bluuebunny/crossref_metadata_2025 huggingface dataset:
Derek Parfit’s Non-Naturalist Cognitivism
Authors: Crisp Roger
Published: September 2023

This chapter concerns Derek Parfit’s development and defence of a form of non-naturalist realism or cognitivism, according to which normative properties exist and must be understood using concepts which form a category of their own, such that they and the facts they may be used to state cannot be explained reductively, in non-normative or ‘naturalist’ terms. After explaining Parfit’s earlier work in metaethics, the chapter turns to Parfit’s On What Matters. His criticism of analytical naturalism, nonanalytical naturalism, and noncognitivism are elucidated. The chapter ends with a discussion of Parfit’s response to objections in four broad areas: metaphysics, epistemology, rationalism, and agreement. The chapter refers throughout to many of the critical responses to Parfit’s views.
Prospects for a Quietist Moral Realism
Authors: Warren Mark D. , Thomasson Amie L.
Published: September 2023

Quietist Moral Realists accept that there are moral facts and properties, while aiming to avoid many of the explanatory burdens thought to fall on traditional moral realists. This chapter examines the forms that Quietist Moral Realism has taken and the challenges it has faced, in order to better assess its prospects. The best hope, this chapter argues, lies in a pragmatist approach that distinguishes the different functions of diverse areas of discourse. This paves the way for a form of Quietism that does not simply remain quiet about the explanatory demands of metaethics, but rather is able to diagnose where they go wrong. By combining a neo pragmatic analysis of the discourse with an easy approach to ontology, we can develop a form of Quietist Moral Realism that is far stronger than critics of quietism have appreciated.
Function, Fitness, Flourishing
Authors: Bloomfield Paul
Published: September 2023

A naturalistic theory of moral realism, based on ancient Greek eudaimonism, is presented using concepts from biological and evolutionary theory. The general empirical claim is that each species evolves traits which promote flourishing in those individual members who develop them. Using biological analogies, Plato (Repub 352d–354c) and Aristotle (NE 1097b21–1098a20) gave their ergon arguments defending the functional excellence of the virtues and their central role in making human lives flourish. A new version of these arguments is based on a contemporary understanding of biological function and individual fitness, and a definition of “eudaimonia” constructed from this naturalistic basis. Human beings will live as well as possible by developing the virtues, for these traits allow us to act as well as possible regardless of the individual circumstances. Many standard objections are resolved, including Enoch’s “just too different” objection, Millgram’s Pollyanna objection, Copp and Sobel’s objection from relativism, and Watson’s gangster objection.
Self-Injury in Prison Populations
Authors: Winicov Natalie
Published: September 2023

This chapter discusses the common phenomenon of self-injury in prison populations. It notes that rates of self-injury are significantly higher among the detainees compared to the general population, referencing that self-injurious behavior is one of the primary causes of morbidity in correctional facilities. One of the most pressing concerns surrounding self-harm in prisons is the strong link between nonsuicidal self-injury (NSSI) and the risk of suicide attempts and completions. The chapter explains how prison deprives its detainees of the freedom to cope with healthy strategies, leading to consequential feelings of loneliness and hopelessness. Numerous research calls for improved prison mental health care and advancement in treatments focusing on NSSI.
Understanding Online Self-Injury Activity
Authors: Pritchard Tyler R. , Lewis Stephen P.
Published: September 2023

This chapter considers the implications of online self-injury activity for research, practice, and outreach. It acknowledges how social media and online platforms have become highly salient means of connecting individuals and obtaining information around the world. Thus, online communication has emerged as particularly relevant among people who have lived experience of nonsuicidal self-injury (NSSI). The chapter looks into the motives of individuals with lived experience of NSSI to go online, such as acceptance, validation, curiosity, understanding, self-expression, help-seeking, and help-giving. It discusses the incorporation of online NSSI activity into assessment and intervention potential in an effort to augment treatment outcomes.
Managing NSSI Across Different Treatment Contexts
Authors: Rockstroh Franziska , Kaess Michael
Published: September 2023

Nonsuicidal self-injury (NSSI) is a common transdiagnostic behavior which can be observed in different clinical contexts and is associated with phenomena such as severe emotion dysregulation, suicidality, and other high-risk behaviors. This chapter gives an overview of the common challenges before and in treatment, and presents recent research on treatment programs on different interventional levels. Core elements and goals of treating NSSI are outlined. In order to gain a clear understanding of the behavior and to establish a transparent treatment plan, the importance of a thorough diagnostic evaluation is discussed. After patients present with self-injuries and acute wound care is provided, an assessment of the behavior itself but also comorbid psychopathology and (acute) suicidality by specifically trained clinicians is always indicated. This chapter presents guidelines for assessing and working with NSSI across different settings to facilitate clinical decision-making. Over the past years, efforts have been made by clinicians and researchers to advance the treatment of NSSI with a particular focus on reaching a wider at-risk population through low-threshold interventions and stepped-care approaches, developing evidence-based treatment programs, and improving recommendations for handling NSSI in inpatient settings. The last section discusses current challenges and future directions for managing NSSI, and a clinical case report sets the chapter’s content into context.
Family Therapy for NSSI
Authors: Baetens Imke , Van Hove Lisa , Buelens Tinne
Published: September 2023

