bluuebunny/crossref_metadata_2025 huggingface dataset:
From Judgment to Amodalism
Authors: Shieh Sanford
Published: May 2019

This chapter shows that Frege’s commitment to the absoluteness of truth rests on commitments central to his later philosophy, after he adopts the sense/reference distinction. For Frege, a thought represents something to be the case, and a judgment is fundamentally the recognition that what a thought represents obtains. Truth is that property of thoughts which one recognizes in virtue of recognizing the obtaining of what thoughts represent. The primary function of a thought is to be a step to the acquisition of knowledge, which is to say, to judgment. If the truth or falsity of a purported thought is relative, then it fails to provide what is required for judgment and is no more than an apparent thought. The truth and falsity of genuine thoughts, by grasping which we can make judgments and acquire knowledge, are absolute.
Numerical Experimentation
Authors: Humphreys Paul
Published: May 2019

I argue here that the computational models of numerical experimentation constitute a distinctively new kind of scientific method, intermediate in kind between empirical experimentation and analytic theory. A parallel is also drawn between extending our senses with scientific instruments and extending our mathematical powers by using computational instruments. A specific application of these methods to Ising Models using the Metropolis algorithm is described in detail. Finally, it is argued that what counts as observable, or what counts as computable, is doubly contingent and is not fixed, being dependent upon the current state of technology and the way the world is.
Synchronic and Diachronic Emergence
Authors: Humphreys Paul
Published: May 2019

This chapter discusses a number of different kinds of diachronic emergence, noting that they differ in important ways from synchronic conceptions. It argues that Bedau’s weak emergence has an essentially historical aspect, in that there can be two indistinguishable states, one of which is weakly emergent, the other of which is not. As a consequence, weak emergence is about tokens, rather than types, of states. The chapter concludes by examining the question of whether the concept of weak emergence is too weak and notes that there is at present no unifying account of diachronic and synchronic concepts of emergence.
Analytic versus Synthetic Understanding
Authors: Humphreys Paul
Published: May 2019

It is argued that understanding is an epistemically more important concept than explanation. Two kinds of understanding are discussed, that based on analysis of the explanandum and a kind that is based on a synthetic method. The distinction between primary and secondary understanding shows that who is asking the why question is of central importance. A problem for causation is introduced that revolves around the degree of isolation that is needed to identify a causal factor and to distinguish causes from their carriers. It is shown that the analytic and synthetic approach can deal with partial understanding, that there can be an increase in understanding without an explanation, and that laws are not necessary for understanding.
The Document in the Digital
Authors: Sriraman Tarangini
Published: May 2019

Considered within the history of documenting welfare beneficiaries in India, the Aadhaar is unprecedented in that the unique number is a digital, portable identity and part of ‘a larger administrative and technological regime’ (Bennett and Lyon 2008) of cloud-based authentication. This chapter argues, however, that the production of this identifier has necessitated miming existing bureaucratic habits of inscription and mobilizing the rhetoric, ritualism and the materiality common to processes of issuing and verifying identification documents. Far from being an ID that is insulated from the host of administratively restrictive genres of identification documents like ration cards and caste certificates, the Aadhaar is relevant only within a paper-based matrix of elite norms of proof, urban spatiality of power brokerage, and the politics of staking out regional identities. Based on an intensive ethnography around a rural poor community, the chapter shows that the current welfare ecology still contingent on address norms requires not so much an electronic number identifier but rather a dynamic interplay of popular, quasi-legal, and legal documents of identity.
Merit Construction and Caste Loopholes in the Indian IT Social Habitus
Authors: Fernandez Marilyn
Published: May 2019

The story of the IT merit culture making project, merit valorization, and caste reproduction is contextualized in the historical development of the Indian IT revolution, with its mixed implications. A portrait of the IT organization, work structures, and the merit culture making project is developed using the work experiences of rank-and-file IT professionals and other scholarly writings. Subjective IT merit metrics, such as English fluency, habits of the mind-intellect-spirit, integration, and other ‘soft’ skills of communication open up loopholes or spaces for introducing, sorting out, and stratifying IT employees by traditional social vectors of caste and even community, and religion. Caste positionality, filtering, and related pattern recognition in the hiring, retention, and promotion decision making in the IT work place have become the conduits through which caste dynamics are reproduced and reinforced in the Indian IT, transforming it into the new vector of inequality.
Residential Typologies and Their Transformation
Authors: Guerrieri Pilar Maria
Published: May 2019

This chapter analyses local adaptations and changes in residential typologies. The ‘traditional’ typology in pre-colonial Delhi and its villages was usually the ‘courtyard’ arrangement, the so-called haveli. In the villages these were simple huts for men, women and animals, organized around an open space. When the British began to build the Civil Lines residential area north of Shahjahanabad, they adopted the bungalow model rather than the haveli one. After Independence there was no returning to the ‘traditional’ courtyard typology, rather the bungalow plot model prevails, which is often reduced and adapted, becoming a house plot. The transition from the classicist bungalow to the medium/small modernist single-family house shows an adjustment to the setting and the pressure that architectural elements undergo. The residential situation is multi-faceted, and the transition, first from the haveli to the bungalow and finally to the small middle class single-family house, is only one of many forms of cultural adjustment.
Indian Democracy and the ‘Moment of Contradiction’
Authors: Singh Anushka
Published: May 2019

