bluuebunny/crossref_metadata_2025 huggingface dataset:
Kinematic lensing with the Roman Space Telescope
Authors: Xu Jiachuan , Eifler Tim , Huff Eric , Pranjal R S , Huang Hung-Jin , Everett Spencer , Krause Elisabeth
Published: December 2022

Kinematic lensing (KL) is a new cosmological measurement technique that combines traditional weak lensing (WL) shape measurements of disc galaxies with their kinematic information. Using the Tully–Fisher relation, KL breaks the degeneracy between intrinsic and observed ellipticity and significantly reduces the impact of multiple systematics that are present in traditional WL. We explore the performance of KL given the instrument capabilities of the Roman Space Telescope, assuming overlap of the High Latitude Imaging Survey (HLIS) and the High Latitude Spectroscopy Survey (HLSS) over 2000 deg2. Our KL suitable galaxy sample has a number density of ngal = 4 arcmin−1 with an estimated shape noise level of σϵ = 0.035. We quantify the cosmological constraining power on Ωm–S8 and wp–wa by running simulated likelihood analyses that account for redshift and shear calibration uncertainties, intrinsic alignment, and baryonic feedback. Compared to a traditional WL survey, we find that KL significantly improves the constraining power on Ωm–S8 (FoMKL = 1.70FoMWL) and wp–wa (FoMKL = 3.65FoMWL). We also explore a ‘narrow tomography KL survey’ using 30 instead of the default 10 tomographic bins; however, we find no meaningful enhancement to the figure of merit even when assuming a significant time dependence in our fiducial dark energy input scenarios.
The choice of μ-vinyliminium ligand substituents is key to optimize the antiproliferative activity of related diiron complexes
Authors: Campanella Beatrice , Braccini Simona , Bresciani Giulio , De Franco Michele , Gandin Valentina , Chiellini Federica , Pratesi Alessandro , Pampaloni Guido , Biancalana Lorenzo , Marchetti Fabio
Published: December 2022

Diiron vinyliminium complexes constitute a large family of organometallics displaying a promising anticancer potential. The complexes [Fe2Cp2(CO)(μ-CO){μ-η1:η3-C(R3)C(R4)CN(R1)(R2)}]CF3SO3 (2a-c, 4a-d) were synthesized, assessed for their behavior in aqueous solutions (D2O solubility, Log Pow, stability in D2O/Me2SO-d6 mixture at 37°C over 48 h) and investigated for their antiproliferative activity against A2780 and A2780cisR ovarian cancer cell lines and the nontumoral one Balb/3T3 clone A31. Cytotoxicity data collected for 50 vinyliminium complexes were correlated with the structural properties (i.e. the different R1–R4 substituents) using the partial least squares methodology. A clear positive correlation emerged between the octanol–water partition coefficient and the relative antiproliferative activity on ovarian cancer cell lines, both of which appear as uncorrelated to the cancer cell selectivity. However, the different effects played by the R1–R4 substituents allow tracing guidelines for the development of novel, more effective compounds. Based on these results, three additional complexes (4p-r) were designed, synthesized and biologically investigated, revealing their ability to hamper thioredoxin reductase enzyme and to induce cancer cell production of reactive oxygen species.
Association of low back pain and sleep quality with presenteeism
Authors: Tezuka M , Oka T , Nakatsuka K , Saeki K , Ono R
Published: December 2022

Background

Low back pain (LBP) and poor subjective sleep quality (SSQ) are major risk factors for presenteeism. However, no studies have investigated whether combined LBP and poor SSQ are associated with presenteeism.

Aims

We aimed to examine whether a combination of LBP and poor SSQ is associated with presenteeism.

Methods

This cross-sectional study included 936 workers (median age, 38 years; men, 89%), with evaluated presenteeism using the work limitations questionnaire. We divided them into ‘no presenteeism’ and ‘presenteeism’ categories. The presence of LBP was defined as a numerical rating scale (NRS) score of ≥1 in current pain intensity. SSQ was assessed using a single question regarding whether the participants typically got enough sleep. We categorized the participants into four groups: (i) LBP + poor SSQ, (ii) non-LBP + poor SSQ, (iii) LBP + good SSQ and (iv) non-LBP + good SSQ. Logistic regression analysis was used to investigate the association between presenteeism and the presence of LBP and poor SSQ, adjusting for age, sex, work type, education, marital status, smoking status, body mass index and weekly working hours.

Results

The data from 533 participants were used for analysis (median age, 38 years; men, 90%, response rate, 66%). Combined LBP and poor SSQ were significantly associated with presenteeism (non-LBP + poor SSQ: adjusted odds ratio = 0.56, 95% CI 0.32–0.96; LBP + good SSQ: 0.33, 0.20–0.56; non-LBP + good SSQ: 0.29, 0.18–0.48).

