bluuebunny/crossref_metadata_2025 huggingface dataset:
A Pilot Randomized Trial of Combined Cognitive-Behavioral Therapy and Exercise Training Versus Exercise Training Alone for the Management of Chronic Insomnia in Obstructive Sleep Apnea
Authors: Cammalleri Amanda , Perrault Aurore A. , Hillcoat Alexandra , Carrese-Chacra Emily , Tarelli Lukia , Patel Rahul , Baltzan Marc , Chouchou Florian , Dang-Vu Thien Thanh , Gouin Jean-Philippe , Pepin Veronique
Published: March 2023

Rationale

Among individuals with obstructive sleep apnea, about 38% will present with comorbid chronic insomnia. Comorbid chronic insomnia and obstructive sleep apnea (COMISA) is associated with poorer daytime functioning and increased morbidity compared to either disorder alone. The treatment of insomnia among individuals with COMISA is suboptimal.

Objectives

To assess the effects of an exercise-training intervention alone as well as a combined cognitive behavioral therapy and exercise training on insomnia symptoms in individuals with COMISA.

Methods

In a pilot randomized-controlled trial, 19 individuals with COMISA were allocated to one of two arms, each comprising of 2 phases of 8 weeks. The first phase examined the effects of exercise training versus relaxation training on insomnia severity and cardiorespiratory fitness. The second phase compared changes in Insomnia Severity Index (ISI) following exercise training alone (EX) or combined Cognitive Behavioural Therapy for Insomnia and exercise training (CBTi-EX). Self-reported insomnia severity, objective sleep parameters during overnight polysomnography, and cardiopulmonary fitness were collected at baseline, 8 and 16 weeks.

Results

Exercise training increased VO2peakand reduced insomnia severity (Hedges’g= 0.82) when compared to relaxation training. Moreover, combined CBTi and exercise training yielded a larger improvement in insomnia severity (Hedges’g=1.48) than exercise training alone (EX). We observed no change in objective sleep measures in both groups.

Conclusions

Exercise training leads to moderate improvements in insomnia severity in individuals with COMISA. Combining exercise training with CBTi leads to larger reductions in insomnia symptoms, with effect sizes similar to the effects of CBTi alone in other populations with chronic insomnia.

Clinical Trial information

“Cognitive behavioural therapy combined with exercise training for adults with both insomnia and obstructive sleep apnea” - (https://doi.org/10.1186/ISRCTN63989489)
The COVID-19 pandemic and supply chain: international cooperation patterns and influence mechanism
Authors: Wang Qiang , Zhang Min , Li Rongrong
Published: March 2023

Purpose

The aim of this study is to undertake a systematic analysis of the supply chain literature to uncover the changes and patterns of international cooperation in the context of the COVID-19 pandemic.

Design/methodology/approach

In this study, the information on supply chain-related publications in the Web of Science (WOS) database is analyzed using statistical techniques and visual approaches. The focus is on the five countries with the highest number of supply chain publications, accounting for approximately 70% of global publications. This in-depth analysis aims to provide a clearer understanding of the cooperation patterns and their impact on the supply chain during the COVID-19 pandemic.

Findings

The results of the study reveal that the growth rate of international cooperation in supply chain research during the COVID-19 pandemic is higher compared to the 5-year and 10-year periods before the pandemic. This suggests that the pandemic has not hindered international cooperation in the field, but instead has increased collaboration. In terms of international cooperation patterns, the findings indicate that China and the USA have a strong partnership, with China being the largest partner for the USA and vice versa. The UK's largest partner is China, India's largest partner is the UK and Italy's largest partner is also the UK. This implies that trade, rather than the pandemic, is a determining factor in supply chain research.

Research limitations/implications

This study examines the patterns of international cooperation in supply chain research during the COVID-19 pandemic, providing insights into the changes and mechanisms of international cooperation in this field. Moreover, the results of this study may offer practical benefits for supply chain operators and managers. By providing a deeper understanding of the international cooperation patterns in the field, this research could contribute to the recovery and growth of the global supply chain.

Social implications

This study's analysis of the impact of crisis events, such as the COVID-19 pandemic, on international cooperation in supply chain research contributes to the theoretical development of the field. Additionally, by examining how academia responds to emergencies, it provides valuable insights for operations and supply chain managers in their pursuit of more effective supply chain management.

Originality/value

This study provides a preliminary examination of the international cooperation patterns of supply chain research in the context of the COVID-19 pandemic, representing a novel and early contribution to the existing literature, helping to expand upon current understanding in the field and provide a more comprehensive perspective. Furthermore, this study offers a practical analysis strategy for future supply chain research, fostering progress and growth in the field.
Effect of lubricant inertia on steady-state characteristics of textured hydrodynamic journal bearing
Authors: Das Debajit , Kakoty Sashindra Kumar
Published: March 2023

Purpose

This paper aims to investigate the effects of inertia of the lubricant on the performance parameters of journal bearings textured with spherical-shaped textures.

Design/methodology/approach

The lubricant is assumed to be Newtonian, and the flow is considered laminar. Considering the lubricant inertia effects, the modified Reynolds equation is discretized using the finite difference method and solved with the Gauss–Seidel successive over-relaxation scheme using the progressive mesh densification method.

