bluuebunny/crossref_metadata_2025 huggingface dataset:
Shanghai
Authors: Shih Mi
Published: October 2020

This article primarily focuses on Shanghai since the late 1980s, a period in which the city began to undergo rapid urbanization, and the resulting sociopolitical, economic, and spatial consequences and dynamics. Shanghai’s acceleration into a highly urbanized society is manifested in several ways. The city’s urban area increased at least fourfold, to over a thousand square kilometers, between 1989 and 2016 (Chengshi Jianshe Tongji Nianjian (城市建设统计年鉴), Zhongguo Chengshi Tongji Nianjian (中国城市统计年鉴)). In the same period, investment in the city’s basic infrastructure grew 33 times to over 155 billion (renminbi) and construction of buildings increased tenfold to almost seventy-five square kilometers (Shanghai Statistical Yearbook, cited under Statistics and Other Official Sources). Urbanization, however, has also dismantled the city’s older fabric and socialist institutions. Several sources, including those cited in this article, show that more than one million households have been relocated from their original neighborhoods since the early 1990s. Large-scale residential relocation and prevalent privatization have, in turn, given rise to a new phenomenon of great sociopolitical significance—weiquan (维权) or rights protection. Contemporary Shanghai, therefore, is an excellent site for study of the unprecedented transformation (in the sense that everything is being turned on its head [fantianfudi, 翻天覆地]) that urbanization has brought to the Chinese people and cities in the reform era more broadly. Changes to institutions, power structures, societal dynamics, identities, the state-market duality, and cultural and historical meanings are all caught up in the urbanization process through which Shanghai has grown into a global city in the 21st century. To study Shanghai and its urbanization processes, this article aims to highlight two general approaches. First, while the role of the state is central to understanding why policies are designed as such, the actual implementation is always filtered through the agency of nonstate societal actors and their contestation and negotiation. Second, while external forces such as globalization and the free- market economy hold important shaping power, it is crucially important to understand how Shanghai handles these forces on its own terms. In other words, context-sensitive nuances, dynamics, particularities, and complexities help us to better understand Shanghai under urban transformation. The cited works to various degrees reflect these two approaches. Many other topics about Shanghai can be found in other Oxford Bibliographies articles, especially those in history, literature, and modernity.
Cities of the Ottoman Empire
Authors: Boyar Ebru
Published: October 2020

The Ottoman city was characterized by being focused around the nucleus of a mosque, market, and public bath, containing military buildings, in particular a castle, and being divided into mahalles/haras (districts, quarters, neighbourhoods). It was further defined by its relationship to Istanbul. However, as one would expect in such a huge empire, cities displayed considerable regional variation and while Istanbul, the capital after 1453 and most populous city of the empire, remained the central reference point, the empire contained other cities of major importance, such as Damascus, Aleppo and Cairo, or Izmir, Edirne, and Thessaloniki. The morphology of the city also changed over time and the importance of individual cities rose and fell throughout the life of the empire.
African Urbanization
Authors: Myers Garth
Published: October 2020

Africa is typically seen in urban studies as both the least urbanized continent and the most rapidly urbanizing one. This perception relies on eliding the substantial differences between urbanization trajectories in North Africa and sub-Saharan Africa. Despite these differences in pace and extent for urbanization in these regions, most themes of the scholarly literature are shared in both northern and sub-Saharan zones. While most of this chapter focuses on works from the sub-Saharan region, the thematic scope is continent-wide. For the continent, the modern scholarly literature on urbanism and urbanization includes titles dating back more than eighty years to the work of the former Rhodes-Livingstone Institute in the Zambian Copperbelt, but urban studies in general experienced a retreat of sorts throughout much of the 1970s and 1980s. Since then, however, there has been a dramatic resurgence of African urban studies literature. Across the social sciences and humanities and across the continent, a wide range of works have emerged that examine the ways cities in Africa are developing. Both the urbanization process and the character of urbanism in the region come under scrutiny in this work. Major debates concern the presence or lack of distinctions between African cities and those elsewhere. Contested questions involve whether African cities are anomalies or dystopias, whether they exhibit unique patterns worthy of scrutiny, and whether they are following expected routes of development. Perhaps the most cogent crystallization of this might be expressed as a debate between Afro-pessimist and Afropolitan perspectives, but the reality is that most of the literature expresses neither of these perspectives exclusively. The new literature of African urban studies is very vast and diverse, but it is possible to discern several broad themes, as reflected in the headings and subheadings in this article. For each of these, the bibliography reflects only a sample of the many works available that examine the themes presented.
Cities in the Early American Republic
Authors: Foster A. Kristen
Published: October 2020

