bluuebunny/crossref_metadata_2025 huggingface dataset:
Don't Eat the Daisies: Disinterestedness and the Situated Aesthetic
Authors: Brady Emily
Published: June 2023

In debates about nature conservation, aesthetic appreciation is typically understood in terms of valuing nature as an amenity, something that we value for the pleasure it provides. In this paper I argue that this position, what I call the hedonistic model, rests on a misunderstanding of aesthetic appreciation. To support this claim I put forward an alternative model based on disinterestedness, and I defend disinterestedness against mistaken interpretations of it. Properly understood, disinterestedness defines a standpoint which precludes self-interest and utility, and it does not entail a passive subject abstracted from who they are. This standpoint is compatible with a ‘situated aesthetic’ in which appreciation of aesthetic qualities is grounded in an embedded subject who is sensitive to the context and narrative of the object. The alternative model provides a conception of aesthetic value which distinguishes it from amenity value, and it also defines a non-instrumental approach that offers the opportunity for enhanced appreciation and attention to nature's value.
Offending against Nature
Authors: Godlovitch Stan
Published: June 2023

Some environmental views characterise the human abuse of nature as an offence against nature itself. What conception of nature would best fit that characterisation? To focus upon such a conception, aesthetic offences against nature are examined and distinguished at the outset from moral offences. Aesthetic offences are divided into those internal to our cultural outlook and external to it. The external outlook, conceiving nature as a thing wholly apart from us, is shown to be necessary to any view of nature being offended against. Central to the external outlook is a conception of nature as the victim of offence without ever being itself an offending agent. Best fitting this is the notion of nature as primordially innocent. Given this metaphorical extension, the awkward consequence arises that any human use of nature constitutes thereby an abuse of it from the external standpoint.
Beyond Human Racism
Authors: Eckersley Robyn
Published: June 2023

In ‘Non-Anthropocentrism? A Killing Objection’, Tony Lynch and David Wells argue that any attempt to develop a non-anthropocentric morality must invariably slide back to either anthropocentrism (either weak or strong) or a highly repugnant misanthropy in cases of direct conflict between the survival needs of humans and nonhuman species. This reply argues that their attempt to expose the flaws in non-anthropocentrism deflects attention away from the crux of the ecocentric critique, which can best be understood if we replace the confusing terms anthropocentrism/non-anthropocentrism with ‘human racism'/ecocentrism (understood as a more inclusive moral perspective which encompasses nonracist humanism). Human racism manifests when a reconciliation of human and nonhuman needs is possible but is nonetheless concealed and/or denied. That is, the best test for discerning prejudice against nonhuman nature is not when individual or social choice are severely circumscribed but rather when such choices are relatively unconstrained. Moreover, their concluding argument that human concern for nonhuman nature should be understood in terms of aesthetic values rather than moral values does not provide reliable grounds for the systematic protection of nonhuman nature.
Nativism and Nature: Rethinking Biological Invasion
Authors: Peretti Jonah H.
Published: June 2023

The study of biological invasions raises troubling scientific, political and moral issues that merit discussion and debate on a broad scale. Nativist trends in Conservation Biology have made environmentalists biased against alien species. This bias is scientifically questionable, and may have roots in xenophobic and racist attitudes. Rethinking conservationists’ conceptions of biological invasion is essential to the development of a progressive environmental science, politics, and philosophy.
The Influence of Institutional Culture on the Formation of Pre-Regime Climate Change Policies in Sweden, Japan and the United States
Authors: Johnson Anne K.
Published: June 2023

This paper tests the claims of cultural theory using the formation of climate change policies in Sweden, the United States, and Japan as case studies. The theory posits that any social group consists of three main cultural types: the egalitarian, the market-oriented, and the hierarchical. Though all groups contain elements of each type, one cultural type usually prevails, giving the group its unique decision-making character. This paper applies cultural theory at the national level, testing to what extent the theory is able to project how countries will respond in addressing the issue of global warming. The results suggest that cultural theory may be useful to those involved in developing international agreements, enabling them to formulate regimes which are compatible with various cultural styles.
Nature Humanised: Nature Respected
Authors: Hepburn Ronald
Published: June 2023

How far is it true that the aesthetic appreciation of nature obscures, rather than illuminates, its objects? Do we not humanise nature, read our own subjectivity into it, sentimentally distort it, in our aesthetic – as distinct from scientific – approaches? I argue that not all humanising falsifies, and that we can respect nature as well as annex its forms and expressive qualities in our aesthetic appreciation. Respecting/humanising are explored as two of the chief key concepts for an understanding of the complexity of aesthetic attitudes to nature.
Forestry and the Art of Frying Small Fish
Authors: Russell David
Published: June 2023

This paper is in the form of a narrative exploration of trees and woods. It embraces both the rational and the non-rational dimensions of experience, and mingles science with a little fancy. It begins by questioning some contemporary attitudes towards woods, then proceeds to consider how they function, it continues with some reflections on the cultural significance of trees and woods, and concludes with some ideas on the implications for woodland management.
Urban Planning and Multiple Preference Schedules: On R.M. Hare's ‘Contrasting Methods in Environmental Planning’
Authors: Paden Roger
Published: June 2023

