bluuebunny/crossref_metadata_2025 huggingface dataset:
The Metaphysics of Sensory Experience
Authors: Papineau David
Published: April 2021

What are the materials of conscious perceptual experience? What is going on when we are consciously aware of a visual scene, or hear sounds, or otherwise enjoy sensory experience? In The Metaphysics of Sensory Experience David Papineau exposes the flaws in contemporary answers to this central philosophical question and defends a new alternative. Contemporary theories of perceptual experience all hold that conscious experiences reach out into the world beyond the mind. According to naïve realism, experiences literally incorporate perceived facts, while representationalism holds that experiences contain ordinary properties of the kind possessed by physical objects. These ideas might seem attractive at first sight, but Papineau shows that they do not stand up to examination. Instead Papineau argues for a purely qualitative account of sensory experience. Conscious sensory experiences are intrinsic states of people with no essential connection to external circumstances or represented properties. This might run counter to initial intuition, but Papineau shows that it is the only view that fits the facts. He develops this qualitative theory in detail, showing how it can accommodate the rich structure of sensory experience. Papineau’s qualitative account has respectable antecedents in the history of philosophy, and is also probably the view adopted by most non-specialists, be they reflective high school students, practising neuroscientists, or philosophers working outside the philosophy of perception. By placing the qualitative theory on a firm footing, Papineau shows all those curious about experience that they need not be restricted to the options on the contemporary philosophical menu.
Business Ethics
Authors: Lutge Christoph , Uhl Matthias
Published: April 2021

Business ethics continues to gain importance in the curricula of business studies courses. This book provides a comprehensive overview of both the essential concepts of business ethics related to the economy as a whole, and the more narrowly understood corporate ethics related to the individual company. In contrast to other works on the same topic, special emphasis is placed on a coherent theoretical foundation that puts tools of economic analysis, including behavioral economics, at the center. In particular, the importance of both empirical research and dilemma structures for business ethics receives special attention. The largest chapter of the book is devoted to corporate ethics and provides students and academics with guidance in the theoretical classification of the variety of concepts that often coexist in the debate. Abstract concepts are illustrated with the help of practice boxes.
Guided by Voices
Authors: Wiland Eric
Published: April 2021

Guided by Voices defends both moral testimony and advice against a wide variety of common worries. It instead argues that it is often wise both to believe what other people tell you about what’s right and wrong, and to trust their advice. Deferring to others about moral matters is a way of gaining moral knowledge and understanding. Accepting testimony about morality can remedy epistemic injustice and forge epistemic solidarity. Best of all, taking advice is a way of forming a joint agent with your adviser, one whose activity is just as good as that of individual agents. Arguing against the presumption that moral reasoning is ideally done alone, Guided by Voices is the first book-length treatment of moral testimony and advice.
Competition within Technology
Authors: Pulkki Jani , Värri Veli-Matti
Published: April 2021

This chapter consist of a philosophical investigation of competition and its adverse effects on human moral growth. It considers competition as a Heideggerian technology, a mechanism, which ‘enframes’ our thoughts, feelings, and presuppositions about possible solutions to the ecocrisis. The history of competitive thought is scrutinized in terms of violent and mechanistically perceived human nature, evolutive mechanism, and the struggle for existence. Furthermore, economic ideas of scarcity, insatiable wants and needs, freedom, and merits are seen important features of defining what competition is. Competition is defined as the pursuit of scarce resources in a free society, and all of the defining concepts of competition are put under critical scrutiny. The chapter shows that competition is not only a neutral economic mechanism, but includes the human pursuit of superiority that impedes the development of empathy and willingness to help others, and limits the way we perceive the world and opportunities for ecological change.
Anarchy over Law? Towards a Genealogy of Modern War Justifications (1789–1918)
Authors: Simon Hendrik
Published: April 2021

Hendrik Simon follows up on Anuschka Tischer’s analysis of European justifications of war. He turns to transformation of this discourse’s vocabulary in the context of the nineteenth century: to this day, most textbooks on the history of international law and international relations contain the proposition that European states held a sovereign right to go to war (liberum ius ad bellum) in the nineteenth-century international order. The latter is still understood as an anarchic mirror image of the modern international order, which (supposedly) emerged in the first half of the twentieth century. This assumption is challenged in this chapter: by outlining a genealogy of modern war justifications, starting with the French Revolutionary Wars, Hendrik Simon seeks to deconstruct liberum ius ad bellum as a myth which emanated from the realist and liberal narratives of the emergence of the modern international order. The fundamental argument is that the ‘long’ nineteenth century is not the anarchic converse of the modern discourse on war and international order—but its epoch of birth.
Peace through Law: Lessons from 1914
Authors: Chimni B.S.
Published: April 2021

The theme ‘peace through law’ has engaged the continued attention of states and international law scholars – and indeed for a much longer time than often assumed, as the chapters in Part III have shown. In the context of the First World War, the urgency of this project again became particularly clear. But despite the changes in the normative and institutional structures since the beginning of the twentieth century, wars are still with us. It is in this context that Bhupinder S. Chimni revisits the rich reflections of the times on the causes of the First World War and asks whether more international law could have prevented the war. The aim is to draw certain lessons for our times.
Foreign Debt and Colonization in Egypt and Tunisia (1862–82)
Authors: Tunçer Ali Coşkun
Published: April 2021

