bluuebunny/crossref_metadata_2025 huggingface dataset:
Les proverbes français et italiens dans la communication orale
Authors: Lambertini Vincenzo
Published: April 2023

Cet article se propose d’étudier les proverbes italiens et français les plus fréquents dans les discours des
séances plénières du Parlement européen (PE) de 2014 à 2022. Après avoir présenté une méthodologie de repérage
corpus-driven des proverbes appliquée à deux corpus de référence français et italien (frWaC et itWaC) et aux
séances plénières du PE, nous analysons quelques exemples de proverbes énoncés dans les discours des plénières. Nous examinons
ainsi leur gestion en interprétation simultanée (IS) de l’italien vers le français et prenons en compte un exemple de
multimodalité liée à l’énonciation des proverbes, pour nous interroger sur son traitement en IS.
Analyse phraséologique du marqueur discursifce m’est aviset de ses variantes dans un corpus d’ancien français
Authors: Denoyelle Corinne , Sorba Julie
Published: April 2023

L’article montre que la construction parenthétiquece m’est avisfonctionne comme un marqueur discursif dans un corpus outillé inédit de romans français en prose du 13esiècle. Nous adoptons une double approche, phraséologique et stylistique, pour étudier le fonctionnement discursif de ce marqueur dans les séquences représentant de l’oral (dialogue des personnages ou paroles du narrateur). La comparaison avec la construction enque P (il/ce) m’est avis quepermet de noter leur origine commune puis leur spécialisation progressive dans la langue. Enfin, un aperçu de l’évolution diachronique du marqueur discursifce m’est avispermet de constater son déclin et son remplacement parà mon avis.
Les phrases préfabriquées des interactions
Authors: Sardier Anne
Published: April 2023

Depuis quelques années, les recherches en phraséologie se développent autour de grands corpus oraux et proposent par exemple d’examiner les phrases préfabriquées des interactions. Ces études explorent la préfabrication dans le cadre des interactions orales. Les recherches en phraséologie ont en outre permis le récent développement de la phraséodidactique en langue seconde. Cependant, il existe peu d’investigation de corpus et peu de propositions didactiques relatives aux apprentissages des unités préformées en langue première.

La présente contribution entend dès lors s’intéresser aux usages des phrases préfabriquées des interactions par de jeunes locuteurs natifs, afin de contribuer au développement d’une réflexion quant à l’acquisition des phraséologismes en langue première. Le corpus oral sur lequel s’appuient les propositions de l’article est constitué d’interactions de 20 élèves de grande section de l’école maternelle (5–6 ans) dans deux types de situations discursives, pour explorer les emplois des phrases préfabriquées typiques de chacune de ces situations.
Donc« et cie »
Authors: Leray Maï
Published: April 2023

Le but de cet article est d’étudier les usages oraux dedoncchez des enfants de français L1 ou L2. La principale hypothèse est que l’association dedoncavec d’autres formes (notammenteuh/hum, aprèset/ouvoilà) entraîne des usages différents de ceux oùdoncest employé seul. Si les résultats montrent que l’expression de la consécution est plus propre àdonc« seul », la distribution des cooccurrents dedoncpermet d’en classer les usages moins (ou non) consécutifs dans trois grandes catégories d’emplois : « introducteurs », « joncteurs » et « clôtureurs ». Finalement, l’article propose des pistes nouvelles pour l’enseignement/apprentissage des emplois dedoncà l’oral en français langue étrangère (FLE) et en français langue maternelle (FLM).
Public procurement law, political economy of the lowest responsive bidding, and the development of the water, sanitation and hygiene sector in Nigeria
Authors: Okolie Aloysius-Michaels , Nnamani Kelechi Elijah , Nwangwu Chikodiri , Agbo Humphrey Nwobodo , Cyril Ike Chinedu
Published: April 2023

This study challenges the argument that the non-enforceability of the procurement law is the bane of infrastructural development in Nigeria. Focusing on the water, sanitation and hygiene (WASH) sector, the article argues that various attempts at procurement regulation were in fact moves to expand capital accumulation in the service delivery sector. Highly placed individuals leverage the lowest responsive bidding mechanism to engage in sharp practices which undermine the development of the WASH sector in the country. Given the prevailing scenario which presents the state, its institutions and laws – including the procurement legislation – as instruments in the hands of the dominant social forces, any investments in and attempts at rule enforcement tend to produce only minimal outcomes.
Noise dynamics of quantum annealers: estimating the effective noise using idle qubits
Authors: Pelofske Elijah , Hahn Georg , Djidjev Hristo N
Published: April 2023

