bluuebunny/crossref_metadata_2025 huggingface dataset:
1447 Trends in Lower Extremity Amputation Incidence in European Union 15+ Countries 1990-2017
Authors: Goodall R , Hughes W , Salciccioli J , Marshall D , Davies A H , Shalhoub J
Published: October 2021

Aim

To assess trends in lower extremity amputation (LEA) incidence in European Union (EU15+) countries for the years 1990-2017.

Method

This was an observational study using data obtained from the 2017 Global Burden of Disease (GBD) Study. Age standardised incidence rates (ASIRs) for LEA (stratified into toe amputation, and LEA proximal to toes) were extracted from the GBD Results Tool (http://ghdx.healthdata.org/gbd-results-tool) for EU15+ countries for each of the years 1990-2017. Trends were analysed using Joinpoint regression analysis.

Results

Between 1990 and 2017, variable trends in the incidence of LEA were observed in EU15+ countries. For LEAs proximal to toes, increasing trends were observed in six of 19 countries and decreasing trends in nine of 19 countries, with four countries showing varying trends between sexes. For toe amputation, increasing trends were observed in eight of 19 countries and decreasing trends in eight of 19 countries for both sexes, with three countries showing varying trends between sexes. Australia had the highest ASIRs for both sexes in all LEAs at all time points, with steadily increasing trends. The USA observed the greatest reduction in all LEAs in both sexes over the time period analysed (LEAs proximal to toes: female patients 22.93%, male patients 29.76%; toe amputation: female patients 29.93%, male patients 32.67%). The greatest overall increase in incidence was observed in Australia.

Conclusions

Variable trends in LEA incidence were observed across EU15+ countries. These trends do not reflect previously observed reductions in incidence of PAOD over the same time period.
989 Sustained and Further Improvements in Management of Open Fractures at a UK Major Trauma Centre
Authors: Ramjeeawon A , Iqbal M , Abourisha E , Ahmad A , Hasan Y , Hawthorne R , Ashraf A , Deakin M
Published: October 2021

Aim

To re-audit pre-operative hospital management of open fractures following further interventions (junior doctor education and awareness, editing of trauma clerking form), after the initial audit and interventions led to improvements in all parameters.

Method

Pre-operative hospital management of open fractures was audited by reviewing patient notes using standards from the NICE (NG37) and BOAST/BAPRAS open fracture management guidelines. Patients included were treated by doctors with full exposure to the further interventions (due to junior doctor changeover the third cycle included fewer patients).

Results

All parameters remained improved in the third audit cycle compared to the first (before interventions were implemented). The following results compare the second (n = 30) and third audit (n = 14) cycles. Patients receiving correct antibiotics (96%vs100%) and in a timely manner (<2 hours) where not given pre-hospital (46%vs60%) improved. Initial neurovascular assessment (93%vs100%), specifying nerves assessed (60%vs71%), assessing all relevant arteries (60%vs71%) and nerves (63%vs71%) and using Medical Research Council (MRC) grading in nerve assessment (3%vs71%) improved, while specifying arteries assessed was similar (87%vs86%). Post-manipulation, neurovascular assessment (93%vs75%) and appropriate nerve examination (90%vs50%) deteriorated, however appropriate vascular assessment (60%vs75%) and use of MRC grading in nerve assessment (0%vs50%) improved. Documentation where neurovascular assessment was not possible, initially (50%vs93%) and post-manipulation (40%vs50%) improved. Photo availability deteriorated (70%vs64%). Tetanus cover (87%vs100%) and appropriate dressing use (47%vs71%) improved.

Conclusions

Most parameters showed sustained and further improvements. The haemodynamic stability variation of these patients may create difficulties in fully adhering to the management standard; in some cases, other acute concerns may take priority.
1181 Thoracic Outlet Syndrome - A Miss(Ed) Diagnosis-Delayed Diagnosis Of Thoracic Outlet Syndrome Is Common And Leads To Poorer Functional Outcomes
Authors: Suresh S , Kaneta G , Wignakumar A , Choksy S , Sinha S , Howard A
Published: October 2021

Thoracic outlet syndrome was first defined by Peet in 1956 as “compression of the neurovascular structures in the interscalene triangle corresponding to the possible etiology of the symptoms”.1 Diagnosis of TOCS still remains controversial due to lack of clear referral pathways and our study aims to create one to prevent adverse treatment outcomes.

Method

A retrospective audit in a single vascular centre over a 11-year period correlating time of onset of symptoms to delivery of care and post intervention benefits

Results

Total of 50 patients were analysed during the study. 30 percent of the patients analysed were noted to be referred to a vascular surgeon 3 years post the initial presentation of symptoms. 60 percent were noted to be referred between 6-2.5 years post initial presentation. Remaining 10 percent were noted to be referred in less than 6 years. It was noted that patients belonging to the group Acohort were noted to have recurrence of symptoms, albeit minor post intervention and treatment of TOCS. Whereas recurrence was noted to be nil/ reduced in the patients intervened in less than 2 years from onset of symptoms. Furthermore, the study also noted that more than 50 percent patients with neurogenic/ venous TOCS had a history of preceeding trauma/ shoulder injury and were noted to be not investigated for TOCS.

