bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive Outcomes in Congenital Hypothyroidism: Impact of Socioeconomic Status – A Case-Control Study
Authors: Grob Francisca , Bedregal Paula , Viviani Paola , Torres Carlos , Becerra Carlos , Leyton Bárbara
Published: April 2022

Objective: Chile is one of the few high-income countries in Latin America, being a pioneer in implementing a national newborn screening (NBS) program in 1992. Currently, it covers 98% of the population, but no long-term outcomes have been described so far. The aim of this study was to report the neurocognitive outcomes of children with congenital hypothyroidism (CH) diagnosed by the NBS program in Chile between 2005 and 2012 and to identify variables associated with the outcomes. Methods: We performed a case-control study in children with CH born in the two largest regions of the country. The Leiter-R and TEVI-R tests were administered at home to 69 children with CH and 68 matched control subjects. Other variables affecting cognition were obtained. Multivariate logistic regression analyses were performed for Leiter-R and TEVI-R tests, using a model for cases alone and another model for cases and controls. Results: No differences in Leiter-R and TEVI-R results were observed between children with CH and the control group. Children who performed better, regardless of whether they had CH, had a higher family income and more assets. Conclusions: These results suggest that the Chilean NBS program strategy results in children with normal language, attention, and memory development. Socioeconomic disadvantage represents a significant detriment in cognitive function.
Association between Baseline Cognitive Function and Longitudinal Functional Outcome Change after Ischemic Stroke
Authors: Kim Yeshin , Chung Jaekyung , Song Jeong Yun , Jang Hyemin , Jang Jae-Won , Kim Seongheon
Published: April 2022

Introduction: Ischemic stroke can cause impairment of daily function and cognitive function. Higher cognitive function is reported in many studies to be associated with better functional outcomes; however, evidence from longitudinal study is lacking. Therefore, in the present study, the association between cognitive function and longitudinal changes of functional outcome was investigated based on stroke severity. Furthermore, whether the effect of cognitive function remained consistent after controlling for depression was investigated. Methods: The data of 423 stroke patients (292 minor strokes, 93 moderate strokes, and 38 severe strokes) were collected. Baseline Mini-Mental State Examination (MMSE) score was considered a predictor, and change of modified Rankin Scale (mRS) score during 12 months of follow-up was the outcome. First, the association between the baseline MMSE score and longitudinal change in the mRS score was analyzed using linear mixed-effects models. Fixed effects were MMSE score group, time, and MMSE score group × time interaction. Additional adjustment was made for the Geriatric Depression Scale (GDS) score. Results: Among the 423 subjects, the mean age was 73.5 years, and 43.4% were female. In the minor stroke group, the high MMSE score group had a decreased mRS score, and the low MMSE score group had an increased mRS score (p < 0.001). This association remained after additional adjustment of the GDS score. Association was not observed between cognitive function and functional recovery in the moderate or severe stroke group. Conclusion: After ischemic stroke, higher baseline global cognitive function was a predictive factor for better functional recovery regardless of depression symptoms in the minor stroke group.
A Case of Brachioradial Pruritus Treated with Chiropractic and Acupuncture
Authors: Golden Kathryn J. , Diana Ryan M.
Published: April 2022

This case report discusses the treatment of brachioradial pruritus (BRP) in a 57-year-old white male veteran with chiropractic and acupuncture. The patient presented with findings consistent with a diagnosis of BRP to include sharp pain, burning, and itching at the bilateral upper extremities over the C5 and C6 dermatomes with acquired excoriations over the affected regions. The only known palliative measure was applying icepacks. Plain film radiographs revealed mild degenerative change at the C4–C5 and C5–C6 levels and postural evaluation observed anterior head carriage with forward-rounded shoulders. He had pain upon palpation and motion restriction in the cervical spinal region. His trial of treatment consisted of manual cervical and thoracic spinal manipulation, manual cervical traction, prescription of a home exercise program, and acupuncture. At the conclusion of this trial, the patient’s symptoms resolved and his acquired excoriations began to show signs of healing. A proposed etiology of BRP is cervical spine disease. There are limited case reports and retrospective studies in the literature that examine conservative care options targeting cervical spinal disease for the treatment of BRP. This case study reviews a patient diagnosed with BRP and confounding cervical spine disease who was treated with chiropractic and acupuncture, experiencing relief from his symptoms.
Longitudinal Optical Coherence Tomography Angiography Findings in Malignant Hypertension Choroidopathy: A Case Report
Authors: Viruni Narine , Ong Sally S. , Wu Jo-Hsuan , Liu T.Y. Alvin
Published: April 2022