This paper explores two interlinked questions: why Tunisia and Egypt were faced with the international financial control after their default in 1868 and 1876, and why the international financial control eventually led to the colonization of these two polities by France and Britain in 1881 and 1882. The chapter maintains that the emergence of international financial control was a multilateral solution to a range of private financial claims against the Egyptian and Tunisian governments following defaults. Yet, international financial control organizations were unable to successfully address the conflicting interests among foreign bondholders, as the existence of foreign bondholders from different European powers acted as a check over the concentration of the power in the hands of a single European country. Only after colonization, when the legal pluralism and multilateral nature of the financial control organizations came to an end, the creditworthiness of Egypt and Tunisia started recovering in international financial markets. At odds with other cases of international financial control in the region, this chapter shows that the success of multilateral international financial control organizations in the first age of financial globalization was not unconditional. Although other cases of international financial control before 1914 offered a solution to competing imperial and bondholder interests, in the case of Egypt and Tunisia, international financial control organizations became obstacles to the ongoing colonization process by Britain and France.
The Fortune of Geopolitical Conditions in Debt Diplomacy
Authors: Angel Gustavo Del , Pérez-Hernández Lorena
Published: April 2021

This chapter revisits the relevance of geopolitical factors during sovereign debt negotiations. We explain how the Mexican government reached an agreement with international creditors for the repayment of its foreign debt in 1942, after more than twenty-five years of unsuccessful negotiations. The agreement, that included a haircut of 90 per cent, was the result of a change in the geopolitical situation of Mexico, when the United States entered the Second World War and considered that country a strategic ally. The agreement, we argue, also derived from Mexico’s proactive stance in debt negotiations and bond repurchasing. This chapter studies the process of negotiations since 1922 and the conditions that allowed Mexico to reach an unusually advantageous settlement.
Settlement Endurance
Authors: O’Flynn. Levy
Published: April 2021

This chapter focuses on the question of settlement endurance—a question that overlaps with but is importantly distinct from the question of settlement achievement (as discussed in Chapter 2). We argue that even a brief popular act of entrenchment may solidify in the form of a lasting constitutional settlement. However, the process by which this act occurs is crucial. We particularly focus on deliberative peace referendums. One claim in this chapter will be that these referendums, by drawing on institutional supports for deliberation, may expose a broad but latent constitutional agreement that may already have existed at the popular (but not the elite) level in a conflict society. The referendum may also clarify the reasons on which an agreement is based, and hence deepen the sense of legitimacy that attaches to it.
Group Secession
Authors: O’Flynn. Levy
Published: April 2021

This chapter looks at Deliberative Peace Referendums in the context of secession—that is, where the members of a territorially concentrated group seek legal and political separation from a larger sovereign state of which the group has been an integral part. They typically do so with the aim of establishing a new sovereign state that enjoys international legal status on a par with other states in the international system. As we will see, secession is essentially unilateral: the decision to secede from the existing state rests ultimately with the seceding group. Consequently, the idea that secession referendums should be based on concurrent consent among more than one group will be out of place. Yet while the consent of the existing state may not be formally required, the degree to which the seceding group seeks to include others in its deliberations may make an important difference to how the legitimacy of the referendum is perceived—domestically, regionally, and internationally. In secession conflicts, therefore, Deliberative Peace Referendum design must reflect both the unilateral nature of the decision and the need to reach out to individuals in the existing state, the wider region, and international community. To this end, we consider (among other matters) both the structure of the ballot and the potential role of mini-publics. However, before doing so, we first discuss a prior question. Various legal and political philosophers disagree about when secession is justified. Some argue that secession cannot be sensibly justified on self-determination grounds. By corollary, they argue that the referendum should play no part in our thinking about secession conflicts. Against this view, we argue that the right to self-determination is an important public value of the sort that Rawls describes. Like all such values, it needs to be weighed in the balance against other, competing public values—which is to say that it can and should be tested through a Deliberative Peace Referendum
Indigenous-Settler Conflicts
Authors: O’Flynn. Levy
Published: April 2021

In this chapter we look at the possibility of using deliberative peace referendums in the context of indigenous-settler conflicts, in which the root of the conflicts lie in historical acts by which colonizing powers asserted their own sovereignty over or in place of that of existing peoples in the same territory. Not all indigenous-settler states experience overt conflict, but those that do sometimes share certain characteristics, such as experiences of dispossession, assimilation and subalterneity. This presents an especially formidable obstacle to public-value deliberation. Adequate deliberative peace referendum design may require a preliminary period in which comprehensive and detailed changes to policies and laws are used to address political and economic inequalities—and a delay in the running of the referendum for years, or even decades. We must also consider whether an additional feature of indigenous-settler societies (apart from structural inequalities that are not, in any case, unique to these societies) will significantly impede deliberation in the course of a peace referendum. Several authors have explored the sharp divergences between the empirical, normative and epistemic views (including views about group sovereignty itself) of indigenous and settler populations. Hence indigenous-settler conflicts will be among the conflict subtypes that most significantly challenge our conception of deliberative peacemaking within the deliberative peace referendum.
Digitalized Invention, Decentralized Patent System
Authors: Ali Feroz
Published: April 2021

