bluuebunny/crossref_metadata_2025 huggingface dataset:
Poor Nutritional Status Is Associated with Arrhythmic Events on 24-Hour Holter Recording
Authors: Kurmus Ferik Ozge , Akbuga Kursat , Tolunay Hatice , Aslan Turgay , Eren Murat , Erkan Aycan Fahri , Ekici Berkay , Akgul Ercan Ebru , Kervancıoglu Celal
Published: April 2022

Background: Malnutrition is associated with cardiovascular disease morbidity and mortality. Arrhythmias may be the cardiac consequences of malnutrition. Objectives: The objective of the study was to evaluate the association between prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score, and arrhythmic events on 24-h electrocardiography (ECG) Holter recording in patients without manifested arrhythmia. Methods: In this retrospective analysis of 477 patients who underwent 24-h ECG Holter monitoring, PNI and CONUT score were calculated and patients were divided into tertiles according to PNI and into three groups according to CONUT score; 0: normal, 1–2: mild risk of malnutrition, ≥3: moderate-severe risk of malnutrition. Arrhythmic events were compared between PNI tertiles and CONUT score groups. Results: Total number of premature atrial contractions, premature ventricular contractions (PVCs), PVC burden, and incidence of paroxysmal atrial fibrillation (PAF) were significantly higher in patients within the lowest PNI tertile. Total number of PVCs, PVC burden, and incidence of PAF were significantly higher in patients with CONUT score ≥3. The cut-off value for PNI to predict the presence of PVC was defined as 39.41 using ROC curve analysis. The area under the curve was 0.650 (p < 0.001). Multivariate analysis showed that PNI was independent predictor of the presence of PVC and PAF. Also, CONUT score was independent predictor of the presence of PVC and PAF. Incidence of nonsustained ventricular tachycardia did not differ between PNI tertiles or CONUT score groups. Conclusion: Poor nutritional status, assessed by PNI and CONUT score, is associated with arrhythmic events on 24-h ECG Holter recording in patients without manifested arrhythmia.
Notas sobre subjetividade e objetividade no Meister de Goethe
Authors: Leandro Renato Costa
Published: April 2022

Sabe-se que o romance Os anos de aprendizado de Wilhelm Meister [Wilhelm Meisters Lehrjahre], publicado entre 1795 e 1796 por Goethe, representa um paradigma na literatura moderna ocidental, principalmente por ser amplamente considerado como o representante definitivo daquilo que conhecemos por romance de formação [Bildungsroman], porém, tal constatação não contempla a vasta e complexa rede de significação filosófica da obra. Partindo deste diagnóstico, e à luz de outros textos de Goethe, bem como de sua fortuna crítica, o presente trabalho tem por objetivo analisar alguns dos movimentos reflexivos e narrativos empreendidos por Goethe na história de Wilhelm Meister, sobretudo as relações entre subjetividade e objetividade, as quais emergem de importantes discussões elaboradas ao logo da obra acerca de noções como dever, querer, destino e acaso.
Filosofia e neurociência: contribuições para a problemática do Livre-arbítrio
Authors: Willkomm Rafael Alberto
Published: April 2022

A questão de se o Livre-arbítrio é compatível ou incompatível com o Determinismo Causal permanece controversa. Atualmente podemos contar com a neurociência para fornecer evidências acerca da produção de nossas ações, todavia, é necessária uma análise dos conceitos utilizados pela neurociência. Em um primeiro momento, visa-se entender quais são as posições defendidas pelas teorias filosóficas sobre o livre-arbítrio. Após, busca-se elucidar qual é o diálogo que pode ser estabelecido entre filosofia e neurociência em relação ao problema do livre arbítrio. Por meio dessa investigação, pode-se construir um argumento que interprete a investigação neurocientífica sob a luz de uma posição libertista. Igualmente mostrando como pode haver decisões indeterminadas que não são aleatórias.
Chinese Executions Visualising Their Differences with European Supplices
Authors: Bourgon Jérôme
Published: April 2022

That the Chinese were singled out by a native cruelty in refined tortures became a widespread representation at the turn of the twentieth century. This cliché relied mainly on photographs of executions that could be diffused worldwide through modern mass media such as illustrated journals or postcards. The instant photographs taken from life provided an exact rendition of what really happened on a Chinese execution ground, and anyone seeing the image could have no doubt as to the reality of Chinese cruelty, which was otherwise ascertained by true or bogus eyewitness reports. The impression was so strong and penetrated so deep in the Western imagination that it still survives as a déjà vu, an ‘eye print’. Thus, the answer to why the Chinese have been represented as natively cruel must proceed from a careful reexamination of the visual documentation on Chinese executions. Western observers or commentators naturally tended to construe capital executions according to what was practiced and abundantly represented in their own civilisation. European executions obeyed a complex model that the author proposes to call ‘the supplice pattern’. The term supplice designates tortures and tormented executions, but it also includes their cultural background. The European way of executing used religious deeds, aesthetic devices and performing arts techniques which themselves called for artistic representations through paintings, theatre, etc. Moreover, Christian civilisation was unique in the belief that the spectacle of a painful execution had a redemptive effect on the criminals and the attendants as well. Chinese executions obeyed an entirely different conception. They were designed to show that punishment fitted the crime as provided in the penal code. All details were aimed to highlight and inculcate the meaning of the law, while signs of emotions, deeds, words, that could have interfered with the lesson in law were prohibited. In China, capital executions were not organized as a show nor subject to aesthetic representations, and they had no redemptive function. This matter-of-fact way of executing people caused Westerners deep uneasiness. The absence of religious background and staging devices was interpreted as a sign of barbarity and cruelty. What was stigmatised was not so much the facts that their failure to conform to the ‘supplice pattern’ that constituted for any Westerner the due process of capital executions.
Balancing Innovation, ‘Ordre Public’ and Morality in Human Germline Editing: A Call for More Nuanced Approaches in Patent Law
Authors: Matthews Duncan , Minssen Timo , Nordberg Ana
Published: April 2022

