bluuebunny/crossref_metadata_2025 huggingface dataset:
Doubled-Semion Model
Authors: Simon Steven H.
Published: December 2023

The Doubled-Semion model is another simple example of generalizing the toric code. Here we start with a planar diagram algebra that is the d=-1, Z2 loop gas. I.e, here a loop is given the value of -1. This is also known as the nontrivial cocyle of Z2. This model can be thought of as the simplest case of a twisted Kitaev Quantum Double, and it is also the simplest example of the Drinfeld double of a modular anyon theory (the double of the semion theory). In this case we construct a Hamiltonian such again we have a loop gas, but now flipping over a plaqutte incurs a sign in the wavefunction if we change the parity of the number of loops. We again turn to the tube algebra to identify the excitations of the model, which are both right- and left-handed semions. We run into a problem related to the nontrivial Frobenius-Schur indicator of the input diagram algebra. However, here we can resolve the issue by choosing a convenient gauge.
Topological Entanglement
Authors: Simon Steven H.
Published: December 2023

If we partition a Hilbert space we can define the entanglement entropy (both von Neumann and Renyi) between the two pieces. We consider breaking up a system into two or more distinct spatial regions and ask about the entanglement between these two regions. Studying the toric code ground state as an initial example, we show that there is an entanglement that scales as the length of the cut between the two regions, but there is also a sub-leading term, known as the topological entanglement entropy, which depends only on the topological properties of the system. While the leading term is nonuniversal, the topological term is robust and can be generalized to any other TQFT. We give three different derivations of the topological entanglement entropy.
Appendix: Kac and Other Resources for TQFTs
Authors: Simon Steven H.
Published: December 2023

A number of tools for determining properties of TQFTs are described. In particular we outline the use of the computer program “Kac”. We also give pointers to other useful resources.
Christianization and Latinization
Authors: Wiśniewski Robert
Published: December 2023

This chapter investigates the mutual impact of Christianization and Latinization in the western provinces of the Roman Empire. First, it explains why Christian communities switched from Greek to Latin and why this process was relatively slow. Second, it shows that in the West there is no evidence of a missionary design focused on the population speaking in vernacular languages, resembling the one in the East. It attributes this difference mostly to a lack of western vernacular-speaking elites. Finally, it argues that religion played only a minor role in either speeding up or slowing down the Latinization in the West in late antiquity. Overall this chapter claims that Latinization smoothed the way for the spread of Christianity, but the inverse impact was not strong. Christian cult and church institutions may have played a role in familiarizing people with Latin and in some places could have tipped the linguistic balance towards it. However, their role in the broader, ongoing linguistic change, which resulted in the Latinization of a large part of Western Europe, was limited.
Understanding Legislative Assemblies
Authors: Martin Shane , Strøm Kaare W.
Published: December 2023

This chapter introduces the challenges of legislative capacity and accountability. The chapter outlines the history and political functions of elected parliaments and legislatures and discusses at greater length the challenges of capacity and accountability in legislative assemblies. Focusing on the three most critical classes of actors that shape or inhabit legislative assemblies, the chapter develops three ideal-typical models of legislative assemblies: the members’ assembly, the leaders’ assembly, and the voters’ assembly. It then discusses the institutions and operations that characterize these models and how they relate to the challenges of capacity and accountability, respectively. Briefly put, one model prioritizes capacity, a second accountability, whereas the third represents more of a compromise between these concerns.
Executive Oversight
Authors: Martin Shane , Strøm Kaare W.
Published: December 2023

To help us understand better the challenges of legislative capacity and accountability within the three ideal-typical models of legislative assemblies developed in Chapter 1 (the members’ assembly, the leaders’ assembly, and the voters’ assembly), this chapter focuses on oversight of the executive and government. The capacity to oversee the executive shapes the fundamental nature of the legislative assembly. A voters’ assembly, for example, should have a high capacity to monitor the executive. This follows from the emphasis on transparency that characterizes such assemblies, and this demand for transparency should pertain to the executive as well as to the legislative branch. Specifically, we explore the existence in our various assemblies of (1) questions and interpellations, (2) investigations and hearings, (3) a legislative audit office, (4) powers to make war, (5) powers to make treaties, and (6), arguably the ultimate form of oversight, powers to dismiss the executive (typically meaning the cabinet) or individual members of the executive.
Incumbency and Re-election
Authors: Martin Shane , Strøm Kaare W.
Published: December 2023

This chapter examines the effects of legislative institutions on an outcome that is both proximate to the operations of all democratic assemblies and critical to their accountability to the citizens: the rate at which elected representatives are re-elected to their offices in subsequent elections. This is an issue that matters to members as well as to leaders and voters. The variance in re-election rates is large, and that there is every reason to think that it may be consequential. There is a range of assembly features that we expect to have a predictable impact on such incumbent re-election rates. We examine the effects of member resources, institutional features, and citizen confidence on legislative re-election rates across our 68 assemblies and find that member resources facilitate incumbent re-election but only under conditions in which citizen confidence can be expected.
Introduction
Authors: Bourne Angela K.
Published: December 2023

