bluuebunny/crossref_metadata_2025 huggingface dataset:
Aquinas’ Reception in Contemporary Metaphysics
Authors: Klima Gyula
Published: January 2021

This chapter reviews Aquinas’ reception in contemporary metaphysics as it is practised today in the analytic tradition, focusing on issues that make this reception problematic. I identify the main trouble spots based on the historical development of the analytic tradition. The discussion will target those major conceptual hurdles inherent in the analytic tradition that Aquinas’ genuine reception faces regarding his metaphysical notions of being and essence and his conception of the hylomorphic composition of material substances. This strategy will allow me to introduce an ‘analytically acceptable’ sketch of the metaphysical foundations of Aquinas’ unique position on the ontological status of the human intellective soul, which places it on a razor-thin borderline between the material and purely spiritual realms of reality, running right across our very being. I conclude with a summary of the conceptual prerequisites of a genuine and full reception of Aquinas’ thought in contemporary metaphysical discourse.
God the Trinity
Authors: Emery Gilles
Published: January 2021

Aquinas occupies a prominent place in today’s discussions of Trinitarian theology. Each of the seven sections of this chapter deals with an aspect that is or should be present in any reception of Aquinas’ doctrine of the Trinity: the centrality of Trinitarian faith in Aquinas’ theology; the nature and purpose of Aquinas’ Trinitarian theology; the cardinal place of the economy of salvation; the relationship between Trinitarian processions and missions; the organization of the ‘treatise’ on God in the Summa theologiae; the divine persons as ‘subsisting relations’; the Son as Word and Image, and the Holy Spirit as Love and Gift. In Aquinas, Trinitarian doctrine provides the interpretive framework for understanding all other theological topics (from creation to eschatology).
Receiving Aquinas’ Sacramental Theology Today
Authors: Blankenhorn Bernhard
Published: January 2021

The chapter surveys trends in sacramental theology that aid or impede a recovery of Aquinas’ sacramental doctrine: the twentieth-century liturgical movement, patristic ressourcement, the emergence of highly specialized liturgical studies, the influence of Heidegger, and the renewal of biblical studies. Some preliminary steps for a sound interpretation of Aquinas’ sacramental theology are considered: attentiveness to writings other than the Summa theologiae, awareness of the link between Trinitarian doctrine and the theology of grace, and a proper integration of Aquinas’ Christology, especially his patristic approach to the mysteries of Christ. Aquinas’ thought includes a theology of worship linked with a holistic anthropology and a rich vision of the moral life (virtue ethics). The chapter concludes with a focus on some of the original elements of Thomas’s Eucharistic theology and shows how it can meet contemporary philosophical and pastoral concerns.
Sixteenth-Century Reformed Reception of Aquinas
Authors: Sytsma David S.
Published: January 2021

The knowledge of Aquinas’ works among Reformed authors of the sixteenth century varies widely from those, such as John Calvin, who rarely cite him, to Peter Martyr Vermigli, who received a doctorate in the via antiqua at Padua and drew heavily on Thomas even after his conversion to Reformed Protestantism. Martin Bucer initiates a trend in the 1530s of placing Thomas among the ‘sounder scholastics’ on account of his Augustinian soteriology. Leading Reformed theologians follow Bucer’s terminology and comparatively positive estimate of Thomas, even while polemicizing against medieval scholasticism and perceived Pelagian tendencies within late medieval theology. By the end of the sixteenth century Reformed theologians regularly cite Thomas favourably, albeit also eclectically. Aquinas’ influence on nascent Reformed orthodoxy, and to a lesser extent earlier theologians, is evident on a wide variety of topics, including prolegomena, biblical hermeneutics, the doctrine of God, predestination, humanity, free will, natural law, and Christology.
Disrupting Media and Politics
Authors: Schultz Julianne
Published: January 2021

This chapter explores how, as the traditional media has become weaker due to digital disruption, falling profitability, and audience fragmentation, the political ecosystem in Australia has also eroded. Significant job losses have reduced the scale of public interest journalism, and the frantic attention-seeking of the 24-hour news cycle has contributed to a perception of chaos in politics. This is manifest in frequent changes of prime minister outside the electoral cycle, and in polarization of opinion and comment online and in traditional media designed to increase impact. Commercial media has long embraced a quasi-institutional role and been happy to use this stature, but has resisted external regulation. Self-regulation of the press and institutional oversight of broadcasting self-regulation are relatively weak; social media and online platforms are not regulated; and the implied right to freedom of political speech, the bedrock of the media’s unique political role, was only ‘found’ by the High Court in 1997. This chapter argues that effective regulation, which addresses the needs of citizens as well as consumers, and other interventions including strengthening public broadcasting and securing legislative (even constitutional) recognition of the democratic value of media freedom are required to invigorate a robust political ecosystem.
Policy Learning in the Australian Public Service
Authors: Stark Alastair
Published: January 2021