Findings

The results from this numerical study indicate that the lubricant inertia improves textured journal bearing performance characteristics significantly. The improvement is more significant in the case of heavily loaded bearings. Furthermore, it is observed that protruded texturing in journal bearings shows better results compared to dimple textured journal bearings.

Originality/value

Understanding the effect of lubricant inertia is essential for efficiently designing textured journal bearings. Thus, the results shown here would be helpful for the researchers and the bearing designers.
Organization–government relationships in sub-Saharan Africa: the emerging public affairs industry in Kenya
Authors: Kiambi Dane , Arceneaux Phillip , Golan Guy
Published: March 2023

Purpose

This paper offers grounded insights on organization–government relationships, or the practice of public affairs, in Kenya.

Design/methodology/approach

In-depth interviews were conducted with senior Kenyan practitioners. Interviewees represent national corporations, multinational corporations with offices in Kenya, consulting agencies, parastatal intergovernmental organizations, national government and county governments.

Findings

Results suggest Kenyan public affairs is centered on relationship management, research and intelligence gathering, risk management and strategic communication. Second, while lobbying is a tactic, it is not synonymous with the broader scope of public affairs strategy. Third, the absence of educational training, a professional body to oversee the profession and the perception of public affairs as “bribery” are threats to the profession's growth.

Research limitations/implications

Findings should not be interpreted to represent “Africa's public affairs industry,” rather a snapshot of the profession contextualized in Kenya.

Practical implications

Kenya needs a professional body to manage the public affairs profession at a national level. It also needs an established curriculum in its higher education environment. Lastly, as one of the fastest growing markets in the world, understanding the public policy environment will benefit multinational organizations looking to expand and operate in Kenya.

Originality/value

This study contributes diverse and inclusive insights on the practice of public affairs in a leading economic and political actor in sub-Saharan Africa. It also expands organization–public relationship theory to articulate engagement with governmental stakeholders.
How hard can it be? A qualitative study following an HRT implementation in a global industrial corporate group
Authors: Häll Agneta , Tengblad Stefan , Oudhuis Margareta , Dellve Lotta
Published: March 2023

Purpose

The purpose of this paper is to critically study the implementation and contextualization of the human resource transformation (HRT) management model within the human resources (HR) function of a global industrial company group.

Design/methodology/approach

A qualitative case study that includes two data collections.

Findings

Implementation of the HRT model led to tensions and conflicting interpretations of the mission of the HR function, and a “tug of war” about the distribution of work both within HR and between HR and line management. Splitting the HR function into three legs made the HR function's learning cycles more difficult. The corporate group had a decentralized and diverse business culture, and contextualization of the HRT model to this setting highlighted the model's embeddedness in the American business culture of centralization and standardization. Implementation of the model also entailed a transition from an employee to an employer perspective within HR.

Research limitations/implications

For an assessment of HR's total work other parts of the HRT model (Ulrich and Brockbank, 2005) need to be involved since HR professionals in the insourced or outsourced shared service center (SSC) and Center of Expertise (CoE) and the e-HR tools are equally important for executing the total HR's mission. Further studies of the problematic human resource business partner (HRBP) role are needed and also what the development of e-HR solutions means for the HR profession.

Practical implications

The authors argue for a continuous development of HR work, along with closer professional contact both with line managers (LMs) and within the HR function, for improved learning cycles and a need for contextualization when implementing management models.

Social implications

The paper discusses the HRT model's impact on HR practitioners’ and LMs’ work practice.

Originality/value

This article shows the need for contextualization when implementing management models. The lack of such contextualization led to severe tensions, and the intentions of an efficient and respected HR function were not achieved. The study contributes an evaluation of the tensions between HRT as a normative and standardized model in business settings accustomed to variety and decentralized decision-making.
External energy security elements and the riskiness of clean energy stocks: a volatility analysis
Authors: Hassan Aminu
Published: March 2023

Purpose

Clean energy stocks are exhibiting signs of increasing volatility reflecting the varied and conflicting strategies employed by nations to pursue energy security objectives. In this regard, this paper aims to examine the response of NASDAQ clean energy stock returns volatility to the influences of external energy security elements including oil price, natural gas price, coal price, carbon price and green information technology stock price.

Design/methodology/approach

The paper uses symmetric and asymmetric generalised autoregressive conditional heteroskedasticity models (GARCH and TGARCH, respectively), which incorporate external energy security elements as exogenous variables, to estimate volatility models for clean energy stock returns.

Findings

Although, prices of oil, coal and natural gas are negatively associated with NASDAQ clean energy returns volatility, only the effect of natural gas price is significant. While carbon price affects NASDAQ clean energy returns volatility positively, green information technology price affects the volatility negatively. These results are robust to exponential GARCH and lead-and-lag robust ordinary least-squares as alternative estimation methods.

Research limitations/implications

The study lumps the effects of all other external and internal factors, including internal energy security elements, in the autoregressive conditional heteroscedasticity (ARCH) term to predict NASDAQ clean energy returns conditional variance. GARCH method does not disentangle individual roles of the factors captured in the ARCH term in predicting volatility.

