bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological versus mechanical aortic valve replacement in non-elderly patients: a single-centre analysis of clinical outcomes and quality of life
Authors: Stocco Fabio , Fabozzo Assunta , Bagozzi Lorenzo , Cavalli Chiara , Tarzia Vincenzo , D’Onofrio Augusto , Lorenzoni Giulia , Chiminazzo Valentina , Gregori Dario , Gerosa Gino
Published: November 2020

OBJECTIVES

The aim of this study was to evaluate short- and long-term clinical outcomes, including the perceived health-related quality of life, in patients younger than 65 years having undergone aortic valve replacement either with biological or mechanical valve prostheses.

METHODS

Between 2002 and 2013, 242 consecutive patients <65 years of age underwent isolated aortic valve replacement at our institution, either with biological (n = 134, 55.4%) or mechanical (n = 108, 44.6%) prostheses. Survival, health-related quality of life, short- and long-term clinical outcomes and echocardiographic data were analysed with a retrospective, single-centre study. Propensity matching was performed.

RESULTS

No significant difference in survival was found between the 2 groups (mechanical versus biological: 100% vs 96.6% at 1 year, 98.2% vs 93.1% at 5 years and 92.3% vs 83.4% at 10 years after surgery, P = 0.091). For all the interviewed patients (n = 161, 66.5%), perceived quality of life at the latest follow-up was excellent. Need for reoperation was higher in the bioprosthetic group (8% vs 0%, P = 0.995), whereas the rate of major bleedings was higher in the mechanical valve group (3% vs 20%, P = 0.094). The mean and maximum transvalvular pressure gradients were 20.5 ± 9.7 and 37.4 ± 17.5 mmHg in the biological group and 14.8 ± 4.8 and 26.6 ± 9.2 mmHg in the mechanical group (P = 0.014).

CONCLUSIONS

No significant differences were found between biological and mechanical valves in terms of patients’ survival, clinical outcomes and quality of life. Mean and maximum transvalvular pressure gradients were significantly higher in the biological group. The majority of patients would opt for the same prosthesis type, if asked to choose again.
Correlation Between Early Plasma Interleukin 37 Responses With Low Inflammatory Cytokine Levels and Benign Clinical Outcomes in Severe Acute Respiratory Syndrome Coronavirus 2 Infection
Authors: Li Ang , Ling Yun , Song Zhigang , Cheng Xiaobo , Ding Longfei , Jiang Rendi , Fu Weihui , Liu Yan , Hu Huiliang , Yuan Songhua , Chen Jian , Zhu Cuisong , Fan Jun , Wang Jing , Jin Yanling , Zhang Miaomiao , Zhu Lingyan , Sun Peng , Zhang Linxia , Qin Ran , Zhang Wei , Qiu Chenli , Shen Yinzhong , Zhang Lin , Shi Zhengli , Zhao Chen , Zhu Tongyu , Lu Hongzhou , Zhang Xiaoyan , Xu Jianqing
Published: November 2020

Background

The immune protective mechanisms during severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection remain to be deciphered for the development of an effective intervention approach.

Methods

We examined early responses of interleukin 37 (IL-37), a powerful anti-inflammatory cytokine, in 254 SARS-CoV-2–infected patients before any clinical intervention and determined its correlation with clinical prognosis.

Results

Our results demonstrated that SARS-CoV-2 infection causes elevation of plasma IL-37. Higher early IL-37 responses were correlated with earlier viral RNA negative conversion, chest computed tomographic improvement, and cough relief, consequently resulted in earlier hospital discharge. Further assays showed that higher IL-37 was associated with lower interleukin 6 and interleukin 8 (IL-8) and higher interferon α responses and facilitated biochemical homeostasis. Low IL-37 responses predicted severe clinical prognosis in combination with IL-8 and C-reactive protein. In addition, we observed that IL-37 administration was able to attenuate lung inflammation and alleviate respiratory tissue damage in human angiotensin-converting enzyme 2–transgenic mice infected with SARS-CoV-2.

Conclusions

Overall, we found that IL-37 plays a protective role by antagonizing inflammatory responses while retaining type I interferon, thereby maintaining the functionalities of vital organs. IL-37, IL-8, and C-reactive protein might be formulated as a precise prediction model for screening severe clinical cases and have good value in clinical practice.
Impact of inclusion rates of crossbred phenotypes and genotypes in nucleus selection programs
Authors: See Garrett M , Mote Benny E , Spangler Matthew L
Published: November 2020

