bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Stenger Jan R.
Published: February 2022

This introduction sets out the crucial role of the theorization of education in society, culture, and religion of late antiquity. It also contextualizes this study within the burgeoning interest in late antique learning and teaching that has unfolded in recent years in classical studies and patristics. The very premise of all the chapters of this monograph is that it is possible to fully understand the centrality of education in the late Roman Empire only by considering, in addition to pedagogical practice, theoretical reflection on education. As this study argues that the discourse on education was more dynamic than has been hitherto acknowledged, the introduction also gives an outline of the areas in which the theorization of education intersected with the major transformations and debates of the period, including the rise of Christianity and changes in the running of the Empire. This also serves to outline the main lines of the argument. The introduction closes by formulating the hypothesis that the discourse on learning and formation resulted in a reinterpretation of the very notion of education, essentially in a renewal of the humanistic ideal of paideia.
Educational Communities
Authors: Stenger Jan R.
Published: February 2022

This chapter focuses on the interconnectedness of education and communities in late antique educational thinking. In the wake of profound changes in politics, society, and religion in the fourth century CE, questions of group allegiance and identity gathered momentum. Leading thinkers promoted educational practices that would reform the thoughts and behaviour of their respective communities. The chapter considers three discourses that put the effects of instruction and learning on the building of communal identities centre stage: catechesis in the fourth-century church (John Chrysostom, Augustine); imperial legislation on schooling (Emperor Julian, Gregory of Nazianzus); and elite culture in fifth-century Gaul (Sidonius Apollinaris). These discourses revolved around the influence exerted by teaching, literary practices, and reading habits on the life and cohesion of cultural and religious groups. Educational thinking thus became an exercise in identity-making. Drawing on the concept of ‘textual communities’, the chapter suggests the notion of ‘educational communities’ for describing how education was utilized to define and demarcate groups in an increasingly fragmented society.
The Life of Paideia
Authors: Stenger Jan R.
Published: February 2022

This chapter focuses on the nexus between education and the choice of lives. The correlation of learning and life was not a novel idea but had very much been in the centre of erudite culture in the imperial era. However, in the Second Sophistic the learned life pivoted on the public persona, the performance of erudition, and success in society. This model did not vanish altogether, but it came under challenge. Thinkers looked for ways in which education could be made meaningful to one’s entire life and personality. Life thus became a locus for debate about genuine education, its contents, and its goals. Biographical and autobiographical texts projected the idea that education did not consist in the formation of the self alone but attained consummation in the civilized intellectual exchange with others and in helping others to develop. They discarded the view that paideia was primarily about the acquisition of knowledge and expertise useful for a career and proposed instead that studies were a praxis giving sense to one’s existence. The Christian and non-Christian visions of the life pervaded by studies and teaching bespeak the belief that the life of paideia had to become manifest in a characteristically humanistic ethos.
The Making of the Late Antique Mind
Authors: Stenger Jan R.
Published: February 2022

The relationship with the classical past, a core element of formal education in any period of Graeco-Roman civilization, is the topic of the final chapter. As the engagement with cultural achievements of the past was key to late antique schooling, reflection on education gave birth to a characteristic sense of temporality, an awareness of the very lateness of late antiquity. The chapter focuses on four writers who articulated this new consciousness: the rhetorical teacher Himerius, the preacher John Chrysostom, Augustine as a letter writer, and Cassiodorus as a monastic educationalist. These authors conceptualized educational practices as a vehicle for self-positioning vis-à-vis temporality. Learning, especially reading practices, was seen by them as correlating with historical consciousness. By this move, learning was reinterpreted as a historical and reconstructive enquiry: while engaging with works of previous centuries, learners were supposed to acquire a sense of temporality and determine their standpoint with regard to intellectual history. Studying the classics produced the times in which the classical authors were writing as a distinct period in time, different from the times in which the late antique readers lived. This handling of the past was characteristic of a postclassical mentality.
Maiden, morphology, and more
Authors: Ledgeway Adam , Smith John Charles , Vincent Nigel
Published: February 2022

This chapter offers a brief overview of how Martin Maiden’s theoretical interests and empirical foci have developed over the course of his career, starting with his early work on metaphony and moving through to his central engagement with the concept of the morphome. We consider the way his explorations of the structure and history of Romance inflexional systems provide essential diachronic confirmation of the need to recognize such a concept and of the way it relates not only to individual items but to the overall organization of the paradigm. We move on from there to consider the place of the morphome and morphome-based thinking within recent developments in morphological theory and in particular the way different approaches define—and in some cases erase!—the boundary between morphology and syntax. The chapter concludes with a brief overview of the individual chapters contained in this volume and the light they shed on the relations between periphrasis and inflexion both with respect to Romance and in broader theoretical terms.
A diachronic perspective on polymorphism, overabundance, and polyfunctionalism
Authors: Sornicola Rosanna
Published: February 2022