Throughout the history of patent law, the manner of representation of invention influenced the process of the patent office in prosecuting them. This chapter traces how changes in the representation of the invention—from material to textual to digital—transformed patent prosecution. Early inventions were represented by working models, the materialized invention that needed little or no examination by the patent office, as they were the inventions themselves. Substantive examination became necessary when the representation of the invention shifted from material to textual, the point in history where the invention became textualized and represented by the patent specification, the written document that encompassed the invention. The textualized invention, apart from effecting critical changes in patent prosecution, centralized the operations of the patent office. With the adoption of new technologies like blockchain and artificial intelligence (AI), the manner of representation of invention will undergo yet another change resulting in the further evolution of patent prosecution. Like digital photography which changed the representation of images by radically changing the backend process, the digitalized invention will change the backend process of the patent office, ie, patent prosecution. The most significant systemic consequence of the digitalization of the invention will be the decentralization of patent system.
Latin Elegy and the Space of Empire
Authors: Lindheim Sara H.
Published: April 2021

This book argues that the subject in Latin elegy, beginning with Catullus, constitutes itself in relation to the dynamically expanding space of empire from the late Republic to the end of the Augustan age. The lack of fixity in the elegiac subject and space of empire go hand in hand. Questions of geographical space become questions about the de-centered, dislocated subject; in imagining geographical space our very nature as subjects comes to the fore. Catullus, Propertius, Tibullus, and Ovid each offers his own unique expression of the gendered subject, and their poetry runs the gamut of responses to the expanding geographical empire. First comes the dream of Roman imperium sine fine, an empire that capaciously stretches to the ends of the inhabited world. And yet, imperium sine fine requires the existence of some sort of fines, even if the fantasy demands that they be overrun. Formlessness, or worse, rapidly alternating forms, gives rise to anxieties and the desire to set down some fines, to establish where, exactly, the boundaries of empire are, what belongs “inside” and what can be relegated to “outside.” But fines, cartographically speaking, are never as stable as we want them to be, and, for a rapidly expanding empire, are always under pressure. The very constitution of the gendered elegiac subject mirrors, anticipates, runs parallel to the problems and anxieties that the map of expanding empire tries to solve, yet simultaneously reveals in its production of space.
A New Model for the Coldwell Complex and Associated Dykes of the Midcontinent Rift, Canada
Authors: Good David J , Hollings Pete , Dunning Greg , Epstein Rachel , McBride John , Jedemann Andrew , Magnus Seamus , Bohay Trevor , Shore Geoff
Published: April 2021

Mafic intrusions on the NE shoulder of the Midcontinent Rift (Keweenawan LIP), including Cu–PGE mineralized gabbros within the Coldwell Complex (CC), and rift parallel or radial dykes outside the CC are correlated based on characteristic trace element patterns. In the Coldwell Complex, mafic rocks are subdivided into four groups: (1) early metabasalt; (2) Marathon Series; (3) Layered Series; (4) Geordie–Wolfcamp Series. The Marathon Series are correlated with the rift radial Abitibi dykes (1140 Ma), and the Geordie–Wolfcamp Series with the rift parallel Pukaskwa and Copper Island dykes. U–Pb ages determined for five gabbros from the Layered and Marathon Series are between 1107·7 and 1106·0 Ma. Radiogenic isotope ratios show near chondritic (CHUR) εNd(1106 Ma) and 87Sr/86Sri values that range from –0·38 to +1·13 and 0·702537 to 0·703944, respectively. Distinctive geochemical properties of the Marathon Series and Abitibi dykes, such as Ba/La (14–37), Th/Nb (0·06–0·12), La/Sm (3·8–7·7), Sr/Nd (21–96) and Zr/Sm (9–19), are very different from those of the Geordie–Wolfcamp Series and a subset of Copper Island and Pukaskwa dykes with Ba/La (8·7–11), Th/Nb (0·12–0·13), La/Sm (6·7–7·9), Sr/Nd (5–7·8) and Zr/Sm (18–24). Each unit exhibits covariation between incompatible element ratios such as Zr/Sm and Nb/La or Gd/Yb, Sr/Nd and Ba/La, and Nb/Y and Zr/Y, which are consistent with mixing relationship between two or more mantle domains. These characteristics are unlike those of intrusions on the NW shoulder of the MCR, but resemble those of mafic rocks occurring in the East Kenya Rift. The results imply that an unusual and long-lived mantle source was present in the NE MCR for at least 34 Myr (spanning the 1140 Ma Abitibi dykes and the 1106 Ma Marathon series) and indicate potential for Cu–PGE mineralization in an area much larger than was previously recognized.
Making a Research Infrastructure: Conditions and Strategies to Transform a Service into an Infrastructure
Authors: Fecher Benedikt , Kahn Rebecca , Sokolovska Nataliia , Völker Teresa , Nebe Philip
Published: April 2021

