bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of ileal indigestible protein on fecal nitrogen excretion and fecal microbiota may be greater compared with total protein concentration of diets in growing pigs
Authors: Sung Jung Yeol , Johnson Timothy A , Ragland Darryl , Adeola Olayiwola
Published: December 2022

In the current study, we hypothesized that an increase in dietary ileal indigestible protein concentration induces an increase in hindgut nitrogen utilization and nitrogen excretion and a shift in fecal microbiota in growing pigs, when compared to pigs given a high total protein diet. Three diets were prepared: 1) standard protein diet based on corn and soybean meal, 2) high-indigestible protein diet in which autoclaved, low-digestible soybean meal replaced soybean meal in the first diet, and 3) high protein diet where the inclusion rate of soybean meal was greater than that of the other diets. The 3 diets were fed to 18 barrows that were fitted with T-cannula at the ileo-cecal junction (initial body weight = 63.4 ± 8.0 kg) in a randomized complete block design with body weight as a blocking factor. Pigs were individually housed in pens and the experiment lasted for 23 d. On days 7 and 21, fecal samples were collected by rectal massage for microbiota analysis. Grab samples of feces were collected on days 20 and 21, and ileal digesta were collected on days 22 and 23 for the determination of energy and nitrogen utilization. Lower apparent ileal digestibility of nitrogen in the high-indigestible protein diet containing autoclaved soybean meal resulted in greater ileal indigestible nitrogen concentration (P < 0.05). Apparent total tract digestibility of nitrogen was lower (P < 0.05), and correspondingly nitrogen concentration and daily fecal nitrogen output were greater (P < 0.05) in the high-indigestible protein diet compared with the other diets. Apparent post-ileal digestibility and hindgut disappearance of nitrogen and gross energy were the greatest (P < 0.05) in the high protein diet, whereas a statistical difference was not observed in those variables between the standard protein diet and the high-indigestible protein diet. Beta diversity metrics of feces in the high-indigestible protein diet on day 21 were different (q < 0.05) from those in the other two diets, which indicates a shift in microbial communities. According to the results of the DESeq2, the direction of microbiota shift induced by the high-indigestible protein diet may have reduced fiber utilization in the hindgut. In conclusion, an increase in dietary ileal indigestible protein concentration increased fecal nitrogen excretion and shifted fecal microbial communities but did not increase nitrogen utilization in the hindgut.
Badges of Misconduct: Consumer Rules to Avoid Abusive Financial Advisers
Authors: Camarda Jeffrey , Lee Steven J , de Jong Pieter , Lee Jerusha
Published: December 2022

The financial advisory industry in the USA lacks professional standardization/regulation. There are few guideposts to assess adviser quality, and risks to consumer welfare abound. Some 91% of investment advisers operate on conflicted sales commission licences, although many market themselves as fiduciaries. Using an adviser misconduct scoring framework we report specific misconduct ratings for each of the 625,980 Financial Industry Regulatory Authority (FINRA) advisers, finding elevated misconduct for Certified Financial Planner (CFP®) professionals and commission/fiduciary licensees. For Chartered Financial Analyst (CFA®) professionals, we found the opposite. We propose a unique scoring system to aid consumers in flagging problematic advisers. We also offer simple regulatory policy recommendations, which could enable stronger consumer protection at minimal cost or bureaucratic burden.
Identifying Economically Feasible Priority Landscape Areas in Idaho for Funding Assistance Programs
Authors: Pokharel Raju , Latta Greg , Washington Chad
Published: December 2022

Market coverage, or merchantability, is more than selling commodities. By offsetting expenditures, it provides an effective tool allowing forest managers to expand funding assistance to improve forest health, habitat, and water quality; reduce fire risk; and sustainably manage forest resources and services. This analysis narrows the focus to mill inputs and evaluates the forest products market extent and competition that exist in Idaho to better prioritize forest health improvement and fire mitigation funding programs. We identify priority landscape areas through market extent and market competition and classify each by quintiles for three harvested wood products (sawlogs, pulpwood, biomass). Generating revenues from selling harvested wood products where barely any markets exist or markets could expand with incentives would allow management projects to be done at a more extensive scope or a lower cost per area. The results can also be used to identify areas to invest in forest product manufacturing facilities. This is valuable information for decision-makers looking to direct public assistance funding toward projects that generate forest products.
Formal and informal support networks as sources of resilience and sources of oppression for temporary foreign workers in Canada
Authors: Salami Bukola , Tulli Mia , Alaazi Dominic A , Juen Jessica , Khasanova Nariya , Foster Jason , Vallianatos Helen
Published: December 2022