This chapter investigates the traditional notions of polymorphism and polyfunctionalism, comparing and contrasting them with the more recent concept of overabundance. These ideas are set in the context of a broader view of developments in morphological theory, in particular those associated with functionalism and natural morphology. The issues are addressed through a study of nominal inflexion in a body of legal texts from Cava dei Tirreni in Campania and a comparison of the patterns discernible there with those of the system of noun declensions encoded in traditional grammars. Variation can be shown to depend not only on the different inflexional patterns associated with different noun classes and on the syntactic context but also on the linguistic competence of the individual scribes and notaries. The reduced paradigm structure to be seen here goes together with an increase in intra-cell variation and argues for the existence of a more complex sequence of historical developments from Latin to Romance than is traditionally assumed. At a theoretical level, these data support the view that morphology is autonomous, while at the same time indicating the need to rethink the core concepts of cell and paradigm and the relations between them. The chapter also underscores the fundamental importance of both diachronic and synchronic considerations in any such theoretical enterprise.
Poetic Examples
Authors: Vincent Bridget
Published: February 2022

This chapter explores key discussions about the value of literary examples for moral philosophy and asks why poetry has been excluded from these discussions. In tracing the underexamined history of ethical criticism’s narrative bias, the chapter reveals that in some cases, poetry has not simply been passively ignored, but rather, actively excluded. I show that this exclusion is grounded in a distortingly narrow definition of the lyric voice—one which is inherited from a specific form of nineteenth-century idealism rather than a definition which is representative of the possibilities of the form as a whole. I show that that once the unhelpfully narrow conception of poetry on which this rejection is based is re-evaluated and its historical contingencies traced, the impetus for considering poetic examples and their unique contributions becomes clear. Most importantly, the chapter shows that testing out theories about literary exemplarity on poems brings up new caveats and methodological concerns which would remain invisible were the category of examples restricted to prose fiction.
The Exemplary Poetry of Geoffrey Hill
Authors: Vincent Bridget
Published: February 2022

The fourth chapter is devoted to Geoffrey Hill’s poetry, including work published posthumously. Focusing on later works, such as A Treatise of Civil Power and The Daybooks, the chapter shows how Hill’s relationship to his literary and intellectual forebears is structured around relations of exemplarity—he treats his forerunners not simply as influences broadly conceived, but rather, as exemplars. The chapter shows how in the late poetry, Hill also reflects on the morally exemplary potential of his own work—including the moral potential of exemplary failure. The chapter ultimately shows how the concept of exemplarity provides important new ways into ongoing debates about Hill’s poetry, particularly around such central preoccupations as memorialization, complicity and culpability, and historical responsibility.
Progressive Times
Authors: Mantie Roger
Published: February 2022

Chapter 4 focuses on the recreation movement (also known as the playground movement or play movement), a social movement that arose in tandem with the settlement house movement. In addition to demonstrating the early associations between recreation movement leaders and early public school music leaders, the chapter illustrates the growing cleavage between the moral paternalism of social reformers such as Joseph Lee, and the “scientific” paternalism of professionals that emerged in the wake of G. Stanley Hall and the child-study movement. Both the reformers and the professionals advocated for the importance of play leaders and play in education, but for different reasons—ones with gendered implications. For the professionals, play was instrumental, serving primarily to support physical development, particularly that of boys. Music was largely absent from their concept of play. By contrast, the reformers considered music and the arts part of play, but mostly for girls. The chapter demonstrates how the initial focus on the play of children that led to the formation of the Playground Association of America would eventually expand to include the recreational activities of adults and the renaming of the organization as the National Recreation Association.
Leisure, Music, and the Common Good
Authors: Mantie Roger
Published: February 2022

To this point in the book, leisure has been discussed primarily as a personal matter. In Chapter 8, the good life is placed more squarely in a social context where leisure and music are considered in terms of the common good. Problems identified and discussed include leisure inequality, consumerism, and individualism. By being placed in the realm of the social, leisure categories, activities, and behaviors are no longer a private or individual affair, but are compared for their potential to be “better leisure” on a collective level. Music making is thus proposed as a form of better leisure based on its collective health and well-being potential.
PROTODRILIDA PETTIBONE, 1982
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Protodrilida (‘first’ or ‘original’ ‘worms’) is a clade that currently comprises around 65 accepted species that are known historically for being members of the now defunct taxon Archiannelida.
POLYGORDIUS SCHNEIDER, 1868
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Depending on your viewpoint, Polygordius is a famous, or infamous, member of Annelida. These worms, nicknamed ‘knot worms’ (Tustison et al., 2020), are generally found in coarse, well-sorted sediments.
APHRODITIDAE MALMGREN, 1867
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Described by Linnaeus (1758), Aphrodita is among the oldest introduced generic annelid names. One characteristic feature of Aphrodita is the presence of fine capillary notochaetae that form a felt over the dorsum.
ACOETIDAE KINBERG, 1856
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Acoetidae are large annelids with many segments and are unusual among scale-worms in being tubiculous (Fig. 8.1a).
IPHIONIDAE KINBERG, 1856
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Iphionidae are highly characteristic scale-worms with an elliptical outline, somewhat like chitons (Figs. 9.1a, b). The adult size is usually 1–3 cm for up to 39 segments.
CHRYSOPETALIDAE EHLERS, 1864
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