This essay present a critical analysis of Hare's article ‘Contrasting Methods in Environmental Planning’. It argues that Hare has drawn an important distinction between two ‘methods’ used in both urban and environmental planning, and that Hare is correct in the conclusion of his argument that one of these methods, ‘the trial-design method’, is superior to the other, ‘the means-end method’. However, this paper presents a new argument in support of that conclusion. This new argument is important for two reasons. First, it points to the existence of at least two different kinds of preference schedule. Second, it supports a type of decision making procedure to be used in ‘multiple-client situations’ different from the one envisioned by Hare. This procedure, oddly enough, resembles the procedures outlined by both Habermas and Rawls. However, it can be defended on recognisably utilitarian grounds.
Environmental Ethics – Values or Obligations? A Reply to O'Neill
Authors: Baxter Brian
Published: June 2023

Onora O'Neill recently argued that environmental ethics could and should be reformulated in terms of a search for the obligations held by moral agents towards each other, with respect to the non-human world. The more popular alternative, which seeks to establish the intrinsic value of the non-human, is plagued with various theoretical difficulties attaching to the concept of value. It is here argued that O'Neill's attempt to determine fundamental obligations of moral agents on the basis of a non-universalisability criterion does not succeed. It is further claimed that such an approach, in spite of the advantages which O'Neill sees it as having, is itself open to serious objection from the viewpoint of environmental ethics, especially as human beings are able in principle to release each other from mutual obligations. It is concluded that, in spite of the difficulties involved, postulations of (intrinsic) value to non-human nature do seem to be indispensable to environmental ethics.
Science and Society in Historical Perspective: Implications for Social Theories of Risk
Authors: Cohen Maurie J.
Published: June 2023

Over the past decade risk society theory has become increasingly prominent within the field of environmental social theory. This perspective contends that conventional political divisions based on class are becoming less salient and are giving way to a politics predicated upon the distribution of risk. There is much in risk society theory, especially its central contention that public anxieties about high consequence-low probability events undermine the legitimacy of science, that has a distinctly German stamp. Through a comparative analysis of how national context has differently shaped science as a public epistemology this paper suggests we should tread carefully in moving to accept the general applicability of this theoretical approach.
National Shades of Green: Comparing the Swedish and Danish Styles in Ecological Modernisation1
Authors: Jamison Andrew , Baark Erik
Published: June 2023

Throughout Europe, science and technology policy within the environmental field is currently in a process of transformation, which has been characterised by many observers as ecological modernisation. Emphasis is being given to preventive principles and so-called cleaner technologies in the quest for a more sustainable development. Each European country has, however, adapted the new doctrines and practices in distinctive ways. The main aim of the paper is to show how contemporary policies have been shaped by history, more specifically, by institutional and cognitive traditions, and by national policy styles. By comparing ‘ecological modernisation’ in Sweden and Denmark, we attempt to indicate how such national cultural differences affect the ways in which science and technology policies in the environmental field are formulated and implemented.
Public Attitudes to Contingent Valuation and Public Consultation1
Authors: Brouwer Roy , Powe Neil , Turner R. Kerry , Bateman Ian J. , Langford Ian H.
Published: June 2023

The use of cost-benefit analysis (CBA) in environmental decisionmaking and the contingent valuation (CV) technique as input into traditional CBA to elicit environmental values in monetary terms has stimulated an extensive debate. Critics have questioned the appropriateness of both the method and the technique. Some alternative suggestions for the elicitation of environmental values are based on a social process of deliberation. However, just like traditional economic theory, these alternative approaches may be questioned on their implicit value judgements regarding the legitimacy of the social-political organisation of the process of value elicitation. Instead of making assumptions a priori, research efforts should be focused on the processes by which actual public attitudes and preferences towards the environment can best be elicited and fed into environmental or other public policy decision-making. In the study presented in this paper, support was found for both the individual WTP based approach and a participatory social deliberation approach to inform the environmental decision-making process, suggesting that a combination of both approaches is most appropriate.
The Disparate Roots of Voluntary Modesty
Authors: Librová Hana
Published: June 2023

The effective solution of environmental problems calls for changes in levels of consumption. Sociologists have described moderation in households of high socio-economic status in affluent countries, and also a type of modesty which cannot be a response to the experience of abundance. However, its essence is not the way of life of a traditional community. Sustainable living based on self-restraint could be considered to be a symptom of the summit of cultural evolution to date. Nevertheless, historical experience warns us against making too much of contemporary cases of moderation.
Environmental Thought as Cosmological Intervention
Authors: Greenbaum Allan
Published: June 2023

An important tradition in popular and academic environmentalist thought concentrates on cosmological issues, to do with overarching (or underlying) views about the nature of reality and the place of humanity in nature. This tradition connects the environmental crisis with anthropocentric and mechanistic cosmologies, and tries to address this crisis through cosmological critique and reconstruction – a practice I call ‘cosmological intervention’. This practice presupposes a link between ‘world view’ and ‘ethos’. I argue that an environmentalist ethos does not necessarily or automatically follow from the world view elements propounded in cosmological interventions. Rather, world view symbolises ethos. Cosmologies favoured by environmentalists describe the abstract and necessary properties of the world in ways which reflect those concrete and contingent properties of the world that the ecology movement seeks to protect, extend and celebrate.
Surgical Safety Audit in India, or Lack Thereof: An Urgent Need for National Policy on Wrong-Site Surgery Registry and Research
Authors: Shekhar Abhinav , Anand Abhinav , Jha Chandan Kumar , Yadav Sanjay Kumar , Sinha Dipendra Kumar
Published: June 2023

