008), and in VERB, the treatment effect on systolic blood pressure was estimated to be −10.1 mmHg (95% CI: [−17.7, −2.8]; P = 0.007). Only the IV analyses suggested an effect of engagement on outcomes; the difference in treatment effects between engagers and non-engagers was −0.29% to −0.51% in the REACH study and −1.08 to −3.25 mmHg in the VERB study.

Discussion

Standard regression and mediation have less power than a modified IV analysis, but the IV approach requires specification of assumptions. This is the first review of the strengths and limitations of various approaches to evaluating the impact of engagement on outcomes.

Conclusions

Understanding the role of engagement in digital health interventions can help reveal when and how these interventions achieve desired outcomes.
Measurement of Cumulative Preterm Neonatal and Maternal Stressors During Neonatal Intensive Care Unit Admission
Authors: Abdelmageed Reham I , Youssef Azza M , EL-Farrash Rania A , Mohamed Haidy M , Abdelaziz Asmaa W
Published: November 2021

Objectives

By nature, the neonatal intensive care unit (NICU) environment is stressful for both infants and mothers. This study aimed to explore and quantify the severity of early life stressors in premature infants admitted to the NICU and evaluate the effect of cumulative neonatal stressors on maternal mental health.

Methods

This cross-sectional study included 100 preterm infants admitted to the NICU for at least 10 days. Daily experiences with painful/stressful procedures for 10 days were determined using the Neonatal Infant Stressor Scale. The included mothers were assessed for their psychological well-being 1 week after NICU admission using the Parental Stressor Scale: NICU and Edinburgh Postnatal Depression Scale.

Results

During the first 10 days of NICU admission, preterm infants experienced an average of 350.76 ± 84.43 acute procedures and an average of 44.84 ± 11.12 cumulative hours of chronic events, with the highest scores recorded on first 3 days of admission. Although intravenous flushing for patency was the most frequent acute procedure, blood gas sampling was the most painful. Forty-five percent of the mothers showed significant depressive symptoms, with the maternal role alteration reported as the most stressful experience, especially for young and new mothers (p < .001). The cumulative stressors experienced by infants were significantly associated with elevated maternal perception of psychological maladjustment (p < .001).

Conclusion

This study confirmed that the NICU environment is stressful for both infants and mothers, with the total cumulative stressors experienced by preemies in the NICU having an negative impact on maternal mental health.
April 27, 2005—Holding On
Authors: McQuellon Richard P.
Published: November 2021

The main subject of this dialogue is facing, accepting, and yielding to death. Nell is managing physical decline and finding meaning in mortal time, recurrent themes in our conversations. She succinctly describes her plan for making sense of death, but she recognizes that her self-prescription is not easy to fulfill. Facing death requires detaching from activities that give meaning and link Nell to the broader world. On most days, she lacks the energy to engage the outside world; she is housebound. In his autobiography, Dr. Paul Kalanithi presents an example of yielding as he describes his slow decline due to lung cancer. Nell is facing death directly like Dr. Kalanithi, with grace, until the very end, literally editing from her deathbed. Nell addresses a central question throughout these dialogues: What makes life worth living when death is imminent? We discuss security objects and Nell tells me about parish priest Fr. Jay, who gives her a ceramic angel when he administers the Sacrament of Anointing of the Sick. She finds comfort in consoling iconography and holding on to her rosary, a crucifix, angels, and the Buddha.
May 17, 2005—Acceptance
Authors: McQuellon Richard P.
Published: November 2021

