bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualität der medizinischen Versorgung von Kindern mit primärer angeborener Hypothyreose
Authors: Hoppmann J. , Vasilakis I. , Vogel M. , Stoll S. , Gesing J. , Gausche R. , Kratzsch J. , Körner A. , Pfäffle R. , Kiess W.
Published: April 2019

Einleitung Die primäre angeborene Hypothyreose ist die häufigste angeborene endokrine Erkrankung. Ziel unserer Studie war es, zu untersuchen, wie hoch die Qualität der medizinischen Behandlung von Kindern mit primärer angeborener Hypothyreose in Deutschland ist und inwiefern die kürzlich veröffentlichten Empfehlungen der Europäischen Gesellschaft für Kinderendokrinologie (European Society for Paediatric Endocrinology [ESPE]) in der Diagnostik und Therapie der Kinder mit einer primären angeborenen Hypothyreose bereits in der Vergangenheit von den behandelnden Ärzten in der alltäglichen Praxis umgesetzt worden sind.

Methoden Hierzu wurden retrospektiv die Daten aller Patienten, die von 1998 bis 2008 ein positives Testergebnis für eine primäre angeborene Hypothyreose im Neugeborenscreening (NGS) im Screeningzentrum Leipzig aufwiesen, analysiert.

Ergebnisse Das NGS wurde mehrheitlich im empfohlenen Zeitraum durchgeführt. Eine ätiologische Zuordnung der angeborenen Hypothyreose gelang in 71 % der Fälle. Die medikamentöse Therapie mit L-Thyroxin (LT4) wurde durchschnittlich mit 8,5 Lebenstagen begonnen. Eine Normalisierung der Schilddrüsenhormone wurde durchschnittlich innerhalb von 11,4 Tagen nach Behandlungsbeginn erreicht. Eine formale audiologische und neurokognitive Testung im Verlauf wurde zwar lediglich in 25 % und 5 % durchgeführt und dokumentiert. Betroffene Kinder erhielten dennoch die notwendigen Fördermaßnahmen auf Grundlage der klinischen Einschätzung der behandelnden Ärzte.

Diskussion Unsere Studie zeigt, dass die Empfehlungen der kinderendokrinologischen Fachgesellschaft bereits mehrheitlich umgesetzt wurden. Die Diagnostik zur ätiologischen Zuordnung der primären angeborenen Hypothyreose, die Durchführung von audiologischen Untersuchungen sowie die Dokumentation und Nachverfolgung der Patienten bedürfen Verbesserung.
Korrigierende Manöver – Physiotherapie bei Adoleszentenskoliose
Authors: Piper Verena
Published: April 2019

Ein Schwimmbadbesuch, der Sportunterricht – Skoliosen entdeckt man bei Jugendlichen zwischen 11 und 17 Jahren meist zufällig. Neben Schule, Hobby und Freunden auch noch zur Physiotherapie? Die Begeisterung hält sich da oft in Grenzen. Der Artikel zeigt, wie Therapeuten die Teenager motivieren können und warum man auch die Eltern einfangen muss.
GROßE Bewegungen im Alltag – Behandlungskonzept für Menschen mit Parkinson
Authors: Geheb Katrin , Diaubalick Anne
Published: April 2019

Das LSVT-BIG-Konzept erscheint zunächst durch seine extrovertierten Übungen ungewohnt. Menschen mit Morbus Parkinson können dadurch jedoch den für ihre Erkrankung typischen kleinen Bewegungen entgegenwirken. Damit lassen sich Sturzprophylaxe, Selbstständigkeit im Alltag und individuelle Ziele erreichen.
„Ganz der Vater“?
Authors: Singer Dominique
Published: April 2019

Liebe Leserinnen und Leser,

Der Rettungswagen auf dem Titelbild dieser Ausgabe der Zeitschrift für Neonatologie und Geburtshilfe (ZGN) wird es Ihnen schon signalisiert haben: Das vorliegende Heft beginnt mit dem zweiten Teil der im Dezember 2018 begonnenen Serie über geburtshilfliche Notfälle, die uns in insgesamt 5 Folgen noch bis ins Jahr 2020 begleiten wird. Während es im ersten Beitrag v. a. um organisatorisch-logistische Erwägungen ging, steht diesmal das konkrete prähospitale Management bei typischen geburtshilflichen Notfällen im Vordergrund, die oft direkt, nicht selten aber auch nur mittelbar oder gar nicht mit der Schwangerschaft zu tun haben. Speziell zu dieser herausfordernden Differentialdiagnose gibt der Beitrag ebenso wertvolle Hinweise wie zu der Frage, was im prähospitalen Setting – verglichen mit der umfassenden klinischen Behandlung – pragmatisch betrachtet überhaupt zu leisten ist.
Physiotherapeutische Bedarfsaspekte bei Kindern mit Mukoviszidose im Alter von 0 bis 18 Jahren
Authors: Behr A. , Jung M.
Published: April 2019

Hintergrund Bei dem Krankheitsbild der Mukoviszidose handelt es sich, trotz hohem Forschungsinteresse, um eine immer noch lebensverkürzende, autosomal-rezessiv vererbbare Stoffwechselerkrankung. Ziel dieser Studie ist es, einen Überblick der aktuellen Therapiesituation von Kindern mit Mukoviszidose zu bekommen, um mit diesen Erkenntnissen den physiotherapeutischen Bedarf auszumachen und hinsichtlich des Therapie-managements zu Hause unterstützend einzuwirken.