Conclusions

Our study lends evidence that delayed diagnosis of thoracic outlet syndrome is common and leads to poorer functional and treatment outcomes. Hence a diagnostic pathway must be proposed and implemented at primary care which caters to diagnosis of TOCS, to avoid delays in delivery of adequate care and treatment.
1231 A Full-Cycle Audit Of ‘Safe’ Surgical Handovers in A Tertiary Centre
Authors: Shakoor Z , West C
Published: October 2021

Aim

1. Assess performance in surgical handovers at Southampton General Hospital (SGH) against RCS ‘Safe Handover’ guidelines Identify any areas for improvement to ensure safe and effective handover of surgical patients

Method

10 evening surgical handovers were anonymously audited In October 2019 against RCS ‘safe handover’ guidelines. The results were subsequently analysed and circulated amongst the surgical department. Handovers were then led consistently by surgical registrars and advanced nurse practitioners (ANPs). A prompt including the RCS handover guidelines was made and distributed to all members of the surgical team and included in departmental inductions. Following this, a further 10 evening handovers were anonymously audited between July and August 2020.

Results

Many aspects of handover performance descriptors described by the RCS in the re-audit improved following the circulation of our prompt including RCS handover guidelines and examples of minimum or good standards of practice for handover. Specifically, handover timeliness, the briefings provided (100% from 70%), the audibility of a single speaker (70% from 30%), the number of educational discussions held during handovers (100% from 50%) and awareness of the on-call overnight consultant (100% from 80%) all vastly improved.

Conclusions

Emphasis on undertaking effective handovers needs to continue as ‘safe' handovers between shifts can protect both patient and doctor safety. This is especially true following the implementation of the European Working Time Directive (EWTD) and a move to full shift working. Handovers are also proposed as opportunities for training which may be helpful especially in an era of reduced hours of surgical training.
1359 Everyone Deserves to Smile: An Audit on The Success Rate of Dental Implants in Complex Maxillofacial Patients
Authors: Lugaric P , Frezzini C , Patterson A
Published: October 2021

Aim

To determine the success rates of dental implants in complex patients treated in the Oral and Maxillofacial Surgery Department at Rotherham General Hospital (RGH).

Method

All patients who received dental implants in the period January 2010 – March 2017 at RGH were included in the audit.

Standards

90% local standard

Results

68 dental implants were placed in 22 patients: 15 patients head and neck reconstruction, 5 atrophic edentulous patients, 2 trauma.

Conclusions

Survival rates for dental implants in the literature is variable ranging from 91 -96% in native bone and mucosa and 46 - 98% in irradiated tissue.
Does Goal Orientation Modulate Satisfaction With Cognitive Performance in Different Age Groups?
Authors: Gong Xianmin , Freund Alexandra M
Published: October 2021

Objectives

The current experiment tested the causal effect of goal orientation on subjective satisfaction with performance on a cognitive task.

Method

A sample of N = 231 young, middle-aged, and older adults (21–79 years) completed a dot-memory task in one of 3 goal orientation conditions aiming for improvement, maintenance, or avoidance of decline in performance.

Results

Bayesian analyses showed that in all age groups, goal orientation influenced actual performance, but did not affect perceived performance or performance satisfaction. Performance satisfaction was positively correlated with perceived performance, but not with actual performance.

Discussion

The findings suggest that whether goal orientation benefits older adults’ subjective well-being might depend on (a) the goal content (previous research targeted personal goals) or (b) whether it enhances their perception of the status quo (and thus reduces the discrepancy between actual and desired states). This study contributes to a better understanding of the role of goal orientation in subjective well-being across adulthood.
PSV-12 The impact of modern diets and growth technologies on animal growth performance and the carbon footprint of cattle feeding
Authors: Crawford David M , Hales Kristin E , Smock Taylor M , Cole Andy , Samuelson Kendall L
Published: October 2021

Both dietary ingredients and technology used in the feedlot cattle industry have evolved in the past 30 years. As consumer concern for the sustainability of the feedlot cattle production increases, it is important to understand how production efficiency and greenhouse gas emissions have changed in this period. For this study, a model was developed to represent feedlot diets and technologies used in 1990 vs. 2020 and evaluate changes in growth performance and carbon footprint. Dietary changes from 1990 to 2020 included the use of byproduct feeds while decreasing corn and dry roughage inclusion rates. In 1990, available technologies included estradiol-only implants and monensin as a feed additive; whereas in 2020 use of combination implants including both trenbolone acetate and estradiol, monensin, and ractopamine hydrochloride (in the final 28 to 42 d) were common. In both 1990 and 2020 use of available technologies increased final body weight (BW), average daily gain (ADG), feed efficiency, and hot carcass weight (HCW) compared to no technology. From 1990 to 2020 initial BW, final BW, ADG, gain to feed ratio, and HCW increased, and dry matter intake decreased. Total days on feed (DOF) also increased by 43 days from 1990 to 2020. Compared to no technology, use of technologies in both 1990 and 2020 decreased total greenhouse gas emissions per animal (CO2e). Because cattle had greater DOF in 2020 than 1990, all sources of greenhouse gas emissions per animal increased. However, when expressed as CO2e/kg BW gain, emissions have decreased by 12.6% because of greater total BW gain in 2020. Feedlots in 2020 produced 48.15% more BW gain with 6.7% less cattle, while only increasing total CO2e by 23.42%, indicating changes in technologies and diet formulations have improved efficiency and reduced the carbon footprint of feedlot cattle production in the past 30 years.
PSII-19 The Effects of Maternal Programming on Dairy Bull Calf Response to an Intravenous Glucose Tolerance Test
Authors: Eaton Lindsey , Barney Amanda , Lally Jordan , Gately Rachael , Hoffman Maria L
Published: October 2021

