bluuebunny/crossref_metadata_2025 huggingface dataset:
The Definition of a Legal Dilemma
Authors: Jeutner Valentin
Published: September 2017

The first part answers the book’s first question: ‘What is a Legal Dilemma?’ It frames the book’s analysis by offering a stipulative definition of the term legal dilemma and its constitutive components as a term of art. Once defined, the term will then be distinguished from numerous related concepts (Section A), such as legal gaps, disagreements, or paradoxes. The first part also considers various circumstances, including international law’s non-hierarchical nature and fragmentation, which increase the potential frequency with which dilemmas may arise (Section B). Finally, this part introduces a distinction between dilemmas responding to epistemic undecidability and to metaphysical undecidability (Section C).
Human Rights and International Humanitarian Law Breaches Attributable to International Organizations
Authors: Ferstman Carla
Published: September 2017

The chapter considers how to determine whether a particular internationally wrongful act is attributable to an international organization, or another actor under international law. It considers the circumstances in which international organizations may breach the human rights and international humanitarian law obligations that they are bound to respect and incur liability in the case of a breach. It also considers when the conduct amounting to a breach is an act of the organization for the purposes of assigning responsibility. It analyses the framework for the attribution of responsibility set out in the Draft Articles on the Responsibility of International Organizations.
Adjudication before Regional and International Courts
Authors: Ferstman Carla
Published: September 2017

International and regional courts provide a degree of oversight over the conduct of international organizations. In some instances, these courts have played an important, albeit indirect role in assessing the validity of international organization conduct in the course of proceedings against States, which has had a modest influence on the procedures of universal international organizations. Regional courts have also played an important role in assessing the acts of regional integration organizations, although the limited personal and subject matter jurisdiction of many of such courts has limited their capacity to adjudicate claims concerning organizations’ human rights and international humanitarian law breaches. There is no international court with a mandate to adjudicate claims brought by individuals concerning the acts of international organizations.
The Direct Responsibility of Organization Employees, Contractors, and Troop Contingents
Authors: Ferstman Carla
Published: September 2017

Organization employees, experts on mission, contractors, and troop contingents may have direct responsibility for wrongful acts. This is stressed in the commentary to Article 66 of the Draft Articles on the Responsibility of International Organizations, which underscores that if the conduct of an individual is attributed to an international organization or a State, this does not exempt that person from the individual criminal responsibility that he or she may incur for his or her conduct. The chapter explores the challenges to pursue civil and criminal remedies against individuals and the role played by international organizations to help secure that responsibility.
Some Concluding Thoughts—Where the Solutions Lie
Authors: Ferstman Carla
Published: September 2017

In this concluding chapter, the main themes of the book are drawn together and several of the key areas where changes might be made are explored. International organizations have progressively begun to recognize that they are obligated to respect human rights and international humanitarian law in the course of their operations. However, there has been a failure to accept the consequences of such obligations; there is a need for international organizations to recognize that the secondary rules pertaining to reparation are applicable automatically upon a breach of a primary obligation, and that they are obligated to put in place the structures to enable those secondary rules to be enforced. There is a need to strengthen oversight structures, improve the access to, and scope of, internal adjudicative mechanisms and accord standing to individuals to pursue international claims against international organizations.
Foreign Banks in the Crisis
Authors: Epstein Rachel A.
Published: September 2017

One reason governments have protected their banks from foreign ownership is that they feared foreign-owned banks would “cut and run”—i.e. abandon their host markets—in a financial crisis. An unexpected finding of this chapter, however, is that while foreign banks’ commitments to host markets have indeed been fleeting in crises, those commitments were weakest when the relationship between foreign banks and host markets was not characterized by ownership. Thus it was foreign ownership through a “second home market” model and bank subsidiaries during the acute phase of the US financial crisis (2008–9) that saved East Central Europe from economic catastrophe. In Western Europe, meanwhile, where foreign bank ownership levels were low but cross-border lending was significant, bank lending retreated behind national borders. This chapter also rejects the argument that the Vienna Initiative, a voluntary bank rollover agreement, compelled foreign-owned banks to maintain their exposures in East Central Europe.
Evo-Devo and the Structure(s) of Evolutionary Theory
Authors: Love Alan C.
Published: September 2017

Many researchers have argued that evolutionary developmental biology (evo-devo) constitutes a challenge to standard evolutionary theory, requiring the explicit inclusion of developmental processes that generate variation and attention to organismal form (rather than adaptive function). An analysis of these developmental-form challenges indicates that the primary concern is not the inclusion of specific content but the epistemic organization or structure of evolutionary theory. Proponents of developmental-form challenges favor moving their considerations to a more central location in evolutionary theorizing, in part because of a commitment to the value of mechanistic explanation. This chapter argues there are multiple legitimate structures for evolutionary theory, instead of a single, overarching or canonical organization, and different theory presentations can be understood as idealizations that serve different investigative and explanatory goals in evolutionary inquiry.
Toward a Nonidealist Evolutionary Synthesis
Authors: Newman Stuart A.
Published: September 2017