Over the past few decades, an increasing number of researchers have studied the treatment of nonsuicidal self-injury (NSSI) in adolescent and adult samples in both clinical and nonclinical settings. Various scholars have emphasized the importance of a motivated family, satisfactory attachment relationships, and family support in obtaining a desirable NSSI treatment outcome. Also, several forms of family-based/systemic therapies, hereinafter identified as family therapy (FT), have shown relative efficacy for the treatment of NSSI (and broader self-injurious thoughts and behaviors). Therefore, the current chapter presents an overview of the available methods and evidence for using family-based approaches (e.g., attachment-based family therapy, emotionally focused family therapy) to treat NSSI. The chapter includes guidelines for FT based on both common elements for psychotherapy (e.g., countertransference) and FT elements (e.g., addressing attachment ruptures and supporting parents or caregivers suffering from secondary stress). Challenges and future directions for clinical practice and research on FT and NSSI are discussed in the concluding paragraph, stressing the need for more tailored interventions and critical view on outcome measurements.
The Epidemiology of Nonsuicidal Self-Injury and Self-Harm in Nonclinical Samples
Authors: Staring Louise , Kiekens Glenn , Kirtley Olivia J.
Published: September 2023

This chapter evaluates current and emerging knowledge about the epidemiology of nonsuicidal self-injury (NSSI) and self-harm in nonclinical populations. It begins by discussing epidemiological patterns of NSSI and self-harm, including global prevalence rates across different age groups, the onset, and course, as well as cohort effects. The chapter then summarizes research on sociodemographic correlates and risk factors, including sex, ethnicity and race, and socioeconomic status. It also looks at the correlates of NSSI and self-harm in low- and middle-income countries. Moreover, the chapter assesses whether rates of NSSI and self-harm have increased more recently due to the COVID-19 pandemic. Finally, it considers challenges, recommendations, and future directions to advance research on the epidemiology of NSSI and self-harm.
Supervised Consumption Services
Authors: Bowles Jeanette , Thumath Meaghan , Kolla Gillian , Dodd Zoë , Arredondo Sanchez Lira Jaime , Crichlow Frank , Beletsky Leo
Published: September 2023

Supervised consumption services (SCS) are spaces where people who use drugs can consume pre-obtained drugs under the guidance of personnel trained to mitigate drug-related health harms and provide wraparound services. First developed during the HIV/AIDS crisis, SCS have gained prominence as an instrument of preventing overdoses and bloodborne disease transmission in locales with high prevalence of public drug injection. Globally, there are now over 120 sanctioned SCS across 13 countries, operating under varying degrees of legal authorization. In addition to reducing overdose deaths and HIV transmission, SCS have been shown to prevent soft tissue infections, link clients to needed medical and social services, facilitate substance use treatment uptake, reduce public drug consumption, and reduce improperly discarded injection equipment. Despite a robust evidence base of positive health and public safety impact, SCS remain controversial and under-used.
A New Future for Cultural Union Workers?
Authors: Shane Rachel , Austin Josh
Published: September 2023

This chapter explores the historical and contemporary circumstances impacting theatrical employment for actors in the United States. Utilizing a theoretical framework of collective action, social identity, and punctuated equilibrium, the research examines the behaviors and values of both a cultural union and its membership. The global pandemic in 2020 caused a significant shift within the theatrical industry, and it is possible that the field may transform significantly. The research indicates a major revision of the purpose and role of a cultural union from a union leadership perspective. Yet the question remains whether actors will adopt the same outlook for the future.
Electrophysiological Methods
Authors: Sprouse Jon , Almeida Diogo
Published: September 2023

This chapter explores the potential value of electrophysiological measures like electroencephalography (EEG) and magnetoencephalography (MEG) for experimental syntax. Our view is that applying M/EEG research in syntax is high-risk/high-reward: if one believes that cognition is mediated by electrical activity in the cortex, and if one believes that syntactic theories are ultimately theories of cognition, then M/EEG is a potential source of information about syntax. Our goal in this chapter is to introduce syntacticians to the fundamentals of M/EEG so that they can decide if the risk/reward ratio is worth it in their own research. We begin by introducing the three content areas necessary to understand M/EEG methods: the basics of electricity, the neurobiology underlying scalp potentials, and the math necessary to extract useful information from the signal. We briefly review some of the ERP and time-frequency results in the sentence processing literature, in order to provide a foundation for thinking about ways to leverage M/EEG results in service of syntax. And we discuss several recent studies that have attempted to directly link syntactic theories with sentence processing and M/EEG measures.
Aphasia and Syntax
Authors: Matchin William , Rogalsky Corianne
Published: September 2023

There is great potential for research in aphasia to inform the study of syntax, and vice versa. However, there is currently little interaction between these fields. This chapter outlines current methods in aphasia research and their application to syntax. Then, a brief history of the interaction of these two fields is presented, particularly the successes and failures in understanding the nature of syntactic deficits in agrammatism. In light of the failures, we propose splitting agrammatism into at least two separate syndromes: deficits in phonological working memory (WM) and deficits in morpho-syntactic WM. This dichotomization captures both apparent domain-general and language-specific features of agrammatism. We then suggest future steps to reconnect syntactic theory to the study of aphasia.
Acceptability Judgements of Binding and Coreference
Authors: Kaiser Elsi , Runner Jeffrey
Published: September 2023

