bluuebunny/crossref_metadata_2025 huggingface dataset:
Rational design of self-assembled RNA nanostructures for HIV-1 virus assembly blockade
Authors: Qu Na , Ying Yachen , Qin Jinshan , Chen Antony K
Published: December 2021

Many pathological processes are driven by RNA-protein interactions, making such interactions promising targets for molecular interventions. HIV-1 assembly is one such process, in which the viral genomic RNA interacts with the viral Gag protein and serves as a scaffold to drive Gag multimerization that ultimately leads to formation of a virus particle. Here, we develop self-assembled RNA nanostructures that can inhibit HIV-1 virus assembly, achieved through hybridization of multiple artificial small RNAs with a stem–loop structure (STL) that we identify as a prominent ligand of Gag that can inhibit virus particle production via STL-Gag interactions. The resulting STL-decorated nanostructures (double and triple stem–loop structures denoted as Dumbbell and Tribell, respectively) can elicit more pronounced viral blockade than their building blocks, with the inhibition arising as a result of nanostructures interfering with Gag multimerization. These findings could open up new avenues for RNA-based therapy.
Introduction
Authors: Weir David , Desmarais Jane
Published: December 2021

This introduction argues that even though decadence and culture are incompatible concepts, the former based on the idea of decay and the latter on the concept of growth, decadence is a type of culture in its own right, however much it may go against the grain of culture at large. This basic paradox is evident in the literature produced by such figures as Charles Baudelaire, J.-K. Huysmans, Rachilde, Arthur Symons, Oscar Wilde, and many others, all of whom drew creative energy from a sense of historical decline, philosophical pessimism, and sexual perversity. Moreover, the culture of decadence concerns not only forms of aesthetic expression such as literature and art, but also sensuous, lived experience, however self-destructive such experience might be. This “lived decadence,” moreover, was—and is—available not only to artists and writers on the margins of society but also to the economically secure and socially ascendant bourgeoisie, the beneficiaries of that very modernity so many decadents set themselves against.
The Disability Rights Movement
Authors: Scotch Richard , Sutton Kara
Published: December 2021

This chapter provides an overview of the social movement advocating for disability rights, including its origins, goals, strategies, structure, and impact. The chapter’s primary focus is on the movement in the United States, although developments in other nations are also discussed. The chapter reviews the origins of the disability rights movement in the 20th century in response to stigma and discrimination associated with disabilities and the medical model of disability; addresses the movement’s advocacy strategies, as well as the social model of disability that provided the conceptual underpinning for its goals and activities; and describes how the major components of the movement, including cross-disability organization, were brought together through collaboration and the common experiences of disability culture.
Spectral Aesthetics and ecological listening in the music of Helena Tulve
Authors: Bauer Amy
Published: December 2021

This chapter analyzes Estonian composer Helena Tulve's unique timbral process in four works: Sula (1999); L'Équinoxe de l'âme for soprano, triple harp or kannel, and string quartet (2008); Arboles lloran por luvia for voices and nyckelharpa (2006); and I am a River for chamber choir (2009). L'Équinoxe de l'âme (The Equinox of the Soul) is based on a text by the Persian mystic and philosopher Shahab al-Din Suhrawardi on the mythical Persian firebird Simurgh. Rather than portraying dissolving as in the orchestral work ice—Sula means to thaw or melt—the timbral transformations of Équinoxe evoke sparks bursting into flame, as well as a philosophical rumination on existence. The remaining vocal works similarly treat their texts with a programmatic flair that blurs the line between the materiality of the sound and its contemplative mood. Tulve's compositional approach can be considered post-spectral in its influences and attention to timbral detail. However, she is also motivated by ecological concerns, and counts herself among a small group of contemporary Estonian composers devoted to expressing this philosophy through music. Her influences meld in a music that prioritizes “slowness”: a sustained focus on spectral detail that reflects the composer's deep-rooted ecological concerns. The chapter thus draws on ideas from ecological theory, timbral analysis, and speculative aesthetics to show how Tulve's compositions express form through timbre and its expression in space, and reflect an ecological aesthetic of listening.
A Critical Introduction
Authors: Stulman Louis , Silver Edward
Published: December 2021

This introductory chapter provides an overview of the book of Jeremiah, its historical background, distinctive literary character, language of trauma and resilience, dominant ideologies, and the state of twentieth- and twenty-first-century Jeremian scholarship. It concludes with an explanation of the goals and structure of the Handbook. Like the ancient book and the prophetic persona, the interpretation of Jeremiah has also been fractured and at times conflictual. Certain recent schools of Jeremiah scholarship explore new spaces for reading the ancient text that reconfigure, redeploy, and move beyond conventional interpretations, while others concentrate on historical issues, examining variant manuscripts and comparative Near Eastern texts. Until now, these divergent schools of thought have worked in relative isolation. This Handbook, the introductory chapter notes, seeks to bridge the gap between the current scholarly debate. It recognizes the importance of both post-historical and hermeneutic interpretive perspectives and ancient contextual approaches. It engages historical methodologies as well as literary and situated readings. This essay suggests that it is an opportune moment, within the frame of a single, field-encompassing volume, for a synthetic anthology that encourages the fruits of these disparate technical subfields to be gathered in order to nourish the field as a whole. Jeremiah, prose and poetry, trauma, Deuteronomistic History, methodology, SBL, Writing/Reading Jeremiah, biblical studies
Jeremiah in Lamentations
Authors: Boase Elizabeth
Published: December 2021

