bluuebunny/crossref_metadata_2025 huggingface dataset:
To Be Given as a Representation
Authors: Hopkins Robert
Published: April 2024

How does imagining differ from perceiving? One important difference lies in their differing relations to observation and to overflow (whether there is more to their objects than subjects are aware of). Sartre and Wittgenstein both make suggestive comments on this score, but any contrast here seems to run across levels in an unacceptable way. To overcome this problem, discussion is first limited to claims about phenomenology. Two key phenomenological notions are then described, the familiar idea that some mental states are transparent, and the less familiar notion that some are Direct. Together, these notions enable us to transcend the framework which threatened the original contrast in terms of observation and overflow.
Profiles in Imagination
Authors: Hopkins Robert
Published: April 2024

What is sensory imagining? This chapter argues that at its core lies a deployment of sensory knowledge. That knowledge, of how the appearance of a property shifts with our relations to its bearers, is key to perception. In imagining, it is put to very different uses, and to very different effect. While in perception sensory knowledge is used to form expectations, in imagining it is deployed in undertaking commitments. And while in perception it is used to impose order on non-perspectival properties with which we are presented, in imagining it orders current and possible acts of representing such properties to ourselves. The resulting view has much in common with Ryle’s account of sensory imagining, but it appeals to elements that Ryle rejected, and in consequence is better able than his position to accommodate the phenomenology of imagining.
Learning from Imagining
Authors: Hopkins Robert
Published: April 2024

What form of access do we have to the contents of sensory imagining? This chapter argues that every aspect of what we imagine we are aware of. (This is not to say we have the corresponding belief, or that we are necessarily aware of it as imagined.) Relatedly, it is not possible to observe what we imagine. Both claims face serious challenges from a series of cases. The chapter shows how the cases and the claims can be reconciled, by drawing on the account of imagining’s structure given in Chapter 4. That account enables us to cede some ground to the cases: there can be aspects of the world as we’ve imagined it of which we are not aware. However, these are not part of the contents of imagining proper; and the process by which we become aware of them is more like inference than observation. The upshot is that our access to sensory imagining closely parallels our access to the contents of our thoughts. What we think and what we imagine is open to us, as what we perceive is not.
Conclusion
Authors: Hopkins Robert
Published: April 2024

This chapter recaps the view developed over the course of the book by comparing it with the dominant current approach to imagining, recreativism, or simulationism. It discusses what the value of imagining might be, on the account offered here; explores whether that account is consistent with the creativity imagining sometimes exhibits, and uses the account to draw a distinction between imagination and fantasy. It closes by asking whether imagining is able to capture Gestalt in ways in which perceiving cannot.
Why focus on trust?
Authors: Seyd Ben
Published: April 2024

Trust is an important concept because it captures key aspects of citizens’ relations with their political rulers. Yet other concepts, such as dissatisfaction and cynicism, also capture important features of these vertical relations. This chapter seeks to establish the status of trust by identifying which aspects of citizens’ relations with political actors and institutions are captured by trust. The chapter first distinguishes different forms of political support, arrayed from ‘specific’ evaluations to more ‘diffuse’ appraisals. It then explores—both conceptually and empirically—where trust sits on this spectrum of support, and whether trust judgements are distinctive from other forms of political support. The analysis extends to consider whether trust has distinctive associations with different civic and political behaviours.
Measuring trust
Authors: Seyd Ben
Published: April 2024

While trust might be measured in various ways, most empirical analyses draw on survey indicators fielded on samples of national populations. These survey measures usually measure trust through single-item indicators that directly reference the concept. This approach makes various assumptions about measuring trust, most notably that such indicators can accurately and fully capture the background concept. Yet this chapter shows that such assumptions often rest on shaky foundations. Aside from important questions over measurement validity, the chapter points to concerns over whether conventional survey indicators of trust tap impressionistic responses rather than more deliberative appraisals and evaluations of incumbent actors rather than of the wider political system, and whether they suppress the variety of beliefs—both positive and negative—that individuals are likely to feel about political actors and institutions. The chapter reviews these problems with conventional indicators of trust and identifies ways in which the measurement of trust might be improved.
The problem of trust
Authors: Seyd Ben
Published: April 2024

The concluding chapter provides an overview of the book’s principal findings. It does so under two headings. First, it considers what the ‘problem’ of trust is. It explores whether western democracies like Britain can be said to be facing a problem of trust, and if so how serious this problem is. Second, it considers what is meant by trust, and what the key characteristics of individuals’ trust are. The chapter thus provides a synthesis of what trust consists of and whether or not we are currently facing a crisis of trust. The chapter also identifies implications of the analysis for two groups: policymakers concerned to boost levels of trust, and scholars involved in the study of trust.
Introduction
Authors: Magree Michael C.
Published: April 2024

This chapter gives the parameters and scope of the work. It explains that the work culminates in the early Christian figure Cyril of Alexandria, who gives the most weight to Christ’s self-emptying in his theology. The chapter also explains that three modern concerns with self-emptying are concerns with Christ’s pre-existence, the immutability of God, and feminist concerns about loss of identity.
Self-Emptying in the Theology of Cyril of Alexandria
Authors: Magree Michael C.
Published: April 2024