Introduction: Opposing Populist Parties in Europe discusses challenges of studying opposition to contemporary populist parties, shortcomings of existing approaches, and a new model of democratic defence as ‘normal politics’. ‘Militant democracy’ and ‘democratic defence’ approaches for studying responses to those challenging the liberal democratic status quo tend to focus on exclusionary, rights-restricting responses by public authorities and party-political responses such as ostracism, policy cooptation, and collaboration in government. While suited for studying responses to relatively small, extremist parties, with little chance of governing alone, a different lens is needed for larger and governing populist parties. Additionally, existing approaches generally fail to acknowledge the ambiguity of populist orientations to democracy. democratic defence as normal politics builds on earlier approaches but also focuses attention on international and civil society responses, and emphasizes routine or ordinary repertoires of opposition in democratic societies, including use of constitutional checks and balances, public protest, and negative framing.
Enforcement through the Constitution, Courts, and Coercion
Authors: Bourne Angela K.
Published: December 2023

Chapter 4, Enforcement through the Constitution, Courts, and Coercion examines how initiatives opposing populist parties (IoPP) may affect populist parties by reducing or increasing their support, diminishing or boosting their resources, inducing moderation or radicalization, and/or curbing their ability to implement illiberal or anti-democratic policies. Constitutional rules, and international human rights and EU law, may allow opponents to block illiberal or undemocratic policies. Populists be convicted, fined, or imprisoned for holocaust denial, racism, corruption, or electoral fraud. Legal strife can taint a party, reducing its support, and force it to moderate, at least ‘front stage’. Agreeing appropriate responses can create internal conflicts. Alternatively, legal troubles may attract sympathy for ‘martyred’ leaders. Coercion or the threat of it may reinforce anti-establishment critiques. The ‘oxygen of publicity’ may be a useful resource and legal problems may both unify and radicalize members. Cases involving European populist parties illustrate these processes.
Restoration of Fallen Soldiers to the Pantheon of National Heroes
Authors: Yoder Jennifer A.
Published: December 2023

The five commemorations discussed in this chapter illustrate revisionist strategies that both whitewash the history of Nazi collaboration and homegrown fascism and blackwash the history of communism. Fascist forces and Nazi collaborators, such as the Ustaše in Croatia and the Waffen-SS in Latvia and Ukraine, are the focus of commemorations that construct an exculpatory and anti-communist memory narrative. Two additional anti-communist forces, Poland’s so-called “cursed soldiers” and resistors of the Red Army’s siege of Budapest, have been mythologized in the service of a national-conservative agenda. These memory challenges operate in a different environment than their counterparts in Western Europe, where the dominant Holocaust-centered memory culture and official commemorations became targets of right-wing mnemonic instrumentalization. In Eastern Europe, the memory cultures are still in flux; they are moving away from Soviet and communist era narratives as they seek to accommodate their national pasts in the broader European mnemonic landscape.
The Present Meanings of the Wartime Past
Authors: Yoder Jennifer A.
Published: December 2023

The concluding chapter reflects on the distinctive characteristics of mnemonic contestation in each of the three meso-regions. While important differences remain, we must recognize that across the case studies discussed in the previous chapters, there were some common characteristics in the emergence of memory challenges and the strategies of memory challengers. What are those differences and what are the implications of their shared features? Are there common circumstances that have produced similar grievances in the three meso-regions? This chapter will consider the potential that memory contestation holds within and between mnemonic regions for producing misunderstanding, animosity and, in the extreme, the deterioration of relationships; but memory contestation could also potentially be harnessed to foster more complex, pluralistic understandings of the difficult past.
Introduction
Authors: Baczko Adam
Published: December 2023

The exercise of justice by an insurgency is a salient dimension of contemporary civil wars. In these situations where dispensing justice is at once a juridical activity, a political weapon, and a stake in the war, how can an armed movement gain recognition for the decisions of its judges as judicial (and not political) acts, despite their having eminently political effects? How did the Taliban judge—who was a Taliban as much as a judge—get the population to recognize him as such? The difficulty in contemplating a Taliban juridical system points to a blind spot in the social sciences. After highlighting the problems with current neopositivist approaches, I propose a sociological approach to law in civil wars based on Bourdieu. The social recognition of the judge as a judge despite the civil war requires the perception of his verdicts as objective, impartial as to the parties involved in the case, but above all detached from what is at stake in the warring context (but which they never are). Taking advantage of ‘the force of the law’ in civil war therefore requires establishing procedures and rules for exercising justice and coercion, even though the legal constraints on the belligerents seem, at first glance, weak or even absent. However, this domination remains extremely precarious, as it depends on the fortunes of war and the competition with other social orders.
Regime justice
Authors: Baczko Adam
Published: December 2023

In 2001, Western intervention revived the struggle over law and justice between the regime it installed and the Taliban movement it had ousted from power. The juridical system gradually introduced by Western countries resulted in increasing uncertainty for the Afghan population. A maladapted corpus of laws, largely dictated by the cyclical priorities of the various donors, as well as the police and the judiciary undermined by nepotism, led to an unbalanced juridical system favouring the elites and inaccessible to the majority of the population. Western lawyers, experts, humanitarians, military officers, and diplomats worked to have laws enacted that conflicted with the other Afghan laws, influenced appointments to key institutions, invented ad hoc committees, and interfered in court cases. Moreover, the judiciary’s lack of independence favoured the regime’s strongmen, the former commanders from the 1990s who seized entire sections of the state apparatus. These violent entrepreneurs exploited a system for appropriating resources by force, in which the courts lent a legal veneer to violent de facto situations.
Legitimation through law
Authors: Baczko Adam
Published: December 2023

