bluuebunny/crossref_metadata_2025 huggingface dataset:
Chapter XVII La Terrasse
Authors: Brontë Charlotte
Published: December 2020

These struggles with the natural character, the strong native bent of the heart, may seem futile and fruitless, but in the end they do good. They tend, however slightly, to give the actions, the conduct, that turn which Reason approves, and which Feeling, perhaps, too...
Chapter XXXIX Old and New Acquaintance
Authors: Brontë Charlotte
Published: December 2020

Fascinated as by a basilisk with three heads, I could not leave this clique; the ground near them seemed to hold my feet. The canopy of entwined trees held out shadow, the night whispered a pledge of protection, and an officious lamp flashed just one...
Chapter VIII Madame Beck
Authors: Brontë Charlotte
Published: December 2020

Being delivered into the charge of the maîtresse, I was led through a long, narrow passage into a foreign kitchen, very clean but very strange. It seemed to contain no means of cooking—neither fireplace nor oven; I did not understand that the great black furnace...
The Professor
Authors: Brontë Charlotte , Smith Margaret
Published: December 2020

The Professor (1845-6), written before Jane Eyre, challenged contemporary expectations of the novel by its brevity, realism, and insistence on a working career both before and after marriage for its hero and heroine. Strikingly up to date for its period, the action begins against a background of the fight for better factory conditions in the 1830s, and finishes in the early 1840s with the spread of liberal ideas which led to the continental revolutions of 1848. This edition is based directly on the author's fair copy manuscript, and also includes 'Emma', Charlotte Brontë's last, unfinished attempt to write a novel after Villette.
The Dead Secret
Authors: Collins Wilkie
Published: December 2020

‘Oh, my God! to think of that kind-hearted, lovely young woman, who brings happiness with her wherever she goes, bringing terror to me! Terror when her pitying eyes look at me; terror when her kind voice speaks to me; terror when her tender hand touches mine!’ Porthgenna Tower on the remote western Cornish coast. Moments before her death, Mrs Treverton dictates a secret to her maid, never to be passed to her husband as she had instructed. Fifteen years later, when Mrs Treverton’s daughter, Rosamond, returns to Porthgenna with her blind husband, Leonard, she is intrigued by the strange and seemingly disturbed Mrs Jazeph’s warning not to enter the Myrtle Room in the ruined north wing. Strong-minded and ingenious, Rosamond’s determined detective work uncovers shocking and unsettling truths beyond all expectation. A mystery of unrelenting suspense and psychologically penetrating characters, The Dead Secret explores the relationship between a fallen woman, her illegitimate daughter, and buried secrets in a superb blend of romance and Gothic drama. Wilkie Collins’s fifth novel, The Dead Secret anticipates the themes of his next novel, The Woman in White in its treatment of mental illness, disguise and deception, and the dispossession of lost identity. Yet a series of comic figures offsets the tension, from the dyspeptic Mr Phippen to the perpetually smiling governess, Miss Sturch. Displaying the talent and energy which made Collins the most popular novelist of the 1860s, The Dead Secret represents a crucial phase in Collins’s rise as a mystery writer, and was his first full-length novel written specifically for serialization.
Thérèse Raquin
Authors: Zola Émile
Published: December 2020

Thérèse Raquin is a clinically observed, sinister tale of adultery and murder among the lower orders in nineteenth-century Paris. Zola's dispassionate dissection of the motivations of his characters, mere ‘human beasts’ who kill in order to satisfy their lust, is much more than an atmospheric Second Empire period-piece. Many readers were scandalized by an approach to character-drawing which seemed to undermine not only the moral values of a deeply conservative society, but also the whole code of psychological description on which the realist novel was based. Together with the important ‘Preface to the Second Edition’ in which Zola defended himself against charges of immorality, Thérèse Raquin stands as a key early manifesto of the French Naturalist movement, of which Zola was the founding father. Even today, this novel has lost none of its power to shock. This new translation is based on the second edition of 1868. The Introduction situates the novel in the context of Naturalism, medicine, and the scientific ideas of Zola's day.
The Awakening
Authors: Chopin Kate
Published: December 2020

‘She wanted to swim far out, where no woman had swum before.’ Kate Chopin was one of the most individual and adventurous of nineteenth-century american writers, whose fiction explored new and often startling territory. When her most famous story, The Awakening, was first published in 1899, it stunned readers with its frank portrayal of the inner word of Edna Pontellier, and its daring criticisms of the limits of marriage and motherhood. The subtle beauty of her writing was contrasted with her unwomanly and sordid subject-matter: Edna’s rejection of her domestic role, and her passionate quest for spiritual, sexual, and artistic freedom. From her first stories, Chopin was interested in independent characters who challenged convention. This selection, freshly edited form the first printing of each text, enables readers to follow her unfolding career as she experimented with a broad range of writing, from tales for children to decadent fin-de siecle sketches. The Awakening is set alongside thirty-two short stories, illustrating the spectrum of the fiction from her first published stories to her 1898 secret masterpiece, ‘The Storm’.
Athénaïse
Authors: Chopin Kate
Published: December 2020

A Story of a Temperament.

