bluuebunny/crossref_metadata_2025 huggingface dataset:
A Modern Plague
Authors: Arnold David
Published: January 2023

Arriving in Bombay in 1896, bubonic plague (a contagion previously associated with the Middle East and with Europe's experience of the Black Death) created a new sense of panic around "oriental" disease. Prompted by fears of the loss of overseas trade, the Government of India's Epidemic Diseases Act of 1897 promulgated draconian measures designed to thwart the onward spread of the disease. In Bombay and elsewhere plague caused alarm and flight from the cities, but aggressive state action also provoked widespread anger and resistance. As plague continued to spread across India, and reached a political crisis point in Poona in 1897, provincial governments were obliged to moderate their intervention and seek support from Indian elites as well as allowing non-Western medical practitioners greater authority. The chapter considers plague in the light of contemporary Indian experience, especially that of women, with personal memoirs and photography allowing unprecedented insight into popular perceptions of disease and public health. The discussion concludes with consideration of the importance of the plague episode to prophylactic inoculation and as a stimulus to bacteriology and Indian medical research.
Conflicted Certification
Authors: Vogel Christoph N.
Published: January 2023

Beyond the socio-economic impact of traceability systems such as iTSCi, another yardstick for "conflict-free" sourcing initiatives is linked to the evolution of conflict around eastern Congo's artisanal mines. This chapter demonstrates the limited positive impact of the fight against "conflict minerals". First, it illustrates how conflict parties, illegal trade, and transnational regulation geographically co-habit, and how they permeate each other while competing for "public authority" in mining areas. Inspired by seminal scholarship on regulation and access, the chapter describes the challenges for reform in a context of competing legal and contested political order. Second, it puts transnational regulation of artisanal mining in perspective with the ongoing fragmentation of armed politics in eastern Congo. As opposed to dominant readings of the resource conflicts nexus, this book refrains from suggesting causality, but emphasises how the certification of eastern Congo's 3T minerals correlates with a perpetuation of violence and new peaks in human rights violations and rebel proliferation.
Transgression
Authors: Hussain Adeel
Published: January 2023

This chapter pieces together the trail of violence that led up to the Second Amendment to the Constitution of Pakistan in 1974, where Ahmadis were constitutionally excluded from claiming Muslim citizenship. It examines several anti-Ahmadiyya riots that occurred in the early years of Pakistan's formation. This chapter ultimately finds that Zulfikar Ali Bhutto's transformation of blasphemy from a criminal offence punishable under the penal code into a constitutional provision had severe legal and political consequences for Pakistan.
Transparency and Subjective Character
Authors: Howell Robert J.
Published: January 2023

In this chapter, I argue that subjective character, if it is phenomenologically substantial, conflicts with the transparency of perceptual experience. More specifically, if subjective character accompanies all conscious states, then it should exist in unreflective perceptual states. These states, however, appear transparent and there is no room for self-referential phenomenology on the unreflective level. I end the chapter by considering an empirical argument for the existence of subjective character based on depersonalization, and I argue that the best interpretation of patient reports is consistent with a lack of subjective character.
Mineness, Deflation, and Transparency
Authors: Soldati Gianfranco
Published: January 2023

It is widely accepted that experience is given in the first person in a special way, different from the way it is presented in the third person. To say that an experience is given to the subject in a special way might be taken to mean that there is a special way a subject can come to know her own experience. The claim under scrutiny is that one cannot accept the idea that there is a special way a subject can come to know her own experience and yet reject the presence of phenomenal mineness. I label this contention the mineness link. I argue against it and propose an alternative. An argument against the mineness link is not as such an argument against phenomenal mineness. The present project might be understood as arguing for the epistemological inefficiency of mineness, rather than for its psychological unreality.
The Sense of Body Ownership
Authors: Orbán Krisztina , Wong Hong Yu
Published: January 2023

One not only feels one’s body ‘from the inside’, but also has a sense of ownership over that body. This sense of body ownership can be compromised in illness and can also be experimentally induced, so that one feels artificial limbs to be one’s own. The convergence of the philosophical, experimental, and clinical literatures on the sense of body ownership has generated much excitement. It would appear that these disciplines are all studying the sense of body ownership. But when one looks more carefully, it is unclear whether these diverse disciplines are trying to answer the same question. In this chapter, we introduce five different questions about the sense of body ownership—constitutive, phenomenological, causal, functional, and mereological questions—so as to get clear on what we are studying when we claim we are studying body ownership, and use these distinctions to draw morals for the current debate.
On Self-Determination
Authors: Stilz Anna
Published: January 2023

This chapter engages with David Miller’s thought on self-determination. While Stilz accepts Miller’s claim that states must be self-determining in the right kind of way to be legitimate, she disagrees that we should draw the limits of the self-determining entity with reference to shared ideas of national cultural identity. Instead, she seeks to explain self-determination’s value by anchoring it in the interest in appropriately seeing oneself as a co-author of the institutions that coercively govern one’s life. What Stilz calls ‘maker freedom’ can be furthered by an individual’s membership in a self-determining group, which can be political or non-political in character. So self-determining peoples need not share objective cultural characteristics, but only need to share a second-order procedural commitment to the group venture. Self-determination is seen as rooted in the fundamental good of autonomy, whereby we are able to lead lives that we can appropriately see as our own.
Decision and Practical Reasoning
Authors: Koralus Philipp
Published: January 2023

