bluuebunny/crossref_metadata_2025 huggingface dataset:
20. Damages
Authors: Atkins Ruth
Published: September 2022

This chapter deals with the primary remedy for breach of contract: damages. It looks at the basic test, which allows for the recovery of expectation loss, and also considers recovery of reliance loss and a restitutionary sum. The assessment for, and availability of, negotiating damages as recently affirmed by the Supreme Court in One Step (Support) LTD v Morris-Garner and Another (2019) is explored. The further limitations on recovery such as remoteness and the ‘duty’ to mitigate are considered, as is the distinction between liquidated damages and penalty clauses. The problem of recovering for non-financial losses—mental distress and the consumer surplus—is also addressed. Finally, the chapter looks at how the rules on penalties have been relaxed with the landmark judgments in Cavendish and ParkingEye (2015).
5. Making the Most of Your Classes in Law
Authors: Moore Imogen , Newbery-Jones Craig
Published: September 2022

This chapter explores the range of different classes and related learning opportunities the student may come across during their legal studies and how to get the best out of them. The chapter explains the main types of law classes, including lectures and other large group classes, tutorials, and seminars, and considers how they differ in aim and approach. It provides guidance on how classes may be conducted and how students can prepare for and benefit most from them. Different approaches to legal learning, including blended learning, problem-based learning, peer learning, and clinical legal education are also considered.
12. Expanding Legal Skills— Mooting, Negotiation, and More
Authors: Moore Imogen , Newbery-Jones Craig
Published: September 2022

This chapter considers further activities and opportunities for the student to put their knowledge of law and their legal skills into practice, and further develop skills that are key to legal practice. This is important for legal careers but also in developing skills to enhance employability more generally. This chapter explores important legal skills-related extracurricular activities that are commonly available within the law programme or on an extracurricular basis, particularly mooting, negotiation, client interviewing, and debating, and the value of these activities in developing legal and general skills including analysis, critical thinking, professionalism, and teamwork.
6. Constitution of trusts
Authors: Barr Warren , Picton John
Published: September 2022

This chapter covers the constitution of trusts. A trust can be created in two ways: by the owner of property becoming a trustee himself or herself or by transferring property to someone else, and, at the same time, imposing a trust on them. In the first instance, a trust will be created if the person who holds the legal title to property free of any existing trust effectively declares themselves trustee of it in favour of specified beneficiaries. On the other hand, if the legal owner of property, the settlor, wishes to subject it to a trust in favour of beneficiaries, but does not wish to serve as trustee themselves, they can create a trust by transferring the property to someone else. In such circumstances, the original owner ceases to have any interest in the property, and the transferee of the property receives it as trustee subject to the trust obligations.
25. Fixed trusts
Authors: Barr Warren , Picton John
Published: September 2022

This chapter looks in detail at the fixed trust. In a fixed trust, the interests of the beneficiaries have already been defined by the settlor. The trustee must carry out those terms and distribute the fund as has been specified. There are six uses of fixed trusts: bare trusts, nominee trusts, custodian trusts, non-trustee custodians, concurrent interests, and consecutive interests. The chapter also discusses the beneficial entitlement to defined interests, as well as the certainty of objects. It then shows how a fixed trust will continue for so long as the trustees hold the trust assets for the beneficiaries. Furthermore, it is possible for the principal or beneficiary under a bare or fixed trust to deal with his equitable interest without terminating the trust.
30. Management and delegation
Authors: Barr Warren , Picton John
Published: September 2022

This chapter explores trustees’ management powers. The management powers of trustees are concerned with looking after property or funds. They do not allow the trustees to choose who benefits. In addition, the powers of management conferred upon a trustee are not the same in every case. Quite obviously, the powers of express trustees are likely to differ significantly from those of constructive trustees upon whom a trust has been imposed because of their improper conduct. In the latter case, the question of the trustees’ powers rarely arises. They are wrongdoers, who are, by definition, acting in breach of duty. How far they are authorized to act is, therefore, unlikely to be an issue.
32. Appointing and changing trustees
Authors: Barr Warren , Picton John
Published: September 2022

This chapter discusses the role of trustees, which is central to the operation of trusts. In most cases, trustees have extensive powers conferred upon them by the trust instrument or by the general law. The way in which they exercise those powers can have a huge impact upon whether or not the objectives of the trust are achieved, and upon the beneficiaries. Choosing the right trustees is, therefore, essential. This chapter thus looks at how the original trustees are appointed and what steps can be taken should the trustees need to be changed through resignation or retirement, or because the settlor or the beneficiaries are no longer content that a trustee should continue in office.
35. Fiduciary duties of trustees and other fiduciaries
Authors: Barr Warren , Picton John
Published: September 2022