Conclusions

Evaluating both LBP and SSQ may be beneficial in considering presenteeism.
Introduction
Authors: Frost-Arnold Karen
Published: December 2022

The introductory chapter details the epistemological frameworks to be used throughout the applied chapters of the book. These frameworks include feminist accounts of objectivity, veritistic systems-oriented social epistemology, epistemologies of ignorance, virtue epistemology, and epistemic injustice studies. The introduction explains the core concepts and commitments of each approach. Additionally, some of these theories might seem to be strange bedfellows to some epistemologists, so the author shows how they are compatible and provide a mutually supporting set of evaluative frameworks. This chapter argues for a social epistemology that values truth and objectivity, while recognizing that inequalities shape our collective ability to attain these goals.
Moderators
Authors: Frost-Arnold Karen
Published: December 2022

Chapter 2 investigates the epistemology of online content moderation, arguing that current corporate practices promote epistemic injustice and exploit workers in traumatizing ways. The chapter argues that the labor model of commercial content moderation prevents workers from developing necessary epistemic virtues. It provides an account of the epistemic exploitation of moderators and suggests ways to make the work less exploitative. Then it draws on this account and internet studies scholars’ use of the metaphor of digital garbage to provide an account of a novel kind of epistemic injustice, which is called ‘epistemic dumping.’ In epistemic dumping, the labor of sorting, handling, and disposing of the toxic epistemic trash of epistemic communities is disproportionately performed by some (typically traditionally oppressed) groups, while other (typically traditionally dominant) groups benefit from this labor though usually being oblivious to its performance or dismissive of the epistemic labor involved in handling the trash.
Lurkers
Authors: Frost-Arnold Karen
Published: December 2022

Chapter 5 analyzes how social media can play a powerful role in educating people about their own privileges and prejudices. It focuses on the epistemic virtues and vices of lurkers, people who spend time in online epistemic communities without directly participating in them. Under the right circumstances, lurking can be an epistemically virtuous activity. However, lurking can also be an oppressive mode of knowledge production, one that treats marginalized subjects as objects of voyeuristic study rather than as epistemic agents. Often lurking should be avoided in lieu of active engagement or simply leaving epistemic spaces altogether. This chapter develops a virtue epistemology that helps us discern when to engage in a conversation, when to be quiet and lurk, and how to avoid hijacking online spaces for marginalized people.
Content-Focused Epistemic Injustice
Authors: Dembroff Robin , Whitcomb Dennis
Published: December 2022

There has been extensive discussion of testimonial epistemic injustice, the phenomenon whereby a speaker’s testimony is rejected due to prejudice regarding who they are. But people also have their testimony rejected or preempted due to prejudice regarding what they communicate. Here, the injustice is content-focused. We describe several cases of content-focused injustice, and we theoretically interrogate those cases by building up a general framework through which to understand them as a genuine form of epistemic injustice that stands in intertwined relationships to other forms of epistemic injustice.
Conceptions of Genuine Knowledge in Wang Yangming
Authors: Lederman Harvey
Published: December 2022

This chapter studies one aspect of the great Ming dynasty philosopher Wang Yangming’s (王陽明 1472–1529) celebrated doctrine of the unity of knowledge and action (zhi xing he yi 知行合一). Wang states that his doctrine does not apply to all knowledge, but only to an elevated form of knowledge, which he sometimes calls “genuine knowledge” (zhen zhi 真知). But what is “genuine knowledge”? I develop and compare four different interpretations of this notion: the perceptual, practical, normative, and introspective models. The main aim of the chapter is to develop these models in more detail than has been done before. But at the end of the chapter I argue that the introspective model is to be preferred over the alternatives.
There’s More to Transparency than Windows
Authors: Prueitt Catherine , Samoilova Kateryna
Published: December 2022

We focus on a fascinating observation shared by philosophers in a number of traditions: when we try to directly examine our experience, the experience itself seems to vanish as we focus on its objects. We examine two scaffolds for understanding this observation that have been dominant in the post-Moore analytic tradition: the window scaffold and the mirror scaffold. We note that these scaffolds have different strengths, but fail to fully capture certain salient features of the transparency datum. We introduce a new scaffold for thinking about the transparency datum. This new scaffold, which we have developed through our cross-cultural engagement with Classical South Asian epistemology, suggests that awareness is like purple, transparency is like polarization, and subject and object are like the red and blue into which purple can be polarized. Experience vanishes when we direct our attention to it like purple vanishes when polarized into red and blue.
“Getting It Oneself” as an Alternative to Testimonial Knowledge and Deference to Tradition
Authors: Tiwald Justin
Published: December 2022

Roughly, moral deference is the practice of forming a moral belief on the basis of some credible authority’s recommendation rather than on one’s own moral judgment. Many philosophers have suggested that the sort of knowledge yielded by moral deference is deficient in various ways. To better appreciate its possible deficiencies, I propose that we look at a centuries-long philosophical discourse that made much of the shortcomings of this sort of knowledge, which is the discourse about “getting it oneself” (zide 自得) in the later (post-classical) Confucian tradition. In this chapter, I offer the first sustained philosophical account of “getting it oneself,” as conceived by its most influential proponents—Cheng Hao, Cheng Yi, and Zhu Xi. I describe its most notable features, including its tendency to enhance epistemic confidence and what I call “self-discovery aspects” of the phenomenon. I then focus on the Neo-Confucian claim that some parts of the deliberative process should be spontaneous or unforced, which, I argue, they saw as necessary for an unbiased appreciation of the inferential force of the reasons for one’s moral conclusions. I conclude by pointing to some of the broader implications of my reading for both the history of philosophy and current debates about moral deference.
Elements of Knowledge-First Epistemology in Gaṅgeśa and Nyāya
Authors: Vaidya Anand
Published: December 2022

