bluuebunny/crossref_metadata_2025 huggingface dataset:
Realist Pace
Authors: Gingrich Brian
Published: July 2021

Reality principle, reality effect: those two notions—psychoanalytical, narratological, epistemological—have determined our understanding of nineteenth-century literature explicitly for at least half a century. But perhaps they were both, after all, functions of narrative pace. That is what this chapter begins by arguing: that what we consider to be realism is largely a function of pace that mediates between two senses of scene. Scene, like summary, is not an altogether coherent unit. One must acknowledge that it is split between a dramatic-presentational aspect and a pictorial-representational one and that that split is decisive for how realist narrative defines its movement. The central example here is Middlemarch, with Balzac and Flaubert in the near background. But the chapter ends by looking far forward, considering the capacity of narrative fiction to pause and to speak to its reader, from Fielding and Eliot to Joyce, Faulkner, Beckett, Richard Wright, Ralph Ellison, and Toni Morrison.
Epiphanic and Everyday Modernisms
Authors: Gingrich Brian
Published: July 2021

The threat to conventional realist pace posed by the lyricism of something like epiphany is the central conflict of this chapter. But it begins by acknowledging another phenomenon: from Flaubert to Hemingway, there has emerged a mode of narration that makes little distinction between scene and summary and also makes little distinction between episodes. Call it interepisodic pacing, a flat refusal to amplify scenes in the service of a dramatic mandate. But then there is Joyce, who begins his career with famously amplified moments of epiphany and then desacralizes them into fleeting moments of consciousness. Between those moments and between the everyday interepisodic events of modernist fiction, a new rhythm and a new pace takes shape. One may see it in Woolf above all. Its deconstruction is envisioned by Mann.
Maintain and Increase Blood Supply to the Brain
Authors: Alessi Charles , Chambers Larry W. , Gray Muir
Published: July 2021

There are two imbalances in diet that increase the risk of dementia: the intake expenditure imbalance and the dietary mix imbalance. It is important to change your food choices Recent research has emphasized the importance of type 2 diabetes (non-insulin dependent) as a factor that increases the risk of dementia. This chapter presents perspectives of what you can do, how your family and friends can help, agencies to seek help from in the community, and types of assistance that can be obtained from the health service to manage type 2 diabetes. Keeping your cholesterol as low as you can and reducing blood pressure is essential. The chapter covers the evidence on statins, as well as the modifiable risk factors affecting blood pressure. The chapter ends by discussing the risks of smoking and smoking cessation support and self-care of atrial fibrillation, beginning with an understanding of the treatment goal and actions to take if the treatment goal is not met or if adverse effects of treatment occur.
Communicating with Data
Authors: Nolan Deborah , Stoudt Sara
Published: July 2021

Communicating with Data: The Art of Writing for Data Science aims to help students and researchers write about their data insights in a way that is both compelling and faithful to the data. This book aims to be both a resource for students who want to learn how to write about scientific findings both formally and for broader audiences and a textbook for instructors who are teaching science communication. In addition, a researcher who is looking for help with writing can use this book to self-train. The book consists of five parts. Part I helps the novice learn to write by reading the work of others. Part II delves into the specifics of how to describe data at a level appropriate for publication, create informative and effective visualizations, and communicate an analysis pipeline through well-written, reproducible code. Part III demonstrates how to reduce a data analysis to a compelling story and organize and write the first draft of a technical paper. Part IV addresses revision; this includes advice on writing about statistical findings in a clear and accurate way, general writing advice, and strategies for proof-reading and revising. Finally, Part V gives advice about communication strategies beyond the witten page, which includes giving talks, building a professional network, and participating in online communities. This part also contains 22 “portfolio prompts” aimed at building upon the guidance and examples in the earlier parts of the book and building a writer’s portfolio of data communication.
Describing Data
Authors: Nolan Deborah , Stoudt Sara
Published: July 2021

This chapter covers how to write about data analyzed for a technical article. Examples are provided for writing a data description, including how to reference the source of the data, describe methods used to collect the data, summarize how the data were cleaned and prepared, and provide information about the variables used in the analysis. This chapter also provides tips on how to present summary statistics.
Writing the First Draft
Authors: Nolan Deborah , Stoudt Sara
Published: July 2021

This chapter describes the typical structure of a formal article and provides guidance about what should be included and emphasized in each section of a paper. The particular importance of placing work in the context of others’ work, while distinguishing what sets the work apart, is emphasized. Examples of report elements show the variety of structures that a formal report could take, depending on the venue and audience, and are based on the emergency-department visits from the previous chapter.
Science Between Myth and History
Authors: Perillán José G.
Published: July 2021