Quantum annealing is a type of analog computation that aims to use quantum mechanical fluctuations in search of optimal solutions of QUBO (quadratic unconstrained binary optimization) or, equivalently, Ising problems. Since NP-hard problems can in general be mapped to Ising and QUBO formulations, the quantum annealing paradigm has the potential to help solve various NP-hard problems. Current quantum annealers, such as those manufactured by D-Wave Systems, Inc. have various practical limitations including the size (number of qubits) of the problem that can be solved, the qubit connectivity, and error due to the environment or system calibration, which can reduce the quality of the solutions. Typically, for an arbitrary problem instance, the corresponding QUBO (or Ising) structure will not natively embed onto the available qubit architecture on the quantum chip. Thus, in these cases, a minor embedding of the problem structure onto the device is necessary. However, minor embeddings on these devices do not always make use of the full sparse chip hardware graph, and a large portion of the available qubits stay unused during quantum annealing. In this work, we embed a disjoint random QUBO on the unused parts of the chip alongside the QUBO to be solved, which acts as an indicator of the solution quality of the device over time. Using experiments on three different D-Wave quantum annealers, we demonstrate that (i) long term trends in solution quality exist on the D-Wave device, and (ii) the unused qubits can be used to measure the current level of noise of the quantum system.
Water isotopes, climate variability, and the hydrological cycle: recent advances and new frontiers
Authors: Dee Sylvia , Bailey Adriana , Conroy Jessica L , Atwood Alyssa , Stevenson Samantha , Nusbaumer Jesse , Noone David
Published: April 2023

The hydrologic cycle is a fundamental component of the climate system with critical societal and ecological relevance. Yet gaps persist in our understanding of water fluxes and their response to increased greenhouse gas forcing. The stable isotope ratios of oxygen and hydrogen in water provide a unique opportunity to evaluate hydrological processes and investigate their role in the variability of the climate system and its sensitivity to change. Water isotopes also form the basis of many paleoclimate proxies in a variety of archives, including ice cores, lake and marine sediments, corals, and speleothems. These records hold most of the available information about past hydrologic variability prior to instrumental observations. Water isotopes thus provide a ‘common currency’ that links paleoclimate archives to modern observations, allowing us to evaluate hydrologic processes and their effects on climate variability on a wide range of time and length scales. Building on previous literature summarizing advancements in water isotopic measurements and modeling and describe water isotopic applications for understanding hydrological processes, this topical review reflects on new insights about climate variability from isotopic studies. We highlight new work and opportunities to enhance our understanding and predictive skill and offer a set of recommendations to advance observational and model-based tools for climate research. Finally, we highlight opportunities to better constrain climate sensitivity and identify anthropogenically-driven hydrologic changes within the inherently noisy background of natural climate variability.
Improving biome and climate modelling for a set of past climate conditions: evaluating bias correction using the CDF-t approach
Authors: Zapolska Anhelina , Vrac Mathieu , Quiquet Aurélien , Extier Thomas , Arthur Frank , Renssen Hans , Roche Didier M
Published: April 2023

Climate model simulations are inherently biased. It is a notably difficult problem when dealing with climate impact assessments and model-data integration. This is especially true when looking at derived quantities such as biomes, where not only climate but also vegetation dynamics biases come into play. To overcome such difficulties, we evaluate the performance of an existing methodology to correct climate model outputs, applied here for the first time to long past climate conditions. The proposed methodology relies on the ‘Cumulative Distribution Function-transform’ (CDF-t) technique, which allows to account for climate change within the bias-correction procedure. The results are evaluated in two independent ways: (i) using forward modelling, so that model results are directly comparable to reconstructed vegetation distribution; (ii) using climatic reconstructions based on an inverse modelling approach. The modelling is performed using the intermediate complexity model iLOVECLIM in the standard global and interactively downscaled over the Europe version. The combined effects of dynamical downscaling and bias correction resulted in significantly stronger agreement between the simulated results and pollen-based biome reconstructions (BIOME6000) for the pre-industrial (0.18 versus 0.44) and mid-Holocene (MH) (0.31 versus 0.40). Higher correlation is also observed between statistically modelled global gridded potential natural distribution and modelled biomes (0.36 versus 0.41). Similarly, we find higher correlation between the reconstructed and the modelled temperatures for the MH (0.02 versus 0.21). No significant difference is found for the Last Glacial Maximum when using temperature reconstructions, due to the low number of data points available. Our findings show that the application of the CDF-t method on simulated climate variables enables us to simulate palaeoclimate and vegetation distribution in better agreement with independent reconstructions.
Evolution of superoscillations for spinning particles
Authors: Colombo Fabrizio , Pozzi Elodie , Sabadini Irene , Wick Brett
Published: April 2023

Superoscillating functions are band-limited functions that can oscillate faster than their fastest Fourier component. These functions appear in various fields of science and technology, in particular they were discovered in quantum mechanics in the context of weak values introduced by Y. Aharonov and collaborators. The evolution problem of superoscillatory functions as initial conditions for the Schrödinger equation is intensively studied nowadays and the supershift property of the solution of Schrödinger equation encodes the persistence of superoscillatory phenomenon during the evolution. In this paper, we prove that the evolution of a superoscillatory initial datum for spinning particles in a magnetic field has the supershift property. Our techniques are based on the exact propagator of spinning particles, the associated infinite order differential operators and their continuity on suitable spaces of entire functions with growth conditions.
Defining Emotions
Authors: Eidinow Esther
Published: April 2023

This chapter examines some of the current academic theories about what emotions are and how they ‘work’, within and across cultures. It establishes a view of emotions as dynamics developed within networks of relationships, socially conceptualized and enacted within familiar schemas or cultural models. Focusing on the role of discourse, as playing a key role in storing and negotiating the meaning and expression of emotions, it suggests that the ‘emotion talk’ of a society offers crucial insights into the nature of both the shared cultural schemas and the individual experiences of an emotion, and the ways in which they interrelate.
Conclusion: ‘Careless Talk…’
Authors: Eidinow Esther
Published: April 2023