Calves are prone to health issues with high mortality observed during the first 3 weeks of life. We hypothesized that dam milk production levels and/or mastitis infection during gestation will lead to reduced insulin production and increased circulating glucose concentration in response to an Intravenous Glucose Tolerance Test (IVGTT) in young dairy bull calves. Calves (n = 45) were selected from dams classified has high producers (HI; Top 25% for herd M305; n = 7), high producers with high somatic cell count (SCC; HIMAST; SCC test during gestation over 200,000 cells/mL; n = 15), moderate producers (MOD; lower 60% for herd M305; n =17) or moderate producers with high SCC (MODMAST; n = 6). IVGTT were performed on the calves at 7 weeks of age. Blood samples were collected prior to (-30, -15 and 0 min) infusion of glucose. After glucose (0.15 grams /kg bw) administration, samples were collected at 2, 5, 10, 15, 30, 60, and 120-minutes post infusion. Serum insulin and glucose concentrations were determined at Cornell Veterinary Medical Diagnostic Laboratory (Ithica, NY). Data were analysed in SAS using Proc Mixed. Insulin:glucose ratio was analysed using Proc Mixed with repeated measures for treatment x time. No effect of maternal milk production and/or mastitis infection during gestation was observed on calf baseline insulin, insulin AUC, baseline glucose or glucose AUC (P ≥ 0.12). Similarly, no difference in Insulin:Glucose ratio was observed in these calves (P = 0.66). In conclusion, high maternal milk production and/or mastitis infection may not have an effect on circulating insulin production in calves in response to an IVGTT. Correlation analyses will be performed on these data, as well as additional analyses, to determine if insulin sensitivity or response (ie: phase 1 response) was altered further.
PSII-16 Potential of sensor technology to detect changes in behavior related to health status of ewes following exposure to mold-contaminated feed
Authors: Gurule Sara C , Aguirre Melissa , Forrest Kylee , Flores Victor V , Wenzel John , Tobin Colin , Bailey Derek , Hernandez Gifford Jennifer A
Published: October 2021

Behavior can be a valuable indicator of an animal’s health and wellness state, emphasizing the importance of monitoring changes in behavior. Sensor technologies can identify changes in animal activity, providing the potential to detect abnormal behavior associated with health status and animal welfare. The aim of this study was to investigate sheep behavior before and after illness caused by mold-contaminated feed using tri-axial accelerometers. Twenty-five ewes were fitted with HerdDogg biometric accelerometer ear tags. Thirteen ewes also had Axivity AX3 accelerometers attached on the opposite side ear tag. Tri-axial accelerometers were attached to mature ewes for the purpose of parturition evaluation, when an unexpected ration change occurred. The entire sheep flock was exposed to mold-contaminated feed, symptoms were immediately observed, and symptomatic ewes were treated with a veterinarian directed protocol. Accelerometer data were evaluated 4 days prior to exposure (d -4 to -1); on day of ration change (d 0); and 4 days post exposure (d 1 to 4). Herddogg accelerometer data from 3 ewes displaying symptoms identified a decrease in activity (P ≤ 0.03) for 2 days after feed exposure compared to the 4 days before exposure. Three days after exposure and 2 days after treatment, no difference in activity was detected (P > 0.05) between pre- and post-activity levels. Herddogg accelerometers can identify similar behavioral changes as Axivity accelerometers. The correlation of the standard deviation of movement intensity derived from the Axivity accelerometer and the Herddogg activity metric was 0.67. It is crucial to detect subtle behavioral changes at onset of illness, to allow for prompt producer intervention before animal health is compromised. These results suggest that real-time or near-real time accelerometers, such as Herddogg, have potential to detect illness in ewes in a pen setting.
PSII-B-23 Implementation of a design thinking approach to problem-based learning in an animal science capstone
Authors: Paudyal Sushil , Frenzel Leslie , Donaldson Jonan , Dunlap Kathrin , Wiegert Jeffrey
Published: October 2021

The objective is to present a strategy for attainment of capstone course objectives using design thinking. Problem based learning has long been incorporated into STEM, and yet inclusion of a formalized design thinking strategy is a novel approach for student-led cooperative learning. Relevancy of content and potential student impact upon the industry was established via the inclusion of stakeholders representing state livestock commodity groups who, via Zoom, met with students to present an overview of challenges facing their respective industries. Students, working in teams, used these conversations to formulate complex problems as the basis of their design thinking process. Subsequent steps of convergent and divergent thinking and low and high-fidelity prototyping led to creation of prototype solutions, which were continuously revised based upon feedback received after deployment. Solutions were prepared for dissemination to varied audiences using multiple communication strategies. Students were required to develop a technical report, scientific poster, infographic, narrated video, and oral presentation. The necessary buy-in from instructors, guest lecturers, students, and stakeholders is significant and a potential challenge to be addressed from the onset of the course. Further, use of design thinking typically requires students to transition from traditional course delivery and assessments to real world situations in which they receive process guidance, but must develop problem solutions themselves. Students required both prompting and restraint to follow the design thinking process. Frequent and transparent communication are helpful in ameliorating student frustration. The student group dynamic was heavily influenced due to covid-19, as teams contained a mix of students physically attending classes and those working remotely. Preliminary feedback suggests that all students engaging remotely via a Zoom meeting helps to create a more equitable and productive working environment. In its first iteration, students are engaged in design thinking and achieving capstone course objectives on schedule.
PSII-B-20 Benefits of a lecture teaching assistant in hiflex courses
Authors: Barnes Taylor , Leatherwood Jessica L , Dunlap Kathrin
Published: October 2021