This chapter discusses the ways in which the Australian Public Service (APS) learns about public policy. The chapter has four sections. First, it presents a typology of policy-learning that can be used to organize research into the policy-learning capacities of a national bureaucracy. Second, it outlines a range of policy-learning successes that can be attributed to the APS and characterizes them using the typology. Third, the chapter examines several long-running criticisms of the APS that seem to be apposite to its capacity to learn lessons in the future. These are also characterized in relation to the typology. Finally, evidence of the APS’s strengths and weaknesses is weighed up in a conclusion, which culminates with an argument that the service’s key strength is its capacity to effectively produce large amounts of ‘single-loop’ and ‘instrumental’ types of policy-learning.
The Field and Study of Deliberative Democracy in Australia
Authors: Hendriks Carolyn M.
Published: January 2021

Australia is recognized globally as an important hub for the study and practice of deliberative democracy. Both a normative and practical project, the field of deliberative democracy aims to improve the quality and inclusivity of public reasoning in collective decision-making. This chapter explores deliberative democracy in Australia from two angles. First, it discusses how a nation typically characterized by its adversarial and more majoritarian democratic system has become a significant international hotspot for scholars and practitioners of deliberative democracy. Second, the chapter examines how deliberative democracy has been applied as a lens to empirically study aspects of Australian politics. There is, the author argues, much more work for deliberative democrats to undertake in the Australian context, particularly in assessing and strengthening the deliberative capacity of the nation’s key political institutions.
Political Leadership
Authors: Strangio Paul
Published: January 2021

Political leadership has traditionally been a relatively minor subfield in Australian political science, notwithstanding the fact that biography has long been a staple for investigating leaders. In common with other comparable democracies, however, the early twenty-first century has witnessed a surge of activity in leadership studies. This chapter explores this intensified research endeavour, identifies its catalysts, delineates and surveys the major currents of that scholarship, and points out its limitations. Among the currents of recent leadership research the chapter surveys are: the belated emergence of debates on the theme of leadership centralization; the hardy perennials of biography and memoir; theoretical borrowings from United States presidential literature; gender and leadership; and leadership rhetoric.
Training cognition with video games
Authors: Cardoso-Leite Pedro , Ansarinia Morteza , Schmück Emmanuel , Bavelier Daphne
Published: January 2021

This chapter reviews the behavioral and neuroimaging scientific literature on the cognitive consequences of playing various genres of video games. The available research highlights that not all video games have similar cognitive impact; action video games as defined by first- and third-person shooter games have been associated with greater cognitive enhancement, especially when it comes to top-down attention, than puzzle or life-simulation games. This state of affairs suggests specific game mechanics need to be embodied in a video game for it to enhance cognition. These hypothesized game mechanics are reviewed; yet, the authors note that the advent of more complex, hybrid, video games poses new research challenges and call for a more systematic assessment of how specific video game mechanics relate to cognitive enhancement.
Transnational Visions of Modernity
Authors: Nolan Mary
Published: January 2021

Throughout Weimar, Germans looked to America and the Soviet Union as models of modernity from which they might learn, adopt, and adapt in an effort to respond to the crises afflicting Germany. Germans across the political and class spectrum studied and travelled to these two nations. Attention focused on Soviet Russia in the first post-war years and after 1928 and on America in between. The ensuing, very public debates on transnational models centred on the distinctive economies of each country, new forms of mass culture, and gender, family, and sexuality. Germans were most impressed by American economic success and new Fordist models of production and consumption, even as they differed on which aspects could be emulated. They were more ambivalent about mass culture, especially Hollywood films. Many felt the American woman challenged German ideas about femininity and domesticity, as did Soviet women and laws about marriage and abortion.
Referral for Imaging in Physical Therapist Practice: Key Recommendations for Successful Implementation
Authors: Keil Aaron Paul , Hazle Charles , Maurer Amma , Kittleson Connie , Watson Daniel , Young Brian , Rezac Scott , Epsley Scott , Baranyi Brian
Published: January 2021

In recent years, the use of diagnostic imaging in physical therapist practice in the United States has gained considerable interest. In several countries around the world and in the US military, patient direct referral for diagnostic imaging has been considered normative practice for decades. US physical therapy program accreditation standards now stipulate that diagnostic imaging content must be included in physical therapist educational curricula. The American Physical Therapy Association has made efforts to pursue practice authority for imaging referral. A recent review of state practice acts and other statutory language concluded that many states have no prohibitions against physical therapists referring for imaging studies. Additionally, physical therapists can now pursue certification as musculoskeletal sonographers. In light of these advances, and with a growing number of physical therapists serving patients who have not yet seen another health care provider, it may be helpful for those who have been actively involved in the use of imaging in physical therapist practice to provide their collective recommendations to serve as a guideline to those interested in incorporating this practice privilege. The purpose of this perspective article is to provide an overview of the key elements necessary for effective implementation of referral for imaging in physical therapist practice while emphasizing the cornerstone of effective communication.
Benefits of implementation of preoperative education classes for hip and knee arthroplasty
Authors: Pelkowski Jessica N. , Yoon Saunjoo L. , Adams Sharon
Published: January 2021

Introduction:

Optimal patient outcomes after orthopaedic surgery rely on cooperative efforts of patients as well as performance of the care team. The purpose of this project was to design and implement a preoperative education class for patients to meet patient expectations, reduce anxiety regarding surgery, and reduce postoperative phone calls.