This chapter extends the erotetic theory to decision-making, allowing the definition of a notion of an erotetic agent. The chapter diagnoses widely discussed decision-making phenomena like framing effects and the endowment effect as structurally similar to the reasoning fallacies discussed in previous chapters. The chapter obtains that, as in previous chapters, erotetic equilibrium secures classical standards of rationality, in this case classically rational choice. The chapter also considers how erotetic reasons-based decision-making can facilitate rapid action, making sense of what are sometimes termed “affordances.” Finally, the chapter considers unique threats the erotetic agent faces, and proposes an argument that deliberative democracy has particular legitimacy for erotetic agents: collective judgment at the end of a suitable deliberative process is a better reflection of group agency because it tends to be a better reflection of individual agency.
Temperature of the Villarrica Lava Lake from 1963 to 2015 Constrained by Phase-Equilibrium and a New Glass Geothermometer for Basaltic Andesites
Authors: Moussallam Yves , Lee Hyun Joo , Ding Shuo , DeLessio Maegan , Everard Jenna Lauren , Spittle Emily , Lu George , Baur Jasper , Glazer Emily , Peccia Ally , Zaman Maheenuz , Alper Nathaniel , Slibeck Bennett
Published: January 2023

Magma/lava temperature is one of the most basic and critical parameters in volcanology. Yet at many active volcanoes, including during eruptions, this parameter remains poorly constrained due to vent accessibility, with estimates from different geothermometers commonly varying by several tens to more than a hundred degrees. One such volcano is Villarrica, one of the most active and hazardous volcanoes in South America and whose crater hosts a persistent lava lake. Here, we use experimentally determined phase equilibria to constrain the temperature of the Villarrica lava lake. The experiments were all performed at ambient pressure (i.e. 0.1 MPa), ranged in temperature from 1000°C to 1250°C and in oxygen fugacity from QFM + 1 to QFM–1 (where QFM stands for the quartz-fayalite-magnetite redox buffer). Within the investigated range, fO2 was found to have little to no effect on the phase equilibria and hence the lava lake fO2 could not be constrained. The temperature range explored, however, did bracket the entire liquidus to solidus assemblage evolution. On the basis of these experiments, two empirical geothermometers calibrated strictly between 1050°C and 1200°C (i.e. not to be used outside this range) were developed for the Villarrica lava lake based on its matrix glass composition and modal proportion. The 2015 state of the natural system was experimentally reproduced at temperatures around 1141°C. In detail, the lava lake melt composition in the period 1963 to 2015 indicates a cooling trend from 1186 ± 19°C in 1963 to 1153 ± 8°C in 1999–2000 and 1149 ± 28°C in 2015. A generic glass geothermometer was also developed for any Basaltic Andesite composition from the compilation of 175 phase equilibria experiments giving the relation: $Melt\ Temperature\ \left({}^{\circ}C\right)=12.43\times {\mathrm{Al}}_2{\mathrm{O}}_3+10.73\times \mathrm{MgO}+8.51\times \mathrm{CaO}+5.91\times \left({Na}_2\mathrm{O}+{K}_2\mathrm{O}\right)+814.08$ with all oxides in wt.% normalized. The geothermometers we have developed can be used to follow future temperature evolutions of the Villarrica lava lake or to estimate the lava temperature at any basaltic andesite eruption. Their application is simple, requiring only petrographic observations (to quantify the melt proportion) or analysis of the melt composition.
Self-filling enclosures to experimentally assess plankton response to pulse nutrient enrichments
Authors: Giménez-Grau Pau , Camarero Lluís , Palacín-Lizarbe Carlos , Sala-Faig Marc , Zufiaurre Aitziber , Pla-Rabés Sergi , Felip Marisol , Catalan Jordi
Published: January 2023

Experimental nutrient additions are a fundamental approach to investigating plankton ecology. Possibilities range from whole-lake fertilization to flask assays encompassing a trade-off between closeness to the “real world” and feasibility and replication. Here we describe an enclosure type that minimizes the manipulation of planktonic communities during the enclosure filling. The enclosure (typically ~100 L volume) consists of a narrow translucent cylinder that can comprise the entire photic zone (or a large part of it in clear deep lakes, e.g. 20-m long) and holds a sediment trap at the bottom for recovering the sinking material. The enclosures are inexpensive and straightforward to build. Thus, many can be used in an experiment, favoring the diversity of treatments and the number of replicates. They also are lightweight with easy transport and use in lakes that cannot be reached by road. The enclosures are fundamentally aimed at investigating the short-term response of the planktonic community, integrated across the photic zone, to pulse perturbations using before and after comparisons and multiple replication and treatments. The pros and cons of the enclosure design are evaluated based on experience gained in Lake Redon, a high mountain ultraoligotrophic deep lake in the Pyrenees.
High-throughput, dynamic, multi-dimensional: an expanding repertoire of plant respiration measurements
Authors: O’Leary Brendan M , Scafaro Andrew P , York Larry M
Published: January 2023