Cities in America’s early republic developed on the edge of two worlds. The majority of these urban areas had been born in colonies that belonged to European powers, including England, France, Spain, and the Netherlands. In this colonial world, cities hugged the Atlantic coast and served the interests of Europe’s mercantile empires. After the American Revolution, however, urban areas developed in line with the interests of the United States, expanding geographically, economically, politically, socially, and culturally. The cities of the early republic were central to the first debates about the fate of the fast-changing republic. On 23 September 1800, on the verge of wresting power from the first generation of Federalist politicians, the Republican Thomas Jefferson wrote to his old friend Dr. Benjamin Rush that he viewed “great cities as pestilential to the morals, the health and the liberties of man.” Jefferson, ever the champion of the independent farmer, argued that cities “nourish some of the elegant arts; but the useful ones can thrive elsewhere, and less perfection in the others with more health virtue & freedom would be my choice.” As president, Jefferson tried to expand his agrarian empire of liberty by purchasing the Louisiana Territory from France in 1803, but he could not stay the growth of cities. After the War of 1812, Americans moved westward in unprecedented numbers and used trading hubs and cities to center and connect their own economic growth. The story of cities in America’s early republic thus unfolds in two parts: the first follows the American Revolution and is anchored by its participants’ belief that republican theories and individual virtue would tie the populace together; the second part is paced by the energy unleashed in the 19th century as liberalism and the boundless possibilities of market capitalism sent Americans across a continent, building, dispossessing, and re-envisioning what it meant to be American. This population remained predominantly rural over the course of the early republic, but the nation’s urban centers often anchored and drove change. While early histories focused more intently on urban development and city planning, recent studies have expanded into an eclectic mix of social history topics, including class development, political culture, immigration, religious development, urban slavery, gender relations, and sexuality. In the end, however, studies dedicated to specific cities have remained at the center of historical inquiry about urban development and life in America’s early republic. One yet unexplored avenue for study that might shift conceptualizations of urban spaces would be to examine dense indigenous population centers in the early republic. Looking at Tippecanoe or the southwestern pueblos, for instance, might alter the heavy association of the word urban with European cultures alone and open new conceptualizations of indigenous America and Euro-America.
David Harvey
Authors: Wyly Elvin
Published: October 2020

David Harvey (b. 1935) is an influential urban theorist, and the world’s most widely cited geographer. He is a distinguished professor of anthropology at the City University of New York, and was formerly a professor of geography at Johns Hopkins, as well as Halford Mackinder Professor of Geography at Oxford. Since earning a BA (1957), MA, and PhD (1962) at Cambridge, Harvey has been a central figure in every major transformation of geography’s philosophy, methodology, and politics. As the “spatial turn” became more influential across the social sciences and humanities, Harvey became a leading interdisciplinary theorist of how urbanization brings together a multitude of diverse economic, sociocultural, and natural processes. Capitalist production is urbanizing. So are social difference, diversity, and inequality. So are relations between humans and animals, plants, and viruses—all the diversity of more-than-human worlds of “nature.” Harvey first achieved prominence at the University of Bristol in the “Quantitative Revolution,” a movement in geography, planning, and urban studies challenging dominant historical, descriptive narratives of locally unique regions and cities. Harvey’s Explanation in Geography (London: Edward Arnold, 1969) was called “the bible” by a new generation committed to a spatial science of positivist analytical rigor, quantified precision, and the development of hypotheses and laws—sifting through the unique and particular to find what is general and universal. Harvey completed Explanation just as he took up a position at Johns Hopkins in 1969, as protests shook cities around the world. In Baltimore and other US cities thrown into crisis by generations of racism and white-flight suburbanization, protests intensified after the assassination of Dr. Martin Luther King Jr., and with spreading rebellion against young men being drafted to serve in the neocolonial Vietnam War. Diving into research on the class and race segregation of Baltimore’s inner city, Harvey found Engels and Marx more reliable guides than modern urban economics. Harvey’s resulting Social Justice and the City (London: Edward Arnold, 1973) inaugurated a new, Marxist revolution in urban studies, geography, and beyond. In the subsequent half-century, Harvey has introduced successive generations to Marxist theory and praxis while adapting and refining Marx’s (somewhat) Eurocentric theory of industrial capitalism—making it relevant for understanding today’s planetary, urban, cosmopolitan, postindustrial, and algorithmic capitalism. Harvey has put his urban historical-geographical materialist methods into sustained dialogue with every generation of New Left academics (feminists, environmentalists, ecofeminists, anarchists, postmodernists, cultural studies theorists, posthumanists, and decolonization/indigenous theorists) as well as “Right to the City” activists fighting for housing and tenants’ rights and racial justice.
Urban Economics
Authors: Behrens Kristian , Thisse Jacques-François
Published: October 2020