The name Chrysopetalidae, from the Latin for ‘golden petals’, refers to the shape and the colour of the shiny, flattened notochaetae which cover the dorsum in one of the three major clades in the group, Chrysopetalinae (Pl. 3c).
HESIONIDAE GRUBE, 1850
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Hesionidae is named after the mythical Hesione, princess of Troy, who was rescued from a sea monster by Hercules. This group of beautiful worms are not uncommon in the sublittoral, especially on rocky and mixed bottoms, and they also seem to thrive in deep-sea environments with many species described from hydrothermal vents (Fig. 15.2c), whalefalls, and methane seeps.
SPHAERODORIDAE MALMGREN, 1867
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Sphaerodoridae is a relatively small annelid group, with around 138 nominal species. The animals can be easily recognized by the conspicuous spherical macro- and microtubercles that give sphaerodorids their name (Figs. 19.1b, c).
LUMBRINERIDAE SCHMARDA, 1861
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Lumbrineridae adults are medium sized to large annelids, ranging from a few centimetres to over half a metre in length and several hundred segments (Pl. 6a).
HISTRIOBDELLIDAE CLAUS AND MOQUIN-TANDON, 1884
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Histriobdellidae (‘Charlie Chaplin worms’) are tiny members of Annelida that live as commensals on a variety of Crustacea. There are currently 13 nominal species placed into Histriobdella, Steineridrilus, and Stratiodrilus, with most of them known from rivers of South America. The name Histriobdella can be loosely translated as ‘clown animal’ and the common name used here refers to the amusing way in which they crawl, which is reminiscent of the walk of the famous comic actor. Living Histriobdellidae are mostly transparent, lacking in chaetae, but distinguished by dark chitinous jaws. Males of Steineridrilus cirolanae and all Stratiodrilus also show a dark chitinous penis in the mid-body and mature females may have a few whitish eggs. Adults range from 0.7 mm (e.g. Steineridrilus cirolanae) to around 1.5 mm in length (e.g. Stratiodrilus novaehollandiae) and have a fixed number of segments. This number appears to be nine in Histriobdella homari and may be a few more in the other taxa. Depending on the taxon, Histriobdellidae live among the branchial filaments, pleopods, or egg masses of their crustacean hosts.
SERPULIDAE RAFINESQUE, 1815
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Serpulidae (fanworms), like Sabellidae, are very well-known owing to their colourful radiolar crown (Pl. 8e–g). Serpulidae are usually easily distinguished from Fabriciidae and Sabellidae in that they live in a calcareous tube, though this is sometimes embedded in coral.
TEREBELLIDAE JOHNSTON, 1846
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

The multiple grooved palps (‘tentacles’) of Terebellidae gives rise to their common name, spaghetti worms. These tentacles are a common sight extending out over the substrate in shallow marine waters worldwide. When disturbed the tentacles, often brightly coloured, can be seen coiling and looping as they are retracted back towards the worm.
LOBATOCEREBRUM RIEGER, 1980
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Lobatocerebrum is a small, exclusively meiofaunal clade with only three known species. The placement of these enigmatic animals has long been problematic, but recent molecular work establishes their placement within Annelida. The animals have an unsegmented, slender, and elongate body with a length of 1–3 mm.
AMPHINOMIDA LAMARCK, 1818
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Amphinomida includes two major groups: Amphinomidae and Euphrosinidae. Amphinomidae occur mainly in littoral warm waters. Some are called fireworms and are known for their brittle chaetae that easily break when touched and produce a burning sensation.
APISTOBRANCHUS LEVINSEN, 1883
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Apistobranchus has small membership and has had a long period of uncertain affinity, though it is now apparent it is part of Chaetopteriformia.
OWENIIDAE RIOJA, 1917
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Oweniidae is a taxon with small membership that, until recently, was more famous for its larval form, the unusual and beautiful ‘mitraria’ (Fig. 77.1g), than for the adults.
An Algorithmic Approach to the Physical Exam for the Pain Medicine Practitioner: A Review of the Literature with Multidisciplinary Consensus
Authors: Wahezi Sayed E , Duarte Robert , Kim Chong , Sehgal Nalini , Argoff Charles , Michaud Kristina , Luu Michael , Gonnella Joseph , Kohan Lynn
Published: February 2022

