bluuebunny/crossref_metadata_2025 huggingface dataset:
« La force des normes » : entretien avec Pierre Macherey
Authors: Pirone Ilaria , Ottavi Dominique
Published: November 2020

Cet article est la retranscription de la conversation que Dominique Ottavi et Ilaria Pirone ont eue avec le philosophe Pierre Macherey. Les recherches récentes des deux auteurs sur les pratiques scolaires inclusives les conduisent à travailler sur la question des normes. C’est sur ce thème qu’elles ont souhaité rencontrer Pierre Macherey. Cette conversation approfondit des réflexions du philosophe sur le rapport du sujet aux normes, et sur le point sémantique d’articulation entre norme, normativité, normal, dans un moment social paradoxal où, si d’un côté, les questions d’éthique sont très débattues, de l’autre, se manifeste un grand repli normatif. Le philosophe a développé ces thématiques en faisant des liens avec les questions éducatives dans le champ scolaire et l’histoire de l’école en France.
Le projet Personnalisé de Scolarisation : dire et malentendu d’un dispositif d’inclusion
Authors: Méloni Dominique
Published: November 2020

Cet article propose d’interroger l’usage d’un dispositif d’institution scolaire, le Projet Personnalisé de Scolarisation. Son analyse offre un angle de vue particulièrement propice à l’appréhension des implications cliniques inhérentes à la politique d’inclusion, car il constitue un moment symbolique de prise de parole et de prise de décisions. Aussi confronterons-nous les conditions d’émergence d’une parole qui puisse garantir une place au sujet avec la logique soutenue par ce dispositif qui invite l’élève à se prononcer sur les conditions de sa scolarité et sur ses choix d’avenir. À l’appui d’une vignette clinique, nous montrerons alors comment un dispositif d’inclusion peut être mis au service du choix de l’exclusion de l’altérité quand la parole parait invoquée pour finalement être confisquée.
L’art et l’art de l’écoute psychanalytique
Authors: de Abreu e Silva Rosane
Published: November 2020

Cet article est le résultat d’une recherche sur l’art et l’art de l’écoute psychanalytique. Il se compose de trois parties. La première partie de ce texte est dédié à une brève incursion sur l’expression des affects dans l’art et sur la question de l’artiste concernant les pulsions qui l’animent et le don en faisant référence à la production littéraire et surtout à celle de l’art visuel où la pulsion scopique est prédominante. Il y est aussi question des relations entre l’art et la psychanalyse et de celles du psychanalyste avec l’artiste. Dans un deuxième temps, le texte reprend une conception de la musique comme un art à l’origine de l’inconscient, l’audition étant la première fonction sensorielle à émerger chez le fœtus. Elle s’exprime aussi dans la musicalité du discours du sujet que le psychanalyste entend dans son harmonie comme dans ses distorsions. Finalement, le texte s’achève sur quelques remarques et exemples cliniques à propos de l’écoute psychanalytique où l’accent est mis sur l’inconscient se présentant non seulement dans le langage verbal, dans l’acte manqué ou dans la lettre qui tombe, mais aussi dans l’intonation, dans les inflexions et dans les modulations de la voix. On attend de l’analyste qu’il donne un sens dans le discours du sujet à cette musicalité qui vient tout droit de l’inconscient.
Aquaporin-4- und Myelin-Oligodendrozyten-Glykoprotein-Antikörper-assoziierte Optikusneuritis: Diagnose und Therapie
Authors: Wildemann Brigitte , Horstmann Solveig , Korporal-Kuhnke Mirjam , Viehöver Andrea , Jarius Sven
Published: November 2020

Die Optikusneuritis (ON) ist vielfach die erste Manifestation einer AQP4-Antikörper-vermittelten NMOSD (AQP4: Aquaporin-4, NMOSD: Neuromyelitis-optica-Spektrum-Erkrankung, Engl.: neuromyelitis optica spectrum disorders) oder einer Myelin-Oligodendrozyten-Glykoprotein-Antikörper-assoziierten Enzephalomyelitis (MOG-EM; auch MOG antibody associated disorders, MOGAD). Für beide Erkrankungen wurden in den vergangenen Jahren internationale Diagnosekriterien und Empfehlungen zu Indikation und Methodik der serologischen Testung vorgelegt. Seit Kurzem liegen zudem Ergebnisse aus 4 großen, internationalen Phase-III-Studien zur Behandlung der NMOSD vor. Mit dem den Komplementfaktor C5 blockierenden monoklonalen Antikörper Eculizumab wurde 2019 erstmalig ein Medikament zur Langzeitbehandlung der NMOSD, die bislang vornehmlich Off-Label mit Rituximab, Azathioprin und anderen Immunsuppressiva erfolgt, auf dem europäischen Markt zugelassen. Für die erst vor wenigen Jahren
erstbeschriebene MOG-EM stehen inzwischen Daten aus mehreren retrospektiven Studien zur Verfügung, die eine Wirksamkeit von Rituximab und anderen Immunsuppressiva in der Schubprophylaxe auch in dieser Indikation nahelegen. Viele der zur Therapie der MS zugelassenen Medikamente sind entweder unwirksam oder können, wie z. B. Interferon-β, eine Verschlechterung des Krankheitsverlaufes bewirken. Beide Erkrankungen werden im Akutstadium mit hochdosierten Glukokortikoiden und Plasmapherese oder Immunadsorption behandelt. Diese Behandlung sollte möglichst rasch nach Symptombeginn eingeleitet werden. Insbesondere die MOG-EM ist durch eine oft ausgeprägte Steroidabhängigkeit gekennzeichnet, die ein langsames Ausschleichen der Steroidtherapie erfordert, und schließt viele Fälle der bislang meist als „idiopathisch“ klassifizierten „chronic relapsing inflammatory optic neuropathy“ (CRION) ein. Unbehandelt kann sowohl die NMOSD- als auch die MOG-EM-assoziierte ON zu schweren,
persistierenden und oft bilateralen Visuseinschränkungen bis hin zur Erblindung führen. Beide Erkrankungen verlaufen meist relapsierend. Neben den Sehnerven sind häufig das Myelon sowie der Hirnstamm und, vor allem bei NMO-Patienten, das Dienzephalon betroffen; supratentorielle Hirnläsionen im kranialen MRT sind, anders als früher gedacht, kein Ausschlusskriterium, sondern häufig. In der vorliegenden Arbeit geben wir einen Überblick über Klinik, Diagnostik und Therapie dieser beiden wichtigen Differenzialdiagnosen der MS-assoziierten und idiopathischen ON.
Plötzliche Belastungsdyspnoe bei einer jungen Frau – internistisch-gynäkologisches Grenzgebiet in der Notaufnahme
Authors: Mehl Lisa , Donner Johanna , Lock Guntram
Published: November 2020