Multiple studies have analysed the incidence of wrong-site surgeries (WSSs) in developed countries. This study aims to find out information relevant to the incidence and pattern of WSS in India. Multiple sources like Medline, EMBASE and the Global Health Library databases were searched for abstracts and citations in all languages published between 1 January 1975 and 31 December 2018, describing any WSS from India. After extensively searching the online databases only one case report related to WSS in India could be found. Zero incidences of WSS in general surgery from India seem fallacious and it is due to non-reporting of such events and the Government of India should implement a national registry to maintain data on WSS, which can lead to improved surgical care.
Analysis of Readmissions Due to VTE—Using Hospital Data to Improve VTE Prophylaxis Compliance: A Quality Improvement Project
Authors: Hussain Muzamil Hamid , Kim Shihyeon , Khan Adnan Ali , Arshad Ainan , Khan Haroon
Published: June 2023

Venous thromboembolism (VTE) is a preventable cause of mortality and morbidity. We performed a retrospective analysis of patient records to identify those readmitted with a diagnosis of VTE within 6 months of the primary admission. The records were evaluated to see whether thromboprophylaxis had been provided to patients at high risk for VTE. A total of 360 hospital encounters between August 1, 2018, and August 31, 2019, with VTE, 57 (16%) encounters were readmissions with a primary diagnosis of deep vein thrombosis within 180 days of their primary stay. A high proportion (44%) of these readmissions were within the first 30 days. 3% (n = 9) of patients developed pulmonary embolism; 35 (61%) did not receive thromboprophylaxis on their primary stay. Thromboprophylaxis is often not utilized appropriately in healthcare settings. Our study showed substantial incidence of hospital readmissions due to VTE which is consistent with prior studies conducted globally. A more stringent adherence to the protocol along with risk stratification may lower rates of VTE admission and reduce associated morbidity and mortality.
Boundary output-feedback control for a moving rigid body-liquid system in the presence of shallow-water sloshing
Authors: Jokar Meysam , Salarieh Hassan , Nejat Pishkenari Hossein
Published: June 2023

We solve the boundary output-feedback tracking problem for a moving rigid body-liquid system described by the linearized Saint-Venant PDEs. The control input is an external force acting on the rigid body. The control law is a boundary state-feedback type augmented with a Luenberger boundary observer, leading to a dynamic feedback law. The main complexity lies in the fact that we can only measure the position and velocity of the rigid body. To get around this limitation, the observer estimates the liquid levels at the cavity walls. We utilize a control Lyapunov functional methodology (with two different functionals for the observer and the dynamic feedback law) and achieve a slosh-free asymptotic convergence to the prespecified equilibrium point (in the sense of an appropriate norm). Finally, through a simulation, we demonstrate the feasibility of the boundary output-feedback controller for the (linear and nonlinear) system.
Effect of d-type rib roughness on the turbulent structure of side wall boundary layer for wave-current combined flow
Authors: Hansda Sunil , Debnath Koustuv , Pal Debashis
Published: June 2023

An experimental study has been carried out in a laboratory flume to characterize the turbulence structure and turbulence anisotropy in the boundary layer over smooth and rough side walls for both current alone and wave-current combined flow situations. The rough side wall of the flume comprises a train of circular ribs (diameter, k) attached vertically maintaining uniform spacing p along the streamwise direction. The experiments are performed for smooth surface and rough (ribbed) surfaces with p/k = 2, 3, and 4 to reproduce different cases of d-type rib roughness. The effect of wave-current interaction has been investigated by superposing waves of two different frequencies. Time series data of three velocity components are obtained using Acoustic Doppler Velocimeter. At the near wall region, roughness with higher p/k value enhances the level of turbulent intensity and Reynolds stress significantly. In a channel with smooth side wall, the wave-current combined flow produces lesser turbulence intensity than the current alone flow near the wall. However, for a ribbed wall case, the effect is completely opposite that is, wave-current interacting flow induces higher intensities compared to the reference current alone flow. Substantial decline in the turbulent length scales at the near wall region are observed for ribbed walls, which reveals the strong effect of roughness elements on the turbulent structure. Superposition of wave reduces the length scales even more for both smooth and rough wall cases. As the spacing between two ribs ( p/ k ratio) increases, the energy dissipation rate increases. The analysis of anisotropy invariant map demonstrates a reduction of anisotropy in the vicinity of ribbed wall compared to that for a smooth wall. For wave-current combined flow, the anisotropy invariant data of Reynolds stress tensor varies dramatically within the boundary of map, reflecting significant changes in the state of turbulence.
A Nomogram Based on the Log Odds of Positive Lymph Nodes Predicts the Prognosis of Patients with Colon Neuroendocrine Tumors After Surgery: A Surveillance, Epidemiology, and End Results Population-Based Study
Authors: Zhang Xue , Zhang Kui , Li Su , Xu Aman
Published: June 2023

Purpose

This work focused on determining the highly efficient nodal classification system from American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) classification (eighth edition), positive lymph node, log odds of positive lymph nodes (LODDS), lymph node ratio, examined lymph node, and establishing the new nomogram for predicting cancer-specific survival in colon neuroendocrine tumors (CNETs).

