bluuebunny/crossref_metadata_2025 huggingface dataset:
The Fugitive
Authors: Corens Liesbeth
Published: January 2019

This chapter argues for the importance of practical loyalty in English Catholics’ political situation. It shows that the assumption that leaving the country compromised political relations is based on an anachronistic coupling of territory and nationality. Instead, this chapter highlights the significance of bonds of loyalty and legal frameworks, and of practical expressions of loyalty over abstract theories. Seemingly unpromising documents such as travel passes and passports provide access to careful negotiations and practical transactions. Expatriate Catholics did not cut themselves off from their king but fostered bonds regardless of their location. These cross-Channel connections were both the corridors which enabled Catholics to uphold their allegiance to the Crown and the lifelines which ensured the continued survival of the English Catholic community in defiance of government measures.
Introduction
Authors: Corens Liesbeth
Published: January 2019

The introduction sets out the methodological framework, and expounds the conceptual shift from exile to confessional mobility. Without summarily dismissing ‘exile’, it argues that adopting a wider term changes perspective, reshapes what we see in the sources, and opens up new questions. Rather than labelling people and reducing their entire identity to that label as their key characteristic, ‘confessional mobility’ focuses on the activity in which complex and conflicted people engage. In the process, it does justice to the broad spectrum of English Catholics who crossed the Channel, challenging scholarship that searches for a single ‘pure’ motivation for travel. Moreover, scrutinizing mobility forgoes an assumed separation and isolation, highlighting the constant cross-Channel communication. Links with the Counter-Reformation on the Continent were not important solely for those who travelled abroad, nor solely for their time abroad: they influenced the entire Catholic community.
The Effects of the International Economic Crisis on Spain’s Environmental Policy
Authors: Fernandez Rosa
Published: January 2019

This chapter employs qualitative analysis to apply the Index of Policy Activity (IPA) to renewables, biodiversity, energy efficiency, and climate change in Spain. These four policy areas are compared, in order to outline differences in policy approaches and factors shaping policy change. The analysis reveals that the economic crisis of 2007–8 has had a profound effect upon Spanish environmental policy, reversing Spain’s progress from being an environmental leader to transforming it into a laggard, especially in relation to renewable energy technologies. A lack of resources has forced the government to abandon its once-praised support schemes and instead to adopt measures that penalize the development of renewable energy. The chapter identifies structural barriers as the main cause of recent policy reversals. Political preferences and issues related to the decentralization of the Spanish government system emerge as central explanatory variables for environmental policy implementation and change.
A Comparison of Execution Quality across US Stock Exchanges
Authors: Wah Elaine , Feldman Stan , Chung Francis , Bishop Allison , Aisen Daniel
Published: January 2019

The fragmented nature of the US equities exchange landscape has given rise to structural inefficiencies, creating the potential for conflicts of interest between market participants. The introduction of the Investors Exchange offers the opportunity to evaluate market quality across exchanges with varying fee structures. The chapter studies four dimensions of market quality—liquidity, execution costs, price discovery, and market stability—and examines structural mechanics responsible for disparities in execution quality. A trend is observed in venue stratification by fee structure: maker-taker exchanges dominate the US equities trading landscape despite greater adverse selection, less stability around executions, significantly longer queues at the inside, and a lower probability of execution in aggregate. This suggests that access fees and rebates perpetuate economic incentives misaligned with the tenets of best execution, and may promote activity detrimental to market quality. The chapter employs a publicly available dataset (Daily TAQ) to facilitate replication of our metrics.
Life's Values
Authors: Goldman Alan H.
Published: January 2019

This book seeks to explain what is of ultimate value in individual lives. Proposed candidates include pleasure, happiness, meaning, and well-being. Only the last is the all-inclusive category of personal value, and it consists in the satisfaction of deep rational desires. Since individuals’ rational desires differ, the book cannot tell you what will maximize your own well-being, what in particular you ought to pursue, although it can tell you to make your desires rational, that is, informed and coherent. It can also explain the nature of the states that typically enter into well-being: pleasure, happiness, and meaning being typically partial causes as well as effects of well-being. All are byproducts of satisfying rational desires and rarely successfully aimed at directly. Pleasure comes in sensory, intentional, and pure feeling forms, each with an opposite in pain or distress. Happiness in its primary sense is an emotion, not a constant state as some philosophers assume, and in secondary senses a mood (disposition to have an emotion) or temperament (disposition to be in a mood). Meaning in life is a matter of events in one’s life fitting into intelligible narratives. Events in narratives are understood teleologically as well as causally, in terms of outcomes aimed at as well as antecedent events. In briefest terms, this book distinguishes and relates pleasure, happiness, well-being, and meaning, and relates each to motivation and value.
Well-Being
Authors: Goldman Alan H.
Published: January 2019

Well-being is what makes life valuable or good for the individual whose life it is. It is the all-inclusive category of personal value. This chapter evaluates the leading accounts: hedonism (pleasure is the measure of well-being), perfectionism (development of human capacities is the measure), objective lists (numerous objective goods make up a good life), and desire satisfaction. Fatal objections are raised to the first three, and an idealized desire satisfaction account is defended against objections typically raised by others to this kind of theory. The successful theory must capture our concept, unify and explain why various things are good for individual persons, and show why we are rationally motivated to pursue well-being.
Meaning in Life
Authors: Goldman Alan H.
Published: January 2019