Numerous methods have been suggested to incorporate crossbred (CB) phenotypes and genotypes into swine selection programs, yet little research has focused on the implicit trade-off decisions between generating data at the nucleus or commercial level. The aim of this study was to investigate the impact of altering the proportion of purebred (PB) and CB phenotypes and genotypes in genetic evaluations on the response to selection of CB performance. Assuming CB and PB performance with moderate heritabilities (h2=0.4), a three-breed swine crossbreeding scheme was simulated and selection was practiced for six generations, where the goal was to increase CB performance. Phenotypes, genotypes, and pedigrees for three PB breeds (25 and 175 mating males and females for each breed, respectively), F1 crosses (400 mating females), and terminal cross progeny (2,500) were simulated. The genome consisted of 18 chromosomes with 1,800 quantitative trait loci and 72k single nucleotide polymorphism (SNP) markers. Selection was performed in PB breeds using estimated breeding value for each phenotyping/genotyping strategy. Strategies investigated were: 1) increasing the proportion of CB with genotypes, phenotypes, and sire pedigree relationships, 2) decreasing the proportion of PB phenotypes and genotypes, and 3) altering the genetic correlation between PB and CB performance (rpc). Each unique rpc scenario and data collection strategy was replicated 10 times. Results showed that including CB data improved the CB performance regardless of  rpc or data collection strategy compared with when no CB data were included. Compared with using only PB information, including 10% of CB progeny per generation with sire pedigrees and phenotypes increased the response in CB phenotype by 134%, 55%, 33%, 23%, and 21% when rpc was 0.1, 0.3, 0.5, 0.7, and 0.9, respectively. When the same 10% of CB progeny were also genotyped, CB performance increased by 243%, 54%, 38%, 23%, and 20% when the rpc was 0.1, 0.3, 0.5, 0.7, and 0.9, respectively, compared with when no CB data were utilized. Minimal change was observed in the average CB phenotype when PB phenotypes were included or proportionally removed when CB were genotyped. Removal of both PB phenotypes and genotypes when CB were genotyped greatly reduced the response in CB performance. In practice, the optimal inclusion rate of CB and PB data depends upon the genetic correlation between CB and PB animals and the expense of additional CB data collection compared with the economic benefit associated with increased CB performance.
Field Competitiveness of Aedes albopictus (Diptera: Culicidae) Irradiated Males in Pilot Sterile Insect Technique Trials in Northern Italy
Authors: Bellini Romeo , Carrieri Marco , Balestrino Fabrizio , Puggioli Arianna , Malfacini Marco , Bouyer Jeremy
Published: November 2020

Vector-borne diseases account for 17% of infectious diseases, leading to more than one million deaths each year. Mosquitoes are responsible for 90% of the casualties and alternative control methods to insecticides are urgently needed, especially against Aedes vectors. Aedes albopictus is a particularly important species, causing major public health problems because it is a vector of several arboviruses and has a strong invasive behavior. Various genetic control methods have been proposed to be integrated into the management strategies of Aedes species, among which the sterile insect technique (SIT), which proved efficient against various insect pests and vectors. However, the ability of released irradiated sterile male mosquitoes to compete with their wild counterparts and induce sterility in wild females, which is critical to the success of this strategy, remained poorly defined. Here, we assessed the field competitiveness of Ae. albopictus irradiated male using data from eight release trials implemented in Northern Italy for 3 yr. Sterile males were capable of inducing a good level of sterility in the wild female population, however, with high variability in time and space. The field competitiveness of the released males was strongly negatively correlated with the ratio of sterile to wild males. This should be taken into consideration when designing future programs to suppress field populations of Aedes mosquitoes.
HMGA2-induced epithelial–mesenchymal transition is reversed by let-7d in intrauterine adhesions
Authors: Song Minmin , Cao Chenrui , Zhou Zhenhua , Yao Simin , Jiang Peipei , Wang Huiyan , Zhao Guangfeng , Hu Yali
Published: November 2020

Intrauterine adhesions (IUAs), the leading cause of uterine infertility, are characterized by endometrial fibrosis. The management of IUA is challenging because the pathogenesis of the disease largely unknown. In this study, we demonstrate that the mRNA and protein levels of high mobility group AT-hook 2 (HMGA2) were increased by nearly 3-fold (P < 0.0001) and 5-fold (P = 0.0095) in the endometrial epithelial cells (EECs) of IUA patients (n = 18) compared to controls. In vivo and in vitro models of endometrial fibrosis also confirmed the overexpression of HMGA2 in EECs. In vitro cell experiments indicated that overexpression of HMGA2 promoted the epithelial–mesenchymal transition (EMT) while knockdown of HMGA2 reversed transforming growth factor-β-induced EMT. A dual luciferase assay confirmed let-7d microRNA downregulated HMGA2 and repressed the pro-EMT effect of HMGA2 in vitro and in vivo. Therefore, our data reveal that HMGA2 promotes IUA formation and suggest that let-7d can depress HMGA2 and may be a clinical targeting strategy in IUA.
UPLC-MS based plasma metabolomics and lipidomics reveal alterations associated with IgG4-related disease
Authors: Gong Yiyi , Zhang Panpan , Liu Zheng , Li Jieqiong , Lu Hui , Wang Yujie , Qiu Bintao , Wang Mu , Fei Yunyun , Chen Hua , Peng Linyi , Li Jing , Zhou Jiaxin , Shi Qun , Zhang Xuan , Shen Min , Zeng Xiaofeng , Zhang Fengchun , Zhang Wen
Published: November 2020

Objective

The pathogenesis of IgG4-related disease (IgG4-RD) remains unclear. Metabolomic profiling of IgG4-RD patients offers an opportunity to identify novel pathophysiological targets and biomarkers. This study aims to identify potential plasma biomarkers associated with IgG4-RD.

