bluuebunny/crossref_metadata_2025 huggingface dataset:
An account of rational inquiry
Authors: Thorstad David
Published: June 2024

This chapter develops a reason-responsive consequentialist view (RRCV) of rational inquiry as a special case of a more general global consequentialist program. As a theory of rightness, global consequentialism holds that we ought to do what is best and that what is best is to promote value. Global consequentialism has been defended not only as an account of rightness, but also as an account of many other normative statuses such as rationality and virtue. I develop a reason-responsiveness conception of rationality and use the reason-responsiveness conception to extend global consequentialism into an account of rational agency. As a special case of this account, we recover a reason-responsive consequentialist account of rational inquiry.
The Standard Picture revisited
Authors: Thorstad David
Published: June 2024

This chapter takes a second look at the relationship between bounded rationality and the Standard Picture. I show how the reason-responsive consequentialist view charts a third way between the two reactions to Standard Picture violations outlined in Chapter 1. This third way leaves the Standard Picture largely intact as a theory of rational attitudes while rejecting the Standard Picture as a guide to rational inquiry. A natural objection is that this approach is too concessive to the Standard Picture because it makes cognitive bounds less relevant to the rationality of attitudes. I argue that my concessive approach is needed to avoid two revisionary consequences: that most traditional attitudinal norms are false, and that all attitudinal norms are normatively non-fundamental.
Approaching Psychopathology from a Psychophysiological Perspective
Authors: Hedges Dawson , Steffen Patrick R.
Published: June 2024

Traditional diagnostic approaches in psychopathology such as the Diagnostic and Statistical Manual (DSM) emphasize a categorical approach that is inadequate to fully conceptualize psychopathology and therefore has limited ability to fully capture diagnosis and inform treatment. Psychophysiological methods, which use a dimensional approach in measurement, provide a stronger foundation for diagnosis and treatment in mental health than do categorical diagnostic methods. Two alternatives to the DSM, the Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP), provide excellent frameworks for conceptualizing psychopathology from a psychophysiological perspective. Moving diagnosis from the traditional categorically based approach, exemplified by the DSM beginning in 1952, to diagnostic schemes that incorporate a dimensional approach emphasizing a holistic view of health and illness has the potential to overcome the inherent limitations of traditional categorical approaches to diagnosis in mental health allowing for more specificity in diagnosis and treatment.
Breathing, Heart Rate Variability, and Their Application in Psychotherapy
Authors: Khazan Inna
Published: June 2024

Breathing practice is one of the most frequently used interventions in psychotherapy practice. It is generally intuitive to teach, and often works well to alleviate suffering in the moment. However, because of its intuitiveness and ease of use, breath training can fall victim to common misconceptions about breathing and, in some cases, actually increase rather than alleviate distress. In addition, not all breath practices commonly in use are based in empirical research. This chapter will provide readers with a clear understanding of relevant respiratory physiology to enable proper teaching of healthy breathing, and a practical step-by-step guide to powerful heart rate variability training—a way to train self-regulation and resilience, and to improve physical and mental health.
Introduction
Authors: Rozin Orit
Published: June 2024

How did Israelis grapple with the emotional complexities of residing in a state tasked with providing existential security to the Jewish people and ensuring the safety of its populace, in the face of considerable challenges. Rooted in the ethos of the Labor movement during the Mandate era, a set of normative emotions emerged as the cornerstone of Israel’s emotional regime. In shaping these norms, the political elite drew inspiration from narratives of heroism of the Spanish Civil War and the unwavering resolve demonstrated by civilians in Britain and the Soviet Union during World War II. These normative emotions, coupled with official rituals and practices designed to instil them in the public, were meant to assuage fear, foster readiness, nurture a moral compass, and cultivate a collective sense of purpose, belonging, and solidarity in the face of adversity.
The Enemy Within
Authors: Rozin Orit
Published: June 2024

Up until 1966, most of Israel’s Palestinian Arab citizens lived under military government, and their feelings toward the Jewish state and the Jewish majority were the subject of intensive surveillance by the Israeli security services. Feelings of hostility and hatred, or their opposite, loyalty and acquiescence, were considered indicative of their intentions. Toward the end of the 1950s, restrictions were lifted gradually, and Palestinian Israelis were incorporated into the Israeli economy. As many workers now resided, at least during the work week, in the cities where they were employed, they aroused feelings of intimidation and suspicion. In response, policy makers sought to construct a “safe inside” in order to enable Israelis to face a “hostile outside.” They depicted most Arab citizens as loyal to the state, especially on the eve of the 1967 War. Nevertheless, a feeling of suspicion persisted.
The Sorrowful Second Best
Authors: Besharov Gregory
Published: June 2024

This chapter drops the assumption of the previous chapters that everything can be known. It considers people who have private information, asks how mechanisms can be used to obtain that information, and discusses the limitations on doing so. From the second-best perspective, the elimination or creation of any single source of market failure has ambiguous welfare consequences. With information limited, so that one does not know the full assortment of market failures or their sizes, judging what to include in a model is a subjective decision that requires context-specific knowledge. With the inefficient outcomes that result, efficiency and equity are no longer separate, and claims about resource allocation depend unavoidably on ethical considerations.
Prohibited Markets
Authors: Besharov Gregory
Published: June 2024