The sixth chapter theorizes the patterns emerging in the working of the law of sedition in India by identifying specific themes along which the law has been used. It focuses on the quotidian life of the law in the hands of the state executives who have the power of law enforcement. It chronicles the various cases of sedition in contemporary times, its use against anti-nuclear movement, students’ organizations, communal politics, the dominant discourse of nation, and so on. Through these narratives, also emerges the idea of sedition in public imaginings and its identification with what is loosely termed as ‘anti-national’ or deshdroh. It also theorizes the relationship between the routine law of sedition and the exceptional or extraordinary counter terror laws. Through the patterns identified, this chapter identifies the Indian liberal democracy being characterized by a ‘moment of contradiction’ in relation to the offence of sedition.
Shedding Functions as Reform
Authors: Mathur Kuldeep
Published: May 2019

This chapter discusses many ‘reform-oriented’ practices that were undertaken and critically examines their general impact on the pursuit of public interest. The first step in the direction of the neoliberal framework of governance was of reducing the size of the government. Apart from efforts at reducing the number of employees, new institutions were established to shrink the state. Water supply is examined here to illustrate some of the issues involved specifically with the growing dominance of ‘efficiency’ as a policy design principle.
Emerging Institutions and the Challenge of Democratic Accountability
Authors: Mathur Kuldeep
Published: May 2019

This chapter reflects on parliamentary accountability of new governance institutions. Parliament has a constitutional agent in the office of the comptroller and auditor general (CAG) to report on the performance of government expenditure. On the one hand, it is contended that since institutions with PPPs include private investment, the CAG does not have a role in auditing them. On the other hand, the view is that these institutions are public authorities and come under the purview of the CAG. The debate is far from settled and public audit is still denied to these institutions. In this chapter, some instances where the CAG has undertaken audit on its own are presented.
Early Historic Gujarat and the Trading World of the Western Indian Ocean
Authors: Ray Himanshu Prabha
Published: May 2019

The chapter discusses the cultural milieu of seafaring activity in Gujarat between the fourth century BCE and the fourth century CE, the objective being to highlight the cultural factors that impacted trans-oceanic contacts. It underscores the autonomy of trading activity, vis-à-vis political organization in this period. Rulers certainly tapped the revenues from trade, but neither controlled nor initiated trade. Trade involved a complex range of transactions, with gifts to those in authority, and prestige commodities required by powerful groups and residents of cities at one end of the scale, while barter and monetary exchanges were the norm at the local and regional level. The chapter is in two sections: the first highlights internal routes across Gujarat that linked the coastal centres to towns and villages; while the second places Gujarat within the early historic sailing world of the western Indian Ocean up to the Red Sea.
Filling Hearts with Joy
Authors: Fee Sarah
Published: May 2019

It is generally recognized that cotton textiles made in the Indian subcontinent dominated global markets until outcompeted by Britain’s industrially manufactures in the early 1800s. However, scholars have now nuanced this meta-narrative by era, Indian sub-region, artisan class, and textile type. Building on studies by Chhaya Goswami and Jeremy Prestholdt, this chapter explores the shifting fates of handcrafted ‘Indian cloth’ imports in the years 1800–1900 in eastern Africa. Employing an object-centred approach, it scrutinizes the category of ‘cloth’ as much as the modifiers of ‘British’, ‘Indian’, ‘Gujarati’, or ‘Kutchi’. It shows that of seven basic cloth types, handcrafted goods from western India held a significant share of many. It supports Haynes’ (2012) work that Indian textile artisans did not merely survive in the age of industrialization; they actively innovated. Colour was often key, highlighting the importance of India’s dyers and printers, often overlooked in favour of spinners and weavers.
Gujarati Merchant Diaspora in South East Asia (Sixteenth and Seventeenth Centuries)
Authors: Maloni Ruby
Published: May 2019

Gujarat was concentric to the early modern Indian Ocean world. The sixteenth and seventeenth centuries witnessed the fine tuning of long distance trading systems. In South East Asia, the Indo-Portuguese trade network flourished in the sixteenth century, followed by the English and the Dutch in the seventeenth. Equilibrium was established between European and Asian traders, both indispensable to the other. Profitable trade in pepper and spices in the eastern archipelago was based on cotton textiles from Gujarat. In the sixteenth century, Cambay stretched out two arms—towards Aden and Malacca. Commercial connections included ports like Acheh, Kedah, Tenasserim, Pegu, Pase, and Pidie. In the seventeenth century, Surat’s mercantile marine facilitated the consolidation of Gujarati trade. This chapter shows how Gujarati merchant diaspora was intrinsic to the intricate patterns of trade practices and traditions of the Indian Ocean.
Merchants and Marts
Authors: Seshan Radhika
Published: May 2019

India’s flourishing trade and production economy in the late medieval times has been well studied, particularly from the point of view of the variety of goods that were exported across the Arabian Sea and the Bay of Bengal. In this context, the ports, particularly those of Gujarat and the Coromandel Coast, have received considerable attention. This chapter seeks to examine the nature of Gujarat’s connections to the hinterland in the sixteenth and seventeenth centuries. Surat, it is well known, was the port of the Mughal Empire; but what about ports like Cambay, or other towns like Ahmedabad or Baroda? What were their connections to the interior? Are there indications of merchants shifting from, for example, Cambay to Surat, as the former port declined in importance? The chapter, thus, focuses on the accessibility, contact, or reach of Gujarati merchants to different places in India.
Martin Jugie and the invention of Palamism
Authors: Russell Norman
Published: May 2019