A recent burst of technological innovation and adaptation has greatly improved our ability to capture respiration rate data from plant sources. At the tissue level, several independent respiration measurement options are now available, each with distinct advantages and suitability, including high-throughput sampling capacity. These advancements facilitate the inclusion of respiration rate data into large-scale biological studies such as genetic screens, ecological surveys, crop breeding trials, and multi-omics molecular studies. As a result, our understanding of the correlations of respiration with other biological and biochemical measurements is rapidly increasing. Difficult questions persist concerning the interpretation and utilization of respiration data; concepts such as allocation of respiration to growth versus maintenance, the unnecessary or inefficient use of carbon and energy by respiration, and predictions of future respiration rates in response to environmental change are all insufficiently grounded in empirical data. However, we emphasize that new experimental designs involving novel combinations of respiration rate data with other measurements will flesh-out our current theories of respiration. Furthermore, dynamic recordings of respiration rate, which have long been used at the scale of mitochondria, are increasingly being used at larger scales of size and time to reflect processes of cellular signal transduction and physiological response to the environment. We also highlight how respiratory methods are being better adapted to different plant tissues including roots and seeds, which have been somewhat neglected historically.
The increasing relevance of immunobiology within a connected animal science curriculum
Authors: Meade Kieran G
Published: January 2023

Modern technological agriculture emerged in the 20th century and has expanded into a global enterprise occupying approximately 38% of the Earth’s land area and accounting for over 40% of the world’s workforce. The United Nations Food and Agriculture Organization estimates that to feed a world population of 9-billion people in 2050 will require an almost doubling of overall food production, including meat, dairy, and egg production over 2010 levels. However, our collective ability to meet this demand cannot be taken for granted. Despite many successes, global agricultural systems now face multiple unprecedented challenges including a dearth of new treatments for livestock diseases. The discovery of antibiotics led to a complacency now reflected in a dependency on exogenous antimicrobials and a growing threat of antimicrobial resistance. Developments within the field of immunobiology had led to significant breakthroughs in understanding of human health and disease. However, despite over 60% of infectious diseases being zoonotic in nature and nonhuman animals acting as an important disease reservoir, research in livestock immunobiology has not been as resourced. As a direct result, recalcitrant animal diseases continue to threaten sustainability of animal production systems, security of the food chain and human health. It is within the context of collective One Health action that ambitious innovation in the connectivity of animal science undergraduate curricula is urgently required, specifically to include threshold concepts in immunobiology. Fostering transformative learning is critical to equip future generations of animal scientists with the knowledge and interdisciplinary skills to counter these existential challenges of our time.
The regulation of data-driven political campaigns in the EU: from data protection to specialized regulation
Authors: Brkan Maja
Published: January 2023

Data-driven political campaigns that heavily rely on political microtargeting are becoming more and more widespread, both in Europe and globally. Over the past years, politicians running for office have globally relied on data about their voters to enhance the effectiveness of their political campaigns through profiling of voters and approaching them through targeted messages on social media. The article identifies the characteristics and uses of data-driven political campaigns and elaborates on the more general question of threats of these campaigns. Further, the article critically examines the provisions of the General Data Protection Regulation that are the most relevant for this type of campaigns. In particular, the article focuses on the rules regarding the legal basis for processing of political opinions of voters and the provision on automated decision-making that offers limited possibilities for decision-making without human intervention. Moreover, the article examines the amended EU legislation on funding of European political parties that exhibits a clear focus on protection of voters’ data. Furthermore, the article considers recently adopted Digital Services Act and two recent EU legislative proposals that will regulate targeted political advertising, namely, the Proposal on transparency and the Recast of Regulation 1141/2014. Finally, the article concludes by addressing the evolution of the regulatory framework applicable to the data-driven political campaigns in the EU.
Moderate alcohol consumption is associated with significant fibrosis progression in NAFLD
Authors: Blomdahl Julia , Nasr Patrik , Ekstedt Mattias , Kechagias Stergios
Published: January 2023

The effect of moderate alcohol consumption on NAFLD histology is disputed. Assessment of alcohol consumption is commonly performed with interview or questionnaires. Phosphatidylethanol (PEth) in blood is a highly sensitive and specific alcohol biomarker, which only forms in the presence of ethanol. PEth has hitherto not been evaluated in longitudinal NAFLD studies. This study aimed to examine the impact of moderate alcohol consumption on histologic progression and evaluate the utility of PEth in NAFLD. NAFLD patients with serial biopsies were reviewed for inclusion in the study. At baseline, all patients reported alcohol consumption <140 g/week. Anthropometric and biochemical measurements were performed at baseline and follow-up. Alcohol consumption was assessed thoroughly at follow-up with clinical interview, the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire, and analysis of PEth in whole blood. Eighty-two patients were included. Mean follow-up time was 17.2 years (SD±6.0). Patients with significant fibrosis progression (defined as progression of ≥2 stages or development of cirrhosis-related complications) reported higher alcohol consumption and had significantly higher PEth. Consumption >66–96 g/week (but <140 g) (i.e. moderate alcohol consumption) was associated with increased risk of significant fibrosis progression compared with no or low consumption. PEth ≥48 ng/mL and binge drinking showed the highest risk for significant fibrosis progression (aOR: 5.9; 95% CI: 1.6–21.4) and aOR: 5.1; 95% CI: 1.4–18.1, respectively). NAFLD patients consuming moderate amounts of alcohol are at increased risk for significant fibrosis progression and development of cirrhosis-related complications. PEth is a potential biomarker to assess harmful alcohol consumption in NAFLD. Patients reporting moderate consumption or exhibiting PEth ≥48 ng/mL should be advised to reduce alcohol consumption.
Psychosocial assessment in liver transplantation (LT): an analysis of short-term outcomes
Authors: Matthews Lindsay A. , Musto Jessica A. , Deiss-Yehiely Nimrod , Daniel Kimberly E. , Lightbourn Christina , Garvey Maureen , Osman Fay , Foley David P. , Rice John R. , Lucey Michael R.
Published: January 2023