Background

Increased utilization of telemedicine has created a need for supplemental pain medicine education, especially for the virtual physical assessment of the pain patient. Traditional clinical training utilizes manual and tactile approaches to the physical examination. Telemedicine limits this approach and thus alternative adaptations are necessary to acquire information needed for sound clinical judgement and development of a treatment plan. Clinical assessment of pain is often challenging given the myriad of underlying etiologies contributing to the sensory experience. The COVID-19 pandemic has led to a dramatic increase in the use of virtual and telemedicine visits, further complicating the ease of assessing patients in pain. The increased reliance on telemedicine visits requires clinicians to develop skills to obtain objective information from afar. While eliciting a comprehensive history and medication assessment are performed in a standard fashion via telemedicine, a virtual targeted physical examination is a new endeavor in our current times. In order to appropriately diagnose and treat patients not directly in front of you, a pivot in education adaptations are necessary.

Objective

To summarize best care practices in the telemedicine physical exam while presenting an algorithmic approach towards virtual assessment for the pain practitioner.

Design

Review of the literature and expert multidisciplinary panel opinion.

Setting

Nationally recognized academic tertiary care centers.

Subjects

Multidisciplinary academic experts in pain medicine.

Methods

Expert consensus opinion from the literature review.

Results

An algorithm for the virtual physical exam for pain physicians was created using literature review and multidisciplinary expert opinion.

Conclusions

The authors here present simple, comprehensive algorithms for physical exam evaluations for the pain physician stemming from a review of the literature.
Potential application of conversational agents in HIV testing uptake among high-risk populations
Authors: Garett Renee , Young Sean D
Published: February 2022

Human Immunodeficiency Virus (HIV) continues to be a significant public health problem, with ~1.2 million Americans living with HIV and ~14% unaware of their infection. The Centers for Disease Control and Prevention recommends that patients 13 to 64 years of age get screened for HIV at least once, and those with higher risk profiles screen at least annually. Unfortunately, screening rates are below recommendations for high-risk populations, leading to problems of delayed diagnosis. Novel technologies have been applied in HIV research to increase prevention, testing and treatment. Conversational agents, with potential for integrating artificial intelligence and natural language processing, may offer an opportunity to improve outreach to these high-risk populations. The feasibility, accessibility and acceptance of using conversational agents for HIV testing outreach is important to evaluate, especially amidst a global coronavirus disease 2019 pandemic when clinical services have been drastically affected. This viewpoint explores the application of a conversational agent in increasing HIV testing among high-risk populations.
Mineral and vitamin supplementation on sheep farms:  a survey of practices and farmer knowledge
Authors: Hession Daniel V , Loughrey Jason , Kendall Nigel R , Hanrahan Kevin , Keady Timothy W J
Published: February 2022

Mineral and vitamin (MV) supplementation is a routine management practice in many pasture-based systems of prime lamb production. The aim of the current study was to establish the MV supplementation practices on Irish sheep farms and farmer’s knowledge and opinions in relation to supplementation strategies and MV deficiencies. A survey, consisting of 22 questions, was administered to all farmers participating in the Teagasc National Farm Survey (NFS) in 2016 which had a sheep enterprise (n = 177). The Teagasc NFS is a stratified random sample of farms with each farm assigned a weighting factor so the results are representative of the national population of farms. Sixty-nine percent of respondents supplemented their flocks with MV in addition to concentrate feed. Twenty-two percent supplemented based on laboratory analysis results (soil, herbage, blood, or tissue analysis). Thirteen percent supplemented based on veterinary advice with only 30% of this advice based on laboratory analysis results. Sixty-five percent supplemented for reasons other than laboratory analysis or veterinary advice; mainly due to tradition and previous experience. The most common stages to supplement ewes were pregnancy (78%), lactation (61%), and pre-mating (50%). Fifty-one percent supplemented lambs post weaning. Mineral buckets (free access solidified molasses-based licks containing MV and in plastic containers) and drenching (oral dosing with MV containing liquid) were the most common methods of supplementing ewes and lambs, respectively. Generic MV products (containing multiple minerals and vitamins) were the most commonly used followed by cobalt only products. Ease of use/labor requirements and cost were the most important factors influencing choice of supplementation method. Forty-six percent rated their level of knowledge on mineral requirements of sheep as “limited or no education/knowledge”. Supplementation with MV did not increase (P > 0.05) ewe productivity (number of lambs reared/ewe joined) or gross margin/ewe. It is concluded that most supplementation decisions in sheep production systems are undertaken in the absence of veterinary advice or laboratory results, therefore are not evidence based. Knowledge transfer activities need to be designed to communicate best practice as regards MV supplementation.
Antihypertensive medication adherence and persistence among Black women
Authors: Abel Willie M. , Greer Danice B. , Sue-Ling Carolyn , Kirkland Tracie W.
Published: February 2022

The prevalence of hypertension in Black women (57.6%) is among the highest in the world. Many of those who identify as Black do not readily adhere to prescribed antihypertensive medications nor persist with long-term therapy. This qualitative study describes self-reported approaches used by Black women with consistent adherence and persistence to medication-taking for BP control.
Leadership Development in U.S. Undergraduate Medical Education: A Scoping Review of Curricular Content and Competency Frameworks
Authors: Matsas Bridget , Goralnick Eric , Bass Michelle , Barnett Erica , Nagle Baily , Sullivan Erin E.
Published: February 2022

Purpose

To inform research on developing or adopting leadership competency frameworks for use in U.S. undergraduate medical education (UME), this scoping review describes the content of U.S. UME leadership curricula, associated competency frameworks, and content delivery.

