bluuebunny/crossref_metadata_2025 huggingface dataset:
Trial registration and time to publication in a retrospective cohort of publicly funded randomised controlled trials in New Zealand 1999–2017
Authors: Jull Andrew , Walker Natalie
Published: October 2022

Objectives

To determine how quickly randomised controlled trials funded by the Health Research Council of New Zealand (HRC) were registered and published, and whether time to publication differed by trial result.

Design

We created a retrospective cohort of trials offered funding from 1999 to 2017 by seeking lists of candidate studies using the Official Information Act 1982. These lists were supplemented by searching the HRC’s online research repository and an open-access database on Figshare. One investigator searched for trial registrations and for dissemination using electronic databases, university websites and ResearchGate. One investigator extracted data from the obtained studies and a second investigator independently corroborated the data entry from a 10% random sample.

Results

We identified 258 trials that were offered funding, 252 trials were conducted and 229 (90.9%) were registered, 179 prospectively by the date of the final search (24 March 2022). Overall, 236 trials were completed by the date of the last search and in 209 (88.6%) trials the results had been disseminated, 200 (84.7%) of which were by journal publication. We obtained the results for 214 trials, 91 (42.5%) of which were positive, 120 (56.1%) of which were null and 3 (1.4%) of which were negative. Median time to publication was 22.7 months for positive trials and 21.5 months for combined null or negative trials (log rank test p=0.83). Median time since trial completion in the trials that had not been published was 43.6 months (IQR 17.1–108.2 months).

Conclusions

Between 1999 and 2017, almost 9 out of every 10 HRC-funded trials had been registered and a similar proportion of completed trials had been published with no difference in time to publication based on type of result. However, only a slim majority of trials had published within the 2-year time frame set by the WHO.
Association between visual status and the frequency of laughterin older Japanese individuals: the JAGES cross-sectional study
Authors: Inoue Akira , Hiratsuka Yoshimune , Takesue Atsuhide , Aida Jun , Kondo Katsunori , Murakami Akira
Published: October 2022

Objective

Although the beneficial effects of laughter are abundantly reported, the physical function that is required as a premise for laughter has not been studied. The aim of this study is to investigate the association between visual status and frequency of laughter in a population-based sample of older adults.

Methods and analysis

We analysed cross-sectional data of community-dwelling independent individuals aged ≥65 years (n=19 452) in Japan. The outcomes were frequency of laughter and number of opportunities to laugh. We used multivariable logistic regression analysis with multiple imputations to investigate the association between visual status and laughter.

Results

The number of participants who laughed almost every day was 8197 (42.1%). After adjusting for individual covariates in the multivariable logistic regression analysis with multiple imputations, visual status was found to be significantly associated with the frequency of laugher and the number of opportunities to laugh (p for trend <0.01). Compare to ‘normal vision’, while excellent/very good vision was associated with increased frequency and number of opportunities to laugh (ORs: 1.72 and 1.25, respectively), poor vision decreased the frequency and number of opportunities to laugh (ORs: 0.86 and 0.87, respectively).

Conclusions

There is a link between visual impairment and laughter, with poor vision having a negative impact while good vision has a positive effect. Improving vision may lead to laughter promotion.
Beta-blockers for tenacious saliva: a case report
Authors: Woodman Myles J. , Howard Paul
Published: October 2022

This case report describes the care of a 75-year-old gentleman with metastatic head and neck cancer who was highly symptomatic with intractable tenacious oropharyngeal secretions. The patient reported subjective benefit from oral atenolol. A literature review was undertaken and identified no previous studies on the use of β-blockers for secretions in malignant disease, although some anecdotal evidence for their use in motor neuron disease. The proposed underlying mechanism is that β1-blockade reduced the protein content of salivary secretions, hence reducing its viscosity. Further studies of both the role of β-adrenoreceptors in the control of secretion viscosity and the potential role of β-blockers in alleviating symptomatic tenacious secretions are warranted.
Development of anti-somatostatin receptors CAR T cells for treatment of neuroendocrine tumors
Authors: Mandriani Barbara , Pellè Eleonora , Mannavola Francesco , Palazzo Antonio , Marsano Renè Massimiliano , Ingravallo Giuseppe , Cazzato Gerardo , Ramello Maria Cecilia , Porta Camillo , Strosberg Jonathan , Abate-Daga Daniel , Cives Mauro
Published: October 2022

Background

Neuroendocrine tumors (NETs) overexpress somatostatin receptors (SSTRs).

Methods

We developed a second-generation, ligand-based, anti-SSTR chimeric antigen receptor (CAR) incorporating the somatostatin analog octreotide in its extracellular moiety.

Results

Anti-SSTR CAR T cells exerted antitumor activity against SSTR+NET cell linesin vitro. The killing activity was highly specific, as demonstrated by the lack of CAR T cell reactivity against NET cells engineered to express mutated variants of SSTR2/5 by CRISPR/Cas9. When adoptively transferred in NSG mice, anti-SSTR CAR T cells induced significant antitumor activity against human NET xenografts. Although anti-SSTR CAR T cells could recognize the murine SSTRs as shown by their killing ability against murine NET cells, no obvious deleterious effects on SSTR-expressing organs such as the brain or the pancreas were observed in mice.