This chapter draws together the arguments of this second part of the book, reflecting on the social power of phthonos. It asks how phthonos appears and spreads in a community—and introduces its connections with gossip.
Conclusion: Envy, Poison, and Death
Authors: Eidinow Esther
Published: April 2023

This chapter draws together the arguments of the previous chapters, looking at the evidence for economic concerns, anxieties about gender roles, and a widespread mindset of suspicion in fourth-century Athens. It suggests that this creates a context in which gossip could become violent civic action
methylR: a graphical interface for comprehensive DNA methylation array data analysis
Authors: Volpe Massimiliano , Das Jyotirmoy
Published: April 2023

Motivation

DNA methylation analysis using arrays is a widely used method in research and clinical studies to study Epigenetics. Although several packages have been published to incur the results, most of them require a deep computational knowledge to perform the analysis. To resolve the limitation and to offer an easily accessible solution for researchers, we developed methylR a graphical tool that can analyze not only the raw data but also performs different downstream analyses with a few mouse clicks.

Results

We used standard and established open-source published packages or pipelines in methylR. We evaluated a publicly available dataset and compared the published results with those obtained with our tool. We implemented eight downstream analysis modules that can perform multidimensional analyses to pathway enrichment. Although the main application is designed for Illumina DNA methylation array data analysis, we made the accessory modules suitable for other kinds of data analysis as well.

Availability and implementation

Freely available at Github: https://github.com/JD2112/methylr; Webserver: https://methylr.research.liu.se.
Decomposing mosaic tandem repeats accurately from long reads
Authors: Masutani Bansho , Kawahara Riki , Morishita Shinichi
Published: April 2023

Motivation

Over the past 30 years, extended tandem repeats (TRs) have been correlated with ∼60 diseases with high odds ratios, and most known TRs consist of single repeat units. However, in the last few years, mosaic TRs composed of different units have been found to be associated with several brain disorders by long-read sequencing techniques. Mosaic TRs are difficult-to-characterize sequence configurations that are usually confirmed by manual inspection. Widely used tools are not designed to solve the mosaic TR problem and often fail to properly decompose mosaic TRs.

Results

We propose an efficient algorithm that can decompose mosaic TRs in the input string with high sensitivity. Using synthetic benchmark data, we demonstrate that our program named uTR outperforms TRF and RepeatMasker in terms of prediction accuracy, this is especially true when mosaic TRs are more complex, and uTR is faster than TRF and RepeatMasker in most cases.

Availability and implementation

The software program uTR that implements the proposed algorithm is available at https://github.com/morisUtokyo/uTR.
Diverging patterns of plasticity in the nucleus basalis of Meynert in early- and late-onset blindness
Authors: Bang Ji Won , Chan Russell W , Parra Carlos , Murphy Matthew C , Schuman Joel S , Nau Amy C , Chan Kevin C
Published: April 2023

Plasticity in the brain is impacted by an individual’s age at the onset of the blindness. However, what drives the varying degrees of plasticity remains largely unclear. One possible explanation attributes the mechanisms for the differing levels of plasticity to the cholinergic signals originating in the nucleus basalis of Meynert. This explanation is based on the fact that the nucleus basalis of Meynert can modulate cortical processes such as plasticity and sensory encoding through its widespread cholinergic projections. Nevertheless, there is no direct evidence indicating that the nucleus basalis of Meynert undergoes plastic changes following blindness. Therefore, using multiparametric magnetic resonance imaging, we examined if the structural and functional properties of the nucleus basalis of Meynert differ between early blind, late blind and sighted individuals. We observed that early and late blind individuals had a preserved volumetric size and cerebrovascular reactivity in the nucleus basalis of Meynert. However, we observed a reduction in the directionality of water diffusion in both early and late blind individuals compared to sighted individuals. Notably, the nucleus basalis of Meynert presented diverging patterns of functional connectivity between early and late blind individuals. This functional connectivity was enhanced at both global and local (visual, language and default-mode networks) levels in the early blind individuals, but there were little-to-no changes in the late blind individuals when compared to sighted controls. Furthermore, the age at onset of blindness predicted both global and local functional connectivity. These results suggest that upon reduced directionality of water diffusion in the nucleus basalis of Meynert, cholinergic influence may be stronger for the early blind compared to the late blind individuals. Our findings are important to unravelling why early blind individuals present stronger and more widespread cross-modal plasticity compared to late blind individuals.
A right ventricular diverticulum with a very special cardiac anomaly
Authors: Song Lingyun , Ling Yunfei , Lin Ke
Published: April 2023

Cardiac diverticula are rare congenital anomalies. Among them, right ventricular diverticula are far fewer than left ventricular diverticula. Herein, we write to share an exceedingly rare case of a special right ventricular diverticulum connecting to left ventricle through a tunnel-like structure originating from the membranous ventricular septum. Surgical closure of the origin of the connecting tunnel was performed, while the right ventricular diverticulum was preserved. Postoperative recovering was uneventful.
clevRvis: visualization techniques for clonal evolution
Authors: Sandmann Sarah , Inserte Clara , Varghese Julian
Published: April 2023

Background

A thorough analysis of clonal evolution commonly requires integration of diverse sources of data (e.g., karyotyping, next-generation sequencing, and clinical information). Subsequent to actual reconstruction of clonal evolution, detailed analysis and interpretation of the results are essential. Often, however, only few tumor samples per patient are available. Thus, information on clonal development and therapy effect may be incomplete. Furthermore, analysis of biallelic events—considered of high relevance with respect to disease course—can commonly only be realized by time-consuming analysis of the raw results and even raw sequencing data.