Between 2001 and 2021, the judicial system was an essential part of the Taliban’s claim that they were the state in Afghanistan. In practice, the political and strategic effectiveness of the courts is difficult to assess, although there are many indications that they facilitated the movement’s implantation in previously hostile regions. The Taliban judges operated in a juridical field polarized by the transposition of political confrontation into law and justice. Therefore, users’ assessments of the competing judicial systems directly impacted the ongoing struggle to impose a monopoly on the law’s application. The legitimization of the Taliban courts was conceivable only in relation to that of the regime courts and the characterizations of the judicial practices of the actors of the intervention. In comparison, Taliban judgments were considered more effective, not the least because they were better respected locally than the government’s. They were felt to be a source of predictability in daily life, helping to establish the legal nature of the Taliban verdicts and thus the legal nature of their hold over the population. However, the international recognition enjoyed by the Kabul regime gave its courts an official—and therefore more lasting—character, which the Taliban judicial system never achieved.
Governing in an Age of Distrust
Authors: Weinberg James
Published: December 2023

Despite the existence of a large literature on themes relating to trust and distrust in politics, there has been no sustained research on the primary objects of trust: politicians. This is an intriguing blind spot with important implications for our understanding of democratic representation and governance. This book tackles this gap head on by asking whether politicians accurately perceive and act upon the trust placed in them. In doing so, the author draws on unique survey and interview data gathered from nationally and locally elected politicians in different countries that have faced a crisis of political trust in recent decades—principally, the United Kingdom, Canada, and South Africa. The author identifies different types of ‘political trustees’ and subsequently analyses the relationship between their perceptions of trust and a variety of outcomes such as politicians’ blame avoidance behaviour and personal well-being. Taking a new and innovative approach to research on trust and elite political behaviour, the author tackles questions that are arguably of paramount importance if we are to understand when, why, and how politicians do or do not deliver on the promise of democracy.
Introduction
Authors: Weinberg James
Published: December 2023

This introductory chapter starts by briefly outlining contemporary patterns of political trust and discussing the specific importance of politicians’ behaviour for this area of public opinion. Drawing down from this ‘anti-politics’ context, the chapter then presents the core argument of this book: that the appraisive potential of trust and distrust in politics depends in large part on whether politicians share in common understandings of these concepts and accurately perceive the trust or distrust placed in them. Finally, the chapter clarifies the key concepts used in the book (the family of ‘felt’ trust concepts) before introducing the data and research it is based upon. This introduction concludes with short summaries of what the reader can expect in each of the remaining chapters
The Chinese Revolution
Authors: Gill Graeme
Published: December 2023

The subject of this chapter is the Chinese Revolution, from around 1930 up until 1970. The Chinese Revolution differs from the French and Russian in that the communists exercised control over significant parts of China before achieving national victory in 1949. As a result, revolutionary and transformational terror coincided in those areas they ruled prior to the achievement of national power. Having achieved control of China nationally in 1949–1950, transformational terror continued to be used in the process of carrying out a program of social transformation, including most importantly agricultural collectivization. Inverted terror broke out with the onset of the Cultural Revolution in 1966, something for which Mao was personally responsible. Throughout, the role of the populace in struggle meetings was important.
Nuclear Orientalism
Authors: Rahim Sana
Published: December 2023

The purpose of Chapter 2 is to look at the dominant discourses around nuclear weapons and understand their dominance by examining their pictures of reason (Pin-Fat, 2010). The first picture examined is the Realist Deterrence Theory, which articulates nuclear deterrence and nuclear politics through an account of power, geopolitics, and the strategic logic of processes such as Mutually Assured Destruction (MAD). The second is the Liberal Institutional Theory, the neoliberal approach to theorizing nuclear politics. This holds that institutions and rules can facilitate mutually beneficial effects (Keohane, 2012). This is done by focusing specifically on Pakistan’s appeals to these pictures of reason. With this, there is a clear understanding of the mainstream approach to the rationality of nuclear weapons and how Pakistan attempts to be a part of this. In the second part of this chapter, postcolonial critique of Western rationality and the construction of threats are introduced.
The Othering of Pakistan
Authors: Rahim Sana
Published: December 2023

This chapter presents an understanding of social reality subjectively, showing how the different labels are produced and attached to both Pakistan and Pakistanis. The chapter questions the ideological representation of the colonial subject as primitive and deviant and the inextricable link between imperial power and representation. Three common tropes or intelligence grids are examined that Pakistanis fell into within the Western Security discourse: ‘juvenile’, ‘dangerous’, and ‘manipulative’. This form of Othering allow Pakistanis to be thought of as predatory, threatening, wicked, and incomprehensible. It is argued that these are similar Orientalist and racist assumptions and underpinnings that are rooted in history and have been narrated over and over again and are used to malign an already marginalized and silenced community.
History of Urban Form of India
Authors: Shankar Pratyush
Published: December 2023