Methode Es handelt sich um eine deskriptive Querschnittstudie, bei der eine schriftliche Befragung anhand eines von der Autorin selbst erstellten Fragebogens durchgeführt wird. Befragt werden Familien Mukoviszidose-kranker Kinder (0–18 J.) aus den Zentren Trier und Frankfurt. Die Rücklaufquote beträgt ca. 55 % (23/42). Einbezogen wurden unter anderen sozialdemokratischen Aspekten, Fragen zur Therapiedichte, der Aufklärung und Weiterbildung sowie zur Therapie und Stressbeteiligung. Die Auswertung begrenzt sich aufgrund der hohen Datenmenge auf 14 von 28 Fragen.

Ergebnis Es besteht in etwa 46 % der Fälle ein Bedarf an Aufklärung und bei rund 70 % an Weiterbildung für die Therapie zu Hause. Es zeigt sich eine Tendenz, dass sich das Therapiemanagement für die Familien teilweise als ein Stressor darstellt.

Diskussion und Ausblick Die Erhebung der exakten Therapiezeit ist anhand dieses Messinstrumentes nur bedingt möglich. Das Thema Stress und Therapiemanagement sollte, trotz der hiesigen Ergebnisse, nicht außer Acht gelassen werden. Es zeigte sich in der Stichprobe ein Bedarf an Aufklärung und Weiterbildung für die Therapie. Dies ist ein Hinweis für die Physiotherapie, das Therapieangebot in diesem Bereich zu optimieren und damit die Familien effektiv zu unterstützen. Weitere Studien in einem größeren Umfang sind nötig, um eine genauere Einschätzung über den aktuellen Bedarf an Aufklä-rung und Weiterbildung zu bekommen.
Dissection Course in Anatomy as Stimulus to Independent Research and to a Real Step into Medicine
Authors: Nikolenko Vladimir , Oganesyan Marine , Zakirov Felix , Kudryashova Valentina , Rizaeva Nelly , Valiullina Polina
Published: April 2019

Objectives In the recent years, many strategies in anatomy education have appeared. However, these innovations reduce the time students can spend on cadaver-based classes, which are considered to be an effective method of learning anatomy. The aim of the present research was to observe the advantages and features of dissection sessions in medical universities.

Materials and Methods The comparative analysis of the academic performance of dissector (n = 30) and nondissector (n = 105) students and a survey questionnaire were conducted. The data was collected through the work of the Dissection Mastery School (DMS) of the Sechenov University, Moscow, Russia, between 2016 and 2018.

Results The data analysis showed significant higher examination results in the dissectors cohort (p < 0.001) and a strong opinion about dissection as a good tool to improve anatomy knowledge (95% of responders). Apart from that, prosection is proven to have advantages in comparison with alternative learning approaches, according to researches performed by colleagues.

Conclusion These data show that dissection still remains one of the most effective and beneficial methods of teaching anatomy in medical universities, and that it should be further integrated into the medical curriculum.
Comparative Morphological Studies of the Stifle Menisci in Donkeys, Goats and Dogs
Authors: Abumandour Mohamed M.A. , Bassuoni Naglaa Fathi , El-Gendy Samir , Karkoura Ashraf , El-Bakary Raafat
Published: April 2019

The present work aims to provide more anatomical information on the stifle joint of the investigated species using computed tomography with gross anatomical cross-sections. The current work analyzed the stifle joint of the pelvic limbs of 12 adult donkeys, goats and dogs of both genders. The medial condyle of the femur was larger than the lateral one in the donkey, while it was smaller and lower than the lateral one in the goat and in the dog. The unsuitable femoral and tibial condyles were adapted by the presence of menisci. In the donkey, the medial meniscus was crescentic in shape, but it was semicircular in the goat, while in the dog, the medial and lateral menisci were C-shaped. In the donkey, the medial meniscus was larger than the lateral one, but in the goat and in the dog, the lateral meniscus was the largest, and more concave and thicker. The lateral meniscus was semicircular in the donkey, but it was shaped like an elongated kidney in the goat. In the goat and in the dog, the central border of two menisci was thin, concave and notched centrally. The meniscal ligaments included cranial and caudal ligaments of the medial and lateral menisci, and meniscofemoral ligament of the lateral meniscus. In the dog, the cranial ligament of the medial meniscus was absent, and the medial meniscus had no bony attachment to the tibia but it attached to the transverse intermeniscal ligament, which connected the cranial horn of the medial meniscus with the cranial ligament of the lateral meniscus. The meniscofemoral ligament connected the caudal pole of the lateral meniscus with the intercondyloid fossa of the femur.
Skew scattering dominated anomalous Nernst effect in La1-xNaxMnO3
Authors: Ghosh Arup , Das Rajasree , Mahendiran Ramanathan
Published: April 2019

We report the anomalous Nernst effect (ANE) in bulk La1-xNaxMnO3 (x = 0.02, 0.05, 0.1, and 0.3) samples whose ferromagnetic Curie temperature (TC) is tunable from 251 K to 310 K. The ANE voltage abruptly increases at TC and decreases for T < TC. The maximum value of ANE is achieved for x = 0.1, which shows the highest magnetization value in the series. The temperature dependent ANE (T < TC) is analyzed with the help of dc resistivity and longitudinal thermopower data using Mott’s relation, and it is found that the ANE in La1-xNaxMnO3 is dominated by skew scattering.
Completing the dark matter solutions in degenerate Kaluza-Klein theory
Authors: Searight Trevor P.
Published: April 2019