Jugie’s seminal articles on Palamas and the Palamite controversy defined ‘Palamism’ as an innovation that proved the fallibility of the ‘Graeco-Roman’ Church. At the Paris Institute of Saint Sergius, Sergius Bulgakov claimed that his sophiology was a creative reworking of Palamas, while Georges Florovsky saw Palamas as the crowning Father of the neopatristic synthesis. But the pioneering work on Palamas was done by Basil Krivoshein, then a monk on Mount Athos, and the Romanian professor, Dumitru Stǎniloae, who was the first to exploit the rich holding of manuscript sources at the Bibliothèque Nationale in Paris. The first work by the Paris Russians was undertaken by Vladimir Lossky and Kiprian Kern. The contacts both of them had with sympathetic Catholics were important. Lossky was given a platform by Jesuits leading the ressourcement movement; Kern’s work was published in French by the Benedictines of Chevetogne.
Could Palamas become ‘the inheritance of all Christians’?
Authors: Russell Norman
Published: May 2019

This chapter considers the treatment of Palamas in recent debates. A major obstacle to his reception is the polemical use made of him by Palamites and anti-Palamites. The methodologies adopted by modern scholars include the expository, the problematic, the antithetical, and the comparative. The problematic method has been the most fruitful, as used by Torstein Tollefsen (who presents the energeiai as the pluralization of the divine unity), Manuel Sumares (who discusses the capacity of creatures to receive divinity), Stelios Ramfos (who highlights the importance of notion of enhypostasia), and Christos Yannaras (who argues that essence and energy are both modes of existence). Recent colloquia have shown the difficulty of demonstrating compatibility between Palamas and the Western intellectual tradition, but Nikolaos Loudovikos argues ably for ‘contiguity’ between Aquinas and Palamas.
Concluding reflections
Authors: Russell Norman
Published: May 2019

Akindynos’ negative assessment of Palamas’ character has been influential, particularly through its strong endorsement by Juan Nadal. Palamas knew how to use social networks and construct arguments to demolish his opponents. In assessing his character, however, the rhetorical conventions of dialectics need to be taken into account. Philosophically Palamas is important for his understanding of participation, his modification of certain Aristotelian categories, and his use of enhypostasia to posit activities or energies of the divine essence that are real, not notional, but have no independent existence apart from the essence. Theologically he maintains that deification is not the perfection of rational nature but the transformation of the believer, who becomes ‘uncreated by grace’ by partaking of the divine mode of existence. The greatest obstacle to the reception of Palamas is perhaps that by his essence–energies distinction he attempts to solve a problem that Western theologians do not have.
Nietzsche’s Metaethics
Authors: Leiter Brian
Published: May 2019

This chapter argues against various attempts to portray Nietzsche as a value realist, someone who thinks either that there are objective facts about value, or that his own evaluative perspective enjoys some other kind of epistemic privilege over its targets. A particular focus is arguments appealing to the idea of will to power. These arguments are shown to fail, both philosophically and textually. An alternative, psychological interpretation of Nietzsche’s interest in will to power is argued to be more plausible.
Moralities are a Sign-Language of the Affects
Authors: Leiter Brian
Published: May 2019

Nietzsche is a sentimentalist about moral judgment, in the manner of Hume and, in the German tradition, Herder: the best explanation of our moral judgments is in terms of our emotional or affective responses to states of affairs in the world, responses that are, themselves, explicable in terms of psychological facts about the judger. Nietzsche understands our basic emotional or affective responses as brute artifacts of our psychological constitution, though there is nothing in Nietzsche’s view to rule out the possibility that more complicated feelings (e.g. “guilt”) might not involve a cognitive component added to the non-cognitive one, even if that is explanatorily otiose. The chapter concludes with a consideration of empirical evidence in support of sentimentalism.
Nietzsche’s Theory of Agency
Authors: Leiter Brian
Published: May 2019

Nietzsche’s repudiation of free will and moral responsibility is documented throughout his corpus, and his arguments for this conclusion—arguments from his distinctive kind of fatalism, his skepticism about the causal efficacy of the will, and his particular brand of epiphenomenalism about the conscious mental states crucial to deliberation—are shown to undermine both compatibilist and incompatibilist views about free will and moral responsibility by engaging the views of many contemporary philosophers working on these topics, including Harry Frankfurt, Galen Strawson, Robert Kane, Derk Pereboom, Gary Watson, and others. In particular, the chapter argues that both “alternate possibilities” and “control” views of free will are vulnerable to Nietzsche’s critique. Some empirical evidence is adduced in support of Nietzsche’s view.
The Case for Nietzschean Moral Psychology
Authors: Leiter Brian , Knobe Joshua
Published: May 2019

This chapter (co-authored with Joshua Knobe) reviews a vast body of evidence from empirical psychology—for example, concerning the role of conscious decision in behavior, and the relative influence of heritability versus upbringing on character traits—demonstrating the superiority of Nietzsche’s moral psychology, as defended throughout the book, to the moral psychologies associated with Aristotle and Kant, which are based on false and often fantastic assumptions about human psychology.
Kakology
Authors: Ruppel Antonia
Published: May 2019