Background:

Our research showed that patients with alcohol-associated liver disease (ALD) had more severe liver disease than those without a diagnosis of ALD yet were less likely to be selected for transplant listing due to their increased psychosocial vulnerability. This study aims to answer whether this vulnerability translates to worse short-term outcomes after transplant listing.

Methods:

A total of 187 patients were approved for liver transplant listing and are included in the present retrospective study. We collected dates of transplantation, retransplantation, death, and pathologic data for evidence of rejection, and reviewed alcohol biomarkers and documentation for evidence of alcohol use.

Results:

The ALD cohort had higher Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) scores (39.4 vs. 22.5, p <0.001) and Model for End-Stage Liver Disease (MELD)-Na scores (25.0 vs. 18.5, p <0.001) compared with the non-ALD cohort. Forty-nine (59.7%) subjects with ALD and 60 (57.1%, p =0.71) subjects without ALD subsequently received a liver transplant. Overall mortality was similar between the 2 groups (20.7% ALD vs. 21.0% non-ALD, p =0.97). Neither the SIPAT score (HR: 0.98, 95% CI: 0.96–1.00, p =0.11) nor MELD-Na score (HR 0.99, 95% CI 0.95-1.02, p =0.40) were associated with mortality. Patients with ALD were more likely to have alcohol biomarkers tested both before (84.1% vs. 24.8% non-ALD, p <0.001) and after liver transplantation (74.0% vs. 16.7% non-ALD, p <0.001). SIPAT score was associated with alcohol use after listing (OR: 1.03, 95% CI: 1.0–1.07, p =0.04), although a return to alcohol use was not associated with mortality (HR: 1.60, 95% CI: 0.63–4.10, p =0.33).

Conclusion:

Patients with ALD had higher psychosocial risk compared with patients without a diagnosis of ALD who were placed on the waitlist, but had similar short-term outcomes including mortality, transplantation, and rejection. Although a high SIPAT score was predictive of alcohol use, in the short-term, alcohol use after transplant listing was not associated with mortality.
Xuanfei Baidu decoction, a Chinese herbal medicine for coronavirus disease 2019 (COVID-19): a randomized clinical trial
Authors: Li Tao , Zhao Min , Zhu Mingjun , Zhang Shixi , He Jiarong , Pan He , Shao Mingyi , Wang Zhen , Fu Yu , Li Ning , Zhao Long , Jin Xinyao , Yang Fengwen , Pang Wentai
Published: January 2023

Objective:

To evaluate the efficacy and safety of Xuanfei Baidu decoction for treating coronavirus disease 2019 (COVID-19).

Methods:

Patients with COVID-19 were enrolled, and eligible patients were randomly allocated to three groups: group A (Xuanfei Baidu decoction combined with conventional treatment), group B (Ganlu Xiaodu decoction combined with conventional treatment), and group C (conventional treatment only). The duration of treatment was 14 days. The primary outcomes were the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid testing from positive to negative and hospitalization days. The secondary outcome was the rate of symptom resolution. The safety outcome was drug-related adverse events.

Results:

In total, 103 patients with ordinary-type COVID-19 were included and randomly allocated to groups A (34 cases), B (35 cases), and C (34 cases). Duration for SARS-CoV-2 nucleic acid testing from positive to negative was shortest in group A [(9.88 ± 3.62) days], followed by groups C [(11.20 ± 2.93) days] and B [(12.69 ± 4.11) days]; differences between the three groups were statistically significant (P = 0.010). The number of hospitalization days was the least in group A [(14.00 ± 6.55) days], followed by groups B [(15.40 ± 4.02) days] and C [(16.38 ± 5.73) days], and differences between groups were statistically significant (P = 0.019). There was no statistically significant difference in the rate of symptom resolution between groups (P > 0.05). No deaths or serious adverse events occurred in either of the groups.

Conclusion:

Considering the treatment of ordinary-type COVID-19, Xuanfei Baidu decoction can shorten the duration from a positive to negative SARS-CoV-2 nucleic acid test, as well as the duration of hospitalization. Moreover, there were no Xuanfei Baidu decoction-induced adverse reactions.

