bluuebunny/crossref_metadata_2025 huggingface dataset:
The Rise of Arbitration in Brazil
Authors: Sester Peter
Published: November 2020

This introductory chapter discusses the rise of arbitration in Brazil. Modern commercial arbitration in Brazil is overtaking classic strongholds of international arbitration, despite its relatively young history. The Brazilian Arbitration Law (BAL) was adopted in 1996, eleven years after Brazil's re-democratization in 1985. The law revoked those parts of the Civil Procedure Code of 1973 particularly detrimental to the success of arbitration in the last century. Rather than integrating the new arbitration law into the existing Civil Procedure Code (CPC), the Brazilian legislator preserved it as a standalone act, thus revoking the CPC's pre-existing arbitration rules. In this way, the legislator facilitated developing an interpretation sui generis, thus preventing the matter from being taken over entirely by scholars of civil procedure law. Today, Brazilian arbitration scholars and practitioners come from many different backgrounds, including commercial, civil, international, and civil procedure law. Even tax, constitutional, and administrative lawyers are part of the community. The chapter then looks at the ratification of the New York Convention (NYC) in Brazil.
International versus National Awards
Authors: Martins Pedro Batista
Published: November 2020

This chapter explores the difference between international and national awards. The Superior Tribunal of Justice (STJ) is, strictly speaking, the last judicial body competent to deal with matters of an infra-constitutional nature. Hence, it is the Court that harmonizes the case law related to arbitration in Brazil. In 2004, the competence to recognize and enforce foreign judicial and arbitral awards was transferred from the Supremo Tribunal Federal (Supreme Court) to the STJ. Immediately after being granted such competence, the STJ introduced very contemporaneous rules on the recognition and enforcement of foreign awards by issuing on May 4, 2005 the Resolution Number 9. It is possible to issue provisional relief during the recognition proceeding; it is also possible to issue partial recognition of foreign arbitral awards; and allowed to enforce provisional relief granted abroad through rogatory letter. The chapter then highlights the main arbitration concepts and addresses the STJ's arbitration case law.
Labour Law Arbitration
Authors: Timm Luciano Benetti , Verçosa Fabiane
Published: November 2020

This chapter highlights labour law arbitration in Brazil. Traditionally, labour law in Brazil recognises two main groups of rights: individual and collective rights. Individual labour relations are concerned with the relationship between individual workers and their employers. Collective labour relations refer to the social relationships generated through processes of consultation and negotiation—over working conditions, labour standards, and other employment issues—between, on the one hand, the workers' collective or their representatives and, on the other hand, the employers or employers’ organization. Even before the Labour Legislation Reform of 2017, Brazilian legal order already provided in its Constitution and in other legal statutes the possibility of arbitration for collective labour rights. On the other hand, before the promulgation of the Labour Legislation Reform, there was no provision under Brazilian Law that would open the possibility of arbitration in the event of individual labour disputes.
Genomic Architecture of Rapid Parallel Adaptation to Fresh Water in a Wild Fish
Authors: Zong Shao-Bing , Li Yu-Long , Liu Jin-Xian
Published: November 2020

Rapid adaptation to novel environments may drive changes in genomic regions through natural selection. However, the genetic architecture underlying these adaptive changes is still poorly understood. Using population genomic approaches, we investigated the genomic architecture that underlies rapid parallel adaptation of Coilia nasus to fresh water by comparing four freshwater-resident populations with their ancestral anadromous population. Linkage disequilibrium network analysis and population genetic analyses revealed two putative large chromosome inversions on LG6 and LG22, which were enriched for outlier loci and exhibited parallel association with freshwater adaptation. Drastic frequency shifts and elevated genetic differentiation were observed for the two chromosome inversions among populations, suggesting that both inversions would undergo divergent selection between anadromous and resident ecotypes. Enrichment analysis of genes within chromosome inversions showed significant enrichment of genes involved in metabolic process, immunoregulation, growth, maturation, osmoregulation, and so forth, which probably underlay differences in morphology, physiology and behavior between the anadromous and freshwater-resident forms. The availability of beneficial standing genetic variation, large optimum shift between marine and freshwater habitats, and high efficiency of selection with large population size could lead to the observed rapid parallel adaptive genomic change. We propose that chromosomal inversions might have played an important role during the evolution of rapid parallel ecological divergence in the face of environmental heterogeneity in C. nasus. Our study provides insights into the genomic basis of rapid adaptation of complex traits in novel habitats and highlights the importance of structural genomic variants in analyses of ecological adaptation.
Novel 2D CaCl crystals with metallicity, room-temperature ferromagnetism, heterojunction, piezoelectricity-like property and monovalent calcium ions
Authors: Zhang Lei , Shi Guosheng , Peng Bingquan , Gao Pengfei , Chen Liang , Zhong Ni , Mu Liuhua , Zhang Lijuan , Zhang Peng , Gou Lu , Zhao Yimin , Liang Shanshan , Jiang Jie , Zhang Zejun , Ren Hongtao , Lei Xiaoling , Yi Ruobing , Qiu Yinwei , Zhang Yufeng , Liu Xing , Wu Minghong , Yan Long , Duan Chungang , Zhang Shengli , Fang Haiping
Published: November 2020