This chapter offers an overview of words for “evil”—in the sense of “morally bad”—in several languages, first among them English. Of each word, I will consider the etymology (i.e. its origins and the changes in its meaning(s) over time), the semantic nuances, and, where it is interesting or relevant, any overlap with other words. Out of the five languages considered, four are European (English, German, Ancient Greek, and Latin); the fifth, Sanskrit, is the oldest written language of India and related to the first four through their common ancestor, Proto-Indo-European. German and English are the most closely related among all these (both being part of the Germanic branch of Indo-European, whereas the others each belong to a separate branch of the Indo-European family of languages), and comparison between two neighboring languages will perhaps offer an interesting contrast to comparison between languages much further removed from each other.
Augustine on Evil
Authors: King Peter
Published: May 2019

Augustine’s account of evil has influenced most later thinkers in the western tradition. He argues for three central theses: (a) evil is the lack of some positive feature that ought to be present, a “privation”; (b) moral evil comes about solely from the less-than-perfect free choices of rational beings; and (c) all suffering—which need not be the result of moral evil but perhaps of natural processes or events—is morally justified. As part of his defense of (b), Augustine states in full generality the problem of evil (namely, how can there be any genuine evil in a world presided over by an omnipotent and benevolent deity?), and articulates in reply the free will defense. The arguments Augustine offers in support of the free will defense, and in favor of (a)–(c), are set forth and their implications assessed. The upshot is a coherent account of evil that dominated the debates for many centuries to come.
Evils, Privations, and the Early Moderns
Authors: Newlands Samuel
Published: May 2019

This chapter focuses on the concept of evil in the works of early modern rationalists—especially Descartes, Spinoza, and Leibniz. Prior to the seventeenth century, there was a consensus among medieval Christians that evil was a privation of goodness. By the eighteenth century, privation theory had been mostly abandoned by leading theists. How and why did this conceptual shift occur? I first explore the nature and role of privation theory in medieval accounts of evil. I then turn to the early modern criticisms of this once dominant concept of evil and trace its abandonment. I conclude by wondering whether the early modern eclipse of privation theory has been wholly salutary for theists.
Satanically Great Instigators and Banal Compliers
Authors: Margalit Avishai
Published: May 2019

This Reflection focuses on three of the great threats we confront in thinking about evil. First, we often forget to distinguish clearly between instigators of evil and compliers with evil. Second, we are too often tempted to think of the instigators as satanically great embodiments of pure evil—outside the moral domain. Second, we are also tempted to think that compliers are all banal and, in some sense, less guilty than the instigators.
An elastin-like recombinamer-based bioactive hydrogel embedded with mesenchymal stromal cells as an injectable scaffold for osteochondral repair
Authors: Cipriani Filippo , Ariño Palao Blanca , Gonzalez de Torre Israel , Vega Castrillo Aurelio , Aguado Hernández Héctor José , Alonso Rodrigo Matilde , Àlvarez Barcia Angel José , Sanchez Ana , García Diaz Verónica , Lopez Peña Monica , Rodriguez-Cabello José Carlos
Published: May 2019

The aim of this study was to evaluate injectable, in situ cross-linkable elastin-like recombinamers (ELRs) for osteochondral repair. Both the ELR-based hydrogel alone and the ELR-based hydrogel embedded with rabbit mesenchymal stromal cells (rMSCs) were tested for the regeneration of critical subchondral defects in 10 New Zealand rabbits. Thus, cylindrical osteochondral defects were filled with an aqueous solution of ELRs and the animals sacrificed at 4 months for histological and gross evaluation of features of biomaterial performance, including integration, cellular infiltration, surrounding matrix quality and the new matrix in the defects. Although both approaches helped cartilage regeneration, the results suggest that the specific composition of the rMSC-containing hydrogel permitted adequate bone regeneration, whereas the ELR-based hydrogel alone led to an excellent regeneration of hyaline cartilage. In conclusion, the ELR cross-linker solution can be easily delivered and forms a stable well-integrated hydrogel that supports infiltration and de novo matrix synthesis.
Wealth preservation by using trusts or private foundations in a civil law environment
Authors: Schurr Francesco A
Published: May 2019

The article describes the use of trusts and private foundations as well as the cultural and legal differences between the two legal instruments. The problems and opportunities arising from any legislative measure that introduces the trust in a civil law jurisdiction will be addressed. The article will focus primarily on the Principality of Liechtenstein. While Liechtenstein is a typical civil law jurisdiction that has embedded partly the Austrian and partly the Swiss legal tradition, a unique trust regime was enacted as early as 1926. On the contrary, the Swiss legislature has never created its own legal instruments for private wealth structuring. Swiss practitioners have relied on foreign tools, such as the Liechtenstein foundation and the Liechtenstein trust. Currently an academic and political debate is underway in Switzerland regarding the introduction of genuinely Swiss vehicles for private wealth structuring. What lessons can be learned from the almost 100 years of Liechtenstein experience?
Interventions for children with reactive attachment disorder
Authors: Vega Heather , Cole Kimberly , Hill Kenneth
Published: May 2019

Characterized by aggressive or violent behaviors, reactive attachment disorder (RAD) affects children who have been repeatedly exposed to traumatic experiences. This article discusses the underlying causes of RAD and provides insight on therapies and interventions.
Age at natural menopause and physical functioning in postmenopausal women: the Canadian Longitudinal Study on Aging
Authors: Velez Maria P. , Alvarado Beatriz E. , Rosendaal Nicole , da Câmara Saionara M. , Belanger Emmanuelle , Richardson Harriet , Pirkle Catherine M.
Published: May 2019

Objective:

The aim of this study was to evaluate the association between categories of age at natural menopause (ANM) and gait speed (slowness) and grip strength (weakness), common measures of physical functioning in older women.