Graphical abstract:

http://links.lww.com/AHM/A44.
Metapneumovirus Infections are Uncommon in Infants Younger than 60 Days of Age Admitted for Sepsis Evaluation
Authors: Tomatis Souverbielle Cristina , Sánchez Pablo J. , Erdem Guliz
Published: January 2023

The epidemiology and clinical manifestations of human metapneumovirus are not well studied in infants younger than 60 days of age. In this retrospective review of infants admitted for sepsis evaluation, we identified HMPV less frequently than other viral etiologies via nasopharyngeal multiplex polymerase chain reaction testing; in only 16 (1.9%) infants. Two infants had apneic episodes, but none had wheezing.
Genotypes and Phenotypes of Uygur Children With Xeroderma Pigmentosum: A Case Study in Xinjiang, China
Authors: Qiu Yun , Wang Wei-Jia , Liang Jun-Qin , Yakeya Buwajieer , Wang Peng , Zhang Jing-Zhan , Kang Xiao-Jing
Published: January 2023

Objective:

Xeroderma pigmentosum (XP) is a rare autosomal recessive dermatosis caused by genetic defects of DNA repair. This study was performed to detect and analyze the genes of 2 Uygur patients with XP and their families and assess the patients’ phenotypes, which may enrich the understanding of the genetic skin disorder spectrum in Xinjiang area.

Methods:

We collected the clinical data from 2 patients with XP and peripheral blood samples from the patients and their family members. The patients’ DNA was sequenced and detected by Sanger sequencing, and gene mutations were screened.

Results:

The proband in family 1 presented with brown maculae at the exposure site and squamous cell carcinoma secondary to a facial rash. The proband had a homozygous nucleotide variation of XPC c.2251-2A> G (A change from A to G in the penultimate position of the intron before the 2251 position in the coding region), which was a shear mutation. In this family, both parents were heterozygous, and no similar mutation detected in the sister. In family 2, the proband had scattered black brown spots and papules on the trunk and limbs. and his younger sister was also a patient. The proband and his younger sister had homonucleotide variation of XPA c.631C> T, which was nonsense mutation, resulting in the codon for Arg No.211 being changed into termination codon (p.arg211X), thus terminating the peptide chain synthesis prematurely. All the normal individuals in the two families were heterozygotes, and homozygous mutations occurred in all the patients, which was consistent with the autosomal recessive inheritance.

Conclusion:

XP is rare in Uygur population. This study expanded the mutation spectrum of XP and provided a basis for early diagnosis, treatment, prognostic prediction, and prenatal genetic consultation.
A Comprehensive Sampling Study on SARS-CoV-2 Contamination of Air and Surfaces in a Large Meat Processing Plant Experiencing COVID-19 Clusters in June 2020
Authors: de Rooij Myrna M.T. , Sikkema Reina S. , Bouwknegt Martijn , de Geus Yvette , Stanoeva Kamelia R. , Nieuwenweg Sigrid , van Dam Adriana S.G. , Raben Ceder , Dohmen Wietske , Heederik Dick , Reusken Chantal , Meijer Adam , Koopmans Marion P.G. , Franz Eelco , Smit Lidwien A.M.
Published: January 2023

Objective

We aimed to assess SARS-CoV-2 contamination of air and surfaces to gain insight into potential occupational exposure in a large meat processing plant experiencing COVID-19 clusters. Methods: Oro-nasopharyngeal SARS-CoV-2 screening was performed in 76 workers. Environmental samples (n = 275) including air, ventilation systems, sewage, and swabs of high-touch surfaces and workers' hands were tested for SARS-CoV-2 RNA by real-time quantitative polymerase chain reaction. Results: Twenty-seven (35.5%) of the (predominantly asymptomatic) workers tested positive with modest to low viral loads (cycle threshold ≥ 29.7). Six of 203 surface swabs, 1 of 12 personal air samples, and one of four sewage samples tested positive; other samples tested negative. Conclusions: Although one third of workers tested positive, environmental contamination was limited. Widespread SARS-CoV-2 transmission via air and surfaces was considered unlikely within this plant at the time of investigation while strict COVID-19 control measures were already implemented.
Ophthalmologic clinical features of ocular myasthenia gravis
Authors: Kim Do-Hyung , Roh Hyeon Cheol , Oh Shin Yeop
Published: January 2023

To investigate the clinical features of ocular myasthenia gravis (OMG) in ophthalmology. A total of 28 patients with ptosis or diplopia who were followed for at least 6 months between March 2016 and February 2022 were included in this study. The clinical symptoms of the patients and test results were analyzed. According to the positivity of serologic or electrophysiologic test, these patients were divided into 2 groups (positive and negative OMG results) and according to the clinical symptoms of diplopia or ptosis for comparison. Ptosis, diplopia, and both ptosis and diplopia were present in 6 (21.43%), 14 (50.0%), and 8 (28.57%) patients, respectively. Acetylcholine receptor auto-antibody (AchR Ab) was positive in 16 (57.14%) of 28 patients and the ice test was positive in 13 (92.86%) of 14 patients with ptosis. Abnormal thymic lesions were presented in 7 (25.0%) patients, and a definite improvement in response to pyridostigmine was observed in 27 (100.0%) patients. Both ptosis and diplopia were significantly higher in the group with positive results than that in the negative results group (P = .025). In addition, both horizontal and vertical diplopia was significantly higher in the group with AchR Ab titer > 5.0 than that in the group with AchR Ab titer < 5.0 (P = .041). After excluding cranial nerve palsy, if there is ptosis and diplopia, especially vertical diplopia, the possibility of OMG should be considered.
Simultaneous treatment of two lung cancer lesions with stereotactic MR-guided adaptive radiation therapy: A case report
Authors: Chen Frank , Cheng Yuan-Kai , Chiang Chen-Han , Lu Tzu-Ying , Huang Chih-Jen
Published: January 2023