Practical implications

Results documented imply that natural gas appears a closer substitute for renewable energy sources than crude oil and coal, such that its price rise is perceived as good news in the NASDAQ clean energy financial market, while a fall is considered bad news. Furthermore, both an increase in carbon price and a decrease in green information technology stock performance are perceived as negative shocks.

Social implications

In assessing risks associated with clean energy stocks, investors and fund managers should carefully consider the effects of external energy security elements.

Originality/value

To the best of the author’s knowledge, the paper is the first to identify external energy security elements and examine their effects on clean energy stock volatility.
Changes in erythropoiesis‐stimulating agent responsiveness after transfer to combined therapy with peritoneal dialysis and hemodialysis for patients on peritoneal dialysis: A prospective multicenter study in Japan
Authors: Maruyama Yukio , Yokoyama Keitaro , Higuchi Chieko , Sanaka Tsutomu , Tanaka Yoshihide , Sakai Ken , Kanno Yoshihiko , Ryuzaki Munekazu , Sakurada Tsutomu , Hosoya Tatsuo , Nakayama Masaaki ,   for the EARTH (Evaluation of the Adequacy of Renal replacement THerapy) study group
Published: March 2023

Introduction

Inadequate dialysis and fluid overload are corrected after starting combined therapy with peritoneal dialysis (PD) and hemodialysis (HD). However, the effects on anemia management has not been elucidated.

Methods

We conducted a prospective, multicenter, observational cohort study of 40 PD patients (age, 60 ± 10 years; male, 88%; median PD duration, 28 months) starting combined therapy and investigated changes in several clinical parameters, including erythropoiesis‐stimulating agent (ESA) resistance index (ERI).

Results

ERI decreased significantly during 6 months after switching to combined therapy (from 11.8 [IQR 8.0–20.4] units/week/kg/(g/dL) to 7.8 [IQR 3.9–18.6] units/week/kg/(g/dL), p = 0.047). Body weight, urinary volume, serum creatinine and the dialysate‐to‐plasma creatinine ratio (D/P Cr) decreased, whereas hemoglobin and serum albumin increased. In subgroup analysis, the changes in ERI were not affected by cause for starting combined therapy, PD holiday and D/P Cr.

Conclusion

Although detailed mechanism was unclear, ESA responsiveness improved after switching from PD alone to combined therapy.
Seeing is believing: How cannabis marketing exposure is associated with cannabis use attitudes and behavior in a permissive medical cannabis policy environment
Authors: Cohn Amy M. , Alexander Adam C. , Ehlke Sarah J. , Smith Michael A. , Lowery Bryce , McQuoid Julia , Kendzor Darla E.
Published: March 2023

Background and Objectives

Oklahoma has a fast‐growing medical cannabis industry, showing a proliferation of industry marketing. While cannabis marketing exposure (CME) is a risk factor for cannabis use and positive attitudes about use, no studies have examined the impact of CME on attitudes and use behavior in a permissive cannabis policy environment, like Oklahoma.

Methods

N = 5428 Oklahoma adults ages 18 and older completed assessments of demographics, past 30‐day cannabis use, and past 30‐day exposure to each of four types of cannabis marketing: outdoor (billboards, signs), social media, print (magazines), and Internet. Regression models examined associations of CME with positive attitudes towards cannabis use, cannabis harm perceptions, interest in obtaining a medical cannabis license (among nonlicensed participants), and past 30‐day cannabis use.

Results

Three quarters (74.5%) reported any past 30‐day CME. Outdoor CME was most prevalent (61.1%), followed by social media (46.5%), Internet (46.1%), and print (35.2%). Correlates of CME included younger age, higher educational attainment and income, and medical cannabis license. In adjusted regression models, past 30‐day CME and number of sources of CME were associated with current cannabis use behavior, positive attitudes about cannabis, lower cannabis harm perceptions, and greater interest in obtaining a medical cannabis license. Similar associations between CME and positive attitudes about cannabis were shown among noncannabis users.

Discussion and Conclusions

Public health messaging should be employed to minimize the potential adverse impacts of CME.

Scientific Significance

No studies have examined correlates of CME in a rapidly growing and relatively unrestrained marketing environment.
Cost‐effectiveness of an adjuvanted recombinant zoster vaccine in adults with inflammatory bowel disease
Authors: Caldera Freddy , Spaulding Aaron C. , Borah Bijan , Moriarty Jim , Zhu Ye , Hayney Mary S. , Farraye Francis A.
Published: March 2023

Background

Recombinant zoster vaccine (RZV) is recommended for all adults ≥19 years of age who are at increased risk for HZ, including patients with inflammatory bowel disease (IBD).

Methods

A Markov model was constructed to compare the RZV cost‐effectiveness with no vaccination in patients with Crohn's Disease (CD) and ulcerative colitis (UC). A simulated cohort of 1 million patients was used for each IBD group at ages 18, 30, 40, and 50. The primary objective of this analysis was to compare RZV cost‐effectiveness in patients with CD and UC, comparing vaccination to no vaccination.