The History of Urban Form of India covers key historical moments in the country from the point of view of urban development. The book is divided into ten chapters that are representing a larger regional and historical era or a particular political-economic arrangement. This book is an attempt to make sense of the complex spaces of Indian cities from a historical perspective. The focus is toward understanding the unique morphology of cities in the Indian sub-continent while trying to unearth the forces that influence the same. The author is particularly interested in understanding if at all Indian cities of the past manage to create a public life or public sphere; a hallmark of a true city. For example how the cities of Deccan develop a culture and spatial practice of suburban public spaces on account of the presence of tombs and abodes of the Sufi saints or how Princely states managed to make good of the partial autonomy they enjoyed during the colonial rule and few of them managed to create new urban practices that contributed to social life and well-being of its citizens. The book also has an interesting comparison between the British, French, and Portuguese colonial practices and its different manifestations in the spaces of their respective colonial cities in India. The book is ideal for scholars of architecture, urban planning, urban design, urban studies, and for people generally curious about cities.
Self-Love and Authoritative Virtue
Authors: Whiting Jennifer
Published: December 2023

This chapter challenges the traditional claim that the ethical views of Aristotle and Kant are so fundamentally opposed that the two are not even in the same business. It reads EE VIII.3’s presentation of the distinction between an agent who is merely good [agathos] and an agent who is fine-and-good [kaloskagathos] as evidence that Aristotle was committed to some version of the “conditionality thesis” associated with Socrates and the Stoics but closely akin to Kant’s view (which may have come through the Stoics) that a good will is the only thing good without qualification. In EE VIII.3 and related texts, Aristotle seems to endorse this view: the value to an agent of any so-called good—apart from phronêsis itself—is conditional on the agent’s phronêsis, aka “authoritative” (as distinct from “natural”) virtue. Without this, these so-called goods fail to benefit—and may even harm—those who possess them.
The Pleasures of Thinking Together
Authors: Whiting Jennifer
Published: December 2023

A commentary on Eudemian Ethics VII.12, where Aristotle argues (as in Nicomachean Ethics IX.9) that the most self-sufficient human being will want to live together with a friend, enjoying awareness of her friend’s thoughts and actions. EN IX.9 does not mention God, but EE VII.12 attacks the common assimilation of the best human being to a God. For, as Aristotle argues in Metaphysics XII, the pleasures of human (as distinct from divine) thought require objects distinct from themselves, the better the objects the more pleasant the thought. Pleasure is crucial here, but commentators miss this because they fail to see how the argument draws on Metaphysics XII’s reply to Plato’s Philebus. Editors have also emended the highly corrupt text in ways that conflate distinct steps in a reasonably clear argument from the value of a subject’s own awareness to pleasure taken in the goodness of its objects (including her friends).
Secreted HLA-Fc fusion profiles immunopeptidome in hypoxic PDAC and cellular senescence
Authors: Rettko Nicholas J , Kirkemo Lisa L , Wells James A
Published: December 2023

Human leukocyte antigens (HLA) present peptides largely from intracellular proteins on cell surfaces. As these complexes can serve as biomarkers in disease, proper identification of peptides derived from disease-associated antigens and the corresponding presenting HLA is important for the design and execution of therapeutic strategies. Yet, current mass spectrometry methods for immunopeptidomic profiling require large and complex sample inputs, hindering the study of certain disease phenotypes and lowering confidence in peptide and allele identification. Here, we describe a secreted HLA (sHLA)-Fc fusion construct for simple single HLA allele profiling in hypoxic pancreatic ductal adenocarcinoma (PDAC) and cellular senescence. This method streamlines sample preparation, enables temporal control, and provides allele-restricted target identification. Over 30,000 unique HLA-associated peptides were identified across 2 different HLA alleles and 7 cell lines, with ∼9,300 peptides newly discovered. The sHLA-Fc fusion capture technology holds the potential to expedite immunopeptidomics and advance therapeutic interest in HLA-peptide complexes.
Clinical heterogeneity and prognostic factors of anti-synthetase syndrome: a multi-centred retrospective cohort study
Authors: Tang Hoi San , Tang Iris Yan Ki , Ho Roy Tsz Chung , Young Joyce Kit Yu , Lai Billy Tin Lok , Chung Judy Yuen Kwan , Yung Amy Ka Man , Cheung Chris Ching Lam , Lee Patrick Man Leung , So Ho
Published: December 2023

Objective

Anti-synthetase syndrome (ASyS) patients have heterogeneous clinical manifestations with different initial presentations, complications and outcomes. This study aimed to assess the clinical characteristics and complications in patients with ASyS, and to identify factors that were associated with the survival of ASyS patients.

Methods

This was a retrospective multicentre longitudinal study. Patients fulfilling either Connor’s criteria or Solomon’s criteria for ASyS were recruited. Electronic health records were reviewed until October 2022. Multivariate Cox regression analysis was used to determine the independent prognostic factors. Auto-antibodies were checked by commercial immunoassays.

Results

A total of 205 patients (anti-Jo1 49.3%, anti-PL7 19.0%, anti-EJ 11.2%, anti-PL12 10.2% and anti-OJ 3.4%) were included. The median follow-up time was 4 years. The time from symptoms onset to diagnosis was significantly longer for non-anti-Jo1 patients (median 5 vs 3 months). Common initial presentations included myositis (56.1%), arthritis (54.6%) and interstitial lung disease (ILD) (54.1%). Patients with anti-Jo1 had significantly higher muscle enzyme levels and more arthritis. All patients with anti-EJ would develop ILD on follow-up and malignancy was noted in 28.6% of the anti-OJ positive patients; 15.6% of the patients died and pulmonary diseases (ILD or pneumonia) were the major causes. Age at diagnosis, malignancy and rapidly progressive ILD were independently associated with mortality, while joint manifestation was a protective factor.

