bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion and Implications
Authors: Cheon Andrew
Published: March 2023

The book’s analysis yields scholarly implications. First, rather than treating state capitalist countries as a monolith, examining their institutional variation reveals strengths and limitations of state ownership. Second, though multiple principals are typically associated with greater agent autonomy, a clear line of authority can help reduce counterproductive agent behavior. It also yields policy implications. First, state capitalism is compatible with democratic governance. Opposition parties without direct access to the NOC can help keep the chief executive more accountable. Second, the improvement of NOC operational efficiency may demand more fundamental bureaucratic reorganization, as counterproductive NOC behavior often reflects the institutional landscape in which it operates. The book concludes with an application of its theory to decarbonization. To achieve decarbonization that not only helps governments meet their political objectives, but also helps NOCs ensure their longer-term commercial viability via a managed transition to renewables, the role of bureaucratic institutions will be even more crucial.
Lapland in Transformation
Authors: Begum Shahnaj
Published: March 2023

Protecting and promoting culture in Lapland are important for sustaining the cultural well-being of the region’s older people. This population includes many Sámi, members of an Indigenous people living throughout northern Finland, Sweden, Norway, and Russia. The people have a distinctive culture and traditional way of life that have sprung from their natural surroundings and together form a unique cultural identity. Today, Lapland is in the midst of a sweeping transformation, sparked by climate change, increased mining activities, changes in sources of livelihood, the advance of digitalization, and shifts in demography. This chapter analyzes the impact of these developments on the cultural well-being of older people in the region, with a special focus on older Sámi. The study draws on interviews conducted by the author in Finnish and Swedish Lapland in 2011 and 2017. Complementing these observations are publications and media reports on Indigenous issues, as well as references to acts, conventions, policies, laws, and regulations related to the protection of Sámi culture. The challenges to traditional life in the region posed by the ongoing transformation threaten the culture and cultural identity of the individuals who call it home. The physical and mental well-being of older persons in Lapland is highly dependent on their culture and surroundings, the sustainability of which relies on the recently elaborated concept of the age-friendly environment. The results of this study will promote the well-being of aging Indigenous and other older people in Lapland.
Writing the Right
Authors: Drolet Jean-François , Williams Michael C.
Published: March 2023

Once considered an exhausted vestige of the past, the radical right has re-emerged in the early twenty-first century as one of the most striking and in many eyes most troubling challenges to the contemporary world order. Along with this re-emergence, sweeping historical and global narratives of anti-liberalism have been revived and reformulated within Western democracies and beyond. This chapter traces the historical lineages of this resurging strand of radical conservatism. While these movements are often seen as “knee-jerk” reactions to globalization, today’s radical right also has its own intellectual vanguard that mobilizes long-standing historical narratives and intellectual legacies to produce ideologically and emotionally powerful attacks on liberal institutions and rationalities of government. Only by taking these narratives seriously is it possible to come to terms with today’s radical right and develop compelling and effective responses to it.
Introduction
Authors: McDowell Daniel
Published: March 2023

The book’s central claim is that US financial sanctions generate political risk in the international currency system. Political risk is defined here as the potential for a political act to raise the expected costs of using a currency for cross-border transactions or as a store of value. Over time, the accumulation of political risk in the system creates incentives for governments to adopt anti-dollar policies to promote the use of currencies or assets other than the dollar for investment and cross-border transactions. Of course, anti-dollar policies may fail. Thus, on their own they do not imply that the dollar is playing a diminishing role in a country’s international economic relations. They merely indicate that the government is attempting to bring about such a shift. When sanctions-induced anti-dollar policies do successfully reduce reliance on the dollar, it signifies de-dollarization—the intentional reduction of the dollar’s role in a nation’s cross-border economic activities. The book explores this argument with a series of empirical chapters that examine the first two decades of the twenty-first century, a period in which the United States steadily increased its use of financial sanctions against foreign adversaries and pariah states.
The Source and Exercise of American Financial Power
Authors: McDowell Daniel
Published: March 2023

Chapter 2 explains how dollar dominance gives the United States the unrivaled capacity to cut off foreign actors from their dollar-based assets and from the global dollar-based financial system. It unpacks the mechanics of the correspondent banking system in which US financial institutions serve as intermediaries in most cross-border financial transactions. It then describes the critical role played by presidential Executive Orders and the US Treasury’s Office of Foreign Assets Control in overseeing and enforcing the US financial sanctions regime. Finally, the chapter presents original data documenting how the United States has used its financial sanctions capabilities with increasing frequency in the first two decades of the twenty-first century, targeting states with specific characteristics. These data are used to illustrate how political risk associated with the dollar varies across countries and over time: the risk of facing sanctions is not equally distributed.
Sanctions, Political Risk, and the Reserve Currency Role
Authors: McDowell Daniel
Published: March 2023