Results

We developed clevRvis, an R/Bioconductor package providing an extensive set of visualization techniques for clonal evolution. In addition to common approaches for visualization, clevRvis offers a unique option for allele-aware representation: plaice plots. Biallelic events may be visualized and inspected at a glance. Analyzing 4 public datasets, we show that plaice plots help to gain new insights into tumor development and investigate hypotheses on disease progression and therapy resistance. In addition to a graphical user interface, automatic phylogeny-aware color coding of the plots, and an approach to explore alternative trees, clevRvis provides 2 algorithms for fully automatic time point interpolation and therapy effect estimation. Analyzing 2 public datasets, we show that both approaches allow for valid approximation of a tumor’s development in between measured time points.

Conclusions

clevRvis represents a novel option for user-friendly analysis of clonal evolution, contributing to gaining new insights into tumor development.
Impact of travel restrictions for travellers from China on the internal spread of SARS-CoV-2 in South Korea
Authors: Han Changhee , Seo Hayoung , Cho Soojung , Chiara Achangwa , Ryu Sukhyun
Published: April 2023

South Korea implemented restrictions on travel from China in January of 2023. In this scenario-based model, we estimated that the travel restrictions for inbound travellers from China were associated with a 0.3–9.8% decrease in the internal spread of SARS-CoV-2 in South Korea (95% Confidence Interval, 0.2–11.7%).
Electrically function-switchable magnetic domain-wall memory
Authors: Sheng Yu , Wang Weiyang , Deng Yongcheng , Ji Yang , Zheng Houzhi , Wang Kaiyou
Published: April 2023

Versatile memory is strongly desired for end users, to protect their information in the information era. In particular, bit-level switchable memory that can be switched from rewritable to read-only function would allow end users to prevent important data being tampered with. However, no such switchable memory has been reported. We demonstrate that the rewritable function can be converted into read-only function by applying a sufficiently large current pulse in a U-shaped domain-wall memory, which comprises an asymmetric Pt/Co/Ru/AlOx heterostructure with strong Dzyaloshinskii-Moriya interaction. Wafer-scale switchable magnetic domain-wall memory arrays on 4-inch Si/SiO2 substrate are demonstrated. Furthermore, we confirm that the information can be stored in rewritable or read-only states at bit level according to the security needs of end users. Our work not only provides a solution for personal confidential data, but also paves the way for developing multifunctional spintronic devices.
Lessons from the 1970s for international monetary reform
Authors: Eichengreen Barry
Published: April 2023

The collapse of the Bretton Woods System in 1971–3 led to ambitious efforts to reform the international monetary system, mainly through the deliberations of the Committee of Twenty (C-20). Many of the issues considered by the C-20 will be familiar to aficionados of twenty-first century discussions of international monetary reform. Ultimately, attempts to reach a consensus in the C-20 were unsuccessful. This paper seeks to identify explanations for that failure in an effort to limit the likelihood that it will be repeated.
Creating a new sovereign debt reconstruction mechanism: why incentives, risk sharing, and CACs will all matter
Authors: Menzies Gordon , Vines David
Published: April 2023

This paper argues that the Covid recession, and aggressive monetary tightening in the US accompanying the post-Covid recovery, are likely to cause a sovereign debt overhang in emerging market economies—i.e. debt which is unlikely to be fully repaid. A sovereign debt reconstruction mechanism (SDRM) seems necessary to avoid widespread disorderly debt write-downs. We discuss a range of procedures that are available, building upon Anne Krueger’s proposal for an SDRM in 2002 (Krueger, 2002a,b). At that time Krugman (1988) had already argued that any SDRM should incentivize debtors so that they put in effort to clear their debts (a Krugman contract). Menzies (2004) went further than this to show that these effects should be further sharpened, creating what he called ‘hyper-incentive effects’ (a Menzies contract). The International Monetary Fund has argued that risk-sharing between debtors and creditors will also be important (IMF, 2020). But we show that risk-sharing will—in general—pull in the opposite direction to incentive effects, and we doubt the extent to which the IMF has recognized this trade-off. Finally, we argue that collective action clauses (CACs) increase the probability of achieving any agreement, whatever it might be. They will help avoid the alternative of disorderly debt write-downs, outcomes which will deliver neither incentive effects nor risk-sharing.
The Euro on the global stage
Authors: Regling Klaus
Published: April 2023