Conclusion

In view of the heterogeneity of clinical presentation of ASyS, a high index of suspicion and early checking of specific autoantibodies might help prompt diagnosis of ASyS and detection of related complications.
Circadian blood pressure dysregulation in children with obstructive sleep apnea
Authors: Khan Md Tareq Ferdous , Smith David F , Schuler Christine L , Witter Abigail M , DiFrancesco Mark W , Armoni Domany Keren , Amin Raouf S , Hossain Md Monir
Published: December 2023

Study Objectives

Obstructive sleep apnea (OSA) adversely affects normal blood pressure (BP) and may disrupt circadian BP patterns. We sought to examine 24-hour circadian BP rhythms in children with OSA and healthy controls.

Methods

Children 5–14 years with OSA and healthy controls underwent 24-hour BP monitoring and actigraphy to quantify sleep. Shape invariant statistical models compared circadian BP patterns (e.g. times of BP peaks, time arrived at peak BP velocity [TAPV]) in the OSA and control groups.

Results

The analytic sample included 219 children (mild OSA: n = 52; moderate-to-severe OSA (MS-OSA): n = 50; controls: n = 117). In the morning, the MS-OSA group had earlier TAPV for DBP than controls (51 minutes, p < 0.001). TAPV in the evening was earlier for the MS-OSA group than controls (SBP: 95 minutes, p < 0.001; DBP: 28 minutes, p = 0.028). At mid-day, SBP and DBP velocity nadirs were earlier for the MS-OSA group than controls (SBP: 57 minutes, p < 0.001; DBP: 38 minutes, p < 0.01). The MS-OSA group reached most BP values significantly earlier than controls; the largest differences were 118 minutes (SBP) and 43 minutes (DBP) (p < 0.001). SBP and DBP were elevated in the MS-OSA group (hours 18–21 and 7–-12, respectively, p < 0.01) compared to controls. The MS-OSA group was prone to “non-dipping” compared to controls (SBP: odds ratio [OR] = 2.16, 95% CI: 1.09, 4.29; DBP: OR = 3.45, 95% CI: 1.21, 10.23).

Conclusions

Children with MS-OSA had changes in circadian BP patterns, namely earlier TAPV and BP peaks and nadirs than controls. Circadian disturbances in BP rhythms may be key to mapping the natural history of BP dysregulation in children with OSA.
Developmental neurotoxicity (DNT) QSAR combination prediction model establishment and structural characteristics interpretation
Authors: Zhang Lu , Li Min , Zhang Dalong , Zhang Shujing , Zhang Li , Wang Xiaojun , Qian Zhiyong
Published: December 2023

With the incidence of neurodevelopmental disorders on the rise, it is imperative to screen and evaluate developmental neurotoxicity (DNT) compounds from a large number of environmental chemicals and understand their mechanisms. In this study, DNT qualitative structure-activity relationship (QSAR) study was carried out for the first time based on DNT data of mammals and structural characterization of DNT compounds was preliminarily illustrated. Five different classification algorithms and two feature selection methods were used to construct prediction models. The best model had good predictive ability on the external test set, but a small application domain (AD). Through combining of three different models, both MCC and AD values were improved. Furthermore, electronical properties, van der Waals volume-related properties and S, Cl or P containing substructure were found to be associated with DNT through modeling descriptors analysis and structure alerts (SAs) identification. This study lays a foundation for further DNT prediction of environmental exposures in human and contributes to the understanding of DNT mechanism.
Risk factors for mortality in an African pediatric emergency department: case of Sourô Sanou Hospital, a prospective, cross-sectional study
Authors: Barro Makoura , Ouattara Cheick Ahmed , Sanogo Bintou , Baby Abdel Aziz , Ouattara Ad Bafa Ibrahim , Nacro Fatimata Sahoura , Traoré Isidore Tiandiogo , Kalmogho Angèle , Ouermi Alain Saga , Ouoba Réné Souanguimpari , Cessouma Klangboro Raymond , Nacro Boubacar
Published: December 2023

Background

Childhood mortality rates remain high in sub-Saharan Africa. This study aimed to assess the causes and associated factors of pediatric emergency mortality at the Sourô Sanou University Hospital of Bobo-Dioulasso.

Methodology

This was a cross-sectional study with prospective collection from June to August 2020. We documented and analyzed demographic and clinical characteristics by means or proportions. Logistic regression was performed to identify the factors associated with childhood mortality.

Results

From 618 pediatric patients admitted to pediatric emergency unit, 80 (12.9%) were documented as death outcomes. The mean age was 34.10 ± 36.38 months. The male sex represented 51.25%. The main diagnoses were severe malaria (61.25%), acute gastroenteritis (11.25%) and pneumonia (10%); 48.75% of the patients were malnourished and only 55% were fully immunized. The average length of hospitalization was 2.73 ± 3.03 days. Mortality was a strongly significant association with late come to the emergency unit (AOR = 1.11, CI = 1.04–1.18), young maternal age (AOR = 0.95, CI = 0.92-0.99) and incomplete vaccination (AOR = 1.94, CI = 1.13-3.31).