Location matters. The most striking example is the highly uneven distribution of population and wealth across space. For example, cities occupy approximately 2 percent of the Earth’s land surface, but host more than half of the world’s population and produce about 80 percent of its economic output. The twenty most populous US metropolitan statistical areas (MSAs) account for almost 45 percent of the total US population and produce 52.2 percent of total US GDP on barely 15.2 percent of total US surface. Similar patterns hold for other countries, with even starker concentrations of population and economic activity in the growing megalopolises of developing countries. This entry discusses why population and economic activity are not more evenly spread across space. The first reason that comes to mind is that places are intrinsically heterogeneous along different dimensions such as topography, resource endowments, access to natural transportation routes, or climate. More importantly, what makes a location desirable to an agent is the unintended byproduct of the other agents’ location choices: everyone cares about her own position, but the actual choice is relative to those of the others. To put it differently, the desirability of a specific location depends on where the others are located. This simple fact is the essence of spatial equilibrium, a formal concept used by economists to analyze the spatial distribution of economic agents and activity. It describes a situation where each economic agent optimally chooses her own location—taking the locations of the others as given—and where these interdependent location choices are mutually compatible. The outcome is determined by the interplay between two sets of competing forces. First, everything else equal, agents want to be close together (“agglomeration forces”). This comes from the fact that moving people, goods, and ideas across space is costly, which pushes toward geographic concentration to reduce these costs and increase the benefits generated by clustering. Second, everything else equal, there are limits to geographic concentration at any point in space, which tends to push agents apart (“dispersion forces”). The main limits to agglomeration lie in competition for land, which is an immobile good in (more or less) limited supply, and different other negatives—congestion, noise, pollution—that increase with geographic concentration. Because only a limited number of agents can be spatially close to each other, most interactions occur across distant locations and are, therefore, costly. Each agent trades off the benefits generated by the agglomeration forces and the costs generated by the dispersion forces to choose his or her own location, which depends on where the others are located. The resulting spatial equilibrium is the outcome of these interdependent optimization processes carried out by economic agents who pursue their own interests.
Urban Poverty
Authors: Cano-Hila Ana Belén
Published: October 2020

Eradicating poverty in all its forms remains one of the greatest challenges facing humanity. For this reason, it was the primary sustainable development goal set for the United Nations Development Programme. While the number of people living in extreme poverty dropped by more than half between 1990 and 2015, too many are still struggling to meet the most basic human needs, and in particular 10 percent of the world’s population lives in extreme poverty; one person in every ten is extremely poor. As of 2015, about 736 million people still lived on less than US $1.90 a day; many lack food, clean drinking water, and proper sanitation. Rapid growth in countries such as China and India have lifted millions out of poverty, but progress has been uneven. Women are more likely to be poor than men as they have less paid work and education and own less property. Consequently, child poverty also is significant high; half of all people living in poverty are under eighteen. In fact, child poverty is one of the most important concerns and priorities for national and international organizations. Progress has also been limited in other regions, such as South Asia and sub-Saharan Africa, which account for 80 percent of those living in extreme poverty. New threats brought on by climate change, conflict, and food insecurity mean that even more work is needed to lift people out of poverty. The Sustainable Development Goals (SDGs) are a bold commitment to finish what we have started and end poverty in all its forms and dimensions by 2030. This involves targeting the most vulnerable, increasing basic resources and services, and supporting communities affected by conflict and climate-related disasters. In fact, urban poverty in megalopolises in the Global South is a relevant issue in international research on poverty. However, this entry is focused on urban poverty, understood as a set of economic and social difficulties that are found in advanced industrial cities. Sociology has always shown an interest in poverty, for example in the early Chicago school’s studies on urbanization, industrialization, immigration, and neighborhoods. While classic figures of sociology such as Max Weber, Émile Durkheim, Talcott Parsons, Georg Simmel, and Auguste Comte did not write a great deal about poverty, a strong concern with it exists in the work of Karl Marx and Friedrich Engels. In recent decades, there has been growing interest in unifying the sociologies of poverty and paying more attention to poverty in the developing world, where the overwhelming majority of poor people live. Hence, this bibliography attempts to address the twofold goals of reviewing the main literature in the field as it exists today and seeking to identify frontier directions for emerging research.
Indian Urbanization
Authors: Sood Ashima
Published: October 2020

Even as late as 2008, over sixty years after Indian independence from British colonial rule, only 30 percent of India’s population lived in urban areas. Not surprisingly, the rural loomed large in the young nation’s postcolonial imagination over the 20th century. Scholarly attention to Indian cities took a sharp upward turn in the new millennium. A constellation of social, economic, political, and cultural forces came together in this “urban turn.” The International Monetary Fund–mandated economic reforms of 1991 over time brought cities to increasing policy prominence as nodes for national and transnational capital flows. At the same time, the 74th Constitutional Amendment Act provided statutory status to urban local bodies as the third tier of elected government in India, after the central government and states. Together, the unfolding of these changes created a profound shift in the political economy of Indian cities. Equally powerful transformations reconfigured the sociocultural landscapes of Indian cities starting in the 1980s and 1990s. The English-educated middle classes had been influential in the politics and cultures of Indian cities since colonial times. However, a sustained period of economic growth in the 1980s and the rise of skill-intensive and eventually globalized services sector economies in the following decades allowed this increasingly urban middle class access to new forms of material and symbolic consumption. Globalized aspirations and assertions accompanied and informed the rise of this class. While the liberalization of import controls brought consumer goods from around the world into Indian marketplaces, the incursion of cable television and in time, the internet, brought exposure to global norms of consumption. Alongside these emerging cultures of consumerism, new global imaginaries of the postindustrial city shaped both popular and policy visions of ‘world-class’ cities. Yet vast swaths of urban India remain outside the ambit of elite discourses. More than four in five urban workers, according to recent data, are informally employed (i.e., they lack even basic job protections). As many as half or more urban residents in many Indian megacities live in unplanned settlements. Some of these shortages of housing and basic services were encoded into colonial planning paradigms. But the cleansing and beautification campaigns that create and maintain world-class cities also drive processes of immiseration as poor groups are pushed out of prosperous city centers. The interplay of these social, cultural, economic, and political transformations and contradictions over the last twenty-five years or more have inspired a vast and burgeoning scholarship on Indian urbanization.
Multimorbidity among persons aged 25–64 years: a population-based study of social determinants and all-cause mortality
Authors: Ferry F R , Rosato M G , Curran E J , O’Reilly D , Leavey G
Published: October 2020