Methods:

This study implemented cross-sectional questionnaires and chart reviews for patients in an orthopaedic group in Florida. Enrollment in a preoperative education class was optional for all patients undergoing partial or total primary or revision knee or hip arthroplasty. There were two groups of participants (n1=50, n2=50). The joint education group completed the class and provided feedback, while the comparison group elected not to take the class. Postoperative phone calls from both groups were compared. Variables included gender, diagnosis of depression and/or anxiety, and availability of a support group.

Results:

The average numbers of phone calls to the office were 2.84 and 5.67 between surgery and the first postoperative visit (x̄=25.18 days and x̄=20.12 days) in the joint education group and the comparison group, respectively. Statistical analysis revealed P=0.011. Ninety percent of participants reported reduction in anxiety regarding surgery regardless of diagnosis of anxiety or depression.

Conclusions:

The preoperative education class resulted in alleviation of surgery-related anxiety. The number of patient phone calls to the office were fewer in the joint education group compared with the comparison group, which suggested better understanding about anticipated postoperative experience. The class provided benefits for patients, healthcare providers, and the clinic.

Level of Evidence:

Level III.
Investigating the effect of innovative storing-restoring hybrid passive ankle-foot orthosis on braking and propulsion impulse of walking in drop-foot patients: a prospective cohort study
Authors: Pourhoseingholi Ensieh , Kamali Mohammad , Saeedi Hassan
Published: January 2021

Background:

Drop foot is a disorder that is characterized by reduction in speed and the patients’ inability to propel the paretic side, which disrupts the walking patterns. Ankle-foot orthoses (AFO) are widely prescribed in these patients in order to facilitate their leg propulsion and foot clearance during the swing phase. The purpose of this study was to use the correlation between effect of innovative AFO on braking and propulsion impulse and speed, in order to interpret the innovative AFO’s influence on the paretic and nonparetic side in drop-foot patients.

Methods:

Ten participants with drop foot walked at their self-selected speed, in order to collect the kinetic and kinematic data. The anteroposterior ground reaction force (GRF) components were extracted from the decomposition method with an innovative storing-restoring hybrid passive AFO and compared with baseline shoes only for both paretic and nonparetic sides.

Results:

There is a strong correlation between the innovative AFO speed and the anteroposterior component of GRF. After that, correlation was found between anteroposterior GRF and the storing-restoring hybrid passive AFO in comparison with baseline shoes only in both the paretic and nonparetic sides.

Conclusions:

This study demonstrated a strong correlation during walking between speed and the propulsion and braking impulses of the anteroposterior component of GRF on both sides.

Level of Evidence:

Level II.
Comparing indirect decompression using elastic nails versus curettage, bone graft substitute, and intramedullary stabilization for the management of unicameral bone cysts in skeletally immature patients: a retrospective case series study
Authors: El Masry Ayman Mohammad , Elkhateeb Tameem Mohamed , Azmy Sherif Ishak , Abdelkader Saad Gad
Published: January 2021

Background:

Unicameral bone cysts account for 20% of benign bone lesions. A variety of treatment modalities exist with variable outcomes. This was a retrospective study that aimed to compare the clinical and radiographic outcomes of two treatment methods for unicameral bone cysts in children: cyst decompression utilizing intramedullary nailing alone versus marginal resection through curettage, intramedullary nailing, and synthetic bone grafting.

Methods:

Seventy-one patients with unicameral bone cysts were treated with one of two techniques: decompression using elastic intramedullary nails (Group 1, 37 patients) or open curettage and grafting with a calcium sulfate bone substitute with fixation by elastic intramedullary nails (Group 2, 34 patients). Outcome parameters included the radiographic healing rate, time to solid union, recurrence rate, functional outcome, and complication rates.

Results:

The mean follow-up period was 30.9 mo for group 1 and 35.9 mo for group 2. The mean Musculoskeletal Tumor Society scoring was 91 for group 1 and 93 for group 2. Radiographic healing showed Capanna grade 1 in 78% of the patients in group 1 and 85% in group 2 with a similar mean time to healing of 8 wk. Recurrence occurred in two patients in group 1 and in one patient in group 2.

Conclusions:

No statistically significant difference exists regarding the outcomes of both treatment techniques. Therefore, we recommend the use of elastic nails for intramedullary nailing alone as a first line of management of primary unicameral bone cyst because it is a less invasive technique with reliable results.

Level of Evidence:

Level IV.
Predictive Physical Manifestations for Progression of Scoliosis in Marfan Syndrome
Authors: Taniguchi Yuki , Matsubayashi Yoshitaka , Kato So , Doi Toru , Takeda Norifumi , Yagi Hiroki , Inuzuka Ryo , Oshima Yasushi , Tanaka Sakae
Published: January 2021

Study Design.

A retrospective study of the prospective cohort.

Objective.