When philosophers these days write of meaning in life, they usually refer to the value or importance of a life, not meaning in any ordinary sense. Older philosophers wrote of the meaning of life as the way our lives fit into God’s plan. For those who have lost faith in such a plan, there is no such meaning. But there is a related sense in which events have meaning in our lives when they fit into intelligible narratives, similar to the way in which words and sentences acquire meaning via their places in broader linguistic entities. It is this way in which events in our lives have meaning that is fully explicated in this chapter.
The Cosmic Mystery Tour
Authors: Mee Nicholas
Published: January 2019

The Cosmic Mystery Tour is a brief account of modern physics and astronomy presented in a broad historical and cultural context. The book is attractively illustrated and aimed at the general reader. Part I explores the laws of physics including general relativity, the structure of matter, quantum mechanics and the Standard Model of particle physics. It discusses recent discoveries such as gravitational waves and the project to construct LISA, a space-based gravitational wave detector, as well as unresolved issues such as the nature of dark matter. Part II begins by considering cosmology, the study of the universe as a whole and how we arrived at the theory of the Big Bang and the expanding universe. It looks at the remarkable objects within the universe such as red giants, white dwarfs, neutron stars and black holes, and considers the expected discoveries from new telescopes such as the Extremely Large Telescope in Chile, and the Event Horizon Telescope, currently aiming to image the supermassive black hole at the galactic centre. Part III considers the possibility of finding extraterrestrial life, from the speculations of science fiction authors to the ongoing search for alien civilizations known as SETI. Recent developments are discussed: space probes to the satellites of Jupiter and Saturn; the discovery of planets in other star systems; the citizen science project SETI@Home; Breakthrough Starshot, the project to develop technologies to send spacecraft to the stars. It also discusses the Fermi paradox which argues that we might actually be alone in the cosmos
Napoleonic Legacies and the Reform Act of 1832
Authors: Eastlake Laura
Published: January 2019

This chapter examines the use of ancient Rome for articulating national values, synthesizing the public image of statesmen, and constructing partisan ideologies in the nineteenth-century political sphere. If the schoolroom was a space in which boys were taught to wield the language and literatures of ancient Rome like weapons in defence of the boundaries of elite male culture, uses of Rome in the political sphere should fluctuate so dramatically between enthusiastic adoption and outright rejection over the course of the nineteenth century. It accounts for such uneasy receptions of ancient Rome in Victorian political discourse by setting them in the wider context of Anglo-French tensions. It suggests that French revolutionary and Napoleonic uses of Rome are crucial for explaining both the very direct engagement of British political commentators with the Roman past immediately after Waterloo, as they sought to detach Rome from associations of revolution, radical republicanism, and violent popular protest; and secondly, the abandonment of such strategies in the period leading up to the Reform Act of 1832, as the Roman parallel became contested and unstable.
Caesar, Cicero, and Anthony Trollope’s Public Men
Authors: Eastlake Laura
Published: January 2019

This chapter charts an increasing, if conflicted, desire in British political discourse generally, and the writings of Anthony Trollope specifically, to re-engage with Caesar, Cicero, and the history of the late republic after a generation of avoiding the more incendiary associations of the Roman past outlined in Chapter 3. Through examination of Anthony Trollope’s deeply political Palliser novels, it maps some of the associations of Liberal, reformist energy and enduring respect for political tradition which Trollope associates with Caesar and Cicero respectively in an age where the rise of Napoleon III threatened to reignite some of the more dynastic French associations of the Roman parallel.
Introduction
Authors: Eastlake Laura
Published: January 2019

This introductory chapter presents the theoretical and methodological approaches used in the book as a whole before identifying in the works of early Victorian writers like Thomas Arnold, John Stuart Mill, and Thomas Babington Macaulay a sense of the privileged insight of the Victorian male into the ancient Roman past. Yet despite the self-confident bombast of such writers on the modernity and liberality of the age, the nineteenth century also experienced unprecedented social, cultural and educational changes which resulted in the fragmenting of masculine identities. It therefore theorizes a way of understanding Rome as a contested space, with an array of possible scripts and narratives that could be harnessed to frame models of masculine ideality, or to vilify perceived deviance from those ideals, and allows for an understanding of masculinity as being rooted in the power of reception.
Christian Philosophy and the Christian Life
Authors: Ebels-Duggan Kyla
Published: January 2019

In this chapter, Kyla Ebels-Duggan considers how Christian philosophers should decide which questions are worth asking. She provides an interpretation and defense of Alvin Plantinga’s claim that Christian philosophers should strive for autonomy, and then argues that this rules out some ways of settling on our questions. Ebels-Duggan then suggests that the questions in which Christian philosophers should take an interest are those arising from or continuous with a distinctively Christian way of life. Along the way she argues that the power of the distinctive tools of philosophy is importantly limited: reasoning alone cannot settle either which questions we should ask or which commitments we should take on.
Teaching Evil
Authors: Sullivan Meghan
Published: January 2019