This report presented the longitudinal optical coherence tomography angiography (OCTA) findings in a patient with malignant hypertension choroidopathy. An 87-year-old woman presented with acute unilateral central vision loss in the setting of hypertensive emergency. Spectral domain optical coherence tomography showed massive serous macular detachment. OCTA revealed extensive flow loss in the neuroretina and choriocapillaris. With blood pressure (BP) normalization and without any ocular intervention, visual acuity recovered on subsequent visits. Flow loss in the neuroretinal capillaries persisted, but significant improvement in the perfusion of the choriocapillaris was observed. This case demonstrates extensive choriocapillaris flow loss in the acute phase of malignant hypertension, and a temporal relationship between BP normalization, improvement of choriocapillaris perfusion, and decrease of subretinal fluid, providing additional insight into the pathophysiology of this life- and sight-threatening systemic condition.
Infantile Appendicitis: A Deceptive Challenge with Disastrous Consequences
Authors: Balachandra Thambirajah , Vadysinghe Amal N. , Sergi Consolato M.
Published: April 2022

Acute appendicitis (AA) in neonates and infants is an infrequent event. In day-to-day practice, death due to AA is hardly ever reported to a coroner or a medical examiner. Here, we report on an 8-month-old infant assigned to the medical examiner as the death occurred within 10 days of a surgical procedure. The cause of death was undetermined. Autopsy revealed gross and histologic features of AA. A postmortem review of the medical records showed signs and symptoms consistent with AA. On the other hand, a recent history of upper respiratory tract infection followed by clinical diagnosis and treatment by a community pediatrician probably blindsided the hospital physicians. This case illustrates the challenges of AA in infancy. The literature review revealed that a misdiagnosis of AA is more likely to occur on several occasions. They include patients who present “atypically,” patients who are not thoroughly examined, patients receiving antipyretic or analgesic medication and discharged, those diagnosed as having gastroenteritis, and patients who do not receive an appropriate discharge or follow-up instructions.
An Incidental Finding of Gastric and Duodenal Pseudomelanosis: A Case Report
Authors: Wael Mohamed Mohamed , Althahabi Rawan , Abubaker Faisal , Sharif Omar
Published: April 2022

Pseudomelanosis of the upper gastrointestinal tract is a rare diagnosis of undetermined significance, most commonly affecting the duodenum. Endoscopically, it is characterized by dark spickled pigmentation . Its development has been linked to certain conditions and medications. Involvement of the stomach is extremely rare with very few cases reported in the literature to date. We report an 85-year-old male who is known to have type 2 diabetes mellitus, dyslipidemia, iron deficiency anemia, and chronic kidney disease who underwent an esophagogastroduodenoscopy for evaluation of upper gastrointestinal bleeding and was found to have gastric and duodenal pseudomelanosis confirmed by biopsy. It is an extremely rare benign condition, but metastatic melanoma has to be ruled out, as was done in this case.
Brief ICF Core Set for Schizophrenia: Development of Criteria for Assessing the Degree of Disability
Authors: Pinho Lara , Lopes Manuel
Published: April 2022

Introduction: A paradigm shift in the assessment and rehabilitation of people with schizophrenia is needed, with an integrative perspective rather than a simple focus on the underlying symptomatology. To this end, it is essential to adopt integrated and continuous care focused on the person in his/her context. As a contribution, the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for schizophrenia has been developed by international experts. The present study aims to develop a scale to classify the degree of disability for each of the categories of the Brief ICF Core Set for schizophrenia. Methods: The classification criteria were first developed by the researchers and then submitted for assessment by national experts in the area of schizophrenia, using the modified e-Delphi method. Results: Two rounds of questions were asked, and a consensus was reached on the development of the Schizophrenia Functioning Core Set, consisting of all categories of the Brief ICF Core Set for schizophrenia and the criteria for classifying the degree of disability. The degree of agreement of the experts was greater than 90% in all categories. Conclusion: The construction of the disability grading criteria was based on the characteristics of schizophrenia as defined in DSM-V, as well as on some functional assessment scales specifically for this disorder. The development of the Schizophrenia Functioning Core Set allows for reducing the subjectivity in the assessment of the functioning of people with schizophrenia, standardizing the application of criteria to assign the degree of disability in each of the categories.
Treatment of Ductal Carcinoma in situ: A Register-Based Study of Norwegian Women Diagnosed between 1995 and 2018
Authors: Skjerven Helle Kristine , Danielsen Anders Skyrud , Schlichting Ellen , Sahlberg Kristine Kleivi , Hofvind Solveig
Published: April 2022

Introduction: The incidence of ductal carcinoma in situ (DCIS) has increased after implementation of mammographic screening. The lesion represents management challenges due to its undetermined growth pattern. We aimed to explore treatment of women aged 48–71 years diagnosed with DCIS between 1995 and 2018, by detection mode and histopathological characteristics. Material and Methods: Data on surgical treatment and radiation therapy (RT) of 4,995 women diagnosed with DCIS were retrieved from the Cancer Registry of Norway. We described the percentage and frequency of breast-conserving treatment (BCT) for participants in BreastScreen Norway (screen-detected) and nonparticipants. We estimated the relative risk (RR) of BCT, using log-binomial regression models. Results: Use of BCT increased from about 40% in 1995 to 85% in 2018. Use of BCT was more common among older than younger women and more commonly used for screen-detected versus tumors detected outside the screening program. Nine out of ten women with tumors ≤10 mm were treated with BCT and two out of ten with tumors >50 mm. RT was given to 89.3% of the women with tumors ≤10 mm, 34.1% of those with tumors classified as van Nuys’ grade 1 and <10 mm and 96.0% of the tumors >50 mm. Use of BCT was less common for tumors >50 mm compared to <10 mm (RR adjusted for age, detection mode, van Nuys’ grade, and localization: 0.26, 95% CI: 0.19–0.36). Conclusion: BCT was increasingly used among women diagnosed with DCIS in Norway during the period from 1995 to 2018, particularly for screen-detected, small lesions with low van Nuys’ grade.
Neoplasias relacionadas ao tabaco: análise de sobrevivência e risco de óbito de dados populacionais de Florianópolis, SC
Authors: Schneider Ione Jayce Ceola , Schmidt Tauana Prestes , Correa Vanessa Pereira , Santos Ana Maria Martins dos , Rocha Bruna Vanti da , Garcia Leandro Pereira , Ceccon Roger Flores
Published: April 2022