In this paper I argue that there are elements of Tim Williamson’s knowledge-first epistemology that can be found in the work of the fourteenth-century philosopher, Gaṅgeśa. He is the father of the new school of Nyāya. I delineate his view about perception and knowledge by comparing it to his predecessor, Gautama Akṣapāda, the father of Nyāya. On Gaṅgeśa’s knowledge is not composed of parts. And a perceptual event, understood as a veridical awareness, is a transient occurrence of perceptual knowledge. I cash out his view of perception as a special form of disjunctivism that focuses on positive and negative causal factors. I apply it to several cases to show how the theory works. I then go on to discuss Gaṅgeśa’s two-tiered theory of knowledge where there is a distinction between perceptual knowledge and certified knowledge and how it relates to the KK-principle, that when one knows they know that they know.
Deploying Feminism in NATO Operations
Authors: von Hlatky Stéfanie
Published: December 2022

Before delving into the case studies, this chapter provides an overview of how Women, Peace and Security norms have been adapted to the NATO context. It first introduces the content of NATO’s Women, Peace and Security policy and action plan, from its adoption to the present day. On the military side too, these norms have been integrated into directives and what NATO calls its gender structure, which plans for the appointment of gender advisors and gender focal points at the strategic, operational, and tactical levels. In discussing the content of those policies and directives, the chapter also details the NATO processes and structures that support implementation. The operational planning process is explained to show how political decisions are translated into military actions on the ground.
Advising and Assisting in Iraq
Authors: von Hlatky Stéfanie
Published: December 2022

The NATO Mission in Iraq started in 2018. The US-led Global Coalition against ISIS was looking to transfer some tasks to NATO as the country’s security forces turned to stabilization and post-conflict reconstruction, yet again. Many NATO allies have sent troops to Iraq before, and this is a key reference point through which gender considerations are assessed: women can be important community stakeholders but can also be the brides of ISIS. Making the wrong gender-based assumptions can lead to costly mistakes. The Canadian commander brings his female gender advisor to all planning meetings and tells his staff to listen: what she says goes, or NATO risks facing a credibility gap. One cannot tell the Iraqi government to make room for more women when one brings an all-male NATO team to the meeting.
Conclusion
Authors: von Hlatky Stéfanie
Published: December 2022

Taking stock of the three case studies, there is clear evidence to show that Women, Peace and Security norms are approached primarily through an operational mindset. When seen as useful for the mission, these norms are taken into account; otherwise, promoting gender equality is brushed aside as someone else’s business. WPS norms have been militarized because soldiers have interpreted them through the prism of their own warfighting culture. This culture is implementation-focused, so noticeable change has occurred but on the military’s terms. In light of these findings, this concluding chapter turns to recommendations. It comments, for example, on the lack of civilian oversight at the mission level, the possibilities for improving the training of gender advisors, and broadening metrics of operational effectiveness.
Restraint, Conflict, and the Fall of the Roman Republic
Authors: Belonick Paul
Published: December 2022

The Romans endlessly harped on “morality,” a cultural feature long ignored as a literary trope or misunderstood as a marker of elite status. This book shows how, instead, social norms of personal restraint were part of a habitus of foundational values that acted as metarules for the Roman aristocratic performative-competitive political system. The book investigates these norms and explicates their positive content in the republican framework and their resulting place in the Romans’ habitual mental map. The book then examines how social norms came into irreconcilable conflict, arguing that—far from Rome progressing from a pristine past moral state to a sad moral nadir—the same “morals” of personal self-control stabilized and destabilized the Republic at different points in time. The values eventually lost their prohibitory force to constrain action, but not because they were abandoned. Rather, disputes over the proper application and meaning of the norms in novel political and social circumstances grew into violent clashes as disputants presented themselves as last-ditch defenders of the essential values and, accordingly, imagined their opponents as bent on the Republic’s destruction, while no normatively acceptable third-party judge could exist to resolve the conflicts. Thus, the aristocracy’s consensus formed and then cracked along axes over what constituted normative restraint behavior, which both accounts for the ubiquity of this cultural feature, and which automatically undermined a central pillar of the performative-competitive structure itself.
Introduction
Authors: Belonick Paul
Published: December 2022

The Introduction explains how the ancient sources are filled with a constant worry about lost “morals” relating to self-control: moderation, temperance, deference, and others. These “morals,” however, sit uncomfortably with another Roman cultural feature: aggressive self-advancement. Modern scholars have modeled how the Roman Republic was a form of performative competition. Scholars have not yet completely resolved this paradox. The Introduction shows how the book will merge those models with ubiquitous Roman source material on self-control, showing how self-control complemented the competition by creating rules for it. But because the competition was for political legitimacy, debates over self-control would necessarily lead to debates over the rules of the “game” itself, with politically fraught consequences. The Introduction explains how the book will illustrate a four-part process by which the debates became unjudgable and intractable, leading to the perception that unrestrained, illegitimate “deviants” were threatening the Republic. That perception has survived in our sources in their obsession with “morals” and their constant fear that “lost” “morals” were endangering the state. What the sources were actually observing was how emotion and turmoil tied to strong normative beliefs with powerful political valences could lead to dehumanization and violence, making the fear that “lost morals” posed a danger to the Republic self-fulfilling.
Moderatio, Modestia, and Temperantia
Authors: Belonick Paul
Published: December 2022

