bluuebunny/crossref_metadata_2025 huggingface dataset:
The Intersectionality between Race, Ethnicity, and Residential-Level Socioeconomic Status in Disparities of Head and Neck Cancer Outcomes: A SEER Study
Authors: Karanth Shama D. , Akinyemiju Tomi , Walker Courtney J. , Yang Danting , Migliorati Cesar A. , Yoon Hyung-Suk , Hong Young-Rock , Washington Caretia J. , Lattimore Chayil , Fredenburg Kristianna M. , Braithwaite Dejana
Published: February 2023

Background:

Head and neck cancer (HNC) mortality differs by race, ethnicity, and socioeconomic status (SES). However, it is unclear whether the relationship between race/ethnicity and HNC-specific mortality varies according to the residence-level SES.

Methods:

Data from the Surveillance Epidemiology and End Results database included participants with primary HNC between 2006 and 2017 (followed through 2018) to assess the joint association of race/ethnicity and census-tract level SES Yost-index groups (quintiles) with all-cause and HNC-specific mortalities. Relative survival rates at 1, 5, and 10 years were calculated. Multivariable Cox proportional hazard regression models estimated hazard-ratios and 95% confidence intervals for all-cause mortality, and Fine-Gray subdistribution hazard models for HNC-specific mortality. Cumulative incidence curves for HNC-specific deaths were estimated.

Results:

76,095 patients were included in the analysis: 63.2% were <65 years, 73.4% male, and 11.3% non-Hispanic (NH) Black. Most patients (58.3%) were diagnosed at regional or distant stages and 20.6% died of HNC. The five-year relative survival rate increased with SES group, with 51.6% in the lowest SES group, and 74.1% in the highest SES group. NH-Black patients had higher risk of all-cause and HNC-specific mortality than NH-White patients, regardless of the SES group. NH-Asian/Pacific Islander and Hispanic patients had higher risk of HNC-specific mortality in some SES groups.

Conclusions:

NH-Black patients of all SES strata had significantly worse outcomes. Other factors, such as healthcare quality, may be associated with persistent disparities.

Impact:

The study highlights the persistence of significant racial disparities in HNC survival across socioeconomic categories. There is need to consider additional factors underlying these disparities.
Genomic and Transcriptomic Characteristics of Metastatic Thyroid Cancers with Exceptional Responses to Radioactive Iodine Therapy
Authors: Boucai Laura , Saqcena Mahesh , Kuo Fengshen , Grewal Ravinder K. , Socci Nicholas , Knauf Jeffrey A. , Krishnamoorthy Gnana P. , Ryder Mabel , Ho Alan L. , Ghossein Ronald A. , Morris Luc G.T. , Seshan Venkatraman , Fagin James A.
Published: February 2023

Purpose:

The determinants of response or resistance to radioiodine (RAI) are unknown. We aimed to identify genomic and transcriptomic factors associated with structural responses to RAI treatment of metastatic thyroid cancer, which occur infrequently, and to test whether high MAPK pathway output was associated with RAI refractoriness.

Experimental Design:

Exceptional response to RAI was defined as reduction of tumor volume based on RECIST v1.1. We performed a retrospective case–control study of genomic and transcriptomic characteristics of exceptional responders (ER; n = 8) versus nonresponders (NR; n = 16) matched by histologic type and stage at presentation on a 1:2 ratio.

Results:

ER are enriched for mutations that activate MAPK through RAF dimerization (RAS, class 2 BRAF, RTK fusions), whereas NR are associated with BRAFV600E, which signals as a monomer and is unresponsive to negative feedback. ER have a lower MAPK transcriptional output and a higher thyroid differentiation score (TDS) than NR (P < 0.05). NR are enriched for 1q-gain (P < 0.05) and mutations of genes regulating mRNA splicing and the PI3K pathway. BRAFV600E tumors with 1q-gain have a lower TDS than BRAFV600E/1q-quiet tumors and transcriptomic signatures associated with metastatic propensity.

Conclusions:

ER tumors have a lower MAPK output and higher TDS than NR, whereas NR have a high frequency of BRAFV600E and 1q-gain. Molecular profiling of thyroid cancers and further functional validation of the key findings discriminating ER from NR may help predict response to RAI therapy.
Tumor-independent Detection of Inherited Mismatch Repair Deficiency for the Diagnosis of Lynch Syndrome with High Specificity and Sensitivity
Authors: Kansikas Minttu , Vähätalo Laura , Kantelinen Jukka , Kasela Mariann , Putula Jaana , Døhlen Anni , Paloviita Pauliina , Kärkkäinen Emmi , Lahti Niklas , Arnez Philippe , Kilpinen Sami , Alcala-Repo Beatriz , Pylvänäinen Kirsi , Pöyhönen Minna , Peltomäki Päivi , Järvinen Heikki J. , Seppälä Toni T. , Renkonen-Sinisalo Laura , Lepistö Anna , Mecklin Jukka-Pekka , Nyström Minna
Published: February 2023