In this article, we explore temporary foreign workers’ (TFWs) access to and experiences with formal and informal supports in Canada. Our study utilized a participatory action research design and four overlapping phases of data collection: individual interviews with current and former TFWs, focus groups, individual interviews with settlement service agencies, and a cross-sectional survey with current and former TFWs. We used an intersectional theoretical framework to analyze these data and explore ways that TFWs interact with formal and informal sources of support for navigating their precarious immigration status and integration in Canada. Our findings show these supports have the potential to both benefit and harm TFWs, depending on their social positioning and availability of institutional resources. The benefits include information that aids settlement and integration processes in Canada, while the harms include misinformation that contributes to status loss. Future research and policy should recognize the complexity of informal and formal support networks available to TFWs. An absence of government support is apparent, as is the need for increased funding for settlement service agencies that serve these workers. In addition, Canada should better monitor employers, immigration consultants, and immigration lawyers to ensure these agents support rather than oppress TFWs.
Effects of dust sources on dust attenuation properties in IllustrisTNG galaxies at z ∼ 7
Authors: Hsu Yuan-Ming , Hirashita Hiroyuki , Lin Yen-Hsing , Camps Peter , Baes Maarten
Published: December 2022

Dust emission from high-redshift galaxies gives us a clue to the origin and evolution of dust in the early Universe. Previous studies have shown that different sources of dust (stellar dust production and dust growth in dense clouds) predict different ultraviolet (UV) extinction curves for galaxies at z ∼ 7 but that the observed attenuation curves depend strongly on the geometry of dust and star distributions. Thus, we perform radiative transfer calculations under the dust–star geometries computed by a cosmological hydrodynamic simulation (IllustrisTNG). This serves to investigate the dust attenuation curves predicted from ‘realistic’ geometries. We choose objects with stellar mass and star formation rate appropriate for Lyman break galaxies at z ∼ 7. We find that the attenuation curves are very different from the original extinction curves in most of the galaxies. This makes it difficult to constrain the dominant dust sources from the observed attenuation curves. We further include infrared dust emission in the analysis and plot the infrared excess (IRX)–UV spectral slope (β) diagram. We find that different sources of dust cause different IRX–β relations for the simulated galaxies. In particular, if dust growth is the main source of dust, a variation of dust-to-metal ratio causes a more extended sequence with smaller IRX in the IRX–β diagram. Thus, the comprehensive analysis of the abundance of dust and metals, the UV slope, and the dust emission could provide a clue to the dominant dust sources in the Universe.
Tale of the Titers: Serologic Testing for SARS-CoV-2—Yes, No, and Maybe, With Clinical Examples From the IDSA Diagnostics Committee
Authors: Colgrove Robert , Bruno-Murtha Lou Ann , Chastain Cody A , Hanson Kimberly E , Lee Francesca , Odom John Audrey R , Humphries Romney
Published: December 2022

Diagnosis of acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection relies on detection of viral antigens or amplified viral nucleic acids. Serology, although invaluable for epidemiology, is not routinely needed clinically. However, in some settings, serologic data may have direct clinical utility: for example, in evaluation of persistent symptoms in patients without a prior diagnosis of acute infection. In contrast, SARS-CoV-2 serologic testing is sometimes used or requested in situations in which existing data do not support it, such as determination of need for vaccination. In this study, we describe available methods of serologic testing and provide cases supported by clinical vignettes of where such tests can be helpful, as well as examples where they are not. These examples may help clarify clinical decision making in this rapidly evolving area.
Fakers
Authors: Frost-Arnold Karen
Published: December 2022

Chapter 4 addresses fake news. It argues that normative social epistemology helps us understand why the fake news problem is a problem, a point that more descriptive studies lack the tools to show. This chapter shows how racism shapes online disinformation and how disinformation fuels racism. Fake news does not just generate a generic form of ignorance; instead, it often feeds a specifically racist form of ignorance: white ignorance. This chapter argues that feminist accounts of objectivity can provide tools for platforms to avoid a flight to neutrality that prevents them from accepting responsibility for their role in the fake news problem.
Conclusion
Authors: Frost-Arnold Karen
Published: December 2022

The conclusion summarizes the argument of the book. The chapter reviews how the epistemological frameworks of social epistemology help us untangle several thorny problems of internet epistemology. Summarizing the socially situated approach to internet epistemology pursued in this book, the chapter recaps the ways in which race, gender, sexuality, colonialism, and capitalism shape online knowledge production. Recognizing the social situatedness of online knowledge (and ignorance) is crucial for answering the normative question: who should we be online? Reflecting on the research ethics methodology adopted in the book and articulated in the Appendix, the conclusion argues that philosophers need to take into account their own positionality and power as they study the internet.
Regional Economic Diversity
Authors: Dore Poornima , Narayanan Krishnan
Published: December 2022

The book is a deep dive into the regional economy of India and attempts to answer questions like what is more conducive to economic development of a nation – specialisation or diversification? Are regions within a developing economy experiencing divergence or convergence as they embark on high growth path? How do we assess the role of economic diversity and measure regional value added when such data is not readily available? And, what are the key determinants of differences across regions in India between 2004-05 and 2011-12. Several key issues which are important for development, namely (i) financial inclusion, (ii) digital literacy, (iii) leveraging the demographic dividend and (iv) boosting cities as engines of growth, depend upon the regional economy’s ability to absorb and respond to policy stimuli. A region’s ability to experience growth is to a large extent determined by its ability to attract either industry or people. This phenomenon is known as agglomeration and affects concentration of firms, development of industrial hubs, policies towards special economic zones, flows of labour and capital, formation and growth of cities. Given the size and diversity within each state in India there is an urgent case for going one step below to identify homogeneous units at a sub state level, viz., NSS regions, something which this book seeks to address. The analysis directs to the need for promoting aspirational regions approach to achieve all round development in the country. The issues discussed would be of interest from the perspective of industrial location, investment, output and market opportunities, policy making, designing fiscal incentive and employment generation.
How to Do Research
Authors: Stewart Robert
Published: December 2022