Method

The authors searched PubMed, Embase, and ERIC databases on June 22, 2020. They included English-language studies that described U.S. UME curricula in which the primary end goal was leadership development. They excluded studies published before January 1, 2000. Data were extracted on leadership competency frameworks and curricular content, audience, duration, electivity, selectivity, learning pedagogies, and outcome measures. The curricular content was coded and categorized within the Medical Leadership Competency Framework (MLCF) using the constant comparative method. A repeated search of the literature on May 14, 2021, did not yield any additional studies.

Results

Of 1,094 unique studies, 25 studies reporting on 25 curricula met inclusion criteria. The course content of the curricula was organized into 91 distinct themes, most of which could be organized into the first 2 competencies of the MLCF: Demonstrating Personal Qualities and Working With Others. Thirteen curricula (52%) aligned with leadership competency frameworks, and 12 (48%) did not appear to use a framework. Number of participants and target learner level varied widely, as did curricula duration, with fewer than half (n = 12, 48%) spanning more than 1 semester. Most curricula (n = 14, 56%) were elective, and many (n = 16, 64%) offered experiential learning. Most studies (n = 16, 64%) reported outcomes as student perception data.

Conclusions

The authors found wide variation in content of U.S. UME leadership development curricula, and few curricula aligned with an established leadership competency framework. The lack of professional consensus on the scope of medical leadership and how it should be taught thwarts effective incorporation of medical leadership training within UME.
Results of Low Distal Femur Periprosthetic Fractures
Authors: Virkus Walter , Lieder Charles , Jang Yohan , Rea Parker , Gaski Greg
Published: February 2022

Objectives:

To compare retrograde intramedullary nail (RIMN) and open reduction internal fixation (ORIF) in very distal periprosthetic distal femur fractures (PDFFs) to determine whether RIMN is an acceptable option for these fractures that are often considered too distal for IMN due to limited bone stock.

Design:

Retrospective comparative series.

Setting:

Level 1 trauma center.

Patients:

Patients were treated with fracture fixation for a very distal PDFF, defined as the fracture extending to the anterior flange of the implant or distal. Fifty-six patients met inclusion criteria, with 8 excluded for less than 12 months of follow-up.

Intervention:

The intervention involved fracture fixation with RIMN or ORIF.

Main Outcome Measurements:

The primary outcome was unplanned return to surgery. Secondary outcomes included fracture union, radiographic alignment, visual analog score, and Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference.

Results:

The mean follow-up period was 27 months. Twelve patients were treated with ORIF and 36 with RIMN. Twenty-one fractures were at the flange, and 27 extended distal to the flange. There were no differences between fixation methods for reoperation, deep infection, nonunion, malunion, visual analog score pain score, and PROMIS Pain Interference score. The mean PROMIS PF score was higher in the RIMN group compared with that in the ORIF group. There were 5 reoperations in the RIMN group (14%) and 3 in the ORIF group (25%).

Conclusions:

This is the largest series, to the best of our knowledge, of a subset of very distal PDFFs. The results suggest that RIMN may be an acceptable treatment option for these very difficult fractures.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Intensive phototherapy vs. exchange transfusion for the treatment of neonatal hyperbilirubinemia: a multicenter retrospective cohort study
Authors: Zhang Meng , He Yang , Tang Jun , Dong Wenbin , Zhang Yong , Zhang Benjin , Wan Hong , Deng Quanmin , Guan Lirong , Xia Bin , Chen Zhong , Ge Min , Zhao Jing , Li Wenxing , Pei Jingjun , Qu Yi , Mu Dezhi
Published: February 2022

Background:

Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia.

Methods:

This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years.

Results:

A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group.