OBJETIVO Estimar a probabilidade de sobrevivência e os fatores prognósticos das neoplasias relacionados ao tabagismo em uma coorte de base populacional. MÉTODOS Trata-se de uma coorte com dados do Registro de Câncer de Base Populacional de Florianópolis, região Sul do Brasil, de 2008 a 2012. Utilizou-se o software Stata 16.0 para estimar as probabilidades de sobrevivência em cinco anos após o diagnóstico, pelo método de Kaplan Meier, e os riscos de óbito, pela regressão de Cox. RESULTADOS Foram incluídos 2.829 registros de câncer relacionados ao tabagismo, mais prevalentes entre pessoas do sexo masculino, com mais de 70 anos, nove anos ou mais de escolaridade, cor branca, com companheiro e diagnóstico metastático. Os agrupamentos mais frequentes foram cólon e reto (28,7%), traqueia, brônquios e pulmões (18,6%) e estômago (11,8%). No acompanhamento, 1.450 foram a óbito. O câncer de pâncreas foi o que apresentou pior probabilidade de sobrevivência (14,3%), seguido pelo câncer de fígado (19,4%). CONCLUSÃO Os fatores de risco para o óbito e as taxas de sobrevivência diferem entre os 13 tipos de câncer relacionados ao tabaco. O diagnóstico precoce e a prevenção primária são estratégias que devem ser aprimoradas para melhorar a sobrevivência e diminuir a carga relacionada a esses tipos de câncer.
Proteomic Characterization of Atherosclerotic Lesions In Situ Using Percutaneous Coronary Intervention Angioplasty Balloons—Brief Report
Authors: Lorentzen Lasse G. , Hansen Gorm M. , Iversen Kasper K. , Bundgaard Henning , Davies Michael J.
Published: April 2022

Background:

Materials extracted from atherosclerotic arteries can disclose data about the molecular pathology of cardiovascular disease, but obtaining such samples is complex and requires invasive surgery. To overcome this barrier, this study investigated whether angioplasty balloons inflated during standard percutaneous coronary interventions retain proteins from treated (dilated) atherosclerotic lesions and whether proteomic analysis of this material could provide data on lesion protein profiles and distinguish between patients with stable and unstable coronary artery disease.

Methods:

Patients with ST-segment–elevation myocardial infarction and stable angina pectoris were subjected to routine percutaneous coronary interventions. All angioplasty balloons inflated in a coronary artery were collected. Proteins retained on the balloons were extracted and analyzed using shotgun proteomic analysis.

Results:

Proteomics identified and quantified 1365 unique proteins captured on percutaneous coronary intervention balloons. Control balloons inflated in the ascending aorta showed minimal nonspecific protein binding, indicating specificity to the luminal region of atherosclerotic lesions of the diseased artery wall. Clustering and principal component analyses showed that ST-segment–elevation myocardial infarction and stable angina pectoris subjects could be separated by variations in protein content and abundance. We identified 206 proteins as differentially abundant between ST-segment–elevation myocardial infarction and stable angina pectoris subjects. Pathway analysis indicated several enriched processes in the ST-segment–elevation myocardial infarction group involved in neutrophil-mediated immunity and platelet activation.

Conclusions:

Disease-related proteins from coronary artery lesions adhere to angioplasty balloons and constitute a source of material for proteomic analysis. This approach can identify proteins and processes occurring in unstable coronary atherosclerotic lesions and suggest novel therapeutic approaches.
Tenascin-X Mediates Flow-Induced Suppression of EndMT and Atherosclerosis
Authors: Liang Guozheng , Wang ShengPeng , Shao Jingchen , Jin Young-June , Xu Liran , Yan Yang , Günther Stefan , Wang Lei , Offermanns Stefan
Published: April 2022

Background:

Endothelial-to-mesenchymal transition (EndMT) has been identified as a critical driver of vascular inflammation and atherosclerosis, and TGF-β (transforming growth factor β) is a key mediator of EndMT. Both EndMT and atherosclerosis are promoted by disturbed flow, whereas unidirectional laminar flow limits EndMT and is atheroprotective. How EndMT and endothelial TGF-β signaling are regulated by different flow patterns is, however, still poorly understood.