I

Athénaïse went away in the morning to make a visit to her parents, ten miles back on rigolet du Bon Dieu.* She did not return in the evening, and Cazeau, her husband, fretted not a little. He...
The Adventures of Sherlock Holmes
Authors: Doyle Arthur Conan
Published: December 2020

The Adventures of Sherlock Holmes is the series of short stories that made the fortunes of the Strand magazine, in which they were first published, and won immense popularity for Sherlock Holmes and Dr Watson. The detective is at the height of his powers and the volume is full of famous cases, including ‘The Red-Headed League’, ‘The Blue Carbuncle’, and ‘The Speckled Band’. Although Holmes gained a reputation for infallibility, Conan Doyle showed his own realism and feminism by having the great detective defeated by Irene Adler - the woman - in the very first story, ‘A Scandal in Bohemia’.
The Mayor of Casterbridge
Authors: Hardy Thomas , Dalziel Pamela
Published: December 2020

‘The woman is no good to me. Who’ll have her?’ Michael Henchard is an out-of-work hay-trusser who gets drunk at a local fair and impulsively sells his wife Susan and baby daughter. Eighteen years later Susan and her daughter seek him out, only to discover that he has become the most prominent man in Casterbridge. Henchard attempts to make amends for his youthful misdeeds but his unchanged impulsiveness clouds his relationships in love as well as his fortunes in business. Although Henchard is fated to be a modern-day tragic hero, unable to survive in the new commercial world, his story is also a journey towards love. This edition is the only critically established text of the novel, based on a comprehensive study of the manuscript and Hardy's extensive revisions.
The Man in the Iron Mask
Authors: Dumas Alexandre
Published: December 2020

One of France's best-selling writers at the time of the novel's composition, Dumas here combines what he considered to be life's essentials – ‘l'action et l'amour’. This historical romance is the climax of his epic of chivalry and valour that began with The Three Musketeers, and it is here that Athos, Porthos, Aramis, and their friend d'Artagnan, once invincible, meet their destinies. This edition provides background information and notes crucial to an understanding of the legend and the novel's setting.
Twenty Years After
Authors: Dumas Alexandre
Published: December 2020

Twenty Years After (1845), the sequel to The Three Musketeers, is a supreme creation of suspense and heroic adventure. Two decades have passed since the musketeers triumphed over Cardinal Richelieu and Milady. Time has weakened their resolve, and dispersed their loyalties. But treasons and strategems still cry out for justice: civil war endangers the throne of France, while in England Cromwell threatens to send Charles I to the scaffold. Dumas brings his immortal quartet out of retirement to cross swords with time, the malevolence of men, and the forces of history. But their greatest test is a titanic struggle with the son of Milady, who wears the face of Evil. In his Introduction to this edition David Coward sets both the author and his exciting tale in their historical and cultural contexts.
Lady Anna
Authors: Trollope Anthony
Published: December 2020

abstract

When it appeared in 1874, Lady Anna met with little success, and positively outraged the conservative - ‘This is the sort of thing the reading public will never stand…a man must be embittered by some violent present exasperation who can like such disruptions of social order as this.’ (Saturday Review) - although Trollope himself considered it ‘the best novel I ever wrote! Very much! Quite far away above all others!!!’ This tightly constructed and passionate study of enforced marriage in the world of Radical politics and social inequality, records the lifelong attempt of Countess Lovel to justify her claim to her title, and her daughter Anna’s legitimacy, after her husband announces that he already has a wife. However, mother and daughter are driven apart when Anna defies her mother’s wish that she marry her cousin, heir to her father’s title, and falls in love with journeyman tailor and young Radical Daniel Thwaite. The outcome is never in doubt, but Trollope’s ambivalence on the question is profound, and the novel both intense and powerful.
Cassy
Authors: Stowe Harriet Beecher
Published: December 2020

“And behold, the tears of such as were oppressed, and they had no comforter; and on the side of their oppressors there was power, but they had no comforter.”—Eccl. 4:1.

It took but a short time to familiarize Tom with all that was to...
A Merry Christmas
Authors: May Alcott Louisa
Published: December 2020

Jo was the first to wake in the gray dawn of Christmas morning. No stockings hung at the fireplace, and for a moment she felt as much disappointed as she did long ago, when her little sock fell down because it was so crammed with...
22 Pleasant Meadows
Authors: May Alcott Louisa
Published: December 2020

Like sunshine after storm were the peaceful weeks which followed. The invalids improved rapidly, and Mr March began to talk of returning early in the new year. Beth was soon able to He on the study sofa all day, amusing herself with the well-beloved cats,...
28 Domestic Experiences
Authors: May Alcott Louisa
Published: December 2020

Like most other young matrons, Meg began her married life with the determination to be a model housekeeper. John should find home a paradise; he should always see a smiling face, should fare sumptuously every day, and never know the loss of a button. She...
Armadale
Authors: Collins Wilkie
Published: December 2020

Armadale tells the devastating story of the independent, murderous, and adulterous Lydia Gwilt. This traditional melodrama also considers the modern theme of the role of women in society.
The Odd Women
Authors: Gissing George
Published: December 2020