Conclusions

Taken together, our results establish anti-SSTR CAR T cells as a potential candidate for early phase clinical investigations in patients with NETs. More broadly, the demonstration that a known peptide drug can direct CAR T cell targeting may streamline the potential utility of multiple peptide motifs and provide a blueprint for therapeutic applications in a variety of cancers.
Measures of intracranial compartments in acute intracerebral haemorrhage: data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial (RIGHT-2)
Authors: Krishnan Kailash , Law Zhe Kang , Woodhouse Lisa J , Dineen Rob A , Sprigg Nikola , Wardlaw Joanna M , Bath Philip M
Published: October 2022

Background and purpose

Intracerebral haemorrhage volume (ICHV) is prognostically important but does not account for intracranial volume (ICV) and cerebral parenchymal volume (CPV). We assessed measures of intracranial compartments in acute ICH using computerised tomography scans and whether ICHV/ICV and ICHV/CPV predict functional outcomes. We also assessed if cistern effacement, midline shift, old infarcts, leukoaraiosis and brain atrophy were associated with outcomes.

Methods

Data from 133 participants from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial trial were analysed. Measures included ICHV (using ABC/2) and ICV (XYZ/2) (by independent observers); ICHV, ICV and CPV (semiautomated segmentation, SAS); atrophy (intercaudate distance, ICD, Sylvian fissure ratio, SFR); midline shift; leukoaraiosis and cistern effacement (visual assessment). The effects of these measures on death at day 4 and poor functional outcome at day 90 (modified Rankin scale, mRS of >3) was assessed.

Results

ICV was significantly different between XYZ and SAS: mean (SD) of 1357 (219) vs 1420 (196), mean difference (MD) 62 mL (p<0.001). There was no significant difference in ICHV between ABC/2 and SAS. There was very good agreement for ICV measured by SAS, CPV, ICD, SFR, leukoaraiosis and cistern score (all interclass correlations, n=10: interobserver 0.72-0.99, intraobserver 0.73-1.00). ICHV/ICV and ICHV/CPV were significantly associated with mRS at day 90, death at day 4 and acute neurological deterioration (all p<0.05), similar to ICHV. Midline shift and cistern effacement at baseline were associated with poor functional outcome but old infarcts, leukoaraiosis and brain atrophy were not.

Conclusions

Intracranial compartment measures and visual estimates are reproducible. ICHV adjusted for ICH and CPV could be useful to prognosticate in acute stroke. The presence of midline shift and cistern effacement may predict outcome but the mechanisms need validation in larger studies.
Reflection Removal with Varied Field of View Images
Authors: Chaurasiya Rashmi , Ganotra Dinesh
Published: October 2022

Due to the presence of an additional glass pane between the camera and the scene, an additional reflection scene is captured in the image apart from the desired object sometimes. Images are more often captured from mobile handsets these days which have multiple cameras. This paper gives the advantage of multiple cameras. There exists a disparity and varied field of view when images are captured with multiple cameras. We use these two factors to act as a cue to remove reflection, as reflection intensity across the image pairs change with different field-of-view. The proposed method is robust and convenient to implement as it does not require an additional hardware, for example, light field camera for stereo images. Also, it does not make assumptions about the appearance or intensity of reflection.
Riemann problems for a hyperbolic system of nonlinear conservation laws from the Liou–Steffen pressure system
Authors: Cheng Hongjun , Yang Hanchun
Published: October 2022

This paper is devoted to a hyperbolic system of nonlinear conservation laws, that is, the pressure system independent of density and energy from the Liou–Steffen flux-splitting scheme on the compressible Euler equations. First, the one-dimensional Riemann problem is solved with eight kinds of structures. Second, the two-dimensional Riemann problem is discussed; the solution reveals a variety of geometric structures; by the generalized characteristic analysis method and studying the pointwise interactions of waves, we construct 29 kinds of structures of solution consisting of shocks, rarefaction waves and contact discontinuities; the theoretical analysis is confirmed by numerical simulations.
A Material Removal Rate Model for Tungsten Chemical Mechanical Planarization
Authors: Xu Qinzhi , Cao He , Liu Jianyun
Published: October 2022

In this work, a new tungsten removal rate model is proposed in the chemical mechanical planarization (CMP) process to investigate the removal mechanism with consideration of the synergistic effect of chemical reaction and mechanical abrasion. Based on the fundamentals of steady-state chemical reaction and mechanical abrasion, a chemical reaction kinetics CMP model is first built up to relate the removal rate to the chemical reagent and mechanical rate parameters. Then the Greenwood-Williamson (GW) contact theory is introduced into the chemical reaction kinetics model to construct a closed-form equation of removal rate, which captures the synergistic coupling effect of chemical and mechanical interactions. Furthermore, the present model is verified by the collected experimental data and utilized to investigate the impact of the design pattern effects on the removal rate. The consistency of the model prediction and the experimental data as well as the removal characteristics of design pattern structures indicate that the new proposed tungsten CMP model can be adopted to elucidate the synergistic effect of chemical and mechanical interactions and perform the sensitivity analysis of the design pattern dependency on removal rate of tungsten films.
Avances en la investigación de los mecanismos moleculares, los blancos terapéuticos y el desarrollo de fármacos para la fibrosis pulmonar idiopática
Authors: Ma Hongbo , Wu Xuyi , Li Yi , Xia Yong
Published: October 2022