The received model of evolution sees all inherited features resulting from deterministic networks of interacting genes, implying that living systems are reducible to information in genetic programs. The model requires these programs and their associated phenotypes to have evolved by an isotropic search process occurring in gradual steps with no preferred morphological outcomes. The alternative is to recognize that clusters and aggregates of cells, the raw material of evolution, constitute middle-scale material systems. This implies the necessity of bringing the modern physics of mesoscale matter into the explanatory framework for the evolution of development. The relevant, often nonlinear, physical processes were mobilized at the inception of the phyla when their signature morphological outcomes first appeared and remain as efficient causes, albeit transformed, in present-day embryos. This physicogenetic perspective reengages with concepts of saltation, orthogenesis, and environment-induced plasticity long excluded from evolutionary theory.
“Chance Caught on the Wing”
Authors: Walsh Denis M.
Published: September 2017

Jacques Monod’s Chance and Necessity poses a paradox for modern biology: Organisms both must be and cannot be purposive systems. To resolve the paradox we must explain purpose by appeals to invariance or invariance by appeal to purpose. The methodology of modern science, however, allows no unreduced appeals to purpose. Monod traces the modern synthesis commitment to ineluctable chance back to its animadversion to teleology. He credits the pre-Socratic Atomist philosopher Democritus with holding that everything in the world is the fruit of chance and necessity. It is becoming increasingly obvious that their purposiveness is pivotal to the dynamics of evolution. This chapter outlines a ‘neo-Aristotelian’ alternative to the neo-Democritean commitments of modern synthesis biology, one that accords the purposiveness of organisms a central explanatory role in evolution.
Introduction: Challenging the Modern Synthesis
Authors: Walsh Denis M. , Huneman Philippe
Published: September 2017

The modern evolutionary synthesis arose out of the conjunction of the Mendelian theory of inheritance and the neo-Darwinian theory of population change early in the 20th century.1 In the nearly 100 years since its inception, the modern evolutionary synthesis has grown to encompass practically all fields of comparative biology—ecology, ethology, paleontology, systematics, cell biology, physiology, genetics, development. Theodosius Dobzhansky’s dictum—“nothing in biology makes sense except in the light of evolution” (...
Russia, Chechnya, and the Geneva Conventions, 1994–2006
Authors: Kramer Mark
Published: September 2017

This chapter discusses Russia’s position vis-à-vis the four Geneva Conventions of 1949 and the two Additional Protocols of 1977 and the implications for the two wars fought by Russian troops against separatist guerrillas in Chechnya in 1994–2006. The chapter begins by tracing the Soviet Union’s policies toward the Conventions and Additional Protocols and the effects (or lack thereof) of these documents on Soviet military operations both abroad and at home from the late 1940s through the early 1990s. The experience with the Conventions and Additional Protocols during the Soviet era has helped to shape the policies of the Russian Federation, which, as the legal successor state to the USSR, inherited the Soviet government’s obligations under international treaties and agreements. The chapter highlights the changes and continuities in post-Soviet Russia’s position and then uses the recent Russian-Chechen wars as a case study.
Conversations with the Living and the Dead
Authors: Ashe Laura
Published: September 2017

This chapter considers the ways in which ideas permeated and changed society over time, through mechanisms that cannot directly be seen in the literary record. It seeks to adumbrate the vibrant oral culture of the period by tracing the movement of ideas between texts, contexts and audiences, using romances, lyrics, sermons, devotional works, anecdotes and proverbs, and accounts of legal cases. Extended discussions are offered of the figure of King Arthur in the Latin of Geoffrey of Monmouth, French of Wace, and English of Laȝamon; the Marian lament at the Passion, in Latin and its French and later English translations; the early Middle English religious lyric; the Mirror of the Church in Latin, French, and English; the South English Legendary, and several other texts.
Ireland
Authors: Barnard Toby
Published: September 2017

This chapter examines the efforts to export Anglicanism to Ireland, with the successes and failures. It considers the extent to which the Irish version diverged from the English one, and the distinctive traits that it developed. It also looks at the Anglican responses to the Roman Catholic Church, which enjoyed the support of over 75 per cent of the population, as well as the growing challenges from Presbyterianism, Methodism, the Quakers, and other Protestant Dissenters. A particularly divisive issue was the attitude to be adopted towards using the Irish language in instruction and evangelization. It concludes that, despite the failure to establish itself as the Church of a majority of the Irish, the Church of Ireland could minister effectively to a minority, composed mostly of those descended from Protestant settlers from England, Scotland, and Wales.
The Church of England and the Churches of Europe
Authors: Claydon Tony
Published: September 2017

In the period 1662–1829 the Church of England saw itself simultaneously as a national Church for England, as a branch of the European Protestant Reformation, and as a part of a community of Churches across the continent. These identities caused tensions by suggesting different answers to the question of who were true Christians abroad. Anglicans might feel affinities both with Roman Catholic establishments and with the Protestant populations who challenged them. These tensions were managed in part by ambiguity and a determination not to press one identity too hard at the expense of others. This allowed the Church to maintain strong links with a wide variety of the faithful overseas. But tensions were also managed by an increasing spirit of accommodation. Both the Toleration Act of 1689 and the eventual emancipation of Dissenters and Catholics were aided by the struggles of the Church to contain its own internal diversity.
Anglicanism and Methodism
Authors: Wilson David R.
Published: September 2017