Chapter 3 examines the dollar’s position as the world’s leading store of value. This enables the United States to freeze foreign actors’ dollar-based assets, effectively cutting adversaries off from their financial wealth. Washington has employed such measures in concentrated efforts to pressure politically connected elites in target countries and as part of broad strategies to coerce or topple authoritarian regimes. The chapter then presents empirical case studies of Russian and Turkish reactions to US sanctions. Though the evidence is strongest in the Russian case, both countries responded with heightened anti-dollar rhetoric, suggesting that Washington’s actions generated political risk concerns in both countries. This rhetoric was accompanied by a suite of anti-dollar policies designed to reduce dependence on the currency. The aim was ostensibly to reduce both countries’ vulnerability to US financial pressure in the future.
Payment Politics
Authors: McDowell Daniel
Published: March 2023

Chapter 6 presents analyses indicating that US sanctions provoked anti-dollar policy responses and may have led to modest de-dollarization in cross-border payments. First, it considers whether central bank currency swap agreements correlate with US sanctions. Such swap agreements can facilitate cross-border trade settlement in non-dollar currencies. The evidence suggests that sanctions, though not the risk of sanctions, are related to the propensity to sign swap deals. Moving beyond anti-dollar policies to measures of de-dollarization, the chapter demonstrates that sanctioned countries, and those at greater risk of facing sanctions, rely less on the dollar for trade settlement—which suggests a link between sanctions and de-dollarization. The chapter concludes by exploring experimental data from a survey of over 1,000 multinational firms in Vietnam. The data illustrate that information about the growing use of US sanctions increases firm managers’ interest in learning about cross-border payments systems based on the euro or the renminbi.
Conclusion
Authors: McDowell Daniel
Published: March 2023

The conclusion considers how US policymakers should respond to the challenges identified in the preceding chapters. While the increased use of financial sanctions is unlikely to jeopardize the dollar’s status as the world’s pre-eminent global currency, targets are adapting to the tool. In time, these adjustments can weaken the effectiveness of US financial coercion, diminishing Washington’s capacity to achieve its aims during international crises. There are methods that can be used to achieve foreign policy objectives that do not politicize the dollar and provoke countervailing currency measures. Other tools that do not present the same risks to the future exercise of US power exist and can be used in place of financial coercion. Policymakers should adopt a more circumspect approach to financial sanctions with an eye toward preserving the efficacy of the tool for the moments where financial coercion really counts.
Twenty Key Elements of High-Participation Negotiations
Authors: McAlevey Jane F. , Lawlor Abby
Published: March 2023

This chapter enumerates the twenty key elements of high-participation negotiations. It covers the challenges of organizing a union. The key elements together are expected to turn routine activities into opportunities, build maximal power for the workers’ side, and see their fundamental source of strength as existing within the demonstrable and verifiable power of workers to move each other to action. High participation in negotiations typically influences everything as it often results in winning better contracts and developing a robust political mobilization structure. Moreover, a high-participation approach to negotiations translates to directly helping skeptical workers overcome their doubts about collective action and sharpening workers’ understanding of their employer.
A Punch in the Face (NJEA)
Authors: McAlevey Jane F. , Lawlor Abby
Published: March 2023

This chapter looks into New Jersey Governor and Republican presidential candidate Chris Christie targeting New Jersey Education Association (NJEA) members. Christie’s efforts to demolish the union by dismantling benefits for K-12 employees, slashing education funding, and expanding charter schools in a largely pro-union blue state boosted his reputation within the Republican Party. However, New Jersey teachers refused to let political grandstanding destroy the top-ranked public education system. The chapter explains that Jennifer Larsen and Alex DeVicaris approached open bargaining with the theory to revamp how associations functioned to become more open and member-driven. According to Marisa Walsh, the open bargaining approach ties people together as a community and lets them feel invested in the success of the educational community and contracts.
Deduction and Necessity
Authors: Alter Torin
Published: March 2023

Chapter 7 explicates the two main arguments that have been offered for the second step of the knowledge argument: the inference from the epistemic gap to a corresponding modal gap. The chapter briefly discusses the argument from the new fact thesis, on which learning old (previously known) truths in new ways implies learning new truths as well—new truths that are not necessitated by old ones. The chapter then discusses a second argument, from implausible modal implications of a posteriori physicalism. Specifically, a posteriori physicalism implies that there are a primitive a posteriori necessities—necessary truths that are not necessary in virtue of following a priori from a priori truths and non-modal truths about the actual world. Finally, the chapter discusses Chalmers’s two-dimensional version of the knowledge argument.
Consciousness and Fundamentality
Authors: Alter Torin
Published: March 2023

This chapter considers whether, if sound, the knowledge argument shows that there are brute facts about consciousness. Strawson and Goff each present arguments that would, if sound, vindicate that conditional claim. This chapter argues that they are mistaken. To establish brute facts about consciousness, it is not enough to show there is an ontological gap between the physical and the phenomenal. One would have to show that there is an ontological gap between the non-phenomenal and the phenomenal. Yet the knowledge argument works partly by exploiting specific features of the physical: features some non-phenomenal entities might lack. That possibility, the chapter argues, shows that the knowledge argument does not generalize in the way that establishing brute facts about consciousness would require.
Introduction
Authors: Desautels-Stein Justin
Published: March 2023