Scientists regularly employ historical narrative as a rhetorical tool in their communication of science, yet there’s been little reflection on its effects within scientific communities and beyond.Â Science Between Myth and History begins to unravel these threads of influence. The stories scientists tell are not just poorly researched scholarly histories, they are myth-histories, a chimeric genre that bridges distinct narrative modes. This study goes beyond polarizing questions about who owns the history of science and establishes a common ground from which to better understand the messy and lasting legacy of the stories scientists tell. It aims to stimulate vigorous conversation among science practitioners, scholars, and communicators. Scientific myth-histories undoubtedly deliver value, coherence, and inspiration to their communities. They are tools used to broker scientific consensus, resolve controversies, and navigate power dynamics. Yet beyond the explicit intent and rationale behind their use, these narratives tend to have great rhetorical power and social agency that bear unintended consequences. This book unpacks the concept of myth-history and explores four case studies in which scientist storytellers use their narratives to teach, build consensus, and inform the broader public. From geo-politically informed quantum interpretation debates to high-stakes gene-editing patent disputes, these case studies illustrate the implications of storytelling in science. Science Between Myth and HistoryÂ calls on scientists not to eschew writing about their history, but to take more account of the stories they tell and the image of science they project. In this time of eroding common ground, when many find themselves dependent on, yet distrustful of scientific research, this book interrogates the effects of mismatched, dissonant portraits of science.
Myth-Historical Quantum Erasure
Authors: Perillán José G.
Published: July 2021

An unhappy complaint by celebrated Irish physicist John Stuart Bell, who challenged an unchecked quantum orthodoxy, opens Chapter 2. At first his quote seems little more than a disgruntled student blowing off steam. Closer examination reveals much higher stakes. This chapter probes Bell’s frustrations toward his physics training at Queen’s University Belfast in the late 1940s. He complained bitterly about an entrenched quantum orthodoxy supported by canonical narratives that took hold in the early 1930s and continued to dominate the field for decades. The orthodox quantum interpretation eventually became synonymous with the city of Copenhagen and was used widely in the international physics community to filter out unwanted alternate interpretations, shut down interpretational debate, and promote a pragmatically productive culture of scientific consensus.
Conclusion-
Authors: Perillán José G.
Published: July 2021

Stories matter. Many stories matter. Stories have been used to dispossess and to malign, but stories can also be used to empower and to humanize.1

—CHIMAMANDA NGOZI ADICHIE

In Chapter 1 we examined the encounter that Errol Morris dubbed Thomas Kuhn’s “ashtray argument.” Morris’s memoir reveals much more than an alleged assault. His book aims to discredit Kuhn’s ideas and to question their legacy in both popular and academic cultures. He considers Kuhn’s ...
Australia’s public utilities—an introduction to an era of reform
Authors: Abbott Malcolm , Cohen Bruce
Published: July 2021

The purpose of this chapter is to provide a general account of the main economic reforms that have taken place in Australia since the 1980s and in doing so provide context for the changes that more specifically took place to the utilities sector during that period. As well as looking at the background for reform in Australia it also looks at how the prevailing economic and political environment impacted on the formulation of public policy. Finally, it touches on the impact that technological change and ideology had in formulating public policy, which in turn drove the changes that occurred to the major utilities companies in Australia.
National Competition Policy—its genesis and design
Authors: Abbott Malcolm , Cohen Bruce
Published: July 2021

This chapter looks more specifically at the reform process leading up to the making of the Competition Principles Agreement in 1995. It also provides an examination of what this Agreement meant for the utilities sector more specifically. In doing so it explores the relationship between the state and federal governments and the impact that this had on the development of the National Competition Policy. The main principles of the Policy that were applicable to the utilities sector are explained, as well as the general background of the reform process and the Competition Principles Agreement 1995.
Registrations
Authors: Ferguson Rex
Published: July 2021

From the beginning of the Second World War until 1952, the UK maintained a National Register and issued all citizens with identity cards (one of only two times in which this has occurred—the other being during the First World War). The National Registration Identity Card was an intrinsic part of the logic of classification which guided life on the home front and organized individuals into categories of usefulness, vulnerability, and risk. Mirroring the simplistic basis of these categories, the National Registration Identity Card was notable for the paucity of information it contained. Rather than working as an authentic token which served to validate identity in itself, when it came to security, the card only really worked when read alongside the more richly detailed register to which it referred. Cross-checking between card and register and, more importantly, opening conversations which rested upon the potential for cross-checking, thus animated attempts to identity individuals in wartime Britain. In retreating from the radical subjectivity of modernist prose, writers of the period, such as Graham Greene and Elizabeth Bowen, produced characterizations that were as similarly shorn of depth as the categories that the home front pushed individuals into and the cards that identified them. In playing upon the genre of the espionage thriller, The Ministry of Fear (1943) and The Heat of the Day (1948) thus narrate identities that are defined by social position and by plots which confirm individuals as often precisely what they initially appear to be.
Secretions
Authors: Ferguson Rex
Published: July 2021