To demonstrate the accurate distribution of the severity of scoliosis in patients with Marfan syndrome, and to identify the predictive physical features for progression of scoliosis in Marfan syndrome.

Summary of Background Data.

To date, no study has unveiled the risk factors for the progression of scoliosis in Marfan syndrome.

Methods.

We retrospectively obtained data from a prospective cohort of the Marfan syndrome clinic at our institute. We enrolled patients whose whole spine radiographs in the standing position were evaluated at the age of 15 or above, from January 2014 to March 2020. The collected variables were physical manifestations defined as in the systemic score of the revised Ghent nosology. We classified the degree of scoliosis into four categories: “not apparent,” “mild” (10° ≤ Cobb < 25°), “moderate” (25° ≤ Cobb < 40°), and “severe” (40° ≤ Cobb or surgery conducted). To identify the risk factors for progression of scoliosis in Marfan syndrome, we conducted univariate and multivariate association analyses between severe scoliosis and each physical manifestation.

Results.

We identified 131 eligible patients (61 men and 70 women) with a mean age of 31.2 years. Scoliosis with a Cobb angle of ≥10° was identified in 116 patients (88.5%). Moderate scoliosis was identified in 33 patients (25.2%) and severe scoliosis in 53 patients (40.5%). The prevalence of each physical manifestation was equivalent to that reported in previous studies. Multivariate logistic regression analysis revealed that female sex (odds ratio, 3.27) and positive wrist sign (4.45) were predictive factors for progression of scoliosis into severe state in patients with Marfan syndrome.

Conclusions.

The present study demonstrated the accurate distribution of the severity of scoliosis and identified the predictive factors for progression of scoliosis in patients with Marfan syndrome.

Level of Evidence: 3
Active Play Network Influences on Physical Activity Among Children Living in Texas Colonias
Authors: Prochnow Tyler , Umstattd Meyer M. Renée , Patterson Megan S. , Trost Stewart G. , Gómez Luis , Sharkey Joseph
Published: January 2021

Physical activity (PA) is beneficial for child health; however, few children meet PA guidelines. Social relationships impact child PA behaviors; however, little is known about this effect in Mexican-heritage populations. This study aims to understand associations between self-reported play networks and PA among Mexican-heritage children. Mexican-heritage children from colonias along the Texas-Mexico border (n = 44; 54.5% girls; mean age = 9.89 years, SD = 0.97) reported information on up to 5 people they played with most often. Linear regression was used to analyze the relationship between composition of children's social network and minutes of moderate- to vigorous-intensity PA (MVPA) and sedentary minutes per day measured by accelerometers. Children who reported a higher percentage of friends as opposed to family members attained significantly more minutes of MVPA per day (β = .27, P = .04). Children who reported playing with individuals in their network more often (β = ‒.28, P = .03) were sedentary for fewer minutes per day. Increasing the connections between children in the neighborhood or community, as well as increasing a child's frequency of active play, may be promising approaches to increasing MVPA and decreasing sedentary behaviors among Mexican-heritage children.
Public perceptions on ethics in the practice of assisted reproductive technologies in Nigeria
Authors: Bamgbopa Kehinde T. , Okonta Patrick I. , Ajayi Richardson , Ogbeche Rose , Igbokwe Cynthia , Onwuzurigbo Kingsley
Published: January 2021

The rapid expansion of assisted reproductive technologies (ART) services in Nigeria has stimulated public interest in the need to address related ethical issues and the institutionalization of regulatory guidelines to regulate the practice of ART in Nigeria in order to protect patients’ rights and safety. This study aims to document the views of various stakeholders in ART regarding salient ethical issues relating to its practice in Nigeria. The Ethics committee of the Association for Fertility and Reproductive Health in Nigeria (AFRH) organized a focus group discussion with participants drawn from different sociocultural/religious backgrounds and professional disciplines to deliberate on 16 key ethical issues in ART practice. Given the understanding that there are no rights or wrong answers when considering the ethics, the participants reached a consensus that access to ART is a fundamental reproductive right for all members of the society regardless of marital status and that choices made are dependent individual circumstances. There was a noticeable progressive shift in opinions on some issues, compared with a previous study, and a persistent negative view of others within the legal and sociocultural dictates of the Nigerian society especially on issues concerning sex selection and orientation. This study provides updated information on the societal viewpoints and perceptions which could aid the promulgation of ethical practice guidelines for ART practitioners in Nigeria.
Elevated estradiol with prolonged mifepristone to treat progesterone-receptor positive meningioma
Authors: Aharon Devora A. , Carpinello Olivia J. , Bishop Lauren A. , DeCherney Alan H.
Published: January 2021

Objective:

To report a finding of persistently elevated estradiol (E2) after prolonged mifepristone use for treatment of progesterone-receptor positive meningioma, an association which has not previously been reported.

Design:

This is a case report.

Setting:

Outpatient Reproductive Endocrine clinic at a tertiary referral center.