`There are half a million more women than men in this unhappy country of ours . . . So many odd women - no making a pair with them.' The idea of the superfluity of unmarried women was one the `New Woman' novels of the 1890s sought to challenge. But in The Odd Women (1893) Gissing satirizes the prevailing literary image of the `New Woman' and makes the point that unmarried women were generally viewed less as noble and romantic figures than as `odd' and marginal in relation to the ideal of womanhood itself. Set in grimy, fog-ridden London, these `odd' women range from the idealistic, financially self-sufficient Mary Barfoot and Rhoda Nunn, who run a school to train young women in office skills for work, to the Madden sisters struggling to subsist in low-paid jobs and experiencing little comfort or pleasure in their lives. Yet it is for the youngest Madden sister's marriage that the novel reserves its most sinister critique. With superb detachment Gissing captures contemporary society's ambivalence towards its own period of transition. The Odd Women is a novel engaged with all the major sexual and social issues of the late-nineteenth century. Judged by contemporary reviewers as equal to Zola and Ibsen, Gissing was seen to have produced an `intensely modern' work and it is perhaps for this reason that the issues it raises remain the subject of contemporary debate.
What Maisie Knew
Authors: James Henry
Published: December 2020

What Maisie Knew (1897) represents one of James's finest reflections on the rites of passage from wonder to knowledge, and the question of their finality. The child of violently divorced parents, Maisie Farange opens her eyes on a distinctly modern world. Mothers and fathers keep changing their partners and names, while she herself becomes the pretext for all sorts of adult sexual intrigue. In this classic tale of the death of childhood, there is a savage comedy that owes much to Dickens. But for his portrayal of the child's capacity for intelligent ‘wonder’, James summons all the subtlety he devotes elsewhere to his most celebrated adult protagonists. Neglected and exploited by everyone around her, Maisie inspires James to dwell with extraordinary acuteness on the things that may pass between adult and child. In addition to a new introduction, this edition of the novel offers particularly detailed notes, bibliography, and a list of variant readings.
The Romance of the Forest
Authors: Radcliffe Ann
Published: December 2020

The Romance of the Forest (1791) heralded an enormous surge in the popularity of Gothic novels, in a decade that included Ann Radcliffe’s later works, The Mysteries of Udolpho and The Italian. Set in Roman Catholic Europe of violent passions and extreme oppression, the novel follows the fate of its heroine Adeline, who is mysteriously placed under the protection of a family fleeing Paris for debt. They take refuge in a ruined abbey in south-eastern France, where sinister relics of the past - a skeleton, a manuscript, and a rusty dagger - are discovered in concealed rooms. Adeline finds herself at the mercy of the abbey’s proprietor, a libidinous Marquis whose attentions finally force her to contemplate escape to distant regions. Rich in allusions to aesthetic theory and to travel literature, The Romance of the Forest is also concerned with current philosophical debate and examines systems of thought central to the intellectual life of late eighteenth-century Europe.
Memoirs of a Woman of Pleasure
Authors: Cleland John
Published: December 2020

Memoirs of a Woman of Pleasure (commonly known as Fanny Hill), the most famous erotic novel in English, was denounced by its author as 'a Book I disdain to defend, and wish, from my soul, buried and forgot'. Cleland's critics too condemned the 'infamous' and 'poisonous' novel when it first appeared in 1748-9. But the proliferation of editions, adaptations, and translations since then bears witness not only to the popularity of scandalous novels, but also to the book's literary merit. Recounted with a lively use of metaphor and some curiously moral asides, Fanny Hill's boisterous education as a London prostitute never quite effaces the ingenuous charm of her country upbringing, and her story places her among the great heroines of eighteenth-century literature.
Melmoth the Wanderer
Authors: Maturin Charles , Baldick Chris
Published: December 2020

abstract

Written by an eccentric Anglican curate, Melmoth the Wanderer (1820) brought the terrors of the Gothic novel to a new fever pitch of intensity. Its tormented villain seeks a victim to release from his fatal pact with the devil, and Maturin’s bizarre narrative structure whirls the reader from rural Ireland to an idyllic Indian island, from a London madhouse to the dungeons of the Spanish inquisition.
Cousin Bette
Authors: Balzac Honoré de , Bellos David
Published: December 2020

Cousin Bette (1846) is considered to be Balzac's last great novel, and a key work in his Human Comedy. Set in the Paris of the 1830s and 1840s, it is a complex tale of the devastating effect of violent jealousy and sexual passion. Against a meticulously detailed backdrop of a post-Napoleonic France struggling with massive industrial and economic change, Balzac's characters span many classes of society, from impoverished workers and wealthy courtesans to successful businessmen and official dignitaries. The tragic outcome of the novel is relieved by occasional flashes of ironic comedy and the emergence of a younger generation which has come to terms with the new political and econimic climate.
The Devil and Other Stories
Authors: Tolstoy Leo
Published: December 2020