This chapter looks at the duty of the trustee to show loyalty to their beneficiaries. The duty of loyalty is owed by most trustees, but a similar duty is also imposed upon others who hold certain positions of trust and confidence, such as agents and company directors. The duty requires the fiduciary to put the interests of the principal above their own, not to put themselves in a position of a potential conflict, nor to receive any secret payment, profit, or commission. There is a degree of circularity in identifying when fiduciary duties are owed. A fiduciary is a person who owes fiduciary duties to another, but whether they can be characterized as a fiduciary depends upon whether they owe fiduciary duties. The essence of fiduciary duties is that they are duties of loyalty.
9. Flexible terms
Authors: Arvind TT
Published: September 2022

This chapter considers how parties try to build flexibility into their contracts, along with the legal hurdles they face. A contract, or contractual clause, is vague if the words the parties have chosen give no real way of deciding what the parties are required to do and whether they have done it. A contract is incomplete if it fails to deal with a matter which is so fundamental that the transaction cannot be performed without agreement being reached on it. The effect of vagueness and incompleteness is to render the clause or contract void in law. Vagueness and incompleteness are often said to be closely related to the requirement of certainty in contracting, which crops up in a number of different areas of contract law. This chapter first discusses certainty and the complex transaction, along with vagueness and open-ended clauses, before turning to incompleteness and agreements to agree.
14. Protecting the public interest
Authors: Arvind TT
Published: September 2022

This chapter examines how English law deals with contracts against the public interest under the doctrine of illegality. The doctrine of illegality reflects a broader principle that applies across private law, that legal actions cannot be founded on illegal acts. In contract law, its implication is that contracts contrary to law or public policy are void. The chapter first considers the problem of illegal behaviour in contracting before discussing the rule-based approach to illegality and its limits. It then reviews the Supreme Court decision in Patel v Mirza and how it gave rise to the ‘range of factors’ approach to illegality. It also looks at criteria that make a contract illegal, including cases where the illegality consisted of criminal and civil wrongs. The chapter concludes with an overview of other types of illegality, such as the ‘injurious to good government’ ground and restraint of trade.
1. Introduction to the Types of Property Rights in Land
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter provides an introduction to the basic concepts of land law. The discussions cover real property and personal property; property rights which give immediate use and enjoyment of land (fee simple estate and leases); property rights against land owned by other people (mortgages, restrictive covenants, easements, profits à prendre, rentcharges, rights of occupation, interest under a resulting or constructive trust, proprietary estoppel, estate contracts, options, and the trust); and proof of title to land (importance of proof of title, methods of proving that a vendor has good title, unregistered title and registered title).
7. Trusts of Land
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses the three types of trust under the old law which operated prior to the commencement of the Trusts of Land and Appointment of Trustees Act 1996 (TOLATA 1996). It also presents criticism of the old law governing bare trusts of land; criticisms of strict settlements and the Settled Land Act 1925; criticisms of the trust for sale; the definition of a trust of land; the need for two trustees for a trust of land; appointment, retirement, and removal of trustees; method of appointment of trustees; unanimity of trustees; the powers of disposition of trustees of land; duties on exercising their powers; exclusion and restriction on trustees of land powers of disposition; and delegation of trustees; powers to beneficiaries.
8. Co-Ownership of Land—the Basic Principles
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses the basic principles of land co-ownership. It covers the two forms of co-ownership: joint tenancy and tenancy in common; the reform of co-ownership in 1925; joint tenancies in the early twentieth century; the current conveyancing practice to create an express trust; rules when there is no express declaration of a trust; resulting and constructive trusts; quantifying the beneficial interest under a constructive trust; severance of joint tenancies; and methods of severance.
11. Leases—the Basic Requirements
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses the basic principles of the law of leases, or ‘landlord and tenant’ law, as it is sometimes called. It covers the essential requirements for a lease; duration of leases and certainty of term; some concepts related to the law of leases; the distinction between leases and licences; how exclusive possession is defined; shared and multiple occupation cases; ‘sham’ tenancies and pretence clauses designed to negate exclusive possession; and formalities for the creation of leases.
14. Termination of Leases
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses the ways in which leases may terminate (natural expiry, giving of notice, merger, surrender, frustration, repudiatory breach by the landlord accepted by the tenant, and forfeiture); forfeiture of leases; modes of forfeiture; forfeiture of a dwelling house; waiver of forfeiture; relief from forfeiture for breaches for non-payment of rent; relief from forfeiture for a breach of covenant other than rent; forfeiture by court proceedings under s146 LPA 1925; remediable or irremediable breaches; relief to subtenants; and the Leasehold Property (Repairs) Act 1938.
19. Prescription for Easements (and Profits)
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses rules common to all three forms of prescription; user ‘as of right’ (without force, without secrecy and without permission), presumed acquiescence, user must be continuous, user must be by or on behalf of a fee simple against a fee simple, and user must be against a servient owner capable of granting an easement; prescription at common law; prescription by lost modern grant; prescription under the Prescription Act 1832; prescriptive easements and profits as legal interests; and extinguishment of easements.
24. The Operation of Mortgages
Authors: Bogusz Barbara , Sexton Roger
Published: September 2022