In this chapter, Meghan Sullivan reflects on difficulties we face in teaching the problem of evil. She describes two approaches to the epistemology of theism—one which insists that answers to challenges be as neutral as possible and one which insists that we are rationally justified in appealing to particular faith commitments when answering challenges. After defending the latter approach from some objections, she argues that taking this approach seriously motivates a more confessional approach to teaching the problem of evil (and other, non-religious philosophical puzzles as well).
Between Isaac Newton and Enlightenment Newtonianism
Authors: Shank J. B.
Published: January 2019

A pervasive, and still stubbornly persuasive, Enlightenment story holds that Isaac Newton’s 1687 Philosophiae naturalis principia mathematica played a decisive role in naturalizing early modern cosmology and physical science. Newton, however, was a committed, if heterodox Christian, and his new physics and astronomy depended crucially on a belief in God’s role as both the architect and ruling Pantokrator of the universe. Enlightenment naturalism, therefore, did not develop directly out of Newton’s Principia even if his new mathematical physics became a vehicle for disseminating it once a naturalist understanding of ‘Newtonianism’ had been forged by others. This chapter traces the genealogies that produced Newton and the cosmology of his Principia, along with the naturalizing alternative that contemporaries misleadingly called Enlightenment ‘Newtonianism’. It shows that while these had become entangled by 1800, their conjunction was a historical creation rather than an outcome determined directly by Newton or his science.
Talking History
Authors: Jahanbegloo Ramin , Thapar Romila , Bhattacharya Neeladri
Published: January 2019

Talking History records a series of conversations that centre on the writing of history, and especially early Indian history, as evident in the works of Romila Thapar. She has focused on the study of early India but is also interested in the link between the past and the present. Whereas she recognizes the importance of analysing texts of ancient India for information on early history, which she does in her various studies of the past, she is also concerned with explaining what happened in the past and why. Assessing the data and its reliability is the first step followed by explaining its historical context and how it contributes to the construction of history. Her emphasis on reliable evidence and logical explanation has led her to oppose the fantasy reconstructions of the past by supporters of religious nationalism. In her more recent work she has challenged the widely held idea that Indian society lacked a sense of history. In this book Thapar shares her insights on history with Ramin Jahanbegloo, an Iranian philosopher, and Neeladri Bhattacharya, a historian of modern India at the Jawaharlal Nehru University. Given the link between aspects of the past and the present, the book begins with recalling Thapar’s early life before becoming a historian and continues with reflections on topics ranging from religion in history to theories of explanation as, for example, Marxism. She discusses objectivity in history, the rational retelling of events, oral history, historicity, and various concepts used in the study of history.
The Archaeology of Coastal Bengal
Authors: Chattopadhyay Rupendra Kumar
Published: January 2019

Research work on coastal Bengal has mostly focused on maritime trading networks. In a clear departure from the existing scholarship, this volume questions the linearity of considering trade as the sole determinant of creation of settlement in the coastal regions. Focusing on settlement strategies, Chattopadhyay unravels how human societies, through successive generations, have adapted to the coastal environment and bio-regime. First-hand data, procured through extensive fieldwork, forms the sound basis of this work. From structural remains, ceramic and bone implements, and stone tools, to terracotta figurines and inscriptions—a vast array of sources is analysed, including epigraphic and literary sources. Significantly, the volume also highlights the interconnection between the coastal geography and the hinterland. Chattopadhyay’s meticulously researched work offers a geographical and temporal frame which allows the research in coastal Bengal to be viewed as an integral part of the archaeological developments in the subcontinent, as well as in the adjoining region of the Southeast Asian countries.
Private International Law
Authors: Govindaraj V.C.
Published: January 2019

In deciding cases of private international law or conflict of laws, as it is widely known, judges of the Supreme Court in India generally consult the works of renowned English jurists like Dicey and Cheshire. This volume argues that our country should have its own system of resolving inter-territorial issues with cross-border implications. The author critically analyses cases covering areas such as the law of obligations, the law of persons, the law of property, foreign judgments, and foreign arbitral awards. The author provides his perspectives on the application of law in each case. The idea is to find out where the judges went wrong in deciding cases of private international law, so that corrective measures can be taken in future to resolve disputes involving complex, extra-territorial issues.
Talking Sociology
Authors: Jahanbegloo Ramin , Gupta Dipankar
Published: January 2019

A well-known name in contemporary sociology, Dipankar Gupta’s wide range of scholarship and popular columns have justly earned him the reputation of being one of India’s leading public intellectuals. Talking Sociology provides a complete panorama of Gupta’s life and works and his contribution to Indian sociology. In this book of conversations, he shares insights into the key areas of Indian sociology, such as the problem of social stratification, citizenship and democracy, and the caste system and ethnic groups in India. In his view, once we understand the discrete nature of caste identity we begin to appreciate the energy behind caste mobilization and, indeed, of the obduracy of this institution itself. It also discusses the influence of prominent thinkers on Gupta’s works, such as Claude Lévi Strauss, Talcott Parsons, André Beteille, and John Rawls. The ninth in the series of Ramin Jahanbegloo’s conversations with the prominent intellectuals who have made a significant impact in shaping the modern Indian thought, this book discusses Gupta’s array of work and its redefinition and reconstruction of the central concepts of sociology, taking it beyond its disciplinary boundaries.
Health and Philosophy in Pre- and Early Imperial China
Authors: Stanley-Baker Michael
Published: January 2019