This chapter examines the complex relationship between Anglicanism and Methodism. Revising the view that Methodism was an ever-separating movement, this chapter contends that the eighteenth-century Church of England was a varied body, with myriad challenges which it confronted through the maintenance of a pastoral ideal, lived out ‘on the ground’ by the parish clergy. The industrializing parish of Madeley, Shropshire (where the incumbent from 1760 to 1785 was the Revd John William Fletcher), is used as a case study. Together with Madeley, other examples of dutiful and evangelically minded clergy who utilized the experimental religion and religious irregularities often associated with Methodists or Dissenters, are surveyed. The chapter concludes that Fletcher and many evangelically minded Anglican-Methodist clergy found the Church of England sufficiently strong and flexible enough to do the work of the Church rigorously and creatively, and that Methodism could serve as a means of Anglican pastoral success.
The Regress and the Duplication Argument
Authors: Textor Mark
Published: September 2017

Brentano held that perceiving and awareness of perceiving are not two distinct mental acts, but one. This view is not intuitively plausible. The chapter assesses in detail Brentano’s main argument—the Duplication Argument—for this view. It starts by considering predecessors of Brentano’s version of the argument in Aristotle and Hamilton and then moves on to Brentano’s version. Brentano’s Duplication Argument does not assume that awareness of mental acts is a propositional attitude. Because of this Brentano’s Duplication Argument is more promising than its predecessors. The chapter also makes clear why it is implausible to credit Brentano with the Infinite Regress Argument.
One Act, Several Conceptual Parts
Authors: Textor Mark
Published: September 2017

The chapter clarifies the conclusion of Brentano’s Duplication Argument. On Brentano’s view, a conscious mental act is directed on two objects, one of them being the act itself, but its plural reference is primitive, not due to the fact that the mental act has parts which each have reference on their own. Because of the plural reference the act can be brought under different partial concepts that are arrived at by abstraction. Brentano’s view is compared with contemporary versions of self-representationalism and shown not to admit of higher orders, double presentations, or indirect presentation of complexes. Brentano’s Duplication Argument makes plausible that awareness of perceiving can’t be such a complex that integrates independently existing mental acts; instead one simple act can have multiple objects.
A Relation ‘that relates itself to itself’, Some Regress Threats, and a Mystery
Authors: Textor Mark
Published: September 2017

Brentano’s metaphysics of consciousness faces several questions: Can a relation be self-relating without leading to counter-intuitive consequences? Has the vicious regress of conscious-making acts really been stopped by Brentano’s theory or is there a revenge regress? In this chapter I answer these questions on Brentano’s behalf. I will assess Gurwitsch’s argument against Brentano and argue that it shows that one of Gurwitsch’s premises is wrong, not that there is a new regress for Brentano. Pothast also does not show that there is a regress threat for Brentano because Brentano does not, as Pothast claims, hold that the secondary presentation presents itself as a presentation of itself. A similar criticism applies to Frank’s attempt to show that Brentano is open to a regress threat. The chapter concludes by investigating what distinguishes conscious and unconscious mental acts, and why and how self-referentiality makes for consciousness.
Attention, Adumbration, and a Neglected Mark of the Mental
Authors: Textor Mark
Published: September 2017

Brentano never investigated whether the ‘peculiar feature’ of inner perception—that it can never become inner observation—that distinguishes our awareness of the mental from other forms of perceptual awareness could serve as the mark of the mental. However, his students Stumpf and Husserl developed marks of the mental that are inspired by this idea. The chapter clarifies Husserl’s Thesis that mental phenomena have no appearances, argues that it is superior to Brentano’s Thesis, and defends it against objections from Reinach and Husserl himself. Husserl himself threw out the baby with the bathwater when he later rejected Husserl’s Thesis. A precisified form of this idea can still unify our intuitions about the mental.
The Intentionality of Enjoyment
Authors: Textor Mark
Published: September 2017

Brentano sees a very close relation between enjoyment and perceptual consciousness. Enjoying an activity is, Brentano proposed, an intuitive model of awareness of an activity. The chapter outlines the Aristotelian background of Brentano’s view of enjoyment, highlighting four suggestions Aristotle made about pleasure. I will assess Brentano’s arguments for the view that the proper objects of enjoyment are only activities (Hedonic Energism), and defend this view against the claims of the Hedonic Objectivists and Subjectivists. In order to understand Brentano’s development of Hedonic Energism, as well as the range of alternatives, we need to take into account that ‘enjoy’ is a polysemous word. Since there is a basic sense of ‘enjoy’ in which we can truly say that we enjoy activities, I conclude that Hedonic Energism is defensible.
The Structure of Enjoyment
Authors: Textor Mark
Published: September 2017