In this dialogue, Nell reflects on the paradox of accepting death and letting go of friends while at the same time enjoying a sense of well-being and happiness. Her main unfinished task is dying. She is impatient with her extended lifespan in mortal time. She is getting better at managing her physical symptoms, allowing her comfort and creating ambivalence about leaving this world. She is finding meaning with being at home with husband Al. Her sense of well-being surprises her, and she wonders if it is an obstacle. She finds her situation—busy living while talking about dying—comical and paradoxical. She laughs at the irony of purchasing expensive nightgowns that may not arrive before she dies. Nell asks me to help her deliver gifts to the people she loves. The task of shedding her possessions and relationships has become more urgent now, yet letting go of the things that help us to remember who we are is no simple task. Nell is managing to detach from her objects even though in contemporary America we are what we own.
May 24, 2005—Finding Home
Authors: McQuellon Richard P.
Published: November 2021

Nell experiences a spiritual crisis. She worries her faith is not complete, reasoning that if she had more faith, she would not fear the unknown of death. The importance of faith and of receiving the Sacrament of Confession and the ritual of anointing the senses is affirmed. Through her brother John’s dream of reuniting, she finally feels what it is like to “go home,” to return to feelings of family, even when those feelings include the recollection of violence, which Nell wisely sees as preparation for death. She is letting go of her family and friends by setting boundaries and closing down phone calls and emails. Holding on and letting go, a fundamental rhythm of life, is shifting toward release. Nell’s dear friend Mary sends her a heartfelt message in a beautiful greeting card where she articulates the painful process of letting go and her hope of their reunion in the next world. When loving family members or friends try to express empathy with cancer patients, it often seems like pity, which irritates rather than comforts. In this peculiar dynamic, the patient experiences the caregiver’s good intention as overly solicitous. Hollow compassion creates distance, not closeness.
Disorders of Consciousness and the Disability Critique
Authors: Johnson L. Syd M
Published: November 2021

Some members of disability communities and activist organizations have strenuously objected to the withdrawal of life-sustaining treatment from persons in the vegetative state/unresponsive wakefulness syndrome, notably in the case of Terri Schiavo. A history of medical neglect and ableism prompts reasonable fears that the rights of disabled persons are threatened by the withdrawal of treatment from patients who lack the ability to decide for themselves. This chapter considers the disability critique of the right to die. Implicit and explicit bias against disabled persons, and the withdrawal of treatment as a means to prevent disability are examined, alongside concerns about epistemic injustice and questions about who has the epistemic authority to speak for those with disorders of consciousness. What we owe to profoundly impaired persons, including those with disorders of consciousness, is what we owe to others: care, careful consideration of their preferences and interests, and respect for their personhood.
Health Surveys
Authors: Vaughan J Patrick , Victora Cesar , R Chowdhury A Mushtaque
Published: November 2021

Surveys are used to collect data on the population distribution and frequency of health behaviours and use of services, health risks and diseases, as well as for the monitoring the implementation of health interventions, services, and programmes. Cross-sectional surveys collect prevalence data and longitudinal surveys collect mainly incidence information. Surveys can provide more accurate data than is available from local health information or surveillance systems. Survey methods are explained, such as on objectives, choice of variables, and sampling. Before undertaking surveys, local teams are advised to seek specialist advice and support.
Presenting Health Information
Authors: Vaughan J Patrick , Victora Cesar , R Chowdhury A Mushtaque
Published: November 2021

Health data become useful information after analysis. It is important to communicate health plans and findings on services and programmes to district and ministry staff, as well as to other health related sectors and other local organizations. Popular methods for presenting and communicating health information include tables, figures, graphs, histograms, bar charts, pie charts, scatter diagrams, and maps. Details for constructing and presenting these are explained. Mobile phones and photographs are useful to record and send health information. The importance of displaying and publicising local health information and achievements is stressed.
History of successful ageing
Authors: Tesch-Römer Clemens , Wahl Hans-Werner , Rattan Suresh I. S. , Ayalon Liat
Published: November 2021