Cyril of Alexandria uses the term kenosis more than any other Christian writer in Greek, and it forms an essential part of his theology of revelation and of his Christology. Theodore of Mopsuestia showed some of the struggles in interpreting self-emptying that accompany a Christology that does not look carefully at how to talk about Christ’s unity. Phrase by phrase Theodore has to divide up Philippians 2:6–11 according to the humanity and the divinity of Christ. Cyril, whether he is contending with non-Nicene or later Nestorian theologies, was convinced that the overall shape of the verses had to be in terms of a single subject, the Word of God, who took on human reality at a particular moment of human history. Cyril used the term kenosis as a sort of keyword for his whole approach to the incarnation. On the one hand, the surprising and confounding reality of the Word genuinely making human weakness and ignorance his own had to be acknowledged. Scripture, Cyril held, had to take priority, so that human categories of “nature” and “immutability” had to be stretched or reshaped in order to account for the radical claims of the Bible. Cyril also held kenosis to be a key statement of divine freedom, such that the Word of God did not take on human weakness out of compulsion or lack of power, but rather in power the Word of God chose freely to be the single subject of human suffering and death.
Conclusion
Authors: Magree Michael C.
Published: April 2024

The book’s conclusion summarizes some of the findings of the interpretation of Christ’s self-emptying in the Greek-speaking world of early Christianity. The main points concern the enduring focus on the subject with the question “Who emptied himself?” At the same time, an enduring point among thinkers was the claim that the strangeness of the language of self-emptying is meant as part of revelation to stretch human categories and reshape them according to what God chose to do in the incarnation. The book concludes with two comparisons. First, the book looks at the corresponding interest in questions of identity against concepts of nature in Richard Bauckham and in the theology of Cyril. Second, the book also treats modern feminist theology’s interest in the consubstantiality of Christ as having strong correspondence to Cyril’s claim about taking on all of human reality without losing anything of the divine nature.
Individuals and Group Identity in Medieval International Law
Authors: Fedele Dante , Wijffels Alain
Published: April 2024

Although medieval law focused in many ways on collective, rather than individual, identities, various interest groups of medieval societies also fostered the legal status of individuals. Two case studies show that legal theory and practice deployed norms which were adjustable to the needs and reality of both group identities and individual persons. The first case study, on the rules governing prisoners of war, makes clear that the individual status of the prisoner notwithstanding, when a ransom had to be negotiated, their social position, and networks played an essential role in determining the conditions of their detention and their release. The second case study, on reprisals, reveals the tensions that existed in both legal theory and practice between a principle of communal solidarity, under which members of a wrongdoer’s community were meant to suffer the consequences of the wrong, and concerns for the legal position and rights of these innocent individuals.
The Individual in International Law from the Contemporary Sacred Natural Law Perspective
Authors: Domingo Rafael
Published: April 2024

This chapter explains from an interdisciplinary perspective some contemporary sacred natural law ideas, doctrines, and arguments that have supported the centrality of the human person in international law. Unlike rational natural law theories, sacred natural law theories are rooted in theological and scriptural accounts of created reality, and they combine reason and revelation in their elaboration and justification of legal arguments. Specifically, the chapter focuses on the metalegal implications of the doctrine of human beings as creatures made in the image of God. All human beings form a united natural community of image-of-God bearers, which grants metalegal legitimacy to human dignity and freedom and the principles of solidarity, inclusiveness, subsidiarity, and diversity, among others.
Global Constitutionalism and the Individual
Authors: Çalı Başak
Published: April 2024

This chapter explores how global constitutionalism provides insights into theorising and interpreting the relationship between individuals, States, and international law. It first argues that the individual plays a central role in global constitutionalism in theorising the functions of States in international law, the structure of international law, and the relationship between international law and domestic law. Secondly, the individual plays significant heuristic roles in the interpretation of existing international legal doctrines and in the assessment of international legal reforms. Global constitutionalism endorses a multilevel constitutional order in which actors within domestic, regional, and international spheres are expected to give meaning to the moral value, agency, and rights of individuals across multiple levels and different contexts. This can both enrich and fragment the significance of the individual in global constitutionalist thinking.
The Conduct of Politics
Authors: Upton Robert E.
Published: April 2024

This chapter examines Tilak’s reflections upon political conduct (rather than studying his own political career as such). Tilak emerges as a theorist of opposition to autocracy, and of civil disobedience in the assertion of the rights of representative self-government. It tackles Tilak’s espousal of political violence through the material for which he was indicted on sedition charges, in1897 and 1908. In the 1908 trial, a significant moment for Tilak as political propagandist, we see also Tilak’s views on the freedom of the press, once more informed by a reading of a British liberal tradition, weaponized in an intellectual contest with the colonial bureaucracy and thus further sharpened within his own thought. During his subsequent imprisonment, Tilak’s thought on political conduct in Gita Rahasya shows how in fact it is closely related, even at such an emotional and physical distance, to the rest of his career. Tilak’s conception of ‘passive resistance’ is also examined, from its inception in the Bengal partition agitation from 1905 through its shifts after his release in 1914, ultimately to ‘responsive cooperation’ in the face of Gandhi’s calls for non-cooperation early in 1920. The chapter also draws attention to Tilak’s ethical justifications, particularly his rootedness in arguments within the dharmashastra, examining his self-conscious development of a Hindu language and ethos for politics in the modern age.
Reinventing Forex, 1919–1939
Authors: Michie Ranald C.
Published: April 2024

