bluuebunny/crossref_metadata_2025 huggingface dataset:
Transamerican Sentimentalism and Nineteenth-Century US Literary History
Authors: Windell Maria A.
Published: September 2020

Transamerican Sentimentalism and Nineteenth-Century US Literary History argues that African American, Native American, Latinx, and Anglo-American women writers use genre to negotiate hemispheric encounters amidst the gendered, racialized, and cultural violence of the nineteenth-century Americas. Although US literary sentimentalism is often framed in national and transatlantic terms, this book argues that the mode was deeply transamerican. Given the popularity of the nineteenth-century sentimental novel, the appearance of its central motifs—tearful embraces, fainting heroines, angelic children—in transamerican US texts is unsurprising. What is remarkable is how texts not generally considered sentimental deploy seemingly insignificant affective episodes to navigate gendered and racialized experiences of conflict throughout the Caribbean and the US–Mexico borderlands. Throughout Transamerican Sentimentalism, marginal characters, momentary gestures, offhand remarks, and narrative commentaries serve to disrupt plots, potentially connecting characters across cultural, racial, national, and linguistic borders. Transamerican sentimentalism cannot unseat the violence of the nineteenth-century Americas, but it does dislocate familiar figures such as the coquette and the mulatta to produce other potential outcomes—including new paradigms for understanding the coquette, a locally successful informal diplomacy, and motivations for violent slave revolt. Transamerican sentimentalism is a fleeting, mercurial, and marginal mode. Frequently overwhelmed by the violence pervading the hemisphere, it could be categorized as a failed venture. Yet it is also persistent; as it recurs throughout the nineteenth century, it opens into alternative African American, Native American, and Latinx avenues for navigating and comprehending US–Americas relations.
Sentimental Diplomacy
Authors: Windell Maria A.
Published: September 2020

Chapter 3 explores instances of “sentimental diplomacy” in the literary aftermath of the US–Mexican War and Indian Removal. It opens by arguing that the heroines of María Amparo Ruiz de Burton’s The Squatter and the Don (1885)—who seek to counter the violence and dispossession of late-nineteenth-century Californios—stand as unrecognized heirs to the women in John Rollin Ridge’s 1854 novel of Mexican banditry, Joaquín Murieta. Amidst the sensational violence of Joaquín Murieta, the first Native American novel, Mexican and Anglo-American women engage in a sentimental diplomacy that resists rampant racialized violence. In both The Squatter and the Don and Joaquín Murieta, sentimental diplomacy offers local possibilities for peace, but in neither novel can it overcome the war’s brutal legacy or the racism and systemic corruption that followed.
Conclusion
Authors: Windell Maria A.
Published: September 2020

Transamerican Sentimentalism concludes by returning to the 1880s and exploring how the mode translates not only across the US–Mexico border but also through language. The coda juxtaposes an 1878 suffragist document that maligns “the Mexicans, Half-Breeds and ignorant, vicious men [who] voted solid against women’s suffrage in Colorado” with Helen Hunt Jackson’s 1884 novel Ramona and José Martí’s 1888 translation thereof. Given their associations with nineteenth-century reform movements, it is perhaps unsurprising that these distinct yet varied documents use sentimentalism to generate connective possibilities. Yet the coda notes how they each also use the mode as a tool of dispossession. Within this contradiction lie the contingent, disjunctive, and anachronistic accumulations that define transamerican sentimentalism—and that open powerful alternative possibilities for hemispheric connection.
Dark Clouds at Dawn
Authors: Fleming James Rodger
Published: September 2020

Joanne Gerould was raised in Cambridge, Massachusetts, where she benefitted from educational opportunities but suffered emotional neglect, especially from her mother.
The Path to Hot Towers
Authors: Fleming James Rodger
Published: September 2020

In collaboration with Herbert Riehl, Joanne developed her signature “hot tower” hypothesis of convection, demonstrating that clouds are the spark plugs of Earth’s general circulation.
Introduction
Authors: Parry Glyn , Enis Cathryn
Published: September 2020

This book puts William Shakespeare’s Stratford upbringing into significant historical context for the first time. It provides new ways of thinking about Warwickshire and Elizabethan England. It uses new archival discoveries about three linked families: the Shakespeares, Ambrose and Robert Dudley, respectively earls of Warwick and Leicester, and the Arden family headed by Edward Arden. It shows that during the 1570s and 1580s William Shakespeare was exposed to the Dudleys’ political, legal, historical, and genealogical claims for their authority in Warwickshire and Stratford, an assault on the county’s collective memory resisted by the Ardens and other gentry. As her proxies, the Dudleys established Elizabeth I’s Protestant regime in the west Midlands, culminating in Edward Arden’s destruction on false treason charges in 1583. By then the Shakespeares had direct experience of the London government’s power in the localities. From 1569 Exchequer informers, backed by influential politicians at Court, accused William’s father John of illegal wool dealing and usury. Contrary to previous claims that he had escaped these charges by 1572, new sources show how the Exchequer’s continuing demands undermined John’s credit rating by 1577, forcing his withdrawal from Stratford politics, and curtailing his business career in the early 1580s. In the fallout from Arden’s destruction the Elizabethan regime punished the Shakespeares’ friends and neighbours the Quineys for their alleged financial links to the traitorous Ardens, despite local knowledge to the contrary, confirming Shakespeare’s sceptical understanding of the realities of power that can be found in his later plays.
The Aftermath
Authors: Parry Glyn , Enis Cathryn
Published: September 2020