Under ambient conditions, the only known valence state of calcium ions is +2, and the corresponding crystals with calcium ions are insulating and nonferromagnetic. Here, using cryo-electron microscopy, we report direct observation of two-dimensional (2D) CaCl crystals on reduced graphene oxide (rGO) membranes, in which the calcium ions are only monovalent (i.e. +1). Remarkably, metallic rather than insulating properties are displayed by those CaCl crystals. More interestingly, room-temperature ferromagnetism, graphene–CaCl heterojunction, coexistence of piezoelectricity-like property and metallicity, as well as the distinct hydrogen storage and release capability of the CaCl crystals in rGO membranes are experimentally demonstrated. We note that such CaCl crystals are obtained by simply incubating rGO membranes in salt solutions below the saturated concentration, under ambient conditions. Theoretical studies suggest that the formation of those abnormal crystals is attributed to the strong cation-π interactions of the Ca cations with the aromatic rings in the graphene surfaces. The findings highlight the realistic potential applications of such abnormal CaCl material with unusual electronic properties in designing novel transistors and magnetic devices, hydrogen storage, catalyzers, high-performance conducting electrodes and sensors, with a size down to atomic scale.
Fiscal sustainability under entitlement spending
Authors: Cerniglia Floriana , Dia Enzo , Hughes Hallett Andrew
Published: November 2020

We develop a simple theoretical framework that can be used not only to assess the stability of debt, but also to evaluate the sustainability of the commitments of the public sector in the presence of entitlement spending. We model the optimal intertemporal path of fiscal variables and the optimal policy responses in this environment, which requires a dynamic framework. Our analysis suggests that even with near-zero interest rates the stability of debt is not guaranteed and that the sustainability of public finances depends on the level of taxes and the persistence of expenditure, as much as on the level of debt. We estimate the model with panel data techniques, finding that our modelling strategy is supported by the empirical evidence and we use calibrated versions of our model to compare different countries.
Discovery of a new extreme changing-state quasar with 4 mag variation, SDSS J125809.31+351943.0
Authors: Nagoshi Shumpei , Iwamuro Fumihide , Wada Kazuma , Saito Tomoki
Published: November 2020

We report the discovery of a quasar, SDSS J125809.31+351943.0 (J1258), which brightened in optical wavelengths for 4 mag from 1983 to 2015: one of the largest quasar brightening events so far. The history of optical photometry data of this quasar from the Catalina Real-time Transient Survey and All Sky Automated Survey for Super Novae (ASAS-SN), mid-infrared photometry data from the WISE satellite, and the broad emission line (BEL) flux obtained by spectroscopy of the Sloan Digital Sky Survey shows significant increases between 2003 and 2015. Investigating the Canada–France–Hawaii Telescope photometric observations in 1983 and the United States Naval Observatory B catalogue, which contains data from 1975 and 1969, we found that the source was 4 mag fainter before than at the peak of the recent ASAS-SN photometry. From the history of these data, we identified J1258 as a new changing-state quasar (CSQ). We also performed follow-up spectroscopic observations in 2018 December and 2019 May using the 2 m telescope at the Nishi-Harima Astronomical Observatory. The results show that the continuum flux and the BEL flux decreased to about 50% of their peak. This indicates that J1258 present two changing states for the BEL flux and continuum flux. We argue that J1258’s variability, especially its brightening event, can be explained by the propagation of the heating front and the accretion disk state transitions based on the timescale and Eddington ratio variations. The estimated mass of the black hole of J1258 is about an order of magnitude larger than the CSQs found so far. Since both the changing timescale and the size of the accretion disk depend on the black hole mass, the J1258 brightening event can be interpreted as a scaled version of the variability in other CSQs. This suggests that samples of distant quasars with larger black hole masses may contain objects with longer and more severe variations.
A Printer’s Odd Plea to Reform Legal Pluralism in Khedival Egypt
Authors: Cheta Omar Youssef , Schwartz Kathryn A
Published: November 2020

In 1871, an Italian-Jewish printer published a peculiar Arabic treatise from Cairo. It promoted strengthening legal pluralism in Khedival Egypt by realigning laws there to accord with those of the Ottoman Empire and European states. Composed by the printer’s legal team, the treatise questioned how justice could be obtained if the extraterritorial privileges of European subjects and protégés were not guaranteed. The printer had been motivated by his own plight: a test of the Egyptian merchant courts left him mired in a catch-22, whereby he could either accept an imperfect verdict, or demand extralegal measures. Choosing the latter option, the treatise embodied his desperate bid to promote his cause. Its importance stems from its very existence. It gave form to the printer’s tricky predicament by grasping at different genres of legal writing; it made his personal story relevant to all by entering it into the public domain; and it audaciously called for strengthening Roman law in Egypt. While the document’s actual influence cannot be ascertained, it anticipated wider historical developments regarding the practice and conception of print and law in the modern Middle East.
Medication safety for children with medical complexity
Authors: Huth Kathleen , Vandecruys Patricia , Orkin Julia , Patel Hema
Published: November 2020