Methods

Thirty newly diagnosed IgG4-RD patients, age-matched healthy controls and post-treated IgG4-RD patients were enrolled. Patients’ clinical data, laboratory parameters and plasma were collected. Plasma was measured for ultraperformance liquid chromatography-tandem mass spectrometry based metabolomics and lipidomics profiling. Multivariate and univariate statistical analyses were conducted to identify potential biomarkers. The receiver operating characteristic and the correlations between biomarkers and clinical parameters were investigated.

Results

The plasma metabolites are altered among healthy controls, newly diagnosed IgG4-RD and post-treated IgG4-RD groups. Of the identified features, eight metabolites were significantly perturbed in the IgG4-RD group, including glyceric acid 1,3-biphosphate (1,3-BPG), uridine triphosphate (UTP), uridine diphosphate glucose (UDP-Glc) or uridine diphosphate galactose (UDP-Gal), lysophospholipids, linoleic acid derivatives and ceramides. Receiver operating characteristic analysis indicated that UTP, UDP-Glc/UDP-Gal and LysoPC (18:1) had high sensitivity and specificity in diagnosis of IgG4-RD. A Pearson correlation analysis showed that 1,3-BPG and UTP were strongly correlated with clinical parameters.

Conclusion

IgG4-RD patients have a unique plasma metabolomic profile compared with healthy controls. Our study suggested that metabolomic profiling may provide important insights into pathophysiology and testable biomarkers for diagnosis of IgG4-RD.
Environmental Laws
Authors: Hill Pamela
Published: November 2020

What is environmental law in the United States?

In the United States environmental law consists of laws enacted by Congress and by state legislatures to address environmental issues, and the written legal decisions of judges resolving environmental disputes arising from these laws. Both are now...
Environmental Protection and the Global Community
Authors: Hill Pamela
Published: November 2020

Is protecting the environment a global concern?

Yes, and this is a relatively recent development, roughly tracking the modern environmental movement of the late twentieth century. The 1945 Charter of the United Nations does not mention protecting the environment, although it lists other important social...
The Revolution of 1979
Authors: Axworthy Michael
Published: November 2020

Who was Ruhollah Khomeini and how did he come to wield such influence over Iranians?

Ruhollah Musavi Khomeini was born in September 1902 in Khomein, a small town between Tehran and Isfahan. He came from a family that had been clerics for several generations and...
Drones
Authors: Kreps Sarah
Published: November 2020

Drones quite possibly represent the most transformative military innovation since jet engines and atomic weaponry. No longer do humans have to engage in close military action or be in the same geographical vicinity as the target. Now, through satellite imaging and remote technology, countries such as the United States can destroy small targets halfway around the world with pinpoint accuracy. In the last several years, many of the military advancements have been rivaled by those in the commercial realm. Civilian industries have clamored to acquire drones for everything from monitoring crops to filming Hollywood movies to delivering packages. Not surprisingly, the use of drones has generated a lively debate, but no book thus far has engaged the range of themes surrounding drones. How do drones work? To what extent has the technology proliferated to other nations outside the US? How can they be used on the ground and in maritime environments? How are they being integrated into both military and civilian life? In Drones: What Everyone Needs to Know, the international relations scholar (and former air force officer) Sarah Kreps provides a concise synthesis of the topic. The book explains how they and the systems associated with them work, how they are being used today, and what will become of the technology in the future. What readers need now is a more practical guide to how this technology is reshaping both military and civilian life; this book is that guide. The drone revolution has already changed warfare, and will soon become a commonplace tool in a civilian context too. It is clear that drone technology is here to stay. Drones: What Everyone Needs to Know explains how the revolution happened, what its current contours are, and where we might be headed next.
Causes of Changing Inequality in the World
Authors: Galbraith James K.
Published: November 2020

When we move toward an analysis of inequalities in the wider world, we are required to cope with far more complex and uncertain data, and at the same time to seek simpler and more abstract theories. With some 220 extant countries, if each one...
Norms and Consequences
Authors: Galbraith James K.
Published: November 2020

The economies of almost all nation-states have experienced significant increases in economic inequality over the past generation, so that with almost no exceptions the world’s peoples belong to more unequal countries than they did in 1960 or even in 1980. Whether the same claim...
A Final Digression: Does Economic Equality Lead to Victory in War?
Authors: Galbraith James K.
Published: November 2020

Not every economic or political attribute is restricted to economic implications alone. And not every aspect of inequality is something everyone needs to know. Therefore we now abandon the question-and-answer format that we have used so far. In this epilogue we take up a...
The Drug War I
Authors: Mahoney Richard D.
Published: November 2020

How did the United States become the world’s leading drug consumer?

Around the time America’s “addiction to coffee” propelled Colombia to become the world’s second-l eading producer of that stimulant in the late 19th century, the United States was already consuming record amounts of...
Plan Colombia
Authors: Mahoney Richard D.
Published: November 2020

How did Plan Colombia come about?