The war in Ukraine draws renewed attention to the question of whether the international monetary and financial system is moving towards a more ‘multipolar’ character. The euro has been the second most important global currency since its creation, and well-placed to help diversify the global financial architecture. This article reviews the evolution of the euro’s international role along with the evolution of the institutional architecture to support it. Previous and ongoing reforms in the European Economic and Monetary Union (EMU) can support the common currency on the international stage.
Quercetin-solid lipid nanoparticle-embedded hyaluronic acid functionalized hydrogel for immunomodulation to promote bone reconstruction
Authors: Zhou Pinghui , Yan Bomin , Wei Bangguo , Fu Liangmin , Wang Ying , Wang Wenrui , Zhang Li , Mao Yingji
Published: April 2023

Bone defects are a persistent challenge in clinical practice. Although repair therapies based on tissue-engineered materials, which are known to have a crucial role in defective bone regeneration, have gathered increased attention, the current treatments for massive bone defects have several limitations. In the present study, based on the immunomodulatory inflammatory microenvironment properties of quercetin, we encapsulated quercetin-solid lipid nanoparticles (SLNs) in a hydrogel. Temperature-responsive poly(ε-caprolactone-co-lactide)-b-poly(ethylene glycol)-b-poly(ε-caprolactone-co-lactide) modifications were coupled to the main chain of hyaluronic acid hydrogel, constructing a novel, injectable bone immunomodulatory hydrogel scaffold. Extensive in vitro and in vivo data showed that this bone immunomodulatory scaffold forms an anti-inflammatory microenvironment by decreasing M1 polarization, while elevating the M2 polarization. Synergistic effects on angiogenesis and anti-osteoclastic differentiation were observed. These findings further proved that administering quercetin SLNs encapsulated in a hydrogel can aid bone defect reconstruction in rats, providing new insights for large-scale bone defect repair.
Stratifying Disaster: State Aid, Institutional Processes, and Inequality in American Communities
Authors: Raker Ethan J
Published: April 2023

Disaster aid is an increasingly costly form of social spending and an often-overlooked way that welfare states manage new forms of risk related to climate change. In this article, I argue that disaster aid programs engender racial and socioeconomic inequalities through a process of assistance access constituted by distinct state logics, administrative burdens, and bureaucratic actors. I test this claim empirically by analyzing 5.37 million applicant records from FEMA’s Individuals and Households Program (IHP) from 2005 to 2016. Results demonstrate that key institutional features—the conditions of eligibility and sufficiency, burdens of proof, and assessments by contracted inspectors—combine in a stepwise process to funnel permanent repair resources to homeowners in whiter communities, while temporary rental aid is granted disproportionately to households in communities of color. Analyses of denial codes suggest racial disparities in appraisals of disaster damage. Among those approved for aid, more benefits accrue to those from comparatively higher income communities, and a decoupling of permanent and temporary housing aid further stratifies socioeconomic growth during recovery. Theoretically, this research advances an account of institutional processes transferable to other analyses of social programs, and it introduces climate risk as a new form of social risk against which welfare states insure citizens.
Response of sleep slow oscillations to acoustic stimulation is evidenced by distinctive synchronization processes
Authors: Navarrete Miguel , Osorio-Forero Alejandro , Gómez Angela , Henao David , Segura-Quijano Fredy E , Le Van Quyen Michel , Valderrama Mario
Published: April 2023

Closed-loop acoustic stimulation (CLAS) during sleep has shown to boost slow wave (SW) amplitude and spindle power. Moreover, sleep SW have been classified based on different processes of neuronal synchronization. Thus, different types of SW events may have distinct functional roles and be differentially affected by external stimuli. However, the SW synchronization processes affected by CLAS are not well understood. Here, we studied the effect of CLAS on the dissociation of SW events based on two features of neuronal synchronization in the electroencephalogram (topological spread and wave slope). We evaluated and classified individual SW events of 14 healthy subjects during a CLAS stimulated (STM) and a control night (CNT). Three main categories of SW events were found denoting (C1) steep slope SW with global spread, (C2) flat-slope waves with localized spread and homeostatic decline, and (C3) multipeaked flat-slope events with global spread. Comparing between conditions, we found a consistent increase of event proportion and trough amplitudes for C1 events during the time of stimulation. Furthermore, we found similar increases in post-stimulus spectral power in θ, β, and σ frequencies for CNT vs STIM condition independently of sleep stage or SW categories. However, topological analysis showed differentiated spatial dynamics in N2 and N3 for SW categories and the co-occurrence with spindle events. Our findings support the existence of multiple types of SW with differential response to external stimuli and possible distinct neuronal mechanisms.
From ontogenesis to clinical practice: waking up to infant sleep
Authors: Anders Thomas F
Published: April 2023

This article describes the author’s research journey exploring infant and toddler sleep. From polygraphic recording in hospital nurseries to using videosomnography in homes, the author traced the longitudinal development of infant/toddler nighttime sleep and waking behaviors. The home-based video observations led to a redefinition of a pediatric milestone; namely, “sleeping through the night,” and provided a framework for assessing and treating infant/toddler nighttime sleep problems.
A Qualitative Inquiry Exploring Clinical Faculty Transition to a Concept-Based Curriculum
Authors: León Teresa G. , Reinhardt Anita C. , Keller Teresa , Kuchler Elizabeth G.
Published: April 2023

AIM

This study explores the transition process clinical faculty experience when changing to teaching in a concept-based curriculum.