What would a microeconomic analysis conclude about chattel slavery? This chapter considers ways that moral considerations enter judgments about the use of markets, from the taboo trade-offs in their use to their effects on social institutions that support economic activity and human rights. The creation of markets in kidneys from live donors is used as an example because analyses have found large gains from their creation. The issues that arise in the analyses demonstrate the need for case-based reasoning reliant not only on general principles but also on moral judgments that are socially and culturally determined.
A Case for the Ethical Screening of Political Leaders
Authors: Ziliotti Elena
Published: June 2024

The chapter reconceptualizes the idea of meritocratic screenings. It maintains that if ethical screenings were applied to the intra-party selection of future political leaders, they could enhance the quality of political leaders in democratic societies. Intra-party ethical screenings do not oppose mechanisms of intra-party democracy. Instead, they compensate for some of the shortcomings of intra-party aggregative and deliberative democracy practices. They also present a compelling means for Confucian democrats to demonstrate that democracy provides the optimal sociopolitical framework for realizing the Confucian ideal of virtuous governance under the circumstances of modern politics. The chapter proposes to realize meritocratic democracy by establishing partisan juries. These juries will assess the future political leaders’ ethical fit for the position. Their deliberation will be facilitated by trained moderators and supported by experts’ opinions and character witnesses’ interviews.
Objections to Intra-Party Ethical Screenings
Authors: Ziliotti Elena
Published: June 2024

This chapter addresses potential criticisms of the model of intra-party ethical screenings. It elucidates why the theory offered in this book is an example of ‘meritocratic democracy’, rather than ‘democratic meritocracy’; illustrates the advantages of ethical screenings over party competition and ethical guides; discusses the Singapore case of the People Action Party’s recruitment system of future party leaders to prove that ethical screenings are already part of some intra-party selection processes. Finally, it addresses the criticism that Daniel A. Bell has raised against Sun Yat-sen’s idea of meritocratic preselections of leaders in a democracy and elucidates the differences between meritocratic democracy and Sun Yat-sen’s proposal.
Subnational Government Borrowing in India
Authors: Dwivedi Hari Krishna
Published: June 2024

This chapter focuses on various aspects of subnational government (SNG) borrowing in India. This involves exploring why SNGs borrow, the sources of borrowing, the operational arrangement for subnational debt, and the various controls on subnational borrowing. The Fiscal Responsibility and Budgetary Management Act (FRBMA) regime has evolved to be one of the most important mechanisms for controlling subnational borrowing in India. However, there are limitations and challenges with the existing regime which the chapter discusses. The chapter also takes on the question of whether the existing fiscal controls in general are adequate to ensure debt sustainability at the subnational level.
Introduction
Authors: Hendry John
Published: June 2024

This chapter sets the scene for the growth of the women’s movement by reviewing the social, political, and cultural context of the ‘long 1860s’, with particular reference to the values, norms, and lifestyles of the educated upper middle classes. It summarizes the position of women in society, including their legal, political, and more general social disabilities: their exclusion from voting and public office, the principle of coverture, the sexual double standard, discrimination in education and work, etc. The logic underlying society’s treatment of women at this time is explored through an analysis of the response by the conservative writer Margaret Oliphant to an unsuccessful attempt in the 1850s to change the law on married women’s property. In tune with society more generally, Oliphant emphasized the importance of social stability and harmony, and of moral duties and virtues over legal formalities.
Institutions of Engagement and Debate
Authors: Hendry John
Published: June 2024

This chapter explores the origins of an organized women’s movement in the late 1850s and the changes in the institutional and intellectual context at this time that enabled it to gain a presence. It covers the pioneering work of Barbara Leigh Smith (later Bodichon) and Bessie Rayner Parkes, their emphasis on women’s work, and their creation of the English Woman’s Journal, Society for the Promotion of Employment for Women, and Victoria Press. This was the first organized women’s movement in Britain. At the same time the foundation of Lord Brougham’s Social Science Association, which admitted women on equal terms, provided them for the first time with a public forum in which to speak and debate. The other critical element of this institutional context was the print culture of weekly, monthly, and quarterly periodicals, increasingly liberal in tone and increasingly dominated, on the liberal side, by ‘broad church’ Anglican intellectuals.
Towards the Higher Education of Women
Authors: Hendry John
Published: June 2024

This chapter picks up on Davies’s campaign for improved female education, beginning with an account of her seminal work, The Higher Education of Women, and its reception, paying particular attention to her ongoing dialogue with Richard Holt Hutton, editor of the Spectator. It traces the origins of her decision, in 1866, to set up herself a university-level women’s college modelled on the Cambridge colleges. This was to be a strange affair, strictly following Cambridge rules of religious affiliation, residence and examination, with students required to sit the same papers within the same time scale as the male undergraduates, while sitting in the countryside between Cambridge and London. The chapter explores how her experience of discord in the suffrage context pushed her to insist on doing things completely her own way, spurning advice and creating unresolved differences with the Cambridge reformers and others who should have been her main supporters.
Introduction
Authors: Chaudhry Faisal
Published: June 2024

