bluuebunny/crossref_metadata_2025 huggingface dataset:
Brown, Empire, and Colonialism
Authors: Doolen Andy
Published: June 2019

This chapter discusses the interrelationships between Charles Brockden Brown’s writings and the historical forces of colonialism and empire. Brown’s novels, journalism, political pamphlets, and historiography explore the impact of US territorial and commercial expansion, the slave trade, political violence, and ideologies of racial difference on the development of the republican political experiment. Brown challenges the ideological divide between British colony and American republic. His writings register how colonialism was part and parcel of the Bildungsroman of a rising republic with imperial designs in North America. This political paradox marked the distinctiveness of Brown’s settler-national voice. Recently, scholarship attuned to the historical forces of colonialism and empire has reorganized the prevailing chronology of Brown studies. It is no longer widely accepted that Brown, after 1800, turned toward conservatism and abandoned aesthetic experimentation. The reception history of Brown’s later work now reads like one of his compelling, contradictory, unpredictable Gothic novels.
Brown and Sex
Authors: Stein Jordan Alexander
Published: June 2019

This chapter considers the various things that sex does and can mean in Charles Brockden Brown’s corpus, with particular attention to his novels. Following on Brown’s discussion in “Walstein’s History,” the chapter takes for granted that sex has at least three different meanings: sex as gender, sex as marriage, and sex as sexuality. Though Brown’s works depict sex in plural ways, the works are not consistent in their representations of the relationship among these plural aspects of sex or in their emphases on which aspects matter most. Sex accordingly has become an interpretative problem for readers of Brown’s novels: what meaning or meanings for sex are being represented, and to what end? The chapter surveys scholarly attempts to make sense of Brown’s engagements with sex in its multiple forms, in an effort to identify which meanings might best serve readers of Brown’s novels.
Brown’s American Gothic
Authors: Miles Robert
Published: June 2019

This chapter argues that Edgar Huntly is the foundational text for the American Gothic, a genre that shadows American history. Noting the strange similarity between Charles Brockden Brown’s romance and Francisco Goya’s The Sleep of Reason, produced in the same year, the chapter argues that Brown and Goya are alike in ironizing the Enlightenment by noting that violence as often arises from reason as from its repression, as much from intellectuals striving to do good as from irrational impulses. Like many Gothic texts, the romance’s presiding metaphor is live burial, in a cave but also in language, in the very instrument of reason. The romance parallels the sleepwalking of the ambiguous foreign other, Clithere, and narrator Edgar; and just as Clithero’s narrative proves to be a compromised tissue of intertextual fantasies and lies, ostensibly benevolent but ultimately murderous, so doubt is cast on the narrator, also dangerously fettered by reason.
Brown, Sensibility, and Sentimentalism
Authors: Burnham Michelle
Published: June 2019

This chapter surveys the treatment of sentimentality and sensibility across Charles Brockden Brown’s fiction within the historical and cultural context of the wider Atlantic world. It considers the changing ways in which literary critics have responded to Brown’s use of sentiment, as well as the role this feature of his fiction has played in determining his place within literary history. The chapter argues that the representation of feeling in Brown’s fiction should be paired with a study of finance, speculation, and consumer society. Brown explores and exposes sympathy’s double bind, which lubricates the wheels of commerce even as it seeks to stop its destructive effects.
Brown and the Novel in the Atlantic World
Authors: Silyn Roberts Siân
Published: June 2019

This chapter situates Charles Brockden Brown’s Gothic and sentimental novels in relation to the broader culture of novelistic miscellany that proliferated before 1820. It considers Brown’s contributions to contemporary narrative theory, his revision of the political economy of sentimentalism and the Gothic, and the historical formalism of episodic and picaresque narratives. It offers an overview of contemporary debates about the moral value of novel reading and considers contemporary calls for a novelistic culture of literary nationalism in terms of a broader, circum-Atlantic system of literary transmission and adaptation. It offers a heuristic account of the social function of the episode or fragment in early American imaginative writings and considers how Brown theorizes his relationship to the generically variable, constitutively elliptical nature of early American literary production more generally.
Brown’s Studies in Literary Geography
Authors: Brückner Martin
Published: June 2019

Examining the literary construction of place in Charles Brockden Brown’s fiction and nonfiction, this chapter argues that the author’s spatial imagination was representative of eighteenth-century geographical thought while also anticipating new humanist theories of cultural geography. Be they cityscapes or desert wilderness, architectural structures or complex spatial systems, Brown’s settings reveal geographic writing protocols and theories of representation that in turn served as creative venues for contemplating political doctrines of territoriality; Enlightenment fantasies of fixed spaces in an age of globalization and landscape aesthetics; and new geographic sensibilities linking the human body to the sensory experience of space and the spatial feeling of emplacement. By recovering Brown’s lifelong enthusiasm for the science of geography, the chapter concludes that in the course of his literary career, Brown not only repudiated writing fiction in favor of textbook geography but preferred geographic over literary authorship.
Introduction
Authors: Barnard Philip , Emmett Hilary , Shapiro Stephen
Published: June 2019