‘It is impossible to explain why Yevgeny chose Liza Annenskaya, as it is always impossible to explain why a man chooses this and not that woman.’ This collection of eleven stories spans virtually the whole of Tolstoy's creative life. While each is unique in form, as a group they are representative of his style, and touch on the central themes that surface in War and Peace and Anna Karenina. Stories as different as 'The Snowstorm', 'Lucerne', 'The Diary of a Madman', and 'The Devil' are grounded in autobiographical experience. They deal with journeys of self-discovery and the moral and religious questioning that characterizes Tolstoy's works of criticism and philosophy. 'Strider' and 'Father Sergy', as well as reflecting Tolstoy's own experiences, also reveal profound psychological insights. These stories range over much of the Russian world of the nineteenth century, from the nobility to the peasantry, the military to the clergy, from merchants and cobblers to a horse and a tree. Together they present a fascinating picture of Tolstoy's skill and artistry. ABOUT THE SERIES: For over 100 years Oxford World's Classics has made available the widest range of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, helpful notes to clarify the text, up-to-date bibliographies for further study, and much more.
The Mystery of Edwin Drood
Authors: Dickens Charles
Published: December 2020

Where is my nephew?, asked Mr Jasper, wildly. 'Where is your nephew?' repeated Neveille. 'Why do you ask me?' 'I ask you,' retorted Jasper, 'because you were the last person in his company, and he is not to be found.' The Mystery of Edwin Drood, Dickens's last novel, lay unfinished at his death. Speculation remains rife as to its probably conclusion; evidence suggests that, fascinated as Dickens was by details of the plotting, his basic concern was for character and appropriate setting, in particular the character of the hero-villain, Jasper. The ancient city of Cloisterham, its cathedral a reminder of mortality, human frailty, and the lawful life, is an effective background for what Dickens daughter called a tale of 'the tragic secrets of the human heart'. Humour is provided by a host of characters ranging fro Mr Grewgious, the admirable though eccentric lawyer, and Miss Twinkleton, guardian of the Young Ladies' Seminary, to Durdles, the hard-drinking stonemason, and Deputy, the irreverent lodging-house boy. This edition contains Dickens's working plans for the novel, and the text is that of the authoritative Clarendon edition. ABOUT THE SERIES: For over 100 years Oxford World's Classics has made available the widest range of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, helpful notes to clarify the text, up-to-date bibliographies for further study, and much more.
A Simple Story
Authors: Inchbald Elizabeth , Spencer Jane
Published: December 2020

When Miss Milner announces her passion for her guardian, a Catholic priest, she breaks through the double barrier of religious vocation and society’s standards of ‘proper’ womanly behaviour. Her love is legitimized when Dorriforth is released from his vows, but she finds her own unorthodox nature cannot conform to a marriage where her husband continues to be a stern moral guide. With a surenees of touch that prefigures Jane Austen, Elizabeth Inchbald shows that there is no simple answer to their predicament, and that their conflict can only be resolved in the next generation.
Captains Courageous
Authors: Kipling Rudyard
Published: December 2020

Harvey Cheyne is the over-indulged son of a millionaire. When he falls overboard from an ocean liner he is rescued by a Portuguese fisherman and, initially against his will, joins the crew of the We're Here for a summer. Through the medium of an exciting adventure story, Captains Courageous (1897) deals with a boy who like Mowgli in The Jungle Book, is thrown into an entirely alien environment. The superstitious, magical world of the sea and the tough, orderly, physical world of the boat form a backdrop to Harvey's regeneration. Kipling describes the fascination skills of the schooner fishermen who would soon be made redundant by the twentieth century, and makes the ship function as a convincing model for a society engaged in a difficult and dangerous task. The introduction to this edition examines its place among other maritime novels and among Kipling's own work, and explanatory notes clarify the seafaring terms and historical and geographical references.
Washington Square
Authors: James Henry
Published: December 2020

‘She will do as I have bidden her.’ Catherine Sloper is heiress to a fortune and the social eminence associated with Washington Square. She attracts the attention of a good-looking but penniless young man, Morris Townsend. His suit is encouraged by Catherine's romantically-minded aunt, Mrs Penniman, but her father, a clever physician, is convinced that his motives are merely mercenary. He will not consent to the marriage, regardless of the cost to his daughter. Out of this classic confrontation Henry James fashioned one of his most deftly searching shorter fictions. First published in 1880 but set some forty years earlier in a pre-Civil War New York, the novel reflects ironically on the restricted world in which its heroine is marooned, seating herself at its close ‘for life, as it were’. In his introduction Adrian Poole reflects on the book's gestation and influences, the significance of place, and the insight with which the four prinicipal players are drawn. The edition includes an account of the real-life tale that sparked James's imaginative genius.
Evolutionary Writings
Authors: Darwin Charles
Published: December 2020

‘Man still bears in his bodily frame the indelible stamp of his lowly origin.’ On topics ranging from intelligent design and climate change to the politics of gender and race, the evolutionary writings of Charles Darwin occupy a pivotal position in contemporary public debate. This volume brings together the key chapters of his most important and accessible books, including the Journal of Researches on the Beagle voyage (1845), the Origin of Species (1871), and the Descent of Man, along with the full text of his delightful autobiography. They are accompanied by generous selections of responses from Darwin’s nineteenth-century readers from across the world. More than anything, they give a keen sense of the controversial nature of Darwin’s ideas, and his position within Victorian debates about man’s place in nature. The wide-ranging introduction by James A. Secord, Director of the Darwin Correspondence Project, explores the global impact and origins of Darwin’s work and the reasons for its unparalleled significance today.
The Sorrows of Young Werther
Authors: Goethe Johann Wolfgang von
Published: December 2020