DNA profiling, in which individual being is identified by its cellular structures, was first developed by the geneticist Alec Jeffreys in the 1980s. That this source of identity also forms the instructions through which living organisms are generated has complicated profiling’s place in the cultural imaginary of the late twentieth century. So, while profiling actually deals only in non-coding regions of the genome—matter often referred to as ‘junk DNA’—the significance of DNA as a substance of forensic analysis, in the late twentieth century imaginary, is its resonance as the apparent blueprint of existence. The notable features that this blurring of concepts brings about include a conceptualization of identity as a mass of information; notions to do with codes and coding; the presence of the body in the fluids which spill beyond its bounds; and a sense of the body as an archive of heredity and primitivism. In writing specifically about genetic research, Richard Powers’s The Gold Bug Variations (1991) serves a dual function in this chapter, as both an explicatory document and thematic example. But the more substantive analysis is reserved for the work of J. G. Ballard which, from its science fiction origins in novels such as The Drowned World (1962), through the controversial era of Crash (1973), to its trilogy of autobiographical texts (Empire of the Sun (1984), The Kindness of Women (1991), and Miracles of Life (2008)) articulates a form of identity that has close, though often oblique, affinities with all the most prominent features of DNA profiling.
Introduction
Authors: Vrabec Helena U.
Published: July 2021

Chapter 1 begins with an introductory section on the data-driven economy and the risks this new type of economy imposes on individuals to provide readers with some necessary background information. It further explains how the regulator responded to the changes in the developing data economy, emphasising the importance of data subject rights within the updated regulatory framework. Subsequently, the chapter clarifies that the aim of this book is to provide a thorough analysis of data subject rights, with a particular concern for their application in the data-driven environments. The chapter also introduces three key concepts that will be used throughout the book: data subjects, data subject (control) rights, and the data-driven economy, as well as delineating the scope of the book and outlining its structure.
Data Subject Rights in Relation to Profiling
Authors: Vrabec Helena U.
Published: July 2021

Chapter 8 focuses on the provisions of Articles 21 and 22 of the GDPR in relation to profiling. The chapter first provides the reader with the essential context on profiling as a building block of the data economy. It then discusses how the GDPR tackles the risks of profiling, providing a legal analysis of the right to object and the right not to be subject to automated decision-making. These two rights, together with the right to information and access to the extent that they refer to automated decision-making, form a cluster of rights that can be referred to as a ‘choice architecture for data subjects’ and can be particularly useful to control profiling.
Introduction
Authors: Lang Gerald
Published: July 2021

The Introduction identifies the 1976 symposium between Bernard Williams and Thomas Nagel as the key moment in the development of the contemporary wide-ranging debate on moral luck. Despite Nagel’s proposal to proceed with an account of luck that can straddle the gap between ethics and epistemology, it is argued that the sort of luck relevant to moral and political philosophy need not be identical with the sort of luck pressed into service by epistemologists. The ‘Lack of Control Account’ of luck will serve adequately for normative issues, even if it leaves theoretical philosophers dissatisfied. Nagel’s familiar taxonomy of types of moral luck is outlined: resultant luck, circumstantial luck, constitutive luck, and causal luck. The treatment of moral luck in this book prescinds from any detailed engagement with issues of free will and responsibility, and also issues of blameworthiness and responsibility. Different views can be taken about these various issues, but the specific challenge of moral luck will still await resolution. That challenge is fundamentally distributive in character, and is typically focused on the apparatus of the pairwise comparison. The anti-luckist programme in normative ethics objects to different assignments of blameworthiness to agents whose acts turn out differently due to luck. The problem here lies with that prior investment in the pairwise comparison. That contention will be pursued across the early chapters of the book.
What Results from Resultant Luck?
Authors: Lang Gerald
Published: July 2021

This chapter distinguishes, in a preliminary way, among different views on the role of luck in ascriptions of blameworthiness. First, there is the ‘Strict Liability Account’, which makes agents blameworthy if and only if their acts cause harm. Second, and in stark contrast, there is the ‘Anti-Luck Account’, which holds that any lucky differences between agents should be neutralized: any lucky differences between them should make no difference to how much agents are blamed. Third, there is the ‘Restricted Luck-Sensitive Account’, which appears to blend elements of these other views. The Restricted Account agrees with the Anti-Luck Account that agents are not eligible for blameworthiness unless they act either maliciously, or negligently, or recklessly. This is the ‘Internal Claim’. But the Restricted Account also contends that agents who have qualified for blameworthiness by satisfying the Internal Claim may then be blameworthy to different degrees, depending on how their acts turn out, even if the differences between them at this stage reflect luck. This is the ‘External Claim’. (The other chapters in Part I of the book will build up a case for the Restricted Account and against the Anti-Luck Account.) This chapter also searches for the fundamental constituents of the Anti-Luck Account, and identifies key roles for the ‘Irrelevance Intuition’ and ‘Fairness Intuition’, and for comparative luck. Finally, it takes issue with anti-luckist ‘accommodation strategies’, which attempt to explain away our habits of assigning different amounts of blameworthiness to agents who seem to be separated only by luck.
Justice, Luck, and Pairwise Comparisons
Authors: Lang Gerald
Published: July 2021