The Oxford Handbook of Charles Brockden Brown provides an up-to-date survey of the life of and full range of writings by Charles Brockden Brown (1771–1810), a key writer of the Atlantic revolutionary age and the early American republic. Through the late twentieth century, Brown was best known as an important author of political romances in the Gothic mode that were widely influential in the Romantic era and has generated large amounts of scholarship as a crucial figure in the history of the American novel. More recent work recognizes him likewise as an influential editor, historian, and writer in other genres such as poetry, short fiction, and essays and as a figure whose work resonated throughout the Atlantic world of the revolutionary age. The Oxford Handbook’s thirty-five chapters build on the research of the most recent scholarly generation to introduce readers to Brown and explore his wide-ranging work.
Brown Studies Now and in Transition
Authors: Murray Hannah Lauren
Published: June 2019

This chapter examines the state of the field of Charles Brockden Brown studies since 2000. Taking a thematic approach, I discuss four dominant strands in twenty-first-century criticism: geographies, medical humanities, economies, and aesthetics. These sections cover the scholarly debate over a transnational, imperial, or postcolonial Brown; consider the new ways in which early national medicine intersects with his fiction; chart the rise of market and class-based criticism; and discuss a return to formal concerns in light of the aesthetic or postcritique turn. The final section of this chapter looks ahead to emergent trends in future Brown scholarship in response to the previous decade’s work.
On Felons and Fallacies
Authors: Emmett Hilary
Published: June 2019

Taking as a point of departure Paul Giles’s recent proposition of an antipodean America whereby America and Australia entered in the late eighteenth century into a triangulated relationship with Britain (as the old colony and the new vis-à-vis their imperial forebear), this chapter posits Edgar Huntly as a novel that is highly aware of the expansion of the business of empire building occurring in the 1780s. Most significantly for the emerging field of antipodean or trans-Pacific American studies, the chapter argues not only that Charles Brockden Brown’s foregrounding of violence between indigenous and settler communities contests the doctrine of terra nullius (uninhabited land) on which Australia was founded but also that his representation of Arthur Wiatte and Clithero Edny as Irish convicts equally stages a critique of transportation.
Stephen Calvert’s Unfinished Business
Authors: Looby Christopher
Published: June 2019

Charles Brockden Brown left Memoirs of Stephen Calvert (1799–1800) unfinished, and its fragmentary state has led to its unjust critical neglect. But its unfinished condition and its serialization (in Brown’s Monthly Magazine) can be seen not as a defect and an accident of publication but as essential components of a metafictional narrative experiment and as reasons for critical interest and speculation. The novel’s eponymous narrator, Stephen, early on tells readers that his history of moral deterioration is unprecedented in its horrors and cannot be imagined; then on the last page, readers are challenged to imagine the rest of an unfinished story that is ostensibly unimaginable. In some ways, this is Brown’s most adventurous novel, involving explosive issues of sex and sexual violence, race and slavery, homoerotic rivalry and sodomy, erotic antinomianism, and grave moral depravity—plot lines that Brown may have found it impossible to carry through to their logical conclusions.
Singing and Praying among Korean Christian Converts (1896–1915)
Authors: Chang Hyun Kyong Hannah
Published: June 2019

In late nineteenth-century Korea, American-style hymn-singing and the related practice of praying began in missionary churches as the number of Christian converts grew at an exceptional rate that was not replicated in any other parts of Asia. Born within the context of colonial pressures from the United States and Japan, Korean Christian singing and praying in the early-twentieth century exhibit a trans-Pacific genealogy of the modern Korean voice, that is, a genealogy that materialized at the intersection of Pacific colonial projects, local experiences, and pre-existing cosmologies. This chapter investigates Korean Christian singing and praying by examining missionary and Korean records, as well as some Japanese colonial sources. Activities directed by the missionaries, hymn-singing, and praying among Korean converts reflected a network of American aesthetic, moral, and economic ideologies. The author argues that Korean Christian singing and praying formed a complex site in which North American religious practices and Korean social mobilization converged in the contexts of Japanese colonialism and US–Japan rivalry in the Pacific. This inquiry allows the author to hear and describe not a Korean voice in mimesis of or opposition to the West, but a trans-Pacific voice, exhibiting a trans-Pacific genealogy. The voice, then, can be understood as a kind of technology through which Korean converts negotiated their way into a “global history” not as full agents or subjects, but in their markedly compromised positions, within multiple shifting power relationships.
Challenging Voices
Authors: Schwartz Jessica A. , Brown April L.
Published: June 2019

The Marshallese Educational Initiative has focused on intercultural pedagogy and outreach with projects such as the Marshallese Oral History Project and Digital Music Archive (MOHP), Nuclear Remembrance Day, and collaborative work with Marshallese college student members of the Ṃanit Club (Culture Club) that emphasize creative “pathways of connection” within their complex diaspora. The throat, in Marshallese sensorial approach, is the metaphorical seat of the emotions that prompts a feelingful care for others, human and nonhuman. Western acculturated individuals might say that they are “of the same heart or mind” if they feel a certain kindred spirit to someone or our community, but Marshallese have an ideal of being of “one throat” (burō wōt juon). Marshallese prize the throat and its resonance in voice as both timbre and a sonorous mediator of their language that vivifies relations of land and lineage, which are connected to their shared cosmological heritage. Contributing to collaborative studies that focus on music in participatory research, the authors work with students to assess the ways in which listening practices can be oriented to Marshallese voices as they sound the challenges of everyday life in a diaspora compelled and sanctioned by centuries of colonial and imperial interventions. Taking aspects of Marshallese intergenerational knowledge transmission into consideration, the chapter shares how the students, as well as nuclear survivors, participate in the voice challenge by stressing their voices as impacted by historical and cultural conditions that necessitate and afford particular vocal emergences.
The Echoing Palimpsest
Authors: Khalil Alexander K.
Published: June 2019