In this article, we examine the making of research infrastructures for digital research. In line with many scholars in this field, we understand research infrastructures as deeply relational and adaptive systems that are embedded in research practice. Our aim was to identify the relevant context factors, actor constellations, organizational settings, and strategies which contribute to the evolution of a basic service into an actual infrastructure. To this end, we conducted thirty-three case studies of non-commercial and commercial research services along the research life cycle. By examining how these services emerge, we hope to gain a better understanding of the conditions and strategies to transform a service into an infrastructure. We are able to identify competitive disadvantages for publicly financed infrastructure projects with regard to the mode of implementation and the resources invested in development and marketing. We suggest that the results of this study are of practical relevance, especially for individuals, communities, and organizations wanting to create research infrastructures, as well as for funders and policy makers wanting to support innovative and sustainable infrastructures.
The N300: An Index for Predictive Coding of Complex Visual Objects and Scenes
Authors: Kumar Manoj , Federmeier Kara D , Beck Diane M
Published: April 2021

Predictive coding models can simulate known perceptual or neuronal phenomena, but there have been fewer attempts to identify a reliable neural signature of predictive coding for complex stimuli. In a pair of studies, we test whether the N300 component of the event-related potential, occurring 250–350-ms poststimulus-onset, has the response properties expected for such a signature of perceptual hypothesis testing at the level of whole objects and scenes. We show that N300 amplitudes are smaller to representative (“good exemplars”) compared with less representative (“bad exemplars”) items from natural scene categories. Integrating these results with patterns observed for objects, we establish that, across a variety of visual stimuli, the N300 is responsive to statistical regularity, or the degree to which the input is “expected” (either explicitly or implicitly) based on prior knowledge, with statistically regular images evoking a reduced response. Moreover, we show that the measure exhibits context-dependency; that is, we find the N300 sensitivity to category representativeness when stimuli are congruent with, but not when they are incongruent with, a category pre-cue. Thus, we argue that the N300 is the best candidate to date for an index of perceptual hypotheses testing for complex visual objects and scenes.
Significant Variation in Blood Transfusion Practice Persists Following Adolescent Idiopathic Scoliosis Surgery
Authors: O’Malley Sandra M. , Sanders James O. , Nelson Susan E. , Rubery Paul T. , O’Malley Natasha T. , Aquina Christopher T.
Published: April 2021

Study Design.

Retrospective case control study.

Objective.

To review current transfusion practise following Adolescent Idiopathic Scoliosis (AIS) surgery and assess risks of complication from transfusion in this cohort.

Summary of Background Data.

No study to date has investigated variation in blood transfusion practices across surgeons and hospitals following AIS surgery.

Methods.

Data were extracted from the Statewide Planning and Research Cooperative System. Using International Classification of Diseases (ICD-9) all patients with (ICD-9) code for AIS (737.30) (“idiopathic scoliosis”) and underwent spinal fusion between 2000 and 2015 were included. Bivariate and mixed-effects logistic regression analyses were performed to assess patient, surgeon, and hospital factors associated with perioperative allogeneic red blood cell transfusion. Additional multivariable analyses examined the association between transfusion and infectious complications.

Results.

Of the 7689 patients who underwent AIS surgery, 21.1% received a perioperative blood transfusion. After controlling for patient factors, wide variation in risk-adjusted transfusion rates was present with a 10-fold difference in transfusion rates observed across surgeons (4.4%–46.1%) and hospitals (5.1%–50%). Patient factors did not explain any of the surgeon or hospital variation. Use of autologous blood transfusion, higher surgeon procedure volume, and greater surgeon years in practice were independently associated with lower odds of allogeneic blood transfusion (P < 0.001), and surgeon and hospital characteristics explained 45% of surgeon variation but only 2.4% of hospital variation. Allogeneic blood transfusion was independently associated with postoperative wound infection (OR = 1.87, 95% CI = 1.20–2.93), pneumonia (OR = 1.68, 95% CI = 1.26–2.44), and sepsis (OR = 2.42, 95% CI = 1.11–5.83).

Conclusion.

Significant variation exists across both surgeons and hospitals in perioperative blood transfusion utilization following AIS surgery. Use of autologous blood transfusion and implementing institutional transfusion protocols may reduce unwarranted variation and potentially decrease infectious complication rates.

Level of Evidence: 3
Management of small bowel adenocarcinoma: making the most of the available evidence to inform routine practice
Authors: Mazlom Hadi , Teuwen Laure-Anne , Peeters Marc
Published: April 2021

Purpose of review

Small bowel adenocarcinoma (SBA) is a rare disease, for which few studies have been conducted so far. Therefore, most treatment recommendations have been extrapolated from trials in colorectal cancer. In this review, we revise available data that could improve the management of SBA, with a particular focus on systemic therapy.