There are many textbooks on research methods, but these tend to be targeted at particular disciplines. Equally, there are plenty of books on popular science and other academic fields, but few that provide an overview of career opportunities or a framework for getting started. The principles underlying humanity’s past and continuing acquisition of knowledge are straightforward and are illustrated here across academic fields, from history to quantum physics—stories of clever and inventive people with good ideas, but also of personalities, politics, and power. This book draws together these strands to provide an informal and concise account of knowledge acquisition in all its guises. Having set out what research hopes to achieve, and why we are all researchers at heart, early chapters describe the basic principles underlying this—ways of thinking which may date back to the philosophers of the Athenian marketplace but are still powerful influences on the way research is carried out today. Drawing on a broad range of disciplines, the book takes the reader well beyond the pure ‘scientific method’, which might work well enough in physics or chemistry but falls apart in life sciences, let alone humanities. Later chapters consider the realities of carrying out research and the ways in which these continue to shape its progress—researchers and their personalities, their employers, funding, publication, political forces, and power structures.
Trust as an Unquestioning Attitude
Authors: Nguyen C. Thi
Published: December 2022

According to most accounts of trust, you can only trust other people (or groups of people). To trust is to think that another has goodwill, or something to that effect. I sketch a different form of trust: the unquestioning attitude. What it is to trust, in this sense, is to settle one’s mind about something, to stop questioning it. To trust is to rely on a resource while suspending deliberation over its reliability. Trust lowers the barrier of monitoring, challenging, checking, and questioning. Trust sets up open pipelines between yourself and parts of the external world. Trust permits external resources to have a similar relationship to one as one’s internal cognitive faculties. This creates efficiency, but at the price of exquisite vulnerability. We must trust in this way because we are cognitively limited beings in a cognitively overwhelming world. Crucially, we can hold the unquestioning attitude towards objects and technologies. When I trust my climbing rope, I stop worrying about its reliability. When I trust my online calendaring system, I simply go to the events indicated, without question. But, one might worry, how could one ever hold such a normatively loaded attitude as trust towards mere objects? How could it ever make sense to feel betrayed by an object? Trust is our engine for expanding and outsourcing our agency—for binding external processes into our practical selves. Thus, we can be betrayed by our smartphones in the same way that we can be betrayed by our memory. When we trust, we try to make something a part of our agency, and we are betrayed when our part lets us down. To unquestioningly trust something is to let it in—to attempt to bring it inside one’s practical functioning. This suggests a new form of gullibility: agential gullibility, which occurs when agents too hastily and carelessly integrate external resources into their own agency.
Me-Knowledge and Effective Agency
Authors: Sarkissian Hagop
Published: December 2022

Sometimes, realizing an ethically desirable outcome X will generate disutility for some whose very cooperation is necessary to realizing X, either in the form of material or social costs, or the abnegation of some of their values or personal principles. How does one gain their assent? Seeing one’s way through such cases may hinge on one’s ability to make plausible first-pass predictions of how others will react to one’s interventions with them. In other words, one should know not simply the warrant of one’s reasons in favor of X, but also how such reasons will be received when issued forth in one’s voice and from one’s person. I call this me-knowledge— knowing the ‘me’ as seen from the perspective of a particular other. Drawing on classical Chinese sources, I argue that such knowledge is crucial to enhance one’s efficacy in the world.
Vaidya on Nyāya and Knowledge-First Epistemology
Authors: Williamson Timothy
Published: December 2022

This paper is a response to ‘Elements of Knowledge-First Epistemology in Gaṅgeśa’ by Anand Vaidya, in which he makes a welcome comparison between the epistemology of the fourteenth-century Nyāya philosopher Gaṅgeśa and the knowledge-first approach developed in Knowledge and its Limits. One significant similarity is that we both treat seeing that p as a way of knowing that p, and the similarities may go much deeper than that. Both Gaṅgeśa’s work and mine may be disjunctivist in a loose but not in a strict sense. It is suggested that knowledge-first epistemology may in general tend to make for more fruitful comparisons with non-Western traditions in epistemology than belief-first epistemology because knowledge-first epistemology is closer to underlying human forms of mindreading. The paper also makes some remarks on the relation between philosophy, its history, and its traditions.
Securing the Environment in Kosovo
Authors: von Hlatky Stéfanie
Published: December 2022

In this first case study, NATO’s Kosovo Force (KFOR) is introduced through the prism of its primary military tasks of ensuring a safe and secure environment for the civilian population as well as freedom of movement across the territory of Kosovo. With over two decades of experience in Kosovo, NATO is at a crossroads strategically; but at the KFOR headquarters, the Italian commander recognizes that there are expectations coming from Brussels about integrating a gender perspective across military tasks. In certain cases, like the all-male Carabinieri force in Priština, there are limits as to what can be achieved. The liaison monitoring teams, who are embedded within local communities, understand the gendered implications of their work better than the barracked infantry units in charge of riot control. If gender is considered, it is in support of military tasks. Otherwise, it tends to get sidelined or ignored altogether.
Uncertainty
Authors: Belonick Paul
Published: December 2022