BACKGROUND

Literature related to faculty support during curricular change is sparse and offers little guidance to assist clinical faculty.

METHOD

A qualitative study was conducted with participants from nursing programs in a statewide consortium. Semistructured interviews were transcribed to identify themes that linked participants’ experiences to transition stages. Additional research included review of clinical assignments and observation of faculty while teaching at a clinical site.

RESULTS

Nine clinical faculty from six nursing programs participated in the study. Five themes linked to the stages of the Bridges Transition Model were identified: Collaboration, Communication, Coordination, Coherence, and Futility.

CONCLUSION

The identified themes revealed that clinical faculty varied in their transition process. These results add to the knowledge of transitional change for clinical faculty.
Treatment of pediatric femur supracondylar fractures: comparison of K-wire fixation versus plate-screw fixation
Authors: Tekin Sezgin Bahadir , Karabulut Çağri , Bozgeyik Bahri , Bahadir Gökçen H.
Published: April 2023

This study aims to compare the clinical and radiological results of patients who underwent plate-screw fixation and K-wire fixation in supracondylar femur fractures in the pediatric population. Patients aged 5–14 years suffering from supracondylar femoral fractures who underwent K-wire and plate-screw fixation were included in the study. Of all patients, follow-up period, age, fracture union time, gender, leg length discrepancy, and Knee Society Score (KSS) data were analyzed. The patients were divided into two groups; fixation with plate (Group A) and fixation with K-wires (Group B). Forty-two patients participated in the study. There was no significant difference between the two groups in terms of age, gender, and follow-up time (P > 0.05). When comparing the KSS results, no statistically significant difference was found between the two groups (P = 0.612). A statistically significant difference was detected between the two groups regarding union time (P = 0.01). When both groups were analyzed, no significant difference was found between the two groups in terms of functional results. Good results can be obtained in both plate-screw and K-wires in pediatric supracondylar femur fractures.
Use of lateral-exit crossed-pin fixation for pediatric supracondylar humeral fractures: a retrospective case series
Authors: Yun Yeo-Hon , Kang Ho Won , Lim Chaemoon , Lee Kwang Ryeol , Song Mi Hyun
Published: April 2023

Surgeons have been reluctant to perform crossed-pin fixation for displaced pediatric supracondylar humeral (SCH) fractures because it carries a risk of iatrogenic ulnar nerve injury. This study aimed to introduce lateral-exit crossed-pin fixation for displaced pediatric SCH fractures and to evaluate its clinical and radiological outcomes, with a particular focus on iatrogenic ulnar nerve injuries. Children who underwent lateral-exit crossed-pin fixation for displaced SCH fractures between 2010 and 2015 were retrospectively reviewed. Lateral-exit crossed-pin fixation involved the introduction of a medial pin from the medial epicondyle, as in the conventional method, followed by pulling the pin through the lateral skin until the distal and medial aspects of the pin were just under the cortex of the medial epicondyle. The time to union and loss of fixation were assessed. Flynn’s clinical criteria (cosmetic and functional factors) and complications including iatrogenic ulnar nerve injury were investigated. A total of 81 children with displaced SCH fractures were treated with lateral-exit crossed-pin fixation. All but one patient achieved union with good alignment, with an average time to union of 7.9 weeks (3.9–10.3 weeks). Only one patient exhibited cubitus varus deformity associated with loss of reduction. All patients recovered to almost their full range of motion. No case of iatrogenic ulnar nerve injury developed; however, iatrogenic radial nerve injury developed in one patient. Lateral-exit crossed-pin fixation provides sufficient stability with a lower risk of iatrogenic ulnar nerve injury in children with displaced SCH fractures. This method is an acceptable technique for crossed-pin fixation.
Differentiating Neurodegenerative Disease from Compressive Cervical Myelopathy Using Motor Evoked Potentials
Authors: Kamei Naosuke , Nakamae Toshio , Maruyama Toshiaki , Nakao Kazuto , Farid Fadlyansyah , Adachi Nobuo
Published: April 2023

Study Design.

A retrospective case-control study.

Objective.

To differentiate neurodegenerative diseases from compressive cervical myelopathy (CCM) using motor evoked potentials (MEPs).

Summary of Background Data.

When considering surgery for CCM, it may be necessary to differentiate the condition from a neurodegenerative disease.

Methods.

A total of 30 healthy volunteers, 52 typical CCM patients with single-level compression of the spinal cord at C4-5 or C5-6, seven patients with amyotrophic lateral sclerosis (ALS), and 12 patients with demyelinating disease of the central nervous system (DDC), including 11 patients with multiple sclerosis and one patient with neuromyelitis optica spectrum disorder, formed our study population. MEPs were recorded from the bilateral abductor digiti minimi (ADM) and abductor hallucis (AH) muscles using transcranial magnetic stimulation and electrical stimulation of the ulnar and tibial nerves. Central motor conduction time (CMCT), peripheral conduction time, amplitude of MEPs, and frequency of F-waves were evaluated. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off value for distinguishing between CCM and ALS.

Results.