This chapter extends the anti-anti-luckist programme to political philosophy, and to the doctrine of luck egalitarianism in particular. Luck egalitarianism affirms that unchosen relative inequalities between agents are unjust. It condemns inequalities that are due to ‘brute luck’, and upholds inequalities that are due to ‘option luck’. Though it can be easily enough stated, luck egalitarianism is actually a complex theory with two separate components: egalitarianism and anti-luckism. Standard luck egalitarianism’s commitment to pairwise comparisons makes it vulnerable to what Susan Hurley calls the ‘Boring Problem’. The Boring Problem points out that any two agents in a pairwise comparison are bound to lack control over the relevant income gap between them, because each of them controls, at best, only one side of that comparison. Though Hurley herself is relatively dismissive of the Boring Problem, it is contended here that, when it is properly appreciated, it inflicts huge damage on luck egalitarianism, which needs in turn to be re-organized as a ‘baseline-sensitive’ theory that dispenses with pairwise comparisons. Baseline-sensitive luck egalitarianism makes decent progress on a number of critical fronts, particularly Saul Smilansky’s ‘Paradox of the Baseline’. But even this form of luck egalitarianism is still open to a worry about how it understands the relationship between its egalitarian default and its case for permissible inequalities, and it has less to say than it should about the structural aspects of a social system that generate inequalities.
Physics of Spin-Orbit-Coupled Oxides
Authors: Cao Gang , DeLong Lance
Published: July 2021

Prior to 2010, most research on the physics and chemistry of transition metal oxides was dominated by compounds of the 3d-transition elements such as Cr, Mn, Fe, Co, Ni, and Cu. These materials exhibited novel, important phenomena that include giant magnetoresistance in manganites, as well as high-temperature superconductivity in doped La2CuO4 and related cuprates. The discovery in 1994 of an exotic superconducting state in Sr2RuO4 shifted some interest toward ruthenates. Moreover, the realization in 2008 that a novel variant of the classic Mott metal-insulator transition was at play in Sr2IrO4 provided the impetus for a burgeoning group of studies of the influence of strong spin-orbit interactions in “heavy” (4d- and 5d-) transition-element oxides. This book reviews recent experimental and theoretical evidence that the physical and structural properties of 4d- and 5d-oxides are decisively influenced by strong spin-orbit interactions that compete or collaborate with comparable Coulomb, magnetic exchange, and crystalline electric field interactions. The combined effect leads to unusual ground states and magnetic frustration that are unique to this class of materials. Novel couplings between the orbital/lattice and spin degrees of freedom, which lead to unusual types of magnetic order and other exotic phenomena, challenge current theoretical models. Of particular interest are recent investigations of iridates and ruthenates focusing on strong spin-orbit interactions that couple the lattice and spin degrees of freedom.
Spin-Orbit Interactions in Ruddlesden-Popper Phases Srn+1IrnO3n+1 (n = 1, 2, and ∞)
Authors: Cao Gang , DeLong Lance E.
Published: July 2021

The Ruddlesden-Popper phases Srn+1IrnO3n+1 (n = 1, 2, and ∞) have been intensively studied, and exhibit many novel behaviors and ground states driven by a rare interplay between strong spin-orbit and Coulomb interactions. One key empirical trend is that most iridates are antiferromagnetic insulators, contrary to conventional wisdom. The spin-orbit-coupled Mott state does not always closely track the magnetic state in iridates. Often, chemical doping can effectively induce a metallic state. Defying expectations, Sr2IrO4, which is the prototypical spin-orbit-coupled Mott insulator, does not become superconducting upon electron doping, but remains insulating under applied pressures extending into the Mbar range, highlighting the extraordinary susceptibility to the lattice degrees of freedom, which is at the heart of the physics driving the iridates.
Lattice-Driven Ruthenates
Authors: Cao Gang , DeLong Lance E.
Published: July 2021

Ruthenates have extended 4d-electron orbitals and comparable Coulomb, crystalline electric field, and spin-orbit interactions, as well as significant p-d orbital hybridization and spin-lattice coupling. The physical properties of ruthenates are highly susceptible to even slight lattice distortions; as a result, external magnetic field, pressure, electrical current, and chemical doping can generate disproportionate responses in structural as well as other physical properties, which can lead to unusual ground states or phenomena. Examples of the unusual, strong coupling of the ruthenates to external stimuli include negative volume thermal expansion via orbital and magnetic order in doped Ca2RuO4, colossal magnetoresistivity via avoiding a spin-polarized state and quantum oscillations in Ca3Ru2O7, and pressure-induced transition from ferromagnetism to antiferromagnetism in Sr4Ru3O10.
Evolutionary Processes and Organizational Adaptation
Authors: Levinthal Daniel A.
Published: July 2021