This article analyses the role that ‘ordre public’ and morality exceptions can play in the granting of patents on inventions in the field of human germline editing and the consequences of this policy option. In order to provide the context for such an analysis, the article will, first, provide an overview of the current patent landscape for relevant genome editing technologies, drawing attention to recent patent disputes and, second, examine ‘ordre public’ and morality exceptions under patent law in international, national and regional law, and the implications for innovation and access to novel treatments. The article argues that patent exceptions should not be used as a blunt policy instrument, nor interpreted in a way that is contrary to the patent system’s overall objectives. The ‘ordre public’ and morality based exceptions in the context of human germline editing should not be interpreted and applied in a way which results in outcomes counterproductive to the goal of balancing innovation with the protection of societal higher normative values. Instead, the application of the exception should be based on a sound understanding of both the underlying science as well as the broader ethical, social, and legal implications, thus enabling case-by-case decisions that provide the basis for patent claim amendments and nuanced purpose-bound protection. Further analysis and debate as to the role that such flexibilities can play in the context of genome editing technologies is therefore both necessary and desirable, and can be facilitated in the ways set out in this article.
What Would It Take to Enable Germline Editing in Europe for Medical Purposes?
Authors: Slokenberga Santa
Published: April 2022

Commonly, the regulation on germline editing in Europe is described through the two prohibitions: the prohibition set out in Article 13 of the Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine and the prohibition that is set out in the EU Clinical Trials Regulation. These prohibitions reflect the European regional position regarding the ethical and legal questions raised by the technology, and an unwillingness to enable such interventions in Europe. Simultaneously, these prohibitions have been shaped prior to the recent breakthroughs in the field, such as the discovery of the CRISPR-Cas technology, which has initiated a new era in the field. This contribution examines what it would take to enable human germline gene editing in Europe for medical purposes. It scrutinises in detail the content and context of the existing bans, as well as mechanisms to lift them. It argues that the bans that are prescribed by each of the European regional legal orders are embedded in strong structures, composed of values and principles. For the human germline gene editing to be enabled in Europe for health-related purposes, the approach to these values and principles needs to change. Only then can the machinery to lift the bans lead to a change.
Genetics and Justice, Non-Ideal Theory and the Role of Patents: The Case of CRISPR-Cas9
Authors: Feeney Oliver
Published: April 2022

There are ongoing concerns of social justice regarding inequalities in the distribution of access to potential genome editing technologies. Working within non-ideal theory, Colin Farrelly advances a justification for the use of patents to speed up the arrival of safe and effective interventions for all, including the socially disadvantaged. This paper argues that such success is less assured when one considers the actual functioning of patents and the practical implications of the patent system in the context of biotechnological innovations. I suggest that non-ideal theoretical approaches risk reverting back to a form of ideal theory if they simply refer to such real-world constraints — e.g. patents — but do not critically assess and fully examine how such constraints manifest themselves in practice. I highlight some considerations that would be important in order to develop and foster a more robust non-ideal approach to justice in biotechnological developments.
Between Rights, Sovereignty and Cooperation
Authors: Camins Emily
Published: April 2022

Although the humanitarian effects of armed conflict are vast and transcend national boundaries, international law does not yet provide an adequate or comprehensive response to the suffering of victims of war. This article argues considerations of State sovereignty have shaped the development of international law on post-war redress, hindering the emergence of individual rights to reparations under international humanitarian law. Meanwhile, alternative models such as victim assistance, which largely preserve sovereignty, are emerging in pockets of international humanitarian law, such as weapons treaties. This article suggests that victim assistance offers a potential model for addressing the harm to victims of armed conflict more broadly.
How Should Theists Respond to Debunking Arguments? A Critique of Hans Van Eyghen’s Arguing from Cognitive Science of Religion
Authors: Launonen Lari
Published: April 2022

Cognitive science of religion has inspired several debunking arguments against theistic belief. Hans Van Eyghen’s book Arguing from Cognitive Science of Religion is the first monograph devoted to answering such arguments. This article focuses on Van Eyghen’s responses to two widely discussed debunking arguments, one by Matthew Braddock and another by John Wilkins and Paul Griffiths. Both responses have potential but also face problems. Even if Van Eyghen manages to show that these authors have not fully excluded the possibility of noninferential theistic belief being underpinned by reliable belief-forming processes, he fails to offer convincing reasons to think the processes are in fact reliable. A positive argument for their reliability might ultimately have to be based on evidence for God’s existence, namely, theistic arguments. The question of the rationality of religious belief (de jure) thus cannot be isolated from the question of God’s existence (de facto).
Hermeneutics of Grief as a Model for the Hermeneutics of Love in Jean-Luc Marion
Authors: Roggero Jorge Luis , Becker Brian
Published: April 2022