‘I have so much and my feeling for her devours everything, I have so much and without her everything is nothing.’ The Sorrows of Young Werther propelled Goethe to instant fame when it first appeared in 1774. Goethe drew on his own unhappy experiences to tell the story of Werther, a young man tormented by his love for Lotte, a tender-hearted girl who is promised to someone else. Overwhelmed by his feelings, Werther begins to see only one way to escape from his anguish. Goethe's story of a sensitive young artist alienated from society channelled the Romantic sensibility of the day and led to a wave of imitations. Werther's searching introspection and the passionate intensity with which he bares his soul have an immediacy that is all the more powerful for being expressed in letters; charting the course of his emotions, they give added drama to the unfolding account. David Constantine's new translation captures the novel's lyric clarity, and his introduction and notes illuminate Goethe's achievement.
An Enquiry Concerning Political Justice
Authors: Godwin William
Published: December 2020

‘To a rational being there can be but one rule of conduct, justice, and one mode of ascertaining that rule, the exercise of his understanding.’ Godwin’s Political Justice is the founding text of philosophical anarchism. Written in the immediate aftermath of the French Revolution, it exemplifies the political optimism felt by many writers and intellectuals. Godwin drew on enlightenment ideas and his background in religious dissent for the principles of justice, utility, and the sanctity of individual judgement that drove his powerful critique of all forms of secular and religious authority. He predicts the triumph of justice and equality over injustice, and of mind over matter, and the eventual vanquishing of human frailty and mortality. He also foresees the gradual elimination of practices governing property, punishment, law, and marriage and the displacement of politics by an expanded personal morality resulting from reasoned argument and candid discussion. Political Justice raises deep philosophical questions about the nature of our duty to others that remain central to modern debates on ethics and politics. This edition reprints the first-edition text of 1793, and examines Godwin’s evolving philosophy in the context of his life and work.
The Conquest of Plassans
Authors: Zola Émile , McGuinness Patrick
Published: December 2020

‘Abbé Faujas has arrived!’ The arrival of Abbé Faujas in the provincial town of Plassans has profound consequences for the community, and for the family of François Mouret in particular. Faujas and his mother come to lodge with François, his wife Marthe, and their three children, and Marthe quickly falls under the influence of the priest. Ambitious and unscrupulous, Faujas gradually infiltrates into all quarters of the town, intent on political as well as religious conquest. Intrigue, slander, and insinuation tear the townsfolk apart, creating suspicion and distrust, and driving the Mourets to ever more extreme actions. The fourth novel in Zola's Rougon-Macquart sequence, The Conquest of Plassans returns to the fictional Provençal town from which the family sprang in The Fortune of the Rougons. In one of the most psychological of his novels, Zola links small-town politics to the greater political and national dramas of the Second Empire.
The Water -Babies
Authors: Kingsley Charles , Douglas-Fairhurst Robert
Published: December 2020

‘This is all a fairy tale…and, therefore, you are not to believe a word of it, even if it is true.’ The Water-Babies (1863) is one of the strangest and most powerful children's stories ever written. In describing the underwater adventures of Tom, a chimney-sweeper's boy who is transformed into a water-baby after he drowns, Charles Kingsley combined comic fantasy and moral fable to extraordinary effect. Tom's encounters with friendly fish, curious lobsters, and characters such as Mrs Doasyouwouldbedoneby are both an exciting fairy tale and a crash course in evolutionary theory. They also reflect the quirky imagination of one of the great Victorian eccentrics. Tom's adventures are constantly interrupted by Kingsley's sideswipes at contemporary issues such as child labour and the British education system, and they offer a rich satiric take on the great scientific debates of the day. This edition reprints the original complete version of the story, and includes a lively introduction, detailed explanatory notes, and an appendix that reprints Kingsley's first attempt to describe the mysterious creatures that live under the sea.
Sentimental Education
Authors: Flaubert Gustave
Published: December 2020

‘For certain men the stronger their desire, the less likely they are to act.’ With his first glimpse of Madame Arnoux, Frédéric Moreau is convinced he has found his romantic destiny, but when he pursues her to Paris the young student is unable to translate his passion into decisive action. He also finds himself distracted by the equally romantic appeal of political action in the turbulent years leading up to the revolution of 1848, and by the attractions of three other women, each of whom seeks to make him her own: a haughty society lady, a capricious courtesan, and an artless country girl. Flaubert offers a vivid and unsparing portrait of the young men of his generation, struggling to salvage something of their ideals in a city where corruption, consumerism, and a pervasive sense of disenchantment undermine all but the most compromised erotic, aesthetic, and social initiatives. Sentimental Education combines thoroughgoing irony with an impartial but unexpectedly intense sympathy in a novel whose realism competes with that of Balzac and whose innovations in narrative plot and perspective mark a turning-point in the development of literary modernism.
Increased proportion of comorbidities but no deterioration of sexual quality of life during a 5-year follow-up in patients with axial spondyloarthritis in the biologic treatment era
Authors: Berg Kari Hansen , Rohde Gudrun , Pripp Are , Prøven Anne , Pirelli Benestad Esben Ester , Østensen Monika , Haugeberg Glenn
Published: December 2020

Objective

To explore patient perception of sexual quality of life (SQOL), an important category of QOL, in male and female patients with axial SpA (axSpA) after a 5 year follow-up.