La fibrosis pulmonar idiopática (FPI) es una enfermedad pulmonar intersticial de carácter mortal. Estudios recientes han identificado el papel clave de la interacción entre las células epiteliales, mesenquimales, inmunitarias y endoteliales desreguladas en la FPI. Además, algunas mutaciones genéticas y ciertos factores ambientales (por ejemplo, el tabaquismo) se han asociado con el desarrollo de la FPI. Con el reciente desarrollo de la tecnología de secuenciación, también se ha señalado que la epigenética, como vínculo intermedio entre la expresión genética y los impactos ambientales, está implicada en la fibrosis pulmonar. Aunque se desconoce la etiología de la FPI, en los últimos años han surgido blancos y agentes terapéuticos novedosos para el tratamiento de la FPI, y el éxito del lanzamiento de la pirfenidona y el nintedanib ha demostrado que la terapia contra la FPI tiene un futuro prometedor. Por lo tanto, nuestro objetivo es conocer en profundidad los mecanismos moleculares subyacentes y los factores patogénicos de la FPI, lo que sería útil para el diagnóstico de la FPI, el desarrollo de fármacos antifibróticos y un mejor pronóstico para los pacientes con FPI. En este estudio resumimos el mecanismo patogénico, los blancos terapéuticos y los ensayos clínicos considerando múltiples tipos de células y mutaciones genéticas, así como factores epigenéticos y ambientales.
The New FibroScan-AST (FAST) Score: Enhancing Diabetes Mellitus Impact on Metabolic-Associated Fatty Liver Disease
Authors: Macedo Silva Vítor , Freitas Marta , Xavier Sofia , Boal Carvalho Pedro , Magalhães Joana , Marinho Carla , Cotter José
Published: October 2022

Background: Metabolic-associated fatty liver disease (MAFLD) is an increasingly prevalent cause of chronic liver disease. In 2020, the FibroScan-AST (FAST) score was internationally validated as a new tool able to identify patients with steatohepatitis who benefit the most from further therapies, based on liver transient elastography (LTE) findings and serum levels of aspartate aminotransferase (AST). We aimed to identify, in MAFLD patients, which metabolic features may predict a higher FAST score. Methods: Retrospective study of consecutive patients with MAFLD submitted to LTE for two consecutive years. Patients without an AST sample collected within 6 months of the LTE were excluded. FAST score was calculated, stratifying the patient’s risk as low (<0.35), medium (0.35–0.67), or high (>0.67). Results: The sample included 117 patients, 53.0% of the female gender, with a mean age of 53 years. On multivariate analysis, patients with type 2 diabetes (T2DM) (p < 0.001), dyslipidemia (p = 0.046), and smoking habits (p = 0.037) presented with significantly higher FAST score values. Furthermore, diabetic patients did not only present significantly higher FAST scores but were also more frequently assigned to the high-risk group according to FAST score criteria (OR = 9.2; 95% CI = 1.8–45.5; p = 0.007). Conclusions: Calculating the FAST score, patients with T2DM presented a significantly higher risk of having significant fibrosis and steatohepatitis. Physicians may rely on this validated instrument to more easily identify which patients with T2DM and MAFLD benefit the most from a specialized follow-up.
Estructurar centros especializados en el diagnóstico y tratamiento de enfermedades pulmonares intersticales – una necesidad no resuelta
Authors: Cortés-Télles Arturo , Ortiz-Farías Diana Lizbeth
Published: October 2022

Background: Early appropriate diagnosis and treatment of interstitial lung diseases (ILD) is crucial to slow disease progression and improve survival. Yet it is unknown whether initial management in an expert centre is associated with improved outcomes. Therefore, we assessed mortality, hospitalisations and health care costs of ILD patients initially diagnosed and managed in specialised ILD centres versus non-specialised centres and explored differences in pharmaceutical treatment patterns. Methods: An epidemiological claims data analysis was performed, including patients with different ILD subtypes in Germany between 2013 and 2018. Classification of specialised centres was based on the number of ILD patients managed and procedures performed, as defined by the European Network on Rare Lung Diseases. Inverse probability of treatment weighting was used to adjust for covariates. Mortality and hospitalisations were examined via weighted Cox models, cost differences by weighted gamma regression models and differences in treatment patterns with weighted logistic regressions. Results: We compared 2022 patients managed in seven specialised ILD centres with 28,771 patients managed in 1156 non-specialised centres. Specialised ILD centre management was associated with lower mortality (HR: 0.87, 95% CI 0.78; 0.96), lower all-cause hospitalisation (HR: 0.93, 95% CI 0.87; 0.98) and higher respiratory-related costs (€669, 95% CI €219; €1156). Although risk of respiratory-related hospitalisations (HR: 1.00, 95% CI 0.92; 1.10) and overall costs (€ -872, 95% CI € -75; €1817) did not differ significantly, differences in treatment patterns were observed. Conclusion: Initial management in specialised ILD centres is associated with improved mortality and lower all-cause hospitalisations, potentially due to more differentiated diagnostic approaches linked with more appropriate ILD subtype-adjusted therapy.
Researchers and their data: A study based on the use of the worddatain scholarly articles
Authors: Bordignon Frédérique , Maisonobe Marion
Published: October 2022