The Gold Standard collapsed during the First World War, ushering in a prolonged period of international currency instability. The war also undermined transnational banking and the links between stock exchanges. The overall effect was not only to create an even greater demand for the facilities of a foreign exchange market but also to force it to reinvent itself. However, throughout the interwar years the assumption was made that the foreign exchange market was both temporary and damaging, with only a return to the Gold Standard capable of delivering currency stabilizing. As that proved impossible, the only alternative was to permit the foreign exchange market to function but only under varying degrees of government control. London emerged as the centre of this new foreign exchange market.
Forex in Chains, 1945–1970
Authors: Michie Ranald C.
Published: April 2024

The foreign exchange market in London was officially closed on the outbreak of the Second World War in 1939. It was not allowed to reopen in London until 1951 and then only under strict control exercised by the Bank of England on behalf of the British Government. After these controls were relaxed in the late 1950s, London’s foreign exchange market began to revive. During the era of strict control in the 1940s and 1950s, the centre of foreign exchange trading moved to New York and Zurich and away from London. However, a London-centred interbank foreign exchange market continued to function, and this grew in importance during the 1960s. As the UK£ declined in importance, trading in London shifted to the US$ assisted by controls imposed on the use of New York by the US government.
Forex Unbound, 1970–1992
Authors: Michie Ranald C.
Published: April 2024

The Bretton Woods system collapsed in the 1970s. The attempt to manage a regime combining fixed exchange rates, free financial flows, and independent but divergent economic policies had proved an impossible task for central banks. In its place, the foreign exchange market expanded to cope with currency volatility. It was through this market that banks could match assets and liabilities in terms of currency by swapping commitments with each other. With the City of London still being the hub of the global banking system, it quickly assumed a central position for the foreign exchange market. Whether by direct dealing between the banks or through a new breed of inter-dealer brokers, foreign exchange trading quickly grew into the largest market in the world during the 1970s and 1980s.
Fostering a Sense of Constitutional Identity amid the Travails of African Constitutionalism
Authors: Fombad Charles M.
Published: April 2024

Since independence, African countries have grappled, in both design and practice, with numerous social, economic, and political disharmonies. These have become particularly manifest following the wave of constitutional reforms that started in the 1990s. This chapter provides the conclusion to a volume that has taken the reader on a journey through the challenges African countries have encountered in their efforts to design constitutions that strive not only to promote constitutionalism but to do so in a manner that reflects the constitutional identity of the different countries. The chapter attempts to answer a series of questions that revolve around the relevance of constitutional identity to the fostering of constitutionalism and good governance and the main lessons that can be drawn from the preceding chapters. It is against this background that it considers ways of promoting constitutional identity in a manner that enhances, rather than undermines, efforts to entrench a culture of constitutionalism and good governance.
Outline
Authors: von Bogdandy Armin
Published: April 2024

Chapter 1 outlines the challenges of the current European situation and the book’s forward-looking response by reconstructing European public law in light of a democratic European society, as envisioned by Article 2 TEU. It explores the concept of society by showing its meaning, roots, implications, and potential to provide a new perspective on European public law. For example, the concept reframes what are so far considered as conflicts between states as conflicts within one society. The concept also provides the EU with a collective singular (e.g. state, people, nation) that so far is missing. The chapter then deepens the book’s approach by presenting it in the light of three key texts that also analyse structural transformations: Leibholz’s Structural Transformation of Modern Democracy, Habermas’s Structural Transformation of the Public Sphere, and Friedmann’s Changing Structure of International Law. The last section positions the book in the tradition of Hegelian thought, thereby explaining its conceptualism, its institutionalism, and its understanding of normativity as being socially embedded as well as transcendental. This section also presents the nation-centred positions that this book challenges, positions which range from Carl Schmitt to the German Federal Constitutional Court to Joseph H. Weiler.
Legitimacy, Authority, and Democratic Duties of Explanation
Authors: Lazar Seth
Published: April 2024

Increasingly secret, complex, and inscrutable computational systems are being used to intensify existing power relations and to create new ones; in particular, they are being used to govern. To be all-things-considered morally permissible new, or newly intense, power relations must meet standards of procedural legitimacy and proper authority. This is necessary for them to protect and realise democratic values of individual liberty, relational equality, and collective self-determination. For governing power in particular to be legitimate and have proper authority, it must meet a publicity requirement: reasonably competent members of the governed community must be able to determine that they are being governed legitimately and with proper authority. The publicity requirement can be satisfied only if the powerful can explain their decision-making to members of their political community. At least some duties of explanation are therefore democratic duties. This chapter first sets out the foregoing argument, then applies it to opaque computational systems, and clarifies precisely what kinds of explanations are necessary to fulfil these democratic values.
Sequential Claims-Balancing, a Weak Limited Aggregationist Proposal
Authors: Graham Peter A.
Published: April 2024