Titles in the Complete series combine extracts from a wide range of primary materials with clear explanatory text to provide readers with a complete introductory resource. This chapter discusses the rights of the mortgagor (rules protecting the equitable right to redeem, ‘clogs’ and ‘fetters’, postponement of redemption, collateral advantages, restraint on trade); statutory regulation of mortgages; leasing of the mortgaged property; undue influence, where a third party pressurizes the mortgagor into cooperating in the granting of a mortgage so that the third party can get a loan from a lending organization; redemption of mortgages; and fire insurance of the mortgaged property.
2. Tenure and Estates
Authors: George Martin , Layard Antonia
Published: September 2022

The doctrine of estates appears to be a logical consequence of tenure. The theory underpinning Land Law in England is that all land belongs to the Crown and that people held the land from the Crown, originally, in return for the performance of services. In this case, the tenants did not actually own the land itself, but only held an interest, or estate, in the land. Certain incidents of ownership can be divided between different people at different times, a process facilitated by the doctrine of estates. This chapter focuses on the doctrines of tenure and estates. It discusses freehold estates, which include the fee simple, the life estate, and the fee tail, as well as the co-existence of estates, ownership and possession of land, and leasehold estates.
13. Proprietary Estoppel
Authors: George Martin , Layard Antonia
Published: September 2022

Estoppel is seen as having two main forms. In the law of contract, it is seen principally as having a defensive function, operating to modify the doctrine of consideration to prevent one party to a contract from fully enforcing his contractual rights against the other. This form of the doctrine, termed promissory estoppel, is seen traditionally as being defensive in nature: it is a shield and not a sword. In land law, by contrast, it has long been accepted that estoppel can operate directly to found a cause of action. When operating in this way, the doctrine is referred to as proprietary estoppel. This chapter discusses how a claim in proprietary estoppel is established, where a claimant relies upon an assurance to their detriment in unconscionable circumstances, as well as how a court decides how to satisfy the equity that arises in a successful claim—the question of remedy.
A Pilot Trial of Thymalfasin (Thymosin-α-1) to Treat Hospitalized Patients With Hypoxemia and Lymphocytopenia Due to Coronavirus Disease 2019 Infection
Authors: Shehadeh Fadi , Benitez Gregorio , Mylona Evangelia K , Tran Quynh-Lam , Tsikala-Vafea Maria , Atalla Eleftheria , Kaczynski Matthew , Mylonakis Eleftherios
Published: September 2022

Background

Thymosin-α-1 (Tα1) may be a treatment option for coronavirus disease 2019 (COVID-19), but efficacy and safety data remain limited.

Methods

Prospective, open-label, randomized trial assessing preliminary efficacy and safety of thymalfasin (synthetic form of Tα1), compared with the standard of care, among hospitalized patients with hypoxemia and lymphocytopenia due to COVID-19.

Results

A total of 49 patients were included in this analysis. Compared with control patients, the incidence of clinical recovery was higher for treated patients with either baseline low-flow oxygen (subdistribution hazard ratio, 1.48 [95% confidence interval, .68–3.25]) or baseline high-flow oxygen (1.28 [.35–4.63]), although neither difference was significant. Among patients with baseline low-flow oxygen, treated patients, compared with control patients, had an average difference of 3.84 times more CD4+ T cells on day 5 than on day 1 (P = .01). Nine serious adverse events among treated patients were deemed not related to Tα1.

Conclusions

Tα1 increases CD4+ T-cell count among patients with baseline low-flow oxygen support faster than the standard of care and may have a role in the management of hospitalized patients with hypoxemia and lymphocytopenia due to COVID-19.

Clinical Trials Registration

NCT04487444.
Analysis of Mitragynine and Speciociliatine in Umbilical Cord by LC–MS-MS for Detecting Prenatal Exposure to Kratom
Authors: Hughs Melissa , Kish-Trier Erik , O’Brien Aidin , McMillin Gwendolyn A
Published: September 2022

Kratom is an herbal drug that is legal in the USA. While it is marketed as a safer alternative to opioids, it can cause opioid-like withdrawal symptoms when discontinued after regular use. Several case studies have shown that kratom exposure in utero can lead to symptoms in newborns consistent with neonatal abstinence syndrome. Here, we present a validated method for the detection of kratom in umbilical cord by liquid chromatography--tandem mass spectrometry. The umbilical cord is homogenized in solvent and kratom analytes are purified by solid phase extraction (strong cation exchange). Diastereomeric kratom alkaloids mitragynine (MG), speciociliatine (SC), speciogynine and mitraciliatine are separated by reverse phase chromatography on a phenyl-hexyl column. Applying this method to residual umbilical cords submitted to our laboratory for drug testing, 29 positive specimens exhibiting varied kratom analyte distributions were observed. MG and SC were the most abundant kratom analytes and were selected as biomarkers of kratom exposure. A cutoff concentration of 0.08 ng/g was established for both MG and SC.
Notes on the Geographical Distribution and Host Preferences in the Order Siphonaptera: Part 5. Ancistropsyllidae, Chimaeropsyllidae, Ischnopsyllidae, Leptopsyllidae and Macropsyllidae
Authors: Lewis Robert E.
Published: September 2022