Due to advances in medical care and innovations in health technology, many children with life-limiting conditions are now living longer. These children are often referred to as ‘children with medical complexity (CMC)’, and they are characterized by chronic conditions, increased health care utilization, and technology dependence. Their complexity of care and inherent fragility lead to higher risk for medication errors, both in-community and in-hospital. High rates of care fragmentation, miscommunication, and polypharmacy in CMC increase opportunities for error, particularly as children transition between health care settings and practitioners. Data on the factors contributing to higher risk of medication errors in this population and how they can be effectively addressed are lacking. This practice point provides clinical guidance for health care professionals to ensure medication safety when caring for CMC, with focus on practical strategies for outpatient and inpatient care.
Le diagnostic et la prise en charge du sepsis grave chez le patient pédiatrique
Authors: Farrell Catherine A
Published: November 2020

Le sepsis est une réponse inflammatoire systémique à une infection présumée ou démontrée. Puisque c’est une cause importante de morbidité et de mortalité, plusieurs sociétés professionnelles ont lancé des initiatives ces dernières années, lesquelles ont débouché sur la rédaction de directives pour déceler le sepsis et le traiter rapidement. Les principaux aspects des directives les plus récentes sont résumés dans le présent point de pratique. Ils incluent la détection de changements à l’état clinique et aux signes vitaux qui doivent évoquer la possibilité de sepsis, tels que la fièvre, la tachycardie et des modifications de la perfusion périphérique, de même que la stabilisation initiale des voies respiratoires, de la respiration et de la circulation. Ils englobent également l’administration opportune d’une thérapie antimicrobienne, l’utilisation de bolus liquidiens et de médicaments vasoactifs et des considérations particulières chez les patients atteints de troubles médicaux sous-jacents, comme l’emploi de corticoïdes pour traiter une possible insuffisance surrénalienne découlant d’une suppression de l’axe hypothalamo-surrénalien. Deux modifications sont apportées aux directives précédentes, soit une réévaluation clinique après chaque bolus liquidien en raison de la crainte d’une surcharge hydrique et le remplacement de la dopamine comme agent vasoactif initial chez les patients pédiatriques hypotendus par de l’adrénaline ou de la noradrénaline en fonction du contexte clinique. Le présent point de pratique porte principalement sur la prise en charge du sepsis chez les nourrissons plus âgés, les enfants et les adolescents.
EP01 Post COVID-19 reactive arthritis
Authors: Waller Rosemary , Price Elizabeth , Carty Sara , Ahmed Azeem , Collins David
Published: November 2020

Case report - Introduction

We present what we believe to be the first reported case of post COVID-19 reactive arthritis, in a previously medically well 16-year-old with no past or family history of inflammatory arthritis.

Case report - Case description

Our patient was a previously medically fit 16-year-old of Caucasian origin who tested positive for COVID-19 in late March 2020. She developed with a 4-day illness with fever, cough, and myalgia from which she made a full and uncomplicated recovery.

Ten days later she developed a new erythematous itchy rash on her legs, trunk, and face and a progressive polyarthralgia affecting her MCPs, wrists, shoulders, hips, and knees. The rash typically lasted for 2 days at one site and was non-scarring. This was associated with a low-grade fever. There were no associated mouth ulcers, photosensitivity, alopecia, Raynaud’s, GI disturbance or respiratory symptoms. She had no relevant family history of autoimmunity, psoriasis or inflammatory bowel disease or travel history and had been prescribed no new medications.

On examination, she had an erythematous rash on the face in a non malar distribution. She had multiple tender joints without definite synovitis. Cardiovascular, respiratory, gastroenterology and neurological examinations were unremarkable.

Investigations revealed a normal full blood count and CRP<1 with normal liver and renal function tests. Her urinalysis was unremarkable. Immunology was negative for ANA, ANCA and rheumatoid factor. Immunoglobulins were normal. Two weeks later her symptoms were fully resolved.

Case report - Discussion

Coronaviruses are single-stranded RNA viruses with nearly 30 strains recognised to infect humans. They induce both an innate and adaptive immune system response. It is hypothesised that a dysregulated innate system response, leading to a prolonged adaptive response triggers damaging inflammation and a potential cytokine storm. This is associated with poor outcome during primary viral infection. Variations in this immune response, with different underlying HLA genotypes could lead to other post infectious immune mediated phenomena, such as Paediatric Multisystem Inflammatory Syndrome - Temporally associated with COVID-19.

There is a European registry collating data about patients with known rheumatic diseases who are admitted with COVID-19. There is emerging data regarding Paediatric Inflammatory Multisystem Syndrome - Temporally associated with SARS-CoV-2 (PIMS-TS). There is a growing suggestion that a subgroup of patients is developing a COVID-19 associated post viral fatigue syndrome. We suggest that a registry to collect information on de novo autoimmune diseases presenting post COVID-19 is also commenced.

Case report - Key learning points

COVID-19 infection is associated with a wide variety of sequalae, including rheumatological ones.