Strategists are encouraged to identify sustained competitive advantages. This volume takes a different tact and provides a perspective on how organizations adapt over time to changing circumstances. This process is characterized as not driven by the inspired wisdom of a grand strategist, but by an ecology of initiatives within the organization. A central role of the organization is to mediate between the market forces in which it operates and the culling and amplification of these initiatives within the organization. In this spirit, a useful touchstone is that of Mendel, who sits intermediate between the blind watchmaker of a purely Darwinian process and a “chess master” strategist as suggested by stylized rational choice approaches. The “Mendelian executive” operates with intentionality, but this intentionality is with respect to the design of the experimental process rather than the identification of specific pathways forward. The two core conceptual pillars of the work are that of path-dependence, what are the adjacent “spaces” to which an organization might move, and “artificial selection,” how the organization mediates aggregate immediate outcomes and the allocation of resources and rewards to the various initiatives and actors within the organization. Entities that have a sustained lifespan are not static, but engage in processes of renewal, whether cells in the human body or lines of business within a firm. A conceptual framework is provided to illuminate some of the fundamental mechanisms underlying this process.
Groupthink, Polythink and the Challenges of Decision-Making in Cabinet Government
Authors: Grube Dennis C , Killick Anna
Published: July 2021

The Chilcot report set out in detail its finding that the Blair Government had been prone to groupthink in its decision-making processes when leading Britain into the Iraq War. Subsequent British prime ministers have been in no hurry to change their style of governing in ways that might broaden decision-making circles and introduce the ‘challenge’ that Chilcot said had been lacking. This article draws on the literature on the psychology of group decision-making to examine the extent to which groupthink remains embedded in the processes of cabinet government in the UK. The article argues that the strongest driver of groupthink is the psychological disposition towards conflict of individual prime ministers. Drawing on interviews with ministers, civil servants and special advisers we suggest that the political authority of the prime minister interacts with their psychological predisposition towards debate to encourage groupthink, polythink or a more positive style of ‘vigilant’ decision-making.
Manipulating exudate composition from root apices shapes the microbiome throughout the root system
Authors: Kawasaki Akitomo , Dennis Paul G , Forstner Christian , Raghavendra Anil K H , Mathesius Ulrike , Richardson Alan E , Delhaize Emmanuel , Gilliham Matthew , Watt Michelle , Ryan Peter R
Published: July 2021

Certain soil microorganisms can improve plant growth, and practices that encourage their proliferation around the roots can boost production and reduce reliance on agrochemicals. The beneficial effects of the microbial inoculants currently used in agriculture are inconsistent or short-lived because their persistence in soil and on roots is often poor. A complementary approach could use root exudates to recruit beneficial microbes directly from the soil and encourage inoculant proliferation. However, it is unclear whether the release of common organic metabolites can alter the root microbiome in a consistent manner and if so, how those changes vary throughout the whole root system. In this study, we altered the expression of transporters from the ALUMINUM-ACTIVATED MALATE TRANSPORTER and the MULTIDRUG AND TOXIC COMPOUND EXTRUSION families in rice (Oryza sativa L.) and wheat (Triticum aestivum L.) and tested how the subsequent release of their substrates (simple organic anions, including malate, citrate, and γ-amino butyric acid) from root apices affected the root microbiomes. We demonstrate that these exudate compounds, separately and in combination, significantly altered microbiome composition throughout the root system. However, the root type (seminal or nodal), position along the roots (apex or base), and soil type had a greater influence on microbiome structure than the exudates. These results reveal that the root microbiomes of important cereal species can be manipulated by altering the composition of root exudates, and support ongoing attempts to improve plant production by manipulating the root microbiome.
Illuminating the hidden world of calcium ions in plants with a universe of indicators
Authors: Grenzi Matteo , Resentini Francesca , Vanneste Steffen , Zottini Michela , Bassi Andrea , Costa Alex
Published: July 2021

The tools available to carry out in vivo analysis of Ca2+ dynamics in plants are powerful and mature technologies that still require the proper controls.
Patient and Provider Attitudes, Beliefs, and Biases That Contribute to a Marginalized Process of Care and Outcomes in Chronic Musculoskeletal Pain: A Systematic Review—Part I: Clinical Care
Authors: Emerson Alicia J , Oxendine Riley H , Chandler Lauren E , Huff Corey M , Harris Gabrielle M , Baxter G David , Wonsetler Jones Elizabeth C
Published: July 2021

Objective

Chronic musculoskeletal pain (CMP) outcomes are affected by numerous variables, including the clinical conversation. When good therapeutic/working alliances are formed, congruent clinical conversations can lead to improved CMP outcomes. Identifying patient/provider attitudes, beliefs, and biases in CMP that can influence the clinical conversation, and thus clinical management decisions, is foundationally important.

Design

The aims of this systematic review were to 1) summarize the evidence of the attitudes and beliefs of patients and health care providers (HCPs) involved in the clinical conversation about CMP, and 2) examine whether and how these perceptions impacted the process of care.