If the objects of enjoyment are activities such as listening, isn’t enjoyment a higher-order mental act? If it is, how can this be squared with Brentano’s (plausible) claims that we take sensory pleasure in physical phenomena? In response to these questions I develop Brentano’s same-order view of enjoyment. Brentano conceptualizes the fact that neither enjoyment nor enjoyed activity are attended to with his notion of a secondary object: both smelling and enjoyment are secondary objects of the act. The question of whether Brentano had two different views of enjoyment, first one that allows for enjoyment of physical phenomena and then later a Higher-Order View of enjoyment, is also addressed. Sensory enjoyment turns out to be a multiple relation to several objects. The assumption that there is only one object of sensory enjoyment is therefore unfounded.
The Cultural Psychology of Globalization
Authors: Bhatia Sunil
Published: September 2017

In this chapter, an interdisciplinary lens is used to examine the contested and multiple meanings, references, and definitions of globalization that vary across the different disciplines of political science, geography, cultural studies, economics, and sociology. It is argued that the lives of Indian youth comprise an important story of our time—a story that remains largely invisible and neglected in psychology. There are huge swathes of Indian urban youth who are experiencing conflicting meanings about their gender roles, marriage, sexual practices, filial obligations, household responsibilities, and child care duties. This chapter shows how contemporary forms of globalization practices, structures, and discourses occur through neoliberalism and the ways in which new urban spaces and identities are being reconfigured. It specifically examines how global and transnational Indianness is constructed in the semiotics and spaces of urban malls and through Indo-German cultural exchange programs.
Emotional Impact of End-of-Life Decisions on Professional Relationships in the ICU: An Obstacle to Collegiality?*
Authors: Laurent Alexandra , Bonnet Magalie , Capellier Gilles , Aslanian Pierre , Hebert Paul
Published: September 2017

Objectives:

End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU.

Design:

Qualitative study with clinical interviews. All interviews were transcribed verbatim and analyzed thematically using interpretative phenomenological analysis.

Setting:

Two independent ICUs at the “Centre Hospitalier de l’Université de Montréal.”

Subjects:

Ten physicians and 10 nurses.

Interventions:

None.

Measurements and Main Results:

During the end-of-life decision-making process, families and patients restructure the decision-making frame by introducing a strong emotional dimension. This results in the emergence of new challenges quite different from the immediacy often associated with intensive care. In response to changes in decision frames, physicians rely on their relationship with the patient’s family to assist with advanced care decisions. Nurses, however, draw on their relationship and proximity to the patient to denounce therapeutic obstinacy.

Conclusions:

Our study suggests that during the end-of-life decision-making process, nurses’ feelings toward their patients and physicians’ feelings toward their patients’ families influence the decisions they make. Although these emotional dimensions allow nurses and physicians to act in a manner that is consistent with their professional ethics, the professionals themselves seem to have a poor understanding of these dimensions and often overlook them, thus hindering collegial decisions.
SELF-INFLICTED LASER HANDHELD LASER-INDUCED MACULOPATHY: A NOVEL OCULAR MANIFESTATION OF FACTITIOUS DISORDER
Authors: Rabiolo Alessandro , Sacconi Riccardo , Giuffrè Chiara , Corbelli Eleonora , Carnevali Adriano , Querques Lea , Sarraf David , Freund K. Bailey , Sadda SriniVas , Bandello Francesco , Querques Giuseppe
Published: September 2017

Purpose:

To report a case of factitious self-inflicted handheld laser-induced maculopathy.

Methods:

A 29-year-old man presented to our clinic complaining of a step-wise progressive loss of vision that abruptly began in his left eye but then became bilateral. He underwent comprehensive ocular examination, including visual acuity testing, biomicroscopic, dilated funduscopic examination, structural optical coherence tomography, en face structural optical coherence tomography, optical coherence tomography angiography, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography.

Results:

Visual acuity was 20/200 in both eyes. Although the multimodal imaging was highly consistent with handheld laser-induced maculopathy, the patient continued to deny this behavior.

Conclusion:

Self-inflicted handheld laser-induced maculopathy may be a novel manifestation of factitious disorder. Clinical suspicion for this should remain high in the presence of the signature multimodal retinal findings despite denial by the patient. This category of patients could benefit from psychiatric referral, to prevent further ocular or extra-ocular self-injury.
Scabies, Periorbital Cellulitis and Recurrent Skin Abscesses due to Panton-Valentine Leukocidin-Positive Staphylococcus aureus Mimic Hyper IgE Syndrome in an Infant
Authors: Krüger Renate , Hanitsch Leif G. , Leistner Rasmus , Schneider-Burrus Sylke , Hoppe Pia-Alice , Steinberg Sylvia , Hauck Fabian , von Bernuth Horst
Published: September 2017

We describe the clinical course of a 2-month-old infant who was evaluated for autosomal dominant Hyper IgE Syndrome based on eczema, periorbital cellulitis, skin abscesses, increased total IgE levels and blood eosinophilia. However, scabies and nasal colonization by Panton-Valentine Leucocidin-positive S. aureus were eventually diagnosed. After specific treatment, the child was asymptomatic.
Discussing Benefits and Risks of Tracheostomy: What Physicians Actually Say*
Authors: Hebert Lauren M. , Watson Anne C. , Madrigal Vanessa , October Tessie W.
Published: September 2017

Objectives:

When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel’s recommendations for what should be presented.