This introduction provides a summary and overview of the key arguments, the method, and chapter contents of the book. Starting with a discussion of the inciting curiosity motivating the book, it also touches on some of the key areas of existing scholarship—relating to South Asia, law and history, and socio-legal theory—that underpin the overarching problem it addresses. The second half of the introduction goes on to provide a detailed summary of the book’s nine chapters while also touching, albeit fleetingly, on connections and reverberations for the law and its rule in today’s subcontinent.
Holding the state together
Authors: Mitra Subrata K.
Published: June 2024

What holds India together? The role of the civil service, army, and the paramilitary forces in defending territorial integrity and creating space for civilian rule, is rarely acknowledged in public discourse or in the Indian media. Instead, the power of containing centrifugal tendencies of regions and dissident groups together is attributed to a mystical process called ‘unity in diversity’. However, folk wisdom does not explain why this does not work always, and how departures from the norm are restored by the keepers of orderly rule, working just under the surface of India’s noisy democracy. This is the main theme of this chapter. It explains how the Ministry of Home Affairs seeks to contain fissiparous tendencies built into the federalizing process, and stem insurgencies through adroit use of instruments built into the constitution, and innovative processes of its own.
Ultima ratio regum
Authors: Mitra Subrata K.
Published: June 2024

The relationship of force and legitimacy is complex, and a conundrum for democratic states. Is orderly rule the outcome of a social contract, with individuals freely choosing to set up an authoritative order? Or is the existence of order a precondition for people to be able to make their choices freely? I respond to this dilemma by pitching the case of India’s post-colonial within the framework of social contract theory. The chapter traces the relationship of force, orderly rule, and legitimacy through a discussion of paramilitary forces, intelligence gathering bodies and the coping strategies of the union government when faced with challenges to security and public order. Balancing orderly rule, security agencies, and accountability is a dynamic process. Multiple agencies with conflicting mandates generate a problem of coordination, leading to blind spots in the security nexus. The chapter explains how Home meets this challenge.
When Home Fails
Authors: Mitra Subrata K.
Published: June 2024

The claim to robustness of India’s orderly, and democratic governance is punctuated by periodic eruptions of collective violence. This gives a touch of ambivalence to the image of the Ministry of Home Affairs as the sentinel of India. I unpack three cases of collective violence—demolition of the Babri Mosque; insurgency in Kashmir; and the challenge of left-wing-extremism—in this chapter, and analyse them in the context of their formation, agency, and their historical genealogy. Seen through this dissection, riots, insurgencies, and violent extremist movements emerge as visible tips of hidden structures, buried in history, collective memory, and cleavages of class, region, and religion. This helps assess the room to manoeuvre for effective intervention that the ministry actually has, and identify factors that limit its capacity to make governance stealthy, possible, cumulative, self-reinforcing, and sustainable.
A quality improvement evaluation of a standardized intervention for children with medical complexity transitioning to adult care
Authors: Esser Kayla , Adams Sherri , Chung Christopher , McKay Taylor , Moore Clara , Wagman Hayley , Lee Stephanie , Orkin Julia
Published: June 2024

Children with medical complexity have medical fragility, chronic disease, technology dependence, and high healthcare use. Their transition to adult health care at age 18 involves medical and social elements and follows no standardized process. Our goal was to improve transition readiness in children with medical complexity using a transition intervention within a Complex Care program. All children with medical complexity aged 14 to 18 were included in this quality improvement (QI) project (n = 54). We conducted a pre- and post-intervention chart review to assess transition outcomes and implemented a transition intervention for 6 months, which included an age-stratified checklist, charting template, and transition rounds. Before the intervention, 72% of 17- to 18-year-old patients had documented transition discussions, which increased to 86%. Patients with a family physician increased as well (61% to 73% for 17- to 18-year-olds). Three transition education rounds were held. The intervention increased transition readiness, provided tools to facilitate transition, and created a forum for conversation.
Action of the AxialU(1) Non-Invertible Symmetry on the ’t Hooft Line Operator: A Lattice Gauge Theory Study
Authors: Honda Yamato , Onoda Soma , Suzuki Hiroshi
Published: June 2024

We study how the symmetry operator of the axial $U(1)$ non-invertible symmetry acts on the ’t Hooft line operator in the $U(1)$ gauge theory by employing the modified Villain-type lattice formulation. We model the axial anomaly by a compact scalar boson, the “QED axion”. For the gauge invariance, the simple ’t Hooft line operator, which is defined by a line integral of the dual $U(1)$ gauge potential, must be “dressed” by the scalar and $U(1)$ gauge fields. A careful consideration on the basis of the anomalous Ward–Takahashi identity containing the ’t Hooft operator with the dressing factor and a precise definition of the symmetry operator on the lattice shows that the symmetry operator leaves no effect when it sweeps out a ’t Hooft loop operator. This result appears inequivalent with the phenomenon concluded in the continuum theory. In an appendix, we demonstrate that the half-space gauging of the magnetic $\mathbb {Z}_N$ 1-form symmetry, when formulated in an appropriate lattice framework, leads to the same conclusion as above. A similar result is obtained for the axion string operator.
Anisotropic Einstein Universes with a Global Magnetic Field and Sasakian Quasi-Killing Spinors
Authors: Matsuno Satsuki , Ueno Fumihiro
Published: June 2024

