bluuebunny/crossref_metadata_2025 huggingface dataset:
France, Italy, and Spain
Authors: Auby Jean-Bernard
Published: March 2021

This chapter compares the respective answers that are provided by the French, Italian, and Spanish systems of administrative liability at two levels. The first one concerns the foundations of present public liability law in the three countries. It considers both constitutional and legislative provisions concerning substance and the rules governing process; that is, administrative appeals and judicial review. The second level is that of the answers given to a range of basic options, including whether liability is imposed on the basis of illegality, with or without wrongdoing, and which type of compensation can be obtained by claimants.
France and the United Kingdom
Authors: Harlow Carol
Published: March 2021

This chapter compares the respective answers of the English and French systems of administrative liability within a wider comparative study that focuses on outcomes. The chapter is in three parts. It first looks briefly at the constitutional and cultural framework in which the rules operate. In France, we find a separate system of administrative courts which handle all questions relating to the administration, including liability, and which have built a sophisticated public law system of non-contractual liability. In the UK, where all questions of liability go to the ‘ordinary’ civil courts, the law is uncodified, and there are gaps in the liability principles. The chapter then looks at basic principles. In France, where the dominant principle is faute de service public, the courts also acknowledge a no-fault principle. In the UK, the strongest form of redress is strict liability for assault, battery, and false imprisonment, but the dominant principle is negligence, and a public authority must owe a duty of care to the claimant to be held liable. In the final part, the chapter answers specific liability questions, making the point that it is often hard to get redress for economic loss. Claimants often fail to get redress for wrongful failures to grant licences or exercise a discretion or statutory power.
Austria, Germany, and Switzerland
Authors: Zumbini Angela Ferrari , Pfersmann Otto
Published: March 2021

This chapter intends to shed light on commonalities and distinctive features of public authority liability in Austria, Germany, and Switzerland. In the first part, background commonalities and background distinctive traits are illustrated, together with the relevant Constitutional provisions. In the second part, a comparative analysis is carried out considering the answers given in the three countries. In particular, the chapter is focused on three kind of administrative action that can cause damages, ie authoritative decisions such as sanctions; the withdrawal of a former benefit; and a physical act. In the third part, the comparative analysis is carried out on cross-cut issues, considering institutional choices. The analysis shows that the outcome may well differ, considering not only the conditions for recognizing damages and their amount, but also for the primacy of alternative remedies, ie annulment.
The Administration and the Judge: Pragmatism in Belgian Case Law (1890–1910)
Authors: Marique Yseult
Published: March 2021

Analysing the administrative case law of the Belgian Supreme Court between 1890 and 1910, this chapter shows that the Supreme Court applied the main features of a positivist legal thought (based on the assumption of clarity, coherence, and completeness of the formal law) to administrative action and its legality. It equipped the central and local institutions of the State with functioning powers, allowing an operational state to develop despite social unrest. As the social and technological context changed at the end of the nineteenth century, the statute book became more confused, however. This gave the Supreme Court ample room to interpret the law creatively and pragmatically. The ‘administrative miracle’ in Belgium is that the Supreme Court did not shackle social forces and unbridle the administration so much that the very course it wanted to avert actually happened. This may be down to the creative judicial genius that the Belgian judiciary developed a formal approach whilst deciding pragmatically on the substance of cases.
Standards of Judicial Review of Administrative Action (1890–1910) in the German Empire
Authors: Weidemann Lilly
Published: March 2021

This chapter examines the administrative jurisdiction of selected states of the German Empire—Baden, Prussia, Württemberg, Bavaria, and Saxony—between 1890 and 1910. A short description of the development of administrative jurisdiction in the German Empire is followed by an overview of the courts included in the analysis and the applicable legislation. The analysed case law covers cases of exclusion of judicial protection (in particular discretionary decisions), questions of admissibility of actions, and procedural constraints. It is highlighted which procedural requirements were considered as ‘essential’ by the courts (eg the right to be heard) with the consequence that their violation would result in an annulment of the decision of the authority and which formal irregularities were deemed irrelevant.
The De Facto Authority of the Caribbean Court of Justice at the Intersection of Trade Liberalisation and Fundamental Rights
Authors: Caserta Salvatore
Published: March 2021

This chapter deals with the trajectory of gaining de facto authority of the Caribbean Court of Justice (CCJ), showing how, in its first fifteen years, the Court has been relatively successful as it achieved both narrow and intermediate authority in both its jurisdictions. The chapter shows how this authority was mostly due to several institutional choices of the part of the Court’s founders and to some bold—yet well-balanced—rulings of the Court, which contributed to overcoming the Caribbean legal elites’ initial lack of trust. The progressive expansion of the Court’s authority occurred mainly in matters relating to individual and fundamental rights (i.e. on death penalty issues and freedom of movement of individuals within the Caribbean Common Market (CARICOM)), while it struggled to move beyond a basic form of authority on trade-related matters. This variable authority of the CCJ proves to be grounded in the operational context of the Court. The most notable difficulties faced were the lack of interest of the business community in judicial solutions, the limited powers granted by the CARICOM Secretariat to file non-compliance cases before the Court, and the reluctance of national judges to engage in a constructive dialogue with their regional counterparts through the medium of the preliminary reference procedure.
The Challenged and Challenging De Facto Authority of the Central American Court of Justice at the Intersection of Pacification, International Law, and Regionalism
Authors: Caserta Salvatore
Published: March 2021