Chapter 2 describes restraining pressures to which the Romans gave the names modus, modestia, moderatio, and temperantia, and examines them in three different arenas: vis-à-vis aristocratic fellows; relating to luxury or lust; and as affecting the Republic’s operation as a whole. The Romans believed that restraint in these three arenas overlapped to support the proper functioning of the Republic. A man able to array these restraining qualities in public and in private would fill his offices well and take orderly part in the distribution of honors because he could operate well with superiors, inferiors, and peers, with the citizenry, with foreigners, and with tradition. Modestia ensured orderly dissemination of offices based on relative merit, of which seniority was a component. Moderatio smoothed tensions that self-advancement might foster, prevented one man from growing too influential, even by merit, and helped order and spread the distribution of prizes in a fluid and semiformal competitive system. It also made the individual exercise of power acceptable to the group; self-advancement in the competition was not truly laudable unless mingled with self-control. Temperantia was the process of tamping down any selfish urges that remained. Hence, theoretically, if all peers displayed the values, they could compete indefinitely too much conflict and without the competition leaving too many men of merit without the proverbial musical chair, making the “game” worthwhile, and the exercise of power by the winners legitimate and acceptable to the group and the “losers.”
Tiberius Gracchus
Authors: Belonick Paul
Published: December 2022

Chapter 4 reexamines the tribunate of Tiberius Gracchus in the light of the restraint norms, showing how Gracchus’ quarrel with his colleague and Gracchus’ murder were, paradoxically, products of the restraint values and set in motion long-term changes to the values’ operation. It argues that by using the restraint values as interpretive tools we can hone in on why this tribunate ushered in unprecedented bloodshed: two groups of aristocrats (or, in the end, one aristocrat alone and a group of aristocratic opponents) each appealed to traditional restraint values in unprecedentedly irreconcilable ways, or appeared unrestrainable in unprecedented ways. The conflict was particularly unjudgable and intractable because Tiberius ushered a novel wedge into Roman politics: the idea that, perhaps, the Senate as a whole or in great part need not be heeded because the senators were collectively stricken with greed, intemperantia, and immoderation, and were thus morally and normatively incapable of acting as a proper judge of his behavior, and thus unworthy of deference, while the People (the theoretical highest power in the Republic) might instead act as sole judge. Violence was the unprecedented solution to this impasse between tradition-based views.
Cataclysm
Authors: Belonick Paul
Published: December 2022

Chapter 6 locates within an unstable long trend of disruption to the meta-rules the clash between Marius and Sulla. At every point, the convoluted paths of the antagonists and the cataclysmic butchery that they unleased were shaped by the confluence of factors in the application and judgment of restraint norms that made nonviolent, intragroup policing ever less viable. The two injected a heavier dose of destabilizing uncertainty into the sensitive mores than had ever been absorbed before, and carried the disruption well past any facile tribune/senate divide or structural idiosyncrasy of the tribunate. The ability of social norms to order the group as a whole peacefully thus weakened, and violence further became the solution to disputes. Although this process did not dictate immediate social collapse, uncertainty now would hang in the background of every future aristocratic interaction. The chapter also explains Sulla’s “new” constitution as a product of the restraint values, as an attempt to fix inter-personal relations and to heal the broken judgment group, rather than a conscious political program. Finally, it explains how Sulla could be a man simultaneously so shocking and so orthodox: he consistently attempted to hew to a kaleidoscopic system of restraint patterns that caused him by turns to be ruthless or orderly, but always in pursuit of upholding what he believed were longstanding values in the contorted habitus.
The Lost Generation of the Republic
Authors: Belonick Paul
Published: December 2022

Chapter 7, “The Lost Generation of the Republic,” follows the actors of the 60s to the 40s who inherited a veneer of structural integrity that concealed highly confused understandings of normative behavior, expressed in a vast array of approaches to restraint. This volatile social context shaped the generation’s decision-making and emotions and heightened their conflicts, rendering them helpless to resolve peaceably among themselves what shame, moderation, and consensus should mean, even as they clung to the profound conviction that these values must somehow be upheld for the sake of the Republic. The chapter shows how the adrift generation inherited the structural features of their ancestors’ government, but replicated, at best, only detached shards of those structures’ supporting social frame—then turned the shards on each other. It focuses on restraint’s role in three representative cases of the period. First, the career of Pompey the Great to 59 bc exemplifies how the moderatio pattern that had traditionally rendered influence and advancement acceptable now instead might only exacerbate invidia and mistrust, which undermined legitimate, institutional grants of power. Second, the conspiracy of Catiline shows the chaotic state of the emotional underpinnings of pudor, verecundia, and care for existimatio that once supported deference. Third, the interactions among M. Licinius Crassus, M. Porcius Cato, and C. Julius Caesar and the formation of the “First Triumvirate” demonstrate how it grew ever more impossible to achieve consensus in judging individual behavior.
Virtue and Happiness
Authors: Gill Christopher
Published: December 2022