We consider an Einstein–Dirac–Maxwell system with two charged massless spinors coupled with an electromagnetic field, and construct a family of exact solutions to the system. The solution spacetime is an anisotropic generalization of the static Einstein universe which has a global cosmic magnetic field generated by the current of the spinors. The magnetic field is a force-free field that has played an important role in the study of cosmic magnetic fields. Our exact solution is regarded as a toy model which describes global cosmic magnetic phenomena in the early universe. The spinors are induced from Sasakian quasi-Killing spinors, and the total Dirac current flows along fibers of the Hopf-fibration. The magnetic field is a contact magnetic field.
Spacecraft potential effects on low-energy ion measurements to be made by probe B1 of Comet Interceptor
Authors: Bergman S , Kasahara S , Stenberg Wieser G
Published: June 2024

Spacecraft charging causes notorious issues for low-energy plasma measurements. The charged particles are accelerated towards or repelled from the spacecraft surface, affecting both their energy and travel direction. The latter results in a distortion of the effective field of view (FOV) of the instrument making the measurements. The Comet Interceptor mission, planned to be launched in 2029, will make a flyby of a long-period or interstellar comet that ideally is dynamically new. The mission comprises one main spacecraft A, developed by the European Space Agency (ESA), and two sub-probes B1 and B2, developed by the Japan Aerospace Exploration Agency and ESA, respectively. The low-energy plasma measurements made by Comet Interceptor will likely be affected by the spacecraft potential in the case of low relative flyby velocities. On probe B1, the Cometary Ion Mass Spectrometer (CIMS) of the Plasma Suite is an ion mass spectrometer, capable of measuring ions with energies down to 10 eV/q. In this work, we use the Spacecraft Plasma Interaction Software to study the influence of the spacecraft potential on the low-energy ion measurements to be made by CIMS in the inner cometary magnetosphere. The results show that the effective FOV of CIMS is distorted at low energies when the flyby velocity is low. The distortion level is highly geometry dependent, and the largest distortions are caused by the magnetometer boom. Furthermore, the results show that cold ions with bulk velocities in the range 1–10 km s−1, flowing both radially away from and inward towards the nucleus, are detectable by the instrument considering the nominal observation geometry.
The therapeutic efficacy of different configuration nano-polydopamine drug carrier systems with photothermal synergy against head and neck squamous cell carcinoma
Authors: Guo Yuhao , Li Bo , Xie Huixu , Wu Chenzhou , Wang Guixue , Yao Kexin , Li Longjiang
Published: June 2024

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignant tumor worldwide. Considering its special anatomical site and the progressive resistance to chemotherapy drugs, the development of more effective, minimally invasive and precise treatment methods is urgently needed. Nanomaterials, given their special properties, can be used as drug carrier systems to improve the therapeutic effect and reduce the adverse effects. The drug carrier systems with photothermal effect can promote the killing of cancer cells and help overcome drug resistance through heat stress. We selected dopamine, a simple raw material, and designed and synthesized three different configurations of nano-polydopamine (nPDA) nanomaterials, including nPDA balls, nPDA plates and porous nPDA balls. In addition to the self-polymerization and self-assembly, nPDA has high photothermal conversion efficiency and can be easily modified. Moreover, we loaded cisplatin into three different configurations of nPDA, creating nPDA-cis (the nano-drug carrier system with cisplatin), and comparatively studied the properties and antitumor effects of all the nPDA and nPDA-cis materials in vitro and nPDA-cis in vivo. We found that the photothermal effect of the nPDA-cis balls drug carrier system had synergistic effect with cisplatin, resulting in excellent antitumor effect and good clinical application prospects. The comparison of the three different configurations of drug carrier systems suggested the importance of optimizing the spatial configuration design and examining the physical and chemical properties in the future development of nano-drug carrier systems. In this study, we also noted the duality and complexity of the influences of heat stress on tumors in vitro and in vivo. The specific mechanisms and the synergy with chemotherapy and immunotherapy will be an important research direction in the future.
Magnetic fibrin nanofiber hydrogel delivering iron oxide magnetic nanoparticles promotes peripheral nerve regeneration
Authors: Hong Juncong , Wu Dongze , Wang Haitao , Gong Zhe , Zhu Xinxin , Chen Fang , Wang Zihang , Zhang Mingchen , Wang Xiumei , Fang Xiangqian , Yang Shuhui , Zhu Jinjin
Published: June 2024