Case Report:

A 48-year-old gravida 1 para 0-0-1-0 with progesterone-receptor positive meningioma, recurrent after multiple debulking surgeries. Patient was treated with mifepristone for 11 years with symptomatic improvement and tumor shrinkage. Levels of follicle-stimulating hormone, luteinizing hormone, and estradiol (E2) were followed throughout the patient’s course of mifepristone therapy. E2 levels were found to be persistently elevated to 500–700 pg/mL.

Materials and Methods:

Enhanced E2 assay, a liquid-chromatography tandem mass spectrometry (LC-MS/MS) based assay, was measured simultaneously with the routinely used immunoassay for 5 years in attempt to obtain a more accurate assessment.

Results:

E2 levels using the standard immunoassay were found to be persistently elevated while the patient was taking mifepristone. Using the enhanced LC-MS/MS assay, E2 was initially elevated, however was subsequently low. After the patient discontinued the medication, E2 levels as measured by the immunoassay normalized.

Conclusions:

Prolonged mifepristone use was found to be associated with markedly elevated E2 levels in our patient. If this is a true elevation, it may help explain the incidence of endometrial hyperplasia and endometrial polyps with prolonged mifepristone use. However, this was likely a false elevation, potentially due to cross-reactivity of mifepristone with the immunoassay, given the normal values obtained with the enhanced LC-MS/MS E2 assay. Whether prolonged mifepristone use may cause true or falsely elevated E2 in a wider population, and the mechanism through which it does so, should be further investigated.
The microbiome in urinary tract infections in children – an update
Authors: Lemberger Ursula , Quhal Fahad , Bruchbacher Andreas , Shariat Shahrokh F. , Hiess Manuela
Published: January 2021

Purpose of review

Urinary tract infection (UTI) is one of the most common pediatric infections worldwide. Recently introduced 16S rRNA sequencing allows detailed identification of bacteria involved in UTI on a species-based level. The urogenital microbiome in children is scarcely investigated, with underlying conditions differing from adults. Improvement in diagnostic and therapeutic approaches can help to minimize unnecessary antibiotic treatments, thereby protecting the physiological microbiome.

Recent findings

Healthy bladders of children display a distinct microbiome than those of adults. UTI is characterized by changes in bacterial composition, with a high prevalence of Enterobacterales. There is a correlation between bacterial species and the pH of the urine, so a characteristic age-related pathogen pattern can be found due to the acidic urine in infants and more alkaline urine in older children. Recently, new methods were proposed to overcome the suboptimal diagnostic performance of urine cultures and urine dipstick test. This allows precise treatment decisions and helps to prevent chronification of UTI, related voiding dysfunctions and renal scaring, systemic abiosis, and the development of antibiotic resistance.

Uropathogens involved in UTIs in children should be identified with precision to allow targeted therapeutic decisions. This can also help preventing the destruction of the microbiome homeostasis, which could result in a life-long dysbiosis. New treatment approaches and recolonization with probiotics are necessary due to increasing intrinsic antibiotic resistance of bacteria.
Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies
Authors: Raicher Irina , Stump Patrick Raymond Nicolas Andre Ghislain , Harnik Simone Bega , de Oliveira Rodrigo Alves , Baccarelli Rosemari , Marciano Lucia H.S.C. , Ura Somei , Virmond Marcos C.L. , Teixeira Manoel Jacobsen , de Andrade Daniel Ciampi
Published: January 2021

Introduction:

Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in “pharmacologically cured” patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient's quality of life, daily activities, and mood.

Objectives:

The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy.

Methods:

Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on drugs prescribed for neuropathic pain and their respective pain relief.

Results:

The pain characteristics based on NPSI did not significantly differ between leprosy and nonleprosy neuropathic pain patients in visit 1 after correction for multiple analyses, and cluster analyses confirmed these findings (ie, no discrimination between leprosy and nonleprosy groups; Pearson χ2 = 0.072,P= 0.788). The assessment of pain relief response and the drugs taken by each patient, linear regression analysis showed that amitriptyline, when effective, had the highest percentage of analgesic relief.

Conclusions:

Neuropathic pain in leprosy is as heterogeneous as neuropathic pain of other etiologies, further supporting the concept that neuropathic pain is a transetiological entity. Neuropathic pain in leprosy may respond to drugs usually used to control pain of neuropathic profile in general, and amitriptiline may constitute a potential candidate drug for future formal clinical trials aimed at controlling neuropathic pain in leprosy.
Cardiorespiratory Fitness and Neuromuscular Performance in Patients Recovered from COVID-19
Authors: Frazão Murillo , da Cruz Santos Amilton , de Assis Pereira Cacau Lucas , Eugênio Silva Paulo , Petrucci Tullio Rocha , Assis Mariela Cometki , de Almeida Leal Rômulo , de Moraes Forjaz Cláudia Lúcia , Brasileiro-Santos Maria do Socorro
Published: January 2021

Objective

COVID-19 affects cardiorespiratory and muscular systems, causing dysfunctions that may persist after recovery from the acute infection and treatment. The aim of this study was to evaluate cardiorespiratory fitness and neuromuscular performance in these patients.