Design:

We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children. A multicenter, multidisciplinary expert panel of clinicians was surveyed to generate a list of recommended benefits and risks for comparison. Primary analysis of statements by clinicians was qualitative.

Setting:

Single-center PICU of a tertiary medical center.

Subjects:

Family members who participated in family-physician conferences regarding tracheostomy placement for a critically ill child from April 2012 to August 2014.

Measurements and Main Results:

We identified 300 physician statements describing benefits and risks of tracheostomy. Physicians were more likely to discuss benefits than risks (72% vs 28%). Three broad categories of benefits were identified: 1) tracheostomy would limit the impact of being in the PICU (46%); 2) perceived obstacles of tracheostomy can be overcome (34%); and 3) tracheostomy optimizes respiratory health (20%). Risks fell into two categories: tracheostomy involves a big commitment (71%), and it has complications (29%). The expert panel’s recommendations were similar to risks and benefits discussed during family conferences; however, they suggested physicians present an equal balance of discussion of risks and benefits.

Conclusions:

When discussing tracheostomy placement, physicians emphasized benefits that are shared by physicians and families while minimizing the risks. The expert panel recommended a balanced approach by equally weighing risks and benefits. To facilitate educated decision making, physicians should present a more extensive range of risks and benefits to families making this critical decision.
Neck Surgery Under Local Anesthesia
Authors: Obradovic Bojan
Published: September 2017

The value of local anesthesia (LA) is widely recognized in oral and maxillofacial surgery. Many procedures can be performed with the use of local anesthetic alone, instilled at or near the site of surgery.

The author presents a patient with neck tumor, where the tumor removal was managed under LA at outpatient clinic. Treatment and postoperative period was routine.

Neck surgery under LA in outpatient environment shows a great potential in adequately selected patients.
The Pierre Robin Mandible is Hypoplastic and Morphologically Abnormal
Authors: Zellner Elizabeth G. , Reid Russell R. , Steinbacher Derek M.
Published: September 2017

Background:

For Pierre Robin sequence (PRS) patients, there is incomplete characterization of 3D differences and effects of mandibular distraction osteogenesis (MDO) on the mandible compared to normal controls.

Methods:

PRS infants who underwent MDO at 2 craniofacial referral centerals with pre- and postoperative computed tomography (CT) scans were identified. A group of age-matched control patients with CTs were identified in the PACS database. Demographic and perioperative data were recorded. Mandibular lengths, angles, and volumes were measured. Morphologic and outcomes data were analyzed in a case-control comparison.

Results:

Sixty-three CT scans were analyzed. Fifteen pre-op PRS patient and 15 control CTs were well matched in terms of age and sex. Mandibular volume (78%), ramus length (87%), and body length (95%) were all decreased in the PRS patients. Anterior symphyseal angle (84%) was significantly reduced in PRS patients while mandibular angle (102%) was maintained. Eighteen post-op PRS patient and 15 control CTs were well matched in terms of age and gender. Mandibular volumes (106%) were normalized following distraction with shorter mandibular rami (88%) and longer mandibular bodies (109%). Postoperatively, mandibular angle (100%) and anterior symphyseal angle (99%) were ultimately indistinguishable from controls.

Conclusions:

The mandible in PRS is dysmorphic compared to age-matched controls. Overall, they have a smaller volume, shorter ramus, and an obtuse symphyseal angle. MDO improves mandibular volume and normalizes the symphyseal angle, but results in a longer mandibular body and shorter mandibular ramus.
Progress on Botulinum Toxin Type A-Induced Pain Relief in the Field of Plastics
Authors: Lu Xiaona , Chen Guocheng , Ren Pengjie , Yang Yan , Fan Fei
Published: September 2017

Objective:

To retrospectively evaluate the effectiveness of Botulinum Toxin Type A (BTX-A) injections relieve pain in the field of plastic surgery and postoperative rehabilitation, and discuss the analgesic mechanism of BTX- A in plastics and related research progress.

Methods:

From appearance to September 1, 2016, PUBMED, EMBASE, and Web of Science were searched, using the key words related to “Botulinum Toxin Type A” and “Pain.” Furtherly, nonplastic surgery-related literature was excluded by manual screening.

Results:

Eleven literatures met the inclusion criteria, including 6 prospective controlled cohorts, 4 patient series, and 1 retrospective cohort. These studies involved Lower Limb, Breast, Hallux, Amputees, and Temporomandibular joint disk disfigurement and enrolled 402 patients. Among the patients, 360 received intraoperative BTX-A injection at the time of the main surgical procedure, 16 injected postoperatively and 26 did not undergo surgery. And 85.32% reported pain alleviation and 69.96% got favorable side effects and no one occurred major adverse effects. But 1.83% accepted injections more than once. Mechanism analysis explained these studies’ results and demonstrated the analgesic effectiveness of BTX-A in plastics with nociceptive pain, inflammatory pain, and neuropathic pain.