Constraints on binding/coreference are a key component of syntactic theory. However, collecting reliable and interpretable acceptability judgments of binding and coreference in an experimental setting requires a distinct methodology from standard acceptability judgments. This is because the researcher needs to ensure that participants are considering the intended coreference pattern when assessing acceptability. This chapter provides guidance for designing experiments to be used with non-linguistically-trained adult native speaker participants to assess the acceptability of different binding/coreference configurations. The chapter covers issues such as how to ensure participants are considering the intended interpretation, how participants provide their responses (binary choices, multi-point scales, etc.), and how other tasks can complement acceptability-based methods.
Regional Book and Print Trades
Authors: Stenner Rachel
Published: September 2023

This chapter narrates the development of the regional book and print trades in England in the early modern period. It has a particular focus on newspaper publishing. The chapter first argues that ‘regional’ is a preferable term to ‘provincial’ when discussing the trades outside London. The chapter then surveys the existing scholarship and outlines the institutional and legislative factors governing the trades. Finally, the chapter presents three short case studies of particular locations: Oxford, York, and Newcastle. For each case study, the chapter traces the unique historical factors influencing that location’s development as a centre for book and print production.
Printing and the Universities
Authors: Peacey Jason
Published: September 2023

This essay traces continuity and change—as well as both visionary thinking and pragmatic experimentation—in relation to the development of learned printing in Oxford and Cambridge. In tracing the ambitions and the challenges that were involved in bringing English printing up to European standards, it explores evidence of the financial, logistical, and administrative dimensions of the print industry, as well as the status and skills of university printers over successive generations. It also situates university printing within the wider context of the English book trade, in terms of both government regulation and fraught relations with the Stationers’ Company. Ultimately, it uses rich surviving documentation regarding the mechanics of printing in order to show how both institutions navigated political constraints and legal controversies, and how, amid considerable wrangling, progress was slowly made towards a situation in which it was possible to produce scholarly editions of remarkably high quality.
The Early Modern Book as Metaphor
Authors: Dolven Jeff
Published: September 2023

No object, save the human body itself, is as generous with figurative possibility as a book. Its metaphorical affordances in the sixteenth and seventeenth centuries begin with the durable features of the codex’s physiology, pages, binding, spine, but equally exploit the changing technologies of printing and the circumstances of the marketplace. This essay canvasses a range of persons and things that were said to be books: bodies, memories, worlds, prophecies, food, drink, commodities, buildings, friends, children. The principal protagonists are Edmund Spenser (a book fantasist: the books in his book are unlike his own book) and Ben Jonson (a book realist: he writes about books like his own). Across these diverse materials the story is told of a historical shift from authorial identification with the capacity of style, to identification with the achievement of a book.
Printing and Book History
Authors: Franklin Alexandra , Lawrence Richard
Published: September 2023

Practical experience of printing is one tool for teaching the early modern book. Haptic learning opens insights into the book as a material object. The aim of such teaching has been to make tangible the dynamics of the creative process and to recapture the point of view of the mostly anonymous craftspeople whose skills and labour contributed to the finished book. The practical exercise of a craft within an academic field of study also prompts us to consider the aesthetic qualities of books not as critics but from the perspective of the makers. This chapter recommends basic materials and equipment as well as exercises to illustrate key points in teaching about the early modern book. It also provides a background to, and a very short history of, practical printing as part of bibliographical and book-historical teaching.
Smooth Elongation of Pavement Cells Induced by RIC1 Overexpression Leads to Marginal Protrusions of the Cotyledon in Arabidopsis thaliana
Authors: Kikukawa Kotomi , Takigawa-Imamura Hisako , Soga Kouichi , Kotake Toshihisa , Higaki Takumi
Published: September 2023

The interdigitated pavement cell shape is suggested to be mechanically rational at both the cellular and tissue levels, but the biological significance of the cell shape is not fully understood. In this study, we explored the potential importance of the jigsaw puzzle-like cell shape for cotyledon morphogenesis in Arabidopsis. We used a transgenic line overexpressing a Rho-like GTPase-interacting protein, ROP-INTERACTIVE CRIB MOTIF-CONTAINING PROTEIN 1 (RIC1), which causes simple elongation of pavement cells. Computer-assisted microscopic analyses, including virtual reality observation, revealed that RIC1 overexpression resulted in abnormal cotyledon shapes with marginal protrusions, suggesting that the abnormal organ shape might be explained by changes in the pavement cell shape. Microscopic, biochemical and mechanical observations indicated that the pavement cell deformation might be due to reduction in the cell wall cellulose content with alteration of cortical microtubule organization. To examine our hypothesis that simple elongation of pavement cells leads to an abnormal shape with marginal protrusion of the cotyledon, we developed a mathematical model that examines the impact of planar cell growth geometry on the morphogenesis of the organ that is an assemblage of the cells. Computer simulations supported experimental observations that elongated pavement cells resulted in an irregular cotyledon shape, suggesting that marginal protrusions were due to local growth variation possibly caused by stochastic bias in the direction of cell elongation cannot be explained only by polarity-based cell elongation, but that an organ-level regulatory mechanism is required.
The Brexit Vote, Productivity Growth, and Macroeconomic Adjustments in the U.K.
Authors: Broadbent Ben , Di Pace Federico , Drechsel Thomas , Harrison Richard , Tenreyro Silvana
Published: September 2023