Classic post viral Reactive arthritis has been seen. A registry to collect information on de novo autoimmune presentations would be highly informative.
Healthcare Costs, School Performance, and Health-related Quality of Life in Adolescence Following Psychotic Experiences in Preadolescence: A Longitudinal Cohort Study
Authors: Rimvall Martin Køster , Wolf Rasmus Trap , Olsen Else Marie , Skovgaard Anne Mette , Clemmensen Lars , Oxholm Anne Sophie , Verhulst Frank , Rask Charlotte Ulrikka , van Os Jim , Jeppesen Pia
Published: November 2020

Psychotic experiences (PEs) are common in the general population in preadolescence. The implications of PEs on socioeconomic outcomes, including educational attainment, are scarcely described. We aimed to estimate how preadolescent PEs were associated with later healthcare costs, school performance, and health-related quality of life (HRQoL) in adolescence. A total of 1607 preadolescents from the general population Copenhagen Child Cohort 2000 were assessed for PEs at age 11–12 years and followed up over 5 years using register-based data on mental and somatic healthcare costs, and school performance at age 16. Furthermore, HRQoL was assessed for a subsample of the children at age 16–17. We adjusted for perinatal and family sociodemographic adversities, prior parental mental illness and healthcare use, child IQ-estimate at age 11–12, and parent-rated general psychopathology of their child. PEs were associated with slightly poorer school performance. However, preadolescents with PEs more often reported HRQoL within the lowest 10th percentile (OR = 2.74 [95% CI 1.71–4.37]). Preadolescents who reported PEs had higher average total healthcare costs over the following 5 years. The costs for individuals with PEs were higher for mental healthcare services across primary to tertiary care, but not for somatic care. After adjustments, PEs remained independently associated with higher costs and poorer HRQoL, but not with poorer school performance. In conclusion, PEs are important in mental health screening of preadolescents and identify a group of young people with increased healthcare service-use throughout adolescence and who report poorer HRQoL in adolescence, over and above parent-rated general psychopathology of their child.
High levels of depressive symptoms among people with lower limb lymphoedema in Rwanda: a cross-sectional study
Authors: Semrau Maya , Davey Gail , Bayisenge Ursin , Deribe Kebede
Published: November 2020

Background

There is a growing body of evidence that mental distress and disorder are common among people with lower limb lymphoedema, although no research has been conducted on this subject in Rwanda.

Methods

This research was embedded within a mapping study to determine the national prevalence and geographical distribution of podoconiosis in Rwanda. Using a cluster sampling design, adult members of households within 80 randomly selected sectors in all 30 districts of Rwanda were first screened and 1143 patients were diagnosed with either podoconiosis (n=914) or lower limb lymphoedema of another cause (n=229). These 1143 participants completed the Patient Health Questionnaire (PHQ)-9 to establish the prevalence of depressive symptoms.

Results

Overall, 68.5% of participants reported depressive symptoms- 34.3% had mild depressive symptoms, 24.2% had moderate, 8.8% moderately severe and 1.2% severe depressive symptoms. The mean PHQ-9 score was 7.39 (SD=5.29) out of a possible 0 (no depression) to 27 (severe depression). Linear regression showed unemployment to be a consistently strong predictor of depressive symptoms; the other predictors were region (province), type of lymphoedema and, for those with podoconiosis, female gender, marital status and disease stage.

Conclusions

Levels of depressive symptoms were very high among people with lower limb lymphoedema in Rwanda, which should be addressed through holistic morbidity management and disability prevention services that integrate mental health, psychosocial and economic interventions alongside physical care.
A Hybrid Genome Assembly Resource for Podosphaera xanthii, the Main Causal Agent of Powdery Mildew Disease in Cucurbits
Authors: Polonio Álvaro , Díaz-Martínez Luis , Fernández-Ortuño Dolores , de Vicente Antonio , Romero Diego , López-Ruiz Francisco J. , Pérez-García Alejandro
Published: November 2020

Podosphaera xanthii is the main causal agent of powdery mildew in cucurbits and, arguably, the most important fungal pathogen of cucurbit crops. Here, we present the first reference genome assembly for P. xanthii. We performed a hybrid genome assembly, using reads from Illumina NextSeq550 and PacBio Sequel S3. The short and long reads were assembled into 1,727 scaffolds with an N50 size of 163,173 bp, resulting in a 142-Mb genome size. The combination of homology-based and ab initio predictions allowed the prediction of 14,911 complete genes. Repetitive sequences comprised 76.2% of the genome. Our P. xanthii genome assembly improves considerably the molecular resources for research on P. xanthii−cucurbit interactions and provides new opportunities for further genomics, transcriptomics, and evolutionary studies in powdery mildew fungi.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
The Influence of Water Deficit Stress on the Grapevine Trunk Disease Pathogens Eutypa lata and Diplodia seriata
Authors: Sosnowski Mark R. , Ayres Matthew R. , Scott Eileen S.
Published: November 2020