Though there was no single Chinese term that corresponds to the English word health, there were a variety of theories about bodily ideals. This chapter follows these theories through three periods of early Chinese history. A key notion is qi, or “vital breath,” that circulates through the body to preserve health; learning methods of breath control can thus prolong life. So-called “Daoist” philosophy draws a parallel between health in the individual and good order in the state, as well as nature or the cosmos as a whole, an idea furthered in medical works of the Han dynasty.
Reflection
Authors: King Helen
Published: January 2019

Perhaps the best-known parts of the Hippocratic Corpus are the case histories collected in the seven treatises known as the Epidemics.1 Like the other medical texts from the Corpus, which date from the fourth century BCE onward, these are mostly concerned with disease, but it is not difficult to read between the lines to identify what is thought to constitute “health.”...
Characterization of hop-and-sink daphniid locomotion
Authors: Skipper A N , Murphy D W , Webster D R
Published: January 2019

This study characterizes the hop-and-sink locomotion of Daphnia magna, a zooplankton species widely studied in a variety of biological fields. Time-resolved tomographic particle image velocimetry (tomo-PIV) is used to obtain 3D kinematics and flow field data with high spatial and temporal resolution. The kinematics data show that the daphniid’s velocity quickly increases during the power stroke, reaching maximum accelerations of 1000 body lengths/s2, then decelerates during the recovery stroke to a steady sinking speed. The hop-and-sink locomotion produces a viscous vortex ring located under each second antennae. These flow structures develop during the power stroke, strengthen during the recovery stroke, and then decay slowly during the sinking phase. The time records of vortex circulation are self-similar when properly normalized. The flow fields were successfully modeled using an impulsive stresslet, showing good agreement between the decay of circulation and a conceptual model of the impulse. While no relationships were found between kinematics or flow field parameters and body size, the total energy dissipated by the daphniid hop-and-sink motion was found to scale exponentially with the vortex strength.
The reach and effectiveness of SIPsmartER when implemented by rural public health departments: a pilot dissemination and implementation trial to reduce sugar-sweetened beverages
Authors: Zoellner Jamie M , Porter Kathleen J , You Wen , Estabrooks Paul A , Perzynski Katelynn , Ray Pamela A , Cantrell Eleanor S
Published: January 2019

SIPsmartER is a theory-based, 6-month, multi-component health literacy intervention shown to improve sugar-sweetened beverages (SSB) behaviors among adults in rural, southwest Virginia. The objective of this pilot trial was to understand the reach and effectiveness of SIPsmartER when delivered by existing staff in public health practice settings. This pre-post research design was conducted in partnership with four medically underserved southwest Virginia Department of Health (VDH) districts. Validated measures and standardized data collection techniques were used. Analyses included descriptive statistics and multilevel mixed-effects linear regressions models. Of 928 individuals screened, 586 (63%) were eligible and 117 (20% of eligible) enrolled in SIPsmartER (79% retained). The sample was majority female (71%) and white (94%) and had ≤high school education (59%) and an annual income of approximately $12,500. Relative to the county population, the enrolled study sample was representative for age and race, yet underrepresented for men and overrepresented for low income and low educational attainment. Significant improvements from baseline to 6 months were observed for the primary SSB outcome (−403 [confidence interval [CI] = −528, −278] SSB kcals/day) (p < .001). SSB-related attitudes, perceived behavioral control, behavioral intentions, and media literacy also significantly improved (all p < .05). SIPsmartER appears to be promising for VDH and potentially other health departments in medically underserved areas. When compared to the previous effectiveness trial, existing VDH staff achieved similar reach and effectiveness for some, but not all, outcomes. Future work is needed on methods to support health departments in developing strategies to reach new participants and to integrate SIPsmartER into sustained practice.
Drought impacts on tree phloem: from cell-level responses to ecological significance
Authors: Salmon Yann , Dietrich Lars , Sevanto Sanna , Hölttä Teemu , Dannoura Masako , Epron Daniel
Published: January 2019