The U.K. economy experienced significant macroeconomic adjustments following the 2016 referendum on its withdrawal from the European Union. To understand these adjustments, this paper presents empirical facts using novel U.K. macroeconomic data and estimates a small open economy model with tradable and non-tradable sectors. We demonstrate that the referendum outcome can be interpreted as news about a future decline in productivity growth in the tradable sector. An immediate fall in the relative price of non-tradable goods induces a temporary “sweet spot” for tradable producers. Economic activity in the tradable sector expands in the short run, while the non-tradable sector contracts. Aggregate output, consumption, and investment growth decelerate.
Electron paramagnetic resonance dose measurements in teeth of tissue donors to the United States Transuranium and Uranium Registries
Authors: Romanyukha A , Tolmachev S Y
Published: September 2023

The United States Transuranium and Uranium Registries (USTUR) is a research program that studies actinide biokinetics in occupationally exposed individuals with known intakes of these elements. Electron paramagnetic resonance (EPR) in tooth enamel was applied to reconstruct external doses of nine USTUR registrants. Only in two cases there is a reasonable agreement between the EPR-measured dose and the worksite external dose record. For two registrants, high EPR doses can be explained by possible cancer radiotherapy. For the remaining five cases, EPR doses significantly exceed official occupational doses with no plausible explanation for the observed discrepancy. More EPR dose measurements need to be done to explain this anomaly.
Radiation exposure determination in a secure, cloud-based online environment
Authors: Shirley Ben C , Mucaki Eliseos J , Knoll Joan H M , Rogan Peter K
Published: September 2023

Rapid sample processing and interpretation of estimated exposures will be critical for triaging exposed individuals after a major radiation incident. The dicentric chromosome (DC) assay assesses absorbed radiation using metaphase cells from blood. The Automated Dicentric Chromosome Identifier and Dose Estimator System (ADCI) identifies DCs and determines radiation doses. This study aimed to broaden accessibility and speed of this system, while protecting data and software integrity. ADCI Online is a secure web-streaming platform accessible worldwide from local servers. Cloud-based systems containing data and software are separated until they are linked for radiation exposure estimation. Dose estimates are identical to ADCI on dedicated computer hardware. Image processing and selection, calibration curve generation, and dose estimation of 9 test samples completed in < 2 days. ADCI Online has the capacity to alleviate analytic bottlenecks in intermediate-to-large radiation incidents. Multiple cloned software instances configured on different cloud environments accelerated dose estimation to within clinically relevant time frames.
Improvement of neutron sensitivity for lithium formate EPR dosemeters: a Monte Carlo analysis
Authors: D’Oca Maria Cristina , Collura Giorgio , Gagliardo Cesare , Bartolotta Antonio , Romeo Mattia , d’Errico Francesco , Marrale Maurizio
Published: September 2023

This work presents the computational analysis of the sensitivity improvements that could be achieved in lithium formate monohydrate (LFM) electron paramagnetic resonance (EPR) dosemeters exposed to neutron beams. Monte Carlo (MC) simulations were performed on LFM pellets exposed to neutron beams with different energy spectra at various depths inside a water phantom. Various computations were carried out by considering different enrichments of 6Li inside the LFM matrix as well as addition of different amounts of gadolinium oxide inside the pellet blend. The energy released per unit mass was calculated with the aim of predicting the increase in dose achievable by the addition of sensitizers inside the pellets. As expected, a larger amount of 6Li induces an increase of energy released because of the charged secondary particles (i.e. 3H ions and α-particles) produced after neutron capture. For small depths in water phantom and low-energy neutron spectra the dose increase due to 6Li enrichment is high (more than three orders of magnitude with respect to the case of with 7Li). In case of epithermal neutron beams the energy released in 6Li-enriched LFM compound is smaller but larger than in the case of fast neutron beams. On the other hand, the computational analysis evidenced that gadolinium is less effective than 6Li in improving neutron sensitivity of the LFM pellets. Discussion based on the features of MC transport code is provided. This result suggests that 6Li enrichment of LFM dosemeters would be more effective for neutron sensitivity improvement and these EPR dosemeters could be tested for dosimetric applications in Neutron Capture Therapy.
Investigation of the provenance of Okinose sand using ESR signals of quartz in granite and granodiorite around Osaka Bay
Authors: Kobayashi Ryo , Kojima Hibiki , Tani Atsushi
Published: September 2023