The prophetic figure of Jeremiah has long been associated with the book of Lamentations. The earliest known attribution of Lamentations to Jeremiah dates to the time of the Septuagint, an attribution that is repeated in other early translations and rabbinic commentary. Since the rise of critical scholarship, however, the authenticity of Jeremiah as author has been questioned, with few contemporary scholars continuing to argue that the prophet was the actual author of the Lamentations. Despite this, the prophet figure/persona continues to be identified within Lamentations, albeit in ways far removed from the direct attribution expressed in earlier periods. This chapter traces the rise and fall of Jeremiah as author of Lamentations, exploring possible reasons why the prophetic figure has been so important in the history of interpretation within Lamentations studies, with a particular focus on the way that Jeremianic authorship has contributed to the theological understanding of the book. The ever-changing understanding of the relationship of Jeremiah with Lamentations has been influenced by the interpretive lenses and needs of successive communities, a trend which will continue into the future as new methods and approaches emerge.
Jeremiah and Homiletics
Authors: Sharp Carolyn J.
Published: December 2021

This chapter explores homiletical possibilities afforded by the book of Jeremiah to the Christian preacher. The earliest layers of contextualization are examined through consideration of preaching on Jeremiah in the early Church, focusing on sermons of Origen. In discussing the early modern period, the chapter attends to the preaching of Reformers Martin Luther and John Calvin. Finally, the chapter reflects on homiletical moves made by contemporary preachers in a variety of ecclesial contexts from the nineteenth century to the present, including Charles Spurgeon and Walter Brueggemann. Noteworthy in the homiletical reception of Jeremiah are four passages: first, the commissioning of Jeremiah (1:4–10), which foregrounds agonistic dimensions of prophetic witness and has served as a focus in liturgies of ordination; second, the lament, “Is there no balm in Gilead?” (8:22), transformed in a renowned African American spiritual into the asseveration that “there is a balm in Gilead,” namely, Jesus; third, Jeremiah’s depiction of the divine word as irresistible, “like a burning fire shut up in my bones” (20:9); and fourth, the promise of the new covenant that God will inscribe on the heart (31:31–34).
Playing with Death
Authors: Davidson Steed Vernyl
Published: December 2021

The task of identifying a single rationale for the violence on display in the book of Jeremiah may end with a coherent answer, but perhaps not a satisfactory one. That violence serves a reforming purpose seems satisfactory to theological readers in search of theodicy, as well trauma analyses that find the violence problematic but understandable. Other interpreters of Jeremiah, such as feminists and postcolonialists, struggle with the gratuitous and seemingly arbitrary nature of the violence. While not an attempt to rationalize the violence, this chapter engages the arbitrariness of the violence through a systematic analysis of four targets of violence in the book of Jeremiah: the prophet, the feminized Israel/Judah as adulterous wife, foreign nations, and the earth. By distinguishing these separate targets, the chapter examines how gender, sexuality, nationality, and speciesism intersect in the enactment of the rhetorical violence in the book. These delineations also set the stage for a central claim of the chapter, that of exceptional violence. Building upon Carl Schmidt’s notion that exceptional violence stems from exceptional vulnerability that requires the state of exception to use unrestrained violence, the chapter considers how the violence as narrated in Jeremiah not only performs this exceptionalism but also has exceptions. By examining who/what dies from the violence in the book, the chapter points out how the politics of death is played out upon different targets.
The Last Stage of the Literary History of the Book of Jeremiah
Authors: Tov Emanuel
Published: December 2021

Presumably the book of Jeremiah underwent several editorial stages for which there is no evidence in the textual witnesses. At the same time, the last stage of the literary growth of that book is reflected in the elements that the Masoretic Text (MT) has in excess of the LXX and the Qumran scrolls 4QJerb,d. These differences are not scribal, but editorial, so that the latter have been named “edition I” and MT “edition II,” with the understanding that edition II was based on a literary form like edition I. This chapter describes the many views that have been expressed in the post-Qumran era on the content, tendencies, and dating of these two editions. It points out that the assumption of “layers” may be more appropriate than “editions.” In the wake of the research of Bogaert, this paper adds an excursus on the apocryphal book of Baruch that was surprisingly appended to the short, not the long, text of Jeremiah. Presumably, when edition I was expanded with Baruch, edition II was already in existence, but maybe at a different place or in a different environment. In any event, we do not know why Baruch was appended to the short and not the long edition.
The Development of Hebrew and the Book of Jeremiah
Authors: Hornkohl Aaron D.
Published: December 2021