This chapter deals with the trajectory of gaining de facto authority of the Central American Court of Justice (CACJ), showing how, different from the Caribbean Court of Justice (CCJ), this Court has thus far failed to leave a significant mark in its operational context. In its early years, the Court fared rather well, especially in terms of its capacity to build a system of community law and to address some institutional difficulties of the Central American Integration System (SICA). However, when the Court became involved with several highly political disputes (i.e. a political clash between two former Nicaraguan Presidents and some territorial disputes among its Member States) in the early 2000s, it encountered strong resistance from several actors in its context of operation. As in the analysis of the CCJ, this chapter explains the fluctuation of the CACJ’s authority by looking at the role played by various contextual factors such as the institutional conflicts between the various organs of Central American integration, the highly polarised national politics of some of the Court’s Member States, and the divergent professional interests of the Central American legal elites.
‘It Is Not the Homosexual Who Is Perverse’
Authors: Griffiths Craig
Published: March 2021

This chapter explores the complex transition from ‘homophile’ to ‘gay’ politics in the early 1970s, particularly focusing on conflicts over Rosa von Praunheim’s film, It Is Not the Homosexual Who Is Perverse, but the Society in Which He Lives—screened on national television in January 1973. The chapter demonstrates that homosexual politics, especially in this early period of gay liberation, between 1969 and 1973, were exceedingly fraught, and cannot be reduced to a simple story of generational conflict between ‘reformist’ or ‘integrationist’ homophiles versus ‘leftist’ or ‘radical’ gays. These debates were not just about what homosexuals thought and felt about wider society, but were informed by what that society thought and felt about them. Through the case study of the furore over Praunheim’s film, this chapter therefore also reveals the ambivalence of the wider public and the liberal media to the early claims of gay liberation.
The Pink Triangle
Authors: Griffiths Craig
Published: March 2021

This chapter is about how the memory of persecution decisively shaped 1970s homosexual politics. First, the chapter explores the ‘rediscovery’ of the Nazi persecution of homosexuals, explaining how the model of the Holocaust was sometimes appropriated as part of this process. The chapter then shows how memory of this persecution, combined with the experience of contemporary discrimination, produced a profound alienation on the part of left-wing gay men from the West German state. Following an analysis of how the pink triangle became a transnational symbol, this chapter evaluates discourses of victimhood in gay liberation. Though the pink triangle was reclaimed from its origins as a badge of shame in the concentration camps, it never became an unequivocal symbol of pride. Finally, the chapter explores how, in the late 1970s, activists of all stripes, the commercial gay press, and the first openly gay parliamentary candidates coalesced around making the history of past persecution a central plank in their efforts to insert themselves into the West German mainstream.
Is It Rational to Be Moral?
Authors: Nichols Shaun
Published: March 2021

Why should all rational agents be moral? This is one ancient and challenging question about moral motivation. But there is another perhaps more tractable question about moral motivation. Why as a matter of fact are most of us motivated by moral considerations? What is it about the kind of creature I am that inclines me to be moral? Moral judgments (e.g. that it’s right to give to a certain charity) seem to be directly motivating. This chapter argues that even non-moral normative judgments often are directly motivating. A primary form of rule representation automatically carries with it motivation force.
Thinking, Understanding, and Knowing
Authors: Ingram Jenni
Published: March 2021

Classrooms are all about thinking, knowing, and understanding. Epistemic issues are at the core of classroom interactions, yet teachers and students, as well as researchers, can treat knowing, thinking, and understanding in very different ways. Claims and demonstrations of knowing or understanding can achieve different actions in classroom interaction, which result in different meanings for what it means to know mathematics or understand mathematics in different classrooms. This negotiation of mathematical knowing or understanding is a theme of classroom interaction that needs further exploration.
Introduction
Authors: Gibson William
Published: March 2021

The introduction develops the idea of the ‘long Revolution’, suggesting that the Glorious Revolution of 1688-9 was not simply an event, but a much longer process. This process began at the start of James II’s reign and continued until about 1720 when the Hanoverian regime was settled. For High Church Tories, like Samuel Wesley, this period presented problems and anxieties that had to be dealt with. Foremost among these was allegiance and loyalty, both in Church and State. However, after 1689 the issue was complicated by the Toleration Act and the decisions of the Church in how to respond to legal freedom for dissenters. A political complication was the division of the clergy into High and Low Churchmen, as well as attempts in Parliament and Convocation to proscribe Dissent. Samuel Wesley’s response to these circumstances was representative of many others who shared his views and his anxieties in this period were those which were more widely held.
Samuel Wesley’s Conformity in 1684
Authors: Gibson William
Published: March 2021