Chapter 1 discusses the key distinctive feature of Stoic ethics, namely, the claim that happiness depends solely on virtue. The chapter explains this claim by analysing the meaning of ‘happiness’ and ‘virtue’ in Stoicism and the relationship between these ideas. Happiness is understood, primarily, as ‘the life according to nature’, meaning the life according to human and universal (world-wide or cosmic) nature. Virtue is seen as expertise in leading a happy life, as so understood. Human nature is conceived as combining rationality and sociability, and universal nature as combining structure, order, and wholeness, and as implanting in animals care for oneself and others of one’s kind. Virtue and happiness are seen as sharing these characteristics of human and universal nature; and this structural similarity goes a long way towards explaining why Stoics see happiness as depending solely on virtue.
Virtue, Indifferents, and Practical Deliberation
Authors: Gill Christopher
Published: December 2022

Chapter 2 is concerned with a second distinctive, and controversial, feature of Stoic ethics, namely, the claim that only virtue and virtue-based happiness are good, whereas other things widely regarded as good such as health and wealth are only ‘preferred indifferents’. The rationale for this claim is that, although preferred indifferents have real and positive value, they do not make the difference between happiness and misery (leading the life according to nature or failing to do so) whereas virtue and vice do make this difference. Correspondingly, correct or right practical deliberation consists of selecting between indifferents (preferred and dispreferred) in a way that expresses the virtues and leads towards a happy life (a life according to nature). Cicero’s On Duties, the only surviving extended Stoic work on this subject, is interpreted as expressing this conception of virtuous practical deliberation.
Stoic Ethics, Human Nature, and the Environment
Authors: Gill Christopher
Published: December 2022

Chapter 7 explores the scope for Stoic ethics to contribute to modern thinking on ethical naturalism, especially in virtue ethics. Stoicism, like Aristotle, conceives virtue-based happiness as the realization of human nature, in a form that makes sense in modern, as well as ancient, terms. Stoicism, as elsewhere, does so in a way that is more fully worked out than in Aristotle, especially in its theory of appropriation. In addition, by extending the ethical framework to include universal nature, the Stoics can contribute significantly to modern attempts to respond ethically to the challenge of climate breakdown. Particularly important is their view that the natural world or universe has intrinsic value and that it embodies order, ideas which can support modern attempts to combat the disorder of climate breakdown.
Stoic Development and Guidance, and Modern Thought
Authors: Gill Christopher
Published: December 2022

Chapter 8 explores the actual and potential contribution of Stoic thinking on development and guidance to modern thought. In modern virtue ethics, Stoicism provides an approach centred on the idea of development in adult life, which provides an alternative to the Aristotelian approach, centred on childhood development. Stoicism also has much to offer on ethical guidance, a topic largely missing in Aristotle. Stoicism has already had a powerful effect on contemporary life-guidance directed at a broad public audience, as illustrated by the work of the organization ‘Modern Stoicism’. The impact of Stoicism in this area suggests that it also has the potential to make a strong contribution to modern ethical theory on ethical guidance.
Exploring Archives, Examining Resources, and Developing Strategies for Research in Peace History
Authors: Chmielewski Wendy E.
Published: December 2022

This chapter examines some of the current resources available to conduct research in peace history, including a survey of institutions where these resources may be found, with examples in each category. The editors of this volume have provided a definition of “peace history,” but a researcher’s own approach to their topic will determine the types of resources used and where research may occur. The creators of “peace history” here include activists, citizen diplomats, government civil servants, politicians, and others who are primarily concerned with ending war, maintaining peace or social stability, assisting victims of war, and creating positive social change as well as those scholars tasked with recording that work or preserving its history.
Defining Struggles
Authors: Howlett Charles F. , Hostetter David L.
Published: December 2022

This chapter explores the activist legacy of opposition to war and for positive peace in the United States since World War I. The modernization of ideas and methods for building peace that developed in the twentieth and early twenty-first centuries are assessed. The changing conceptions of pacifism, nonviolence, and conscientious objection, as well as the evolving role of communications technologies as reflected in culture, are examined. The dynamic tension between advocacy for transformative change and efforts for incremental reform in relation to ending war and building peace are analyzed, with attention to the role of gender, race, class, age, and heritage. The influence of peace activism, in its many forms, on policy, its role in restraining militarism and its relationship to broader social change movements are evaluated.
EVALUATION OF PATIENT-SPECIFIC IMRT QUALITY ASSURANCE AND POINT DOSE MEASUREMENT FOR COMPLEX HEAD AND NECK AND BRAIN CANCER USING GAFCHROMIC EBT3 FILM
Authors: Gedam Varsha R , Pradhan Anirudh
Published: December 2022