A complete set of wave solutions is given for the weak field in a Kaluza-Klein theory with degenerate metric. In the five-dimensional version of this theory, electromagnetism is described by two vector fields, and there is a reflection symmetry between them which unifies them with gravitation; wave behavior in the extra dimension has been interpreted as dark matter. Here, three independent dark matter solutions are found, and for two of them, it is shown how they must be combined into a single solution in order to obey the reflection symmetry. The unification is also expanded to six dimensions to prepare the way to include further forces.
REEP3 and REEP4 determine the tubular morphology of the endoplasmic reticulum during mitosis
Authors: Kumar Darshan , Golchoubian Banafsheh , Belevich Ilya , Jokitalo Eija , Schlaitz Anne-Lore
Published: April 2019

The endoplasmic reticulum (ER) is extensively remodeled during metazoan open mitosis. However, whether the ER becomes more tubular or more cisternal during mitosis is controversial, and dedicated factors governing the morphology of the mitotic ER have remained elusive. Here, we describe the ER membrane proteins REEP3 and REEP4 as major determinants of ER morphology in metaphase cells. REEP3/4 are specifically required for generating the high-curvature morphology of mitotic ER and promote ER tubulation through their reticulon homology domains (RHDs). This ER-shaping activity of REEP3/4 is distinct from their previously described function to clear ER from metaphase chromatin. We further show that related REEP proteins do not contribute to mitotic ER shaping and provide evidence that the REEP3/4 carboxyterminus mediates regulation of the proteins. These findings confirm that ER converts to higher curvature during mitosis, identify REEP3/4 as specific and crucial morphogenic factors mediating ER tubulation during mitosis, and define the first cell cycle-specific role for RHD proteins.
ResPRE: high-accuracy protein contact prediction by coupling precision matrix with deep residual neural networks
Authors: Li Yang , Hu Jun , Zhang Chengxin , Yu Dong-Jun , Zhang Yang
Published: April 2019

Motivation

Contact-map of a protein sequence dictates the global topology of structural fold. Accurate prediction of the contact-map is thus essential to protein 3D structure prediction, which is particularly useful for the protein sequences that do not have close homology templates in the Protein Data Bank.

Results

We developed a new method, ResPRE, to predict residue-level protein contacts using inverse covariance matrix (or precision matrix) of multiple sequence alignments (MSAs) through deep residual convolutional neural network training. The approach was tested on a set of 158 non-homologous proteins collected from the CASP experiments and achieved an average accuracy of 50.6% in the top-L long-range contact prediction with L being the sequence length, which is 11.7% higher than the best of other state-of-the-art approaches ranging from coevolution coupling analysis to deep neural network training. Detailed data analyses show that the major advantage of ResPRE lies at the utilization of precision matrix that helps rule out transitional noises of contact-maps compared with the previously used covariance matrix. Meanwhile, the residual network with parallel shortcut layer connections increases the learning ability of deep neural network training. It was also found that appropriate collection of MSAs can further improve the accuracy of final contact-map predictions. The standalone package and online server of ResPRE are made freely available, which should bring important impact on protein structure and function modeling studies in particular for the distant- and non-homology protein targets.

Availability and implementation

https://zhanglab.ccmb.med.umich.edu/ResPRE and https://github.com/leeyang/ResPRE.

Supplementary information

Supplementary data are available at Bioinformatics online.
Develop machine learning-based regression predictive models for engineering protein solubility
Authors: Han Xi , Wang Xiaonan , Zhou Kang
Published: April 2019

Motivation

Protein activity is a significant characteristic for recombinant proteins which can be used as biocatalysts. High activity of proteins reduces the cost of biocatalysts. A model that can predict protein activity from amino acid sequence is highly desired, as it aids experimental improvement of proteins. However, only limited data for protein activity are currently available, which prevents the development of such models. Since protein activity and solubility are correlated for some proteins, the publicly available solubility dataset may be adopted to develop models that can predict protein solubility from sequence. The models could serve as a tool to indirectly predict protein activity from sequence. In literature, predicting protein solubility from sequence has been intensively explored, but the predicted solubility represented in binary values from all the developed models was not suitable for guiding experimental designs to improve protein solubility. Here we propose new machine learning (ML) models for improving protein solubility in vivo.

Results

We first implemented a novel approach that predicted protein solubility in continuous numerical values instead of binary ones. After combining it with various ML algorithms, we achieved a R2 of 0.4115 when support vector machine algorithm was used. Continuous values of solubility are more meaningful in protein engineering, as they enable researchers to choose proteins with higher predicted solubility for experimental validation, while binary values fail to distinguish proteins with the same value—there are only two possible values so many proteins have the same one.

Availability and implementation

We present the ML workflow as a series of IPython notebooks hosted on GitHub (https://github.com/xiaomizhou616/protein_solubility). The workflow can be used as a template for analysis of other expression and solubility datasets.