Recent findings

For advanced/irresectable disease, first-line doublet chemotherapy remains standard of care. It is uncertain whether extending treatment to triplet chemotherapy brings added benefit. Pembrolizumab is an accepted treatment modality for mismatch repair-deficient tumors, yet might also be active in microsatellite stable tumors. More trials with immunotherapy are underway. Although there is no place for anti-EGFR monotherapy, the addition of cetuximab to chemotherapy should be investigated further. Two trials suggest an added value of bevacizumab to chemotherapy, yet larger trials are needed to confirm these data. For localized disease, the role of (neo)adjuvant chemotherapy is under investigation.

For decades, patients with SBA have probably been treated suboptimal by basing treatment recommendations on data from colorectal cancer. An effort for SBA-specific trials and/or inclusion of SBA patients in basket trials is of utmost importance in order to improve outcome for these patients.
Inverse Association of Poultry, Fish, and Plant Protein Consumption With the Incidence of Cardiovascular Disease
Authors: Chrysant Steven G. , Chrysant George S.
Published: April 2021

Cardiovascular disease (CVD) remains a major cause of death and disability worldwide and food intake plays an important role in its onset or prevention. It is also well known that consumption of red meat (processed and unprocessed) is associated with an increased incidence of CVD, coronary heart disease (CHD), and premature death. However, little is known about the association of consumption of poultry, fish, and plant protein with the incidence of CVD, CHD, and mortality. Several recent studies, reviews, and meta-analyses have shown an inverse association of consumption of these foods with the incidence of CVD, CHD, and death. In order to get a better perspective about the current consumption of these foods, a focused Medline search of the English language literature was conducted between 2010 and 2020 using the terms poultry, fish, plant protein consumption, cardiovascular disease, CHD, mortality; 28 articles with pertinent information were retrieved. The analysis of data from these articles suggests an inverse relationship between the consumption of these foods and the incidence of de novo CVD or worsening of preexisting CVD. They also demonstrate that the consumption of these foods is still low and that great effort should be made to inform the public about the benefits of switching from red meat to increased consumption of poultry, fish, and plant protein. All the data from the retrieved articles regarding the consumption of these foods, together with collateral literature, will be discussed in this review.
Using Telehealth Approaches to Address Social Determinants of Health and Improve Pregnancy and Postpartum Outcomes
Authors: DIXON-SHAMBLEY KAMILAH , GABBE PATRICIA T.
Published: April 2021

Telehealth has expanded its reach significantly since its inception due to the advances in technology over the last few decades. Social determinants of health (SDOH) negatively impact the health of pregnant and postpartum women and need to be considered when deploying telehealth strategies. In this article, we describe telehealth modalities and their application to improve the SDOH that impact pregnancy and postpartum outcomes. Physicians and patients alike report satisfaction with telehealth as it improves access to education, disease monitoring, specialty care, prenatal and postpartum care. Ten years ago, we developed a program, Moms2B, to eliminate disparities in pregnancy outcomes for underserved women. Using a case study, we describe how Moms2B, devoted to improve the SDOH for pregnant women, transitioned from an in-person to a virtual format. Telehealth benefited women before the recent coronavirus disease 2019 pandemic and increasingly after emergency authorizations has allowed telehealth to flourish.
Basic Evaluation of Urinary Incontinence
Authors: RAZA-KHAN FAREESA
Published: April 2021

Urinary incontinence is a significant, quality of life health condition affecting millions of women. Incontinence is increasingly common as the population ages, and women present with varying degrees of bother. With basic in-office evaluation, most subtypes of urinary incontinence can be defined, evaluated, and treated. Basic in-office evaluation involves a detailed history with a review of current medical problems and medications, a physical examination, and selective in-office testing.
Chiropractic Care for the Pregnant Body
Authors: CONNER SHAYNA N. , TRUDELL AMANDA S. , CONNER CRAIG A.
Published: April 2021

Chiropractic care is a commonly used treatment modality for musculoskeletal pain in pregnancy. Low back pain, pelvic pain, and other neuromuscular complaints are prevalent in pregnancy and contribute to significant maternal discomfort in many women. Nonpharmacologic therapies to relieve pain are increasingly important during pregnancy because of the opioid epidemic. Chiropractic treatment is one of the potential therapies that offers intervention without medications. This article provides an evidence-based review of the epidemiology of chiropractic use in obstetrics, commonly treated conditions, related physiology of pregnancy, and safety of spinal manipulation.
Effect of Cytokine Adsorption on Survival and Circulatory Stabilization in Patients Receiving Extracorporeal Cardiopulmonary Resuscitation
Authors: Supady Alexander , Zahn Timm , Rieder Marina , Benk Christoph , Lother Achim , Bode Christoph , Wengenmayer Tobias , Staudacher Dawid , Kellum John A. , Duerschmied Daniel
Published: April 2021