The notion of successful ageing has been one of the most successful but also one of the most controversial concepts of ageing research over the last 60 years. Attempts to uncover the secret of successful ageing have often resembled something like a quest for the Golden Fleece. And that quest continues within contemporary gerontology—so far with no end in sight. As shown in this introductory chapter, human history is full of strivings to live a youthful life without end. Still, controversies over successful ageing continue. In the following chapters of the book various conceptual models are analysed, and strategies and interventions for successful ageing discussed.
Biological perspectives on successful ageing
Authors: Rattan Suresh I. S.
Published: November 2021

From a biological perspective, ageing is generally considered as a downhill phase of life, with a progressive decline in physiological functionality and an increase in the chances of chronic diseases and death. The onset of this phase of life does not start with birth because the early phase of life is a constructive phase of growth, development, maturation, and reproduction. Ageing sets in and happens progressively, exponentially, and intrinsically in the period of survival beyond the naturally evolved essential lifespan of a species. Ageing can be defined as a progressive shrinkage of the homeodynamic space having the fundamental characteristics of stress tolerance, damage control, and constant remodelling. Biologically successful ageing thus implies maintaining, recovering, or even enhancing those abilities that support survival and health in the framework of homeodynamic space.
Physical–spatial–technological environments and successful ageing
Authors: Tesch-Römer Clemens , Wahl Hans-Werner , Rattan Suresh I. S. , Ayalon Liat
Published: November 2021

In this chapter the authors argue that physical, spatial, and technological environments are relevant to successful ageing both in a conceptual and in a practical sense. Conceptually, efforts towards ageing successfully cannot be discussed separately from the various external forces that serve as constraining or enhancing influences in this respect. From a practical point of view, interventions aimed at improving one’s environment become increasingly relevant as an individual’s resources and reserve capacities dwindle. Environments for ageing successfully may be characterized in terms of person–environment docility vs proactivity, person–environment fit vs lack of fit, and person–environment agency vs belonging. The authors link these concepts with various models of successful ageing and discuss practical implications for housing, long-term care environments, neighbourhoods, municipalities, and use of digital technology.
Successful ageing and ageism
Authors: Ayalon Liat
Published: November 2021

The concept of successful ageing has instigated the imagination of laypeople, policy stakeholders, and researchers because it offers an alternative to gloomy stereotypes of decline, disability, and dependence commonly associated with old age. Successful ageing proposes an opportunity to transition smoothly from middle-life into old age, with none of the negative stereotypes commonly associated with old age. However, this opportunity comes at a price. This chapter aims to describe and illustrate the ageist features inherited in the concept of successful ageing and its negative, unintended consequences on older people and society at large. The chapter also describes how other- and self-directed ageism may prevent people from ageing successfully. Recommendations for concept refinement and policy are discussed.
Diagnostic evaluation of sacroiliac disease
Authors: Canzanello Nicholas C. , Hagedorn Jonathan M.
Published: November 2021

The diagnosis of sacroiliac joint dysfunction is often difficult and requires a thoughtful and thorough workup to uncover. A proper diagnosis is required so that appropriate treatment can be provided for the chronic pain patients suffering from sacroiliac joint dysfunction. This chapter discusses the symptoms of sacroiliac joint dysfunction (including inciting factors, location, and inflammatory etiologies), the components of a physical examination (including detailed explanations of several physical examination maneuvers, as well as their reliability), the utility of diagnostic injections, the imaging techniques that are useful in this setting (radiography, ultrasound, computed tomography, magnetic resonance imaging), and laboratory evaluation that might be required in this setting (bloodwork).
Lateral branch blocks
Authors: Homra Benjamin K. , Eshraghi Yashar , Guirguis Maged
Published: November 2021

The posterior sacral network is a complex meshwork of lateral branches of the dorsal sacral rami that innervate the posterior aspect of the sacroiliac joint. Pain arising from this joint can be diagnostically targeted using either a fluoroscopic or ultrasound technique to determine if the patient would benefit from radiofrequency ablation of the lateral branches. Injecting local anesthetic near the dorsal foramina using these techniques will temporarily block the transmission of pain by the lateral branches from the sacroiliac joint. This chapter covers the anatomy of the posterior sacral network, discusses the details of the two techniques for lateral branch blocks and evidence for their utility, provides information about the risks and contraindications associated with the techniques, and concludes by discussing the implications of the procedure.
Imaging techniques for sacroiliac joint injections
Authors: Weisbein Jacqueline
Published: November 2021