From Jean-Luc Marion’s examination of Gustave Courbet and his painting, it is shown how grief can operate as a model for the hermeneutics of love. This hermeneutics of grief, in turn, makes possible a consideration of all phenomena, and not only the human, as saturated phenomena.
Reflections on Anthrobombing: Experiments in Performing, Publishing and Becoming with (Other) Publics
Authors: Papageorgiou Alexandros , Siotou Alexandra , Papailias Penelope
Published: April 2022

This article is based on a two-year collaborative research program on public anthropology in Greece focused on narrative experimentation with stand-up comedy and alternative publishing with handmade books, or cartoneras. Viewing in anthropology a powerful tool to dismantle prevalent commonsense about nationalism, gender norms and capitalist progress, we “bombed” time-spaces in which academic discourse is not usually present. The embodied experience of performing and publishing in an “anthropological way” outside of spaces of academic communication led to insights about the potential of humor, multimodal forms and performance for anthropology, new questions about “who anthropology is for” and “what makes knowledge anthropological”, and an emergent concern for becoming-with, rather than just bombing, publics.
Clarifying the typification of the name Kalanchoe orgyalis (Crassulaceae subfam. Kalanchooideae)
Authors: SMITH GIDEON F. , FIGUEIREDO ESTRELA
Published: April 2022

When describing Kalanchoe orgyalis Baker (1882: 110) [Crassulaceae subfam. Kalanchooideae, Kalanchoe Adanson (1763: 248) subg. Kalanchoe] (Figs 1 & 2), Baker cited two collections, “Baron 105! 249!”, both of which were therefore collected by Reverend Richard Baron (1847–1907), with both presumably originating from “West Betsileo, on stony ground and about woods” (Baker 1882: 110), in Madagascar. Baron, at the time a missionary with the London Missionary Society, spent about 35 years in Madagascar and, apart from his evangelical work, was also a proficient naturalist (Dorr 1997: 28–29, Smith & Figueiredo 2021a). Herbarium material that Baron collected in Madagascar mostly made its way to the Royal Botanic Gardens, Kew, from where the novel material was described (Smith & Figueiredo 2021a: 195).
Cirsium paludigenum and C. zhejiangense (Asteraceae) are synonymous with C. sieboldii and C. yezoense
Authors: JIN ZI-CHAO , CHEN YOU-SHENG
Published: April 2022

Based on observations on both herbarium specimens (including type materials) and living plants in their type localities, we demonstrate that Cirsium paludigenum and C. zhejiangense, two taxa recently described both from Zhejiang province of China, are indistinguishable from C. sieboldii and C. yezoense, two species with their type localities from Japan. We therefore reduce C. paludigenum to the synonymy of C. sieboldii, and C. zhejiangense to the synonymy of C. yezoense. The distribution area of both C. sieboldii and C. yezoense are widely expanded in China.
The identity of Artemisia brevis (Asteraceae, Anthemideae) from Xinjiang, China
Authors: GUO XIN-QIANG , WANG LONG , YANG QIN-ER
Published: April 2022

Critical observations on herbarium specimens (including type material) and living plants in the wild indicate that Artemisia brevis (= A. argyrophylla var. brevis) (Asteraceae, Anthemideae), described from Xinjiang in China, differs remarkably from A. argyrophylla but is not essentially different from A. rupestris, an easily recognizable species quite common in Xinjiang. We therefore place A. brevis and A. argyrophylla var. brevis in synonymy with A. rupestris.
ISIS’s COVID-19 Messaging on Twitter: An Analysis of Tweet Sentiment and Emotions
Authors: Lee Claire Seungeun , Colautti John D.
Published: April 2022

Terrorist groups have integrated social discourse into their narratives to exploit public fear. The COVID-19 pandemic has provided an opportunity to measure how ISIS modified narratives, stimulated group communication, reinforced enemy hatred, and employed new mobilization/recruitment strategies. Using Significance Quest Theory, this study examines ISIS’s Twitter activity related to COVID-19 ( N = 630,201) and how the group leverages the psychological effects and the social disruption. This study employs a two-stage analysis of tweet sentiment and emotion with a statistical analysis of retweet-motivating factors to explore how ISIS manages its narrative, needs, and network. Results show content with higher negative sentiment scores had more retweets across all sample sets. Insights include deeper understanding of extremist activity and group adaptation to external changes.
Reconfiguring colonial hierarchies: Examining the ‘European versus native wrestling’ debate in the late nineteenth-century India
Authors: Thomas Ajay Jacob
Published: April 2022