Conclusion

The in-hospital mortality rate was 12.94%; younger maternal age, delay in consultation, unimmunized or incompletely immunized status and shorter hospital stays were significantly associated with death.
Development and Validation of a Multiplex TaqMan Probe qPCR Assay Specific for Three Rust Fungi Infecting Meliosma myriantha
Authors: Na Dong-Hwan , Lee Dong Jae , Choi Young-Joon
Published: December 2023

Rust fungi are the largest group of obligate plant pathogens and cause severe damage to global forests and agricultural security. Meliosma myriantha, a tree species native to East Asia (China, Japan, and Korea), is vulnerable to three rust species: Neophysopella meliosmae, N. meliosmae-myrianthae, and N. vitis. The early symptoms of infection are indistinguishable between these species, making an accurate and rapid diagnosis challenging. The urediniospores of N. meliosmae-myrianthae and N. vitis are also known to infect economically relevant grapevines (Vitis spp.) and ivies (Parthenocissus spp.), respectively, rendering early detection and identification even more important. To address this issue, we developed a multiplex quantitative polymerase chain reaction assay equipped with TaqMan probes targeting the internal transcribed spacer rDNA sequences specific to the three rust pathogens. This assay successfully detected minute quantities (5 fg for N. meliosmae-myrianthae and 50 fg for N. meliosmae and N. vitis) of DNA from the three Neophysopella species and demonstrated consistent reliability when applied to fresh and herbarium samples collected from M. myriantha, grapevines, and ivies. In conclusion, this novel assay is a rapid and robust diagnostic tool for the three rust pathogens, N. meliosmae, N. meliosmae-myrianthae, and N. vitis, and offers the potential to identify and detect their global movement and spread to grapevines, ivies, and trees.
Racial Disparities in Hysterectomy Route for Benign Disease: Examining Trends and Perioperative Complications From 2007 to 2018 Using the NSQIP Database
Authors: Carey Erin T. , Moore Kristin J. , McClurg Asha B. , Degaia Ayana , Tyan Paul , Schiff Lauren , Dieter Alexis A.
Published: December 2023

(Abstracted from J Minim Invasive Gynecol 2023;30(8):627–634)

One of the most common gynecological procedures performed within the United States, the trends of hysterectomy types have changed over the past 30 years, with the 1990s demonstrating predominantly abdominal hysterectomies, whereas current trends tend to favor minimally invasive hysterectomies (MIHs) using laparoscopic or vaginal routes. In addition, within the hysterectomy trend, it is notable that higher rates of abdominal hysterectomy and postoperative complications occur for Black and Hispanic women as seen across varying health care systems.
Intravenous Versus Locally Injected Tranexamic Acid in a Fragility Hip Fracture Population: A Retrospective Review
Authors: Davis Stephen L. , Solomito Matthew J. , Kumar Mandeep
Published: December 2023

OBJECTIVE:

Evaluate differences between blood transfusion and complication rates among fragility hip fracture patients treated with locally injected (Local) versus intravenous (IV) tranexamic acid (TXA).

METHODS

Design:

Retrospective comparative cohort

Setting:

Tertiary referral orthopedic specialty hospital; Level I trauma center

Patient Selection Criteria:

Patients aged 50 years and over who underwent surgical treatment for a proximal femur fragility fracture (OTA/AO 31A and 31B). between March 2018 and April 2022 with or without the use of local TXA during wound closure or IV TXA.

Outcome Measures and Comparisons:

Post-operative blood transfusion, venous thromboembolism (VTE), surgical site infections (SSI), and 30-day readmissions compared between those who received IV TXA, Local TXA, and controls that did not receive any TXA.

RESULTS:

746 patients (258 received IV TXA, 252 received Local TXA, and 236 control that did not receive any TXA) were studied. Both Local and IV TXA groups received fewer blood transfusion versus controls. IV TXA was associated with a transfusion rate reduction of 12% compared to Local TXA (p<0.001). Regression analysis indicated that IV TXA reduced the odds of a post-operative blood transfusion by 48% compared to Local TXA (p=0.017). There were no differences in complication rates among the groups; however, patients receiving IV TXA had a significantly lower 30-day readmission rate (5%) than the control (13.9%) or Local (13.8%) TXA groups (p=0.001).

CONCLUSION:

Intravenous TXA significantly reduced the risk of postoperative transfusion compared to controls and patients receiving Local TXA. There was no increased risk of complications, and a lower 30-day readmission was observed for the IV TXA group. IV TXA appears to be a safe and effective way to reduce post-operative blood transfusion in patients with fragility hip fractures.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Diabetes Mellitus and Poor Glycemic Control Are Associated With a Higher Risk of Lumbar Spinal Stenosis
Authors: Shemesh Shai , Laks Asaf , Cohen Itzik , Turjeman Adi , Blecher Ronen , Kadar Assaf
Published: December 2023

Study Design.

A large-scale retrospective case-control study.

Objective.

Examine diabetes as a risk factor for lumbar spinal stenosis (LSS) development and evaluate the impact of diabetes duration, glycemic control, and associated complications on this risk.

Summary of Background Data.

Diabetes mellitus, a multiorgan disorder impacting various connective tissues, induces histological changes in spinal structures, particularly the ligamentum flavum. While clinical studies suggest a higher incidence of LSS in diabetic patients, substantial epidemiological research on the likelihood of LSS diagnosis in individuals with diabetes is scarce.

Materials and Methods.