According to Limited Aggregationism, sometimes relatively weak claims to be rescued can be deontically aggregated and other times not: while it may be permissible, even required, to save a thousand young healthy people from suffering permanent paraplegia rather than save a single young healthy person from suffering permanent quadriplegia, there is no number of people it is morally required to save from suffering a temporary hangnail rather than save a single young healthy person from death. Despite the intuitive plausibility of Limited Aggregationism, all of the Limited Aggregationist proposals in the literature have counterintuitive consequences. A novel version of Limited Aggregationism, Sequential Claims-Balancing, is introduced and defended.
Structures of Sufficiency
Authors: Knight Carl
Published: April 2024

Sufficientarianism is generally understood as the view that we ought to provide a sufficient amount of advantage, defined according to a metric such as welfare, resources, or capabilities. The standard version uses not just this bare idea of ‘sufficiency of advantage’, but sufficiency of advantage for some goal (for instance, contentment, compassion, or dignity). This chapter poses a dilemma for standard sufficientarianism: either it agrees with the counterpart ‘direct theory’ that just says secure the goal, in which case it seems the structurally simpler direct theory should be preferred, or it disagrees with the direct theory, a disagreement that is hard to justify given the sufficientarian shares the goal. Sufficientarians can escape the dilemma by endorsing any of three less complex alternative theories.
Lotteries, Queues, and Bottlenecks
Authors: Hersch Gil , Rowe Thomas
Published: April 2024

How should we make distributive decisions when there is not enough of the good to go around, or at least not enough of it right now? What does fairness require in such cases? In what follows, we distinguish between cases of scarcity and bottleneck cases, and we argue that both arguments for lotteries and arguments for queues have merit, albeit for different distributive scenarios. When dealing with scarcity not everyone can get the good. A secondary good that can be distributed fairly is the chances of obtaining the good. In cases of scarcity, lotteries are the best way of allocating chances of obtaining the good fairly. When dealing with bottlenecks, the secondary good that can and ought to be distributed fairly is waiting time. Queues are best suited to distribute the good of waiting time fairly.
Chios–Lesbos–Samos
Authors: Christesen Paul , Lentini Giuseppe , Murray Sarah , Simonton Matt
Published: April 2024

The poleis on Chios, Lesbos, and Samos attained considerable power and prosperity during the Archaic period. Those poleis had much in common, not least a location that put them on what was at the time the eastern edge of the Greek world, with the attendant opportunities and perils. All three islands were ideal bases for maritime commerce, fell under Persian control, and subsequently participated in the Ionian Rebellion and the Delian League. At the same time, each of the three islands had unique traits and history. Chios was remarkable for its political stability, wealth, and large slave population. Lesbos was wracked by internecine struggle and famed for its poetic tradition. Samos under the tyrant Polycrates built a massive fleet and equally massive temples. The history of the Archaic period looks very different when seen from the eastern Aegean rather than Athens or Sparta, and Chios, Lesbos, and Samos thus merit careful examination in any study of the Archaic Greek world.
Building a Song
Authors: Batiste Larry D. , Dozier Lamont
Published: April 2024

In this chapter, the author describes the components necessary to build a song. The reader will gain knowledge of essential ingredients needed to craft a song, song structure, how to create song sections, and how they function. There are a plethora of combinations and decisions that can be made when constructing the parts of a song. This chapter explores how to strategically utilize the combinations and efficiently make the decisions needed to complete a unique song. Diving into examples from some of the greatest hits, this chapter goes beyond the basic components and takes a deeper dive into the art of songwriting.
Internet Radio
Authors: Batiste Larry D. , Glass Preston
Published: April 2024

This chapter explains the history of internet radio in detail: from its concept and operations to the founders of the first internet stations, to how the reader can start and run an internet radio station. It also details how the internet station makes money and how to get music played on internet radio stations. This chapter talks about the various types of radio formats and how to approach getting radio airplay. This reading also includes tips on how to prepare a song in terms of formatting, appropriate length, media kits, press and media materials, and understanding metadata for submissions for consideration to radio stations. The author explains the role of a radio promoter, their fees, and how to find a good one, as well as ways to work with a minimal promotion budget.
D.I.Y. Masters—Finding Success Without a Major Record Label
Authors: Batiste Larry D.
Published: April 2024

This chapter explores do-it-yourself options for songwriters to market and promote their music. While exploring the pros and cons of working with a major record label, the author highlights how and why being an independent wartist can be a viable option. The chapter continues by offering insight and perspective from industry trailblazers on the art and the business of seeking and maintaining financial opportunity independently. The chapter contains multiple accounts of independent singer/songwriters, including Fantastic Negrito, Meklit Hadero, Cornell “CC” Carter, and Kev Choice, who have achieved a reasonable amount of success without the help of a major recording contract.
Transcription factor DIVARICATA1 positively modulates seed germination in response to salinity stress
Authors: Zhang Da , He Tan , Wang Xumin , Zhou Chenchen , Chen Youpeng , Wang Xin , Wang Shixiang , He Shuangcheng , Guo Yuan , Liu Zijin , Chen Mingxun
Published: April 2024