Writing in 2000, Stephen M. Walt identified the “central paradox” of America’s unchallenged global power as one in which the United States “enjoys enormous influence but has little idea what to do with its power or even how...
9/ 11, International Intervention, and the Islamic Republic of Afghanistan
Authors: Rubin Barnett R.
Published: November 2020

What happened in the run-up to 9/11?

Osama bin Laden and Ayman al-Zawahiri, the leaders of al-Qaeda, returned to Afghanistan from Khartoum, Sudan, in May 1996. There they joined a small but growing group of international radical Islamists belonging to different groups. Uzbeks were...
Protecting Personal Information
Authors: Francis Leslie P. , Francis John G.
Published: November 2020

Introduction

When you think about your privacy, you may care a great deal about your personal information. Notice the possessive pronoun: you may think about information about you as “yours,” maybe even as your property. Some of you reading this may consider particular types of...
Privacy and Educational Information
Authors: Francis Leslie P. , Francis John G.
Published: November 2020

Introduction

Like health care, education raises complex privacy issues. Education is very important to people’s prospects in life. In the United States and in Europe, people do not have a great deal of choice about accessing education, at least before they become adults. In addition,...
Privacy Within and Beyond Families and Groups
Authors: Francis Leslie P. , Francis John G.
Published: November 2020

Introduction

So far in this volume, we have considered privacy as a value for individuals. Yet families or groups might also want to assert privacy as a value. Children, parents, or other family members might want to keep secrets from one another, but may be...
Privacy on the Internet and in Social Media
Authors: Francis Leslie P. , Francis John G.
Published: November 2020

Introduction

This chapter addresses three sets of questions concerning privacy, the Internet, and social media. We first consider features of the Internet that are particularly important to whether you can have privacy on it. Then, we explore privacy policies: where they can be found (if...
Privacy and Security
Authors: Francis Leslie P. , Francis John G.
Published: November 2020

Introduction

Security appears in many forms in discussions about privacy. There is physical security of persons and their possessions. Attacks on your physical security may be a privacy violation, or they may occur because your privacy is violated in other ways. There is information security—that...
Puerto Rico Under us Rule, 1898–1952
Authors: Duany Jorge
Published: November 2020

How did the US government acquire the Island?

On July 25, 1898, US troops invaded Puerto Rico as part of the war against Spain. The Island was a secondary military asset to US objectives (Cuba was the primary target at the time). After a brief...
Buddhist Teachings
Authors: Wright Dale S.
Published: November 2020

Do Buddhists believe in God?

As you may have noticed, our discussions so far have hardly mentioned God. Buddhist teachings aren’t oriented around a theistic concept of God, God as creator or ruler or savior. Although images of the Buddha as savior or supreme being...
Behavioral Finance
Authors: Baker H. Kent , Filbeck Greg , Nofsinger John R.
Published: November 2020

People tend to be penny wise and pound foolish and cry over spilt milk, even though we are taught to do neither. Focusing on the present at the expense of the future and basing decisions on lost value are two mistakes common to decision-making that are particularly costly in the world of finance. Behavioral Finance: What Everyone Needs to KnowR provides an overview of common shortcuts and mistakes people make in managing their finances. It covers the common cognitive biases or errors that occur when people are collecting, processing, and interpreting information. These include emotional biases and the influence of social factors, from culture to the behavior of one’s peers. These effects vary during one’s life, reflecting differences in due to age, experience, and gender. Among the questions to be addressed are: How did the financial crisis of 2007-2008 spur understanding human behavior? What are market anomalies and how do they relate to behavioral biases? What role does overconfidence play in financial decision- making? And how does getting older affect risk tolerance?
Does Trade Hurt American Jobs?
Authors: Krueger Anne O.
Published: November 2020

The temptation to use protection to increase employment is understandable, but consideration of the economics makes it doubtful whether protection will increase employment, even in an industry receiving protection. When the spillover effects of protection are to reduce demand, harm the competitiveness of using...
The EU and Brexit
Authors: Krueger Anne O.
Published: November 2020

How was the EU formed?

The European Union (EU) started out as the European Coal and Steel Community (ECSC) with six member nations (Belgium, France, Germany, Italy, Luxembourg, and the Netherlands). The underlying motive for forming the ESC and for subsequent economic integration was...
NAFTA and USMCA
Authors: Krueger Anne O.
Published: November 2020

How are NAFTA and USMCA different?

The North American Free Trade Agreement (NAFTA) came into force at the beginning of 1994. It was an “FTA plus” between Canada, Mexico, and the US. There had been some strenuous opposition to the preferential trading arrangement (PTA)...
The Future of International Trade
Authors: Krueger Anne O.
Published: November 2020

There is no doubt that intensifying trade links among the countries of the world have played an important, and largely beneficial, role in the evolution of the world economy. The open multilateral trading system that emerged and strengthened after the Second World War led...
Opioid Overdose
Authors: Olsen Yngvild , Sharfstein Joshua M.
Published: November 2020

What affects the risk of opioid overdose?

Several factors influence the risk of overdose from opioids, including a person’s level of tolerance; the amount, potency, and type of the opioid taken; age; other medical conditions; and the presence of other sedating substances or medications....
Citizenship Through Birth
Authors: Spiro Peter J.
Published: November 2020

Why do states give anyone citizenship at birth?