Patient-specific intensity-modulated radiation therapy (IMRT) quality assurance (QA) is essential for complex radiotherapy treatment as it involves complex intensity modulation and high-dose gradient regions. IMRT QA was performed by point dose verification and two-dimensional (2D) dose distribution measurement using gamma method. Calibrated External Beam Therapy 3 (EBT3) film was used for point dose and pre-treatment verification of 10 IMRT plans, five complex Head and Neck (HN) and five brain cases. The gamma passing rate (GPR) was evaluated for 3%/3 mm gamma criteria and compared with 2D array. Isocentre dose was measured for all 10 IMRT plans on EBT3 film. Percentage deviation of point dose measurement from TPS calculated was found 0.4% for brain cases and 2.9% for HN cases. The GPR for 3%/3 mm criteria was obtained higher than 95% for brain and HN cases. Results suggest that film dosimetry is also a reliable verification system for patient-specific IMRT QA as the 2D array.
Perspectives on the narrowing and clustering of research trajectories: an epistemic threat to medical progress?
Authors: Khurana Mark P , Madsen Emil Bargmann
Published: December 2022

Evidence suggests that a certain degree of clustering and narrowing of research trajectories is occurring, both on the individual and disease levels. Mechanisms of this process include biases in funding, a lack of coordination among funders, the significant funding role of for-profit actors, and lobbying by special interest groups. The implication is that fewer individuals might control the direction of research and certain diseases could garner a disproportionate amount of attention and resources, which could be an epistemic threat to medical progress. In this perspective article, we highlight the scale of the issue, mechanisms underlying this process, and their effects on medical progress. The article also explores potential solutions to counteract an excessive narrowing and clustering, highlighting the importance of individual researchers, patients, research organizations, and funders in ensuring that a sufficiently-diverse set of medical research trajectories are being pursued.
Phenotypic divergence in sleep and circadian cycles linked by affective state and environmental risk related to psychosis
Authors: Purple Ross J , Cosgrave Jan , Alexander Iona , Middleton Benita , Foster Russell G , Porcheret Kate , Wulff Katharina
Published: December 2022

Study Objectives

Environmental cues influence circadian rhythm timing and neurochemicals involved in the regulation of affective behavior. How this interplay makes them a probable nonspecific risk factor for psychosis is unclear. We aimed to identify the relationship between environmental risk for psychosis and circadian timing phenotypes sampled from the general population.

Methods

Using an online survey, we devised a cumulative risk exposure score for each of the 1898 survey respondents based on 23 empirically verified transdiagnostic risks for psychosis, three dimensions of affect severity, psychotic-like experiences, and help-seeking behavior. Quantitative phenotyping of sleep and circadian rhythms was undertaken using at-home polysomnography, melatonin and cortisol profiles, and 3-week rest–activity behavior in individuals with a high-risk exposure load (top 15% of survey respondents, n = 22) and low-risk exposure load (bottom 15% of respondents, n = 22).

Results

Psychiatric symptoms were present in 100% of the high-load participants and 14% of the low-load participants. Compared to those with a low-load, high-load participants showed a later melatonin phase which was reflected by a greater degree of dispersion in circadian timing. Phase relationships between later circadian melatonin phase and later actigraphic sleep onsets were maintained and these were strongly correlated with self-reported sleep mid-points. No differences were identified from polysomnography during sleep between groups.

Conclusion

Distinguishing circadian timing from other sleep phenotypes will allow adaptation for dosage of time-directed intervention, useful in stabilizing circadian timekeeping physiology and potentially reducing the multisystemic disruption in mental health disorders.
From Female Migrant Sex Workers to Migrant Workers: When the Danish Labor Market Encounters the Policy Field of Anti-Trafficking
Authors: Spanger Marlene
Published: December 2022

This article explores how the policy field of anti-trafficking has been further complicated by a shift of focus from female migrant sex workers to migrant workers in Denmark. As a discursive terrain established through various discourses produced by articulations, practices, and interests, Danish anti-trafficking is an excellent example of how highly regulated and different state institutions together with trade unions establish regimes of prostitution, migration, crime, and labor market. Together, these regimes create the complex policy field of anti-trafficking. The article demonstrates how a trade union, as a part of the labor market regime, is a new player. Despite this new player in the anti-trafficking policy field, the article argues that the figure of “the migrant worker” becomes invisible as logics and categories of “labor exploitation” and “labor rights” collide with the ideas of rescuing poor migrant women selling sex.
Metabolic evaluation of first-time uncomplicated renal stone formers: A prospective study
Authors: Ranjan Satish Kumar , Mittal Ankur , Mirza Anissa Atif , Kumar Sunil , Panwar Vikas Kumar , Navriya Shivcharan , Mandal Arup Kumar , Mammen Kim Jacob
Published: December 2022

Background

Nephrolithiasis is a global health problem. The recurrence rate after the first stone clearance is approximately 50% at 5 years. Metabolic abnormalities are an important factor responsible for stone recurrence. Our prevalidated study aimed to evaluate metabolic abnormalities associated with first-time uncomplicated renal stone formers (FTURSF).