The Covid-19 pandemic has required implantation of online education strategies, even for animal science courses, that are traditionally delivered face-to-face (F2F). As universities reopened many students were given the option of attending classes either F2F or remotely via live stream. This scenario, where some students are present in-person while others are present online simultaneously, is referred to as hiflex teaching. Face-to-face and online teaching strategies are established and literature contains pedagogical information, however hiflex teaching presents previously unencountered challenges. It can be difficult for instructors to maintain engagement with, essentially, two separative audiences of students. The objective was to address this issue by providing a graduate teaching assistant (TA) to large lecture courses, where traditionally TA positions were reserved only for lab courses. The hypothesis was that this would enable both audiences to receive appropriate focus. In this study, a TA attended the F2F lecture for an introductory equine science course (total students: n = 75; remote students: n= ~55), with the role of monitoring the simultaneous Zoom session with remote students. We found that questions from remote students increased when they had the ability to post them in real-time using the Zoom chat feature, as opposed waiting for a break in instruction in F2F situations. Having the TA present in the classroom enabled them to answer basic questions via Zoom, and to interact with the instructor should a question arise online that would benefit all students in the course. This allowed the instructor to effectively teach without taking up valuable class time alternating between programs on the computer and risking missing an online student question. This approach received positive feedback from the instructor and students alike. Additionally, it provided a novel teaching experience for a graduate TA. Similar strategies may be used to help to facilitate future success in hiflex courses.
Intrinsic Motivation, Psychological Needs, and Competition: A Self-Determination Theory Analysis
Authors: Ryan Richard M. , Reeve Johnmarshall
Published: October 2021

Competition is an apt place to experience intrinsic motivation, as competitive settings are often rich with optimal challenges and immediate, effectance-relevant feedback. Yet competition can also undermine intrinsic motivation and sustained engagement by introducing controlling pressures and negative feedback. To explain the contrasting effects of competitive settings on intrinsic motivation, this chapter presents a self-determination theory analysis. According to the theory, when elements of competitive settings are experienced as controlling or pressuring, they undermine competitors’ autonomy, decreasing intrinsic motivation. However, when these elements are perceived as both non-controlling and competence-informing, they can satisfy both autonomy and competence needs, enhancing intrinsic motivation. Unpacking these motivational crosscurrents, the authors identify the motivational implications of different elements of competition, including competitive set, pressure to win, feedback and competitive outcomes, challenge, leaders’ motivating styles, team interpersonal climate, and intrapersonal events such as ego-involvement. The authors also examine both positive and negative effects of competition on the need for relatedness. The chapter concludes by discussing how conditions that foster the need-satisfying aspects of competition not only enhance intrinsic motivation but also help prevent the emergence of competition’s darker sides, such as cheating, doping, objectifying opponents, aggression, and poor sportspersonship.
Japan
Authors: Evangelista Stefano
Published: October 2021

In the second half of the nineteenth century, literary decadence developed in parallel with japonisme, the taste for Japanese art and culture that seized Western countries following Japan’s opening to foreign trade. This article starts with an analysis of how the intertwining of japonisme and art for art’s sake pioneered by visual artists influenced writers associated with decadence, such as Walter Pater, Arthur Symons, and Oscar Wilde. The evolving relationship between decadence and japonisme assumed a distinctive character in the work of Lafcadio Hearn, who lived in Japan all through the 1890s and wrote a series of influential books about the country. The article closes with an account of how ideas of decadence traveled back to Japan. Yōshū Chikanobu’s color prints reverse the orientalist gaze of Western artists by documenting a Japanese fascination with European culture that traditionalists viewed as a symptom of decadence. As Japanese literature opened itself to cosmopolitan influences, key writers such as Natsume Sōseki, Tanizaki Junichirō, and Mishima Yukio borrowed from Western literatures to provide ambivalent depictions of Japan’s social and cultural changes.
Sensory and Perceptual Abilities in People With Down Syndrome
Authors: Bertone Armando , Guy Jacalyn , Marcone Christina
Published: October 2021

During typical development, the efficiency with which distinct image attributes, objects such as faces, and emotions are analyzed depends on the development of ocular functioning (sensory level) and brain mechanisms mediating perceptual abilities (neural level). Compared to typically developing individuals, ocular differences are more frequent in persons with Down syndrome (DS) and include an increased incidence of refractive errors, i.e. hyperopia and myopia, and difficulties with accommodation (focusing up close). In most cases, these conditions can be corrected with bifocals, resulting in greatly improved literary skills that underlie reading, particularly for younger persons with DS. In addition, individuals with DS seem to benefit from the spatially structured presentation of visual material when learning, another accommodation that can be implemented during instruction. Finally, although not specific to DS, young children and adults with DS generally identify and recognize emotions less efficiently than do persons without DS. However, among persons with DS, these difficulties seem to be more pronounced for more intense emotions, including fear and anger. In sum, visual profiles based on sensory and perceptual performance can advance our understanding of atypical information processing among persons with DS, as well as provide practical information aimed at improving learning and instruction.
Religious Rituals and Logical Thought in Durkheim
Authors: Karsenti Bruno
Published: October 2021