All the presently known species of the siphonapteran families Ancistropsyllidae, Chimaeropsyllidae, Ischnopsyllidae, Leptopsyllidae and Macropsyllidae are listed and their principal hosts and geographic distribution are discussed. Author and date of description are included for each taxon.
Variation in Life Table Characteristics among three Geographic Strains of Culex Pipiens Quinquefasciatus
Authors: Walter Nancy M. , Hacker Carl S.
Published: September 2022

Life tables were generated for 3 geographic strains of Culex pipiens quinquefasciatus. Significant differences could be demonstrated among these strains for mean life expectancy of males and females, net reproductive rate and intrinsic rate of increase. Survivorship functions were similar for all 3 strains and resembled those of other mosquitoes, man and drosophilids. The numaer of eggs/raft decreased as female mosquitoes aged, and the mean number of eggs/raft did not differ significantly among the strains.
Description of the Larva, Pupa and Egg of Anopheles (Lophopodomyia) Squamifemur Antunes with Notes on Development (Diptera: Gulicidae)
Authors: Boreham Melvin M. , Baerg David C.
Published: September 2022

Females of Anopheles squamifemur were collected by horse-baited trap in the Panama Canal Zone, and oviposition obtained. The larva, pupa and egg are described and illustrated for the first time, and the male genitalia are refigured from associated specimens. Taxonomic comparisons are made with other species of the subgenus Lophopodomyia. Data are presented on the bionomics of A. squamifemur, with observations on the laboratory development of the immature stages.
Musca Hervei Villeneuve, 1922 as an Intermediate Host of Eyeworms (Thelazia) in Japan
Authors: Shinonaga S. , Miyamoto K. , Kano R. , Maeda S.
Published: September 2022

An investigation of the relation between flies and thelaziar parasites was made in Chiba city, Japan. The number of flies infesting cattle and emerging from cattle dung, the natural infection late of Thelazia spp. in Musca herrei and the number of these worms infesting the eyes of cattle were investigated monthly from January 1972 to May 1973. The number of flies infesting cattle was maximum in September, and thereafter decreased together with decreasing temperature. The natural infection rate in M. hervei and the number of parasites in the eyes of cattle reached a maximum in October, presumably a consequence of the September peak in fly numbers. Both sexes of M. hervei were ible to transmit thelazian parasites, but the natural infection rate was higher in females than in males, probably because the former have a greater preference for the cow body. Infected flies were found from April to November, and thelazian adults in the eyes of cows were obtained throughout the year excep. March. On the other hand, the larvae were obtained from June to November in 1972 and in May 1973. These observations indicate that transmission to the eyes of cattle begins in May and continues until November when most of the flies disappear. Flies newly infected with thelazian larvae appear again in etrly spring of the next year, front the end of March to the beginning of April.
Orientation and Developmental Inhibition in the Housefly by Certain Terpenoids
Authors: Sharma R. N. , Saxena K. N.
Published: September 2022

Several terpenoids were tested on the eggs, larvae and adults of the housefly, Musca domestica L., for effects on their orientation and development. Eugenol and farnesol attracted the flies and inhibited their embryonic/larval development. In certain doses, l-imonene, citronellol and carvone attracted the flies but did not inhibit their development. The remaining terpenoids inhibited the development of the flics in different doses but repelled them to varying degrees. The possibility jf housefly control by compounds with acceptable odors and having both the properties of attracting flies as well as inhibiting their development is discussed.
Clash of Titans: A MUSE dynamical study of the extreme cluster merger SPT-CL J0307-6225
Authors: Hernández-Lang D , Zenteno A , Diaz-Ocampo A , Cuevas H , Clancy J , Prado P H , Aldás F , Pallero D , Monteiro-Oliveira R , Gómez F A , Ramirez Amelia , Wynter J , Carrasco E R , Hau G K T , Stalder B , McDonald M , Bayliss M , Floyd B , Garmire G , Katzenberger A , Kim K J , Klein M , Mahler G , Nilo Castellon J L , Saro A , Somboonpanyakul T
Published: September 2022

