bluuebunny/crossref_metadata_2025 huggingface dataset:
Making Extremists
Authors: Collins Kathleen
Published: June 2023

Karimov’s brutal repression of Islam and widespread torture of Muslims led to a second, violent Islamist wave. Chapter 9 traces the dynamics of the IMU’s emergence, rise, and decline, and argues that Karimov’s policy was the fundamental driver of the IMU. However, radical Islamist ideologies—particularly those of al-Qaeda—strongly influenced the movement’s agenda, tactics, and offshoots. Finding shelter and associational space to network inside Taliban-controlled Afghanistan, the IMU mobilized and fought for nearly two decades. Adopting al-Qaeda’s violent ideology, the IMU not only was militant but also used terrorism and suicide bombing. The chapter further explains how, despite the obstacles to growth in a war zone, the IMU attracted recruits and remained durable by constructing sacred authority, building new networks, and adapting its ideology to attract support from al-Qaeda. Although never posing a serious challenge to Uzbekistan, the IMU did regularly threaten the International Security Assistance Force and U.S. policy in Afghanistan.
Religious Liberalization and Civil Islam in Kyrgyzstan
Authors: Collins Kathleen
Published: June 2023

Chapter 11 discusses the nonemergence of Islamism in Kyrgyzstan in the 1990s, even while the first wave mobilized in neighboring states. The chapter argues that President Akayev’s religious liberalization from perestroika through the early 2000s precluded the birth of an Islamist movement in Kyrgyzstan during this period. Instead, ordinary “Muslim politics” and “civil Islam” emerged. Muslim politics involved imams voicing opinions on political matters or politicians using Muslim symbols to appeal to voters—as in some Western democracies. Civil Islam involved the emergence of dynamic Muslim organizations that played a civic role, from education to human rights work. Muslim politics and civil Islam were not always liberal, but they did not reject democratic politics. Even potential religious entrepreneurs, who were prominent in southern Kyrgyzstan, did not pursue their preference for an Islamic state; they recognized that the pluralist, albeit flawed, democratic system in Kyrgyzstan protected Islam and their religious freedom.
Building Permanently Active National Committees, 1912–1932
Authors: Heersink Boris
Published: June 2023

This chapter focuses on the history of the Democratic and Republican National Committees (DNC and RNC) in the period 1912–1932. Starting after the 1912 election, both committees retained active headquarters for the first time. The chapter shows how throughout this period national committee chairs like Will Hays, George White, Cordell Hull, and John Raskob focused on building up their committee’s publicity role and using it to promote what they believed to be the most effective party brand to win electoral support in future elections. However, the chapter also shows that this branding role could be controversial: for example, Raskob’s attempts at branding the Democratic Party as opposed to Prohibition caused considerable outrage among conservative Democrats. And, at other times, the committees saw considerable decline—either because of financial difficulties or because branding was not in the interest of incumbent presidents.
“We Either Have a National Party or We Do Not Have,” 1953–1968
Authors: Heersink Boris
Published: June 2023

This chapter assesses the activities of the Democratic and Republican National Committees during the presidencies of Dwight Eisenhower, John F. Kennedy (JFK), and Lyndon Johnson (LBJ). The chapter shows that during the 1950s, the Democratic National Committee (DNC) changed its electoral strategy from a “unity” approach—focused on downplaying civil rights in the hopes of regaining Southern support—to one of presenting the Democratic Party as a liberal party supporting civil rights, unions, and more active federal government. However, after the 1960 election, the DNC’s role declined—particularly under LBJ, who saw little use in the DNC as a branding organization. In contrast, Eisenhower maintained an active Republican National Committee (RNC) with the hope of rebranding the GOP as a moderate, centrist party. After the 1960 election, conservatives gained control of the RNC and instead used it to promote conservative policies and appeal to White Southern voters. After Barry Goldwater’s dramatic 1964 defeat, moderates regained control of the RNC and again promoted the GOP as a moderate party, while also appealing to Black voters in major cities.
“Reagan’s Party” versus “Recapturing the Center of American Politics,” 1981–2000
Authors: Heersink Boris
Published: June 2023

This chapter assesses the activities of the Democratic and Republican National Committees (DNC and RNC) during the presidencies of Ronald Reagan, George H. W. Bush, and Bill Clinton. The chapter shows that during the Reagan–Bush era, the RNC focused much of its activities on promoting the president as party leader. Most importantly, the RNC embraced Reagan fully and began promoting the GOP as “Reagan’s party” throughout his two terms in office. During the same period, the DNC struggled with reframing the image of the Democratic Party in the wake of massive defeats in the 1980, 1984, and 1988 presidential elections. Throughout this period, DNC chairs aimed to promote the party as a moderate, centrist party that was tough on crime, hawkish on foreign policy, and open to cutting major federal government programs. After Clinton’s victory in 1992, the DNC initially promoted his policies and administration—to the frustration of many Democrats in Congress. Even after the massive Democratic losses in 1994, the DNC invested heavily in promoting Clinton’s re-election, though it did so in part with questionable donations. The RNC, after 1992, invested heavily in new communication tools and used it to attack Clinton and the Democrats. Notably, the party did not try to set policy as much—in part because of the increasingly early start of presidential primary campaigns.
Living communities in rivers and streams
Authors: Hildrew Alan , Giller Paul
Published: June 2023