Methods:

Flow chamber experiments in vitro and endothelium-specific knockout mice were used to study the role of tenascin-X in the regulation of EndMT and atherosclerosis as well as the underlying mechanisms.

Results:

In human endothelial cells as well as in human and mouse aortae, unidirectional laminar flow but not disturbed flow strongly increased endothelial expression of the extracellular matrix protein TN-X (tenascin-X) in a KLF4 (Krüppel-like factor 4) dependent manner. Mice with endothelium-specific loss of TN-X (EC-Tnxb-KO) showed increased endothelial TGF-β signaling as well as increased endothelial expression of EndMT and inflammatory marker genes. When EC-Tnxb-KO mice were subjected to partial carotid artery ligation, we observed increased vascular remodeling. EC-Tnxb-KO mice crossed to low-density lipoprotein receptor-deficient mice showed advanced atherosclerotic lesions after being fed a high-fat diet. Treatment of EC-Tnxb-KO mice with an anti-TGF-beta antibody or additional endothelial loss of TGF-beta receptors 1 and 2 normalized endothelial TGF-beta signaling and prevented EndMT. In in vitro studies, we found that TN-X through its fibrinogen-like domain directly interacts with TGF-β and thereby interferes with its binding to the TGF-β receptor.

Conclusions:

In summary, we show that TN-X is a central mediator of flow-induced inhibition of EndMT, endothelial inflammation and atherogenesis, which functions by binding to and by blocking the activity of TGF-β. Our data identify a novel mechanism of flow-dependent regulation of vascular TGF-β, which holds promise for generating new strategies to prevent vascular inflammation and atherosclerosis.
I Am Onan: Rereading the So-Called Transgression of Wasting Seed
Authors: Noya Ludwig Beethoven J.
Published: April 2022

In this article, I aim to read Onan’s action in Gen 38 not simply as an act of transgression but also as a form of resistance to oppressive structures. I will demonstrate that Onan is resisting the dominating structure of levirate marriage that was strongly connected with patriarchy, heteronormativity, and hegemonic masculinity. To support this argument, I divide this article into three parts. First, I revisit the earlier interpretations of Onan’s narrative. Then, I explain Onan’s situational context and discuss the possibility of reading his narrative through the postcolonial, queer, and gender-critical lenses. Finally, I conclude that Onan’s action is an act of resistance toward oppressing systems of culture and that his act takes into account Tamar’s interest in achieving proper livelihood.
The Islamic Law of Pearling: Ritual Obligation and Economic Practice in the Arabian Gulf, ca. 1910–1940
Authors: Caeiro Alexandre
Published: April 2022

In the first half of the twentieth century, the legal landscape of the Arabian sheikhdoms was pluralistic and fragmented. The legal actors who settled disputes included local rulers, qāḍīs, pearl merchants, tribal shaykhs, and British officials. Drawing on fatwas and correspondence between religious scholars and notables in Baghdad, Cairo, Damascus, Doha, Kuwait and Manama, I examine how Islamic law shaped pearling – the region’s central economic activity – during this critical juncture. I show that Islamic law furnished a structure and repertoire of argumentation that actors in the industry were able to mobilize selectively. I argue that seasonal questions about diver obligations during Ramadan led to broader debates about the economic arrangements that structured the trade, in particular usury and labor coercion. These debates reflect shifting power dynamics in the Gulf and the impact of new ideas about Islam and capitalism in the age of print.
Dianoia & Plato’s Divided Line
Authors: Storey Damien
Published: April 2022

This paper takes a detailed look at the Republic’s Divided Line analogy and considers how we should respond to its most contentious implication: that pistis and dianoia have the same degree of ‘clarity’ (σαφήνεια). It argues that we must take this implication at face value and that doing so allows us to better understand both the analogy and the nature of dianoia.
The nematode genus Haliplectus Cobb, 1913 (Chromadorea: Haliplectidae): phylogenetic relationships, description of a new species from the Persian Gulf, southern Iran, and a tabular key to valid species
Authors: Gharahkhani Azadeh , Pourjam Ebrahim , Leduc Daniel , Pedram Majid
Published: April 2022

The family Haliplectidae is reported from Iran for the first time and Haliplectus iranicus sp. n., from a mangrove forest in the Persian Gulf, is described. The new species is characterised by one ventromedian supplement near to cloacal aperture and a group of three supplements, 10-15 μm anterior to cloacal opening, absence of protuberant caudal papillae and tail sexual dimorphism. A tabular key containing morphometric data and morphological information of 26 valid Haliplectus species is presented. Near full length SSU rDNA sequences are provided for H. iranicus sp. n. Our SSU analysis strongly indicates that Haliplectus does not belong to the order Plectida as in the current classification, and confirms the monophyly of Haliplectus based upon currently available data, but phylogenetic relationships of the genus remain uncertain. In fact, the classification of Haliplectidae is considered incerta sedis within the class Chromadorea.
Religion as a Security Threat
Authors: Hassan Hamdy A
Published: April 2022