The increasing prevalence of the grapevine trunk diseases Eutypa and Botryosphaeria dieback has been attributed, in part, to abiotic stresses imposed on vineyards as production intensifies worldwide. The aim of this study was to evaluate the influence of water deficit irrigation practices on the infection of pruning wounds by Eutypa lata and Diplodia seriata and the subsequent rate of colonization. Two vineyard trials were conducted over two consecutive seasons in South Australia, one in the Riverland with ‘Cabernet Sauvignon’ with four irrigation treatments (100, 50, 25, and 12.5% of the standard irrigation program) and another in the Barossa Valley with ‘Shiraz’ on six rootstocks and own roots, either irrigated or not irrigated. According to leaf water potential assessments, vines with reduced irrigation were generally in water deficit and therefore subjected to stress. On the whole, incidence of wound infection and distance of colonization were similar between irrigation treatments for both pathogens, except in the Riverland, where E. lata colonized canes to a greater extent in well-watered vines than those in water deficit. Only vines on rootstock ‘Ramsey’ in the Barossa Valley had greater extent of colonization by E. lata in the nonirrigated vines. There was no correlation between internal staining and colonization, with both pathogens recovered to nearly 20 cm ahead of the staining. Water deficit did not increase the susceptibility of grapevine pruning wounds to infection or colonization of the subtending tissue by E. lata and D. seriata. In fact, there was evidence of lower susceptibility to colonization by E. lata in vines subjected to severe water deficit.
Mapping for Adult-Plant Resistance Against Septoria Tritici Blotch in a Common Wheat Line Murga
Authors: He Xinyao , Azzimonti Gustavo , Sánchez-Vidaña Mariel del Rosario , Pereyra Silvia A. , Sansaloni Carolina , Hernández-Anguiano Ana María , Chawade Aakash , Singh Pawan K.
Published: November 2020

Septoria tritici blotch (STB) is a major foliar disease globally that is notorious for quickly developing fungicide resistance, making host resistance an indispensable component in mitigating STB. The International Maize and Wheat Improvement Center (CIMMYT) wheat line Murga is well known for its high, durable, and broad-spectrum resistance against STB infection. This study aimed to investigate the resistance mechanism of Murga to facilitate its utilization in breeding. A recombinant inbred line population was derived from a cross between Murga and STB-susceptible line Huirivis#1, comprising 297 progenies. The population was evaluated for adult-plant STB resistance in Toluca, Mexico (from 2017 to 2019), and in La Estanzuela, Uruguay (from 2016 to 2018). Genotyping was performed with the DArTseq platform. Quantitative trait locus (QTL) mapping indicated a major and stable QTL on chromosome 3DL, explaining a phenotypic variation for STB of 41.2 to 62.5% in Mexico and 27.5 to 40.3% in Uruguay. This QTL was regarded as Stb16 based on the comparison of its physical position, the possible origin from synthetic wheat, and its broad-spectrum resistance. Additional QTLs with minor effects were identified on chromosomes 2B, 2D, 3A, 3B, and 5B. The QTL on 5BS was significant in four of the six environments and must be new. Murga was the resistant donor for all QTLs except for those on 2B and 3A. Being an elite breeding line, Stb16 carrier Murga could be used as a promising STB resistance donor. Rational employment of Stb16 could contribute to STB management yet avoid the rapid emergence of Stb16-virulent isolates.
Management of Isolated Anal Strictures in Crohn’s Disease
Authors: Lightner Amy L. , Click Benjamin , Yamamoto Takayuki , Spinelli Antonino , Kotze Paulo
Published: November 2020

BACKGROUND:

Anorectal stricturing is a particularly morbid manifestation of Crohn’s disease resulting in a diminished quality of life related to pain, incontinence, and recurrent operative interventions.

OBJECTIVE:

To determine the role of medical therapy, endoscopic dilation, and surgical intervention for the treatment of isolated anorectal stricturing.

DATA SOURCES:

An organized search of MEDLINE, PubMed, EMBASE, Scopus, and the Cochrane Database of Collected Reviews was performed from January 1, 1990 through May 1, 2020.

STUDY SELECTION:

Full text papers which included management of isolated anorectal strictures in the setting of Crohn’s disease.

INTERVENTION(S):

Medical and surgical management.

MAIN OUTCOME MEASURES:

Symptomatic relief, need for proctocolectomy.

RESULTS:

Our search identified a total of 553 papers; after exclusion based on title (n = 430) and abstract (n = 47), 76 underwent full text review with 65 relevant to the management of anorectal strictures. A summary of the retrospective reports suggests that medical therapy can help control luminal inflammation, but fibrosis may ultimately set in resulting in a need for endoscopic or surgical intervention. Surgical options are limited in the anal canal due to inflammation and ulceration and concomitant perianal fistulizing disease. While fecal diversion can provide symptomatic relief, successful restoration of intestinal continuity remains uncommon and most patients ultimately undergo a total proctocolectomy with end ileostomy.

LIMITATIONS:

Limited literature published, all retrospective in nature.

CONCLUSIONS:

Despite significant advances in medical and surgical therapy in Crohn’s disease over the last decades, there is clearly an unmet need in the management of anorectal strictures in Crohn’s disease.
Sex Differences in Neuromodulation Treatment Approaches for Traumatic Brain Injury: A Scoping Review
Authors: Phillips Angela , Sami Sohrab , Adamson Maheen
Published: November 2020

Objective:

Neuromodulatory brain stimulation interventions for traumatic brain injury (TBI)–related health sequelae, such as psychiatric, cognitive, and pain disorders, are on the rise. Because of disproportionate recruitment and epidemiological reporting of TBI-related research in men, there is limited understanding of TBI development, pathophysiology, and treatment intervention outcomes in women. With data suggesting sex-related variances in treatment outcomes, it is important that these gaps are addressed in emerging, neuromodulatory treatment approaches for TBI populations.

Methods:

Four research databases (PubMED, EMBASE, CINAHL, and PsycINFO) were electronically searched in February 2020.