We present MUSE spectroscopy, Megacam imaging, and Chandra X-ray emission for SPT-CL J0307-6225, a $z = 0.58$ major merging galaxy cluster with a large BCG-SZ centroid separation and a highly disturbed X-ray morphology. The galaxy density distribution shows two main overdensities with separations of 0.144 and 0.017 arcmin to their respective BCGs. We characterize the central regions of the two colliding structures, namely 0307-6225N and 0307-6225S, finding velocity derived masses of M200, N = 2.44 ± 1.41 × 1014M⊙ and M200, S = 3.16 ± 1.88 × 1014M⊙, with a line-of-sight velocity difference of |Δv| = 342 km s−1. The total dynamically derived mass is consistent with the SZ derived mass of 7.63 h$_{70}^{-1}$ ± 1.36 × 1014M⊙. We model the merger using the Monte Carlo Merger Analysis Code, estimating a merging angle of 36$^{+14}_{-12}$ ° with respect to the plane of the sky. Comparing with simulations of a merging system with a mass ratio of 1:3, we find that the best scenario is that of an ongoing merger that began 0.96$^{+0.31}_{-0.18}$ Gyr ago. We also characterize the galaxy population using Hδ and [O ii] λ3727 Å lines. We find that most of the emission-line galaxies belong to 0307-6225S, close to the X-ray peak position with a third of them corresponding to red-cluster sequence galaxies, and the rest to blue galaxies with velocities consistent with recent periods of accretion. Moreover, we suggest that 0307-6225S suffered a previous merger, evidenced through the two equally bright BCGs at the centre with a velocity difference of ∼674 km s−1.
Quoting Popular Songs
Authors: Baumgartner Michael
Published: September 2022

This chapter focuses on the numerous popular songs as musical quotations that are integrated into Godard’s films and video productions in a self-reflexive manner. In Une femme est une femme, the female protagonist and her male friend listen in a bar to Charles Aznavour’s “Tu t’laisses aller,” which appears—as a rarity in Godard’s films—in its entirety. Godard’s shift from the performance aspect in musical comedies to the focus on listening is intended as a self-conscious strategy. Godard conveys with Aznavour’s song that listening is as important an activity as performing songs in musical films. A second self-reflexive treatment of songs denounces the striving for impeccable and stunning song performances of Hollywood’s studio era. Godard introduces intentional imperfections into the song renderings in his films. A lackluster vocal performance, inferior recording quality, and a rough editing style, as markers of self-reflexivity, are noticeable in Anna Karina’s rendering of Jean Ferrat’s “J’entends, j’entends” in Bande à part. A final investigation explores Riccardo Cocciante’s “La nostra lingua italiana,” which concludes Chapter 3A of Godard’s Histoire(s) du cinéma. Cocciante’s song is metafilm music for three reasons: (1) Its musical style as a popular, somewhat sentimental ballad resists in aesthetical terms the intention of Godard’s metacinematic approach to film history. (2) The song’s integration into Histoire(s) du cinéma represents the only musical quotation in its complete form in the entire essayistic series. (3) The canzone is actively involved, in close conjunction with the other filmic devices, in exploring cinema’s theory, aesthetics, history, and practice, in particular the impact of neorealism on the history of cinema.
Referencing Silent-Film Music
Authors: Baumgartner Michael
Published: September 2022

This is the first of three chapters exploring a subcategory of musical quotation as metafilm music: the musical referencing of a style, genre, or specific filmic mode. Godard expresses in Pierrot le fou, Passion, and Histoire(s) du cinéma a career-long interest in silent-film music that assumes in the context of sound film the role of metafilm music. In other words, Godard investigates with sound-film music the dramaturgical function of silent-film music. He applies a self-reflexive, silent-film music approach with only Antoine Duhamel’s music on the soundtrack to two sequences in Pierrot le fou, in which he investigates the interplay between music and montage. A longer sequence in Passion features Antonín Dvořák’s Piano Concerto, which not only connects various spaces but also reinforces the characters’ exaggerated gestures as a self-reflexive device. Dvořák’s concerto self-consciously refers to the essential function of music in silent cinema: as a tool for sonically shaping the film’s dramaturgical trajectory, visually backed up by the corresponding choreography of the actors. Finally, in Chapter 4B of Histoire(s) du cinéma, Arvo Pärt’s orchestral Festina lente is used as a vehicle for a biting criticism of cinema’s duplicitous accomplishments. Together with the institution of cinema, the music assumes the role of an accessory disseminating rumors and peddling stories to its innocent viewers. The music is here metafilm music, because the topic is silent cinema, with music playing an essential part in reflecting on cinema’s and its own ontology.
Credit Building or Credit Crumbling? A Credit Builder Loan’s Effects on Consumer Behavior and Market Efficiency in the United States
Authors: Burke Jeremy , Jamison Julian , Karlan Dean , Mihaly Kata , Zinman Jonathan
Published: September 2022

A randomized encouragement design yields null average effects of a credit builder loan (CBL) on consumer credit scores. But machine learning algorithms indicate the nulls are due to stark, offsetting treatment effects depending on baseline installment credit activity. Delinquency on preexisting loan obligations drives the negative effects, suggesting that adding a CBL overextends some consumers and generates negative externalities on other lenders. More favorably for the market, CBL take-up generates positive selection on score improvements. Simple changes to CBL practice, particularly to provider screening and credit bureau reporting, could ameliorate the negative effects for consumers and the market.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
CRISPRthripsis: The Risk of CRISPR/Cas9-induced Chromothripsis in Gene Therapy
Authors: Amendola Mario , Brusson Mégane , Miccio Annarita
Published: September 2022