Supplementary information

Supplementary data are available at Bioinformatics online.
Left ventricular remodelling and change in left ventricular global longitudinal strain after cardiac resynchronization therapy: prognostic implications
Authors: van der Bijl Pieter , Kostyukevich Marina V , Khidir Mand , Ajmone Marsan Nina , Delgado Victoria , Bax Jeroen J
Published: April 2019

Aims

Cardiac resynchronization therapy (CRT) can reduce left ventricular end-systolic volume (LVESV), and a decrease of ≥15% is defined as a response. CRT can also improve LV global longitudinal strain (GLS). Changes in LVESV and LV GLS are individually associated with outcome post-CRT. We investigated LVESV and LV GLS changes and prognostic implications of improvement in LVESV and/or LV GLS, compared with no improvement in either parameter.

Methods and results

Baseline and 6-month echocardiograms were analysed from CRT recipients with heart failure. LV reverse remodelling was defined as a ≥15% reduction in LVESV at 6 months post-CRT. A ≥5% absolute improvement in LV GLS was defined as a change in LV GLS. A total of 1185 patients were included (mean age 65 ± 10 years, 73% male), and those with an improvement in LVESV and LV GLS (n = 131, 11.1%) had significantly lower mortality compared with other groups. On multivariable analysis, an improvement in both LVESV and LV GLS [hazard ratio (HR): 0.47; 95% confidence interval (CI): 0.31–0.71; P < 0.001] or an improvement in either LVESV or LV GLS (HR: 0.57; 95% CI: 0.47–0.71; P < 0.001) were independently associated with better prognosis, compared with no improvement in either parameter.

Conclusion

Either a reduction in LVESV and/or an improvement in LV GLS at 6 months post-CRT are independently associated with improved long-term prognosis, compared with no change in both LVESV and LV GLS. This supports the use of LV GLS as a meaningful parameter in defining CRT response.
Ambulatory care-sensitive emergency department cases: a mixed methods approach to systemize and analyze cases in Germany
Authors: Schuettig Wiebke , Sundmacher Leonie
Published: April 2019

Background

Internationally, emergency departments (ED) are treating increasing numbers of patients with conditions that could have been managed appropriately in ambulatory care (AC) settings. The aim of our study was to develop the first consensus-based list of AC-sensitive conditions commonly seen in German EDs and explore predictors of these visits.

Methods

Our study used a Delphi survey of 30 physicians to compile a list of conditions they agreed were amenable to AC treatment. The group identified reasons why patients visit EDs instead of AC. We used the results to inform spatial regression models analysing the association of patient characteristics and attributes of AC with AC-sensitive ED visits based on 2015 district-level data.

Results

Our study provides a list of AC-sensitive conditions based on the German ED context. Results suggest that, up to the age of 70 years, the older the patients, the less likely they seek EDs for these conditions. Results of our regression analyses suggest that AC-sensitive ED rates were significantly higher in districts with lower physician density. Patients’ urgency perception and preferences were identified as main drivers of AC-sensitive ED visits.

Conclusion

Future policy measures should aim to help guide patients through the healthcare system so that they receive the best care in place that is most appropriate in terms of quality, safety and continuity of care. A list of AC-sensitive ED conditions can be used as a monitoring instrument and for further analyses of routine data to inform policy makers seeking to improve resource use and allocation.
General practitioners’ concepts on issuing out-of-pocket prescriptions for hypnotics and sedatives in Germany
Authors: Schmalstieg-Bahr Katharina , Müller Christiane A , Hummers Eva
Published: April 2019

Background

In Germany, almost 50% of prescriptions for benzodiazepines and drugs as Zolpidem and Zopiclone are as out-of-pocket (OOP) prescriptions—requiring patients to buy the drug at their own expense—although almost 90% of the population has statutory health insurance covering medication costs.

Objective

To understand why general practitioners (GPs) choose this prescribing method since needed medications are insurance covered, and unnecessary drugs should not be prescribed at all.

Methods

In this qualitative study, 17 semi-structured interviews with GPs were conducted, audio recorded and transcribed verbatim. Transcripts were analysed with grounded theory to extract a model explaining the described behaviour.

Results

Knowing the significant medical risks and insecurity about regulations makes GPs wish to avoid hypnotics and sedatives. They achieve this by ‘Creating a barrier’ (central phenomenon) and employing the strategy ‘Using an out-of-pocket prescription’, which not only generates costs for the patient but also reduces the physicians´ legal and financial accountability. The perceived patient type, expected problem duration and diagnosis influence the decision about the prescription form: patients with an alcohol or drug addiction or those with ‘uncomplicated’ insomnia are more likely to receive an OOP prescription. Patients with any psychiatric diagnosis will likely receive a statutory health insurance prescription.

Discussion

Current regulations do not provide guidance to GPs regarding hypnotics and sedatives. A clear regulatory framework and guidelines could possibly reduce physicians’ defensive attitudes about these drugs and their use of OOP prescriptions. The approach to use OOP prescriptions as a barrier to reduce patients’ medication use lacks evidence regarding effectiveness.
Understanding the Barriers and Enablers to Using Outdoor Spaces in Nursing Homes: A Systematic Review
Authors: van den Berg Maayken E L , Winsall Megan , Dyer Suzanne M , Breen Fidelma , Gresham Meredith , Crotty Maria
Published: April 2019

Background and Objectives

Despite acknowledged benefits of residents in nursing homes spending time outdoors, little is known about factors related to their use of outdoor space. This systematic review summarizes reported barriers and enablers to nursing home residents’ use of outdoor spaces.