This chapter explores the voice as palimpsest through the experience of Stylianos Floikos, one of the few remaining cantors (or psaltes) at the Ecumenical Patriarchate of Constantinople in Istanbul, Turkey. Stylianos, like other psaltes, while interpreting melodies either from neumatic scores or from memory, creates inaudible yet profoundly affective resonance with his own previous interpretations and those of other psaltes. Through this process, both he and those listening experience the act of realizing a melody as a dialogue with past voices rendered present. This multilayered, polyphonic experience of voice forms the context through which both personal and cultural identity are apprehended and renegotiated.
Proximity/Infinity
Authors: Young Miriama
Published: June 2019

This chapter looks at the mediated voice and acoustic space, particularly where the voice in recording occupies small interior spaces, termed pod-music. It surveys a range of recorded vocal music to show ways in which contemporary composition, performance, recording, and production practices exploit the personal listening environment that headphones and mobile listening enable. Not only is our experience of the recorded voice mediated and shaped by the devices on which we record and audition them, but vocal and sound production practice are in turn shaped by these technologies. Further, mediation of recording technology and transmission impacts how we hear the voice as proximal, intimate, or infinite in various contexts. The discussion begins with headphone listening before turning to the creation of recorded music: vocal production, recording, and the aesthetics of postproduction for interior modes of dissemination.
NH3 observations of the S235 star-forming region: Dense gas in inter-core bridges
Authors: Burns Ross A , Handa Toshihiro , Omodaka Toshihiro , Sobolev Andrej M , Kirsanova Maria S , Nagayama Takumi , Chibueze James O , Kohno Mikito , Nakano Makoto , Sunada Kazuyoshi , Ladeyschikov Dmitry A
Published: June 2019

Star formation is thought to be driven by two groups of mechanisms; spontaneous collapse and triggered collapse. Triggered star formation mechanisms further diverge into cloud–cloud collision (CCC), “collect and collapse” (C&C) and shock-induced collapse of pre-existing, gravitationally stable cores, or “radiation driven implosion” (RDI). To evaluate the contributions of these mechanisms and establish whether these processes can occur together within the same star-forming region, we performed mapping observations of radio-frequency ammonia and water maser emission lines in the S235 massive star-forming region. Via spectral analyses of main, hyperfine, and multi-transitional ammonia lines we explored the distribution of temperature and column density in the dense gas in the S235 and S235AB star-forming region. The most remarkable result of the mapping observations is the discovery of high-density gas in inter-core bridges which physically link dense molecular cores that house young proto-stellar clusters. The presence of dense gas implies the potential for future star formation within the system of cores and gas bridges. Cluster formation implies collapse, and the continuous physical links, also seen in re-imaged archival CS and 13CO maps, suggest a common origin to the molecular cores housing these clusters, i.e a structure condensed from a single, larger parent cloud, brought about by the influence of a local expanding H$\,$ ii region. An ammonia absorption feature co-locating with the center of the extended H$\,$ ii region may be attributed to an older gas component left over from the period prior to formation of the H$\,$ ii region. Our observations also detail known and new sites of water maser emission, highlighting regions of active ongoing star formation.
Terrorism and Ressentiment in Revolutionary Russia*
Authors: Morrissey Susan K
Published: June 2019

During the late nineteenth century, revolutionary terrorism emerged as a political tactic in Europe and across the world, where it formed one part of anti-colonial, anti-capitalist and national liberation movements. While its public spectacle took advantage of the new media landscape to communicate affective and political messages, terrorism was ultimately a ‘weapon of the weak’, a means for individuals and small groups to fight against the increasingly powerful modern state. The turn to insurgent violence was consequently imbricated with the experience of state violence. Focusing on a period of revolutionary unrest and heightened political violence in early twentieth-century Russia, this article takes a micro-historical approach to examine how individuals and radical parties came to explain, justify, and incite terrorist acts through narratives of vengeance and ressentiment. Drawing on recent scholarship by anthropologists and historians of emotion and bypassing psychological modes of explanation, it tracks specific articulations of political subjectivity that combine claims to (popular) sovereignty, universalism, dignity and rights with the language of honour and shame. The terrorist act was frequently justified as a sovereign right derived from the experience of state violence upon the body.
Expansion of 1 mL of Solution by Ultrasound-Guided Injection Between the Trapezius and Rhomboid Muscles: A Cadaver Study
Authors: Kimura Hiroaki , Kobayashi Tadashi , Zenita Yoshihiro , Kurosawa Ayato , Aizawa Shin
Published: June 2019

Objective

An ultrasound-guided interfascial injection, which targets the space between the epimysia, is often performed for myofascial neck and shoulder pain. However, the relationship between the injection volume and clinical effectiveness has been controversial. We conducted an anatomical study with cadavers to measure the distribution of a small amount of pigment solution injected into the interfascial space.