Data is one of the most used terms in scientific vocabulary. This article focuses on the relationship between data and research by analyzing the contexts of occurrence of the word data in a corpus of 72,471 research articles (1980–2012) from two distinct fields (Social sciences, Physical sciences). The aim is to shed light on the issues raised by research on data, namely the difficulty of defining what is considered as data, the transformations that data undergo during the research process, and how they gain value for researchers who hold them. Relying on the distribution of occurrences throughout the texts and over time, it demonstrates that the word data mostly occurs at the beginning and end of research articles. Adjectives and verbs accompanying the noun data turn out to be even more important than data itself in specifying data. The increase in the use of possessive pronouns at the end of the articles reveals that authors tend to claim ownership of their data at the very end of the research process. Our research demonstrates that even if data-handling operations are increasingly frequent, they are still described with imprecise verbs that do not reflect the complexity of these transformations.
The History and Deep Time of Climate Crisis
Authors: Power Amanda
Published: October 2022

A question that is not widely asked, but perhaps should be, is: how responsible are historians for today’s threats to much of life on earth? What part has been played by western historical constructions of the human past, the sense of temporality and meaning on which it has been based, and the ethical imperatives it encodes? In what ways has the modern, professionalised discipline, with its roots in Judeo-Christian universalism and ideas of historical exceptionalism, together with European imperial, enlightenment, and nationalist projects, taken possession of deep time and used it to delegitimise other ways of thinking about humans and the planetary past? How can thinking with deep time help historians to undo westernised modernity’s tight grip on space and time, and craft approaches to the past that give urgently needed room to all life and non-life, relationships, and possibilities?
Social Accountability in Challenging Environments: Case Studies from Egypt
Authors: Khodary Yasmin
Published: October 2022

Through deploying the 2015 World Bank framework of contextual drivers for social accountability, this article seeks to examine three recent social accountability initiatives (sais) in the agriculture, health, and local development sectors in Egypt to identify the contextual drivers and success factors of sais operating in challenging environments. The article aims to answer the following questions: what roles do recent sais in Egypt play? What are the challenges that sais encounter? And how do such challenges (re)shape the processes and dynamics of sais? The article finds that in challenging environments–where invited spaces are controlled, citizens’ collective action is limited, and commitment by state-officials is not guaranteed–the role of interlocutors becomes key in boosting the effectiveness of sais. It plays the role of a mediator, mobilizer to citizen and state action, and information intermediary, which generates, simplifies, and disseminates information. In this sense, this article draws on the critical missing link in sais through an in-depth analysis of the role of interlocutors in overcoming challenging or constraining circumstances.
‘The Hagia Sophia Cause’ and the Emergence of Ottomanism in the 1950s
Authors: Azak Umut
Published: October 2022

Focusing on the symbolism of the Hagia Sophia for the conservative nationalist movement, this article examines the emergence of Ottomanism as an attempted challenge to the Kemalist reading of Ottoman history. The Hagia Sophia, the former imperial church that was converted into a mosque by Sultan Mehmed ii and served as the imperial mosque of the Ottomans, lost its religious function and was opened as a museum in 1934 by governmental decision. This ‘secularization’ of the building could be openly criticized especially after the transition to multiparty democracy in the late 1940s. Demands for reconverting the museum into a mosque were gradually transformed into public campaigns led by the protagonists of the conservative nationalist movement. This article analyses these campaigns as reflected in the printed press from the 1950s onwards and explores how the Hagia Sophia has since been instrumentalized for the reproduction of a xenophobic, anti-Western, Islamic and Ottomanist nationalism.
Khmer onset voicing at the end of the 13th century
Authors: MASPONG Sireemas
Published: October 2022

Khmer displays extensive diachronic phonological restructuring (Huffman, 1976), especially in the realization of initial stops. These changes include (i) devoicing and merger of voiced and voiceless stops, and (ii) the emergence of implosives from pre-vocalic voiceless stops. However, the details and the chronology of these changes remain unclear in many respects. This paper proposes a chronology of the two changes based on philological evidence: Chinese transcriptions of Khmer words in the Zhēnlà Fēngtǔ Jì (ZFTJ), a travel account from the late 13th century. Previous research on ZFTJ by Pelliot (1951) suggested that implosives had already emerged at the time of transcription, while the merger of voiced and voiceless stops had at least started. This is at odds with the general view of Khmer language history. I motivate a revised analysis of the Khmer transcriptions in the ZFTJ and show that the devoicing and merger of voiced and voiceless stops in fact had not yet occurred at the end of the 13th century. There is, however, not enough evidence from ZFTJ to confirm whether implosives had already emerged.
A Mamluk Pen Box Connected to the Thousand and One Nights and the Historian Ibn ʿAbd al-Zahir
Authors: Behrens-Abouseif Doris
Published: October 2022