Results

Overall, vaccination is cost‐effective for both CD and UC, with the incremental cost‐effectiveness ratio (ICERs) below $100,000/quality‐adjusted life years (QALY) for all age cohorts. For patients with CD, 30 years of age and older, and those with UC 40 years and older, vaccination was both more effective and less expensive than the non‐vaccinated strategy (CD ≥30: ICERs $6183–$24,878 and UC ≥40: ICERs $9163–$19,655). However, for CD patients under 30 (CD 18: ICER $2098) and UC patients under 40 (UC = 18: ICER $11,609, and UC = 30: $1343), costs were greater for vaccinated patients, but there was an increase in QALY. One‐way sensitivity analysis of age indicates that cost break‐even occurs at age 21.8 for the CD group and 31.5 for the UC group. In probabilistic sensitivity analysis, 92% of both CD and UC simulations indicated that vaccination was preferred.

Conclusion

In our model, vaccination with RZV was cost‐effective for all adult patients with IBD.
Does the ARRIVE trial merit changing obstetric practice? Some reflections four‐year postrelease
Authors: James‐Conterelli Sascha , Kennedy Holly Powell
Published: March 2023

Background

It has been 4 years since the release of the study Labor Induction versus Expectant Management in Low‐Risk Nulliparous Women, also known as the ARRIVE trial. As researchers and speakers who frequently present to the United States and international audiences about models of care and strategies to support normal physiologic labor and birth, we have had ample opportunity to engage with practitioners who consistently ask about our perspectives on the ARRIVE trial's findings and methods. Many note the marked increase in pressure they feel to induce at 39 weeks since the study's publication in 2018.

Methods

In this commentary, we discuss some of the concerns that have been brought up during these conversations.

Results/Conclusion

We focus on the trial's key findings and reflect on factors critical to consider as translation into clinical practice is negotiated.
Real‐world outcomes upon second‐line treatment in patients with chronic lymphocytic leukaemia
Authors: Vainer Noomi , Aarup Kathrine , Andersen Michael Asger , Wind‐Hansen Lise , Nielsen Tine , Frederiksen Henrik , Enggaard Lisbeth , Poulsen Christian Bjørn , Niemann Carsten U. , Rotbain Emelie C.
Published: March 2023

For chronic lymphocytic leukaemia (CLL), targeted drugs have become the standard of care, in particular for second‐line treatment. In this study, overall survival (OS), treatment‐free survival (TFS) and adverse events (AE) were registered retrospectively in a Danish population‐based cohort upon second‐line treatment for CLL. Data were collected from medical records and the Danish National CLL register. For 286 patients receiving second‐line treatment, three‐year TFS was higher upon targeted treatment (ibrutinib/venetoclax/idelalisib) [63%, 95% confidence interval (CI) 50%–76%] compared with fludarabine, cyclophosphamide and rituximab or bendamustine and rituximab (FCR/BR) (37%, CI: 26%–48%) and chlorambucil+/−CD20‐antibody (CD20Clb/Clb) (22%, CI: 10%–33%). Upon targeted treatment, three‐year OS estimates were higher for targeted treatment (79%, CI: 68%–91%) compared with FCR/BR (70%, CI: 60%–81%) or CD20Clb/Clb (60%, CI: 47%–74%). The most common AEs were infections and haematological AEs; 92% of patients treated with targeted drugs had AEs, 53% of which were severe. Upon FCR/BR and CD20Clb/Clb, AEs were present for 75% and 53% respectively, of which 63% and 31% were severe. These real‐world data demonstrate higher TFS and a tendency towards higher OS following targeted second‐line treatment for CLL compared to chemoimmunotherapy, also for patients who may be frailer and more comorbid.
Identifying metro station types based on transfer purposes: An application of bike‐sharing data in Xiamen, China
Authors: Shao Haiyan , Jin Cheng , Xu Jing , Zhong Yexi , Qiu Mengxin
Published: March 2023

With the networking of urban rail transit and the large‐scale development of bike‐sharing, metro and bike‐sharing connection has become the preferred way of daily travel for residents of Xiamen. Current studies mainly identify metro station types based on node and place orientation, lacking behaviour‐based investigation. To fill this gap, this study aims to explore the classification of metro stations based on transfer purposes by combining bike‐sharing and point of interest data in Xiamen, using buffer analysis, kernel density estimation, and DBSCAN clustering algorithm comprehensively. The results indicate the following. (1) Distinct transfer purposes have significant agglomeration characteristics and present poly‐centric spatial pattern, an authentic portrayal of Xiamen's land use function. (2) The heterogeneity of connection flow between different transfer purposes and metro stations is apparent. The distribution of flow and flow direction within the same transfer purpose is also in non‐equilibrium. (3) Based on traffic connection analysis, metro stations are divided into seven types: transportation hub, employment‐oriented, residence‐oriented, job‐housing balance, school‐oriented, traffic‐tourism integration, and business connection types. The obtained results assist in improving the transportation connection environment, perfecting urban land use planning, and enhancing low‐carbon and green travel.
A few “big players”: Systems approach to immigrant employment in a mid‐sized city
Authors: Crea‐Arsenio Mary , Newbold K. Bruce , Baumann Andrea , Walton‐Roberts Margaret
Published: March 2023