As in all forms of human association, states are composed of individual members. In theory, states could delay the conferral of citizenship until individuals reach adulthood and the fully formed identity that comes with it. In...
Dual Citizenship
Authors: Spiro Peter J.
Published: November 2020

Why did states once abhor dual nationality?

Dual nationality was once considered a threat to morality and to the international order. As the American diplomat George Bancroft remarked in 1849, states should “as soon tolerate a man with two wives as a man with...
Geopolitics and the Future: The Philippines in the World
Authors: Rood Steven
Published: November 2020

For the Philippines, it seems that geography is often destiny. The islands’ location, rather than the resources they held, was what made them attractive to the Spanish imperial enterprise. While the Spanish tried but failed to get to the Spice Islands, they ended up...
What Could Make an Eating Disorder Better or Worse?
Authors: Walsh B. Timothy , Attia Evelyn , Glasofer Deborah R.
Published: November 2020

Since eating disorders are potentially so serious, it is important to consider what factors may make the problem better or worse. Often individuals with eating disorders may want to tackle only some parts of the illness. For example, someone who has episodes of binge...
Are Children Affected by Eating Disorders?
Authors: Walsh B. Timothy , Attia Evelyn , Glasofer Deborah R.
Published: November 2020

Unfortunately, being young does not protect kids from developing eating disorders. Research in children suggests that half of young girls and a quarter of young boys report dieting in a given year, with nearly a third of girls and 15% of boys describing eating...
Can Eating Disorders Be Prevented?
Authors: Walsh B. Timothy , Attia Evelyn , Glasofer Deborah R.
Published: November 2020

Prevention is a holy grail in medicine: The perfect way to deal with any illness is to prevent it from occurring in the first place. This is equally true of eating disorders. All sensible professionals who specialize in studying and treating eating disorders would...
Korea’s Hot War Turns Cold: Korea in the Cold War
Authors: McEachern Patrick
Published: November 2020

What is the Juche philosophy of self-reliance?

In 1955, North Korean leader Kim Il Sung delivered a major speech that introduced the world to the Juche idea. Coming just seven years after the establishment of the DPRK, two years after the...
Kosovo in Yugoslavia
Authors: Judah Tim
Published: November 2020

The reconquest was brutal. Serbian forces returning to Kosovo remembered the treatment they had received at the hands of Albanians during their retreat in 1915 and Albanians remembered their treatment at the hands of the Serbs in 1912 and 1913. Serbian troops, officially “Yugoslav”...
The US Special Forces
Authors: Prados John
Published: November 2020

The assassination of Osama bin Laden by SEAL Team 6 in May 2011 will certainly figure among the greatest achievements of US Special Forces. After nearly ten years of searching, they descended into his Pakistan compound in the middle of the night, killed him, and secreted the body back into Afghanistan. Interest in these forces had always been high, but it spiked to new levels following this success. There was a larger lesson here too. For serious jobs, the president invariably turns to the US Special Forces: the SEALs, Delta Force, the Green Berets, and the USAF’s Special Tactics squad. Given that secretive grab-and-snatch operations in remote locales characterize contemporary warfare as much as traditional firefights, the Special Forces now fill a central role in American military strategy and tactics. Not surprisingly, the daring and secretive nature of these commando operations has generated a great deal of interest. The American public has an overwhelmingly favorable view of the forces, and nations around the world recognize them as the most capable fighting units: the tip of the American spear, so to speak. But how much do we know about them? What are their origins? What function do they fill in the larger military structure? Who can become a member? What do trainees have to go through? What sort of missions do Special Forces perform, and what are they expected to accomplish? Despite their importance, much of what they do remains a mystery because their operations are clandestine and the sources elusive. In The US Special Forces: What Everyone Needs to Know, eminent scholar John Prados brings his deep expertise to the subject and provides a pithy primer on the various components of America’s special forces. The US military has long employed Special Forces in some form or another, but it was in the Cold War when they assumed their present form, and in Vietnam where they achieved critical mass. Interestingly, the Special Forces suffered a rapid decline in numbers after that conflict despite the fact that the United States had already identified terrorism as a growing security threat. The revival of Special Forces began under the Reagan administration. After 9/11 they experienced explosive growth, and are now integral to all US military missions. Prados traces how this happened and examines the various roles the Special Forces now play. They have taken over many functions of the regular military, a trend that Prados does not expect will end any time soon. This will be a definitive primer on the elite units in the most powerful military the world has ever known.
Conflict-Related VAWG
Authors: True Jacqui
Published: November 2020

Is VAWG inevitable during war and armed conflict?

No, it is not. Yet VAWG appears to have always been a part of warfare. Historically, VAWG during war and armed conflict has been viewed as the “spoils of war,” in the sense that it followed...
Men, Masculinities, and VAWG
Authors: True Jacqui
Published: November 2020

How does masculinity affect VAWG?