This chapter is a linguistic examination of the book of Jeremiah which contributes to understanding both the development of ancient Hebrew and the place of the book in that history. Since the inception of critical study of the Hebrew Bible, scholars have engaged in the linguistic periodization of its constituent texts. According to the regnant paradigm, Biblical Hebrew divides into pre-exilic Classical Biblical Hebrew (CBH) and post-exilic Late Biblical Hebrew (LBH). Scholars employ control samples and rigorous methods to identify linguistic features characteristic of particular chronolects and to periodize texts based on concentrations of characteristic features, all the while taking into account the “noise” caused by other sources of linguistic diversity, textual fluidity, and literary development. The present chapter focuses on linguistic diachrony and the book of Jeremiah. It examines where the book fits into the history of ancient Hebrew—arguing that it represents a transitional Hebrew between CBH and LBH; how diachronic sensitivity supports or contradicts theories concerning the book’s formation and development (including the theory of short and long versions and other notions of a composite text); and how the awareness of chronolects can contribute to the exegesis of interpretive cruxes.
Language Variation in the Book of Jeremiah and Its Cultural and Social Background
Authors: Polak Frank H.
Published: December 2021

Syntactic-stylistic analysis of the linguistic variation in the book of Jeremiah points to the cultural/sociohistorical context of the different text groups. The poignant, emotional style of Jeremianic poetry (Mowinckel’s A corpus) is marked by the often extremely high frequency of short clauses, and the low incidence of subordinate clauses and noun groups (similarly in most texts in Jeremiah 30–31; 46–51). These features characterize the “lean, brisk style” of spontaneous spoken discourse/oral literature. Noun groups and subordinate clauses are highly frequent in the narrative corpus (B) and parenetic prose (C), whereas short clauses are far less frequent, as characteristic of the “intricate, elaborate style” of written texts. Where these corpora reflect the scribal desk, corpus A is close to the oral arena. Detailed analysis shows, however, that all corpora are open-ended. These considerations suggest an initial oral-written symbiosis in the prophetic performance and the commission to writing of the prophetic utterances. In the scribal milieu of the Babylonian/Persian era, a new class of religious formulators took up the prophetic tradition and reformulated it in the complex style characteristic of the scribal desk.
The Jeremian Oracles against the Nations
Authors: Graybill Rhiannon
Published: December 2021

A substantial portion of the book of Jeremiah consists of the Oracles against the Nations (OAN), a common prophetic genre of threats and predictions of violence directed at foreign nations. In Jeremiah, the OAN are significantly different in the Masoretic (Hebrew) and Septuagint (Greek) texts, including their length, their internal order, and their location in the book. While the function of the OAN is unclear, their literary character is undeniable. Primarily poetry, they present a dense collection of evocative images of violence and destruction. Sound, gender, and the “nation” are all themes of interest in the OAN. The OAN are a crucial part of the book of Jeremiah as a whole.
The Historical Jeremiah
Authors: Leuchter Mark
Published: December 2021

Jeremiah scholars are generally cautious in drawing assumptions about the historical reliability of the material found in the book of Jeremiah. Yet the sources within the book possess literary patterns that provide oblique information to create a broad-stroke outline of what was known and remembered about the prophet himself. Approached with an eye to cultural memory, three features of the Book of Jeremiah provide ways to recover some dimensions of the historical prophet: the rhetorical shape of chapters 1–25 (in both the MT and LXX traditions), the book’s points of contact between the Levites and the Deuteronomistic tradition, and the unique characterization of scribes and scribalism within the book in relation to oracles ascribed to Jeremiah. These avenues of inquiry enable us to cautiously arrive at a tentative understanding of the Jeremiah of history.
Jeremiah
Authors: Biddle Mark E.
Published: December 2021

This chapter examines the complex contents and elusive structure of the book of Jeremiah. Beginning with the familiar poetry/prose distinction, consideration of a series of other characteristics reveals a nuanced and varied picture of the contents of the book of Jeremiah. Four categories of poetry and five of prose emerge: “oracular,” “eschatological,” “liturgical,” and the “Oracles against the Nations”; and “sermons,” “reports of public events,” “reports of Jeremiah’s private reception of the divine word,” the Deuteronomistic addendum to the book, and editorial structuring devices such as headings and introductions. Despite the difficulty of determining the principle or principles manifest in the structure of the book of Jeremiah, the editors/curators of the tradition(s) left certain clear indications of their organizing activity. Headings, the designation “scroll/book,” and themes unify collections within the book. Here, the problem of two versions manifests itself, with MT and LXX diverging with respect to the order, structure, and contents of the second and third major sections of the book.
The Figure of Jeremiah in the Work of Stefan Zweig and Rainer Maria Rilke
Authors: Görner Rüdiger
Published: December 2021

The prophet and the prophetic feature prominently in Rainer Maria Rilke’s Neue Gedichte (1907) and in Stefan Zweig’s one and only pacifist drama Jeremias (1917). This chapter examines the poetic and rhetorical significance of their renderings of the Jeremiah myth through in-depth textual and structural analysis. It shows the critical attitude towards the prophetic as expressed in Rilke’s poem “Jeremia” challenging the divine voice, which had turned the prophet into its mere mouthpiece. Furthermore, it discusses the interrelation between Rilke’s poem and Zweig’s drama in thematic terms, as well as the influence of Nietzsche’s Zarathustra on both.
Jeremiah’s Non-Burial Refrain
Authors: Jobe Sarah C.
Published: December 2021