Living communities in streams and rivers are diverse and spatially variable. Are differences driven by environmental factors or by species interactions? Communities are assembled from species locally available with traits that enable them to survive. Dispersal ability can also limit presence. At large scales, most groups of organisms (with interesting exceptions) are most diverse at low latitudes. At smaller scales, there are strong patterns along rivers, and laterally and vertically away from the channel. Communities change with time, so can we distinguish ‘natural’ fluctuations from sustained change? Sustained changes are often associated with anthropogenic impacts (e.g. on water quality, or due to climatic shifts). How important is ‘disturbance’ (discrete events, such as floods and droughts) for communities—and how far is it mitigated by refugia? The physical nature of river systems as branching networks with divided local communities in different ‘patches’ could promote overall stability via dispersal among them.
Structures of Autobiographical Understanding
Authors: Hagberg Garry L.
Published: June 2023

This chapter looks into the deep analogies (as suggested by Wittgenstein) between the work of a draughtsman who renders all the relations between the parts of a building perspicuously and the work of the autobiographer who does very much the same in achieving word-borne self-understanding. The chapter then progresses to a discussion of the literary structuring devices we use (of a broadly Aristotelian kind) as “self-architects” in the composition of a “dot-connecting” self-narrative, and the special sense in which the achievement of a stabilized long-arc life-narrative can prove cathartic. And we see here that words of self-description can, when first negotiated and then settled in, function in a way that is more powerful in self-constitutive terms than we might initially have imagined.
The Transformation of the ECB in Sovereign Bond Markets
Authors: Borger Vestert
Published: June 2023

This chapter considers whether the European Central Bank (ECB) may be viewed as having become a ‘new entity’ based on its activity on sovereign bond markets. It concludes that the ECB has not simply evolved, it has transformed. This transformation of the ECB, evidenced by its Securities Markets Programme (SMP) and Outright Monetary Transactions (OMT) programme, forms part of a broader constitutional overhaul of the currency union during the sovereign debt crisis, characterized by a widening of its conception of stability. The chapter first illustrates how this transformation was initiated by the heads of state and government when they committed to safeguard financial stability on 11 February 2010 and was subsequently developed through interaction between these political leaders and the ECB. It then analyses how the transformation was sealed by the European Court of Justice in Gauweiler. The chapter finally argues that the transformation brings with it an institutional repositioning of the ECB, not least in relation to courts. It illustrates this by showing how both the German Constitutional Court and the European Court of Justice grappled with the question of how intensely to review the ECB when they had to rule on its third bond programme, the Public Sector Purchase Programme (PSPP).
Doxastic Rationality
Authors: Wedgwood Ralph
Published: June 2023

Chapter 2 is concerned with the distinction that most contemporary epistemologists express by distinguishing between “propositional” and “doxastic” justification. The goal is to develop an account of this distinction that applies, not just to full or outright beliefs, but also to partial credences—and indeed, in principle, to attitudes of all kinds. The standard way of explaining this distinction, in terms of the “basing relation”, is criticized, and an alternative account—the “virtue manifestation” account—is proposed in its place. This account has a certain kinship with the epistemological approach that is known as “reliabilism”, but it also has certain key differences—above all, it is compatible with an internalist view of rationality.
The Measurement of Incorrectness
Authors: Wedgwood Ralph
Published: June 2023

Chapter 8 turns to the question of how to measure the incorrectness of the intermediate doxastic attitudes—that is, partial degrees of belief that do not involve believing (or disbelieving) anything with certainty. It is argued that the incorrectness score for each precise credence in a particular proposition must have the features that are known as symmetry, continuity, and strict propriety. It follows that this score is simply the well-known Brier score (the square of the difference between the credence and the proposition’s real truth value); and, as argued in the previous chapter, the score for a whole system of such precise credences is simply a weighted sum of its scores for the propositions over which it is defined. Then it is explained how to generalize this approach to deal with belief-systems involving imprecise credences, attitudes of suspended judgment, and conditional credences (or inferences).
Justifying Equity’s Control of Power
Authors: Hudson Jessica
Published: June 2023

This chapter examines the concept of fiduciary status, and its relevance and limits as a justification for equity’s control of power. Some of the problems with fiduciary status have been pointed out before, particularly in relation to one equitable control, fiduciary loyalty. This chapter makes the broader argument that fiduciary status should not be relied upon to justify equity’s control of power generally, including but not limited to, fiduciary loyalty. Fiduciary status is a convenient analytical shortcut or bypass to what is the (real) justification for this phenomenon; equity’s commitment to the terms on which a power is held. The chapter goes on to consider how equity’s commitment to the terms may, in the future, help to answer some of the questions that fiduciary status has previously been relied upon to answer, such as equity’s role in controlling contractual powers and the value(s) underpinning fiduciary loyalty.
Back to the Theoretical Approach
Authors: Rucht Dieter
Published: June 2023