The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 nuclease system has allowed the generation of disease models and the development of therapeutic approaches for many genetic and non-genetic disorders. However, the generation of large genomic rearrangements has raised safety concerns for the clinical application of CRISPR/Cas9 nuclease approaches. Among these events, the formation of micronuclei and chromosome bridges due to chromosomal truncations can lead to massive genomic rearrangements localized to one or few chromosomes. This phenomenon, known as chromothripsis, was originally described in cancer cells, where it is believed to be caused by defective chromosome segregation during mitosis or DNA double-strand breaks. Here, we will discuss the factors influencing CRISPR/Cas9-induced chromothripsis, hereafter termed CRISPRthripsis, and its outcomes, the tools to characterize these events and strategies to minimize them.
Intraocular foreign body during cataract surgery
Authors: Thompson Alexander , Osher Robert H. , Werner Liliana , Park Sally , Wilkinson Samuel
Published: September 2022

Introduction:

A large foreign body entered the anterior chamber through the infusion tubing during phacoemulsification.

Patient and Clinical Findings:

A 70-year-old woman presented for routine cataract extraction with implantation of a posterior chamber intraocular lens. During the phacoemulsification, a white fleck was captured on video entering the eye through the infusion tubing.

Diagnosis, Intervention, and Outcomes:

The fleck was removed immediately with a forceps through the main incision, and the surgery was completed. The fragment was preserved and sent for analysis. Scanning electron microscopy and energy-dispersive x-ray spectroscopy were used to determine its composition.

Conclusions:

The origin of the fragment was consistent with the spike used to pierce the bag containing the balanced salt solution.
Work–Family Conflict, Organizational Identification, and Professional Identification Among Chinese Nurses From a Resource Perspective
Authors: YANG Chunjiang , CHEN Aobo , SHENG Nan
Published: September 2022

Background

The miserable work conditions faced by many nurses around the world make them particularly prone to work–family conflict.

Purpose

This study was designed to explain from a resource perspective how and when nurses experiencing work–family conflict are more likely to exhibit decreased levels of organizational identification and professional identification.

Methods

A time-separation research design was used, and data were collected from 322 nurses in five hospitals in China. All of the hypotheses were tested using conduct structural equation modeling.

Results

The results showed that work–family conflict had negative effects on organizational identification and professional identification via emotional exhaustion. In addition, job meaningfulness may have a buffering effect on the negative impact of work–family conflict on emotional exhaustion, organizational identification, and professional identification.

Conclusions/Implications for Practice

The results advance knowledge on how and when work–family conflict damages organizational identification and professional identification. Providing family support, relieving emotional exhaustion, and enhancing job meaningfulness are necessary to support the organizational and professional identification of nurses.
Educating Nurses During a Pandemic to Manage Mechanically Ventilated Patients
Authors: Kramer Margaret , Fultz Julia , Smoot Brittany , Sutherland Shanda , Wells Nicole , Monroe Martha , Davies Claire C.
Published: September 2022

Providing care for critically ill patients diagnosed with COVID-19 presented a number of challenges. Initially, few treatment strategies were available; however, evidence of pulmonary complications led to patients’ need for ventilators. This article describes the rapid development and implementation of a mechanical ventilation cross-training program for acute care nurses.
Impact of Individual Components of Emergency Department Pediatric Readiness on Pediatric Mortality in US Trauma Centers
Authors: Remick Katherine , Smith McKenna , Newgard Craig D. , Lin Amber , Hewes Hilary , Jensen Aaron R , Glass Nina , Ford Rachel , Ames Stefanie , GCPH Jenny Cook , Malveau Susan , Dai Mengtao , Auerbach Marc , Jenkins Peter , Gausche-Hill Marianne , Fallat Mary , Kuppermann Nathan , Mann N Clay
Published: September 2022

Background

Injured children initially treated at trauma centers with high emergency department (ED) pediatric readiness have improved survival. Centers with limited resources may not be able to address all pediatric readiness deficiencies and there currently is no evidence-based guidance for prioritizing different components of readiness. The objective of this study was to identify individual components of ED pediatric readiness associated with better-than-expected survival in US trauma centers to aid in the allocation of resources targeted at improving pediatric readiness.

Methods

This cohort study of U.S. trauma centers used the National Trauma Data Bank (2012-2017) matched to the 2013 National Pediatric Readiness Project assessment. Adult and pediatric centers treating at least 50 injured children (age < 18 years) and recording at least one death during the 6-year study period were included. Using a standardized risk-adjustment model for trauma, we calculated the observed-to-expected (O/E) mortality ratio for each trauma center. We used bivariate analyses and multivariable linear regression to assess for associations between individual components of ED pediatric readiness and better-than-expected survival.

Results

Among 555 trauma centers, the O/E mortality ratios ranged from 0.07 to 4.17 (IQR 0.93, 1.14). Unadjusted analyses of 23 components of ED pediatric readiness showed that trauma centers with better-than-expected survival were more likely to have a validated pediatric triage tool, comprehensive quality improvement processes, a pediatric-specific disaster plan, and critical airway and resuscitation equipment (all p < 0.03). The multivariable analysis demonstrated that trauma centers with both a physician and a nurse pediatric emergency care coordinator had better-than-expected survival, but this association weakened after accounting for trauma center level. Child maltreatment policies were associated with lower-than-expected survival, particularly in Level III-V trauma centers.