Design

An experimental cadaveric study.

Setting

An institutional clinical anatomy laboratory.

Methods

We performed 20 ultrasound-guided injections with pigment solutions of 1.0 mL each into the space between the trapezius muscle and rhomboid muscle bilaterally on 10 cadaver specimens. Cadavers were then dissected and macroscopically evaluated for pigment distribution on the fascia of the muscular surfaces. The pigment distribution area of each injection site was visually confirmed and calculated using automatic area calculation software.

Results

Pigment solution exclusively within the interfascial space was visually confirmed in 95% (19/20) of injection sites. The median pigmented surface area (interquartile range) was 24.50 (16.17–30.76) cm2 on the deep side of the trapezius muscle and 18.82 (13.04–24.79) cm2 on the superficial side of rhomboid muscle; these measurements were statistically significantly different (P = 0.033).

Conclusions

A pigment solution comprising as little as 1.0 mL injected under ultrasound guidance separated two adjacent muscles and spread to the wide area within the interfascial space. The difference in the pigment distribution area between the two adjacent muscles can be explained by the path made by the injection needle and several layers of fascia between the epimysium.
Reid's Regress
Authors: Cuneo Terence , Harp Randall
Published: June 2019

Thomas Reid's Essays on the Active Powers presents what is probably the most thoroughly developed version of agent-causal libertarianism in the modern canon. While commentators today often acknowledge Reid's contribution, they typically focus on what appears to be a serious problem for the view: Reid appears to commit himself to a position according to which acting freely would require an agent to engage in an infinite number of exertions of active power. In this essay, we maintain that, properly understood, Reid's version of agent-causal libertarianism generates no regress of exertion. Our discussion begins by presenting Reid's account of free action and why it appears vulnerable to a worrisome regress. We then consider three attempts to address the regress in the contemporary literature offered by William Rowe, Gideon Yaffe, and James Van Cleve, which we find unsatisfactory. We then develop a solution to the worry—one that takes very seriously both what Reid means by an ‘efficient’ cause and his appeal to normative features when explaining action. We call it the ‘networked capacity’ view.
Total-evidence phylogeny of the Rhinomirini, taxonomic review of its subgroupings (Insecta: Heteroptera: Miridae: Cylapinae) and description of new Australian taxa
Authors: Namyatova Anna A , Cassis Gerasimos
Published: June 2019

Rhinomirini (Insecta: Heteroptera: Miridae: Cylapinae) is a heterogeneous tribe of uncertain systematic position. We provide a phylogenetic analysis of this tribe based on morphological characters and molecular markers. Monophyly of the tribe was not supported by our findings. The Rhinocylapus complex and Rhinomiriella complex are transferred to Fulviini. Rhinomirini are restricted to the Rhinomiris complex. The record of Rhinomirini in Australia is considered dubious. The genera Punctifulvius and Yamatofulvus are transferred to the Rhinocylapus complex. The Rhinocylapus complex is recorded from Australia for the first time, with four new species: Mycetocylapus alexeyi sp. nov., Punctifulvius austellus sp. nov., Punctifulvius aquilonius sp. nov. and Rhinocylapoides valentinae sp. nov. The Philippine species Mycetocylapus major is synonymized with Mycetocylapus minor. The Australian species Rhinomiriella tuberculata is redescribed, and females of this species are described for the first time. Rhinomiriella aidani sp. nov. is described as new to science. The female genitalia of Proamblia elongata, Rhinocylapidius velocipidoides and Rhinomiris conspersus and the male genitalia of Rhinomiris conspersus and Rhinomiridius aethiopicus are illustrated and discussed. Sexual dimorphism in the Rhinocylapus complex and wing modifications in Cylapinae are discussed.
Reflections From the Rearview Mirror: Internal Medicine Physicians’ Reactions to Clinical Feedback After Transitions of Responsibility
Authors: Bowen Judith L. , Ilgen Jonathan S. , Regehr Glenn , Cate Olle ten , Irby David M. , O’Brien Bridget C.
Published: June 2019

Purpose

Learning from practice is important for continuous improvement of practice. Yet little is known about how physicians assimilate clinical feedback and use it to refine their diagnostic approaches. This study described physicians’ reactions to learning that their provisional diagnosis was either consistent or inconsistent with the subsequent diagnosis, identified emotional responses to those findings, and explored potential consequences for future practices.

Method

In 2016–2017, 22 internal medicine hospitalist and resident physicians at Oregon Health & Science University completed semistructured interviews. Critical incident prompts elicited cases of patient care transitions before the diagnosis was known. Interview questions explored participants’ subsequent follow-up. Matrix analysis of case elements, emotional reactions, and perceived practice changes was used to compare patterns of responses between cases of confirming versus disconfirming clinical feedback.