The perspectives of interaction, social construction, and process-orientation complement each other and can be integrated in a general approach to study social movements. Based on this approach, a refined conceptualization of social movement is proposed. Social movements are conceived of as both collective actors and action systems. In studying social movements, researchers should maintain a delicate balance between closeness and detachment in a spirit of engaged scholarship that is value-oriented and respects scientific standards. Gradually, a stock of solid knowledge about social movements is built. Future research can better exploit the potential of hermeneutic analyses, engage in closer cooperation of historians and sociologists, and take a broader comparative view on social movements as products and producers of social change.
The Case for a Funded Pension with a Defined Benefit
Authors: Otsuka Michael
Published: June 2023

Chapter 2—‘The Case for a Funded Pension with a Defined Benefit’—clarifies and assesses the concepts and principles, within and beyond financial economics, that underlie the regulation, valuation, and investment of defined benefit (DB) schemes to secure pension promises. With funded occupational DB pensions, in contrast to collective defined contribution (CDC), longevity and investment risk is borne, at least directly, by the sponsoring employers rather than their workers. This gives rise to the problem of how to ensure that employers will deliver the benefit they have promised, which is typically an inflation-protected income in retirement until death. This chapter assesses the merits of the ‘actuarial approach’ to funding an open, ongoing DB pension scheme at a low rate of contributions invested for the long term in ‘growth assets’ such as equities and property. It also considers the merits of the contrasting ‘financial economics approach’, which calls for a higher rate of contributions set as the cost of purchasing government and corporate bonds that ‘match’ the liabilities by providing guaranteed streams of income that closely approximate the promised pension payments. It shows how the UK’s large, multi-employer Universities Superannuation Scheme (USS) provides a model for the actuarial approach. The ‘last man standing’ mutuality of this scheme constitutes a reciprocity-based prototype for the delivery of DB pensions across society more generally, involving the collective pooling of risks across geographic space as well as over succeeding generations. Such an arrangement justifies the actuarial approach to the funding of DB over the financial economics approach.
Conclusion
Authors: Otsuka Michael
Published: June 2023

The book concludes by posing and answering the following question: why should those who are young, able-bodied, and productive agree to pay for the pensions of those who are elderly, infirm, and out of work? Those who have recently reached the age of majority do not now know how long they will live in retirement or how well any investments they try to save up during the next decades for their retirement would fare. From the perspective of the beginning of their working lives, it is therefore rational for each to enter into an agreement with others, who also do not yet know their fates, that, if one turns out to be among the unfortunate whose private pension pots would not have yielded enough for one’s retirement, one will receive much more in retirement, whereas those whose pension pots would have overflowed their retirements will receive somewhat less. But this arrangement will work only if each agrees to bind oneself in advance so that, if one turns out to be among the fortunate, one is not allowed to defect from the collective pension scheme and go it alone. It is rational for each to agree to share one another’s fates by pooling risks across both space and time, on fair terms of social cooperation for mutual advantage.
Koulaks and Cocos
Authors: Clift Aaron
Published: June 2023

This chapter focuses on anticommunism among French agriculturalists. No party could hope to attain power without at least some measure of support in the countryside. The PCF recognized this and launched campaigns to gain the allegiance of the peasantry, a political surge that anti-communists reacted to by trying to inoculate the peasants against communist appeals. Moreover, anticommunism became a central component of a wider struggle for political control of French agriculture. It arose out of Liberation-era attempts by the Left to consolidate France’s diverse agricultural associations into a single confederation, a move which provoked a conservative backlash and attempts to champion their independence. Their debates reveal interrelationships between anticommunism and anti-statism, anti-Americanism, and anti-urbanism as well as concerns about the future of private property, class relations in the countryside, and the role of agriculture in a developing rural economy.
Recent progress in low-temperature CVD growth of 2D materials
Authors: Zhang Xiang , Lai Jiawei , Gray Tia
Published: June 2023

Two-dimensional (2D) materials have emerged as a promising class of materials with unique physical and chemical properties that offer exciting prospects for various applications. Among all the synthesis methods, chemical vapor deposition (CVD) techniques have demonstrated great advantages in the large-scale production of 2D materials with a controlled thickness. One of the main challenges in the growth of 2D materials is the need for high temperatures and crystalline substrates, which restrict the scalability and compatibility of 2D materials with existing manufacturing processes, due to the high thermal budget and the necessity to transfer the 2D films to secondary substrates. Low-temperature growth methods for 2D materials have the potential to overcome this challenge and enable the integration of 2D materials into a wide range of devices and applications. In recent years, there have been substantial efforts to develop low-temperature growth techniques for different 2D materials, including graphene, hexagonal boron nitride and transition metal dichalcogenides. These methods include thermal CVD, plasma-enhanced CVD, atomic layer deposition and metal-organic chemical vapor deposition. This review not only discusses the progress in the growth but also highlights the applications of low-temperature-grown 2D materials in various fields, such as field effect transistors, sensors, photodetectors, catalysts, batteries and supercapacitors.
Nonlinear, Multicomponent Physical Exercise With Heart Rate Variability-Guided Prescription in Women With Breast Cancer During Treatment: Feasibility and Preliminary Results (ATOPE Study)
Authors: González-Santos Ángela , Lopez-Garzon Maria , Gil-Gutiérrez Rocío , Salinas-Asensio María del Mar , Postigo-Martin Paula , Cantarero-Villanueva Irene
Published: June 2023

Objective

The purpose of this study was to examine the feasibility, safety, adherence, and preliminary efficacy of the ATOPE program during radiotherapy (RT) or chemotherapy (CT) for women with breast cancer.