Methods

Patients recovered from mild (n=31) and severe (n=17) COVID-19 were evaluated and compared to healthy subjects (n=15). All volunteers underwent a maximal cardiopulmonary exercise test with simultaneous acquisition of electromyography (EMG). Power output, oxygen uptake (VO2), pulse oxygen (O2Pulse), cardiovascular efficiency (ΔHR/ΔVO2), ventilation (VE), breathing reserve (BR) and ventilatory efficiency (VE/VCO2 slope) were analyzed. From EMG, power output for type Ia and IIa activation as well as total neuromuscular efficiency (Δwatts/Δ%RMS) were determined.

Results

Patients with severe COVID-19 presented lower VO2, O2Pulse and VE than mild COVID-19 patients and healthy subjects (p < 0.05 for all comparisons). No differences in ΔHR/ΔVO2, BR or VE/VCO2 slope were observed among the groups (p > 0.05 for all comparisons). Type IIa and IIb fibers were activated at lower power output in severe than in mild COVID-19 patients and healthy subjects (p < 0.05). Δwatts/Δ%RMS was lower in severe than in mild COVID-19 patients and healthy subjects (p < 0.05).

Conclusion

Patients recovered from severe COVID-19 present low cardiorespiratory fitness, activate glycolytic fibers at low power outputs, and show low neuromuscular efficiency; while patients recovered from mild COVID-19 do not present these sequels.
The impact of high dose oral cotrimoxazole in patients with COVID-19 with hypoxic respiratory failure requiring non-invasive ventilation: A Case Control Study
Authors: Singh Saurabh , John Thomas , Kumar Prashant , Quadery Syed Rehan
Published: January 2021

Background

COVID-19 can be fatal in a significant proportion of people who develop critical illness, resulting in hypoxic respiratory failure secondary to Acute Respiratory Distress Syndrome (ARDS) which is thought to be mediated by a cytokine storm syndrome. Steroids have been shown to be of some benefit, but the mainstay of treatment remains supportive.

Methods

The data was collected retrospectively from consecutive, newly diagnosed patients presenting to the critical care facility of I Q City Medical College Hospital, Durgapur, India between June and November 2020 with critical COVID-19 on non-invasive ventilation treated with high dose oral cotrimoxazole (CTX) in addition to standard therapy (ST) and compared with patients with critical COVID-19 receiving standard therapy alone.

Results

201 patients were identified. Of which 151 patients received CTX in addition to ST (mean age ± SD 59 ± 13 years, 81% male and mean BMI ± SD 28 ± 2) and 50 patients received ST alone (mean age ± SD 63 ± 12, 64% male and mean BMI ± SD 27 ± 2). We observed that the patients with critical COVID-19 receiving CTX in addition to ST had significantly better outcomes including reduced in-patient mortality (13% versus 40%, p <0.001), length of hospital and critical care unit stay (mean, 11 versus 15 days (p <0.001) and 6 versus 11 days (p <0.001) respectively), and the need for mechanical ventilation (16% versus 42%, p <0.001) with improved CRP at day 7 (mean, 38mg/L versus 62mg/L, p = 0.001).

Conclusion

These results may be due to the antibiotic and anti-cytokine effects of CTX. Clinical trials are currently underway to test our observations.
The positive side of peer pressure: employees as “enforcers” of positive cultural values
Authors: Lilly Juliana
Published: January 2021

Purpose

This paper discusses how peer pressure works and how to use it in a positive way to encourage employees to behave in ways that are beneficial to the organization.

Design/methodology/approach

This viewpoint is prepared by an independent writer offering practical suggestions to improve employee compliance by applying academic theory.

Findings

Organizations can create positive peer pressure through institutionalized socialization tactics that set clear expectations for behavior. These expectations become ingrained in culture leading to employees acting as “enforcers” of cultural values.

Originality/value

This article saves executives and researchers hours of reading time by presenting decades of research in a condensed and easy-to-read format.
Regulation of glutamine synthetase activity by transcriptional and posttranslational modifications negatively influences ganoderic acid biosynthesis in Ganoderma lucidum
Authors: Zhu Jing , Song Shuqi , Sun Zehua , Lian Lingdan , Shi Liang , Ren Ang , Zhao Mingwen
Published: January 2021

Glutamine synthetase (GS), a central nitrogen metabolic enzyme, plays important roles in the nitrogen regulation network and secondary metabolism in fungi. However, the mechanisms by which external nitrogen sources regulate fungal GS activity have not been determined. Here, we found that GS activity was inhibited under nitrate conditions in Ganoderma lucidum. By constructing gs‐silenced strains and adding 1 mM GS inhibitor to inhibit GS activity, we found that a decrease in GS activity led to a decrease in ganoderic acid biosynthesis. The transcription of gs increased approximately five fold under nitrate conditions compared with that under ammonia. Electrophoretic mobility shift and yeast one‐hybrid assay showed that gs was transcriptionally regulated by AreA. Although both gs expression and GS protein content increased under nitrate conditions, the GS activity still decreased. Treatment of recombinant GS with SIN‐1 (protein nitration donor) resulted in a strengthened nitration accompanied by a 71% decrease in recombinant GS activity. Furthermore, intracellular GS could be nitrated from mycelia cultivated under nitrate conditions. These results indicated that GS activity could be inhibited by NO‐mediated protein nitration. Our findings provide the first insight into the role of transcriptional and posttranslational regulation of GS activity in regulating secondary metabolism in fungi.
Inch by inch; Row by row
Authors: Thorp John M
Published: January 2021