Chapter 5, “Uncertainty,” shows how the restraint values became highly disputed in the decades following Tiberius Gracchus’ death as the after-effects of his tribunate bled beyond his own narrow situation to disrupt the meta-rules of Republican governance more broadly. Although the elite continued to value restraint, the tangled evidence of the period shows that questions of how to practice restraint rightly and who could judge it rightly became highly charged and unresolvable, as a series of factors converged. Growing imperial luxury stressed the Roman nobility’s homogeneity in a social context that tightly linked a man’s political weight and normative claims to legitimate power to his reputed level of private self-restraint. Meanwhile, the changes to interpeer deference initiated by Tiberius meant that one man could now declare large portions of the senatorial group incontinent and thus unworthy judges, making the man largely immune to pressures to defer. Tiberius’ turn to the People and away from his colleague had also reconfigured pudor and verecundia, the other underpinnings of the deference ideal, which helped make interpeer conflict unresolvable. Amid these changes, the Roman habit of moralization and “toggle-switch” thinking encouraged viewing these restraint-based changes in terms of simplistic good and evil, which quickly led men to analogize “unrestrained” fellow citizens to wicked foreign enemies worthy of death. Dehumanization and violence ensued. The generations that followed accepted the changed landscape as a new normal, then stretched the after-effects to even further lengths in a cumulative causal loop.
Practical Ethics
Authors: Woodruff Paul
Published: December 2022

An introduction to the three starting points for a Socratic approach to practical ethics: caring for the health of the soul (epimeleisthai tes psuches), avoiding moral injury, and recognizing human ignorance. In a real life example, a young officer must decide whether to allow that a prisoner be tortured. His Oxford education, which introduced him to utilitarian and deontological ethics, does not help, as he reports in a letter. The Socratic approach recommended in this book is shown to be more practical. Had he supported the torture he would have done himself and others a moral injury. An appendix to the chapter introduces the subject of moral injury as it is now understood by social scientists and those working to help the injured—such as war veterans—recover.
‘Appropriation’
Authors: Gill Christopher
Published: December 2022

A distinctive feature of Stoic thinking on ethical development is that it is seen as a natural process, which realizes key features of human and universal nature: this is the focus of Chapter 4. This idea is expressed in the theory of ‘appropriation’ (oikeiosis), especially in its advanced, rational, stages. In Cicero, On Ends 3, appropriation is subdivided into the development of virtue and virtue-based happiness through the selection of indifferents (16–22), and the progressive deepening of interpersonal and social relationships (62–8). However, a complete process of ethical development involves both strands, interconnected with each other, as we find in On Duties 1. Cicero, in both works, presents engagement in localized social relationships as compatible with recognizing the fundamental kinship of all human beings, conceived as rational and sociable; and this view is found in most other Stoic sources for this subject.
Stoicism and Modern Virtue Ethics
Authors: Gill Christopher
Published: December 2022

Chapter 6 discusses what Stoic ethical theory, as interpreted here, can contribute distinctively to modern virtue ethics, as an alternative to Aristotle, the main ancient prototype. It is argued that the Stoic theory is morally rigorous in a way that is compatible with modern virtue ethics, while also being more self-consistent and fully worked out than Aristotelian ethics. This point applies to the virtue-happiness relationship, in particular the combination (found in both Aristotle and Stoicism) of the ideas that virtue is intrinsically desirable and that it brings about happiness, viewed as the overall goal of a human life. Also, Stoic ethics offers a fresh and distinctive account of self-other relationships, though one which is more straightforwardly compatible with modern ideas about altruism than Aristotelian thinking.
Inequalities in the Challenges Affecting Children and their Families during COVID-19 with School Closures and Reopenings: A Qualitative Study
Authors: Galasso Ilaria , Watts Gemma
Published: December 2022

School closure is one of the most debated measures undertaken to contain the spread of the Coronavirus disease (COVID-19) pandemic. The pandemic has devastating health and socio-economic effects and must be contained, but schools play a vital role in present and future well-being, capabilities and health of children. We examine the detrimental consequences of both the closure and reopening of schools, by focusing on inequalities in the challenges affecting children and their families. This paper is grounded on Irish and Italian data from a multi-national longitudinal qualitative interview study. Research participants articulated a variety of issues and challenges that highlight inequalities in access to education during school closures, in the supportiveness of home setting, and in school preparedness to reopen, often mirroring or exacerbating pre-existing inequalities. The reported unequal lived experiences indicate that some harms are actionable, and already suggest some potential harm mitigation strategies. We conclude by advocating for enhanced public consultation to help mitigate the consequences of public dilemmas in general, and to help detect and tackle inadequacies and inequalities for school children through and beyond the pandemic, by learning from the experience of the concerned actors.
Minimal gaps and additive energy in real-valued sequences
Authors: Regavim Shvo
Published: December 2022