Methods:

We analyzed data from the Canadian Longitudinal Study on Aging, which included participants from seven cities across Canada collected in 2012. The sample was restricted to women who reported to have entered menopause (N = 9,920). Women who had a hysterectomy before menopause were excluded since the age at which this surgical procedure was performed was not available. ANM was categorized into five groups: less than 40 (premature), 40 to 44 (early), 45 to 49, 50 to 54, and more than 54. We conducted linear regressions to assess the association between ANM and gait speed (m/s) and grip strength (kg) adjusting for participant age, education, body mass index, smoking, use of hormone therapy, height, and province of residence.

Results:

Mean ANM was 49.8 (95% confidence interval [CI]: 49.7-50.0), with 3.8% of women having a premature menopause; the average gait speed was 0.98 m/s (standard deviation: 0.22), the average grip strength was 26.6 kg (standard deviation: 6.39). Compared to women with ANM of 50 to 54, women with premature menopause had 0.054 m/s (95% CI −0.083, −0.026) lower gait speed when adjusting for age and study site. In the fully adjusted model, the association was attenuated, 0.032 m/s (95% CI −0.060, −0.004). ANM was not associated with grip strength.

Conclusion:

Our study suggests that premature menopause (<40 years) may be associated with lower gait speed (slowness) among Canadian women. No association was observed between ANM and grip strength. Future studies should include a life course approach to evaluate whether social and biological pathways modify the association between age at menopause and physical function in populations from different contexts.
Radon and Progeny Detection Using Tensioned Metastable Fluid Detectors
Authors: Boyle Nathan , Archambault Brian , Hemesath Mitch , Taleyarkhan Rusi
Published: May 2019

Radon and other alpha-emitting nuclides in air can be a significant risk for health hazards in the workplace and in dwellings. Radon gas in US homes causes over 21,000 deaths from lung cancer annually, according to the US Environmental Protection Agency (US EPA). Alpha-emitting radionuclides from airborne contamination in the nuclear industry also constitute a known safety and security-safeguards related issue. Purdue University, along with Sagamore Adams Laboratories LLC, have developed the tensioned metastable fluid detector (TMFD) sensor technology for general-purpose alpha-neutron-fission. For radon detection, radon gas in air is sparged through the TMFD detection fluid, after which this radon-bearing fluid is placed into a tensioned metastable state. In this metastable state, an audible-visible cavitation (alpha radiation) detection event is created and electronically recorded. Tailoring the level of tension enables spectroscopic information through energy discrimination of radon and its progeny; This is also applicable to other alpha emitting isotopes (Pu, Cm, U…). TMFDs boast high intrinsic detection efficiencies (>95%) for alpha spectroscopy while remaining blind to background beta and gamma radiation even in ~103 R h−1 fields. The immunity to beta and gammas allows for reusability of the detection fluid through immunity to beta buildup from thoron and radon progeny. TMFD technology was used to measure the concentration of radon and radon progeny in air for concentrations from 74 Bq m−3 to 740 Bq m−3. The system measures radon concentration between these levels within 24 h with an intrinsic relative error (IRE) of ± 15% according to the standards set forth by the American Association of Radon Scientists and Technicians-National Radon Proficiency Program (AARST-NRPP) Device Evaluation Program (DEP). Precision evaluation defined using the relative standard deviation set by the AARST-NRPP measured a deviation of <5%, which exceeds the requirement of <25%. Temperature effects from 10°C and 27°C were assessed and corrected for dynamically. A radon decay correction method was introduced to correct for the radon activity decrease in the detection fluid over the counting period due to the ~3.8 d half-life. Blind testing was also successfully performed* with standards from the Bowser-Morner Radon Reference laboratory (2018); within 6 h, the TMFD-based technology accurately measured the concentration of radon to within 20% of the reference standards. Non-condensing relative humidity levels up to 95% per AARST-NRPP were assessed for and were found to have no impact on radon detection. This work improves upon the previous work by splitting the calibration curve into two distinct regions and adds additional information pertaining to the effects of relative humidity on the system.
Integrating Oral Health: Physician Assistant Education in 2017
Authors: Glicken Anita Duhl , Savageau Judith A. , Flick Tiffany A. , Lord Cynthia Booth , Harvan Robin A. , Silk Hugh
Published: May 2019

Purpose

This study describes the inclusion of oral health in physician assistant (PA) education programs in 2017. A 2014 study found that 78% of responding programs (n = 98 of 125) had integrated this content into their curriculum. The current study represents a partnership between the National Interprofessional Initiative on Oral Health, the Center for Integration of Primary Care and Oral Health, and the PA Leadership Initiative in Oral Health. The PA profession was one of 14 health professions surveyed to assess the quantity and quality of oral health integration, including barriers to and facilitators of change.