Injections into the sacroiliac joint for both diagnostic and therapeutic purposes have become commonplace. There have been advances in the use of regenerative therapies other than prolotherapy, such as platelet-rich plasma and stem cells. Prior to the introduction of image-guided techniques, blind injections were performed. However, data have consistently shown that without image guidance, injections failed to be accurately placed within the joint. Therefore, the use of image guidance, whether by computed tomography, fluoroscopy, or ultrasound, is imperative to ensure accurate placement of the injectate. This chapter discusses these three types of imaging techniques for sacroiliac joint injections.
Preoperative considerations for peripheral nerve stimulation of the sacroiliac joint
Authors: Antony Ajay B.
Published: November 2021

This chapter reviews preoperative factors to be considered before performing peripheral nerve stimulation of the sacroiliac joint. When designing a preoperative plan, it is important to consider the type of anesthesia to be administered, anticoagulation management, infection risk, and other relevant medical comorbidities that may complicate the procedure. These factors vary depending on the patient, and in many cases coordination with other specialists is required. Optimization of patient comorbidities, appropriate management of anticoagulation, and planning strategies to minimize infection risk (including the use of perioperative antibiotics) are paramount to ensure the best possible outcomes for the patient undergoing this procedure.
The mandible
Authors: van Gijn Daniel R. , Dunne Jonathan
Published: November 2021

The mandible is the largest of the facial bones, occupying a prominent position upon and providing the foundation for the lower third of the face. Despite holding the honour of being the strongest bone in the face, its protrusive location makes it vulnerable to injury – particularly in relation to aggressively placed fists, steering wheels and concrete. Anatomically, the mandible consists of a symmetrical, horseshoe shaped body continuous with paired broad rami posteriorly. The former houses the lower teeth within the alveolus whilst the latter provides attachment for the four principle muscles of mastication from the its medial and lateral surfaces and coronoid and condylar processes. In addition to the aforementioned muscles of mastication, the mandible provides origin to the muscles of the tongue, the floor of mouth and some muscles of facial expression.
The cranial nerves
Authors: van Gijn Daniel R. , Dunne Jonathan
Published: November 2021

There are 12 pairs of cranial nerves that are individually named and numbered using Roman numerals. Only some cranial nerves are mixed in function, i.e. they carry both sensory and motor fibres; others are purely sensory or motor and some may also carry pre- or post-ganglionic parasympathetic fibres. They pass through foramina in the base of the skull and are the olfactory (through cribriform plate to the nasal cavity), optic (through the optic foramen to the eye), oculomotor (through the cavernous sinus and superior orbital fissure to supply the eye), trochlear (as per oculomotor), trigeminal (three main branches that pass through the superior orbital fissure, foramen rotundum and foramen ovale, respectively), abducens (as per oculomotor), facial (through stylomastoid foramen to supply muscles of facial expression), vestibulocochlear (through the internal acoustic canal to control balance and hearing), glossopharyngeal, vagus, accessory (all pass through the jugular foramen) and hypoglossal (through the hypoglossal canal to control movements of the tongue) nerves.
The neck
Authors: van Gijn Daniel R. , Dunne Jonathan
Published: November 2021