Even after the introduction of extracorporeal cardiopulmonary resuscitation (ECPR), survival after cardiac arrest remains poor. Excess release of vasoactive cytokines may be a reason for cardiovascular instability and death after ECPR. Recently, an extracorporeal cytokine adsorption device (CytoSorb) to reduce elevated levels of circulating cytokines has been introduced. So far, it remains unclear if this device may improve survival and cardiovascular stabilization after ECPR. We report data from our investigator-initiated, single-center ECPR registry. We compared 23 ECPR patients treated with cytokine adsorption with a propensity-matched cohort of ECPR patients without cytokine adsorption. We analyzed survival, lactate clearance, vasopressor need, and fluid demand in both groups and performed between-group comparisons. Survival to discharge from intensive care unit (ICU) was 17.4% (4/23) in the cytokine adsorption group and 21.7% in the control group (5/23,
P
> 0.99). In both groups, we observed a decrease of serum-lactate, need for vasopressors, and fluid demand during the first 72 hours after ECPR. However, in direct comparison, we did not find significant between-group differences. In this retrospective registry study employing propensity score matching, cytokine adsorption in severely ill patients after ECPR was not associated with improved ICU survival nor a decrease of lactate, fluid, or vasopressor levels. Due to small case numbers and the retrospective design of the study, our results neither disprove nor confirm a clinically relevant treatment effect of cytokine adsorption. Results from larger trials, preferably randomized-controlled trials are required to better understand the clinical benefit of cytokine adsorption after ECPR.
Paradoxical hidradenitis suppurativa in Crohn’s disease patients receiving infliximab: a case report and review of literature
Authors: Salvatori Silvia , Marafini Irene , Monteleone Giovanni
Published: April 2021

The introduction of TNF blockers in the therapeutic armamentarium of inflammatory bowel diseases (IBD) has largely advanced the way by which clinicians manage these disorders. However, some patients develop de novo immune-mediated diseases during the treatment. We here present the case of paradoxical hidradenitis suppurativa, a chronic inflammatory skin disease characterized by the development of recurrent nodules and abscesses in intertriginous areas, in a 20-year-old, nonsmoker, normal-weight women, with no family history of hidradenitis suppurativa or IBD, diagnosed with nonstricturing nonpenetrating ileocolonic Crohn’s disease in 2013, during treatment with infliximab. Infliximab discontinuation was followed by a significant improvement of skin lesions. We also discuss 22 additional cases of paradoxical hidradenitis suppurativa in IBD patients on TNF antagonists reported in the literature with the aim to identify potential risk factors for the development of such a complication. All the patients had Crohn’s disease, and the majority of them were women (19/23; 82.6%). All cases occurred during therapy with anti-TNF agents [14/23 (61%) patients were treated with adalimumab and 9/23 (39%) patients were treated with infliximab]. The therapeutic approach directed at maintaining/holding the undergoing biologic therapy is still uncertain. Further studies are needed to determine the most appropriate treatment choice toward ongoing biologic therapy.
Artificial intelligence in bladder cancer prognosis: a pathway for personalized medicine
Authors: Pinar Ugo , Pradere Benjamin , Roupret Morgan
Published: April 2021

Purpose of review

This review aims to provide an update of the results of studies published in the last 2 years involving the use of artificial intelligence in bladder cancer (BCa) prognosis.

Recent findings

Recently, many studies evaluated various artificial intelligence models to predict BCa evolution using either deep learning or machine learning. Many trials evidenced a better prediction of recurrence-free survival and overall survival for muscle invasive BCa (MIBC) for deep learning-based models compared with clinical stages. Improvements in imaging associated with the development of deep learning neural networks and radiomics seem to improve post neo-adjuvant chemotherapy response. One study showed that digitalized histology could predict nonmuscle invasive BCa recurrence.

BCa prognosis could be better assessed using artificial intelligence models not only in the case of MIBC but also NMIBC. Many studies evaluated its role for the prediction of overall survival and recurrence-free survival but there is still little data in the case of NMIBC. Recent findings showed that artificial intelligence could lead to a better assessment of BCa prognosis before treatment and to personalized medicine.
Loneliness, Death Perception, and Spiritual Well-Being in Adult Oncology Patients
Authors: Kavalalı Erdoğan Tuğba , Koç Zeliha
Published: April 2021

Background

Holistic nursing care requires taking into consideration the spiritual and emotional dimensions of the patient.

Objective

The aim of this study was to determine the relationships among loneliness, death perception, and spiritual well-being in adult oncology patients.

Methods

This cross-sectional, descriptive-correlational study was conducted between March 20, 2018, and September 20, 2018. A total of 347 oncology inpatients participated in this study. Data were collected using the UCLA Loneliness Scale (UCLA-LS), the Personal Meanings of Death Scale, and the Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale (FACIT-Sp).

Results

A significant negative relationship was found between UCLA-LS total scores and FACIT-Sp total scores (r = −0.217, P < .01). Positive significant relationships between FACIT-Sp total scores and the Afterlife (r = 0.425, P < .01), Motivation/Legacy (r = 0.468, P < .01), and Extinction (r = 0.337, P < .01) subdimension scores of the Personal Meanings of Death Scale were also found. Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale total scores were affected by age (B = −0.158), having graduated from a university (B = −7.859), living in the city center (B = −5.607), current diagnosis (B = −0.416), surgical treatment (B = −5.291), and receiving chemotherapy (B = 5.304). The UCLA-LS scores were unrelated to the sociodemographic and clinical characteristics of the patients (P > .05).

Conclusion

Oncology patients experience moderate levels of loneliness, which decrease as their spiritual well-being levels increase. Patients with higher levels of spiritual well-being were found to attribute more positive meanings to death.