Methods

A broad spectrum of demographic, disease-related, treatment and SQOL data was collected at baseline and at the 5 year follow-up. SQOL was assessed by the SQOL-Female (SQOL-F) questionnaire. For statistical analysis, McNemar’s tests, paired t-tests and multiple regression analyses were applied.

Results

A total of 245 axSpA patients (168 men and 77 women) from outpatient clinics were examined (mean age 46 years, mean disease duration 11.9 years at baseline). Compared with baseline, the patients had lower CRP, lower Maastricht Ankylosing Spondylitis Enthesitis Scores, lower BASFI scores, less use of smoking and significantly more patients were treated with biologic DMARDs at the 5 year follow-up. Patient perception of SQOL was basically unchanged at the 5 year follow-up despite a significantly increased proportion of comorbidities, including cardiovascular, endocrine and gastrointestinal disease. A decrease in SQOL after 5 years was observed only in patients exercising <1 h/week at baseline (P = 0.048) and in patients >65 years old.

Conclusion

In our axSpA patients, no statistically significant changes in SQOL were observed over 5 years, despite a significant increase in comorbidities. Overall disease symptoms decreased, indicating better disease control. Increased use of biologic drugs at the 5 year follow-up may have contributed to this favourable outcome.
Analysis of Pathogen Distribution and Its Antimicrobial Resistance in Bloodstream Infections in Hospitalized Children in East China, 2015–2018
Authors: Wang Cuicui , Hao Wei , Yu Ruihua , Wang Xiaokang , Zhang Jing , Wang Bo
Published: December 2020

This study analyzed the pathogen distribution in bloodstream-infected (BSI) children hospitalized in Shandong Province from 2015 to 2018, to identify prevention strategies and select empiric antimicrobial therapy for BSI in children. Blood sample data from 14 107 children from 162 hospitals of Shandong Province were obtained from the China Antimicrobial Resistance Surveillance System and analyzed with WHONET 5.6 software. The results of the blood culture test showed the growth of 70.6% Gram-positive and 29.4% Gram-negative bacteria. Of the 14 107 blood isolates, 59.3% were collected from males and 40.7% were from females. Coagulase-negative staphylococci (47.1%) were the most commonly distributed pathogens. The distribution of pathogens varied according to age group and season. All Staphylococcus isolates were susceptible to vancomycin, teicoplanin and linezolid. Clinically, significant declines in penicillin-resistant Streptococcus pneumonia and carbapenem-resistant Escherichia coli were observed during the study period; however, detection rates of carbapenem-resistant Klebsiella pneumoniae increased over time (p < 0.05). Empiric antimicrobial therapy should be prescribed according to corresponding regional pediatric antimicrobial-resistant data.
Effect of Continuing Professional Development on Health Professionals’ Performance and Patient Outcomes: A Scoping Review of Knowledge Syntheses
Authors: Samuel Anita , Cervero Ronald M. , Durning Steven J. , Maggio Lauren A.
Published: December 2020

Purpose

Continuing professional development (CPD) programs, which aim to enhance health professionals’ practice and improve patient outcomes, are offered to practitioners across the spectrum of health professions through both formal and informal learning activities. Various knowledge syntheses (or reviews) have attempted to summarize the CPD literature; however, these have primarily focused on continuing medical education or formal learning activities. Through this scoping review, the authors seek to answer the question, What is the current landscape of knowledge syntheses focused on the impact of CPD on health professionals’ performance, defined as behavior change and/or patient outcomes?

Method

In September 2019, the authors searched PubMed, Embase, CINAHL, Scopus, ERIC, and PsycINFO for knowledge syntheses published between 2008 and 2019 that focused on independently practicing health professionals and reported outcomes at Kirkpatrick’s level 3 and/or 4.

Results

Of the 7,157 citations retrieved from databases, 63 satisfied the inclusion criteria. Of these 63 syntheses, 38 (60%) included multicomponent approaches, and 29 (46%) incorporated eLearning interventions—either standalone or in combination with other interventions. While a majority of syntheses (n = 42 [67%]) reported outcomes affecting health care practitioners’ behavior change and/or patient outcomes, most of the findings reported at Kirkpatrick level 4 were not statistically significant. Ten of the syntheses (16%) mentioned the cost of interventions though this was not their primary focus.

Conclusions

Across health professions, CPD is an umbrella term incorporating formal and informal approaches in a multicomponent approach. eLearning is increasing in popularity but remains an emerging technology. Several of the knowledge syntheses highlighted concerns regarding both the financial and human costs of CPD offerings, and such costs are being increasingly addressed in the CPD literature.
Seizures
Authors: Hessler Amy , Dolbec Katelyn
Published: December 2020

Epilepsy is a common disease that affects 1.5 million women of childbearing age in the United States. Approximately 24,000 women with epilepsy give birth each year. The challenges for women with epilepsy extend from menarche to postmenopause, including prepregnancy, pregnancy, intrapartum and postpartum periods, menopause, and postreproductive age. The most up-to-date neurology and epilepsy guidelines provided in this monograph will enable obstetrician–gynecologists to provide care to women with this complex condition across the life span.
Histopathologic Spectrum of Morphea
Authors: Chiu Yvonne E. , Abban Cynthia Y. , Konicke Kathryn , Segura Annette , Sokumbi Olayemi
Published: December 2020