Research Design and Methods

Multiple databases were searched to May 2018. Qualitative or mixed methods studies describing barriers/enablers to use of outdoor areas by residents of nursing homes (aged 65 years and older), as reported by residents, staff, or family members were included. Study quality rating, thematic analysis, and stratified analyses were performed and confidence in findings assessed using GRADE-CERQual.

Results

Twenty-four studies were included. Nineteen collected data from residents, 15 from staff/caregivers, 7 from families. Major themes and key findings concerned: design of the outdoor area (importance of garden greenery and built features), safety concerns and staffing issues, weather and seasons (appropriate shade and shelter), design of the main building (easy to open doors and nearby access points) and social activities.

Conclusions and Implications

Providing gardens with seasonal plants and interactive features, weather protected seating, manageable doors at accessible thresholds, planned social activities, and appropriate clothing are fundamental to facilitate nursing home residents’ access to the outdoors. Cultural change at an organizational level, addressing perceptions of safety as a barrier is important. Incorporation of the recommendations in this review by architects, facility managers, and policy makers in the design and management of nursing homes, may increase use of outdoor areas and improve the quality of life of residents.

Registration

The protocol is registered in Prospero (CRD42018100249).
Placental DNA methylation levels at CYP2E1 and IRS2 are associated with child outcome in a prospective autism study
Authors: Zhu Yihui , Mordaunt Charles E , Yasui Dag H , Marathe Ria , Coulson Rochelle L , Dunaway Keith W , Jianu Julia M , Walker Cheryl K , Ozonoff Sally , Hertz-Picciotto Irva , Schmidt Rebecca J , LaSalle Janine M
Published: April 2019

DNA methylation acts at the interface of genetic and environmental factors relevant for autism spectrum disorder (ASD). Placenta, normally discarded at birth, is a potentially rich source of DNA methylation patterns predictive of ASD in the child. Here, we performed whole methylome analyses of placentas from a prospective study MARBLES (Markers of Autism Risk in Babies—Learning Early Signs) of high-risk pregnancies. A total of 400 differentially methylated regions (DMRs) discriminated placentas stored from children later diagnosed with ASD compared to typically developing controls. These ASD DMRs were significantly enriched at promoters, mapped to 596 genes functionally enriched in neuronal development, and overlapped genetic ASD risk. ASD DMRs at CYP2E1 and IRS2 reached genome-wide significance, replicated by pyrosequencing and correlated with expression differences in brain. Methylation at CYP2E1 associated with both ASD diagnosis and genotype within the DMR. In contrast, methylation at IRS2 was unaffected by within DMR genotype but modified by preconceptional maternal prenatal vitamin use. This study therefore identified two potentially useful early epigenetic markers for ASD in placenta.
Endoscopist-Directed Propofol as an Adjunct to Standard Sedation: A Canadian Experience
Authors: Heron Valérie , Golden Charlotte , Blum Seymour , Friedman Gad , Galiatsatos Polymnia , Hilzenrat Nir , Stein Barry L , Szilagyi Andrew , Wyse Jonathan , Battat Robert , Cohen Albert
Published: April 2019

Background

Sedation practices vary widely by region. In Canada, endoscopist-directed administration of a combination of fentanyl and midazolam is standard practice. A minority of cases are performed with propofol.

Aims

To describe the safety of nonanaesthetist administered low-dose propofol as an adjunct to standard sedation.

Methods

This was a single-centre retrospective study of patients having undergone endoscopic procedures with propofol sedation between 2004 and 2012 in a teaching hospital in Montreal. Procedures were performed by gastroenterologists trained in Advanced Cardiovascular Life Support. Sedation was administered by intravenous bolus by a registered nurse, under the direction of the endoscopist. Outcomes of procedures were collected in the context of a retrospective chart review using the hospital’s endoscopy database.

Results

Of patients undergoing endoscopies at our centre, 4930 patients received propofol as an adjunct to standard sedation with fentanyl and midazolam. Cecal intubation rate for colonoscopies (n = 2921) was 92.0%. Gastroscopies (n = 1614), flexible sigmoidoscopies (n = 28), endoscopic retrograde cholangiopancreatography (n = 331) and percutaneous endoscopic gastrostomy insertion (n = 36) had success rates, defined as successful completion of the procedure within anatomical limits, of 99.0, 96.4, 94.0 and 91.7%, respectively. The average dose of propofol used for each procedure was 34.5 ± 20.8 mg. Fentanyl was used in 67.4% of procedures at an average dose of 94.3 ± 17.5 mcg. Midazolam was used in 92.7% of cases at an average dose of 3.0 ± 0.7 mg. Reversal agents (naloxone or flumazenil) were used in 0.43% of the cases (n = 21). Patients who received propofol were discharged uneventfully within the usual postprocedure recovery time. One patient required sedation-related hospitalization. For patients having received propofol in addition to standard sedation agents, 99.6% experienced no adverse events. There were no mortalities.