Deputy Editor‐in‐Chief, Dr John M Thorp Jr, discusses his top articles from this issue in an audio podcast available at: https://soundcloud.com/bjog/februaryeditors-choice-2021.
Random forests for predicting species identity of forensically important blow flies (Diptera: Calliphoridae) and flesh flies (Diptera: Sarcophagidae) using geometric morphometric data: Proof of concept
Authors: Khang Tsung Fei , Mohd Puaad Nur Ayuni Dayana , Teh Ser Huy , Mohamed Zulqarnain
Published: January 2021

Wing shape variation has been shown to be useful for delineating forensically important fly species in two Diptera families: Calliphoridae and Sarcophagidae. Compared to DNA‐based identification, the cost of geometric morphometric data acquisition and analysis is relatively much lower because the tools required are basic, and stable softwares are available. However, to date, an explicit demonstration of using wing geometric morphometric data for species identity prediction in these two families remains lacking. Here, geometric morphometric data from 19 homologous landmarks on the left wing of males from seven species of Calliphoridae (n = 55), and eight species of Sarcophagidae (n = 40) were obtained and processed using Generalized Procrustes Analysis. Allometric effect was removed by regressing centroid size (in log10) against the Procrustes coordinates. Subsequently, principal component analysis of the allometry‐adjusted Procrustes variables was done, with the first 15 principal components used to train a random forests model for species prediction. Using a real test sample consisting of 33 male fly specimens collected around a human corpse at a crime scene, the estimated percentage of concordance between species identities predicted using the random forests model and those inferred using DNA‐based identification was about 80.6% (approximate 95% confidence interval = [68.9%, 92.2%]). In contrast, baseline concordance using naive majority class prediction was 36.4%. The results provide proof of concept that geometric morphometric data has good potential to complement morphological and DNA‐based identification of blow flies and flesh flies in forensic work.
The International Federation for Emergency Medicine report on emergency department crowding and access block: A brief summary
Authors: Javidan Arshia P , Hansen Kim , Higginson Ian , Jones Peter , Lang Eddy ,   IFEM Task Force on Emergency Department Crowding and Access Block
Published: January 2021

Objective

To develop comprehensive guidance that captures international impacts, causes, and solutions related to ED crowding and access block.

Methods

Emergency physicians representing 15 countries from all the International Federation for Emergency Medicine (IFEM) regions composed the task force. Monthly meetings were held via video‐conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020.

Results

A total of 14 topic dossiers, each relating to an aspect of ED crowding, were researched and completed collaboratively by members of the task force.

Conclusions

The IFEM report is a comprehensive document intended to be used in whole or by section to inform and address aspects of ED crowding and access block. Overall, ED crowding is a multifactorial issue requiring systems‐wide solutions applied at local, regional, and national levels. Access block is the predominant contributor of ED crowding in most parts of the world.
Stress response and characterization of oil‐in‐water emulsions stabilized with Kluyveromyces marxianus mannoprotein
Authors: Hajhosseini Ashraf , Doroud Delaram , Sharifan Anousheh , Eftekhari Zohreh
Published: January 2021

This study was intended to investigate physico‐chemical, rheological, and emulsifying properties of oil‐in‐water emulsions prepared from the Kluyveromyces marxianus mannoprotein (KMM). Also, the stress‐response function of the KMM emulsions was compared with that of the whey protein concentrate (WPC) emulsions in terms of zeta potential, size, and rheology. The stress experiments were conducted at different pH (3 to 9), ionic composition (0 to 500 mM NaCl), and temperatures (30 to 90 °C). The extracted KMM with a molecular weight of 107.2 kDa had 28.8% proteins and 68.22% carbohydrates. With increasing the KMM concentration to 1.5% (w/w), the zeta potential, droplet size, and apparent viscosity of the emulsions reached −35 mV, ∼1 μ, and ∼9 mPa·s, respectively. After applying pH, ionic composition, and temperature, the KMM emulsions were more stable than the WPC emulsions. In conclusion, KMM can be used as a bioemulsifier and be more effective in stabilizing emulsions than WPC.

Practical Application

Yeasts are a rich source of natural materials. In this study, we extracted mannoproteins from the yeast cell wall and evaluated their functional properties to be used as an emulsifier in oil‐in‐water emulsions. The results of this study confirm that the yeast‐derived mannoproteins are good at stabilizing these emulsions either in the presence or absence of different environmental conditions.
Large fiber peripheral neuropathy in systemic sclerosis: A prospective study using clinical and electrophysiological definition
Authors: Raja Jasmin , Balaikerisnan Tharshannia , Ramanaidu Letchumy Praba , Goh Khean Jin
Published: January 2021

Aim

The reported prevalence of peripheral neuropathy in systemic sclerosis (SSc) is variable between 0.01% to 28%, probably due to differences in sample size, study design and population. Our aim is to determine the prevalence of large fiber peripheral neuropathy in SSc and to identify any contributing factors.