Conclusion:

The results suggest that BTX-A may induce postoperative pain associated with plastic surgeries relief. But the available data of outcome assessment involved in this review are inconsistent and failed to meet methodological rigor. And pain alleviations are influenced by many factors. So further randomized controlled clinical trials with large sample sizes are needed to support this practice, determine standard usage methods, and establish corresponding specification systems.
The Effect of Dexpanthenol-Vitamin A (Nazalnem) on Silastic Splints After Nasal Septal Surgery
Authors: Yildirim Güven , Kumral Tolgar Lütfi , Altindağ Cem , Özdemir Erdi , Uyar Yavuz
Published: September 2017

Objective:

To investigate the effect of dexpanthenol-vitamin A (Nazalnem) ointment applied to the surface of silastic splints with an airway immediately after nasal septal surgery on postoperative complaints and nasal mucosa function.

Materials and Methods:

The study enrolled 60 patients undergoing nasal septoplasty surgery. Group 1 (n = 30) received silastic splints with ointment containing dexpanthenol-vitamin A (Nazalnem), and Group 2 (n = 30), the control group, received silastic splints with vaseline. Of these patients, 2 patients from the Group 1 and 9 from the Group 2 were excluded.

A thin layer of ointment was applied to the flat side of a silastic splint with an airway. The splints were removed on the second postoperative day. Patients were evaluated preoperatively and 1 and 2 weeks postoperatively using a visual analog scale and the Sino-Nasal Outcome test (SNOT-22). Mucociliary clearance (MCC) tests were performed at the same times.

Results:

Visual analog scale for nasal crusting, nasal congestion, and foul odor was better in Group 1 than in Group 2 both at 1 week and at 2 weeks postoperatively (P < 0.05).

The SNOT scores were significantly lower in Group 1 than in Group 2 at 1 week (P < 0.01), but did not differ at 2 weeks postoperatively (P > 0.05).

Postoperatively, the MCC were insignificant between the groups and within the groups at 1 and 2 weeks (P > 0.05).

Conclusion:

Although Dexpanthenol-Vitamin A ointment had no direct effect on wound healing, it had significant effects on crusting, obstruction, and foul smell. However, silastic splints with dexpanthenol did not improve the MCC of the nose.
Mandibular Condyle Reconstruction With Fibula Free-Tissue Transfer: The Role of the Masseter Muscle
Authors: Gravvanis Andreas , Anterriotis Dimitrios , Kakagia Despoina
Published: September 2017

Background:

Free fibula flap is an option for primary restoration after disarticulation mandibular resection, though literature on technique refinements is scarce. The authors hypothesized that inset of the masseter, the key mandibular elevator muscle, at the reconstructed mandible may optimize functional recovery.

Methods:

All patients undergoing reconstruction of mandibulectomy–condylectomy defect (January 2009 to January 2014) by means of a fibular flap were prospectively studied. The neocondyle was formed by the distal portion of the fibula and placed directly into the glenoid fossa with preservation of the temporomandibular disc. The deep portion of the masseter was inset at the angle of the reconstructed mandible.

Condylar position was postoperatively evaluated by panoramic radiographs. Patients self-evaluated speech, chewing, swallowing, and facial appearance.

Results:

Two patients had immediate and 3 delayed reconstruction involving condyle ramus body, in the study period. During a mean follow-up of 32 months, 4 patients had satisfactory occlusion, 1 patient had an open-bite deformity, but was able to masticate solid food and maintain an oral diet. Although no significant condyle dislocation was recorded, 2 patients had slight ipsilateral deviation on mouth opening. Nevertheless, cosmesis was satisfactory and all patients maintained intelligible speech. Functional score was 13.6 ± 1.14 and facial appearance score was 4 ± 0.7.

Conclusion:

The free fibula transfers with direct seating of the fibula into the condylar fossa followed by masseter muscle reinsertion provides acceptable functional reconstruction of the mandibulectomy–condylectomy defect.
Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort
Authors: Schauer Daniel P. , Feigelson Heather Spencer , Koebnick Corinna , Caan Bette , Weinmann Sheila , Leonard Anthony C. , Powers J. David , Yenumula Panduranga R. , Arterburn David E.
Published: September 2017

Objective:

To determine whether bariatric surgery is associated with a lower risk of cancer.

Background:

Obesity is strongly associated with many types of cancer. Few studies have examined the relationship between bariatric surgery and cancer risk.

Methods:

We conducted a retrospective cohort study of patients undergoing bariatric surgery between 2005 and 2012 with follow-up through 2014 using data from a large integrated health insurance and care delivery systems with 5 study sites. The study included 22,198 subjects who had bariatric surgery and 66,427 nonsurgical subjects matched on sex, age, study site, body mass index, and Elixhauser comorbidity index. Multivariable Cox proportional-hazards models were used to examine incident cancer up to 10 years after bariatric surgery compared to the matched nonsurgical patients.