Background

Despite increasing multimorbidity across the lifespan, little is known about the co-occurrence of conditions and risk factors among younger adults. This population-based study examines multimorbidity, social determinants and associated mortality among younger and middle-age adults.

Method

Analysis was based on the Northern Ireland population aged 25–64 years enumerated in the 2011 Census (n = 878 345), with all-cause mortality follow-up to 2014 (8659 deaths). Logistic regression was used to examine social determinants and Cox proportional hazards models in the analysis of associated mortality.

Results

Prevalence of multimorbidity was 13.7% in females and 12.7% in males. There was a strong association between multimorbidity that included mental/cognitive illness and deprivation. Among those never married, multimorbid physical conditions were less likely [relative risk ratios (RRR) = 0.92: 95% confidence interval (CI) = 0.88, 0.95 for males; and RRR = 0.90: 0.87, 0.94 for females]. Rurality was associated with lower physical multimorbidity (RRR = 0.92: 0.89, 0.95) but higher mental/cognitive multimorbidity (RRR = 1.35: 1.12, 1.64) among females. All multimorbid categories were associated with elevated risk of mortality.

Conclusion

The health and economic challenges created by multimorbidity should be addressed further ‘upstream’. Future multimorbidity research should include younger adults to inform the development of preventative interventions and align health and social care services more closely with patients’ needs.
Intravenous immunoglobulin for corticosteroid-resistant intestinal Henoch-Schönlein purpura: worth a controlled trial against corticosteroids?
Authors: Morotti Francesco , Bracciolini Giulia , Caorsi Roberta , Cattaneo Lorella , Gattorno Marco , Ravelli Angelo , Felici Enrico
Published: October 2020

Objectives

Henoch–Schönlein purpura (HScP) may present in children with severe, occasionally refractory, gastrointestinal (GI) involvement. The use of corticosteroids (CSs) is commonplace in the management of the disease, but to date no standardized protocol is available and, although rare, resistance to CS therapy may be challenging to clinicians. IVIG has been proposed as an effective alternative to CSs, but to date no controlled trial has been conducted to ascertain their real efficacy. We share our personal experience of successful IVIG treatment in two cases of GI HScP, comparing it with similar experiences reported in literature.

Methods

Retrospective clinical data collection, comparison with available literature.

Results

We describe two children with severe HScP GI vasculitis refractory to high-dose intravenous CSs that responded rapidly to IVIG administration, with complete recovery within a few days. Patient characteristics and response to IVIG administration were comparable to those of other previously reported cases.

Conclusion

Our observation confirms that IVIG may be useful in the treatment of CS-resistant HScP-related GI vasculitis in children, and highlights the need for more structured research, including a randomized trial against CSs, in order to ascertain their real effectiveness.
Phylogeny, species delimitation and population structure of the steppe-inhabiting land snail genusHelicopsisin Eastern Europe
Authors: Balashov Igor A , Neiber Marco T , Hausdorf Bernhard
Published: October 2020

We here study the steppe-inhabiting land snail genus Helicopsis (Gastropoda: Geomitridae: Helicellinae) across Eastern Europe using mitochondrial 16S rDNA sequences and nuclear AFLP markers and compare the biogeographical patterns with those of other steppe-inhabiting organisms. The subdivision of Central and Eastern European Helicopsis reflects the geographical subdivision of the European steppe belt in Pontic, Pannonian and Northern steppes. The subdivision within Helicopsis is deeper, at the species level, than in most other steppe-inhabiting groups. Helicopsis populations from the Pontic steppes can be classified into two sister-species. Helicopsis lunulata includes mainly populations with depressed conical shells previously identified as H. striata, but also populations with disc-like shells previously identified as H. instabilis, and it is distributed mainly west of the Dnieper River. Most Helicopsis populations from east of the Dnieper, especially from Crimea, belong to the variable H. filimargo that includes H. gasprensis, H. retowskii, H. arenosa, H. luganica, H. martynovi and H. subfilimargo. The species inhabiting the Pannonian Basin and the Northern steppes form a well-supported monophylum, including H. hungarica in the Pannonian Basin, H. austriaca at the fringe of the Eastern Alps and H. striata mainly in the Northern steppes.
Timing of Intubation and Its Implications on Outcomes in Critically Ill Patients With Coronavirus Disease 2019 Infection
Authors: Matta Atul , Chaudhary Siddique , Bryan Lo Kevin , DeJoy Robert , Gul Fahad , Torres Ricardo , Chaisson Neal , Patarroyo-Aponte Gabriel
Published: October 2020