Methods

From the Surveillance, Epidemiology, and End Results database, 943 CNET cases undergoing radical operation were enrolled, and randomized as training ( n  =  663) or validation set ( n  =  280). For the above 5 lymph node classification systems, their prediction performances were compared with C-index, Akaike information criterion (AIC), and area under the receiver operating characteristic curve. Univariate together with multivariate regression was carried out for identifying independent risk factors. Afterward, this work established 1 nomogram and confirmed its accuracy based on C-index, calibration curves, together with the area under the curve value. Besides, it was compared with the AJCC TNM classification system with regard to model prediction performance.

Results

LODSS achieved the greatest area under the curve and C-index, whereas the smallest AIC. Upon multivariate regression, age, histologic grade, T stage, M stage, and LODDS independently predicted the risk of CNETs. For the validation set, the C-index of the nomogram was 0.794, and the area under the curves at 1, 3, and 5 years was 0.826, 0.857, and 0.870, separately. Additionally, as revealed by the C-index, AIC, decision curve analysis, as well as Kaplan–Meier analysis, our nomogram had superior performance to the AJCC TNM classification system.

Conclusions

For postoperative patients with CNETs, the LODDS might achieve the best prediction performance. Moreover, the LODDS-based nomograms might show superior survival prediction performance to the AJCC TNM classification system (eighth edition).
Knowledge, Attitude, and Practice on Antenatal Care Among Pregnant Women and its Association With Sociodemographic Factors: A Hospital-Based Study
Authors: Bashir Sumaira , Ansari Abdul Haseeb , Sultana Arshiya
Published: June 2023

Knowledge, attitude, and practices (KAP) for an antenatal check-up during pregnancy is a key indicator of a healthcare facility in a community. Antenatal care (ANC) is a useful practice for lowering infant and maternal mortality. Therefore, the present study was planned to estimate knowledge, attitudes, and practices regarding ANC among pregnant women and determine its association with sociodemographic factors. This hospital-based cross-sectional study was conducted on 400 pregnant women through convenience sampling from March 2020 to February 2021. A semistructured questionnaire included sociodemographic and obstetrical history, and scored questionnaire on KAP was used. The analysis included parametric, nonparametric, and Pearson correlation coefficient tests. The finding of the study revealed that pregnant women had average knowledge (96%), positive attitudes (98.75%), and good practices (58.5%) toward ANC. The level of overall knowledge had a positive correlation with the practices toward ANC ( r = 0.18, P < 0.001). The sociodemographic association showed that age, type of family, education, and occupation had a significant association with awareness and practices about ANC. Furthermore, the practice of ANC in our study area was low despite good knowledge and attitude toward ANC. Further, exploratory studies are required and need to be planned to improve practices in prenatal care and ultimately improve their health.
IP3R at ER-Mitochondrial Contact Sites: Beyond the IP3R-GRP75-VDAC1 Ca2+ Funnel
Authors: Atakpa-Adaji Peace , Ivanova Adelina
Published: June 2023

Membrane contact sites (MCS) circumvent the topological constraints of functional coupling between different membrane-bound organelles by providing a means of communication and exchange of materials. One of the most characterised contact sites in the cell is that between the endoplasmic reticulum and the mitochondrial (ERMCS) whose function is to couple cellular Ca2+ homeostasis and mitochondrial function. Inositol 1,4,5-trisphosphate receptors (IP3Rs) on the ER, glucose-regulated protein 75 (GRP 75) and voltage-dependent anion channel 1 (VDAC1) on the outer mitochondrial membrane are the canonical component of the Ca2+ transfer unit at ERMCS. These are often reported to form a Ca2+ funnel that fuels the mitochondrial low-affinity Ca2+ uptake system. We assess the available evidence on the IP3R subtype selectivity at the ERMCS and consider if IP3Rs have other roles at the ERMCS beyond providing Ca2+. Growing evidence suggests that all three IP3R subtypes can localise and regulate Ca2+ signalling at ERMCS. Furthermore, IP3Rs may be structurally important for assembly of the ERMCS in addition to their role in providing Ca2+ at these sites. Evidence that various binding partners regulate the assembly and Ca2+ transfer at ERMCS populated by IP3R-GRP75-VDAC1, suggesting that cells have evolved mechanisms that stabilise these junctions forming a Ca2+ microdomain that is required to fuel mitochondrial Ca2+ uptake.
Efficacy and safety of oral corticosteroids to treat outpatients with acute exacerbations of COPD in primary care: a multicentre pragmatic randomised controlled study
Authors: Thebault Jean-Laurent , Roche Nicolas , Abdoul Hendy , Lorenzo Alain , Similowski Thomas , Ghasarossian Christian
Published: June 2023

Aim

To compare prednisone and placebo for the treatment of outpatients treated for acute exacerbations of chronic obstructive pulmonary disease (COPD) in a primary care setting.

Methods

A multicentre, parallel, double-blind, pragmatic randomised controlled trial was performed in France. A total of 66 general practitioners included patients aged ≥40 years with cumulative smoking of ≥10 pack-years and a diagnosis of certain or likely acute exacerbation of COPD. Oral prednisone (40 mg) or placebo were administered daily for 5 days. The main outcome was treatment failure at 8 weeks, defined as a composite criterion based on the occurrence of at least one of the following: unplanned visit to an emergency department or to a practitioner in the ambulatory setting, hospital admission or death. The planned sample size was 202 patients per group.