On-going climate change is increasing the risk of drought stress across large areas worldwide. Such drought events decrease ecosystem productivity and have been increasingly linked to tree mortality. Understanding how trees respond to water shortage is key to predicting the future of ecosystem functions. Phloem is at the core of the tree functions, moving resources such as non-structural carbohydrates, nutrients, and defence and information molecules across the whole plant. Phloem function and ability to transport resources is tightly controlled by the balance of carbon and water fluxes within the tree. As such, drought is expected to impact phloem function by decreasing the amount of available water and new photoassimilates. Yet, the effect of drought on the phloem has received surprisingly little attention in the last decades. Here we review existing knowledge on drought impacts on phloem transport from loading and unloading processes at cellular level to possible effects on long-distance transport and consequences to ecosystems via ecophysiological feedbacks. We also point to new research frontiers that need to be explored to improve our understanding of phloem function under drought. In particular, we show how phloem transport is affected differently by increasing drought intensity, from no response to a slowdown, and explore how severe drought might actually disrupt the phloem transport enough to threaten tree survival. Because transport of resources affects other organisms interacting with the tree, we also review the ecological consequences of phloem response to drought and especially predatory, mutualistic and competitive relations. Finally, as phloem is the main path for carbon from sources to sink, we show how drought can affect biogeochemical cycles through changes in phloem transport. Overall, existing knowledge is consistent with the hypotheses that phloem response to drought matters for understanding tree and ecosystem function. However, future research on a large range of species and ecosystems is urgently needed to gain a comprehensive understanding of the question.
Climate variability impacts on diversification processes in a biodiversity hotspot: a phylogeography of ancient pseudoscorpions in south-western Australia
Authors: Harms Danilo , Roberts J Dale , Harvey Mark S
Published: January 2019

The south-western division of Australia is the only biodiversity hotspot in Australia and is well-known for extreme levels of local endemism. Climate change has been identified as a key threat for flora and fauna, but very few data are presently available to evaluate its impact on invertebrate fauna. Here, we derive a molecular phylogeography for pseudoscorpions of the genus Pseudotyrannochthonius that in the south-west are restricted to regions with the highest rainfall. A dated molecular phylogeny derived from six gene fragments is used for biogeographic reconstruction analyses, spatial mapping, environmental niche-modelling, and to infer putative species. Phylogenetic analyses uncover nine clades with mostly allopatric distributions and often small linear ranges between 0.5 and 130 km. Molecular dating suggests that the origins of contemporary diversity fall into a period of warm/humid Palaeogene climates, but splits in the phylogeny coincide with major environmental shifts, such as significant global cooling during the Middle Miocene. By testing several models of historical biogeography available for the south-west, we determine that Pseudotyrannochthonius is an ancient relict lineage that principally follows a model of allopatric speciation in mesic zone refugia, although there are derivations from this model in that some species are older and distribution patterns more complex than expected. Ecological niche models indicate that drier and warmer future climates will lead to range contraction towards refugia of highest rainfall, probably mimicking past variations that have generated high diversity in these areas. Their conservation management will be crucial for preserving the unique biodiversity heritage of the south-west.
Salvage of failed trapeziectomy, ligament reconstruction and tendon interposition with suture button suspensionplasty for basilar joint arthritis
Authors: Yang Kai , Graf Alexander , Kim Nicholas , Sanger James , Matloub Hani
Published: January 2019

Background:

Thumb basilar joint arthritis is a common pathology treated by hand surgeons. Trapeziectomy followed by various reconstructive techniques have been described; however, treatment options after failed primary trapeziectomy and ligament reconstruction (LRTI) with painful subsidence are not well studied. Suture button suspensionplasty has emerged as a new primary reconstructive procedure in recent years. We aim to report our experience of using suture button suspensionplasty as a salvage procedure for patients presenting with recurrent painful subsidence after primary surgical intervention.

Methods:

A retrospective chart review of all patients undergoing suture button suspensionplasty between 2016-2017 was performed. Patients who had the procedure after failed primary trapeziectomy and LRTI were included in the study. Patient demographic data, diagnostic imaging, clinical presentation, operative details, surgical pathology, and clinical outcomes were reviewed.

Results:

Thirty-two button suspensionplasties were performed in the 2-year span. Five patients underwent surgery for failure of previous trapeziectomy with ligament reconstruction. All patients had Eaton stage III arthritis at original presentation. The average age was 59 yr. Average follow-up was 13 mo (11-18 mo). All patients reported significant improvement in pain and hand function after revision surgery. One patient had a second revision surgery because of failure of the first revision secondary to a fall. Postoperative Disabilities of Arm Shoulder and Hand (DASH) score range from 13.3 to 25, with an average of 19.8.

Conclusions:

Suture button suspensionplasty is a viable option for patients who present with painful subsidence after failure of primary surgical intervention for basilar joint arthritis.
The core pattern of Chinese herbal formulae and drug–herb concurrent usage in patients with dementia
Authors: Lin Shun-Ku , Tzeng Jeng-Nan , Lai Jung-Nien
Published: January 2019

More than 40% dementia patients received traditional Chinese Medicine treatment. However, the prescription pattern of Chinese herbal formulae (CHF) for treating neurocognitive or behavioral disorders in patients with dementia has not been elucidated. This large-scale survey aimed is to evaluate core patterns of CHF and drug–herb concurrent use in patients with dementia.

We analyzed patients with a diagnosis of dementia from one million cohorts of the Longitudinal Health Insurance Database in the National Health Insurance Research Database, between 1997 and 2008. Of 18,141 newly diagnosed dementia patients, 3471 patients received CHF for mental and nervous system diseases. There were 13,254 outpatient visits, with 60,968 formulae prescriptions. We calculate the frequency and proportion of combined use, identify drug–herb concurrent usage, and determine core prescription patterns. Also, we drew network graphs of co-prescription pairs which occurred more than 200 times.