Using nationwide data, a total of 49,576 patients diagnosed with LSS based on International Classification of Diseases-10 codes were matched with controls of the same number based on age and sex. Employing a multivariable logistic regression model, the study assessed for the association between spinal stenosis and diabetes, while adjusting for confounders.

Results.

We found a higher likelihood of LSS diagnosis in diabetic patients [odds ratio (OR) 1.39, 95% CI: 1.36 – 1.43, P<0.001]. Those with hemoglobin A1c ≥7% and ≥1 diabetes-related complication also had an elevated likelihood (OR: 1.19, 95% CI: 1.08–1.31, P=0.001). Prolonged diabetes exposure increased the risk. Diabetes diagnosis reduced median survival by around 4.5 years for both stenosis and nonstenosis patients; spinal stenosis diagnosis alone minimally impacted survival. Relative to individuals diagnosed with diabetes mellitus at the age of 65 or older, the OR for developing LSS were 1.22 (95% CI: 1.18–1.27, P<0.001) when DM was diagnosed at 50 to 65 years old and 1.67 (95% CI: 1.56–1.79, P<0.001) for those under 50 years old. Multivariate analysis revealed a significantly increased risk of all-cause mortality in patients with DM and spinal stenosis (hazard ratio: 1.36, 95% CI: 1.29–1.44, P<0.001) and those with DM without stenosis (hazard ratio: 1.49, 95% CI: 1.41–1.57, P<0.001) compared with controls.

Conclusions.

Diabetic patients with prolonged disease, poor glycemic control, and diabetes-related complications face an elevated risk of developing LSS. Recognizing the reciprocal adverse relationship between these conditions is crucial in clinical practice and designing public health measures for managing both conditions.

Level of Evidence.

4.
Comparison of the efficacy of intranasal atomised dexmedetomidine versus intranasal atomised ketamine as a premedication for sedation and anxiolysis in children undergoing spinal dysraphism surgery
Authors: Hebbar K Chethan , Reddy Ashwini , Luthra Ankur , Chauhan Rajeev , Meena Shyam C. , Tripathi Manjul
Published: December 2023

BACKGROUND

Preoperative anxiety leads to adverse clinical outcomes and long-term maladaptive behavioural changes. The role of intranasal atomised dexmedetomidine and atomised ketamine as premedication to produce sedation and anxiolysis in paediatric neurosurgical patients has not been extensively studied.

OBJECTIVE

To study the efficacy of intranasal atomised dexmedetomidine and intranasal atomised ketamine as premedication in producing sedation and facilitating smooth induction in children undergoing spinal dysraphism surgery.

DESIGN

A prospective randomised double-blind trial.

SETTING

A tertiary teaching hospital.

PATIENTS

Sixty-four children aged 1 to 10 years undergoing spinal dysraphism surgery

METHODS

Children were randomised to receive intranasal atomised dexmedetomidine 2.5 μg kg−1(Group D,n = 32) and intranasal atomised ketamine 5 mg kg−1(Group K,n = 32) 30 min before surgery.

OUTCOMES MEASURED

The primary outcome was to compare the level of sedation in both groups using the University of Michigan Sedation Score (UMSS). The secondary outcomes included an assessment of the ease of parental separation, intravenous cannulation and satisfactory mask acceptance along with perioperative vitals (heart rate, blood pressure and oxygen saturation). The incidence of emergence agitation and time to discharge were also noted.

RESULTS

The degree of sedation was significantly better in Group D as compared to Group K at 20 min (UMSS, 1.55 ± 0.51versus1.13 ± 0.34, difference, −0.406; 95% CI, −0.621 to −0.191;P = 0.0001) and 30 min (2.32 ± 0.6versus1.94 ± 0.50, difference, −0.374; 95% CI, −0.650 to −0.100;P = 0.007). The ease of parental separation, venous cannulation and mask acceptance (P = 0.83, 0.418 and 0.100 respectively) were comparable in both groups. The heart rate was lower in group D at 10, 20 and 30 min post-drug administration but was clinically insignificant. The incidence of emergence agitation and time to discharge was also similar with no adverse events reported.

CONCLUSION

Intranasal atomised dexmedetomidine produces greater sedation as compared to intranasal atomised ketamine with comparable ease of parental separation, venous cannulation and mask acceptance with no adverse effects.
Outcomes of Digit Replantation in Children: A Systematic Review
Authors: Huang Ryan S. , Mihalache Andrew , Hasan Asad , Wong Riff Karen W.Y.
Published: December 2023

Background:

Children have been suggested to benefit from digit replantation due to a greater neurogenerative capacity. We aimed to conduct a systematic review on digit replantation in children to provide a comprehensive overview of survival rates and functional outcomes.

Methods:

A systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Controlled Register of Trials for studies published between 1980 and 2023. We included peer-reviewed studies reporting on digit survival rates in pediatric patients under the age of 18 years who underwent single or multiple digit replantations distal to the metacarpophalangeal joint. Preoperative, intraoperative, and postoperative outcomes were extracted, and pooled estimates were derived using univariable analysis.