We study the minimal gap statistic for sequences of the form $\left( \alpha x_n \right)_{n = 1}^{\infty}$ where $\left( x_n \right)_{n = 1}^{\infty}$ is a sequence of real numbers, and its connection to the additive energy of $\left( x_n \right)_{n = 1}^{\infty}$. Inspired by a recent paper of Aistleitner, El-Baz and Munsch we show conditionally on the Lindelöf Hypothesis that if the additive energy is of lowest possible order then for almost all α, the minimal gap $\delta_{\min}^{\alpha} (N) = \min \left\{\alpha x_m - \alpha x_n \bmod \ 1 : 1 \leq m \neq n \leq N \right\}$ is close to that of a random sequence, a result Rudnick showed for integer-valued sequences. We also show unconditional results in this direction, as well as some converse theorems about sequences with large additive energy.
3D printed-electrospun PCL/hydroxyapatite/MWCNTs scaffolds for the repair of subchondral bone
Authors: Cao Yanyan , Sun Lei , Liu Zixian , Shen Zhizhong , Jia Wendan , Hou Peiyi , Sang Shengbo
Published: December 2022

Osteochondral defect caused by trauma or osteoarthritis exhibits a major challenge in clinical treatment with limited symptomatic effects at present. The regeneration and remodeling of subchondral bone play a positive effect on cartilage regeneration and further promotes the repair of osteochondral defects. Making use of the strengths of each preparation method, the combination of 3D printing and electrospinning is a promising method for designing and constructing multi-scale scaffolds that mimic the complexity and hierarchical structure of subchondral bone at the microscale and nanoscale, respectively. In this study, the 3D printed-electrospun poly(ɛ-caprolactone)/nano-hydroxyapatites/multi-walled carbon nanotubes (PCL/nHA/MWCNTs) scaffolds were successfully constructed by the combination of electrospinning and layer-by-layer 3D printing. The resulting dual-scale scaffold consisted of a dense layer of disordered nanospun fibers and a porous microscale 3D scaffold layer to support and promote the ingrowth of subchondral bone. Herein, the biomimetic PCL/nHA/MWCNTs scaffolds enhanced cell seeding efficiency and allowed for higher cell–cell interactions that supported the adhesion, proliferation, activity, morphology and subsequently improved the osteogenic differentiation of bone marrow mesenchymal stem cells in vitro. Together, this study elucidates that the construction of 3D printed-electrospun PCL/nHA/MWCNTs scaffolds provides an alternative strategy for the regeneration of subchondral bone and lays a foundation for subsequent in vivo studies.
Long-term host–pathogen evolution of endogenous beta- and gammaretroviruses in mouse lemurs with little evidence of recent retroviral introgression
Authors: Kessler Sharon E , Tsangaras Kyriakos , Rasoloharijaona Solofonirina , Radespiel Ute , Greenwood Alex D
Published: December 2022

Madagascar’s flora and fauna have evolved in relative isolation since the island split from the African and Indian continents. When the last common ancestors of lemurs left Africa between 40 and 70 million years ago, they carried a subset of the viral diversity of the mainland population within them, which continued to evolve throughout the lemur radiation. Relative to other primate radiations, we know very little about the past or present viral diversity of lemurs, particularly mouse lemurs. Using high-throughput sequencing, we identified two gammaretroviruses and three betaretroviruses in the genomes of four species of wild mouse lemurs. The two gammaretroviruses and two betaretroviruses have not previously been described. One betaretrovirus was previously identified. All identified viruses are present in both Lorisiformes and Lemuriformes but absent from haplorrhine primates. The estimated ages of these viruses are consistent with the estimated divergence dates of the host lineages, suggesting they colonized the lemur genome after the Haplorrhine–Strepsirrhine split, but before the Lorisiformes–Lemuriformes split and before the colonization of Madagascar. The viral phylogenies connect multiple lineages of retroviruses from non-lemur and non-Madagascar-native species, suggesting substantial cross-species transmission occurred deep in the primate clade prior to its geographic dispersal. These phylogenies provide novel insights into known retroviral clades. They suggest that the origin of gammaretroviruses in rodents or bats may be premature and that the Jaagsiekte sheep virus clade may be older and more broadly distributed among mammals than previously thought.
Attitudes Toward Medication for Opioid Use Disorder Among Pregnant and Postpartum Women and People Seeking Treatment
Authors: Banks Devin E. , Fentem Andrea , Li Xiao , Paschke Maria , Filiatreau Lindsey , Woolfolk Candice , Cavazos-Rehg Patricia
Published: December 2022

Objectives

Pregnant and postpartum women and people (PPWP) who use opioids experience higher rates of morbidity, preterm labor, and stillbirth than those who do not. Although medication for opioid use disorder (MOUD) is the standard of treatment, utilization among PPWP has remained low because of MOUD stigma and misconceptions. The current report examined general and pregnancy-related MOUD attitudes, norms, and self-efficacy among PPWP seeking treatment.

Methods

Participants (n = 33) receiving MOUD at a Midwestern clinic reported beliefs about MOUD in general using the Attitudes toward Methadone Questionnaire (modified to include all MOUD) and during pregnancy/postpartum using an investigator-generated scale based on previous research. Participants responded using a 5-point scale from “strongly agree” to “strongly disagree” with higher scores indicating more positive attitudes. Analyses examined the bivariate association of attitudes with MOUD subjective norms and self-efficacy, also measured via investigator-generated scales.