Conclusions:

In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
The Patient Pathway Review for Atrial Fibrillation
Authors: Kwok Chun Shing , Lip Gregory Y.H.
Published: February 2022

The care pathway for patients with atrial fibrillation (AF) is variable and this variability is explored in a patient pathway review. This review describes events that may take place for a patient with AF considering the “ideal” and the “real-world” pathway and attempts to rationalize them by considering the patient, clinician, health service, and societal perspective. In the “ideal” pathway, AF in a patient is either identify before or after stroke. The “real-world” pathway introduces the concepts that symptoms may influence patient decision-making to seek help, AF may be identified incidentally, and healthcare professionals may fail to identify AF. The management of AF includes no treatment or treatment such as stroke prevention, rate or rhythm control, and comorbidity management. The overall outcomes for patient depend on the presence of symptoms and response to therapies. The two major priorities for patients are symptomatic relief and avoidance of stroke. While most clinicians will find that initial AF management is not challenging but there may be incidental opportunities for earlier identification. From the healthcare service perspective, noncardiologists and cardiologists care for patients with AF, which results in much heterogeneity management. From the societal perspective, the burden of AF is significant resulting in substantial cost from hospitalizations and treatments. People with AF can take on different paths, which depend on factors related to the patient’s decision-making, clinical decision-making, and patient’s response to the treatment. A streamlined approach to a holistic and integrated care pathway approach to AF management is needed.
Combined Endonasal and Orbital Approach for Resection of Orbital Apical Tumors
Authors: Cohen Liza M. , Grob Seanna R. , Krantz Kenneth B. , Feldman Kenneth A. , Rootman Daniel B.
Published: February 2022

Purpose:

Tumors of the medial orbital apex can be challenging to resect. Primary endonasal resection can be limited by requirements for fat retraction and poor angulation for lateral orbital dissection. Orbital resection alone can have space limitations and a limited view for dissection of the posterior aspect of the tumor. The combined transorbital transnasal approach integrates the retraction and instrumentation advantages of the transorbital approach with the optical and space advantages of the transnasal approach.

Methods:

In this cross-sectional cohort study, patients who underwent surgical resection of an apical orbital tumor via a combined endoscopic and orbital approach from 2014 to 2019 were identified. Clinical history, examination findings, imaging, surgical technique, histopathology, and complications were reviewed.

Results:

Six patients were included. Patients presented with proptosis (5), optic neuropathy (3), and motility restriction (2). Surgery involved a medial orbitotomy and endoscopic ethmoidectomy ± sphenoidotomy, medial wall removal, and periosteum opening. The lesion was prolapsed into the sinus, dissected at the apex via the orbital approach, and removed through the nasal cavity. Pathologic diagnoses were cavernous venous malformation (4), venolymphatic malformation (1), and metastatic carcinoid (1). Improvement in pain (2/2), optic neuropathy (2/3), and proptosis (5/5) were noted. Complications included ethmoid mucocele and nasal polyps.

Conclusions:

The combined endonasal and orbital approach involves prolapsing the lesion into the nasal cavity to aid in dissection on the lateral and posterior aspects, maximizing visibility of the tight intraconal space. This technique can be performed by a team of orbital surgeons experienced in both orbital and endonasal surgery.
Near Miss Research in the Healthcare System
Authors: Feng Ting-ting , Zhang Xin , Tan Ling-ling , Liu Di , Dai Li-cao , Liu Hua-ping
Published: February 2022

OBJECTIVES

The aim of this study was to depict a comprehensive description of near miss research and clarify research gaps.

BACKGROUND

Learning from near miss can provide early warnings and is critical for proactive and prospective risk management. Because of the lack of structured reviews, there is little knowledge about how near miss management has been managed in the past.

METHODS

This review was conducted following the Arksey and O'Malley's methodology and reported by the PRISMA Extension for Scoping Reviews.

RESULTS

Sixty-seven research articles were included. The results revealed that the most investigated fields include near miss reporting, near miss characteristics, and good catch project. Poor theoretical investigation, underreporting, and inconsistent outcome indicators are major problems.

CONCLUSIONS

Solely understanding causes of near misses cannot guarantee effective learning; we also need to apply appropriate learning theories. Advanced technologies should be applied to solve long-standing underreporting issues. Accurate and consistent indicators should be applied in near miss research and management.
Did we do the right thing? The appropriateness of orthopedic operative interventions during the height of the coronavirus disease 2019 pandemic
Authors: Batti Kevin , Sharfman Zachary T. , Dimitroulias Apostolos , Sen Milan
Published: February 2022

Purpose:

During the coronavirus disease (COVID) pandemic elective surgeries were cancelled and operative indications curtailed to counteract shortages in resources. We aimed to review each orthopedic operative indication at an urban Level 1 Trauma Center inundated with COVID. We aimed to classify the appropriateness of each operative intervention and determine if exposure to COVID impacted morbidity or mortality.

Methods:

All orthopedic procedures between March 16, 2020 and May 16, 2020 were reviewed. The most urgent surgical indication for each procedure was classified by 2 fellowship trained orthopedic trauma surgeons and 2 senior residents. The appropriateness of the operative intervention was determined. The American Academy of Orthopedic Surgery (AAOS) and American College of Surgeons (ACS) guidelines for surgery during the pandemic were considered.