Design:

This PRISMA Scoping Review (PRISMA-ScR)–guided report contextualizes the importance of reporting sex differences in TBI + neuromodulatory intervention studies and summarizes the current state of reporting sex differences when investigating 3 emerging interventions for TBI outcomes.

Results:

Fifty-four studies were identified for the final review including 12 controlled trials, 16 single or case series reports, and 26 empirical studies. Across all studies reviewed, 68% of participants were male, and only 7 studies reported sex differences as a part of their methodological approach, analysis, or discussion.

Conclusion:

This review is hoped to update the TBI community on the current state of evidence in reporting sex differences across these 3 neuromodulatory treatments of post-TBI sequelae. The proposed recommendations aim to improve future research and clinical treatment of all individuals suffering from post-TBI sequelae.
Novel approaches in occupational asthma diagnosis and management
Authors: Quirce Santiago , Domínguez-Ortega Javier , Luna Juan A.
Published: November 2020

Purpose of review

To describe the recent findings of the last 2 years on the epidemiology and phenotypes of occupational asthma, as well as new developments in its diagnosis and management.

Recent findings

Data from nine longitudinal studies showed a population attributable fraction for the occupational contribution to incident asthma of 16%. The main phenotypes of occupational asthma are: occupational asthma caused by high-molecular-weight (HMW) or low-molecular-weight (LMW) agents, irritant-induced asthma and occupational asthma-chronic obstructive pulmonary disease overlap. Among the variety of causative agents of occupational asthma, food-derived components are increasingly being reported, accounting for up to 25% cases of occupational asthma and/or occupational rhinitis. Recently, a specific inhalation challenge (SIC)-independent model has been developed to calculate the probability of occupational asthma diagnosis in workers exposed to HMW agents. In this model, work-specific sensitization, bronchial hyperresponsiveness, inhaled corticosteroid use, rhinoconjunctivitis and age 40 years or less were the most relevant predictive factors. Specific IgE measurements showed a pooled sensitivity of 0.74 and a specificity of 0.71 in the diagnosis of occupational asthma for HMW agents, while a lower sensitivity (0.28) and a higher specificity (0.89) was shown for LMW agents. Cessation of exposure to workplace sensitizers is the cornerstone of management of work-related conditions.

An early and precise diagnosis of occupational asthma is crucial, allowing appropriate management and implementation of preventive strategies.
The Prevalence of Intimate Partner Violence and Association With Depression in University Students
Authors: Musa Arif , Valdez Alfonso J. , Aguilar Jose L. , Pendi Kasim , Wolitzky-Taylor Kate B. , Lee Danny , Lee Joshua , Safani David
Published: November 2020

The purpose of this cross-sectional study was to determine the prevalence of intimate partner violence (IPV) among university students, investigate the potential predictors of IPV in this population, and study the link between IPV and depression. The survey included sociodemographic, relationship quality, and depression-related questions. From 498 respondents, the prevalence of IPV was 4.8%, depression was 30.9%, and suicidal ideation was 20.3%. After adjusting for covariates and confounders, relationship satisfaction (odds ratio [OR], 0.201; 95% confidence interval [CI], 0.101–0.401; p < 0.001) and jealousy (OR, 0.270; 95% CI, 0.094–0.776; p = 0.015) were significant predictors of IPV. Relationship satisfaction predicted depressive disorders (OR, 0.504; 95% CI, 0.365–0.698; p < 0.001). IPV trended toward predicting the presence of a depressive disorder (OR, 0.436; 95% CI, 0.170–1.113; p = 0.083). Relationship satisfaction and jealousy predicted IPV. Although IPV did not predict depression, poor relationship satisfaction increased the odds of depression, implicating the influence of relationship satisfaction on both IPV and depression.
Estimated Proportions and Characteristics of National Survey Respondents Reporting New Diagnoses of Schizophrenia or Other Psychoses in the Past Year as Compared With Prior Years
Authors: Bommersbach Tanner , Rhee Taeho Greg , Stefanovics Elina , Rosenheck Robert
Published: November 2020

Epidemiologic data on first-episode psychosis is limited due to the infrequency of cases in the general population. This study uses the National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309) to examine population-based estimates of early psychosis based on adults who report a first-time diagnosis of schizophrenia from a doctor in the past year and compares them with those receiving diagnoses in previous years. Altogether, 60 respondents reported past-year schizophrenia (170 per 100,000) or 6.7% of 901 with any reported schizophrenia. Mean age was 41.4 ± 2.1, and they reported significantly higher rates of any past-year substance use disorder (44.7%) than individuals diagnosed in previous years (27.7%), specifically alcohol use disorder. Compared with other samples (many of which excluded older adults), this study suggests that early psychosis may affect older populations more than previously recognized, but comorbidity with substance use disorders showed similar elevations.
An Intervention to Change Illness Representations and Self-Care of Individuals With Type 2 Diabetes: A Randomized Controlled Trial
Authors: Chan Virginia W.Y. , Kong Alice P.S. , Lau Joseph T.F. , Mak Winnie W.S. , Cameron Linda D. , Mo Phoenix K.H.
Published: November 2020

Objective

Suboptimal self-care by individuals with diabetes mellitus (DM) is a significant public health concern. The common-sense model (CSM) proposes that illness representations are associated with coping and health outcomes across various conditions. The present study examined the efficacy of a CSM-based intervention in improving illness representations, self-care, self-care self-efficacy, use of adaptive coping strategies, and glycated hemoglobin among individuals with type 2 DM (T2DM).