Rationale:

Lung cancer is 1 of the most prevalent cancers globally. Definitive stereotactic ablative radiotherapy (SABR) is suggested for those who are unfit for or refuse surgical intervention. Here we present a patient with 2 lung cancer lesions who received SABR simultaneously with magnetic resonance Linear accelerator (Linac)-magnetic resonance (MR).

Patient concerns:

A 46-years-old man had history of left lower lung cancer post lobectomy in 2018. Two recurrent tumors were found 2 years following, then became enlarged 4 months later.

Diagnoses:

The recurrent tumors were found by computed tomography.

Interventions:

SABR was indicated due to inoperability and small size. Simulation was done both by computed tomography and MR scan with ViewRay MRIdian Linac, with the prescription dose being 50 gray in 4 fractions performed every other day within 2 weeks. The 2 lesions were irradiated at the same time with a single isocenter with mean treatment time was 78 minutes.

Outcomes:

No acute side effect was noted. Follow-up chest computed tomography scan 14 months after SABR showed mild consolidation and pneumonitis over the upper irradiated site favoring radiation-related reasons, while pneumonitis was resolved over the lower irradiated site. Positron emission tomography showed no definite evidence of FDG-avid recurrence. The patient has survived over 18 months following SABR and more than 4 years from the first diagnosis of lung cancer without significant adverse effects.

Lessons:

Simultaneous SABR for multiple lung lesions is quite challenging because tumor motion by breathing can increase the risk of missing the target. With help by MR-Linac, simultaneous SABR to multiple lung lesions can be performed safely with efficacy.
The triglyceride-glucose index and contrast-induced nephropathy in non-ST elevation myocardial infarction patients undergoing percutaneous coronary intervention
Authors: Gursoy Erol , Baydar Onur
Published: January 2023

The triglyceride glucose (TyG) index is an indicator of insulin resistance and associated with increased risk of diabetes mellitus and cardiovascular events. Our study investigates the correlation between TyG index and contrast induced nephropathy (CIN) in non-diabetic patients with non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). 350 non-diabetic NSTEMI patients (183, 52.3% male) undergoing PCI were retrospectively enrolled. The enrolled cohort was divided into 2 groups based on the calculated TyG index, namely values < 8.65 or higher. CIN was defined as an increase in serum creatinine > 25% or 0.5 mg/dL from baseline in the first 48 to 72 hours after PCI. A total of 56 (16%) cases of CIN were diagnosed. In contrast to patients with lower TyG indexes, patients with higher TyG indexes (≥8.65) had a higher frequency of CIN, 9.5%. versus 20.8% respectively (P .004). Patients with CIN also had higher TyG indexes (8.74 ± 0.12 vs 8.67 ± 0.11, P < .001). In addition, TyG index, age, and glomerular filtration rate were identified as independent risk factors for CIN in logistic regression model (OR: 2.5 CI: 1.3–4.6, P .006, OR: 1.0 CI: 1.0–1.1, P < .001, OR: 1.0 KI: 1.03–1.06, P .025). In the ROC analysis, the area under the curve predictive of CIN was 0.666 (P < .001, 95% [CI] 0.58–0.75) with a cutoff value of 8.69 (sensitivity 71,4%, specificity 55.1%) TyG index. Higher TyG indexes are associated with an increased risk of CIN in non-diabetic patients with NSTEMI.
Medical and economic burden of delirium on hospitalization outcomes of acute respiratory failure: A retrospective national cohort
Authors: Taha Ahmed , Xu Huiping , Ahmed Roaa , Karim Ahmad , Meunier John , Paul Amal , Jawad Ahmed , Patel Manish L.
Published: January 2023