The neck occupies the space between the clavicles and thoracic inlet inferiorly, to the base of the skull and inferior border of the mandible superiorly. The cervical part of the vertebral column provides the support for the skull above and strength and movement to the neck proper. The anterior neck provides passage for the major neurovascular supply to and drainage from the head, neck and intracranial region, transmits the upper aerodigestive tract and houses the thyroid and parathyroid glands. In the posterior neck a large mass of extensor musculature is situated posterior to the cervical vertebrae. Cranial nerves nine through twelve descend into the neck: nine (glossopharyngeal) and twelve (hypoglossal) meander towards the oropharynx and tongue, respectively; cranial nerve eleven (accessory) deflects backwards to supply the sternocleidomastoid and trapezius muscles whilst the tenth cranial nerve (vagus) wanders inferiorly within the carotid sheath between and posterior to the common carotid artery and internal jugular vein, before disappearing into the thoracic and abdominal cavities.
The orbit and its contents
Authors: van Gijn Daniel R. , Dunne Jonathan
Published: November 2021

The function of the orbit is to protect and accommodate the globe in order to maximise its function. The bony orbits are paired four-sided conical cavities within the skull each comprising seven bones – ranging from the paper thin ethmoid and lacrimal plate medially to the buttress thick zygoma laterally. The conical shape consists of an apex posteriorly and a base anteriorly forming the outer margin. The medial wall and floor begin to blend towards the apex forming a posteromedial bulge as the orbit takes on a three-walled pyramidal structure. The walls are lined by periosteum (periorbita), which is continuous with the periosteal layer of the dura mater at the apex, the orbital septa and the fascial sheaths of the extraocular muscles. There are five principal openings of the orbit – three principal foramina located at the apex that transmit the neurovascular supply of the orbit and two lesser foramina located on the medial wall.
The mouth
Authors: van Gijn Daniel R. , Dunne Jonathan
Published: November 2021

The mouth is the common aperture to the aerodigestive tract. With the coordinated assistance of the tongue and lips it contributes to the formation of meaningful sound whilst the presence of intact dental arches allow for mastication. The oral cavity proper represents the atrium beyond the lips reaching to the palatoglossal arches posteriorly, where the oropharynx begins beyond the oropharnygeal isthmus. It is restricted by the cheeks laterally, the hard and soft palate superiorly and the mobile tongue resting on the mylohyoid muscle inferiorly. The paired major salivary glands drain into the oral cavity along with numerous minor salivary glands. The tongue is a thick, mucosa covered muscular structure concerned with mastication, taste, talking and swallowing. The palate is the roof of the mouth, separating the oral and nasal cavities and participating in speech and swallowing. It can be divided into two parts: a bony anterior hard palate and soft posterior palate.
Embryology of the head and neck
Authors: van Gijn Daniel R. , Dunne Jonathan
Published: November 2021

Development of the head is dominated by the changing shape of the brain and the formation of pharyngeal arches through which blood from the ventrally placed heart can pass to the dorsal aorta. The origin of the cell population within the head and neck is important as it predicts the behaviour and attributes of the cells and their progeny. The neural crest gives rise to an extensive mesenchymal population which contributes to the skull and enters and patterns the pharyngeal arches. The skull (neurocranium) forms around the developing brain and its emerging nerves. The base of the skull forms initially in cartilage (endochondral ossification) and the vault forms from neural crest mesenchyme (intramembranous ossification). The face and jaws (viscerocranium) form around the developing pharynx from a series of pharyngeal arches (numbered 1,2,3,4 and 6) which pass from the lateral sides of the pharynx to meet ventromedially.
HIV medicine
Authors: Burton Rosie , Houston Ana
Published: November 2021

Epidemiology, Virology and immunology, infection, Antiretroviral therapy, opportunistic infections, Antiretroviral drugs, doses and adverse effects, viral failure, Common clinical problems in HIV, HIV-related malignancy, Immune Reconstitution Inflammatory Syndrome (IRIS), HIV prevention strategies, Prevention of mother to child transmission (PMTCT), Post-exposure prophylaxis
Chest medicine
Authors: Graham Stephen
Published: November 2021