Chinese medicine prescription patterns changed as dementia progressed.

During the first 3 years after the diagnosis of dementia, Jia-Wei-Xiao-Yao-San, Gan-Mai-Da-Zao-Tang, and Ban-Xia-Bai-Zhu-Tian-Ma-Tang were the core CHF prescribed for mental and nervous system disorders. However, during the later stages of dementia, Suan-Zao-Ren-Tang, Gui-Pi-Tang, Jia-Wei-Xiao-Yao-San, and Wen-Dan-Tang were the core CHF prescribed. Benzodiazepines were the most common sedative drugs combined with traditional Chinese formulae.

The results of this study suggest that TCM prescription were different in various stages of dementia, and indicated the frequently combined use of the TCM formulae and Benzodiazepines in dementia care.
Clinical characteristics and prognosis of 2887 patients with hepatocellular carcinoma
Authors: Wang Chun-yan , Li Shengmian
Published: January 2019

This study was aimed to estimate the survival rate characteristics of 2887 hepatocellular carcinoma (HCC) patients in the single-center and identify useful prognostic factors to help in the clinical management of patients with HCC.

Two thousand eight hundred eighty-seven patients diagnosed with HCC at the Fourth Hospital of Hebei Medical University, China, between January 2002 and December 2015 were involved.

The causes and baseline characteristics were summarized. Median survival time was 9.0 (20.0) months. Overall, HCC patients showed 1-, 2-, 3-, and 5-year survival rates equal to 49.3%, 35.3%, 26.6%, and19.5% respectively. The median survival time of HCC patients first hospitalized in 2009 to 2015 was higher than those in 2002 to 2008. The results showed that the Barcelona clinic liver cancer (BCLC) stage and Tumor size were independent prognostic factors to HCC patients.

The survival rate of HCC patients has increased in recent years, but the overall survival rate and the prognosis were poor.
Impact of atrial fibrillation on in-hospital mortality of ischemic stroke patients and identification of promoting factors of atrial thrombi – Results from the German nationwide inpatient sample and a single-center retrospective cohort
Authors: Keller Karsten , Geyer Martin , Münzel Thomas , Ostad Mir Abolfazl , Gori Tommaso
Published: January 2019

Ischemic stroke is one of the leading causes of death and disability. Atrial fibrillation (AF) is a well-recognized risk factor for ischemic stroke.

We aimed to investigate the impact of AF on in-hospital mortality of ischemic stroke patients and to identify parameters associated with intra-cardiac thrombogenic material.

Patients were selected by screening the nationwide sample for ischemic stroke by ICD-Code (I63), stratified for AF. In this cohort, the association between in-hospital deaths and AF was investigated.

In a second study, we performed a retrospective analysis of patients who underwent transesophageal echocardiography (TEE) for various reasons, assigned these to 2 groups based on the heart-rhythm (sinus-rhythm [SR] vs AF) and examined associations between clinical and echocardiographic parameters and intra-cardiac thrombogenic material.

The Nationwide sample comprised 292,401 inpatients (48.5% females) with ischemic stroke. Incidence was 360 per 100,000 citizens, with an age-dependent increase. In-hospital mortality rate was 8.2%; AF patients had 1.85-fold higher mortality rate (12.1% vs 6.5%).

In the retrospective study, 219 patients (median age 67 [59.1–77.3] years, 39.3% females) were included: 115 patients with AF (median age 71 [59.0–78.0] years, 41.7% females) and 104 patients (median age 68 [56.3–76.8] years, 36.5% females) with SR. Solid thrombus or spontaneous-echo-contrast) was detected in 16 TEEs. Atrial dimensions were significantly enlarged in AF patients. Age, blood-flow velocity in LAA, LAA diameters, atrial areas, AF, and CHA2DS2-VASc-score were associated with thrombogenic material.

Incidence of ischemic stroke increased with age. AF was connected with higher stroke mortality. Presence of intra-cardiac thrombogenic material was associated with AF and most CHA2DS2-VASc-score factors. AF was associated with larger atrial dimensions and larger cavities favored thrombogenic material.
Association of BAX hypermethylation with coronary heart disease is specific to individuals aged over 70
Authors: Zhang Limei , Ji Huihui , Huang Yi , Hu Haochang , Li Bin , Yang Yong , Yu Hang , Chen Xiaoying , Li Wenxia , Liu Fang , Wang Shi , Wang Chunming , Chen Ke , Bao Yingchun , Liu Haibo , Duan Shiwei
Published: January 2019

Introduction:

As a member of B-cell lymphoma-2 (BCL-2) gene family, BCL-2 associated X (BAX) is important for cell apoptosis. In this work, we investigated the association of BAX promoter DNA methylation with coronary heart disease (CHD) in Han Chinese.

Methods:

A SYBR green-based quantitative methylation specific PCR (qMSP) was used to test BAX methylation levels in 959 CHD cases and 514 controls.