Seed germination is a critical checkpoint for plant growth under unfavorable environmental conditions. In Arabidopsis (Arabidopsis thaliana), the abscisic acid (ABA) and gibberellic acid (GA) signaling pathways play important roles in modulating seed germination. However, the molecular links between salinity stress and ABA/GA signaling are not well understood. Herein, we showed that the expression of DIVARICATA1 (DIV1), which encodes a MYB-like transcription factor, was induced by GA and repressed by ABA, salinity, and osmotic stress in germinating seeds. DIV1 positively regulated seed germination in response to salinity stress by directly regulating the expression of DELAY OF GERMINATION 1-LIKE 3 (DOGL3) and GA-STIMULATED ARABIDOPSIS 4 (GASA4) and indirectly regulating the expression of several germination-associated genes. Moreover, NUCLEAR FACTOR-YC9 (NF-YC9) directly repressed the expression of DIV1 in germinating seeds in response to salinity stress. These results help reveal the function of the NF-YC9–DIV1 module and provide insights into the regulation of ABA and GA signaling in response to salinity stress during seed germination in Arabidopsis.
Coding with the machines: machine-assisted coding of rare event data
Authors: Overos Henry David , Hlatky Roman , Pathak Ojashwi , Goers Harriet , Gouws-Dewar Jordan , Smith Katy , Chew Keith Padraic , Birnir Jóhanna K , Liu Amy H
Published: April 2024

While machine coding of data has dramatically advanced in recent years, the literature raises significant concerns about validation of LLM classification showing, for example, that reliability varies greatly by prompt and temperature tuning, across subject areas and tasks—especially in “zero-shot” applications. This paper contributes to the discussion of validation in several different ways. To test the relative performance of supervised and semi-supervised algorithms when coding political data, we compare three models’ performances to each other over multiple iterations for each model and to trained expert coding of data. We also examine changes in performance resulting from prompt engineering and pre-processing of source data. To ameliorate concerns regarding LLM’s pre-training on test data, we assess performance by updating an existing dataset beyond what is publicly available. Overall, we find that only GPT-4 approaches trained expert coders when coding contexts familiar to human coders and codes more consistently across contexts. We conclude by discussing some benefits and drawbacks of machine coding moving forward.
Roundtable: Four Nations
Authors: Akhtar Shahmima , Hanna Erika , Hession Peter , Hussain Mobeen , Kumar Krishan , Lloyd-Jones Naomi , Ohlmeyer Jane , Stewart Ian
Published: April 2024

Nations have long since preoccupied historians. Histories of how nations came to be, how they persisted, and how nations were unmade are innumerable. As a political unit of analysis, the nation has fascinated and divided. On the one hand, histories of the nation have traced the origins of particular nation states, analysing how a large body of people becomes united within a geographic territory through a shared language, a shared identity, and a shared culture. On the other hand, such histories have been criticized for reifying the nation-state, stressing the majority over the minority, and ultimately for obfuscating differences. The nation as a structure can indeed serve the needs of the ruling establishment to create a governing society. How then, can historians retain the nation as a unit of analysis without for example valorizing England in histories of the UK? Why is it so often that in histories of Britain, Ireland, Scotland, and Wales are mentioned as a comparable case and not the focus itself? Is it possible to ensure that histories of the British Isles reject and refuse implicit hierarchies that routinely prioritize one nation over other nations? Fundamentally, is it even worthwhile to study the nation instead of, for example, focusing on specific gendered groups, or ethnic communities or labour movements for instance? By focusing on thematic experiences rather than the nation-state can historians avoid inadvertently reproducing structural inequality in twenty-first-century Britain?
The Ben Pimlott Memorial Lecture 2022: Patterns of Harm and Resistance: The Early History of Transphobic Algorithmic Bias
Authors: Hicks Mar
Published: April 2024

This piece explores an early example of transphobic algorithmic bias in an electronic computing system in the UK government, which was designed to collect taxes and apportion welfare state benefits. It argues that the logic of computation has long been used to obfuscate political decisions and launder government disdain for the rights and needs of marginalized groups.
Pathogenic and Comparative Genomic Analysis of Ralstonia pseudosolanacearum Isolated from Casuarina
Authors: Wang Xiaoqing , Li Chuhao , Huang Shaohua , Gao Huagui , Li Yonglin , Chen Xuemei , Huang Liangzhou , Luo Jianhua , Zhang LianHui , Zhou Xiaofan
Published: April 2024