Results

Participants described 51 cases. When clinical feedback confirmed provisional diagnoses (17 cases), participants recalled positive emotions, judged their performance as sufficient, and generally reinforced current approaches. When clinical feedback was disconfirming (34 cases), participants’ emotional reactions were mostly negative, frequently tempered with rationalizations, and often associated with perceptions of having made a mistake. Perceived changes in practice mostly involved nonspecific strategies such as “trusting my intuition” and “broadening the differential,” although some described case-specific strategies that could be applied in similar contexts in the future.

Conclusions

Internists’ experiences with posttransition clinical feedback are emotionally charged. Internists’ reflections on clinical feedback experiences suggest they are primed to adapt practices for the future, although the usefulness of those adaptations for improving practice is less clear.
Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice
Authors: Coutinho Anastasia J. , Levin Zachary , Petterson Stephen , Phillips Robert L. , Peterson Lars E.
Published: June 2019

Purpose

A family physician’s ability to provide continuous, comprehensive care begins in residency. Previous studies show that patterns developed during residency may be imprinted upon physicians, guiding future practice. The objective was to determine family medicine residency characteristics associated with graduates’ scope of practice (SCoP).

Method

The authors used (1) residency program data from the 2012 Accreditation Council for Graduate Medicine Education Accreditation Data System and (2) self-reported data supplied by family physicians when they registered for the first recertification examination with the American Board of Family Medicine (2013–2016)—7 to 10 years after completing residency. The authors used linear regression analyses to examine the relationship between individual physician SCoP (measured by the SCoP for primary care [SP4PC] score [scale of 0–30; low = small scope]) and individual, practice, and residency program characteristics.

Results

The authors sampled 8,261 physicians from 423 residencies. The average SP4PC score was 15.4 (standard deviation, 3.2). Models showed that SCoP broadened with increasing rurality. Physicians from unopposed (single) programs had higher SCoP (0.26 increase in SP4PC); those from major teaching hospitals had lower SCoP (0.18 decrease in SP4PC).

Conclusions

Residency program characteristics may influence family physicians’ SCoP, although less than individual characteristics do. Broad SCoP may imply more comprehensive care, which is the foundation of a strong primary care system to increase quality, decrease cost, and reduce physician burnout. Some residency program characteristics can be altered so that programs graduate physicians with broader SCoP, thereby meeting patient needs and improving the health system.
Hip Arthroscopy Successfully Treats Femoroacetabular Impingement in Adolescent Athletes
Authors: Litrenta Jody , Mu Brian H. , Ortiz-Declet Victor , Chen Austin W. , Perets Itay , Wojnowski Natalia M. , Domb Benjamin G.
Published: June 2019

Background:

There is evidence that femoroacetabular impingement (FAI) is increasingly prevalent among adolescent athletes. Abnormal contact forces across the hip and alterations in bony morphology characteristic of FAI may be especially detrimental in this group, given their young age and active lifestyle.

Purpose:

The purpose of this study was to report the findings, outcomes, and return to sport percentage among adolescent athletes with FAI treated with hip arthroscopy.

Methods:

A retrospective review of all patients younger than 18 years who underwent hip arthroscopy for FAI at a single institution was performed. All athletes who were attempting to return to sport and underwent hip arthroscopy were included. Patients with previous hip surgery and/or hip conditions were excluded. Arthroscopic procedures and an assessment of intra-articular findings were recorded. Patient-reported outcome measures were recorded at 3 months, 1 year, and 2 years postoperatively, and included the modified Harris hip score, the nonarthritic hip score, hip outcome score—sports subscale, visual analogue scale for pain, and patient satisfaction. Return to sport percentage and ability levels were also noted.

Results:

There were 96 eligible cases of adolescent athletes treated with hip arthroscopy; 81 (84.4%) hips in 69 patients had 2-year follow-up. Running/track and field was the most common sport (25), followed by soccer (12), dance (10), baseball/softball (9), and basketball (6). There were 61 females and 20 males, whose average age was 15.9±1.2 y (range: 13.1 to 18.0 y). The most common procedures were labral repair (81.5%), iliopsoas fractional lengthening (72.8%), femoroplasty (69.1%), and acetabuloplasty (66.7%). Capsular repair or plication was performed in most patients (81.5%). Cartilage damage was more common on the acetabulum than the femur, with Outerbridge grade 2 or higher occurring in 23.5% and 4.9% of hips, respectively. Statistically significant improvements were seen in all patient-reported outcomes from preoperative to minimum 2-year follow-up. A total of 84.0% of patients had returned to their sport at latest follow-up. There were 6 (7.4%) patients who underwent revision arthroscopy at a mean of 37.3 months postoperatively.

Conclusion:

Symptomatic FAI in adolescent athletes can be successfully treated with hip arthroscopy, with a higher return to sport rate and low complications and reoperation rate at minimum 2-year follow-up.
Interval Endurance and Resistance Training as Part of a Community-Based Secondary Prevention Program for Patients With Diabetes Mellitus and Coronary Artery Disease
Authors: Christle Jeffrey W. , Knapp Sebastian , Geisberger Marisa , Cervenka Marina , Moneghetti Kegan , Myers Jonathan , Halle Martin , Boscheri Alessandra
Published: June 2019

Purpose:

High-intensity interval training (HIIT) has been observed to improve health and fitness in patients with cardiovascular disease. High-intensity interval training may not be appropriate in community-based settings. Moderate-intensity interval training (MIIT) and resistance training (RT) are emerging as effective alternatives to HIIT. These have not been well investigated in a community-based cardiac maintenance program.