In critically ill patients with coronavirus disease 2019, there has been considerable debate about when to intubate patients with acute respiratory failure. Early expert recommendations supported early intubation. However, as we learned more about this disease, the risks versus benefits of early intubation are less clear. We report our findings from an observational study aimed to compare the difference in outcomes of critically ill patients with coronavirus disease 2019 who were intubated early versus later in the disease course. Early need for intubation was defined as intubation either at admission or within 2 days of having a documented Fio
2 greater than or equal to 0.5. In the final sample of 111 patients, 76 (68%) required early intubation. The mean age among those who received early intubation was significantly higher (69.79 ± 12.15 vs 65.03 ± 8.37 years; p = 0.038). Also, the patients who required early intubation had significantly higher Sequential Organ Failure Assessment scores at admission (6.51 vs 3.48; p ≤ 0.0001). The outcomes were equivocal among both groups. In conclusion, we suggest that the timing of intubation has no impact on clinical outcomes among patients with coronavirus disease 2019 pneumonia.
Nurse-Led Positive Psychology Intervention Is Feasible in Patients With Heart Failure
Authors: Taylor Erin , Sparks Denise , Rukavina Madeline , Biddle Martha , Wells Gretchen L.
Published: October 2020

Background

Negative psychological states have been linked with poor cardiovascular outcomes, including heart failure (HF). Positive psychological states have been associated with superior outcomes, with little focus on interventions designed to increase positive psychological states in patients with HF.

Objective

The aim of this study was to test the acceptability and feasibility of a nurse-led positive psychology intervention.

Methods

A convenience sample of patients with HF was enrolled at a single academic medical center. The participants were coached in the Best Possible Self intervention by a trained nurse. Participants were then contacted by telephone to determine continued practice and satisfaction with the intervention.

Results

Eighty-seven patients were approached to enroll 60 patients with a yield rate of 69%. The intervention was feasible and acceptable as 80% continued the intervention until study completion.

Conclusion

Patients with HF are willing to participate and accept a nurse-led positive psychology intervention.
The Developmental Eye Movement Test in French Children
Authors: Moiroud Lionel , Royo Anaïs , Bucci Maria Pia
Published: October 2020

SIGNIFICANCE

This study reported that the Developmental Eye Movement (DEM) test for French children is similar to the American ones and that all parameters of the DEM test improve up to the age of 10 years.

PURPOSE

The DEM test has been normalized for several different populations of children, but there are no published norms for French children. This study aimed to determine values of the DEM test for French-speaking children.

METHODS

A total of 327 children from 6 to 12 years of age participated in the study. The DEM test was administered as outlined in the manual.

RESULTS

Significant differences were found between the ages, and DEM test scores improved with age until about 10 years. Developmental Eye Movement test scores were similar to those reported in American children.

CONCLUSIONS

Cortical and central structures responsible for oculomotor and attentional capabilities are developing until about 10 years of age, and that could explain the improvement of the DEM test score up to this age. Furthermore, values of the DEM test in French children are similar to the American ones that are currently used as norms by French clinicians.
Eye Care Provider Availability for the Medicare Population in U.S. States That Have Expanded Optometrist Scope of Practice
Authors: Gibson Diane M.
Published: October 2020

SIGNIFICANCE

Estimating a broader set of measures of local eye care provider availability than used in prior research offers information that is useful for policy decisions related to access to eye care.

PURPOSE

The purpose of this study was to examine whether policy-relevant information was gained when measures of local eye care provider availability in addition to the estimated travel time (ETT) to the closest provider were estimated for the population 65 years or older in Kentucky, New Mexico, and Oklahoma. These states have expanded surgical scope of practice for optometrists.

METHODS

This study used block group–level population data from the 2010 U.S. Decennial Census and eye care provider office address information from the 2016 Medicare Provider Utilization and Payment Data. Geographic information system analysis was used to calculate ETTs between individuals and eye care providers. Expanded measures of availability included the difference in ETT to an individual's second closest and closest ophthalmologist, the difference in ETT to an individual's closest ophthalmologist and closest optometrist, and whether only one ophthalmologist at the closest office accepted Medicare. Descriptive statistics were calculated for each state and by urbanicity.

RESULTS

Of the population 65 years or older in each state, between 10.8 (Kentucky) and 16.6% (Oklahoma) had a one-way ETT to the second closest ophthalmologist >15 minutes longer than to the closest ophthalmologist, between 21.1 (Kentucky) and 27.6% (Oklahoma) had a one-way ETT to the closest ophthalmologist >15 minutes longer than to the closest optometrist, and between 56.4 (Kentucky) and 70.0% (Oklahoma) had only one ophthalmologist at the closest office who accepted Medicare. Findings differed substantially by urbanicity.