The ‘empire’ as a project has always been fraught with tensions across several dimensions. And that tension is evident in the relationship between the ‘coloniser’ and the ‘colonised’ throughout the social, political and economic spectrum. At times, many of these tensions spill over in interesting ways at the most unexpected moments revealing lesser-known dimensions of the colonial relations. The 1891 wrestling match between the English Champion wrestler Tom Cannon and the Maharajah of Jodhpur’s court wrestler, Karim Bux in Calcutta, the British Indian capital, was one such moment. This article is an attempt to demonstrate how wrestling matches between a European and a native could become a flash point that it became, among other things, an occasion for the natives to question the ‘superiority’ of Europeans.
The Travail and Feasibility of Returning Home of Gwoza Women in New Kuchingoro Internally Displaced Persons Camp, Nigeria
Authors: Bamidele Seun , Pikirayi Innocent
Published: April 2022

The lived experiences of women in Internally Displaced Persons (IDPs) camps are poorly understood despite the centrality of this issue in discourses on victims’ experiences. This study examines the travail of Gwoza women in New Kuchingoro IDPs camp in Abuja, Nigeria. It attempts to identify the survival strategies adopted by women and the possibility of their returning home, in northeastern Nigeria. The study adopted a qualitative research design utilising both primary and secondary data. Insights for data analyses were drawn from transactional theory of stress and coping strategies. The study reveals that Gwoza women rely largely on humanitarian aid from NGOs, while the federal government has largely failed to fulfil that role. Reliance on subsistence farming and humanitarian aid implies that their coping or survival strategy is only tentative. Gwoza women also regard the issue of security as a source of livelihood crucial to their survival, which they are unlikely to get should they return home where they will be exposed to attacks by the insurgent Boko Haram. Moreover, the Nigerian government has not given them any assurance on the provision of adequate security and means of livelihood upon return. They are thus compelled to remain in camp.
Role of Board Functions in Bank Performance: Direct and Indirect Effects of Board Independence
Authors: Handa Rekha
Published: April 2022

The present study attempts to explore the Indian banking sector from 2007 to 2017 for its performance and for the influence of important characteristics like ownership of banks, board functioning and the effect of independent directors. The results establish that the type of bank has a significant impact on performance metrics, board characteristics and bank-specific features. Moreover, the positive significant influence of board size and board independence is confirmed using panel data analysis. Further, the partially mediating role of independent directors on the relationship of financial performance (measured through return on assets and return on equity) and board characteristics is confirmed using mediation analysis. The present research holds important insights for policymakers, regulators and stakeholders of the banking sector, with a push to reorient their emphasis on board independence and board functioning for better financials of banks in India.
Comparison of venous pCO2 and exhaust pCO2 for calculating CO2 production during cardiopulmonary bypass
Authors: Gerritse Matthijs , van Hoeven Marloes , Overdevest Eddy
Published: April 2022

Introduction

Carbon dioxide production (VCO2i), oxygen consumption and oxygen delivery can be monitored during cardiopulmonary bypass (CPB) as markers for tissue perfusion. This study examines if inline venous pCO2 (PvCO2) monitoring can be used as an alternative to exhaust gas pCO2 (ExCO2) to calculate VCO2i.

Methods

PvCO2 and ExCO2 were monitored continuously during 40 elective coronary artery bypass grafting (CABG) procedures. VCO2i was calculated with ExCO2 as well as PvCO2.

Results

Mean PvCO2 was 0.27 mmHg higher than mean ExCO2 (p < .001). The 95% limits of agreement of PvCO2 and ExCO2 were [‐2.99, 3.53] mmHg which is within the limits proposed by the Clinical Laboratory Improvement Amendments of 2019. VCO2i was calculated using both PvCO2 and ExCO2 (PvVCO2i; ExVCO2i). A strong linear correlation was found for ExVCO2i and PvVCO2i (R2= .94, p < .001).

Conclusion

In conclusion, the differences in VCO2i calculation between the two methods are unlikely to be clinically relevant during normothermic CABG procedures. VCO2i can be calculated with either a capnograph or inline venous pCO2 monitoring.
Anti-fascism – a new horizon
Authors: Fekete Liz
Published: April 2022

In an extended version of a presentation on 3 February 2022 to the Stuart Hall Foundation’s fifth Annual Conversation on ‘Manufacturing Dissent: Moments of Solidarity’, the director of the Institute of Race Relations asks whether a refreshed anti-fascism, that tackles the global war against the poor, New Right ‘culture wars’, ‘total policing’ and the surveillance state, can act as an inspiration for diffuse struggles to come together into communities of resistance.
The Creative Emergents of Wandering and Wondering
Authors: Bunkers Sandra Schmidt
Published: April 2022

In this article, the author explores wandering and wondering through the lens of educational theory, philosophy, psychology, complexity theory, and the humanbecoming paradigm. A fictional story concerning wanderers is presented to highlight the creative power of the imagination involved with wandering and wondering.
Concept Inventing: Feeling Trusted
Authors: Doe Mi Jin
Published: April 2022

With the humanbecoming concept inventing model, the scholar conceptualized a novel idea about the universal humanuniverse living experience of feeling trusted. The now-truth of feeling trusted is cherished acknowledgment with sureness-unsureness arising with gracious alliances. The ingenuous proclamation of feeling trusted as a theoretical statement is valuing the originating of connecting-separating and as an artform is the film of The King’s Speech. The conceptualization of feeing trusted using the humanbecoming concept inventing model contributes to the advancement of nursing knowledge of universal humanuniverse living experiences.
Is Death the Enemy? Reconsidering the Significance of Metaphor in End of Life
Authors: Milton Constance L.
Published: April 2022