The non-burial refrain in the book of Jeremiah is often overlooked in favor of the repeated Jeremian verb pairs “to pluck up and to pull down, to destroy and overthrow, to build and to plant” introduced in Jeremiah 1:10. This chapter argues that the non-burial refrain serves as the book’s dominant metaphor for exile from the perspective of those left behind. The non-burial refrain testifies to conditions on the ground in sixth-century bce Judah, including beliefs about the dead and shifting burial practices, while encoding traumatic memories from the siege and fall of Jerusalem. Furthermore, the non-burial refrain functions as a vehicle by which the text of Jeremiah suggests, refutes, and revises its claims about the role of the God of Israel in the Babylonian exile. Specifically, Jeremiah explores the idea that God is responsible for the slaying and scattering of Judah, then moves to a belief that God is the one who will ultimately consecrate, inter, and gather a fallen people after cataclysmic military defeat.
Jeremiah and Gender
Authors: Maier Christl M.
Published: December 2021

This chapter explores salient features of gendered language and gender performance in Jeremiah from a feminist perspective. At first sight, the book witnesses a patriarchal world of male privilege and female subordination, which is expressed by gendered language and sexualized metaphors. The personification of Jerusalem—Judah as adulterous wife of YHWH and the devastation of her female body—generates horrific images that express the shame and humiliation of its ancient audiences, but are unbearable for postmodern readers. Inspecting some passages more closely, this chapter reveals flaws in this rhetoric of shaming and breaches in gender performance that help to deconstruct an allegedly rigid gender hierarchy and to seek ways to alternative interpretations of the divine-human relationship.
Jeremiah
Authors: Claassens L. Juliana
Published: December 2021

This chapter explores the various dimensions of the narrative portrayal of Jeremiah as a traumatized prophet. The author proposes that the book of Jeremiah could be considered as an extended trauma narrative with the prophet as one of its leading characters, seeking to make sense of the exceedingly traumatic events associated with the Babylonian invasion and exile that threatened to subsume Jeremiah and his fellow Judeans. Particularly what have been called the Confessions of Jeremiah (Jer 11:18–20; 12:1–6; 15:10–21, 17:14–18; 18:18–23; 20:7–13) seem to be particularly suited to be read in terms of the rhetorical strategies identified by Laurie Vickroy, according to which characters in trauma narratives are shown to react to wound-inflicting circumstances. The author argues that these various dimensions of Jeremiah as Traumatized Prophet are not only central to an understanding of the book of Jeremiah, but also may help readers, both then and now, deal with the reality of trauma that includes the various options for sense-making amidst trauma.
Jeremiah and His Prophecies in the New Testament
Authors: Williams Catrin H.
Published: December 2021

This chapter examines the various modes of reference to Jeremiah in the writings of the New Testament. It begins with an investigation of the three explicit references to the prophet Jeremiah in the Gospel of Matthew before expanding the discussion to examine various allusions to the content of Jeremiah’s prophecies in the four canonical gospels. The study will then consider the contribution of Jeremiah to Paul’s understanding of his apostolic ministry and also focus on the influence of the Jeremianic concept of “new covenant” on the understanding of the salvific significance of Christ both in Paul’s letters and in the epistle to the Hebrews. It concludes with an exploration of the various ways in which Jeremiah’s prophecies are employed in the book of Revelation, including the oracles of judgment against Babylon.
Constitutional Politics
Authors: Kang Won-Taek
Published: December 2021

In 1948, the Constitution was enacted by the Constitutional National Assembly, and a presidential system was adopted. But it was a hybrid system with both presidential and parliamentary system elements. Even though nine constitutions have been promulgated since then, this characteristic has remained fundamentally unchanged. Under the authoritarian regimes, the dictators forcibly revised the Constitution to strengthen their power and extend their terms of office. Constitutional politics, then, was fraught with serious conflict. South Korea was democratized in 1987, and the Constitution was democratically revised accordingly. The most important thing in this new Constitution was the restoration of the popularly elected presidential system. But the 1987 Constitution was modelled on the 1962 Constitution, and does not fit well with today’s democratized and diverse Korean society. The need to decentralize the authority and power of central government is another reason for constitutional reform.
Executive Politics
Authors: Lee Jongkon
Published: December 2021

This chapter explains the historical origins of strong bureaucratic power in South Korea and recent changes in which the concentration of bureaucratic power has weakened. In the 1960s and 1970s, economic growth was South Korea’s top priority, and economic policy agencies such as the Economic Planning Board (EPB) led the nation’s overall policy decisions under the protection of the powerful president, Park Chung-hee. As the economy grew, however, various social demands, such as welfare, labour rights, and environmental protection, were expressed by the public, and many institutions that could reflect these demands grew within the bureaucracy in the 1980s and 1990s. As a consequence, the influence of the EPB was relatively reduced. Since the 2000s, democratization has matured and the ability of the National Assembly to make policy decisions and keep the administration in check has been strengthened. As a result, the bureaucrats’ influence on policy further diminished.
Conservative Democratisation
Authors: Kang WooJin
Published: December 2021