Methods

This single-blind, pretest–posttest feasibility study included 38 women with breast cancer at the beginning of their treatment. The ATOPE program consisted of 12 to 18 sessions of a multimodal physical exercise program, prescribed based on daily heart rate variability and clinimetric assessments using the ATOPE+ mHealth system. Overall health was assessed with quality of life, autonomous balance, and body composition, whereas health-related fitness was measured through functional capacity, physical activity levels, and upper and lower limb strength.

Results

The rates of recruitment, retention, and adherence were 52.35, 73.68, and 84.37%, respectively, and the satisfaction rating was 9.2 out of a possible 10 points. The perceived health status change score was 3.83 points, scored on a −5 to 5 point scale. No adverse effects were found. Compliance results showed that the ATOPE+ mHealth system was used on 73.38% of the days, and the Fitbit bracelet (Google, Mountain View, CA, USA) was used on 84.91% of the days. Women stayed physically active 55% of days. Regarding preliminary results, for overall health, the percentage of body fat in the RT group decreased by 1.93%, whereas it increased by 5.03% in the CT group. Lower limb strength increased in the RT group, specifically knee extensor isometric strength (6.07%), isokinetic knee flexors 180 degree/second (1.53%), and isokinetic knee extensors 300 degree/second (4.53%), in contrast with the reductions found in the CT group (11.07, 18.67, and 14.89%, respectively).

Conclusion

The ATOPE program, through nonlinear prescription based on daily monitoring with the ATOPE+ mHealth system, is feasible and safe for application during breast cancer treatment. The results suggest that the overall health can be maintained or even improved regarding most variables.

Impact

This study focused on the feasibility, safety, and completion of a physical therapist-led program at early diagnosis for adults with breast cancer. The multimodal, supervised, tailored, nonlinear physical exercise program is feasible and safe, showed a good completion rate, and was able to prevent the quality-of-life deficits that are often triggered by systemic breast cancer treatment. This study highlights the importance of daily morning assessments using the ATOPE+ mHealth system in patients with breast cancer to prescribe nonlinear physical exercise.
Scattering by a Perforated Sandwich Panel: Method of Riemann Surfaces
Authors: Antipov Y A
Published: June 2023

The model problem of scattering of a sound wave by an infinite plane structure formed by a semi-infinite acoustically hard screen and a semi-infinite sandwich panel perforated from one side and covered by a membrane from the other is exactly solved. The model is governed by two Helmholtz equations for the velocity potentials in the upper and lower half-planes coupled by the Leppington effective boundary condition and the equation of vibration of a membrane in a fluid. Two methods of solution are proposed and discussed. Both methods reduce the problem to an order-2 vector Riemann–Hilbert problem. The matrix coefficients have different entries, have the Chebotarev–Khrapkov structure and share the same order-4 characteristic polynomial. Exact Wiener–Hopf matrix factorization requires solving a scalar Riemann–Hilbert on an elliptic surface and the associated genus-1 Jacobi inversion problem solved in terms of the associated Riemann θ-function. Numerical results for the absolute value of the total velocity potentials are reported and discussed.
New application of saline contrast-enhanced electrical impedance tomography method for right ventriculography besides lung perfusion: detection of right-to-left intracardiac shunt
Authors: He H , Wang N , Zhang M , Jiang J , Cui N , Frerichs I , Long Y , Zhao Z
Published: June 2023

Aim

Saline contrast-enhanced electrical impedance tomography (EIT) has been used to identify the respiratory failure etiologies through assessment of regional lung perfusion at the bedside. In this study, we introduce a novel approach to detect right-to-left intracardiac shunt based on the center of heart (CoH) parameter determined from the early phase of impedance–time curve after saline bolus injection.

Methods and result

The timepoints when the saline bolus enter the heart (T0) and the lung regions (T1) are identified at first. A moving time window from T0 to T1 is then generated with steps of 0.5 s and the slope of the impedance–time curve in each pixel within the window calculated. CoH is calculated as the geometric center of pixel slope values in the right-to-left image direction. To illustrate how this method works in practice, we calculated the CoH values at T0 to T1 in 10 control hypoxic patients with no right-to-left shunt. In addition, we examined two critically ill patients with right-to-left intracardiac shunt. One was postcardiac surgery patient who had a residual atrial septal defect by color doppler of transesophageal echocardiograph. The other patient had a congenital heart disease of ventricular septal defect by color doppler of trans-thoracic echocardiography. A large difference in CoH between T0 to T1 was observed in the two patients with intracardiac shunt than in the control patients (11.06 ± 3.17% vs. 1.99 ± 1.43%, P = 0.030).