Lynch syndrome (LS) is the most common hereditary cancer syndrome. Early diagnosis improves prognosis and reduces health care costs, through existing cancer surveillance methods. The problem is finding and diagnosing the cancer predisposing genetic condition. The current workup involves a complex array of tests that combines family cancer history and clinical phenotypes with tumor characteristics and sequencing data, followed by a challenging task to interpret the found variant(s). On the basis of the knowledge that an inherited mismatch repair (MMR) deficiency is a hallmark of LS, we have developed and validated a functional MMR test, DiagMMR, that detects inherited MMR deficiency directly from healthy tissue without need of tumor and variant information. The validation included 119 skin biopsies collected from clinically pathogenic MMR variant carriers (MSH2, MSH6) and controls, and was followed by a small clinical pilot study. The repair reaction was performed on proteins extracted from primary fibroblasts and the interpretation was based on the MMR capability of the sample in relation to cutoff, which distinguishes MMR proficient (non-LS) from MMR deficient (LS) function. The results were compared with the reference standard (germline NGS). The test was shown to have exceptional specificity (100%) with high sensitivity (89%) and accuracy (97%). The ability to efficiently distinguish LS carriers from controls was further shown with a high area under the receiving operating characteristic (AUROC) value (0.97). This test offers an excellent tool for detecting inherited MMR deficiency linked to MSH2 or MSH6 and can be used alone or with conventional tests to recognize genetically predisposed individuals.

Significance:

Clinical validation of DiagMMR shows high accuracy in distinguishing individuals with hereditary MSH2 or MSH6 MMR deficiency (i.e., LS). The method presented overcomes challenges faced by the complexity of current methods and can be used alone or with conventional tests to improve the ability to recognize genetically predisposed individuals.
Associations between Early Thyroid-Stimulating Hormone Levels and Morbidities in Extremely Preterm Neonates
Authors: Chen Li-Wen , Chu Chi-Hsiang , Lin Yung-Chieh , Chen Hsiao-Jan , Kao Shu-Min , Huang Chao-Ching
Published: February 2023

Introduction: High-end cutoffs of thyroid-stimulating hormone (TSH) have been emphasized for hypothyroidism therapy in extremely preterm infants, but the significance of low TSH levels remains unknown. This study hypothesized that the spectrum of TSH levels by newborn screening after birth signifies specific morbidities in extremely preterm neonates. Methods: The multicenter population cohort analyzed 434 extremely preterm neonates receiving TSH screening at 24–96 h of age in 2008–2019. Neonates were categorized by blood TSH levels into group 1: TSH <0.5 µU/mL, group 2: 0.5 ≤ TSH <2 µU/mL, group 3: 2 ≤ TSH <4 µU/mL, and group 4: TSH ≥4 µU/mL. Neonatal morbidities were categorized using the modified Neonatal Therapeutic Intervention Scoring System. Results: The four groups differed in gestational age, birth weight, and the postnatal age at blood sampling so did the proportions of mechanical ventilation usage (p = 0.01), hypoxic respiratory failure (p = 0.005), high-grade intraventricular hemorrhage (p = 0.007), and periventricular leukomalacia (p = 0.048). Group 1 had higher severity scores for respiratory distress syndrome (RDS; effect size 0.39 [95% confidence interval [CI]: 0.18–0.59]) and brain injury (0.36 [0.15–0.57]) than group 2, which remained significant after adjusting for gestational age, birth weight, dopamine usage, and the postnatal age at TSH screening (RDS: mean + 0.45 points [95% CI: 0.11–0.79]; brain injury: +0.32 [0.11–0.54]). Conclusions: Low TSH levels in extremely preterm neonates are associated with severe RDS and brain injuries. Studies recruiting more neonates with complete thyroid function data are necessary to understand central-peripheral interactions of the hypothalamic-pituitary-thyroid axis.
Clinical Significance of Persistent Hematuria Degrees in Primary IgA Nephropathy: A Propensity Score-Matched Analysis of a 10-Year Follow-Up Cohort
Authors: Huang Ziyuan , Zhang Ji , Chen Bo , Li Duo , You Xiaohan , Zhou Yin , Qiu Wenxian , Ding Xiaokai , Chen Chaosheng
Published: February 2023

Introduction: The clinical significance of persistent hematuria degrees has not been expounded in primary IgA nephropathy (IgAN) and requires further research. Methods: From January 2003 to May 2022, a total of 684 IgAN patients with persistent hematuria were enrolled to conduct a retrospective single-center study. Patients whose hematuria degree at baseline was higher than the second tertiles of the whole were included in the high-degree hematuria cohort (Hh), and the low-degree hematuria cohort (Lh) was constructed with 1:1 matched cases from the rest according to age, gender, and estimated glomerular filtration rate (eGFR) at baseline and follow-up time. Survival was determined using the Kaplan-Meier method (K-M) and generalized linear mixed-effects model (GLMM). Risk factors for survival were determined according to the Cox proportional hazards model. Results: Both the Hh and Lh consisted of 228 cases. While the demographic data and the renal function at baseline were matched, both the K-M (p = 0.02) and GLMM (p = 0.04) proved that the prognosis of the Hh was significantly worse than that of the Lh within 10 years of follow-up. The higher persistent hematuria degree was an independent risk factor (3.93; 95% confidence interval, 1.33–11.6) associated with reaching the endpoint (eGFR decreased from the baseline ≥30% continuously or reached end-stage renal disease [ESRD]). The Hh had a significantly higher proportion of crescent (p = 0.003). The prognosis of the Hh was significantly worse than that of the Lh when accompanied by the crescent and presented an indistinct difference if the crescent was absent. Conclusions: The clinicopathologic manifestation of IgAN patients with persistent high-degree hematuria was severer, and the prognosis was worse than those with persistent low-degree hematuria.
Ferramenta físico-digital no auxílio ao co-design em ambientes de saúde: uma simulação exploratória
Authors: Graton Fernando Gargantini , Mandola Juliana Bambini , Imai César
Published: February 2023