Results:

After a mean follow-up of 3.5 years, we identified 2543 incident cancers. Patients undergoing bariatric surgery had a 33% lower hazard of developing any cancer during follow-up [hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.60, 0.74, P < 0.001) compared with matched patients with severe obesity who did not undergo bariatric surgery, and results were even stronger when the outcome was restricted to obesity-associated cancers (HR 0.59, 95% CI 0.51, 0.69, P < 0.001). Among the obesity-associated cancers, the risk of postmenopausal breast cancer (HR 0.58, 95% CI 0.44, 0.77, P < 0.001), colon cancer (HR 0.59, 95% CI 0.36, 0.97, P = 0.04), endometrial cancer (HR 0.50, 95% CI 0.37, 0.67, P < 0.001), and pancreatic cancer (HR 0.46, 95% CI 0.22, 0.97, P = 0.04) was each statistically significantly lower among those who had undergone bariatric surgery compared with matched nonsurgical patients.

Conclusions:

In this large, multisite cohort of patients with severe obesity, bariatric surgery was associated with a lower risk of incident cancer, particularly obesity-associated cancers, such as postmenopausal breast cancer, endometrial cancer, and colon cancer. More research is needed to clarify the specific mechanisms through which bariatric surgery lowers cancer risk.
Pervasive epistasis modulates neurodevelopmental defects of the autism-associated 16p11.2 deletion
Authors: Iyer Janani , Singh Mayanglambam Dhruba , Jensen Matthew , Patel Payal , Pizzo Lucilla , Huber Emily , Koerselman Haley , Weiner Alexis T. , Lepanto Paola , Vadodaria Komal , Kubina Alexis , Wang Qingyu , Talbert Abigail , Yennawar Sneha , Badano Jose , Manak J. Robert , Rolls Melissa M. , Krishnan Arjun , Girirajan Santhosh
Published: September 2017

As opposed to syndromic CNVs caused by single genes, extensive phenotypic heterogeneity in variably-expressive CNVs complicates disease gene discovery and functional evaluation. Here, we propose a complex interaction model for pathogenicity of the autism-associated 16p11.2 deletion, where CNV genes interact with each other in conserved pathways to modulate expression of the phenotype. Using multiple quantitative methods inDrosophilaRNAi lines, we identified a range of neurodevelopmental phenotypes for knockdown of individual 16p11.2 homologs in different tissues. We tested 565 pairwise knockdowns in the developing eye, and identified 24 interactions between pairs of 16p11.2 homologs and 46 interactions between 16p11.2 homologs and neurodevelopmental genes that suppressed or enhanced cell proliferation phenotypes compared to one-hit knockdowns. These interactions within cell proliferation pathways were also enriched in a human brain-specific network, providing translational relevance in humans. Our study indicates a role for genetic interactions within CNVs and identifies potential therapeutic targets for neurodevelopmental disorders.
Acute Social Stress Engages Synergistic Activity of Stress Mediators in the VTA to Promote Pavlovian Reward Learning
Authors: Tovar-Diaz Jorge , Pomrenze Matthew B. , Pahlavan Bahram , Kan Russell , Drew Michael R. , Morikawa Hitoshi
Published: September 2017

Stressful events rapidly trigger activity-dependent synaptic plasticity in certain brain areas, driving the formation of aversive memories. However, it remains unclear how stressful experience affects plasticity mechanisms to regulate learning of appetitive events, such as intake of addictive drugs or palatable foods. Using rats, we show that two acute stress mediators, corticotropin-releasing factor (CRF) and norepinephrine (NE), enhance plasticity of NMDA receptor-mediated glutamatergic transmission in the ventral tegmental area (VTA) through their differential effects on inositol 1,4,5-triphosphate (IP)-dependent Ca2+signaling. In line with this, acute social defeat stress engages convergent CRF and NE signaling in the VTA to enhance learning of cocaine-paired cues. Furthermore, defeat stress enables learning of a food-paired cue with no delay between the cue onset and food delivery. We propose that acute stress mediators synergistically regulate IP3-Ca2+signaling in the VTA to promote appetitive Pavlovian conditioning, likely enabling learning of cues with no predictive value.
Quantification of anti-parasite and anti-disease immunity to malaria as a function of age and exposure
Authors: Rodriguez-Barraquer Isabel , Arinaitwe Emmanuel , Jagannathan Prasanna , Kamya Moses R , Rosenthal Philip J. , Rek John , Dorsey Grant , Nankabirwa Joaniter , Staedke Sarah G. , Kilama Maxwell , Drakeley Chris , Ssewanyana Isaac , Smith David L , Greenhouse Bryan
Published: September 2017