Methods

A systematic search of CINAHL, PubMed, Scopus, Sociology Database in ProQuest, and Web of Science used the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Included studies were those investigating vulnerable adult populations with chronic pain. Study bias was examined with the Downs and Black tool.

Results

Seven retrospective studies were included. When making pharmaceutical management decisions, HCPs demonstrated negative implicit biases toward minorities and women. When making referrals to multidisciplinary care, HCPs demonstrated negative implicit biases toward women with lower educational attainment. Unmet patient expectations resulted in higher dropout rates at multidisciplinary pain management programs. Patients’ trust was influenced by the health care setting, and patients often had limited options secondary to health insurance type/status.

Conclusion

These findings suggest that patients with CMP may experience a marginalized process of care due to HCPs’ negative implicit biases, unmet patient expectations, and the health care setting. Results suggest several factors may contribute to inequitable care and the recalcitrant nature of CMP, particularly in vulnerable populations with limited health care choices.
Issues in Public Health in India - Keynote address by Keshav Desiraju, Former Secretary of Health and Family Welfare to the Government of India
Authors: Desiraju Keshav
Published: July 2021

The state of public health in India can be studied in terms of disease burden, health human resources and health care financing. There are many regional variations within these broad areas, and many complexities. Communicable and non-communicable diseases remain major challenges, as do maternal and infant mortality. At every level, trained human resources are scarce. Government budgetary resources are inadequate and the current discussion in India on universal health care appears to be biased towards privately provided care. At the same time, there have been remarkable achievements, often diminished by the size of India’s population.

Public health is about social justice and the task before India today is to demonstrate the political will, the administrative ability and the democratic vision to achieve universal health care. Can this come about?
Fibromyalgianess and glucocorticoid persistence among patients with rheumatoid arthritis
Authors: Wallace Beth I , Moore Meriah N , Heisler Andrew C , Muhammad Lutfiyya N , Song Jing , Clauw Daniel J , Bingham Clifton O , Bolster Marcy B , Marder Wendy , Neogi Tuhina , Wohlfahrt Alyssa , Dunlop Dorothy D , Lee Yvonne C
Published: July 2021

Objectives

Over one-third of patients with RA exhibit evidence of fibromyalgianess, which is associated with higher rates of disability and inadequate responsiveness to RA treatment. Patients with RA often remain on glucocorticoids long-term, despite the known risk of dose-dependent morbidity. We undertook this study to examine the relationship between fibromyalgianess and glucocorticoid persistence among RA patients.

Methods

We followed participants with active RA on oral prednisone for ∼3 months after initiating a new DMARD. Fibromyalgianess was measured using the Fibromyalgia Survey Questionnaire (FSQ), previously shown to correlate with key FM features often superimposed upon RA. Severity of fibromyalgianess was stratified as follows: FSQ <8 low, FSQ 8–10 moderate and FSQ >10 high/very high. The association between baseline fibromyalgianess and glucocorticoid persistence, defined as prednisone use at 3-month follow-up visit after DMARD initiation, was assessed using multiple logistic regression adjusted for baseline demographics, RA duration, serostatus and inflammatory activity assessed using swollen joint count and CRP.

Results

Of the 97 participants on prednisone at baseline, 65% were still taking prednisone at follow-up. Fifty-seven percent of participants with low baseline fibromyalgianess had persistent glucocorticoid use, compared with 84% of participants with high or very high fibromyalgianess. After adjustment for non-inflammatory factors and inflammatory activity, participants with high/very high baseline fibromyalgianess were more likely to be taking prednisone at follow-up relative to those with low fibromyalgianess [odds ratio 4.99 (95% CI 1.20, 20.73)].

Conclusion

High fibromyalgianess is associated with persistent glucocorticoid use, independent of inflammatory activity.
Adipose tissue-derived stromal vascular fraction for treating hands of patients with systemic sclerosis: a multicentre randomized trial Autologous AD-SVF versus placebo in systemic sclerosis
Authors: Daumas Aurélie , Magalon Jérémy , Jouve Elisabeth , Casanova Dominique , Philandrianos Cécile , Abellan Lopez Maxime , Mallet Stéphanie , Veran Julie , Auquit-Auckbur Isabelle , Farge Dominique , Levesque Hervé , Benhamou Ygal , Arnaud Laurent , Giraudo Laurent , Dumoulin Chloé , Giverne Camille , Boyer Olivier , Giuliani Alexandra , Bourgarel Véronique , Harlé Jean-Robert , Schleinitz Nicolas , Brunet Julie , Pers Yves-Marie , Ferreira Rosanna , Cras Audrey , Boccara David , Larghero Jérome , Château Joseph , Hot Arnaud , Dignat-George Françoise , Magalon Guy , Sabatier Florence , Granel Brigitte
Published: July 2021

Objective

To assess the superiority of adipose tissue-derived stromal vascular fraction (AD-SVF) injection into the fingers vs placebo in reducing hand disability in systemic sclerosis (SSc) patients.