Although delirium in patients with acute respiratory failure (ARF) may evolve in any hospital setting, previous studies on the impact of delirium on ARF were restricted to those in the intensive care unit (ICU). The data about the impact of delirium on ARF hospitalizations outside of the ICU is limited. Therefore, we conducted the first national study to examine the effect-magnitude of delirium on ARF in all hospital settings, that is, in the ICU as well as on the general medical floor. We searched the 2016 and 2017 National Inpatient Sample databases for ARF hospitalizations and created “Delirium” and “No delirium” groups. The outcomes of interest were mortality, endotracheal intubation, length of stay (LOS), and hospitalization costs. We also aimed to explore any potential demographic, racial, or healthcare disparities that may be associated with the diagnosis of delirium among ARF patients. Multivariable logistic regression was used to control for demographics and comorbidities. Delirium was present in 12.7% of the sample. Racial disparities among African Americans were also significant. Delirious patients had more comorbidities, higher mortality, and intubation rates (17.5% and 9.2% vs 10.6% and 6.1% in the “No delirium” group [P < .001], respectively). Delirious patients had a longer LOS and higher hospitalization costs (5.9 days and $15,395 USD vs 3.7 days and $9393 USD in “No delirium” [P < .001], respectively). Delirium was associated with worse mortality (adjusted odds ratio 1.49, confidence interval [CI] = 1.41, 1.57), higher intubation rates (adjusted odds ratio 1.46, CI = 1.36, 1.56), prolonged LOS (adjusted mean ratio 1.40, CI = 1.37, 1.42), and increased hospitalization costs (adjusted mean ratio 1.49, CI = 1.46, 1.52). A racial disparity in the diagnosis of delirium among African Americans hospitalized with ARF was noted in our sample. Patients in small, non-teaching hospitals were diagnosed with delirium less frequently compared to large, urban, teaching centers. Delirium predicts worse mortality and morbidity for ARF patients, regardless of bed placement and severity of the respiratory failure.
Caregiver Perceptions of an Interdisciplinary Intensive Therapy Program: A Qualitative Study
Authors: Hall Jamie B. , Chole Dana , Pruitt Taylor C. , Linkeman Kylie
Published: January 2023

Purpose:

To explore perceptions of caregivers of children with neurodevelopmental conditions participating in an interdisciplinary intensive therapy program.

Methods:

Semi-structured interviews were completed with caregivers. The intensive program consisted of occupational, physical, and/or speech therapy 3 to 6.5 hours/day, 3 to 5 days/week, for 4 weeks. Team-based collaborative goal setting was used to determine each child's plan of care. Reflexive thematic analysis identified interview themes.

Results:

Thirteen caregivers participated. Children ranged in age from 6 to 13 years; diagnoses included cerebral palsy (n = 10), spina bifida (n = 1), ataxia (n = 1), and stroke (n = 1). An overarching theme of Immersive was identified; other themes included Everybody's Empowered, Principles of Neuroplasticity, Progress Across the ICF (International Classification of Functioning, Disability, and Health) Framework, It Takes a Team, and Benefits Outweigh the Challenges.

Conclusions:

Caregivers valued interdisciplinary intensive therapy. For children with complex rehabilitation needs, an interdisciplinary, intensive therapy program may be a viable alternative to traditional therapy models for service delivery.
Relationship between phantom limb pain, function, and psychosocial health in individuals with lower-limb loss
Authors: Gunterstockman Brittney M. , Knight Ashley D. , Mahon Caitlin E. , Childers W. Lee , Cagle Tyler , Hendershot Brad D. , Farrokhi Shawn
Published: January 2023

Introduction:

The adverse influence of chronic pain on function and psychological health in the general population is well understood. However, the relationship between phantom limb pain (PLP) after limb loss with function and psychological health is less clear. The study purpose was to assess the influences of PLP presence and intensity on function and psychosocial health in individuals with lower-limb loss (LLL).

Methods:

One hundred two individuals with major LLL completed a study-specific questionnaire on the presence and intensity of their PLP. The Patient-Reported Outcomes Measurement Information System —29 questionnaire was also administered.

Results:

Of 102 participants, 64% reported PLP, with a mean intensity of 4.8 ± 2.3 out of 10. Individuals with vs. without PLP demonstrated significantly greater sleep disturbances (p = 0.03), whereas the differences in function, fatigue, pain interference, depressive symptoms, anxiety, or ability to participate in social roles and activities were not statistically different between groups (p > 0.05). Of note, mean scores for many of the Patient-Reported Outcomes Measurement Information System—29 short forms among the current sample were similar to the mean of the general population, minimizing the potential clinical impact of PLP on these domains.

Conclusions:

Our findings indicate a lack of meaningful associations between PLP presence or intensity with function, and psychosocial health among individuals with LLL. These findings conflict with previous research suggesting an adverse relationship between PLP, function, and psychosocial health after limb loss.
PET/CT Reveals Localized Inflammation in the Temporal, Vertebral, and Lower Extremity Arteries in Giant Cell Arteritis
Authors: Kawamata Nozomi , Abe Yoshiyuki , Makiyama Ayako , Ashizawa Karin , Tamura Naoto
Published: January 2023

18F-FDG PET/CT is increasingly being used in the diagnosis of systemic vasculitis syndromes, especially large-vessel vasculitis. We present a case of giant cell arteritis in an 84-year-old man who exhibited large-vessel lesions in the periphery but none in the trunk. This case highlights the usefulness of PET/CT for revealing localized inflammation.
PLATELET SUPPRESSION BY TIROFIBAN AMELIORATES PULMONARY COAGULATION AND FIBRINOLYSIS ABNORMALITIES IN THE LUNGS OF MOUSE ANTIBODY-MEDIATED TRANSFUSION-RELATED ACUTE LUNG INJURY
Authors: Yuan Xin , Jiang Peng , Qiao CongChao , Su Na , Sun Pan , Lin Fangzhao , Li Changqing
Published: January 2023