Religious extremism presents an ideological perspective found in most major religions and is currently associated with various forms of religiously motivated acts of violence. A conceptual framework is adopted to study the warning features of religious extremism and apply it to case studies of Nigeria, Uganda, and the Central African Republic (CAR). The application of a religious jihadism model to Christianity provides a comparative basis for assessing Islamic radical jihadism, helping to understand religion as a security threat, with particular reference to Christian contexts and examples. Using extremist rhetoric and the mobilization of Christian rituals, members of religious groups attempt to renegotiate their position in the public space within a society from which they are excluded due to political, social, and economic dynamics based on their exclusion. This study finds no significant difference between Islamic jihad and Christian jihad, as each seeks to politically exploit religion for political ends.
Dialogic Interactions: Communication between Human Being and God according to the Philosophy of Franz Rosenzweig
Authors: Alon-Altman Talya
Published: April 2022

This article examines the communication between human being and God in the Jewish philosophy of the German-Jewish philosopher, Franz Rosenzweig (1886–1929). It observes Rosenzweig’s Jewish philosophy in light of communication theories and wishes to use the theoretical wealth of this relatively new discipline—communication—in order to deepen the philosophical discussion. The encounter described in this article is not an encounter that takes place in Rosenzweig’s writings, but rather an attempt to bring Rosenzweig into dialogue with modern theories of communication. This new perspective can enrich our view of philosophy of religion and to offer a new perception of communication.
Hobbes and the Indirect Workings of Political Consent
Authors: Ramelet Laetitia
Published: April 2022

This paper brings to light an unexplored aspect of Hobbes’s argument that political authority rests upon subjects’ consent. Consent enacts a transfer of subjects’ right of nature to the sovereign, yet she already possesses a natural right to everything. What moral difference, then, does this make to her possession of power, and how? In my reading, the difference lies in the rise of new obligations befalling the sovereign by means of an indirect mechanism: That many individuals, hoping for safety, transfer their right of nature to the sovereign triggers an obligation for her to accept the role of a ruler and perform the duties attached to it, for the sake of the peace enjoined by the laws of nature. This reading should also confirm the possibility of a consensual foundation for the Hobbesian right to punish and shed new light on Hobbes’s notion of tacit consent.
Indigenous Peoples in the Arctic Council: A Unique Feature?
Authors: Alfredsson Gudmundur
Published: April 2022

The website of the Arctic Council rather proudly refers to the designation of Indigenous peoples as ‘permanent participants’ in the Council’s work as a unique feature, but some Indigenous leaders are less than fully satisfied. In this article it is argued that this arrangement in significant ways falls behind the role of Indigenous peoples in the United Nations, in particular its human rights and environment programs. Drawing on this comparison, the article concludes with placing a few suggestions before the Arctic Council.
From Victims to Contributors: A Human Rights Approach to Climate Change for the Indigenous Peoples of the Arctic
Authors: Osakada Yuko
Published: April 2022

A human rights approach to climate change, which has been claimed by the Indigenous peoples, consisted of procedural and substantive demands. Their procedural demands have mostly been realized in establishing the Local Communities and Indigenous Peoples Platform and the LCIP Platform Facilitative Working Group (FWG), where they can participate on equal footing with state parties. It could be argued that the LCIP Platform and the FWG have empowered Indigenous peoples who have hitherto been perceived as mere victims of climate change by making them contributors who provide their traditional knowledge related to addressing and responding to climate change. By contrast, their substantive demands have been imperfectly accepted. This might be improved in the Platform’s future activities. In doing so, the Inuit leader has pointed out that it is important to distinguish between local communities and Indigenous peoples in the UN Framework Convention on Climate Change (UNFCCC) processes. This article will argue its feasibility depends on Indigenous peoples’ further efforts to convince state parties to accept such distinctions based on the applicability of the UN Declaration on the Rights of Indigenous Peoples.
The Role of Governance in Promoting the Resilience of Arctic Communities
Authors: Westrate Rachel , Mackie Sarah E.
Published: April 2022

Arctic Indigenous communities have faced, and overcome, threats to their lifestyles, livelihoods and communities for thousands of years and in doing so have maintained communities with deep cultural roots and close connections to the land on which they live. Modern Arctic Indigenous communities also face threats to their existence. These threats range from the environmental impacts of climate change forcing wholescale relocation of an entire village to noise from oil and gas exploration causing the relocation of the whale migration out of reach of hunters.

The article examines the concept of resilience and the role which governance can play in promoting the resilience of Arctic communities, and therefore their ability not only to survive but also to thrive. The article develops a theory of resilience, dividing types of resilience into in-situ and ex-situ resilience to allow the comparison of seemingly disparate examples. Through the use of a systematic comparative case analysis technique, the article explores the lessons which can be learned about the role of good governance in ensuring the promotion of resilience in Arctic communities in the future.
Co-management as a Foundation of Arctic Exceptionalism: Strengthening the Bonds between the Indigenous and Westphalian Worlds
Authors: Zellen Barry Scott
Published: April 2022