Materials and methods

In this prospective, exploratory, time-bound, descriptive study, 30 first-time renal stone formers were evaluated for metabolic abnormalities. High-risk stone formers were excluded from the study. Data were collected in a predefined proforma, transferred to an Excel sheet, and analyzed using the Statistical Package for Social Sciences 20 and Epi Info 7. Fisher exact test, Mann-Whitney U test, paired t test, and Pearson correlation coefficient were used for statistical analyses.

Results

The mean age of the participants was 35.57 ± 11.07 years, with a male-to-female ratio of 1.72. The most common abnormality was a 24-hour urine volume of <2.5 L in 73.33% of the participants. One or more metabolic abnormalities were detected in 76.67% of the participants. Other common metabolic abnormalities detected were hypocitraturia (60%), hypercalciuria (16.67%), hyperoxaluria (13.33%), and hyperuricosuria (3.33%). Parathyroid adenoma was detected in one participant (3.33%).

Conclusions

Our study documented significant metabolic abnormalities in FTURSF. Therefore, a simplified metabolic evaluation protocol should be adopted while evaluating FTURSF. Detection of an underlying metabolic abnormality would enable the early institution of preventive measures to reduce stone recurrence and related complications.
Causes and Management of Pruritus Ani
Authors: Sacks Olivia A. , Beresneva Olga
Published: December 2022

CASE SUMMARY:

A 48-year-old healthy man presented to the office reporting a long-standing history of anal pruritus. He had tried various over-the-counter creams without much success. Besides an anal fissure in the past, which responded to nitroglycerin ointment, his medical history was unremarkable. On physical examination, he was found to have grade I hemorrhoids and mild fecal smearing on perianal skin. Recent colonoscopy and laboratory work ordered by the primary care provider were normal. He was counseled on common inciting agents and local irritants and was advised on hygiene, diet modification, and stool-bulking agents. The colorectal surgeon recommended that the patient keep a journal about his symptoms, foods, and household chemicals used. He was seen twice more over the course of 6 months to pinpoint the cause of his pruritus. A short-course trial of topical steroid, barrier cream, and topical tacrolimus was not helpful. A biopsy of perianal skin was performed and was unrevealing. Eventually, given the persistence of symptoms, it was decided that he would undergo methylene blue injection to address his pruritus (Fig. 1). The procedure consisted of several intradermal and subcutaneous injections of 10 mL of 1% methylene blue combined with 7.5 mL of 0.25% bupivacaine with adrenaline (1/100,000) and 7.5 mL 0.5% lidocaine. After the methylene blue injection, the severity of his symptoms improved, but pruritus still persisted. A methylene blue injection of the same concentration was repeated in 3 months with complete resolution of symptoms.
Localized Instantaneous Dose Rates from Inhaled Particles of 239Pu
Authors: Hetrick Lucas , Klumpp John , Poudel Deepesh
Published: December 2022

In this work, the authors present instantaneous local dose rates from particles of plutonium-239 oxide (239PuO) embedded in various regions of the respiratory tract. For comparison, a small number of simulations were performed in a representative region of the respiratory tract with other chemical compounds including pure metallic 239Pu, 239PuO2, 239PuO3, 239Pu2O3, and 239Pu(NO3)4. A small number of simulations were also performed with 238PuO, weapons grade Pu, and Pu from a typical radioisotope thermoelectric generator (RTG) source for the same reason. The self-shielding effect is minor for very small particles but gradually becomes more significant as the particle size increases. For particles that are 0.1 μm and larger (excluding Pu nitrate), the calculated dose rate within several microns of the particle may be sufficient to damage lung cells, but the implications of damage to such a small volume of tissue are unclear. However, it is reasonable to assume that clinical effects will be observed if a large enough volume of tissue is damaged, as might happen when large numbers of particles are inhaled. The instantaneous dose rate around a particle may be predictive of deterministic effects, scar tissue formation, and biokinetics.
Mechanical Device Malfunction of the HeartMate II Versus the HeartMate 3 Left Ventricular Assist Device: The Rotterdam Experience
Authors: van der Heiden Cornelis W. , Zijderhand Casper F. , Veen Kevin M. , Constantinescu Alina A. , Manintveld Olivier C. , Brugts Jasper J. , Bekkers Jos A. , Birim Ozcan , Bogers Ad J. J. C. , Caliskan Kadir
Published: December 2022