This chapter traces the Stratford fallout from the condemnation of John Somerville, which undermined the social status of the Shakespeares’ close friends and neighbours, Adrian and Richard Quiney. After seizing Somerville’s estate the Exchequer concluded that the Quineys, having ostensibly borrowed money from Somerville, must now pay it immediately to the queen, despite their argument that the money actually belonged to the dowry of John’s underage sister, Margaret Somerville. Margaret’s subsequent unavailing attempts to recover her money, and the Quineys to avoid paying the queen, revealed to Stratford society the limitations of the traditional collaborative relationship between central government and local worthies responsible for maintaining the queen’s authority in their regions. The Exchequer applied the strict letter of the law: John Somerville’s signature and seal on the loan agreement counted for more than the equitable claims of the Quineys. More than the rental incomes diverted to the queen for the next decade to repay their debt, the Quineys suffered loss of face, since the Exchequer under Burghley made it evident that their previous public service did not entitle them to special consideration from their sovereign and her officers, because of their innocent association with Catholic ‘traitors’. The Exchequer continued to hound Margaret Somerville for a small debt until well into the reign of James, during which period Shakespeare acknowledged the name in 3 Henry VI, not as a discreet signal of his Catholic sympathies, of which this chapter shows no proof survives, but a comment on the abuse of power.
‘The Venerable Head’
Authors: Robinson D.H.
Published: September 2020

This introductory chapter sets out the argument of The Idea of Europe and the Origins of the American Revolution. It gives an overview of the ways in which colonial thinking about European geopolitics and European civilization shaped American politics and culture during the century prior to the Revolution. The introduction then reflects on the current historiographical consensus on the origins of the Revolution and the interplay of international relations with political culture in the eighteenth century. It concludes with some remarks on the challenges of writing histories of political culture and discusses the methodological problems of writing about the public sphere.
‘The Temper of the People’
Authors: Robinson D.H.
Published: September 2020

This chapter provides a cultural context for the political debate in eighteenth-century British North America. It charts the emergence and describes the contours of a colonial public sphere, which paralleled similar transformations in European politics during the same period. It explores the media of colonial politics, from newspapers to public oratory, as well as the social settings in which news was spread and debated, from tavern halls to tea gardens, and the codes of conduct that accompanied them, from commerce to refinement. It shows how the colonial public sphere connected with a wider British and European republic of letters, from the circulation of news and opinion around the Atlantic world to the participation of colonists in the Grand Tour. And finally, it discusses the problems and methods of interpreting public utterances.
‘In a National Light’
Authors: Robinson D.H.
Published: September 2020

This chapter shows how continentalism and colonial British nationalism created a distinctive language of political legitimation in the colonies during the mid-eighteenth century. This standard of behaviour was imposed on a wide range of wartime activities, from the voluntary and commercial practices of militia associations and privateers to fast and thanksgiving days. But it also assumed a critical role as a barometer against which to judge the conduct of colonial legislatures, and it was in this capacity that it underwrote a dramatic revolution in colonial politics during the crisis point of the Seven Years War. The same barometer was also applied to British statesmen and military men like William Pitt, the Earl of Bute, and Admiral John Byng. At the end of the conflict, the beginnings of the patriot movement would use its rhetoric to debate the virtues of the Treaty of Paris.
‘Magna Britannia’
Authors: Robinson D.H.
Published: September 2020

This chapter reveals the continuity of colonial thinking about geopolitics after the end of the Seven Years War. It shows how the unsettled state of Europe continued to trouble colonists after 1763. From its earliest days, the patriot movement warned about the renewal of international tensions, criticizing British colonial policy alongside the isolationist turn of British foreign policy as sources of weaknesses. Despite the conquest of Canada, the prospect of a French war of revenge and the spectre of French infiltration continued to dominate colonial discourse, maintaining its hold over conspiratorial thinking. These fears reached a height in the late 1760s and early 1770s, when a string of international crises in Poland, Corsica, the Falkland Islands, and Sweden unleashed a series of major war scares that shaped and tempered patriot manoeuvrings during the imperial crisis.
‘Events Abroad’
Authors: Robinson D.H.
Published: September 2020

This concluding chapter recapitulates the argument of The Idea of Europe and the Origins of the American Revolution, and offers a few reflections on the post-revolutionary period. It traces its implications of colonial geopolitical thinking for the competing American futurities of Thomas Jefferson and Fisher Ames after 1783, as well as the transition from formal to effective independence and American foreign policy in the nineteenth century and beyond.
Conclusion
Authors: Levin Yael
Published: September 2020