Results

Respondents reported positive attitudes toward MOUD use during pregnancy, with most agreeing it was safe. However, up-to-half of participants reported uncertainty regarding the appropriate dosage of MOUD and its impact on the fetus and/or neonate. Both general and pregnancy/postpartum-related MOUD attitudes were positively associated with subjective norms toward MOUD.

Conclusions

Pregnant and postpartum women and people reported high uncertainty about MOUD use despite currently using it, emphasizing the need for strategies that assess and mitigate MOUD-related stigma. Findings suggest that familial support and stigma impact attitudes toward MOUD and highlight the importance of accurate psychoeducation and social supports for patients and their families to improve the acceptance and utilization of MOUD among PPWP.
Stapled Antimesenteric Functional End-to-End Anastomosis Following Intestinal Resection for Crohn’s Disease
Authors: Duan Ming , Wu Enhao , Xi Yue , Wu You , Gong Jianfeng , Zhu Weiming , Li Yi
Published: December 2022

BACKGROUND:

Anastomotic recurrence after bowel resection is problematic in patients with Crohn’s disease. Antimesenteric functional end-to-end handsewn (Kono-S) anastomosis is associated with a low risk of anastomotic recurrence in patients with Crohn’s disease.

IMPACT OF INNOVATION:

Kono-S anastomosis is effective but may be time-consuming. This study aimed to describe stapled antimesenteric functional end-to-end anastomosis for patients with Crohn’s disease.

TECHNOLOGY MATERIALS AND METHODS:

The mesentery of the affected bowel segment was divided. A 5-cm-wide stapled functional end-to-end anastomosis was performed approximately 6 cm from the affected segment. The bowel was divided transversely exactly 90° to the intestinal lumen and the mesentery, and a supporting column was then constructed.

PRELIMINARY RESULTS:

From January 2018 to June 2021, 17 stapled antimesenteric functional end-to-end anastomoses were performed. The mean operative time was 106 (range, 80–135) minutes, and the time to construct the stapled antimesenteric functional end-to-end anastomosis was 21 (range, 18–28) minutes. The mean follow-up time was 8.9 (range, 1–15) months. In total, 10 patients underwent surveillance endoscopy. The average Rutgeerts score was 0.8 (range, 0–4), and the incidence of endoscopic recurrence was 11.8%. No postoperative mortality or anastomotic leakage was observed.

CONCLUSION:

Stapled antimesenteric functional end-to-end anastomosis may be a safe and time-saving procedure for patients with Crohn’s disease.

FUTURE DIRECTIONS:

Further prospective studies with a large sample size are warranted.
AI-based classification algorithms in SPECT myocardial perfusion imaging for cardiovascular diagnosis: a review
Authors: Papandrianos Nikolaos I. , Apostolopoulos Ioannis D. , Feleki Anna , Moustakidis Serafeim , Kokkinos Konstantinos , Papageorgiou Elpiniki I.
Published: December 2022

In the last few years, deep learning has made a breakthrough and established its position in machine learning classification problems in medical image analysis. Deep learning has recently displayed remarkable applicability in a range of different medical applications, as well as in nuclear cardiology. This paper implements a literature review protocol and reports the latest advances in artificial intelligence (AI)-based classification in SPECT myocardial perfusion imaging in heart disease diagnosis. The representative and most recent works are reported to demonstrate the use of AI and deep learning technologies in medical image analysis in nuclear cardiology for cardiovascular diagnosis. This review also analyses the primary outcomes of the presented research studies and suggests future directions focusing on the explainability of the deployed deep-learning systems in clinical practice.
Trends in Neonatal Extracorporeal Membrane Oxygenation During a Venovenous Cannula Shortage*
Authors: Hatch L. Dupree , Bridges Brian C. , Chapman Rachel L. , Danko Melissa E. , Schumacher Robert E. , Patrick Stephen W.
Published: December 2022

OBJECTIVES:

To report temporal trends in venovenous extracorporeal membrane oxygenation (ECMO) use for neonatal respiratory failure in U.S. centers before and after functional venovenous cannula shortage due to withdrawal of one dual lumen venovenous cannula from the market in 2018.

DESIGN:

Retrospective cohort study.

SETTING:

ECMO registry of the Extracorporeal Life Support Organization.

PATIENTS:

Infants who received neonatal (cannulated prior to 29 d of age) respiratory ECMO at a U.S. center and had a record available in the ECMO registry from January 1, 2010 to July 20, 2021.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Primary outcome was receipt of venovenous ECMO (vs venoarterial or other), and secondary outcomes were survival to hospital discharge and adverse neurologic outcomes. Using an interrupted time series design, we fit multivariable mixed effects logistic regression models with receipt of venovenous ECMO as the dependent variable, treatment year modeled as a piecewise linear variable using three linear splines (pre shortage: 2010–2014, 2014–2018; shortage: 2018–2021), and adjusted for center clustering and multiple covariates. We evaluated trends in venovenous ECMO use by primary diagnosis including congenital diaphragmatic hernia, meconium aspiration, pulmonary hypertension, and other. Annual neonatal venovenous ECMO rates decreased after 2018: from 2010 to 2014, adjusted odds ratio (aOR) for yearly trend 0.98 (95% CI 0.92–1.04), from 2014 to 2018, aOR for yearly trend 0.90 (95% CI 0.80–1.01), and after 2018, aOR for yearly trend 0.46 (95% CI 0.37–0.57). We identified decreased venovenous ECMO use after 2018 in all diagnoses evaluated, and we failed to identify differences in temporal trends between diagnoses. Survival and adverse neurologic outcomes were unchanged across the study periods.