Successful collaboration between the Indigenous peoples and the sovereign states of Arctic North America has helped to stabilize the Arctic region, fostering meaningful Indigenous participation in the governance of their homeland through the introduction of new institutions of self-governance at the municipal, tribal and territorial levels, and successful diplomatic collaborations at the international level through the Arctic Council. Undergirding each of these pillars of Indigenous participation in Arctic governance is a mutuality of commitment to the principle of co-management of the Arctic that has united Indigenous peoples and the state across Arctic North America. Co-management has become so widely and reciprocally embraced by tribal peoples and states alike that it now provides a stable foundation bridging the Indigenous, transnational world with the Westphalian world of states and statecraft. This stability and the reciprocal and over time increasingly balanced relationship between sovereign states and Indigenous stakeholders has yielded a widely recognized spirit of international collaboration often referred to as Arctic exceptionalism. Along the way, co-management has transformed into both a mechanism of, and powerful paradigm for, trans-Arctic diplomacy that fosters not only greater domestic unity between tribe and state, but between states as well, catapulting mechanisms designed for domestic resource management to the international stage. Arctic exceptionalism has come under recent strain from the renewal of great power competition in the Arctic. As Arctic competition between states rises, the multitude of co-management systems and the multi-level, inter-governmental and inter-organizational relationships they have nurtured across the region can help to neutralize new threats from intensifying inter-state tensions.
Appraising the Modus of Conservation and Sustainable Use of Arctic Marine Biodiversity of Areas beyond National Jurisdiction under the Umbrella of the BBNJ Treaty
Authors: Hasan Sabrina
Published: April 2022

Arctic Ocean (AO) is opening the door for commercial activities due to the opening of previously inaccessible areas which has attracted the concern of the protection of the Arctic marine biodiversity through the effective implementation of legally binding instruments that will be influential to the implementation of scientific cooperation between Arctic and Non-Arctic States. Moreover, diplomatic issues among the Arctic States along with the gaps in the laws and regulations regarding Arctic Ocean governance have raised the concern to come up with an effective legal regime for the conservation and sustainable use of Arctic marine biodiversity. Though there are some applicable legal instruments in existence, the rapid changes in the AO and increased human activities have called for a stronger one. Now the question is whether that regime shall be within national or regional framework and how the upcoming internationally legally binding instrument for the conservation and sustainable use of biodiversity beyond national jurisdiction (BBNJ Treaty) can be an influential and effective instrument to promote the conservation and sustainable use of Arctic marine biodiversity which are beyond national jurisdiction. Therefore, the paper highlights the existing issues concerning Arctic marine biodiversity of the areas beyond national jurisdiction (ABNJ) and analyses these concerns regarding how the conservation and sustainable use of Arctic marine biodiversity can be promoted under the BBNJ treaty.
The Polluter-Pays Principle in a Transboundary Context – the Case of Arctic Ocean Continental Shelf Oil Production
Authors: Savov Ognyan
Published: April 2022

In terms of international law, States are obliged to abstain from causing significant transboundary harm. Part of this obligation is the enforcement of the polluter-pays principle. Although acknowledged by States, its extraterritorial application is the exception rather than the rule. The purpose of this article is to consider how, in the absence of a regional regime catering for the transboundary pollution victims, the Arctic Ocean littoral States adhere to those obligations while engaged in Arctic Ocean continental shelf oil production.
An Ecological Reading of Sovereignty Claims in Antarctica
Authors: Flores Carolina
Published: April 2022

Article IV of the Antarctic Treaty has “frozen” the controversies over sovereignty in Antarctica. However, the seven States claiming sovereignty over the continent still have an important role in the Antarctic Treaty System. One of the areas where they show leadership is in environmental protection, which is a pivotal principle of Antarctica’s regime since the adoption of the Environmental Protocol in 1991. Their active role cannot be explained under a Westphalian interpretation of sovereignty, where states have absolute power over the exploitation of their natural resources. Notwithstanding, under a human-based interpretation of sovereignty, the conduct of the Claimant States may have a clearer explanation.

This article will look into the practices of the Claimant States over the Antarctic to understand if and how their sovereignty claims may be linked to environmental protection.
The Impact of the BBNJ Agreement on the Legal Framework for the Governance of the Central Arctic Ocean
Authors: Nishimoto Kentaro
Published: April 2022

The negotiations on the development of an international legally binding instrument under the United Nations Convention on the Law of the Sea on the conservation and sustainable use of marine biological diversity of areas beyond national jurisdiction (“BBNJ Agreement”) could have a major impact on the governance of the Central Arctic Ocean, depending on how the BBNJ Agreement structures its relationship with relevant regional instruments, frameworks, and bodies, and whether the agreement will recognise any special rights or interests for ‘adjacent States’ in the governance of areas beyond national jurisdiction. Given the regulatory gaps in Arctic Ocean governance, the BBNJ Agreement has a potential gap-filling role. The BBNJ process could either stimulate the development of a regional regulatory framework for the CAO or shift the regional approach prevalent in many aspects of Arctic Ocean governance to a more globally oriented approach by adding a global layer of governance.
Sharing Arctic Science: Applying the Common Heritage and Common Concern of Humankind in the Arctic
Authors: Dervovic Medy
Published: April 2022