The chapter reads the tensions observed throughout this study with recent critical re-evaluations of human experience. Conrad’s art, and the modernism with which it is associated, have long been read as centering on questions of knowledge and truth, concealment and revelation, doubt and the desire to know. A more ontologically-driven thinking of modernism shows that the oscillations between Being and Becoming are meaningful not only as competing forces in critical practice and philosophical discourse, but as a gauge for significant changes in the way we engage with and represent the world. Conrad’s writing unmoors time from its chronological measure, frees the subject of the limits of the Cartesian cogito, and abandons telos in the charting of narrative form. Where conceptual logic cancels out difference in an attempt to create a coherent, recognizable picture, Conrad’s work repeatedly returns to the life force of difference.
Vectors and tensors: Algebra
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

This chapter introduces vectors and second-order tensors, and presents the fundamental rules and standard results of vector and tensor algebra. It briefly discusses fourth-order tensors. The most important results for vectors and tensors are presented in both direct and component form.
Kinematics
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

This chapter develops the necessary mathematics for describing general deformations that a solid body may undergo, a topic known as kinematics. Definitions of motion, displacement, velocity, and acceleration which are vectors, and the deformation gradient and displacement gradient which are tensors are given. The mapping of material vectors by the deformation gradient tensor as a basic concept in describing the large deformation kinematics of a deformable body is presented. The powerful polar decomposition theorem is discussed and applied to the deformation gradient tensor to show that it can be decomposed into a stretch followed by a rotation, or a rotation followed by a stretch. Non-linear measures of strain are defined in terms of the stretch tensors. The important case of small deformations, which results in linear measures of strain, is discussed. For small strains the important decomposition of the state of strain that separates a volumetric strain from a non-volumetric or deviatoric strain is presented.
Principles of minimum potential energy and complementary energy
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

With the displacement field taken as the only fundamental unknown field in a mixed-boundary-value problem for linear elastostatics, the principle of minimum potential energy asserts that a potential energy functional, which is defined as the difference between the free energy of the body and the work done by the prescribed surface tractions and the body forces --- assumes a smaller value for the actual solution of the mixed problem than for any other kinematically admissible displacement field which satisfies the displacement boundary condition. This principle provides a weak or variational method for solving mixed boundary-value-problems of elastostatics. In particular, instead of solving the governing Navier form of the partial differential equations of equilibrium, one can search for a displacement field such that the first variation of the potential energy functional vanishes. A similar principle of minimum complementary energy, which is phrased in terms of statically admissible stress fields which satisfy the equilibrium equation and the traction boundary condition, is also discussed. The principles of minimum potential energy and minimum complementary energy can also be applied to derive specialized principles which are particularly well-suited to solving structural problems; in this context the celebrated theorems of Castigliano are discussed.
Small deformation theory of species diffusion coupled to elasticity
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

This chapter presents a coupled theory for transport of a single atomic (or molecular) chemical species through a solid that deforms elastically. Consideration is limited to isothermal conditions and circumstances in which the deformations are small and elastic, and the changes in species concentration from a reference concentration are small --- a framework known as the theory of linear chemoelasticity. Underlying the presented approach is the notion that the solid can deform elastically but it retains its connectivity and does not itself diffuse. To account for the energy flow due to species transport, the notion of chemical potential of the species is introduced. First the basic equations of the fully-coupled linear theory of anisotropic linear chemoelasticity are derived, and then these equations are specialized for the case of isotropic materials.
Small deformation rate-independent plasticity based on a postulate of maximum dissipation
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

This chapter introduces the concept of maximum dissipation. The elastic set is introduced, and the plastic dissipation is maximized over the elastic set using classical methods from linear programming theory. The plastic flow direction is seen to be generally normal to the yield surface when the plastic dissipation is maximized. The Kuhn-Tucker complementarity conditions are seen in this context to arise from the postulated optimization problem, and the elastic set is seen to be necessarily convex. The concept of maximum dissipation is applied to a Mises material and the models of the earlier chapters are seen to be recovered.
Finite elasticity
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

This chapter provides an overview of the theory of finite elasticity including a review of finite deformation kinematic measures, stress tensors for finite deformation, the concept of material frame invariance and change of frame, and constitutive relations. Material symmetry is discussed, and the important case of isotropy is presented. Special considerations needed for incompressible isotropic materials are elaborated upon.
Finite elasticity of elastomeric materials
Authors: Anand Lallit , Govindjee Sanjay
Published: September 2020

This chapter presents several technologically important constitutive relations for elastomeric materials. In particular, the Neo-Hookean, Mooney-Rivlin, Ogden, Arruda-Boyce, and Gent free energy functions are discussed in the context of incompressible response. Extensions to the slightly compressible case are also detailed, this includes a presentation of a number of possible volumetric response relations and their properties.
Why Menelaus?
Authors: Stelow Anna R.
Published: September 2020

This chapter assesses the depiction of Menelaus in non-Homeric archaic poetry. What emerges most clearly about Menelaus, from the bits and pieces remaining from non-Homeric archaic poetry, is relationships: chiefly with Agamemnon and Helen; but also with Nestor and his sons, Antenor, and with kinsmen and hosts on Crete. The Cyclic fragments, scant as they are, disclose something of Menelaus’ stature independent of Agamemnon. The Cypria particularly shows Menelaus in the events leading up to the Trojan War largely acting on his own, or the gods’, initiative. Meanwhile, the Hesiodic Catalogue of Women emphasizes Menelaus’ success by virtue of his wealth at the great world-historical moment, not the Trojan War per se but earlier, in the wooing of Helen. In what remains of Menelaus in archaic lyric, the relationships with Agamemnon and Helen are also prominent. In Alcman, he is celebrated, with Helen and the Dioscuri, as the recipient of choral song at a place called Therapne. In Stesichorus, Menelaus is sidelined while Helen turns prophet. In the extant fragments of Sappho, Menelaus is mentioned along with his brother and wife.
Menelaus Εὐρυβίης‎
Authors: Stelow Anna R.
Published: September 2020