CONCLUSIONS

Using a portfolio of travel time–based measures enhances the understanding of local eye care provider availability.
Dry Eye Disease in University-based Clinics in Canada: A Retrospective Chart Review
Authors: Bitton Etty , Elder Marian , Srinivasan Sruthi , Luensmann Doerte , Jones Lyndon W.
Published: October 2020

SIGNIFICANCE

Dry eye disease (DED) imposes a substantial burden on patients, which can lead to significant economic consequences for society. We provide insights into the DED patient population and DED diagnostic/management practices in Canada, which to date have been inadequately addressed in the literature.

PURPOSE

The purpose of this study was to describe DED patient demographic/clinical characteristics alongside DED diagnosis/management in university-based optometry clinics in Canada.

METHODS

This was a retrospective chart review of nonconcurrent non-Sjögren patients with DED at two university-based optometry clinics in Montreal and Waterloo. Waterloo charts with a diagnosis of DED and all charts from the Montreal dry eye clinic were considered for inclusion.

RESULTS

Overall, 200 charts were reviewed. Most patients were female (Montreal, 76%; Waterloo, 72%), and the mean age was 57.2 ± 14.9 years at Montreal and 52.6 ± 20.1 years at Waterloo. Patients commonly reported multiple health conditions (e.g., allergies [Montreal, 44%; Waterloo, 36%]), and high use of systemic nonocular medications was observed (Montreal, 76%; Waterloo, 62%). Clinical signs and symptoms of DED were recorded more often in Montreal patients than in Waterloo patients (e.g., dryness symptoms, 100 vs. 72%; tear breakup time, 100 vs. 60%). Warm compresses (Montreal, 63%; Waterloo, 83%) and artificial tears (Montreal, 94%; Waterloo, 96%) were the most frequently recommended nonmedical treatment and ocular lubricant, respectively. Topical steroids were the most frequently prescribed medications (Montreal, 22%; Waterloo, 21%), with typically three to four different interventions recommended per patient at each clinic. No relationship was found between symptoms and clinical signs or recommended interventions.

CONCLUSIONS

This retrospective chart review provided the demographics, clinical characteristics, diagnosis, and management options for DED patients in Canadian university-based optometry clinics. The more comprehensive assessments conducted at Montreal may be beneficial to better monitor the progression of DED and to determine treatment effects over time.
“Good Catch, Kiddo”—Enhancing Patient Safety in the Pediatric Emergency Department Through Simulation
Authors: Shaikh Ulfat , Natale JoAnne E. , Till Dale A. , Julie Ian M.
Published: October 2020

Objectives

Adverse events that affect patient safety are a significant concern in pediatrics. Increasing situational awareness, identifying errors and near misses, and reporting them using organizational incident reporting systems enables mitigation of harm.

Methods

We designed and tested a brief, interactive, and easily replicable simulation activity for medical students, and emergency medicine interns and pediatric interns to strengthen their skills and enhance their self-efficacy in identifying and reporting patient safety hazards. Hazards fell into the categories of situational safety, patient identification and privacy, infection prevention, treatment errors, and issues with electronic health records (EHRs).

Results

The simulation training significantly increased the self-efficacy of medical students and interns in identifying and reporting patient safety hazards. Learners were very satisfied with the simulation training, successfully recognized key patient safety hazards, provided feedback to improve the training, and improved their ability to report hazards through organizational incident reporting systems. Patient safety hazards associated with patient misidentification were recognized most frequently, whereas safety hazards associated with EHRs were missed with the greatest frequency.

Conclusions

The simulation training enabled learners to identify hazards and near misses and enhanced their ability to report hazards through organizational incident reporting systems. Learners at all levels of training identified safety hazards at comparable rates, which demonstrates the role that trainees play in critically observing clinical settings with fresh eyes and identifying and reporting patient safety hazards. Interventions to promote patient safety need to prioritize building situational awareness of potential hazards associated with EHR use.
Molecular Magnetic Resonance Imaging of Liver Fibrosis and Fibrogenesis Is Not Altered by Inflammation
Authors: dos Santos Ferreira Diego , Arora Gunisha , Gieseck Richard L. , Rotile Nicholas J. , Waghorn Philip A. , Tanabe Kenneth K. , Wynn Thomas A. , Caravan Peter , Fuchs Bryan C.
Published: October 2020

Rationale and Objectives

Fibrosis is characterized by progressive replacement of normal tissue by extracellular matrix. Diagnosis relies on biopsies as noninvasive methods for detection and quantification of fibrosis are still limited. This work aimed to address the ability of 2 molecular magnetic resonance (MR) probes, EP-3533 and Gd-Hyd, to identify fibrosis and fibrogenesis, respectively, independently of the presence of underlying inflammation in a mouse model of chronic liver disease caused by infection with Schistosoma mansoni.