Methods

We performed a double-blind, multicentre, phase II trial from October 2015 to January 2018 in France. SSc patients with a Cochin Hand Function Scale (CHFS) ≥20/90 were randomized 1:1 to receive injection of AD-SVF or placebo. AD-SVF was obtained using the automated processing Celution 800/CRS system. The placebo was lactated Ringer’s solution. The primary efficacy end point was the change of the CHFS score from baseline to 3 months. Secondary efficacy endpoints included the CHFS score at 6 months, hand function, vasculopathy, hand pain, skin fibrosis, sensitivity of the finger pulps, Scleroderma Health Assessment Questionnaire, patients and physician satisfaction, and safety.

Results

Forty patients were randomized. The AD-SVF and placebo groups were comparable for age, sex ratio, disease duration, skin fibrosis of the hands and main cause of hand disability. After 3 months’ follow-up, hand function significantly improved in both groups with no between-group difference of CHFS (mean change of −9.2 [12.2] in the AD-SVF group vs −7.6 [13.2] in the placebo group). At 6 months, hand function improved in both groups.

Conclusion

This study showed an improvement of hand function in both groups over time, with no superiority of the AD-SVF. Considering the limits of this trial, studies on a larger population of patients with homogeneous phenotype and hand handicap should be encouraged to accurately assess the benefit of AD-SVF therapy.

Trial registration

ClinicalTrials.gov, https://clinicaltrials.gov, NCT02558543. Registered on September 24, 2015.
Colorism in Punishment among Hispanics in the Criminal Justice System
Authors: Lanuza Yader R , Petersen Nick , Omori Marisa
Published: July 2021

Although scholars have documented skin tone stratification in punishment and among Hispanics in some domains, no study has examined colorism among Hispanics across multiple stages of the criminal justice process. By linking official court records and mugshot photographs of a sample of 6,523 adults arrested in Miami-Dade County between 2012 and 2015, we examine whether Hispanics are subjected to colorism, and the role of selection in shaping the association between skin color and punishment at sentencing. We find colorism in conviction and incarceration and show that selection processes partly account for some of the association between skin tone and punishment at sentencing. These findings are driven by Hispanics who are categorized as Black. Given the demographic importance of Hispanics to the future of the United States, our investigation suggests that skin stratification will continue to be an important source of inequality in American society.
The liability of foundation councils: an uphill battle for beneficiaries?
Authors: Auer Sebastian
Published: July 2021

The question of liability of a foundation council remains one of the most important issues in foundation law practice and is at the root of many conflicts in the Liechtenstein foundation landscape. This article seeks to contribute to a better understanding of the key principles of this topic by outlining some of the elements forming the very complex legal framework of Liechtenstein's laws of liability. A closer look at the more recent hot-button issues in light of the Supreme Court's case law reveals a multitude of legal issues ultimately rendering attempts by beneficiaries to hold the foundation council accountable an uphill battle.
Risk factors for fatal scorpion envenoming among Brazilian children: a case–control study
Authors: Almeida Ana Caroline C , Carvalho Fernando M , Mise Yukari F
Published: July 2021

Background

Scorpion envenoming is relatively frequent in tropical and subtropical regions and potentially fatal. We aimed to identify risk factors for fatal scorpion envenoming among Brazilian children.

Methods

A case–control study investigated all fatal cases of scorpion envenoming among children up to 10 y old, reported to the Brazilian Diseases Surveillance System between 1 January 2007 and 18 July 2016. Controls were randomly sampled from children who survived the envenoming over this period. Data were analysed using logistic regression.

Results

Of the 254 cases and 1083 controls investigated, the identified risk factors were age ≤5 y, occurred in a rural area, time-to-treatment ≥3 h, treatment with scorpion antivenom (SAV) but either excessive or insufficient number of vials, treatment with antivenom that was neither SAV nor anti-spider and no antivenom administered compared with the standard recommended treatment. Treatment effectiveness at preventing fatal scorpion envenoming was 77.0% when time-to-treatment was <3 h and 75% in children 9–10 y of age. SAV was 63% effective at preventing death when administered early at the recommended dosage.