Canada's immigration policy is regarded globally as a best practice model for selecting highly skilled migrants. Yet, upon arrival many immigrants face challenges integrating into employment. Where immigrants settle is one factor that has been shown to impact on employment integration. In Canada, regionalization policies have resulted in more immigrants settling in small to mid‐sized cities. It is important to understand how these local systems are organized to promote immigrant integration into employment. Using a systems approach, this paper presents a case study of immigrant employment in a mid‐sized city in Ontario, Canada. Through a document review and stakeholder interviews, a systems map was developed, and local perspectives were analyzed. Results demonstrate that in a mid‐sized city, few organizations play a large role in immigrant employment. The connections between these core organizations and the local labour market are complex. Any potential challenges to the system that interfere with these connections can cause a delay for newcomers seeking employment. As cities begin to experience growth driven by immigration, there is a need to ensure local services are not only available but also working effectively within the larger employment system.
A Semi‐Procedural Convolutional Material Prior
Authors: Zhou Xilong , Hašan Miloš , Deschaintre Valentin , Guerrero Paul , Sunkavalli Kalyan , Kalantari Nima Khademi
Published: March 2023

Lightweight material capture methods require a material prior, defining the subspace of plausible textures within the large space of unconstrained texel grids. Previous work has either used deep neural networks (trained on large synthetic material datasets) or procedural node graphs (constructed by expert artists) as such priors. In this paper, we propose a semi‐procedural differentiable material prior that represents materials as a set of (typically procedural) grayscale noises and patterns that are processed by a sequence of lightweight learnable convolutional filter operations. We demonstrate that the restricted structure of this architecture acts as an inductive bias on the space of material appearances, allowing us to optimize the weights of the convolutions per‐material, with no need for pre‐training on a large dataset. Combined with a differentiable rendering step and a perceptual loss, we enable single‐image tileable material capture comparable with state of the art. Our approach does not target the pixel‐perfect recovery of the material, but rather uses noises and patterns as input to match the target appearance. To achieve this, it does not require complex procedural graphs, and has a much lower complexity, computational cost and storage cost. We also enable control over the results, through changing the provided patterns and using guide maps to push the material properties towards a user‐driven objective.
Functional community structure modulates zooplankton production rates across boreal lakes
Authors: St‐Gelais Nicolas F. , del Giorgio Paul A. , Beisner Beatrix E.
Published: March 2023

Although there is a general consensus in ecology that more diverse communities tend to be more productive, it is still unclear whether this holds for aquatic ecosystems, especially with indicators of productivity rates and not just standing biomass proxies. Furthermore, most evidence is based on the results of experimental studies in which biodiversity was assessed through taxonomic richness, although functional indicators could be more relevant.

Consequently, we still have a poor understanding of how real community performance is linked to the various features of community structure in natural aquatic ecosystems. Here we explicitly assessed the effect of functional traits and diversity on crustacean zooplankton productivity rates measured across 84 boreal Canadian lakes spanning wide limnological gradients. Productivity was assessed using the chitobiase enzyme method. Redundancy analyses and structured equation modelling were used to assess the relationship between zooplankton production rates, community structure (diversity and functional composition), while accounting for standing biomass and environmental factors

After controlling for the effect of environmental factors, zooplankton production rates were positively linked to dominance (lower functional evenness) by certain feeding traits (Daphnia filtration and Chydorus filtration), demonstrating an identity (selection) effect.

Overall, the magnitude of the functional compositional effect on production was comparable to the aggregate effect of the environmental variables. Our study demonstrates that zooplankton functional community structure plays an important role in the regulation of a pivotal lake ecosystem function.
Differences in leaf gas exchange strategies explain Quercus rubra and Liriodendron tulipifera intrinsic water use efficiency responses to air pollution and climate change
Authors: Mathias Justin M. , Smith Kenneth R. , Lantz Kristin E. , Allen Keanan T. , Wright Marvin J. , Sabet Afsoon , Anderson‐Teixeira Kristina J. , Thomas Richard B.
Published: March 2023

Trees continuously regulate leaf physiology to acquire CO2 while simultaneously avoiding excessive water loss. The balance between these two processes, or water use efficiency (WUE), is fundamentally important to understanding changes in carbon uptake and transpiration from the leaf to the globe under environmental change. While increasing atmospheric CO2 (iCO2) is known to increase tree intrinsic water use efficiency (iWUE), less clear are the additional impacts of climate and acidic air pollution and how they vary by tree species. Here, we couple annually resolved long‐term records of tree‐ring carbon isotope signatures with leaf physiological measurements of Quercus rubra (Quru) and Liriodendron tulipifera (Litu) at four study locations spanning nearly 100 km in the eastern United States to reconstruct historical iWUE, net photosynthesis (Anet), and stomatal conductance to water (gs) since 1940. We first show 16%–25% increases in tree iWUE since the mid‐20th century, primarily driven by iCO2, but also document the individual and interactive effects of nitrogen (NOx) and sulfur (SO2) air pollution overwhelming climate. We find evidence for Quru leaf gas exchange being less tightly regulated than Litu through an analysis of isotope‐derived leaf internal CO2 (Ci), particularly in wetter, recent years. Modeled estimates of seasonally integrated Anet and gs revealed a 43%–50% stimulation of Anet was responsible for increasing iWUE in both tree species throughout 79%–86% of the chronologies with reductions in gs attributable to the remaining 14%–21%, building upon a growing body of literature documenting stimulated Anet overwhelming reductions in gs as a primary mechanism of increasing iWUE of trees. Finally, our results underscore the importance of considering air pollution, which remains a major environmental issue in many areas of the world, alongside climate in the interpretation of leaf physiology derived from tree rings.
The humanistic and economic burden of problem joints for children and adults with moderate or severe haemophilia A: Analysis of the CHESS population studies
Authors: Chowdary Pratima , Nissen Francis , Burke Tom , Aizenas Martynas , Czirok Tünde , Dhillon Harpal , O'Hara Jamie
Published: March 2023