Conclusion

Saline bolus EIT for lung perfusion might be used as ventriculography to identify the right-to-left intracardiac shunt at the bedside.
Clinical and demographic features with outcome predictors of adult patients with acute intoxication admitted to a medical intensive care unit in the Mediterranean part of Croatia
Authors: Kovacic Vedran , Kvartuc Lukas , Mikacic Marijana , Jerkovic Ivan , Begovic Tanja Ilic , Maras Marina , Nazlic Jurica
Published: June 2023

Background

The objective of the study was to assess the demographics, clinical parameters, and outcome of acute intoxications among adult patients admitted to a medical intensive care unit in southern Croatia.

Materials and Methods

An observational retrospective study was conducted over a 1-year period. The subjects were patients admitted to the intensive care unit for acute poisoning.

Results

In all, 81 subjects (32.1% females) aged 43.16 ± 14.77 years were admitted to the intensive care unit because of poisoning (14.97% of the total annual intensive care unit admissions). Psychiatric disorders were previously established in 76.5% participants, and 69.1% of all acute intoxications were classified as suicidal. Non-suicidal subjects differed from suicidal subjects in age (37.36 ± 9.71 vs. 45.75 ± 15.93 years; P = 0.009), in pCO2 (6.38 ± 1.78 vs. 5.50 ± 1.26 kPa; P = 0.020), in length-of-stay in intensive care unit (median 1.00, interquartile range 1.00 vs. median 2.00, interquartile range 2.00 days; P = 0.022), and in length-of-stay in hospital (median 2.00, interquartile range 2.00 vs. median 10.50, interquartile range 15.25 days; P < 0.001). Three (3.7%) patients died. Pharmaceutical psychoactive drug intoxications were the most common poisoning cases; of these, diazepam was the most frequent (16.8%), followed by ethanol (9.0%) and alprazolam (7.8%). Benzodiazepines/hypnotics were the most common group (28.7%), followed by antipsychotics (13.2%). Intoxications with more than 1 poison accounted for the largest number of cases (67.9%). The number of toxins was significantly correlated with length-of-stay in the hospital (rho = −0.265; P = 0.008), systolic blood pressure (rho = −0.318; P = 0.002), and diastolic blood pressure (rho = −0.262; P = 0.009). The electrocardiogram was considered abnormal in 50.62% of the cases.

Conclusion

Acute intoxicants were most commonly caused by psychiatric pharmaceutical drugs. Multidrug exposure was a typical pattern of acute intoxication.
European Company Law in transformation—Striving for participation and sustainability
Authors: Grundmann Stefan
Published: June 2023

European Company Law, a European Union (EU)-level company law (as ‘federal policy’), has passed the 50-year mark these years. Twenty-five of those years were dominated by a market function approach, the ‘black-box’ approach, where the company was seen from outside and guaranteeing necessary information for those outside the corporation, rational information users (namely long-term creditors and investors), was paramount. A transformation away from this approach began some 30 years ago; the last 20 years were dominated, first, by an approach that strongly increased participation and true multiple ‘voices’ in companies—as an approach meant to empower and heat up discussion, it can be termed the ‘red-box’ approach. This is an approach where more structural information and empowerment took place, and relations within the company were more in the focus of the legislature as well. The advent of new economic sociology could also be sensed, as the EU became more of a political Union or the concept of a competition of legislatures became a potential reality, such as with Centros. As a common denominator, the ‘wisdom of the crowds’ would seem to be more in the focus. The second phase of these last 20 years, primarily in the last decade, was then dominated by a fixing of certain long-term goals from the outside, fostering a goal of sustainability. Again, important general trends of theoretical thought emerged, and this phase can therefore be seen as a ‘green-box’ approach. A framework constitution of values is the aim of such an approach. This article brings together EU company law as a federal task and the development of these three phases, including the history of thought and political developments, as well as their theoretical and political underpinning. The article does this mainly for development at the EU level (ius communitatis), but also provides a link to (comparative) national developments and inspiration (ius commune).
Original Research: Can a Palliative Care Lay Health Advisor–Nurse Partnership Improve Health Equity for Latinos with Cancer?
Authors: Larson Kim L. , Mathews Holly F. , Melendez Carlos R. , Hupp Teresa , Estrada Michelle , Moye Janet P. , Passwater Chelsea C. , Muzaffar Mahvish
Published: June 2023

Purpose:

A palliative care infrastructure is lacking for Latinos with life-threatening illness, especially in rural regions of the United States. The purpose of this study was to develop and evaluate a community-based palliative care lay health advisor (LHA) intervention for rural-dwelling Latino adults with cancer.

Methods:

An exploratory mixed-methods participatory action research design was carried out by an interprofessional research team that included community and academic members. Fifteen Latino community leaders completed a 10-hour palliative care training program and then served as palliative care LHAs. Although 45 Latinos with cancer initially agreed to participate, four withdrew or died and six were not reachable by the LHAs, for a final total of 35 patient participants.