Conclusion

Specific components of ED pediatric readiness were associated with pediatric survival among US trauma centers.

Level of Evidence

Care management, level III.
Finite Element Analysis for Better Evaluation of Rib Fractures: A Pilot Study
Authors: Bauman Zachary M. , Herrmann Sven , Kött Thomas , Binkley Jana , Evans Charity H. , Kamien Andrew , Cemaj Samuel , Berning Bennett , Cantrell Emily
Published: September 2022

Introduction

Modeling rib fracture stability is challenging. Computer generated finite element analysis(FEA) is an option for assessment of chest wall stability(CWS). The objective is to explore FEA as a means to assess CWS, hypothesizing it is a reliable approach to better understand rib fracture pathophysiology.

Methods

Thoracic anatomy was generated from standardized skeletal models with internal/external organs, soft tissue and muscles using DICOM data. Material properties were assigned to bone, cartilage, skin and viscera. Simulation was performed using ANSYS Workbench. Meshing the model was completed identifying 1.3 and 2.1 million elements and nodes. An implicit solver was used for a linear/static finite element analysis with all bony contacts identified and applied. All material behavior was modeled as isotropic/linear elastic.

6 load cases were evaluated from a musculoskeletal AnyBody model; forward flexion, right/left lateral bending, right/left axial rotation and 5 kg weight arm lifting. Standard application points, directions of muscle forces, and joint positions were applied.

10 fracture cases (unilateral and bilateral) were defined and 66 model variations were simulated. 43 points were applied to each rib in the mid-/anterior axillary lines to assess thoracic stability. Three assessment criteria were used to quantify thoracic motion: normalized mean absolute error(NMAE), normalized root mean square error(NRMSE), and normalized interfragmentary motion(NIFM).

Results

All three analyses demonstrated similar findings that rib fracture deformation and loss of CWS was highest for left/right axial rotation. Increased number of ribs fracture demonstrated more fracture deformation and more loss of CWS compared to a flail chest segment involving less ribs. A single rib fracture is associated with ~3% loss of CWS. NIFM deformation can increases by 230%. CWS can decrease by over 50% depending on fracture patterns.

Conclusion

FEA is a promising technology for analyzing CWS. Future studies need to focus on clinical relevance and application of this technology.

Level of Evidence

IV
Gametocyte production in incident P. falciparum infections: a longitudinal study in a low transmission setting under intensive vector control
Authors: Andolina Chiara , Ramjith Jordache , Rek John , Lanke Kjerstin , Okoth Joseph , Grignard Lynn , Arinaitwe Emmanuel , Briggs Jessica , Bailey Jeffrey , Aydemir Ozkan , Kamya Moses R , Greenhouse Bryan , Dorsey Grant , Staedke Sarah G , Drakeley Chris , Jonker Marianne , Bousema Teun
Published: September 2022

Malaria transmission depends on the presence of Plasmodium gametocytes that are the only parasite life stage that can infect mosquitoes. Gametocyte production varies between infections and over the course of infections. Infection duration is influenced by host and parasite characteristics, and is highly important for gametocyte production but poorly quantified. Between 2017-2019 an all-age cohort from Tororo, eastern Uganda was followed by continuous passive and routine assessments. Among 104 longitudinally monitored incident infections coming from 98 individuals, we observed that nearly all infections lasting 3 or more months initiated gametocyte production prior to clearance. However, the majority of infections were of shorter duration (<28 days) and were cleared before gametocytes were detectable. Infections in individuals with sickle-cell trait were more likely to produce gametocytes and produced gametocytes at higher densities. Our findings suggest that a large proportion of infections may be too short in duration and of too low density to contribute to onward transmission.
Fetal QRS Detection by Multiple Channel Temporal Pattern Search Applied to the NInFEA Database
Authors: Hopenfeld Bruce
Published: September 2022

Background

In some cases, the fetal electrocardiogram (ECG) has a relatively low signal to noise ratio. Much of the literature pertaining to fetal ECG processing focuses on methods for separating the fetal ECG from the maternal ECG rather than detecting the fetal QRS in high noise conditions. This paper describes the application of a previously described pattern search methodology (TEPS) for detecting the fetal QRS in noisy ECGs.

Algorithm Summary

Signals are processed in non-overlapping 5 s segments. The maternal QRS peaks are detected in a segment from a reliable lead. Next, for each of a potentially large number of leads, after removing the maternal QRS peaks from the set of searchable peaks, single channel TEPS is applied to search for provisional fetal peak sequences. The provisional sequences are scored according to previously described single channel TEPS quality measures: temporal regularity, peak pair amplitude ratios, and number of skips. The provisional sequences across all leads are aggregated according to their average RR intervals and scores. The most likely average RR interval for the segment is estimated from this aggregation by forming a score weighted average of the RR intervals. Sequences with RR intervals close to the chosen RR interval are selected to form a set of high quality sequences. To account for the possibility of peak time offsets between different channels, these sequences are time aligned by time lagged cross correlation. An optimal sequence is formed from these time aligned sequences, with optimality criteria based on peak timing coherence, temporal regularity, and skips.