CONCLUSIONS:

Venovenous ECMO for neonatal respiratory failure in U.S. centers decreased after 2018 even after accounting for temporal trends, coincident with withdrawal of one of two venovenous cannulas from the market.
Brief Report: Impact of Methamphetamine Use and Rectal STIs on Systemic and Rectal Mucosal Inflammation
Authors: Blair Cheríe S. , Fulcher Jennifer A. , Cho Grace D. , Gorbach Pamina M. , Shoptaw Steve , Clark Jesse L.
Published: December 2022

Background:

Methamphetamine (MA) use is associated with sexual risk behavior as well as systemic and mucosal inflammation, suggesting parallel biological and behavioral mechanisms of HIV transmission among men who have sex with men (MSM) who use MA. Data evaluating the combined biological effects of MA use with concomitant rectal gonococcal and/or chlamydial (GC/CT) infection on inflammation are limited.

Setting:

Secondary analysis of stored rectal and plasma specimens from 100 MSM participating in an NIDA-funded longitudinal cohort in Los Angeles, CA.

Methods:

This cross-sectional analysis evaluated systemic and rectal inflammatory markers under 2 conditions: (1) recent MA use (by urine drug screen) and (2) rectal GC/CT infection. We evaluated 50 participants with recent MA use (25 with and 25 without rectal GC/CT) and 50 MSM without MA use (25 with and 25 without rectal GC/CT). Log-transformed plasma and rectal immune markers were regressed on MA exposure and rectal GC/CT, controlling for HIV status and age.

Results:

Median age was 32 (range 19–45) years, and 58% of participants were living with HIV. Plasma tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-1ß, and rectal IL-6 were associated with rectal GC/CT and MA use, independent of HIV status. Higher levels of rectal TNF-α, IL-1ß, and IL-17a were associated with rectal GC/CT.

Conclusions:

Systemic and rectal inflammation was positively associated with rectal GC/CT and MA use. Condomless sex in the setting of GC/CT- and MA-induced immune activation may provide a basis for synergistic biobehavioral mechanisms that promote HIV/STI transmission among MSM who use MA.
An allometric prior enhances acoustic niche partitioning signal
Authors: Memet Edvin , Farrell Brian , Mahadevan L.
Published: December 2022

The acoustic niche hypothesis suggests that vocal signals of sympatric animal species are structured so as to minimize acoustic interference and facilitate communication. Accordingly, each species attempts to establish its own acoustic bandwidth so that intra-species signals are not masked. Detecting a non-random partitioning of the frequency spectrum among sympatric species could constitute evidence for the existence of acoustic avoidance behaviour. However, results from previous studies have been mixed or inconclusive, possibly as a consequence of overlooking the importance of physiological and ecological constraints. Here we introduce an improved test that incorporates prior information on body mass to account for the allometric correlation between mass (size) and vocalization frequency. By correcting for the bias induced by this correlation, the new test uncovers evidence of acoustic niche partitioning as a function of frequency in several tropical bird communities that would not be detected under a more standard test. Separately, we introduce a spatial version of the acoustic partitioning test which, in theory, could prove effective when data are collected from multiple sites located in close spatial proximity.
Muricauda abyssi sp. nov., a marine bacterium isolated from deep seawater of the Mariana Trench
Authors: Wang Di , Wu Yong , Liu Yang , Liu Bilin , Gao Yuxin , Yang Yuxue , Zhang Yan , Liu Chen , Huo Yingzhe , Tang Aoyu , Xu Yunping , Wei Yuli
Published: December 2022

A Gram-stain-negative, non-motile and rod-shaped bacterium, designated as strain W52T, was isolated from deep seawater of the Mariana Trench and characterized phylogenetically and phenotypically. The strain could grow at 10–47 °C (optimum 32 °C), at pH 5.0–8.0 (optimum 6.0) and with 0–9% NaCl (optimum 3 %, w/v). The results of phylogenetic analysis based on 16S rRNA gene sequences indicated that W52T was related to members of the genus

Muricauda

and shared the highest identity with

Muricauda oceani

501str8T (99.0 %), followed by

Muricauda aquimarina

JCM 11811T,

Muricauda ruestringensis

DSM 13258T,

Muricauda oceanensis

40DY170T,

Muricauda beolgyonensis

KCTC 23501T and

Muricauda zhangzhouensis

12C25T with 97.0–98.8 % sequence similarity. 16S rRNA gene sequence identities between W52T and other members of the genus