The trained palliative care LHAs delivered information on home symptom management and advance care planning to assigned participants. Palliative care nurses led the training and were available to the LHAs for consultation throughout the study. The LHAs made an average of three telephone calls to each participant. The Edmonton Symptom Assessment System–Revised (ESAS-r) and the four-item Advance Care Planning Engagement Survey (ACPES-4) were administered pre- and postintervention to determine the intervention's effectiveness. Encounter forms were transcribed, coded, and analyzed using case comparison.

Results:

The major finding was that significant improvements were shown for all four items of the ACPES-4 among both the LHAs (posttraining) and the participants (postintervention). Information on advance care planning was shared with 74.3% of the 35 participants. Participants showed clinical improvement in physical symptom scores and clinical deterioration in emotional symptom scores following the intervention, although these changes did not reach statistical significance. The advisors noted that participants were anxious about how to explain cancer to children, the uncertainty of their prognosis, and medical expenses. This sample was younger than those of other cancer studies; 51.4% were under age 50 and 73.1% had at least one child in the home.

Conclusions:

A community-based palliative care LHA–nurse partnership was shown to be a feasible way to engage in conversations and deliver information about advance care planning to rural-dwelling Latino adults with cancer. The positive results led to the regional cancer center's decision to select “cultural care” as its 2022 goal for maintaining its accreditation with the Commission on Cancer.
Minimally Invasive Decompression With Noninstrumented Facet Fusion Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion for Stenosis Associated With Grade 1 Lumbar Degenerative Spondylolisthesis
Authors: Kim Daniel C. , Laskay Nicholas , Alcala Christopher , Schwender James
Published: June 2023

Study Design:

Retrospective matched cohort study.

Summary of Background Data:

With a growing interest in minimally invasive spine surgery (MIS), the question of which technique is the most advantageous for patients with low-grade degenerative lumbar spondylolisthesis (DLS) still remains unclear.

Objective:

To compare patient-reported outcomes, perioperative morbidity, and rates of reoperation between MIS decompression with either unilateral noninstrumented facet fusion (MIS-F) or with transforaminal interbody fusion (MIS-T) for grade 1 DLS.

Methods:

Twenty patients who underwent MIS-T and 20 patients with MIS-F were matched based on age, sex, and preoperative ODI, VAS back, and VAS leg. All patients had DLS with at least 4 millimeters of translation on standing radiographs. Exclusion criteria included prior level surgery, multilevel instability, disk impinging on the exiting nerve root, spondylolisthesis from significant facet arthropathy, or foraminal compromise from disk collapse. ODI, VAS back, VAS leg, and patient satisfaction measured by the North American Spine Society questionnaire were tracked at 3, 6, 12, and 24 months postoperatively. Minimum clinically important differences and substantial clinical benefits were calculated.

Results:

MIS-F and MIS-T resulted in decreased ODI at 3, 6, and 12 months following the index procedure. Sixty percent of MIS-F and 83% of MIS-T patients reached minimum clinically important difference at 1 year postoperatively; however, using the threshold of 30% ODI reduction from baseline, 67% of MIS-F and 83% MIS-T (P = 0.25) achieved this goal. Forty-three percent of MIS-F and 59% of MIS-T patients met substantial clinical benefits. Satisfaction at 1 year, measured by a score of 1 or 2 on the North American Spine Society questionnaire, was 64% for MIS-F and 83% for MIS-T.

Conclusions:

MIS-F and MIS-T are effective treatment options for spinal stenosis associated with low-grade DLS. Both techniques result in comparable patient-reported outcomes and satisfaction up to 2 years and have similar long-term reoperation rates. More evidence is required to delineate optimal selection characteristics for MIS-F versus MIS-T.
RNA Sequencing Analysis of CD4+ T Cells Exposed to Airway Fluid From Children With Pediatric Acute Respiratory Distress Syndrome
Authors: Ripple Michael J. , Huang Min , Stephenson Susan T. , Mohammad Ahmad F. , Tidwell Mallory , Fitzpatrick Anne M. , Kamaleswaran Rishikesan , Grunwell Jocelyn R.
Published: June 2023

IMPORTANCE:

CD4+ T cells contribute to lung inflammation in acute respiratory distress syndrome. The CD4+ T-cell response in pediatric acute respiratory distress syndrome (PARDS) is unknown.

OBJECTIVES:

To identify differentially expressed genes and networks using a novel transcriptomic reporter assay with donor CD4+ T cells exposed to the airway fluid of intubated children with mild versus severe PARDS.

DESIGN:

In vitro pilot study.

SETTING:

Laboratory-based study using human airway fluid samples admitted to a 36-bed university-affiliated pediatric intensive care unit.

PATIENTS/SUBJECTS:

Seven children with severe PARDS, nine children with mild PARDS, and four intubated children without lung injury as controls.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We performed bulk RNA sequencing using a transcriptomic reporter assay of CD4+ T cells exposed to airway fluid from intubated children to discover gene networks differentiating severe from mild PARDS. We found that innate immunity pathways, type I (α and β), and type II (γ) interferon response and cytokine/chemokine signaling are downregulated in CD4+ T cells exposed to airway fluid from intubated children with severe PARDS compared with those with mild PARDS.