This concluding chapter examines Simonides’ ‘Plataea Elegy’. Sometime not long after the Greek defeat of the Persian army at Plataea, Simonides composed an elegy to commemorate this world-historical event in ostentatiously epic terms. Menelaus makes an appearance in the elegy, with the Dioscuri, as patron of the Spartan contingent. The intriguing poem provides a final glimpse of Menelaus as the archaic period draws to a close. It suggests that Menelaus’ place in the cultic environment of archaic Sparta was matched by a significant role in Spartans’ self-definition. The chapter then assesses Simonides’ description of Menelaus as εὐρυβίης‎. Simonides seems to have been the first to adapt the epithet εὐρυβίης‎ to describe a hero. Public performance of the elegy would have provided the opportunity for quick and widespread dissemination of the newly re-discovered word. Its special use then became normative in the lyric diction of epinician poets in the early to mid-fifth century.
Roles of Chinese Police Amidst the COVID-19 Pandemic
Authors: Jiang Feng , Xie Chuanyu
Published: September 2020

This article provides an overview of frontier issues of policing in China by examining the roles of police during the pandemic. It starts with a short introduction to the challenges and overall performance of China in keeping social order in the context of coronavirus disease (COVID-19). Then, it outlines four major missions the Chinese police have pursued, each with a sketch of what has been done and how law enforcement officials have managed to achieve their goals. It follows with a further insight into their strategies in social control in connection with the latest reforms on policing. Finally, it concludes briefly with features of Chinese policing.
A Cost-effective Technical Tip for Surgical Management of Pediatric Distal Radius and Ulna Fractures at Metadiaphyseal Junction
Authors: Tang Quen O. , As-Sultany Mohammed , Makki Daoud
Published: September 2020

Significantly displaced paediatric distal radius and ulna fractures which occur at the meta-diaphyseal junction frequently require surgical fixation due to the highly unstable configuration. The location of the fracture is often too proximal for transfixing with K-wires and too distal for intra-medullary TEN (titanium elastic nailing). We describe a simple cost-effective technique to stabilise such an injury using a readily available 2mm stainless steel kirschner-wire.
Current management of the vascular subtype of Ehlers–Danlos syndrome
Authors: Benrashid Ehsan , Ohman John Westley
Published: September 2020

Purpose of review

Vascular Ehlers–Danlos syndrome (vEDS) is the most severe form of EDS, affecting the synthesis of type III collagen. It is notable for decreased life expectancy and morbidity, including spontaneous vessel rupture. The present review summarizes recent findings that have improved the ability to manage and delineate the natural history of vEDS.

Recent findings

Recent EDS consortium guidelines for the diagnosis of vEDS have emerged and outlined clinical features and molecular diagnostic tools to help facilitate rapid diagnosis. Although medical interventions to help halt the disease progression remain limited, improved awareness of vEDS by patients and practitioners have resulted in increased average life expectancy. Early excitement with celiprolol has been tempered by a lack of high-quality studies. Likewise, the creation of multidisciplinary care teams and tertiary referral centers is helping improve outcomes. Unfortunately, there remain limitations in terms of the surgical management (including more advanced endovascular techniques) of these patients and the morbidity associated with these interventions.

Although new consensus guidelines have emerged to facilitate the diagnosis of those with vEDS, there remain limitations in terms of interventions and medical therapy that can be provided for these patients. Life expectancy does appear to be improving however with increased awareness and coordinated multidisciplinary efforts among medical geneticists, general practitioners, and interventionalists alike.
Influence of Sleep Dysfunction on Concussion Assessment Outcomes Among Adolescent Athletes After Concussion and Healthy Controls
Authors: Blaney Nicholas A. , Trbovich Alicia , Ernst Nathan , Eagle Shawn R. , Collins Michael W. , Kontos Anthony P.
Published: September 2020

Background:

Sleep dysfunction (SD) is associated with a high symptom burden and lower neurocognitive performance after concussion and on baseline testing without injury. However, few studies have compared concussed athletes and controls with and without SD on clinical outcomes.

Objective:

To evaluate differences in clinical outcomes among both concussed athletes and matched controls with and without SD.

Design:

Retrospective cross-sectional study.

Participants:

Participants aged 12 to 20 years were recruited from a concussion clinic (n = 50 patients) and research registry/flyers (n = 50 healthy age-/sex-matched controls). Participants were categorized by self-reported SD into one of 4 groups: sport-related concussion (SRC) + SD, SRC only, SD only, and controls.

Main Outcome Measures:

Post-Concussion Symptom Scale (PCSS), Vestibular/Oculomotor Screening (VOMS), and neurocognitive testing (Immediate Postconcussion Assessment Cognitive Test).