South Korea celebrated the thirtieth anniversary of democratization in 2017. Over the thirty years since democratization in 1987, Korea has successfully institutionalized democracy. The last thirty years of democracy in Korea, however, have a dual aspect. The fierce resistance of students and civil society triggered the democratization process in 1987. However, the political pact between the political elites institutionalized the democratic transition. The 1987 system created through the political pact between political elites with the exclusion of civil society’s influence functioned as a political cartel and a high barrier to new political forces. One of the significant consequences of this cartel system has been the underrepresentation of political minorities such as youth and non-regular workers. Democracy does not mean elite rotation. The democratization of democracy must begin for Korean democracy, which started a new cycle after the 2016–2017 Candlelight Uprising, to become a responsive system that reflects many citizens’ preferences.
Chaebol
Authors: Rhyu Sang-young
Published: December 2021

Chaebol is a very contentious word in Korea, both practically and theoretically. Chaebols serve as genes, deeply imprinted on the structural characteristics and historical origins of all sectors, including politics, society, and culture, as well as the economy and business management in South Korea. The assessment of Chaebols is largely expressed using one of three metaphors: angels, demons, or necessary evils in South Korea’s political economy. The democratization in 1987 and the 1997 Asian economic crisis served as dual pressures that triggered economic reform and resulted in extensive institutional change and Chaebol reform. Under the pressures of globalization and democratization, the country’s developmental state and Chaebols are all going through the process of reform and evolution. The sustainability and future of Chaebols will depend on how innovative they are in the global market and how much they can enhance social trust in South Korea.
Dispossession as Destination
Authors: Wynyard Matthew
Published: December 2021

The systematic dispossession of Māori land in the 19th and 20th centuries formed the basis of Aotearoa New Zealand’s capitalist economy and contributed to persistent patterns of inequality between Pākehā and Māori. Māori were, and largely remain, excluded from the land-based economy of Aotearoa New Zealand. This chapter draws on an emergent body of Indigenous critical theory that seeks to reformulate or “indiginize” Marx’s theory of primitive accumulation to better account for Indigenous experiences of colonization. It describes the settler-colonial process in Aotearoa New Zealand, including the myriad attempts of settlers and the Crown to eliminate Māori and separate us from our ancestral lands. Ultimately, however, this chapter argues that the settler colonialism in Aotearoa New Zealand is, in part at least, a failed project. Māori have not been eliminated and the umbilical connection to the lands of our ancestors has not been severed.
Defining “Doctor Shopping” with Dispensing Data: A Scoping Review
Authors: Delcher Chris , Bae Jungjun , Wang Yanning , Doung Michelle , Fink David S , Young Henry W
Published: December 2021

Background

“Doctor shopping” typically refers to patients that seek controlled substance prescriptions from multiple providers with the presumed intent to obtain these medications for non-medical use and/or diversion. The purpose of this scoping review is to document and examine the criteria used to identify “doctor shopping” from dispensing data in the United States.

Methods

A scoping review was conducted on “doctor shopping” or analogous terminology from January 1, 2000, through December 31, 2020, using the Web of Science Core Collection (seven citation indexes). Our search was limited to the United States only, English-language, peer-reviewed and US federal government studies. Studies without explicit “doctor shopping” criteria were excluded. Key components of these criteria included the number of prescribers and dispensers, dispensing period, and drug class (e.g., opioids).

Results

Of 9,845 records identified, 95 articles met the inclusion criteria and our pool of studies ranged from years 2003 to 2020. The most common threshold-based or count definition was (≥4 Prescribers [P] AND ≥4 Dispensers [D]) (n = 12). Thirty-three studies used a 365-day detection window. Opioids alone were studied most commonly (n = 69), followed by benzodiazepines and stimulants (n = 5 and n = 2, respectively). Only 39 (41%) studies provided specific drug lists with active ingredients.

Conclusion

Relatively simple P x D criteria for identifying “doctor shopping” are still the dominant paradigm with the need for ongoing validation. The value of P x D criteria may change through time with more diverse methods applied to dispensing data emerging.
Ascertaining Design and Implementation Requirements for a Perioperative Neurocognitive Training Intervention for the Prevention of Persistent Pain After Surgery
Authors: Holzer Katherine J , Haroutounian Simon , Meng Alicia , Wilson Elizabeth A , Steinberg Aaron , Avidan Michael S , Kozower Benjamin D , Abraham Joanna
Published: December 2021

Background

Persistent postsurgical pain (PPSP) is a common complication that impacts quality of life, often necessitating long-term opioid treatment. Certain neurocognitive factors, including reduced performance on cognitive flexibility tasks, are associated with increased risk of PPSP. We examine the perceptions of surgical patients and clinicians with regard to perioperative pain management activities and needs; patient acceptance and use of a perioperative neurocognitive training intervention; and implementation feasibility.

Methods

We conducted both individual and focus group interviews with patients undergoing thoracic surgery and clinicians in an academic medical center. The Consolidated Framework for Intervention Research guided the development of interview questions related to the adoption and implementation of a neurocognitive intervention to mitigate PPSP. A thematic analysis was used to analyze the responses.