Morphea is an autoimmune skin disease with protean clinical manifestations. Histologic features are similarly variable, and skin biopsies may be nondiagnostic. A single-institution retrospective cohort study was conducted. Morphea patients who had a biopsy in 2005–2015 were included, and a histopathological review was conducted by 2 pathologists. There were 51 biopsy specimens from 40 subjects. The most common histologic features were dermal sclerosis (90%), dermal thickening (78%), collagen homogenization (86%), a superficial and deep infiltrate (76%), a moderate–abundant inflammatory infiltrate (73%), and periadnexal fat loss/decreased skin appendages (71%). Twenty-four specimens were not diagnostic of morphea. In these specimens, the main clues to diagnosis included the presence of dermal sclerosis (79%), subtle collagen homogenization (75%), dermal thickening (58%), moderate-to-abundant plasma cells (50%), and perineural inflammation (50%). There were no statistically significant differences between active and inactive lesions, nor untreated and treated lesions. The histopathologic features of morphea are variable and a high proportion of biopsies are not diagnostic. Clinicians and pathologists should have a high degree of suspicion to correctly make the diagnosis of morphea.
Treatment of gestational trophoblastic disease in the 2020s
Authors: Clark James J. , Slater Susanna , Seckl Michael J.
Published: December 2020

Purpose of review

This review demonstrates the evidence for new systemic anticancer treatments and how they integrate within conventional management for gestational trophoblastic neoplasia (GTN). We present the evidence on atypical placental site nodules, and how they incorporate within the GTN spectrum, as well as updates regarding GTN staging and follow-up.

Recent findings

First-line treatment for GTN still lies in conventional chemotherapy, although the introduction of anti-PD1/PD-L1 immune checkpoint inhibitors has shown significant promise in management of relapsed disease, with responses reported in multiple relapsed choriocarcinomas as well as epithelioid trophoblastic tumours and placental site trophoblastic tumours (ETT/PSTT). Following completion of treatment, ETT/PSTT still require life-long surveillance but for other GTN, no recurrences have been detected after 7 years.

Checkpoint inhibitors are likely to play an increasing role in the future management of GTN management. Further refinement of prognostic factors to identify those most at risk of GTN recurrence is warranted so that surveillance can be focussed on those most at risk, whilst minimizing unnecessary intervention for those at lower risk.
Early Complications With Preloaded Descemet Membrane Endothelial Keratoplasty Are Not Dependent on Optisol-GS Washout or Trypan Blue Restaining
Authors: Greenwald Miles F. , Nanji Afshan A. , Clements John L. , Stutzman Richard D. , Stoeger Christopher G. , Chamberlain Winston D.
Published: December 2020

Purpose:

To describe the intraoperative and early postoperative complications using preloaded Descemet membrane endothelial keratoplasty (DMEK) grafts with intraocular injection of the graft in Optisol-GS and omission of trypan blue restaining.

Methods:

This is a retrospective case series of 132 consecutive eyes with Fuchs endothelial dystrophy or endothelial failure who underwent DMEK using preloaded donor tissue prepared as previously described. The graft was not restained with trypan blue by the surgeon, and Optisol-GS was injected with the graft into the eye instead of being rinsed from the injector. Early postoperative complications (0–8 wk) including intraoperative fibrin formation, intraocular inflammation, elevated intraocular pressure, partial graft detachment requiring rebubble, and early graft failure were recorded.

Results:

No eyes developed intraoperative fibrin formation or postoperative inflammation (such as toxic anterior segment syndrome) or elevated intraocular pressure. For eyes with Fuchs corneal dystrophy, our rebubble rate was 21% (22/106 eyes). Early graft failure was noted in 2% (3/132 eyes), which is similar to previous reports.

Conclusions:

Our results suggest that injection of Optisol-GS into the anterior chamber during DMEK graft injection does not lead to increases in intraoperative or early postoperative complications. Trypan blue restaining is not necessary for intraoperative visualization. This simplification can reduce graft manipulation and save time and resources for this procedure.
Omega-3 fatty acids and human skeletal muscle
Authors: Ferguson Emily J. , Seigel Joel W. , McGlory Chris
Published: December 2020

Purpose of review

To examine recent findings related to the influence of omega-3 (ω-3) fatty acid supplementation on skeletal muscle anabolism with a particular focus on situations of skeletal muscle disuse.

Recent findings

Skeletal muscle disuse results in a reduction in fed and fasted rates of skeletal muscle protein synthesis leading to the loss of skeletal muscle mass. Recent evidence has suggested that supplementation with ω-3 fatty acids during a period of skeletal muscle disuse increases the ω-3 fatty acid composition of skeletal muscle membranes, heightens rates of skeletal muscle protein synthesis, and protects against skeletal muscle loss. The protective effects of ω-3 fatty acids towards skeletal muscle during disuse appear to be related to changes in mitochondrial bioenergetics suggesting crosstalk between mitochondria and the regulation of skeletal muscle protein synthesis.