Methods

An electronic cover letter explaining the research purpose was emailed to all US PA education program directors along with a link to a web-based survey. Most questions were followed by predefined response options; some questions offered an opportunity to include narrative responses or comments.

Results

There was greater inclusion of oral health curriculum in 2017 than in 2014, for both the number of programs including oral health education and the breadth of their curriculum.

Conclusions

Efforts to equip PA faculty to integrate oral health core clinical competencies into their curriculum should continue, because existing strategies appear to be sustainable and effective in expanding oral health content across PA programs.
Serum interleukin-18
Authors: Dong Guangsu , Wang Fei , Xu Liang , Zhu Min , Zhang Bin , Wang Bin
Published: May 2019

The aim of this study is to determine the biological function of serum interleukin-18 (IL-18) on prognosis in acute respiratory distress syndrome (ARDS).

From October 2016 to September 2017, 150 patients with ARDS in the ICU were enrolled according to the Berlin 2012 definition. The enzyme-linked immunosorbent assay (ELISA) was used to detect the expression level of IL-18 in serum isolated from the patients. Patients were divided into survival group (82 cases) and non-survival group (68 cases) and followed up for at least 2 months. The serum IL-18 expression level on the prognosis was calculated by receiver operating characteristic curve (ROC).

The expression level of serum IL-18 was significantly higher in the non-survival group than that in the survival group (P < .05). Based on the ROC curve, the sensitivity and specificity of IL-18 as a predictor of prognosis at a cutoff of 509.5 pg/mL were 88% and 82%, respectively, and the area under the curve (RUC) was 0.84 (P < .05).

The expression level of serum IL-18 could be used to evaluate the possible outcomes of patients with ARDS.
Management of neuropathic pain induced by cubital tunnel syndrome using pulsed radiofrequency
Authors: Kwak Soyoung , Jeong Daeun , Choo Yoo Jin , Chang Min Cheol
Published: May 2019

Rationale:

Recently, pulsed radiofrequency (PRF) has been applied to alleviate neuropathic pain caused by various peripheral nerve pathologies. This report describes and discusses the cases of 2 patients with cubital tunnel syndrome who responded well to PRF for the management of neuropathic pain.

Patient concerns:

Patients 1 and 2 presented with numeric rating scale (NRS) scores of 4 and 3 for neuropathic pain due to right cubital tunnel syndrome, respectively.

Diagnoses:

Cubital tunnel syndrome was confirmed by nerve conduction study/electromyography.

Interventions:

PRF stimulation of the right ulnar nerve was performed at the medial epicondyle level under the guidance of ultrasound.

Outcomes:

At the 2-week and 1-, 2-, 3-, and 6-month follow-up assessments after the PRF procedure, the pain of patient 1 was completely relieved. In patient 2, at the 2-week follow-up, the pain was completely relieved, and at the 1-, 2-, 3-, and 6-month follow-up assessments, the NRS score was 1. No adverse effects were observed in either patient.

Lessons:

PRF on the ulnar nerve seems to be a useful tool for treating neuropathic pain due to cubital tunnel syndrome.
Colonic mucinous adenocarcinoma causing intussusception and distant metastasis
Authors: Xu Xiaohui , Kong Zhiyuan , Yi Ke , Wang Bing , Lei Qingjun , Wang Yi
Published: May 2019

Rationale:

Cases of intussusception caused by mucinous carcinoma have been rarely reported, and those caused by colonic mucinous adenocarcinoma (MAC) with distant metastasis were even fewer.

Patient concerns:

A 60-year-old woman who complained of severe pain around the navel with nausea and vomiting for a week was admitted on November 28, 2017. There were multiple watery stools and abdominal pain was worsened over the prior week.

Diagnosis:

She was diagnosed by abdominal computed tomography, current medical history, and abdominal signs. Her initial diagnosis was acute abdomen, intussusceptions, and intestinal obstruction. The final diagnosis was MAC, which was based on postoperative pathology.

Interventions:

The patient received emergency laparotomy, followed by 5 courses of chemotherapy with oxaliplatin plus capecitabine, and then 6 courses with 5-fluorouracil + oxaliplatin + calcium leucovorin.

Outcomes:

The patient was in good nutritional condition, and no obvious tumor recurrence or metastasis was found until July 9, 2018.

Lessons:

Even though the prognosis of colonic MAC is poor, being able to receive timely surgical treatment, good nutritional status and reasonable postoperative chemotherapy are the key factors to prolonging patient's survival.
Endometriosis on the surface of the uterus mimicking a malignant tumor
Authors: Pang Lihong , Shi Honghui , Wang Tao , Zhu Lan , Lang Jinghe , Fan Qingbo , Liu Haiyuan , Yu Xin , Cao Yang , Xiao Yu
Published: May 2019

Rationale:

The purpose of this case report was to raise awareness regarding endometriosis on the surface of the uterus mimicking malignant tumor and thus manage it accurately.

Patient concerns:

A 40-year-old Asian woman with a 2-year history of lower abdomen pain was admitted to our department with elevated serum cancer antigen (CA) 125 level, weight loss, and pelvic mass from 20 days previously. Magnetic resonance imaging revealed a high volume of effusion in the pelvic cavity, an irregular occupying lesion on the surface of the fundus of the uterus, and multiple nodules.