Implications for Practice

Spiritual well-being, loneliness, and death perception should be periodically evaluated in oncology patients, and appropriate nursing interventions should be planned.
Prostate-Specific Membrane Antigen Expression in Patients With Differentiated Thyroid Cancer With Thyroglobulin Elevation and Negative Iodine Scintigraphy Using 68Ga-PSMA-HBED-CC PET/CT
Authors: Verma Priyanka , Malhotra Gaurav , Meshram Vilas , Chandak Ashok , Sonavane Sunita , Lila Anurag R. , Bandgar Tushar R. , Asopa Ramesh V.
Published: April 2021

Purpose of the Report

Prostate-specific membrane antigen (PSMA) is a member of superfamily of zinc-dependent exopeptidases that is robustly expressed in prostate cancer cells and nonprostatic solid tumor neovasculature including microvessels of thyroid tumors. Its expression in differentiated thyroid cancer (DTC) has been confirmed in many recent studies, but systematic studies exploring PSMA expression in patients with DTC with thyroglobulin elevation and negative iodine scintigraphy (TENIS) are lacking. The aim of the present study was to evaluate the role of PSMA scan in TENIS patients with DTC.

Methods

Nine consecutive patients with DTC with proven TENIS syndrome (6 men and 3 women with age range 29–68 years and mean age of 48 years) underwent 18F-FDG PET/CT as per the institution protocol. Thereafter, they were subjected to 68Ga-PSMA-HBED-CC PET/CT as per the institution protocol within a week of FDG PET imaging. Prostate-specific membrane antigen expression (SUVmax) in the lesions was compared with 18F-FDG PET and CT scan findings.

Results

In 5 of 9 patients with TENIS, the metastatic lesions showed PSMA expression. A total of 14 lesions were seen on the CT scan. Prostate-specific membrane antigen PET detected 9 of 14 lesions (64.28%) (SUVmax ranging from 10.1 to 45.67; median SUVmax of 16.31), whereas FDG PET was positive in 11 of 14 lesions (78.57%). The lesions that showed PSMA uptake was localized to bones (5 of 9) and lungs (4 of 9). Two lesions that were localized to iliac crest and acetabulum were missed on FDG PET but were seen on CT and PSMA PET scan.

Conclusions

The results of this pilot study indicate that 68Ga-HBED-CC-PSMA PET/CT demonstrates PSMA expression in TENIS patients with lesions being localized to the bones and lungs. 68Ga-PSMA PET/CT could be useful for the identification of TENIS patients who might benefit from PSMA-targeted radionuclide therapy.
Efficacy and Safety of the 64Cu(II)Cl2 PET/CT for Urological Malignancies
Authors: Mascia Manlio , Villano Carlo , De Francesco Valerio , Schips Luigi , Marchioni Michele , Cindolo Luca
Published: April 2021

Purpose of the Report

The aim of this study was to evaluate safety and efficacy of copper-64(II)dichloride (64Cu(II)Cl2) as a new PET tracer for urological malignancies (UMs).

Methods

Patients with UM were enrolled in a prospective study. All patients were staged with preoperative CT and 64Cu(II)Cl2 PET/CT. Patient characteristics, anatomical and functional imaging, and final histopathology were recorded. Surgical specimens for histopathological examination were collected. To determine time-activity curves for 64Cu(II)Cl2 uptake in UM and normal tissues, SUVs were calculated. The safety of 64Cu(II)Cl2 was assessed.

Results

Twenty-three patients were included. An administered activity of 174.7 MBq (4.72 mCi) for 64Cu(II)Cl2 was equal to 9.80 mSv of the effective dose. The median SUVmax values were 5.7, 0.9, 1.8, and 9.8 for the prostate, bladder, penis, and kidney, respectively. Median SUVmax values were higher in organs with a malignancy in comparison with healthy tissue (prostate [11.5 vs 5.3, P < 0.001], bladder [6.2 vs 0.9, P = 0.007], and penis [3.9 vs 1.3, P = 0.027]), but not in the kidneys (5.0 vs 10.4, P = 0.998). The highest area under the curve (AUC) was reported for prostate cancer (AUC, 0.978), and the lowest for penile cancer (AUC, 0.775). The detection rates based on the best suggested cutoff according to the SUVmax were 85.7% (6/7) for prostate and bladder and 83.3% (5/6) for penile cancer. Neither drug-related effects nor physiologic responses occurred, nor adverse reactions.

Conclusions

64Cu(II)Cl2 is an effective and well-tolerated tracer in patients with UM. Our results show higher SUVmax in cancer patients than in healthy subjects. Our findings suggest that 64Cu(II)Cl2 PET/CT is useful in patients affected by prostate, bladder, and penis cancer.
Asymmetric Amyloid Deposition as an Early Sign of Progression in Mild Cognitive Impairment Due to Alzheimer Disease
Authors: Yoon Hai-Jeon , Kim Bom Sahn , Jeong Jee Hyang , Kim Geon Ha , Park Hee Kyung , Chun Min Young
Published: April 2021

Purpose

In typical Alzheimer disease with dementia (ADD), amyloid pathologies affect both cerebral hemispheres symmetrically. However, the spatial distribution of amyloid-β (Aβ) in the early stage of ADD or over the course of disease has not been investigated. Therefore, we explored asymmetric pattern of Aβ deposition in both hemispheres according to the ADD continuum using 18F-florbetaben PET.