In The Elementary Forms of Religious Life, ritual has a central function in Durkheim’s argument. It is on its redefinition that the constitution of sacred things rests, in relation to the constitution of the group itself and to the formation of categories of thought. In this study, we restore the basis of this conception: the interpretation of the ritual of the intichiuma, and more particularly its mimetic dimension, which prevails over its sacrificial dimension. The relationship between practice and objective thought then turns out to be the touchstone of the concept of the sacred developed by Durkheim.
Time and Democratic Deliberation
Authors: Fumagalli Corrado
Published: October 2021

This chapter delves into debates about time and democratic deliberation. Deliberative democrats have developed sequential models but tend to think of time mainly as a background variable. Critics have drawn attention to the inadequacy of deliberation in accelerated society but, in so doing, have conflated arguments about the pace of democratic deliberation with arguments about its durational time. Democratic deliberation may be slow and inconclusive, but one aspect does not necessarily entail the other. It is against this backdrop that the chapter sheds light on a diachronic reading of fallibilism in order to advance a more favorable reading of inconclusiveness.
Transcranial Electrical Stimulation Devices
Authors: Truong Dennis Q. , Khadka Niranjan , Peterchev Angel V. , Bikson Marom
Published: October 2021

Transcranial electrical stimulation (tES) devices apply electrical waveforms through electrodes placed on the scalp to modulate brain function. This chapter describes the principles, types, and components of tES devices as well as practical considerations for their use. All tES devices include a waveform generator, electrodes, and an adhesive or headgear to position the electrodes. tES dose is defined by the size and position of electrodes, and the waveform, duration, and intensity of the current. Many sub-classes of tES are named based on dose. This chapter focuses on low-intensity tES, which includes transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), and transcranial pulsed current stimulation (tPCS). tES electrode types are reviewed, including electrolyte-soaked sponge, adhesive hydrogel, high-definition, hand-held solid metal, free paste on electrode, and dry. Computational models support device design and individual targeting. The tolerability of tES is protocol specific, and medical-grade devices minimize risk.
Transcranial ultrasound modulation
Authors: Pauly Kim Butts , Qiu Zhihai , Legon Wynn
Published: October 2021

Ultrasound neuromodulation is a promising technology for probing brain function and treating brain dysfunction given its non-invasiveness and high spatiotemporal resolution. Recent years have witnessed rapid advances in this field including both stimulatory and inhibitory effects in cortical and subcortical brain regions. This chapter summarizes the basic physics and recent findings on the mechanisms of ultrasound neuromodulation and experimental applications in cell and tissue preparations, rodents, large animals, non-human primates, and humans. The ultrasound hardware is briefly described, as well as the major relevant tradeoffs in pulse parameters. Safety data as well as general considerations and limitations for using ultrasound for neuromodulation are also discussed.
Slaving Practices in the Early Greek World
Authors: van Wees Hans
Published: October 2021

The Greek world contained many slave societies from the beginning of the archaic age. By the time of Homer and Hesiod, ownership of numerous non-Greek slaves was an integral part of elite status. Despite earlier views to the contrary, imported ‘barbarian’ slaves did not replace an older spectrum of ‘dependent’ native Greek workers but if anything preceded the forms of slavery imposed on indigenous populations. Debt-bondage emerged only in the late seventh century. This may also have been when so-called ‘helotic’ slaveries were extended across Messenia, Thessaly, and Crete, and when they were imposed on the native peoples of Syracuse and Byzantium. The latter part of the archaic age saw larger-scale employment of imported slaves in regions that began to specialize in labour-intensive forms of agriculture such as viticulture, but the basic patterns and practices of slave-owning emerged at the start of the archaic age and remained the same throughout.
Material Evidence
Authors: Dyson Stephen L.
Published: October 2021

Slaves were central to every aspect of Roman society. However¸ they are difficult to identify in the archaeological record. Most were genetically similar to the free population. Unlike slaves in the American ante-bellum South they did not have distinctive residential systems and foodways that can be differentiated archaeologically from those of free persons. Structures related to slavery like market buildings or slave barracks are not easily identified. In contrast, freed slaves, common in ancient Rome are very visible, especially in mortuary monuments. This chapter surveys the extent to which material evidence can shed light on various aspects of the life course of slaves, from enslavement through slave life, to death or manumission.
Gladiators
Authors: Carter Michael J.
Published: October 2021

This paper argues for the professionalism of the gladiators and their combat-spectacles. It examines the rules that governed the combats, the expectations placed on those engaged in them, their extensive training, the organization of those involved and the costs associated with the spectacle. The stress is on the skill, courage, and discipline displayed by the gladiators in combat. It also considers the attitudes of the spectators: their knowledge of the combat techniques and their expectations are key to evaluating the social and cultural impact of the spectacle in Roman society. Given the time, energy, and resources devoted to staging and watching gladiatorial combats, there is little doubt about their social and cultural significance. A variety of evidence is employed, especially epigraphic, in order to reconstruct the events in the arena.
Cult and Competition
Authors: Dillon Matthew J. P.
Published: October 2021