This chapter explores Samuel Wesley’s decision to abandon his family’s commitment to Dissent and conform to the Church of England around 1684. Wesley was raised in a Dissenting family and educated at a Dissenting academy. His decision to conform to the Church of England was therefore surprising and there have been a number of explanations for it. This chapter explores the range of motives for Wesley’s decision and presents new evidence for the reasons for this decision. The decision was undoubtedly influenced by the desire to go to the University of Oxford. Other accounts have suggested that Wesley was unhappy with the attitudes of his fellow students at the dissenting academy he attended, and that he had developed a strong commitment to the idea of Charles I as a martyr. He may also have attended Oxford with the intention to remain a Dissenter but gradually found himself drawn to the Church of England. Other influences may have been his future wife, Susanna, who had conformed at the age of twelve.
Tories, Whigs, Dissenters, and Debt in 1705
Authors: Gibson William
Published: March 2021

Chapter 4 considers one of the best-known episodes in Wesley’s life, his poverty and imprisonment for debt in 1705. He was arrested and held in Lincoln Gaol. It argues that the case against Wesley was not simply one of financial mismanagement. Rather, Wesley was also the victim of a Whig conspiracy to punish him for his politics and his rancorous attacks on Dissenters. This happened during heightened tension between the Whigs and the Tories during the general election of 1705—itself caused by the attempt to pass the Occasional Conformity Bill to relieve Dissenters. It also shows how Tories, especially in Oxford, rallied to raise money to help secure his release from gaol. In particular, Arthur Charlett, Master of University College and Archdeacon John Hutton collaborated to bring Wesley’s predicament to the attention of the university as a means to raise the concerns of Tory clergy in the country.
Making Deep History
Authors: Gamble Clive
Published: March 2021

The time revolution of 1859 changed forever the relationship between humans and time. In the space of a calendar year, and at a furious pace, the belief that all human history could be fitted into 6,000 years was shattered. The evidence for such a fundamental change was small, handheld stone tools found in the gravel quarries of the Somme among the bones of ancient animals. The task facing the antiquarian and the geologist was formidable. The tools had to be accepted as artificial and their association with extinct animals demonstrated beyond doubt. The successful proof, made on 27 April 1859, opened up ‘a vast lapse of ages’ for human history and led Charles Darwin to declare it ‘the most interesting subject which Geology has turned up for many a long year’. This book explores the time revolution through the Victorian world of two businessmen and a banker: John Evans, Joseph Prestwich, and John Lubbock. It draws in their sisters, wives and households and their scientific collaborators—Darwin, Falconer, Lyell, Huxley, and the French antiquary Boucher de Perthes. It tells the story of the time revolution through chapters devoted to the day, month, year, and decade. This chronology drives the narrative forward using the words and pictures of the principals. A direction emerges with each chronological step from discovery to presentation, reception, consolidation, and widespread acceptance of their case.
The Measurable Brain
Authors: Healy Susan D.
Published: March 2021

In this chapter, in order to provide an understanding of the data on which the comparative analyses are based, I describe the methods that have been most commonly used to collect data on brain size. The key to the success of a comparative evolutionary analysis is sample size, the larger the better. To answer the question ‘why do some animals have big brains?’, brains have been measured directly in a variety of ways and brain size has also been inferred (in around half of the analyses) from skull volume. I describe the most commonly used methods briefly, along with the pros and cons of their use and interpretation.
The Ecological Brain
Authors: Healy Susan D.
Published: March 2021

In this chapter, I examine the evidence for a role for the preeminent selection pressure, ecology, in shaping animal brains and in causing changes in brain size within and among species. I describe what ‘ecology’ has meant in comparative analyses, e.g. foraging, range size, and life history variables. I provide evidence for a clear association between ecology and the size of sensory-motor brain regions and go on to use the relationship between space and the hippocampus to show the generality of this relationship beyond food storing. I discuss the strength of the data showing that migration, foraging, and domestication have caused changes in brain size. I conclude that while there is evidence of domestication, in particular, having changed whole brain size, it is at the level of brain regions that there is overwhelming evidence for an effect of ecology on brain size.
The Innovative Brain
Authors: Healy Susan D.
Published: March 2021

Not least because humans are inveterate inventors, innovation is considered to be a reason that other animals have big brains. The Innovative Brain Hypothesis really came into being when Lefebvre et al. suggested that innovation could be a way to assess cognitive abilities in wild animals, which tend not to be amenable to cognitive testing in the traditional, laboratory context. The collection of a data set of foraging innovations in birds (and a similar data set later collected for primates) has provided opportunities to test the main hypothesis in this chapter. Innovations were later divided into technical and non-technical innovations, with the former perhaps leading to more correlations with brain size than the latter. I conclude that this is a very appealing hypothesis but that the evidence is not especially persuasive.
The Technical Brain
Authors: Healy Susan D.
Published: March 2021