Methods

Sixty-eight subjects, including 15 Aβ-negative normal controls, 28 Aβ-positive mild cognitive impairment (Aβ+ MCI), and 25 Aβ-positive ADD (Aβ+ ADD) subjects, were enrolled. Differences in the asymmetry index and SUV ratio in each of the 6 target regions (4 cortical lobes, cingulate, precuneus) plus composite region between groups were explored.

Results

The composite and target regional asymmetry indices were significantly different between groups and was highest in Aβ+ MCI (composite, occipital, and temporal, P < 0.001; frontal, P = 0.004). The composite and target regional SUV ratios were significantly different according to 3 groups with gradual increase and were highest in Aβ+ ADD (composite and all target regions, P < 0.001).

Conclusions

The asymmetric pattern of amyloid deposition was distinct between Aβ-negative normal controls and Aβ+ MCI. This pattern disappeared as the disease progressed. These data indicate that asymmetric amyloid deposition may be an early sign of MCI over the course of ADD.
Central Nervous System Involvement of Hemophagocytic Lymphohistiocytosis
Authors: Allard Bastien , Delcroix Olivier , Le Lez-Soquet Servane , Sacaze Elise , Querellou Solène
Published: April 2021

Hemophagocytic lymphohistiocytosis is rare life-threatening syndrome, hereditary or acquired, mainly affecting children. Hemophagocytic lymphohistiocytosis is an immune deficiency characterized by severe inflammation caused by uncontrolled proliferation of activated lymphocytes and macrophages. The usual biological and clinical data may associate polyadenopathy, hepatosplenomegaly, fever, multivisceral damages, and cytopenias with potential multiorgan dysfunction and death. We report the case of a 4-year-old girl, hospitalized for recurrent cerebellar symptoms (ataxia) associated later with fever and pancytopenia. 18F-FDG PET/CT revealed a node pathological uptake, which was biopsied and confirmed a diagnosis of hemophagocytic lymphohistiocytosis.
Synchronous Bilateral Adrenal Gland Metastases of Bladder Carcinoma Revealed on 18F-FDG PET/CT
Authors: Erol Özge , Ergül Nurhan , Algün Gedik Arzu , Beyhan Ediz , Çermik Tevfik Fikret
Published: April 2021

Bilateral adrenal metastases from bladder carcinoma have been reported rarely. We report an 86-year-old man with urothelial bladder carcinoma who had received chemotherapy and radiotherapy. Bilateral synchronous adrenal gland metastases were observed on 18F-FDG PET/CT.
Secretory Leukocyte Proteinase Inhibitor Protects Acute Kidney Injury Through Immune and Non-Immune Pathways
Authors: Guerrieri Diego , Ambrosi Nella Gabriela , Romeo Horacio , Salaberry Juan , Toniolo María Fernanda , Remolins Carla , Incardona Claudio , Casadei Domingo , Chuluyan Eduardo
Published: April 2021

Acute kidney injury (AKI) is characterized by rapid loss of excretory function and is the clinical manifestation of several disorders affecting the kidney. The aim of the present study was to investigate the mechanism of action of Secretory Leukocyte Proteinase Inhibitor (SLPI) that protects the kidneys form AKI. In vivo and in vitro experiments were performed to assess the effect of SLPI on kidney injury. Animal models of kidney injury was generated by 40 min obstruction of kidney artery and vein (ischemia-reperfusion injury model) or daily administration of 60 mg/kg/day of gentamicine for 5 day (gentamicin-associated AKI model). For in vitro assessment, human renal epithelium HK-2 cells were cultured under serum starvation conditions or with tacrolimus. The administration of SLPI (250 μg/kg, i.p.) reduced elevated plasma creatinine and blood urea nitrogen levels, tissue myeloperoxidase content, and acute tubular necrosis induced by kidney damage. Furthermore, SLPI treatment reduced CD86, CD68, CD14, CCL2, TNFα, and IL-10 transcripts in kidney biopsies. To further analyze a direct effect of SLPI on renal epithelial cells, HK-2 cells from human renal epithelium were cultured under serum starvation conditions or with tacrolimus. Both conditions induced apoptosis of HK-2 cells which was reduced when SLPI was present in the culture medium. Furthermore, SLPI favored the proliferation and migration of HK-2 cells. An analysis of the gene profiles of HK-2 cells treated with calcineurin inhibitors affected inflammatory and non-inflammatory pathways that were reversed by SLPI. Among them, SLPI down modulated the expression of CCL2, SLC5A3, and BECN1 but up-regulated the expression of TLR4, ATF4, ATF6, HSP90B, BBC3 SLC2A1, and TNFRSF10B. Overall, these results suggest that SLPI, in addition to its activity on immune cells, may directly target tubular epithelial cells of the kidney to mediate the nephroprotective activity in AKI.