Os Estabelecimentos Assistenciais de Saúde (EAS) são edifícios que passam por constantes revisões em seus projetos arquitetônicos com o objetivo de melhorar os aspectos de qualidade e segurança para os usuários finais destes ambientes. Uma forma de se estabelecer as mudanças estruturais necessárias nos ambientes de saúde é o entendimento das relações entre os usuários e o ambiente construído, com base na atuação de suas funções e necessidades ambientais, uma vez que a participação dos usuários no processo de projeto pode trazer benefícios tanto para a satisfação do usuário como para o próprio desempenho dos edifícios. O uso de mockups de simulações virtuais tem apresentado grandes contribuições na análise e avaliação de projetos de ambientes de saúde por possibilitar a imersão do usuário no processo de concepção do projeto. Dessa forma, este artigo tem como objetivo verificar as potencialidades e limitações da utilização de uma ferramenta físico-digital para auxiliar na representação e comunicação no Co-Design, além de identificar as inconsistências da programação do software e do comportamento dos objetos virtuais. Foi realizado um teste de verificação por meio de uma simulação exploratória de viabilidade e usabilidade com a utilização de mockups virtuais, onde o foco estava nas análises de disposição de equipamentos e mobiliário de um ambiente de saúde. A ferramenta físico-digital demonstrada neste artigo ainda se encontra em fase de desenvolvimento e necessita de ajustes para a sua aplicação final junto aos usuários dos ambientes de saúde.
Aplicação dos requisitos de proteção passiva para o Cross Laminated Timber - CLT segundo a ABNT NBR 155575:2021
Authors: Felix Patricia Meira de Alcântara Costa , Ono Rosaria , Oliveira Fabiana Lopes de
Published: February 2023

O desenvolvimento de novos materiais e tecnologias na construção civil vêm contribuindo para a introdução de sistemas construtivos industrializados inovadores e um exemplo disso é o Cross Laminated Timber – CLT. No Brasil, já se tem vários exemplos de construções que adotaram este sistema, com tendência a aumentar, porém, para ser aplicado num mercado mais amplo, incluindo a faixa da construção para habitações baixa renda, os sistemas construtivos inovadores precisam ser avaliados e homologados com base nos padrões técnicos de desempenho mínimo estabelecidos no país. Para sistemas em estrutura de madeira ainda não há uma normativa nacional que trata da questão da segurança contra incêndio. Entretanto, com base nos requisitos estabelecidos da norma ABNT NBR 15575:2021, o comportamento ao fogo do CLT pode ser avaliado e os critérios tanto para o desenvolvimento do projeto como para o seu processo de fabricação nacional pode ser especificado, para sua melhor incorporação nas decisões projetuais. Este artigo apresenta uma análise de parâmetros existentes para a avaliação da segurança contra incêndio de sistemas construtivos em CLT, e propõe a aplicação de critérios para a avaliação de desempenho do CLT no Brasil, a fim de garantir a segurança aos usuários, tendo como recorte as edificações habitacionais unifamiliares, isoladas, geminadas ou sobrepostas, no âmbito nacional.
Sistema de customização em massa para a melhoria da qualidade projetual de ampliações de casas no contexto de HIS
Authors: Dalla Vecchia Luisa Rodrigues Félix
Published: February 2023

Esse trabalho propõe um sistema de customização em massa para o contexto de habitação de interesse social para as faixas de renda mais baixa dos programas habitacionais. Parte-se de estudos anteriores que analisaram este contexto em conjunto com as possibilidades da customização em massa. Este estudo utiliza a estrutura para customização em massa baseada em três atributos – desenvolvimento de espaço de soluções, design de processos robustos e navegação de escolhas – para desenvolver o sistema de customização em massa. Este trabalho argumenta que a diferenciação das casas deve acontecer pós-ocupação. Para tanto, estruturou-se processos e sistemas que permitem auxiliar as famílias em suas opções projetuais para que suas necessidades sejam atendidas, à medida que estas mudam ao longo do tempo, sem criar problemas para a cidade. Os processos propostos são vistos como uma estratégia para otimizar o uso de recursos para a melhoria dos ambientes das casas e da cidade. O sistema de customização em massa proposto tem potencial para ampliar o alcance das ações de assistência técnica, quanto ao projeto individual de reformas, permitindo atingir muitas famílias sem a necessidade de aumentar os recursos para tal fim na mesma proporção. Este sistema diferencia-se de outras estratégias de customização em massa para habitação por incluir os processos de pós-ocupação como parte da fabricação do produto customizado. Além disso, este trabalho mostra que é possível concentrar o objetivo da estratégia de customização em massa em benefícios mais amplos para a sociedade, além dos benefícios individuais.
Verticalização residencial em Londrina, PR: legislação urbana e potencial para outras tipologias
Authors: Dias Ricardo da Silva , Guadanhim Sidnei Junior
Published: February 2023