A submarine dune on the seabed in the Okinose area of Osaka Bay, Japan, was found to be composed mainly of coarse quartz sand. To investigate the provenance of this sand, quartz extracted from granite and granodiorite sources near Osaka Bay was measured by electron spin resonance; E1′, Ti-Li and Al centres were detected in all samples. Although the heat-treated E1′ centre was found not to be useful for the present provenance study, the ratio of the signal intensities of the Ti-Li centre to the Al centre classified the potential sources into two groups, based on their likelihood. The results indicated that granite and granodiorite from Awaji Island as well as Rokko granite could be the source of the Okinose sand.
The implementation of artificial intelligence to the low-cost metaphase finder
Authors: Furukawa Akira
Published: September 2023

Biological dosimetry is used to estimate one’s dose by biological phenomena. The most popular and ‘gold standard’ phenomenon is the appearance of dicentric chromosomes in metaphases. The metaphase finder is a tool for biological dosimetry that finds metaphase cells on glass slides. It consists of an automated microscope, auto-focus system, X-Y stage, camera and computer. It does the image analysis of the microscopic images of the glass slides and displays the positions of metaphase cells. In this paper, the author reported that the prototype of AI-implemented metaphase finder was combined with the microscope system by file sharing and image transfer program, and that the metaphase finder system’s accuracy was compared with previous non-AI system, using the same samples.
Estimation of external dose for wild Japanese macaques captured in Fukushima prefecture: decomposition of electron spin resonance spectrum
Authors: Mitsuyasu Yusuke , Oka Toshitaka , Takahashi Atsushi , Kino Yasushi , Okutsu Kenichi , Sekine Tsutomu , Yamashita Takuma , Shimizu Yoshinaka , Chiba Mirei , Suzuki Toshihiko , Osaka Ken , Sasaki Keiichi , Suzuki Masatoshi , Fukumoto Manabu , Shinoda Hisashi
Published: September 2023

The signal intensities of CO2− radicals in teeth can be utilised as an individual indicator of the cumulative external dose for animals. To accurately determine the external dose, it is desirable to analyse the CO2− radical intensity and improve its detection limit. We recently reported a dose–response in the range of 0–200 mGy and estimated the absorbed dose for seven wild Japanese macaques captured in/around the related areas to the Fukushima Daiichi Nuclear Power Plant accident. Herein, for further improvement of this method, we examined the electron spin resonance spectra of the teeth of these seven and an additional four macaques captured in Fukushima by applying two spectrum-decomposition algorithms.
Transcription Factor TCF3 Promotes Macrophage-Mediated Inflammation and MMP Secretion in Abdominal Aortic Aneurysm by Regulating miR-143-5p/CCL20
Authors: Li Yuejin , Li Rougang , Li Yu , Li Guosan , Zhao Yiman , Mou Houyu , Chen Yi , Xiao Le , Gong Kunmei
Published: September 2023

Damage to the abdominal aortic wall and the local inflammatory response are key factors resulting in abdominal aortic aneurysm (AAA) formation. During this process, macrophage polarization plays a key role. However, in AAA, the regulatory mechanism of macrophages is still unclear, and further research is needed. In this study, we found that the transcription factor TCF3 was expressed at low levels in AAA. We overexpressed TCF3 and found that TCF3 could inhibit MMP and inflammatory factor expression and promote M2 macrophage polarization, thereby inhibiting the progression of AAA. Knocking down TCF3 could promote M1 polarization and MMP and inflammatory factor expression. In addition, we found that TCF3 increased miR-143-5p expression through transcriptional activation of miR-143-5p, which further inhibited expression of the downstream chemokine CCL20 and promoted M2 macrophage polarization. Our research indicates that TCF3-mediated macrophage polarization plays a key regulatory role in AAA, complementing the role and mechanism of macrophages in the occurrence and development of AAA and providing a scientific basis for AAA treatment.
Anaplastic Large Cell Lymphoma With Intraocular or Ocular Adnexal Involvement: A Case Report and Systematic Review
Authors: Rafizadeh Seyed Mohsen , Ghahvehchian Hossein , Rajabi Mohammad Taher , Heidari Mostafa , Rahmanikhah Elaham
Published: September 2023

Purpose:

To review the existing literature on patients with anaplastic large cell lymphoma (ALCL) affecting the globe and/or ocular adnexa, and to present a report documenting the clinical course of a patient with ALCL that involved their globe and ocular adnexa.

Methods:

PubMed, Scopus, and Google scholar were systematically searched for all cases of ALCL involving intraocular or adnexal ocular structures from inception to May 2023. Moreover, a new reported case added to the cases found in searches.

Results:

The review identified 1680 studies, with 8 meeting inclusion criteria. A total of 9 patients were included with a mean age of 29.7 years (median: 30.0, range: 1.3–48). Primary ALCL was present in 5/9 (55.6%) patients. The most common ophthalmic manifestations included periorbital swelling (5/8), chemosis (5.8), and decreased vision (5/7). Misdiagnoses were initially made in 3 patients, and the lag time to correct diagnosis from 3 weeks to 3 months. CD30 expression was positive in all cases, and 6/9 patients were positive for anaplastic lymphoma kinase, resulting in 6/9 patients being diagnosed with anaplastic lymphoma kinase-positive ALCL. In terms of management modalities, chemotherapy was administered in 8/9 patients, while radiation therapy was utilized in 4/9 patients, and 2 underwent autologous stem cell transplantation. Five (55.6%) patients succumbed to ALCL while 4 (44.4%) were alive and disease-free at the last follow-up. The median times from the initial presentation of ALCL to death, ophthalmic presentation to death, and diagnosis to death were 4.12 months (range: 1.1–168.0), 2.62 months (range: 1.1–144), and 4.00 months (range: 0.10–168), respectively. The median follow-up duration was 21.0 months (range: 1.1–168.0).