This chapter introduces the main themes of the book, including the sovereign’s right of exclusion in international law, the rise of the antidiscrimination principle, neoliberal colorblindness, pragmatism, and the consolidation of international law’s ideology of postracial xenophobia.
Modern Racial Ideology as Naturalizing Juridical Science
Authors: Desautels-Stein Justin
Published: March 2023

Chapter 4 introduces the first element of international law’s modern racial ideology, “legal functionalism.” The discussion begins with the critique of German legal science in the work of Rudolph von Jhering, and then moves into the work of the French jurist, Francois Geny. The chapter then examines the rise of functionalism in international legal thought, and how functionalism helped birth a modern racial ideology through the elaboration of a new logic of inclusion.
On the Inevitability of Racial Borders
Authors: Desautels-Stein Justin
Published: March 2023

Chapter 9 asks whether it remains valuable to analyze the sovereign’s right to exclude in the context of globalization. The chapter’s answer is “yes.” It is a commonplace criticism of globalization to say that global governance is undemocratic. The nature of the claim often turns on the assumption that for democracy to be effective, it must attach to a discrete people. The demand for democratic closure is a demand for borders that align with a shared culture, or common ethnos. The chapter examines how these typical characterizations of a bounded demos smuggle a conception of the racial xenos.
The Polish Legislation on Administrative Procedure
Authors: Piątek Wojciech
Published: March 2023

This chapter provides an overview of how administrative procedure developed in Poland between 1920 and 1970, with a focus on the influence exerted by the 1925 Austrian General Administrative Procedure Act. The analysis contains information about historic and legal circumstances in which new Polish legislation before and after the Second World War was passed, as well as specific procedural regulations devoted to discovery proceedings, the right to a hearing, a party’s duty to give reasons, and a system of legal remedies. The influence of both the Austrian General Administrative Procedural Act from 1925 and Austrian legal culture is taken into consideration. It is illustrated in two dimensions as a form of legal regulation and in the personal context of Polish lawyers, mainly judges, who were educated in the Austrian zone before the First World War (when Poland was under the occupation of Austria, Prussia, and Russia from 1795 to 1918), and influenced the Polish legal order with Austrian legal culture in various fields. One of those lawyers was the first president of the Polish Supreme Administrative Court (SAC), established in 1922, Jan Sawicki, whose biography is presented as an example of Austrian–Polish legal interactions. Nevertheless, the input of Polish academia, the practice of the administrative authorities, and the jurisprudence of the SAC, are not omitted. Those factors composed with the impact of the Soviet regime after the Second World War meant that the influence of the Austrian legislation on the administrative procedure in Poland was significant but not entirely overwhelming.
The Austrian Legislation on Administrative Procedure
Authors: Augsberg Ino
Published: March 2023

The chapter explains the reception of the Austrian Administrative Procedure Act (APA) in Germany. In doing so, it not only addresses the particularities of the German federal system. It also sheds light on the different reception of the Austrian ideas in the times of the Weimar Republic, under National Socialism and in the young Federal Republic. The background to the analysis is the relationship between Austrian and German law in general and legal scholarship in particular, which, despite numerous similarities, is also marked by striking differences. In this regard, the reception of the Austrian APA can serve as an exemplary illustration of this relationship.
The Spanish Model of Administrative Procedure (APA 1889/APA 1958)
Authors: Barnes Javier
Published: March 2023

This chapter deals with the Spanish model of general administrative procedure law, which began with the Act of 1889, was profoundly reformed 69 years later by the Act of 1958, and is still of notable influence in the Ibero-American world. This chapter outlines the features of this model, such as the legal concept of administrative procedure. This historical and comparative analysis of the Spanish model seeks to contribute to a better understanding of the autonomy of the different families and generations of administrative procedure, as well as the role of ‘codification’ in the field of administrative procedures, and how this is neither equivalent nor comparable to the process of civil codification. It also provides some lessons on comparative methods in the field of administrative procedure.
The Austrian AVG
Authors: Zumbini Angela Ferrari
Published: March 2023

This chapter presents an outline and reconstruction of the essential elements and characteristics of the Austrian procedural model followed by an in-depth examination of some comparative scenarios together with a number of reflections of an institutional nature aiming to resolve some apparent contradictions. The analysis shows that the roots of the Austrian Administrative Procedure Act of 1925 are embedded in the solid foundations of administrative case law from the imperial era. Indeed, the AVG simply transposed into positive law many aspects of the principles that emerged in the 50 years of activity of the Verwaltungsgerichtshof. However, it should not be forgotten that codification was primarily adopted in order to fulfil an international treaty and allow loans to Austria in order to restore its economic and financial situation—an external imposition for economic reasons. A genesis so contextualised also allows a complete understanding of the AVG’s structural and functional aspects. The objectives of uniformity, simplification, and efficiency contribute to creating a minimal and adaptable model that at the same time affords protection to the rights of the parties involved. Moreover, the fundamental and distinctive features of the Austrian procedural model thus reconstructed constitute a guideline for interpreting its paths of entry into other legal systems, both in terms of positive law and the history of ideas. These paths of entry showed precisely how the AVG of 1925 dominated the scene of administrative law and its dogmatics in Central Europe for at least 50 years.
Prologue
Authors: Lok Matthijs
Published: March 2023

In the prologue, the polarization of the European Past in the early twenty-first century is discussed. Proponents of the European Union usually promote a narrative of an inevitable successful, peaceful integration after centuries of internal conflict and war. Self-proclaimed ‘conservatives’, by contrast, view the recent history of Europe as one of decline and betrayal by its cosmopolitan liberal elites. Parallels, subsequently, are drawn between the polarization of the past in the twenty-first and twentieth century and in the age eighteenth-century revolutions. Just as after the world wars of the twentieth century, a broad spectrum of writers, academics, statesmen, and officials in the decades around 1800 turned to history to make sense of a confusing and troubling world.
An Unfinished History
Authors: Lok Matthijs
Published: March 2023

The second chapter (‘An Unfinished History’) describes the construction of a canon of ‘European historians’ in the eighteenth century, as well as an enlightened narrative of European history. The chapter, moreover, will demonstrate how this historical narrative and the notion of ‘modern Europe’ was adapted by the French revolutionary Nicolas Bonneville in 1789 for revolutionary purposes, showing the political malleability and politicization of enlightened historiography in the revolutionary decade. The chapter will point to the similarities between the interpretation of European history by revolutionaries and counter-revolutionaries alike, for instance related to the ideas of European freedom, pluralism, or moral and spiritual regeneration.
Equilibrium against Empire
Authors: Lok Matthijs
Published: March 2023

The fifth chapter (‘Equilibrium against Empire’) discusses the reinvention of eighteenth-century theories of the European balance by those opposed to the Napoleonic imperial system. German authors, in particular, articulated the idea of Europe as a pluralist continent, whose unique freedom was the result of centuries of political and cultural fragmentation and lack of centralization, and who presented the German Empire and the German Nation as the crucial building blocks of this system. I will mainly investigate the case of Adam Müller, ‘the German Montesquieu’, and his work ‘The Elements of Statecraft’ (1809). I frame Müller as an enlightened Christian cosmopolitan, but I will also point out the boundaries of his cosmopolitanism. In many ways the counter-revolutionary authors such as Müller and Friedrich (von) Gentz both rejected and adapted Kant’s plan for a ‘perpetual peace’.
The Pluralist Republic
Authors: Lok Matthijs
Published: March 2023

The sixth chapter (‘The Pluralist Republic’) follows the trajectory of Niklas Vogt, a Catholic historian and political advisor of the archbishop of Mainz, and teacher of Metternich. In developing his pluralist idea of the ‘European Republic’, Vogt drew on sources from different countries and languages, including, of course, German sources, exemplifying the transnational character of enlightened ideas of European diversity. Vogt’s idea of a pluralist European Republic, representative of late-Enlightenment reformist thought, was, moreover, subsequently used to defend the cause of the Counter-Revolution, the Napoleonic Empire and, more half-heartedly, the Vienna order, demonstrating the political elasticity of this concept.
Revivals of Historical Europeanism
Authors: Lok Matthijs
Published: March 2023

The ninth chapter (‘Revivals of Historical Europeanism’) begins with a discussion of counter-revolutionary views on empire. Then the chapter demonstrates that the perspective of historical Europeanism allows us to study the renewal and adaptation of political traditions beyond the traditional ideological dividing lines of nineteenth-century conservatism, liberalism, and socialism. This chapter argues that enlightened notions of historical Europeanism and cosmopolitanism survived in the age of romantic nationalism in unsuspected and surprising ways. Throughout the nineteenth and twentieth centuries, these ideas of European history and civilization were rediscovered and adapted to new political contexts. The watersheds of the ‘revolutions’ of 1830, 1848, 1871, 1918, and 1945 were important turning points in the remaking of the historical Europeanist tradition.
Boundary Work between Computational ‘Law’ and ‘Law-as-We-Know-it’
Authors: Hildebrandt Mireille
Published: March 2023

This chapter enquires into the use of big data analytics and prediction of judgment to inform both law and legal decision-making. The main argument is that the use of data-driven ‘legal technologies’ may transform the ‘mode of existence’ of law as-we-know-it, whose characteristics depend on its text-based nature. To explain why and how computational ‘law’ would be different, the author deciphers the mathematical assumptions of machine learning and natural language processing, opening the black box of algorithmic ‘insights’ at the level of its underlying research design. This allows her to compare the force of such computational ‘law’ with the force of law as-we-know-it. She then identifies some of the challenges as to legal protection, demonstrating the need for ‘by design’ approaches to anchor rule of law safeguards in the architecture of computational ‘law’, clarifying how and why ‘legal protection by design’ is not equivalent with ‘legal by design’ or ‘techno-regulation’.
Social Experimentation in an Unjust World
Authors: Barrett Jacob , Buchanan Allen
Published: March 2023

There is a resurgence of interest in social experimentation as a means of promoting social progress, including progress in justice. In this chapter, we first advance an argument in favor of social experimentation drawing on its capacity to resolve uncertainty both about how to achieve socially valuable goals and about which goals are worth pursuing. We then identify four challenges: the information problem (experiments may not yield relevant information), the selection bias problem (potentially informative experiments may not be undertaken), the uptake problem (the information generated by experiments may not be put to good use), and the risk problem (experiments may carry unacceptable risks). Finally, we argue that certain injustices can exacerbate all four problems, rendering social experimentation a less reliable path to progress, and, in cases of severe injustice, perhaps even a regressive force. The upshot is not that we should abandon social experimentation, but that we should temper our expectations and focus on constructing conditions under which experimentation is more likely to be progressive. Specifically, to render social experimentation a more reliable engine for social progress of any sort, we must remedy or mitigate the injustices that diminish its value.
A Taxonomy of Non-honesty in Public Health Communication
Authors: Brown Rebecca C H , de Barra Mícheál
Published: March 2023

This paper discusses the ethics of public health communication. We argue that a number of commonplace tools of public health communication risk qualifying as non-honest and question whether or not using such tools is ethically justified. First, we introduce the concept of honesty and suggest some reasons for thinking it is morally desirable. We then describe a number of common ways in which public health communication presents information about health-promoting interventions. These include the omission of information about the magnitude of benefits people can expect from health-promoting interventions, and failure to report uncertainty associated with the outcomes of interventions. Next we outline some forms of behaviour which are generally recognised by philosophers as being non-honest, including deception, manipulation, and so on. Finally, we suggest that many of the public health communicative practices identified earlier share features with the non-honest behaviours described and suggest this warrants reflection upon whether such non-honesty is justified by the goals of public health communication.
Copper-mediated chemodynamic therapy with ultra-low copper consumption by doping cupric ion on cross-linked (R)-(+)-lipoic acid nanoparticles
Authors: Cui Rong , Li Bing , Liao Chunyan , Zhang Shiyong
Published: March 2023

Cu-mediated chemodynamic therapy (CDT) has attracted prominent attention owing to its advantages of pH independence and high efficiency comparing to Fe-mediated CDT, while the application of Cu-based CDT agents was impeded due to the high copper consumption caused by the metabolism loss of copper and the resultant potential toxicity. Herein, we developed a new copper-mediated CDT agent with extremely low Cu usage by anchoring copper on cross-linked lipoic acid nanoparticles (Cu@cLAs). After endocytosis into tumor cells, the Cu@cLAs were dissociated into LA and dihydrolipoic acid (DHLA) (reduced form of LA) and released Cu2+ and Cu+ (oxidized form of Cu2+), the two redox couples recycled each other in cells to achieve the efficient killing of cancer cells by delaying metabolic loss and increasing the ROS level of tumor cells. The self-recycling was confirmed in cells by the sustained high Cu/DHLA content and persistent ROS generation process. The antitumor study based on the MCF-7/R nude mice gave the Cu@cLAs a tumor inhibitory rate up to 77.9% at the copper of 0.05 mg kg−1, the first dosage reported so far lower than that of normal serum copper (0.83 ± 0.21 mg kg−1). This work provides not only a new promising clinical strategy for the copper excessive use in copper-mediated CDT, but also gives a clue for other metal mediated disease therapies with the high metal consumption.
Using Disasters to Estimate the Impact of Uncertainty
Authors: Baker Scott R , Bloom Nicholas , Terry Stephen J
Published: March 2023

Uncertainty rises in recessions and falls in booms. But what is the causal relationship? We construct cross-country panel data on stock market returns to proxy for first- and second-moment shocks and instrument these with natural disasters, terrorist attacks, and political shocks. Our IV regression results reveal a robust negative short-term impact of second moments (uncertainty) on growth. Employing multiple vector autoregression estimation approaches, relying on a range of identifying assumptions, also reveals a negative impact of uncertainty on growth. Finally, we show that these results are reproducible in a conventional micro–macro business cycle model with time-varying uncertainty.
Structural Racism Hurts All Nurses
Authors: Sumpter Danica , Richard-Eaglin Angela , Ndiwane Abraham
Published: March 2023

Why health care must be reenvisioned through a DEI lens.
Minimal Clinically Important Differences of Patient-Reported Outcomes Measurement Information System Physical Function in Patients With Tibial Shaft Fracture
Authors: Thorne Tyler , Kellam Patrick , Nelson Chase , Li Haojia , Zhang Yue , Cizik Amy , Marchand Lucas , Haller Justin M.
Published: March 2023

Objective:

To calculate the minimal clinically important differences (MCIDs) of patient-reported outcomes measurement information system physical function (PROMIS PF) scores for patients with operatively treated tibial shaft fractures.

Design:

Retrospective Cohort Study.

Setting:

A Level 1 trauma center.

Patients:

All operatively treated tibial shaft fractures identified by Current Procedural Terminology codes.

Intervention:

Enrolled patients treated acutely with operative fixation of their tibia.

Main Outcome Measurements:

MCIDs were calculated by distribution-based and anchor-based methods, calculated from PROMIS PF scores completed at least at two-time points postoperatively. MCIDs were calculated at different time points including overall, 7–12 weeks, 3–6 months, and 6–24 months. MCIDs were calculated for different subgroups including open fractures, closed fractures, any complications, and no complications.

Results:

MCID for PROMIS PF scores was 5.7 in the distribution-based method and 7.84 (SD 18.65) in the anchor-based method. At 6–24 postoperatively, the months the distribution-based MCID was 5.95 from a postoperative baseline 27.83 (8.74) to 42.85 (9.61), P < 0.001. At 6–24 months, the anchor-based MCID was 10.62 with a score difference between the improvement group of 16.03 (10.73) and the no improvement group of 5.41 (15.75), P < 0.001. Patients with open fractures (distribution-based 6.22 and anchor-based 8.05) and any complications (distribution-based 5.71 and anchor-based 9.29) had similar or higher MCIDs depending on the methodology used than the overall cohort MCIDs.

Conclusion:

This study identified distribution-based MCID of 5.7 and anchor-based MCID of 7.84 calculated from PROMIS PF scores in operative tibial shaft fractures. Distribution-based methods yielded smaller MCIDs than anchor-based methods. These MCID scores provide a standard to compare clinical and investigational outcomes.
The Humeral Head Push–Pull Plate Technique: An Alternative Way to Stabilize the Humeral Head in Varus Angulated Proximal Humeral Fractures in the Elderly
Authors: Putzeys Guy
Published: March 2023

Despite the introduction of different surgical techniques and implants, osteoporotic varus displaced fractures of the proximal humerus treated with an angular stable plate have still a high risk of recurrence and/or screw penetration leading to revision surgery. Here, we describe a technique where we use an alternative approach to stabilize the humeral head by the use of apical subchondral bone anchors tightened to an angular stable plate. This technique eliminated the need for screws in the upper part of the humeral head, allowing the upper angular stable screws to be redirected to the inferomedial part of the humeral head. We named this technique the humeral head push–pull plate technique or H2P3 in its abbreviated form. The technique is presented in combination with a case series.
Evaluation of a New Hospital Building’s Impact on Clinical Outcomes and Consumer Experience in Medical Inpatients
Authors: Koundakjian Dylan C. , Tompkins Bradley J. , Repp Allen B.
Published: March 2023

Hospitals often seek to improve the effectiveness and experience of care through new building construction. However, the association between the built hospital environment, patient outcomes, and patient experience remains unclear. This retrospective matched cohort study leveraged natural experimental conditions to characterize major clinical outcomes and patient experience in medicine patients admitted to a new hospital building incorporating evidence-based design features compared with controls admitted to legacy buildings. Among patients discharged between June 1, 2019, and March 1, 2020, there were no significant differences in intensive care unit transfer, inpatient mortality, 30-day readmission, 30-day mortality, or length of stay. However, discharge from the new hospital building was associated with a higher percentage of top box scores on the Hospital Consumer Assessment of Healthcare Providers and Systems overall hospital rating item (60% vs 76%, P = 0.02). Further studies are needed to identify specific hospital design features that influence patient experience and clinical outcomes.
The Lung Microbiome in Carcinogenesis and Immunotherapy Treatment
Authors: Kennedy Kathleen , Khaddour Karam , Ramnath Nithya , Weinberg Frank
Published: March 2023

Lung cancer is the leading cause of cancer-related deaths. Over the past 10 years, significant advances in treatment modalities, including immune checkpoint inhibitor (ICI) blockade, have led to improved outcomes. Elucidating predicative biomarkers in responders and nonresponders to ICI will lead to development of therapeutic targets that could enhance ICI efficacy. Recently, the gut microbiome was identified as a predictive biomarker for ICI in patients with multiple cancer types. However, it is unclear how other host microbiomes influence tumorigenesis and response to ICI. Other groups have explored the lung microbiome as it relates to carcinogenesis and immunotherapy efficacy. In this review, we explore the role of the lung microbiome in health and disease. We also review the current state of lung microbiome research as it relates to tumorigenesis and treatments and provide potential insights into how the lung microbiome could improve outcomes in patients with cancer.
The Microbiome and Liver Cancer
Authors: Myojin Yuta , Greten Tim F.
Published: March 2023

The gut microbiome and liver are anatomically and functionally connected. The impact of the gut microbiota or microbial metabolites on liver cancer progression via immune cells has been recently revealed across various preclinical models. Commensal gut microbes of liver cancer patients differ from control subjects, and their composition is affected by the etiology of the hepatocellular carcinoma. The gut microbiota represents a potential novel target for intervention as shown in patients with melanoma, but we still lack data in patients with hepatocellular carcinoma. Fecal microbiota transplantation and dietary approaches may improve immunotherapy efficacy, and a couple of clinical trials are ongoing. In liver cancer, the ongoing recognition of interactions between gut microbes and the tumor immune microenvironment provides an exciting therapeutic avenue to complement established immunotherapy.
Neurosyphilis Gumma Misdiagnosed as Brain Abscess: [RETRACTED]
Authors: Likun Mu , Wang Mingxin , Cheng Lifeng , Liu Pengfei , Wang Kaixuan
Published: March 2023

Objective:

To explore the diagnostic essentials of neurosyphilis (NS) gumma, and to decrease the misdiagnosis and missed diagnosis rates of this disease by enriching the physicians with characteristic knowledge of NS.

Methods:

The clinical diagnosis and treatment of a patient with NS gumma were reported. The clinical manifestations, classification, and diagnostic points were analyzed retrospectively.

Results:

The patient was admitted to the hospital with fever and limb weakness. Brain magnetic resonance imaging showed multiple space-occupying lesions and positive serum Treponema pallidum gelatin agglutination test. The patient was misdiagnosed as having a brain abscess and underwent a craniotomy. The postoperative pathologic diagnosis was syphilis gumma. The patient was improved and discharged after penicillin anti-syphilis treatment, and the follow-up recovery was satisfactory.

Conclusion:

Neurosyphilis gumma is rare in clinical practice, and the clinical manifestations, imaging examination, and serological examination lack specificity, which is often misdiagnosed and missed. Clinical diagnosis should be considered in combination with multiple examinations such as clinical features of patients, positive serological tests for syphilis, elevated cerebrospinal fluid cell counts and protein quantification, imaging examination, and postoperative pathologic examination.
GLOBAL SIGNATURES OF THE MICROBIOME AND METABOLOME DURING HOSPITALIZATION OF SEPTIC PATIENTS
Authors: Long Xiangyu , Mu Sucheng , Zhang Jin , Xiang Hao , Wei Wei , Sun Jian , Kuang Zhongshu , Yang Yilin , Chen Yao , Zhao Huixin , Dong Yiming , Yin Jun , Zheng Huajun , Song Zhenju
Published: March 2023

Background: The gut plays an important role in the development of sepsis and acts as one of the possible drivers of multiple-organ dysfunction syndrome. This study aimed to explore the dynamic alterations in the gut microbiota and its metabolites in septic patients at different stages of intensive care unit (ICU) admission. Methods: In this prospective observational study, a total of 109 fecal samples from 23 septic patients, 16 nonseptic ICU patients and 10 healthy controls were analyzed. 16S rRNA gene sequencing and ultra-performance liquid chromatography coupled to tandem mass spectrometry targeted metabolomics were used for microbiota and metabolome analysis. A prediction model combining the Sequential Organ Failure Assessment score, Klebsiella, taurocholic acid, and butyric acid was used to predict the prognosis of sepsis. Results: The diversity and dominant species of the gut microbiota of septic patients were significantly disturbed. The proportions of normal gut microbiota, such as Firmicutes on the phylum level, as well as Faecalibacterium, Subdoligranulum, Ruminococcus, Agathobacter, and Blautia on the genus level, were decreased at different stages of ICU admission, while the proportions of potential pathogenic bacteria, such as Proteobacteria on the phylum level, and Enterococcus and Stenotrophomonas on the genus level were significantly increased. In addition, the amount of short-chain fatty acids and secondary bile acids decreased in septic patients, while that of the primary bile acids increased markedly. Bacterial richness and diversity were lower in the nonsurviving patients than those in the surviving patients in the later stage of ICU admission. In the nomogram model, the higher abundance of Klebsiella, concentration of taurocholic acid, and Sequential Organ Failure Assessment score, combined with a lower butyric acid concentration, could predict a higher probability of death from sepsis. Conclusions: Our study indicated that the dynamical alterations of gut microbiota and its metabolites were associated with the prognosis of the sepsis. Based on these alterations and clinical indicators, a nomogram model to predict the prognosis of septic patients was performed.
Early surgical stabilization of rib fractures for flail chest is associated with improved patient outcomes: An ACS-TQIP review
Authors: Simmonds Alexander , Smolen Julia , Ciurash Mathew , Alexander Kyle , Alwatari Yahya , Wolfe Luke , Whelan James F. , Bennett Jonathan , Leichtle Stefan W. , Aboutanos Michel B. , Rodas Edgar B.
Published: March 2023

BACKGROUND

Rib fractures are a common in thoracic trauma. Increasingly, patients with flail chest are being treated with surgical stabilization of rib fractures (SSRF). We performed a retrospective review of the Trauma Quality Improvement Program database to determine if there was a difference in outcomes between patients undergoing early SSRF (≤3 days) versus late SSRF (>3 days).

METHODS

Patients with flail chest in Trauma Quality Improvement Program were identified by CPT code, assessing those who underwent SSRF between 2017 and 2019. We excluded those younger than 18 years and Abbreviated Injury Scale head severity scores greater than 3. Patients were grouped based on SSRF before and after hospital Day 3. These patients were case matched based on age, Injury Severity Score, Abbreviated Injury Scale head and chest, body mass index, Glasgow Coma Scale, and five modified frailty index. All data were examined using χ2, one-way analysis of variance, and Fisher's exact test within SPSS version 28.0.

RESULTS

For 3 years, 20,324 patients were noted to have flail chest, and 3,345 (16.46%) of these patients underwent SSRF. After case matching, 209 patients were found in each group. There were no significant differences between reported major comorbidities. Patients with early SSRF had fewer unplanned intubations (6.2% vs. 12.0%; p = 0.04), fewer median ventilator days (6 days Q1: 3 to Q3: 10.5 vs. 9 Q1: 4.25 to Q3: 14; p = 0.01), shorter intensive care unit length of stay (6 days Q1: 4 to Q3: 11 vs. 11 Q1: 6 to Q3: 17; p < 0.01), and hospital length of stay (15 days Q1: 11.75 to Q3: 22.25 vs. 20 Q1: 15.25 – Q3: 27, p < 0.01. Early plating was associated with lower rates of deep vein thrombosis and ventilator-acquired pneumonia.