In this chapter I discuss the data for tool use having driven increases in brain size. Because humans habitually make and use tools and because hominid brain size appears to have increased around the time that we see tools in the fossil record, tool use has been suggested to be key to increasing brain size. As an increasing number of animals are being shown to use tools, and sometimes to make them, there is an opportunity to use the comparative method to examine whether tool making really has led to brain size increases. I discuss issues with attributes of tasks used to test physical cognition and propose that nest building is a plausible model behaviour with which to look at all aspects of physical cognition, including its neural bases. I conclude that the data are far too few to give much support to the Technical Brain Hypothesis.
The Social Brain
Authors: Healy Susan D.
Published: March 2021

The first discussion of a relationship between sociality and intelligence came in the middle of the twentieth century, especially by Humphrey who suggested that living socially demanded intellectual abilities above and beyond those required by an animal’s ecology. This led to the Social Intelligence Hypothesis, and then the Machiavellian Intelligence Hypothesis, both proposing that sociality was the main driver of the superior intellect of primates, especially humans. Two key challenges for this hypothesis are that sociality is difficult to quantify and cognition is not well tested by problem solving. More importantly, as data from more species have been examined, the analyses increasingly fail to show that sociality explains variation in brain size, even in primates. I conclude that appealing as this hypothesis is, it does not do a very compelling job of explaining variation in brain size.
The Divine Ideas Tradition in Christianity
Authors: McIntosh Mark A.
Published: March 2021

We can understand the multiple roles that the divine ideas tradition played in the history of Christian thought by beginning with an analogy: as a great author draws upon her own consciousness and self-understanding to give life to all the realities within the world of her novels, in an analogous way, the divine ideas teaching holds, God’s eternal and infinite knowing and loving of Godself is the creative exemplar or archetype for the existence of every creature in time, and also the intelligible form or idea by which the truth of every creature may be known. Intensifying the transformation of Plato’s forms by the Middle Platonists, Augustine grounds the divine ideas firmly within Trinitarian theology. We can trace the role of the divine ideas across the full range of Christian doctrines as well as in its influence upon the mystical or contemplative dimension of Christian theology.
The Intelligible Beauty of Creation
Authors: McIntosh Mark A.
Published: March 2021

The divine ideas tradition offers powerful conceptual tools by which Christian theologians and mystics recognized and revered the intelligible beauty of creation, and the hidden presence of the divine in all beings. For thinkers like Origen, Augustine, Maximus, and Eckhart, the eternal Word in which God knows Godself perfectly thereby includes God’s knowing of all possible finite beings, and the intimate presence of the Word at the heart of every creature calls it towards its truest reality. This perspective reaches an apex in the symbolic understanding of the universe prominent in medieval thinkers, and the waning of this tradition (in part as a result of Nominalist thought) is explored by various narratives of disenchantment. The Trinitarian and Christological grounding of the divine ideas becomes obscured by the time of the later Renaissance, and the divine ideas are deployed within discourses such as alchemy, guaranteeing their apparent obsolescence.
Beatitude and the Goodness of Truth
Authors: McIntosh Mark A.
Published: March 2021

By exploring four analogical acts of knowledge, we can discern the significant role of the divine ideas in the journey of creation into a beatific participation in God’s own knowing of Godself. The primordial ground for all acts of knowing truth lies within the Trinitarian knowing of Godself, and Aquinas among others already interprets this infinite knowing of truth as God’s own beatitude. Exponents of the divine ideas tradition highlight aspects of the human act of knowing truth as already participating in a limited way in the beatific knowing of God. Within our world, the death and resurrection of Christ re-establishes the possibility of the human encounter with divine knowing and loving that is at the ground of all truth. The beatific vision draws rational creatures into God’s knowing of Godself and therein to a vision of all creatures in God.
Agenda-Setting and Business-Government Relations across the EU’s Policy-Making Cycle
Authors: Coen David , Katsaitis Alexander , Vannoni Matia
Published: March 2021

This chapter examines the policy cycle’s role in agenda-setting and business mobilization. The chapter draws from theories on agenda-setting and deliberative theory. It discusses agenda-setting procedures in the EU’s context and their impact on business mobilization. Conversely, it addresses business strategies to influence the EU’s agenda, and policy outcomes across the policy-making process. Empirically, it employs extensive surveys of business and policy-makers. The chapter also includes a case study on business strategies across the policy cycle focusing on the car emissions scandal (Diesel-gate). Finally, the chapter provide a rare and systematic glimpse into members of the European Parliament’s perceptions of business lobbying across the policy cycle. In doing so, it contributes to discussions on influence, insiders/outsiders, consultations, business lobbying coalitions, and deliberation in policy-making.
Revolving Doors or Sliding Doors in Brussels? Lobbying Strategies and Capabilities
Authors: Coen David , Katsaitis Alexander , Vannoni Matia
Published: March 2021