Methods

A two-arm randomized controlled trial was used. A total of 455 T2DM patients were recruited from an outpatient DM clinic and randomized to an intervention group that consisted of five weekly group-based education sessions or a control group that received five weekly educational booklets. Evaluation was conducted at baseline and at 1- and 6-month follow-up.

Results

The 2 × 3 linear mixed-model analysis using a modified intention to treat revealed a significant time by condition interaction effect on level of self-care (F(2,840) = 7.78, p < .001), self-care self-efficacy (F(1.89,794.57) = 14.40, p < .001), and use of adaptive coping strategies (F(1.94,812.93) = 4.75, p = .010) in which participants in the intervention group reported greater improvement in such aspects compared with those in the control group. A significant time effect was observed in some dimensions of illness representations. No significant effect was found in glycated hemoglobin. Participants reported positive feedback to the intervention and perceived improvement in various domains.

Conclusions

The CSM-based intervention was effective in improving self-care and coping among DM patients. The intervention also demonstrated high feasibility and acceptability. Findings provided important insights in improving health-related outcomes for patients with T2DM using the CSM framework.
Somatosensory Illusions Elicited by Sham Electromagnetic Field Exposure: Experimental Evidence for a Predictive Processing Account of Somatic Symptom Perception
Authors: Wolters Carolin , Harzem Jana , Witthöft Michael , Gerlach Alexander L. , Pohl Anna
Published: November 2020

Objective

According to the predictive processing theory of somatic symptom generation, body sensations are determined by somatosensory input and central nervous predictions about this input. We examined how expectations shape predictions and consequently bodily perceptions in a task eliciting illusory sensations as laboratory analogue of medically unexplained symptoms.

Methods

Using the framework of signal detection theory, the influence of sham Wi-Fi on response bias (c) and somatosensory sensitivity (d′) for tactile stimuli was examined using the somatic signal detection task (SSDT). A healthy student sample (n = 83) completed the SSDT twice (sham Wi-Fi on/off) in a randomized order after watching a film that promoted adverse health effects of electromagnetic fields.

Results

When expecting a Wi-Fi signal to be present, participants showed a significantly more liberal response bias c (p = .010, ηp
2
= 0.08) for tactile stimuli in the SSDT as evidence of a higher propensity to experience somatosensory illusions. No significant alteration of somatosensory sensitivity d′ (p = .76, ηp
2
< 0.002) was observed.

Conclusions

Negative expectations about the harmfulness of electromagnetic fields may foster the occurrence of illusory symptom perceptions via alterations in the somatosensory decision criterion. The findings are in line with central tenets of the predictive processing account of somatic symptom generation. This account proposes a decoupling of percept and somatosensory input so that perception becomes increasingly dependent on predictions. This biased perception is regarded as a risk factor for somatic symptom disorders.
Carpal Tunnel Release Despite Normal Nerve Conduction Studies in Carpal Tunnel Syndrome Patients
Authors: Lee Jun-Ku , Yoon Byung-Nam , Cho Jin Woo , Ryu Han-Seung , Han Soo-Hong
Published: November 2020

Purpose

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy, often requiring carpal tunnel release (CTR) surgery. Often, a nerve conduction study (NCS) is performed before CTR; however, there are various reports questioning the sensitivity of NCS, and some patients do undergo CTR despite normal NCS results. We had the following purposes: (1) to report clinical outcome of CTS patients who undergo CTR despite normal NCS, (2) to identify the characteristics and compare those with abnormal NCS patients in terms of basic features and risk factors, and (3) to analyze and compare normal and abnormal NCS results.

Materials and Methods

Medical records of 546 CTS (30 normal NCS and 516 abnormal NCS) patients were retrospectively reviewed. Of 30 normal NCS patients, 7 were excluded, leaving 23 patients in the experimental group. We investigated the influence of age, sex, operative arm, and body mass index, as well as medical conditions known to be risk factors for CTS. In normal NCS patients, as a functional score, we investigated Boston carpal tunnel scores before and after CTR. The NCS results were compared in terms of median motor and median sensory testing. In normal NCS patients, NCS data were compared with that of the contralateral nonoperated wrists.

Results

There were 18 women and 5 men in the normal NCS group (mean age 43.7 years). On physical examination, 22 (94.7%) patients showed a positive Tinel test, 19 (82.6%) showed a positive Phalen test, 8 (34.8%) complained of nocturnal paresthesia, and only 1 (4.3%) presented with thenar atrophy. In 19 of 23 patients, the Boston CTS scores showed significant improvement after CTR. Normal NCS patients were significantly younger and significantly heavier and more likely to be a current smoker. In NCS analysis of normal NCS patients, the operated wrists were closer to the reference values than nonoperated wrists.