Methods

Three groups of mice that develop either mild type 2 inflammation and fibrosis (wild type), severe fibrosis with exacerbated type 2 inflammation (Il10−/−Il12b−/−Il13ra2−/−), or minimal fibrosis with marked type 1 inflammation (Il4ra∂/∂) after infection with S. mansoni were imaged using both probes for determination of signal enhancement. Schistosoma mansoni–infected wild-type mice developed chronic liver fibrosis.

Results

The liver MR signal enhancement after either probe administration was significantly higher in S. mansoni–infected wild-type mice compared with naive animals. The S. mansoni–infected Il4ra∂/∂ mice presented with little liver signal enhancement after probe injection despite the presence of substantial inflammation. Schistosoma mansoni–infected Il10−/−Il12b−/−Il13ra2−/− mice presented with marked fibrosis, which correlated to increased signal enhancement after injection of either probe.

Conclusions

Both MR probes, EP-3533 and Gd-Hyd, were specific for fibrosis in this model of chronic liver disease regardless of the presence or severity of the underlying inflammation. These results, in addition to previous findings, show the potential application of both molecular MR probes for detection and quantification of fibrosis from various etiologies.
Academic Productivity in Plastic Surgery: A Comparison of US and International Medical Graduates
Authors: Edalatpour Armin , Nkana Zeeda H. , Bentz Michael L. , Afifi Ahmed M.
Published: October 2020

Introduction:

International medical graduates (IMGs) make up nearly 10% of plastic surgeons in the United States, yet there is little information regarding their relative contributions to the field of academic plastic surgery. This study compares the research productivity and academic rank of IMG academic plastic surgeons and their US medical graduate (USMG) counterparts.

Method:

A cross-sectional study was performed to include all IMG and USMG full-time academic plastic surgeons in the United States. For each IMG and USMG academic plastic surgeon, bibliometric variables such as the Hirsch index (h-index), i10-index, total number of publications, total number of citations, and greatest number of citations for a single published work were computed.

Results:

One-hundred and forty-four full-time IMG and 828 USMG academic plastic surgeons met inclusion criteria. There were no significant differences between IMGs and USMGs regarding h-index, i10-index, total number of publications, and total number of citations. Both IMGs and USMGs have higher numbers of publications following graduation from a plastic surgery residency or fellowship as compared to pre-residency or fellowship (37.2 ± 71.5 versus 8.0 ± 19.2 and 45.0 ± 73.1 versus 9.1 ± 15.5, respectively).

Conclusions:

IMG and USMG plastic surgeons have nearly equivalent research productivity. Both cohorts continue to have high research outputs following graduation from a plastic surgery residency or fellowship.
Sexually Inactive Status in Women With Pelvic Organ Prolapse Before Colpocleisis and Postoperative Satisfaction and Regret Rate
Authors: Wang Yi-Ting , Zhang Kun , Yang Jun-Fang , Yao Ying , Wang Hui-Fang , Han Jin-Song
Published: October 2020

Purpose

The aim of the study was to investigate the sexually inactive status of patients with pelvic organ prolapse before colpocleisis and postoperative satisfaction and regret rate.

Methods

A retrospective study of patients with pelvic organ prolapse who underwent colpocleisis was conducted in our hospital from January 2007 to April 2019. Records were reviewed before surgery for general clinical characteristics, duration, and reasons for being sexually inactive. Follow-up was conducted by telephone about patient satisfaction, Patient Global Impression of Improvement score, and regret rate after surgery.

Results

The mean age of the 247 patients was 73.8 ± 5.58 years. A total of 76.9% (190/247) described the duration of being sexually inactive, and the mean time was 12.6 ± 8.69 years. The 247 patients gave the following reasons for being sexually inactive: 52.2% (129/247) were widowed and 37.2% (92/247) reported the physical health factors of their spouses or sexual partners. The first male factor was nervous system disease (37.0%, 34/92). A total of 5.3% (13/247) were patient-related factors and 5.3% (13/247) were factors of both the male and female. A total of 195 patients underwent follow-up, the rate was 78.9% (195/247), and the follow-up time was 39.7 ± 37.5 (2–140) months. A total of 98.5% (192/195) of patients were very satisfied. A total of 98.9% (193/195) of patients were very much improved or improved in Patient Global Impression of Improvement score. A total of 1.02% (2/195) of patients regretted having colpocleisis nearly 2 years later.