Method

A prospective cross‐sectional study of 60 SSc patients were evaluated for large fiber neuropathy using the modified clinical Total Neuropathy Score (cTNS) and nerve conduction study (NCS) of the upper and lower limbs. A combination of clinical (cTNS score ≥ 2) and NCS criteria (≥2 abnormal nerves including 1 sural [symmetrical polyneuropathy] and NCS abnormalities consistent with individual nerves/nerve roots [focal neuropathy]) was used to diagnose peripheral neuropathy.

Results

The majority had limited cutaneous subset (75%). Mean age was 55.73 (SD ± 13.04) years and mean disease duration was 8.61 (SD ± 8.09) years. Twenty‐two (36.7%) had combined clinical and NCS criteria for peripheral neuropathy, 14 (23.3%) with symmetrical polyneuropathy and 8 (13.3%) with focal neuropathy. Symmetrical polyneuropathy patients had significantly lower hemoglobin levels (11.2 vs. 12.35 g/L; P = .047). Serum vitamin B12 levels were normal, therefore excluding vitamin B12 deficiency. No other associations were found for both polyneuropathy and focal neuropathy with demography, co‐morbid diseases and SSc disease factors such as Raynaud's phenomenon and modified Rodnan skin score.

Conclusion

Large fiber neuropathy is common in SSc patients, which could contribute to non‐lethal burden in SSc with sensory loss and muscle weakness. Apart from lower hemoglobin in polyneuropathy, there were no associations with disease‐specific features or co‐morbid diseases.
Florence Nightingale and the Spanish nursing school of Santa Isabel De Hungría (1896)
Authors: Santainés‐Borredá Elena , Camaño‐Puig Ramón
Published: January 2021

Purpose

The Spanish surgeon Federico Rubio‐Galí worked at St. Thomas Hospital in England at the time when Florence Nightingale founded the Nightingale Training School for Nurses (1860). Apparently, he was quite aware of Nightingale's nursing work and expertise and it is known that founded the first Spanish nursing school, in Madrid, in 1896. This led us to wonder if the emergence of his school was purely by chance or was connected to what its founder learned in England. Likely, this learned knowledge led him to apply Nightingale's ideas and to put them into practice in his institution.

Methods

We used content analysis techniques and developed categories and subcategories to search for ideological similarities between Nightingale and Rubio‐Galí.

Findings

The results reflected similarities and coincidences on several issues, mainly related to ventilation, light, infection, hygiene, food, rest, practical training, and observation, among others.

Conclusions

The concepts listed by Nightingale and Rubio‐Galí are important for the analysis of nursing from an epistemological and ontological perspective. We concluded that Rubio‐Galí was fully aware of Nightingale's ideas and that he implemented several of them in his institution.

Implications for nursing practice

Historical research always implies progress in the field of practice and knowledge, permitting arise new issues. The data presented in this article open new questions for practice and the history of Spanish nursing.
Metformin treatment in late middle age improves cognitive function with alleviation of microglial activation and enhancement of autophagy in the hippocampus
Authors: Kodali Maheedhar , Attaluri Sahithi , Madhu Leelavathi N. , Shuai Bing , Upadhya Raghavendra , Gonzalez Jenny Jaimes , Rao Xiaolan , Shetty Ashok K.
Published: January 2021

Metformin, a drug widely used for treating diabetes, can prolong the lifespan in several species. Metformin also has the promise to slow down age‐related cognitive impairment. However, metformin's therapeutic use as an anti‐aging drug is yet to be accepted because of conflicting animal and human studies results. We examined the effects of metformin treatment in late middle age on cognitive function in old age. Eighteen‐month‐old male C57BL6/J mice received metformin or no treatment for 10 weeks. A series of behavioral tests revealed improved cognitive function in animals that received metformin. Such findings were evident from a better ability for pattern separation, object location, and recognition memory function. Quantification of microglia revealed that metformin treatment reduced the incidence of pathological microglial clusters with alternative activation of microglia into an M2 phenotype, displaying highly ramified processes in the hippocampus. Metformin treatment also seemed to reduce astrocyte hypertrophy. Additional analysis demonstrated that metformin treatment in late middle age increased adenosine monophosphate‐activated protein kinase activation, reduced proinflammatory cytokine levels, and the mammalian target of rapamycin signaling, and enhanced autophagy in the hippocampus. However, metformin treatment did not alter neurogenesis or synapses in the hippocampus, implying that improved cognitive function with metformin did not involve enhanced neurogenesis or neosynaptogenesis. The results provide new evidence that metformin treatment commencing in late middle age has promise for improving cognitive function in old age. Modulation of microglia, proinflammatory cytokines, and autophagy appear to be the mechanisms by which metformin facilitated functional benefits in the aged brain.