Symptoms of respiratory disease, Pneumonia, Atypical pneumonia, Legionnaires' disease, Recurrent pneumonia, Nosocomial pneumonia, Aspiration pneumonia, Management of pneumonia: adults, Viral pneumonia SARS and HN, Management of pneumonia: children, Paediatric acute respiratory, infections: epiglottitis, Acute laryngotracheobronchitis: croup, Bacterial tracheitis, Bronchiolitis, Whooping cough, Lymphocytic interstitial pneumonitis, Diphtheria, Pleural effusion, Lung abscess, Fungal pulmonary infections, Paragonimiasis lung flukes, Tropical pulmonary eosinophilia, Asthma, Acute severe asthma, Chronic obstructive pulmonary disease, Bronchiectasis, Lung cancer, Interstitial lung disease, Acute respiratory distress syndrome, Pulmonary embolism, Pneumothorax
Gastroenterology
Authors: Jones Kelsey D.J.
Published: November 2021

Disorders of the mouth and pharynx?, Dyspepsia, dysphagia and reflux, Upper GI bleeding, Oesophageal varices, Acute abdominal pain, Acute diarrhea, Persistent diarrhea, Compendium of diarrhea-causing pathogens, Travelers’ diarrhea, Food poisoning, Intestinal flukes, Schistosomiasis (bilharzia), Soil-transmitted helminths (STH), Toxocariasis, Perianal complaints, Acute pancreatitis, Biliary disease, Liver flukes, Liver disease, Viral hepatitis, Alcohol and drug-induced hepatitis, Chronic liver disease and cirrhosis, Portal hypertension, Liver failure, Amoebic liver disease, Liver cancer, Hydatid disease
Renal medicine
Authors: Modi Gopesh K. , Jha Vivekanand
Published: November 2021

Assessing renal function, Urinalysis, Proteinuria, Hematuria, Chyluria, Imaging in renal disease, Kidney biopsy, Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), Diabetic Nephropathy, End Stage Renal Disease and Dialysis, Kidney Transplantation, Glomerular diseases, Acute glomerulonephritis, Urinary schistosomiasis (bilharzia), Infections and Kidney Disease, Rapidly Progressive glomerulonephritis, Tubulointerstitial Disease, Urinary Tract Infection, Vesico-ureteric reflux, Renal Stones, Renal Disease in Pregnancy, Renal Artery Stenosis, Renal Mass, Inherited Renal Diseases
Dermatology
Authors: Weiss Robert
Published: November 2021

Infections of the skin?, Skin infestations?, Ulcers?, Rashes?, Dermatitis eczema?, Psoriasis?, Pityriasis rosea?, Lichen planus?, Drug eruptions?, Vasculitis?, Erythema nodosum?, Urticaria?, Erythema multiforme?, Blistering disorders?, Connective tissue diseases?, Disorders of pigmentation?, Skin cancers?, Common cutaneous viral infections?, Varicella zoster virus?, Poxvirus infections?, Cutaneous leishmaniasis?, Lymphoedema elephantiasis?, Lymphatic filariasis?, Onchocerciasis 'river blindness'?, Loiasis Loa loa?, Dracunculiasis Guinea worm?, Other parasites that invade the skin?, Cutaneous larva migrans?, Larva currens?, Podoconiosis?, The non-venereal treponematoses?
Multisystem diseases and infections
Authors: Ashley Elizabeth , Bern Caryn , Borok Margaret , Brotherton Helen , Chappuis Francois , Chung Cecilia , Crump John , Durrheim David N. , Frean John , Griffith Kevin , Horby Peter , Karsten Jaap , Peacock Sharon , Pirioue Erwan , Salam Alex , Sigfrid Louise , Spencer Robert C. , Stein Charles , Warrell David
Published: November 2021