Results:

Seventy-six surgical encounters were performed on 71 inpatients including 99 total procedures. No outpatient procedures were performed. Fifty-four of 71 patients were male. There was a mean age of 51.6 years. Of 71 patients, 41 presented to the emergency department without trauma activation with a mean time to presentation of 2.7 days post injury. The most urgent surgical indications included 18 hip fractures, 18 periarticular fractures, 17 open fractures, 7 severe infections, 5 pelvic fractures, 5 femoral shaft fractures, 3 spinal injuries, 1 tibial fracture, 1 tendon injury, and 1 clavicle fracture. Four procedures could have been delayed for conservative management without causing significant harm. Upon discharge 13/71 patients had tested positive for COVID, 41/71 had remained negative throughout their hospital stay, and 17/71 patients never were tested. Four patients contracted COVID in the hospital. There were 4 in hospital deaths, 2 attributed to hypoxemic respiratory failure secondary to COVID pneumonia.

Conclusion:

It was determined that 72/76 cases were considered appropriate in following guidelines of the AAOS and ACS. This highlights the value of halting outpatient procedures and limiting patient exposure to COVID. Comprehensive patient/provider discussions addressing the risks, benefits, alternatives to surgery, and the risk of exposure to respiratory illness are vital. It behooves the surgical team to follow established guidelines such as those of the AAOS and ACS when triaging orthopedic patients for a surgical admission.
Estimation of HIV incidence from analysis of HIV prevalence patterns among female sex workers in Zimbabwe
Authors: Ali M. Sanni , Wit Mariken D.E. , Chabata Sungai T. , Magutshwa Sitholubuhle , Musemburi Sithembile , Dirawo Jeffrey , Rice Brian , Platt Lucy , Bansi-Matharu Loveleen , Harriet Jones , Mharadze Tendayi , Chiyaka Tarisai , Mushati Phillis , Mugurungi Owen , Yekeye Raymond , Mpofu Amon , Phillips Andrew N. , Cowan Frances M. , Hargreaves James R.
Published: February 2022

Objectives:

To estimate HIV incidence among female sex workers (FSW) in Zimbabwe: using HIV prevalence by age and number of years since started selling sex (YSSS).

Design:

We pooled data from FSW aged 18–39 participating in respondent-driven sampling surveys conducted in Zimbabwe between 2011 and 2017.

Methods:

For each year of age, we estimated: HIV prevalence (P

t
) and the change in HIV prevalence from the previous age (P

t
− P

t−1). We then estimated the rate of new HIV infections during that year of age: I

t
 = P

t
− P

t−1/(1 − P

t−1), and calculated HIV incidence for 18–24 and 25–39 year-olds separately as the weighted average of I

t
. We estimated HIV incidence for FSW 1–5 years and 6–15 years since first selling sex using the same approach, and compared HIV prevalence among FSW first selling sex at their current age with the general population.

Results:

Among 9906 women, 50.2% were HIV positive. Based on HIV prevalence increases by age, we estimated an HIV incidence of 6.3/100 person-years at risk (pyar) (95% confidence interval [CI] 5.3, 7.6) among 18–24 year-olds, and 3.3/100 pyar (95% CI 1.3, 4.2) among 25–39 year-olds. Based on prevalence increases by YSSS, HIV incidence was 5.3/100 pyar (95% CI 4.3, 8.5) between 1 and 5 years since first selling sex, and 2.1/100 pyar (95% CI −1.3, 7.2) between 6 and 15 years.

Conclusions:

Our analysis is consistent with very high HIV incidence among FSW in Zimbabwe, especially among those who are young and recently started selling sex. There is a critical need to engage young entrants into sex work in interventions that reduce their HIV risk.
Evaluating strategies for spatial allocation of vaccines based on risk and centrality
Authors: Singer Benjamin J. , Thompson Robin N. , Bonsall Michael B.
Published: February 2022

When vaccinating a large population in response to an invading pathogen, it is often necessary to prioritize some individuals to be vaccinated first. One way to do this is to choose individuals to vaccinate based on their location. Methods for this prioritization include strategies that target those regions most at risk of importing the pathogen, and strategies that target regions with high centrality on the travel network. We use a simple infectious disease epidemic model to compare a risk-targeting strategy to two different centrality-targeting strategies based on betweenness centrality and random walk percolation centrality, respectively. We find that the relative effectiveness of these strategies in reducing the total number of infections varies with the basic reproduction number of the pathogen, travel rates, structure of the travel network and vaccine availability. We conclude that when a pathogen has high spreading capacity, or when vaccine availability is limited, centrality-targeting strategies should be considered as an alternative to the more commonly used risk-targeting strategies.
Computational simulations of the 4D micro-circulatory network in zebrafish tail amputation and regeneration
Authors: Roustaei Mehrdad , In Baek Kyung , Wang Zhaoqiang , Cavallero Susana , Satta Sandro , Lai Angela , O'Donnell Ryan , Vedula Vijay , Ding Yichen , Marsden Alison Lesley , Hsiai Tzung K.
Published: February 2022