CONCLUSIONS:

We identified gene networks important to the PARDS airway immune response using bulk RNA sequencing from a novel CD4+ T-cell reporter assay that exposed CD4+ T cells to airway fluid from intubated children with severe and mild PARDS. These pathways will help drive mechanistic investigations into PARDS. Validation of our findings using this transcriptomic reporter assay strategy is needed.
Temporal correlation between the first melanoma and the first noncutaneous tumor in CKDN2A genotyped patients
Authors: Gironi Laura Cristina , Esposto Elia , Zottarelli Francesca , Giorgione Roberto , Farinelli Pamela , Zavattaro Elisa , Cammarata Edoardo , Di Cristo Nunzia , Ogliara Paola , Camillo Lara , Giordano Mara , Mellone Simona , Pasini Barbara , Ambrosi Alessandro , Savoia Paola
Published: June 2023

CDKN2A pathogenic variants are well known to be associated with cutaneous melanoma and noncutaneous tumors (NCTs). Herein, we investigated the temporal correlation between the first cutaneous melanoma and NCT both in CDKN2A mutation carriers (MUT) and in wild-type melanoma patients, a poorly explored issue to date. Two hundred forty-five cutaneous melanoma patients were genotyped for the CDKN2A gene and divided into 51 MUT and 189 wild-type; the remaining five variant carriers were excluded from the analyses. MUT developed a significantly higher number of cutaneous melanoma than wild-type, while 13.7% in both genotyped groups received a diagnosis of at least one malignant NCT, without statistically significant differences. The onset of the first cutaneous melanoma preceded that of the first malignant or benign NCT in both MUT and wild-type patients by an average of 4.5 and 3.02 years, respectively. Considering only malignant tumors, the diagnosis of melanoma preceded that of the first NCT on an average of 8 and 4.34 years, in MUT and wild-type patients respectively. We emphasize the relevance to adopt a global vision for the primary and secondary surveillance of patients affected by cutaneous melanoma, not only limited to high-risk for multiple primary skin cancers but also to NCT that may develop several years after the diagnosis of the first cutaneous melanoma.
Differentiating the effects of fine and coarse particulate air pollution on the onset of stable and unstable angina: a case-crossover study in 305 Chinese cities
Authors: Jiang Yixuan , Zhang Qingli , Zhu Xinlei , Xue Xiaowei , He Qinglin , Gao Ya , Chen Renjie
Published: June 2023

Background and purpose:

Associations between fine and coarse particulate matters (i.e., PM2.5 and PM2.5–10, respectively) and the onset of angina have rarely been investigated. We aimed to systematically explore the impacts of PM2.5 as well as PM2.5–10 on the onset of stable and unstable angina at the hourly timescale.

Methods:

We performed a time-stratified case-crossover study among 995,734 angina patients from 1,655 hospitals in 305 Chinese cities from January 2015 to December 2021. Concentrations of PM2.5 and PM2.5–10 were collected at the hourly timescale from nearby fixed-site monitoring stations. Hourly onset information of unstable and stable angina was obtained from the Chinese Cardiovascular Association Database-Chest Pain Center. We applied conditional logistic regressions combined with polynomial distributed lag models to explore the lagged exposure–response associations. Subgroup analyses were performed to explore potential effect modifiers including age, sex, season, and region.

Results:

Transient exposure to PM2.5 was significantly associated with elevated risk of unstable and stable angina onset. The associations occurred immediately in the concurrent hour of exposure, attenuated thereafter, and turned to null at approximately lag 12 h for unstable angina and 9 h for stable angina. Each interquartile range increase in the PM2.5 concentrations over 0 to 12 h was associated with 1.32% (95% confidence interval [95% CI]: 0.94%–1.70%) and 1.69% (95% CI: 0.99%–2.39%) increase in the onset risk of unstable and stable angina, respectively. The results remained similar after controlling for co-pollutants. Greater magnitudes of associations were found among females and during cold season. Null associations were observed between PM2.5–10 and any type of angina.

Conclusion:

Our study indicates that acute exposure to PM2.5, rather than PM2.5–10, was significantly associated with the onset of both unstable and stable angina, underscoring the need of continued efforts in controlling particulate matter air pollution.
Comparison of incidence of acute kidney injury after robot-assisted radical prostatectomy with that after open retropubic and extraperitoneal laparoscopic radical prostatectomies in patients with prostate cancer
Authors: Sato Shunsuke , Tanaka Toshiaki , Maehana Takeshi , Hashimoto Kohei , Kobayashi Ko , Masumori Naoya
Published: June 2023

Background

We retrospectively evaluated the postoperative renal function in patients who had undergone radical prostatectomy to compare the incidences of postoperative acute kidney injury (AKI) among the patients who had undergone robot-assisted radical prostatectomy (RARP), retropubic radical prostatectomy (RRP), and extraperitoneal laparoscopic radical prostatectomy (exLRP).