Em Londrina, PR é possível aumentar o potencial construtivo de empreendimentos verticais por meio da aplicação de uma fórmula prevista na lei de uso e ocupação do solo. Existe a possibilidade de reduzir a Taxa de Ocupação do pavimento tipo para a ampliação do Coeficiente de Aproveitamento. Os edifícios verticais são comuns em Londrina e, em muitos casos, ocupam grandes lotes com extensas áreas muradas que isolam os pavimentos térreos do espaço público, prejudicando a vitalidade do espaço urbano. Diante disso, o objetivo deste trabalho é verificar como a fórmula prevista em lei influencia na configuração dos edifícios, em especial no sentido da verticalização e também estudar o potencial para tipologias alternativas, mantendo parâmetros comuns adotados pelo mercado imobiliário. O método de levantamento e abordagem por cenários foi adotado para alcançar o objetivo. Como resultado, verificou-se que não há relação direta entre o dispositivo legal e a excessiva verticalização, pois os lotes estudados são de grande porte, dispensando a necessidade de reduzir a Taxa de Ocupação para obter aumento no Coeficiente de Aproveitamento. Por outro lado, constatou-se que, se a Taxa de Ocupação tender ao máximo permitido (de 40 a 50%), seria possível reduzir drasticamente a altura dos edifícios. As alternativas com menos pavimentos, associadas ao tratamento adequado entre lote e passeio público, muros e gradis, maior permeabilidade visual, diálogo entre espaços públicos e privados, fachadas ativas e variedade de públicos e de usos, incluindo atividades comerciais em áreas estratégicas, poderiam amenizar a negação da rua inerente ao modelo atual
Optimizing Prepregnancy Cardiovascular Health to Improve Outcomes in Pregnant and Postpartum Individuals and Offspring: A Scientific Statement From the American Heart Association
Authors: Khan Sadiya S. , Brewer LaPrincess C. , Canobbio Mary M. , Cipolla Marilyn J. , Grobman William A. , Lewey Jennifer , Michos Erin D. , Miller Eliza C. , Perak Amanda M. , Wei Gina S. , Gooding Holly ,   on behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Hypertension; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke Council
Published: February 2023

This scientific statement summarizes the available preclinical, epidemiological, and clinical trial evidence that supports the contributions of prepregnancy (and interpregnancy) cardiovascular health to risk of adverse pregnancy outcomes and cardiovascular disease in birthing individuals and offspring. Unfavorable cardiovascular health, as originally defined by the American Heart Association in 2010 and revised in 2022, is prevalent in reproductive-aged individuals. Significant disparities exist in ideal cardiovascular health by race and ethnicity, socioeconomic status, and geography. Because the biological processes leading to adverse pregnancy outcomes begin before conception, interventions focused only during pregnancy may have limited impact on both the pregnant individual and offspring. Therefore, focused attention on the prepregnancy period as a critical life period for optimization of cardiovascular health is needed. This scientific statement applies a life course and intergenerational framework to measure, modify, and monitor prepregnancy cardiovascular health. All clinicians who interact with pregnancy-capable individuals can emphasize optimization of cardiovascular health beginning early in childhood. Clinical trials are needed to investigate prepregnancy interventions to comprehensively target cardiovascular health. Beyond individual-level interventions, community-level interventions must include and engage key stakeholders (eg, community leaders, birthing individuals, families) and target a broad range of antecedent psychosocial and social determinants. In addition, policy-level changes are needed to dismantle structural racism and to improve equitable and high-quality health care delivery because many reproductive-aged individuals have inadequate, fragmented health care before and after pregnancy and between pregnancies (interpregnancy). Leveraging these opportunities to target cardiovascular health has the potential to improve health across the life course and for subsequent generations.
Passiflora brauliensis, a new species of Passiflora supersection Laurifoliae (Passifloraceae) from the volcanic forest of Costa Rica
Authors: KUETHE J.R. , RODRÍGUEZ-BARBOZA GARED , ÁLVAREZ-ALCÁZAR LEONARDO
Published: February 2023

A new species from Costa Rica is described following a closer analysis of the Passiflora nitida complex. Given that the actual true identification of Passiflora nitida typified from Venezuela but distributed throughout South America was rather poorly constrained, the new species presented here was long identified incorrectly as supposedly being a form of P. nitida, for it sharing several floral characteristics. Following intense revision of the source literature, supplemented by fieldwork across Central America, the Costa Rican accessions of “Passiflora nitida” appeared to be significantly different from its South American counterpart in several morphological and habitational characteristics. While it was found that true Passiflora nitida only inhabits non-volcanic terrains, Passiflora brauliensis sp. nov. presented in this paper attributes to be the only member of this complex endemic to solely volcanic regions, where it is found in wet lowland to premontane transitional forest on the eastern flanks of Costa Rica’s most active volcanoes. The ecology, distribution, and association with the Passiflora nitida complex is highlighted, as well as its relationship with the other species within Passiflora supersect. Laurifoliae found throughout Latin America.
Lectotypification of Muscari heldreichii (Asparagaceae) from Greece
Authors: BÖHNERT TIM , LOBIN WOLFRAM
Published: February 2023