Introduction

Adequate prophylactic treatment and physical activity improve joint health and clinical outcomes for people with haemophilia A (HA). However, non‐clinical joint‐related burden of moderate (MHA) and severe (SHA) HA has not been well characterised.

Aim

To quantify the joint health‐related humanistic and economic burden of MHA and SHA in Europe.

Methods

A retrospective analysis of the cross‐sectional CHESS population studies using a patient‐centric measure of joint health (problem joints, PJs: chronic joint pain and/or limited range of movement due to compromised joint integrity with or without persistent bleeding) was conducted. Descriptive statistics summarised health‐related quality of life (HRQoL), work productivity/activity impairment and costs by number of PJs (0, 1 or ≥2) and HA severity.

Results

A total of 1171 patients were included from CHESS‐II (n = 468) and CHESS‐PAEDs (n = 703). In both studies, 41 and 59% of patients had MHA and SHA, respectively. Prevalence of ≥2 PJs was similar with MHA and SHA (CHESS‐II: 23 and 26%; CHESS‐PAEDs: 4 and 3%, respectively). HRQoL was worse with an increasing number of PJs (CHESS‐II: .81 vs. .66 with 0 and ≥2 PJs, respectively, for MHA; .79 vs. .51 for SHA; CHESS‐PAEDs: .64 vs. .26 and .72 vs. .14). Total costs increased with increasing PJs regardless of severity in CHESS‐II (€2923 vs. €22,536 with 0 and ≥2 PJs, respectively, for MHA; €11,022 vs. €27,098 for SHA) and CHESS‐PAEDs (€6222 vs. €11,043 for MHA; €4457 vs. €14,039 for SHA).

Conclusion

Presence of PJs was associated with a substantial humanistic and economic burden on patients with MHA or SHA across the lifespan.
Beyond the Apophatic Circle: Rethinking the Debate Between Jean‐Luc Marion and Jacques Derrida
Authors: Wise Ryan M.
Published: March 2023

This study offers a new perspective on the much‐discussed debate between French phenomenologist Jean‐Luc Marion and postructuralist theorist Jacques Derrida on the question of ‘negative theology’ and the Christian mystical tradition. It argues that Marion's critique of Derrida betrays a fundamental misunderstanding, specifically, that it fails to recognise that Derrida is not interested in negative theology qua theology, but rather as a discursive practice with certain resources for the performative ‘unsaying’ of logocentric systems. It continues to show that Derrida's principal object is not the God of apophatic theology, but the broader, juridico‐political implications of all ‘transcendental signifieds’. Finally, it suggests that Marion's oversight of these facts in his defence of the apophatic tradition unwittingly legitimates Derrida's critique, to the extent that it insulates the Christian tradition from external criticism, and thereby limits the responsiveness of that tradition to the demands of justice.
Assessment of Blood Loss Following Injury
Authors: Clarke Ruscoe , Fisher Mary R.
Published: March 2023

this paper and the subsequent papers on “ The Illness of Trauma ” and “ Blood Volume Studies in Acute Injury ” are based on a programme of combined clinical and laboratory study which is the work of a team rather than of the individuals who have prepared particular papers. The team included members of the clinical staff of the Birmingham Accident Hospital and research staff of the Medical Research Council Industrial Injuries and Burns Research Unit. Dr. Fisher is in receipt of a grant from the Medical Research Council.

Our thanks are due to the active co‐operation and continued interest and advice of Dr. J. P. Bull, Director of the Research Unit, to Dr. S. Sevitt and Dr. W. Weiner for their interest and co‐operation in helping to make available adequate supplies of suitable blood; to the surgeons and anaesthetists of the Birmingham Accident Hospital for allowing us to study their patients and use their observations; to Miss J. Frost for assistance in the laboratory; to Messrs. R. Gill and C. Richardson of the Hospital photographic department; to Miss D. MacGirr, Miss V. Clarke and others for secretarial assistance; to the Birmingham Regional Hospital Board for a grant for extra secretarial assistance for this purpose. We would like to thank Mr. W. Gissane, Clinical Director of the Birmingham Accident Hospital, for his active support and encouragement. In particular we would like to pay tribute to the nursing staff for their detailed assistance over a period of years, and especially to Miss M. Davies and Miss J. Needham. Finally, we wish to acknowledge the interest and often enthusiastic co‐operation of so many of our patients.