Results

175 patients were included from February 2015 to May 2017 (43% of the planned sample). All-cause 8-week treatment failure rate was 42.0% in the prednisone group and 34.5% in the placebo group (relative risk 1.22, 95% CI 0.87–1.69, p=0.25). Respiratory-related 8-week treatment failure rate was 27.6% in the prednisone group and 13.6% in the placebo group (relative risk 2.00, 95% CI 1.15–3.57, p=0.015).

Conclusion

Although the planned sample size was not achieved, the study does not suggest that oral corticosteroids are more effective than placebo for the treatment of an acute exacerbation of COPD in a primary care setting.
A pipeline for sample tagging of whole genome bisulfite sequencing data using genotypes of whole genome sequencing
Authors: Xu Zhe , Cheng Si , Qiu Xin , Wang Xiaoqi , Hu Qiuwen , Shi Yanfeng , Liu Yang , Lin Jinxi , Tian Jichao , Peng Yongfei , Jiang Yong , Yang Yadong , Ye Jianwei , Wang Yilong , Meng Xia , Li Zixiao , Li Hao , Wang Yongjun
Published: June 2023

Background

In large-scale high-throughput sequencing projects and biobank construction, sample tagging is essential to prevent sample mix-ups. Despite the availability of fingerprint panels for DNA data, little research has been conducted on sample tagging of whole genome bisulfite sequencing (WGBS) data. This study aims to construct a pipeline and identify applicable fingerprint panels to address this problem.

Results

Using autosome-wide A/T polymorphic single nucleotide variants (SNVs) obtained from whole genome sequencing (WGS) and WGBS of individuals from the Third China National Stroke Registry, we designed a fingerprint panel and constructed an optimized pipeline for tagging WGBS data. This pipeline used Bis-SNP to call genotypes from the WGBS data, and optimized genotype comparison by eliminating wildtype homozygous and missing genotypes, and retaining variants with identical genomic coordinates and reference/alternative alleles. WGS-based and WGBS-based genotypes called from identical or different samples were extensively compared using hap.py. In the first batch of 94 samples, the genotype consistency rates were between 71.01%-84.23% and 51.43%-60.50% for the matched and mismatched WGS and WGBS data using the autosome-wide A/T polymorphic SNV panel. This capability to tag WGBS data was validated among the second batch of 240 samples, with genotype consistency rates ranging from 70.61%-84.65% to 49.58%-61.42% for the matched and mismatched data, respectively. We also determined that the number of genetic variants required to correctly tag WGBS data was on the order of thousands through testing six fingerprint panels with different orders for the number of variants. Additionally, we affirmed this result with two self-designed panels of 1351 and 1278 SNVs, respectively. Furthermore, this study confirmed that using the number of genetic variants with identical coordinates and ref/alt alleles, or identical genotypes could not correctly tag WGBS data.

Conclusion

This study proposed an optimized pipeline, applicable fingerprint panels, and a lower boundary for the number of fingerprint genetic variants needed for correct sample tagging of WGBS data, which are valuable for tagging WGBS data and integrating multi-omics data for biobanks.
Prevention of M2 polarization and temporal limitation of differentiation in monocytes by extracellular ATP
Authors: Scherr Benedikt F. , Reiner Martin F. , Baumann Flavia , Höhne Kerstin , Müller Tobias , Ayata Korcan , Müller-Quernheim Joachim , Idzko Marco , Zissel Gernot
Published: June 2023

Background

Elevated levels of extracellular adenosine triphosphate (ATP) modulate immunologic pathways and are considered to be a danger signal in inflammation, lung fibrosis and cancer. Macrophages can be classified into two main types: M1 macrophages are classically activated, pro-inflammatory macrophages, whereas M2 macrophages are alternatively activated, pro-fibrotic macrophages. In this study, we examined the effect of ATP on differentiation of native human monocytes into these macrophage subtypes. We characterized M1 and M2 like macrophages by their release of Interleukin-1beta (IL-1β) and Chemokine (C–C motif) ligand 18 (CCL18), respectively.

Results

Monocytes were stimulated with ATP or the P2X7 receptor agonist Benzoylbenzoyl-ATP (Bz-ATP), and the production of various cytokines was analyzed, with a particular focus on CCL18 and IL-1β, along with the expression of different purinergic receptors. Over a 72 h period of cell culture, monocytes spontaneously differentiated to M2 like macrophages, as indicated by an increased release of CCL18. Immediate stimulation of monocytes with ATP resulted in a dose-dependent reduction in CCL18 release, but had no effect on the concentration of IL-1β. In contrast, delayed stimulation with ATP had no effect on either CCL18 or IL-1β release. Similar results were observed in a model of inflammation using lipopolysaccharide-stimulated human monocytes. Stimulation with the P2X7 receptor agonist Bz-ATP mimicked the effect of ATP on M2-macrophage differentiation, indicating that P2X7 is involved in ATP-induced inhibition of CCL18 release. Indeed, P2X7 was downregulated during spontaneous M2 differentiation, which may partially explain the ineffectiveness of late ATP stimulation of monocytes. However, pre-incubation of monocytes with PPADS, Suramin (unselective P2X- and P2Y-receptor blockers) and KN62 (P2X7-antagonist) failed to reverse the reduction of CCL18 by ATP.