Conclusions

Fatal scorpion envenoming was associated with younger age, incident occurring in a rural area, late treatment and inadequate antivenom treatment. SAV was effective at preventing death when administered early.
Risk for development of active tuberculosis in patients with chronic airway disease—a systematic review of evidence
Authors: Hamada Yohhei , Fong Christopher J , Copas Andrew , Hurst John R , Rangaka Molebogeng X
Published: July 2021

Reports suggest an increased risk of tuberculosis (TB) in people with chronic airway diseases (CADs) such as chronic obstructive pulmonary disease (COPD), but evidence has not been systematically reviewed. We performed a systematic review by searching MEDLINE and Embase for studies published from 1 January 1993 to 15 January 2021 reporting the association between the incident risk of TB in people with CADs (asthma, COPD and bronchiectasis). Two reviewers independently assessed the quality of individual studies. We included nine studies, with two from low-income high TB burden countries. Three cohort studies reported a statistically significant independent association between COPD and the risk of TB in high-income countries (n=711 389). Hazard ratios for incident TB ranged from 1.44 to 3.14 adjusted for multiple confounders including age, sex and comorbidity. There was large between-study heterogeneity (I2=97.0%) across studies. The direction of effect on the TB risk from asthma was inconsistent. Chronic bronchitis or bronchiectasis studies were limited. The small number of available studies demonstrated an increased risk of TB in people with COPD; however, the magnitude of the increase varies by setting and population. Data in high TB burden countries and for other CADs are limited.
Communication in Health Care
Authors: Ellahham Samer
Published: July 2021

Permanent or temporary migration results in communication issues related to language barriers. The migrant’s mother tongue is often different from that of the host country. Even when the same language is spoken, communication barriers arise because of differences in accent. These communication barriers have a significant negative impact on migrants accessing health care and their ability to understand instructions and seek follow-up care. A multidisciplinary team often has professionals from various countries. These migrant health care professionals find it difficult to communicate with patients of the host country and with their colleagues. Communication barriers, therefore, result in miscommunication or no communication between health care professionals and between health care professionals and patients. This increases the risk of medical errors and impacts quality of care and patient safety. This review looks at the impact of communication barriers in health care and endeavors to find effective solutions.
Recurrence in infantile tibia vara (Blount disease) after high tibia and fibula osteotomy
Authors: Van Greunen Eduard , Firth Gregory Bodley
Published: July 2021

Infantile Tibia Vara (ITV or Blount disease) often recurs after surgical correction of the deformity. Vastly different recurrence rates have been reported in the literature. The main objective of this study was to identify any risk factors for the recurrence of ITV following high tibia and fibula valgus osteotomy. This was a retrospective cohort comparative study of 44 patients with ITV (16 with bilateral involvement) who underwent a total of 60 high tibia and fibula osteotomies. Demographics, family history, BMI, walking age and age at surgery were recorded. Pre-, post- and follow-up weight-bearing anatomic femorotibial angles, were measured from X-rays. The limbs were divided into Langenskiöld stages based on preoperative X-rays. The study found an overall recurrence rate of 63.3% for children who had a high tibia and fibula osteotomy for ITV. Surgery after the age of 4 years, advanced Langenskiöld stages (stages 3–5) and overcorrection of less than 15 degrees of valgus were identified as risk factors for recurrence. This study recommends performing a high tibia and fibula valgus osteotomy before the age of 4 years in ITV to avoid recurrence. Overcorrection of the high tibia and fibula osteotomy to 15 degrees of valgus should be considered in older patients with high Langenskiöld stages at time of presentation.
Total Transperineal Laparoscopic Proctectomy for the Treatment of Crohn’s Proctitis
Authors: Springer Jeremy E. , Guber Robert D. , Davids Jennifer S. , Sturrock Paul R. , Alavi Karim , Maykel Justin A.
Published: July 2021

INTRODUCTION:

Completion proctectomy is traditionally performed using a combination of abdominal and perineal approaches. Access to and exposure of the pelvis through the abdominal cavity can be limited in patients with prior surgery or inflammatory conditions. We describe a novel technique for a total transperineal approach for proctectomy for Crohn’s proctitis, avoiding technical challenges, risks, and recovery associated with abdominal surgery.

TECHNIQUE:

We utilized the skills and expertise acquired from our experience with transanal total mesorectal excision to perform a total transperineal laparoscopic proctectomy in a male patient with medically refractory proctitis. He previously underwent an anterior resection, drainage of a chronic presacral abscess, omental pedicle flap transposition to the pelvis, and end colostomy for severe Crohn’s colitis. The total transperineal laparoscopic proctectomy approach avoids the need for abdominal access, including the risks associated with abdominal entry, adhesiolysis, pelvic access and visualization, and wound-related issues. Following an initial intersphincteric perineal dissection, the GelPOINT Path minimal access platform is utilized to perform a total transperineal proctectomy.

RESULTS:

The patient recovered uneventfully and was discharged to home 2 days after surgery. At 1-month postoperative follow-up, the patient is recovering well with complete healing of the perineal wound.

CONCLUSION:

We demonstrate the feasibility, safety, and technical steps of a minimally invasive completion proctectomy for fistulizing Crohn’s proctitis by using a total transperineal approach. This approach allowed us to utilize direct, inline, high-definition visualization to access and safely operate in the distal aspects of a narrow, scarred, and fibrotic pelvis while avoiding the need for any abdominal access. Advanced experience with redo pelvic and minimally invasive transanal surgery is critical. See Video at http://links.lww.com/DCR/B664.