Results:

Compared with the SRC only group, the SRC + SD group performed worse on all neurocognitive domains, had a higher total symptom score, and endorsed more symptoms on most VOMS items. In addition, the SRC + SD group was at an increased likelihood of having at least 1 abnormal VOMS item compared with SRC only group. The SRC only group had neurocognitive test scores and symptom reports statistically similar to the SD only group.

Conclusion:

Sleep dysfunction after concussion is related to worse neurocognitive performance and higher concussion symptom reporting. This study extended findings to suggest vestibular symptomology is worse among athletes with SD after injury compared to injured athletes without SD. Similar performances on concussion assessments for the SRC only and SD only groups suggest SD may appear similar to clinical presentation of concussion, even at baseline in the absence of SRC.
Radiological Prevalence of Popliteal Artery Entrapment in Individuals With Anterior Leg Compartment Chronic Exertional Compartment Syndrome
Authors: Johnson Shelby E. , Finnoff Jonathan T. , Amrami Kimberly K. , Jelsing Elena J.
Published: September 2020

Objective:

Determine the radiological prevalence of popliteal artery entrapment (PAE) in subjects with anterior leg compartment chronic exertional compartment syndrome (CECS).

Design:

Retrospective review.

Setting:

Tertiary care center.

Patients:

Of 71 patients diagnosed with anterior leg compartment CECS using an in-scanner exercise-based magnetic resonance imaging (MRI), 64 also completed Fast Imaging Employing Steady-State Acquisition (FIESTA) imaging.

Interventions:

Electronic health records of patients diagnosed with anterior leg compartment CECS using an in-scanner exercise-based MRI between 2009 and 2018 were reviewed.

Main Outcome Measures:

Demographics, symptom laterality, and results of vascular work-up.

Results:

Magnetic resonance imaging was positive for PAE in 33 of 64 (51.6%). Vascular evaluation was performed in 30 of 33 (90.9%). Of these 30, ankle-brachial indices (ABIs) with PAE maneuvers were performed in 29 (96.7%) and positive in 25 (86.2%). Pre-exercise and post-exercise ABIs were performed in 29 (96.7%) and abnormal in 20 (69.0%). Thirteen arterial duplex ultrasounds were performed; 10 were consistent with PAE (76.9%). An MR angiogram was performed in 8 (26.7%) and consistent with PAE in all. One computed tomography angiogram (3.3%) was completed and was normal. Overall, one or more tests were positive for PAE in all 30 with vascular evaluation.

Conclusions:

The radiological prevalence of PAE and anterior leg CECS was 51.6%. All subjects with vascular studies (90.9%) had one or more tests confirming radiological PAE. These findings suggest that the coexistence of PAE and CECS is common, and the PAE protocol used has a high correlation with vascular studies.
Anxiety and Depressive Symptoms During the COVID-19 Emergency Period: A Comparative Cross-Sectional Study in Professional Football
Authors: Gouttebarge Vincent , Ahmad Imtiaz , Mountjoy Margo , Rice Simon , Kerkhoffs Gino
Published: September 2020

Objective:

The primary objective of our study was to establish the prevalence of anxiety and depressive symptoms among professional football (ie, soccer; hereinafter “football”) players during the COVID-19 emergency period, drawing comparisons with players assessed before exposure to the COVID-19 emergency period.

Design:

Observational comparative cross-sectional study by means of electronic questionnaire.

Setting:

Professional football.

Participants:

A total of 468 female (mean age: 22.8 years) and 1134 male (mean age: 26.0 years) players participated. The non–COVID-19 comparison group consisted of 132 female (mean age: 23.1 years) and 175 male (mean age: 24.8 years) professional footballers.

Intervention:

N/A.

Main Outcome Measures:

Anxiety symptoms were measured with the validated Generalized Anxiety Disorder 7 and depressive symptoms with the validated Patient Health Questionnaire 9. Both instruments have been widely used in both clinical and research settings among different populations, showing excellent psychometric properties.

Results:

During the COVID-19 emergency period, the 2-week prevalence of symptoms consistent with a diagnosis of generalized anxiety disorder and depression was 18.2% and 21.6%, respectively, among female professional footballers and 15.5% and 12.9%, respectively, among male players. The 2-week prevalence of anxiety and depressive symptoms among professional footballers was significantly higher during the COVID-19 emergency period than before the global pandemic (P < 0.01). Differences were most pronounced for those worried about the playing future.

Conclusions:

The COVID-19 emergency period is associated with increased symptoms of anxiety and depression in professional footballers, especially among those worried about their future as players.
Obesity, vitamin D deficiency and old age a serious combination with respect to coronavirus disease-2019 severity and outcome
Authors: Biesalski Hans K.
Published: September 2020

Purpose of review

Old age, obesity and vitamin D deficiency are considered as independent risk factors for severe courses of COVID-19. The aim of the review is to discuss common features of these risk factors and the impact of vitamin D.

Recent findings

The recently discovered relationship between vitamin D and the infection pathway of the virus via the renin--angiotensin system (RAS) and the adipokines leptin and adiponectin play an important role. The frequency of studies showing a relationship between a low vitamin D status in comorbidities and severe COVID-19 courses makes an impact of vitamin D effects likely.