The genus Muscari Miller (1754: 926; Asparagaceae) comprises about 80 species (Böhnert et al. 2023) of mainly spring-flowering geophytes and, like many other genera in the Mediterranean, it has a long and turbulent taxonomic history (Garbari & Greuter 1970, Davis & Stuart 1980, Speta 1982). The most recent attempt to formalize the generic boundaries was made by using genome-wide single nucleotide polymorphism data resulting in a comprehensive generic treatment in its widest sense that accepts five subgenera, of which one is described as new (Böhnert et al. 2023). The genus in its current circumscription sensu Böhnert et al. (2023) is mainly distributed in the Mediterranean region, but reaches as far as temperate Europe in the west to Afghanistan in the east (Davis & Stuart 1980, Breckle & Rafiqpoor 2010), while Turkey and Greece must be regarded as centres of species diversity for the genus (Davis & Stuart 1984, Dimopoulos et al. 2013, Böhnert & Lobin 2017). Several species have attracted horticultural attention for centuries and subsequently many species have been described from cultivation, which led to a complex taxonomic situation, and several taxonomic names still remain without typification.
Diagnose of the nominal subgenus of Edessa and description
of the E. sexdens group (Heteroptera, Pentatomidae, Edessinae)
Authors: MENDONÇA MARIA THAYANE DA SILVA , SILVA VALÉRIA JULIETE DA , FERNANDES JOSÉ ANTÔNIO MARIN
Published: February 2023

The subgenus Edessa, the largest and to date the most confusing taxon of Edessa is diagnosed here, comprising 79 species listed in this work. The subgenus is characterized by the humeral angles conical, somewhat developed, and projected, with apex rounded or somewhat acuminated, but never acute, shyny and impunctate or with a few punctures. The E. sexdens group, composed of 22 species, is proposed here to the subgenus Edessa. This group can be characterized by the anterior arms of the metasternal process with excavated apex; connexival segments with a pair of dark spots; ventral side of the abdomen raised medially; rounded shallow excavation near each spiracle; area between dorsal rim of the pygophore and posterolateral angles grooved; superior process of the genital cup laminar and continued ventrally by a carina, oblique to the parameres; parameres with three lobes; area between dorsal rim of the pygophore and posterolateral angles grooved. The species of the E. sexdens group are distributed in the Neotropical region, from Mexico to Argentina. Descriptions, measurements, and illustrations are provided. An identification key and distributional map are presented. The species Edessa suturata Dallas, 1851 is considered junior synonym of E. alces Erichson, 1848; E. inclyta Walker, 1868, E. fuscidorsata Distant, 1881, and E. gnu Breddin, 1905 are considered junior synonyms of E. electa Walker, 1868; E. olivacea Stål, 1862 and E. ventralis Walker, 1868 are considered junior synonym of E. phoenicopus Dallas, 1851; E. nigromarginata Distant, 1881 is considered junior synonym of E. sexdens Fabricius, 1803; E. subandina Breddin, 1994 is considered a valid species; Edessa dentata (Dallas, 1851) and Edessa excellens (Walker, 1868) are considered junior synonym of E. (E.) urus Erichson, 1848.
An Exploratory Study: Undergraduates’ Perspectives on how Threshold Concepts Influence Professional Identity
Authors: O’Mahony Shenae E. , Joosten Annette V. , O’Brien Jennifer
Published: February 2023

Background. Threshold concepts are key to professional identity development, transforming the way individuals think, act, and perceive the world. Purpose. To understand how occupational therapy students describe their professional identity, its importance, and how threshold concepts contribute to identity. Method. Mixed-method survey of final-year occupational therapy students ( n = 58) at an Australian University. Findings. (i) High agreement on most identity and threshold questions; but up to 24% uncertain about confidence/competence in understanding specific concepts; (ii) occupation-focus is unique to our professional identity; (ii) identity develops over time; (iii) occupation-based, client-centered, and evidence-based practices are central to thinking like and becoming an occupational therapist; and (iv) practice education provides context for threshold concepts to be transformative. Implications. Identity is defined by a focus on occupation and its relationship to health. Traversing threshold concepts through academic and practice education is essential to developing professional identity.
Comparing Chinese and EU trade agreement strategies: lessons for normative power Europe?
Authors: Sampson Michael , Theuns Tom
Published: February 2023

This article compares the EU and China’s approaches to negotiating free trade agreements (FTAs). We show how China’s approach is more gradualist with regards to coverage of issues, and argue that this gives China advantages, which it leverages in later deals. While there are important differences in the scope and approach of EU trade negotiations, we argue that the EU could gain similar advantages by incorporating more Chinese-style gradualism to how it negotiates FTAs. Paradoxically, we argue that mirroring Chinese strategy in this regard could be used by the EU to secure very different ends from China’s such as normative reforms in the areas of human rights, the rule of law, and democratic government. More gradualism would allow the EU to scale up trade cooperation and regulatory convergence in an incremental manner while autocratic partner countries make democratic reforms, and would also enlarge the scope of more coherent positive conditionality.
The Effect of Music Classes Conducted in Northern Cypriot Schools with the Kodály Approach on the Musical Development of Students: A Pilot Study
Authors: Soykunt Neriman , Çoban Sibel , Öztuğ Emine Kıvanç
Published: February 2023