This study aimed to explore the ameliorating effects of the platelet surface glycoprotein IIb/IIIa receptor antagonist tirofiban on coagulation and fibrinolytic abnormalities in a mouse model of antibody-mediated transfusion-associated acute lung injury (ALI). This is important because ALI is a major cause of death attributable to the occurrence of adverse transfusion reactions. No information on a definite diagnosis or pathological mechanism exists, and targeted treatment options are not available. In this study, wild-type male Balb/c mice aged 8 to 10 weeks were randomly divided into the TRALI model, blank control, tirofiban intervention, and isotype control groups. After different treatment exposures, the mice were observed for 2 h before being killed, and lung tissue samples were collected. To explore the intervention effect of tirofiban, the degree of lung injury was quantified by estimating the lung wet/dry ratio, rectal temperature, survival rate, total protein, and myeloperoxidase and via hematoxylin-eosin staining. Furthermore, the coagulation, anticoagulation, and fibrinolysis assays were measured by automatic coagulation instrument and enzyme-linked immunosorbent assay kits, and the fluorescence densities of platelets and fibrin were quantified using immunofluorescence to analyze the effects of tirofiban on the platelet and fibrin interactions of TRALI. Compared with the TRALI model group, the lung injury indices in the tirofiban intervention group decreased significantly, and survival rates also improved. Furthermore, the level of coagulation and fibrinolytic abnormalities were obviously lower than those in the TRALI model group. In conclusion, our findings suggest that tirofiban might interfere with TRALI by inhibiting platelet activation and improving coagulation and fibrinolytic abnormalities.
Impact of Urinary Incontinence on Postpartum Sexual Function
Authors: Badreddine Jad , Pope Rachel , Sheyn David
Published: January 2023

Objective

The aim of the study is to evaluate the incidence of urinary incontinence (UI) and its impact on sexual function among women within 3 years of delivery.

Methods

This was a cross-sectional study of 531 participants who gave birth by any method in the past 3 years. Participants were administered the Edinburgh Depression Screening Questionnaire, Generalized Anxiety Disorder–7 questionnaire, the Overactive Bladder Symptom Score questionnaire, Incontinence Impact Questionnaire, Sexual Function Questionnaire’s Medical Impact Scale, and Decreased Sexual Desire Screener. The primary outcome of interest was the report of any sexual dysfunction and urinary symptoms.

Results

There were 531 total participants of 600 who completed the survey in its entirety. The mean age of the cohort was 29.6 ± 7.1 years, the majority were non-Hispanic White (76.6%). It was found that 55% of the women (n = 292) reported postpartum UI (73% [n = 213] stress incontinence, 26.7% [n = 78] urgency incontinence, and 0.003% [n = 1] mixed incontinence). Sexual dysfunction was more likely to be reported in participants with UI compared with those without UI (34.2% vs 17.8%, P < 0.001). Urinary incontinence was found to be associated with any form of sexual dysfunction after adjustment for confounders (adjusted odds ratio [aOR], 1.63; 95% confidence interval [CI], 1.07–2.14). Additional variables that were correlated with sexual dysfunction were perceived difficulty healing after any delivery injury (aOR, 4.79; 95% CI, 1.11–20.72), current breastfeeding (aOR, 3.29; 95% CI, 1.26–8.59), and an increasing Generalized Anxiety Disorder–7 score (aOR, 1.10 per 1-point increase; 95% CI, 1.05–1.15).

Conclusion

Urinary incontinence is independently associated with sexual dysfunction and should be systematically evaluated during postpartum care.
Underrepresentation in Pelvic Floor Disorder Patient-Reported Outcomes: Whose Outcomes Are We Measuring?
Authors: Shinnick Julia K. , Siddique Moiuri , Jarmale Spandana , Raker Christina , Brown Oluwateniola , Sung Vivian W. , Carberry Cassandra L.
Published: January 2023

Importance

Patient-reported outcome (PRO) instruments measure the patient's perspective. It is unclear whether commonly used PRO measures were tested in populations that had racial and ethnic distributions comparable with those reported in U.S. census data.

Objective

The aim of this study was to compare the proportion of non-White race and Hispanic ethnicity participants with their expected proportion based on U.S. census data for PRO instruments with U.S.-based validation studies.

Study Design

This was a retrospective review of PRO measures considered by the Pelvic Floors Disorders Consortium Working Group on Patient-Reported Outcomes in their 2020 consensus publication. Study and participant information were abstracted from PRO validation studies. Racial and ethnic representation in U.S.-based studies were compared with U.S. census data. The primary outcome was the representation quotient of reported races and ethnicities, calculated as the reported percentage of the study population identifying with a race and/or ethnicity divided by the proportion of the U.S. population identifying with that race and/or ethnicity when the study was published.

Results

Forty-five studies with 21,080 total participants were included. Race was reported in 17 of 45 studies (37.8%), and ethnicity was reported in 7 of 45 (15.6%). Most studies did not specify how race and ethnicity information was collected. For U.S.-based studies, the representation quotient of White participants from 1995 to 2019 was 1.15. Indigenous American/Native American/American Indian/Alaska Natives had the lowest representation quotient (0.22). Reporting of ethnicity increased over time (P = 0.001), although there was no significant change in the reporting of race or the representation of various races and ethnicities (P > 0.05).

Conclusion

Non-White and Hispanic patients may be underrepresented in U.S.-based validation studies for PRO instruments in pelvic floor disorders.