Anamnese Eine 39-jährige Patientin wird wegen plötzlicher ausgeprägter Belastungsdyspnoe unter dem V. a. eine Lungenarterienembolie zugewiesen. Sie berichtet zudem über eine gerade abgeschlossene Kinderwunschbehandlung.

Untersuchungen und Diagnose Bei klinisch gutem Allgemeinzustand finden sich laborchemisch eine deutliche Erhöhung der D-Dimere und des hCGs, sonografisch ein ausgeprägter Aszites, ein großer rechtsseitiger Pleuraerguss sowie multizystische, deutlich vergrößerte Ovarien. In Zusammenschau mit der Anamnese wird die Diagnose eines ovariellen Hyperstimulationssyndroms (OHSS) gestellt. Diese Diagnose wird durch die Gynäkologen bestätigt und als Grad II–III (moderat bis schwer) klassifiziert.

Therapie und Verlauf Bis auf eine Thromboembolie-Prophylaxe mit Certoparin 3000 IE/d wird keine Therapie durchgeführt; die Erkrankung verläuft selbstlimitierend.

Schlussfolgerung Das OHSS ist primär ein gynäkologisches Krankheitsbild, dennoch können auch Internisten über die Leitsymptome Belastungsdyspnoe oder abdomineller Schmerz damit in Kontakt kommen. Früh erkannt sind die Symptome gut zu behandeln und schwere Verläufe können meist verhindert werden. In diesem Fall konnten Anamnese und Sonografie die initiale Verdachtsdiagnose einer Lungenarterienembolie widerlegen.
Off-label use of 0.4 % sodium hyaluronate teardrops: a safe and effective solution for submucosal injection in gastric endoscopic submucosal dissection
Authors: Arantes Vitor , Aliaga Ramos Josue , Abdul Rani Rafiz , Yoshida Naohisa
Published: November 2020

Background and study aims Submucosal (SM) injection is a critical step in endoscopic submucosal dissection (ESD). In Japan, use of viscous solutions such as sodium hyaluronate are recommended; the commercially product available is MucoUp (Seikagaku Co. and Boston Scientific Japan Co., Japan). Nevertheless, MucoUp is expensive and unavailable in many Western countries. For the past 8 years, we have been using low-cost sterile teardrops solution composed of 0.4 % sodium hyaluronate (Adaptis Fresh, Legrand Laboratory, Brazil). This solution is readily available in drugstores with a cost of approximately US$ 10.00 for each 10-cc bottle. The aim of this study was to present the clinical outcome with off-label sodium hyaluronate use for SM injection in gastric ESD.

Patients and methods A single-center retrospective study of collected data investigating consecutive patients that underwent gastric ESD between 2012 and 2019. ESD was performed using 0.4 % sodium hyaluronate teardrop for SM injection and Flush Knife BT 2.5 (Fujifilm Co., Japan). The following data were analyzed: clinical-pathological features, en-bloc, R0 and curative resection rate, procedure duration, adverse events, and clinical outcome.

Results ESD was performed with sodium hyaluronate for submucosal injection in 78 patients. The en-bloc resection rate and R0 resection rate were 96.1 % and 92.3 %, respectively. The curative resection rate for epithelial lesions was 83.8 %. Adverse events occurred in 5 cases (6.3 %): delayed bleeding (3.8 %, 3 cases) and perforation (2.5 %, 2 cases); all managed successfully by clipping and thermal coagulation. The mean volume of sodium hyaluronate solution used per patient was 10 cc (SD: ± 8 cc). During follow-up (mean: 17 months; SD: ± 14.5 months), two patients developed metachronous lesions (2.5 %).