Results

Forty patients and 15 clinicians participated. Interviews revealed that there is minimal discussion between clinicians and patients about PPSP. Most participants were receptive to a neurocognitive intervention to prevent PPSP, if evidence demonstrating its effectiveness were available. Potential barriers to neurocognitive training program adoption included fatigue, cognitive overload, lack of familiarity with the technology used for delivering the intervention, and immediate postoperative pain and stress. Implementation facilitators would include patient education about the intervention, incentives for its use, and daily reminders.

Conclusion

The study identified several guiding principles for addressing patients’ and clinicians’ barriers to effectively implementing a neurocognitive training intervention to mitigate PPSP after surgery. To ensure the sustainability of neurocognitive interventions for preventing PPSP, such interventions would need to be adapted to meet patients’ and clinicians’ needs within the perioperative context.
Outcomes in patients with systemic sclerosis undergoing early vs delayed intervention with potential disease-modifying therapies
Authors: Yomono Keina , Kuwana Masataka
Published: December 2021

Objective

To examine whether early therapeutic intervention, compared with delayed intervention, is beneficial for patients with early SSc.

Methods

This is a single-centre, retrospective cohort study of SSc patients who received CYC, MMF, MTX or tocilizumab for diffuse cutaneous SSc (dcSSc) or interstitial lung disease (ILD) within 6 years after disease onset. The patients were divided into early and delayed intervention groups based on the disease duration of ≤18 and >18 months at treatment introduction, respectively. Clinical worsening was defined as the development of any original or revised ACR Composite Response Index in SSc (CRISS) step 1 event or progressive fibrosing ILD (PF-ILD).

Results

There was no difference in baseline characteristics between the early (n = 25) and delayed (n = 21) intervention groups except forced vital capacity, which was better in the early vs delayed intervention groups. The early intervention group less frequently had stable pulmonary function over 1 year than did the late intervention group (odds ratio 0.087, 95% CI: 0.0079, 0.51; P = 0.003). The active disease was significantly decreased from 79% to 42% in the early intervention group (P = 0.007), but the change in the delayed intervention group was not statistically significant (68% to 42%; P = 0.11). Cumulative rates free from clinical worsening events defined by revised ACR-CRISS and PF-ILD were significantly higher in the early vs delayed intervention groups (P = 0.03 and 0.003, respectively).

Conclusion

A therapeutic ‘window of opportunity’ might exist in SSc patients.
Generalized pain hypersensitivity and associated factors in gout
Authors: ten Klooster Peter M , Kraiss Jannis T , Munters Rik , Vonkeman Harald E
Published: December 2021

Objectives

Previous studies have indicated that a sizeable proportion of patients with inflammatory arthritis present with features characteristic of central pain sensitization. However, this has not yet been examined in patients with gout. The objective of this study was to explore the presence of generalized pain hypersensitivity and associated factors in patients with diagnosed gout.

Methods

A cross-sectional survey was performed in outpatients with crystal proven gout using the generalized pain questionnaire (GPQ) to screen for the presence of generalized pain hypersensitivity. Additional self-reported socio-demographic and medical information was collected and several patient-reported outcome measures were completed. Univariable logistic regressions and multivariable LASSO regression analysis with 10-fold cross-validation was used to explore relationships with patient characteristics, clinical features and PROMs.

Results

Of the 97 included patients (84.5% male; mean (s.d.) age: 68.9 ± 11.9 years), 20 patients (20.6%, 95% CI: 13.0, 30.0) reported possible generalized pain hypersensitivity defined as a GPQ score ≥11 (range: 0–28; mean (s.d.) GPQ: 6.3 ± 5.3). Lower age, concomitant fibromyalgia and more experienced difficulties in performing their social role were independently associated with generalized pain hypersensitivity. Notably, use of urate lowering therapy was significantly lower in those with generalized pain hypersensitivity.

Conclusions

Generalized pain hypersensitivity appears to be quite common in gout, despite its more intermittent nature compared with other inflammatory arthritides. As this kind of pain does not respond well to regular treatment, screening for non-inflammatory pain may be important for improving pain management in gout.
The Impact of the Affordable Care Act on Outpatient Spine Trauma Consult Follow-up
Authors: Canseco Jose A. , Karamian Brian A. , Patel Parthik D. , Hilibrand Alan S. , Rihn Jeffrey A. , Kurd Mark F. , Anderson D. Greg , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: December 2021

Study Design:

This was a retrospective cohort study

Objective:

The objective of this study was to assess the impact of the Affordable Care Act (ACA) on spine trauma patient follow-up.

Summary of Background Data:

Although damage to the spinal column accounts for a small proportion of all traumatic injuries, it results in a significant burden on the patient, provider, and health care system. Postoperative follow-up is essential to direct rehabilitation, prevent early deterioration, and manage complications early in the postoperative period. Previous studies have established the role of insurance coverage on follow-up compliance, however, the impact of the ACA on follow-up has been scant.