Conclusion

The use of low-dose propofol as an adjunct to fentanyl and midazolam, administered by a registered nurse under the direction of the endoscopist was safe and effective in patients at our centre.
Genetic Control of Facultative Parthenocarpy in Nicotiana tabacum L.
Authors: Dexter-Boone Abigail , Humphry Matt , Shi Rui , Lewis Ramsey S
Published: April 2019

Investigation of parthenocarpy, the production of fruit without fertilization, in multiple plant species could result in development of technologies for conferring seedless fruits and increased stability of fruit formation in economically important plants. We studied parthenocarpy in the model species Nicotiana tabacum L., and observed variability for expression of the trait among diverse genetic materials. Parthenocarpy was found to be partially dominant, and a single major quantitative trait locus on linkage group 22 was found to control the trait in a doubled haploid mapping population derived from a cross between parthenocarpic cigar tobacco cultivar “Beinhart 1000” and nonparthenocarpic flue-cured tobacco cultivar, “Hicks.” The same genomic region was found to be involved with control of the trait in the important flue-cured tobacco cultivar, “K326.” We also investigated the potential for the production of maternal haploids due to parthenogenesis in parthenocarpic tobacco seed capsules. Maternal haploids were not observed in parthenocarpic capsules, suggesting a requirement of fertilization for maternal haploid production due to parthenogenesis in N. tabacum.
Sequent calculus for 3-valued paraconsistent logic QMPT0
Authors: Nide Naoyuki , Goto Yuki , Fujita Megumi
Published: April 2019

We present a sequent calculus of a paraconsistent logic QMPT0, which has the paraconsistent-type excluded middle law (PEML) as an initial sequent. Our system shows that the presence of PEML is essentially important for QMPT0. It also has special rules when the set of constant symbols is finite. We also discuss the cut-elimination property of our system.
The Shape and Structure of the ‘Usable Past’: An Empirical Analysis of the Use of Precedent in International Adjudication
Authors: Ridi Niccolò
Published: April 2019

How do international adjudicators use precedent? This question has been addressed several times in the literature, but doctrinal accounts have generally failed to consider the aggregate dimension of the phenomenon. This article seeks to provide an alternative outlook by offering a large-scale computational analysis of the body of jurisprudence of three international fora (the ICJ, the WTO Appellate Body and investment arbitration tribunals) and comparing their citation patterns with those of other judicial bodies—national and international. Building on a very large dataset (comprising over 200,000 citations), it employs network analysis tools to measure the evolution of international law citation networks. It then unpacks this emerging complexity by considering what, in a precedent, holds ‘citing value’, highlighting the expansion of the range of precedential resources as well as the consecration of established authorities. Finally, the article considers three examples of computational analysis of citations to precedent in order to better gauge the level of engagement with the past.
Arbitration Costs
Authors: Franck Susan D.
Published: April 2019

Investment treaty arbitration (sometimes called ISDS or investor-state dispute settlement) has become a flashpoint in the backlash against globalization, with costs becoming an area of core scrutiny. Yet “conventional wisdom” about costs is not necessarily wise. To separate fact from fiction, this book reality tests claims about investment arbitration and fiscal costs against hard data so that policy reforms can be informed by scientific evidence, rather than intuition or cognitive illusions. The exercise is critical, as investment treaties grant international arbitrators the power to order states—both rich and poor—to pay potentially millions of dollars to foreign investors when states violate the international law commitments made in the treaties. Meanwhile, the cost to access and defend the arbitration can also be in the millions of dollars. This book uses cognitive psychology insights and hard data to explore the reality of investment treaty arbitration, identify core demographics and basic information on outcomes, and drill down on the costs of parties’ counsel and arbitral tribunals. It offers a nuanced analysis of how and when cost-shifting occurs, parses tribunals’ rationalization (or lack thereof) of cost assessments, and models the variables most likely to predict costs, using data to point the way toward evidence-based normative reform. With an intelligent interdisciplinary approach that speaks to ongoing reform at entities such as the World Bank’s ICSID and UNCITRAL, this book provides the most up-to-date study of investment treaty dispute resolution costs, offering new insights that will shape the direction of investment treaty and arbitration reform more broadly.
Medjugorje and the Supernatural
Authors: Klimek Daniel Maria
Published: April 2019

In June 1981, six young Croatians in the village of Medjugorje, in the former Yugoslavia, reported that the Virgin Mary had appeared to them. The Medjugorje visionaries say that the Virgin Mary has returned every day since then, bringing them important messages from heaven to convey to the world. Throughout history, people have reported encountering extraordinary religious experiences—apparitions of the Virgin Mary, visions of Jesus Christ, weeping statues and icons, the stigmata, physical healings and miracles, and experiences of the afterlife—and interpreted them as supernatural in origin. Scholars have often tried to reinterpret such experiences, including those described by the great mystics of history like Francis of Assisi, Catherine of Siena, and Teresa of Avila, into natural or psychopathological categories, such as hysteria, hallucination, delusion, epileptic seizures, psychosis, the workings of the unconscious mind, or fraud. Are such reductionist explanations valid? Over the past three decades the Medjugorje visionaries have been subjected to extensive medical, psychological, and scientific examination, even while undergoing their visionary experiences. Daniel Maria Klimek argues that the case of Medjugorje affords a rare opportunity to understand a deeper dimension of extraordinary religious phenomena. Klimek concludes that the scientific studies in Medjugorje make a significant contribution in challenging a history of reductionism in scholarship on extraordinary religious experiences, the science pointing to something “more” in the experiences of the visionaries.
The Sound and Smell of Suffering
Authors: Otis Laura
Published: April 2019