Conclusions Off-label use of teardrops with 0.4 % sodium hyaluronate for submucosal injection was demonstrated to be safe and able to provide an effective submucosal cushion that facilitates SM dissection in gastric ESD procedures.
Development of Composition and Technologies of Dental Film with
Ketorolac Trometamine
Authors: Bakhrushina Elena O. , Demina Natalia B. , Kashperko Alena S. , Vakina Marina G. , Anurova Maria N. , Zhilyakova Elena T. , Krasnyuk Ivan I.
Published: November 2020

The report presents the results of the development of dental films with
ketorolac trometamine based on the natural biodegradable polymers from the
groups of sodium alginates and xanthan gums in combination with lightly
crosslinked acrylic polymer carbopol. Physicochemical properties, such as
moisture, mucoadhesion, thickness, tensile strength, disintegration in
phosphate buffer were determined in obtained samples of this dosage form. A
comparison of physicochemical properties of experimental samples and
commercial model of dental film has allowed establishing the perspective
composition of complex matrix of films with ketorolac trometamine for use in
dentistry.
Flowering of Blandfordia grandiflora (Christmas bells) in response to fire frequency and temperature
Authors: Griffith Stephen J. , Rutherford Susan
Published: November 2020

Blandfordia grandiflora (Blandfordiaceae) is a resprouting perennial herb in wet heathland of coastal and tableland habitats on mainland eastern Australia. It has attractive turbinate flowers of considerable horticultural value. Blandfordia grandiflora is reported to have an enhanced flowering response in the first post-fire flowering season, and management prescriptions advocate frequent fire as beneficial for the species. Nonetheless, the present study appears to be the first to document the flowering response and fate of individual plants exposed to a range of fire frequencies (3-, 6- and 9-year intervals) over an extended period. We also examined the flowering response in unburnt habitat. High survival rates (>95%) were observed for B. grandiflora plants in heathland that had remained unburnt for a minimum of 30 years. Flowering after experimental burns was found to peak in the second post-fire flowering season rather than the first, and there was no clear fire frequency effect. Maximum levels of flowering during the second post-fire season reached 38 to 56% of individuals, although in some years post-fire flowering during this peak season was as low as 23%. Comparatively few plants flowered during the second-year peak season after every fire, and ~34% of individuals in both the 6- and 9-year burn treatments failed to flower at any time. Inter-fire flowering was also observed, and in some instances this flowering was not significantly different to the level achieved during the peak post-fire flowering season. For example, ~9% of individuals flowered 5–7 times over a 12-year period despite being burnt on only four occasions. Flowering after vernalisation (winter-chilling) was observed in unburnt heathland, and the level of this response was not significantly different to peak post-fire flowering in some years. The findings are examined in the context of evolutionary and habitat processes within a climate change framework. Future studies should focus on the complex interactions between climate, fire and soil for not only B. grandiflora, but more importantly for the diverse assemblage of plant species in wet heathland.
Design and applications of graphene-based flexible and wearable physical sensing devices
Authors: Li Xinming , Chai Yang
Published: November 2020

The rise of human–machine interaction and the internet of things technology requires the development of functionalized sensors that are mechanically flexible and fabulously wearable. Therefore, the emergence of new materials and devices is particularly important for technology design and development. Graphene has the atomically level thickness, mechanical flexibility, lightweights, and high conductivity and transparency. Especially, the large specific area of graphene enables the perception of external stimuli with high sensitivity, which is expected to be used in flexible sensor technology. In this review, we will introduce the research progress of graphene in flexible physical signal sensors, including the device structure design and the applications of these devices in wearable technology. We will overview the development of new directions of sensors, such as miniaturization, intelligence, and multi-modal. We will also focus on the latest technical progress of related sensing devices and point out the challenges and directions of future development of wearable sensors.
Chronic ischaemic heart disease and rivaroxaban: which patients derive the greatest benefit?
Authors: Bolognese Leonardo , Felici Massimo
Published: November 2020

Patients with established cardiovascular (CV) disease may suffer further CV events, despite receiving optimal medical treatment. Although platelet inhibition plays a central role in the prevention of new events, the use of anticoagulant therapies to reduce events in atheromatous disease has, until recently, been overlooked. The recent Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS) trial showed that rivaroxaban 2.5 mg twice daily given with low-dose aspirin reduces the incidence of the composite endpoint of stroke, heart attack, and death in patients with stable coronary artery disease. Although there are some limitations to the study, COMPASS offers promising conclusions and may change secondary prevention in patients with stable CV disease. This article reviews the results of the COMPASS study and how these results may affect patient management in everyday clinical practice.
New interventional solutions in calcific coronary atherosclerosis: drill, laser, shock waves
Authors: Laricchia Alessandra , Colombo Antonio
Published: November 2020

In the percutaneous treatment of coronary stenoses, it is essential to take into account the presence of calcifications as this influences the short- and long-term post-procedural outcomes. Today in the catheterization laboratory, there are several tools for the treatment of calcium; exploiting the different operating mechanisms, possibly even combining them together, is part of a modern approach to coronary angioplasty that aims to optimize results. To this end, each procedure must be properly planned and, in this perspective, intracoronary imaging (such as optical coherence tomography and intravascular ultrasound) is an essential aid to guide the procedure and show results.
Atrial fibrillation and ischaemic heart disease: should we use acetylsalicylic acid beside anticoagulants?
Authors: Volpe Massimo , Gallo Giovanna
Published: November 2020