Metaphors are important ways to language meaning and illustrate imaginative thinking for the healthcare disciplines. Normative ethics focus on metaphors of war, torture, and art that guide thinking in end-of-life decision-making. This article begins a discussion of novel, imaginative thinking for consideration of metaphors such as holding on–letting go as paradoxical ways of being and quality during end of life. The discussion will be viewed through a case study utilizing the philosophical, theoretical lens of humanbecoming.
A Retrospective Cohort Evaluation of a Pharmacist-Led Approach for Transitioning Patients to an Angiotensin Receptor—Neprilysin Inhibitor
Authors: Rana Krishna , Jay Jessica , Patel Sonalie , Sueta Carla , Deyo Zack
Published: April 2022

Background: Heart failure guidelines recommend replacing an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) with an angiotensin receptor neprilysin inhibitor (ARNI) to reduce morbidity and mortality in NYHA Class II–III patients with reduced ejection fraction (HFrEF). Objective: This study aims to determine if a pharmacist-led outpatient ARNI replacement and titration program led to more patients achieving target doses of ARNI compared to usual care. Methods: A single health system, retrospective electronic medical record review identified 791 patients with active ARNI prescriptions and at least two outpatient cardiology visits with a pharmacist or usual care provider between January 2015 through September 2018. The primary outcome was the percentage of patients who achieved a target ARNI dose of 97/103 mg twice daily. The secondary outcomes were the median dose achieved, number of visits required to achieve target dose, hospitalizations, and all-cause death. Results: ARNI was initiated and continued by a pharmacist in 64 patients and 727 by usual care. More patients in the pharmacist group, 60.9% (n = 39), achieved target dose vs. 18.0% (n = 131) of patients managed by usual care (95% CI, 0.31–0.55, p < 0.0001). The pharmacist group also had higher median total daily dose of ARNI (200 mg (IQR = 300) vs 100 mg (IQR = 100), p < 0.0001) and more likely to achieve a higher total daily dose in fewer visits. Conclusions: An advanced practice provider pharmacist-led outpatient ARNI replacement and titration program was more effective in achieving target doses of ARNI in HFrEF patients as compared to usual care.
The flow mechanism of the shock structure and secondary flow control in transonic centrifugal compressors with leading edge sweep
Authors: Zi-liang LI , Qing-kuo LI , Ge HAN , Xin-gen LU , Jun-qiang ZHU
Published: April 2022

Limitations still exist in the research on the effects of leading edge sweep on transonic centrifugal compressors. The lack of understanding of this mechanism also leads to confusion regarding the magnitudes of the performance changes that occur due to the use of leading edge sweep. According to a detailed numerical simulation verified by experiments on two different compressors, the effect and flow mechanism of leading edge sweep on transonic centrifugal compressors were investigated in detail to alleviate the confusion as clearly as possible. The conclusions show that leading edge sweep has different impacts on shock waves at different positions; a forward sweep leading edge can weaken the strength of the shock wave in front of the leading edge, while a backward sweep leading edge can weaken the strength of the passage shock wave that is swallowed in the blade passage. The improved compressor performance attributed to leading edge sweep is due to the weakening of the shock waves and the interaction between the shock waves and the secondary flow of the inducer tip. Furthermore, the intensity of the inducer tip secondary flow influences the potential for improved performance induced by using sweep leading edges in transonic centrifugal compressors. This study provides a valuable reference for applying leading edge sweep to existing transonic centrifugal compressors or future advanced centrifugal compressor designs.
Small intestine necrosis in catastrophic antiphospholipid syndrome: A rare and severe case
Authors: Christiansen Tobias K , Nilsson Anna Christine , Madsen Gunvor I , Voss Anne
Published: April 2022

Catastrophic antiphospholipid syndrome (CAPS) is a multisystem autoimmune disease with widespread thrombotic events. In this case report, we present a young man with primary antiphospholipid syndrome (PAPS) admitted to the hospital with abdominal pain and vomiting. Abdominal computed tomography showed pneumoperitoneum and acute explorative laparotomy revealed small intestinal necrosis indicating small vessel thrombosis without involvement of large intestine. “Triple therapy” was initiated after surgery and the patient was treated in an intensive care unit for 72 days before being discharged to a rehabilitation clinic. A review of the literature regarding CAPS affecting small intestine shows it is extremely rare and may be associated with higher mortality.
Central Bank Autonomy and Stock Market Index in Nigeria: An ARDL and TYDL Granger Causality Approach
Authors: Olurin Enitan Olurotimi , Olokoyo Felicia Omowunmi , Adetiloye Kehinde Adekunle
Published: April 2022