The article discusses a remarkable Mamluk pen box in the Louvre, focusing on its inscriptions, which consist of three poems: one by the historian Muhyi ’l-Din Ibn ʿAbd al-Zahir, another by his son Taj al-Din, and a third, anonymous poem cited in a tale of The 1001 Nights. The article tries to trace the history of the pen box and reconstruct its original layout.
Discrimination of Brief Empty Time Intervals when the First Marker Is Tactile
Authors: Azari Leila , Drouin Joanie , Plante Guillaume , Grondin Simon
Published: October 2022

The present study investigated the discrimination of brief empty time intervals and compared three different sensory modality conditions for marking time: when two successive signals are tactile (intramodal condition, TT), and when a first tactile signal is followed by a either a visual (V) or an auditory (A) signal (intermodal conditions: TV and TA). Twelve participants completed a bisection task over the course of eight experimental sessions. Three factors were manipulated: the marker modality (TT, TV, and TA), the duration range (300 and 900 ms), and the preparation (certainty, uncertainty). In the latter case, participants knew that the first marker was T, but were uncertain about the modality of the second marker. In general, TT intervals were better discriminated than intermodal intervals at 300 ms, but this effect fades at 900 ms. No difference in the discrimination level was observed between the intermodal conditions. For the perceived duration, there was no difference between TT and TA conditions, but the TV intervals were perceived as longer than the TT intervals. As well, the TV intervals were perceived as longer than the TA intervals. These results are interpreted in terms of attentional and sensory effects caused by the signals themselves (onset and alerting properties, prior entry).
Fragment d’une statue d’Osiris consacrée par Douat-neter-(em)-âouy-Khonsou
Authors: Thiers Christophe
Published: October 2022

Dans ce volume dédié à la mémoire de Ramadan El-Sayed, dont la riche bibliographie en langue française témoigne d’un intérêt pour la documentation de l’Egypte tardive et ptolémaïque (statues conservées au Musée du Caire, Cachette de Karnak), je souhaiterais présenter un modeste fragment de statue osiriaque initialement repéré en 2011 dans le magasin dit de Gadaya à Karnak.
Humanitarianism’s New Business Model
Authors: Barnett Michael
Published: October 2022

There has been a transformation in the relationship between the corporate and humanitarian worlds over the last two decades, as the humanitarian sector has integrated a corporate mentality that would have once been viewed as downright deplorable by humanitarian actors. The search for a “new business model” is symbolic of the times. After situating the historical moment in terms of the relationship between humanitarianism and neoliberalism, the article examines three defining elements of this model: humanitarian finance; the role of corporations and markets for addressing life-threatening circumstances; and a business-oriented rationalization. These developments can constrain and possibly soil the legitimacy of humanitarianism. They might also alter humanitarianism’s practices and distort what humanitarian is. Such concerns raise the sociological question of: what function does humanitarianism play in the world order? Where does humanitarianism’s new business model fit?
China’s “New Philanthropy”: Cultivating Elite Chinese Philanthropists
Authors: Crane Elizabeth H.
Published: October 2022

Faced with glaring economic inequality within China, and the need to grow soft power globally, president Xi Jinping has identified the urgent need to usher in a “new era of socialism with Chinese characteristics,” and has specifically called for the expansion of “xin cishan” (新慈善), or “new philanthropy.” Both as a new phenomenon in the prc, and as a novel type, “new philanthropy” represents an opportunity for the nation to envision and cultivate charitable practice that mediates between market economics and socialist ethics, and grants China a moral authority that is legible to a Western gaze yet resistant to cultural imperialism. Based on yearlong ethnographic research inside an elite philanthropy training program, this article outlines three different visions that were found to coexist: philanthropy-as-new-revolution, philanthropy-as-new-legacy, and philanthropy-as-new-tradition. I also examine how wealthy participants responded to these various interpellations—part of a process I call “philanthropic subjectification.”
Judgment, Doubt, and Self-Doubt: A Reflexive Turn from the Borderland of Lampedusa
Authors: Corso Alessandro
Published: October 2022

As borders kill under the premises of saving lives and distributing order, border regimes emerge in everyday life as sites of uncertainty, fragility, and doubt. The paper explores the spaces of uncertainty that pervade everyday life at the borderlands of Europe with a particular focus on the island of Lampedusa (Italy), and it deploys doubt as an analytical tool to produce a reflexive turn in border studies. From an autoethnographic perspective, it calls for a re-evaluation of the directions we take as scholars when we think and write about borders. By exploring the potential of selfreflection as a path for knowledge of the "other", the paper suggests a shift in gaze which builds on judgment and self-dialogue as forms of responsibility.
The ECtHR’s Decision to Dismiss the First Request Submitted Under Article 29 of the Convention on Human Rights and Biomedicine
Authors: Asta Gabriele
Published: October 2022