Conclusions

ATP prevents spontaneous differentiation of monocytes into M2-like macrophages in a dose- and time-dependent manner. These effects were not mediated by P2X and P2Y receptors.
Effects of intra-operative administration of subanesthetic s-ketamine on emergence from sevoflurane anesthesia: a randomized double-blind placebo-controlled study
Authors: Liu Tiantian , Zhang Xinxin , Li Ao , Liu Tingting , Yang Xue , Zhang Huanhuan , Lei Yanling , Yang Qianzi , Dong Hailong
Published: June 2023

Background

Ketamine is administered in the perioperative period for its benefits in analgesia, anti-agitation and anti-depression when administered at a small dose. However, it is not clear whether the intra-operative administration of ketamine would affect emergence under sevoflurane anesthesia. To investigate this effect, we designed this trial.

Methods

In this randomized, double-blind, placebo-controlled study, we enrolled 44 female patients aged 18–60 who were scheduled to elective laparoscopic gynecological surgeries. All patients were randomly assigned to saline or s-ketamine group. In s-ketamine group, patients received 0.125 mg/kg s-ketamine 30 min after the start of surgery. In saline group, patients were administered the same volume of saline. Sevoflurane and remifentanil were used to maintain general anesthesia. The primary outcome was emergence time. We also assessed postoperative agitation, cognitive function, and delirium. In addition, we collected and analyzed prefrontal electroencephalogram (EEG) during and after general anesthesia.

Results

There were no significant differences in emergence time between s-ketamine group and saline group (10.80 ± 3.77 min vs. 10.00 ± 2.78 min, P = 0.457). Neither postoperative agitation (4 [3, 4] vs. 4 [3, 4], P = 0.835) nor cognitive function (25.84 ± 2.69 vs. 25.55 ± 2.19, P = 0.412) differed between groups. No postoperative delirium was observed in either group. Subanesthetic s-ketamine resulted in active EEG with decreased power of slow (-0.35 ± 1.13 dB vs. -1.63 ± 1.03 dB, P = 0.003), delta (-0.22 ± 1.11 dB vs. -1.32 ± 1.09 dB, P = 0.011) and alpha (-0.31 ± 0.71 dB vs. -1.71 ± 1.34 dB, P = 0.0003) waves and increased power of beta-gamma bands (-0.30 ± 0.89 dB vs. 4.20 ± 2.08 dB, P < 0.0001) during sevoflurane anesthesia, as well as an increased alpha peak frequency (-0.16 ± 0.48 Hz vs. 0.31 ± 0.73 Hz, P = 0.026). EEG patterns did not differ during the recovery period after emergence between groups.

Conclusion

Ketamine administered during sevoflurane anesthesia had no apparent influence on emergence time in young and middle-aged female patients undergoing laparoscopic surgery. Subanesthetic s-ketamine induced an active prefrontal EEG pattern during sevoflurane anesthesia but did not raise neurological side effects after surgery.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2100046479 (date: 16/05/2021).
Effects of intraoperative esketamine addition on gastrointestinal function after benign gynaecological laparoscopic surgery: a double-blind, randomized controlled study
Authors: Ma Yuhua , Zhang Ran , Cao Xue , Zhang Lin , Bao Suozhu , Ren Jie , Ma Weiwei
Published: June 2023

Background

Gastrointestinal hypokinesis can occur transiently after benign gynecologic surgery. Opioids cause the side effect of postoperative gastrointestinal hypokinesis, but an opioid-sparing anaesthetic protocol based on esketamine reduces intraoperative opioid consumption. Therefore, this study hypothesised that an opioid-sparing anaesthetic protocol based on esketamine would shorten the gastrointestinal function recovery time after benign gynaecological laparoscopic surgery.

Methods

This was a prospective randomized controlled double-blind study conducted in a single centre. All patients scheduled for elective benign laparoscopic gynaecological surgery at Xing’an Meng People’s Hospital, Inner Mongolia Autonomous Region, from November 2021 to April 2022 were consecutively enrolled and randomly divided into the opioid-sparing anaesthesia group (Group OS) and the conventional anaesthesia group (Group C). Postoperative first exhaust time, feeding time and postoperative nausea and/or vomiting (PONV) were analyzed in both groups.

Results

A total of 71 patients were enrolled in this study, including 35 in Group OS and 36 in Group C. The general condition, operative time, type of surgery, intraoperative bleeding, intraoperative fluid volume and intraoperative urine volume were not statistically different between the two groups. Compared with Group C, significantly shorter first postoperative flatus time (11 [8, 14] h vs. 14 [11, 18], p = 0.003) and anaesthesia resuscitation time (7 [6, 9] h vs. 9 [7, 11] h, p = 0.013)were observed in the OS group. The incidence of PONV in Group OS was significantly lower compared with Group C (11.4% vs. 41.7%, p = 0.007).

Conclusion

The esketamine-based opioid-sparing anaesthetic protocol can shorten the postoperative first flatus time after benign laparoscopic surgery in gynaecology, and reduce the incidence of PONV. In addition, the application of esketamine may reduce the postoperative opioid dose requirement of patients.