Muricauda

were below 97.0 %. The major respiratory quinone was MK-6. The polar lipids were phosphatidylethanolamine (PE), one unidentified aminolipid and three unidentified lipids. The strain had iso-C15 : 0, iso-C17 : 0 3-OH and iso-C15 : 1G as the major fatty acids. The G+C content of the genomic DNA was 41.7 %. The combined genotypic and phenotypic data indicated that strain W52T represents a novel species of the genus

Muricauda

, for which the name Muricauda abyssi sp. nov. is proposed, with the type strain W52T (=MCCC 1K05111T= KCTC 82315T).
Mediodorsal thalamus regulates sensory and mapping uncertainties in flexible decision making
Authors: Zhang Xiaohan , Halassa Michael M. , Chen Zhe Sage
Published: December 2022

The mediodorsal (MD) thalamus is a critical partner for the prefrontal cortex (PFC) in cognitive flexibility. Accumulating evidence has shown that the MD regulates task uncertainty in decision making. However, the mechanism of this cognitive process remains unclear. Here we used a reverse-engineering approach and trained biologically-constrained computational models to delineate these mechanisms. We found that the inclusion of an MD-like feedforward module increased robustness to sensory noise, enhanced working memory and enabled rapid context switching in the recurrent PFC network performing two versions of context-dependent decision-making tasks with sensory and mapping uncertainties. Incorporating genetically identified thalamocortical pathways and interneuron cell types replicated neurophysiological findings of neuronal tuning and uncovered attractor-like population dynamics. Our model revealed key computational mechanisms of context-invariant MD in regulating cueing uncertainty and context switching. It also made experimentally testable predictions linking cognitive deficits with disrupted thalamocortical connectivity, prefrontal excitation-inhibition imbalance and dysfunctional inhibitory cell types.
Development and evaluation of an open-source, standards-based approach to explainable artificial intelligence for managing co-morbidity and clinical guidelines using argumentation techniques and the Transition-based Medical Recommendation model
Authors: Domínguez Jesús , Prociuk Denys , Marović Branko , Čyras Kristijonas , Cocarascu Oana , Ruiz Francis , Mi Ella , Mi Emma , Ramtale Christian , Rago Antonio , Darzi Ara , Toni Francesca , Curcin Vasa , Delaney Brendan
Published: December 2022

I.

A.

Objective

Clinical Decision Support (CDS) systems (CDSSs) that integrate clinical guidelines need to reflect real-world co-morbidity. In patient-specific clinical contexts, transparent recommendations that allow for contraindications and other conflicts arising from co-morbidity are a requirement. We aimed to develop and evaluate a non-proprietary, standards-based approach to the deployment of computable guidelines with explainable argumentation, integrated with a commercial Electronic Health Record (EHR) system in a middle-income country.

B.

Materials and Methods

We used an ontological framework, the Transition-based Medical Recommendation (TMR) model, to represent, and reason about, guideline concepts, and chose the 2017 International Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline and a Serbian hospital as the deployment and evaluation site, respectively. To mitigate potential guideline conflicts, we used a TMR-based implementation of the Assumptions-Based Argumentation framework extended with preferences and Goals (ABA+G). Remote EHR integration of computable guidelines was via a microservice architecture based on HL7 FHIR and CDS Hooks. A prototype integration was developed to manage COPD with comorbid cardiovascular or chronic kidney diseases, and a mixed-methods evaluation was conducted with 20 simulated cases and five pulmonologists.

C.

Results

Pulmonologists agreed 97% of the time with the GOLD-based COPD symptom severity assessment assigned to each patient by the CDSS, and 98% of the time with one of the proposed COPD care plans. Comments were favourable on the principles of explainable argumentation; inclusion of additional co-morbidities were suggested in the future along with customisation of the level of explanation with expertise.

D.

Conclusion

An ontological model provided a flexible means of providing argumentation and explainable artificial intelligence for a long-term condition. Extension to other guidelines and multiple co-morbidities is needed to test the approach further.

E.

Funding

The project was funded by the British government through the Engineering and Physical Sciences Research Council (EPSRC) – Global Challenges Research Fund.1
Potential policy interventions for slowing the spread of artemisinin-resistantpfkelchR561H mutations in Rwanda
Authors: Zupko Robert J. , Nguyen Tran Dang , Ngabonziza J. Claude S. , Kabera Michee , Li Haojun , Tran Thu Nguyen-Anh , Tran Kien Trung , Uwimana Aline , Boni Maciej F.
Published: December 2022

Artemisinin combination therapies (ACTs) are highly effective at treating uncomplicatedPlasmodium falciparummalaria. However, the emergence of a novelpfkelch13R561H mutation in Rwanda, with associated delayed parasite clearance, suggests that drug policy interventions are needed to delay the fixation and slow the spread of this mutation. Using a spatial, stochastic, individual-based model calibrated and validated for the Rwanda’s malaria epidemiology, we evaluate seventeen strategies aimed at minimizing treatment failures and delaying the spread of R561H. The primary measures evaluated are projected treatment failures and R561H allele frequency over three, five, and ten years. Lengthening courses of treatment, deploying multiple first-line therapies, and custom rotation strategies all provide a benefit when compared to the status quo. The best intervention options, five years into the future, result in slower spread of R561H (0.16 allele frequency difference) and absolute treatment failure counts that are 44% lower than projected under the status quo.