Materials and Methods:

A retrospective cohort study was performed upon institutional review board approval of spine trauma patients consulted by orthopedic spine or neurosurgery from January 2013 to December 2013 (pre-ACA) and January 2015 to December 2015 (post-ACA). Patient demographics, surgical case characteristics, and follow-up compliance were assessed via manual chart review. Multivariate regression analysis was used to identify predictors of follow-up in the overall cohort, as well as within nonoperative and operative patients.

Results:

A total of 827 patients were included in the final analysis after inclusion and exclusion criteria. Overall, patient follow-up significantly increased after implementation of the ACA (P<0.001), with pre-ACA follow-up at 35.0% (144/411) and post-ACA follow-up at 50.0% (208/516). Multivariate regression analysis further corroborated these findings, showing post-ACA status associated with a 1.66-fold higher likelihood of follow-up. Among nonoperative patients, the ACA failed to make a significant difference in follow-up (P=0.56), however, patients treated operatively showed a significantly higher likelihood of follow-up (odds ratio=2.92, P<0.001).

Conclusions:

Postoperative follow-up is an essential part of patient care, aiding in improving clinical outcomes and limiting the economic burden on the health care system. This study suggests that passage of the ACA significantly improved patient follow-up for operatively managed patients but not for nonoperatively managed patients.

Level of Evidence:

Level III.
Gait analysis as a robust pain behavioural endpoint in the chronic phase of the monoiodoacetate-induced knee joint pain in the rat
Authors: Han Felicity Y. , Brockman David A. , Nicholson Janet R. , Corradini Laura , Smith Maree Therese
Published: December 2021

The monoiodoacetate-induced rat model of osteoarthritis knee pain is widely used. However, there are between-study differences in the pain behavioural endpoints assessed and in the dose of intraarticular monoiodoacetate administered. This study evaluated the robustness of gait analysis as a pain behavioural endpoint in the chronic phase of this model, in comparison with mechanical hyperalgesia in the injected (ipsilateral) joint and development of mechanical allodynia in the ipsilateral hind paws. Groups of Sprague–Dawley rats received a single intraarticular injection of monoiodoacetate at 0.5, 1, 2 or 3 mg or vehicle (saline) into the left (ipsilateral) knee joint. An additional group of rats were not injected (naïve group). The pain behavioural methods used were gait analysis, measurement of pressure algometry thresholds in the ipsilateral knee joints, and assessment of mechanical allodynia in the ipsilateral hind paws using von Frey filaments. These pain behavioural endpoints were assessed premonoiodoacetate injection and for up to 42-days postmonoiodoacetate injection in a blinded manner. Body weights were also assessed as a measure of general health. Good general health was maintained as all rats gained weight at a similar rate for the 42-day study period. In the chronic phase of the model (days 9–42), intraarticular monoiodoacetate at 3 mg evoked robust alterations in multiple gait parameters as well as persistent mechanical allodynia in the ipsilateral hind paws. For the chronic phase of the monoiodoacetate-induced rat model of osteoarthritis knee pain, gait analysis, such as mechanical allodynia in the ipsilateral hind paws, is a robust pain behavioural measure.
Effects of the psychoactive compounds in green tea on risky decision-making
Authors: Liley Anna. E. , Joyner Haleigh N. , Gabriel Daniel B.K. , Simon Nicholas W.
Published: December 2021

Epigallocatechin-3-gallate (EGCG) and caffeine are the two primary compounds found in green tea. While EGCG has anxiolytic and anti-inflammatory effects, its acute effects on cognition are not well understood. Furthermore, despite widespread green tea consumption, little is known about how EGCG and caffeine co-administration impacts behavior. Here, we investigated the effects of multiple doses of either EGCG or caffeine on a rat model of risk-taking. This was assessed using the risky decision-making task (RDT), in which rats choose between a small, well-tolerated reward and a large reward with escalating risk of mild footshock. Rats were tested in RDT after acute systemic administration of EGCG, caffeine or joint EGCG and caffeine. EGCG caused a dose-dependent reduction in risk-taking without affecting reward discrimination or task engagement. Caffeine did not impact risk-taking, but elevated locomotor activity and reduced task engagement at high doses. Finally, exposure to both EGCG and caffeine had no effect on risk-taking, suggesting that low-dose caffeine is sufficient to mask the risk-aversion caused by EGCG. These data suggest EGCG as a potential therapeutic treatment for psychological disorders that induce compulsive risky decision-making.
Evidence for spontaneous cannabinoid withdrawal in mice
Authors: Paronis Carol , Iliopoulos-Tsoutsouvas Christos , Papanastasiou Ioannis , Makriyannis Alex , Bergman Jack , Nikas Spyros P.
Published: December 2021