Conclusions:

ALCL involving the globe and ocular adnexa is a rare and highly malignant tumor that can mimic benign clinical conditions. Early biopsy and aggressive treatment with chemotherapy regimens such as CHOP and radiation therapy may be useful.
Bilateral Dilated Superior Ophthalmic Veins in a Patient With an Arteriovenous Dialysis Fistula
Authors: Schultz Hannah , Bacorn Colin , Cristiano Brian C. , Carey Andrew R. , Carper Michael G. , Gailloud Philippe , Miller Neil R. , Campbell Ashley A.
Published: September 2023

A 64-year-old man presented with 4 months of diplopia. He had end-stage renal disease requiring a cephalic transposition brachiocephalic fistula that was no longer in use following successful renal transplantation. On presentation, he had bilateral proptosis, extraocular movement restriction, chemosis, tortuous episcleral vessels, and caruncular injection. Non-contrast CT of the orbits demonstrated dilation of both superior ophthalmic veins, and CT angiography showed asymmetric enlargement of both cavernous sinuses and superior ophthalmic veins. A carotid-cavernous fistula was suspected, but cerebral angiography revealed shunting from the old fistula with intracranial drainage and cerebral venous hypertension. Aberrant retrograde drainage resulted from anatomical compression of the left brachiocephalic vein. The fistula was ligated, and at 1-week follow-up, the patient had marked improvement in extraocular movements and orbital congestion with near complete resolution of diplopia. Postoperative CT angiography obtained 2 months later demonstrated decreased size of both superior ophthalmic veins, consistent with improvement of venous hypertension.
Clinical outcomes of conversion surgery following immune checkpoint inhibitors and chemotherapy in stage IV gastric cancer
Authors: Liang Huayuan , Yan Xiao , Chen Xinhua , Li Zhiwei , Qiu Yaopeng , Li Fengping , Wang Minghao , Huang Zhicheng , Huang Kaihua , Xie Qing , Zhang Huimin , Li Guoxin , Liu Hao , Zhao Liying
Published: September 2023

Background:

The clinical benefit of conversion surgery following immunochemotherapy in patients with stage IV gastric cancer (GC) remains uncertain. This study aims to clarify the clinical outcomes of conversion surgery for such patients.

Methods:

This retrospective cohort study enrolled consecutive patients with stage IV GC treated with a combination of immune checkpoint inhibitors (ICIs) and chemotherapy and/or anti-HER2 targeted therapy as first-line therapy. Cumulative survival curves were estimated using Kaplan-Meier method. Logistic regression and Cox regression analyses were conducted to identify factors associated with conversion surgery and survival, respectively.

Results:

Among the 136 patients included in the study. The disease control rate was 72.1% (98/136), with objective response rate in 58.8% (80/136) and complete response rate in 5.9% (8/136). Among 98 patients with disease control, 56 patients underwent palliative immunochemotherapy with median PFS and OS at 9.2 and 16.2 months, respectively; the remaining 42 patients underwent conversion surgery, yielding an unreached median PFS over a 19.0-month median follow-up, accompanied by one-year OS and PFS rates of 96.6% and 89.1%, respectively. The R0 resection rate reached 90.5% (38/42). 7 out of 42 patients achieved pathological complete response, of whom 3 patients demonstrated HER2 positivity. No serious complications leading to death were observed during the perioperative period. Multivariate analysis indicated that PD-L1 CPS ≥5 (odds ratio, 0.22; 95% CI, 0.08-0.57; P=0.002) favored successful conversion surgery, while signet ring cell carcinoma (hazard ratio, 6.29; 95% CI, 1.56–25.36; P=0.010) was the poor prognostic factor associated with survival in patients who underwent conversion surgery.

Conclusions:

Conversion surgery holds the potential for significant survival benefits in stage IV GC patients who have achieved a favorable clinical response to immunochemotherapy. Individuals with signet ring cell carcinoma may experience increased post-conversion surgery recurrence.
Long-term outcomes of microsurgery and stereotactic radiosurgery as the first-line treatment for arteriovenous malformations: A propensity score-matched analysis using nationwide multicenter prospective registry data
Authors: Han Heze , Gao Dezhi , Ma Li , Li Ruinan , Li Zhipeng , Zhang Haibin , Yuan Kexin , Wang Ke , Zhang Yukun , Zhao Yang , Jin Weitao , Jin Hengwei , Meng Xiangyu , Yan Debin , Li Runting , Lin Fa , Hao Qiang , Wang Hao , Ye Xun , Kang Shuai , Pu Jun , Shi Zhiyong , Chao Xiaofeng , Lin Zhengfeng , Lu Junlin , Li Youxiang , Zhao Yuanli , Sun Shibin , Chen Yu , Chen Xiaolin , Wang Shuo ,   on behalf of Registry of Multimodality Treatment for Brain Arteriovenous Malformation in Mainland China (MATCH)
Published: September 2023

Background:

This study aimed to compare the risk and benefit profile of microsurgery (MS) and stereotactic radiosurgery (SRS) as the first-line treatment for unruptured and ruptured arteriovenous malformations (AVMs).