There is a direct relationship between vitamin D, body fat and age in COVID-19 courses. With age, the ability of the skin to synthesize vitamin D decreases, and leads to vitamin D-deficits. If the skin is insufficiently exposed to sunlight, severe deficits can develop. As vitamin D plays an important role not only in the immune system but also in the RAS, and thus at the point where the virus attacks, a good vitamin D supply is an important basis for reducing the risk of severe COVID-19 processes. Treatment with vitamin D supplements should be based on severity of the vitamin D deficiency.
Patterns of Vasoactive Agent Initiation Among Children With Septic Shock in the Pediatric Emergency Department
Authors: Jeffreys Kristen L. , Eckerle Michelle , Depinet Holly
Published: September 2020

Objective

The aim of the study was to describe patterns of initiation (and factors associated with delayed initiation) of vasoactive agents among pediatric emergency patients with septic shock.

Methods

Patients with septic shock from November 2013 to September 2016 who had a vasoactive agent initiated for documented hypotension were classified as “guideline adherent” (hypotensive following the final fluid bolus and had vasoactive agents initiated within 60 minutes) or “delayed initiation” (hypotensive after the final bolus and were initiated on vasoactive agents after >60 minutes). Patient-level factors (demographics, presence of underlying condition including central venous catheter, and markers of disease severity) and outcomes (mortality, length of stay) were compared between groups.

Results

Of the 37 eligible patients, 17 received vasoactive agents within “guideline adherent” timelines and 10 were “delayed initiation.” An additional group was identified as “transient responders”; these patients were normotensive after a final fluid bolus but developed hypotension and were initiated on a vasoactive agent within 2 hours after admission (n = 10). We found no significant difference between the “guideline adherent” and “delayed initiation” groups according to patient-level factors or outcomes; “transient responders” were more likely than other groups to have a central venous catheter and had longer lengths of stay.

Conclusions

Although there are perceived barriers to vasoactive agent initiation, we found no significant difference in patient-level factors between the timely and delayed groups. This study also identified a group of patients labeled as transient responders, who initially appeared volume responsive but who required vasoactive support within several hours. This cohort requires further study.
Evidence-Based Diagnostic Test Accuracy of History, Physical Examination, and Imaging for Intussusception
Authors: Hom Jeffrey , Kaplan Carl , Fowler Susan , Messina Catherine , Chandran Latha , Kunkov Sergey
Published: September 2020

Introduction

Intussusception is the most common cause of pediatric small bowel obstruction. Timely and accurate diagnosis may reduce the risk of bowel ischemia. We quantified the diagnostic test accuracy of history, physical examination, abdominal radiographs, and point-of-care ultrasound.

Method

We conducted a systematic review for diagnostic test accuracy of history, physical examination, and imaging concerning for intussusception. Our literature search was completed in June 2019. Databases included Medline via Ovid, Embase, Scopus, and Wiley Cochrane Library. We conducted a second review of the literature up to June 2019 for any additional studies. Inclusion criteria were younger than 18 years and presenting to the emergency department for abdominal complaints, consistent with intussusception. We performed data analysis using mada, version 0.5.8. We conducted univariate and bivariate analysis (random effects model) with DerSimonian-Laird and Reitsma model, respectively. QUADAS-2 was used for bias assessment.

Results

The literature search identified 2639 articles, of which 13 primary studies met our inclusion criteria. Abdominal pain, vomiting, and bloody stools had positive likelihood ratios LR(+) between 1 and 2, whereas the negative likelihood ratio, LR(−), ranged between 0.4 and 0.8. Abnormal abdominal radiograph had LR(+) of 2.5 and LR(−) of 0.20, whereas its diagnostic odds ratio was 13. Lastly, point-of-care ultrasound had LR(+) of 19.7 and LR(−) of 0.10. The diagnostic odds ratio was 213.

Conclusions

History and physical examination had low diagnostic test accuracy. Abdominal radiographs had low diagnostic test accuracy, despite moderate discriminatory characteristics. Point-of-care ultrasound had the highest diagnostic test accuracy to rule in or rule out intussusception.
Fate of Patients With Intraductal Papillary Mucinous Neoplasms of Pancreas After Resection According to the Pathology and Margin Status
Authors: Kim Hyeong Seok , Han Youngmin , Kang Jae Seung , Choi Yoo Jin , Byun Yoonhyeong , Kim Haeryoung , Lee Kyung Bun , Kim Hongbeom , Kwon Wooil , Jang Jin-Young
Published: September 2020

Objective:

This study evaluated the associated factors and prognosis according to pathology and margin after surgical resection of intraductal papillary mucinous neoplasms (IPMN).

Background:

There is limited information on recurrence patterns according to pathology and margin in IPMN.

Methods:

Total 577 patients who underwent operation for IPMN at a tertiary center were included. Factors associated with recurrence, survival, and recurrence outcomes according to pathology and margin were analyzed.