Methods:

Patients with coronary artery disease and/or diabetes mellitus participated in clinical examinations and a 6-mo exercise program. Center-based MIIT and home-based moderate continuous intensity exercise were performed for 3-5 d/wk for 30-40 min/session. RT, nutritional counseling, coping, and behavioral change strategies were offered to all patients. Within-group changes in clinical metrics and exercise performance were assessed on a per-protocol basis after 6 mo.

Results:

Two hundred ninety-two patients (74%) concluded the 6-mo program. There were no serious adverse events. The peak oxygen uptake and peak workload increased significantly, 21.8 ± 6.1 to 22.8 ± 6.3 mL/kg/min and 128 ± 39 to 138 ± 43 W, respectively (both P < .001). Submaximal exercise performance increased from 68 ± 19 to 73 ± 22 W (P < .001). Glycated hemoglobin decreased from 6.57 ± 0.93% to 6.43 ± 0.12%, (P = .023). Daily injected insulin dosage was reduced from 42 IU (interquartile range: 19.0, 60.0) to 26 IU (interquartile range: 0, 40.3, P < .001).

Conclusions:

MIIT and RT were feasible and effective in a community-based cardiac maintenance program for patients with cardiovascular disease, improving exercise performance, and blood glucose control.
Intratympanic Triamcinolone Acetonide as Treatment Option for Idiopathic Sudden Sensorineural Hearing Loss
Authors: Dahm Valerie , Nieratschker Michael , Riss Dominik , Kaider Alexandra , Auinger Alice , Honeder Clemens , Arnoldner Christoph
Published: June 2019

Introduction:

Corticosteroids represent the most commonly used treatment option for patients with idiopathic sudden sensorineural hearing loss. In the past, these compounds were mainly formulated and tested for intravenous or oral administration. Intratympanic application is increasingly being used, often as salvage treatment. The most suitable corticosteroid for local application has yet to be identified. Trials have suggested that triamcinolone acetonide has superior molecular properties for this treatment modality.

Methods:

The main aim of this study was to retrospectively assess the first audiometric results of patients diagnosed with idiopathic sudden sensorineural hearing loss and treated simultaneously with systemic prednisolone and intratympanic triamcinolone acetonide. This data was then compared to systemic treatment only, as well as to historic cohorts treated intratympanically with widely used corticosteroids, namely dexamethasone or methylprednisolone.

Results:

90 patients received intravenous prednisolone only, and 89 individuals underwent intravenous treatment combined with three to four simultaneous intratympanic applications of triamcinolone. Eight patients received intratympanic triamcinolone as first-line treatment. After adjusting data for sex, time since onset, age, and severity of hearing loss, no statistically significant difference between the two main treatment groups could be identified. No major adverse events were observed, specifically no otitis media or persistent vertigo. Two perforated tympanic membranes healed spontaneously within several days.

Conclusion:

While the exact role of intratympanic injections requires additional trials, triamcinolone resulted in similar outcomes compared to studies using dexamethasone or methylprednisolone. Due to favorable pharmacological properties, triamcinolone represents a safe and efficacious alternative for intratympanic treatment in idiopathic sensorineural hearing loss.
Crucial Aspects for Using Computational Fluid Dynamics as a Predictive Evaluation Tool for Blood Pumps
Authors: Gross-Hardt Sascha H. , Sonntag Simon J. , Boehning Fiete , Steinseifer Ulrich , Schmitz-Rode Thomas , Kaufmann Tim A.S.
Published: June 2019

The suitability of computational fluid dynamics (CFD) as a regulatory tool for safety assessment of medical devices is still limited: A lack of standardized validation and evaluation methods impairs the quantitative comparability and reliability of simulation studies, particularly regarding the assessment of hemocompatibility. This study investigated important aspects of validation and verification for three common turbulence modeling approaches (laminar, k-ω shear stress transport [SST] and stress-blended eddy simulation [SBES]) and three different mesh refinements. Simulation results for pressure head, characteristic velocity, and shear stress for the benchmark blood pump model of the Food and Drug Administration critical path initiative were compared with its published experimental results. For the highest mesh resolution, all three models predicted the hydraulic pump characteristics with a relative deviation averaged over six operating conditions below 6.1%. In addition, the SBES model showed an accurate agreement of the characteristic velocity field in the pump’s diffusor region (relative error <2.9%), while the laminar and SST model calculated significantly elevated and deviating velocity amplitudes (>43.6%). The ability to quantify shear stress is fundamental for the prediction of blood damage. In this respect, this study demonstrated that: 1) a close agreement and validation of both pressure head and characteristic velocity was feasible and 2) the shear stress quantification demanded higher near-wall mesh resolutions, although such high resolutions were not required for the validation of only pressure heads or velocity. Hence, a mesh verification analysis for shear stresses may prove significant for the development of credible CFD blood damage predictions in the future.
MMP-2 and MMP-9 gene polymorphisms act as biological indicators for ulinastatin efficacy in patients with severe acute pancreatitis
Authors: Ling Lan , Li Yan , Li Hong , Li Wen , Zhang Hong-Bo
Published: June 2019

Background:

Severe acute pancreatitis (SAP) is a severe form of inflammatory disease with a high mortality rate. Ulinastatin, as a urinary trypsin inhibitor (UTI), is a glycoprotein playing a critical role in SAP. Consequently, we identified the hypothesis that both matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) gene polymorphisms might promote the efficacy of ulinastatin in SAP.