Following the trend of granting autonomy to monetary authorities around the world beginning from the mid-1900s, the Central Bank of Nigeria had its share of gradual autonomy from 1991 culminating in the 2007 legislation. This study investigated the effect of central bank autonomy (CBA) on the stock market index (SMI) in Nigeria with data on market index, foreign direct investment (FDI), gross domestic product per capita, inflation rate, terms of trade, trade openness and effective central bank autonomy index from 1985 to 2018. The study adopted the autoregressive distributed lag and Toda–Yamamoto and Dolado–Lutkepohl approach to Granger causality. The study finds that there is no long-run relationship between the variables estimated, though short-run relationships exist. CBA has a statistically negative impact on the SMI, while FDI has a positive significant relationship with the SMI only in the short run. The only significant causality runs from FDI to SMI. The study, therefore, recommends that the Central Bank of Nigeria should have a higher level of instrument autonomy and should endeavour to come out with monetary policies that encourage diversification of the economy and engender growth in the capital market.
Predictors of postoperative pain, opioid consumption, and functionality after arthroscopic shoulder surgery: A prospective observational study
Authors: Zeeni Carine , Abou Daher Layal , Shebbo Fadia M , Madi Naji , Sadek Nada , Baydoun Hasan , Al-Taki Muhyeddine , Aouad Marie T
Published: April 2022

Purpose

This study aims to identify predictors of postoperative pain and opioid consumption after shoulder surgery to help optimize postoperative pain protocols.

Study Design

Observational cohort study.

Methods

One thirty-four patients undergoing arthroscopic shoulder repair were included. Variables related to the patient, surgery and anesthesia were collected and correlated with postoperative pain intensity, analgesic consumption, and functionality up to 1-month post-surgery. We used mixed-effect linear models to estimate the association of gender, interscalene block (ISB), preoperative shoulder pain, non-steroidal anti-inflammatory drugs (NSAIDs) consumption before surgery, and type of surgery with each of the following outcomes: postoperative pain scores, opioid consumption, and functionality. We further analyzed the data for pain scores and opioid consumption per body weight using the multiple linear regression analysis to demonstrate the aforementioned associations specifically at 1 h, 6 h, 12 h, 24 h, 72 h, 1 week and 1 month after surgery.

Results

Omitting the ISB was associated with higher postoperative pain and cumulative opioid consumption over the first 24 h after surgery. Rotator cuff repair and stabilization surgeries were found to be predictive of higher postoperative pain at 24 h, 72 h, and 1 week and lower functionality at 1 week after surgery. Preoperative shoulder pain and NSAIDs consumption were also predictive of postoperative pain and cumulative opioid consumption.

Conclusion

Omitting a single shot ISB is a strong predictor of postoperative pain and opioid consumption in the early postoperative phase, beyond which the type of surgery, particularly rotator cuff repair and stabilization surgery, emerges as the most important predictor of postoperative pain and functionality.
Postmortem diagnoses in South American camelids and factors influencing diagnostic rate in the Upper Midwest USA, 2009–2019
Authors: Clarke Lorelei L. , Breuer Ryan M.
Published: April 2022

South American camelids (SACs) have become increasingly popular as livestock and companion animals in the Midwestern United States. With increased ownership, postmortem evaluations and samples available for diagnostic assessment are being submitted more frequently to veterinary diagnostic laboratories. We searched archived pathology records at the Wisconsin Veterinary Diagnostic Laboratory (WVDL) between 2009–2019 for SAC cases. Postmortem records from 166 alpacas and 27 llamas were included, with an average of 1.42 diagnoses per animal. The overall average diagnostic rate was 79.8%. Abortion and neonatal cases (fetus to 1-wk-old) had the lowest diagnostic rate (33.3%) and was the only group with a diagnostic rate statistically significantly lower than the average. The most common diagnoses were gastrointestinal parasitism and suboptimal nutritional status or inanition; 78% of cases diagnosed with suboptimal nutritional status were also parasitized. The gastrointestinal parasites identified most frequently were Eimeria sp. and strongyles, especially Nematodirus sp. Our findings may aid allocation of diagnostic resources to better serve regional SAC populations and provide a framework for practitioners who send samples to laboratories for analysis. Submission of whole bodies, euthanized animals, fresh tissue, and inclusion of placental tissues in abortion cases are recommended for optimal diagnostic outcome.
Hemodialysis Catheter Breakage in an Infant
Authors: Nieto-Vega Francisco A , García-Rojas Ángela , Moreno-González Inmaculada , Martínez-Rivera Verónica , Rodríguez-Mesa José M , Rosa-Camacho Vanessa
Published: April 2022

A 3-month-old male infant was admitted to our unit due to acute decompensation of chronic kidney disease of unknown etiology. Further investigation led to the diagnosis of primary hyperoxaluria type 1. As the patient did not recover, hemodialysis was initiated with a non-tunneled femoral catheter. A tunneled Hickman catheter was placed in the internal jugular vein. The patient experienced moderate intradialytic exit-site bleeding and catheter malfunction, which initially responded to pressure and postural changes. During the third session, the patient suffered cardiopulmonary arrest. After stabilization, a chest hematoma was identified. Fluoroscopy revealed a catheter breakage. Despite initial stabilization, the patient developed septic shock due to Pseudomonas aeruginosa and died several days later. Hemodialysis is sometimes necessary in children under 24 months with chronic kidney disease. Vascular access is a major challenge in these patients due to lack of appropriate catheter sizes and high complication rates. Hemodialysis catheter fracture is an uncommon complication, and diagnosis can be difficult when the breakage involves the subcutaneous segment. Persistent intradialytic bleeding and mechanical malfunction should raise suspicion of this complication and should elicit catheter revision under fluoroscopy. Without prompt diagnosis, catheter breakage may have fatal consequences, as in our case.
The creator did not give me more than I can handle: Exploring coping in parents of Black autistic children
Authors: Lewis Ericka M , Dababnah Sarah , Hollie Kelley R , Kim Irang , Wang Yao , Shaia Wendy E
Published: April 2022