Materials and Methods:

We included AVMs underwent MS or SRS as the first-line treatment from a nationwide prospective multicenter registry in *BLINDED*. We used propensity score-matched methods to balance baseline characteristics between MS and SRS groups. The primary outcomes were long-term hemorrhagic stroke or death, and the secondary outcomes were long-term obliteration and neurological outcomes. Subgroup analyses and sensitivity analyses with different study designs were performed to confirm the stability of our findings.

Results:

Of 4286 consecutive AVMs in the registry from 2011.08 to 2021.12, 1604 patients were eligible. After matching, 244 unruptured and 442 ruptured AVMs remained for the final analysis. The mean follow-up duration was 7.0 years in the unruptured group and 6.1 years in the ruptured group. In the comparison of primary outcomes, SRS was associated with a higher risk of hemorrhagic stroke or death both in the unruptured and ruptured AVMs (unruptured: hazard ratio [HR] 4.06, 95%confidence interval [CI] 1.15-14.41; ruptured: HR 4.19, 95%CI 1.58-11.15). In terms of the secondary outcomes, SRS was also observed to have a significant disadvantage in long-term obliteration (unruptured: odds ratio [OR] 0.01, 95%CI 0.00-0.04; ruptured: OR 0.09, 95%CI 0.05-0.15). However, it should be noted that SRS may have advantages in preventing neurofunctional decline (unruptured: OR 0.56, 95%CI 0.27-1.14; ruptured: OR 0.41, 95%CI 0.23-0.76). Results of subgroup analyses and sensitivity analyses were consistent in trend but with slightly varied powers.

Conclusions:

This clinical practice-based real-world study comprehensively compared MS and SRS for AVMs with long-term outcomes. MS is more effective in preventing future hemorrhage or death and achieving obliteration, while the risk of neurofunctional decline should not be ignored.
The impacts of climate change, energy policy and traditional ecological practices on future firewood availability for Diné (Navajo) People
Authors: Magargal Kate , Wilson Kurt , Chee Shaniah , Campbell Michael J. , Bailey Vanessa , Dennison Philip E. , Anderegg William R. L. , Cachelin Adrienne , Brewer Simon , Codding Brian Frank
Published: September 2023

Local-scale human–environment relationships are fundamental to energy sovereignty, and in many contexts, Indigenous ecological knowledge (IEK) is integral to such relationships. For example, Tribal leaders in southwestern USA identify firewood harvested from local woodlands as vital. For Diné people, firewood is central to cultural and physical survival and offers a reliable fuel for energy embedded in local ecological systems. However, there are two acute problems: first, climate change-induced drought will diminish local sources of firewood; second, policies aimed at reducing reliance on greenhouse-gas-emitting energy sources may limit alternatives like coal for home use, thereby increasing firewood demand to unsustainable levels. We develop an agent-based model trained with ecological and community-generated ethnographic data to assess the future of firewood availability under varying climate, demand and IEK scenarios. We find that the long-term sustainability of Indigenous firewood harvesting is maximized under low-emissions and low-to-moderate demand scenarios when harvesters adhere to IEK guidance. Results show how Indigenous ecological practices and resulting ecological legacies maintain resilient socio-environmental systems. Insights offered focus on creating energy equity for Indigenous people and broad lessons about how Indigenous knowledge is integral for adapting to climate change.

This article is part of the theme issue ‘Climate change adaptation needs a science of culture’.
Efficiency traps beyond the climate crisis: exploration–exploitation trade-offs and rebound effects
Authors: Segovia-Martin Jose , Creutzig Felix , Winters James
Published: September 2023

Higher levels of economic activity are often accompanied by higher energy use and consumption of natural resources. As fossil fuels still account for 80% of the global energy mix, energy consumption remains closely linked to greenhouse gas (GHG) emissions and thus to climate change. Under the assumption of sufficiently elastic demand, this reality of global economic development based on permanent growth of economic activity, brings into play the Jevons Paradox, which hypothesises that increases in the efficiency of resource use leads to increases in resource consumption. Previous research on the rebound effects has limitations, including a lack of studies on the connection between reinforcement learning and environmental consequences. This paper develops a mathematical model and computer simulator to study the effects of micro-level exploration–exploitation strategies on efficiency, consumption and sustainability, considering different levels of direct and indirect rebound effects. Our model shows how optimal exploration–exploitation strategies for increasing efficiency can lead to unsustainable development patterns if they are not accompanied by demand reduction measures, which are essential for mitigating climate change. Moreover, our paper speaks to the broader issue of efficiency traps by highlighting how indirect rebound effects not only affect primary energy (PE) consumption and GHG emissions, but also resource consumption in other domains. By linking these issues together, our study sheds light on the complexities and interdependencies involved in achieving sustainable development goals.