Note: In this and the three succeeding papers Figure Numbers in heavy type refer to illustrations on the Plates.
LGBT‐Inclusive Education in Liberal Pluralist Societies
Authors: Easton Christina Elizabeth
Published: March 2023

What should be the aim of LGBT‐inclusive, state‐mandated curricula in liberal, pluralist societies? In this article, I identify two distinct aims that such curricula might have. The first, LGBT Respect, aims to teach that LGBT individuals have equal political status and rights. The second, LGBT Approval, aims to teach a positive attitude towards LGBT relationships, including that there is nothing wrongful about these forms of relationship. I examine what arguments in favour of these different aims are available to the liberal concerned with accommodating pluralism. To capture this concern, I adopt political liberalism's strict standard for legitimate political interventions that these must have justifications that all reasonable citizens can accept. This initially seems to recommend curricula that aim at LGBT Respect but stop short of LGBT Approval. Can the political liberal go any further? I propose and critically discuss the most promising arguments in favour of LGBT Approval, including the need to prevent harm to children, ensure political equality, and secure the social conditions needed for the development of the primary good of self‐respect. I tentatively conclude that there exists a cumulative case for state‐mandated curricula aiming at LGBT Approval, at least in the contingent, nonideal circumstances that currently obtain.
Healthcare delivery research in older adults with cancer: A review of National Institutes of Health‐funded projects
Authors: Sun Virginia , Tuovinen Priyanga , Jacobsen Paul B. , Smith Ashley Wilder
Published: March 2023

Background

Cancer is a disease of aging, and most people with cancer are older than 65. However, widespread uptake of evidence‐based approaches that facilitate quality care delivery for older adults with cancer are lacking. This project aimed to review National Institutes of Health (NIH) grants funded in the last decade that focused on healthcare delivery in aging and older adults with cancer, and to examine grant‐related characteristics, study designs, and scientific topics included.

Methods

A search was conducted of all extramural NIH research grants awarded between fiscal year 2012 to 2021. We examined NIH terms; keyword searches of titles, abstracts, and specific aims were implemented to maximize search efficiency. Extraction criteria focused on grant‐related and study characteristics. A priori scientific topics for coding included geriatric assessment, care decision‐making, communication, care coordination, physical and psychosocial functioning/symptoms, and clinical outcomes.

Results

A total of 48 funded grants met the inclusion criteria. A near‐equal split was observed between R03, R21, and R01 grants. Most grants did not include family caregivers or focus on end‐of‐life care. Most grants included multiple cancers and were conducted during active treatment and in hospital/clinic settings. Common scientific topics included geriatric assessment, care decision‐making, physical and psychosocial functioning/symptoms, communication, and care coordination. Few grants focused on cognitive functioning.

Conclusions

Several gaps in the portfolio were identified, including family caregiver inclusion, end‐of‐life care, and studies focusing on cognitive functioning.
The possible forms of professionalism: credibility and the performance of queer sexualities among barristers in England and Wales
Authors: MASON MARC , VAUGHAN STEVEN , WEIL BENJAMIN
Published: March 2023

This article constitutes the first account of sexual minority barristers’ experience of and relation to professionalism at the Bar. Drawing on survey and interview data, it presents the Bar as a site of heteronormativity, where masculinist heterosexuality is pervasively assumed and publicly valorized. The ‘credible’ barrister – authoritative, respected, competent – is constructed as heterosexual. In this context, sexual minority barristers risk a loss of credibility in coming out or being out in the workplace. Our data presents mechanisms by which these individuals manage the public expression of their sexuality. Some – in contrast to heterosexual colleagues – deny entirely the professional relevance of their sexuality. Others adopt assimilationist strategies, curating a ‘credible’ public persona: out, but otherwise conforming to heteronormative expectations and values. While the data includes exceptions that give cause for hope, many sexual minority barristers experience professionalism as pressure to render their sexuality effectively invisible, at significant cost personally and professionally.
Clinical and immunological evaluation of peri‐implant tissues around ultra‐polished and conventionally‐polished zirconia abutments. A 1‐year follow‐up randomized clinical trial
Authors: Valantijiene Valda , Mazeikiene Asta , Alkimavicius Jonas , Linkeviciene Laura , Alkimaviciene Evelina , Linkevicius Tomas
Published: March 2023

Purpose

This is a randomized clinical trial to compare the clinical and immunological performance of ultrasmooth versus conventionally‐smooth zirconia abutments placed subgingivally after a period of 1 year.

Materials and methods

Sixty‐two bone level platform‐switched implants (NobelParallel CC) were placed epicrestally in the mandibular molar or premolar region in 62 patients. After osseointegration, implants were restored with auto polymerizing acrylic resin crowns and subsequently randomly allocated to two groups according to the type of screw‐retained zirconia crown prescribed. The control group received custom zirconia restoration with the subgingival zirconia part conventionally polished, whereas the test group implants were restored with ultra‐polished zirconia abutments. Periodontal parameters (PD, PI, and BOP) and marginal bone level changes (MBLC) were recorded for each implant 2 months after insertion (T0), 1 month after final delivery of the crown (T2), and at the 1‐year follow‐up (T3). Immunological mediators from gingival crevicular fluid (IL‐1α, IL‐1ra, and TNF‐α) were inspected at 1 month after provisional (T1) and accordingly at T2 and T3. Data was analyzed statistically, and significance level was set to α = 0.05.