Why is it the case that men perpetrate the vast majority of all VAWG? While not all men commit this violence, being a man is a significant risk factor for the perpetration of VAWG. Some evolutionary accounts see violence...
Culture and VAWG
Authors: True Jacqui
Published: November 2020

Is the recognition of VAWG universal or culturally relative?

Violence against women and girls presents itself in different forms across all cultures. Culture itself is a dynamic and changing concept. Within various cultures both the recognition and the prevalence of VAWG depend on who...
VAWG and the Media
Authors: True Jacqui
Published: November 2020

How do the media represent VAWG?

Media representations of VAWG are poor. Even if they do not explicitly blame victims, the media often objectify, sensationalize, stigmatize, or cast doubt on their credibility. Women and girls are often presented in a binary fashion as either...
Policy Frameworks and Solutions
Authors: True Jacqui
Published: November 2020

How can we protect victims of VAWG?

The protection of victims is a central pillar of policy responses to VAWG and an obligation of all states in international law. Protection requires the delivery of an effective criminal justice system, as well as the provision...
Philosophical Arguments
Authors: Waldau Paul
Published: November 2020

Here we turn to some important distinctions that everyone needs to know. These distinctions can become very technical and academic if one wishes to go that way, but the basic issues are relatively easy to understand. This chapter starts with the key distinction between...
Education, the Professions, and the Arts
Authors: Waldau Paul
Published: November 2020

Education, the professions, and the arts have all been a rich part of human ingenuity. Each has also played important roles in humans’ past interactions with other living beings, and each will surely play such roles in future possibilities.

The “education” examined here is...
Venezuela in the Twentieth Century
Authors: Tinker Salas Miguel
Published: November 2020

When was oil discovered?

Petroleum and natural gas seeps, produced by fissures in the earth, dot the landscape in various regions of eastern and western Venezuela. The indigenous people labeled these occurrences menes, and they used the viscous substance to weatherproof structures,...
Oil and Revolution: The Rise of Hugo Chávez
Authors: Tinker Salas Miguel
Published: November 2020

How did Chávez, a former coup leader, win the 1998 presidential election?

During the 1990s, the political landscape in Venezuela shifted as important segments of society, across the entire socioeconomic spectrum, lost faith in the traditional political parties and their ability to reform. Recurring...
Human Nature and Ethics
Authors: Brennan Jason
Published: November 2020

Do libertarians believe everyone is selfish?

A popular misconception holds that libertarians believe everyone is selfish all the time. According to this misconception, libertarians believe altruism is an illusion. Whenever a person seems to act for the sake of others, she in fact only...
Contemporary Problems
Authors: Brennan Jason
Published: November 2020

What would libertarians do about illegal immigrants?

Libertarians would grant amnesty to undocumented immigrants. They advocate open borders and free immigration.

Libertarians advocate free immigration in part because immigration restrictions are highly inefficient. When economists try to measure the deadweight loss immigration restrictions cause,...
Advancing Nursing Policy Advocacy Knowledge
Authors: Chiu Patrick
Published: November 2020

Nursing policy advocacy continues to be recognized as a key part of a nurse's role by educators, professional associations, and regulators. Despite normative calls on nurses to engage in political action and advocacy, limited theories, models, and frameworks exist to support this practice within nursing. Using Walt and Gilson's Health Policy Triangle Framework, this article explores the theoretical underpinnings of policy advocacy to enhance nursing's contemporary role in advancing social justice. Specific consideration is placed on the type of nursing and policy knowledge and perspectives required to understand policy content, contexts, processes, and actors.
Theory Development Process of Situation-Specific Theories
Authors: Im Eun-Ok
Published: November 2020

The purpose of this analysis was to determine the development process of situation-specific theories that were published in refereed journals. Fifteen situation-specific theories were retrieved through multiple databases and included in this analysis. Four themes reflecting the commonalties and differences in the theorizing process were extracted: (a) multiple, but no homogeneous steps; (b) various combinations of induction and deduction through unique strategies; (c) deduction from all types of theories/theoretical works; and (d) the use of multiple theories and/or multiple studies. On the basis of the findings, directions for future theoretical development in nursing were proposed.
Age-related Changes in T1 and C7 Slope and the Correlation Between Them in More Than 300 Asymptomatic Subjects
Authors: Inoue Taro , Ando Kei , Kobayashi Kazuyoshi , Nakashima Hiroaki , Ito Keigo , Katayama Yoshito , Machino Masaaki , Kanbara Shunsuke , Ito Sadayuki , Yamaguchi Hidetoshi , Koshimizu Hiroyuki , Segi Naoki , Kato Fumihiko , Imagama Shiro
Published: November 2020

Study Design.

A cross-sectional analysis using T1 slope (T1S) and C7 slope (C7S) in asymptomatic individuals.

Objective.

The aim of this study was to identify normative values, ranges of motion (ROMs), age-related changes in T1S and C7S, and correlation between the two slopes.

Summary of Background Data.

Few studies have reported age-related changes in the T1S and C7S angles. Additionally, studies investigating the effects of cervical position on these slopes are limited.

Methods.