Coexistence of atrial fibrillation and ischaemic heart disease is very common and patients affected by these conditions are exposed to both a high ischaemic and haemorrhagic risk. The choice of an appropriate combination of anticoagulant therapy with single or dual antiplatelet treatment is indeed one of the most relevant and contemporary challenges in clinical practice. Several studies and meta-analyses pointed out that 1 year after an acute coronary syndrome or percutaneous revascularization, the use of the sole anticoagulant therapy is not associated with increased risk of major cardiovascular events, whereas there is a substantial reduction of clinical significant bleeding events, as compared to patients treated also with antiplatelet medications. However, there are no clear-cut data regarding the possibility to implement this strategy in each patient, regardless the cardiovascular risk class. Furthermore, for patients requiring a combined anticoagulant and antiplatelet treatment, the available data seem to favour an association of direct anticoagulant and inhibitors of P2Y12, rather than regimens including aspirin. These data are derived mainly from observational studies, with all their limitations. The use of aspirin could be beneficial in patients with significant comorbidities, such as diabetes mellitus, or with severe peripheral atherosclerotic disease, involving the carotids and other large arteries.
Vascular dysfunction promotes regional hypoxia after bevacizumab therapy in recurrent glioblastoma patients
Authors: Gerstner Elizabeth R , Emblem Kyrre E , Yen Yi-Fen , Dietrich Jorg , Jordan Justin T , Catana Ciprian , Wenchin Kevin Lou , Hooker Jacob M , Duda Dan G , Rosen Bruce R , Kalpathy-Cramer Jayashree , Jain Rakesh K , Batchelor Tracy T
Published: November 2020

Background

Hypoxia is a driver of treatment resistance in glioblastoma. Antiangiogenic agents may transiently normalize blood vessels and decrease hypoxia before excessive pruning of vessels increases hypoxia. The time window of normalization is dose and time dependent. We sought to determine how VEGF blockade with bevacizumab modulates tumor vasculature and the impact that those vascular changes have on hypoxia in recurrent glioblastoma patients.

Methods

We measured tumor volume, vascular permeability (Ktrans), perfusion parameters (cerebral blood flow/volume, vessel caliber, and mean transit time), and regions of hypoxia in patients with recurrent glioblastoma before and after treatment with bevacizumab alone or with lomustine using [18F]FMISO PET-MRI. We also examined serial changes in plasma biomarkers of angiogenesis and inflammation.

Results

Eleven patients were studied. The magnitude of global tumor hypoxia was variable across these 11 patients prior to treatment and it did not significantly change after bevacizumab. The hypoxic regions had an inefficient vasculature characterized by elevated cerebral blood flow/volume and increased vessel caliber. In a subset of patients, there were tumor subregions with decreased mean transit times and a decrease in hypoxia, suggesting heterogeneous improvement in vascular efficiency. Bevacizumab significantly changed known pharmacodynamic biomarkers such as plasma VEGF and PlGF.

Conclusions

The vascular signature in hypoxic tumor regions indicates a disorganized vasculature which, in most tumors, does not significantly change after bevacizumab treatment. While some tumor regions showed improved vascular efficiency following treatment, bevacizumab did not globally alter hypoxia or normalize tumor vasculature in glioblastoma.
The Process of Creating and Disseminating Exercise Programs by Physical Therapists for Older Adults With Chronic Back Pain
Authors: Hay Melissa E , Connelly Denise M
Published: November 2020

Objective

The purpose of this study was to enhance the understanding of the process that physical therapists undertake when creating and disseminating exercise programs for older adults with chronic backpain.

Methods

Constructivist grounded theory methodology was used as an accessible mode of researching pragmatic clinical practices. Physical therapists from outpatient, ambulatory care clinic settings participated in in-depth, individual interviews (n = 9) and in-clinic observations (n = 5). Data collection and analysis were iterative processes. Codes were generated based on recurrent themes, and constant comparative analysis was used to compare data. Analysis and data collection were concluded when theoretical sufficiency was reached.

Results

Physical therapist participants described the process of creating and implementing exercise plans as involving listening to the patient’s story, determining function, physical therapy care, supported integration, and, ultimately, returning back to living and life with chronic back pain. Participants worked through the 5 phases at different rates, often recurrently, when treating older adults with chronic back pain. The phases are positioned within a shared alliance between physical therapy provider and patient, with a transfer of responsibility occurring throughout treatment and follow-up sessions, progressing toward patient independence. This transfer of responsibility served as the core category for the process herein.

Conclusions

This research highlights the importance of listening to patients’ stories when engaging in physical therapy care. Focusing on function, providing education and exercise as components of care, and supporting integration of exercise into everyday life are considerations for providing care for older adults with chronic back pain in physical therapist practice and, ultimately, for returning tolife.

Impact

With aging populations and with the increasing prevalence of chronic conditions, this research offers insight into a process for physical therapists to enact exercise engagement for improved health and quality of life for older adults with chronic backpain.
Variation Margins, Fire Sales, and Information-constrained Optimality
Authors: Biais Bruno , Heider Florian , Hoerova Marie
Published: November 2020

In order to share risk, protection buyers trade derivatives with protection sellers. Protection sellers’ actions affect the riskiness of their assets, which can create counterparty risk. Because these actions are unobservable, moral hazard limits risk sharing. To mitigate this problem, privately optimal derivative contracts involve variation margins. When margins are called, protection sellers must liquidate some assets, depressing asset prices. This tightens the incentive constraints of other protection sellers and reduces their ability to provide insurance. Despite this fire-sale externality, equilibrium is information-constrained efficient. Investors, who benefit from buying assets at fire-sale prices, optimally supply insurance against the risk of fire sales.
A 10-Year Retrospective Study of Postdural Puncture Headache in 32,655 Obstetric Patients
Authors: Costa A.C. , Satalich J.R. , Al-Bizri E. , Shodhan S. , Romeiser J.L. , Adsumelli R. , Abola R.E. , Steinberg E.S. , Bennett-Guerrero E.
Published: November 2020

(Can J Anaesth. 2019;66:1464–1471)