Results

After 1 year, there were no significant changes in PD control—2.18 ± 0.89 mm and test—2.5 ± 0.72 mm (p = 0.073). PD between T2 and T3 dropped significantly in the test group (p = 0.037) and remained stable in the control group. PI was not different in both groups at T0 (p = 0.518) and T2 (p = 0.817). At T3, the test group (0.9 ± 1.01) had a significantly lower PI than the control group (1.55 ± 1.23) (p = 0.035). There was no difference in BOP positive cases between groups after 1 year (control—61.3%, test—51.7%, and p = 0.455). The amount of IL‐1ra decreased significantly in the test group (41.75 ± 57.58) (p = 0.001) but not in the control group (59.59 ± 70.43) (p = 0.177). MBLC for the control and test groups after 1 year were 0.68 ± 0.7 and 0.94 ± 0.65 mm (p = 0.061).

Conclusions

PD dynamics, PI, BOP, and IL‐1ra revealed better outcomes around ultra‐polished zirconia abutments than around conventionally polished zirconia abutments.
Auxiliary delivered school based oral health promotion among 12–14‐year‐old children from a low resource setting–A cluster randomized trial
Authors: Narayan Vivek , Thomas Susan , Gomez Mary shimi S. , Bhaskar Bindu V. , Rao Arun Krishna
Published: March 2023

Objectives

This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12–14‐year‐old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India.

Methods

The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3 months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self‐administered KAP questionnaire were evaluated at baseline and 1‐year follow‐up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance.

Results

The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001).

Conclusions

Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.
Lewis Cliff 87223, an anomalous enstatite chondrite and the diversity of enstatite chondrites
Authors: Goss Kaitlyn R. , Gray Mabel L. , Weisberg Michael K. , Ebel Denton S.
Published: March 2023

We studied a thin section of Lewis Cliff (LEW) 87223, an unusual EL3‐related, enstatite chondrite (EC) that has primary and secondary features not observed in other ECs. We studied its metal‐rich nodules, possible shock features, and chondrules, eight of which are Al‐rich chondrules (ARCs). LEW 87223 has petrologic and compositional features similar to EL3s. Enstatite is the dominant mineral; chondrule boundaries are well defined; Si content of metal (0.5–0.6 wt%) is consistent with typical EL3; it has Cr‐bearing troilite, oldhamite, and alabandite; and its O‐isotopic composition is similar to other ECs. However, metal abundance in LEW 87223 (~13 vol%) is slightly higher than in other EL3s and its metal nodules are texturally and mineralogically different from other ECs. Both high and low Ni metals are present, and its alabandite has higher Fe (27.8 wt% Fe) than in other EL3s. Silicates appear darkened in plane polarized light, largely due to reduction of Fe from silicate. A remarkable feature of LEW 87223 is the high abundance of ARCs, which contain Ca‐rich plagioclase and varying amounts of Na‐rich plagioclase along chondrule edges and as veins. This suggests Na metasomatism and the possibility of hydrothermal fluids, potentially related to an impact event. LEW 87223 expands the range of known EC material. It shows that ECs are more diverse and record a wider range of parent body processes than previously known. LEW 87223 is an anomalous EL3, potentially the first member of a new EC group should similar samples be discovered.
Collybiopsis pakistanica (Omphalotaceae, Agaricales, Basidiomycota), a new mushroom species from Margalla Hills, Pakistan and two new combinations
Authors: Razzaq Fauzia , Khalid Abdul Nasir , Ashraf Shazia
Published: March 2023

A new species, Collybiopsis pakistanica, from Margalla Hills National Park, Pakistan, is described based on micro‐morphological and molecular phylogenetic analyses. This species is characterized by its milky white pileus, yellowish orange or light yellow to orange at central disc and margins, lacrymoid basidiospores, cheilocystidia with median construction, and broadly utriform and clavate to narrowly utriform pleurocystidia and epithelioid hymeniderm pileipellis. Its placement as a new taxon of Collybiopsis is confirmed by phylogenetic analyses of ITS and nrLSU sequences. Two new combinations, Collybiopsis ugandensis and Collybiopsis pleurocystidiata are also proposed as these species are transferred from Gymnopus.
Phyllactinia cornicola, a new species of powdery mildews from Pakistan
Authors: Zafar Irsa , Afshan Najam‐ul‐Sehar , Khalid Abdul Nasir
Published: March 2023

A new powdery mildew fungus, Phyllactinia cornicola (Erysiphaceae) infecting dogwood trees is described from Azad Jammu & Kashmir, Pakistan. Identification is based upon morpho‐anatomical features and molecular analysis. This species is characterized by having shorter conidiophores, and smaller chasmothecia, asci and ascospores compared to P. guttata and P. corni. Phylogenetic analysis based on ITS sequences supports its recognition as novel species of Phyllactinia. A comprehensive description, along with photographs and a phylogram to show its exact position, as well as a comparison with closely related taxa is provided.