A total of 388 asymptomatic subjects (162 males and 226 females) for whom T1S measurement was performed on radiographs were enrolled in the study. The T1S and C7S angles were measured using neutral radiography of the cervical spine. ROMs were assessed by measuring the difference in alignment in the neutral position, flexion, and extension.

Results.

The mean C7S and T1S angles were 19.6° (22.2° in males, 17.9° in females) and 24.0° (26.7° in men and 22.1° in women), respectively. The T1S angle was significantly greater than the C7S angle. Both the C7S and T1S angles significantly increased with age. The flexion ROM of C7S was higher than that of T1S, whereas no significant difference was detected between the extension ROMs of the two slopes. The flexion ROMs of the two slopes did not change, whereas the extension ROMs significantly increased with age. A significant positive correlation was observed between the C7S and T1S angles (r

2
 = 0.75).

Conclusion.

The normative values and age-related changes in C7S and T1S were analyzed. Both the C7S and T1S angles increased with age. The C7S angle was strongly correlated with the T1S angle, suggesting that C7S can substitute T1S on radiographic images.

Level of Evidence: 3
Do-search
Authors: Karvanen Juha , Tikka Santtu , Hyttinen Antti
Published: November 2020

Epidemiologic evidence is based on multiple data sources including clinical trials, cohort studies, surveys, registries, and expert opinions. Merging information from different sources opens up new possibilities for the estimation of causal effects. We show how causal effects can be identified and estimated by combining experiments and observations in real and realistic scenarios. As a new tool, we present do-search, a recently developed algorithmic approach that can determine the identifiability of a causal effect. The approach is based on do-calculus, and it can utilize data with nontrivial missing data and selection bias mechanisms. When the effect is identifiable, do-search outputs an identifying formula on which numerical estimation can be based. When the effect is not identifiable, we can use do-search to recognize additional data sources and assumptions that would make the effect identifiable. Throughout the article, we consider the effect of salt-adding behavior on blood pressure mediated by the salt intake as an example. The identifiability of this effect is resolved in various scenarios with different assumptions on confounding. There are scenarios where the causal effect is identifiable from a chain of experiments but not from survey data, as well as scenarios where the opposite is true. As an illustration, we use survey data from the National Health and Nutrition Examination Survey 2013–2016 and the results from a meta-analysis of randomized controlled trials and estimate the reduction in average systolic blood pressure under an intervention where the use of table salt is discontinued.
Association between physician practice Medicaid acceptance and employing nurse practitioners and physician assistants
Authors: Barnes Hilary , Richards Michael R. , Martsolf Grant R. , Nikpay Sayeh S. , McHugh Matthew D.
Published: November 2020

Background

Access to care is often a challenge for Medicaid beneficiaries due to low practice participation. As demand increases, practices will likely look for ways to see Medicaid patients while keeping costs low. Employing nurse practitioners (NPs) and physician assistants (PAs) is one low-cost and effective means to achieve this. However, there are no longitudinal studies examining the relationship between practice Medicaid acceptance and NP/PA employment.

Purpose

The purpose of this study was to examine the association of practice Medicaid acceptance with NP/PA employment over time.

Methods

Using SK&A data (2009–2015), we constructed a panel of 102,453 unique physician practices to assess for changes in Medicaid acceptance after newly employing NPs and PAs. We employed practice-level fixed effects linear regressions.

Results

Our results showed that, among practices employing both NPs and PAs, there was a roughly 2% increase in the likelihood of Medicaid participation over time. When stratifying our sample by practice size and specialty, the positive correlation localized to small primary care and medical practices. When both NPs and PAs were present, small primary care practices had a 3.3% increase and small medical practices had a 6.9% increase in the likelihood of accepting Medicaid.

Conclusion

NP and PA employment was positively associated with increases in Medicaid participation.

Practice Implications

As more individuals gain coverage under Medicaid, organizations will need to decide how to adapt to greater patient demand. Our results suggest that hiring NPs and PAs may be a potential lower cost strategy to accommodate new Medicaid patients.
Hospice inpatient services provision, utilization, and financial performance
Authors: He Mengying , O’Connor Stephen J. , Qu Haiyan , Menachemi Nir , Shewchuk Richard M.
Published: November 2020

Background

Hospice performance is an overlooked area in the health care field due to the difficulty of measuring quality of care and the infrequent quality inspection. Based on the daily reimbursement mechanism for different levels of hospice care, inpatient services provision could influence both hospice-level length of stay (LOS) and financial performance.

Purpose

The objective of this study was to explore the relationship between hospice inpatient services provision and hospice utilization and financial performance.

Methodology/Approach

A longitudinal secondary data set (2009–2013) was merged from three sources: (a) Hospice Cost Reports from the Centers for Medicare & Medicaid Services, (b) the Provider of Services files, and (c) the Area Health Resources Files. The dependent variable in this study was hospice average LOS and financial performance measured by total operating margin (TOM) and return on assets. The independent variable was hospice inpatient services’ offering. Mixed-effects regression models were used in the multivariate regression analyses.

Results

When comparing to hospices not providing inpatient services, offering inpatient services by staff was negatively related to average LOS (b = −0.063, p < .05) and TOM (b = −0.022, p < .05). The combination method with providing inpatient services by staff and under arrangement was negatively associated with return on assets (b = −0.073, p < .05).