Significant differences were observed in the amplitude of MEPs and frequency of F-waves evoked by peripheral nerve stimulation between patients with CCM and ALS. The MEP amplitude of AH was more accurate in differentiating between the two diseases compared to ADM (cut-off value, 11.2mV, sensitivity, 87.5%; specificity, 85.7%). All seven patients with ALS showed reduced frequency of F waves from ADM or AH, but none of the healthy volunteers or patients with other diseases demonstrated this finding. Moreover, there were no significant differences between CCM and DDC in any of the assessments.

Conclusion.

The amplitude of MEPs and frequency of F waves evoked by peripheral nerve stimulation could be helpful in differentiating ALS from CCM.
THE LONG-TERM FOLLOW-UP OF AUTOLOGOUS BLOOD CLOT-ASSISTED LYOPHILIZED HUMAN AMNIOTIC MEMBRANE COVERING TREATMENT UNCLOSED MACULAR HOLE
Authors: Chen Hao , Lin Wei , Tang Yongping , Wei Yong
Published: April 2023

Purpose:

The objectives were to assess the long-term morphological and functional outcome of eyes with unclosed macular hole (MH) in which the internal limiting membrane (ILM) has been peeled in previously vitrectomy with autologous blood clot (ABC)-assisted lyophilized human amniotic membrane (LhAM) graft covering.

Methods:

12 eyes with MH unclosed in previous surgery were selected and studied. ABC-assisted LhAM graft was used to cover the MH in vitrectomy. The main clinical outcomes including best-corrected visual acuity (BCVA), closure of MH and the outcome of LhAM graft were recorded.

Results:

The mean minimum diameter of the MH was 641.7±245.9 μm and the mean axial length was 27.3 ± 3.50 mm. The LhAM graft was maintained in the former position and all the MH closed in 10 eyes, whereas the graft slipped and the MH unclosed in 2 eyes. The MH closure rate was 83.3 % and the mean BCVA improved significantly from 1.47 ± 0.58 logMAR (Snellen 20/590) preoperatively to 1.17 ± 0.60 logMAR (Snellen 20/296) postoperatively. During 18-36 months follow-up, LhAM grafts were attached to the retinal surface in 9 eyes, detached from the retinal surface in one eye, dislocated from the fovea in one eye as well as inserted into retina in one eye, and macular atrophy occurred in one eye.

Conclusion:

ABC-assisted LhAM graft covering provided a simple and effective treatment option for unclosed MH and reduce surgical trauma. Although the graft remained on the macular surface for a long time, it does not affect the recovery of MH and postoperative vision.
Vision-Related Quality of Life in Patients With Keratoconus With Enantiomorphic Topography After Bilateral Intrastromal Corneal Ring Implantation
Authors: Rodrigues Pablo Felipe , Moscovici Bernardo Kaplan , Hirai Flavio , Mannis Mark Joel , de Freitas Denise , Campos Mauro , Nosé Walton
Published: April 2023

Purpose:

The aim of this study was to evaluate the quality of life (QOL) after intrastromal ring implantation in patients with keratoconus.

Methods:

This was a prospective, randomized, interventional study. We analyzed 60 eyes of 30 patients aged 16 to 35 years who were treated at the Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, Brazil. The Visual Function Questionnaire (VFQ-25) and Short-Form 36 Questionnaire (SF-36) were used before intracorneal ring segment (ICRS) implantation and at 3, 6, and 12 months after surgical intervention.

Results:

The mean corrected visual acuity improved from a mean of 0.32 ± 0.2 logMAR (20/40) preoperatively to 0.14 ± 0.11 logMAR (20/25) 1 year postoperatively (P = 0.001). The mean spherical equivalent varied from −7.24 ± 3.47 preoperatively to −4.13 ± 2.41 postoperatively (P = 0.001). The overall composite score for the VFQ-25 improved from 55.1 preoperatively to 80.4 1 postoperatively (P = 0.001). SF-36 showed statistically significant improvement in all scores. When analyzing the correlation between visual acuity and VFQ composite score, a significant correlation was found between both variables (Pearson correlation coefficient of −0.40, P = 0.001).

Conclusions:

Patients with keratoconus had increased psychological symptoms and lower QOL and improved psychosocial criteria associated with corneal remodeling and decreased visual dependence on others after surgery. Extrapolation of these data to the whole keratoconus population suggests that ICRS implantation could improve QOL in these patients.
Alprazolam
Authors: Mamtani Harkishan , Chaturvedi Santosh K.
Published: April 2023

Background

Although alprazolam is approved only for use in panic disorder and generalized anxiety disorder, it is used for numerous other conditions, not only by psychiatrists but also by medical professionals in general. This commentary critically analyzes the use of alprazolam.

Methods

A narrative review approach was adopted, using relevant articles and textbooks, to compile pertinent literature for the aforementioned topic.

Results

Among all its adverse reactions, the most bothersome concern about the use of alprazolam is its potential for abuse and dependence. This can be attributed to certain unique pharmacokinetic and pharmacodynamic properties of this benzodiazepine. Also, the withdrawal triggered by use of alprazolam is challenging to treat. Alternate pharmacological and non-pharmacological strategies for use in anxiety and insomnia are available, which might be safer than alprazolam. Also, policy changes can serve as an answer to curb alprazolam abuse to some extent. Alprazolam might still be a good choice for individuals who do not have a history of abuse of other substances, with adequate psychoeducation and close monitoring of their usage pattern.