Conclusions

The main reason for being sexually inactive was having been widowed. Colpocleisis was associated with high satisfaction rates and low regret rate.
The characteristics of oxygen concentration and the role of correction factor in real-time GI Breath Test
Authors: Lee Siu Man , Falconer Imogen HE , Madden Trudi , Laidler Peter O
Published: October 2020

A high quality end-expiratory breath sample is required for a reliable GI breath test result. Oxygen (O2) concentration in the breath sample can be used as a quality marker. This study investigated the characteristics of oxygen concentration in breath sample and the issues with using a correction factor in real-time breath test. The results indicated 95.4% of 564 patients were able to achieve an O2 concentration below 14% in their end-expiratory breath. A further 293 samples were studied and revealed that the distribution of O2 concentration was between 16.5% and 9.5%. Applying a correction factor to predict the end-expiratory H2 and CH4 values led to an average error of −36.4% and −12.8% respectively. The correction factor algorithm based on limiting O2 at 14% would have resulted in false negative result for 50% of the positive cases. This study has also indicated the continuous O2 measurement is essential to ensure breath sample quality by preventing secondary breathing during real-time breath collection.
The importance of the human factor during the evolution of SARS-CoV-2 pandemic: the successful case of the Italian strategy
Authors: Scarpazza Cristina , Musumeci Gianluca , Ciani Andrea S. Camperio
Published: October 2020

In Italy, 311,364 cases and 35,851 deaths of people who tested positive for SARS-CoV-2 were registered as of September 29th, 2020. To avoid the spreading of the virus, mathematical models predicting the course of infection’s spread1 become the basis to plan stringent countermeasures. We applied a published algorithm to real data up to September 27th, modeling two scenarios where predicted and real data were compared: a conservative scenario with a lockdown still ongoing and a scenario reflecting what actually happened in Italy, where the lockdown has been removed. Results revealed that the number of individuals in life-threatening condition is much lower than predicted, as well as the number of symptomatic individuals. Contrarily, the number of asymptomatic individuals is much higher than predicted. This suggest that human beings are not passive victims, but active fighters able to change the course of the infection creating adaptive strategies against the infection’s spread.
A global atlas of genetic associations of 220 deep phenotypes
Authors: Sakaue Saori , Kanai Masahiro , Tanigawa Yosuke , Karjalainen Juha , Kurki Mitja , Koshiba Seizo , Narita Akira , Konuma Takahiro , Yamamoto Kenichi , Akiyama Masato , Ishigaki Kazuyoshi , Suzuki Akari , Suzuki Ken , Obara Wataru , Yamaji Ken , Takahashi Kazuhisa , Asai Satoshi , Takahashi Yasuo , Suzuki Takao , Shinozaki Nobuaki , Yamaguchi Hiroki , Minami Shiro , Murayama Shigeo , Yoshimori Kozo , Nagayama Satoshi , Obata Daisuke , Higashiyama Masahiko , Masumoto Akihide , Koretsune Yukihiro , FinnGen Kaoru Ito , Terao Chikashi , Yamauchi Toshimasa , Komuro Issei , Kadowaki Takashi , Tamiya Gen , Yamamoto Masayuki , Nakamura Yusuke , Kubo Michiaki , Murakami Yoshinori , Yamamoto Kazuhiko , Kamatani Yoichiro , Palotie Aarno , Rivas Manuel A. , Daly Mark J. , Matsuda Koichi , Okada Yukinori
Published: October 2020

Current genome-wide association studies (GWASs) do not yet capture sufficient diversity in populations and scope of phenotypes. To expand an atlas of genetic associations in non-European populations, we conducted 220 deep-phenotype GWASs (diseases, biomarkers, and medication usage) in BioBank Japan (n=179,000), by incorporating past medical history and text-mining of electronic medical records. Meta-analyses with the UK Biobank and FinnGen (ntotal=628,000) identified ∼5,000 novel loci, which improved the resolution of genomic map of human traits. This atlas elucidated landscape of pleiotropy as represented by MHC locus, where we conducted HLA fine-mapping. Finally, we performed statistical decomposition of matrices of phenome-wide summary statistics, and identified latent genetic components, which pinpointed responsible variants and biological mechanisms underlying current disease classifications across populations. The decomposed components enabled genetically-informed subtyping of similar diseases (e.g., allergic diseases). Our study suggests a potential avenue for hypothesis-free re-investigation of human diseases through genetics.
Seroprevalence of SARS-CoV-2 antibodies and associated factors in health care workers: a systematic review and meta-analysis
Authors: Galanis Petros , Vraka Irene , Fragkou Despoina , Bilali Angeliki , Kaitelidou Daphne
Published: October 2020

Background

Health care workers (HCWs) represent a high risk population for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Aim

To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and to find out the factors that are associated with this seroprevalence.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and pre-print services (medRχiv and bioRχiv) were searched from inception up to August 24, 2020.

Findings

Forty-nine studies, including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% CI: 6.7-10.9%). Seroprevalence was higher in studies that were conducted in North America (12.7%) compared to those in Europe (8.5%), Africa (8.2), and Asia (4%). Meta-regression showed that increased sensitivity of antibodies test was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender, Black, Asian, and Hispanic HCWs, work in a coronavirus disease 2019 (COVID-19) unit, patient-related work, frontline health care workers, health care assistants, personal protective equipment shortage, self-reported belief for previous SARS-CoV-2 infection, previous positive polymerase chain reaction test, and household contact with suspected or confirmed COVID-19 patients.

Conclusion

The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures, sufficient and adequate personal protective equipment, and early recognition, identification and isolation of HCWs that are infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.