The present article is aimed at critically assessing the ECtHR’s decision to dismiss the first request submitted under Article 29 of the Convention on Human Rights and Biomedicine (“Oviedo Convention”) by the Council of Europe’s Committee on Bioethics, for the purpose of clarifying certain aspects of the interpretation of Article 7 of the Oviedo Convention. While the ECtHR ultimately decided not to render the advisory opinion on the grounds that it would be outside its competence, the decision is of interest because it nonetheless was an occasion for the Court to assert in general terms its jurisdiction under Article 29 of the Oviedo Convention and to define the contours of its advisory competence. Yet, it will be argued that the Court’s reasoning is rather unconvincing, if not mistaken, and that it ultimately results in an unclear definition of the boundaries of its jurisdiction. The lack of clarity is further exacerbated by the fact that the Court seems to have treated as questions of competence some issues that most likely would have had to be addressed within the framework of propriety. This aspect will appear rather distinctly if one compares the ECtHR’s approach to the solutions adopted by other international courts and tribunals. This comparison will also be useful in order to suggest an alternative path that the Court could have followed, and which would have not only represented a more correct and coherent reasoning but also avoided the likely outcome of its decision, that is putting its advisory competence under the Oviedo Convention back in the attic.
Near-Inertial Surface Currents around Islands
Authors: Siegelman Mika N. , Firing Eric , Merrifield Mark A. , Becker Janet M. , Musgrave Ruth C.
Published: October 2022

Motivated by observations of enhanced near-inertial currents at the island chain of Palau, the modification of wind-generated near-inertial oscillations (NIOs) by the presence of an island is examined using the analytic solutions of Longuet-Higgins and a linear, inviscid, 1.5-layer reduced-gravity model. The analytic solution for oscillations at the inertial frequency f provides insights into flow adjustment near the island but excludes wave dynamics. To account for wave motion, the numerical model initially is forced by a large-scale wind field rotating at f, where the forcing is increased then decreased to zero. Numerical simulations are carried out over a range of island radii and the ocean response detailed. Near the island, wind energy in the frequency band near f can excite subinertial island-trapped waves and superinertial Poincaré waves. In the small-island limit, both the Poincaré waves and the island-trapped waves are very near f, and their sum resembles the Longuet-Higgins analytic solution but with increased amplitude near the island. The flow field can be viewed as primarily a far-field NIO locally deflected by the island plus an island-trapped contribution, leading to enhanced near-inertial currents near the island, on the scale of the island radius. As the island size is increased, the island-trapped wave frequency deviates further from f and its amplitude depends strongly on the frequency bandwidth and wavenumber structure of the wind forcing. In the large-island limit, the island-trapped wave resembles a Kelvin wave, and the sum of incident and reflected Poincaré waves suppresses the near-inertial current amplitude near the island.

Significance Statement

Strong, impulsive winds over the ocean excite currents that rotate in the opposite direction to Earth’s rotation. This work examines how these wind-generated currents, known as near-inertial oscillations (NIOs), are modified by the presence of an island. Around small islands, the primary response is locally enhanced near-inertial currents. Alternatively, around large islands, near-inertial currents are weaker. Understanding how these currents behave should provide insight into the physical processes that drive current variability near islands and spur local mixing.
How I manage inpatient consultations for quantitative neutrophil abnormalities in adults
Authors: Zon Rebecca L. , Berliner Nancy
Published: October 2022

Neutrophilia and neutropenia commonly lead to inpatient hematology consultation. Quantitative neutrophil abnormalities have a broad differential and include diagnoses that are important to recognize because they may be associated with increased mortality. Neutrophilia can reflect etiologies such as infection, medications, inflammation, splenectomy, and congenital disorders. Neutropenia can arise from infection, medications, autoimmune destruction, sequestration, nutritional deficiency, malignancy, and congenital neutropenia syndromes. In the evaluation of all abnormalities of neutrophil number, the timing of the change, and the patient’s historical neutrophil count are crucial.
The efficacy and safety of an adapted opioid-free anesthesia regimen versus conventional general anesthesia in gynecological surgery for low-resource settings: a randomized pilot study
Authors: Tochie Joel Noutakdie , Bengono Bengono Roddy Stephan , Metogo Junette Mbengono , Ndikontar Raymond , Ngouatna Serges , Ntock Ferdinand Ndom , Minkande Jacqueline Ze
Published: October 2022

Introduction

There is scarce data on the safety and efficacy of opioid-free anesthesia (OFA), in resource-limited settings due to the non-availability of dexmedetomidine, the reference OFA agent. We aimed to demonstrate the feasibility, efficacy and safety of a practical OFA protocol not containing dexmedetomidine, adapted for low-resource environments in very painful surgeries like gynecological surgery.

Methods

We conducted a randomized pilot study on ASA I and II women undergoing elective gynecological surgery at a tertiary care hospital in Cameroon. Patients were matched in a ratio of 1:1 into an OFA and a conventional general anesthesia (CGA) group. The OFA protocol entailed the intravenous (IV) magnesium sulfate, lidocaine, ketamine, dexamethasone, propofol, and rocuronium, followed by isoflurane and a continuous infusion of a calibrated mixture of magnesium sulfate, ketamine and clonidine. The CGA protocol was IV dexamethasone, diazepam, fentanyl, propofol, and rocuronium, followed by isoflurane and reinjections of fentanyl propofol and a continuous infusion of normal saline as placebo. The primary endpoints were the success rate of OFA, isoflurane consumption and intraoperative anesthetic complications. The secondary endpoints were postoperative pain intensity, postoperative complications, patient satisfaction assessed using the QoR-40 questionnaire and the financial cost of anesthesia.