In this chapter, we explore the micro-level and concentrates on business and its government affairs offices in Brussels. We assess business strategic choices in hiring different types of staff, and its variation across national and corporate lines. While business has overall similar tools to lobby the EU, it employs distinctly different approaches. We look at the educational and professional background of its staff, and the role it plays in its lobbying strategies. In doing so, we reveal substantial variation across firms’ strategic approaches and the central driving factors motivating the observed variance. Moreover, we underscore common approaches as a reaction to the EU’s evolution. Theoretically, the chapter builds on the firm’s micro-capabilities.
The private life ofCystodinium:in situobservation of its attachments and population dynamics
Authors: Tapics Tara , Gregory-Eaves Irene , Huot Yannick
Published: March 2021

Phytoplankton images were collected using an Imaging Flow Cytobot moored in the mesotrophic lake Lac Montjoie (Quebec, Canada). Cystodinium—an unusual dinoflagellate genus—was found during manual classification of the images into taxonomic groups while building an automated classifier. Cystodinium’s particularity is that while it can take a typical motile dinoflagellate form, it is thought to exist primarily as an immotile photosynthetically competent parasitic cyst in the shape of a crescent moon. Observations presented here are of this immotile lunate cyst. Manually classified images revealed that the majority of the Cystodinium found (86%) were attached to other microalgae or detrital material while the rest were unattached. The established auto-classifier was only able to correctly identify unattached Cystodinium images and thus was used to generate time series as cells per 100 mL for the unattached cell subset. Our observations, coupled with a literature review, lead us to question the parasitic nature of this taxonomic group.
Altered cortical morphology in major depression disorder patients with suicidality
Authors: Li Huiru , Zhang Huawei , Yin Li , Zhang Feifei , Chen Ziqi , Chen Taolin , Jia Zhiyun , Gong Qiyong
Published: March 2021

Background

Major depressive disorder (MDD) is associated with high risk of suicide, but the biological underpinnings of suicidality in MDD patients are far from conclusive. Previous neuroimaging studies using voxel-based morphometry (VBM) demonstrated that depressed individuals with suicidal thoughts or behaviors exhibit specific cortical structure alterations. To complement VBM findings, surface-based morphometry (SBM) can provide more details into gray matter structure, including the cortical complexity, cortical thickness and sulcal depth for brain images.

Objective

This study aims to use SBM to investigate cortical morphology alterations to obtain evidence for neuroanatomical alterations in depressed patients with suicidality.

Methods

Here, 3D T1-weighted MR images of brain from 39 healthy controls, 40 depressed patients without suicidality (patient controls), and 39 with suicidality (suicidal groups) were analyzed based on SBM to estimate the fractal dimension, gyrification index, sulcal depth, and cortical thickness using the Computational Anatomy Toolbox. Correlation analyses were performed between clinical data and cortical surface measurements from patients.

Results

Surface-based morphometry showed decreased sulcal depth in the parietal, frontal, limbic, occipital and temporal regions and decreased fractal dimension in the frontal regions in depressed patients with suicidality compared to both healthy and patient controls. Additionally, in patients with depression, the sulcal depth of the left caudal anterior cingulate cortex was negatively correlated with Hamilton Depression Rating Scale scores.

Conclusions

Depressed patients with suicidality had abnormal cortical morphology in some brain regions within the default mode network, frontolimbic circuitry and temporal regions. These structural deficits may be associated with the dysfunction of emotional processing and impulsivity control. This study provides insights into the underlying neurobiology of the suicidal brain.
Reframing Clinical Paradigms: Strategies for Improving Patient Care Relationships
Authors: Singh Shailen , Orlando Julie M , Alghamdi Zainab S , Franklin Katherine A , Lobo Michele A
Published: March 2021

This article presents strategies for reframing clinical paradigms to build better therapeutic relationships with patients and the members of their support network from the unique and important lens of a parent and disability researcher. First, a brief history of the evolution of models of care is presented, and implementation of the current biopsychosocial model is discussed. Then, evidence-based practice and the role of the patient perspective is considered. Next, specific examples, tools, techniques, guidelines, and resources to foster the demonstration of patient-informed respect and patient-centered communication in clinical practice are provided. Examples and resources are presented that can be accessed and implemented immediately, without cost to the practitioner and with the vast potential to improve care, therapeutic relationships, and patient outcomes. It is important for health care providers and researchers in all practice areas and across all experience levels to regularly evaluate their psychosocial skills. It is critical that the voices of patients and the members of their support network are central in this process. This can enable health care providers to acknowledge areas for growth and to implement changes effectively and efficiently at the individual level to facilitate changes across the broader spectrum of health care practice.
ANCA in systemic sclerosis, when vasculitis overlaps with vasculopathy: a devastating combination of pathologies
Authors: Hughes Michael , Kahaleh Bashar , Denton Christopher P , Mason Justin C , Matucci-Cerinic Marco
Published: March 2021