Results:

Among 548 patients analyzed, 353 had low-grade dysplasia (LGD), 78 had high-grade dysplasia (HGD), and 117 had invasive IPMN. Total 50 patients developed recurrences, with 4 resection margins, 10 remnant pancreas, 11 locoregional, and 35 distant recurrences. Invasive IPMN showed worse 5-year cumulative recurrence risk (LGD vs HGD vs invasive: 0.7% vs 4.3% vs 37.6%, P < 0.001) and 5-year survival rate (89.0% vs 84.0% vs 48.4%, P < 0.001). Recurrence risk increased after 5 years, even in LGD and HGD. Malignant margin (HGD and invasive) had worse 5-year cumulative recurrence rate (R0 vs LGD vs malignant: 8.3% vs 5.9% vs 50.6%, P < 0.001) and 5-year survival rate (80.7% vs 83.0% vs 30.8%, P < 0.001). Carbohydrate antigen 19–9 >37 (P = 0.003), invasive IPMN (P < 0.001), and malignant margin (P = 0.036) were associated with recurrence.

Conclusions:

Invasive IPMN developed more recurrences and had worse survival than LGD or HGD, indicating the need for more efficient postoperative treatment strategies. Patients with LGD and HGD also need regular follow-up for recurrence after 5 years. Malignant margins need additional resection to achieve negative or at least LGD margin.
Curative Surgery and Ki-67 Value Rather Than Tumor Differentiation Predict the Survival of Patients With High-grade Neuroendocrine Neoplasms
Authors: Asano Daisuke , Kudo Atsushi , Akahoshi Keiichi , Maekawa Aya , Murase Yoshiki , Ogawa Kosuke , Ono Hiroaki , Ban Daisuke , Tanaka Shinji , Tanabe Minoru
Published: September 2020

Objective:

To elucidate the role of surgery in patients with high-grade neuroendocrine neoplasms (hg-NENs) and Ki-67 more than 20%.

Background:

Although surgery is the first treatment choice in patients with low-grade NENs, whether it increases the survival of patients with hg-NENs is debatable.

Methods:

Between 2005 and 2018, 63 patients pathologically diagnosed with hg-NENs treated at our institution were retrospectively analyzed. The risk factors for overall survival (OS) and recurrence-free survival were analyzed, and OS was compared between each treatment group.

Results:

The median observation time was 21.2 months, and the median Ki-67 value was 52%. Patients with hg-NENs were classified into low Ki-67 (Ki-67 <52%) and high Ki-67 (Ki-67 ≥52%) groups. Multivariate analysis for OS identified surgery (P = 0.013) and low Ki-67 value (P = 0.007) as independent risk factors, whereas morphological differentiation defined by the WHO 2017 criteria showed no association with OS. Patients with low Ki-67 value subjected to R0/1, R2, and chemotherapy had a median survival time of 83.8, 16.6, and 28.1 months, respectively. The median survival time for R0/1 group was significantly longer than that for chemotherapy group (P = 0.001). However, no difference in survival was reported between patients from R0/1 and chemotherapy groups with high Ki-67. Ki-67 value could determine recurrence-free survival (P = 0.006) in patients who underwent R0/1 surgery for pancreatic hg-NENs.

Conclusions:

R0/1 surgery predicted prognoses in the low Ki-67 group. The indication of surgery for patients with hg-NENs did not depend on tumor differentiation.
ICTV Virus Taxonomy Profile: Caulimoviridae
Authors: Teycheney Pierre-Yves , Geering Andrew D. W. , Dasgupta Idranil , Hull Roger , Kreuze Jan F. , Lockhart Ben , Muller Emmanuelle , Olszewski Neil , Pappu Hanu , Pooggin Mikhail M. , Richert-Pöggeler Katja R. , Schoelz James E. , Seal Susan , Stavolone Livia , Umber Marie , Report Consortium ICTV
Published: September 2020

Caulimoviridae is a family of non-enveloped reverse-transcribing plant viruses with non-covalently closed circular dsDNA genomes of 7.1–9.8 kbp in the order Ortervirales. They infect a wide range of monocots and dicots. Some viruses cause economically important diseases of tropical and subtropical crops. Transmission occurs through insect vectors (aphids, mealybugs, leafhoppers, lace bugs) and grafting. Activation of infectious endogenous viral elements occurs in Musa balbisiana, Petunia hybrida and Nicotiana edwardsonii. However, most endogenous caulimovirids are not infectious. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the family Caulimoviridae, which is available at ictv.global/report/caulimoviridae.
Transcriptomic analysis of cyanobacterial alkane overproduction reveals stress-related genes and inhibitors of lipid droplet formation
Authors: Arias Daisy B. , Gomez Pinto Kevin A. , Cooper Kerry K. , Summers Michael L.
Published: September 2020

The cyanobacterium

Nostoc punctiforme

can form lipid droplets (LDs), internal inclusions containing triacylglycerols, carotenoids and alkanes. LDs are enriched for a 17 carbon-long alkane in

N. punctiforme

, and it has been shown that the overexpression of the aar and ado genes results in increased LD and alkane production. To identify transcriptional adaptations associated with increased alkane production, we performed comparative transcriptomic analysis of an alkane overproduction strain. RNA-seq data identified a large number of highly upregulated genes in the overproduction strain, including genes potentially involved in rRNA processing, mycosporine-glycine production and synthesis of non-ribosomal peptides, including nostopeptolide A. Other genes encoding helical carotenoid proteins, stress-induced proteins and those for microviridin synthesis were also upregulated. Construction of