Despite cultural pressures to “suck up” one’s pain, some rebellious literary characters make their suffering known. In E. M. Forster’s A Room with a View, the aging spinster Charlotte Bartlett makes her unhappiness audible through well-timed sighs. Forster represents his characters’ emotions through metaphors of frozen or flowing water, darkness and sunlight, and rushing electric trams. In Virginia Woolf’s Mrs. Dalloway, history tutor Doris Kilman resents her unjust dismissal from school due to her Germanic background. Woolf describes Doris’s emotions through metaphors of awkward movements, sensations of bursting, and bad smells. Doris and Charlotte make sure that the more prosperous, conventional characters in these novels can see, hear, and smell their unhappiness. By making their misery known, they remind readers of the injustice in societies where the main characters are enjoying privileges that others do not.
The Great Conversation
Authors: Lane Belden C.
Published: April 2019

Thomas Berry lamented that humans have dropped out of the Great Conversation with the rest of the natural world. We’ve objectified a world of things—imagining they exist solely for human use. If nature speaks, we are no longer listening. Yet the saints of the great spiritual traditions have long perceived trees, islands, rivers, and canyons as teachers, mirroring the inner world of the soul. Hildegard of Bingen attended to the greening power of trees. Ignatius Loyola was shaped by a cave experience. The Baal Shem Tov spoke the languages of birds, plants, and clouds. Focusing on a cottonwood tree as his own principal tutor, Belden Lane asks how the masters incorporated these earthy mentors into their spiritual lives. He backpacks into wild terrain to experience the power these nature archetypes had for them. Hiking through a recently burned Wyoming forest, for example, he understands Catherine of Siena’s fascination with fire as an image of the Divine. The book asks how spiritual guides in nature can serve us at various stages of our lives: As the child longs to fly like a bird; the adolescent seeks to flame out like a star; the adult needs the river’s flow; the elder ascends the mountain. All of these demand intensive soul work. Reconnecting with nature is the great ecological and spiritual necessity of our times. The earth and our souls depend upon it. As Stephen Jay Gould affirms, “We won’t fight to save what we haven’t learned to love.”
Basic Premises and Method
Authors: Walen Alec D.
Published: April 2019

The reigning method in moral philosophy is the search for reflective equilibrium. An interesting feature of contemporary moral philosophy is how much weight most theorists put on matching intuitions in test cases, rather than finding plausible, relevant, high-level moral principles that can be used to generate mid-level principles and judgments in particular situations. This chapter covers four themes in two groups. The first group concerns the author’s general approach to moral theory. It includes the role of theory and cases in the author’s own work and the role of evidence and facts in justification. The second group concerns two topics specifically relevant to just war theory: reductive individualism and the distinctive causal structure of eliminative killing.
Intervening Agency and the Right of Non-Sacrifice
Authors: Walen Alec D.
Published: April 2019

This chapter argues for the extension of an idea from the previous chapter, that of a right of non-sacrifice. It argues that this right exists in certain cases of intervening agency: when the intervening agent presents the primary agent with a choice either to submit to suffering a harm or to resist, knowing that the intervening agent will then harm others. The argument proceeds in four parts. First, the chapter explains why such a case is puzzling; second, it dismisses two unsuccessful attempts to resolve the puzzle; third, it explains why intervening agency sometimes has the effect of changing the nature of the causal structure in which an agent acts, though noting as well that intervening agency is not unique in having that effect; and finally, it explores how these ideas might be relevant to just war theory and eliminative killing in that context.
Introduction
Authors: Bahar Matthew R.
Published: April 2019

A Thanksgiving Day pageant at Plymouth Harbor, Massachusetts, in 1970 revealed the extent to which modern Americans have forgotten an important chapter of their early past. Though profoundly significant in the political, economic, and cultural development of both Native and colonial societies in the Northeast, the history of Wabanaki sea power has been intentionally and inadvertently overlooked by myriad peoples. New Englanders in the era of the American Revolution ignored their history of victimhood at the hands of Indians and their dependency on the British Empire to mitigate it. The story has since been buried deeper by popular and academic writing informed by historical assumptions about American Indians, the Atlantic world, and piracy.
New Waves, New Prospects
Authors: Bahar Matthew R.
Published: April 2019

Over the course of the seventeenth century, sail facilitated a new Wabanaki identity, from the Mi’kmaq coasts of Acadia to the Abenaki woodlands of southern Maine. The technology afforded them the mobility through which they recognized their shared experience of English expansion and the seapower with which they orchestrated a coordinated campaign of violence and theft against intruding colonists from New England. The destruction strategically coincided with a wider conflagration ravaging southern New England in 1675, King Philip’s War. By the time chief-sagamore Madockawando agreed to cease hostilities in 1677, the new Native alliance had succeeded in reducing the neighboring English presence to a tributary vassalage and enriching the emergent headquarters at Penobscot with plundered sailing technology, artillery, and captives.
Glorious Revolutions, 1678–1699
Authors: Bahar Matthew R.
Published: April 2019

To its Native signatories, the Casco Bay Treaty of 1678 recognized a post-war order where the Dawnland’s rightful inheritors commanded deference and cooperation from its colonial neighbors. By accepting their status as a dependent community whose presence represented a revocable privilege granted by Native leaders such as Madockawando, outsiders gained access to a newly regenerated northeast and began building new lives alongside its first people. But peace proved ephemeral. The rapid expansion of English colonialism after 1680 reintroduced many of the problems that antagonized Indian-settler relations earlier in the century. New evils compounded the old. Desperately hoping to win back the confidence of its people, especially those employed in the increasingly vital fishing industry, New England authorities implemented an aggressive policy for coastal security by severing Native access to the ocean. Within a decade of its formal recognition in the peace treaty of 1678, Wabanaki sovereignty over land and sea faced threats new and old.
Imperial Breakdown and the Crisis of Confederacy, 1727–1763
Authors: Bahar Matthew R.
Published: April 2019