Methods:

A total of 235 patients with SAP were treated by intravenous drip of ulinastatin for the duration of 10 days. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed for testing the distribution of genotypes and alleles frequency of MMP-2 and MMP-9 gene polymorphisms, and analyzing association of MMP-2 rs243865, MMP-2 rs2285053, MMP-9 rs3918242, or MMP-9 rs17576 with efficacy of ulinastatin in patients with SAP. Shesis software was adopted for analyzing single genotypes of MMP-2 and MMP-9 gene polymorphisms site A Generalized Multifactor Dimensionality Reduction (GMDR) model and a logistic regression analysis were used for analyzing effect of MMP-2 and MMP-9 gene polymorphisms on the efficacy of ulinastatin in treating patients with SAP.

Results:

CC genotype of MMP-2 gene rs243865 C>T was observed to have a better positive effect in promoting the efficacy of ulinastatin in comparison with CT and TT genotypes. Haplotype CCTG, CCTA, CTTG, and CTTA were combined by MMP-2 and MMP-9 gene polymorphisms which have the ability to increase the efficacy of ulinastatin in treating patients with SAP. MMP-2 gene rs243865 C>T site polymorphism was served as a favorable factor while the MMP-9 gene rs3918242 C>T site polymorphism was noticed as an unfavorable factor for the efficacy of ulinastatin in treating patients with SAP.

Conclusion:

The key findings clearly demonstrated that both the MMP-2 rs243865 and MMP-9 rs3918242 gene polymorphisms served as biological indicators for the efficacy of ulinastatin in treating patients with SAP.
Effects of coenzyme Q10 intervention on diabetic kidney disease
Authors: Zhang Xiaofeng , Shi Zhaofeng , Liu Qian , Quan Haohao , Cheng Xiaohong
Published: June 2019

Background:

The diabetic kidney disease (DKD) has become a seriously kidney disease that commonly caused by diabetes mellitus (DM). Oxidative stress response plays an essential role in the genesis and worsening of DKD and Coenzyme Q10 (CoQ10) has been reported the promising clinical effectiveness on DKD treatment. However, there is lack of relative evidence-based medical evidence currently.

Objective:

The systematic review and meta-analysis was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, which conducted to evaluate the effectiveness of CoQ10 in combination with other western medicine for DKD therapy through the randomized controlled trials (RCTs) and experimental studies.

Methods:

RCTs and experimental studies were searched based on standardized searching rules in 12 medical databases from the inception up to June 2018 and a total of 8 articles (4 RCTs and 4 experimental studies) were enrolled in the meta-analysis.

Results:

The results revealed that CoQ10 combined with other western medicine show statistical differences in the laboratory parameters of fasting plasma glucose (FPG), Hemoglobin A1c (HbA1c), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), and malondialdehyde (MDA) amelioration after DKD therapy compared with control group. However, LDL-C and Urea level for RCTs and Urine output and Glucose for experimental studies on DKD was not superior to control group.

Conclusion:

We need to make conclusion cautiously for the effectiveness of CoQ10 application on DKD therapy. More standard, multicenter, double-blind RCTs, and formal experimental studies of CoQ10 treatment for DKD were urgent to be conducted for more clinical evidence providing in the future. The underlying pharmacological mechanism of CoQ10 needs to be researched and revealed for its future application on DKD therapy.
Dose optimization strategy of sacrum limitation in cervical cancer intensity modulation radiation therapy planning
Authors: Guo Qi , Cai Shang , Qian Jianjun , Tian Ye
Published: June 2019

The aim of this study was to investigate the dose optimization strategy for the sacrum to reduce the risk of pelvic insufficiency fracture (PIF).

Using a retrospective study design, we analyzed data from 28 patients with cervical cancer who underwent postoperative adjuvant radiotherapy in our department from June 2017 to January 2018. Among these patients, 20 (71.4%) underwent external beam radiation therapy in the pelvic lymphatic drainage area (node-negative patients). Overall, 8 patients (28.6%) underwent radiotherapy in the pelvic lymphatic drainage area with a simultaneous integrated boost (node-positive patients). Furthermore, 20 patients were assigned to 2 groups of plans according to the prescribed doses of 5000 and 4500 cGy/25. Each group had 3 plans according to 3 different dose limit conditions: “pelvic bones and sacrum unlimited,” “pelvic bones limited,” and “pelvic bones + sacrum limited.” The irradiation dose of the sacrum and pelvis was analyzed in three limited optimization models.