In patients with SSc, the coexistence of ANCA-associated vasculitis (SSc-AAV) has been reported to be associated with a severe disease course, including significant pulmonary and renal involvement. The presence of ANCA is not uncommon in patients with SSc, and therefore clinicians must maintain a high index of clinical suspicion about SSc-AAV. p-ANCA and anti-myeloperoxidase antibodies are the most common antibodies observed. Patients typically present with clinical features of microscopic polyangiitis or renal-limited vasculitis. There are multiple areas of potential interaction in the pathogenesis of SSc and AAV, which can exacerbate/compound vascular disease. In addition, similar patterns of major internal organ involvement (e.g. lung and kidneys) are seen in both conditions. We highlight a diagnostic approach to SSc-AAV and the paucity of data to inform management. As such, SSc-AAV is typically treated as per isolated AAV, which can potentially be hazardous in patients with SSc (e.g. due to the association between high-dose steroid and scleroderma renal crisis). We propose that this rare clinical entity warrants rigorous investigation, including definition of a therapeutic strategy to ameliorate the potentially devastating combination of pathologies in SSc-AAV.
EVALUATION OF RADIATION DOSES USING CONE BEAM COMPUTED TOMOGRAPHY IN ENDOVASCULAR AORTIC REPAIR AND SCOLIOSIS PROCEDURES
Authors: Strandberg Louise , Jonasson Pernilla , Larsson Maria
Published: March 2021

The aim of this project was to evaluate the radiation dose to patients for cone beam computed tomography (CBCT) in endovascular aortic repair (EVAR) and scoliosis procedures and to compare radiation doses between CBCT and computed tomography (CT). An anthropomorphic phantom and Siemens and General Electric X-ray equipment were used. Default protocol settings were used for comparison of protocols and modalities. The ratio between the highest and lowest CBCT effective dose, for each equipment, had a maximum of 13 (Artis Pheno) for EVAR and 1.8 (Artis Zeego) for scoliosis. It is difficult to predict which modality gives the highest effective dose, e.g. for the CT protocol ‘Aorta before EVAR’ the ratio between effective doses varied from 0.12 to 1.8, between CBCT and CT. For CBCT EVAR, the effective dose and dose area product decreased using collimation or zoom.
CE: Chemotherapy-Induced Peripheral Neuropathy
Authors: Knoerl Robert
Published: March 2021

Chemotherapy-induced peripheral neuropathy (CIPN) occurs in more than 68% of patients receiving the neurotoxic chemotherapy agents commonly used to treat breast, gastrointestinal, gynecologic, and hematologic malignancies. CIPN, often experienced initially as numbness, tingling, or pain in the upper or lower extremities, may progress to the point where the resultant decline in physical function requires a reduction in the chemotherapy dose. This article provides nurses with strategies to use in assessing, managing, and educating patients who are at risk for or who are already experiencing CIPN. Currently, the American Society of Clinical Oncology endorses only one treatment for CIPN: duloxetine 60 mg/day. Discussing CIPN with patients before chemotherapy is initiated and throughout the course of treatment promotes its early identification and management, which may minimize its impact on physical function and chemotherapy dosing, reducing the patient's risk of experiencing chronic symptoms after chemotherapy ends.
First Into the Lifeboats: Protecting Medical Student Education During the Hahnemann University Hospital Closure
Authors: Weber Valerie D. , Farabaugh Dana C. , Fuchs Amy C. , Smith Robin C. , Kocsis Jenna E.
Published: March 2021

The announcement of the closure of Philadelphia’s Hahnemann University Hospital in June 2019 sent shock waves through the academic community. The closure had a devastating impact on the residents and fellows who trained there, the patients who had long received their care there, and faculty and staff who had provided care there for decades. Since its beginnings, the hospital, established as part of Hahnemann Medical College in 1885, was a major site for medical student education. The authors share the planning before and actions during the crisis that protected the educational experiences of third- and fourth-year medical students at Drexel University College of Medicine assigned to Hahnemann University Hospital. The lessons they learned can be helpful to leadership in academic health systems in the United States facing a diminishing number of clinical training sites for medical and other health professions students, a situation that is likely to worsen as the COVID-19 pandemic continues to weaken the health care ecosystem.
Medical Students on the Virtual Front Line: A Literature Review Elective to Provide COVID-19 Clinical Teams With Essential Information
Authors: Boscamp Jeffrey R. , Duffy Christopher P. , Barsky Carol , Stanton Bonita F.
Published: March 2021

Problem

At the Hackensack Meridian School of Medicine (HMSOM) in New Jersey, clinical activities for students were suspended on March 15, 2020, due to the COVID-19 pandemic. Clinical teams at Hackensack Meridian Health (HMH) needed resources for identifying and assimilating the medical literature regarding COVID-19, which was expanding and evolving daily. HMH leaders reached out to HMSOM leaders for assistance. The HMSOM leadership and faculty quickly organized a literature review elective.