Casuarina equisetifolia is crucial in protecting coastal regions of China against typhoon attacks but has faced a substantial challenge due to wilt disease caused by pathogens of the Ralstonia solanacearum species complex (RSSC). Although the initial outbreak of Casuarina wilt in the 1970s was effectively controlled by disease-resistant C. equisetifolia varieties, the disease has recently re-emerged in coastal regions of Guangdong. In this study, we report the isolation, characterization, and comparative genomic analysis of 11 RSSC strains from diseased C. equisetifolia at various locations along the coast of Guangdong. Phylogenomic analysis showed that the strains were closely related and clustered with phylotype I strains previously isolated from peanuts. Single-gene-based analysis further suggested these strains could be derived from strains present in Guangdong since the 1980s, indicating a historical context to their current pathogenicity. Casuarina-isolated strains exhibited notably higher virulence against C. equisetifolia and peanuts than the representative RSSC strains GMI1000 and EP1, suggesting host-specific adaptations that possibly contributed to the recent outbreak. Comparative genomic analysis among RSSC strains revealed a largely conserved genome structure and high levels of conservation in gene clusters encoding extracellular polysaccharide biosynthesis, secretion systems, and quorum sensing regulatory systems. However, we also found a number of unique genes in the Casuarina-isolated strains that were absent in GMI1000 and EP1, and vice versa, pointing to potential genetic factors underpinning their differential virulence. These unique genes offer promising targets for future functional studies. Overall, our findings provide crucial insights into the RSSC pathogens causing Casuarina wilt in Guangdong, guiding future efforts in disease control and prevention.
“It’s Time to Do It, to Make It a Major Part of Medicine”: Faculty Experience With a Shift Toward an Antioppressive Medical School Curriculum
Authors: McDonald Jordan A. , Rincón Alejandra , Daniel Rosny , O’Sullivan Patricia S. , Hauer Karen E.
Published: April 2024

Purpose

Health inequities compel medical educators to transform curricula to prepare physicians to improve the health of diverse populations. This mandate requires curricular focus on antioppression, which is a change for faculty who learned and taught under a different paradigm. This study used the Concerns-Based Adoption Model (CBAM) to explore faculty perceptions of and experiences with a shift to a curriculum that prioritizes antioppressive content and process.

Method

In this qualitative study, authors interviewed faculty course directors and teachers at the University of California, San Francisco School of Medicine from March 2021 to January 2022. Questions addressed faculty experience and understanding regarding the curriculum shift toward antioppression, perceptions of facilitators and barriers to change, and their interactions with colleagues and learners about this change. Using the CBAM components as sensitizing concepts, the authors conducted thematic analysis.

Results

Sixteen faculty participated. Their perceptions of their experience with the first year of an antioppression curriculum initiative were characterized by 3 broad themes: (1) impetus for change, (2) personal experience with antioppressive curricular topics, and (3) strategies necessary to accomplish the change. Faculty described 3 driving forces for the shift toward antioppressive curricula: moral imperative, response to national and local events, and evolving culture of medicine. Despite broad alignment with the change, faculty expressed uncertainties on 3 subthemes: uncertainty about what is an antioppressive curriculum, the scientific perspective, and fear. Faculty also reflected on primary facilitators and barriers to accomplishing the change.

Conclusions

The shift to an antioppressive curriculum compels faculty to increase their knowledge and skills and adopt a critical, self-reflective lens on the interplay of medicine and oppression. This study’s findings can inform faculty development efforts and highlight curricular leadership and resources needed to support faculty through this type of curricular change.
HIV/HBV coinfection remodels the immune landscape and natural killer cell ADCC functional responses
Authors: Sun Bo , da Costa Kelly A.S. , Alrubayyi Aljawharah , Kokici Jonida , Fisher-Pearson Natasha , Hussain Noshin , D’Anna Stefano , Piermatteo Lorenzo , Salpini Romina , Svicher Valentina , Kucykowicz Stephanie , Ghosh Indrajit , Burns Fiona , Kinloch Sabine , Simoes Pedro , Bhagani Sanjay , Kennedy Patrick T.F. , Maini Mala K. , Bashford-Rogers Rachael , Gill Upkar S. , Peppa Dimitra
Published: April 2024

Background and Aims:

HBV and HIV coinfection is a common occurrence globally, with significant morbidity and mortality. Both viruses lead to immune dysregulation including changes in natural killer (NK) cells, a key component of antiviral defense and a promising target for HBV cure strategies. Here we used high-throughput single-cell analysis to explore the immune cell landscape in people with HBV mono-infection and HIV/HBV coinfection, on antiviral therapy, with emphasis on identifying the distinctive characteristics of NK cell subsets that can be therapeutically harnessed.

Approach and Results:

Our data show striking differences in the transcriptional programs of NK cells. HIV/HBV coinfection was characterized by an over-representation of adaptive, KLRC2-expressing NK cells, including a higher abundance of a chemokine-enriched (CCL3/CCL4) adaptive cluster. The NK cell remodeling in HIV/HBV coinfection was reflected in enriched activation pathways, including CD3ζ phosphorylation and ZAP-70 translocation that can mediate stronger antibody-dependent cellular cytotoxicity responses and a bias toward chemokine/cytokine signaling. By contrast, HBV mono-infection imposed a stronger cytotoxic profile on NK cells and a more prominent signature of “exhaustion” with higher circulating levels of HBsAg. Phenotypic alterations in the NK cell pool in coinfection were consistent with increased “adaptiveness” and better capacity for antibody-dependent cellular cytotoxicity compared to HBV mono-infection. Overall, an adaptive NK cell signature correlated inversely with circulating levels of HBsAg and HBV-RNA in our cohort.