Conclusion

Hospice inpatient services provision was associated with average LOS and financial performance.

Practice Implications

Offering the inpatient services to patients by staff decreased average LOS and TOM. Hospice agencies may seek strategies to maintain their financial sustainability through outsourcing.
CONCOMITANT PYOGENIC LIVER AND INTRAOCULAR ABSCESSES IN KLEBSIELLA ENDOGENOUS ENDOPHTHALMITIS: CASE REPORT AND REVIEW OF LITERATURE
Authors: Fan Kenneth C. , Patel Nimesh A. , Sengillo Jesse D. , Hudson Julia L. , Davis Janet L.
Published: November 2020

Purpose:

To describe a rare presentation of Klebsiella pneumoniae endogenous endophthalmitis with concurrent intraocular and liver abscesses.

Methods:

Case Report.

Results:

A middle-aged man presented with a red and painful eye with a preceding febrile gastrointestinal illness. Examination and work-up revealed concomitant intraocular and liver abscesses that were treated by pars plana vitrectomy, drainage of subretinal abscess, inpatient admission, and systemic antibiotics. The patient ultimately underwent enucleation of the eye because of persistent pain and poor visual prognosis.

Conclusion:

Klebsiella pneumoniae endogenous endophthalmitis is a rare and potentially devastating disease that requires high clinical suspicion and early diagnosis. Practitioners should consider systemic etiologies and communicate guarded prognoses in this serious systemic disease.
Fatal SARS-CoV-2 Inflammatory Syndrome and Myocarditis in an Adolescent: A Case Report
Authors: Beaudry Jeanette T. , Dietrick Barbara , Lammert Dawn B. , Constas Alexander , McCaw Julia , Hammond John , Buendia Matthew , Stein Julie E. , Pekosz Andrew , Schuette Jennifer , Mostafa Heba H. , Hooper Jody E. , Bernier Meghan , Agwu Allison , Feldman Leonard S.
Published: November 2020

Background:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an entity in children initially characterized by milder case presentations and better prognoses as compared with adults. Recent reports, however, raise concern for a new hyperinflammatory entity in a subset of pediatric COVID-19 patients.

Methods:

We report a fatal case of confirmed COVID-19 with hyperinflammatory features concerning for both multi-inflammatory syndrome in children (MIS-C) and primary COVID-19.

Results:

This case highlights the ambiguity in distinguishing between these two entities in a subset of pediatric patients with COVID-19-related disease and the rapid decompensation these patients may experience.

Conclusions:

Appropriate clinical suspicion is necessary for both acute disease and MIS-C. SARS-CoV-2 serologic tests obtained early in the diagnostic process may help to narrow down the differential but does not distinguish between acute COVID-19 and MIS-C. Better understanding of the hyperinflammatory changes associated with MIS-C and acute COVID-19 in children will help delineate the roles for therapies, particularly if there is a hybrid phenotype occurring in adolescents.
Determination of Pressure Injury Prevalance and Risk Factors in Children
Authors: Akpolat Refiye , Aslan Fatma Eti , Şişman Hamide , Alptekin Dudu , Akil Yasemin
Published: November 2020

Aim

Pressure injury is a serious health problem not only among adults but also among children. However, anatomical and physiological differences of the children may affect the prevalence of pressure injury. The current study aimed at determining the prevalence of pressure injuries and its risk factors for use in designing prevention programs.

Method

This was a 1-day in-depth assessment of all children who were hospitalized at a tertiary center in Turkey. Included were children who were admitted without pressure injuries. Observation and face-to-face interviews were undertaken to assess each child for the presence or absence of pressure injury using an Individual Characteristics Form, the Braden Scale, and the Braden Q Scale for Predicting Pressure Injury Risk. In addition, each child was assessed with the Glasgow Coma Scale and given a nutritional assessment.

Findings

Pressure injury had developed in 17 of the 143 patients (12%). For these children, average age was 66.2 ± 616 months, mean body weight was 19.7 ± 16.5 kg and most of them were determined as underweight according to a body mass index of 70.6% (12 children). Male gender was identified in 64.7% (11 children). Among the children in whom pressure injury developed, it was seen that average hemoglobin value was 9.5 ± 1.6 g/dl and average albumin value was 2.7 ± 0.2 g/dl. It was found out that mean Glasgow Coma Scale score was 10.7 ± 4.6 and mean Braden Risk Score was 15.3 ± 5.2, which indicates moderate risk. Furthermore, 58.8% of the children were treated in the intensive care unit; 52.9% of the children (nine children) had neurological problems, whereas 70.6% of them (12 children) had chronic medical problems. It was discovered that the rate of the patients whose pressure injury was Grade 1 was 47.1% (eight children).

Conclusion

In the current study, prevalence of pressure injury was 12%. Most of the children in whom pressure injuries developed had low body mass index and albumin values and neurological and chronic diseases, showing that these children were under risk for pressure injuries. The results obtained from the current study will be evaluated as evidence to prevent and treat pressure injuries at the institution where the study was done.