Results:

Although BAX methylation was not associated with CHD in the total samples, further breakdown analysis by age showed that BAX hypermethylation was significantly associated with CHD for individuals aged over 70 (median percentage of methylation ratio [PMR], 10.70% in cases versus (vs) 2.25% in controls, P =.046). Moreover, BAX methylation was associated with smoking and lipoprotein A (Lp(a)) for individuals aged over 70 (CHD: smoking P = .012, Lp(a) P = .001; non-CHD: smoking P = .051, Lp(a) P = .004). Further analysis of Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) data showed BAX expression was upregulated by 5-aza-2’-deoxycytidine demethylation agent (fold = 1.66, P = .038) and inversely correlated with BAX methylation (r = −0.428, P = 8E-05).

Conclusions:

Our study supported that BAX hypermethylation might contribute to CHD risk via downregulation of BAX expression for individuals aged over 70.
Primary plasmablastic plasmacytoma in the stomach of an immunocompetent adult
Authors: Ding Wei , Tan Yulin , Qian Yan , Xue Wenbo , Wang Yibo , Xi Cheng , Gu Kefeng , Xu Yixin , Xu Xuezhong
Published: January 2019

Rationale:

Extramedullary plasmacytomas (EMP) are tumors composed by a monoclonal population of plasma cells that arise in extraosseus tissues, occupying <5% of all plasma cell neoplasms. Gastrointestinal solitary extramedullary plasmacytoma is rare, just comprises about 5% of all EMPs. The most common site is small intestine. The gastric incidence is much rare and especially the plasmablastic plasmacytoma in the stomach.

Patient concerns:

A 65-year-old man had an epigastric discomfort and mass for about 2 months. Gastroscopy revealed a malignant tumor in the gastric body. Abdomen computed tomography (CT) showed that the gastric cavity was filled, and the irregular soft tissue shadow was seen in the greater curvature, and the enhancement was obvious. To get more tissue, we conducted stomach puncture biopsy. Pathology showed small-round cell malignant tumors. And immunohistochemical examinations revealed that the tumor tend to be a plasma cell tumor.

Diagnosis:

Gastric plasma cell tumor.

Interventions:

Distal gastrectomy was performed to treat the tumor.

Outcomes:

In addition to ascites caused by hypoproteinemia, there were no postoperative complications. Postoperative pathologic report showed plasmablastic plasmacytoma. Histopathologic examination of the specimen revealed plasmablastic plasmacytoma originating in the stomach with transmural extension, but without lymph node metastasis. The patient is regularly followed up at a postoperative clinic and is doing well, and at present there is no plan for adjuvant treatment.

Lessons:

Surgical resection is good option for gastrointestinal EMP.
Melatonin for the treatment of gastroesophageal reflux disease; protocol for a systematic review and meta-analysis
Authors: Bang Chang Seok , Yang Young Joo , Baik Gwang Ho
Published: January 2019

Background:

Melatonin generated in the gastrointestinal tract has mucosal protective effect with inhibiting gastric acid secretion, while increasing gastrin release, which in turn stimulates the contractility of lower esophageal sphincter. Gastroesophageal reflux disease (GERD) is also known to have association with sleep disturbance. However, melatonin or melatonin receptor agonist has not been included in the treatment of GERD. This study aimed to evaluate the efficacy of melatonin for the treatment of GERD.

Methods:

We will search the core databases [MEDLINE (through PubMed), the Cochrane Library, and Embase] from their inception to December 2018 by 2 independent evaluators. The P.I.C.O. is as follows; Patients: who have GERD, Intervention: melatonin or melatonin receptor agonist treatment, Comparison: patients without melatonin or melatonin receptor agonist treatment, Outcome: clinical indices (or crude number or proportion of improvement) for the evaluation of symptomatic improvement which enable comparison of efficacy between patients with melatonin or melatonin receptor agonist and the control group. All types of study design will be sought with full-text will be included. The risk of bias will be assessed using the ROBINS-I tool. Descriptive data synthesis is planned and quantitative synthesis will be used if the included studies are sufficiently homogenous. Publication bias will be assessed with quantitative analyses if more than 10 articles are enrolled.

Results:

The results will provide evidence for the efficacy of melatonin or melatonin receptor agonist for the treatment of GERD.

Conclusion:

This study will provide evidence of melatonin or melatonin receptor agonist treatment for GERD.
Left ventricular deformation in relation to the geometric pattern in hypertensive patients
Authors: Xu Ting-Yan , Yang Yan , Li Jing-Jing , Li Yan , Wang Ji-Guang
Published: January 2019

This study aimed to evaluate left ventricular deformation in relation to the geometric pattern in hypertensive patients with normal left ventricular ejection fraction using speckle tracking echocardiography (STE).

Transthoracic echocardiography was performed in 80 hypertensive patients and 50 age- and gender-matched normotensive subjects. Left ventricular geometric pattern was defined according to left ventricular mass index and relative wall thickness as normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy, respectively. Quantitative measurements of longitudinal, circumferential, and radial strain were performed for endocardial, middle, and epicardial layers of the left ventricular wall at each segment.