Materials and methods

Patients with prostate cancer who had undergone radical prostatectomy at our institution between 2008 and 2014 were included. Robot-assisted radical prostatectomy was performed using an intraperitoneal approach in a 25-degree Trendelenburg position, whereas other procedures were performed with the patient in the supine position. We evaluated the serum creatinine levels and estimated glomerular filtration rates immediately after surgery and on postoperative day 1. We evaluated the incidence of AKI after prostatectomy using the Acute Kidney Injury Network criteria of the Kidney Disease: Improving Global Outcomes guidelines.

Results

A total of 150 consecutive patients were included, with each of the 3 groups (RARP, RRP, and exLRP) comprising 50 patients. Postoperative AKI was observed in 15 (30.0%), 1 (2.0%), and 3 (6.0%) patients in the RARP, RRP, and exLRP groups, respectively. Stage 1 AKI was observed in all the patients except one. The incidence of AKI in RARP group was significantly higher than that in the other groups (p < 0.001). In the RARP group, the serum creatinine level was significantly elevated immediately after the surgery; however, it returned to baseline on postoperative day 1. Surgical procedures were the only independent factor associated with AKI incidence.

Conclusions

This study suggest that compared with RRP and exLRP, RARP is associated with a higher incidence of postoperative AKI, although most patients recover rapidly. Intra-abdominal pneumoperitoneum may contribute to AKI onset.
Proton pump inhibitor treatment is associated with acute-on-chronic liver failure in patients with advanced cirrhosis
Authors: Sturm Lukas , Gahm Chiara , Schultheiss Michael , Reincke Marlene , Huber Jan Patrick , Boettler Tobias , Thimme Robert , Bettinger Dominik
Published: June 2023

Background:

Acute-on-chronic liver failure (ACLF) is a fatal complication of cirrhosis. Hence, identification of risk factors for ACLF is crucial. Previous studies have linked proton pump inhibitor (PPI) treatment to complications of cirrhosis, however, a possible effect of PPI treatment on the risk of ACLF has not been investigated yet. Therefore, the present study aimed to characterize the impact of PPI treatment on ACLF development.

Methods:

A total of 642 patients hospitalized due to complications of cirrhosis were retrospectively identified, and PPI treatment during an observation period of 3 years following the hospitalization was reviewed. Subsequently, 74 patients with newly initiated PPI treatment at the time of hospitalization (PPI group) were 1:1 propensity score matched to 74 patients who received no PPI treatment (no-PPI group). Primary end point was the development of ACLF during the observation period, and secondary endpoints were mortality and upper gastrointestinal bleeding.

Results:

PPI and no-PPI groups had comparably severe chronic liver disease at baseline. Nevertheless, the cumulative incidence of ACLF in the presence of death as competing risk was markedly higher in the PPI group compared with the no-PPI group. ACLF-related deaths contributed significantly to a higher 3-year mortality in the PPI group. Uni and multivariable competing risk regression models confirmed that PPI treatment was an independent predictor of ACLF in the study collective (subdistribution HR: 1.892, 95% CI: 1.092–3.281, p = 0.023). The impact of PPI treatment on ACLF development was particularly strong in patients with a model for end-stage liver disease score >12. Upper gastrointestinal bleeding was slightly less frequent in the PPI group.

Conclusions:

The present results indicate that PPI treatment could be a risk factor for ACLF in patients with advanced cirrhosis.
Ectrodactyly–Ectodermal Dysplasia–Cleft Syndrome: Ocular Findings and Surgical Treatment
Authors: Grauhan Lea D. , Gericke Adrian , Brueggemann Felix B. , Pfeiffer Norbert , Wasielica-Poslednik Joanna
Published: June 2023

Purpose:

Ectrodactyly–ectodermal dysplasia–cleft (EEC) syndrome is a rare genetic disorder. We present ocular findings and their treatment in patients with EEC.

Methods and Results:

We report on 3 female patients (aged 59, 45, and 11 years) suffering from EEC with varying extraocular and ocular severity of phenotypic expression of the disease. Slit-lamp biomicroscopy, visual acuity, and medical treatment were evaluated over 4 months to 4 years. All patients experienced visual impairment and foreign body sensation. Examination revealed bilateral chronic blepharitis, dry eye syndrome, and corneal vascularization and clouding due to limbal stem cell deficiency (LSCD). Patient #1 presented a corneal ulcer with severe stromal thinning on the right eye. Allogeneic simple limbal epithelial transplantation (allo SLET), penetrating keratoplasty combined with allo SLET, and in total 5 amniotic membrane transplantation were performed to preserve the integrity of the eye. In patients #2 and #3, conservative therapy with lubricant eye drops, topical steroids, and antibiotics was sufficient to stabilize LSCD. In all cases, corneal epithelialization and improvement of visual acuity were achieved.

Conclusions and Importance:

To the best of our knowledge, this is the first report of surgical treatment in a patient with EEC. Allo SLET may be a surgical option to treat LSCD associated with EEC.