Approach

Eight second-year medical students participated in a literature review elective course to research and synthesize the COVID-19 clinical literature to provide synopses of best practices for various clinical teams. By March 23, students were searching the literature and writing reports independently, mentored by a senior dean (an infectious diseases specialist) and supported by the associate dean of libraries and library team. The library team updated and categorized student reports daily on a website dedicated to the elective.

Outcomes

During the 6-week elective, 8 students produced 70 reports synthesizing the emerging COVID-19 literature to help answer practitioners’ clinical questions in real time. One student report was posted on the American Academy of Ophthalmology website. All 70 were published online in Elsevier’s health education faculty hub. On course evaluations, students expressed regret about not being directly involved in patient care but articulated their gratitude to be able to contribute to the clinical teams.

Next Steps

In June 2020, the students returned to their clinical clerkships as COVID-19 clinical volumes declined and personal protective equipment became more available. Students continued to be available to the clinical teams to assist with COVID-19 questions. This literature review elective can serve as a model for other medical schools to use to deploy students to help synthesize the evolving literature on COVID-19 or other rapidly emerging research topics.
Well-being and Perceived Stigma in Individuals With Rheumatoid Arthritis and Fibromyalgia
Authors: Van Alboom Maité , De Ruddere Lies , Kindt Sara , Loeys Tom , Van Ryckeghem Dimitri , Bracke Piet , Mittinty Manasi M. , Goubert Liesbet
Published: March 2021

Introduction:

The presence or absence of clearly defined symptoms and underlying pathophysiology may be a crucial variable related to variability in well-being and stigmatization in individuals with chronic pain (ICPs). In the context of pain, absence of clearly defined symptoms and pathophysiology deviates from the widely endorsed biomedical model and as such, may lead to stigmatization, which in turn could be related to ICPs’ well-being.

Objectives:

The present study compared physical, psychological, social well-being, and perceived stigmatization in individuals with clearly defined symptoms and underlying pathophysiology (rheumatoid arthritis, RA) and individuals with less well understood symptoms and pathophysiology (fibromyalgia, FM) using daily diaries. Furthermore, the association between daily perceived stigmatization and daily well-being was examined.

Materials and Methods:

Seventy-nine participants with FM, 86 participants with RA, and 33 participants with both diagnoses completed a diary for 14 consecutive days.

Results:

Compared to individuals with RA, individuals with FM and individuals with both diagnoses reported worse daily well-being. After controlling for age, pain duration, and daily pain, differences between FM and RA remained significant for social well-being and completion of plans. Differences between RA and the dual diagnosis group remained significant for completion of plans, negative affect, and isolation. Furthermore, results suggested more stigmatization in individuals with FM than in individuals with RA. Individuals with both diagnoses reported equal stigmatization as individuals with FM, but more stigmatization than individuals with RA. Finally, increased levels of perceived stigma were associated with lower well-being.

Discussion:

Findings highlight that the absence of clearly defined symptoms and pathophysiology could be contributing to greater feelings of stigmatization, which may be detrimental for ICPs’ well-being.
All aperture fixation technique of anatomical medial patellofemoral ligament (MPFL) reconstruction with semitendinosus double loop graft: a retrospective case series
Authors: Mahmoud Ahmed Nageeb , Ebied Wessam Fakhry , Bassiony Ayman , Gameel Saleh
Published: March 2021

Background:

The all-aperture fixation technique for anatomical medial patellofemoral ligament (MPFL) reconstruction using a double-loop semitendinosus autograft has been proposed as a strong and biomechanically sound surgical procedure. The aim of the study was to describe the surgical procedure and report the early and mid-term results of MPFL reconstruction using patellar knotless anchors and femoral interference screws. These procedures were performed in the same institution.

Methods:

This is a retrospective case series studying 10 patients with chronic patellofemoral instability who underwent anatomical MPFL reconstruction by means of patellar knotless anchors and femoral interference screws. The Tegner–Lysholm score with clinical data such as apprehension test and knee range of motion (ROM) were assessed preoperatively and postoperatively.

Results:

After a mean follow-up of 19.4 mo, all the cases had good clinical outcomes, and none of the cases had any recurrence. The mean Lysholm score and knee ROM significantly improved from 59 and 101 preoperatively to 80.2 and 125, respectively (P<0.001).

Conclusions:

The technique of anatomical double-bundle MPFL reconstruction by patellar knotless anchors and femoral interference screws is an effective, reproducible, and easy technique for restoring stability and function of the patellofemoral joint.