N. punctiforme

strains with several upregulated genes or operons on multi-copy plasmids resulted in reduced alkane accumulation, indicating possible negative regulators of alkane production. A strain containing four genes for microviridin biosynthesis completely lost the ability to synthesize LDs. This strain exhibited wild-type growth and lag phase recovery under standard conditions, and slightly faster growth under high light. The transcriptional changes associated with increased alkane production identified in this work will provide the basis for future experiments designed to use cyanobacteria as a production platform for biofuel or high-value hydrophobic products.
Estimating Risk of Mechanical Ventilation and Mortality Among Adult COVID-19 patients Admitted to Mass General Brigham: The VICE and DICE Scores
Authors: Nicholson Christopher J. , Wooster Luke , Sigurslid Haakon H. , Li Rebecca F. , Jiang Wanlin , Tian Wenjie , Cardenas Christian L. Lino , Malhotra Rajeev
Published: September 2020

Background

Risk stratification of COVID-19 patients upon hospital admission is key for their successful treatment and efficient utilization of hospital resources.

Objective

To evaluate the risk factors associated with ventilation need and mortality.

Design, setting and participants

We established a retrospective cohort of COVID-19 patients from Mass General Brigham hospitals. Demographic, clinical, and admission laboratory data were obtained from electronic medical records of patients admitted to hospital with laboratory-confirmed COVID-19 before May 19th, 2020. Using patients admitted to Massachusetts General Hospital (MGH, derivation cohort), multivariable logistic regression analyses were used to construct the Ventilation in COVID Estimator (VICE) and Death in COVID Estimator (DICE) risk scores.

Measurements

The primary outcomes were ventilation status and death.

Results

The entire cohort included 1042 patients (median age, 64 years; 56.8% male). The derivation and validation cohorts for the risk scores included 578 and 464 patients, respectively. We found seven factors to be independently predictive for ventilation requirement (diabetes mellitus, dyspnea, alanine aminotransferase, troponin, C-reactive protein, neutrophil-lymphocyte ratio, and lactate dehydrogenase), and 10 factors to be predictors of in-hospital mortality (age, sex, diabetes mellitus, chronic statin use, albumin, C-reactive protein, neutrophil-lymphocyte ratio, mean corpuscular volume, platelet count, and procalcitonin). Using these factors, we constructed the VICE and DICE risk scores, which performed with C-statistics of at least 0.8 in our cohorts. Importantly, the chronic use of a statin was associated with protection against death due to COVID-19. The VICE and DICE score calculators have been placed on an interactive website freely available to the public (https://covid-calculator.com/).

Limitations

One potential limitation is the modest sample sizes in both our derivation and validation cohorts.

Conclusion

The risk scores developed in this study may help clinicians more appropriately determine which COVID-19 patients will need to be managed with greater intensity.
Exposure to stressors and antimicrobials induces cell-autonomous ultrastructural heterogeneity of an intracellular bacterial pathogen
Authors: Schulte Marc , Hensel Michael , Miskiewicz Katarzyna
Published: September 2020

Despite being clonal, bacterial pathogens show a remarkable physiological heterogeneity during infection of host and within host cells. This diversity is reflected by distinct ultrastructural morphotypes in transmission electron microscopy (TEM). Gram-negative bacteria visualized at high resolution by TEM show a rather simple composition of cytoplasm with a centrally located nucleoid and large number of ribosomes. The cytoplasm is separated from the external environment by inner and outer membranes. In this study, we show that individual cells ofSalmonella entericaserovar Typhimurium (STM) are ultrastructural divergent in standard culture conditions, as well as during their intracellular lifestyle in mammalian host cells. STM can basically be discriminated into two morphotypes based on the criterion of cytoplasmic density. We identified environmental conditions which affect cytoplasmic densities. Using chemical treatments and defined mutant strains, we were able to link the occurrence of an electron-dense type to oxidative stress and other noxes. Furthermore, ultrastructural analyses of STM during infection and fluorescence reporter analyses for cell viability were combined in a correlative light and electron microscopy approach. We provide evidence that two newly characterized ultrastructural types with lucent or dense cytoplasm represent viable cells. Moreover, the presence of electron-dense types is stress related and can be experimentally induced only when amino acids are available in the environment. This study sheds more light on diversities between individual bacteria in populations and possible physiological meanings like a stress response to explain the diversities discussed.

Importance

Bacterial pathogens show a remarkable resilience to adverse conditions during infection. Although being genetically identical, a clonal population may contain dead, dormant, slowly as well as rapidly proliferating cells. The physiological state of individual cells in a population may be analyzed by fluorescent probes or reporters. In contrast, reliable markers to interrogate single cells regarding viability, response to environmental cues, and exposure to antimicrobial compounds are sparse for ultrastructural approaches. For intracellularSalmonella entericawe observed distinct ultrastructural morphotypes. Using defined experimental conditions, these morphotypes were linked to reactions of bacteria to stressors or antimicrobials. The parameters defined here provide criteria for the interpretation of bacterial heterogeneity on the ultrastructural level.