Peripheral nerve injury is a debilitating condition that have a profound impact on the overall quality of an individual’s life. The repair of peripheral nerve defects continues to present significant challenges in the field. Iron oxide magnetic nanoparticles (IONPs) have been recognized as potent nanotools for promoting the regeneration of peripheral nerves due to their capability as biological carriers and their ability to template the hydrogel structure under an external magnetic field. This research used a fibrin nanofiber hydrogel loaded with IONPs (IONPs/fibrin) to promote the regeneration of peripheral nerves in rats. In vitro examination of PC12 cells on various concentrations of IONPs/fibrin hydrogels revealed a remarkable increase in NGF and VEGF expression at 2% IONPs concentration. The biocompatibility and degradation of 2% IONPs/fibrin hydrogel were assessed using the in vivo imaging system, demonstrating subcutaneous degradation within a week without immediate inflammation. Bridging a 10-mm sciatic nerve gap in Sprague Dawley rats with 2% IONPs/fibrin hydrogel led to satisfactory morphological recovery of myelinated nerve fibers. And motor functional recovery in the 2% IONPs/fibrin group was comparable to autografts at 6, 9 and 12 weeks postoperatively. Hence, the composite fibrin hydrogel incorporating 2% IONPs exhibits potential for peripheral nerve regeneration.
Synergic effect of combined xenogeneic mesenchymal stem cells and ceftriaxone on acute septic arthritis
Authors: Sung Pei-Hsun , Yin Tsung-Cheng , Chiang John Y , Chen Chih-Hung , Huang Chi-Ruei , Lee Mel S , Yip Hon-Kan
Published: June 2024

Background

This study tested the hypothesis that combined ceftriaxone (Cef) and human umbilical cord-derived mesenchymal stem cells (HUCDMSCs) was better than either therapy for alleviating acute septic arthritis (ASA).

Methods and results

Adult-male C57BL/6 mice were categorized into control group (Clt), group A (ASA only), group B [ASA + Cef (5 mg/kg, IM per day, at days 2 to 16 after ASA induction)], group C [ASA + HUCDMSCs (5 × 105 per mice at days 2, 3, 4 after ASA induction)], and group D (ASA + Cef + HUCDMSCs). Animals were euthanized by day 28. The result demonstrated that the body weight was significantly lower, whereas the ratio of kidney or spleen weight to WB, circulatory WBC count, bacterial colony-formation-unit from circulatory/kidney extraction were significantly higher in group A than in other groups (all P < .001). The proinflammatory cytokines (IL-6/TNF-α) of knee joint fluid were lowest in Clt and significantly and progressively reduced from groups A to D, whereas the circulatory levels of these 2 parameters at the time points of days 3/7/28 exhibited an identical pattern as knee joint fluid among the groups (all P-value < .0001). The scores of vertebral-bone destructions/inflamed synovium were lowest in Clt, highest in group A, significantly higher in group C than in groups B/D, and significantly higher in group C than in group D (all P < .0001).

Conclusion

Combined antibiotics and Cef and HUCDMSCs was superior to just one therapy for suppressing circulatory and tissue levels of inflammation and knee joint destruction in ASA.
Therapeutic potential of extracellular vesicles derived from human amniotic epithelial cells for perinatal cerebral and pulmonary injury.
Authors: Kumar Naveen , Bidkhori Hamid Reza , Yawno Tamara , Lim Rebecca , Inocencio Ishmael Miguel
Published: June 2024

Lung and brain injury that occurs during the perinatal period leads to lifelong disability and is often driven and/or exacerbated by inflammation. Human amniotic epithelial cells (hAEC), which demonstrate immunomodulatory, anti-fibrotic, and regenerative capabilities, are being explored as a therapeutic candidate for perinatal injury. However, limitations regarding scalable manufacturing, storage, transport, and dose-related toxicity have impeded clinical translation. Isolated therapeutic extracellular vesicles (EVs) from stem and stem-like cells are thought to be key paracrine mediators of therapeutic efficacy. The unique characteristics of EVs suggest that they potentially circumvent the limitations of traditional cell-based therapies. However, given the novelty of EVs as a therapeutic, recommendations around ideal methods of production, isolation, storage, and delivery have not yet been created by regulatory agencies. In this concise review, we discuss the pertinence and limitations of cell-based therapeutics in perinatal medicine. We also review the preclinical evidence supporting the use of therapeutic EVs for perinatal therapy. Further, we summarize the arising considerations regarding adequate cell source, biodistribution, isolation and storage methods, and regulatory roadblocks for the development of therapeutic EVs.
Family Language Preference, Not Provider-Family Language Concordance, Predicts Integrated Psychology Treatment Engagement in a Spanish-English Bilingual Clinic
Authors: Senior Christopher J. , Carroll Ian , Diaz-LePage Ana , Milaniak Izabela , Zambrana Katherine , Malkoff Anne , Marchante-Hoffman Ashley , Hughes-Reid Cheyenne , Hatchimonji Danielle
Published: June 2024

Objective:

Monolingual Spanish speakers—many of whom identify as Hispanic/Latine—often experience barriers to accessing psychology services, including language access. Integrated primary care (IPC) clinics, where individuals receive psychological services within primary care, aim to improve service accessibility. However, minoritized populations are less likely to engage with these services than non-Hispanic/Latine White individuals. Few studies examine psychology treatment engagement within pediatric integrated clinics for Spanish-speaking families. This study investigated differences in psychology treatment engagement for Spanish-speaking families and the role of patient-provider language concordance within pediatric IPC.