From the end of Father Rale’s War in 1727 to the end of the Seven Years’ War in 1763, Wabanaki political interests fractured along generational and regional lines as sagamores in Massachusetts and Acadia struggled to navigate increasingly disparate geopolitical contexts. To perpetuate the gains secured in Father Rale’s War and enshrined in Dummer’s Treaty, Penobscot leaders embarked on a course of nonviolent diplomacy with the English in the late 1720s and 1730s. Warriors and hunters found themselves caught between an ocean declared off limits by their own leaders and an interior stripped of its resources by a nonsustainable fur trade. By retiring the old way of the sea for a future of imagined prosperity ashore, headmen ultimately jeopardized the economic viability and social cohesion of Wabanakia. Hastening the collapse of their Native dominion was the collapse of their French ally’s North American empire in the Seven Years’ War.
Beyond the rapist
Authors: Harris Kate Lockwood
Published: April 2019

The final chapter provides a summary of the book’s key claims. It also applies the arguments developed in previous chapters to other cases, including gun violence on U.S. campuses, the legal standard “deliberate indifference,” and USA Gymnastics’ problems with sexual assault. In so doing, it shows not only how the book’s arguments transfer to other contexts, but also how a feminist new materialist approach can guide U.S. university responses to high rates of assault. The chapter includes concrete suggestions for how campuses can move “beyond the rapist.” Moreover, through these recommendations and analyses of other cases, the chapter shows how a feminist new materialist approach can build theory about the complex relationships among violence, organization, and communication.
Climate Change, Social Justice
Authors: Mason Lisa Reyes , Rigg Jonathan
Published: April 2019

Climate change is a physical process but also a profoundly social and political challenge with many social justice issues. People who have contributed the least to climate change already suffer the worst consequences. This chapter makes a case for grounding climate change questions and solutions in community inclusion—in engagement of and partnership with people whose lives are directly affected—based on the principles of social justice. It then describes five intersecting dimensions of “climate reductionism” that must be addressed to articulate why climate change must be contextualized and understood through the lens of local social, economic, and political contexts. The chapter highlights the guiding questions and organization of the book’s chapters, and it concludes with a call to address the “wicked problem” of climate change in partnership with communities and in ways that value local expertise in policy pursuits.
Urban Development, Vulnerabilities, and Disasters in Indonesia’s Coastal Land Reclamations
Authors: Padawangi Rita
Published: April 2019

Urban development redistributes environmental impacts, shifts disaster vulnerabilities, and transforms socioeconomic landscapes of the city. Does social justice matter in urban development discourse? If so, to whom? And what are the implications to urban development? This chapter examines two case studies in Indonesia—land reclamation projects in Jakarta and Bali—as representations of development pressures with considerable impact on the environment. It reviews social and spatial justice literature and its application to Southeast Asia; analyzes data from interviews, news articles, and policy documents to identify elements of social justice in existing development discourses; and concludes with a discussion of how social justice is used by civil society actors but absent in policy documents and official development practices. Implementation of social justice in policies, which includes the voices of marginalized groups through anti-reclamation social movements, provides possible policy suggestions for a more just future.
How Things Count as the Same
Authors: Seligman Adam B. , Weller Robert P.
Published: April 2019

How do human beings craft enduring social groups and long-lasting relationships? Given the myriad differences that divide one individual from another, why do we recognize anyone as somehow sharing a common fate with us? How do we live in harmony with groups that may not share that sense of common fate? Such relationships lie at the heart of the problems of pluralism that increasingly face so many nations today. This book answers a seemingly simple question, which forms the core of how we constitute ourselves as groups and as individuals: What counts as the same? Note that “counting as” the same differs from “being” the same. Counting as the same is thus not an empirical question about how much or how little one person shares with another or one event shares with a previous event. Nevertheless, as humans we construct sameness all the time. In the process, of course, we also construct difference. Creating sameness and difference, however, leaves us with the perennial problem of how to live with difference instead of seeing it as a threat. In this book we suggest that there are multiple ways in which we can count things as the same and that each of them fosters different kinds of group dynamics and different sets of benefits and risks for the creation of plural societies. While there might be many ways to understand how people construct sameness, three seem especially important and form the focus of our analysis: we call them memory, mimesis, and metaphor.
Infinity and Life
Authors: Nachtomy Ohad
Published: April 2019

This chapter aims to trace some of the major steps Leibniz takes before drawing the line between living and nonliving things. The author first presents a brief sketch of the way in which Leibniz uses infinity initially to describe, and ultimately to define, living beings. In so doing, the author traces the development of the way Leibniz uses two concepts—infinity and life—that initially seem disparate, until they come together in his distinction between natural and artificial machines. As will become clear in this brief survey, according to Leibniz, to be living and active turns out to be a prerequisite for being a real entity. In other words, Leibniz comes to associate being with being animate, or being activated by some soul-like thing—anima, entelechy, or substantial form, as he variously terms the source of activity and life in living beings.