Ancient Greek festivals honoured the gods with sacrifice, procession, and frequently with contests of an athletic nature. While these competitions were watched by hundreds and sometimes thousands of people, especially in the case of Panhellenic festivals, the primary purpose of these contests was not to delight crowds but to honour the gods. Athletics in Ancient Greece were organized within religious frameworks, occurring within a festival honouring a particular god, and often with sacred truces being proclaimed so that contestants and spectators could travel safely to athletic venues. Athletes swore oaths to the gods not to cheat, and prayed to them for victory. Girls could compete in running races in honour of goddesses. Zeus was believed to watch the games of the Olympia festival, and the goddess Nike was represented in art as crowning the successful athlete on behalf of the gods. Sport and cult were inextricably combined in ancient Greece.
Impact of Foliar Application of Acibenzolar-S-Methyl on Rose Rosette Disease and Rose Plant Quality
Authors: Babu Binoy , Paret Mathews L. , Martini Xavier , Knox Gary W. , Riddle Barron , Ritchie Laura , Aldrich Jim , Kalischuk Melanie , Da Silva Susannah
Published: October 2021

Rose rosette disease (RRD) caused by rose rosette emaravirus (RRV) is a major issue in the U.S. rose industry with no effective method for its management. This study evaluated the effect of foliar application of acibenzolar-S-methyl (ASM), a plant systemic acquired resistance inducer, in reducing RRD disease severity on Rosa species cv. Radtkopink (‘Pink Double Knock Out’) under greenhouse conditions, and the effect of ASM on plant growth under commercial nursery production conditions. ASM at 50- or 100-mg/liter concentrations at weekly intervals significantly reduced RRD severity compared with the untreated control in two of the three greenhouse trials (P < 0.05). The plants in these trials were subsequently pruned and observed for symptoms, which further indicated that application of ASM at 50- or 100-mg/liter concentrations lowered disease severity compared with the untreated control (P < 0.05) in these two trials. Plants treated with ASM at 50- or 100-mg/liter concentrations had delayed incidence of RRD compared with the nontreated controls. Plants treated with ASM at the 50- or 100-mg/liter rate in all three trials either did not have RRV present or the virus was present in fewer leaf samples than untreated controls as indicated by quantitative reverse transcription PCR analysis. Overall, plants treated with ASM at the 50-mg/liter concentration had 36 to 43% reduced RRD incidence compared with the water control. The treatment of two cultivars of rose, ‘Radtkopink’ and ‘Meijocos’ (‘Pink Drift’), with weekly foliar applications of ASM at the three rates (0.5, 0.75, and 1.0 oz/A) indicated that ASM had no negative effect on flowering or plant growth at even the highest rate of application.
Complete Genome and Plasmid Sequence Data of Three Strains of Xanthomonas arboricola pv. corylina, the Bacterium Responsible for Bacterial Blight of Hazelnut
Authors: Pothier Joël F. , Kałużna Monika , Prokić Andjelka , Obradović Aleksa , Rezzonico Fabio
Published: October 2021

Xanthomonas arboricola pv. corylina is the causal agent of bacterial blight of hazelnut. The bacterium has been listed as an A2 quarantine pathogen in Europe since 1978 and on the regulated non-quarantine pest list since 2019. Three isolates from various geographic regions and isolated at different times were sequenced using a hybrid approach with short- and long-read technologies to generate closed genome and plasmid sequences in order to better understand the biology of this pathogen.
GLI-1 polymorphisms of Hedgehog pathway as novel risk and prognostic biomarkers in melanoma patients
Authors: Dunjic Marija , Lukic Nikola , Djordjevic Boban , Uzelac Bojana , Ostojic Nikola , Supic Gordana
Published: October 2021

In adult organisms, deregulation of the sonic hedgehog (SHH) signaling pathway is significantly correlated with different malignancies. Currently, data associating genetic polymorphisms in the SHH pathway with melanoma are scarce and largely unknown. The objective of our study was to elucidate an association between gene polymorphisms in the SHH pathway and prognosis of melanoma skin cancer patients. The current study investigated the association of PTCH1 (rs357564), SMO (rs2228617) and GLI1 (rs2228224, rs2228226), polymorphisms with melanoma predisposition and prognosis. Single-nucleotide polymorphisms were assessed by TaqMan SNP Genotyping Assays. The study involved 93 melanoma patients and 97 individuals in the control group. Melanoma patients with the variant mutant genotype GG of GLI1 rs2228226 polymorphism had poorer overall survival and recurrence-free survival (P = 0.0001 and P = 0.037, respectively). The multivariate analysis revealed that disease progression [hazard ratio (HR) = 14.434, P = 0.0001] and the GLI1 rs2228226 polymorphism (HR = 4.161, P = 0.006) persisted as independent prognostic factors. Mutated allele carriers (combined heterozygous and mutated genotypes) for GLI1 rs2228224 G and GLI1 rs2228226 G allele significantly increased melanoma risk [odds ratio (OR) = 2.261, P = 0.007; OR = 2.176, P = 0.010]. Our study demonstrated that genetic variants in GLI1, downstream member of the HH signaling pathway, are the risk factors for melanoma susceptibility and it can be a novel marker for melanoma prognosis. As a crucial SHH signaling member, GLI1 can also be regarded as a novel drug target for anti-cancer treatment in melanoma.
Residential proximity to hydraulically fractured oil and gas wells and adverse birth outcomes in urban and rural communities in California (2006–2015)
Authors: Tran Kathy V. , Casey Joan A. , Cushing Lara J. , Morello-Frosch Rachel
Published: October 2021

Background:

Prenatal exposure to hydraulic fracturing (HF), a chemically intensive oil and gas extraction method, may be associated with adverse birth outcomes, but no health studies have been conducted in California.