The use of neuraxial analgesia for labor and cesarean delivery anesthesia has increased over the past 30 years. A common complication of neuraxial blockade is accidental dural puncture (ADP) and the development of a postdural puncture headache (PDPH). Women who develop a PDPH may have debilitating symptoms which can interfere with their ability to care for their neonates. Furthermore, ADP and PDPH may result in chronic headaches or even more severe morbidity such as a subdural hematoma. PDPH can result in delays in hospital discharge for patients. The most reliable treatment for PDPH remains the epidural blood patch (EBP). The primary aim of this study was to describe the incidence of ADP as well as the rates of PDPH and EBP in parturients who had a neuraxial block during their delivery over a 10-year period. Secondarily, the authors examined delays in hospital discharge related to PDPH.
The Impact of Occupational Activities During Pregnancy on Pregnancy Outcomes: A Systematic Review and Meta-analysis
Authors: Cai C. , Vandermeer B. , Khurana R. , Nerenberg K. , Featherstone R. , Sebastianski M. , Davenport M.H.
Published: November 2020

(Am J Obstet Gynecol. 2020;222:224–238)

Over the past several decades, there has been an increase in the proportion of women who work. Some evidence suggests that adverse pregnancy outcomes including miscarraige and preterm delivery may be associated with physically demanding work during pregnancy, but previous systematic reviews have not found conclusive evidence for or against this association. This review aimed to evaluate the impact of physically demanding work on pregnancy outcomes and to establish a dose-response relationship between volumes of physically demanding occupational activities and pregnancy outcomes.
Trends in Postpartum Hemorrhage in the United States From 2010 to 2014
Authors: Reale S.C. , Easter S.R. , Xu X. , Bateman B.T. , Farber M.K.
Published: November 2020

(Anesth Analg. 2020;130:e119–e122)

Postpartum hemorrhage (PPH), an important source of maternal morbidity and mortality in the United States, increased 27.5% from 1995 to 2004 (with the main cause being rising rates of uterine atony). Improvement initiatives such as protocol dissemination, transfusion guideline creation, blood loss quantification, simulation development, and predelivery risk stratification all play a role in fighting against this largely preventable cause of maternal morbidity and mortality. This study aimed to evaluate PPH trends such as frequency, etiology, and associated maternal morbidity to further these improvement initiatives.
Coronavirus Disease 2019 (COVID-19) and Pregnancy: Responding to a Rapidly Evolving Situation
Authors: Rasmussen S.A. , Jamieson D.J.
Published: November 2020

(Obstet Gynecol. 2020;135:999–1002)

In December 2019, a cluster of patients with pneumonia of unknown etiology emerged in Wuhan, China. It was discovered in early January 2020 that the causative pathogen was a novel coronavirus, later named SARS-CoV-2. By March 11, 2020, the virus had spread globally and the World Health Organization declared a pandemic. As the situation with the novel coronavirus rapidly evolves, there are many key questions that remain to be answered about the disease and how it affects pregnant women and their neonates. This commentary aims to summarize key questions and available data, and makes relevant recommendations to obstetricians and their pregnant patients.
Perinatal Outcomes Following Bariatric Surgery Between a First and Second Pregnancy: A Population Data Linkage Study
Authors: Ibiebele I. , Gallimore F. , Schnitzler M. , Torvaldsen S. , Ford J.B.
Published: November 2020

(BJOG. 2020;127:345–354)

Obesity in women of reproductive age and pregnant women is a risk factor for maternal and neonatal morbidities, including fetal growth restriction, gestational diabetes, and childhood obesity. Bariatric surgery is a successful long-term solution to treat obesity and its comorbidities, and, as rates of both obesity and bariatric surgery rise, is an increasingly important consideration in reproductive health care. While other studies have assessed pregnancy outcomes after bariatric surgery, this study examined differences in perinatal outcomes for women who had bariatric surgery between their first and second pregnancies and those who did not. Further, the study assessed trends in bariatric surgery as well as characteristics of women having bariatric surgery.
The Effect of Cognitive Aid Design on the Perceived Usability of Critical Event Cognitive Aids
Authors: Clebone A. , Burian B.K. , Tung A.
Published: November 2020

(Acta Anaesthesiol Scand. 2020;64:378–384)

Although cognitive aids have been developed to facilitate a consistent, organized response during high stress and time-sensitive situations, they are not always utilized—potentially because they are perceived as difficult to use by clinicians. This study aimed to assess the usability of critical event cognitive aids designed to transfer discrete information in comparison to “step-by-step” linear cognitive aids that list recommended actions.
Infrared Thermography to Assess Dermatomal Levels of Labor Epidural Analgesia With 1 mg/mL Ropivacaine Plus 0.5 mg/mL Sufentanil: A Prospective Cohort Study
Authors: Bouvet L. , Roukhomovsky M. , Desgranges F.P. , Allaouchiche B. , Chassard D.
Published: November 2020

(Int J Obstet Anesth. 2020;41:53–58)

Epidural analgesia is considered the gold standard for labor analgesia. However, there are times when this technique fails to provide adequate analgesia and inadequate and/or failed epidural analgesia predicts failed conversion to anesthesia for cesarean delivery. The effectiveness of epidural analgesia can be determined early via verbal pain scores and testing the upper limit of the sensory block using cold sensation. Unfortunately, these methods are relatively subjective and can be unreliable. Thus, an objective tool for assessment of epidural spread of local anesthetic would be invaluable. This preliminary cohort study aimed to assess whether lumbar epidural analgesia brought forth significant change in cutaneous temperature (as measured by infrared thermography). In addition, the study also assessed whether the use of infrared thermography could aid in the prediction of failed epidural analgesia.
Motherhood and Anesthesiology: A Survey of the American Society of Anesthesiologists
Authors: Kraus M.B. , Dexter F. , Patel P.V. , Dodd S.E. , Thomson H.M. , Girardo M.E. , Hertzberg L.B. , Pearson A.C.S.
Published: November 2020