The planning target volume conformity index and homogeneity index, based on different optimization modes in the 4500 and 5000 cGy plans, showed no significant differences. The D50% and Dmean of the pelvis + sacrum limited mode were significantly lower than those of the pelvic limited mode (P < .001). The dose of the sacrum and pelvis in the 4500 cGy plan in the lymphatic drainage area was significantly lower than that of the 5000 cGy plan (P < .001). In the lymph node boost group, the irradiation dose of the sacrum and pelvis was significantly increased (P ≤ .001).

Increasing the limitation of the sacrum, on the basis of pelvic bone limitation, in cervical cancer intensity-modulated radiation therapy can significantly reduce the dose to the sacrum. Compared with the dose of 5000 cGy to the lymphatic drainage area, the dose of 4500 cGy was the largest influencing factor to reduce the dose to the sacrum.
Peritoneal sarcoidosis
Authors: Lee Seung Wook , Lee Min Hee , Lee Ji Eun , Choi Seo Youn , Yi Boem Ha , Jung Jung Min
Published: June 2019

Rationale:

Sarcoidosis is an idiopathic granulomatous disease. Although the lungs are most commonly involved, any organ may be affected. To assist with future diagnoses, we describe a rare case of peritoneal sarcoidosis in a young female patient, and present a literature review.

Patient concerns:

A 32-year-old female patient presented to our institution with abdominal discomfort. She was evaluated with contrast-enhanced abdominal computed tomography (CT), and multiple enlarged lymph nodes were detected at the hepatic artery and left gastric artery nodal stations. The patient was lost during follow-up, but returned after 7 months and again underwent abdominal CT. This revealed diffuse nodular thickening of the peritoneum and the appearance of omental cake in her abdomen.

Diagnosis:

Excisional biopsy of a lymph node was performed and extrapulmonary sarcoidosis was confirmed.

Interventions:

The patient was treated with corticosteroid.

Outcomes:

A follow-up abdominal CT scan after two weeks revealed decreases in the numbers and sizes of the previously enlarged lymph nodes, and improvement in the ascites and peritoneal thickening.

Lessions:

Peritoneal sarcoidosis should be considered as an additional differential diagnosis when peritoneal carcinomatosis or tuberculous peritonitis are suspected. In this regard, serum levels of angiotensin-converting enzyme (ACE) may be a valuable diagnostic indicator of unusual sarcoidosis presentations.
Expression of microRNA-3133 correlates with the prognosis in patients with clear cell renal cell carcinoma
Authors: Chen Xiaoyan
Published: June 2019

Clear cell renal cell carcinoma (ccRCC) represents a prevalent urological malignancy among men worldwide. MicroRNAs (miRNAs) are involved in the progression of diverse human cancers. The aim of this study was to explore the expression profile and prognostic value of microRNA-3133 (miR-3133) in ccRCC.

The expression of miR-3133 in ccRCC tissues and non-cancerous tissues was measured by quantitative real-time polymerase chain reaction (qRT-PCR). Chi-square test was applied to evaluate the relationship between miR-3133 expression and clinical characteristics. Overall survival curve was constructed by Kaplan–Meier with log-rank test. The prognostic value of miR-3133 in ccRCC was estimated by Cox regression analysis.

MiR-3133 was downregulated in ccRCC samples compared to the matched noncancerous samples (P <.01). Moreover, its expression level was correlated with T stage, vascular invasion and lymph node metastasis (all P <.05). Survival curves demonstrated that patients with low level of miR-3133 underwent lower overall survival than those with high level (log rank test, P = .002). MiR-3133 might be an independent prognostic biomarker in ccRCC patients (HR = 2.802, 95% CI = 1.391–5.646, P = .004).

MiR-3133 is downregulated, and plays inhibitory roles in aggressive progression of ccRCC. MiR-3133 may be an independent prognostic biomarker for ccRCC.
Upper pole sleeve fracture of the patella secondary to patellar dislocation
Authors: Li Yingzhi , Yu Haichi , Huang Bingzhe , Zhang Wei , Wang Yaxiong , Liu Xiaoning
Published: June 2019

Rationale:

Upper pole sleeve fractures of the patella are rare in adolescents; however, they are serious injuries that require early diagnosis and treatment.

Patient concerns:

We present a rare case of a 15-year-old girl who suffered a sleeve fracture at the superior pole of the right patella. The patient had a history of dislocation of the patella 2 weeks ago. Physical examination showed tenderness on palpation over the upper pole of the patella and absence of active movement of the knee accompanied by swelling and joint effusion. A plain radiograph showed an avulsed fragment of the superior pole of the patella.

Diagnoses:

Magnetic resonance imaging showed a superior pole patellar avulsion fracture and dysfunction of the knee extensor mechanism.

Interventions:

Under general anesthesia, the patient underwent open surgery for reduction of the patellar fracture and reconstruction of the knee extension apparatus through an anterior approach.

Outcomes:

Six months after the operation, the knee function was fully restored, there was absence of pain and swelling, and the patient was able to return to sports.

Lessons:

Upper pole sleeve fracture of the patella is usually serious and it needs to be diagnosed and treated as soon as possible, the sports medicine practitioner must be aware of this type of injury.