Diagnoses:

Postoperative pathology confirmed the diagnosis of endometriosis.

Interventions:

Diagnostic laparoscopy revealed large crunchy tissue and soft nodules on the surface of the posterior wall of the uterus and approximately 2000 mL of bloody ascites. The result of the frozen-section analysis of the tissue on the surface of the uterus indicated endometriosis. The surgical procedure was converted to laparotomy due to bleeding after biopsy.

Outcomes:

The patient's recovery was uneventful. Three months after the operation, the patient had a good general state without periodic pain, and the CA125 level returned to normal.

Lessons:

A large mass occurring in the pelvic cavity could be indicative of endometriosis, especially if accompanied by a history of period pain. Preoperative positron emission tomography may increase the accuracy of the diagnosis.
Evaluation of Y-site compatibility of home total parenteral nutrition and intravenous loop diuretics
Authors: Watrobska-Swietlikowska Dorota , Pietka Magdalena , Klek Stanislaw
Published: May 2019

In chronic kidney disease (CKD), the design of the parenteral nutrition (PN) regimen becomes more challenging where only individualized PN is appropriate, coupled with the increased risk of unintended interactions with diuretic therapy. In an effort to ensure safe therapy in the home, we assessed the physical stability of bespoke PN formulations intended for use in CKD in the simultaneous presence of Y-site compatibility of furosemide and torasemide. The patient's daily needs were determined based on both metabolic demands as well as the demand for fluids.

Complete admixtures were subjected to physical stability analysis consisting of visual inspection, a validated light microscope method, pH measurement, zeta potential measurement, and characterization of oily globule size distribution. Y-site compatibility of furosemide and torasemide with the formulated admixtures was also performed.

The total parenteral admixture was stable over 7 days at +4°C and 24 h at +25°C and compatible via the Y-line together with furosemide and torasemide over 12 h at +25°C.

The stability assessment guarantees the safety and efficiency of home PN with loop diuretics therapy in CKD patients. This means that these patients do not need long hospitalization and they can be safely treated at home. Furthermore, this study proved that torasemide is the same safety diuretic as furosemide, which has a great impact on clinical practice.
Prognostic value of long noncoding RNA ROR in patients with cancer in China
Authors: Li Shuai , Yue Xin-Can , Sun Chao-Yan , Qin Hai-Yan , Zhang Xiao-Yang
Published: May 2019

Background:

For cancer, it is common that there is usually a dysregulation of the long noncoding RNA regulator of reprogramming (LncRNA ROR). To illustrate the application of LncRNA ROR, which serves as the prognostic marker for the malignant tumors, it is of great importance to conduct a meta-analysis.

Methods:

There were 3 databases being applied. The data used were collected before January 5, 2018. These 3 databases include the OVID, PubMed, and Science databse. To further explore the association between the expression and survival of LncRNA ROR, it calculated the 95% confidence intervals (CIs) and hazard ratios (HRs). Meanwhile, the odds ratios (ORs) have been calculated for the evaluation of the correlation between the pathological and expression parameters of LncRNA ROR.

Results:

There were 8 researches participated by 720 patients. According to the HR, it has been implied that there was a high LncRNA ROR expression related with the weak disease-free survival (DFS) (HR = 3.48, 95% CI, 2.24–5.41) and overall survival (OS) (HR = 2.47, 95% CI, 1.76–3.47) among the cancer patients with none dramatic heterogeneity. There was also a correlation among lymph node metastasis (OR = 5.38, 95% CI, 2.21–13.12), high tumor stage (OR = 3.80, 95% CI, 1.95–7.41), and larger tumor size (OR = 4.43, 95% CI, 1.26–15.51).

Conclusions:

Thus, it can be predicted about the lymph node metastasis and high tumor stage, larger tumor size, DFS, and poor OS based on the high LncRNA ROR. This suggests that high LncRNA ROR can be used as a new indicator of poor prognosis in cancer.
A case report of a severe fluoropyrimidine-related toxicity due to an uncommon DPYD variant
Authors: De Falco Vincenzo , Natalicchio Maria Iole , Napolitano Stefania , Coppola Nicola , Conzo Giovanni , Martinelli Erika , Zanaletti Nicoletta , Vitale Pasquale , Giunta Emilio Francesco , Vietri Maria Teresa , Vitiello Pietro Paolo , Ciardiello Davide , Marinaccio Anna , De Vita Ferdinando , Ciardiello Fortunato , Troiani Teresa
Published: May 2019

Introduction:

Fluoropyrimidines such as 5-fluorouracil (5-FU) and its orally active prodrug, capecitabine, are widely used in the treatment of gastrointestinal cancer, including colorectal cancer. Dihydropyrimidine dehydrogenase (DPD) plays an important role in the 5-FU metabolism. Dihydropyrimidine dehydrogenase gene (DPYD) is a highly polymorphic gene with several hundreds of reported genetic variants and DPD activity levels vary considerably among individuals, with different 5-FU-related efficacy and toxicity. About 5% of the population is deficient in DPD enzyme activity. The most well studied DPYD variant is the IVS14+1G>A, also known as DPYD ∗2A. In this report, we present a case of a patient with a double heterozygote DPYD variant (DPYD activity score: 0,5 according to Clinical Pharmacogenetics Implementation Consortium) who experienced a severe fluoropyrimidine-related toxicity resolved without any consequence.