ω-3 fatty acid ingestion is a potential preventive therapy to combat skeletal muscle-disuse atrophy but additional, appropriately powered randomized controlled trials are now needed in a range of populations before firm conclusions can be made.
The N6-methyladenosine RNA modification in acute myeloid leukemia
Authors: Yankova Eliza , Aspris Demetrios , Tzelepis Konstantinos
Published: December 2020

Purpose of review

In recent years, the N6-methyladenosine (m6A) modification of RNA has been shown to play an important role in the development of acute myeloid leukemia (AML) and the maintenance of leukemic stem cells (LSCs). In this review we summarise the recent findings in the field of epitranscriptomics related to m6A and its relevance in AML.

Recent findings

Recent studies have focused on the role of m6A regulators in the development of AML and their potential as translational targets. The writer Methyltransferase Like 3 and its binding partner Methyltransferase Like 14, as well as the reader YTH domain-containing family protein 2, were shown to be vital for LSC survival, and their loss has detrimental effects on AML cells. Similar observations were made with the demethylases fat mass and obesity-associated protein and AlkB homologue 5 RNA demethylase. Of importance, loss of any of these genes has little to no effect on normal hemopoietic stem cells, suggesting therapeutic potential.

The field of epitranscriptomics is still in its infancy and the importance of m6A and other RNA-modifications in AML will only come into sharper focus. The development of therapeutics targeting RNA-modifying enzymes may open up new avenues for treatment of such malignancies.
Kidney and pancreas transplant candidacy
Authors: Regmi Surakshya , Rattanavich Rungwasee , Villicana Rafael
Published: December 2020

Purpose of review

Kidney and/or pancreas transplantation candidacy criteria have evolved significantly over time reflecting improved pre and post-transplant management. With improvement in medical care, potential candidates for transplant not only are older but also have complex medical issues. This review focuses on the latest trends regarding candidacy for kidney and/or pancreas transplantation along with advances in pretransplant cardiac testing.

Recent findings

More candidates are now eligible for kidney and/or pancreas transplantation owing to less stringent candidacy criteria especially in regards to age, obesity, frailty and history of prior malignancy. Pretransplant cardiovascular assessment has also come a long way with a focus on less invasive strategies to assess for coronary artery disease.

Criteria for kidney and/or pancreas transplantation are expanding. Patients who in the past might have been declined because of numerous factors are now finding that transplant centers are more open minded to their candidacy, which could lead to better access to organ transplant wait list.
A Retrospective Study and Literature Review of Cervical Villoglandular Adenocarcinoma: A Candidate Paradigm of Silva System Pattern A
Authors: Zhang Yixuan , Wang Yuxiang , Liu Yan , Yang Jing , Liu Congrong
Published: December 2020

The aim was to investigate the clinicopathologic characters of cervical villoglandular adenocarcinoma (VGA), the authors retrospectively reviewed 4 cases of VGA, including clinical characteristics, pathology, managements, together with outcome information. The median age of the patients was 42 (range: 37 to 58), with 3 of them presenting with stage IB disease and 1 presenting with IVB. Human papillomavirus infection was tested in 3 of the patients, with all positive with high-risk type. Three of the patients underwent a radical hysterectomy with bilateral salpingo-oophorectomy plus bilateral pelvic lymphadenectomy, and 2 of them underwent subsequent chemotherapy. One patient received a bilateral salpingo-oophorectomy plus pelvic and periaortic lymphadenectomy and postoperative radiochemotherapy. Lymph node metastasis was detected in 1 patient. The follow-up time ranged from 56 to 120 months (median: 70 mo). Except for 1 person who experienced recurrence, all patients are alive at present and no recurrence occurred. In conclusion, VGA is a rare subtype of adenocarcinoma of the uterine cervix with distinct exophytic, villous-papillary growth pattern and extremely excellent prognosis, which corresponds with pattern A in Silva system, while its underlying mechanism and genetic background is still far from well known.
Utilization of Imaging in the Management of Pediatric Dog Bites
Authors: Borg Breanna A. , Kato Patrick J. , Donoghue Lydia , Shanti Christina M.
Published: December 2020

Introduction

We hypothesized that imaging is overused in the initial workup of dog bite patients. To reduce radiation exposure, we aim to determine which circumstances surrounding dog bites, patient population, and injury patterns would necessitate imaging studies for management.

Methods

A retrospective review was performed on all patients presenting with dog bites to our level I pediatric trauma center between 2013 and 2015. Data collected included: circumstances surrounding the injury, patient demographics, injuries, and imaging studies performed. Our analysis focused on maxillofacial and head CT scans, and plain radiographic studies of the limbs, hands, and feet. Imaging studies were considered positive if there was evidence of bony injury.

Results

We identified 615 patients with dog bites, with 114 patients having had at least one imaging study performed (a total of 145 imaging studies to analyze). Only 13 (11%) patients had a positive study. In the CT scan group, 6 (22.2%) of 27 studies were positive. In the plain radiographic group, 7 (5.9%) of 118 studies were positive.

Conclusions

Our review indicates that imaging studies are overused in the initial workup of these patients, and the majority of these studies are negative. This study confirms that it is feasible to institute guidelines for ordering imaging studies in dog bite patients. This will ultimately reduce radiation exposure and the cost of care for these injuries.