Conclusions

Surgeons should evaluate the possibility of other combined lesions before CTR in normal NCS patients. Normal NCS can be present with a CTS diagnosis, especially in younger patients. Nevertheless, CTR after failed conservative management, despite normal NCS, could relieve subjective symptoms and function.
Excluding Antibiotics in the Management of Nonoperative Orbital and Zygomatic Fractures
Authors: Pessino Kenneth , Cook Tracey , Layliev John , Bradley James P. , Bastidas Nicholas
Published: November 2020

Introduction

Indications for prophylactic antibiotic therapy in nonoperative, closed fractures of the orbit and zygoma remain controversial and are based on anecdotal data. The purpose of this study was to report the incidence of infectious sequelae among patients who presented to our institution with stated fractures and who were not administered prophylactic antibiotic therapy. The authors hypothesized that an increase in infectious complications would not be seen in these patients.

Methods

The authors conducted a prospective single site study from October 2015 to December 2019. Patients with closed, nonoperative fractures involving the orbit and/or zygoma were included. These patients did not receive prophylactic antibiotic therapy for their fracture patterns, and infectious complications including orbital cellulitis, meningitis, and bacterial sinusitis were noted if present during follow-up.

Results

Of 301 patients with closed, nonoperative orbital and/or zygomatic fractures, 268 were included in the study and 33 were excluded because of administration of antibiotics. The average age was 60 years, and the most common mechanism of injury was a traumatic fall. Fracture types included 100 orbital wall, 133 orbital floor, 15 orbital rim, 23 orbital roof, 48 zygoma, and 44 zygomaticomaxillary compound fractures. Infectious sequelae were not identified in any patient.

Conclusions

Of the 268 patients included in the study, no infectious complications were identified during the follow-up period. This outcome further supports that the use of prophylactic antibiotics is not indicated for closed, nonoperative fractures involving the orbital and/or zygoma. Prospective randomized control studies would be useful to support this outcome and better guide clinical antibiotic prescribing practices.
COVID-19 Therapeutics for Solid Organ Transplant Recipients; 6 Months Into the Pandemic: Where Are We Now?
Authors: Avery Robin K.
Published: November 2020

As in the general population with coronavirus 2019 (COVID-19) infection, therapeutic interventions in solid organ transplant (SOT) recipients have evolved over time. The preceding 6 months of the pandemic can be divided into 2 main therapeutic eras: the early era and the later era. The first era was characterized by the widespread use of drugs such as hydroxychloroquine with or without azithromycin, lopinavir–ritonavir, and tocilizumab. More recently, with the publication of larger trials, there has been increasing use of remdesivir, dexamethasone, and convalescent plasma, with the rapid proliferation of clinical trials including a wide variety of investigational and repurposed agents with antiviral or immunomodulatory effects. This overview focuses on what is known about the effects of different therapies in SOT recipients with COVID-19, mainly from case series and, more recently, larger multicenter registries; as well as outlining the information that will be needed to optimize management and outcomes in SOT recipients with COVID-19 in the future.
COVID-19 Mortality Following Mass Gatherings
Authors: Miron Oren , Yu Kun-Hsing , Wilf-Miron Rachel , Davidovitch Nadav
Published: November 2020

We examined Coronavirus Disease-2019 (COVID-19) mortality following 5 mass gatherings at outdoor rallies in the United States, during August 2020. We found that COVID-19 mortality started increasing 19-24 days after the mass gathering. In a 50-mile radius there was a 2.1-fold increase in COVID-19 mortality, and in a 51-100 miles radius there was a 1.4-fold increase. Our results suggest that precautions should be taken in mass gatherings and in at least a 50-mile radius, in order to limit COVID-19 mortality.
Surgically Implanted Electrodes Enable Real-Time Finger and Grasp Pattern Recognition for Prosthetic Hands
Authors: Vaskov A. K. , Vu P. P. , North N. , Davis A. J. , Kung T. A. , Gates D. H. , Cederna P. S. , Chestek C. A.
Published: November 2020

Currently available prosthetic hands are capable of actuating anywhere from five to 30 degrees of freedom (DOF). However, grasp control of these devices remains unintuitive and cumbersome. To address this issue, we propose directly extracting finger commands from the neuromuscular system via electrodes implanted in residual innervated muscles and regenerative peripheral nerve interfaces (RPNIs). Two persons with transradial amputations had RPNIs created by suturing autologous free muscle grafts to their transected median, ulnar, and dorsal radial sensory nerves. Bipolar electrodes were surgically implanted into their ulnar and median RPNIs and into their residual innervated muscles. The implanted electrodes recorded local electromyography (EMG) with Signal-to-Noise Ratios ranging from 23 to 350 measured across various movements. In a series of single-day experiments, participants used a high speed pattern recognition system to control a virtual prosthetic hand in real-time. Both participants were able to transition between 10 pseudo-randomly cued individual finger and wrist postures in the virtual environment with an average online accuracy of 86.5% and latency of 255 ms. When the set was reduced to five grasp postures, average metrics improved to 97.9% online accuracy and 135 ms latency. Virtual task performance remained stable across untrained static arm positions while supporting the weight of the prosthesis. Participants also used the high speed classifier to switch between robotic prosthetic grips and complete a functional performance assessment. These results demonstrate that pattern recognition systems can use the high-quality EMG afforded by intramuscular electrodes and RPNIs to provide users with fast and accurate grasp control.

Surgically implanted electrodes recorded finger-specific electromyography enabling reliable finger and grasp control of an upper limb prosthesis.