Conclusion

There is a need to reconsider the need for long-term use of benzodiazepines in general, and alprazolam in particular. However, they still might be an appropriate choice in individuals where abuse and dependence are less likely.
Nomograms for predicting the recurrence probability and recurrence-free survival in patients with hepatocellular carcinoma after conversion hepatectomy based on hepatic arterial infusion chemotherapy: a multicenter, retrospective study
Authors: Deng Min , Lei Qiucheng , Wang Jiamin , Lee Carol , Guan Renguo , Li Shaohua , Wei Wei , Chen Huanwei , Zhong Chong , Guo Rongping
Published: April 2023

Background:

This study aimed to establish and validate nomograms to predict the probability of recurrence and recurrence-free survival (RFS) in patients with hepatocellular carcinoma (HCC) after conversion hepatectomy based on hepatic arterial infusion chemotherapy (HAIC).

Methods:

Nomograms were constructed using data from a retrospective study of 214 consecutive patients treated with HAIC-based conversion liver resection between January 2016 and July 2020. Nomograms predicting the probability of tumor recurrence and RFS were established based on predictors selected by multivariate regression analysis. Predictive accuracy and discriminative ability of the nomogram were examined. Bootstrap method was used for internal validation. External validation was performed using cohorts (n=128) from three other centers.

Results:

Recurrence rates in the primary and external validation cohorts were 63.6 and 45.3%, respectively. Nomograms incorporating clinicopathological features of tumor recurrence and RFS were generated. Concordance index (C-index) scores of the nomograms for predicting recurrence probability and RFS were 0.822 (95% CI, 0.703–0.858) and 0.769 (95% CI, 0.731–0.814) in the primary cohort, and 0.802 (95% CI, 0.726–0.878) and 0.777 (95% CI, 0.719–0.835) in the external validation cohort, respectively. Calibration curves indicated good agreement between the nomograms and actual observations. Moreover, the nomograms outperformed the commonly used staging systems. Patients with low risk, stratified by the median nomogram scores had better RFS (low risk vs. high risk, 36.5 vs. 5.2 months, P<0.001). The external validation cohort supported these findings.

Conclusions:

The presented nomograms showed favorable accuracy for predicting recurrence probability and RFS in HCC patients treated with HAIC-based conversion hepatectomy. Identifying risk factors and estimating tumor recurrence may help clinicians in the decision-making process regarding adjuvant therapies for patients with HCC, which eventually achieves better oncological outcomes.
Ethnic disparities in waitlist outcomes of patients with nonalcoholic steatohepatitis listed for liver transplantation in the US
Authors: Lim Wen Hui , Yong Jie Ning , Ong Christen En Ya , Ng Cheng Han , Tan Darren Jun Hao , Zeng Rebecca Wenling , Chung Charlotte Hui , Kaewdech Apichat , Chee Douglas , Tseng Michael , Wijarnpreecha Karn , Syn Nicholas , Bonney Glenn K. , Kow Alfred , Huang Daniel Q. , Noureddin Mazen , Muthiah Mark , Tan Eunice , Siddiqui Mohammad Shadab
Published: April 2023

NASH is the fastest-growing cause of liver cirrhosis and is the leading indication for liver transplantation (LT). However, significant racial and ethnic disparities in waitlist outcomes and LT allocation may unfairly disadvantage minorities. Our aim was to characterize racial and ethnic disparities in waitlist mortality and transplantation probability among patients with NASH. This is a retrospective analysis of the United Network for Organ Sharing registry data of LT candidates from January 1, 2000 to December 31, 2021. Outcomes analysis was performed using competing risk analysis with the Fine and Gray model. The multivariable adjustment was conducted, and mixed-effect regression was used to compare the model for end-stage liver disease scores at listing and removal. Of 18,562 patients with NASH cirrhosis, there were 14,834 non-Hispanic Whites, 349 African Americans, 2798 Hispanics, 312 Asians, and 269 of other races/ethnicities; African American (effect size: 2.307, 95% CI: 1.561–3.053, and p < 0.001) and Hispanic (effect size: 0.332, 95% CI: 0.028–0.637, p = 0.032) patients were found to have a significantly higher model for end-stage liver disease scores at the time of listing than non-Hispanic Whites. African Americans had a higher probability of receiving LT relative to non-Hispanic Whites (subdistribution HR: 1.211, 95% CI: 1.051–1.396, and p = 0.008). However, Hispanic race/ethnicity was associated with a lower transplantation probability (subdistribution HR: 0.793, 95% CI: 0.747–0.842, and p < 0.001) and increased waitlist mortality (subdistribution HR: 1.173, CI: 1.052–1.308, and p = 0.004) compared with non-Hispanic Whites. There are significant racial and ethnic disparities in waitlist outcomes of patients with NASH in the US. Hispanic patients are less likely to receive LT and more likely to die while on the waitlist compared with non-Hispanic Whites despite being listed with a lower model for end-stage liver disease scores.