Although the behavioral effects of acute and chronic exposure to cannabinoids have been extensively studied in mice, spontaneous withdrawal following exposure to cannabinoids has not been well characterized in this species. To address this issue, different groups of mice were treated for 5 days with saline, 20–36 mg/kg/day of the CB partial agonist Δ9-tetrahydrocannabinol (Δ9-THC), or 0.06–0.1 mg/kg/day of the CB high-efficacy agonist AM2389. Initial studies assessed changes in observable behavior (paw tremors) that were scored from the recordings taken at 4 or 24 h after the last injection. Subsequently, radiotelemetry was used to continuously measure body temperature and locomotor activity before (baseline), during, and after the 5-day dosing regimens. Results show that increases in paw tremors occurred following 5-day exposure to AM2389 or Δ9-THC. In telemetry studies, acute AM2389 or THC decreased both temperature and activity. Rapid tolerance occurred to the hypothermic effects of the cannabinoids, whereas locomotor activity continued to be suppressed following each drug injection. In contrast, increases in locomotor activity were evident 12–72 h after discontinuing daily injections of either 0.06 or 0.1 mg/kg/day AM2389. Increases in locomotor activity were also noted in mice treated daily with 30 or 36, but not 20 mg/kg/day Δ9-THC; these effects were smaller and appeared later than effects seen in AM2389-treated mice. These results indicate that the discontinuation of daily treatment with a CB high-efficacy agonist will yield evidence of spontaneous withdrawal that may reflect prior dependence, and that the degree of cannabinoid dependence may vary in relation to the dose or efficacy of the agonist injected daily.
Optimizing Symmetry after Unilateral Mastectomy and Reconstruction with a Less Form-stable Prepectoral Implant
Authors: Schwartz Jean-Claude D. , Binstock Michael
Published: December 2021

Implant-based breast reconstruction after bilateral mastectomy allows for excellent symmetry between the reconstructed breasts. After unilateral mastectomy, it is difficult to achieve symmetry between the reconstructed and native breast. In the past, anatomical implants provided a reconstruction that more closely resembled the shape of a native breast compared with the cohesive, round subpectoral implants commonly placed today. Here, we describe the use of a less form-stable round implant placed in the prepectoral plane after mastectomy which provides improved symmetry with the contralateral native breast.
RETINITIS PIGMENTOSA SINE PIGMENTO
Authors: Lee Eun Kyoung , Lee Sang-Yoon , Ma Dae Joong , Yoon Chang Ki , Park Un Chul , Yu Hyeong Gon
Published: December 2021

Purpose:

To investigate the clinical findings, natural course, and pigment development of patients with retinitis pigmentosa (RP) sine pigmento using multimodal imaging.

Methods:

We reviewed the medical records of 810 consecutive patients with RP and assessed serial ultra-widefield fundus photography, fundus autofluorescence, and optical coherence tomography images. Electrophysiological and visual field analysis findings were also reviewed.

Results:

Of the 774 patients with RP who met the inclusion criteria, 88 were diagnosed with RP sine pigmento, with a prevalence of 11.4%. The mean age of the patients was 35.57 years compared with 49.83 years for patients with typical RP. Fifty-nine patients (67%) demonstrated minimal color change, whereas 29 (33%) presented with grayish flecks in the retinal pigment epithelium on fundus photography. All patients with RP sine pigmento had abnormalities on fundus autofluorescence, and the commonest fundus autofluorescence findings were punctate or reticular hypoautofluorescence. Of the 62 patients without pigmentation at the first visit and at the follow-up visits, 14 (22.6%) had developed pigmentation at their follow-up visit, with an average time of 3.92 years. Most patients retained a visual acuity of ≥20/50 within the age of 50 years.

Conclusion:

Diagnosing RP sine pigmento based solely on ophthalmoscopic findings is more difficult than in more typical cases. Multimodal imaging can provide insights into the clinical characteristics to facilitate the diagnosis, classification, and follow-up of patients.
CILIOCHOROIDAL EFFUSION IN CENTRAL SEROUS CHORIORETINOPATHY
Authors: Terao Nobuhiro , Imanaga Naoya , Wakugawa Sorako , Sawaguchi Shota , Tamashiro Tamaki , Yamauchi Yukihide , Koizumi Hideki
Published: December 2021

Purpose:

To investigate the prevalence of ciliochoroidal effusion (CE) in central serous chorioretinopathy (CSC) using anterior-segment optical coherence tomography and its association with the clinical features of CSC.

Methods:

Overall, 164 eyes of 164 patients with CSC and 51 eyes of 51 age- and sex-matched normal control participants were retrospectively examined. Anterior-segment optical coherence tomography was used to assess patients with CSC and control subjects for CE and scleral thickness. Central serous chorioretinopathy eyes were divided into two groups: eyes with CE (CE group) and eyes without CE (non-CE group). Scleral thickness was measured at the point that was 6 mm posterior to the scleral spur in four directions.

Results:

Among the 164 eyes with CSC, 32 eyes (19.5%) displayed CE, and this proportion was significantly higher than that in control subjects (2.0%) (P = 0.001). Scleral thickness was significantly greater in the CE group compared with the non-CE group at all four directions (P < 0.05 for all). Multivariable analysis revealed that the mean scleral thickness (odds ratio: 1.01; 95% confidence interval: 1.00–1.02; P = 0.007) was significantly associated with the incidence of CE.

Conclusion:

Central serous chorioretinopathy may accompany fluid accumulation in the anterior segment more frequently than previously expected in association with thick sclera.