Results

We enrolled a total of 36 women undergoing gynecological surgery; 18 in the OFA group and 18 in the CGA group. The success rate of OFA was 100% with significant lesser consumption of isoflurane in the OFA group, no significant intraoperative complication and better intraoperative hemodynamic stability in the OFA group. Postoperatively, compared to the CGA group, the OFA group had statistically significantly less pain during the first 24 h, no morphine consumption for pain relief, had less hypoxemia during the first six hours, less paralytic ileus, less nausea and vomiting, no pruritus and better satisfaction. The mean financial cost of this adapted OFA protocol was statistically significant lesser than that of CGA.

Conclusion

This OFA regimen without dexmedetomidine for a low-resource setting has a promising success rate with few perioperative complications including mild intraoperative hemodynamic changes, decrease postoperative complications, pain, and opioid consumption in patients undergoing elective gynecology surgery.

Trial registration

This study was registered at clinicaltrials.gov on 03/02/2021 under the registration number NCT04737473.
Transesophageal echocardiographic imaging of the coronary sinus: a retrospective analysis of mid-esophageal views and a novel transgastric view
Authors: Chen Tzonghuei , Hayward Geoffrey , Apruzzese Patricia , Maslow Andrew
Published: October 2022

Background

Transesophageal echocardiographic imaging plays an important role in assessing coronary sinus anatomy prior to placement of a retrograde cardioplegia cannula. The coronary sinus can be imaged in the long axis by advancing the TEE probe from the mid-esophageal 4-chamber view or using a modified mid-esophageal bicaval view, while a short axis view can be obtained in the mid-esophageal 2-chamber view. While use of a transgastric view is only briefly mentioned in the literature as an alternative to mid-esophageal views, the authors commonly include it in our comprehensive transesophageal echocardiographic exam of the coronary sinus. This study examines the various imaging strategies. We hypothesize that the transgastric view offers comparable coronary sinus imaging to the mid-esophageal views.

Methods

After approval by our institutional review board, the intraoperative transesophageal echocardiographic exams for 50 consecutive elective cardiac surgical patients with a comprehensive echocardiographic assessment of the coronary sinus were retrospectively reviewed and analyzed to evaluate imaging of the coronary sinus in the various views. For each view, we noted and recorded if the coronary sinus and coronary sinus cannula were visualized. Statistical analysis required pairwise comparisons between each of the 4 views. P values were calculated using McNemar’s Exact test.

Results

Both the coronary sinus and coronary sinus cannula were visualized a majority of the time for each view. There was no statistically significant difference between each view in its ability to visualize the coronary sinus, nor was there a statistically significant difference between each view in its ability to visualize the coronary sinus cannula.

Conclusions

Use of a transgastric window provides the echocardiographer with an effective alternate modality for imaging the coronary sinus when mid-esophageal views are limited.
Clustering of characteristics associated with unplanned pregnancies: the generation R study
Authors: Enthoven Clair A. , El Marroun Hanan , Koopman-Verhoeff M. Elisabeth , Jansen Wilma , Lambregtse-van den Berg Mijke P. , Sondeijker Frouke , Hillegers Manon H. J. , Bijma Hilmar H. , Jansen Pauline W.
Published: October 2022

Background

Unplanned or unintended pregnancies form a major public health concern because they are associated with unfavorable birth outcomes as well as social adversity, stress and depression among parents-to-be. Several risk factors for unplanned pregnancies in women have previously been identified, but studies usually take a unidimensional approach by focusing on only one or few factors, disregarding the possibility that predictors might cluster. Furthermore, data on predictors in men are largely overlooked. The purpose of this study is to determine predictors of unplanned versus planned pregnancy, to determine predictors of ambivalent feelings regarding pregnancy, and to investigate how characteristics of men and women with an unplanned pregnancy cluster together.

Methods

This study was embedded in Generation R, a multiethnic population-based prospective cohort from fetal life onwards. Pregnancy intention was reported by 7702 women and 5367 partners. Information on demographic, mental, physical, social, and sexual characteristics was obtained. Logistic regression, multinomial regression and cluster analyses were performed to determine characteristics that were associated with an unplanned pregnancy, with ambivalent feelings regarding the unplanned pregnancy and the co-occurrence of characteristics in women and men with unplanned pregnancy.

Results

Twenty nine percent of the pregnancies were unplanned. Logistic regression analyses showed that 42 of 44 studied predictors were significantly associated with unplanned pregnancy. The most important predictors were young age, migration background, lower educational level, lower household income, financial difficulties, being single, lower cognitive ability, drug use prior to pregnancy, having multiple sexual partners in the year prior to the pregnancy, younger age of first sexual contact and a history of abortion. Multinomial regression analyses showed that a Turkish or Moroccan background, Islamic religion, little financial opportunities, being married, having ≥3 children, high educational level, more mental health and social problems and older age of first sexual contact were associated with prolonged ambivalent feelings regarding pregnancy. Different combinations of characteristics were observed in the four clusters of women and men with unplanned pregnancy.