(Anesth Analg. 2020;130:1296–1302)

Over the last 2 decades, rates of women entering medical school have risen to near parity with men. However, despite gender equivalence in medical school enrollment, rates of female anesthesiologists lag severely behind. Though data are lacking in anesthesiology, causes of the leadership and specialty gaps for surgical residencies have been reviewed in recent publications, finding potential deterrents such as changing career plans due to motherhood, lack of formally institutionalized maternity leave policies, gender discrimination, perceived stigma associated with pregnancy, and perceived incompatibility of surgery with rewarding family life. In congruence with these findings for surgery, a study of major medical specialties determined anesthesiology to have the highest rate of maternal discrimination. The aim of this study was to survey women members of the American Society of Anesthesiologists (ASA) to better understand motherhood-related factors associated with women’s likelihood to recommend against a career in anesthesiology.
Maternal Age and Risk of Cesarean Section in Women With Induced Labor at Term—A Nordic Register-based Study
Authors: Bergholt T. , Skjeldestad F. , Pyykönen A. , Rasmussen S. , Tapper A. , Bjarnadóttir R. , Smárason A. , Másdóttir B. , Klungsøyr K. , Albrechtsen S. , Källén K. , Gissler M. , Løkkegaard E.
Published: November 2020

(Acta Obstet Gynecol Scand. 2020;99:283–289)

Following a decades-long upward trend of maternal age at childbirth, rates of labor induction (IOL) and cesarean deliveries (CDs) have also increased worldwide. Given those patterns, the authors of this study aimed to assess how maternal age and induction of labor impacted the rate of CD in both nulliparous and multiparous women.
Preoperative Cefazolin Rather Than Clindamycin or Metronidazole Is Associated With Lower Postpartum Infection Among Women With Chorioamnionitis Delivering by Cesarean Delivery
Authors: Venkatesh K.K. , Hughes B.L. , Grotegut C.A. , Strauss R.A. , Stamilio D.M. , Heine R.P. , Dotters-Katz S.K.
Published: November 2020

(Am J Obstet Gynecol MFM. 2020;2:100074)

Routine antibiotic prophylaxis has been shown to decrease the risk of postpartum maternal infection for women undergoing cesarean deliveries who have chorioamnionitis. However, the optimal antibiotic regimen to reduce postpartum infection in women presumed to have chorioamnionitis who deliver by cesarean remains to be defined. The current treatment for chorioamnionitis includes a base regimen of intrapartum antibiotics, usually consisting of intravenous ampicillin or penicillin and gentamicin. In the setting of a cesarean delivery, additional antibiotics are administered, including cefazolin, metronidazole, or the current standard clindamycin. This study investigated whether antibiotic therapy with cefazolin versus clindamycin or metronidazole reduced the risk of postpartum infection among women who received a base regimen of antibiotics to treat chorioamnionitis and had a cesarean delivery.
Effectiveness of Routine Third Trimester Ultrasonography to Reduce Adverse Perinatal Outcomes in Low-risk Pregnancy (the IRIS Study): Nationwide, Pragmatic, Multicentre, Stepped Wedge Cluster Randomized Trial
Authors: Henrichs J. , Verfaille V. , Jellema P. , Viester L. , Pajkrt E. , Wilschut J. , van der Horst H.E. , Franx A. , de Jonge A.
Published: November 2020

(BMJ. 2019;367:l5517)

Fetal growth restriction affects 7% to 10% of pregnancies and is a major risk factor for perinatal morbidity and death, as well as cardiovascular disease in adulthood. Small for gestational age (SGA) infants can be detected during usual prenatal care with serial fundal height measurements. While routine ultrasonography during the third trimester more frequently detects SGA infants than usual prenatal care, there is a lack of evidence indicating this practice reduces the incidence of severe adverse perinatal outcomes. Previous studies on the subject have been underpowered or were not clearly linked with appropriate management practices following an SGA diagnosis. This Intrauterine growth restriction Risk Selection (IRIS) study developed a multidisciplinary protocol for detecting and managing suspected fetal growth restriction and used a stepped wedge cluster randomized design to evaluate the effectiveness of routine ultrasonography in the third trimester combined with usual care, compared with usual care alone, in decreasing severe adverse perinatal outcomes.
Acute Postcesarean Pain Is Associated With In-hospital Exclusive Breastfeeding, Length of Stay, and Postpartum Depression
Authors: Babazade R. , Vadhera R.B. , Krishnamurthy P. , Varma A. , Doulatram G. , Saade G.R. , Turan A.
Published: November 2020

(J Clin Anesth. 2020;62:109697)

In 2011, 79% of newborns in the United States were breastfed, but by 6 months of age, only 49% of these were still breastfed [in accordance with the CDC recommendation of exclusive breastfeeding (EBF) for at least 6 mo]. By 12 months, a mere 27% of infants born in 2011 were still breastfed. Higher risks exist for infants not EBF for 6 months, in comparison with those EBF, including gastrointestinal infections, atopic eczema, respiratory illness, type II diabetes, obesity later in life, and leukemia. Six months of EBF is estimated to prevent one tenth of child deaths, but also to reduce child and mother medical costs by $3 billion each year. As breastfeeding within the first postdelivery hour is an important predictor for the success of EBF, this study’s aim was to investigate the association between postoperative pain and breastfeeding during hospital stay following cesarean delivery to determine any factors that may prevent successful EBF.
Acute Herpes Simplex Virus Hepatitis in Pregnancy
Authors: Calix R.X. , Loeliger K.B. , Burn M.S. , Campbell K.H.
Published: November 2020