Methods:

We conducted a retrospective cohort study of 979,961 births to mothers in eight California counties with HF between 2006 and 2015. Exposed individuals had at least 1 well hydraulically fractured within 1 km of their residence during pregnancy; the reference population had no wells within 1 km, but at least one oil/gas well within 10 km. We examined associations between HF and low birth weight (LBW), preterm birth (PTB), small for gestational age birth (SGA), and term birth weight (tBW) using generalized estimating equations and assessing urban-rural effect modification in stratified models.

Results:

Fewer than 1% of mothers (N = 1,192) were exposed to HF during pregnancy. Among rural mothers, HF exposure was associated with increased odds of LBW (odds ratio [OR] = 1.74; 95% confidence interval [CI] = 1.10, 2.75), SGA (OR = 1.68; 95% CI = 1.42, 2.27) and PTB (OR = 1.17; 95% CI = 0.64, 2.12), and lower tBW (mean difference: –73 g; 95% CI = –131, –15). Among urban mothers, HF exposure was positively associated with SGA (OR = 1.23; 95% CI = 0.98, 1.55), inversely associated with LBW (OR = 0.83; 95% CI = 0.63, 1.07) and PTB (OR = 0.65; 95% CI = 0.48, 0.87), and not associated with tBW (mean difference: –2 g; 95% CI = –35, 31).

Conclusion:

HF proximity was associated with adverse birth outcomes, particularly among rural Californians.
Acute Kidney Injury and Fluid Overload in Pediatric Extracorporeal Cardio-Pulmonary Resuscitation: A Multicenter Retrospective Cohort Study
Authors: Gist Katja M. , Misfeldt Andrew , Sahay Rashmi D. , Gorga Stephen M. , Askenazi David J. , Bridges Brian C. , Paden Matthew L. , Zappitelli Michael , Gien Jason , Basu Rajit K. , Jetton Jennifer G. , Murphy Heidi J. , King Eileen , Fleming Geoffrey M. , Selewski David T. , Cooper David S.
Published: October 2021

Acute kidney injury (AKI) and fluid overload (FO) are common complications of extracorporeal membrane oxygenation (ECMO). The purpose of this study was to characterize AKI and FO in children receiving extracorporeal cardiopulmonary resuscitation (eCPR). We performed a multicenter retrospective study of children who received eCPR. AKI was assessed during ECMO and FO defined as <10% [FO−] vs. ≥10% [FO+] evaluated at ECMO initiation and discontinuation. A composite exposure, defined by a four-group discrete phenotypic classification [FO−/AKI−, FO−/AKI+, FO+/AKI−, FO+/AKI+] was also evaluated. Primary outcome was mortality and hospital length of stay (LOS) among survivors. 131 patients (median age 29 days (IQR:9, 242 days); 51% men and 82% with underlying cardiac disease) were included. 45.8% survived hospital discharge. FO+ at ECMO discontinuation, but not AKI was associated with mortality [aOR=2.3; 95% CI: 1.07–4.91]. LOS for FO+ patients was twice as long as FO− patients, irrespective of AKI status [(FO+/AKI+ (60 days; IQR: 49-83) vs. FO−/AKI+ (30 days, IQR: 19–48 days); P = 0.01]. FO+ at ECMO initiation and discontinuation was associated with an adjusted 66% and 50% longer length of stay respectively. Prospective studies that target timing and strategy of fluid management, including its removal in children receiving ECPR are greatly needed.
Pancreatic Pain—Knowledge Gaps and Research Opportunities in Children and Adults
Authors: Uc Aliye , Andersen Dana K. , Apkarian A. Vania , Bellin Melena D. , Colloca Luana , Drewes Asbjørn M. , Dunbar Ellyn K. , Forsmark Christopher E. , Goodman Marc T. , Kapural Leonardo , Koob George F. , Palermo Tonya M. , Pandol Stephen J. , Pasricha Pankaj , Phillips Anna E. , Piomelli Daniele , Saloman Jami L. , Schwarzenberg Sarah Jane , Singh Vikesh K. , Sowa Gwendolyn , Strouse Thomas , Treisman Glenn J. , Windsor John A. , Yadav Dhiraj
Published: October 2021

A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to focus on research gaps and opportunities in pancreatic pain. The event was held on July 21, 2021, and structured into 4 sessions: (1) pathophysiology; (2) biomarkers, mediators, and pharmacology of pain; (3) pain assessment; and (4) pain treatment challenges and opportunities. The current state of knowledge was reviewed; many knowledge gaps and research needs were identified that require further investigation. Common themes included the need to better understand the underlying mechanisms of pain in pancreatic diseases, the relationship of visceral neural pathways and central pain centers, the role of behavioral factors and disorders on the perception of pain, and differences in pain perception and processes in children when compared with adults. In addition, the role of genetic risk factors for pain and the mechanisms and role of placebos in pain treatment were discussed. Methods of pain assessment including quantitative sensory testing were examined, as well as the process of central sensitization of pain. Finally, newer approaches to pain management including cognitive behavioral therapy, nerve stimulation, experimental (nonopioid) drugs, and cannabinoid compounds were covered.
Modified Lengthening Temporalis Myoplasty Using an Intraoral Approach
Authors: Hayashi Ayato , Natori Yuhei , Suda Shunichi , Kamimori Tomoki , Nojiri Gaku , Uchiyama Mizuki , Labbé Daniel
Published: October 2021

Background:

Lengthening temporalis myoplasty (LTM) is a unique and definite facial reanimation procedure that involves inserting the whole temporal tendon directly into the nasolabial fold. However, the nasolabial fold incision remains one of the difficulties of this procedure, particularly in young or female patient. To avoid the need for this incision, the authors developed an intraoral approach to manipulate the temporal muscle tendon toward the nasolabial fold. in this study, we describe the details of this procedure.