Conclusions:

This study provides new insights into the differential signature and functional profile of NK cells in HBV and HIV/HBV coinfection, highlighting pathways that can be manipulated to tailor NK cell-focused approaches to advance HBV cure strategies in different patient groups.
Superficial Temple Lymphatic Malformation Appeared 13 Years after Initial Presentation With Orbital Lymphatic Malformation
Authors: Altwijri Rahaf J. , Ahmed Ali Y. , Alsuhaibani Adel H.
Published: April 2024

A 26-year-old male with a history of orbital lymphangioma and compressive optic neuropathy presented with recurrent proptosis in the OS. After examination and imaging, a left orbital lymphatic malformation and a new subcutaneous temporal-parietal vasculo-lymphatic malformation were diagnosed. The patient underwent a bleomycin injection for the orbital malformation and an excisional biopsy for the temporal lesion, leading to symptom resolution. Recurrence of lymphatic malformations and hemorrhage typically occurs at the same site, here we report a patient with the appearance of a new site lesion with orbital recurrence.
Pediatric Orbital Juvenile Xanthogranuloma: A Case Series and Review of the Literature
Authors: Lee Ming-Han H. , Smith Ebony J. , Hardy Thomas G. , Graf Nicole , Tumuluri Krishna
Published: April 2024

Purpose:

Juvenile xanthogranuloma (JXG) is a subtype of histiocytosis characterised histologically by foamy non-Langerhan cells with Touton giant cells. It typically manifests as a single self-limiting cutaneous nodule in the pediatric population. Orbital JXG is extremely rare, and its clinical course and management are not well understood or defined. Herein we present 3 cases of orbital JXG and provide a detailed literature review.

Methods:

Review of 3 cases with orbital JXG and literature review of all published cases.

Results:

Three presented cases demonstrate the heterogeneous clinical course of orbital JXG. Although centred around the use of steroids, there is neither robust evidence nor consensus on its management. The wider JXG literature is currently concentrated around the classification of JXG with respect to histiocytosis, especially the exclusion of extracutaneous JXG as separate diseases. This separation is based on clinical, histopathological, and molecular findings. It is unclear where orbital JXG best fits in this emerging classification of JXG.

Conclusion:

Our review of the cases and literature on orbital JXG show that it may manifest with variable clinical course and its molecular pathogenic mechanism may be different to that of the cutaneous JXG.
Comparative Effectiveness of Long-Acting Injectable Versus Oral Antipsychotics in Patients With Schizophrenia Using the Prevalent New User Design and Subgroup Analyses
Authors: Okada Yusuke , Inada Ken , Akazawa Manabu
Published: April 2024

Background

We compared the effectiveness of long-acting injectable antipsychotics (LAIs) and oral antipsychotics (OAs) in treating schizophrenia, focusing on whether the benefits of LAIs over OAs are evident even in the prevalent new user design and on effect heterogeneity.

Methods

We conducted a prevalent new user cohort study using 2 administrative claims databases in Japan. We included patients with schizophrenia initiated on LAIs and propensity score–matched patients on OA. We compared the risks of psychiatric hospitalization and treatment discontinuation based on hazard ratios (HRs) using the Cox proportional hazards model. Effect heterogeneity was evaluated using subgroup analyses.

Results

In total, 2520 patients using LAI and OA were identified as matched cohorts. Long-acting injectable antipsychotics were associated with a higher psychiatric hospitalization risk than OAs (HR, 1.41; 95% confidence interval [CI], 1.06–1.88) in the entire population; however, LAIs were associated with lower risk in the group with a low proportion of days covered and psychiatric hospitalization history (HR, 0.51; 95% CI, 0.30–0.89). Long-acting injectable antipsychotics were associated with a lower risk of treatment discontinuation than OAs (HR, 0.76; 95% CI, 0.66–0.87) in the entire population; in the subgroup analyses, a consistent trend was observed in all strata (LAIs had a lower risk).

Conclusions

Using a prevalent new user design, this study confirmed that LAIs have an advantage regarding treatment continuity. Long-acting injectable antipsychotics had higher psychiatric hospitalization risk than OAs in the entire population; however, this study suggested the presence of effect heterogeneity due to psychiatric hospitalization history.
Randomized Placebo-Controlled Clinical Trial of Dutasteride for Reducing Heavy Drinking in Men
Authors: Covault Jonathan , Tennen Howard , Feinn Richard
Published: April 2024

Background

Prior studies indicate that neuroactive steroids mediate some of alcohol's effects. Dutasteride, widely used to treat benign prostatic hypertrophy, is an inhibitor of 5-alpha reductase enzymes, which play a central role in the production of 5α-reduced neuroactive steroids. The purpose of this study was to test dutasteride's tolerability and efficacy for reducing drinking.