The purpose of this research is to examine the effects of music classes conducted with the Kodály approach on the musical development of students. The research was carried out with the mixed method embedded design. The quantitative dimension of the research was carried out with the pre-test post-test control group experimental design, whereas, the case study comprises the qualitative dimension. The study group consisted of 24 experimental and 21 control group students. A lesson observation form, an aural skills test and an interview form were used to collect data in the study. The quantitative data was analyzed with SPSS 24.0, whereas the qualitative data was analyzed using the content analysis method. It was determined that the experimental group students were more successful than the control group students in their musical, rhythmic and melodic knowledge and skills. In addition, it is understood that the students found the classes conducted with the Kodály approach entertaining and instructive, and that the education in these classes was more comprehensible and more lasting with the use of Turkish Cypriot folk songs as a tool in music education in Northern Cypriot schools.
“Just Be White (JBW)”: Incels, Race and the Violence of Whiteness
Authors: Gheorghe Ruxandra M.
Published: February 2023

Largely operating online, incels are predominantly male individuals who are frustrated by their involuntary celibacy—their inability to get a romantic or sexual partner. Their worldview is grounded in hostile sexism largely directed at women and shared contempt for mainstream dating standards and feminism. Some incels posit that they can undertake specific racially-defined actions (i.e., skin bleaching, lying about one's ethnicity, cosmetic surgery) to increase their access to women by appearing more white and, hence, more desirable. By thematically analyzing 10 online incel forums on the topic of race, this research identifies the role of race as a sustaining facilitator of networked misogyny and white supremacy. Despite these racialized efforts to appear more white, many incels conclude that these efforts to change themselves are largely ineffective in increasing their access to women. Seeing as over half of incels seek counseling and social work services, this research puts forth several implications for social workers supporting incel clients and highlights the importance of understanding the role that race plays in incel clients’ rhetoric—not only in reproducing racism, but also in provoking violence-sustaining affects (e.g., anger, disappointment, resentment) that generate a shared sense of betrayal and reinforce gender-based violence.
Experimental investigation on effect of gas/spray interactions on transient diesel spray behaviors
Authors: Wang Zhijian , Li Yanfei , Li Zhijie , Wang Jingshan , Ma Xiao , Shuai Shijin
Published: February 2023

The ever-increasing rail pressure in diesel engines may cause the injection induced shock waves. In the present study, different gases (N2 and CO2) were used as the ambient mediums in order to understand the effect of shock waves induced by the high-speed jets on the near-field spray penetration. The tests were carried out in an optically-accessible constant volume vessel and a single-hole diesel injector was used. The injection pressure ( Pinj) ranged from 80 to 150 MPa and the ambient density ( ρambient) are 11.25, 22.52, and 33.81 kg/m3, respectively. Schlieren imaging was used to capture the shock waves ahead of the sprays with a frame speed of 100,000 fps and high-speed imaging was used to capture the spray penetration evolution with a frame speed of 300,000 fps in order to provide sufficient high temporal and spatial resolutions of the spray development. Shock waves can be observed under CO2 atmosphere over all the tested conditions and almost invisible under N2 atmosphere. The timings of occurrence and detachment of the shock waves are advanced with the increase in ρambient, but less sensitivity to Pinj. The difference in penetration lengths for N2 and CO2 atmosphere are not consistent as Pinj and ρambient varied, indicating the complicated role of shock waves in influencing the spray behaviors. Several mechanisms for the generation of shock waves were discussed, as well the physical meaning of the timing to the peak velocity of the spray tip with breakup time.
Qualia in late precolonial Pueblo rock art: An exploration of conventionalized sensorial experience in Rio Grande Style petroglyphs
Authors: Mattson Hannah
Published: February 2023

Although the application of semiotics to the archaeological study of rock art is not new, Peircean perspectives are still uncommon, and those implementing the concepts of qualisigns and qualia are only rarely employed. Yet, an approach centered on sensuous properties can serve as a valuable complement to other materiality- and landscape-based frameworks popular in contemporary rock art research. Using Ancestral Pueblo rock art from the Middle and Northern Rio Grande region of the U.S. Southwest as an example, I offer an archaeological narrative of how social values may be attached to conventionalized qualia rooted in sensorial experiences. Specifically, I examine how diverse media—rock art, shields, objects of adornment, and feathers—were connected through luminosity and security, culturally conceptualized qualitative properties that became formalized and enregistered in the context of new social institutions and modes of group conduct appearing during the 14th century CE.
The more the merrier? A network analysis of construct content validity in school leadership literature
Authors: Wang Yinying , Ahn Joonkil
Published: February 2023

School leadership research literature has a large number of widely used constructs. Could fewer constructs bring more clarity? This study evaluates construct content validity, defined as the extent to which a measure's items reflect a theoretical content domain, in school leadership literature. To do so, we reviewed 29 articles that used Teaching and Learning International Survey (TALIS) as data sources to study school leadership, and developed a construct co-occurrence network in which nodes represented constructs in the 29 reviewed articles and ties connected a pair of constructs that used the same TALIS survey items. Among the 82 constructs, 43 constructs had overlapping measures with one another in the TALIS literature on school leadership. Results of network analysis suggest three problematic issues with constructs of TALIS literature on school leadership: (1) same measures for different constructs, (2) different measures for the same constructs, and (3) missing alignment between theoretical and operational definitions. To strive for construct clarity, we provide four recommendations for future research: (1) efforts to prevent construct proliferation, (2) alignment of theoretical and operational definitions, (3) rigorous evaluation of construct validity, and (4) following a fundamental principle of parsimony.
In Vitro Enhanced Osteogenic Potential of Human Mesenchymal Stem Cells Seeded in a Poly (Lactic-co-Glycolic) Acid Scaffold: A Systematic Review
Authors: Maita Karla C. , Avila Francisco R. , Torres-Guzman Ricardo A. , Sarabia-Estrada Rachel , Zubair Abba C. , Quinones-Hinojosa Alfredo , Forte Antonio J.
Published: February 2023

Study Design

Human bone marrow stem cells (hBMSCs) and human adipose-derived stem cells (hADSCs) have demonstrated the capability to regenerate bone once they have differentiated into osteoblasts.