Methods:

A retrospective chart review examined data from a multiethnic sample of 887 patients (M age = 8.97 yrs, 55.69% male, 64.83% Hispanic/Latine, 6.99% non-Hispanic/Latine White, 41.71% Spanish-preferring) from an urban pediatric IPC clinic serving a high proportion of Hispanic/Latine, Spanish-speaking families. We examined the association between language preference and patient-provider language concordance on service engagement using hierarchical linear regression.

Results:

Spanish-preferring families were more likely than English-preferring families to engage in psychology services. Working with a Spanish-speaking provider during an initial psychology visit was unrelated to psychology treatment engagement for Spanish-preferring families.

Conclusion:

Higher engagement for Spanish-preferring families seems to reflect the clinic's reputation as a center for linguistically accessible services. While linguistic accessibility remains important, our study did not detect an effect of language concordance during the initial psychology visit and subsequent treatment engagement. The findings highlight the importance of providing culturally responsive and linguistically accessible mental health services for Spanish-speaking families.
“Your Child Should Not Return”: Preschool Expulsion Among Children With Attention-Deficit/Hyperactivity Disorder as an Early Indicator of Later Risks
Authors: Claussen Angelika H. , Wolicki Sara Beth , Danielson Melissa L. , Hutchins Helena J.
Published: June 2024

Objective:

Young children with attention-deficit/hyperactivity disorder (ADHD) can have challenging behaviors putting them at risk for preschool expulsion and for adverse outcomes across child development, health, and education. We examined the association of preschool expulsion with ADHD symptoms, diagnosis, treatment, and functioning among children with ADHD.

Methods:

Using the cross-sectional National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome on 2947 children aged 5 to 17 years ever diagnosed with ADHD, parents reported on preschool expulsion, ADHD symptoms, diagnosis, treatment, and functioning. Weighted analyses included calculations of estimated means, prevalence, and prevalence ratios.

Results:

Preschool expulsion was experienced by 4.4% of children ever diagnosed with ADHD (girls: 1.5%; boys: 5.7%). Children with preschool expulsion had lower mean ages at first concern about ADHD symptoms, ADHD diagnosis, and initiation of ADHD medication and had higher prevalence of severe ADHD symptoms and other mental, behavioral, or developmental disorders. A history of preschool expulsion was associated with difficulties with overall school performance, organized activities, writing, handwriting, and the parent-child relationship, but not with math, reading, or peer or sibling relationships. Children with preschool expulsion more often received school supports, behavioral classroom management, peer intervention, and social skills training.

Conclusion:

Among children ever diagnosed with ADHD, history of preschool expulsion was associated with more severe ADHD symptoms, other disorders, earlier diagnosis and medication initiation, and academic and social impairment. Health care providers can use preschool expulsion as an indicator of risk for children with ADHD and connect families to effective treatments.
Engagement and Satisfaction With Care Navigation Support Following Telehealth Autism Evaluation
Authors: Klein Brian , Ramaker Margo , Fitterling Caroline , James Cristina , Rouse Maura , Fauntleroy-Love Kristin D. , McNally Keehn Rebecca , Enneking Brett
Published: June 2024

Objective:

Care navigation support is designed to help connect families with health care resources. Given that children with autism have more unmet needs than their peers, such a service may be especially valuable to families who have recently received a diagnosis. This study sought to examine engagement in care navigation support after an autism telehealth evaluation. Specifically, we report on what demographic and diagnostic factors predicted engagement in care navigation support and satisfaction with this service.

Methods:

Care navigation was offered to 220 families receiving autism telehealth evaluations between April 2020 and April 2022. Survey data from initial evaluation appointments and 2 follow-up care navigation meetings (approximately 1–3 months and approximately 9–12 months after evaluation), along with data from medical records, were collected and analyzed to determine whether any traits predicted engagement in care navigation. Satisfaction with care navigation was also analyzed.

Results:

Of 220 families, 48.2% (n = 106) participated in a care navigation meeting within 1 to 3 months after an evaluation and 59.5% (n = 131) participated in at least 1 meeting across 2 time periods. The findings did not support the hypothesis that a diagnosis of autism would predict engagement. Analyses found that child sex (female compared with male) and child race and ethnicity (children of color compared with White children) predicted engagement. For those who engaged in care navigation, high satisfaction was reported.

Conclusion:

Participants' engagement rates and satisfaction levels suggest care navigation is a valuable service for families after a telehealth autism evaluation.
Evaluating Patient-reported Outcomes after Bilateral Reduction Mammoplasty: A Comparison of Reduction Techniques at a University Hospital
Authors: Hinson Chandler S. , Karne Sridhar , Rosser Brandon , Bouillon Victoria , Brooks Ronald M.
Published: June 2024

Background:

Macromastia, defined as the abnormal enlargement of breasts, burdens individuals physically and psychologically, impacting their daily lives beyond aesthetics. Reduction mammoplasty offers relief by restoring proportional breast volume and appropriate contour. Surgical success relies on choosing a suitable individualized operative technique tailored to the patient’s presentation and postoperative goals. This study examines postoperative, patient-reported outcomes across different reduction techniques to gauge the impact of reduction technique on overall patient perspective of aesthetic and functional satisfaction.