(Obstet Gynecol. 2020;135:396–400)

Genital herpes simplex virus (HSV) infection is one of the most common sexually transmitted infections and poses risks to both pregnant women and their fetuses and newborns. In rare cases, HSV infection can cause severe maternal disease, including viral sepsis, encephalitis, and hepatitis. Although rare, HSV hepatitis can cause acute liver failure or death, and delaying or missing a diagnosis of HSV hepatitis can have serious consequences. This case study described an atypical case of HSV-1 hepatitis to demonstrate the diagnostic challenges associated with this disease as well as the necessity for early treatment.
Primary Cutaneous Desmoplastic Melanoma With Collagen Rosettes and Pseudoglandular Features
Authors: Donati Michele , Nožička Jan , Kastnerova Liubov , Hajkova Veronika , Persichetti Paolo , Michal Michal , Kazakov Dmitry V.
Published: November 2020

Primary cutaneous desmoplastic melanoma (DM) is a group of rare melanocytic tumors arising on severely sun-damaged skin, histologically characterized by the proliferation of spindled melanocytes in a prominent desmoplastic stroma, with a range of morphological presentations. In this article, we report a unique case of primary cutaneous DM composed of a nodular proliferation of highly pleomorphic spindled and epithelioid cells, pseudoglandular structures, clear cell change, and unusual collagen rosettes. Immunohistochemical analysis showed a strong and diffuse positivity for S-100 protein, SOX-10, nestin, p75 (nerve growth factor receptor), WT1, and p53. Molecular analysis detected a mutation in the NF1 gene [c.4084C > T, p.(Arg1362Ter)], 2 different pathogenic mutations in TP53 [c.742C > T, p.(Arg248Trp), AF:12%, COSM1640831 and c.528C > G, p.(Cys176Trp), AF:12%, COSM11114], and a mutation in GNAS [c.601C > T, p.(Arg201Cys), AF: 9%, COSM123397]. To the best of our knowledge, this is the first case reporting collagen rosettes and pseudoglandular features in primary cutaneous DM.
Adding Insult to Injury: Levator Ani Avulsion in Women With Obstetric Anal Sphincter Injuries
Authors: Heliker Bhumy Davé , Kenton Kimberly , Leader-Cramer Alix , Brown Oluwateniola , Bochenska Katarzyna , Geynisman-Tan Julia , Mueller Margaret , Lewicky-Gaupp Christina
Published: November 2020

Objective

In women with obstetric anal sphincter injuries, we compared the rate of major levator ani avulsion after forceps-assisted delivery versus spontaneous vaginal delivery.

Methods

Prospective cohort of primiparous women with obstetric anal sphincter injuries. The primary outcome was the rate of major levator ani avulsion as measured by 3-dimensional transvaginal ultrasonography performed between 1 and 2 weeks postpartum. Secondary outcomes included ultrasonographic anteroposterior hiatal diameter, levator hiatal area, and levator-urethra gap, and differences in validated pelvic disorder questionnaires scores at 1 to 2 and 13 weeks postpartum.

Results

Sixty-two women (30 spontaneous deliveries, 32 forceps deliveries) were included in the final analysis. After controlling for delivery variables, women who underwent forceps-assisted delivery were more likely to experience a major avulsion as compared with those who underwent spontaneous delivery (21/32, [65.6%] vs 8/30 [26.7%]; odds ratio, 5.9; 95% confidence interval, 1.5–24.5; P = 0.014). They were also more likely to have larger levator-urethra gaps bilaterally (P = 0.012, 0.016). After controlling for potential confounders, levator ani avulsion was independently associated with persistent anal incontinence symptoms at 13 weeks postpartum (P = 0.02).

Conclusions

In women with obstetric anal sphincter injuries, the risk of levator ani avulsion is almost 6 times higher after forceps-assisted vaginal delivery as compared with spontaneous vaginal delivery. In those with avulsion, recovery of anal continence is compromised, suggesting that adding insult (avulsion) to injury (obstetric anal sphincter injury) may have negative functional consequences.
Temporal and spatial differences in the post-breeding behaviour of a ubiquitous Southern Hemisphere seabird, the common diving petrel
Authors: Fromant Aymeric , Bost Charles-André , Bustamante Paco , Carravieri Alice , Cherel Yves , Delord Karine , Eizenberg Yonina H. , Miskelly Colin M. , Arnould John P. Y.
Published: November 2020

The non-breeding period plays a major role in seabird survival and population dynamics. However, our understanding of the migratory behaviour, moulting and feeding strategies of non-breeding seabirds is still very limited, especially for small-sized species. The present study investigated the post-breeding behaviour of three distant populations (Kerguelen Archipelago, southeastern Australia, New Zealand) of the common diving petrel (CDP) (Pelecanoides urinatrix), an abundant, widely distributed zooplanktivorous seabird breeding throughout the southern Atlantic, Indian and Pacific oceans. The timing, geographical destination and activity pattern of birds were quantified through geolocator deployments during the post-breeding migration, while moult pattern of body feathers was investigated using stable isotope analysis. Despite the high energetic cost of flapping flight, all the individuals quickly travelled long distances (greater than approx. 2500 km) after the end of the breeding season, targeting oceanic frontal systems. The three populations, however, clearly diverged spatially (migration pathways and destinations), and temporally (timing and duration) in their post-breeding movements, as well as in their period of moult. Philopatry to distantly separated breeding grounds, different breeding phenologies and distinct post-breeding destinations suggest that the CDP populations have a high potential for isolation, and hence, speciation. These results contribute to improving knowledge of ecological divergence and evolution between populations, and inform the challenges of conserving migratory species.
Identification of candidate genes controlling chilling tolerance of rice in the cold region at the booting stage by BSA-Seq and RNA-Seq
Authors: Guo Zhenhua , Cai Lijun , Chen Zhiqiang , Wang Ruiying , Zhang Lanming , Guan Shiwu , Zhang Shuhua , Ma Wendong , Liu Chuanxue , Pan Guojun
Published: November 2020