There is a paucity of studies that center on the lived experiences of Black families raising autistic children, and major gaps remain in our understanding of how parents of Black autistic children cope with stressors. Drawing from the Black family stress and coping model, this mixed-methods study explored coping strategies utilized by parents of Black autistic children. Twenty-two parents completed the Ways of Coping Questionnaire and participated in semi-structured interviews. Using grounded theory methods, we conducted data collection and analyses simultaneously until we did not identify new themes. Our quantitative and qualitative results were generally aligned. We found that parents used an array of coping strategies, at times combining different methods, to address complex stressors. Parents also expressed the need for more social support from providers, as well as a desire for inclusive spaces where they could engage with other parents whom they felt could better relate to the stressors they encountered. Study findings also suggest that kinship support, church involvement, and collective socialization are key protective factors in Black communities. Therefore, understanding the role culture plays in the use and effectiveness of coping strategies is essential to improving healthcare and other systems of care.

Lay abstract

Parents of Black autistic children use several strategies to cope with daily stressors. These strategies include seeking social support, self-care, and optimism. We asked parents about their experiences receiving treatment services for their autistic child and how they reduce parenting stress. Twenty-two parents completed a coping survey and participated in individual interviews. Few studies have explored the experiences of Black families raising autistic children, and it’s important for healthcare and other systems of care to understand the role culture, race, and ethnicity play in the use of coping strategies. In our study, the majority of parents relied on social support to relieve stress and identified partners, family, and community members, as their most useful sources of support. Connecting with other parents of autistic children, through support groups and social media, also helped parents relieve stress. Parents discussed using self-care activities (e.g. church, exercising, listening to music) to cope with stressors. Several parents described how prayer and meditation helped them reframe stressful situations and gain more patience and appreciation for “what’s important.” The findings of this work demonstrate the need for professionals to have ongoing and deeper conversations about the ways in which parents deal with stressors. In particular, clinicians should leverage the strengths of Black families and promote strategies that are culturally informed and engaged.
Extrinsic venous compression secondary to spine osteophytes
Authors: Gonzalez-Urquijo Mauricio , Torrealba Jose , Vargas Jose Francisco , Mertens Renato , Mariné Leopoldo , Valdés Francisco
Published: April 2022

Objective

This study aims to report two cases of symptomatic extrinsic compression of the inferior vena cava and left iliac vein caused by vertebral osteophytes.

Methods

We present two case reports of extrinsic venous compression by vertebral osteophytes. Both cases were endovascularly treated, with a successful outcome. A review of the literature of this unusual condition is also presented.

Results

The first patient is an 80-year-old woman who presented to the vascular surgery clinic with bilateral lower extremity edema and pain. A computed-tomography angiography (CTA) revealed extrinsic compression of the inferior vena cava from enlarged osteophytes. Venography and intravascular ultrasound were performed, confirming the diagnosis. A self-expanding venous stent was successfully deployed in the inferior vena cava relieving the extrinsic compression. The edema resolved the following day and was discharged without complications. The second patient is a 61-year-old male that presented to the emergency department with a left iliofemoral deep venous thrombosis. CTA showed left iliac vein compression by a lumbar osteophyte. Percutaneous thrombectomy was successfully achieved and an expanding stent was deployed covering the entire lesion. One month after the procedure the patient died from COVID-19‐associated respiratory failure.

Conclusion

Osteophytes must be considered when dealing with extrinsic venous compression, especially in elderly people.
Practical issues in operationalizing the design and outcome evaluation of cluster randomized trials
Authors: Donnell Deborah
Published: April 2022

Trial designs using cluster-level randomization are necessary when interventions have intended effects that cannot be measured with individual randomization. When an intervention is intrinsically only able to be delivered to a cluster or when implementation of an individual level intervention is only feasibly implemented at a cluster level, cluster-level randomization is required. In designing the strategy for evaluation of the primary outcome of a cluster randomized trial, there are a multitude of important decisions to consider. While these decisions are guided primarily by the intervention—who benefits, what is the intended effect and when will it be achieved—there are important detailed choices that affect potential bias and statistical power, and implementation considerations that require compromise for considerations of feasibility and practicality. Through the lens of three large completed cluster randomized trials in HIV prevention, we present specific choices made for the overall evaluation plan, together with some of the detailed considerations, compromises and modifications that occurred during trial implementation.
Caught in the crossfire: The Uyghurs in America’s propaganda war with China
Authors: Gilbert Simon
Published: April 2022