Malaria immunity is complex and multi-faceted, and fundamental gaps remain in our understanding of how it develops. Here, we use detailed clinical and entomological data from three parallel cohort studies conducted across the malaria transmission spectrum in Uganda to quantify the development of immunity against symptomaticPlasmodium falciparumas a function of age and transmission intensity. We focus on: anti-parasite immunity (i.e; ability to control parasite densities) and anti-disease immunity (i.e; ability to tolerate higher parasite densities without fever). Our findings suggest a strong effect of age on both types of immunity, that remains significant after adjusting for cumulative exposure. They also show a non-linear effect of transmission intensity, where children experiencing the lowest transmission appear to develop immunity faster than those experiencing higher transmission. These findings illustrate how anti-parasite and anti-disease immunity develop in parallel, reducing the probability of experiencing symptomatic malaria upon each subsequentP. falciparuminfection.
Genetic drivers of repeat expansion disorders localize to 3-D chromatin domain boundaries
Authors: Sun James , Zhou Linda , Emerson Daniel J. , Gilgenast Thomas G. , Titus Katelyn , Beagan Jonathan A. , Phillips-Cremins Jennifer E.
Published: September 2017

More than 25 inherited neurological disorders are caused by the unstable expansion of repetitive DNA sequences termed short tandem repeats (STRs). A fundamental unresolved question is why specific STRs are susceptible to unstable expansion leading to severe pathology, whereas tens of thousands of normal-length repeat tracts across the human genome are relatively stable. Here, we unexpectedly discover that nearly all STRs associated with repeat expansion diseases are located at boundaries demarcating 3-D chromatin domains. We find that boundaries exhibit markedly higher CpG island density compared to loci internal to domains. Importantly, disease-associated STRs are specifically localized to ultra-dense CpG island-rich boundaries, suggesting that these loci might be hotspots for epigenetic instability and topological disruption upon unstable expansion. In Fragile X Syndrome, mutation-length expansion at theFmr1gene results in severe disruption of the boundary between TADs. Our data uncover higher-order chromatin architecture as a new dimension in understanding the mechanistic basis of repeat expansion disorders.
Functional Brain Network Estimation with Time Series Self-scrubbing
Authors: Li Weikai , Qiao Lishan , Wang Zhengxia , Shen Dinggang
Published: September 2017

Functional brain network (FBN) has been becoming an increasingly important measurement for exploring the cerebral working mechanism and mining informative biomarkers for assisting diagnosis of some neurodegenerative disorders. Despite its potential performance in discovering the valuable patterns hidden in the brains, the estimated FBNs are often heavily influenced by the quality of the observed data (e.g., BOLD signal series). In practice, a preprocessing pipeline is usually employed for improving the data quality prior to the FBN estimation; but, even so, some data points in the time series are still not clean enough, possibly including original artifacts (e.g., micro head motion), non-resting functional disturbing (e.g., mind-wandering), and new “noises” caused by the preprocessing pipeline per se. Therefore, not all data points in the time series can contribute to the subsequent FBN estimation. To address this issue, in this paper, we propose a novel FBN estimation method by introducing a latent variable as an indicator of the data quality, and develop an alternating optimization algorithm for scrubbing the data and estimating FBN simultaneously in a single framework. As a result, we can obtain more accurate FBNs with the self-scrubbing data. To illustrate the effectiveness of the proposed method, we conduct experiments on two publicly available datasets to identify mild cognitive impairment (MCI) patients from normal control (NC) subjects based on the estimated FBNs. Experimental results show that the proposed FBN modelling method can achieve higher classification accuracy, significantly outperforming the baseline methods.
TMS SMART – Scalp Mapping of Annoyance Ratings and Twitches caused by Transcranial Magnetic Stimulation
Authors: Meteyard Lotte , Holmes Nicholas
Published: September 2017

The magnetic pulse generated during Transcranial magnetic stimulation [TMS] also stimulates cutaneous nerves and muscle fibres, with the most commonly reported side effect being muscle twitches and sometimes painful sensations. These sensations affect behaviour during experimental tasks, presenting a potential confound for ‘online’ single-pulse TMS studies. Our objective was to systematically map the degree of disturbance (ratings of annoyance, pain, and muscle twitches) caused by TMS at 43 locations across the scalp. Ten participants provided ratings whilst completing a choice reaction time task, and ten participants provided ratings whilst completing a ‘flanker’ reaction time task. TMS over frontal and inferior regions resulted in the highest ratings of annoyance, pain, and muscle twitches caused by TMS. In separate analyses we predicted the difference in reaction times (RT) under TMS by scalp location and subjective ratings. Frontal and inferior scalp locations showed the greatest cost to RTs under TMS (i.e., slowing), with midline sites showing no or minimal slowing. Increases in subjective ratings of disturbance predicted longer RTs under TMS. Critically, ratings were a better predictor of the cost of TMS than scalp location or scalp-to-cortex distance, and the more difficult ‘flanker’ task showed a greater effect of subjective disturbance. The peripheral sensations and discomfort caused by TMS pulses significantly and systematically influence RTs during single-pulse, online TMS experiments. We provide the data as an online resource (www.tms-smart.info) so that researchers can select control sites that account for the level of general interference in task performance caused by online single-pulse TMS.