Wall shear stress (WSS) contributes to the mechanotransduction underlying microvascular development and regeneration. Using computational fluid dynamics, we elucidated the interplay between WSS and vascular remodelling in a zebrafish model of tail amputation and regeneration. The transgenic
Tg
(
fli1:eGFP
;
Gata1:ds-red
) zebrafish line was used to track the three-dimensional fluorescently labelled vascular endothelium for post-image segmentation and reconstruction of the fluid domain. Particle image velocimetry was used to validate the blood flow. Following amputation to the dorsal aorta and posterior cardinal vein (PCV), vasoconstriction developed in the dorsal longitudinal anastomotic vessel (DLAV) along with increased WSS in the proximal segmental vessels (SVs) from amputation. Angiogenesis ensued at the tips of the amputated DLAV and PCV where WSS was minimal. At 2 days post amputation (dpa), vasodilation occurred in a pair of SVs proximal to amputation, followed by increased blood flow and WSS; however, in the SVs distal to amputation, WSS normalized to the baseline. At 3 dpa, the blood flow increased in the arterial SV proximal to amputation and through anastomosis with DLAV formed a loop with PCV. Thus, our
in silico
modelling revealed the interplay between WSS and microvascular adaptation to changes in WSS and blood flow to restore microcirculation following tail amputation.
Sporosarcina jiandibaonis sp. nov., isolated from saline soil
Authors: Kong Delong , Xia Zhanfeng , Gao Yan , Zhou Yiqing , Jiang Xu , Xu Piao , Guo Wei , Ruan Zhiyong
Published: February 2022

A Gram-stain-positive, aerobic, motile, rod-shaped bacterium, designated strain LAM9210T, was isolated from a saline soil sample collected from Lingxian County, Shandong Province, PR China. Analysis of the 16S rRNA gene sequence of the isolate revealed highest sequence similarities to the type strain of

Sporosarcina pasteurii

NCIMB 8841T (97.6 % sequence similarity). The genomic G+C content was 40.4 mol%. The average nucleotide identity and in silico DNA–DNA hybridization values between strain LAM9210T and the type strain of the most closely related species

S. pasteurii

NCIMB 8841T were 73.6 and 20.6 %, respectively. Strain LAM9210T was found to grow at 10–40 °C (optimum, 30 °C), at pH 6.0–10.0 (optimum, pH 9.0) and with 0–6 % (w/v) NaCl (optimum, 0.5 %), respectively. The major fatty acids were anteiso-C15 : 0 and iso-C14 : 0. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol and one unidentified phospholipid. Menaquinone-7 was detected as the predorminant respiratory quinone. Strain LAM9210T contained glycine, lysine, alanine and glutamic acid as the diagnostic amino acids in the cell-wall peptidoglycan. On the basis of phenotypic, phylogenetic and genotypic data, strain LAM9210T is considered to represent a novel species of the genus

Sporosarcina

, for which the name Sporosarcina jiandibaonis sp. nov. is proposed. The type strain is LAM9210T (=CGMCC 1.18607T=GDMCC 1.2002T=JCM 32514T).
Assessing the Profile of Unvaccinated COVID-19 Individuals in African American and Latinx Communities in Eastern Pennsylvania
Authors: Colvin Kenya M. , Camara Kennedy S. , Adams Latasha S. , Sarpong Adline P. , Fuller Danielle G. , Peck Sadie E. , Ramos Anthony S. , Acevedo Ariana L. , Badume Meless A. , Briggs Shae-lyn A. , Chukwurah Tiffany N. , Davila-Gutierrez Zanett , Ewing James A. , Frempong Jemimah O. , Garrett Amirah A. , Grampp Steven J. , Gillespie Jahasia W. , Herrera Emmanuel J. , Maddox Emis J. , Pelaez John C. , Quartey Olivia L. , Rodriguez Fanny , Vasquez Luis A. , Piper Brian J. , Gowtham Swathi
Published: February 2022

Background

Throughout US history, chronic and infectious diseases have severely impacted minority communities due to lack of accessibility to quality healthcare, accurate information, and underlying racism. These fault lines in the care of minority communities in the US have been further exposed by the rise of COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy among African American and Latinx communities in Eastern Pennsylvania (PA).

Methods

Survey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish.

Results

Out of a total of 181 participants that met inclusion criteria of completed surveys, results indicate that 63.5% (n=115) were acceptant of the COVID-19 vaccine whereas the remainder 36.5% (n=66) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.77, 95% CI: 1.13, 6.79) than non-Hispanic whites. Those who believed the COVID vaccine was ineffective (OR: 8.29, 95% CI: 3.78,18.2), and that the virus is not serious (OR: 8.28, 95% CI: 1.11, 61.8) showed the greatest odds of hesitancy.

Conclusions

Contributing factors of vaccine hesitancy in minority communities were age, concern for vaccine efficacy, and education. Understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic.