bluuebunny/crossref_metadata_2025 huggingface dataset:
Erdheim-Chester Disease with BRAF V600E Mutation and a Concomitant Myeloid Malignancy Sharing NRAS and IDH2 Mutations
Authors: Prabhakaran Nitya , Jour George , Balar Arjun , Ward Nicholas
Published: February 2023

Erdheim-Chester disease (ECD) is a rare clonal histiocytic process that is characterized by a foamy (xanthomatous) proliferation often associated with Touton giant cells. The diagnosis is often challenging and not exclusively a histologic diagnosis, as it requires correlation with unique clinical, radiographic, and recently described molecular findings. Activating mutations involving the MAPK pathway including BRAF, ARAF, N/KRAS, and MEK are recurrent in the disease. However, it is increasingly being described that mutations associated with clonal hematopoiesis are also found in bone marrow specimens of patients with ECD, as well as higher frequency of overt concomitant myeloid malignancy including acute myeloid leukemia, myeloproliferative neoplasms, myelodysplastic syndromes, and mixed myeloproliferative neoplasms/myelodysplastic syndromes. Herein, we report a unique case of a patient presenting with BRAFV600E-positive ECD with peripheral blood findings consistent with a concurrent myeloid malignancy featuring co-occurrence of NRAS and IDH2 mutations.
Is the Supine Position Suitable for Ultrasound-Guided Percutaneous Nephrolithotomy in Patients with Complex Renal Stones?
Authors: Xiao Bo , Zeng Xue , Zhang Gang , Ji Chaoyue , Jin Song , Bai Wenjie , Tang Yuzhe , Wang Bixiao , Li Jianxing
Published: February 2023

Introduction: The aim of the study was to assess the safety and efficacy of ultrasound (US)-guided percutaneous nephrolithotomy (PCNL) for complex renal stones when performed in a modified supine position. Methods: We retrospectively reviewed the charts of patients who underwent PCNL for complex renal stones at our institution between August 2018 and December 2021. During this time, 188 consecutive patients underwent US-guided PCNL in the prone position (P group, n = 129) or in the flank-free modified supine position (S group, n = 59). Patient demographics and intraoperative and postoperative data were analyzed. Results: Successful renal access was achieved in all patients. The baseline demographics were comparable between the two groups. The numbers of renal access were significantly higher (2.1 ± 0.4 vs. 1.2 ± 0.2, p = 0.002), and the operation time was comparable (79.1 ± 14.6 min vs. 96.2 ± 19.6 min, p = 0.06) between the two groups. The postoperative hospital stay was also shorter in the P group (6.2 ± 1.5 d vs. 10.2 ± 1.7 d, p = 0.008). The postoperative hemoglobin loss was similar between the P and S groups (1.7 ± 0.4 g/dL vs. 1.8 ± 0.3 g/dL, p = 0.12). The stone-free rate was significantly lower in the S group (57.5% vs. 82.7%, p < 0.001). There were no embolization or septic complications. Twelve patients (20.3%) in the S group underwent simultaneous or staged retrograde flexible ureteroscopy to remove residual stones. Conclusion: US-guided PCNL in the modified supine position was a safe treatment for complex renal stones. However, the single-session stone clearance rate was not ideal. The supine flank-free position may be unsuitable for US-guided PCNL in patients with complex renal stones according to our preliminary findings.
Assessment of Change in Practice of Routine Tracheal Suctioning Approach of Non-Vigorous Infants Born through Meconium-Stained Amniotic Fluid: A Pragmatic Systematic Review and Meta-Analysis of Evidence outside Randomized Trials
Authors: Ramaswamy Viraraghavan Vadakkencherry , Bandyopadhyay Tapas , Nangia Sushma , Kumar Gunjana , Pullattayil Abdul Kareem , Trevisanuto Daniele , Roehr Charles Christoph , Lakshminrusimha Satyan
Published: February 2023

Aim: The 2015 recommendation of the International Liaison Committee on Resuscitation of no routine tracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid (MSAF) was based on very low certainty of evidence (CoE) necessitating ongoing monitoring. The aim of this systematic review was to perform a meta-analysis of observational studies comparing the effect of implementing immediate resuscitation without routine tracheal suctioning versus with routine suctioning in neonates born through MSAF. Methods: MEDLINE, Embase, CENTRAL, and Web of Science were searched. Observational studies with a before-and-after design were included. Two authors extracted data independently. CoE based on GRADE recommendations was performed. Results: 13 studies were included. Clinical benefit or harm could not be excluded for the composite primary outcome of mortality or requirement of extracorporeal membranous oxygenation (ECMO) (relative risk, 95% confidence interval: 0.74 [0.47–1.17]), and mortality (0.68 [0.42–1.11]). “Routine tracheal suctioning” epoch had possibly lesser risk of meconium aspiration syndrome (MAS) when compared to “no routine tracheal suctioning” epoch (0.68 [0.47–0.99]). “Routine tracheal suctioning” epoch also possibly had a lower risk of hospital admission for respiratory symptoms, requirement of non-invasive respiratory support, invasive mechanical ventilation, surfactant treatment, air leak, and low-flow oxygen therapy. Clinical benefit or harm could not be excluded for the outcome of mortality or ECMO among those diagnosed with MAS (1.09 [0.86–1.39]), but “routine tracheal suctioning” was possibly associated with lower risk of respiratory morbidities among those diagnosed with MAS. The CoE was very low for most of the outcomes evaluated. Conclusions: Due to the very low CoE for the outcomes evaluated, no definitive conclusions can be drawn warranting the need for additional studies.
Mixed Neuroendocrine and Non-Neuroendocrine Neoplasm of Pancreas: What Do We Know, What Have We Learnt?
Authors: Dhakre Vijay W. , Galande Sneha Tukaram , Patil Varsha Gunvant , Shah Nikita C. , Rathod Chetan , Sethna Kaiumarz S. , Amrapurkar Anjali D.
Published: February 2023

Pancreatic adeno-mixed neuroendocrine non-endocrine (pMINEN) tumors are extremely rare [Pancreatology. 2021;21(1):224–235]. They are known to have distal metastasis at presentation and have a comparatively lower survival rate than similar staged neuroendocrine (NEN) carcinoma, adenocarcinoma, and small-cell lung tumor from which its treatment patterns are extrapolated. Also, very less is known about its molecular structure and natural courses. There is a dearth of data about pMINEN in the literature, and also there is a lack of large multicentral trials due to which the MINEN tumors do not have a standard universal management protocol. We discuss here the clinical dilemmas that arise during diagnosis and reporting and urge to form a multicentric trial to formulate a focused protocolized approach. We describe here our encounter with a pancreatic head lesion which on immunohistochemical analysis turned out to be a pMINEN with moderately differentiating ductal adenocarcinoma and low-grade NEN tumor. Radical R0 surgery with multimodal treatment (chemotherapy + radiotherapy) gains improved survival in long term.
Mitogen-Activated Pathway Kinase Inhibitor-Associated Retinopathy: Do Features Differ with Upstream versus Downstream Inhibition?
Authors: Francis Jasmine H. , Foulsham William , Canestraro Julia , Harding James J. , Diamond Eli L. , Abramson David H. , Drilon Alexander
Published: February 2023

Introduction: Many cancers have derangement of the mitogen-activated pathway kinase (MAPK), making this pathway blockade a therapeutic target. However, inhibitors of MAPK can result in adverse effects including retinopathy. This study compares clinical and morphological characteristics of serous retinal disturbances in patients taking agents with variable inhibition of MAPK: either direct interference of mitogen-activated protein kinase kinase (MEK) or extracellular signal-regulated kinase (ERK) inhibitors or with indirect inhibition via interference with FGFR signaling. Methods: This retrospective observational study of prospectively collected pooled data is from a single tertiary oncology referral center. Of 339 patients receiving MAPK inhibitors (171, 107, and 61 on FGFR, MEK, and ERK inhibitors, respectively) for treatment of metastatic cancer, this study included 128 eyes of 65 patients with evidence of retinopathy confirmed by optical coherence tomography (OCT). The main outcome was characteristics of treatment-emergent choroid/retinal OCT abnormalities as compared to baseline OCT. Results: In all patients on one of three drug classes (FGFRi, MEKi, ERKi), the retinopathy manifested as subretinal fluid foci that were bilateral, fovea involving, and reversible without intervention. There were notable differences between the three classes of drugs: the proportion of patients with retinopathy, number of fluid foci per eye, proportion of eyes with intraretinal edema, and the proportion of symptomatic patients was least for the upstream target (FGFR inhibitors) and greatest for the downstream targets (MEK or ERK inhibitors). Conclusion: This study shows MAPK pathway inhibitors may cause subretinal fluid foci with unique clinical and morphological characteristics depending on the target (FGFR, MEK, or ERK) implicated. Retinopathy is more common, more symptomatic, and more severe (more fluid foci, more expansive fluid configurations) the further downstream the MAPK pathway is inhibited.
Indicators of Kidney Fibrosis in Patients with Type 2 Diabetes and Chronic Kidney Disease Treated with Dulaglutide
Authors: Tuttle Katherine R. , Wilson Jonathan Matthew , Lin Yanzhu , Qian Hui-Rong , Genovese Federica , Karsdal Morten Asser , Duffin Kevin L. , Botros Fady T.
Published: February 2023

Introduction: In the AWARD-7 study in patients with type 2 diabetes and moderate-to-severe chronic kidney disease, once-weekly dulaglutide slowed the decline in estimated glomerular filtration rate (eGFR) and decreased the urine albumin/creatinine ratio compared to insulin glargine at the end of 52 weeks of treatment. In this exploratory post hoc analysis, changes in two fibrosis biomarkers, serum PRO-C6 (type VI collagen formation) and urine C3M (type III collagen degradation), were evaluated. Methods: In the groups treated with dulaglutide 1.5 mg or insulin glargine (N = 330), serum PRO-C6 and urine C3M were measured using competitive enzyme-linked immunosorbent assays. Biomarker changes were assessed by a mixed-effects model for repeated measures. Pearson correlation analyses were conducted to determine associations between changes in kidney fibrosis biomarkers and eGFR measures at 52 weeks. Results: At weeks 26 and 52 of treatment in the overall population, serum PRO-C6 levels were significantly lower in the dulaglutide group versus insulin glargine group with percent change from baseline of (least squares mean ± standard error) −4.6% ± 1.9 and −0.2% ± 2.2 versus 5.7% ± 2.0 and 8.0% ± 2.3 (p < 0.01), respectively, and urine C3M levels were significantly higher in the dulaglutide group versus insulin glargine group with percent change from baseline of 10.9% ± 8.2 and 20.7% ± 8.8 versus −10.0% ± 6.5 and −16.9% ± 6.4 (p < 0.05), respectively. These findings appeared greater in the subgroup with macroalbuminuria. Serum PRO-C6 negatively correlated with eGFR, while urine C3M positively correlated with eGFR. Conclusion: Dulaglutide treatment was associated with biomarker changes that indicated lower type VI collagen formation and higher type III collagen degradation compared to treatment with insulin glargine, suggesting a potential drug effect to reduce kidney fibrosis.
Acute toxicity test of water and ethanol extract from african leaf (Gym-nanthemum amygdalina Del.) on zebra fish embrio (Danio rerio)
Authors: Agus Setiani Lusi , Wiendarlina Ike Yulia , Arlindini Afifah Marissa
Published: February 2023

Bitterleaf or African Leaf is a herbal plant empirically used to relieve fever and kidney disease. Pharmacological research reports that the leaves have antibacterial, anti-inflammatory, and antidiabetic properties, and a toxicity test was also conducted to ensure their safety. Therefore, this experiment aimed to obtain LC50 of African Leaf (Gymnanthemum amygdalina Del.) ethanol and water extract with the ZFET (Zebra Fish Embryo Acute Toxicity) method and also to observe the toxicity effect of zebrafish (Danio rario) embryo's morphology after the induction of the extract. The experiment refers to the OECD No.236 of 2013 as a guideline, and it was shown that African Leaf's ethanol extract LC50 values were obtained at 6.3629 ppm. Furthermore, the water extract LC50 value was obtained at 25.0520 ppm, and the African Leaf extract was categorized in the toxic category. The leaf extract has a harmful effect on zebrafish embryos, resulting in malformations of the tail, notochord, pericardium, and yolk sac.
Left Atrial Strain in the Assessment of Diastolic Function in Heart Failure: A Machine Learning Approach
Authors: Carluccio Erberto , Cameli Matteo , Rossi Andrea , Dini Frank Lloyd , Biagioli Paolo , Mengoni Anna , Jacoangeli Francesca , Mandoli Giulia Elena , Pastore Maria Concetta , Maffeis Caterina , Ambrosio Giuseppe
Published: February 2023

Background:

Diastolic dysfunction (DD) assessment in heart failure is still challenging. Peak atrial longitudinal strain (PALS) is strongly related to end-diastolic pressure and prognosis, but it is still not part of standard DD assessment. We tested the hypothesis that a machine learning approach would be useful to include PALS in DD classification and refine prognostic stratification.

Methods:

In a derivation cohort of 864 heart failure patients in sinus rhythm (age, 66.6±12 years; heart failure with reduced ejection fraction, n=541; heart failure with mildly reduced ejection fraction, n=129; heart failure with preserved ejection fraction, n=194), machine learning techniques were retrospectively applied to PALS and guideline-recommended diastolic variables. Outcome (death/heart failure rehospitalization) of the identified DD-clusters was compared with that by guidelines-based classification. To identify the best combination of variables able to classify patients in one of the identified DD-clusters, classification and regression tree analysis was applied (with DD-clusters as dependent variable and PALS plus guidelines-recommended diastolic variables as explanatory variables). The algorithm was subsequently validated in a prospective cohort of 189 heart failure outpatients (age, 65±13 years).

Results:

Three distinct echocardiographic DD-clusters were identified (cluster-1, n=212; cluster-2, n=376; cluster-3 DD, n=276), with modest agreement with guidelines-recommended classification (kappa=0.40;
P
<0.001). DD-clusters were predicted by a simple algorithm including E/A ratio, left atrial volume index, E/e′ ratio, and PALS. After 36.5±29.4 months follow-up, 318 events occurred. Compared to guideline-based classification, DD-clusters showed a better association with events in multivariable models (C-index 0.720 versus 0.733,
P
=0.033; net reclassification improvement 0.166 [95% CI, 0.035–0.276],
P
=0.013), without interaction with ejection fraction category. In the validation cohort (median follow-up: 18.5 months), cluster-based classification better predicted outcome than guideline-based classification (C-index 0.80 versus 0.78,
P
=0.093).

Conclusions:

Integrating PALS by machine learning algorithm in DD classification improves risk stratification over recommended current criteria, regardless of ejection fraction status. This proof of concept study needs further validation of the proposed algorithm to assess generalizability to other populations.
Burden of Hypertensive Crisis in Patients With End-Stage Kidney Disease on Maintenance Dialysis: Insights From United States Renal Data System Database
Authors: Pothuru Suveenkrishna , Chan Wan-Chi , Mehta Harsh , Vindhyal Mohinder R. , Ranka Sagar , Hu Jinxiang , Yarlagadda Sri G , Wiley Mark A. , Hockstad Eric , Tadros Peter N , Gupta Kamal
Published: February 2023

Background:

There is paucity of information on the incidence, clinical characteristics, admission trends, and outcomes of hypertensive crisis (HTN-C) in patients with end-stage kidney disease (ESKD) who are on maintenance dialysis.

Methods:

We conducted a retrospective observational study of HTN-C admissions in patients with end-stage kidney disease using the United States Renal Data System. We identified patients with end-stage kidney disease aged ≥18 years on dialysis and were hospitalized for HTN-C from January 2006 to August 2015.

Results:

A total of 54 483 patients with end-stage kidney disease were hospitalized for HTN-C during the study period. After study exclusions, 37 214 patients were included in the analysis. A majority of patients were Black, there were more women than men and the South region of the country accounted for a great majority of patients. During the study period, hospitalization rates increased from 1060 per 100 000 beneficiary years to 1821 (
P
trend
<0.0001). Overall, in-hospital mortality, 30-day, and 1-year mortality were 0.6%, 2.3%, and 21.8%, respectively, and 30-day readmission rate was 31.1%. During the study period, most study outcomes showed a significant decreasing trend (in-hospital mortality 0.6%–0.5%, 30-day mortality 2.4%–1.9%, 1-year mortality 23.9%–19.7%,
P
trend
<0.0001 for all).

Conclusions:

Hospitalizations for HTN-C have increased consistently during the decade studied. Although temporal trends showed improving mortality and readmission rates, the absolute rates were still high with 1 in 3 patients readmitted within 30 days and 1 in 5 patients dying within 1 year of index hospitalization.
The Role of Coupled North Pacific Atmosphere–Ocean Interactions in Impacts of Tibetan Plateau Snow Anomalies on the Northern Hemisphere Winter Atmospheric Circulation
Authors: Liu Shizuo , Wu Qigang , Yao Yonghong , Schroeder Steven R.
Published: February 2023

Previous studies indicate observed influences of autumn and winter Tibetan Plateau (TP) snow-cover anomalies on the winter Pacific–North American (PNA) teleconnection. This study simulates atmospheric and oceanic responses to persistent autumn–winter TP snow forcing using an atmospheric general circulation model (AGCM) and a coupled atmospheric-oceanic general circulation model (AOGCM), and quantifies the role of atmosphere–ocean interactions over North Pacific in TP snow effects. The AOGCM experiment induces a stronger and more realistic remote PNA response to heavy TP snow anomalies, and also a significant winter horseshoe-like North Pacific sea surface temperature (SST) pattern resulting from an anomalous equivalent barotropic cyclone, or a strengthened Aleutian low, with associated cyclonic wind stress anomalies. The horseshoe-like SST anomaly pattern is used as boundary forcing (without prescribed heavy TP snow) in another AOGCM experiment, which simulates an enhanced winter Aleutian low and a PNA-like response similar to the original AOGCM responses, indicating that that the direct Pacific–North American atmospheric response to persistent TP snow forcing in the AGCM is amplified in the AOGCM by the North Pacific midlatitude atmosphere–ocean interactions. This suggests that the mechanisms of the winter PNA responses to TP snow forcing involve dynamical atmospheric processes such as horizontal propagation of Rossby wave energy and transient eddy feedbacks, and also North Pacific atmosphere–ocean interactions, which provide a positive feedback on the development of the remote PNA teleconnection.

Significance Statement

The Tibetan Plateau has a 2.5 million km2 area and a 4000 m average elevation, and is often called “the third pole” because of its polar-like climate in midlatitude Eurasia. A heavy Tibetan Plateau snow cover increases the albedo effect and causes tropospheric cold temperature and low height changes that can be carried or advected to the North Pacific by the prevailing westerlies. The purpose of this study is to better understand how Tibetan Plateau snow anomalies influence the North Pacific and the remote atmospheric circulation through numerical simulations. Our results find that those North Pacific responses amply the direct atmospheric response to Tibetan Plateau snow-cover anomalies. This greatly improves our understanding of physical mechanisms of Tibetan Plateau snow impacts.
Terdiurnal Radiational Tides
Authors: Ray R. D. , Boy J.-P. , Erofeeva S. Y. , Egbert G. D.
Published: February 2023

Terdiurnal atmospheric tides induce an S3 radiational ocean tide, similar to radiational tides S1 and S2 in the diurnal and semidiurnal bands. Although of small amplitude, the terdiurnal tide has some intriguing properties. The tide has an unusually pronounced seasonal variation, manifested by annual sidelines here denoted R3 and T3, which causes the tide to nearly vanish during times near an equinox. Forcing is generally largest in the winter hemisphere. Complicating matters, the two sideline frequencies coincide with those of nonlinear compound tides SK3 and SP3. Whether radiational tides or nonlinear tides (or both) are appearing at any given tide gauge can usually be determined by the relative amplitudes and phase differences of the two sidelines. The amplitudes of R3 and T3 are generally comparable; the amplitudes of SK3 and SP3 are not. Proper identification can lead to a small improvement in tidal prediction, but more importantly can lead to improved physical interpretation. An example from recent measurements under the Ross Ice Shelf bears on the role of nonlinearity in interactions between the ocean tide and the floating ice shelf.
Comparison between the Operational and Statistical Daily Maximum and Minimum Temperature Forecasts on the Central Coast of Peru
Authors: Aliaga-Nestares Vannia , De La Cruz Gustavo , Takahashi Ken
Published: February 2023

Multiple linear regression models were developed for 1–3-day lead forecasts of maximum and minimum temperature for two locations in the city of Lima, on the central coast of Peru (12°S), and contrasted with the operational forecasts issued by the National Meteorological and Hydrological Service—SENAMHI and the output of a regional numerical atmospheric model. We developed empirical models, fitted to data from the 2000–13 period, and verified their skill for the 2014–19 period. Since El Niño produces a strong low-frequency signal, the models focus on the high-frequency weather and subseasonal variability (60-day cutoff). The empirical models outperformed the operational forecasts and the numerical model. For instance, the high-frequency annual correlation coefficient and root-mean-square error (RMSE) for the 1-day lead forecasts were 0.37°–0.53° and 0.74°–1.76°C for the empirical model, respectively, but from around −0.05° to 0.24° and 0.88°–4.21°C in the operational case. Only three predictors were considered for the models, including persistence and large-scale atmospheric indices. Contrary to our belief, the model skill was lowest for the austral winter (June–August), when the extratropical influence is largest, suggesting an enhanced role of local effects. Including local specific humidity as a predictor for minimum temperature at the inland location substantially increased the skill and reduced its seasonality. There were cases in which both the operational and empirical forecast had similar strong errors and we suggest mesoscale circulations, such as the low-level cyclonic vortex over the ocean, as the culprit. Incorporating such information could be valuable for improving the forecasts.

Significance Statement

We wanted to compare the temperature of the operational forecast of the Meteorological and Hydrological Service, an atmospheric model, and persistence with the observed temperatures on the Peruvian central coast. In addition, we generated an empirical forecast model considering both atmospheric and local predictors. We got better results with this empirical model, considering the highest Pearson correlations and the lowest RMSE values. These results will allow us to use this empirical model as the main tool to automate the forecast on the central coast of Peru. Future work should be aimed at testing the skill of this model for forecasting in other cities of Peru.
Comparison of faecal calprotectin using two collection and extraction strategies for the BÜHLMANN CALEX® Cap – possible implications for clinical cut-offs?
Authors: Bruce Helen , Osypiw Jacqueline , Prajapati-Jha Geeta , O’Driscoll Shane , Brealey Martin , Benton Sally C
Published: February 2023

Background

Faecal calprotectin has been identified as a useful biochemical marker in the differentiation of inflammatory bowel disease and irritable bowel syndrome. Typically, patients send faecal specimens in a pot for manual extraction by the laboratory. During the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) pandemic, the routine laboratory service was temporarily suspended due to the potential increased risk to staff. In this study we investigated the possibility of patients collecting samples directly into the faecal extraction tubes.

Method

Patients submitted paired faecal samples for calprotectin analysis using a standard faecal container (current practice) and followed instructions for faecal collection using the BÜHLMANN CALEX® Cap device. Samples were returned to the laboratory immediately after collection. Laboratory staff manually extracted the calprotectin from the faecal samples using the CALEX® Cap prior to analysis of both extracts on the Cobas c702.

Results

91 paired faecal samples were included in the study. Clinical correlation was found to be 70% with numerical correlation showing a positive bias for the patient-collected CALEX® Cap sample when compared to the laboratory-extracted faecal sample around the clinical decision points 100–250 μg calprotectin/g faeces.

Conclusion

The study shows that collection of a faecal sample using the CALEX® Cap works well and is a good alternative to using standard containers. The correlation gives rise to the possibility that faecal calprotectin is not stable when collected into standard collection containers. Prior to further roll-out of this process, questions surrounding the current cut-offs would need to be addressed.
Financial capability training for social workers in Singapore: Towards more effective practice
Authors: Deepa V , Ghoh Corinne , Sherraden Margaret
Published: February 2023

In most countries around the world, social workers assist financially vulnerable people, but they often do so with little or no training in finance. This article examines the development and pilot testing of a financial curriculum to be used in social work education and training in Singapore. Feedback from social workers informed development of the curriculum, which is practical and capability-based. The study covers two phases: first curriculum development, then pilot testing. Focus group methods are used to analyse the process and effectiveness of curriculum development and the initial training outcomes.
Ghosts of the Black Decade: How legacies of violence shaped Algeria’s Hirak protests
Authors: Kilavuz M Tahir , Grewal Sharan , Kubinec Robert
Published: February 2023

Episodes of mass political violence, such as genocide and civil war, have been thought to both encourage and discourage future political mobilization. We square these competing hypotheses by disaggregating between protest onset and resilience. We argue that exposure to mass violence decades ago should on average decrease protest onset, by heightening fears of repression and retribution. However, conditional on protesting, prior exposure to violence should increase protest longevity, by generating greater political grievances that fuel commitment to the cause. We find evidence of both effects in Algeria during the 2019–20 Hirak protests that toppled President Abdelaziz Bouteflika. Pairing an original dataset on massacres during the 1990s civil war with a rolling online survey of 18,000 Algerians in 2019–20, we find that areas exposed to greater violence in the 1990s had on average fewer, but more committed, protesters in 2019–20.
Joining forces: Social coalitions and democratic revolutions
Authors: Dahlum Sirianne
Published: February 2023

When are mass protest movements able to overthrow authoritarian regimes and promote democratic transitions? This article considers whether socially diverse protest movements are more conducive to democratization than movements restricted to one or a few social groups. Coalitions across social groups should impose higher costs on authoritarian regimes through access to a wide range of resources, strategies and sources of leverage. Heterogenous protest coalitions are also more likely to socially overlap with regime supporters and the security forces, which should encourage regime splits and defections. But, diverse protest movements may also be more vulnerable to fragmentation and in-fighting, which may particularly threaten prospects of democracy in the aftermath of an authoritarian regime breakdown. Analyzing new global data mapping the social group composition of anti-regime protest campaigns from 1900 to 2013, the article finds consistent evidence that socially diverse protest movements are more likely to overthrow authoritarian regimes, and this is not driven by protest size. Socially diverse movements are also more likely to end in the short- and long-run establishment of more democratic institutions, suggesting that heterogenous protest movements’ potential for bringing about democracy is more promising than expected. These findings speak to the importance of securing broad and not only large mass movements to promote democracy.
Epistemic and Deontic Authority in Parent–Teacher Conference: Referring to the Expert as a Discursive Practice to (Jointly) Undermine the Teacher’s Expertise
Authors: Caronia Letizia
Published: February 2023

This article investigates the interactional constitution of a phenomenon recurrently reported by teachers who complain about a loss of authority, a systematic delegitimization of their role. Adopting a conversation analysis informed approach to a single-case study from a corpus of parent–teacher conferences, we illustrate how challenging the teachers’ expertise is accomplished by participants as an outcome of some identifiable communicative practices. Particularly, we analyze the practices of “quoting” and “referring to the expert” as interactional resources differently exploited by participants: While parents challenge the teachers’ epistemic authority and lay the foundation for claiming the right to decide what do to with their son in the classroom, teachers contribute to this epistemic positioning and cede their expert knowledge-based deontic rights, that is, the right to decide the best practices to adopt in the classroom. In the discussion, we advance that the participants’ interactive competence in navigating the complex epistemic landscape of the encounter profoundly impacts on the local definition of reciprocal epistemic and deontic rights and responsibilities. Indications for teachers’ education are provided in the conclusion.
Anorexia nervosa and the law: Legal mechanisms for involuntary treatment in Ireland
Authors: Dunne Eimear
Published: February 2023

Anorexia nervosa is a form of eating disorder associated with significant morbidity and mortality, such that patients can become physically unwell and need medical treatment. Body image can be distorted, meaning that underweight people may believe they need to lose weight, leading to treatment refusal in some cases. Consequently, involuntary treatment is sometimes used in severe cases of anorexia, which may include nasogastric (tube) feeding to restore weight. Wardship is used in Ireland to obtain the court’s consent for treatment of unwilling patients with anorexia nervosa, as it is legally uncertain whether mental health legislation can be applied for treatment of these patients. This article will explore the current legal mechanisms for involuntary treatment of anorexia nervosa in Ireland, analysing both wardship and mental health legislation.
Commercial uses of antitranspirants in crop production: A review
Authors: Mphande Wiza , Farrell Aidan D , Kettlewell Peter S
Published: February 2023

Global food security is at risk due to the predicted climate change, making it imperative for agronomists to provide adaptive technologies that will sustain and improve food production. Rainfed agriculture, prone to drought, covers an estimated 80% of global cropland. One of the adaptive technologies is the use of antitranspirants – products that are applied on plants to reduce transpirational water loss and increase crop performance under drought conditions. The benefits of improving antitranspirant adoption in drought mitigation are expected to be high, especially in many drought-prone low-income countries where crop production is almost wholly dependent on rainfall. The objective of this article was to review the commercial uses of antitranspirants in food and non-food crop production. The review revealed that in horticulture, antitranspirants have several commercial uses, in addition to drought mitigation, such as transplanting shock amelioration, protection of fruit against sunburn, enhancement of nutritional quality, synchronising fruit ripening, protection of fruit and nut trees against diseases. Use of antitranspirants in arable farming has been neglected for three main reasons: first, arable crops have lower market value, for example, in Melbourne (Australia) in October 2022, a tonne of grapes was worth US$ 2694.82 compared to US$ 277/tonne of wheat. Second, molecular genetics applied to crop breeding has risen as an alternative approach to drought mitigation, shifting attention from antitranspirants. Finally, the erroneous research conclusion in the 1970s that antitranspirants could not increase yield because they reduced photosynthesis discouraged commercialisation of antitranspirants in arable farming. An antitranspirant breakthrough to either lower the cost or create a multi-purpose product is needed for the production of arable crops, especially major cereals, as has been the case for non-drought amelioration uses in horticulture.
Reflective Inclusion: Learning from Activists What Taking a Deliberative Stance Means
Authors: Felicetti Andrea , Holdo Markus
Published: February 2023

Researchers are increasingly recognizing that social movements are crucial for realizing deliberative democratic values. However, this raises two important questions: (1) what actions should count as deliberation and (2) whether we should demand more from activists than merely provoking or encouraging deliberation in a society. Building on current research on activists’ actual engagement with deliberation, we argue that the standard of taking a “deliberative stance” (being respectful, sincere, and public-minded) is a good starting point for addressing both questions. By taking a deliberative stance, movements benefit from deliberation themselves and contribute to deliberative systems. However, we should also acknowledge that forms of deliberation change, and discovering new forms is a crucial part of what movements do for democracy. We propose to adopt a principle we call “reflective inclusion,” which allows us to engage abductively with new actions that might expand and deepen our understanding of what deliberation may look like.
The prevalence of substance use disorders and associated characteristics among patients admitted to a psychiatric hospital in Botswana
Authors: Otlhapile Othalefile E. , Gitau Catherine W. , Kuria Mary W.
Published: February 2023

Objective

Substance use disorders (SUDs) have increased substantially across the globe, and has become one of the world’s most significant public health and socioeconomic challenge. This study examined the prevalence and patterns of substance use disorders among patients admitted to the main psychiatric hospital in Botswana, the Sbrana Psychiatric Hospital.

Method

This was a cross-sectional study of patients admitted to a major psychiatric hospital in Botswana. SUDs were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v13.0. Bivariate analysis was conducted to determine the association between socio-demographic characteristics and SUDs. Multivariate logistic regression was used to control for confounders.

Results

The final analysis involved 101 patients. Participants ranged in age from 18-60 years, and over half (59.4%) were male. The majority of participants (85.1%) had used potentially addicting substances at least once during their lifetime, with 63.4% having current substance use disorders. The most frequently used substances were tobacco, cannabis, alcohol, and cocaine at 58.4%, 42.6%, 34.7% and 12.8% respectively. SUDs were more common among participants who were male, ages 18–35 years, single, had a tertiary education, or were unemployed.

Conclusions

There is a high prevalence of substance use and SUDs among psychiatric patients in Botswana. Screening for and interventions to manage SUDs should be part of routine care at psychiatric health care facilities in this country. Consideration should be given to the screening of all patients admitted to psychiatric hospitals in Botswana for SUDs using the ASSIST.
Radical Reorganization of Environmental Policy: Contemporaneous Evidence from Brazil
Authors: Capelari Mauro Guilherme Maidana , Pereira Ana Karine , Rivera Nathaly M. , de Araújo Suely Mara Vaz Guimaráes
Published: February 2023

An overview of environmental policy in Brazil since President Jair Bolsonaro took office in January 2019 suggests that the rise to power of a new political elite has led to a radical change in Brazil’s trajectory of climate change initiatives and environmental protection. The new elite is associated with the disruption of two factors historically relevant for the design of environmental policy: the participation of civil society in the governance of public policy and multilateralism in matters of environment policy.

Uma análise das políticas ambientais brasileiras desde a tomada de posse de Jair Bolsonaro da presidência da República em Janeiro 2019 constata que o aparecimento de uma nova elite política acarretou em uma alteração radical na trajetória do Brasil com respeito às suas iniciativas sobre a mudança climática e a preservação ambiental. Houve uma perturbação de dois fatores por causa desta elite política que eram historicamente importantes pela elaboração de políticas ambientais: a participação de organizações de sociedade civil na governança de políticas públicas e o multilateralismo.
Between Markets and Barracks: The Economic Policy Narrative of Brazilian Authoritarianism
Authors: Søndergaard Niels
Published: February 2023

In recent years, a series of right-wing populists has ascended to power in both the Global North and the Global South. While these leaders frequently have provided challenges to liberal democracy, neoliberal modes of economic governance have often been part of their agendas. Analysis of the economic policy narrative of the Brazilian President Jair Bolsonaro’s electoral campaign in 2018 through the theoretical lens of authoritarian neoliberalism reveals that it has worked by the relegation of economic matters to technocratic management outside the sphere of democratic debate and the instrumentalized estrangement of groups and institutions opposed to his political views.

Recentemente, uma série de populistas direitistas têm chegado ao poder tanto nos países do norte como naqueles do sul. Enquanto estes lideres frequentemente apresentam desafios às democrâcias liberais, modos neoliberais de governança econômica muitas vezes desempenham um papel nas suas agendas. Uma análise da narrativa da política econômica na campanha presidencial do Presidente Jair Bolsonaro no Brasil em 2018 mediante uma visão teorética de neoliberalismo autoritário indica que ela funcionou pela relegação de assuntos econômicos a gestores tecnocrâticos que ficam fora da esféra de debate democrâtico e pelo afastamento instrumentalizado de grupos e instituições que se opõem às idéias políticas de Bolsonaro.
How to Find Mr/Miss Right? The Mechanism of Search Among Online Daters in Shanghai
Authors: Shen Yang , Qian Yue
Published: February 2023

Although online dating tools have become increasingly diverse over the decades, little is known about the search strategies of individuals or their choices of using certain dating platforms. Based on interviews with 29 heterosexual, highly-educated daters conducted in Shanghai, we examine their strategies for finding a partner online. Online daters can be categorized into three distinct dating types depending on their mating goals and mate preferences: dating, xiangqin (matchmaking), and mixed. We investigated the underlying gendered factors that drove them to specific dating types and guided their choices of online dating platforms. Despite the heterogeneity in dating types, online dating exhibited homophily effects, which may reinforce social inequality in China’s marriage market. While existing research often contrasted online dating with “traditional venues” and used online dating to symbolize modernity, we illustrate the subtlety between xiangqin and dating, thereby challenging the widely-used dichotomy of traditionality and modernity in conceptualizing family-related behaviors.
Bernard Stiegler and the Internation Project: An Introduction
Authors: Bishop Ryan
Published: February 2023

This article serves as the introduction to the Annual Review special section entitled ‘Bernard Stiegler and the Internation Project: Computational Practices and Circumscribed Futures’. As such, it introduces the collective undertaking of the Internation Project in relation to Stiegler’s long career as a thinker, educator and community organizer. The introduction pursues a number of themes addressed in the section’s contributions, including pharmacological logic, transindividuation, computational practices, bifurcation and negentropy (means of slowing entropic processes at individual and collective levels). All of these themes pertain to the climate crises the world collectively faces and posit means by which futures can be conceived in less detrimental and destructive economic, social, technological and intellectual ways. The Internation Collective as represented and furthered in this special section responds to the demands of climate crises through a macroeconomic model designed to combat entropy at various scales, from the bio-chemical to the biosphere.
Notes on Structuralism: Introduction
Authors: Manghani Sunil
Published: February 2023

This commentary introduces a section of the journal titled ‘Notes on Structuralism’. It centres around two interviews. The first, from 1987, is with the structural anthropologist Mary Douglas (who speaks on various aspects of her work, including on Purity and Danger). The second is an interview with Roland Barthes, who, speaking in 1965, was at the height of his structuralist phase. The interview focuses upon the structural analysis of narrative and prefigures the well-known volume of Communications on the subject. The interviews are supplemented with introductions and: a commentary on Barthes’ interview by Jonathan Culler, who contextualizes the development of Barthes’ thinking around narrative (as it leads to the publication of S/Z), The article concludes with reflections on structuralism with regards to contemporary practices of big data, AI and large language models.
Clinical assessment can be lifesaving: Salvage of catastrophic cerebral ischemia by conversion to central extracorporeal membrane oxygenation
Authors: Ivanov Yaroslav , Buratto Edward , Konstantinov Igor E. , Clifford Michel , Brizard Christian P. , Horton Stephen
Published: February 2023

Peripheral veno-artertial extracorporeal membrane oxygenation (VA-ECMO) is commonly used in the paediatric population for intractable respiratory and cardiac failure. One of the devastating complications of VA-ECMO is severe brain damage due to ischemia or haemorrhage. We describe a case of peripheral cervical VA-ECMO complicated by evolving right cerebral ischemia which was rescued with rapid conversion from peripheral to central VA-ECMO support. Notably, the patient had a complete circle of Willis. Following conversion, we observed complete resolution of neurological symptoms with full functional recovery.
Morbid obesity’s impact on COVID-19 patients requiring venovenous extracorporeal membrane oxygenation: The covid-19 critical care consortium database review
Authors: Javidfar Jeffrey , Zaaqoq Akram M , Labib Ahmed , Barnett Adrian G , Hayanga JW Awori , Eschun Greg , Yamashita Michael H , Jacobs Jeffrey P , Heinsar Silver , Suen Jacky Y , Fraser John F , Bassi Gianluigi Li , Arora Rakesh C , Peek Giles J ,   on behalf of the Covid-19 Critical Care Consortium (COVID Critical)
Published: February 2023

Introduction: Obesity is associated with a worse prognosis in COVID-19 patients with acute respiratory distress syndrome (ARDS). Veno-venous (V-V) Extracorporeal Membrane Oxygenation (ECMO) can be a rescue option, however, the direct impact of morbid obesity in this select group of patients remains unclear.

Methods: This is an observational study of critically ill adults with COVID-19 and ARDS supported by V-V ECMO. Data are from 82 institutions participating in the COVID-19 Critical Care Consortium international registry. Patients were admitted between 12 January 2020 to 27 April 2021. They were stratified based on Body Mass Index (BMI) at 40 kg/m2. The endpoint was survival to hospital discharge.

Results: Complete data available on 354 of 401 patients supported on V-V ECMO. The characteristics of the high BMI (>40 kg/m2) and lower BMI (≤40 kg/m2) groups were statistically similar. However, the ‘high BMI’ group were comparatively younger and had a lower APACHE II score. Using survival analysis, older age (Hazard Ratio, HR 1.49 per-10-years, CI 1.25–1.79) and higher BMI (HR 1.15 per-5 kg/m2 increase, CI 1.03–1.28) were associated with a decreased patient survival. A safe BMI threshold above which V-V ECMO would be prohibitive was not apparent and instead, the risk of an adverse outcome increased linearly with BMI.

Conclusion: In COVID-19 patients with severe ARDS who require V-V ECMO, there is an increased risk of death associated with age and BMI. The risk is linear and there is no BMI threshold beyond which the risk for death greatly increases.
An exploratory interpretivist study of how adults with substance use disorders experience peer social connectedness during recovery-oriented songwriting
Authors: Bourdaghs Sonia , Silverman Michael
Published: February 2023

Despite evidence linking social connectedness (SC) and substance use disorders (SUD) treatment outcomes, there remains a gap in the literature about how people with SUD experience SC during music therapy. The purpose of this study was to understand how adults with SUD on an inpatient detoxification unit experienced SC during group-based songwriting. Participants were 12 adults with SUD who attended a single-group recovery-oriented songwriting session. After four sessions, we conducted individual semi-structured interviews with participants and used an inductive approach to thematic analysis to analyze interviews. Five themes emerged. The first two themes addressed how the songwriting session influenced SC: (1) songwriting facilitated participation and recognition of shared experiences with peers and (2) collaboratively creating a musical product was a positive experience that facilitated peer connections. Although not specific to the songwriting intervention, the final three themes described how social relationships, addiction, and recovery interacted and influenced each other more broadly: (3) addiction is associated with damaged relationships and isolation, (4) relationships and social support can aid or hinder recovery, and (5) reluctance to form relationships in treatment. Implications for clinical practice, limitations, and suggestions for future research are provided.