Methods

Men (n = 142) with heavy drinking (>24 drinks per week) and a goal to either stop or reduce drinking to nonhazardous levels were randomized to placebo or 1 mg dutasteride daily for 12 weeks. We hypothesized that dutasteride-treated patients would be more successful in reducing drinking.

Results

Generalized linear mixed models that included baseline drinking, treatment, time and their 2-way interaction identified significant interactions of treatment-time, such that dutasteride treatment reduced drinking more than placebo. During the last month of treatment, 25% of dutasteride-treated participants had no hazardous drinking (no heavy drinking days and not more than 14 drinks per week) compared with 6% of placebo-treated participants (P = 0.006; NNT = 6). Sensitivity analysis identified baseline drinking to cope as a factor associated with larger reductions in drinking for dutasteride compared with placebo-treated participants. Dutasteride was well tolerated. Adverse events more common in the dutasteride group were stomach discomfort and reduced libido.

Conclusion

Dutasteride 1 mg daily was efficacious in reducing the number of heavy drinking days and drinks per week in treatment-seeking men. The benefit of dutasteride compared with placebo was greatest for participants with elevated baseline drinking to cope motives.
Diagnostic challenge: a case report of primary breast tuberculosis mimicking recurrent pyogenic breast abscess
Authors: Thapaliya Ishwor , Kumari Khusbu , Oli Pradeep , Karki Susmin , Deo Aakash
Published: April 2024

Introduction:

Breast tuberculosis (BTB) is a rare form of extrapulmonary tuberculosis with its primary form considered even rarer.

Case presentation:

A 28-year-old female initially diagnosed with a breast abscess presented with chronic right breast pain and nipple discharge. Despite initial treatment, symptoms recurred, and further investigations revealed a space-occupying lesion. Fine needle aspiration confirmed recurrent breast abscess, but subsequent DNA detection of tubercular bacilli in the pus sample led to a diagnosis of primary BTB, necessitating antitubercular therapy.

Clinical discussion:

BTB, being rare and often misdiagnosed as an abscess, poses diagnostic challenges. However, persistent symptoms despite treatment should prompt consideration of BTB in TB endemic regions.

Conclusion:

Primary BTB might not have any systemic symptoms to drag the clinician towards a possible diagnosis so culturing the aspirate for acid-fast bacilli or looking for MTB DNA in the available clinical sample should always be kept in mind for better outcomes.
Consequences of Inpatient Falls in Acute Care: A Retrospective Register Study
Authors: Heikkilä Anniina , Lehtonen Lasse , Junttila Kristiina
Published: April 2024

Aims

The objectives of this study were (1) to explore the consequences of falls; (2) to find out time and place of the fall events; and (3) to explore the impact of falls on the length of hospital stays in adults’ inpatient acute care.

Background

In hospitals, falls are the most common accidents that can occur to a patient during hospitalization. Injuries resulting from serious falls can cause lifelong harm to the patient due to loss of well-being and independence.

Design

A retrospective, cross-sectional, register study based on the data from electronic patient records was conducted.

Methods

The data included 114,951 inpatients, of which 743 had fallen. Data was collected between January 2014 and December 2016.

Results

One-third of falls caused injury. Most injuries were to the head area, and the most common injuries were pain or confusion. The falls usually occurred at the beginning of the treatment in the patient’s room or on the way to the toilet. Falls in the hospital increased the length of stay.

Conclusions

A large proportion of falls occur at the beginning of treatment, so it is important to start fall prevention measures as soon as the patient arrives at the hospital.
Practicality and Hemodynamic Advantage of Microvascularly Augmented Pectoralis Major Musculocutaneous Flap
Authors: Miyazaki Hidetaka , Kumegawa Shinji , Kudo Toshifumi , Wada Yoshitaka , Ueno Kazuki , Takahashi Yasuhiro , Tanaka Kae , Asamura Shinichi
Published: April 2024

We have recently shown that including the blood flow from the lateral thoracic artery (LTA) in addition to the thoracoacromial artery in the pectoralis major muscle musculocutaneous (PMMC) flap (bipedicle PMMC flap) can increase the perfusion of the flap. We also developed the concept of the supercharged PMMC flap, in which the LTA included in the flap was once cut and anastomosed to a cervical artery under a microscope. It is an effective solution to maintain the additional blood flow from the LTA, when the length of the LTA is compromised for reconstruction. The mandibular reconstruction of an oral cancer patient was performed with a supercharged PMMC flap. Intraoperative indocyanine green angiography was performed in a single pedicle, bipedicle, and supercharged conditions, and the videos were analyzed with a quantitative assessment system of perfusion using some parameters. As a result, blood supply from the LTA was essential for flap survival in this patient, and supercharging from the cervical artery improved flap perfusion compared with the perfusion in the bipedicle condition. The supercharged PMMC flap can resolve the compromise of pedicle length and be also hemodynamically advantageous, thus making the reconstruction more reliable than the conventional technique.