Objective

This systematic review aimed to evaluate the in vitro osteogenic differentiation potential of these cells when seeded in a poly (lactic- co-glycolic) acid (PLGA) scaffold.

Methods

A literature search of 4 databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in January 2021 for studies evaluating the osteogenic differentiation potential of hBMSCs and hADSCs seeded in a PLGA scaffold. Only in vitro models were included. Studies in languages other than English were excluded.

Results

A total of 257 studies were identified after the removal of duplicates. Seven articles fulfilled our inclusion and exclusion criteria. Four of these reviews used hADSCs and three used hBMSCs in the scaffold. Upregulation in osteogenic gene expression was seen in all the cells seeded in a 3-dimensional scaffold compared with 2-dimensional films. High angiogenic gene expression was found in hADSCs. Addition of inorganic material to the scaffold material affected cell performance.

Conclusions

Viability, proliferation, and differentiation of cells strongly depend on the environment where they grow. There are several factors that can enhance the differentiation capacity of stem cells. A PLGA scaffold proved to be a biocompatible material capable of boosting the osteogenic differentiation potential and mineralization capacity in hBMSCs and hADSCs.
Improving Technical Outcome in Osteochondral Allograft Transplantation of the Femoral Trochlea: The Role of Contoured Guides, Experience Level, Graft Size, and Graft Position
Authors: Delman Connor M. , Haffner Max , Rinaldi Peter , Lum Zach C. , Jamali Amir A. , Wilson Machelle , Lee Cassandra A.
Published: February 2023

Background:

The use of coring instrumentation for osteochondral allograft (OCA) transplantation of the femoral trochlea is challenging due to the complex topography of this anatomical area.

Purpose:

We sought to determine the effect of flat guides versus guides contoured to the surface of the trochlea on graft step-off in trochlear OCAs performed on a foam bone model. We also determined the effect of surgeon experience level and graft size on step-off.

Study Design:

Controlled laboratory study.

Methods:

Allograft harvesters were produced in 3 different sequential sizes with either a flat or a contoured undersurface. The guides matched one another in all aspects of shape and size except for the undersurface contour. The contoured undersurface generally matched the surface of the bone model trochlea but was not customized to that surface. A total of 72 foam femora were obtained. Identical trochlear stellate lesions of 3 different sizes (small, medium, and large) were created using 3-dimensional printed surface templates. A total of 6 surgeons (3 attending and 3 resident surgeons) performed OCAs of each trochlear lesion. Each surgeon performed 1 graft for each size and each guide type (n = 6 per surgeon). A specialized digital caliper was prepared that allowed the measurement of graft step-off to within 0.01 mm at a distance of 5 mm between the 2 sensors. The measurements were performed at 8 positions around the clockface of the grafts.

Results:

Grafts performed with the contoured guides had a mean step-off of 0.43 ± 0.37 mm. Grafts performed with the flat guides had a mean step-off of 0.74 ± 0.78 mm ( P < .0001). Experience level did not have a significant effect on graft step-off ( P = .81). There was no identifiable pattern indicating higher step-off at any one position on the clockface.

Conclusion:

In this study, contoured grafts had significantly lower step-offs compared with flat guides. Experience level, clockface position, and graft size did not affect step-off.
Role of Radiotherapy in Thyroid-Related Ophthalmopathy: A Case Series
Authors: Ravishankar Bellala , Madhvi Bellala Venkata , Tyagi Tulika , Srivastava Vishy , Kuppusamy Anandakrishnan , Prithviraj Bellala , Rishik Bellala
Published: February 2023

Purpose

To explore the role of radiotherapy (RT) in management of moderate to severe thyroid-related eye disease in terms of efficacy, treatment outcome, and response.

Material and methods

A case series of 5 patients with moderate to severe Graves Ophthalmopathy treated with orbital RT between July 2020 and March 2021. Patient symptoms and ophthalmic findings prior to RT and after 6 months post RT were analyzed. Computed tomography was performed before and after RT to compare orbital (muscles) volume change. Endpoints including improvement in ocular symptoms such as diplopia, proptosis, extraocular movement were compared. Acute and long-term complications were documented to assess its safety and treatment response.

Results

Addition of RT improved diplopia, visual acuity, proptosis, and color vision significantly. RT also decreased upper lid edema, optic nerve compression, and reduced intraocular muscle bulk. Extraocular muscles diameter reduced significantly. Patients experienced relief of symptoms and significant reduction in diplopia clinically.