Method:

The authors performed their intraoral approach procedure in 5 patients with established complete facial paralysis. instead of making an incision at the nasolabial fold to approach the coronoid process, the authors made the incision at the buccal mucosa. The results were evaluated both subjectively and objectively.

Results:

The authors achieved facial reanimation without leaving any obvious scar on the face or neck and the effect of static reconstruction is obvious, even immediately after the surgery. All the patients obtained good facial movement within 4 months (2.5 months in average), and improved all evaluated parameters postoperatively. No infections or other major complications were reported following surgery; however, 1 patient developed a slight dimple that required revision.

Discussion:

The authors could advance temporal tendon toward nasolabial fold firmly obtaining sufficient surgical field similar to that of nasolabial fold incision, and achieved fairly good results without an obvious scar on the face.

Establishing LTM without nasolabial fold incision, we could expand the indication of LTM more widely, and it could be more familiar procedure for smile reanimation in all generation.
Correction of a Secondary Bilateral Cleft Lip Nasal Deformity in Adults Using Repositioning of Both Lower Lateral Cartilages and Nasal Tip Plasty Through an Open Bilateral Reverse-U Incision
Authors: Ryu Jeong Yeop , Lee Jung Ho , Lee Joon Seok , Lee Jeong Woo , Choi Kang Young , Cho Byung Chae
Published: October 2021

Background:

Correcting a secondary bilateral cleft lip nasal deformity is very complex with many challenges due to its complexity. This study presents the surgical results after correcting a secondary bilateral cleft lip nasal deformity using isolation and repositioning of the lower lateral cartilages, the columellar strut, and an onlay graft on the nasal tip.

Method:

Eighteen patients who had bilateral cleft lip nasal deformities and who had surgery performed between September 2013 and December 2019 were included in this study. The age of the patients ranged between 19 and 52 years. Open rhinoplasty with bilateral reverse-U incision was performed. The lower lateral cartilages were isolated and repositioned. Nasal tip support is provided using a columellar strut with a septal cartilage or Medpor strut. In the vertical component of the nasal tip, a conchal cartilage graft was used. The mean follow-up period was 2 years (ranging from 1 to 6 years).

Results:

Fourteen of the 18 patients underwent photogrammetric evaluation. After surgery, the projection of the nasal tip and angle increased, but nasal bridge length decreased. The columella–labial angle significantly increased by 10.1% after surgery which was statistically significant (P < 0.05). The angle between the nostril axes significantly decreased by 46.2% postoperatively and also reached statistical significance (P < 0.05), indicating that the displaced alar base and lower nostril sill improved and the major axis of the nostril changed more vertically oblique. All patients were pleased with their surgical results.

Conclusion:

The proposed technique was highly effective in correcting secondary bilateral cleft lip nasal deformities in adults.
Forces Exerted in Craniofacial Distraction Osteogenesis
Authors: Kalmar Christopher L. , Wes Ari M. , Mazzaferro Daniel M. , Bartlett Scott P. , Taylor Jesse A.
Published: October 2021

Background:

The purpose of this study was to develop a methodology for quantifying linear forces of distraction osteogenesis, and thereafter apply this methodology to measure and compare distraction force magnitudes between cranial vault distraction osteogenesis (CVDO) and mandibular distraction osteogenesis (MDO).

Methods:

Patients undergoing CVDO or MDO as inpatients had distraction forces acquired with a digital torque-measuring screwdriver. Torque measurements were then converted into linear distraction force values, which were then compared across distraction types and protocols with appropriate statistics.

Results:

CVDO was performed on 7 patients (41.2%), and MDO was performed on 10 patients (58.8%). Across the entire cohort, the average maximum force per activation was 27.0 N, and the average elastic force was 10.7 N. Maximum force (CVDO: 52.9 N versus MDO: 12.9 N; P < 0.001) and elastic force (CVDO: 22.0 N versus MDO: 4.5 N; P < 0.001) were significantly higher in patients undergoing CVDO than MDO. Multivariate regression demonstrated that maximum activation force was significantly associated with sequential days of distraction (B= + 1.1 N/day; P < 0.001), distraction rate (B= + 8.9 N/mm/day; P = 0.016), distractor hardware failure (B= + 10.3 N if failure; P = 0.004), and distraction type (B= + 41.4 N if CVDO; P < 0.001).

Conclusions:

Cranial vault distraction requires significantly more linear distraction force than mandibular distraction. Maximum forces increase with each day of distraction, as well as with increased distraction rates. Linear distraction force methodology from this study may provide the foundation for future development of optimized procedure-specific or patient-specific distraction protocols.