Addressing climate change effectively and efficiently requires a more in-depth understanding of its impacts and the interrelationships between climate patterns around the world. Given the magnitude of climatic and oceanic changes in the Arctic, marine scientific research in this region is of particular interest to humankind as it would improve mitigation and remediation strategies. The application of the Common Heritage and Common Concern of Humankind principles to Arctic Science aims at enhancing international scientific cooperation in the Arctic and generalizing the sharing of Arctic Scientific Data and Results. Despite exhibiting inherent conceptual limitations, both concepts show potential to legally and inclusively frame the Sharing of Arctic Science for the benefit of humankind. Moreover, this application contributes to the debate on a sui generis concept reflecting the need to face future challenges of climate change for the sake of humankind.
Incorporating Traditional Ecological Knowledge into Science under the Law of the Sea via the Arctic Ocean Governance
Authors: Seta Makoto
Published: April 2022

As indicated in Goal 14 of the Sustainable Development Goals, the international community tackles marine biodiversity and ecosystem conservation. However, the information on such biodiversity and ecosystems is limited compared to terrestrial conservation. Therefore, global ocean governance needs to acquire such knowledge and situate this knowledge into the decision-making process. In more recent contexts, the scientific approach is gaining acceptance. Meanwhile, the international movement towards human rights protection has gained strength and respect for diversity has also been confirmed. In this tendency, it is natural that the international community seeks to incorporate the ecological knowledge derived from the experience of various actors, so-called Traditional Ecological Knowledge (TEK), into the global ocean governance. This tendency is quite strong in the Arctic, where scientific evidence has not accumulated, and many people live with TEK. Therefore, the framework to harmonise science with TEK in the Arctic Ocean is a worthy model for the rest of waters in the globe. For this purpose, the paper examined three agreements: the Agreement on Enhancing International Arctic Scientific Co-operation (Science Agreement), the Agreement to Prevent Unregulated High Seas Fisheries in the Central Arctic Ocean (CAOFA), and the United Nations Convention on the Law of the Sea on the Conservation and Sustainable Use of Marine Biological Diversity of Areas beyond National Jurisdiction (BBNJ) Agreement, a universal treaty.
Different Models of Forbearance and Mortgage Enforcement Proceedings
Authors: Visser Irene , Breedeveld Jamie A. , Hasnaoui Yassine
Published: April 2022

The international credit crisis of 2008–2013 changed the legal landscape of mortgage enforcement proceedings in Europe dramatically. The growing influence of the international right to housing, the increasing attention towards homeowner protection, the renewed policies towards mortgage financing and the changes in national legislation, make the study of these proceedings relevant and interesting. Moreover, the phase between default of the mortgage debtor and the actual start of these proceedings is becoming more and more relevant because of these developments. Nonetheless, this phase is quite underresearched, especially from a comparative legal research point of view. Our comparative study therefore takes a different approach than classical comparative studies on mortgage enforcement procedures. With this project, we investigate the approaches of mortgage lenders after the mortgage debtor is in default with his mortgage obligations. These approaches can be based on legislation, self-regulation or agreements with the mortgagor. The aim of this project is to discover how these regulations function in practice. This paper provides an introduction to this emerging legal comparative research project on, what we call, default resolution approaches in Europe. We explain the main interests involved in default resolution approaches and the dimensions that should be taken into account in our study. We then sketch our comparative framework for further research.
Nontheoretical Presuppositions in Science and Scholarship: Critique of an Uncritical Critique
Authors: van Haeften Chris
Published: April 2022

Introduction to the translation of “De niet-theoretische voor-oordeelen in de wetenschap: Critiek op een oncritische critiek” by Herman Dooyeweerd (1938), Philosophia Reformata 3 (4), pp. 193–201.
Sodium Bicarbonate and Acetic Acid: An Effective Anaesthetic for Three Spotted Tilapia, Oreochromis andersonii Fingerlings
Authors: Haihambo Wilhelm , Gabriel Ndakalimwe Naftal
Published: April 2022

This study aimed to study the effectiveness of different concentrations of sodium bicarbonate (baking soda) combined with acetic acid (vinegar) in three spotted tilapia (Oreochromis andersonii) fingerlings. Fingerlings (body weight 0.82 ± 0.00 g, and body length of 3.91 ± 0.03 cm) were subjected to three concentrations of sodium bicarbonate (30 g/L, 40 g/L and 60 g/L) combined with three concentrations of acetic acid (30 ml/L, 45 ml/L and 60 ml/L), each replicated five times to assess the anaesthesia induction and recovery time. Sodium bicarbonate and acetic acid induced anaesthesia in three spotted tilapia fingerlings regardless of the concentration used. However, high concentrations induced anaesthesia within a short period of time. Meanwhile, the full recovery time increased with concentration combinations. In essence, low concentrations of sodium bicarbonate and acetic could be recommended for anaesthetizing three spotted tilapia fingerlings. However, more studies on sodium bicarbonate and acetic acids as anaesthetics in aquaculture and fisheries is deemed necessary.
The Nexus of Carcerality and Access and Success in Postsecondary Education
Authors: Huerta Adrian H. , Britton Tolani
Published: April 2022