Conclusion

External beam radiation is a safe and effective intervention in thyroid ophthalmopathy. Our study demonstrated that radiation is effective in decreasing inflammatory signs, symptoms, and muscle bulk. This treatment modality is well tolerated, and long-term complications are tolerable.
Examining the Rural Context: Supporting Paraeducator Training and Development With Limited Resources
Authors: Adamson Reesha M. , Nelson Jessica , Turner Jon S. , Post Felicity
Published: February 2023

Supporting the development and training of paraeducators can be complex; however, that support in rural settings can be especially challenging. The unique structure of rural settings, often with limited personnel and available resources, can create challenges for recruiting and retaining quality candidates within the field of paraeducation. This study explored the perceptions and experiences of rural educators who support paraeducators and their training. Participants were interviewed about how their individual classroom and school district training models support paraeducators. Specific questions were targeted at opportunities for and quality of professional development, performance feedback, and models of support for rural paraeducators in rural areas throughout the Midwest. Overall, seven themes emerged from interviews revolving around the need for initial training to be more specific to setting and student needs, creation of cohesive meeting times with intensive training for the most challenging students, the need for structured meetings, and a clearinghouse of resources and support.
Population aggregates from administrative data samples–how good are they?
Authors: vom Berge Philipp
Published: February 2023

Researchers regularly use administrative micro-data samples to approximate subgroup aggregates from the full population. In this paper, I argue that the most commonly used method to do this is often not optimal. I outline some alternatives and compare their relative performance in selected cases. I also discuss the effect of statistical disclosure control on the aggregated data and how researchers can reduce bias resulting from censoring.
Influence of systolic blood pressure trajectory on in-hospital mortality in patients with sepsis
Authors: Zhu Jia-Liang , Yuan Shi-Qi , Huang Tao , Zhang Lu-Ming , Xu Xiao-Mei , Yin Hai-Yan , Wei Jian-Rui , Lyu Jun
Published: February 2023

Background

Numerous studies have investigated the mean arterial pressure in patients with sepsis, and many meaningful results have been obtained. However, few studies have measured the systolic blood pressure (SBP) multiple times and established trajectory models for patients with sepsis with different SBP trajectories.

Methods

Data from patients with sepsis were extracted from the Medical Information Mart for Intensive Care-III database for inclusion in a retrospective cohort study. Ten SBP values within 10 h after hospitalization were extracted, and the interval between each SBP value was 1 h. The SBP measured ten times after admission was analyzed using latent growth mixture modeling to construct a trajectory model. The outcome was in-hospital mortality. The survival probability of different trajectory groups was investigated using Kaplan-Meier (K-M) analysis, and the relationship between different SBP trajectories and in-hospital mortality risk was investigated using Cox proportional-hazards regression model.

Results

This study included 3034 patients with sepsis. The median survival time was 67 years (interquartile range: 56–77 years). Seven different SBP trajectories were identified based on model-fit criteria. The in-hospital mortality rates of the patients in trajectory classes 1–7 were 25.5%, 40.5%, 11.8%, 18.3%, 23.5%, 13.8%, and 10.5%, respectively. The K-M analysis indicated that patients in class 2 had the lowest probability of survival. Univariate and multivariate Cox regression analysis indicated that, with class 1 as a reference, patients in class 2 had the highest in-hospital mortality risk (P < 0.001). Subgroup analysis indicated that a nominal interaction occurred between age group and blood pressure trajectory in the in-hospital mortality (P < 0.05).

Conclusion

Maintaining a systolic blood pressure of approximately 140 mmHg in patients with sepsis within 10 h of admission was associated with a lower risk of in-hospital mortality. Analyzing data from multiple measurements and identifying different categories of patient populations with sepsis will help identify the risks among these categories.
Short-term postoperative changes in the choroidal vascularity index in patients with a unilateral epiretinal membrane
Authors: Ruan Kaiming , Zhang Yun , Cheng Dan , Qiao Yilin , Yu Yufeng , Wu Minhui , Zhu Xueying , Tao Jiwei , Shen Meixiao , Shen Lijun
Published: February 2023

Background

To investigate short-term choroidal structural and vascular changes after epiretinal membrane (ERM) surgery.

Methods

In this retrospective study, 65 patients with unilateral ERM underwent pars plana vitrectomy combined with cataract surgery and were examined one day before surgery and one week, one month, and three months after surgery. Choroidal thickness (CT) and choroidal vascular index (CVI) were evaluated using horizontal enhanced depth imaging optical coherence tomography (EDI-OCT) scans and were further calculated using semi-automatic algorithms using MATLAB R2017a.

Results

Preoperatively, CVI was higher in eyes with ERM (61.70 ± 5.17%) than in fellow eyes (59.99 ± 5.26%). CVI increased significantly at one week after surgery (62.14 ± 5.02%) and decreased at 1 and 3 months after surgery (60.76 ± 4.97% and 60.4 ± 4.83%, respectively). The change was pronounced in the nasal region (p < 0.001) and central region (p < 0.05). CT in the temporal macula increased at 1 week (239.65 ± 72.98 μm) after surgery and decreased at 1 and 3 months after surgery (222.15 ± 71.91 μm and 222.33 ± 65.72 μm, respectively; p < 0.01).

Conclusions

Short-term postoperative variations in the choroid have been demonstrated in eyes with ERM. This may be related to the release of macular traction. CVI assessment using EDI-OCT may be a useful tool for investigating choroidal structural changes accompanying ERM and postoperative period.