Patient concerns:

A 46-years-old Caucasian man with diagnosis of left colon adenocarcinoma underwent left hemicolectomy on July 2017: pT3 G3 N1c M0. According to the disease stage, he started an adjuvant therapy with XELOX using capecitabine at 50% of total dose, because of his DPYD IVS14+1G>A variant, detected before the treatment. DIAGNOSIS: After few days, despite of this dose reduction, he experienced life-threatening adverse events such as mucositis G3, diarrhea G3, neutropenia G4, thrombocytopenia G4, and hyperbilirubinemia G3 according to Common Terminology Criteria for Adverse Events v 5.0.

Interventions:

As first, we set up an intensive rehydration therapy, antibiotic and antifungal prophylaxis, Granulocyte-Colony Stimulating Factors, and supportive blood transfusions. Additional genetic tests revealed a double heterozygote variant of DPYD gene (DPYD IVS14+1G>A and 2846A>T) which is a very rare situation and only 3 cases are described in literature, all of them concluded with patient's death.

Outcomes:

After 3 weeks of intensive therapy, the patient was fully recovered. Furthermore, all the whole-body CT scans performed since discharge from the hospital until now, have confirmed no evidence of disease.

Conclusions:

Recent studies demonstrated that screening strategy for the most common DPYD variants allowed for avoiding toxicities and saving money. This report underlines the importance of genotyping DPYD before treatment and emphasizes the role of genotype-guided dose individualization.
Analysis of the function of MAGE-A in esophageal carcinoma by bioinformatics
Authors: Chen Xiaohua , Cai Sina , Wang Liping , Zhang Xiaona , Li Wenhui , Cao Xiaolong
Published: May 2019

Background:

Melanoma-associated antigen-A (MAGE-A) was recognized as high-expressed in many solid tumors including esophageal carcinoma (EC), nevertheless, was reported to be low/not-expressed in normal tissues. Thus, it was considered as an extraordinary appropriate target for treatment especially in immunotherapy. Therefore, it demanded more detail knowledge on the precise function of MAGE-A.

Methods:

In this study, we used the data from the Cancer Genome Atlas dataset (TCGA-ESCA) to analyze the expression and survival for MAGE A3/4/11 (the subtype of MAGE-A) using the online tool of UALCAN. Furthermore, the high-throughput sequencing data of the patients with esophageal squamous-cell carcinoma (ESCC) from TCGA dataset were performed to analyze the correlation test, gene ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment of MAGE A3/4/9/11 using LinkeDomics (online tool) and ClueGO (inner software of Cytoscape). Finally, relative gene expressions of MAGE A3/4/9/11 were verified by quantitative real-time PCR (q-PCR) in the patients with EC.

Results:

MAGE A3/4/11 was high-expressed in tissues of patients with ESCC, and there was no difference in survival time for patients between the high-expressed with the low/medium-expressed. The Go enrichment analysis showed that the 4 MAGE-A subtypes (MAGE-A3/4/9/11) were enriched in the regulation of the adaptive immune response, translational initiation, interleukin-4 production, response to type I interferon, and skin development, respectively. The KEGG results showed that they were enriched in T cell receptor signaling pathway (MAGE-A3), Th1 and Th2 differentiation, antigen processing and presentation (MAGE-A4), cytokine-cytokine receptor interaction (MAGE-A9), and chemokine signaling pathway (MAGE-A11).

Conclusion:

MAGE A3/4/9/11 was high-expressed in EC, and were enrolled in the regulation of immune response. They may consider as candidate immune target for EC treatment and provided the messages for further research in the function of MAGE-A.
Development of model to predict end-stage renal disease after coronary artery bypass grafting
Authors: Lee Yeonhee , Park Jiwon , Jang Myoung-Jin , Moon Hong Ran , Kim Dong Ki , Oh Kook-Hwan , Joo Kwon Wook , Lim Chun Soo , Kim Yon Su , Na Ki Young , Han Seung Seok
Published: May 2019

Because end-stage renal disease (ESRD) increases the risks of morbidity and mortality, early detection and prevention of ESRD is a critical issue in clinical practice. However, no ESRD-prediction models have been developed or validated in patients undergoing coronary artery bypass grafting (CABG).

This is a retrospective multicenter cohort study, recruited between January 2004 and December 2015. A cohort of 3089 patients undergoing CABG in two tertiary referral centers was analyzed to derive a risk-prediction model. The model was developed using Cox proportional hazard analyses, and its performance was assessed using C-statistics. The model was externally validated in an independent cohort of 279 patients.

During the median follow-up of 6 years (maximum 13 years), ESRD occurred in 60 patients (2.0%). Through stepwise selection multivariate analyses, the following three variables were finally included in the ESRD-prediction model: postoperative Acute kidney injury, underlying Chronic kidney disease, and the number of antiHypertensive drugs (ACHE score). This model showed good performance in predicting ESRD with the following C-statistics: 0.89 (95% confidence interval [CI] 0.84–0.94) in the development cohort and 0.82 (95% CI 0.60–1.00) in the external validation cohort.

The present ESRD-prediction model may be applicable to patients undergoing CABG, with the advantage of simplicity and preciseness.