Trial registration

: This study was registered with the China Clinical Trials Registry (registration number: ChiCTR2100052528, 30/10/2021).
Associations between social support and poverty among older adults
Authors: Liao Hui , Li Sangsang , Han Dan , Zhang Mei , Zhao Jie , Wu Yunyi , Ma Ying , Yan Chaoyang , Wang Jing
Published: June 2023

Background

With population aging becoming a pressing global concern, social support is more meaningful for older adults. In particular, financial supports, such as health insurance and financial assistance derived from family, all play great role in assistance affairs. Research shows social support possibly has an impact on poverty, but the association between formal and informal supports is unclear. We are aimed at verifying the association between distinct social supports and exploring whether this association would affect poverty alleviation for older adults.

Methods

A total of 2,683 individuals aged 60 years or older who have medical expenses were included in a survey conducted by the China Health and Retirement Longitudinal Study in 2018. A chi-square analysis and an independent samples T test all were used to explore the differences of social supports among old people with different economic condition. A binary logistic regression was aimed at analyzing the association between social supports and poverty for older adults. The structural equation model was established to evaluate the association between formal support and informal support and the mechanism(s) of social supports affecting poverty.

Results

The overall average rate of reimbursement for outpatient care was 0.20 with standard deviation 0.22, and the average reimbursement rate of inpatient care for the poor older adults is nearly 5% lower than the average of the non-poor older adults. We found that having private health insurance and higher reimbursement rate of inpatient care were associated with lower likelihood of living in poverty for older adults. Formal support would directly affect poverty, but its impact on poverty through informal support is insignificant even if formal support is negatively associated with informal support.

Conclusion

A dilemma in reducing the economic burden of disease and receiving family assistance for older adults was revealed, and a more complete health security and higher level of medical expenses compensation would be beneficial to prevent poverty. Optimizing the primary healthcare and increasing the percentage of insurance compensation, policies that focus on the specific cultural values and strengthening the role of supplementary insurance are advantaged for alleviating poverty among older adults.
Analysis of m7G-Related signatures in the tumour immune microenvironment and identification of clinical prognostic regulators in breast cancer
Authors: Huang Qinghua , Mo Jianlan , Yang Huawei , Ji Yinan , Huang Rong , Liu Yan , Pan You
Published: June 2023

Background

Breast cancer is a malignant tumour that seriously threatens women’s life and health and exhibits high inter-individual heterogeneity, emphasising the need for more in-depth research on its pathogenesis. While internal 7-methylguanosine (m7G) modifications affect RNA processing and function and are believed to be involved in human diseases, little is currently known about the role of m7G modification in breast cancer.

Methods and Results

We elucidated the expression, copy number variation incidence and prognostic value of 24 m7G-related genes (m7GRGs) in breast cancer. Subsequently, based on the expression of these 24 m7GRGs, consensus clustering was used to divide tumour samples from the TCGA-BRCA dataset into four subtypes based on significant differences in their immune cell infiltration and stromal scores. Differentially expressed genes between subtypes were mainly enriched in immune-related pathways such as ‘Ribosome’, ‘TNF signalling pathway’ and ‘Salmonella infection’. Support vector machines and multivariate Cox regression analysis were applied based on these 24 m7GRGs, and four m7GRGs—AGO2, EIF4E3, DPCS and EIF4E—were identified for constructing the prediction model. An ROC curve indicated that a nomogram model based on the risk model and clinical factors had strong ability to predict the prognosis of breast cancer. The prognoses of patients in the high- and low-TMB groups were significantly different (p = 0.03). Moreover, the four-gene signature was able to predict the response to chemotherapy.

Conclusions

In conclusion, we identified four different subtypes of breast cancer with significant differences in the immune microenvironment and pathways. We elucidated prognostic biomarkers associated with breast cancer and constructed a prognostic model involving four m7GRGs. In addition, we predicted the candidate drugs related to breast cancer based on the prognosis model.
Factors associated with quality of life in patients receiving lung transplantation: a cross-sectional study
Authors: Takahashi Ryo , Takahashi Tamao , Okada Yoshinori , Kohzuki Masahiro , Ebihara Satoru
Published: June 2023

Background

With improved prognosis after lung transplantation (LTx), improving health-related quality of life (HRQL) in patients who have undergone LTx is a key goal. Although HRQL is improved significantly after transplantation, it is poorer than that in ordinary healthy people. However, the factors associated with poor HRQL remain unclear. This cross-sectional study aimed to identify the factors associated with poor HRQL in patients who have undergone LTx.

Methods

Between December 2018 and May 2022, 80 patients who had undergone LTx completed St. George’s Respiratory Questionnaire (SGRQ) as a disease-specific quality of life measure, the Short Form-12 (SF-12) as a generic quality of life measure, and modified Medical Research Council (mMRC) scale of dyspnea. The groups were assigned according to the median SGRQ-total score and the Japanese population standard for SF-12, and those with good HRQL were compared with those with poor HRQL. Independent factors were evaluated using multivariate analysis.