This special issue of American Behavioral Scientist focuses on college preparation, access, and success for individuals impacted by carceral systems and practices in K-12 and higher education. Carcerality is (in)formal rules that center discipline, punishment, and control of individuals. Most recently, the embodiment of carceral practices has become more visible throughout the educational system, particularly for students of color. Attitudes, practices, and policies shape how K-12 and higher education students are perceived and treated as risks. In turn, these attitudes and policies lead to decisions about whether students merit investments that increase the likelihood of success in the education system. In the face of these structural barriers, students resist and overcome these policies and the systemic underinvestment in their education. This volume of articles centers the interconnection between education and criminal (in)justice to understand how both fields interact and position minoritized students in the social, academic, and behavioral margins. Articles explore the experiences of system-impacted students in K-12, higher education, theoretical application of risk, the impact of carceral laws and policies on educational access, and response to practices and policies that can counter carceral efforts in education systems.
Pediatric Aortic Injury From a BB Gun Injury Requiring Emergent Thoracotomy
Authors: Sunderland Michaelia , Lafranchise Elizabeth , Durrant Audrey
Published: April 2022

Background

The leading cause of morbidity and mortality in the pediatric population is unintentional injury. Emergent thoracotomies are rarely performed in pediatric patients, especially in the very young pediatric population. We present a case of a 10-year-old male who survived emergent clamshell thoracotomy for penetrating chest trauma.

Our patient sustained aortic lacerations after being shot with an air-powered rifle. Thoracotomy was performed in the emergency department. The incision was extended to a clamshell thoracotomy for repair of the aortic lacerations. He survived and made a full recovery.

Conclusion

This case is one of the youngest reported survivors of an emergent thoracotomy. Air-powered gun injuries can be life-threatening despite their perception as safe toys for children. Surprisingly, there is very little regulation on sale of air guns to minors in the United States. Increased public awareness and regulation of sale may prevent unintentional injury in this population.
Performance-Based Assessment of Trauma Systems: Estimates for the State of Ohio
Authors: Parikh Priti P. , Parikh Pratik , Hirpara Sagarkumar , Vaishnav Monit , Sebastian Susan , McCarthy Mary C. , Jansen Jan , Winchell Robert J.
Published: April 2022

Objectives

There are no widely accepted metrics to determine the optimal number and geographic distribution of trauma centers (TCs). We propose a Performance-based Assessment of Trauma System (PBATS) model to optimize the number and distribution of TCs in a region using key performance metrics.

Methods

The proposed PBATS approach relies on well-established mathematical programming approach to minimize the number of level I (LI) and level II (LII) TCs required in a region, constrained by prespecified system-related under-triage (srUT) and over-triage (srOT) rates and TC volume. To illustrate PBATS, we collected 6002 matched (linked) records from the 2012 Ohio Trauma and EMS registries. The PBATS-suggested network was compared to the 2012 Ohio network and also to the configuration proposed by the Needs-Based Assessment of Trauma System (NBATS) tool.

Results

For this data, PBATS suggested 14 LI/II TCs with a slightly different geographic distribution compared to the 2012 network with 21 LI and LII TC, for the same srUT≈.2 and srOT≈.52. To achieve UT ≤ .05, PBATS suggested 23 LI/II TCs with a significantly different distribution. The NBATS suggested fewer TCs (12 LI/II) than the Ohio 2012 network.

Conclusion

The PBATS approach can generate a geographically optimized network of TCs to achieve prespecified performance characteristics such as srUT rate, srOT rate, and TC volume. Such a solution may provide a useful data-driven standard, which can be used to drive incremental system changes and guide policy decisions.
The Homeless Population: Medical Refugees in a Mature Trauma System
Authors: Skicki Edward J. , Morgan Madison , Brown Catherine , Bresz Kellie , Bradburn Eric
Published: April 2022

Introduction

On any given day, there are >550,000 homeless persons in the United States. Little research has examined the relationship between the homeless population and traumatic injuries. We hypothesized that homeless trauma patients have a higher mortality compared to those who are not homeless.

Methods

The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003-2018 for all adult (age ≥15) patients admitted to trauma centers in Pennsylvania. Homelessness was defined as homeless on admission or homeless as their discharge status. Patient demographics, comorbidities, and clinical variables were compared between homeless and non-homeless patients. Logistic regression was used to control for age, gender, injury severity, injury type, admission Glasgow Coma Scale, and systolic blood pressure to assess morbidity and mortality.

Results

773 patients were identified upon query. Homeless trauma patients were more likely to be male, younger, black, and of Hispanic ethnicity. Compared to non-homeless, they were more likely to have a positive drug screen or mental illness at the time of injury. They were not more significantly injured than their counterparts; however, in adjusted analysis, the homeless had significantly higher odds of both complications (Adjusted Odds Ratio [AOR]: 3.11; 95%CI: 2.64-3.66, P < .001) and mortality (AOR: 1.79; 95%CI: 1.29-2.50, P = .001).

Conclusion

Although homeless patients were not more severely injured than the general trauma population, they had significantly higher odds of both complications and mortality. This population represents a very vulnerable community in need of medical intervention and injury prevention programs.