Results:

Twenty-two studies reporting on 761 patients and 814 digit replantations were included in our study. Most replantations occurred in the index (n = 74), Tamai zone I (n = 168), and from clean-cut injuries (n = 190). The mean survival rate was 76% (n = 618/814), with a mean range of motion at the distal interphalangeal joint ranging from 64 degrees to 90 degrees and two-point discrimination ranging from 3.8 mm to 6.4 mm. Compared with clean-cut injuries, digit replantations from avulsion [odds ratio (OR), 0.81; 95% confidence interval (CI), 0.74–0.89] or crush (OR, 0.71; 95% CI, 0.59–0.82) injuries were associated with a lower odds of survival. Digit replantations performed with two venous (OR, 1.43, 95% CI; 1.28–1.59) or arterial anastomoses (OR, 1.65; 95% CI, 1.48–1.81) were associated with a higher odds of survival.

Conclusions:

Our systematic review suggests that digit replantation may be a viable option in children. Further research is required to explore functionality after digit replantation in diverse pediatric populations.
A randomized trial of mailed outreach with behavioral economic interventions to improve liver cancer surveillance
Authors: Mehta Shivan J. , McDonald Caitlin , Reitz Catherine , Kastuar Shivani , Snider Christopher K. , Okorie Evelyn , McNelis Kiernan , Shaikh Hamzah , Cook Tessa S. , Goldberg David S. , Rothstein Kenneth
Published: December 2023

Background:

Surveillance rates for HCC remain limited in patients with cirrhosis. We evaluated whether opt-out mailed outreach increased uptake with or without a $20 unconditional incentive.

Methods:

This was a pragmatic randomized controlled trial in an urban academic health system including adult patients with cirrhosis or advanced fibrosis, at least 1 visit to a specialty practice in the past 2 years and no surveillance in the last 7 months. Patients were randomized in a 1:2:2 ratio to (1) usual care, (2) a mailed letter with a signed order for an ultrasound, or (3) a mailed letter with an order and a $20 unconditional incentive. The main outcome was the proportion with completion of ultrasound within 6 months.

Results:

Among the 562 patients included, the mean age was 62.1 (SD 11.1); 56.8% were male, 51.1% had Medicare, and 40.6% were Black. At 6 months, 27.6% (95% CI: 19.5–35.7) completed ultrasound in the Usual care arm, 54.5% (95% CI: 47.9–61.0) in the Letter + Order arm, and 54.1% (95% CI: 47.5–60.6) in the Letter + Order + Incentive arm. There was a significant increase in the Letter + Order arm compared to Usual care (absolute difference of 26.9%; 95% CI: 16.5–37.3; p<0.001), but no significant increase in the Letter + Order + Incentive arm compared to Letter + Order (absolute difference of −0.4; 95% CI: −9.7 to 8.8; p=0.93).

Conclusions:

There was an increase in HCC surveillance from mailed outreach with opt-out framing and a signed order slip, but no increase in response to the financial incentive.
Exploring the potential mechanism of Taohong Siwu decoction in the treatment of avascular necrosis of the femoral head based on network pharmacology and molecular docking
Authors: Chen Rui , Song Chao , Qiu Junjie , Su Qifan , Wang Xiaoqiang , Deng Guanghui , Cheng Kang , Chen Xiaoyu , Xiang Wei , Liu Tao , Chen Xiaojun , Wu Jiaqi
Published: December 2023

Based on network pharmacology and molecular docking, this study seeks to investigate the mechanism of Taohong Siwu decoction (THSWD) in the treatment of avascular necrosis of the femoral head (AVNFH). The Traditional Chinese Medicine Systems Pharmacology database was used in this investigation to obtain the active ingredients and related targets for each pharmaceutical constituent in THSWD. To find disease-related targets, the terms “avascular necrosis of the femoral head,” “necrosis of the femoral head,” “steroid-induced necrosis of the femoral head,” “osteonecrosis,” and “avascular necrosis of the bone” were searched in the databases DisGeNET, GeneCards, Comparative Toxicogenomics Database, and MalaCards. Following the identification of the overlap targets of THSWD and AVNFH, enrichment analysis using gene ontology, Kyoto Encyclopedia of Genes and Genomes, Reactome, and WikiPathways was conducted. The “THSWD-drug-active compound-intersection gene-hub gene-AVNFH” network and protein-protein interaction network were built using Cytoscape 3.9.1 and string, and CytoHubba was used to screen hub genes. The binding activities of hub gene targets and key components were confirmed by molecular docking. 152 prospective therapeutic gene targets were found in the bioinformatics study of ONFH treated with THSWD, including 38 major gene targets and 10 hub gene targets. The enrichment analysis of 38 key therapeutic targets showed that the biological process of gene ontology analysis mainly involved cytokine-mediated signaling pathway, angiogenesis, cellular response to reactive oxygen species, death-inducing signaling complex. The Kyoto Encyclopedia of Genes and Genomes signaling pathway mainly involves TNF signaling pathway, IL-17 signaling pathway, and the Recactome pathway mainly involves Signaling by Interleukins, Apoptosis, and Intrinsic Pathway for Apoptosis. WikiPathways signaling pathway mainly involves TNF-related weak inducer of apoptosis signaling pathway, IL-18 signaling pathway. According to the findings of enrichment analysis, THSWD cured AVNFH by regulating angiogenesis, cellular hypoxia, inflammation, senescence, apoptosis, cytokines, and cellular proliferation through the aforementioned targets and signaling pathways. The primary component of THSWD exhibits a strong binding force with the key protein of AVNFH. This study sheds new light on the biological mechanism of THSWD in treating AVNFH by revealing the multi-component, multi-target, and multi-pathway features and molecular docking mechanism of THSWD.