Results

With regard to the SGRQ, there were significant differences in the forced expiratory volume in 1 s (FEV1) (P = 0.041), use of bronchodilators (P = 0.026), 6-min walk distance (6MWD) (P < 0.001), and Mmrc (P < 0.001) between better and poorer HRQL. For the SF-12 physical component summary score (PCS), age (P = 0.017), sex (P = 0.011), FEV1 (P < 0.001), forced vital capacity (FVC) (P < 0.001), diagnosis (P = 0.011), handgrip force (P = 0.003), 6MWD (P < 0.001), and Mmrc (P < 0.001) varied. Multivariate analyses revealed that Mmrc was the only independent factor in the SGRQ (P < 0.001, odds ratio [OR] = 6.65, 95% confidence interval [CI]: 2.49–17.74) and SF-12 PCS (P = 0.001, OR = 0.185, 95% CI: 0.07–0.52). There were significant correlations between the SGRQ-Total score and SF-12 PCS (correlation coefficient = -0.612, P < 0.001).

Conclusions

Dyspnea may be an independent factor of poor disease-specific and generic HRQL in LTx patients. The management of dyspnea may improve the HRQL in patients who have undergone LTx.
Use of a comprehensive systemic ultrasound evaluation in the diagnosis and analysis of acute lateral region ankle sprain
Authors: Song Jae Hwang , Moon Jeong Jae , Shin Woo Jin , Ko Kwang Pyo
Published: June 2023

Background

For the diagnosis of acute lateral ankle sprain, many clinicians use ultrasound; they typically focus on the lateral ligament complex, which is the most common site of lesions in ankle sprain. However, this approach risks missing other foot and ankle lesions. The present study aimed to provide and analyze the results of a new ultrasound method of diagnosis for acute lateral ankle sprain which can thoroughly investigate overall lesions of the foot and ankle.

Methods

Retrospective cross-sectional cohort study of 123 patients who underwent diagnostic ultrasound within 1 week of acute lateral ankle injury was performed. Causes of ankle sprain, incidence and severity of each ligament injury, location of anterior talofibular ligament (ATFL) injury, accompanying ligament injury, and occult fracture were analyzed.

Results

Among the 102 cases of ATFL injuries, 60 (58.5%) had islolated ATFL injury, 28 (27.5%) had accompanying calcaneofibular ligament injury (CFL), and 14 (13.7%) had accompanying midtarsal or syndesmosis injury. ATFL injuries occurred on the fibula attachment in 48 (47.1%) cases, ligament mid-substance in 24 (23.5%) cases, and talus attachment in 30 (29.4%) cases. Among the 165 lesions from 123 cases, injuries of the fourth or fifth dorsal tarsometatarsal (12 cases, 7.3%), bifurcate (11 cases, 6.7%), and anterior tibiofibular (11 cases, 6.7%) ligaments were not rare.

Conclusion

These findings suggest that an ultrasound examination involving investigation of the midtarsal joint and syndesmotic ligament, as well as the ATFL and CFL, is useful for comprehensive, systemic diagnosis of acute lateral ankle sprain.
Extensive skin necrosis following total hip arthroplasty performed through the direct anterior approach
Authors: Idris Nimatullah , Zingg Matthieu , Gauthier Morgan , Oranges Carlo M. , Kalbermatten Daniel F. , Hannouche Didier
Published: June 2023

Background

Total hip arthroplasty is a widely performed surgical procedure, which enables patients to regain mobility, alleviates pain, and improves overall quality of life. Periarticular multimodal drug infiltration (PAI) is increasingly being used as an effective postoperative pain management, decreasing the systemic consumption of opioids. Extensive postoperative skin necrosis without a deep joint infection as a complication of total hip arthroplasty with PAI has not yet been described.

Case presentation

A 71-year-old patient who underwent total hip arthroplasty of the right hip for primary osteoarthritis through the Direct Anterior Approach presented postoperatively a large area of necrotic skin at the incision. Joint infection was excluded. An extensive debridement was performed and the tissue defect was reconstructed by a pedicled anterolateral thigh flap. The skin maintained a satisfactory appearance at 1 year postoperatively, and the hip was pain-free with restored ranges of motion. The patient was able to walk with no support and without limitation.

Conclusion

We address the possible risk factors, discuss the use of epinephrine in PAI and explore possible treatment options for such a complication.
Axillary skin crease incision versus conventional posterolateral incision in open repair of patent ductus arteriosus for extremely low birth weight infants: a retrospective study
Authors: Okamoto Mitsumasa , Tsuruno Yudai , Fukuzawa Hiroaki
Published: June 2023

Background

Thoracotomy with posterolateral incision (PLI) is commonly used for surgical repair of patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants. Some reports have described thoracotomy for PDA using an axillary skin crease incision (ASCI) in consideration of cosmetic problems such as surgical wounds and thoracic deformities, but the details remain unclear.

Methods

In this study, we performed clipping ligation by thoracotomy with ASCI for ELBW infants with PDA from 2011 to 2015 for the purpose of improving cosmetic results, and retrospectively compared the results with those for conventional PLI cases performed from 2016 to 2020.

Results

ASCI was found to be associated with serious surgical complications and showed a significant difference in outcome parameters only for surgery time, suggesting a safety problem for ASCI. Considering these results, PLI allows clipping of the nearby PDA from the thoracotomy wound while looking straight ahead, whereas the PDA in ASCI is positioned deep and oblique to the thoracotomy wound, so the clipping angle is limited and accurate completion of the procedure is difficult.

Conclusions

Regarding PDA repair in ELBW infants, ASCI shows a high risk of serious surgical complications. Conventional PLI remains preferable for safe and accurate results.