Data

The above procedure was applied to 60 ECG signals (avg. duration approximately 31 s) from the Non-Invasive Multimodal Foetal ECG-Doppler Dataset for Antenatal Cardiology Research (“NInFEA”). The NInFEA dataset also includes ultrasound recordings from which RR intervals may be extracted.

Results

Out of 59 records, RR intervals were well tracked in 57 records. (One of the 60 NInFEA records was excluded due to the inability to obtain a sinus rhythm peak sequence from the ultrasound recording). For these 57 records, 84% and 95% of the ECG RR intervals were within 5 ms and 10 ms, respectively, of the ultrasound derived RR intervals. The mean and median average absolute value RR interval difference (between ECG and ultrasound) over 5 second segments were 3.2 ms and 2.4 ms respectively, with 93% of segments having a mean average absolute value RR interval difference less than 7ms.

Conclusion

The TEPS methodology shows promise for ECG based fetal sinus rhythm monitoring.
Neuroimaging profiling identifies distinct brain maturational subtypes of youth with mood and anxiety disorders
Authors: Ge R , Sassi R , Yatham LN , Frangou S
Published: September 2022

Mood and anxiety disorders typically begin in adolescence and have overlapping clinical features but marked inter-individual variation in clinical presentation. The use of multimodal neuroimaging data may offer novel insights into the underlying brain mechanisms. We applied Heterogeneity Through Discriminative Analysis (HYDRA) to measures of regional brain morphometry, neurite density, and intracortical myelination to identify subtypes of youth, aged 9-10 years, with mood and anxiety disorders (N=1931) compared to typically developing youth (N=2823). We identified three subtypes that were robust to permutation testing and sample composition. Subtype 1 evidenced a pattern of imbalanced cortical-subcortical maturation compared to the typically developing group, with subcortical regions lagging behind prefrontal cortical thinning and myelination and greater cortical surface expansion globally. Subtype 2 displayed a pattern of delayed cortical and subcortical maturation indicated by higher cortical thickness and subcortical volume and lower cortical surface area expansion and myelination compared to the typically developing group. Subtype 3 showed evidence of atypical brain maturation involving globally lower cortical thickness and surface coupled with higher myelination and neural density. Subtype 1 had superior cognitive function in contrast to the other two subtypes that underperformed compared to the typically developing group. Higher levels of parental psychopathology, family conflict, and social adversity were common to all subtypes, with subtype 3 having the highest burden of adverse exposures. These analyses comprehensively characterize pre-adolescent mood and anxiety disorders, the biopsychosocial context in which they arise, and lay the foundation for the examination of the longitudinal evolution of the subtypes identified as the study sample transitions through adolescence.
Effectiveness of the COVID-19 vaccines against severe disease with Omicron sub-lineages BA.4 and BA.5 in England
Authors: Kirsebom Freja C. M. , Andrews Nick , Stowe Julia , Ramsay Mary , Lopez Bernal Jamie
Published: September 2022

The Omicron sub-lineages BA.4 and BA.5 were first detected in England in April 2022. A case surge followed despite England having recently experienced waves with BA.1 and BA.2. This study used a whole population test-negative case-control study design to estimate the effectiveness of the vaccines currently in use as part of the UK COVID-19 vaccination programme against hospitalisation following infection with BA.4 and BA.5 as compared to BA.2 during a period of co-circulation. Incremental VE was estimated in those vaccinated with either a third or fourth dose as compared to individuals with waned immunity who had received their second dose at least 25 weeks prior. Vaccination status was included as an independent variable and effectiveness was defined as 1-odds of vaccination in cases/odds of vaccination in controls. During the study period, there were 32,845 eligible tests from hospitalised individuals. Of these, 25,862 were negative (controls), 3,432 were BA.2, 273 were BA.4, 947 were BA.5 and 2,331 were either BA.4 or BA.5 cases. There was no evidence of reduced VE against hospitalisation for BA.4 or BA.5 as compared to BA.2. The incremental VE was 56.8% (95% C.I.; 24.0-75.4%), 59.9% (95% C.I.; 45.6-70.5%) and 52.4% (95% C.I.; 43.2-60.1%) for BA.4, BA.5 and BA.2, respectively, at 2 to 14 weeks after a third or fourth dose. VE against hospitalisation with BA.4/5 or BA.2 was slightly higher for the mRNA-1273 booster than the BNT162b2 booster at all time-points investigated, but confidence intervals overlapped. These data provide reassuring evidence of the protection conferred by the current vaccines against severe disease with BA.4 and BA.5.