The longitudinal strain in hypertension was lower for all 3 layers in concentric (n = 20) and eccentric hypertrophy (n = 20) than normotensive subjects (n = 50, P < .01). It was also significantly lower for the endocardial layer in concentric remodeling (n = 20, P = .04 vs normotensive subjects). The circumferential strain in hypertension was higher in normal geometry or concentric remodeling, lower in concentric hypertrophy, and at similar level in eccentric hypertrophy, in comparison with normotensive subjects. The difference from normotensive subjects was statistically significant for the endocardial and middle layers in normal geometry (P < .03), for the endocardial layer in concentric remodeling (P < .02), and for the middle and epicardial layers in concentric hypertrophy (P≤.001). The radial strain and twist did not differ between normotensive and hypertensive subjects (P > .08).

Left ventricular deformation in hypertension occurs with various geometric patterns disproportionately in the endocardial, middle and epicardial layers and differently in the longitudinal and circumferential orientations.
Clinical analysis of uterine artery embolization combined with double balloon catheter plus curettage for patients with placenta previa who underwent pregnancy termination and suffered antenatal massive hemorrhage in the 2nd trimester
Authors: Tang Fei , Du Shuguo , Zhao Yun , Sun Guoqiang , Lin Ying , Li Ruyan , Wu Xufeng
Published: January 2019

Rationale:

It is very difficult to treat patients with placenta previa who underwent pregnancy termination and suffered antenatal massive hemorrhage in the 2nd trimester.

Patient concerns:

In this study, case 1 was with fetal malformation of 18-trisomy syndrome at gestation of 19 weeks + 2 days, case 2 was with fetal malformation of 18-trisomy syndrome at gestation of 22 weeks + 1 day, and case 3 was for intrauterine fetal death at gestation of 27 weeks. All the 3 cases were completely placenta previa.

Diagnoses:

For the 3 patients, completely placenta previa was confirmed by ultrasound examination after hospitalization and underwent pregnancy termination for fetal death or fetal malformation in the 2nd trimester.

Interventions:

The 3 patients with placenta previa underwent pregnancy termination by mifepristone combined with ethacridine lactate in the 2nd trimester for intrauterine fetal death or fetal malformation from June 2017 to May 2018, and suffered antenatal massive hemorrhage during termination. Uterine artery embolization (UAE) was immediately performed to achieve hemostasis, then double balloon catheter (DBC) was carried out to promote cervical ripen, at last curettage was implemented with the help of ultrasound. After all these procedures, the clinical outcomes were observed.

Outcomes:

The antenatal bleeding volume of these 3 patients were about 500, 600, and 550 mL. After implementing the combined treatment, all patients completed the abortion. The UAE-DBC time interval and DBC-curettage time interval were 58.4 and 6.0 hours, respectively, for case 1, whereas almost 0 (i.e., immediately) for cases 2 and 3. Case 1 had a fever lasting for 3 days, and the maximum body temperature was up to 39°C after UAE. Moreover, the blood culture was positive for Escherichia coli after curettage in case 1, whereas it was negative in the other 2 cases.

Lessons:

The UAE-DBC–curettage combined treatment is safe and effective for patients with placenta previa who undergo pregnancy termination and suffered massive antenatal hemorrhage in the 2nd trimester. Future studies are needed to advance our observation.
Cinnamon
Authors: Singletary Keith
Published: January 2019

Cinnamon has been used for centuries as a culinary ingredient, as a traditional medicine, and more recently considered as a complementary agent for controlling symptoms of diabetes, the metabolic syndrome, and other conditions. Prior to 2008, few studies addressed these proposed benefits of cinnamon in controlled human trials. However, during the past decade, numerous clinical trials investigated the efficacy of cinnamon supplementation in alleviating hyperglycemia, dyslipidemia, polycystic ovary syndrome, and certain inflammation-associated conditions. There is considerable variability among trials in the form, dose, and duration of cinnamon treatment, as well as in participant characteristics, all of which complicate making a synthesis of the available literature. This report briefly summarizes these studies and considers recommendations for cinnamon and human health based on the current scientific evidence.
Nursing Students' Knowledge of the Nurse's Role in the Management of Dysphagia
Authors: L. C. Jones Christina , Porterfield Susan
Published: January 2019

Purpose

The purpose of this study was to evaluate nursing students' knowledge of the nurse's role in the interprofessional management of dysphagia.

Design

A quasi-experimental, pretest–posttest educational intervention was used in this study.

Methods

Thirty-eight pretest and 37 posttest undergraduate nursing students participated. An addendum to the original study assessed knowledge retention in a separate group of nursing students who had received a similar educational intervention 1.5 years prior.

Findings

Statistically significant changes were found between pretests and posttests. The knowledge retention group performed more poorly in some areas, suggesting that initial instruction was not reinforced beyond the novice level.

Conclusions

Educating nursing students about the nurse's role in the management of dysphagia will increase their knowledge, but this knowledge must be reinforced for integration into clinical practice. More research is needed to determine what education nursing students receive on dysphagia and what the role of the nurse is in the management of dysphagia.

Clinical Relevance

Dysphagia negatively impacts clinical and rehabilitation outcomes. Because nurses may lack sufficient training in the management of dysphagia, healthcare organizations should offer such training to new hires and then periodically thereafter. Likewise, practicing nurses who serve as preceptors should be prepared to train nursing students and new nurses how to safely manage dysphagia.