The Uyghur people of China's far west are at the centre of a propaganda war between the United States and China. Western media claims about their treatment may well be exaggerated, but the oppression of the Uyghurs is real. In linking its actions to the war on terror, China has created an increasingly violent spiral of repression and resistance. The United States is cynically using this to justify measures that are really about economic competition. Freedom for the Uyghurs can only come as part of a China-wide movement for change.
New composition of tungsten has a broad range of antiviral activity
Authors: Avagyan Hranush , Mirzoyan Anaida , Mirzoyan Ferdinand , Izmailyan Roza , Hakobyan Sona , Voskanyan Henry , Semerjyan Zara , Avetisyan Aida , Arzumanyan Hranush , Karalova Elena , Abroyan Liana , Hakobyan Lina , Bayramyan Nane , Gevorgyan Nazeli , Karalyan Alexander , Karalyan Zaven
Published: April 2022

The water-based combination of two inorganic chemical compounds such as sodium tungstate dihydrate-Na2WO4 × 2H2O and Aluminum sulfate octadecahydrate-Al2 (SO4) 3 × 18H2O that we have conditionally named ‘Vomifal’ has a broad antiviral activity in various DNA and RNA viruses, including Human Herpes Virus (HHV), African Swine Fever Virus (ASFV), Vaccinia Virus (VV), Hepatitis C Virus (HCV), Foot and Mouth Disease Virus (FMDV), Influenza A virus (A/Aichi/2/68 (H3N2)). In vitro and In vivo assays in several tissue cultures as well as in laboratory animals, conformed ‘Vomifal’ has a very low toxicity and the antiviral properties partially are due to its ability to induce gamma-IFN. Based on the results obtained, we can assume the presence of at least two mechanisms of the antiviral action of the studied drug. First or early stage - an unknown mechanism, possibly related to the effect on cellular receptors. Second or late stage – main antiviral properties probably associated with an interferonogenic effect.
MRI multiparametric scoring system for pial blood supply of intracranial meningiomas
Authors: Higaki Fumiyo , Inoue Satoshi , Oda Wakako , Matsusue Eiji , Hiraki Takao
Published: April 2022

Background

Meningiomas are occasionally fed by pial blood supply (PBS). It is postulated that peritumoral flow void (PTFV), peritumoral brain edema (PTBE), and absence of an arachnoid plane (AP) are useful parameters for evaluating PBS.

Purpose

To determine whether conventional magnetic resonance imaging (MRI) using a multiparametric scoring system (MSS) is a useful way to predict PBS.

Material and Methods

Forty-six patients were included and divided: PBS and non-PBS groups. Differences between the groups in six parameters of MR imaging were analyzed: tumor size, tumor location, PTBE grade, AP grade, PTFV, and MIB1 labeling index (MIB1-LI) grade. Cutoff values were determined using receiver operating characteristic (ROC) curve analysis for the differentiation of both groups based on statistically significant parameters. All cases were scored as 1 (PBS) or 0 (non-PBS) for each parameter according to set thresholds. Individual scores were totaled for each case, yielding a combined score for each case to obtain a cutoff value using ROC curve analysis for the MSS.

Results

Peritumoral brain edema grade, AP grade, PTFV, and MIB-LI grade were statistically associated with PBS. Receiver operating characteristic curve analyses showed that PTBE grade 3 or 4, AP grade 3 or 4, and PTFV positivity had the highest accuracy of 69%, 64%, and 68%, respectively. Regarding the MSS, a cutoff value of 2 had the highest accuracy of 71%; PBS diagnosis was indicated by at least two of the three parameters, namely, PTBE grade, AP grade, and PTFV.

Conclusion

The MSS is a useful way to predict PBS in intracranial meningiomas on MRI.
The impact of infrapatellar fat pad excision versus preservation after total knee replacement on anterior knee pain, functional outcome and patellar height: Randomized controlled trial
Authors: Fahmy Mahmoud , Seifeldin Ahmed Fouad
Published: April 2022

Introduction

Although better surgical exposure is encountered with the excision of infrapatellar pad of fat (IPPF) during total knee replacement (TKR), some studies showed an increase in anterior knee pain and other specific complications associated with such a step. The purpose of this study was to add in literature a new comparison between IPPF excision and preservation during TKR, focusing on the anterior knee pain, functional range, oxford knee score and patellar height through a randomized clinical trial

Methods

This prospective randomized study was conducted from 2016 to 2019 on 90 patients with knee osteoarthritis treated with elective primary TKA by same surgeons at one hospital with the same implant design with a mean follow up of 18 month. Patients were randomized into two groups: one group including patients with IPPF complete excision and the other group include patients with IPPF preservation. No patella resurfacing was done. Pre and postoperative anterior knee pain was recorded and compared using VAS score in addition to Oxford knee score.

Results

At 6 months follow-up, 10 knees and 14 knees (27%) had anterior aching discomfort with a mean postoperative extension were −5.3 and −5.2 in IPPF preservation and excision group patients, respectively. There was no statistically significant differences between both groups regarding anterior knee pain, range of motion, oxford knee score or patellar height measurement through the follow up period. No patellar complications were recorded in all cases.

Conclusion

Although Infrapatellar fat pad excision in TKA resulted in a minor increase in number of patients with postoperative anterior knee pain, it was of no statistically significant difference. Hence, whenever a better surgical exposure is needed, IPPF excision should be considered. Additional large scale randomized studies should be added to the calling literature for more result validation and guidelines formulation.