Methods:

A retrospective review identified reduction mammoplasty patients by a single surgeon between 2018 and 2022. Exclusion criteria included augmentation-related or cancer reconstructive procedures. Phone interviews were conducted using a survey adapted from BREAST-Q to assess postoperative outcomes in patients. Data analysis included Pearson chi-square test in STATA 16.1.

Results:

Among 155 patients identified, 64 completed the survey. Average postsurgical interval was 24 months postoperative. After stratifying patients by operative technique, there was no significant difference in postoperative satisfaction among the cohorts with regard to nipple and breast appearance, sensation, symmetry, or shape.

Conclusions:

This study highlights no significant disparity in perceived aesthetic or functional outcomes among different reduction mammoplasty techniques. Personalized considerations, such as patient factors, surgical expertise, and anatomical specifics, should guide technique selection, emphasizing individualized approaches over presumed superior methods for optimal results.
Landmark analysis of the risk of recurrence after resection or ablation for HCC: A nationwide study
Authors: Kraglund Frederik , Skou Nikolaj , Villadsen Gerda Elisabeth , Jepsen Peter
Published: June 2024

Background:

The risk of HCC recurrence at particular landmarks since the initial treatment is unknown. With this registry-based study, we aimed to provide a nuanced description of the prognosis following resection or ablation for HCC, including landmark analyses.

Methods:

Using the Danish nationwide health care registries, we identified all patients who received resection or ablation in 2000–2018 as the first HCC treatment. HCC recurrence was defined as a new HCC treatment > 90 days after the first treatment. We conducted competing risk landmark analyses of the cumulative risk of recurrence and death.

Results:

Among 4801 patients with HCC, we identified 426 patients who received resection and 544 who received ablation. The 2 treatment cohorts differed in cirrhosis prevalence and tumor stage. The 5-year recurrence risk was 40.7% (95% CI 35.5%−45.8%) following resection and 60.7% (95% CI: 55.9%−65.1%) following ablation. The 1-year recurrence risk decreased over the landmarks from 20.4% (95% CI: 16.6%−24.6%) at the time of resection to 4.7% (95% CI: 0.9%−13.9%) at the 5-year landmark. For ablation, the risk decreased from 36.1% (95% CI: 31.9%−40.4%) at the time of treatment to 5.3% (95% CI: 0.4%−21.4%) at the 5-year landmark. The risk of death without recurrence was stable over the landmarks following both resection and ablation.

Conclusions:

In conclusion, the risk of recurrence or death following resection or ablation for HCC is high from the treatment date, but the risk of recurrence decreases greatly over the survival landmarks. This information is valuable for clinicians and their patients.
Dose-Response Relationship Between Perceived Control and Depression in Patients With Chronic Heart Failure
Authors: Wang Yaqi , Xu Xueying , Lv Qingyun , Zhang Xiaonan , Zhao Yue , Zang Xiaoying
Published: June 2024

Background

Little is known regarding the relationship between perceived control and depression in patients with chronic heart failure (CHF), particularly in terms of their dose-response relationship.

Objective

The aim of this study was to explore this relationship based on linear and nonlinear hypotheses and potential subgroup differences in patients with CHF.

Methods

A total of 308 patients with CHF were included in the study. Data on perceived control, depression, and relevant covariates, such as gender, age, New York Heart Association classification, and comorbidity burden, were collected. Logistic regression, Spearman correlation, and restricted cubic spline analysis were used for data analysis.

Results

Compared with the patients in the first quartiles of perceived control scores (0–16), those in the other 3 quartiles had a lower risk of depression (odds ratios of 0.29, 0.21, and 0.20, respectively; P < .05). Furthermore, a negative correlation between perceived control and depression (r = −0.317, P < .01) was observed. The restricted cubic spline analysis revealed an “L-shaped” curve relationship between perceived control and the presence of depression (P for nonlinear < .01). Compared with patients with a perceived control within the 5th percentile (10 scores), as the perceived control increased, the risk of depression rapidly decreased from “1” until it reached a threshold (20 scores) and stabilized. This trend remained consistent across the subgroups grouped by gender, age, New York Heart Association classification, and comorbidity burden.

Conclusions

Interventions targeting perceived control may hold valuable implications for reducing the risk of depression in patients with CHF, particularly those who have not yet reached the threshold.
Trauma-Induced Vestibular Dysfunction: Improved Repair Under Local Treatment With α1-Antitrypsin
Authors: El-Saied Sabri , Kaminer Benyamin M. , Kaplan Daniel M. , Shitrit Rivka , Manilis Idan , Amar Amit , Lewis Eli C.
Published: June 2024

Aim

To characterize vestibular recovery in a mouse model of unilateral labyrinthotomy under local AAT and dexamethasone treatment.

Background

Alpha1-antitrypsin (AAT) is a circulating tissue-protective molecule that rises during inflammatory conditions and promotes inflammatory resolution. Its local concentration in human perilymph inversely correlates with the severity of inner ear dysfunction; concomitantly, mice that overexpress AAT and undergo inner ear trauma rapidly restore vestibular function. Locally applied AAT has yet to be examined in this context, nor has it been directly compared with anti-inflammatory corticosteroid treatment.