CONCLUSION

In trauma-accredited centers, patients with flail chest who underwent early SSRF (<3 days) had better outcomes, including fewer unplanned intubations, decreased ventilator days, shorter intensive care unit LOS and HLOS, and fewer DVTs, and ventilator-associated pneumonia.

LEVEL OF EVIDENCE

Therapeutic/Care Management; Level IV.
Bradyrhizobium zhengyangense sp. nov., isolated from effective nodules of Arachis hypogaea L. in central China
Authors: Zhang Junjie , Wang Nan , Li Shuo , Peng Shanshan , Andrews Mitchell , Zhang Xiaoxia , Zhang Yanming , Yu Hui , Song Jiangchun , Chen Wenfeng , Wang Entao , Li Youguo
Published: March 2023

Three slow-growing rhizobial strains (WYCCWR 12678, WYCCWR 12774 and WYCCWR 13023T) isolated from effective nodules of Arachis hypogaea L. (cultivated peanut) sampled in Zhengyang County, Henan Province, central China were characterized using a polyphasic approach. The three strains were assigned to the genus

Bradyrhizobium

based on phylogenetic analysis of their 16S rRNA sequences. Phylogenetic analysis based on their concatenated recA-glnII-gyrB-dnaK-rpoB gene sequences placed the strains into a distinct lineage. Whole-genome average nucleotide identity (ANI) values between WYCCWR 13023T and WYCCWR 12774 and WYCCWR 12678 were 99.43 and 99.31% respectively. ANI values between WYCCWR 13023T and the most closely related strains were all below 93 %. The digital DNA–DNA hybridization (dDDH) values between WYCCWR 13023T and ‘

B. guangzhouense

’ CCBAU 51670T,

B. manausense

BR 3351T and

B. guangdongense

CCBAU 51649T, the three most closely related type strains, were 50.40, 43.50 and 39.20% respectively. Phenotypic characterization also allowed the differentiation of the novel strains from their most closely related type strains. Based on the genotypic and phenotypic features, we conclude that the three strains represent a novel species for which the name Bradyrhizobium zhengyangense sp. nov. is proposed, with WYCCWR 13023T (=GDMCC 1.3180T=HAMBI 3760T) as the type strain.
The utility of ChatGPT for cancer treatment information
Authors: Chen Shan , Kann Benjamin H. , Foote Michael B. , Aerts Hugo JWL , Savova Guergana K. , Mak Raymond H. , Bitterman Danielle S.
Published: March 2023

The use of large language models (LLMs) such as ChatGPT for medical question-answering is becoming increasingly popular. However, there are concerns that these models may generate and amplify medical misinformation. Because cancer patients frequently seek to educate themselves through online resources, some individuals will likely use ChatGPT to obtain cancer treatment information. This study evaluated the performance and robustness of ChatGPT in providing breast, prostate, and lung cancer treatment recommendations that align with National Comprehensive Cancer Network (NCCN) guidelines. Four prompt templates were created to explore how differences in how the query is posed impacts response. ChatGPT output was scored by 3 oncologists and a 4th oncologist adjudicated in cases of disagreement. ChatGPT provided at least one NCCN-concordant recommendation for 102/104 (98%) prompts. However, 35/102 (34.3%) of these also included a recommendation that was at least partially non-concordant with NCCN guidelines. Responses varied based on prompt type. In conclusion, ChatGPT did not perform well at reliably and robustly providing cancer treatment recommendations. Patients and clinicians should be aware of the limitations of ChatGPT and similar technologies for self-education.
Positive selection of neuregulin 1 (NRG-1) among three long-lived vertebrates
Authors: Copes Neil , Canfield Clare-Anne Edwards
Published: March 2023

Maximum lifespan is a species-specific trait that can vary over a broad range, even between closely related species. We selected the few long-lived vertebrates for which reference genome data is available, specifically the blue whaleBalaenoptera musculusand the Pinta Island tortoiseChelonoidis abingdonii. For these species, we used established methods of CpG dinucleotide analysis and allometric estimation to compare predicted maximum longevity with the maximum longevities reported in the AnAge database and in the literature. Additionally, we compared protein sequences between these species and closely related short-lived vertebrates. Orthologous protein sequences with higher pairwise alignment scores between either long-lived species, or between short-lived species, than between long-lived and short-lived relatives were identified. High-scoring orthologs were investigated for evidence of positive selection and convergent evolution, and for evidence of deleterious effect on phenotype. Analysis revealed no evidence for either convergent evolution or predicted deleterious protein sequences changes within these orthologs, however evidence of positive selection was identified in two genes: NRG-1 and GALNT17. Further comparison to protein sequences from the long-lived bowhead whale (Balaena mysticetus) additionally supported NRG-1 as exhibiting evidence of positive selection among the selected long-lived species.