Differential diagnosis of fevers?, Fever without localizing features?, Sepsis?, Cancer?, General rules of cancer management?, Rheumatoid arthritis?, Osteoarthritis?, Systemic lupus erythematosus?, Typhoid and paratyphoid fevers?, Rickettsioses?, Bartonella?, Ehrlichia?, Coxiella?, Relapsing fevers?, Leptospirosis?, Brucellosis?, Plague?, Melioidosis?, Anthrax?, African trypanosomiasis?, American trypanosomiasis?, Visceral leishmaniasis (kala-azar)?, Infectious mononucleosis?, Measles?, Arboviruses and zoonotic haemorrhagic fever viruses , Ebola and Marburg virus diseases, Crimean-Congo haemorrhagic fever, Rift Valley fever, Lassa fever, Hantavirus infections, Severe fever and thrombocytopenia, Zika virus, Japanese encephalitis , Dengue virus, Yellow fever, West Nile virus , Kyasanur Forest Disease, Chikungunya, Ross River fever, O'nyong nyong
Immunization
Authors: Mutsaerts Eleonora , Madhi Shabir A.
Published: November 2021

Immunization strategies and schedules?, Transport and storage of vaccines?, Needle use and disposal?, Administration of vaccines ?, Adverse reactions?, Contraindications to vaccination?, Immunization of HIV+ individuals?, Expanded program on immunization recommended vaccines?, Other vaccines?
Obstetric emergencies
Authors: Rijken Marcus , McGready Rose , Meguid Tarek
Published: November 2021

Respectful Maternal Care, Antenatal care, Early pregnancy bleeding?, Hypertensive emergencies?, Pregnancy-related infection?, Obstetric haemorrhage?, Intrapartum emergencies?
What Does Fat Do?
Authors: Denton Nathan
Published: November 2021

Despite how much we may think and talk about fat in our lives and in society, we rarely take a moment to consider what it actually does. Contemplating the evolutionary history of fat is probably the last thing on someone’s mind when their trousers feel a bit tight. We love to hate fat, especially on our own bodies, but fat is not inherently bad. On the contrary, our hatred and fear is being directed at an ancient organ that is essential for life. Perpetually misunderstood, fat’s bad reputation derives from our preoccupation with the negative health effects associated with having too much of it. In order to succeed in the monolithic battle against obesity threatening the planet’s health and wealth, we must first understand fat itself, more specifically white adipose tissue, the major type of fat in the body. In order to understand the nature of fat, however, we must first consider energy metabolism more generally. The next section considers how the body handles fat, carbohydrate, and protein under various conditions to illustrate the central role that adipose tissue plays in our bodies each and every day.
Conclusion
Authors: Denton Nathan
Published: November 2021

Fat is much more than a physical imperfection, practical inconvenience, or health risk. Instead, it is a fascinating, mysterious, and misunderstood tissue that represents an ancient link between energy metabolism, reproductive biology, immunity, appetite, and even thermoregulation. It also forms the foundation of the curves which define the archetypal human female and male body shapes, which have since enabled the human body to transcend mere physicality and become social, economic, and political barometers. Laden with increasingly complex, nuanced, and even paradoxical meanings, mounting evidence indicates that the amount and distribution of fat not only provide our body with a distinctive shape, but are also a strong determinant of our health. Adipose tissue carries many negative connotations due to the numerous ailments associated with having too much of it, but it is not inherently bad. On the contrary, it has a legacy that clearly indicates it is essential for life.
The virtuous doctor
Authors: Smajdor Anna , Herring Jonathan , Wheeler Robert
Published: November 2021

This chapter explores virtue ethics. It explains how this approach emphasises the importance of medical professionals’ virtues such as compassion, wisdom and justice. While this approach can promote flexibility, and accommodates human responses, it can face challenges if it is not clear what the virtuous thing to do is.
Deontology
Authors: Smajdor Anna , Herring Jonathan , Wheeler Robert
Published: November 2021

This chapter considers deontological approaches to medical ethics. It emphasises the importance of duty in moral decision-making. It addresses the idea that human beings should never use one another as a mere means. The chapter also considers some of the challenges posed to deontological thought and the links between deontology and human rights.