Rice is sensitive to low temperatures, specifically at the booting stage. Chilling tolerance of rice is a quantitative trait loci that is governed by multiple genes, and thus, its precise identification through the conventional methods is an arduous task. In this study, we investigated the candidate genes related to chilling tolerance at the booting stage of rice. The F2 population was derived from Longjing25 (chilling-tolerant) and Longjing11 (chilling-sensitive) cross. Two bulked segregant analysis pools were constructed. A 0.82 Mb region containing 98 annotated genes on chromosomes 6 and 9 was recognized as the candidate region associated with chilling tolerance of rice at the booting stage. Transcriptomic analysis of Longjing25 and Longjing11 revealed 50 differentially expressed genes (DEGs) on the candidate intervals. KEGG pathway enrichment analysis of DEGs was performed. Nine pathways were found to be enriched, which contained 10 DEGs. A total of four genes had different expression patterns or levels between Longjing25 and Longjing11. Four out of the 10 DEGs were considered as potential candidate genes for chilling tolerance. This study will assist in the cloning of the candidate genes responsible for chilling tolerance and molecular breeding of rice for the development of chilling-tolerant rice varieties.
Dinosaur diversification rates were not in decline prior to the K-Pg boundary
Authors: Bonsor Joseph A. , Barrett Paul M. , Raven Thomas J. , Cooper Natalie
Published: November 2020

Determining the tempo and mode of non-avian dinosaur extinction is one of the most contentious issues in palaeobiology. Extensive disagreements remain over whether their extinction was catastrophic and geologically instantaneous or the culmination of long-term evolutionary trends. These conflicts have arisen due to numerous hierarchical sampling biases in the fossil record and differences in analytical methodology, with some studies identifying long-term declines in dinosaur richness prior to the Cretaceous–Palaeogene (K-Pg) boundary and others proposing continued diversification. Here, we use Bayesian phylogenetic generalized linear mixed models to assess the fit of 12 dinosaur phylogenies to three speciation models (null, slowdown to asymptote, downturn). We do not find strong support for the downturn model in our analyses, which suggests that dinosaur speciation rates were not in terminal decline prior to the K-Pg boundary and that the clade was still capable of generating new taxa. Nevertheless, we advocate caution in interpreting the results of such models, as they may not accurately reflect the complexities of the underlying data. Indeed, current phylogenetic methods may not provide the best test for hypotheses of dinosaur extinction; the collection of more dinosaur occurrence data will be essential to test these ideas further.
Research on the effects of hydrothermal synthesis conditions on the crystal habit of MIL-121
Authors: Wang Fei , Zhu Liang , Wei Qingyan , Wang Yanfei
Published: November 2020

The investigation of the influence of hydrothermal synthesis conditions such as synthetic temperature, the amount of solvent, addition of additives including sodium hydroxide, lithium chloride and 2-methylimidazole on the morphology and size of MIL-121 was carried out. The experimental results indicated the significant impact of hydrothermal synthesis conditions on the morphologies and sizes of MIL-121 crystals. The synthesis temperature has little effect on the morphology, which is mainly reflected in the change of the aspect ratio, but the effect on the size is significant under low-temperature conditions. Additives have an important influence on the morphology and size of MIL-121. Our study provides a potential for the improvement of MIL-121 adsorption performance.
Genetic Liability to Cannabis Use Disorder and COVID-19 Hospitalization
Authors: Hatoum Alexander S. , Morrison Claire L. , Winiger Evan A. , Johnson Emma C. , Agrawal Arpana , Bogdan Ryan
Published: November 2020

Behavioral and life style factors plausibly play a role in likelihood of being hospitalized for COVID-19. Genetic vulnerability to hospitalization after SARS-CoV2 infection may partially relate to comorbid behavioral risk factors, especially the use of combustible psychoactive substances. Paralleling the COVID-19 crisis has been increasingly permissive laws for recreational cannabis use. Cannabis Use Disorder (CUD) is a psychiatric disorder that is heritable and genetically correlated with respiratory disease, independent of tobacco smoking. By leveraging genome-wide association summary statistics of CUD and COVID-19, we find that at least 1/3rd of the genetic vulnerability to COVID-19 overlaps with genomic liability to CUD (rg=.34, p=0.0003). Genetic causality as a potential mechanism of risk could not be excluded. The association between CUD and COVID-19 remained when accounting for genetics of trying marijuana, tobacco smoking (ever smoking regularly, cigarettes per day, smoking cessation, age of smoking initiation), BMI, fasting glucose, forced expiration volume, education attainment, and Townsend deprivation index. Heavy problematic cannabis use may increase chances of hospitalization due to COVID-19 respiratory complications. Curbing excessive cannabis use may be an essential strategy in COVID-19 mitigation.