Conclusions

Many predictors are related with unplanned pregnancies, ambivalent feelings toward the pregnancy, and we identified very heterogeneous groups of women and men with unplanned pregnancies. This calls for heterogeneous measures to prevent unplanned pregnancies.
Implementation of evidence on management of pleural diseases: insights from a territory-wide survey of clinicians in Hong Kong
Authors: Lui Macy M. S. , Yeung Yiu-Cheong , Ngai Jenny C. L. , Sin Kit-Man , Lo Yi-Tat , Cheung Alice P. S. , Chiang Ka-Yan , Chan Yu-Hong , Chan Ken K. P. , Lam Connie H. K. , Law Wei-Lam , Fung Siu-Leung , Lam Wai-Kei , Lam David C. L. , Shek Lam-Hin , Wong Ida W. Y. , Yau Anthony P. Y. , Lee Yun-Chor Gary , Chan Johnny W. M.
Published: October 2022

Background

Major advances in management of common pleural diseases have taken place in the past decade. However, pleural diseases are often managed by physicians of diverse training background and research on implementation of new knowledge is scanty. We aim to evaluate the practice pattern in pleural medicine among physicians in Hong Kong, for identification of possible gaps for clinical service improvement.

Methods

The Hong Kong Thoracic Society undertook a cross-sectional questionnaire survey in 2019, targeting clinicians of various subspecialties in internal medicine and levels of experience (basic and higher trainees, specialists) from twelve regional hospitals of diverse service scopes throughout Hong Kong. Respondents were selected by non-probability quota sampling. The questionnaire tool consisted of 46 questions covering diagnostic and therapeutic aspects of common pleural diseases. The responses were anonymous, and analysed independently using SPSS statistics software.

Results

The survey collected 129 responses, 47(36%) were from clinicians specialized in respiratory medicine. Majority of the respondents (98%) managed pleural diseases, including performing pleural procedures in their practice. Fifty-five percent of all the respondents had not received any formal training in transthoracic ultrasonography. A significant proportion of clinicians were unaware of pleuroscopy for investigation of exudative pleural effusion, indwelling pleural catheter for recurrent malignant pleural effusion, and combined intra-pleural Alteplase plus DNase for treatment of pleural infection (30%, 15% and 70% of non-respiratory clinicians respectively). Significant heterogeneity was found in the management of pleural infection, malignant pleural effusion and pneumothorax among respiratory versus non-respiratory clinicians. Contributing factors to the observed heterogeneity included lack of awareness or training, limited accessibility of drugs, devices, or dedicated service support.

Conclusion

Significant heterogeneity in management of pleural diseases was observed among medical clinicians in Hong Kong. Continuous medical education and training provision for both specialists and non-specialists has to be strengthened to enhance the implementation of advances, improve quality and equity of healthcare provision in pleural medicine.
Trends in mortality from alcohol, opioid, and combined alcohol and opioid poisonings by sex, educational attainment, and race and ethnicity for the United States 2000–2019
Authors: Buckley Charlotte , Ye Yu , Kerr William C. , Mulia Nina , Puka Klajdi , Rehm Jürgen , Probst Charlotte
Published: October 2022

Background

The ongoing opioid epidemic and increases in alcohol-related mortality are key public health concerns in the USA, with well-documented inequalities in the degree to which groups with low and high education are affected. This study aimed to quantify disparities over time between educational and racial and ethnic groups in sex-specific mortality rates for opioid, alcohol, and combined alcohol and opioid poisonings in the USA.

Methods

The 2000–2019 Multiple Cause of Death Files from the National Vital Statistics System (NVSS) were used alongside population counts from the Current Population Survey 2000–2019. Alcohol, opioid, and combined alcohol and opioid poisonings were assigned using ICD-10 codes. Sex-stratified generalized least square regression models quantified differences between educational and racial and ethnic groups and changes in educational inequalities over time.

Results

Between 2000 and 2019, there was a 6.4-fold increase in opioid poisoning deaths, a 4.6-fold increase in combined alcohol and opioid poisoning deaths, and a 2.1-fold increase in alcohol poisoning deaths. Educational inequalities were observed for all poisoning outcomes, increasing over time for opioid-only and combined alcohol and opioid mortality. For non-Hispanic White Americans, the largest educational inequalities were observed for opioid poisonings and rates were 7.5 (men) and 7.2 (women) times higher in low compared to high education groups. Combined alcohol and opioid poisonings had larger educational inequalities for non-Hispanic Black men and women (relative to non-Hispanic White), with rates 8.9 (men) and 10.9 (women) times higher in low compared to high education groups.

Conclusions

For all types of poisoning, our analysis indicates wide and increasing gaps between those with low and high education with the largest inequalities observed for opioid-involved poisonings for non-Hispanic Black and White men and women. This study highlights population sub-groups such as individuals with low education who may be at the highest risk of increasing mortality from combined alcohol and opioid poisonings. Thereby the findings are crucial for the development of targeted public health interventions to reduce poisoning mortality and the socioeconomic inequalities related to it.