Mechanical device malfunction remains a known issue in left ventricular assist devices (LVADs). We investigated the incidence of mechanical device malfunction in the HeartMate II and HeartMate 3 LVADs. We conducted a retrospective study of all HeartMate II and HeartMate 3 LVADs implanted in our center. We evaluated major malfunction, potential major malfunction, minor malfunction, and need of device exchange. In total, 163 patients received an LVAD; in 63 (39%) a HeartMate II, and in 100 (61%) a HeartMate 3, median support time of respectively 24.6 months (interquartile range [IQR]: 32.4) and 21.1 months [IQR: 27.2]. Mechanical device malfunction, consisting of both major and potential major malfunction, occurred significantly less in the HeartMate 3 patients with a hazard ratio (HR) of 0.37 (95% confidence interval [CI]: 0.15–0.87, p = 0.022). Major malfunction alone occurred significantly less in HeartMate 3 patients with a HR of 0.18 (95% CI: 0.05–0.66, p = 0.009). HeartMate 3 patients had a significantly decreased hazard of a pump or outflow graft exchange (HR 0.13, 95% CI: 0.08–0.81, p = 0.008). System controller defects occurred significantly less in HM 3 patients (p = 0.007), but battery-clips defects occurred significantly more in HM 3 patients (p = 0.039). Major device malfunction including pump or outflow graft exchange occurred significantly less in HeartMate 3 compared to HeartMate II, while minor malfunctions were similar. Periodical assessment of the technical integrity of the device remains necessary during long-term LVAD support.
Characteristics and Outcomes of Cardiac Arrest in Adult Patients Admitted to Pediatric Services: A Descriptive Analysis of the American Heart Association’s Get With The Guidelines-Resuscitation Data*
Authors: O’Halloran Amanda J. , Grossestreuer Anne V. , Balaji Lakshman , Ross Catherine E. , Holmberg Mathias J. , Donnino Michael W. , Kleinman Monica E. ,   for the American Heart Association’s Get With The Guidelines-Resuscitation Investigators
Published: December 2022

OBJECTIVES:

Differences between adult and pediatric in-hospital cardiac arrest (IHCA) are well-described. Although most adults are cared for on adult services, pediatric services often admit adults, particularly those with chronic conditions. The objective of this study is to describe IHCA in adults admitted to pediatric services.

DESIGN:

Retrospective cohort analysis from the American Heart Association’s Get With The Guidelines-Resuscitation registry of a subpopulation of adults with IHCA while admitted to pediatric services. Multivariable logistic regression was used to evaluate adjusted survival outcomes and compare outcomes between age groups (18–21, 22–25, and ≥26 yr old).

SETTING:

Hospitals contributing to the Get With The Guidelines-Resuscitation registry.

PATIENTS:

Adult-aged patients (≥ 18 yr) with an index pulseless IHCA while admitted to a pediatric service from 2000 to 2018.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A total of 491 adult IHCAs were recorded on pediatric services at 17 sites, during the 19 years of review, and these events represented 0.1% of all adult IHCAs. In total, 221 cases met inclusion criteria with 139 events excluded due to an initial rhythm of bradycardia with poor perfusion. Median patient age was 22 years (interquartile range, 19–28 yr). Ninety-eight percent of patients had at least one pre-existing condition. Return of spontaneous circulation occurred in 63% of events and 30% of the patients survived to discharge. All age groups had similar rates of survival to discharge (range 26–37%; p = 0.37), and survival did not change over the study period (range 26–37%; p = 0.23 for adjusted survival to discharge).

CONCLUSIONS:

In this cohort of adults with IHCA while admitted to a pediatric service, we failed to find an association between survival outcomes and age. Additional research is needed to better understand resuscitation in this population.
Effects of a microprocessor-controlled ankle-foot unit on energy expenditure, quality of life, and postural stability in persons with transtibial amputation: An unblinded, randomized, controlled, cross-over study
Authors: Colas-Ribas Christophe , Martinet Noel , Audat Gaelle , Bruneau Antoine , Paysant Jean , Abraham Pierre
Published: December 2022

Background:

Microprocessor-controlled prostheses are designed to improve mobility and quality of life through better balance and energy restoration in persons with transtibial amputation. Quasi-active microprocessor-controlled ankles (MPA) adapt to variable terrain by ankle angle adjustment.

Objectives:

To compare energy expenditure, balance, quality of life, and satisfaction of Proprio-foot®(a quasi-active MPA model) with standard prescribed ankle prosthesis (prescribed ankle-foot units [PA]) (standard energy storage and return prosthesis).

Study design:

Multicenter, unblinded, randomized, controlled, cross-over study.

Methods:

Energy expenditure (primary outcome) was assessed by oxygen uptake (VO2) measured at the maximum level reached with the 2 prostheses during treadmill walking at progressively increasing incline and speed. Balance was assessed by stabilometry in different static positions. Quality of life and satisfaction were assessed by “Short Form 36” questionnaire (0-100) and byEvaluation de la Satisfaction envers une Aide Technique(0–5) questionnaires after wearing each of the 2 prostheses for 34 days.

Results:

Forty-five patients tested the 2 prostheses. No statistical difference in VO2was observed. Significant improvement of balance was observed both during standing on an incline or decline with MPA and PA (p< 0.01). Short Form 36 questionnaire physical scores and Short Form 36 questionnaire mental scores were 68.5 ± 19.5 vs. 62.1 ± 19.6 (p< 0.01) and 72.0 ± 20.8 vs. 66.2 ± 20.9 (p< 0.01) in MPA and PA, respectively.Evaluation de la Satisfaction envers une Aide Techniquescore on the device was not statistically significant between the 2 groups (MPA 4.4 ± 0.5 vs. PA 4.3 ± 0.5,p= 0.360).

Conclusion:

Proprio-foot®improved balance, quality of life, and patient satisfaction despite no reduction or increase in energy expenditure in comparison with standard energy storage and return prosthesis.