Methods

Wild-type mice C57BL/6 underwent a unilateral inner ear injury. Nine microliters of saline, clinical-grade AAT (180 μg/site), dexamethasone (4 mg/site), or both were applied locally on Days 0, 1, and 2 (n = 5/group). Vestibular function was assessed for 7 days. An in vitro human epithelial gap closure assay was performed using A549 cells in the presence of AAT and/or dexamethasone.

Results

Upon labyrinthotomy, all groups displayed severe vestibular dysfunction. Saline-treated mice showed the longest impairment. That group and the dexamethasone group displayed partial to no recovery, while AAT-treated mice exhibited complete recovery within 7 days; at this time point, dexamethasone-treated mice exhibited 50% recovery. Objective vestibular testing showed similar outcomes. In vitro, cotreatment with AAT and dexamethasone resulted in a gap closure dynamic that was superior to AAT alone at 6 h and superior to DEX alone at 48 h.

Conclusion

Locally applied AAT treatment is superior to locally applied dexamethasone in promoting vestibular recovery in vivo. Ongoing studies are exploring the potential advantages of AAT combined with early low-dose dexamethasone therapy.
Early Postoperative Changes in Von Willebrand Factor Activity Are Associated With Future Bleeding and Stroke in HeartMate 3 Patients
Authors: Jahangiri Parsa , Veen Kevin M. , van Moort Iris , Bunge Jeroen H. , Constantinescu Alina , Sjatskig Jelena , de Maat Moniek , Kluin Jolanda , Leebeek Frank , Caliskan Kadir
Published: June 2024

Hemocompatibility-related adverse events (HRAEs), particularly gastrointestinal bleeding, remain a frequent complication after left ventricular assist device (LVAD) implantation. The current study sought to describe and analyze whether early (<60 days) postoperative von Willebrand factor (VWF) activity assays predict the risk of gastrointestinal bleeding and stroke. A prospective single-center study including 74 HeartMate 3 device recipients between 2016 and 2023 was undertaken. The postoperative trajectory of the VWF profile was analyzed using linear mixed-effect models and Cox models were used to quantify associations between an early postoperative dip (≤0.7) in VWF activity assay measurements and late outcomes. Preoperatively, the mean VWF:Activity (Act)/Antigen (Ag) and VWF:Collagen Binding (CB)/Ag ratios were 0.94 (95% confidence interval [CI] = 0.81–1.02) and 0.95 (95% CI = 0.80–1.03), respectively, decreasing to 0.66 (95% CI = 0.57–0.73) and 0.67 (95% CI = 0.58–0.74) within 40 days (p < 0.05). In patients with VWF:CB/Ag and VWF:Act/Ag ratios ≤0.7 significantly more gastrointestinal bleeding (hazard ratio [HR]: 2.53; 95% CI = 1.1–5.8, and HR: 3.7; 95% CI = 1.5–9.2, respectively) and hemorrhagic stroke events (HR: 3.5; 95% CI = 1.6–7.6 and HR: 4.9; 95% CI = 2.1–11.7, respectively) were observed throughout the entire late (>60 days) postoperative period. In patients with VWF:Act/Ag ratio ≤0.7 less ischemic stroke events were observed (HR: 0.11; 95% CI = 0.01–0.85). In conclusion, VWF:Act/Ag and VWF:CB/Ag ratios ≤0.7 in the early postoperative phase can be used as biomarkers to predict HRAEs during long-term LVAD support.
The anconeus-triceps lateral flap approach in terrible triad of the elbow: good outcome in a series of ten cases
Authors: Le Gia Anh Thy , To Kha , Dang Nghia Thanh , Nguyen Viet Tan , Phan Tri Nguyen , Nguyen Van Thai , Ton Thi Thanh Thao , Vo Thanh Toan
Published: June 2024

Introduction:

Standard surgical management for the terrible triad of the elbow (TTE) has been established since 2004, yet postoperative complications are common and consensus on optimal management is absent. Different surgical algorithms for treating TTE and their efficacy have been reported worldwide, yet evidence from Vietnam remains limited.

Methods:

Ten cases diagnosed with TTE admitted to the Hospital of Traumatology and Orthopedics, a tertiary orthopedic center in Ho Chi Minh City, were presented to demonstrate the effectiveness and rate of postoperative complications following our stepwise surgical procedures using the anconeus-triceps lateral flap approach. The intraoperative “drop sign”, quantitative assessment of pain and level of upper arm disability (via VAS and QuickDASH score) was mentioned to assess the algorithm’s benefit. All patients’ information was retrieved from medical records from August 2022 to January 2024.

Results:

All 10 cases required repair of the lateral ligament complex and underwent surgery within 2 days of hospitalization. Immediate postoperative imaging revealed no drop sign, and none of the patients experienced elbow dislocation nor the need for repeated surgery, and a full range of elbow motion was demonstrated at 3–6 months follow-up.

Conclusion:

TTE is a challenging injury that almost always obligates surgical correction. The anconeus-triceps lateral flap approach, with its advantages of better visualization and preservation of certain essential stabilizing muscles of the elbow, was demonstrated to yield a high success rate and low postoperative complication rate.