Level of Evidence:

Level IV.
Comparison of closed and open reduction internal fixation of acutely displaced unstable lateral humeral condylar fractures in children: a prospective cohort study
Authors: Kotb Mohamed Ismail , Alagamy Sherif A. , Saleh Mohamed Khalid
Published: March 2021

Background:

Lateral humeral condylar fractures in children are considered the second most common type of fractures in pediatric elbows after supracondylar fracture. Conservative treatment of these types of fracture usually fails. Open reduction and internal fixation of these types of fractures has been the treatment of choice with regard to anatomical reduction and stable internal fixation. Complications of open reduction range from mild complications, such as scars of the skin incision, to severe, such as avascular necrosis of the lateral condyle. Closed reduction and percutaneous fixation of the fracture may give the same results as open reduction with regard to reduction and healing of the fracture but without the complications of open reduction.

Methods:

This prospective interventional study was conducted in 60 patients who had lateral humeral condylar fractures. Patients were grouped into two equal groups: one group was managed by closed reduction and internal fixation (CRIF), and the second group was managed by open reduction and internal fixation (ORIF).

Results:

The two groups were compared after the operation and 1-year follow-up. There was no difference between the two groups with regard to fracture healing and complications, with the exception of complications of wound healing and skin scarring after open reduction.

Conclusions:

Closed reduction and percutaneous pinning of lateral humeral condylar fractures gave the same results in bone healing without the complications of skin-incision healing that were found in open reduction.

Level of Evidence:

Level III.
A large aneurysmal bone cyst of the clavicle in a 5-year-old child: a case report and review of literature
Authors: Alrabayah Mustafa , Alisi Mohammed S. , Abdulelah Ahmed A. , Atiyat Bashir , Alnawaiseh Hadeel
Published: March 2021

Aneurysmal bone cyst of the clavicle is rarely reported in the literature. The average age of diagnosis in the reported cases is 12 years with female gender and medial third location predilection. We reported a case of a 5-year-old male child who presented with an incidental finding of right clavicular lesion on chest radiograph. Further evaluation revealed an aneurysmal bone cyst in the lateral end of the right clavicle. On the initial follow-up visit (after 6 months of observation), the lesion size increased to four-folds of the initial size. Complete subperiosteal resection was done with no recurrence noticed up to 4 months postoperatively. This study illustrates the importance of listing the aneurysmal bone cyst in the differential diagnosis of expansile clavicular lesions in young children.
The Intrarater and Inter-rater Reliability of Radiographic Evaluation of the Posterior Tibial Slope in Pediatric Patients
Authors: Fletcher Amanda N. , Liles Jordan L. , Pereira Gregory F. , Danilkowicz Richard M. , Amendola Annunziato , Riboh Jonathan C.
Published: March 2021

Background:

In young athletes, an association exists between an increased posterior tibial slope (PTS) and the risk of primary anterior cruciate ligament (ACL) injury, ACL graft rupture, contralateral ACL injury, and inferior patient reported outcomes after ACL reconstruction. In spite of this, there is no consensus on the optimal measurement method for PTS in pediatric patients. The purpose of this study was to evaluate the reliability of previously described radiographic PTS measurement techniques.

Methods:

A retrospective review was performed on 130 patients with uninjured knees between the ages of 6 and 18 years. The medial PTS was measured on lateral knee radiographs by four blinded reviewers using three previously described methods: the anterior tibial cortex (ATC), posterior tibial cortex (PTC), and the proximal tibia anatomic axis (PTAA). The radiographs were graded by each reviewer twice, performed 2 weeks apart. The intrarater and inter-rater reliability were assessed using the intraclass correlation coefficient (ICC). Subgroup analyses were then performed stratifying by patient age and sex.

Results:

The mean PTS were significantly different based on measurement method: 12.5 degrees [confidence interval (CI): 12.2-12.9 degrees] for ATC, 7.6 degrees (CI: 7.3-7.9 degrees) for PTC, and 9.3 degrees (CI: 9.0-9.6 degrees) for PTAA (P<0.0001). Measures of intrarater reliability was excellent among all reviewers across all 3 methods of measuring the PTS with a mean ICC of 0.87 (range: 0.82 to 0.92) for ATC, 0.83 (range: 0.82 to 0.87) for PTC, and 0.88 (range: 0.79 to 0.92) for PTAA. The inter-rater reliability was good with a mean ICC of 0.69 (range: 0.62 to 0.83) for the ATC, 0.63 (range: 0.52 to 0.83) for the PTC, and 0.62 (range: 0.37 to 0.84) for the PTAA. Using PTAA referencing, the PTS was greater for older patients: 9.9 degrees (CI: 7.7-9.4 degrees) vs 8.5 degrees (CI: 9.2-10.7 degrees) (P=0.0157) and unaffected by sex: 9.5 degrees (CI: 8.8-10.1 degrees) for females and 9.0 degrees (CI: 8.0-10.0) for males (P=0.4199). There were no major differences in intrarater or inter-rater reliability based on age or sex.

Conclusions:

While the absolute PTS value varies by measurement technique, all methods demonstrated an intrarater reliability of 0.83 to 0.88 and inter-rater reliability of 0.61 to 0.69. However, this study highlights the need to identify PTS metrics in children with increased inter-rater reliability.

Level of Evidence:

IV, Case series.