This article is part of the theme issue ‘Climate change adaptation needs a science of culture’.
HAEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS AFTER INTRAVESICAL BCG ADMINISTRATION FOR BLADDER CANCER PRESENTING WITH MULTIORGAN FAILURE
Authors: Liatsos GD , Manousopoulou Georgia , Poulaki Aikaterini , Iliaki Agapi , Mariolis Ilias , Vassilopoulos Dimitrios
Published: September 2023

Bacillus Calmette-Guérin (BCG), is administered intravesically as an adjuvant immunotherapy for the treatment of non-muscle invasive bladder cancer. While mild non-infectious problems can occur in up to 85% of cases, significant local and systemic complications have been reported in 1-5% of cases. We report the case of a patient with superficial bladder cancer who developed multiorgan failure after intravesical BCG instillation including the kidney and liver with subsequent haemophagocytic lymphohistiocytosis. Our case illustrates the first reported combination of secondary haemophagocytic lymphohistiocytosis with severe renal and liver failure after BCG immunotherapy for bladder carcinoma. Treatment strategy is discussed.
Default mode network spatio-temporal electrophysiological signature and causal role in creativity
Authors: Bartoli E. , Devara E. , Dang H.Q. , Rabinovich R. , Mathura R.K. , Anand A. , Pascuzzi B.R. , Adkinson J. , Bijanki K.R. , Sheth S.A. , Shofty B.
Published: September 2023

The default mode network (DMN) is a widely distributed, intrinsic brain network thought to play a crucial role in internally-directed cognition. It subserves self-referential thinking, recollection of the past, mind wandering, and creativity. Knowledge about the electrophysiology underlying DMN activity is scarce, due to the difficulty to simultaneously record from multiple distant cortical areas with commonly-used techniques. The present study employs stereo-electroencephalography depth electrodes in 13 human patients undergoing monitoring for epilepsy, obtaining high spatiotemporal resolution neural recordings across multiple canonical DMN regions. Our results offer a rare insight into the temporal evolution and spatial origin of theta (4-8Hz) and gamma signals (30-70Hz) during two DMN-associated higher cognitive functions: mind-wandering and alternate uses. During the performance of these tasks, DMN activity is defined by a specific pattern of decreased theta coupled with increased gamma power. Critically, creativity and mind wandering engage the DMN with different dynamics: creativity recruits the DMN strongly during the covert search of ideas, while mind wandering displays the strongest modulation of DMN during the later recall of the train of thoughts. Theta band power modulations, predominantly occurring during mind wandering, do not show a predominant spatial origin within the DMN. In contrast, gamma power effects were similar for mind wandering and creativity and more strongly associated to lateral temporal nodes. Interfering with DMN activity through direct cortical stimulation within several DMN nodes caused a decrease in creativity, specifically reducing the originality of the alternate uses, without affecting creative fluency or mind wandering. These results suggest that DMN activity is flexibly modulated as a function of specific cognitive processes and supports its causal role in creative thinking. Our findings shed light on the neural constructs supporting creative cognition and provide causal evidence for the role of DMN in the generation of original connections among concepts.
A highly divergent SARS-CoV-2 lineage B.1.1 sample in a patient with long-term COVID-19
Authors: Nabieva Elena , Komissarov Andrey B. , Klink Galya V. , Zaitsev Stanislav V. , Sergeeva Maria , Fadeev Artem V. , Komissarova Kseniya , Ivanova Anna , Pisareva Maria , Kudrya Kira , Danilenko Daria , Lioznov Dmitry , Hisner Ryan , Gueli Federico , Peacock Thomas P. , Roemer Cornelius , Bazykin Georgii A.
Published: September 2023

We report the genomic analysis of a highly divergent SARS-CoV-2 sample obtained in October 2022 from an HIV+ patient with presumably long-term COVID-19 infection. Phylogenetic analysis indicates that the sample is characterized by a gain of 89 mutations since divergence from its nearest sequenced neighbor, which had been collected in September 2020 and belongs to the B.1.1 lineage, largely extinct in 2022. 33 of these mutations were coding and occurred in the Spike protein. Of these, 17 are lineage-defining in some of the variants of concern (VOCs) or are in sites where another mutation is lineage-defining in a variant of concern, and/or shown to be involved in antibody evasion, and/or detected in other cases of persistent COVID-19; these include some “usual suspects,” such as Spike:L452R, E484Q, K417T, Y453F, and N460K. Molecular clock analysis indicates that mutations in this lineage accumulated at an increased rate compared to the ancestral B.1.1 strain. This increase is driven by the accumulation of nonsynonymous mutations, for an average dN/dS value of 2.2, indicating strong positive selection during within-patient evolution. Additionally, there is reason to believe that the virus had persisted for at least some time in the gastrointestinal tract, as evidenced by the presence of mutations that are rare in the general population samples but common in samples from wastewater. Our analysis adds to the growing body of research on evolution of SARS-CoV-2 in chronically infected patients and its relationship to the emergence of variants of concern.